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Background. More than 1 million colorectal cancers (CRC) are diagnosed annually. This cancer is the cause of 600,000 deaths, and many of these deaths can be reduced by screening. Colonoscopy is the best screening method and tool to diagnose CRC, but it causes anxiety and worry in patients. In addition, no appropriate tool has so far been introduced for assessing anxiety in these patients. Accordingly, the present study aimed to design and psychometrically evaluate a tool for assessing anxiety in patients undergoing colonoscopy. Methods. This methodological study used a descriptive-cross-sectional approach to design a psychometric questionnaire. To this end, 106 patients participated in this research, and the questionnaire was completed online. The validity of the list and the analysis of its main components were determined through exploratory factor analysis with varimax rotation and confirmatory factor analysis. The reliability of the tool was also checked with Cronbach’s alpha. Results. Overall, 20 terms of the questionnaire were examined by exploratory analysis, and 5 factors explained 57.76% of the total variance. The internal consistency of the tool with Cronbach’s alpha was 0.91. Conclusion. The findings of the research revealed that the tool for assessing anxiety in patients undergoing colonoscopy with 20 items and 5 factors has adequate validity and reliability and can be used to assess the anxiety of colonoscopy patients. Practical Implications. The results of this research can change policies in the field of treatment to reduce the anxiety of colonoscopy patients. [ABSTRACT FROM AUTHOR]

Background and purpose: Health tourism is one of the dimensions of sustainable development to help Mazandarn’s economic dynamic. A strong agreement is doubted in identifying factors influencing the attraction of health tourists. This study was implemented to design a questionnaire to measure the factors influencing the attraction of healthy tourists and investigate its psychometric properties. Materials and methods: This study was done with a combinatorial approach in three steps, including relevant literature and the opinions of experts as long as health tourists' opinions of Mazandaran province were applied to the development of the item pool. Then, content validity, face validity, construct validity, and reliability of the questionnaire were assessed for the psychometric properties of the questionnaire. The final questionnaire was approved after performing 17 interviews and applying professional expertise in the qualitative part. In the first stage of the quantitative part content validity was studied by 10 people from an expert panel, and its face validity, the questionnaire was completed by 10 participants. Finally, the construct validity of the designed instrument was calculated using exploratory factor analysis using SPSS 24 software and confirmatory factor analysis using AMOS 24 software by asking 300 people familiar with health tourism in Mazandaran province. The internal and external validity were determined using Cronbach's alpha and test-retest in 25 people. Results: The results of the literature review and interviews with experts in the first and second stages of the study led to the design of 76 items. In the next step, the changes in the qualitative stage 15 questions did not receive favorite points in Content validity ratio (CVR) and content validity index (CVI) calculation in the quantitative part of content validity. Then face validity was applied and the item effect index for 8 items was lower than 1.5 in the quantitative stage of face validity. Then the questionnaire with 53 items was entered into construct validity. In the exploratory factor analysis, the value of KMO was equal to 0.778. Furthermore, the value of Bartlett's test of significance was less than 5%. Based on the rotated matrix of components, eight factors with positive values were obtained. The results of exploratory factor analysis showed that 7 items had a factor loading of less than 0.4, which were removed from the questionnaire, and finally, 46 items remained. In the confirmatory factor analysis stage, the factor load of all dimensions was in good condition and the P-value was in the acceptable range. Cronbach alpha rate was calculated as 0.831. The external reliability was lower than 0.05 (ICC= 0.90, P<0.001). Conclusion: The designed questionnaire, due to the low number of questions, the simplicity of the sentences, as well as the acceptable validity and reliability, can be used to identify and investigate the factors affecting the attraction of health tourists. Normalization of the questionnaire in other cultures is suggested. It is hoped that the findings of this study will be utilized by researchers, healthcare and tourism system managers, and other stakeholders to inform the planning of interventions aimed at increasing medical tourism. Additionally, it is hoped that the results of this study will serve as a springboard for future research in this area. [ABSTRACT FROM AUTHOR]

Background Staff training in organizations is a measure for developing human capital. The pathology of this process needs to be assessed to understand the current situation and solve the challenges and limitations. Objective This study aims to assess the pathology of the training process for the incident command system (ICS) staff of hospitals in Guilan Province using the three-pronged approach. Methods This is a qualitative-quantitative study. The study population in the qualitative phase included experts in the hospital ICS. In the quantitative phase, the study population included all ICS managers and staff in the Guilan Province hospitals (n= 548). The data collection tool was a semi-structured interview in the qualitative phase and a researcher-made questionnaire in the quantitative phase. For data analysis, MAXQDA software, version 2020 was used in the qualitative phase and SPSS software, version 26 was used in the quantitative phase. Results The results in the qualitative phase showed the extraction of 55 open codes, 25 axial codes, and 6 selective codes in the form of three domains of processes, context, and structure. The results in the quantitative phase showed that among all the domains, the process domain-related factors with a percentage of variance (impact) of 0.262 were more harmful than context- and structure-related factors in the training process. Conclusion The pathology assessment based on the three-pronged model is an effective method for determining the training priorities for the hospital ICS staff. The use of this model during a crisis can be an effective step for identifying shortcomings to solve them and take appropriate measures for the ICS staff training. [ABSTRACT FROM AUTHOR]

Background & Aims Healthcare providers are responsible for providing services to mothers and infants during disasters. The purpose of this study is to determine their educational needs for maternal and newborn care during disasters in Iran. Materials & Methods This is a cross-sectional study that was conducted in 2017 on 208 healthcare providers (nurses, practical nurses, and midwives) from nine armed forces hospitals in Tehran, Iran who were selected by a census method. The data collection tool was a researcher-made questionnaire with acceptable face validity, content validity, and structure, with a Cronbach’s alpha of 0.94. The data were analyzed using descriptive and inferential statistics in SPSS software, version 16. Results The mean score on the educational needs assessment scale was higher in the fields of sexual violence management (4.30±0.01) and information management (4.28±0.01), indicating the high need for education in these areas. The lowest scores were in the fields of postpartum care in newborns (2.19±0.96) and responsiveness (2.98±0.89). In total, the educational needs of healthcare providers were high (3.3±0.43). Conclusion The readiness of healthcare providers in Iran to provide maternal and newborn care during disasters is low and needs more attention. Therefore, it is recommended to compile and revise university educational programs and implement continuous education programs based on the results of this study in the proposed areas (especially sexual violence management and information management) in a regular, periodic, and continuous manner. [ABSTRACT FROM AUTHOR]

Background and Aims: Anterior crossbite is one of the most common orthodontic problems. Parents' level of awareness determines how they deal with their child's anterior crossbite problems. In the present study, the level of knowledge, attitude and practice of parents of primary school children about anterior crossbite was evaluated. Material and Methods: In this cross-sectional descriptive study, a questionnaire was designed to assess parents' knowledge, attitude and practice of children's anterior crossbite. Face validity was confirmed through interviews, content validity was assessed by CVR calculation and construct validity was assessed using exploratory factor analysis. The questionnaire was provided to 250 parents and its construct validity and reliability were calculated using SPSS software. The final questionnaire was completed by another 250 parents to assess parents' knowledge, attitude and practice. Results: Based on factor analysis, the questionnaire was classified into 6 domains. The average scores in the areas of "treatment awareness", "complication awareness", "treatment attitude", "diagnosis attitude", "treatment practice" and "prevention performance" are equal to 19.48 ± 3.33 (out of 25), 10.19 ± 2.01 (out of 15), 7.53 ± 2.79 (out of 20), 9.83 ± 2.31 (out of 15), 19.4 ± 3.46 (out of 25), and 9.41 ± 2.07 (out of 15), respectively. Conclusion: Parents had good knowledge, attitude and practice regarding anterior crossbite and only the "attitude towards diagnosis" of parents was relatively low which requires training in this field. [ABSTRACT FROM AUTHOR]

Background and Aim: An accurate evaluation of hospitals' performance in dealing with disasters can be a major role in improving hospital preparedness. The Hospital Disaster Risk Management Evaluation (HDRME) Model was developed and approved in 2018 using international models and the opinion of experts. This research was conducted with the aim of validating a questionnaire for evaluating disaster risk management in hospitals based on the standards and measures of this model. Methods: In this validation study, a questionnaire based on the HDRME Model including 200 measures in 8 domains (management and leadership, risk assessment, planning, prevention and mitigation, preparedness, response, recovery, and key performance results) was designed. The face validity and content validity were verified both qualitatively and quantitatively (using experts' opinions, CVR, and CVI). The reliability of the questionnaire was evaluated by Cronbach's alpha method and Inter class correlation coefficient (ICC). The questionnaires were completed by two surveyors separately and independently in 30 hospitals at Tehran University of Medical Sciences, and the results were compared and analyzed. Results: The face validity and content validity of the questionnaire were approved by experts. The results showed that Cronbach's alpha and Inter class correlation coefficient (ICC) was 0.99, which showed that the questionnaire had good reliability. The average score of the hospitals from the questionnaire was 36%. The highest score was related to the domain of prevention/mitigation (51/22) and risk assessment (44/81), and the lowest score was related to the domain of planning (24/75) and recovery (26/97). Conclusion: The questionnaire designed from the disaster risk management evaluation model has good validity and reliability and could be used as a valid questionnaire to evaluate this issue in the country's hospitals. [ABSTRACT FROM AUTHOR]

Background and Aim: Military personnel are prone to depression due to their job's nature and requirements. Therefore, the use of accurate and efficient screening tools to diagnose depression is essential. The aim of this study is to investigate the psychometric properties of the Iranian version of the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) in the military community. Methods: The present study is a descriptive-correlational and validation study. In this regard, a sample of 410 volunteers was chosen from the 505th specialized military psychiatric hospital of the Islamic Republic of Iran. In addition to the demographic questionnaire, participants also completed the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) and the Beck Depression Inventory II (BDI-II). Then the face and content validity, internal consistency, test-retest validity, cut-off point, and sensitivity and specificity of the inventory were analyzed by using qualitative method, Cronbach's alpha, Pearson correlation coefficient, independent means comparison test, and receiver operating curve analysis which were all done via the SPSS-26 software. Results: The results showed that this inventory has good content and face validity. The internal consistency of 0.91 and the reliability coefficient of the test-retest indicates the stability of the scores in the interval of 3 days. The independent t-test showed that this inventory can differentiate between depressed and non-depressed people. The sensitivity of the inventory was 0.87 and its specificity was 0.73. Therefore, according to the most appropriate sensitivity and specificity, the cut-off point of the quick inventory of depressive symptomatology was 17. Conclusion: The findings indicated that the list of quick inventory of depressive symptomatology has good validity and reliability among the Iranian military population and can be used in research and clinical situations. [ABSTRACT FROM AUTHOR]

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Background & Aims: One of the main pillars of sports education as well as leadership and leadership of the coaching team. The coach is the center of guidance and development of sports in any society. Coaches' efforts are successful when they have the necessary sports knowledge (1). The position and role of coaches and the effects of their performance and personality traits in sports are very important, so that coaches have a significant role in team development, development of technical skills and social and cultural behaviors of players (2). Another important issue in the present era and in the sports environment is the issue of mental health, which has attracted the attention of many researchers. The goal of mental health is to create mental health by preventing mental illness and creating a healthy environment for proper human relationships. According to the World Health Organization, a person's health does not simply include a state of complete physical health; It also includes the dimensions of mental and social health, the ability to communicate appropriately and in harmony with others, change and modify the individual and social environment, and resolve conflicts and personal desires in a positive, just and appropriate way, which is a necessity of coaching (6). The importance of coaching is so great that various researches have been done about it and contradictory results have been obtained. For example, Zare et al. (2019) in their research emphasized the role of coaches in the development of players' skills in all dimensions, especially the development of psychological skills (8). In general, the role and position of coaches is clear to everyone, but what remains an issue in this direction is how to prepare and promote coaches for this serious responsibility. Coaching is one of the most complex sports professions and one of the most effective areas that can lead to the development of sports and training of athletes. Therefore, in this regard, it is necessary to have a suitable system to promote knowledge, mental health and job skills so that trainers can use the most appropriate training courses (scientific and practical) to play their role and responsibilities (10) . Therefore, the researcher seeks to identify and prioritize the factors affecting the development of knowledge, mental health and practical skills. Methods: The present research is quantitative and qualitative in terms of data, applied in terms of purpose, exploratory in terms of field, field data collection in terms of time and time in terms of time period. The statistical population of this research in the qualitative part included sports experts and sports coaching and in the quantitative part were 508 Olympic sports coaches, from which 306 people were randomly selected as a sample. A researcher-made questionnaire prepared by fuzzy Delphi method was used to collect information. The face, content and structure validity of the questionnaire were confirmed by experts in the field of quality, factor analysis and structural equations, respectively. Also, the reliability of the questionnaire in a pilot study on 30 people in the study population and using Cronbach's alpha test in all components was calculated to be more than 0.70. Finally, descriptive statistics, exploratory factor analysis, one-sample t-test and structural equation analysis using SPSS and Expert Choice software were used to analyze the data. Results: The initial estimate of the share of each variable showed that the values of all of them are equal to one. It was also found that the common variance of all items is more than 0.5. Therefore, all variables (items) will remain in the analysis. According to Table 3, 71 items in the present study can be reduced to 11 factors and from the combination of these 71 items, a new structure can be designed based on the factors with the new combination and the data can be analyzed based on that data. Also, Table 3 showed that the contribution of each factor in explaining the variance of 71 items related to the factors affecting the development of applied knowledge and skills for coaching levels in Iran is different and decreasing. Finally, according to the results for level 3 coaches, the highest weight was related to individual factors, education, advertising and media. Also, according to the results for level 2 trainers, the highest weight was related to managerial factors, localization of knowledge and knowledge enhancement. And for level 1 educators, the highest weight was related to talent identification and basic factors, localization of knowledge and managerial factors. Conclusion: Undoubtedly, the growth and development of coaching knowledge in the country on the one hand and its decline and decline on the other hand, is rooted in several factors, which will be difficult to determine the share of each. There is no doubt that the scientific study and identification of the existing problems in this field on the one hand and the efforts of the officials to solve these problems on the other hand will be successful in promoting it as much as possible. However, it should be noted that the research community is made up of experts and qualified trainers in the country and their opinion can really pave the way for success and development of knowledge and practical skills for coaching levels in Iran. Therefore, it seems that paying attention to the opinions of these experts can be one of the best data needed for managers to make decisions regarding the implementation of coaching promotion programs in the country. On the other hand, structural equation modeling also confirms this and shows that the identified factors can be effective in developing knowledge and practical skills for coaching levels in Iran and therefore using the results of this study can further improve the coaching of the field. Various sports in the country was promising. [ABSTRACT FROM AUTHOR]

The role of marketing capabilities in e-commerce and its ability to improve the performance of industrial organizations has received serious attention from business researchers. In this regard, the aim of the present study was to investigate the effects of e-commerce marketing capabilities and export experience on export performance with the mediating role of distribution efficiency. This study was applied in terms of purpose and library-field in terms of data collection. The method of the study was descriptive-survey. The statistical population of the study was the managers of the Fars Industry, Mining, and Trade Organization, which included a total of 318 people. In this regard, using the Morgan table, 175 people were selected based on the simple random sampling method and questionnaires were distributed among them in-person by visiting the Fars Industry, Mining, and Trade Organization. The data collection tool was a questionnaire that the content validity of the questionnaires was confirmed based on the opinions of professors and experts. Also, after distributing the questionnaires and collecting the data, the values of AVE and CR coefficients for all variables above 0.5 indicated convergent validity and the output of the Fornell Larker table showed divergent validity. The results of the study showed that e-commerce marketing capabilities, export experience, and distribution efficiency had a positive effect on export performance. E-commerce marketing capabilities had a positive effect on the efficiency of distribution. But, the export experience did not have a significant effect on the efficiency of distribution. Distribution efficiency also played a mediating role in the relationship between e-commerce marketing capabilities and export performance. But the efficiency of distribution did not play a mediating role in the relationship between export experience and export performance. [ABSTRACT FROM AUTHOR]

Introduction: Various symptoms have been attributed to tooth eruption. Further, parents use different strategies to reduce or eliminate these symptoms. This study was aimed to evaluate parental information about eruption of primary teeth in Isfahan, Iran. Materials & Methods: This descriptive, cross-sectional survey was conducted on 100 parents having six-month- to three-year-old children referring to the dental clinics or offices in Isfahan. A questionnaire with validated face and content validity was designed to collect data. It included questions about demographic characteristics, eruption time and the first erupted tooth, symptoms of eruption, and control of symptoms. Data were analyzed by frequency distribution, relative frequency, descriptive indices, and Chi-square test via SPSS 22. Results: The most frequent symptoms parents agreed with included high tendency to bite and chew, high saliva flow, and gingival inflammation, respectively. Fever was the most frequent symptom the majority of parents disagreed with. The most frequent methods used by the parents included hugging the child and amusing the child. The most frequent disagreement was reported for the use of sleeping drugs. No significant correlation between parental information about tooth eruption and economic status, parental education, parental age, and number of children was found. The mean score of parental information was 2.37 ± 0.97 and degree of response was 96% (p value < 0.05). Conclusion: Parents’ knowledge about tooth eruption was moderate and acceptable awareness on symptoms of tooth eruption and methods of decreasing the symptoms was found. [ABSTRACT FROM AUTHOR]

Background and Aims: Regarding the need for social accountability in dental education, community-based dental courses has been established to improve the oral health of the community and compensate the shortcomings of the health system. Due to the importance of evaluation, the aim of this study was to determine the dental students’ attitudes and believes in the last year of their study towards the community-based dental education. Materials and Methods: This cross-sectional study was performed on 159 dental students in the sixth year (October and February, 2018) of Isfahan dental school by census. These students took the relevant questionnaire, which was developed by researchers in three sections of “attitudes toward field activities”, “lessons and experiences of field activities during dentistry training” and “barriers and problems of field activities”. Its content and face validity was confirmed. They completed it on their own and after collecting information and descriptive analyzes, the relationship between the gender and entry group with attitude scores was analyzed by Mann-Whitney U test. Results: Out of a total of 102 questionnaires which were answered (response rate of 64%), half of the students believed in the need to provide dental services in the form of mobile/outreach services for the community. 90% of the students agreed with the combination of field education with routine education in the dental schools. They also considered these services as an opportunity to use their experiences and knowledge to promote oral health in the community. 84% of them believed that their self confidence improved while providing services outside the faculty. In many of the propositions in the field of attitude to provide service in the field, a significant percentage (50 to 60%) did not have an opinion. Conclusion: There was a good and positive aspects in many areas of attitude toward providing services in social fields as well as attitude towards the lessons learned from community-based dental education. However, we should consider the attitude-emotional aspects of educational objectives in the community-based courses in dental schools. [ABSTRACT FROM AUTHOR]