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Background & Aims: The experience of mourning leads to many emotions in people. As a result, learning emotion regulation strategies affects the experience of bereavement in bereaved people and is a kind of moderator of the experience of bereavement. People use strategies called emotion regulation to change emotional triggers, situations of emotional experience, amount and intensity, duration, and way of experiencing emotion internally or externally. In the cognitive strategies of emotion regulation, the focus is on thoughts and cognition in anxiety management. Using emotion regulation strategies in any form and manner has an important role in all periods of life. Effective emotion regulation strategies are related to high self-confidence, positive emotions, how to deal with various types of stress, and more constructive social and personal interactions. People with the ability to regulate emotions can control their impulses, feeling sad and hopeless, anxiety, adapt to problems, and accept themselves and the conditions, which leads to reducing psychological damage. Therefore, strengthening and learning these strategies in people, especially teenagers, is effective and one of the necessary skills to manage the bereavement experience. Considering the importance of variables of coping styles and cognitive emotion regulation strategies in the experience of normal bereavement and exit from the experience of abnormal bereavement, it is necessary and necessary to use appropriate therapeutic approaches to promote them. One of the therapeutic approaches that has received much attention in recent years is schema therapy. In cognitive psychology, schema is defined as an organized pattern of thinking and behavior and as a mental framework of pre-formed ideas. In the form of a schema, a person perceives the world and the world around him and organizes his new information. These strongly affect our thoughts and emotions, and if they are ineffective, they can cause emotional problems. In schema therapy, attempts are made to adjust these schemas using various experimental, behavioral, and cognitive techniques to reduce the invocation of incompatible emotions. Some researchers say that abnormal grief is a chronic problem and coexisting with other disorders, one should focus on schemas and consider targeting schemas as an effective factor in treatment. Schema therapy is designed as a cognitive-behavioral therapy targeting maladaptive schemas to treat long-lasting and chronic disorders. Therefore, it can be effective as an efficient method to help experience normal mourning and go through the natural period of mourning. The review of these studies shows that despite the importance of the role of dysfunctional schemas in abnormal grief and ineffective emotional regulation strategies, these two therapeutic methods have been used very little with the aim of intervention in abnormal grief, and these interventions have been very few about abnormal grief in adolescents. Is. In addition to this, there was no research on intervention in abnormal grief caused by Corona, and the researches were only limited to investigating the symptoms of grief caused by Corona, screening tools in this regard, and people's lived experiences in this regard. Therefore, applying schema therapy and checking its effectiveness can be a way to find the most effective treatment methods for teenagers with bereavement caused by Corona. Meanwhile, few studies have investigated this method of treatment for grief, especially grief caused by corona in teenagers. Based on this, the question of the current research is whether schema therapy is effective in coping styles and cognitive emotion regulation strategies of students with abnormal grief caused by Corona. Methods: In this research, the statistical population was first and second high school students with grief disorder caused by Corona in Yazd city in 2021 and 2022. The sample included 30 people (15 people in the experimental group with the schema therapy method, and 15 people in the control group) who were selected purposefully. The tools of the current research included the stress coping strategies questionnaire (Andler and Parker, 1999) and the cognitive emotion regulation questionnaire (Granfsky and Kraich, 2001). Schema therapy intervention based on Yang's schema therapy was implemented in 10 consecutive one-hour sessions in the experimental group. No intervention was done in the control group. Multivariate covariance analysis was used to analyze the data. Results: The findings showed that schema therapy was effective in positive and negative emotional regulation strategies and emotion-oriented and avoidant coping styles in the sample group. Conclusion: According to the present finding, it is necessary to use this treatment method to reduce the injuries and symptoms of abnormal grief by focusing on emotional regulation strategies and coping styles of people. One of the limitations of the present study is that only the effectiveness of schema therapy in teenagers with abnormal grief caused by Corona has been investigated, and its generalization to other societies should be done with caution. Also, there is no exact assurance of the absence of coexistence with other disorders, which also affects the generalizability. Research with a follow-up period can provide more complete findings related to the effectiveness of schema therapy. [ABSTRACT FROM AUTHOR]

Background & Aims: Learning disability is one of the important constructs in exceptional education. One of the goals of educational systems is to raise the level of students' ability to increase the academic efficiency of learners. According to the Statistical Manual of Mental Disorders, a learning disability has been renamed to a specific learning disability, and reading disorder, writing disorder, and math disorder, each of which was once a distinct and independent disorder, are now considered to specify a specific learning disorder. A neurodevelopmental disorder in children that is caused by genetic and environmental factors and affects brain function in the areas of understanding and processing verbal and non-verbal information; in a way that lasts at least 6 months. This disorder leads to problems in learning and using academic skills in the form of carelessness, poor comprehension, slow reading, difficulty in spelling, problems in written expression, problems in mastering the meaning of numbers or calculations, and problems in mathematical reasoning. These problems are not related to mental retardation, developmental delay, uncorrected vision or hearing problems, or motor or neurological disorders, they are specifically meant in this way. In the education and treatment of learning disorders, one of the most important methods introduced is the sensory integration method. Sensory integration refers to processes whose information enters the brain through the eyes, ears, mouth, nose, skin, muscles, joints, and sense of balance. Ayres presented a theory called sensory integration to relate behavior and neural function, especially sensory information, which examines the specific connections of neural function, sensorimotor behavior, and academic learning in a hypothetical framework, and aims to find specific patterns of dysfunction. In children with learning and sensory problems special treatment methods for these groups. The method of sensory integration is a neurological flow that receives and organizes sensory information from the body and the environment of a person and uses it to function more effectively and better in the environment. This method leads to the improvement of excellent brain functions and the abstract levels of the brain from which mathematics is applied; it increases and thus improves the educational efficiency of these students. This intervention engages the child's senses with exercises in the form of a game, and this situation helps coordination and precision in the functioning of the child's senses. Agent concentration is important in maintaining integrity and improving learning performance, so it can play an effective role in improving reading and writing disorders. The basic assumption of this educational method is that children with learning disorders have problems in these sensory pathways. Much research has been conducted and its effectiveness has been confirmed regarding the effectiveness of this educational method in children with learning disabilities. Learning disorder affects brain function in the areas of understanding and processing verbal and non-verbal information; therefore, it is important to identify decisive intervention methods in this field. The purpose of this study was to investigate the effectiveness of the central nervous system reorganization method on explicit and implicit memory, mental retention ability, and visual-spatial skills of students with special learning disabilities. Methods: The statistical population of this research included all students with specific learning disabilities who referred to the learning disabilities centers of Rafsanjan city in the academic year of 2019-2020, 90 of whom were selected randomly in three groups of sensory integration using the purposeful sampling method., reorganization of the central nervous system, and the control group were replaced. Research tools included Bogard and Roos's (1991) mental fluid retention task, Snodgrass and Vanderwaart's (1980) manifest and latent memory questionnaire, and Kornoldi's (1998) visual-spatial memory test. Data analysis was done using repeated measurement with mixed design and multivariate analysis of variance using SPSS-24 software. Results: The Results showed that the effect of the group in the component of mental maintenance (p < 0.01 and F = 70.99), explicit memory (p < 0.01 and F = 293.26 (162 and 2)), hidden memory (p < 0.01 and F = (162, 2) 65.17) and visual-spatial skills of children are significant, so there is an obvious difference between mental retention, overt and hidden memory, and visual-spatial skills. There are three groups and between the effectiveness of educational methods considering learning disorders. Also, sensory integration training has been effective in increasing mental retention, explicit and implicit memory, and visual-spatial skills of students with specific learning disorders. On the other hand, the difference between the two groups of sensory integration and the nerve reorganization method showed that the effects of the sensory integration group on increasing mental retention, explicit and implicit memory, and visual-spatial skills of students are more than the central nervous reorganization group. Conclusion: It was concluded that the methods of sensory integration and reorganization of nerves are effective in increasing mental retention, explicit and implicit memory, and visuospatial skills of students with specific learning disorders, and this effectiveness in the training of the sensory integration group compared to Reorganization of the nerves in the ability to maintain a higher and greater mental capacity. [ABSTRACT FROM AUTHOR]

Background & Aims: Job burnout is a psychological syndrome involving the three axes of emotional exhaustion, depersonalization, and personal accomplishment, and it occurs when a person in the workplace is subjected to prolonged stress with severe psychological and physical consequences (2). Burnout will lead to a low quality of work, customer or clients’ dissatisfaction, psychological consequences such as depression, and even physical illnesses. Since job burnout is a disabling condition that decreases the quality of services in workplaces, it is necessary to identify the underlying psychosocial risk factors involved in this condition. A growing body of literature has documented that various psychosocial risk factors can cause burnout including job motivation, lack of adequate support from managers, high workload and stress, and psychological or physical disorders (6). High workload and stressful work environment considered as important factors that contributed to the job burnout, but all people working at a stressful work environment dos not suffer from job burnout (15). It seems that some personal risk factors make people susceptible to job burnout. Psychological and personality factors considered as important personal risk factors that may play a decisive role in the development or maintenance of job burnout (17). Job burnout is one of the most disabling conditions that threaten the mental and physical health of workers in medical settings. While job burnout has been studies in different medical settings (3) there is a dearth of research in the dentistry settings and further research is needed. Dentists are one of the medical groups that are at high risk of burnout due to different environmental risk factors causing stress at work (5). Limited studies have been done on the role of psychological and personality factors involved in job burnout among dentists. This study aimed to explore the relationship between pathological personality traits and psychological distress (depression, anxiety and stress) with job burnout among dentists. Methods: The method of this research was a descriptive-correlational study. The statistical population included all general and specialist dentists working in public clinics and private offices. Using a convenience sampling method study questionnaires were distributed electronically among channels and groups of dentists. Inclusion criteria include having work experience more than 2 years in the dentistry settings, current employment, being between 31 to 70 years old, not having a history of severe psychiatric illness and willingness to participate in research. The tools used in this study included the Maslach Burnout Inventory (MBI), Personality Inventory for DSM-5 (PID-5) and Depression, Anxiety and Stress-21 (DASS-21). After distributing the questionnaires, 758 completed questionnaires were received from the participants, of which 641 valid questionnaires were separated for analysis and the rest that were incompletely or uniformly completed were discarded. In order to analyze the data of the present study, descriptive indices, t-test, and Pearson’s correlation was used. All statistical analyses were conducted using IBM Statistical Package for the Social Sciences (SPSS) for Windows, Version 22. Results: The results showed that pathological personality traits and psychological components, as well as demographic characteristics (such as age, gender, marital status) and job-related variables (such as working hours, work history), affect job burnout in dentists. In terms of job burnout dimensions, in terms of emotional exhaustion, depersonalization, and lack of personal accomplishment, 0.5%, 7.8%, and 21.8% of respondents were in a high burnout state, respectively. There was a significant relationship between all three dimensions of job burnout and gender, and emotional exhaustion was more in men than women, and depersonalization and lack of personal success were more in women than men. Moreover, there was a significant relationship between all three dimensions of job burnout and marital status, so that emotional exhaustion and depersonalization were more in single people than in married people, and the lack of personal success was more in married people than in single people. There was a significant relationship between emotional exhaustion and education level, and it was more common among general dentists than specialist. There was a significant and direct correlation between the job burnout dimensions of working hours per week and the lack of personal success. Depersonalization was also higher in people with more than 40 hours of work per week. There was a significant and inverse correlation between work experience and depersonalization, and the intensity of the correlation was also weak. Conclusion: In general, in addition to demographic variables (age, gender, marital status) and job-related variables (education and working hours), personality traits and mood states such as depression, anxiety and stress can explain job burnout among dentists. How job burnout can affect the five areas of personality is due to the fact that work is one of the issues that humans deal with on a daily basis and the tensions and pressures that cause job burnout can chronically affect the psychological structure of a person and affect the five areas of personality. On the other hand, personality traits affect the type of facing problems, pressures and tensions from the work environment. The results can have theoretical and practical implications in providing appropriate psychological interventions for dentists suffering from job burnout. At the theoretical level, the results of this research can help to better understand personal factors that aggravate and maintain burnout among dentists. At the practical level, the results can have practical implications in providing suitable psychological interventions for dentists suffering from job burnout. These results provide further support for the development of new treatments that target individual factors in burnout and teach skills to help develop individual skills. Nevertheless, the findings must be interpreted in the context of its limitations. The crosssectional nature of our study impedes any inferences about causality or temporality of associations among the variables investigated. Therefore, longitudinal experimental studies are encouraged to explore whether the associations reported here actually resemble predictions and mediations in prospective designs in which causal relationships and temporal ordering of variables can be statistically detected. Only self-report measures were used in this research, which could introduce biases such as social desirability. Conducting experimental studies with more objective measurement tools on dentists with job burnout can be beneficial for finding better results. Despite these limitations present findings can pave the way for the future research and updated critical literature. This study adds to the growing literature on the field and remediate the dearth of studies in this area. [ABSTRACT FROM AUTHOR]

Background & Aims: Schizophrenia is a mental disorder with frequent psychosis, whose symptoms include delusions, hallucinations, disordered speech or behavior, and impaired cognitive ability. The cause of this disease becoming a debilitating disorder for patients and their families is its early onset and chronic course, which affects one percent of the population. Antipsychotic drugs are only effective in treating half of the patients, and the pathological mechanism of schizophrenia is not fully understood. In addition, these drugs improve generally positive symptoms (such as hallucinations and thought disorders that are at the core of the disease), but negative (such as social isolation) and cognitive symptoms (such as learning and attention disorders) remain untreated. On the other hand, these drugs have severe neurological and metabolic side effects and may lead to sexual dysfunction. Schizophrenia is a multifactorial disorder that involves the interaction of several genes, environmental factors, and epigenetic processes. Over the past ten years, genetic research has yielded new findings that have given rise to hope for the biological origins of schizophrenia. The genetic role is caused by a large number of alleles, including alleles with small effects that can be identified by GWAS studies. The drug treatments that are available for schizophrenia have poor efficacy for many patients in which the mentioned genetic factors are very effective. Identifying the causes of this disease is an important step in the field of improving the treatment for this disorder, which is estimated to be half to one third of the genetic factors influencing the development of schizophrenia by common alleles reported in GWAS studies. Thus, GWAS studies are potentially an important tool for understanding the biological process of schizophrenia. GWAS Catalog is a complete collection of all published studies at the genome level, which makes it possible to investigate and identify the cause, understand the mechanism of the disease, and identify new treatment methods in this disease. In recent years, many efforts have been made to identify biomarkers in the diagnosis, prevention and treatment of schizophrenia, each of which introduces specific genes and pathways that overlap with other mental disorders. In this study, in order to investigate important genes and biological pathways in the development of schizophrenia, the genes reported in the GWAS catalog bioinformatics database were examined so that in the future, with more studies, it can help to treat and diagnose these patients more accurately. Methods: In the present study, using the GWAS catalog database and searching for the word Schizophrenia, a list of 3344 SNPs was extracted from 80 research articles. In the next step, the SNPs that cause schizophrenia and other related diseases were extracted (1165 SNPs that were the result of 19 studies). Then, among the SNPs obtained in the previous steps, those with lower and equal p-values were 5*10^-8, isolated and checked using ensemble.org in the BioMart section, in order to find the closest genes. Then, the results of BioMart were sorted and collected based on the obtained genes, and the duplicates were removed (removal of duplicate genes) and finally 336 genes were obtained. (In general, for 554 SNPs, the gene was identified, and for the other 574 SNPs, the gene name was not found, which are extragenic.) In the next step, the above list was entered in BioMart and the names of the desired genes were obtained. (Part of Ensemble genes 107; NCBI gene (formerly Entrezgene) accession) which resulted in a total of 339 genes. In the last step, the genes obtained from the previous step were checked using the Enrich R site, and through this site, the pathways that were related to the studied genes were extracted and compared with the results of different articles. Results: In this study, after entering the results in Biomart, 339 genes were obtained. Also, after entering the above list in the Enrich R site, the important pathways in which these genes are active were obtained. Pathways which Adjusted-P value was below 0.05 were considered as reliable results. Conclusion: This study was conducted on schizophrenia by analyzing the data of GWAS catalog database to identify the mechanism of the disease and the pathways involved as well as the main and important genes of drug candidates. One of the important pathways in this study was Glucuronidation, which was one of the first pathways obtained from Wiki Pathway studies, which is often involved in the metabolism of substances such as drugs, pollutants, bilirubin, androgens, estrogens, mineralocorticoids, glucocorticoids, fatty acid derivatives, retinoids. and bile acids play a role. This pathway is mainly carried out in the liver, although the enzyme responsible for its catalysis. UGTs are widely expressed in the brain, but at lower levels than in the liver. Brain UGTs are inducible or inhibitable that affect drug release in the central nervous system. UGTs, cytochrome P450s, and transporters act together to influence the pharmacokinetics of drugs in the brain. After glucuronidation, many drugs have the ability to cross the blood-brain barrier. Another pathway is ascorbate metabolism. Ascorbate (vitamin C) is a vital antioxidant molecule in the brain. However, it has several other important functions, participating as a cofactor in several enzymatic reactions, including catecholamine synthesis, collagen production, and HIF-1α regulation. Ascorbate is transported to the brain and neurons through the sodium-dependent vitamin C transporter (SVCT2), which causes the accumulation of ascorbate in cells against a concentration gradient. The highest concentrations of ascorbate in the body are found in the brain and neuroendocrine tissues such as the adrenals, although the brain is the hardest organ to deplete ascorbate. Together with the regional asymmetry in the distribution of ascorbate in different regions of the brain, this shows the important role of ascorbate in the brain. The next pathway was the porphyrin metabolism pathway, which disruption in this pathway can cause neurological symptoms, neuropathy and a wide range of psychiatric symptoms in addition to specific diseases, until in 1939, Waldenstrn reported that schizophrenia in families with Acute intermittent porphyria (AIP) is very common, but no statistics were provided. Another study found that 5 of 40 AIP probands had hallucinations, suggesting a possible link between psychosis and AIP. A study in Sweden found that people with AIP were four times more likely to develop schizophrenia or bipolar disorder. In addition, first-degree relatives of these people are twice as likely to be diagnosed with schizophrenia and bipolar disorder. The other pathway was the pathway of retinoid metabolism, the first evidence linking this pathway to schizophrenia is that retinoid toxicity or deficiency frequently leads to the manifestation of symptoms that, although more severe in scope, are similar to those of schizophrenia. For example, mental disorder, mental defect, large ventricles, microcephaly and various major and minor congenital anomalies, among which cranial anomalies are prominent. Such deficits have been reported frequently among schizophrenic samples. With the increasing documentation of the prominent role of retinoids in the development of the central nervous system, the possibility of retinoid involvement in schizophrenia is strengthened. Another important pathway was drug metabolism, which drugs that are widely used today in the treatment of mental disorders, including depression, psychosis, and mood stabilizers, in many cases are associated with many side effects, and only a small number of patients respond appropriately to These drugs show Many factors, including genetic factors, are effective in the effectiveness of drugs, which are of interest today. According to the present study, it can be concluded that genetics and especially polymorphisms play a very important role in the development of schizophrenia and that these genes can be used in the diagnosis and treatment of this disease. In the future, the genes of these pathways can be studied more reliably in schizophrenia for diagnostic and therapeutic purposes. The genes obtained in this research can be suitable and new options for future studies on schizophrenia and optimization of treatment methods. [ABSTRACT FROM AUTHOR]

Background & Aims: Academic success is one of the most important criteria for the evaluation of educational systems. Academic progress is a term used to refer to the results of the individual’s performance in mental areas that are taught in school, college and university and is considered as a very important indicator for predicting his or her personal and social prosperity (Spinath, 2012). The multidimensional nature of academic performance requires that further research be conducted to identify the relevant factors. In addition, the early 2020 was marked by the outbreak and pandemic of a novel viral disease known as COVID-19. To control the spread of the disease and reduce the resulting cross-infections, governments decided to switch to online mode of teaching. Although the online learning method was promising in maintaining the educational courses and minimizing the disruptions imposed to learning routines, it created more challenges for the learners; one of the most important challenges was an increase in teachers and parents’ complaints regarding a decline in the academic performance of the learners. Therefore, it is of particular importance to examine the predictor variables of academic performance under the special conditions caused by Covid-19. An important variable related to academic performance is personality traits. Based on the results of various studies, the personality traits of the learners, as a psychological factor, affect the learners’ academic progress (De Baca et al., 2010). The results of former research shows that agreeableness and conscientiousness are positive predictors and emotionality is a negative predictor of high academic performance. In most studies, the role of extroversion and openness to experience in predicting academic performance was positive but weak (Gulam et al., 2021). Another psychological structure that is likely to predict students' academic performance is resilience. The findings of different studies show that resilience increases students' effort and persistence in pursuing issues and completing challenging assignments, thereby facilitating the possibility of achieving high-level learning outcomes. On the contrary, people with low resilience against the difficulties of assignments and possible problems give up very quickly during the learning process and fail to achieve the expected academic results (Novotný & Křeménková, 2016). Another factor that influences students' academic performance is self-efficacy (cited by Talsma, Robertson, Thomas, & Norris, 2022). It seems that self-efficacy increases the learner’s hope of success in a specific field through increasing motivation, and thus increases his or her persistence in doing assignments (Honicke & Broadbent, 2016). In addition, high self-efficacy by declining anxiety plays an essential role in a person's academic success (Maier et al., 2021). On the other hand, the results of a few other studies (including those by Baker, Caswell & Eccles, 2018; Li, Han, Wang, Sun, & Cheng, 2018; Comfort & Wernicke, 2016; Iglesia, Stover, & Lipris, 2014) indicate a relationship between social support and academic performance. It seems that the student's perception of social support strengthens the individual's psychological capital: a concept that includes positive variables such as hope, resilience, self-efficacy and optimism. Previous studies, focusing on a number of these variables, have shown their relationship with each other and their effect on academic performance. In fact, the simultaneous examining of these variables can determine their relative efficiency in predicting academic performance. In the current study, the researcher, inspired by multivariable phenomena, has attempted to compile and experimentally test a comprehensive theoretical model including the most important predictor variables of academic performance among female students at senior high school. Methods: The research method was correlational with a structural equation modeling. The statistical population of the present study included all the female students of senior high schools in District 2 of Tehran in the academic year of 2021-2022, from which a sample of 400 students were selected using a multi-stage cluster sampling method. After entering the data in SPSS software, the data were analyzed using the structural equation modeling method with AMOS software. Data collection tools included McCree and Costa’s (2008) five-factor NEO-FFI-R questionnaire, the Multidimensional Perceived Social Support Scale by Zimmet, Dahlem, Zimet and Farley (1988), Scherer et al.’s (1982) general self-efficacy scale, Connor and Davidson's (2003) Resilience Scale and Pham and Taylor's (1999) Standard Academic Performance Questionnaire. Results: With regard to the findings, the fit indices such as the ratio of chi-square to the degree of freedom (df/χ²) with a value of 4.24, the incremental fit index (IFI) with a value of 0.96, the comparative fit index (CFI) with a value of 0.95, goodness of fit index (GFI) with a value of 0.93, Tucker-Lewis index (TLI) of0.91, adjusted goodness of fit index (AGFI = 0.90), and root mean square error of approximation (RMSEA) with a value of 0.07 indicates a good fit of the proposed model with the data. The coefficients of the direct path and their direction have been determined. These coefficients are significant at the level (χ² ≥ 0.05) and the direct hypotheses related to them have been confirmed. It should be noted that in the figure representing the proposed model (Figure 1), the predictor variables explain a sum of 74% of the variance of the dependent variable (academic performance). It should be noted that in the present study, indirect hypotheses were investigated through the mediating variables of self-efficacy and resilience with the bootstrap method. The results showed: - Personality traits have a significant indirect relationship with academic performance through resilience (the lower limit of the confidence interval is 0.0282 and the upper limit is 0.0950). - The indirect relationship of personality traits with academic performance is not significant through self-efficacy (the lower limit of the confidence interval is -0.0231 and the upper limit is 0.0727). - Social support has a significant indirect relationship with academic performance through resilience (the lower limit of the confidence interval is 0.0304 and the upper limit is 0.1308). - The indirect relationship of social support with academic performance is significant through selfefficacy (the lower limit of the confidence interval is 0.0431 and the upper limit is 0.1131). Conclusion: The findings of the present study showed that the proposed model of students' academic performance based on personality traits and perceived social support mediated by resilience and self-efficacy under covid-19 conditions had a good fit with the data. In general, the predictor variables have explained about 74% of the variance of the dependent variable (academic performance) in the current study. To explain the model, it can be said that the variables of personality traits and social support have a causal relationship with academic performance. Also, these variables affect students' academic performance through the mediating variables of resilience and self-efficacy. By clarifying some of the predictor variables of academic performance, this study highlights the important roles of parents, school personnel, and social media: Firstly, by creating peace in families, schools, and the community, they should improve the adaptive personality traits of children and adolescents. Secondly, by providing all kinds of necessary support and showing healthy role models, they should set the foundation for for the formation of self-confidence and resilience in students. It should be noted that due to the nature of the current research (correlation), one should be very cautious in inferring the causal relationships between the variables of personality traits, social support, self-efficacy, resilience and academic performance. [ABSTRACT FROM AUTHOR]

Background & Aims: Patent ductus arteriosus (PDA) is one of the congenital disorders in premature neonates, which is strongly associated with increased mortality in them. Currently, echocardiography is the method of choice for detecting PDA, and due to the high cost of this method and its lack of easy access, finding a suitable and low-cost alternative method, including the use of clinical parameters to quickly detect PDA in premature neonates and determine the cases in need Treatment is very important. Therefore, in this study, we decided to investigate the sensitivity and specificity of clinical criteria in the diagnosis of PDA in comparison with the echocardiography method. Preterm neonates refer to neonates who are born before 37 weeks from the first day of the last menstrual period (1) due to developmental delay and also weakness in the immune system, these neonates are about 40 times more than neonates with normal weight at risk of mortality (2). The ductus arteriosus is a vein that connects the pulmonary artery to the aorta. This duct is the fetal vascular connection between the pulmonary artery and the aorta artery, which diverts blood from the pulmonary bed to the systemic circulation during the fetal period (3). In the uterus, blood is shunted from the lungs due to the high pressure in the lungs. Therefore, the blood leaves the right ventricle, enters the ductus arteriosus, and from there enters the aorta (4). The ductus arteriosus contracts after birth and usually closes within 72 hours after birth. If this active contraction does not occur after birth, the ductus arteriosus will remain open. Usually, within 10 to 15 hours after birth, this contraction causes the functional closure of the ductus arteriosus, which starts from the side of the pulmonary artery and finally progresses to the end of the aorta (5). Therefore, keeping this duct open causes the oxygen-rich blood in the aorta to mix with the deoxygenated blood flowing in the pulmonary artery. Therefore, a lot of blood is transferred to the lungs, which increases the pressure on the heart, increases the blood pressure in the pulmonary veins, and also impairs the ventilation of the lungs (6). A large blood shunt from the ductus arteriosus increases pulmonary blood flow and also decreases systemic blood flow (7). Neonates with reduced systemic blood circulation are exposed to dangerous complications such as increased systolic and diastolic pressure, increased oxygen demand, pulmonary edema, tachycardia, active pericardium, heart failure, intracerebral hemorrhage, pulmonary hemorrhage, and necrotizing enterocolitis (8). Methods: This cross-sectional study was conducted on preterm neonates with PDA and preterm neonates without PDA who were admitted to the NICU department of Akbarabadi Hospital in Tehran during 2017 and 2018. In this study, 124 preterm neonates with a gestational age of 25 to 37 weeks were included in the study. Preterm neonates with convulsions, life-threatening infections, clinical or radiographic evidence of necrotizing enterocolitis, evidence of hemorrhage, congenital neurological disorders, metabolic and genetic syndromes, pulmonary hypoplasia syndrome, congenital heart anomalies, and other fatal abnormalities., were excluded from the study. Also, a checklist was provided in which case and demographic information related to preterm neonates was recorded. Parameters such as birth age, height and weight, gender, duration of hospitalization in NICU, duration of mechanical ventilation, history of any underlying or congenital disease (such as heart and lung disease, sepsis, other infectious diseases, diseases respiratory, history of cardiac arrest, etc.), neurological diseases, type of birth (NVD or cesarean section), gestational age, mothers' age were also recorded. After initial examinations and selection of patients based on inclusion and exclusion criteria, various clinical parameters in newborns including heart rate, peripheral pulse status, precordial pulse status, heart murmur status, cardiothoracic ratio, first minute Apgar score and Fifth, the deterioration of the respiratory condition was investigated in terms of physical and clinical examinations. A heart rate less than 160 was given a score of zero, a heart rate between 160 and 180 was given a score of 1, and a heart rate greater than 180 was given a score of 2. Cardiothoracic ratio less than 0.6, 0.6 to 0.65 and more than 0.65 were determined with zero, 1 and 2 scores, respectively. The status without murmur, systolic murmur and diastolic murmur were defined with 0, 1 and 2 scores, respectively. Normal peripheral pulse score zero, brachial banding score 1, brachial and dorsalis pedis banding score 2, precordial pulse not visible and not palpable with score 0, palpable precordial pulse with score 1 and visible precordial pulse with score 2. The scores of each of the clinical criteria were added together and a score equal to or greater than 3 was considered to be associated with the incidence of hemodynamically significant PDA. Then echocardiography was performed in the examined neonates by an experienced pediatric cardiologist. The results of this research were analyzed by SPSS software. In this study, p value equal to or less than 0.05 was considered statistically significant. To determine the sensitivity and specificity of clinical factors in determining PDA requiring treatment, the ROC diagram and the area under the ROC curve were used. The results related to the sensitivity and specificity of each of the physical and clinical examinations as a factor in the diagnosis of active PDA in need of treatment were compared with echocardiography results. Results: Based on statistical analysis and ROC curve performed in this study, the relationship between scores calculated based on Clinical criteria were demonstrated with PDA. Based on this, it can be said that by measuring clinical criteria and calculating the score can be detected PDA. Also based on the ROC curve analysis at point (score) 3, the sensitivity value is 65% and the specificity value is 95%, and at point (score) 2 the sensitivity value is 90% and the specificity value is 87%. Conclusion: AUC = 0.94 for the diagnosis of hs-PDA indicates the fact that the definition of the score parameter based on the clinical criteria presented in this research can help in the diagnosis of PDA without echo. Only the difference between the pre-ductal and post-ductal oxygen saturation and the intensity of the dorsalis pedis pulse should be taken into account. Also, since the level of sensitivity is higher in the score of two, and this means that the false negative cases are less in the score of two, therefore, the score of two can be a more appropriate score for detecting cases that need treatment. According to the ROC curve of 5 clinical criteria for the diagnosis of hemodynamically PDA, the order of effectiveness of these 5 criteria are CTR, precordial pulse, heart murmur, heart rate and peripheral pulse respectively. [ABSTRACT FROM AUTHOR]

Background & Aims: The aim of this study was to evaluate the effectiveness of group nutrition training based on play therapy on anxiety and tendency to food diversity in preschool children with avoidance- restriction of food. Methods: The design of this study was a quasi-experimental pretest-posttest with a control group and a follow-up stage. The study population, available preschool children (3 to 5 years) had one of the eating disorders. By purposive sampling, 20 children with clinical symptoms of avoidance disorder / food restriction living in Sanandaj were selected; Which were randomly assigned to experimental and control groups. At first, a 3-hour group training session was held for the mothers of the children in the experimental group on parenting style, child nutrition and introduction of games. Subsequently, the experimental group received 120 minutes of 120 minutes of group nutrition training through play therapy, to collect data from the Wardell, Guthrie, Sanderson, and Rapaport (2001) Children's Eating Behavior Questionnaire and the Revised Child Anxiety Anxiety Scale (CMAS). Reynolds and Richmond (1987). To describe the data, tables and graphs were used frequently, as well as central indices and scatter indices such as mean and standard deviation. To answer the questions, repeated measures analysis of variance and multivariate covariance were used. Data were analyzed using SPSS software version 24. Results: An educational and treatment package to reduce avoidance- restrictive eating disorder was developed by a therapist who was validated by child clinical psychologists and nutrition and education experts. Findings showed that the significance level of anxiety and tendency to food diversity variables is less than 0.05. As a result, it can be said that there is a significant difference between the mean scores of these variables in the pre-test, post-test and follow-up stages. Considering the significance of the interaction of the stages * of the group, it is concluded that the rate of change in the variables of anxiety and tendency to food diversity during the pre-test, post-test and follow-up stages were not the same in the experimental and control groups; That is, treatment based on group nutrition education of preschool children with avoidance / restriction disorder based on play-therapy has been effective in reducing anxiety and tendency to food diversity. There is a difference between pre-test and post-test stages; That is, the intervention was effective in reducing anxiety and promoting dietary diversity. There is also a difference between the pre-test and follow-up stages and the significance level of 1.00 shows that there is no difference between the means between the post-test and follow-up stages; That is, the effectiveness of the intervention in the follow-up phase has shown that it has remained stable. It can be said that there is a difference between the children in the experimental group who received the intervention and the children in the control group in at least one of the variables of anxiety. The difference is 44% in the posttest and 78% in the follow-up. The level of significance obtained also shows that there is a difference between the children in the experimental group who received the intervention and the children in the control group at least in terms of one of the variables of the tendency to food diversity. The difference is 92% in post-test and 96% in follow-up. In the post-test, the level of significance of the components of physiological symptoms and anxiety is significant at the level of 0.05; That is, the intervention had an effect on reducing the physiological symptoms of anxiety and worry in children in the experimental group; However, the significance level of 0.102 obtained by Mankova test in the third component (social anxiety) shows that the intervention was not effective in reducing children's social anxiety in the post-test stage. In the follow-up stage, the level of significance of the components of physiological symptoms, anxiety and social anxiety is significant at the level of 0.05; That is, the intervention had an effect on reducing the physiological symptoms of anxiety, worry and social anxiety in children in the experimental group, and the rate of this effect in the component of physiological symptoms was 51%, anxiety 67% and social anxiety 42%. Also, the level of significance of the components of food pleasure, desire to drink, emotional overeating, excuse about food and emotional undereating is significant at the level of 0.05; That is, the intervention had an effect on the mentioned components in the post-test stage of the experimental group. The extent of this effect was in the components of food enjoyment (82%), desire to drink (72%), emotional overeating (82%), food excuses (42%) and emotional undereating (56%); However, the significance level of 0.183 and 0.433 obtained by Mancoa test in the fourth and fifth components (satiety responses and slow eating) shows that the mentioned intervention was not effective on these components in the post-test stage. In the follow-up stage, the significance level of all components is significant at the 0.05 level; That is, the intervention had an effect on the tendency to food diversity in children in the experimental group and the extent of this effect on the components of food enjoyment (90%), desire to drink (81%), emotional overeating (90%), satiety responses (35%), There were slow eating (51%), food excuses (57%) and emotional undereating (70%). Conclusion: According to the findings and the effect of the treatment package developed in this study on dependent variables, its use in therapeutic settings for children with avoidance / restriction of food is recommended to reduce anxiety and expand their dietary diversity. Also, considering that the subject of this study was to reduce children's social anxiety, satiety responses and slow eating; It has not been effective, so researchers can look into this in future research. [ABSTRACT FROM AUTHOR]

Background & Aims: The concern about the quality of life of the elderly living in resident at home and nursing homes has been one of the controversial issues. Some studies believe that if the mental health of the elderly is provided and a suitable atmosphere is created in the nursing homes, better health care and treatment can be provided to the elderly and their life expectancy can be increased; But on the other hand, some studies believe that caring for the elderly at home and with other family members can have an effective role on their psychological health; so that the results of some studies indicate that this group of elderly people have a higher life expectancy; But on the other hand, it can threaten their physical health and make them prone to other chronic diseases and malnutrition. Admission to a nursing home evokes emotional consequences, including feelings of rejection, psychological tension, depression, instability, loss of home and the chance to contact family and friends. Research shows that the living environment of the elderly plays a very important role in their psychological health. It has been shown in various researches that the level of quality of life and mental health, happiness and social health in the elderly living in nursing homes is lower than that of the elderly living at home; Based on this, it can be concluded that there is a relationship between living in a nursing home and the psychological state of the elderly, but it cannot be said with certainty that the low mental health of the elderly indicates living in a nursing home; Because some studies have shown that the diseases and disabilities of elderly people living in nursing homes are more than other elderly people, and disabilities lead them to care centers; Maybe this factor also has an effective role in reducing their mental health. Based on this, the implementation of a comparative study in the elderly with high performance and control of physical disabilities will clarify the role of living in a nursing home in the state of mental health of the elderly, which is addressed in the present study. Also, some studies indicate that the stay of the elderly in the nursing home is associated with the feeling of exclusion and their feeling of loneliness plays an effective role. Also, the research showed that the elderly living in the nursing home experienced a feeling of insecurity and rejection and described their transition from home to the nursing home as painful; In other words, living in a nursing home can have an effective role in reducing the mental health of the elderly. Elderly people who have a high level of rejection feel that they are of no use to themselves and those around them and cannot be effective; Also, the results of this study showed that the feeling of rejection, due to its high relationship with social incompetence, has an effective role in increasing depression symptoms in these elderly people; Based on this, it can be concluded that living in a nursing home, rejection and depression are closely related. In this regard, the results of some studies show that the elderly living in nursing homes have far more symptoms of depression, anxiety and stress and report less satisfaction with life. Nowadays, due to the increase in the number of elderly people and the shrinking of families, caring for the elderly is a very important issue, and detailed and comprehensive programs for the care of this sensitive age group should be provided by conducting field research and formulating detailed care policies. Compared to younger people, older people with depression usually have multiple co-occurring medical and cognitive disorders, and depression that occurs in older patients is often underdiagnosed or undertreated. Also, previous studies have shown that inactivity and disability are factors affecting the feeling of exclusion of the elderly; which, if accompanied by family rejection, can lead to an increase in psychological distress in the elderly. Considering the importance of this topic, the present study compared the perception of rejection and depression symptoms in elderly people living in nursing homes and resident at home. Methods: The current research was descriptive and based on causal-comparative method. The statistical population of this research includes two groups of elderly people in Rasht city in 2020 who were living in nursing homes or living with their families. The sample size was calculated using G*Power software. From each group, 120 elderly people participated in a targeted manner and answered the Perceived Rejection Scale: PRS and the Geriatric Depression Scale: GDS-15. For both groups, the age gap is between 65 and 90 years, having minimum physical health to communicate and answer the questions of the questionnaire, not suffering from cognitive impairment diseases such as (Alzheimer, stroke and dementia), not being engaged in economic activity. And retirement from governmental and nongovernmental institutions and having informed consent and willingness to participate in the research were considered as entry criteria. Also, failure to answer at least 10% of the questionnaire questions, fatigue and unwillingness to complete the questionnaire were considered as exit criteria. Data analysis was performed using SPSS-24 statistical software and multivariate analysis of variance. Results: The results of multivariate analysis of variance showed that the perception of rejection (F = 14.25, P = 0.001) and depressive syndrome (F = 17.280, P = 0.001) in the elderly living in nursing homes were significantly higher than the elderly were in the control group (P <0.001). Conclusion: Overall, the results of this study showed that the perception of rejection and depression symptoms in elderly people living in nursing homes is more than that of elderly people living at home; But this difference cannot be attributed to the presence of the elderly in the nursing home. But in general, it can be concluded that elderly people living in nursing homes are more in need of appropriate interventions and educational programs to reduce the feeling of rejection and depression symptoms than the elderly people living at home. Therefore, it is suggested to provide educational and therapeutic programs to improve the psychological condition of these elderly people. [ABSTRACT FROM AUTHOR]

Background & Aims: The aim of this current research was investigating the effectiveness of painting therapy in a scientific rather than traditional way on anxiety and learning disabilities in single-supervisor children. Methods: The research method was a quasi-experimental design with pre- and posttest with control group. The statistical population of this research is consisted of male and female single-supervisors students in the second to fifth grades of elementary school. and the studied sample was including 30 students in the experimental and control groups which were matched based on gender and educational bases. The research instrument was the revised “Colorado Learning Disabilities Questionnaire (CLDQ) (Colorado Willcutt et al., 2011) and protocol of Painting Therapy (Case, 2020) includes 12 painting and language training sessions, which were held online due to the closure of schools in the Corona crisis. Resullts: Analysis of pre- and post-test results showed that therapeutic painting reduces the disabilities of social anxiety, reading, problem and social recognition, perception of Spatial, and math, of students in experimental group. In general explanation of the findings of this study, it can be said that painting is a child’s language.The students with social anxiety and learning disabilities were able to connect with their inner and outer worlds with the simplest possible means beyond the pleasure they created for themselves.they revealed themselves verbally figuratively. Many single parent families have many problems due to disability and lack of family support, and parental care for their children’s social activities outside of school is very limited. In most single-parent families, prent-child relationships cannot be as well established as in normal families. Single Parents students often suffer from high levels of anxiety; these students often have lower academic status, more communication problems, and poor social skills. Excessive absenteeism from school leads to maladaptation and the formation of social anxiety and learning difficulties in them.Students with socil anxiety disorder also become anxious about simple tasks such as buttoning their clothes or ordering food in front of others. They think that if they ask a question, they may look stupid, afraid to eat in public, throw food on the floor, or if they enter a room, their feet will get stuck and they will fall to the ground and be clumsy.They become more anxious in the presence of peers with higher social status. Social anxiety makes learning difficult for these students and affects their abilities.Single Prents student with social anxiety and learning disabilities had many problems in their relationships, they were usually alone and had no friends, they dhd not even have any activities in online classes and did not participate in conversations, some of these students did not show any fear or anxiety in their appearance behaviors, but they had an avoidance mechanism that is a sign of social anxiety. Some students manifested widespread social anxiety and distress for no apparent reason, and finally another group immediately expressed the anxieties and fears they faced on a daily basis with great anxiety (Haberty, 2016). Painting Therapy with Single-Parents students has become one of the best Art Therapy methods for early intervention in emotional issues, and their adaptation. Students with social anxiety and learning disabilities did not have the means to express themselves, and painting spoke in their place through codes such as Sun, Tree, House, Man, etc…,Without any conditions. Based on their dvawings, the children ejected the killers of love and their painful problems were made possible.Whether children’s painting is called a code language, a cry of love, or a creative catcher, it as a projection of the children’s world, revealed their whole personality. Painting and making, with expressive expression, brout a fundamental change in the child, which led them to a higher understanding of themselves. Art activities and productions and considered not because of their aesthetic appeal but brcause of their analytical and therapeutic role. Psychological refinement enabled these students to actively seek solutions to life’s problems by creating creative and spontaneous activities. Psychological refinement causes obivious barriers to transformation and dissolution, and their morbid symptoms are alleviated (Case & Dally, 2020).Therapeutic Painting not onhy identified the cause of many of the students emotional,and psychological problems, but also was effective in preventing disorders students mental health through early interventions.Therapeutic Painting enhances uditory, visual, attentional, motor coordination, memory enhancement, and communication between the right and left hemispheres of the brain in solving behavioral problems by promoting creativity and enabling perceptual- motor development resulting from fine eye-hand coordination. Psychology and expression of unconsciousness were effective in the verbal expression and caused a positive transformation and improvement of morbid symptoms of students with social anxiety and learning disabilities and solving their problems. Conclusion: The results of the follow-up test were confirmed after 8 weeks with the stability of the positive changes. [ABSTRACT FROM AUTHOR]

Background & Aims: The coronavirus 2019 first spread from Wuhan, Hubei Province, China, and became a global epidemic in just two months, according to the World Health Organization. As of March 23, 2020, the unknown virus has spread rapidly worldwide, infecting more than 187 countries and killing a significant number of people worldwide. COVID-19 is an acute respiratory infectious disease characterized by the main symptoms of fever, cough, and shortness of breath. With the outbreak of COVID-19 and subsequent changes such as the closure of high-risk jobs and the implementation of emergency public health measures and home quarantine, social and economic relations and the way people lived were severely affected. During the spread of the virus, strict measures such as social distancing and mask-wearing were taken to control the spread of the disease in different parts of the world. One of the measures taken to curb COVID-19 was establishing home quarantine, which in turn can have a variety of consequences, including increased anxiety and stress. Patients with or suspected of COVID-19 are often afraid of the aftermath of the deadly virus, such as long-term health effects or death. People in quarantine may also experience fatigue, loneliness, depression, and anger. Additionally, common symptoms of COVID-19 such as fever, body aches, loss of taste and smell, hypoxia, cough, and dry throat can increase COVID-19 anxiety in patients, which may cause psychological distress. High levels of fatigue and anxiety resulting from quarantine conditions significantly increase the need for extreme care, but due to the unknown nature of coronavirus 2019 and the lack of definitive treatment, individuals may have difficulty responding to this need. This intensifies fear, anxiety, and depression in people. Another variable that can be associated with pandemic diseases, such as COVID-19, is coping styles and types of symptoms in high-stress patients. Since the beginning of the COVID19 epidemic, there has been a wave of stress and anxiety, first among Chinese citizens and then around the world. People must use appropriate and effective coping strategies to control and reduce the stress caused by these conditions. Overall, COVID-19 anxiety, specifically health anxiety, can lead to cognitive errors, threat-related distortion, immunosuppressive behaviors, and destructive behaviors in healthy individuals who develop high levels of COVID-19 anxiety. In this regard, the present study aimed to compare psychological distress and coping styles in students with different levels of COVID-19 anxiety. Methods: The research design was descriptive and causal-comparative. The statistical population of the study included undergraduate, graduate, and Ph.D. students of the University of Tehran, Iran, in the second semester of 2020-2021. In the present study, 200 students (100 students with high levels of COVID-19 anxiety and 100 students with low levels of COVID-19 anxiety) participated in the study through an online survey conducted via WhatsApp and Instagram. Inclusion criteria included belonging to the research community, having internet access, being between 18 and 30 years of age, and reporting personal satisfaction with their current living situation. The omission of questions was also considered as a criterion for leaving the research. Due to the epidemic of COVID-19, the closure of universities and educational institutions, and to prevent the spread of COVID-19, samples of this study were collected online. Participants were assessed using the COVID-19 Anxiety Inventory, psychological distress, and coping styles and then grouped. To identify students with COVID-19 anxiety, 338 questionnaires were distributed among the participants. Individuals who obtained a standard deviation above the mean COVID-19 anxiety scale were included in the analysis as a group with high levels of COVID-19 anxiety. Finally, data analysis was performed using multivariate and univariate variance with SPSS software version 24. It should be noted that in the present study, ethical considerations based on Helsinki ethics were observed. Results: The results of the Eta squared analysis show that the difference between the two groups in the studied variables is significant, with an Eta squared value of 0.71. This means that 71% of the variance related to the difference between the two groups is due to the interaction of COVID-19 anxiety and the studied variables. The results of multivariate analysis of variance showed that stress (68.55), anxiety (79.77), depression (94.17), Emotion-oriented Coping (98.81), Problem-oriented Coping (102.74), and Avoidanceoriented coping (114/48) were all significant at the level of 0.01. These findings indicate that there is a significant difference between the two groups in these variables (P<0.01). This means that students with different levels of COVID-19 anxiety differ in their use of psychological distress and coping styles. Specifically, students with high levels of COVID-19 anxiety had higher levels of psychological distress, emotion-oriented coping, and avoidance-oriented coping than students with low COVID-19 anxiety. Conclusion: Findings from this study showed that students with high levels of COVID19 anxiety have more depression, anxiety, and stress than other students. As a result, students with high levels of COVID-19 anxiety may become more sensitive to physical signs and symptoms, which can lead to increased levels of COVID-19 anxiety. On the other hand, the results of this study indicate that people with high levels of COVID-19 anxiety are less inclined to use problem-solving coping styles and are more likely to use emotion-oriented and avoidance-oriented coping styles. However, problem-solving coping styles can further reduce the harms of experiencing COVID-19 and the stress that results from it. Although stressors play an important role in exacerbating chronic and pandemic diseases, it should be borne in mind that how people deal with stressful situations plays an important role in their health. Therefore, psychologists and counselors need to pay more attention to these areas to reduce the severity of anxiety in students. [ABSTRACT FROM AUTHOR]

Background & Aims: Unintended pregnancy is considered a concern based on human rights and public health approaches. In the program of action of the International Conference on Population and Development in Cairo in 1994, it was emphasized that couples and individuals have a basic right to make free and responsible decisions about the number and spacing of children (1). Unintended pregnancy is an important public health concern in both developing and developed countries, because it has many social and health consequences (2). Global estimates of the incidence of unintended pregnancy and its consequences were first published in 1995. Based on those estimates, it was estimated that 38% of all pregnancies were unintended, and more than half of them, i.e. 22% of all pregnancies, ended in abortion (3). Some previous studies (26, 27) have found a relationship between women’s fertility knowledge and unintended pregnancy. Therefore, fertility knowledge should be considered as one of the most important variables affecting unintended pregnancy. Fertility knowledge is defined as a process during which men and women become aware of their potential for childbearing (28). Accurate knowledge and understanding about fertility facts is essential for women and couples in making appropriate decisions about whether, when and how to get pregnant (29). Several studies (30-36) that have been conducted among various samples have shown the low level of fertility knowledge among the investigated samples. The few studies conducted in Iran (37-39) have also shown insufficient fertility knowledge among men and women. No study was found that specifically examined the relationship between fertility knowledge and unintended pregnancy, so this research is an attempt to study the effect of fertility knowledge on the incidence of unintended pregnancy among married women of reproductive age. Methods: The present quantitative study was carried out with survey method in 2022. The statistical population of the present study was all married women aged 15 to 49 attending the health centers of Zarrin-shahr city in Isfahan province. For this purpose, 400 women of the statistical community were randomly surveyed. Zarrin-Shahr city had 6 health centers, and by referring to all 6 centers, a total of 400 eligible women surveyed. A questionnaire was used to collect data. The questionnaire consisted of two parts: the first part included individual questions as well as questions related to fertility, and the second part included the measurement of fertility knowledge, which was used from the standard questionnaire (40). The aforementioned questionnaire consists of 9 multiplechoice questions, one of which is the correct answer. If all 9 items are answered correctly, the score will be 9, and if all the questions are answered incorrectly, the score will be zero, so the range of women’s fertility knowledge scores based on this scale fluctuates between zero and 9. In this study, for a better understanding of women’s fertility knowledge, the final score of each respondent has been converted into a range of scores from zero to 100. The age of the spouses, the place of birth of the women, the years of education of the spouses, the employment status of the spouses, the duration of marriage, the household monthly income and the class identity of the women were the independent variables. Unintended pregnancy of women was also a dependent variable. Results: The results showed that 52.3 percent of women, that is, more than half of them, had low fertility knowledge, while 13.8 percent of them had a lot of this knowledge. The results showed that 25% of the studied women had a history of at least one unintended pregnancy. There was a positive and significant correlation between fertility knowledge and unintended pregnancy. An increase in the level of fertility knowledge was correlated with a decrease in unintended pregnancy. The increase in age of women and their husbands was associated with an increase in unintended pregnancy, that is, they recorded a positive and significant correlation. The findings also showed that increasing the duration of marriage is associated with a significant increase in unintended pregnancies. This means that the correlation between the duration of marriage and unintended pregnancy is positive and significant. The increase in the level of education of women and their husbands was related to the reduction of unintended pregnancies. The mentioned positive correlation was statistically significant. The variables of employment status of women and husbands, place of birth of women, class identity of women and household monthly income of women had no significant correlation with unintended pregnancy. The results of the regression analysis showed that fertility knowledge is the only variable that has a statistically significant effect on the odds of unintended pregnancy. Increasing fertility knowledge had led to a decrease in the incidence of unintended pregnancy. Age, spouse’s age, spouse’s education, duration of marriage are variables that had significant bivariate relationships with unintended pregnancy, which lost their significance after controlling other research variables. The odds ratio showed that increasing one unit of fertility knowledge can reduce the odds of unintended pregnancy by 1.6%. The coefficients of determination showed that the used regression model is able to predict between 7.9% and 11.7% of the odds of unintended pregnancy. Conclusion: Based on the findings of this research and considering the relatively low score of women in fertility knowledge, it can be said that the promotion and improvement of women’s fertility knowledge should be given serious attention in health and population programs. The low knowledge of women’s fertility in the discussion of infertility also confirms the importance of addressing this issue at the macro level. If women’s knowledge of the factors affecting infertility increases, it may affect the level of fertility and decrease the childlessness ratio of the population. Improving fertility knowledge, according to the evidence reviewed in this research, can lead to a reduction in unintended pregnancies and subsequently to a reduction in induced abortions. Reducing induced abortions can also increase the health level of mothers and even reduce maternal mortality. Therefore, in general, it can be said that the promotion of fertility knowledge can affect the quality of women’s and mothers’ health on the one hand, and even the population’s size on the other hand. [ABSTRACT FROM AUTHOR]

Background and Aim: The global epidemic of the disease caused by the coronavirus (COVID-19), a severe acute respiratory syndrome that appeared in December 2019, not only as a threat to the health and lives of millions of people around the world was considered Although Covid-19 could have negative effects on educational activities, social distancing has stimulated the growth of online educational activities so that there is no disruption in education. The electronic learning system has created educational environments that are not dependent on any specific location or time and allows teachers to teach a course simultaneously or asynchronously or use a combination of these two modes. Electronic learning as an educational medium in the classroom is a new experience for the teacher and students, which can be an effective step towards stabilizing and accelerating students' learning. On the other hand, the most important characteristics of secondary school learners that teachers should pay attention to can be classified into three types: cognitive, emotional, and social. The primary period is one of the most important and sensitive periods of study, and since it is essential for teachers and educators to pay attention to the different characteristics of students' growth, and to know that electronic learning requires a series of hardware tools and its extensive use may increase the level of violence. Mental Health Mental health is an issue beyond the absence or absence of mental illness. The positive aspect of mental health, which the World Health Organization relies on, is included in health: "Health is a state of physical, mental, and social well-being, not just the absence of illness or disability." Therefore, mental health is a state of well-being in which a person recognizes his abilities and can adapt to the normal stresses of life and be useful and productive in terms of work. Since there is no social interaction (compared to the common and usual form in the real environment) in the context of electronic learning, learners must be able to maintain their level of mental health. As a result, students who have more mental health and have the necessary abilities to deal with common academic challenges can be more self-regulated and self-efficient than other students, and as a result, they are more successful. It seems that virtual education has entered a new phase in our country and more attention has been paid to virtual education. On the other hand, those involved have become more aware of the importance of distance and e-learning-based education. Therefore, it is expected that with the development of the necessary infrastructure, such as the development of the nationwide Internet network and increasing its speed, the production of interactive educational software, and the use of the experiences gained in this pandemic, we will witness the increasing prosperity of virtual education. According to the research findings, there is little information on the relationship between electronic learning and the mental health of students, so the present study was conducted to investigate the structural relationship between electronic learning and the mental health of secondary school students in Golpayegan city, and seek answers to This question will be whether there is a significant relationship between e-learning and mental health of secondary school students in Golpayegan city. Methods: The present research is applied in terms of purpose and descriptive and correlational in terms of method, and the statistical population of this research includes all male students in the second year of high school in Golpayegan city who were studying in the academic year of 2021-2022. The number of the statistical population was equal to 850 people according to the inquiry from the Statistics Unit of the Golpayegan Education Department. According to the table of Karjesi and Morgan, 265 people were selected through a simple random sampling method. The research tools included three electronic learning questionnaires by Watkin et al. (2004) and Goldberg's mental health questionnaire (1972), both of which were standard questionnaires. Descriptive statistics were used to describe the demographic variables and SPSS software was used to check the research hypotheses. Results: The results of the research showed that there is a relationship between electronic learning and the mental health of secondary school students in Golpayegan city. Conclusion: In general, it can be acknowledged that in viral crisis conditions, electronic learning can be used to improve the academic performance of students, and in this way, their mental health level can be improved to stay away from the study environment due to the conditions. Viral, saved. The Department of Education is one of the most fundamental organizations in the world today, and students have a direct relationship with this organization, this shows the key and vital role of this department in their complex lives. Knowledge of electronic learning and better use of it can facilitate and predict the quality and continuity of mental health and lead to the implementation of programs in a scientific manner and avoid unwise actions. Mental health refers to having understanding and decision-making and positive psychological characteristics that facilitate the growth and development of a person and enable the achievement of goals. While students are thinking about their survival, they should take a step beyond this view and pay attention to the consequences and effects on society. E-learning is considered an important issue for education and the factor of its survival, in this, paying attention to the mental health of students and using an effective solution for it is discussed. An office-like education must pay attention to all levels of education (in-person and out-of-person) properly. According to the results of the study, it is suggested that the Department of Education must create workshops with the title of e-learning and the importance of virtual space (by explaining the new global concepts and approaches to using virtual space in education). To strengthen the level of knowledge development in students. To increase the desired psychological outcomes, sufficient and suitable training courses should be held to familiarize teachers and students with the principles and basics of mental and physical health. Human considerations such as respondents' dishonesty and the interference of others' opinions, especially classmates, could be effective in people's responses to questionnaires. Restrictions in attracting the cooperation of some people with the researcher due to the spread of Corona regarding the distribution of questionnaires and the delay in returning several questionnaires were limiting factors of the research. [ABSTRACT FROM AUTHOR]

Background & Aims: Today, information technology is used as a tool to improve education in organizations and universities. Due to the dependence of education on information technology, the framework of e-learning has been welcomed as a method at the global level. The development of the mobile Internet has led to rapid progress in online learning, offering new perspectives for teaching and learning and a completely different learning experience than traditional education. Online learning takes advantage of network technology and multimedia technology to transcend the boundaries of conventional education. The electronic learning system as an educational approach of the present age has always faced the complications related to the way of interaction and the motivation of academic progress in learning. With the rapid changes in the global education system, the increasing demand to enter the university system to achieve information literacy that is far beyond the capacity and facilities of higher education and the realization of a suitable and converging position with the phenomenon of globalization and the need to respond to the increasing demand for different education that Educational justice and user-centeredness is its main core and nurtures the attraction of domestic and foreign talented students. The most important activity and research center in any country is an organization called a university. In universities of medical sciences, the medical education system plays an effective role in efficient education in order to ensure and promote the health of the society. The corona virus crisis has affected the educational systems in all countries of the world, including Iran, and has led to the closure of face-to-face courses in schools and universities. Finally, the implementation of virtual education and the necessity of its success is undoubtedly due to the welcome of respected university professors in its implementation, and the importance and necessity of the research topic requires that the key element of the virtual education method, which is the respected professors of virtual education of the university, be encouraged and more incentives to continue their work and continue the virtual education method. Facing such an expansion and rapid movement of science and knowledge and the continuous change of the needs of the higher education society makes it use a logical and scientific method against the new educational methods in order to be able to find various effective factors in the learning of students and the electronic learning environment. identify On the other hand, providing a comprehensive program in the field of education requires a comprehensive understanding of the issues. Methods: The research strategy is survey and the research method is quantitative. The statistical population of the research was all the professors and experts of virtual education of the University of Medical Sciences in the North Khorasan province in the number of 440 people. The statistical sample was obtained by stratified random sampling in the number of 206 people. The research tool includes a researcher-made questionnaire with 51 questions or items. SPSS software and structural equations were used to analyze the data of this research. Results: The findings of the research in the quantitative model of factors affecting the establishment of electronic education system in universities of medical sciences include 13 categories and 51 components. According to the results of the dimensions of the e-learning system deployment model and its prioritization, including expert staff, educational content and materials, students, hardware, cultural infrastructure, pedagogical infrastructure, human infrastructure, requirements, economic infrastructure, external factors, Administrative infrastructure, technology infrastructure and management and leadership were identified. Conclusion: The results of the data showed that by strengthening the identified dimensions, it is possible to improve the electronic education system in universities of medical sciences. Elearning readiness assessment allows officials and policy makers to adopt appropriate policies and plan development plans in such a way as to create a complementary and balanced environment for e-learning research. The effective use of information and communication technologies in the process of education and work in electronic learning environments requires that learners accept new roles in the learning process. Including the fact that learners should be information seekers and be able to judge and evaluate the value of vast information that is available for their use in the global Internet. In such conditions, the role of educators changes from transferring knowledge and information to facilitating the learning process. Therefore, electronic education requires new programs, policies, strategies, goals, methods, and generally new patterns in the current conditions of globalization. The increasing access to suitable hardware and software for electronic education, especially the development of the Jahangaster Web network, has opened a new horizon for educational institutions. It seems that the use of these facilities for education will help to realize some of the ideals that are mentioned as quality criteria of education, such as: inclusiveness, lifelong learning, active learning, interaction in learning and multimedia. Although some educational institutions, in recent years, have taken steps to provide complete educational courses electronically, but still not much evidence has been published about the evaluation results of these programs. Considering the general advantages of electronic education and its special capabilities in medical education, it seems inevitable to integrate it into the current educational programs of universities, so that conventional education is presented as a combination of traditional education and electronic education. This is especially noticeable in the case of the country's educational system, which has many audiences with a wide variety of interests, experiences and educational needs. The importance of change in university education, along with the high cost of providing electronic education infrastructure, especially the necessary software, shows the necessity of a long-term program approach in the integration of electronic education in the country's current education system. In this regard, it is necessary to use the experiences of other universities and organize the facilities and activities and use the capabilities available in both public and private sectors. The requirement of this approach is to create a scientific insight into various aspects of electronic education and design the process of change based on existing conditions and logical ideals in education. If this insight is accompanied by the serious determination of the officials and policy makers of the country's education system, it is hoped that in the not too distant future, valuable steps can be taken to improve the quality of education and its greater productivity, even though electronic education methods have many advantages, the integration of their use With the specialized programs of each field, it is still considered a big challenge. [ABSTRACT FROM AUTHOR]

Background & Aims: Suicide is a tragedy for the individual, family, and society. The probability of suicide is operationally defined based on four indicators of hopelessness, suicidal thoughts, hostility-impulsivity, and negative self-evaluation, and it has been shown that these four factors can distinguish normal people from suicidal people. The suicide process also includes thinking, planning, acting, and finally completing the suicide. This behavior is inherently self-motivated, meaning that the person is doing it themselves, and intentionality is an inherent characteristic of doing it. According to studies conducted in this field, these events depict the progressive behavior of suicide in such a way that the occurrence of each increases the risk of the next stage in this circle. Knowing the risk and protective factors that can reduce suicidal thoughts will play a major role in preventing people from entering this costly and deadly chain, especially in early adulthood. Self-efficacy is one of the compatible cognitive characteristics that are considered important factors in the protection of suicidal thoughts and have significant effects on the perception of stress and coping mechanisms in the fields of psychological and physical medicine. Also, self-efficacy has a significant effect on a person's behavioral style, effort, and persistence. People with low self-efficacy usually feel powerless, unlike people with high self-efficacy who are more in control and less threatened in stressful situations, so a person with suicidal thoughts is likely to have a lower sense of self-efficacy. The relationship between attachment styles and self-efficacy and suicidal thoughts has been examined in past research, and the results have shown that secure attachment style has a positive relationship with self-efficacy and a significant negative relationship with suicidal thoughts or factors related to suicide attempts. But at the same time, the mediating role of selfefficacy about attachment styles with suicidal thoughts has not been investigated. In this research, the researcher seeks to fill this research gap. Those were considered the main predictive variables for suicidal thoughts. Also, considering the role of self-efficacy in adjusting and regulating one's emotions, it can be considered a mediating role as in past research. Methods: The statistical population of this correlation study included all the students of Shiraz Azad University in 1402-1401, which was equal to 19635 people based on the statistics obtained from the education of Shiraz Azad University. To determine the sample size, Cochran's formula was used and according to the calculations, the sample size was determined to be 380 people. Collins and Reed's (1990) attachment style questionnaire, Scherer et al.'s self-efficacy (1982), and Beck's suicidal thoughts (1961) were used. SPSS and Lisrel software were used for data analysis. Results: The results showed that secure attachment style has a direct and significant effect on the feeling of self-efficacy and an inverse and significant effect on suicidal thoughts, and at the same time, the feeling of self-efficacy has an inverse and significant effect on suicidal thoughts. Also, the results showed that the mediating role of self-efficacy in the impact of attachment styles (secure, avoidant, ambivalent) on students' suicidal thoughts is significant at the 99% confidence level. Conclusion: In general, it can be concluded that increasing attachment styles can be a solution to increase the sense of self-efficacy, so it can be introduced as a solution to reduce suicidal thoughts. Self-efficacy leads to greater effort and persistence with obstacles and difficulties. Also, self-efficacy affects motivation through goal setting. If a person feels highly efficient in a specific field, he sets higher goals for himself, is less afraid of failure, and finds new strategies if the old strategies fail. But if the feeling of efficiency is low, the person avoids the task completely. Or quickly clears the scene if it encounters problems. It is suggested that therapists and health professionals use the results of this research in addition to prevention as a therapeutic intervention to prevent the emergence of dysregulated behaviors such as suicide. According to the results of the present study, it is suggested that health experts prioritize and choose the type of treatment for people with suicidal thoughts, as well as save time and money and achieve the maximum benefit from the methods of teaching self-efficacy and resilience skills. To use in this study, subjects were not interviewed and clinically evaluated, and selfreport tools were used to collect data. Therefore, the results of the current research, like many other research, due to the use of questionnaires and self-report tools, may lead the participants to use methods based on obtaining social approval and avoiding stigma related to inadequacy, instead of actual behavior. Someone has encouraged me. As a result, caution should be used in the interpretation of research data. [ABSTRACT FROM AUTHOR]

Background & Aims: The social developments of the past decades at the global level have faced the family system with new and diverse changes, challenges, issues, and needs. During this period, the family has been increasingly threatened by multiple and complex causes and factors. When the functions of the family, such as biological, social, cognitive, and emotional functions are damaged one after the other, its members gradually lose their sense of satisfaction. The gradual decrease in the satisfaction of family members due to incompatibility between couples first causes psychological dissociation and then social dissociation. In fact, the functioning of the family is formed based on the relationship between the spouses, and the conflicts between them cause the family system to undergo serious problems. One of the factors that can be mentioned as an influential factor in the occurrence of marital conflicts is intimacy, which in fact, with the reduction of this factor, the process of incompatibility moves forward quickly, and as an essential factor, it can be paid. Marital compatibility can be more in couples that have a higher level of intimacy. In other words, couples with higher intimacy are more capable of facing problems and changes related to their relationship, and as a result, they experience higher marital satisfaction and compatibility. On the other hand, communication skills are considered to be complex processes that enable a person to behave in such a way that others consider him/her adequate. Skills are the necessary abilities to perform purposeful and successful behaviors. Communication skills are the ability to symbolically and efficiently convey the meanings and messages that a person has in mind. When the couple's communication is of better quality, they can be closer to each other and can share their thoughts and feelings, as a result, they feel more intimate and avoid possible misunderstandings that arise in marital conflicts. They prevent seizures. Various treatment methods have been used to solve marital problems. The existence of incompatibility and unhealthy functioning of the family leads to the emergence of various family complications and damages. Therefore, it is necessary to implement therapeutic interventions to increase the functioning of couples, and one of the most effective therapeutic approaches in this field is schema therapy. Schema therapy is effective in improving the sense of closeness and psychological state of couples, marital relations, communication documents and sexual performance of couples, communication beliefs, and marital compatibility, and reducing the desire for divorce. The schema therapy approach is a fundamental evolution in cognitive therapy. The schema therapy approach was formed and developed at the heart of the cognitive therapy approach, based on the attachment theory. Schemas, as traces of a complex set of cognitions, feelings, and tendencies to react, are placed in the neural networks of the brain based on previous experiences. As soon as these patterns are activated in the later stages of life, people will feel trapped. By presenting the role of schemas and coping responses in conceptualizing psychological problems, schema therapy has been able to play a greater role in explaining psychological problems. Despite conducting various studies in the field of the effect of the use of treatment protocols on marital psychological characteristics, there are still many gaps in this field. Each of the conducted research is limited to certain statistical societies and cannot be generalized to the whole society. Also, the way of implementing treatment protocols may be of different quality, which requires repeating these training and comparing their results to reach the final conclusion. Conducting the present research can bring significant and interesting results by examining the effectiveness of the schema therapy protocol. Despite the effectiveness of schema therapy in improving subjects' behaviors in various studies, there have been few studies that have been conducted to investigate the effectiveness of schema therapy on intimacy and communication skills. Therefore, the research gap in this field is quite evident. Considering that the compatibility of couples plays an important role in the stability of the family, schema therapy can be used to achieve this goal, so the research question is whether schema therapy can affect intimacy and communication skills in incompatible couples. Is it effective for counseling centers in Tehran? Methods: It is a semi-experimental research method with a pre-test-post-test design and a control group and a follow-up period. The statistical population included all incompatible couples who referred to the counseling centers of Tehran in the first half of 1400, and by taking possession of the existing files of incompatible couples who referred to the counseling centers of Tehran, the number of 10 couples (10 men and 10 women) who due to conflicts Marital have referred to counseling centers in Tehran using available sampling method and were placed in two groups of 5 couples (5 couples in the experimental group, 5 couples in the control group). The data collection tool was Thompson and Walker's Marital Intimacy Questionnaire (1983), Matson's Communication Skills Questionnaire (1983), and Spanier's Marital Compatibility Questionnaire (1976). In this research, Yang's schema therapy protocol was used for schema therapy training, which was used for three months and in 10 sessions of 120 minutes, as shown in table no. The mixed variance analysis test with repeated measurements was used to analyze the data. Results: The results showed that schema therapy is effective and stable in intimacy and related skills in incompatible couples. Also, the difference between the scores of all components in the pre-test and post-test stages, as well as pre-test and follow-up is significant (P<0.01), while the difference between the post-test and the follow-up stage is not significant. (P>0.01). This finding means that schema therapy has not only improved the marital intimacy components of couples in the experimental group, but this effect has also been stable in the follow-up phase. Also, the results of Table 6 show that the difference between the scores of communication skills in the pre-test and post-test stages as well as pre-test and follow-up is significant (P<0.01), while the difference between The test and the follow-up phase are not significant (P>0.01). This finding means that schema therapy has not only improved the communication skills of couples in the experimental group, but this effect has also been stable in the followup phase. Conclusion: According to the results of this research, in general, schema therapy has a significant and stable effect on intimacy and communication skills in incompatible couples. In other words, schema therapy has improved intimacy and communication skills in incompatible couples. Every study has some limitations, and this study, like other studies, is not exempt from this case, which can be mentioned as the following limitations. In this research, only questionnaires were used to collect information, and due to practical limitations, interviews were not used to collect knowledge data. Also, the limitation of the sample size and the sampling method inevitably used the available sampling method. The main limitation of this research is that the current research sample was selected from among incompatible couples referring to counseling centers in Tehran, and the generalization of the results of this research to other people should be done with caution. Also, in this research, the possible effect of some intervening variables such as family, cultural, social, and economic factors and personality traits such as mental health or underlying family problems and their role in the research variables were not investigated, which found generalizability. It reduces research. [ABSTRACT FROM AUTHOR]

Background & Aims: Considering the lack of research in finding an effective approach in the field of bipolar disorder management and the career success of people with this disorder, the present study aims to compare the effectiveness of vocational rehabilitation programs with career counseling based on the cognitive-behavioral approach on the career success of them, and the following questions were answered: Is the effect of a vocational rehabilitation program with career counseling based on the cognitive-behavioral approach different on the subjective career success of people with bipolar disorder? Is the effect of the vocational rehabilitation program different from career counseling based on the cognitive-behavioral approach to the objective job success (income) of people with bipolar disorder? Is the effect of the vocational rehabilitation program different from career counseling based on the cognitive-behavioral approach to the objective career success (promotion) of people with bipolar disorder? Methods: The design of the current research was semi-experimental, of a pre-test-post-testfallow-up type with a waiting group. All participants referred by a psychiatrist to a counseling clinic and diagnosed as having bipolar disorder were purposefully selected for the research, and among them, the volunteers were interviewed and diagnosed with a clinical interview based on the criteria of the DSM-5. To select the research sample, inclusion and exclusion criteria were considered. 24 people were selected by the available sampling method and randomly assigned to groups. 8 people in the experimental group with a vocational rehabilitation program, 8 people in the experimental group with career counseling based on the cognitive-behavioral approach, and 8 people in the waiting group. Before starting the interventions, a pre-test was taken from all 24 participants. After that, the people assigned to the two test groups received the relevant interventions in 10 sessions of 100 minutes (in the experimental intervention with the vocational rehabilitation program and the career counseling intervention based on the cognitive-behavioral approach) and the people present in the waiting group did not receive any intervention. The people participating in the interventions did not have any knowledge or contact with each other, and they tried to maintain is lack of knowledge and communication until the end of the intervention and prevent the exchange of information. For the vocational rehabilitation program and career counseling based on the cognitivebehavioral approach, a pre-developed program was used separately, the validity and reliability of which had been checked and confirmed (5). Moreover, the vocational rehabilitation program, in addition to 10 intervention sessions for the individual with bipolar disorder, included two intervention sessions for the family and two sessions for the employer or his colleague, which are carried out if the individual needs and consents to these two intervention sessions were down. At the end of the interventions, all the people in the experimental and waiting groups filled out the questionnaires again as a post-test. One month after the implementation of the post-test, the research samples filled out the research questionnaires for the third time to implement the follow-up phase. To measure the subjective dimension of career success, the job satisfaction questionnaire (29) and the objective dimension of career success were measured by measuring the amount of income and job promotion. Research data were analyzed using descriptive statistics (mean and standard deviation) and inferential (variance analysis with repeated measures) using SPSS V. 16 software (30). Based on the background of the research, pre-test variables, age, and gender were covariate. Results: In the post-test stage, the vocational rehabilitation program showed more effectiveness in subjective career success than the career counseling based on the cognitivebehavioral approach (p<0.007) and the waiting group (p<0.006), but none of the two interventions, there was no significant effect on objective career success (p<1). Also, in the follow-up phase of the vocational rehabilitation program, it was more effective on subjective career success than the career counseling based on the cognitive-behavioral approach (p<0.003) and the waiting group (p<0.0001), but between the scores of the participants in the intervention of career counseling based on the cognitive-behavioral approach and the waiting group no significant difference was observed (p<0.26). Besides, there was no significant difference between the objective career success scores (income) of the participants in the two research interventions and the waiting group (p<0.2). In comparison, between the objective career success scores (promotion) of the participants in the two research interventions, there was no significant difference with the waiting group (p<0.36). Conclusion: According to the data obtained from the results of the research, it can be said that the vocational rehabilitation program has been effective in increasing subjective career success scores, and even after one month of receiving the intervention, the effectiveness of this method has not decreased. Also, career counseling based on the cognitive-behavioral approach has not been effective in the subjective career success of people with bipolar disorder. Besides, none of the two interventions have been effective on the objective career success (income and promotion) of the people participating in the research. In general, according to the results of the research and the explanations presented, it seems that considering the clinical observations, the subjective career success of people with bipolar disorder during the interventions, especially in the vocational rehabilitation program, compared to the career counseling based on the Cognitive-behavioral approach more specifically deals with the career and its appendices, and in addition to managing people, it teaches a person how to build and deal with a real career future. Therefore, it is not far-fetched that a specialized vocational rehabilitation program that is specially designed for vocational interventions will be more effective (5). It is also important to note that increasing income is not a short-term process and requires a long time (34). In addition, this research coincided with the era of Coronavirus and the recession and closure of businesses (36), but under the influence of the interventions, at least the previous income level of the individual in these challenging conditions was maintained. Based on the clinical evidence from the reports of the people present in the research, especially the people who participated in the intervention of the vocational rehabilitation program, after participating in the intervention, these people were able to achieve a higher human credit status in the workplace than before, and the positive feedback of people around these people has confirmed that. Therefore, it seems that in addition to the objective promotion, maybe we can have a word called spiritual promotion, which based on the positive feedback these people received from the people around them at the workplace, is considered a great career success for these people. Will be In fact, it may be possible to talk about the existence of a kind of spiritual promotion in the workplace, which has not been mentioned in research so far (5). This study provides evidence of the effectiveness of the vocational rehabilitation program in increasing the career success of people with bipolar disorder. This new perspective can be used as a reliable source on the career interventions of people with bipolar disorder and can be effective as an early rehabilitation intervention in reducing the career issues of these people. [ABSTRACT FROM AUTHOR]

Background & Aims: Staphylococcus aureus is one of the human pathogens that causes a wide range of diseases such as endocarditis, blood, bone, skin and soft tissue infections (1). One of the resistant strains of this bacterium is methicillin-resistant strains of Staphylococcus aureus (MRSA), which has been reported as a serious risk by the Centers for Disease Control and Prevention. One of the pathogenic mechanisms and antibiotic resistance of this bacterium is the formation of biofilm, which causes this bacterium to bind to different surfaces (2). Biofilm-forming strains have become resistant to many antibiotics, so that biofilm-forming strains form extracellular matrices that are immune to the immune system and antibiotics. Various genes are involved in biofilm production, one of which is the icaB gene, which plays a key role in the production of poly N-acetyl glucose amine and biofilm production. The design of new antimicrobial drugs for the treatment of this bacterium is important, so finding a suitable treatment option for the treatment of infections caused by this bacterium is one of the challenges of researchers (3). Recent advances in nanotechnology have suggested alternative solutions, such as drug delivery systems, that increase drug specificity and efficiency (4). One of these drug delivery systems is nanosystems, which are composed of bilayer nonionic surfactants. Due to the importance of nanosystems, the aim of this study was to synthesize nanoparticles containing naproxen, to investigate their physicochemical properties and their antimicrobial and antifouling effects against Staphylococcus aureus strains. Methods: Nanosomes containing naproxen were synthesized by thin layer hydration method. The confinement efficiency is indicative of the drug encapsulated in the nanosystem structure relative to the drug used. For this purpose, the nanonosomal formulation was first centrifuged at 4 ° C at 14000 g for 45 minutes. The nanosystem containing the drug precipitates and the free drug remains in the supernatant. The absorbance of the supernatant sample at 270 nm was read by a spectrophotometer and the amount of free drug was calculated from the initial value. The Physico-chemical characteristics of prepared nanoniosome encapsulated naproxen was determined using scanning electron microscopy (SEM), Dynamic light scattering (DLS). The in vitro drug release study was done using dialysis bag (6). The Staphylococcus aureus strains were recovered from 100 clinical samples and their antibiotic resistance patterns were studied using disk diffusion method. The antibacterial activity of nanoniosome loaded naproxen and free naproxen were investigated using well diffusion and micro-dilution methods (7). The icaB biofilm gene expression analysis in S. aureus isolates which are treated with nanoniosome loaded naproxen and free naproxen were examined using Real Time PCR methods (8). Draw diagrams and Statistical analysis was performed by GraphPad Prism software version 7 and SPSS version 23, and one-way analysis of variance was used for statistical analysis and p <0.05 was considered significant. Results: In this study, using different molar ratios of surfactant, cholesterol and drug, different formulations of nanosystems containing naproxen were synthesized. The optimal niosome size synthesis was measured by DLS method. The results of electron microscopy (SEM) show that the synthesized nanonosomes have a spherical structure. In this study, the dialysis bag method was used to evaluate the drug release pattern. Figure 2 shows the pattern of naproxen release from nanosystems and free naproxen over 72 hours. Out of 100 clinical specimens, 15 specimens of Staphylococcus aureus were isolated and identified using microbiological methods. The results of antibiotic resistance profile test showed that out of 15 strains, 10 strains were methicillin resistant (MRSA). The antibacterial activity of nanoniosome encapsulated naproxen and free naproxen showed that the MIC was reduced by 2 to 4 times. The results of the well diffusion method showed that nanoniosomes containing naproxen had more significant antimicrobial power than free naproxen, so that the diameter of the growth inhibition zone increased with increasing nanosystem concentration. Real-Time PCR was used to evaluate the effect of nanoniosoms containing naproxen and free naproxen on icaB biofilm gene expression in Staphylococcus aureus strains. Also, after treating Staphylococcus aureus strains with naproxen-containing nanosystem sub-inhibitory concentration, it was shown that the expression of icaB gene was significantly reduced compared to the 16S rRNA reference gene (p <0.05). Conclusion: In this study, naproxen was encapsulated as a drug compound in the nanoniosome structure and its physical and chemical properties including size, morphology, drug enclosure percentage and drug release were studied. The results of this study showed that the synthesized nanoniosome in the optimal formulation had a spherical shape, the average size was 125.3 nm with a confinement percentage of 66.84%. Drug release results also showed that naproxen in the formulated form in nanonosomes has a much slower release pattern than free naproxen, which is a suitable feature of a drug delivery system. The results of the antimicrobial test showed that naproxen-containing nanoniosome had more significant antimicrobial effects than free naproxen compared to free naproxen, reducing the MIC by 2 to 4 times. One of the antimicrobial mechanisms of nanoniosome containing naproxen is the fusion of nanoniosome with bacterial cell membranes, which can deliberately release the drug into the cytoplasm of the cell and cause bacterial cell death (10). The results of this study showed that nanoparticles containing naproxen have more significant anti-biofilm effects than free naproxen compared to free naproxen and can significantly reduce the expression of biofilm gene (11). One of the reasons for the anti-biofilm effects of naproxen-containing nanosystems is the greater penetration of naproxen-containing nanosystems into the biofilm structure, which can cause the death of bacteria, a decrease in the number of bacteria, and the conversion of biofilms into planktonic cells (12). [ABSTRACT FROM AUTHOR]

Background & Aims: In today's societies, breast cancer has significantly threatened women's health (1). Successful cancer treatment can also destroy tumor germ cells (2, 3). Treatment methods based on immune checkpoint molecules are considered (4). PD-L1 overexpression suppresses the immune response to cancer cells and causes epithelial-tomesenchymal transition (EMT) and cancer stem cell (CSC) phenotypes, metastasis and chemical resistance (5). Overexpression of PD-L1 and MUC1 is observed in approximately 90 TNBCs. In this present study, we investigated the inhibitory effect of miR-143-3p on MUC1 expression as an oncogene that has the most impact on PDL-1 overexpression in BC cell lines MCF-7 (less aggressive BC), MDA-MB-231, and BT549 (metastatic BC model). The suppressive effect of miR-143-3p on the expression of this oncogene as a direct effect and PDL1 level as an indirect result in BC cell lines was investigated. Besides, the effect of miR-143-3p overexpression on BC cell lines proliferation through downregulation of candidate oncogene was investigated. Methods: First, the targeting of miR-143-3P on MUC1 3 'UTR was confirmed by using bioinformatics software and then by dual luciferase assay. The expression level of miR143-3P and MUC1 were measured in breast cancer lines compared to the normal line. After transfection of miR-143-3P into breast cancer cell lines, MUC1 and PD-L1 expression in mRNA levels were evaluated by using qRT-PCR. The miR-143-3p effects on MUC1 and PD-L1 expression and its impact on cell proliferation was investigated by using MTT assay, (mean ± SD). Results: The result of the dual luciferase assay was obtained from cloning the 3'UTR of the MUC1 gene in the psi-check2 vector and sequencing. According to the prediction analysis, the 3′-UTR of MUC1 gene has been considered as a putative miR-143-3p binding site (Target scan database). Transfecting miR-143-3p into MDA-MB-231, BT549, MCF-7 cells harboring MUC1 3′-UTR decreased the luciferase activity to to 55% ± 1/73, 57% ± 1 /15, 59 % ± 3/51% respectively, in comparison with the control (P < 0.01) (mean ± SD). he expression of miR-143-3p was significantly downregulated in BC cell lines compared to their control, and its downregulation was negatively correlated with MUC1 overexpression (r= -0.6419, p = 0.0244). Increased expression of miR-143-3P, decreased the mRNA level of MUC1 in MDA-MB231 to 1/3 ± 0/7, BT549 to 1/1 ±0/45 and in MCF7 to 0/4± 0/21, compared whit untransfected cells. MiR-143-3p introduction to BC cells downregulates PDL-1 indirectly. Overexpression of miR-143-3P reduces the MUC1expression, and the reduction of MUC1 expression reduces PD-L1 expression mRNA level in MDA-MB231 to 3/4±0.45, BT549 to 3/1±0.56, MCF7 to 0/53±0.48, compared whit un transfected cells (fig4A). miR-143-3p inhibits BC cellular proliferation. An MTT assay revealed that miR-143-3p overexpression significantly suppressed the proliferation in MCF-7 to 52% ± 1.55, BT549 to 48% ± 2.45 MDA-MB231 to 43% ± 3.36, compared whit non-transfected cells 72 h after transfection. Conclusion: Breast cancer treatment has made significant progress in recent years, and a new treatment called immunotherapy, which uses the body's immune system to treat cancer, has become popular (6). One of the symptoms of breast cancer tumors is the overexpression of MUC1. A high expression level of MUC1 is associated with poor prognosis in cancer patients (7, 8). In an animal model of breast cancer, intravenous injection of MUC1 suppresses the immune system and accelerates the death of tumorbearing mice. The serum level of MUCl expression is also associated with suppression of the immune system in patients with metastatic adenocarcinoma treated with active specific immunotherapy (8, 9). As we mentioned earlier, MUC1 can increase the expression of PD-L1 by recruiting MYC and NF -kB p65 to the PD-L1 promoter in some solid tumors, such as triple negative breast cancer (10). the mechanisms underlying PDL1 expression in MUC1-positive tumor tissue were investigated, and the potential of targeting PD-L1 to inhibit the progression of MUC1-overexpressing colon cancer in mice, Therefore, the role of MUC1 in tumor immune evasion has been confirmed and can be a basis for using PD-L1 inhibitors in MUC1-positive colon cancer (8). microRNAs can regulate the expression of immune checkpoint receptors and their ligands (11). Changes in the expression of miR-143 often play a role in tumorigenesis (12). In 2020, Y Tokumaru and his colleagues showed by studying breast cancer samples with estrogen receptors that the high expression of microRNA-143 is associated with a favorable tumor immune microenvironment and better survival in breast cancer. They reported that miR143 is a tumor suppressor microRNA that exhibits anti-tumor function by targeting KRAS signalling pathways in various malignancies. The high expression of miR-143 in cancer cells with a favorable tumor immune microenvironment regulates the positivity of anticancer immune cells. The suppression of pre-cancerous immune cells is related and leads to better survival of breast cancer patients (13). In this study, we demonstrated MUC1 was potential as a novel target of miR-143-3p, therefore, the dual-luciferase reporter assay verified that miR-143-3p directly targeted MUC1 and inhibited this transcription. We found miR-143-3p downregulated in breast cancer cell lines compared to the normal line via qRT-PCR. In the current study, the qRTPCR results illustrated an inverse relation between MUC1 mRNA expression and miR143-3p expression in breast cancer cell lines. We investigated indirect targeting of PDL1 via MUC1 targeting by miR-143-3p., be able to be prevent the cell proliferation in breast cancer cell line. Therefore we recognized, targeting MUC1 may be a novel strategy for BC therapy and prevent the progression of breast cancer and miR-143-3p as a promising candidate for miR restoration therapy in BC patients. [ABSTRACT FROM AUTHOR]

Background & Aims: rug abuse is a major health challenge all over the world, and the majority of society thinks that drug abuse is mainly a male phenomenon. While drug abuse in women is increasing. Women experience a stressful life with drug abuse and need more support from family and society. If they do not receive the necessary support, they will be stuck in the cycle of addiction and it will be difficult for them to bear failures. Pregnancy with substance abuse poses serious risks to women's mental, psychological, physical and physical health and threatens the mental, social, political and economic health and safety of the society. In this context, midwifery personnel play a role as active people in the health care team and as one of the important sources of information to the community members in increasing social support and bearing more failures. The present study was conducted with the aim of determining the role of social support in coping with the failure of pregnant women with substance abuse who referred to Hazrat Zainab Hospital in Shiraz in 2021. Methods: The current study is a descriptive-cross-sectional study and the statistical population of all pregnant women with substance abuse referring to the clinic, laboratory, IVF unit, ultrasound, emergency department, and inpatient departments who, based on their self-report, declared that they suffered from substance abuse in a 12-month period. The consumption of substances such as cigarettes, opium, opium juice, heroin, crack, glass, hashish, morphine, cocaine, amphetamine, methadone, marijuana, NAS, pan, bong, flower, alprazolam, buponorphine and other substances and in different sections. Hazrat Zainab Hospital was in Shiraz. 200 people were included in the study by continuous sampling. The inclusion criteria included: having Iranian nationality, women aged 18 and above, ability to read and write, being married and with drug abuse according to the individual, mental and physical conditions were suitable.While respecting the privacy and confidentiality of information, demographic questionnaires, VAX social support and Harrington's failure tolerance were completed. Sampling continued from Mehr to Esfand 1400. Data analysis was done with SPSS 22 software with descriptive and analytical statistics tests of frequency, percentage, mean and standard deviation, Pearson correlation coefficient and multiple regressions. Results: In the present study, 200 Iranian pregnant mothers with substance abuse with an average age of 34 years, average age of marriage 21.70 ± 4.51 years, majority of married women, housewives, with unfavorable economic status and no insurance were examined. Women and spouses with primary and secondary education levels had the highest frequency compared to other people. Women with working spouses also had the highest frequency compared to other people. 56% of these women had an unwanted pregnancy and 50 of these women had a history of prison and half of them had a history of prison once. The reason for the conviction of 60% of women was for carrying drugs, 30% for theft and 10% for other reasons. Women with 2 children had the highest frequency. The average social support score of pregnant women with substance abuse was 53.4 ± 2.32, which indicates unfavorable social support. Social support in the support of friends dimension had the highest mean (2.44 ± 0.91) and the support of community members had the lowest mean (2.24 ± 0.64). Social support was more in wives and husbands with middle and higher education levels. The mean failure tolerance score was 136.73±22.5, and failure tolerance was inversely correlated with social support (P=0.012) in the dimension of not tolerating stress, not tolerating discomfort, and not tolerating injustice and dissatisfaction. Conclusion: The social support received by pregnant women with drug abuse is not optimal and these women receive most of their support from friends, family and acquaintances, which provides the basis for more harm to them and makes them more prone to fall into the trap. Addictive Most of these women have not been able to bear failures, so it seems necessary to design and hold life-enhancing programs. Social support in these women was related to the level of education and favorable economic status, which can be helped by promoting education and improving the economic situation by creating simple jobs and educational spaces for these women. [ABSTRACT FROM AUTHOR]

Background & Aims: The pituitary gland is located near the center of the cranium base, caudally surrounded by a bony basket structure of the sphenoid bone named "Sella Turcica." The adjacent structures, such as optic chiasma stated superiorly, are of clinical and surgical importance(1, 2). Surgery is the first-line treatment for the large nonfunctional pituitary adenomas with clinical signs and symptoms (e.g., optic chiasma compression) and most functional adenomas (4). The very primary surgical access to pituitary adenomas was provided via trans-facial or trans-cranial approaches. The trans-sphenoidal approach was introduced later in the early 1900. However, this approach was abandoned due to serious complications and a higher mortality rate (5-8). With the advent of the microscope and later the endoscope and its application in the trans-sphenoidal approach, the endoscopic endonasal transsphenoidal approach (EETSA) has been rapidly accepted and well established for its advantages such as a better visualization, more complete tumor resection, and lower complications (8-10). However, as the access to a pituitary adenoma is provided through a bony defect in the sella turcica floor, postoperative cerebrospinal fluid (CSF) leak is a risk with the recently reported prevalence of 0/5-12% in endoscopic approach (11-16). To avoid it, various reconstruction strategies and materials have been introduced. In nonrigid reconstructions, materials such as fat, fascia, dural replacements, mucosal or muscular grafts, and pedicled mucosal flap of the nasal septum, middle or inferior turbinate are used. In rigid reconstructions, bone, cartilage, titanium mesh, ceramic implants, and bone cement are adopted (8,21). None of them being known superior to the other, heterogenous algorithms have been designed principally based on the grade or risk of CSF leak (22, 23). Rigid reconstruction is supposed to strengthen and protect the reconstructed area well. However, donors cite morbidities in autografts (e.g., nasal bone or cartilage) (24), infection transmission in allografts (e.g., cadaveric iliac crest) (25), high costs, low biocompatibility, infection, and radiologic artifacts in synthetic grafts (e.g., Medpor) (26) are among the challenges both the patients and the surgeons encounter (19). Moreover, minimal data exist on the spontaneous sella turcica re-ossification following EETSA, which can debate the necessity of rigid reconstruction. This pilot study consequently aims to consider the possible self-repair of sella turcica without any rigid reconstruction in eight patients with pituitary adenoma. Methods: In this retrospective pilot study, the pituitary adenoma data bank of Rasoul Akram hospital's skull base research center was reviewed for the patients who had undergone EETSA between March 2014 to February 2018. Those with available pre-operation paranasal sinuses CT scan, data bank documented measures of the intra-operation bony defect, evidence of the complete tumor resection according to the MRI three months after the surgery, and no evidence of tumor recurrence based on the last MRI ( 2018 or 2019) were included if no revision surgery or radiotherapy before or/and after the operation was conducted. They were accidentally called, and the first ten patients accessible by the documented phone number were invited to take a paranasal sinuses CT scan to evaluate sella turcica spontaneous re-ossification after informed consent. The CT scans were evaluated, and measurements, including the maximum diameters of bone defect in the coronal and sagittal planes on the CT scans - using the Picture Archiving and Communication Systems (PACS) - Osirix system-, were compared with the defect size created intraoperatively. The area of the defect was calculated using the equation for the area of an Ellipse (major radius multiplying by minor radius Multiplying by pi.) All procedures performed in this study were in accordance with the ethical standards of the Iran University of Medical Sciences research ethics committee (IR.IUMS.REC.1395.29082) and with the 1964 Helsinki Declaration and its later amendments. Median and interquartile ranges (IQ) were used for the descriptive analysis of quantitative variables. Mann-Whitney test was used to compare independent quantitative variables, and Wilcoxon Signed Ranked test was used for quantitative dependent variables. The Spearman test evaluated the correlations. The statistical software IBM SPSS Statistics for Windows version 22.0 (IBM Corp. Released 2013, Armonk, New York) was used for the statistical analysis. P values <0.05 were considered statistically significant. Results: Eight patients with no rigid reconstruction were included in the final analysis, with a median age of 40/5 years old (IQ=17), of whom six were female. After a median of 46 months (IQ=20.5, range 12-60), length, width, and the area of the bony defect were significantly reduced (21.5 to 9.3 mm, 15.6 to 9.4, and 297.90 to 77.5 mm2, respectively p values=0.01) leading to the median of 74.1% (IQ=11.2%, range 67.8-99.2%) self-repair of the primary bony defect. The area of the intraoperative bony defect was significantly correlated with the final bony regenerated area and with the area of defect remaining after follow-up. (r=0.929, p value=0.001, and r=0.976, p value≤0.001, respectively) . A negative correlation between age and the bony regeneration speed (the monthly percentage of the repaired area) was also detected. (r=-0.762, p value= 0.02) Conclusion: In this study, spontaneous bony regeneration was shown to occur in all eight studied individuals (median of 74.1%, range of 67.8-99.2%) with various types of pituitary adenomas and primary defect areas (median of 297.9, range of 78.5 to 575.52 mm2) after a median of 46 months. The results align with the only previous study that reported spontaneous ossification in 94% of the 17 patients with pituitary adenomas in the median of 36 months (27). There are no more available data on sella turcica spontaneous bony regeneration. However, there is evidence of potential spontaneous re-ossification of the mandible, which is of the same bone type (irregular), showing even better healing without reconstruction strategies (29, 32- 35). CSF leak risk, which is the most salient concern in EETSA, determines the reconstruction strategy in the skull base surgeries. Nonrigid reconstruction, whether intraoperative CSF leak is present or not, has led to permissible postoperative CSF leak (38,42,43). Moreover, the postoperative CSF leak rate was not significantly different with or without the use of Buttress in a recent meta-analysis (38). Putting all these findings together and considering the natural sphenoid spontaneous bony regeneration capability, the authors suggest that rigid reconstruction of sella turcica following EETSA may not be necessary. [ABSTRACT FROM AUTHOR]

Background & Aims: Myocardial infarction is one of the most important ischemic cardiopathies (1). Despite progressive improvement in medical therapy and standard care, Exercise-based rehabilitation programs have been shown to improve the exercise capacity of patients with myocardial infarction through a multifactorial effect (2). In this context, high-intensity interval exercise is a growing field of research (3). Many studies have shown that High-intensity interval training (HIIT) has more protective effects on myocardial tissue than aerobic exercise (6). Therefore, this study aimed to investigate the effect of a period of low-volume, high-intensity interval aerobic exercise on heart structural and functional indicators in patients with myocardial infarction. Methods: In this semi-experimental study with pretest-A post testdesign,20 patients with documented MI (without regular exercise history) volunteered to participate in the research randomly in two control groups (n=10) and exercise group (n=10).The subjects trained for 3 d/week for 12 weeks (one session on a treadmill and another session on an exercise bike), under the supervision of an expert physician and exercise physiologistspecialists. We asked the control group patients not to engage in any other leisure exercise during the study. The rationale formixing bike and treadmill was to avoid the osteoarticular effects of two treadmill days by considering the HIIT program. We calculated the optimize dexercise zone using the Karvonen formula, which calculates the exercise heart rate as a percentage of the heart rate reserve, added to the resting heart rate (11). The training intensity was adjusted by constantly changing the treadmill's speed and incline or the bike's power and speed to ensure that we performed all training sessions with the target heart rate (HR)(9). Training intensity was controlled by monitoring participants' heart rate (HR) using a Polar HR monitor (Polar Electro OY, Finland). Heart rate, blood pressure, and perceived exertion were evaluated using the Borg Scale (6 to 20 points) before, during, and after each session (12). We measured the structural and functional indices of the heart using an echocardiography device in baseline conditions and after 12 weeks of training. We performed all examinations at rest in the left lateral decubitus position according to the guidelines of the American Society of Echocardiography (16). We analyzed data using paired t-test and independent t-test. All statistical tests were performed with SPSS software version 28.0 (IBM SPSS, Inc, Armonk, NY). Values of p <0.05 were considered statistically significant. Results: End-diastolic diameter, end-diastolic volume, injection fraction, left ventricular stroke volume, and peak oxygen consumption of the training group was significantly increased compared to the baseline conditions and compared to the control group (P<0.05) and Resting heart rate, systolic and diastolic blood pressure showed a significant decrease (P<0.05). But there was no significant change in the thickness of the posterior wall at the end of the diastoleof the left ventricle. Conclusion: The main results of this study showed that the HIIT training protocol with the low-volume produced positive and significant changes in systolic blood pressure, diastolic blood pressure, resting heart rate and VO2 peak, which shows a positive training response in these patients. But we found no improvement in the control group and only systolic and diastolic blood pressure remained unchanged. Also, in the parameters of resting heart rate, systolic and diastolic blood pressure and VO2 peak, a significant difference was found between the HIIT group and the control group, which is related to the improvement of physical activity level and functional capacity. These findings show the effectiveness of a low-volume HIIT program in improving clinically important parameters. The results of the present study showed that left ventricular end-diastolic volume, left ventricular ejection fraction (EF) and stroke volume (SV) increased significantly after HIIT exercises compared to the control group. Recent studies have shown that physiological adaptations of the left ventricle following exercise are divided into three general sections: 1) physiological hypertrophy of existing myocytes, which is associated with increased production of specific growth factors; 2) activation of cardiac stem cells, which increase the number and their differentiation leads to myocytes and vascular cells and 3) accumulation of new heart cells called new myocytes and vascular cells (32, 33). These cellular changes depend on the intensity and duration of exercise, which is associated with increased contractile muscle mass, cardiac function, and decreased wall tension. Therefore, since the results of the present study show an improvement in left ventricular function index in patients with MI following low volumes of HIIT training, it is likely that low volume of HIIT volumes could be stimulated the above mechanisms and play an important role in improving cardiovascular function. The results of the present study showed that the end-diastolic diameter of the left ventricle increased significantly in the HIIT group compared to the control group. Therefore, it can be said that 12 weeks of low-volume HIIT training has led to an increase in blood volume and venous return (because of skeletal muscle pumping and venous contraction), which according to Frank-Starling's law, increases ventricular stretch and ventricular contractility. It has led to an increase in injection fraction, which ultimately causes an increase in stroke volume and a decrease in resting heart rate, and one reason for the significant increase in VO2 peak after 12 weeks of low-volume HIIT training may be the increase in blood volume and ventricular end-diastolic diameter. Be left, because these two mechanisms cause an increase in the number of mitochondria and their enzyme contents, capillary density and better blood flow in active muscles and heart muscles (38). Also, the results showed that the average thickness of the posterior wall of the left ventricle at the end of diastole in the HIIT group had a slight and non-significant increase. Reports show that aerobic activity causes a volume load on the heart, an increase in the heart chambers, especially the left ventricle, and a relative increase in the ventricular walls of the heart (39). Perhaps the reason for the non-significant changes in the thickness of the posterior wall at the end of left ventricular diastole in this study was the rapid filling of the left ventricle during ventricular diastole or the small volume of the exercise program, because the volume of the exercise program was not enough to cause obvious structural changes. In summary,interval aerobic training with low volume and high intensity improves the structure and function of the left ventricle, but we need more training volume to achieve more obvious structural changes in the left ventricle of patients with MI. [ABSTRACT FROM AUTHOR]

Background & Aims: Overweight and obesity are related to increased risk of coronary heart disease, stroke, high blood pressure, type 2 diabetes and some specific cancers. In recent years, inactivity, obesity and metabolic syndrome have been increasing in developing societies (2). Among various diseases, polycystic ovary syndrome is among the cases that are strongly related to obesity (3). Studies in recent decades have shown that PCO syndrome can be a pro-inflammatory stage, because among them cardiovascular diseases, diabetes 2, insulin resistance and metabolic syndrome are seen with a high incidence (4). In the meantime, investigating and identifying the inflammatory causes of this condition for the above reasons can help specialists in its treatment with the process of reducing its negative effects through aerobic exercise. In this regard, the above research investigated some inflammatory factors such as E-selectin and nuclear factor kappa B (NF-κB). To improve the physical condition of obese people, instead of medicine, sports activities, both anaerobic and aerobic, are used, and each of these activities affects the improvement of physical condition through different mechanisms (2). Researchers believe that regular and not heavy exercise is a healthy and natural method for patients with polycystic ovary syndrome apart from clinical treatments (18). Physical activity improves menstrual irregularity, ovulation, ovarian morphology and fertility by reducing abdominal fat, blood sugar, blood fat, reducing insulin resistance, affecting hormone secretion and reducing cardiovascular risk factors. Be (7). But the question is, what exercise? With what intensity? And for how long? Treatment with all kinds of drugs may cause male characteristics, and unfortunately, most of the side effects are irreversible, so non-drug treatment strategies are necessary and need to be examined and studied. On the other hand, by reviewing the research done inside and outside the country, no research has been done on the effect of Tabata exercise on the research variables and even aerobic exercise on the research variables in women with polycystic ovary syndrome, so the purpose of this research is to determine The effect of a session of Tabata exercise in water and metformin on E-selectin and NF-κB in obese women with PCOS. Methods: The current research was semi-experimental and applied with a pre-test-post-test research design. For this purpose, 30 women with a body mass index greater than 29.9 in Isfahan city, who were diagnosed with polycystic ovary syndrome by an endocrinologist or gynecologist and diagnostic tests and ultrasound, were considered as a statistical sample. They were selected and randomly divided into two experimental groups (metformin + exercise in water) and control. 24 Before starting the exercises, the subjects first completed the personal information questionnaire and blood was taken after 12 hours of overnight fasting to determine the level of the variables. Experimental group for 12 weeks, 3 sessions a week and each session 40 minutes of exercises in the water (including 10 minutes of walking forward, backward, sideways and soft running in the shallow part of the pool where the water level is below the neck and Then they performed stretching exercises. Then they performed Tabata exercise with a special exercise song played in the pool for 20 minutes, and then they did 10 minutes of stretching and cooling (22) and 500 mg metformin twice consumed during the day and after breakfast and dinner. 48 hours after the last training session, blood was taken again from all subjects. At the end, descriptive statistics (mean and standard deviation), Shapiro-Wilk test to check the normality of data distribution and covariance analysis to check research hypotheses using spss/21 software at a significance level of α≤0.05 were used. became. Results: The results showed that the E-selectin factor in obese women with PCOS at the end of the period in the group of Tabata exercise in water and metformin intake had a significant difference compared to the control group (P=0.001 and F=134.6). Tukey's post hoc test results It showed that there is a significant difference between the pre-test of the Tabata training group in water and the post-test of the Tabata training group in water on the one hand, and between the post-test of the Tabata training group in water and the pre-test and post-test of the control group on the other hand, but between the other groups. There is no significant difference. (Table 2). The results showed that Tabata exercise in water and metformin consumption have a significant effect on NF-Κb factor in obese women with PCOS (P=0.025 and F=354.3). The results of Tukey's post hoc test showed that there is a significant difference between the pretest of the Tabata group in water and the post-test of the Tabata group in water, but there is no significant difference between the other groups (Table 3). Conclusion: The results showed that the E-selectin factor was significantly higher in obese women with polycystic ovary syndrome at the end of the period in the aerobic exercise and metformin group than in the control group. The results of the follow-up test showed that there is a significant difference between the pre-test of the Tabata aerobic training group and the post-test of the Tabata aerobic training group on the one hand, and between the post-test of the Tabata aerobic training group and the pre-test and post-test of the control group on the other hand, but between the other There is no significant difference between the groups. Aerobic exercises decreased VCAM-1 and ICAM-1 adhesive molecules; While its effects on E-selectin and P-selectin have been inconsistent. Of course, it seems that the effect of aerobic exercise on these conditions depends on the type and duration of the exercise intervention and the disease conditions such as the presence of ischemia. As presented in this review, there is a high level of evidence that sports activity has a positive effect on key factors in the development of atherosclerosis. This can partly explain the scientifically proven anti-atherogenic effects of aerobic exercise and has significant clinical effects (23). The results showed that the NF-Κb factor in obese women with polycystic ovary syndrome was significantly lower in the aerobic exercise and metformin group at the end of the period than in the control group. The results of Tukey's post hoc test showed that there is a significant difference between the pre-test of the Tabata aerobic exercise group and the post-test of the Tabata aerobic exercise group, but there is no significant difference between the other groups. In the explanation above, it can be stated that NF-κb is stimulated and activated in response to cellular stimuli. So far, about 450 stimuli, including physical, chemical, physiological and oxidative stimuli, have been identified for NFκB. Also, mitogens, receptor ligands, bacteria, viruses, parasites, fungi and their products, pro-inflammatory cytokines and some pathological conditions are among the stimuli of this transcription factor (28). The transcription factor NFκB is responsible for supplying a large number of pro-inflammatory genes, including cytokines, chemokines, immune receptors, enzymes and other pro-inflammatory molecules (29). Inappropriate activity of NFκB is one of the mechanisms of some diseases, especially those associated with inflammation (30). [ABSTRACT FROM AUTHOR]

Background & Aims: Today, sport is considered one of the most important human welfare needs. Exercise and physical activity as a main strategy in helping the goals of body and soul health and increase the level of activity of the immune system and prevention of various diseases, and creating mental and physical security in sports, highlights the issue of athletes' health. (1). One of the most important of these sports is football. Football is not just a sport and its situation has been undergoing growing and expanding changes due to economic, social, cultural, health and even political influences (2). Has created constructive competition (3). Accidents on sports fields are an integral part of sports events. Sports activities, even with the implementation of all reasonable precautions, will have a level of risk, and in addition to all the benefits of sports programs, there is a possibility of sports injuries (4). For this reason, having a specialist physician who is aware of sports injuries during sports injuries is a requirement when holding sports competitions. Also, this physician must have full access to the athlete's medical information in order to perform better (8). Electronic storage of athletes' medical information can improve the physician's treatment process and lead to many potential benefits such as scientific research, statistical records of diagnostic and treatment methods, reporting, and time and cost savings (11). Weinstein et al. (2013) state in their research that when one of the players is injured, the treatment of injuries and disorders should be done by a doctor. The first step for the injured person is to diagnose and manage the injury by the doctor when the injury occurs. The second is the doctor's referral to the medical record and the initial treatment and transfer of the athlete to medical centers (12). Consonon et al. (2014) say that the importance of injury diagnosis is one of the essential factors for treatment and this is possible only with the presence of a physician at that time to prevent the destructive effects of injury. Time is the relationship between intermittent injuries and medical records (13). But Nordstrom (2014) is of the opinion that during the period of complete treatment and recovery, the primary care physician should be aware of the athlete's treatment process because it is possible to ignore some injuries and all this process should be recorded in the sports medicine file. (14). According to Peterson (2020), the assessment of sports injuries should be done by a sports medicine specialist. A high percentage of sports experts believe that having a sports doctor in stadiums and having a sports medicine file is a necessity for holding a match. It is a sport and shows the attention of sports officials to the health of players (15). In order to achieve the desired success, sports organizations must not only think about meeting the material needs of their athletes, but also prioritize their expectations about physical health after sporting events, and to meet such expectations as a necessity for Athletes' loyalty look. (16). Aman et al. (2018) in their research pointed out that doing sports, both at the amateur and professional levels, has a high risk of injury. They also showed that the probability of lower limb injuries in rugby and football is the highest. Has; Therefore, the presence of a physician at the time of the race is very important and vital to accelerate treatment (17). Gritch (2019) concluded in his research that amateur athletes strongly advocated the use of sports medical services to protect themselves from potential injuries (18); Also, other researchers such as Mirza Kooshaki et al. (2017) in their research entitled Developing Health Development Strategies with the Approach to Physical and Sports Activities concluded that public knowledge through the media, support for workplaces in sports, and encouraging physicians To prescribe sports activities, provide facilities to sports investors, observe sports standards of schools and universities, develop monitoring and counseling centers for citizens' health, employ sports experts in urban and rural health centers and houses, determine the role of each Government agencies in the field of sports, determining the share of sports from the financial credit of the health system transformation plan, urban design with a healthy city approach, preventing the orientation of sports management from financial credits, preventing the orientation of sports management of government agencies to championship and professional sports, The formation of the Deputy Minister of Health in the Ministry of Sports and the use of information and monitoring system were among the health development strategies with the approach of physical activity and sports (19). Methods: In the present study, the paradigm of qualitative research has been used. One of the reasons for the need for qualitative research is that qualitative methods can provide more detailed details of phenomena that are difficult to present in quantitative ways. مختلف Among the various qualitative methods, the network of themes method has been used. Answering the first and second research questions related to determining the indicators and effective factors on the health of football players with a sustainable development approach and explaining the relevant model and to achieve this research goal tried to use a qualitative research method of descriptive exploratory type. The present study is a qualitative descriptive-exploratory study. The sampling method is non-random, targeted and available. Data collection in 1399-1400 and the method of data collection was semi-structured interview. The statistical population is all experts of sports managers and health managers (physicians and medical staff) of the Islamic Republic of Iran. Semi-structured interviews with the question "What do you think are the health indicators of football players with a sustainable development approach?" The beginning and the rest of the questions were based on the answers of the interviewees. After interviewing 12 people in the field of physical education and sports medicine, the researcher felt that he had reached a theoretical similarity, but to be more sure, he continued the interviews up to 15 people, but what was said after 14 people was completely repetitive, and at the same time the interview And the basic themes are over. Results: After reviewing the interviews and removing similar codes; 113 codes were collected, which indicates the position of the health of football players with a sustainable development approach. These concepts were presented under three general topics: basic, organizing and comprehensive. Some of these topics include the coordination of sports federations with the Health Organization, the establishment and expansion of sports medical centers, the use of medical and sports specialists in sports clubs, determining the role of each One of the parts of sports medicine in providing services, forming the deputy of health in the Ministry of Sports, using the information and monitoring community system in the field of health, health development strategies, creating health networks in all parts of the country's football sport, creating upstream documents such as plan Health transformation, creating a document for the prevention of non-communicable diseases at all levels of football players, establishing organizations in the field of sports health at all levels of football in the country. Conclusion: The fact that the country's sports authorities pay the necessary attention to the health of athletes is a necessity for sustainable development and this issue should create a close relationship between medical staff and athletes. [ABSTRACT FROM AUTHOR]

Background & Aims: The family is the smallest unit of society and its health and disease are directly or indirectly involved in the health and disease of the community; but despite the importance of the family as a good environment for socializing and educating future generations, today many families suffer from traumas such as divorce, marital disputes, suicide, runaway children and other issues. They have shaken and in some cases destroyed the healthy family relationship that is necessary for the survival and strengthening of the family. The phenomenon of marital boredom is a kind of burnout and physical, emotional, and psychological exhaustion that is caused by the mismatch between expectations and reality in married life. Boredom is gradual and less sudden. In fact, love and intimacy gradually fade away and decay. At worst, boredom means the total breakdown of marital relationships. The behavioral-cognitive approach is one of the most important therapeutic approaches that has attracted the attention of psychologists. Today, the application of the behavioral-cognitive approach in couple therapy has been approved. Considering that the problem of marital boredom in couples, which is caused by annoyance, frustration, despair, and a large psychological-emotional distance between couples, is one of the main reasons for emotional divorce, and if not properly addressed and treated, It provides the ground for formal divorce of couples, so it is important to pay attention to this phenomenon and treat its destructive effects on the marital and family system. On the other hand, supervised and clinical research on emotion-oriented couple therapy and cognitive-behavioral couple therapy and their effect on conflict and boredom in couples are small, so the present study to compare the effectiveness of emotion-focused couple therapy and cognitive couple therapy- Behavior on the boredom of the couple seems necessary. Since in order to increase marital satisfaction and strengthen marital relations, it is necessary to pay attention to the cause and effect of incompatibility and as mentioned, both of these theories have completely different views on this category (incompatibility), in this study, the effectiveness of couples Emotion-oriented therapy is examined in comparison with rational-emotional-behavioral couple therapy to determine which of these two approaches is more effective in reducing boredom. Methods: The present study is semi-experimental in terms of applied purpose and method of implementation. The research design of this study is a pre-test and post-test design with a control group. The statistical population of this study included all women who were referred to Azar Clinic in Kermanshah from the beginning of April 2017 to June 2017 due to marital conflicts and family conflicts to solve their problems and out of 200 patients, 30 people were randomly replaced in experimental group one (n = 10), experimental group two (n = 10) and control group (n = 10). They were selected and replaced using random sampling and random substitution. In general, the inclusion criteria in this study included those who had partial or desirable social and family commitments and mild or relative mental and physical health, and their performance in the way of adaptation and interpersonal relationships with their spouse was difficult and demanding. Eliminating marital problems and boredom, in other words, promoting mental health and increasing life satisfaction, have been intended to continue living together. Exclusion criteria were also couples with a history of severe addiction, longterm and frequent incarceration, leaving or running away from home, severe mental illness with psychiatric symptoms, extramarital sex complained of by one or more couples, or had severe physical illnesses that were medically diagnosed and were unable to maintain marital relationships, which according to the assessments that were made at the beginning of the referral were not included in the list of the statistical population of this study. In the present study, the marital boredom questionnaire was used. This scale was invented by Pines in 2003. The questionnaire has 21 items that include 3 main components of physical fatigue (eg feeling tired, lethargic, and having sleep disorders), emotional exhaustion (feeling depressed, hopeless, trapped), and mental exhaustion (such as feeling worthless, frustrated). And anger towards his wife). Also in this study, the experimental group participated in emotion-focused couple therapy sessions and cognitive-behavioral couple therapy sessions that lasted approximately two months and two sessions per week. Data were analyzed using Spss-21 statistical software. Results: The statistical results showed that emotion-oriented couple therapy and cognitive-behavioral couple therapy were effective in reducing marital boredom and also emotion-focused couple therapy and cognitive-behavioral couple therapy were equally effective in marital boredom (P <0.001). Conclusion: In general, according to the results, it can be stated that to reduce couples' boredom, emotion-based couple therapy, and cognitive-behavioral couple therapy can be used, and couples can use these approaches to deepen their life expectancy. Emotional couple therapy is used to reduce turmoil in adult romantic relationships and to reconstruct couples' interactive patterns. During treatment, small steps are taken toward safe emotional engagement, which allows couples to reassure each other and reduce conflict. Like other studies in the field of behavioral sciences, the present study also faced limitations, including the study sample, which consisted of a couple who filed for divorce due to a severe marital dispute and went to family court counseling centers. They have referred. Due to this, the generalizability of research results to other couples who have not filed for divorce despite severe marital discord should be done with caution. Also, the participants in the study were couples who simultaneously announced their readiness to participate in the study, so caution should be exercised in generalizing the findings of this study. It is better that such interventions be performed at least on couples with a history of divorce without separation. They should also be referred. It is also suggested that the effectiveness of the approaches used in this study be compared with other approaches and follow-up should be considered in the study to evaluate the continuity of therapeutic effects over time. [ABSTRACT FROM AUTHOR]

Background & Aims: Nerve stem cell transplantation is one of the effective strategies for repairing nerve lesions. Oligodendrocytes are myelinated cells located in the central nervous system and are involved in the formation of myelin axons (8). Oligodendrocytes express O-A proteins, especially O4, which is a marker for the cell body and oligodendrocyte processes, during differentiation and maturation in the central nervous system (29). The results of some studies have shown that glial cells that express only O4 protein have the potential to become precursors of astrocytes and oligodendrocytes and can increase the growth stages in stem cells (29). Glial fibrillary acid protein (GFAP) is known as a specific marker for the identification of astrocytes in the central nervous system. This protein is the main cytoskeleton constituent of astrocytes (27) and plays an important role in maintaining, repairing and maintaining the white matter integrity of the central nervous system as well as the blood-brain barrier (35). The aim of this study was to compare the effect of High intensity interval training with hind limb suspension on the level of GFAP and O4 in glial and neuronal stem cell of male rats. Methods: Twenty-four male wistar rats (body weight = 189.25 ± 5.71g.) were randomly divided into four groups: HIIT+HLS (n= 6), HIIT (n= 6), HLS (n= 6) or CON (n= 6). The exercise protocol was performed on a rodent treadmill for 6 weeks, 5 sessions per week. The rats were sampled and studied 24 h after last training session. Glial fibrillary acidic protein (GFAP) and monoclonal antibody O4 (O4) were analyzed before and after the training interventions. To suspend the lower limb, the animal's tail was first cleaned and dried using cotton and alcohol. Then two-thirds of the mouse tail was taped longitudinally from the beginning to the end third. Next, three pieces of kinesio-tape were placed transversely on the mouse tail, so that normal blood flow was not disturbed. We attached the upper end of the kinesio-tape to the suspension hook and then has been attached the hook to the cage movable bar chain so that the angle between the animal's chest and the floor of the cage is 30 degrees and the mouse legs do not come into contact with the floor of the cage. The suspension system, including a movable bar, pulley and hook, was mounted on top and on both parallel sides of the cage, allowing the animal to have full access to all parts of the cage by moving freely around a 360-degree axis. Data analysis was used using Shapiro-Wilk and Levine tests to investigate the natural distribution of data and homogeneity of variances and one-way and post-hoc Bonferroni statistics to test research hypotheses. Results: The results suggested that the percentage of changes in the amounts of fibrillary acidic protein of the cerebral hippocampus of the brain in the intense interval training group + group under the conditions of the hind legs compared to the control group showed a significant decrease (p≥0.001). Also, the percentage of changes in cerebral hippocampal glial fibrillary acid protein in the lower extremity suspension group increased significantly more than the control group (p≥0.001), but the percentage of changes in this protein in the intense interval training group compared to the group There was no significant difference in control (p≥1,000). The results of the data obtained from the percentage of changes in the O4 protein of the cerebral hippocampus of the groups showed that this change was significantly lower in the group of intense interval training with the conditions of the hind limb suspended than the control group (p≥0.001). Also, the percentage of O4 changes in the cerebral hippocampus in the lower extremity suspension group was significantly higher than the control (p≥0.001). In addition, the percentage of changes in the intense interval training group was not significantly different from the control group (p≥0.465). Conclusion: The results of this study revealed that HIIT+HLS was being able to prevent damage to the cells of the central nervous system and direct the neural stem cells towards the production of neurons, astrocyte and oligodendrocyte. Mesenchymal stem cells are currently the main choice for cellular treatment of neuropsychiatric diseases. Mechanical stimuli have been reported to play a decisive role in the final fate of stem cells and their cell differentiation pathways, so that the path and flow of induced signals and activated factors determine cellular fate in time, position, and mediate an appropriate number (36). Studies have shown that the proliferation, differentiation, and cytoskeleton organization of stem cells are affected by microgravity and tend to produce neurons or nerve cells (31). Astroglia cells also act as neuronal stem cells and participate in neurogenesis. Evidence suggests a very important role for these cells during plasticity. These cells are involved in the neurogenesis of the adult mammalian brain in the ventricular region, and in the sub-granular region and the olfactory bulb. On the other hand, previous research has shown that lactate production during intense interval trainings and suspension of hind legs can play an important role in the development of oligodendrocytes and myelination, so that increasing lactate production as a substrate in myelination, and used by the nervous system. Considering this issue, it is possible to use this exercise mode in the condition of lower limb suspension as a treatment method or non-pharmacological supplement effective in neuromuscular disorders and other related diseases, to enhance fitness in athletes, improve injury and also prevention of adverse effects of being in weightlessness, especially on space missions. In general, the results show that intense interval training with hind leg suspension conditions had a greater effect on health and no damage to the hippocampus of the brain of a healthy male rat than other groups (intense interval, suspension or control group). Since no research has been done on the effect of intense interval training under the conditions of hind limb suspension on cellular changes in the hippocampus and human brain, judgment in this regard needs further study. Findings of this study may help in the rehabilitation process of people with neuromotor disorders, injured athletes, the elderly, sedentary people, as well as the conditioning program of athletes in various sports to adapt to the use of such exercises. [ABSTRACT FROM AUTHOR]

Background & Aims: Diabetic neuropathy is the most common diabetic complication. In more than 50% of patients with diabetic neuropathy, significant and irreversible nerve damage occurs before diagnosis. Diabetic neuropathy is associated with increased mortality (2). Half of patients with diabetic neuropathy suffer from neuropathic pain. These painful symptoms are usually severe and often lead to depression, anxiety and sleep disorders and reduced quality of life (2). Oxidative stress caused by hyperglycemia causes damage to mitochondria in nerve cells, but its mechanisms are not fully understood (4, 5). Sequential oxidation reactions in the mitochondria cause unpaired electron leakage in the electron transfer chain in the inner mitochondrial membrane and the production of free radicals (4). Mitochondria are primary targets for ROS-induced injury; because they are the main site of ROS formation in diabetic hyperglycemia (4). Therefore, examining the factors affecting the structural and functional components of mitochondria, such as electron transfer chain components, can provide useful information for the goals and programs of treatment and prevention of neurological damage caused by diabetic neuropathy. Cytochrome C is a small hemoprotein in the inner membrane of the mitochondria; this protein is highly soluble in water and is a key component of the electron transfer chain (6). Velayutham et al. In a study stated that cytochrome C and Fe3 play a significant role in the harmful effects of ischemia / reperfusion and diabetes due to increased production of superoxide radicals (7). On the other hand, insulin therapy has been shown to modulate neurotrophin-dependent treatment of mitochondrial membranes and the expression of genes associated with metabolite pathways and the mitochondrial electron transport chain (8). Although much research has been done on the effect of exercise on diabetic neuropathy, there is no research specifically examining the effect of exercise on cytochrome C as one of the factors affecting the mitochondrial function of the nervous system in mice with diabetic neuropathy; Therefore, the aim of the present study was to determine the effect of six weeks of aerobic exercise on the level of cytochrome C in the sensory part of the spinal cord in rats with diabetic neuropathy. Methods: In the present experimental study, 12 male Wistar rats were divided into 4 groups: healthy exercise, control exercise, control diabetes and control diabetes. In order to induce diabetes, half of the rats became intraperitoneally diabetic by injecting a single dose of streptozotocin (STZ) (55 mg / kg body weight). Forty-eight hours after STZ injection, hyperglycemic rats with serum glucose above 300 mg / dL were considered diabetic. To confirm the neuropathy of rats, the thermal hyperalgesia test was used with a tail-flick device (20). After confirmation of neuropathy, the animals were placed in the diabetic neuropathy group. The training program included 6 weeks of running training on the treadmill in 5 sessions per week. After dissection of the animals, the dorsal part of the spinal cord was analyzed as sensory neurons. Immunohistochemistry was used to measure the amount of cytochrome C protein. One-way analysis of variance and Tukey's post hoc test were used for statistical analysis. Statistical analysis was performed using SPSS software version 26 at a significant level of P ≤ 0.05. Results: The results showed that six weeks of aerobic training reduced blood glucose in the diabetic group compared to the control diabetic group (P = 0.002), but there was not observed make a significant difference in the weight of rats. The results also showed that after the training period, the level of cytochrome C protein in the healthy exercise group significantly increased compared to the healthy control group (P = 0.041) and in the diabetic group the exercise significantly decreased compared to the control diabetes group (P < 0.001). Conclusion: The results of the present study showed that induction of diabetes increased the level of cytochrome C in spinal tissue in diabetic neuropathic rats compared to healthy groups. Previous research has shown that diabetic neuropathy is associated with mitochondrial degradation due to stress due to hyperglycemia and oxidative stress due to diabetes (21, 22); in the present study, an increase in cytochrome C in diabetic neuropathy groups was positively correlated with an increase in glucose levels. In the study of the effect of exercise on cytochrome C levels, the results of the present study showed that after six weeks of aerobic exercise, a significant increase in cytochrome C protein content of spinal cord sensory tissue was observed in healthy exercise rats compared to the healthy control group. While in the diabetic exercise group, the results showed a significant decrease in cytochrome C levels compared to the diabetic control group, which showed the difference in the effect of exercise on changes in cytochrome C of sensory neurons in mice with diabetic neuropathy compared to healthy mice. Scientific research has shown that exercise is one of the effective factors in reducing hyperglycemia due to diabetes (11, 25), on the other hand, by controlling blood sugar, the level of inflammatory factors and oxidative stress in these patients is reduced (26, 27); It can be said that aerobic exercise with glycemic control reduces mitochondrial stress and thus reduces cytochrome C as one of the mechanisms of apoptosis signaling (23, 24), in the cells of the spinal cord, Which can prevent the complications of diabetic neuropathy as well as neuropathic pain. The results of the present study also showed that six weeks of aerobic exercise increased the amount of cytochrome C protein in the spinal cord of healthy rats, this was consistent with the results of Yoo et al. (28) and Bashiri and Pourrazi (29) who studied the effect of exercise on cytochrome C in the myocardial of healthy rats. It can be said that the increase in cytochrome C levels in healthy rats is one of the adaptations associated with aerobic exercise and indicates an increase in mitochondrial capacity in ATP production. It can be said that changes in cytochrome C in spinal sensory tissue are different in adapting to six weeks of training in healthy rats with neuropathy, and the increase in cytochrome C in healthy rats is associated with increased mitochondrial capacity in energy production. While the reduction of cytochrome C in rats with diabetic neuropathy is associated with a reduction in hyperglycemia and indicates the protective role of exercise on nerve tissue and reducing neuropathic damage caused by diabetes. According to the results, in addition to controlling hyperglycemia in diabetic patients, aerobic exercise can be used as one of the non-pharmacological and useful treatment methods in reducing the complications of diabetic neuropathy. [ABSTRACT FROM AUTHOR]

Background & Aims: Anterior cruciate ligament (ACL) injury is regarded as one of the most frequent knee joint injuries. ACL injury is typically non-contact and occurs during activities such as cutting, accelerating, and landing after a jump. According to the video analysis, the mechanism of non-contact ACL injuries consist of several common components such as hip adduction and internal rotation, knee valgus, tibia external rotation, and ankle eversion; Combination of these components called "dynamic knee valgus". In this situation, the role of hip abductor and external rotator muscles is to eccentrically control hip adduction and internal rotation. In closed-kinetic-chain, adequate stability in hip joint provides better knee control. Evidence for this is seen in a reported greater hip abduction correlated with less knee valgus during single leg squat. Specifically, lower eccentric hip abductor peak torque is associated with higher peak knee valgus during landing Although the literature showed the positive effects of the preventive programs, most of them include exercises that involve combination of muscles groups, so the mechanisms by which muscles group reduce dynamic knee valgus are unclear. To the best of our knowledge, no study has addressed the effectiveness of an isolated hip abductor and external rotator strengthening on dynamic knee valgus during jumplanding task. Therefore, the purpose of the current study was to determine whether an isotonic strengthening which targeting the hip abductor and external rotator would improve the dynamic knee valgus during landing. We hypothesized that dynamic knee valgus would improve post isolated hip abductor and external rotator strengthening program. Methods: Present study is a randomized controlled trial carried out by single-blinded parallel group. Thirty-two males with knee valgus angle more than 8 degree were randomized into a training (n=16) or control group (n=16). In pre-screen session, in order to determine dynamic knee valgus eligibility for participants, subjects were asked to perform single-leg jump-landing task. Subjects landed forward from the 31-cm height box with their dominant leg onto a marked place at a distance of 40% their height. The subjects landed on their dominant leg and immediately performed a countermovement jump to achieve maximal height. A digital video camera was set up on tripod at the height of the subject’s knee, 2 meter in front of the subjects landing place, and lined up vertical to the frontal plane. The frame that knee has highest medial displacement was exported into Auto CAD 2016 software (version 20.1) for calculation of knee dynamic valgus angle. In pre-test sessions, each subject warmed up for 5 minutes (walking and jogging around the laboratory at a self-selected pace), and then was instrumented with 40 retro-reflective markers. The positions of the markers were recorded at 200 Hz using a motion capture system (Qualisys AB, Gothenburg, Sweden) with eight Ocus cameras and were synchronized with a force plate (Kistler AG, made in Switzerland) collected data at 2000 Hz. Each subject completed an initial static, standing calibration trial to align local coordination system with global coordinate system, and then performed 3 attempts to singleleg jump-landing task (as described in pre-screen) with dominant leg (30 seconds rest between each attempt). Eccentric and concentric peak torques of dominant leg hip abductor (side-lying position) and external rotator (seated position with 90° flexion in the hip and knee) were quantified by a single examiner using KinCom 500H isokinetic dynamometer (Chattecx Corp. Inc. Hixson, TN). The training group carried out 8 weeks of bilateral hip abductor and external rotator strengthening 3 times per week. Each session included 3 phases: 1: warm-up, 5 minutes Walking and jogging, 2: strengthening exercises, 35 minutes hip abductor and external rotator muscles exercises, 3: cool down, 5 minutes walking. In the post-test session, participants followed the same procedure used for the pre-test session. Each participant wore the same shoes in pre and post-test sessions to prevent injury and control footwear differences effect, and all tests were completed at the same time in pre and post-test sessions. Results: During the course of the study, two subjects withdraw from the study due to personal problems (one subject in CG and one subject in TG) and one subject sustained injury due to an accident (in TG). So, data from 29 subjects were used for statistical analysis. The ANCOVA evaluating changes in hip strength from baseline to the end of the 8-week hip strengthening program revealed a significant difference between TG and CG for concentric (P<0.001) and eccentric hip abduction (P=0.002) and concentric (P=0.007) and eccentric hip external rotation (P=0.001) peak torques. Paired-sample t tests were performed to determine the training effect on the hip muscle strength. At the post-test, the TG demonstrated greater concentric (1.6±0.55 vs 2.01±0.42 Nm/Kg; P<0.001) and eccentric hip abductor (1.41±0.51 vs 1.77±0.43 Nm/Kg; P=0.004) and concentric (0.94±0.21 vs 1.07±0.19 Nm/Kg; P=0.01) and eccentric hip external rotator (0.92±0.18 vs 1.11±0.21 Nm/Kg; P<0.001) peak torques compared with pre-test. No significant differences in muscle strength were observed for the control group between pre-test and post-test. The ANCOVA evaluating changes in knee kinematic from baseline to the end of the 8-week hip strengthening program revealed a significant difference between TG and CG for peak knee valgus (P=0.02) and knee valgus range of motion (ROM) (P=0.04). After the 8-week intervention, the TG demonstrated lower peak (-5.62 ± 7.36 vs -2.74 ± 5.94; P=0.02) and range of motion (ROM) on dynamic knee valgus angle (-9.66 ± 5.56 vs -7.31 ± 3.87; P=0.04) compared with pre-test, whereas significant changes were not noted in the control group (P>0.05). Conclusion: Hip abductor and external rotator weakness is a well-documented impairment in subjects with increased dynamic knee valgus during landing and has been postulated to contribute to non-contact ACL injury. This study was conducted to investigate the effects of isolated hip abductor and external rotator exercises on lower extremity kinematic, as well as concentric and eccentric abductor and external rotator torques in male subjects who present with excessive dynamic knee valgus during landing. The most important finding of the current study was a reduction in peak and knee valgus range of motion during landing in training group. These changes might be due to an increase in concentric and eccentric hip abductor and external rotator peak torques in training group as a result of the 8-weeks resistance training. Our findings support the isolated hip abductor and external rotator strengthening as a viable preventive and rehabilitative exercises program option for subjects who shows excessive dynamic knee valgus impairment in the hope of preventing non-contact ACL injury. [ABSTRACT FROM AUTHOR]

Background & Aims: Sedentary life and vitamin D deficiency are considered related factors to increased inflammation and oxidative stress in obese conditions. Being overweight and obese is determined by increased adipose tissue due to hypertrophy and hyperplasia of fat cells (1). Previous research has shown that overweight and obesity are associated with vitamin D deficiency (3). Vitamin D deficiency is one of the most important and common health problems associated with several diseases such as kidney disease, diabetes, cardiomyopathy and Alzheimer's disease. Vitamin D plays an important role in regulating several cellular pathways for the synthesis of antioxidants (4).The best biomarker to determine the status of vitamin D is the concentration of 25-hydroxyvitamin D. Serum levels below 20 ng /ml are defined as vitamin D deficiency (3). Large adipocytes with complete local oxygen consumption induce hypoxia, which may lead to cellular inflammation and secretion of inflammatory cytokines by activating oxidative stress pathways (4). Oxidative stress, in turn, plays a causal role in obesity (6). A strong association between oxidative stress and vitamin D deficiency has been reported (8).Vitamin D has antiinflammatory effects and affects inflammatory processes and immune cells through different pathways, including regulating the production of anti-inflammatory cytokines (12). Interleukin 10(IL-10) is a potent anti-inflammatory cytokine that is synthesized in several organs (13). It has been observed in experimental studies that with obesity, serum IL-10 levels decreased in mice on a high-fat diet, and this reduction played a very important role in obesityinduced inflammation in other organs (15, 16). Exercise is recommended as an important nonpharmacological treatment for the prevention or treatment of obesity and its metabolic and somatic cellular complications (19). Systematic studies and available meta-analyzes have shown that high-intensity interval training (HIIT) has more significant effects on reducing abdominal and visceral fat and improving cardiorespiratory fitness in overweight and obese adults than moderate-intensity continuous exercise (21, 22). Today, lack of time is one of the main reasons for non-participation of people in regular sports activities (23). Due to the association of obesity and overweight with inflammatory factors and oxidative stress, it is necessary to conduct further studies focusing on the effect of low-risk and cheaper interventions such as HIIT and/or vitamin D consumption in the prevention or treatment of oxidative-inflammatory complications. Therefore, the present study investigated the HIIT with vitamin D intake on IL-10 and lipid peroxidation levels in overweight women with IL-10 deficiency. Methods: This single-blind clinical trial was conducted on 52 overweight women with vitamin D deficiency and ages ranging 23-29 years old. After selecting the subjects by the available sampling method, they were randomly divided into control, interval, vitamin D and combination groups. The HIIT was performed with the 12x1-min running bouts at 80-90% maximum heart rate (HRmax) interspersed with 1-min active recovery at 50% HRmax in between bouts for 8 weeks. Vitamin D and combination groups took vitamin D once a week with food for 8 weeks (30).The vitamin D and combination groups received 50,000 IU of vitamin D per week (29). Levels of 25-hydroxyvitamin D less than 20 ng /ml were considered as vitamin D deficiency. Blood samples were collected in the pre- and post-test stages, followed by 12 hours of fasting and serum was frozen at -80 ° C. The serum was then frozen at -80 ° C and used to measure the research variables. Then, serum levels of variables were determined using a special commercial kit and laboratory methods. Malondialdehyde (MDA) levels were measured as an indicator of lipid peroxidation. One-way analysis of variance test with repeated measures and Bonferroni post hoc was also used to compare intergroup differences. In addition, the rate of change of variables was tested through Kruskal-Wallis and U Mann-Whitney tests. The significance level was considered P<0.05 and all statistical analysis was performed using SPSS software version 22. Results: The results of one-way analysis of variance test with repeated measures showed that there is a significant difference between IL-10 and MDA levels of inactive women during the two stages before and after eight weeks, regardless of the group factor. Also, the effect of group (regardless of time factor) and the interactive effect of time×group on the levels of these variables are significant (P<0.05). The MDA levels in interval, vitamin D and combination groups decreased significantly and IL-10 levels increased significantly after 8 weeks(P<0.001). But the combined intervention had a stronger effect on the change of MDA and IL-10 levels compared to the other two interventions (P<0.001). In addition, the effect of HIIT on decreasing MDA levels was greater than vitamin D intake (P=0.018), and no significant difference was found between the amount of IL-10 changes in these two groups (P=0.184). Conclusion: Both vitamin D deficiency (9) and obesity (33) cause overproduction of ROS, increasing oxidative stress. Reactive oxygen species (ROS) interacts with unsaturated lipids within the cell membrane and causes lipid peroxidation, which in turn significantly increases MDA levels, leading to the inactivation of many proteins and cellular receptors, causing cell membrane damage (34). Vitamin D can exert its strong anti-inflammatory activity by inhibiting the expression and activation of the pro-inflammatory transcription factor nuclear factor kappa B (NF-kB), which has optimal effects on oxidative stress (32). Regular exercise can greatly improve the efficiency of enzymatic and non-enzymatic antioxidant defense systems and enhance the body's ability to eliminate peroxidants. Exercise can inhibit NF-κB activation in human T cells by reducing ROS-producing factors, such as tumor necrosis factorα (40). Exercise can also reduce oxidative stress by increasing the bioavailability of nitric oxide (42). However, the effect of HIIT on reducing MDA and consequent oxidative stress has been more effective than vitamin D supplementation, which may be related to the synergistic effects of these two interventions in the oxidation-antioxidant balance shift towards the superiority of antioxidant defense. It seems that HIIT and vitamin D intake can be exert their protective effects in overweight individuals with vitamin D deficiency by a decrease in the MDA and increasing the anti-inflammatory index of IL-10. Although these effects developed with combined intervention, but HIIT was associated with a greater reduction in MDA than vitamin D intervention. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the response rate to the hepatitis B vaccine and the factors affecting it in people with advanced kidney failure undergoing hemodialysis. Materials and Methods: This cross-sectional study was conducted from 2019 to 2021 at Ziyaian Hospital in Tehran. For patients undergoing hemodialysis, serum levels of the nutritional, inflammatory, and bone and mineral markers were measured before hepatitis B vaccine injection. They then received hepatitis B vaccine, and 6 months later the serum level of hepatitis B antibody was measured. In case of no immune response to the vaccine, a second injection was given. Then the rate of lack of immune response to the vaccine in the subjects under study was determined and the levels of nutritional, inflammatory, and bone factors were compared between those who responded to the vaccine and those without an immune response. Results: 54 people were included in the study. In the first round of vaccination, 45 people participated, of whom 62.2% responded to the vaccine and 37.8% did not respond. 26 people participated in the second round of vaccination, in which 69.2% (18 people) responded to the vaccine and 30.8% (8 people) did not respond to the second round of the vaccine. In the non-response group to the vaccine, the serum levels of albumin, and cholesterol were significantly lower and the serum level of neutrophils and the ratio of neutrophils to lymphocytes was significantly higher than in the patients with response to the vaccine. Conclusion: Inflammatory and nutritional factors can affect the immune response to hepatitis B vaccine. Therefore, it is recommended to check the nutritional status of these patients and encourage them to follow up on the results of the vaccine. [ABSTRACT FROM AUTHOR]

Background Considering that no study on the efficacy of dexmedetomidine during endoscopic retrograde cholangiopancreatography (ERCP) has been performed in Iran so far, we decided to evaluate the efficacy and effectiveness of dexmedetomidine and patient satisfaction in patients undergoing ERCP. Materials and Methods: A double-blind clinical trial was performed (2020) among 80 patients undergoing ERCP grade ASA I, and II who had no asthma, cardiovascular diseases, and no history of allergies to propofol and dexmedetomidine. The patients were randomly divided into two groups (fentanyl and propofol) and (fentanyl and dexmedetomidine). Their heart rate per minute, mean arterial pressure, respiration rate per minute, and blood oxygen saturation at intervals of 5 and 15 minutes after the start and end of the procedure, the level of patient cooperation, and endoscopies satisfaction were compared. Results: Mean age of the propofol group was 63/13±17/88 and the dexmedetomidine group was 16/99±58/55 (P=0.191). Mean heart rate and respiration rate per minute were not different significantly in any of the time intervals. Mean arterial pressure in the propofol group before, 5, and 15 minutes after the start and end of ERCP were higher than dexmedetomidine group (105/95±15/91, 123/75±25/54, 118/10±13/06 and 14/61±117/50, respectively). The percentage of oxygen saturation at 5 minutes and at the end of the procedure was higher in the propofol group (P=0.01 and P=0.03, respectively) Conclusion: Due to fewer side effects and more satisfaction of patients receiving propofol; this drug is preferred for these patients. [ABSTRACT FROM AUTHOR]

Background In this study, we investigated the expression profile of this disease to identify new hub genes to help diagnose hepatocellular carcinoma (HCC). Materials and Methods: Weighted gene co-expression network (WGCNA) analysis was used in this study to identify key modules and hub genes associated with HCC in the GSE176271 dataset. We also looked at the clinical significance of key genes and the biological pathways linked to them in external databases. We validated the identified hub genes using data from the GEPIA and XenaBrowser databases. Results: The Midnight blue module was found to be significantly related to the pathological stage (r=0.94, P=1e-11). Five hub genes (CLEC4M, CLEC4G, FCN2, OIT3, and ASPG) were associated with prognosis using DEG identification and WGCNA analysis. The three biological pathways associated with the Midnight blue module were copper ion detoxification, cell ion homeostasis, and complement activation, as well as the lectin pathway. Conclusion: The current study's findings provide new and effective molecular targets for the detection of HCC, which can improve patients’ prognosis. [ABSTRACT FROM AUTHOR]

Background and Aim Crisis management is an important field of management, especially in the field of health. This study aims to investigate the factors affecting the development of disaster management mechanisms in hospitals of Arak, Iran. Methods & Materials In this regard, 240 questionnaires were distributed among hospital and nursing managers in Arak. The questionnaire had acceptable reliability with Cronbach’ alpha value of 0.897. Ethical Considerations This study was approved by the ethics committee of Arak University of Medical Sciences (code: 1274.1401.REC.ARAKMU.IR). Results Then, by using structural equation modeling in LISREL software, the designed model was analyzed. Finally, by using statistical tests, the research hypotheses were examined. Conclusion The results showed the significant effect of three factors of “lack of stability in business environment”, “risk taking”, and “organizational culture” on the development of the mechanism of crisis management. [ABSTRACT FROM AUTHOR]

Background and Aim Old age is a critical period in life. Due to advances in technologies and improvement in healthy conditions, the number of aged population is increasing. Hence, it is necessary to pay attention to their life satisfaction and attitudes towards aging. The present study aims to assess the effectiveness of a psychological empowerment program on life satisfaction and attitude towards aging in older women living in Tehran, Iran. Methods & Materials The study population consists of all women aged 60-70 years referred to a charity foundation in Tehran, Iran in 2020. Of these, 24 women were selected by a convenience sampling method. They were randomly assigned to the intervention (n=12) and control (n=12) groups. Using a pre-test/post-test design, the elderly first completed the life satisfaction index-Z and the attitude towards aging questionnaire. Then, the experimental group received the psychological empowerment program at 8 sessions. After the intervention, the questionnaires were completed again by both groups. Multivariate analysis of covariance was used to analyze the collected data in SPSS software, version 19. Ethical Considerations This study was approved by the Research Ethics Committee of Islamic Azad University of Arak Branch (Code: IR.IAU.ARAK.REC.1400.027). Results There was a significant difference in life satisfaction (F=9.673, P=0.006) and attitudes towards aging (F=8.385, P=0.009) between the two groups. The psychological empowerment program significantly improved life satisfaction and attitudes towards aging in older women. Conclusion The psychological empowerment program is effective in improving life satisfaction and attitude towards aging in older women living in Tehran. It can be used by experts in the fields of counseling, geriatrics, psychology, and health. [ABSTRACT FROM AUTHOR]

Background and Aim This study aims to investigate the effect of nurses’ autonomy on the quality of patient care based on Kramer and Schmalenberg’s model Methods & Materials This is a causal-comparative study. Participants were 101 nurses of Imam Khomeini Hospital in Arak, Iran from the intensive care unit and internal medicine, surgery, pediatrics, gynecology, orthopedics, and emergency departments. The data collection tools were Moghimi and Ramazan’s patent care quality questionnaire and an autonomy assessment questionnaire based on Kramer and Schmalenberg’s autonomy model. The data were analyzed in SPSS software. Ethical Considerations This study was approved by the ethics committee of Islamic Azad University of Arak Branch (Code: IR.IAU.ARAK.REC.1397.66). Results The mean autonomy score of nurses was 3.16 ±0.35, indicating a desirable level. Nurses of all departments had limited autonomy. In the internal department, nurses had unsanctioned autonomy, while in the surgical department, they had autonomous nursing care action. The regression models were significant for all departments except for the internal department. With an increase of one unit in limited autonomy in the intensive care unit, autonomous nursing care in the surgical department, and limited autonomy in pediatrics, gynecology, orthopedics, and emergency departments among the nurses, the quality of care can be increased by 0.253, 0.187, 0.522, 0.205, 0.466 and 0.129, respectively. Conclusion Nurses’ autonomy can increase the quality of patient care. The nursing managers need to empower nurses and provide an environment for them to apply their knowledge in practicing autonomy. [ABSTRACT FROM AUTHOR]

Background & Aims Nurses are the largest group of healthcare providers, especially during the COVID-19 pandemic. Patients with COVID-19 are in dire need of spiritual care due to being alone in quarantine, away from their families. The present study aims to assess the spiritual care competence of nurses in the special care units for COVID-19 in teaching hospitals in Arak, Iran Materials & Methods This is a descriptive cross-sectional study. Participants were 142 nurses working in the special care units for COVID-19 in hospitals affiliated to Arak University of Medical Sciences in 2022, who were selected by a census method. The data collection tool was the spiritual care competence scale. The data were analyzed in SPSS software, version 16. Results The mean total score of spiritual care competence was 100.71±14.45, which was higher than the median score of 81. The spiritual care competence had a significant relationship with marital status (P=0.044), willingness to work overtime (P<0.001), age (P=0.011), total work experience (P=0.03), and work experience in the special care unit (P=0.025), such that spiritual care competence was higher in older married nurses with a willingness to work overtime and a higher work experience. Conclusion The spiritual care competence of nurses in the study hospitals is at a favorable level. The results of this study can help future studies in improving the quality of nursing care and the competence of nurses in spiritual care. [ABSTRACT FROM AUTHOR]

Background & Aims Infant hospitalization in the neonatal intensive care unit (NICU) causes loss or delay in mother-infant attachment. On the other hand, quarantine and social distancing during the COVID-19 epidemic had psychological consequences, such as increased fear of infection. This study aims to determine the relationship between mother-infant attachment and fear of COVID-19 in mothers with neonates admitted to the NICUs of selected hospitals in Tehran, Iran, during the COVID-19 pandemic. Materials & Methods In this descriptive-correlational study, participants were 195 mothers with neonates admitted to the NICUs of selected teaching hospitals affiliated to Iran University of Medical Sciences in 2021. Data collection tools were a demographic form, the fear of COVID-19 scale (FCoV-19S), and Avant’s mother-infant attachment behaviors questionnaire, which were completed by the researcher. Data were analyzed in SPSS software using independent t-test, Kruskal-Wallis test, Mann-Whitney U test, and ANOVA. Results The mean score of FCoV-19S was 19.04±5.40, and the mean score of mother-infant attachment was 70.12±50.65. No significant relationship was observed between the fear of COVID-19 and motherinfant attachment (P>0.05). Fear of COVID-19 had a significant relationship with the interest in the baby’s gender (P=0.001) and the mother’s education level (P=0.041). Mother-infant attachment had a significant relationship with interest in the baby’s gender (P=0.01) and infant hospitalization due to jaundice (P=0.049). Conclusion Mother-infant attachment of the mothers in this study is low, and their fear of COVID-19 is almost high. There is no significant correlation between the fear of COVID-19 and mother-infant attachment. It is necessary to pay attention to effective factors in promoting emotional attachment between mothers and neonates hospitalized in the NICUs. It is also recommended that the medical staff and nurses pay attention to this group of mothers during pandemics such as COVID-19 and use some techniques to reduce their fear of infection. [ABSTRACT FROM AUTHOR]

Background & Aims The present study aims to compare the effects of emotion regulation training and mindfulness-based cognitive therapy (MBCT) on the resilience and self-compassion of women with irritable bowel syndrome (IBS). Materials & Methods This is a quasi-experimental study with a pre-test/post-test/follow-up design. The study population consists of 300 women with IBS who visited the clinics of internal medicine physicians in Ilam, Iran, in 2018-2019. The sample size was determined 20 for each group based on the Fleiss method. Therefore, 60 were selected by a simple cluster sampling method and based on the entry criteria. They were divided into three groups of emotion regulation (n=20), MBCT (n=20), and control (n=20). After the interventions, the post-test and follow-up assessments were conducted for the groups. The instruments were the Connor-Davidson resilience scale and the self-compassion scale of Neff (2003). For data analysis, SPSS software, version 23 and repeated measures analysis of variance were used. Results Both emotion regulation training and MBCT had a significant effect on the resilience and self-compassion of women (P=0.001), where MBCT had a greater effect compared to emotional regulation training. Conclusion The MBCT can be used as an effective method to increase resilience and self-compassion of women with IBS. [ABSTRACT FROM AUTHOR]

Background & Aims Due to having multiple tasks in ensuring the health of patients, primary healthcare workers are under many stresses that may lead to job burnout. The present study aims to determine the relationship between occupational stress and job burnout of primary healthcare workers. Materials & Methods This descriptive, correlational study was conducted in 2019 on 128 primary healthcare workers in Saveh and Zarandieh cities, who were selected by a census method. Data was collected by a demographic form, the Maslach Burnout Inventory (MBI), and Spielberger’s job stress survey (JSS). Descriptive statistics were used to describe the data, and independent t-test, analysis of variance, and Pearson correlation test were used to analyze data in SPSS software, version 18. Results The mean score of JSS was 140.7±48.6, which was lower the median score (150). The mean frequency score was 23.43±8.3 for the MBI dimension of emotional exhaustion, 17±4.78 for depersonalization, and 14.43±6.74 for personal accomplishment. Occupational stress had a positive and significant relationship with the frequency of emotional exhaustion (r=0.59, P<0.001) and depersonalization (r=0.22, P<0.001), and a negative and significant relationship with the frequency of personal accomplishment (r=-0.47, P<0.001). This indicates that with the increase of occupational stress, the frequency of job burnout in two dimensions of emotional exhaustion and depersonalization increases, while the frequency of personal accomplishment decreases. Conclusion Primary healthcare workers in the study region have moderate occupational stress and a high level of job burnout in the areas of depersonalization and personal accomplishment. Considering the high level of job burnout and its relationship with occupational stress in these healthcare workers, and the fact that these factors can have a negative impact on the quality of healthcare services, it is necessary to carry out necessary interventions to reduce and manage occupational stress and job burnout of primary healthcare workers. [ABSTRACT FROM AUTHOR]

Background & Aims Special attention should be paid to empowering healthcare providers, including nurses. Empowerment as the clinical skill is an important goal of nursing education. The present study aims to determine the effect of a nursing manager psychological empowerment program on the management skills of nursing students. Materials & Methods This interventional study was conducted in Imam Khomeini Hospital in Tehran, Iran. Participants were 84 students in nursing management internship from Tehran University of Medical Sciences and 19 nursing managers. The nursing students were divided into two control (n=42) and intervention (n=42) groups. The intervention was a psychological empowerment program for nursing managers. After intervention, the management skills of students was assessed using a checklist completed by observation and interviewing ward supervisors. Data were analyzed in SPSS software, version 16. Results The management skills of students in the intervention group significantly increased after receiving the empowerment program by 0.274 units. Conclusion Psychological empowerment of nursing managers can improve the management skills of nursing students. The results of this study can be used to persuade nursing managers to receive psychological empowerment training, which can lead to psychological improvement of the work environment, nurses and nursing students. [ABSTRACT FROM AUTHOR]

Background & Aims The early mobility of a patient hospitalized in the intensive care unit (ICU) is a very complicated issue and requires coordination between the departments and between all ICU staff, including physicians, nurses, and physiotherapists. Early mobilization program is safe and feasible and has positive results for the patient, medical staff, families, and health system. The present study aims to determine the barriers to early mobility of patients admitted to the ICUs of hospitals in Kohgiluyeh and Boyer-Ahmad Province, Iran. Materials & Methods This is a descriptive cross-sectional study conducted in 2020-2022. The study population consists of the ICU staff of hospitals in Kohgiluyeh and Boyer-Ahmad Province, including physicians, nurses, and physiotherapists. Sampling was done by a census method. The data were collected using a demographic form and a researcher-made questionnaire of early mobility barriers of ICU patients and analyzed in SPSS software, version 18 using descriptive and inferential statistics. Results In the present study, 174 nurses, physicians, and physiotherapists answered the questionnaire, where 57.8% were female and 59.8% were single. Among the barriers to early mobility, the patient-related barriers had the lowest mean (0.411±0.108) and cultural barriers had the highest mean (0.478±0.146). Conclusion It is necessary to investigate the barriers to early mobility of patients admitted to the ICU of study hospitals, especially the cultural barriers. In this regard, there is a need to design a clinical protocol to manage and reduce these barriers. [ABSTRACT FROM AUTHOR]

Background Various drugs are used as adjuvants to improve the quality of supraclavicular block method. Objective This study aims to investigate the effect of adding dexmedetomidine to lidocaine in the supraclavicular block method in patients candidate for upper extremity surgery. Methods This double-blind randomized controlled clinical trial was conducted on 61 patients candidate for upper extremity fracture surgery receiving the supraclavicular block method from 2017 to 2018. They were randomly divided into two groups of lidocaine-normal saline (30 mL of 1.5% lidocaine plus normal saline) and lidocaine-dexmedetomidine (30 mL of 1.5% lidocaine plus 1 μg/kg of dexmedetomidine). The supraclavicular block characteristics and intraoperative hemodynamic changes were measured. Results There was no statistically significant difference between the two groups regarding the demographic factors. The mean age of patients was 43.09±10.92 years, and most of them were male. The mean onset time of sensory-motor blockade was faster and the duration of sensory-motor blockade and analgesia were longer in the lidocaine-dexmedetomidine group than in the other group. These differences were statistically significant. There was significant differences in hemodynamic parameters among nine assessment times in each group and between the two groups. Conclusion Adding dexmedetomidine to lidocaine in the supraclavicular block method accelerates the blockade onset and increases the duration of blockade and analgesia after surgery without causing any considerable side effects. [ABSTRACT FROM AUTHOR]

Background People who take statins respond differently to them due to genetic differences. One of the most significant enzymes involved in drug metabolism is cytochrome P450 2D6 (CYP2D6) enzyme, coded by the CYP2D6 gene. Individuals who carry two non-functional alleles in this gene are considered as poor metabolizers. Recognizing poor metabolizers may help prevent adverse effects of drugs. Objective This study aims to assess the association of CYP2D6*4, as the most frequent non-functional allele of CYP2D6 gene, and response to atorvastatin in patients with high low-density lipoprotein (LDL) level in northern Iran. Methods A total of 180 patients with high LDL level underwent treatment with atorvastatin for 8 weeks to assess their response. They were assessed in terms of CYP2D6*4 polymorphism using the amplification-refractory mutation system/polymerase chain reaction method and the results were validated by the sanger sequencing method. At the end, the association between CYP2D6*4 allele and response to atorvastatin was assessed. Results In patients, the percentage of the CYP2D6*4 variant was 7%. This allele was not observed in homozygous patients. There was no significant association between CYP2D6*4 polymorphism and response to atorvastatin, which might be due to low frequency of CYP2D6*4 in patients. The observed allelic frequency was close to the frequency reported in previous studies for healthy Iranian people. Conclusion It seems that CYP2D6*4 polymorphism is not the cause of poor metabolism in poor metabolizers in northern Iran. Therefore, to diagnose poor metabolizers in this region, further studies on other genes are recommended. [ABSTRACT FROM AUTHOR]

Background Oral lesions can affect people’s quality of life by interfering with chewing, swallowing, and speech. These lesions may originate from epithelial or mesenchymal tissues. Malignant oral lesions can be life-threatening. Epidemiological data of oral lesions in Iran is limited. Objective This study aims to investigate the frequency of oral lesions in Rasht, Iran. Methods In this cross-sectional study, histopathologic data of oral lesions reported by Razi laboratory in Rasht from 2015 to 2019 were evaluated. The data collected: Patients’ age and sex, histopathologic findings, and location, type and origin of lesions. Non-specific diagnoses and dental and bone lesions were excluded. Results A total of 259 pathologic reports were included. The mean age patients was 52.09±19 years, and 40.2% were male. Oral lesions in patients aged <40 years were mainly benign (64.2%), whereas half of lesions in patients ≥70 years were mostly malignant. Tongue was the most common location of the lesions (34.7%) and the main location for malignant lesions (46.7%). Benign lesions were significantly higher in females whereas malignant lesions were significantly higher in males (P=0.011). Epithelial tissues were the most common site of origin (49%) and salivary glands were the least common site of origin (11.6%) for oral lesions. Conclusion Malignant oral lesions are more common in Iranian men aged >70 years, where the tongue is the most common site of involvement and epithelial tissue is the main site of origin. [ABSTRACT FROM AUTHOR]

Background The coronavirus disease 2019 (COVID-19) pandemic led to depression, stress and mental health problems in medical students working in hospitals. Objective The present study aims to evaluate the professional quality of life (QoL) of medical interns in Rasht, Iran during the COVID-19 pandemic. Methods This cross-sectional study was conducted on 152 medical interns working in hospitals affiliated to Guilan University of Medical Sciences in 2020. The professional QoL was assessed using the professional quality of life scale (ProQOL). Results The mean scores of compassion satisfaction, burnout, and secondary traumatic stress were 38.4±8.3, 30.9±5.4, and 25.3±7.5, respectively. Compassion satisfaction had a significant relationship with marital status, history of underlying diseases, being resident of the city, and work shift duration. Conclusion The professional QoL of medical interns in Rasht is low. Considering the differences in the spread of COVID-19 in Iran, it is necessary to conduct more study in other cities and on other medical trainees. [ABSTRACT FROM AUTHOR]

Background & Aims: : Coronavirus (Covid-19) is a large family of viruses that may cause respiratory infections from colds to more severe diseases such as MERS and Sars. Recently, this virus has been named Covid-19. contextual factors surrounding covid-19; including ease of transmission, lack of immunity among the global population, delayed testing, limited medical equipment, and uncertainty of the path of the pandemic; There is a level of public anxiety that shows the importance of investigating the issue. Research has reported a relationship between well-being and more effective coping strategies. Currently, psychological conceptualizations of unhealthy coping preferences often focus on individual coping strategies that are conceptualized as illness or part of the illness, for example, eating disorders, substance use disorders, self-harm, suicide, rather than biological causes. Psychological distress, antecedents of unhealthy coping strategies, and total coping strategies. Understanding the relationship between coping strategies and overwhelming distress is essential to inform diagnosis and the best targets for interventions. While healthy and unhealthy conceptualizations of coping strategies are empirically supported, to date there has been no assessment of the continuum of coping, implying that the use of coping preferences varies depending on the level of distress and relationship. According to healthy coping theory, people use unhealthy coping strategies when they feel better about a difficult situation, even if they risk other negative consequences to feel better, but this does not happen. between healthy and unhealthy coping strategies. The high individual morbidity and mortality and societal costs associated with the chronic use of unhealthy coping preferences highlight the need to understand better their relationship to overwhelming distress and healthy coping strategies. In the new theory of stress, coping skill is a major composite function that is often used due to individual differences in response to stress. Coping skills are also affected by homelessness and the special conditions of street children and adolescents for several reasons. Since the level of mental health among humans has been significantly reduced during the covid-19 epidemic and has been taken into consideration. High prevalence rates of depression, sleep disorders, and post-traumatic stress disorder (PTSD) have been reported at the peak of the disease outbreak in China; Symptoms of psychological distress are expected to be long-lasting and warrant the need for evidence-based psychological treatments aimed at immediate stress relief and prevention of psychological distress in this population. Research Background Cognitivebehavioral therapy (CBT) is effective in the treatment and prevention of several stress-related disorders in the human population. Among the treatments that can be effective for posttraumatic stress disorder and psychological events after an unexpected event is a cognitivebehavioral therapy. Cognitive-behavioral group therapy is one of the most widely used methods and one of the most important choices in the field of psychological treatment of this disorder, which has wide applications. This treatment consists of four components: exposure, prevention of response, and connection between events and thoughts. It uses maladaptive thoughts to improve cognition, emotion, and behavior by changing cognition. According to the mentioned materials, this research has addressed the question of whether cognitive behavioral therapy affects the resilience and preference of coping actions of patients who have recovered from the corona pandemic (COVID-19) at the height of the epidemic. Methods: This research was a semi-experimental type of research with a pre-test-post-test and control group. The statistical population of this research included all recovered patients of the Corona pandemic at the peak of the epidemic in Isfahan, 30 people were selected by purposeful sampling and randomly assigned to two experimental and control groups (15 people in each group). After the pre-test, the experimental group received the cognitive behavioral therapy program for 12 sessions, and then the post-test was performed. The data required for the research were collected using the scale of preference for confrontational actions by Carver, Shier, and Weintraub (1989). The resulting data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (analysis of variance) with the help of SPSS-20 software. Results: The findings showed that cognitive behavioral therapy led to an increase in problemoriented confrontational preference and a decrease in emotion-oriented and avoidance confrontational preference in the members of the experimental group had a significant effect (P<0.01). Conclusion: Based on the findings, it can be concluded that cognitive behavioral therapy can be considered an effective treatment in reducing the problems and psychological indicators of patients who have recovered from the corona pandemic. This research finding can be explained that in cognitive behavioral therapy, tasks such as functional analysis, skill training, and dealing with impulsive desire are presented to people, which creates a feeling of mastery and empowerment in people, and is effective in improving the person's coping preference. In cognitive-behavioral therapy, people learn that they should not ignore problems and should accept problems and act to solve them. They learn to follow clear policies and try to see the bright side of things and control their emotions. In this way, they learn to take advantage of the guidance of others, but not to interfere with their problems, instead of just seeking support from others. This method teaches people to have a plan for their life (and especially their recovery). This research, like other research, has limitations such as the impossibility of holding face-to-face meetings (due to the corona situation) and the limitations related to the participation of both sexes in the interventions (the training was conducted only among female patients who have recovered from the corona pandemic). It comes with It is also suggested that in future research, the influence of other factors involved in the psychological problems of patients who have recovered from the corona pandemic should be controlled during training. Also, according to the results of this study and the effectiveness of cognitive behavioral therapy, it is suggested to conduct long-term follow-up in a larger sample in future research to evaluate the stability of the results, and also to implement educational and therapeutic courses based on cognitive therapy for patients who have recovered from the corona pandemic. [ABSTRACT FROM AUTHOR]

Background & Aims: Learning disorder is a neurodevelopmental disorder in children that occurs due to genetic and environmental factors and affects brain function in the areas of understanding and processing verbal and non-verbal information; therefore, it is important to identify decisive intervention methods in this field. Learning disability is one of the most controversial topics of exceptional education. One of the goals of educational systems is to raise the level of students' ability to increase the academic efficiency of learners. According to the Statistical Manual of Mental Disorders, a learning disability has been renamed to a specific learning disability, and reading disorder, writing disorder, and math disorder, each of which was once a distinct and independent disorder, are now considered to specify a specific learning disorder. A neurodevelopmental disorder in children that is caused by genetic and environmental factors and affects brain function in the areas of understanding and processing verbal and non-verbal information; in a way that lasts at least 6 months. This disorder leads to problems in learning and using academic skills in the form of carelessness, poor comprehension, slow reading, difficulty in spelling, problems in written expression, problems in mastering the meaning of numbers or calculations, and problems in mathematical reasoning. These problems are not related to mental retardation, developmental delay, uncorrected vision or hearing problems, or movement or neurological disorders, they are specifically meant in this way. In the education and treatment of learning disorders, one of the most important methods introduced is the sensory integration method. Sensory integration refers to processes whose information enters the brain through the eyes, ears, mouth, nose, skin, muscles, joints, and sense of balance. Ayres presented a theory called sensory integration to relate behavior and neural function, especially sensory information, which examines the specific connections of neural function, sensorimotor behavior, and academic learning in a hypothetical framework, and aims to find specific patterns of dysfunction in Children with learning and sensory problems and special treatment methods for these groups. The method of sensory integration is a neurological flow that receives and organizes sensory information from the body and the environment of a person and uses it for more effective and better functioning in the environment. This method leads to the improvement of excellent brain functions and the abstract levels of the brain from which mathematics is applied; increasing and thus improving the educational efficiency of this student. This intervention engages the child's senses with exercises in the form of a game, and this situation helps coordination and precision in the functioning of the child's senses. Agent concentration is important in maintaining integrity and improving learning performance, so it can play an effective role in improving reading and writing disorders. The basic premise of this educational method is that children with learning disorders have problems in these sensory pathways. Much research has been done on the effectiveness of this educational method in children with learning disabilities and its effectiveness has been confirmed. The purpose of this study was to compare the effectiveness of the sensory integration method and the central nervous system reorganization method on the explicit and implicit memory of students with specific learning disabilities. Methods: The present study was a pre-test-post-test experiment with a control group and a follow-up period in terms of its practical purpose and design. The statistical population of the research included all students with specific learning disorders (reading/writing, math, and mixed disorders) who were referred to educational and clinical centers in Rafsanjan city in the academic year of 2020-2021, 90 of them were selected using the purposeful sampling method. Completely randomly, they were replaced in three experimental groups of 30 people, including the sensory integration group, the central nervous reorganization experimental group, and the control group. The research tools included the mental fluid maintenance task of Bogard and Rus (1991) and experimental groups of sensory integration training protocol (for 12 sessions and 90 minutes each session) and central nervous system reorganization protocol (for 8 sessions of 90 minutes each session). Data analysis was also done using repeated measurement with mixed design and multivariate analysis of variance using SPSS-24 software. Results: The Results showed that the effect of the group (control, sensory integration, and reorganization of the central nerves) was significant in the component of mental maintenance (p<0.01 and F=70.99). Also, the effect of disorder (reading/writing, math, and mixed) in mental maintenance (p>0.05 and F = 0.716) is not significant, so there is no significant difference between the scores of the groups according to learning disorders. Also, in the between-case factor of the interaction of the group and disorders (reading/writing, math, and mixed), the mental maintenance component (p<0.05 and F=2.85) is significant, and there is a significant difference between the effectiveness of educational methods considering learning disorders. The way that effects of the sensory integration group on the students' mental maintenance ability were more than the central nervous system reorganization group. Conclusion: The present study, like other studies, had limitations, including the uncontrollability of some important psychological factors, such as emotional characteristics and personality traits, along with the biological-neurological foundations involved in specific learning disorders. Considering that the research was carried out in a learning disorder center, generalizing the results to wider groups and different educational levels should be done with caution. Also, the specificity of the research sample only to students with learning disorders in Rafsanjan city limits the generalization of the results to other groups and cultures. Therefore, it is suggested that similar research should be evaluated for other students with special needs with wider samples, students in different educational levels, and different cities and cultures. On the one hand, it is suggested that clinical, educational, and exceptional specialists in the fields of occupational therapy, learning promotion, educational counseling, guidance centers, learning disorders centers, school health centers, and educators use the results of this study to help children with learning disabilities. Based on these findings, it can be concluded that the methods of sensory integration and nerve reorganization are effective in increasing the mental retention of students with specific learning disorders, and this effectiveness in the training of the sensory integration group is more than nerve reorganization. It is higher and more in the ability to keep the mind. Therefore, it is suggested that clinical, educational, and exceptional specialists use the method of integrated sensory interventions and nerve reorganization for students in different educational levels and cultures with learning disabilities. [ABSTRACT FROM AUTHOR]

Background & Aims: Today, the spread of the Corona virus has created significant changes in the nature and function of higher education, especially universities, which the digital university, the evolutionary path approach of the university and higher education centers are facing. It starts with the Corona crisis and after that. The emergence of the Covid-19 virus and its epidemic at the beginning of 2020 and in the last months of 2018 led to fundamental changes in the higher education programs of the world and Iran. According to the statistics of the International Union of Universities, since the global spread of the Corona virus, 146 countries have closed their education in all academic levels (59 percent), and in some areas, education has been active in a limited way (30 percent), and 10 percent are in difficult conditions. Burundi has continued its normal activities, among them 67% of universities in the world have used electronic education, 24% did not have proper infrastructure and the rest of the universities were also closed. Based on this, today and in the digital era, it is essential that the maturity of universities and higher education centers aligns itself with these developments and can make the most of the technological capacities of the new era to realize the goals of higher education. It has been discussed, but the digital university has not been examined in the form of a coherent model, and the existing researches have mostly focused on the learning aspect and few components of the digital university. A digital university is an organization that needs to pay attention to its key dimensions so that it can take advantage of the capacities of the present era and bring itself to a principled and planned adaptation. Therefore, the general goal of the current research was to identify the factors affecting the provision of digital universities during the corona pandemic and post-corona in medical sciences universities. Methods: The purpose of this research is practical, which was carried out with a mixed approach (qualitative and quantitative) with an exploratory design. In the qualitative approach, the Delphi method was used in two rounds, and in the quantitative approach, as it examined the existing situation, a descriptive survey method was used. In the qualitative part, the statistical population was 25 professors of the major medical sciences universities of the first region who had a doctorate degree, more than 10 years of teaching experience and the scientific rank of associate professor and above, and in the quantitative part, the directors and assistant professors (senior experts) of the faculties., department managers and faculty members of Shahid Beheshti University of Medical Sciences numbering 1851, in the qualitative part using the purposeful sampling method and considering the saturation law, 14 people were selected as a statistical sample, and in the quantitative part based on the formula Cochran at 95% confidence level and α=5% measurement error, 320 people were selected as a statistical sample by stratified random sampling method. In order to collect data, a researcher's questionnaire made by Digital University was used. Results: The results showed that among the different dimensions of the Debjebatal University questionnaire, it should be mentioned that the "university culture" dimension has the highest rank with an average rating of 4.56. Comparing the average ratings shows that the most important features or dimensions in the second and third place are "educational content and curriculum" and the average rating of these dimensions is 50.4 and 2.4, respectively. Teaching and learning methods are in the fourth place with a value of 19.4, human resources and educational infrastructure are in the fifth place with a value of 65.3, and university policy is in the sixth place with a value of 24.3. Conclusion: Based on the findings of the research, in order to improve the main components of research in higher health education centers and to help the officials and managers of higher education in the country's health sector, to formulate long-term strategies for the effect of competence on scientific authority, in higher health education centers, it is one of the practical consequences of this research. . In this study, the aim of the professors of the University of Medical Sciences is to familiarize the professors with the category of digital university and the need to pay attention to it as a platform to achieve this goal, to play a role in the realization of a good life for the individual and the society, in an appropriate way, according to the process of development and evolution. Identity, it is necessary for students to acquire a set of necessary skills first. It is hoped that the results of the present research can make university administrators and officials aware of the importance of this issue so that they can take effective and practical steps towards the success and implementation of the present research. The limitations of the research in this study are: limiting the statistical population to the University of Medical Sciences, the geographical scope of the research, and unfortunately, in the case of a number of articles, access to the full text of the articles was not possible. The problem of communicating with some professors of the university and determining the time needed to conduct the interview was one of the problems and limitations of the study. According to the results, it is suggested that the Ministry of Science, Research and Technology presents successful management and strategic experiences of national and international universities and institutions of higher education inside and outside the country as practical examples to universities and institutions. By forming future research teams, the university administrators should predict the issues and problems facing the organization in terms of paying attention to digitalization paradigms. Develop scientific parks and international research centers in universities in order to expand the activities of managers and professors in the direction of moving towards digitalization. [ABSTRACT FROM AUTHOR]

Background & Aims: Nowadays, one of the most important concerns of education administrators, parents, and students is the discussion of learning to achieve academic success. On the other hand, traditional teachings are not effective either; because they cannot meet the needs of today's learners. For this purpose, teachers are looking for new methods and approaches for better and more effective education. Quality education is another important concern of teachers. The teachers have well understood that the uniformity and lack of initiative in the teaching method cannot provide the basis for the academic growth and success of the students. Also, one of the educational inefficiencies in today's schools is the inadequacy of the teaching time with the educational content in the classrooms, especially in the interaction between the teacher and the student, which has seriously challenged the educational program. As a result, teachers should look for a new approach to teaching and learning that has a different look at the classroom. One of the most appropriate of these new methods of education is individual education, including reverse education. The reverse teaching method is one of the new teaching methods that has received a lot of attention in the last decade. Reverse education is one of the approaches that in recent years, especially since 2004, has drawn the attention of experts and those involved in education and learning. For years, teachers have been looking for ways to change traditional teaching methods. Even the most dynamic speeches are boring. The application of information and communication technology in education has made a new type of learning possible in such a way that learning is possible in environments other than the classroom environment. The flipped classroom is changing the educational space from a large place to an individual learning space and providing learning content outside the classroom. Acquiring new information and learning at home and homework is done in schools. The teacher prepares and records a video file from the classroom and provides it to the learners through online software before the class starts. With the expansion of information technology and the penetration of remote communication tools into the depth of society, the tools and methods of education have been transformed, in such a way that every person can, at any time and in any place, with the facilities at his disposal and in Learn in the period determines. Even when the Internet emerged, this phenomenon was more seriously considered. Therefore, according to the above, the main problem of the current research is to answer the question, does reverse education affect academic resilience and academic motivation of 11th-grade female students in Sari City? Methods: In terms of practical purpose, this research was a field data collection method, and in terms of descriptive nature, it was a quasi-experimental type (pre-test-post-test with a control group). The statistical population included all 11th grade female students in Sari city in the year 1400-1401, numbering 1450 people, 40 of which were randomly selected from the 11th grade students of the second secondary school and after the pre-test was conducted among 40 people, 30 people who got the lowest score (15 people in the experimental group and 15 people in the control group) were selected as samples. The data collection tool was Samuels's (2004) and Harter's (2001) standard academic resilience questionnaires. For data analysis, regression and univariate covariance (ANCOA) were performed using Spss22 software. Results: The results showed that reverse education affects academic resilience and academic motivation of 11th-grade female students in Sari City. It can be said that reverse education has increased the academic resilience of 11th-grade female students in Sari. Conclusion: In general, it can be concluded that teachers' teaching approaches play an important role in encouraging learners to adopt the best learning method. On the other hand, reverse education creates a suitable environment for the relaxation of students to enter the class without stress and anxiety and be fully prepared, their self-confidence and participation in class activities also increase and that's all. It improves the level and level of resilience of students. Also, students have important capacities whose flourishing is a necessary and basic condition for the success and development of today's societies, but the existence of multiple risk factors in this path always leads to short-term and long-term personal and social damages. During their studies, many students face problematic social and educational situations in the classroom, at home, and in the community, which can lead to their failure in school and face their future life with weakness and disability. According to the results, it is suggested that using the reverse teaching method by the teachers for the academic resilience of the students, to create and strengthen academic motivation, and that the teachers use this method of short recorded lectures as a supplement to the book. Use reference books and prepare compact tablets for at least 2-3 weeks before the start of classes. [ABSTRACT FROM AUTHOR]

Background & Aims: In expressing the relationship between servant leadership and knowledge sharing, it should be said that despite the comprehensiveness of the concept of servant leadership style within the organization, there is little research on its relationship with knowledge sharing and social capital in organizations. It doubles the research in this area. In expressing the relationship between servant leadership and social capital, it should be said that servant leadership style can affect all aspects of social capital; In other words, by creating mutual trust and influence in followers and modeling, empowering followers, creating their competence and merit, increase the social capital of the organization. In other words, one of the factors affecting the level of social capital is the type of leadership style adopted by managers. In fact, leaders can grow people by adopting a service-oriented leadership style and investing in people by building trust between themselves and their followers, serving them, and sacrificing personal interests against them in the organization's decisions and missions. Through spiritual nourishment, involvement of followers in organizational affairs, giving responsibility to the followers with authority and being flexible and steadfast, it helps to promote social capital and in this way, in addition to benefiting from people with high human capital, Benefit from the advantage of expanding social capital in your organization. The present study seeks to design a model on the concepts of servant leadership style and knowledge sharing in relation to each other and social capital as a mediating variable in Mazandaran University of Medical Sciences and thus helps to expand the existing knowledge in this area. N. Given the above, it is clear that "servant leadership style" is associated with the variables "social capital" and "knowledge sharing" and can be a source of positive effects on the organization, so the researcher's preoccupation to answer this question. What is the model of the relationship between servant leadership style and knowledge sharing with the mediating role of social capital in Mazandaran University of Medical Sciences? Methods: This research was method-mixed in terms of method. The study population in the qualitative part included the president of the university, managers of the department, the director and managers of the eight vice-chancellors of the university and the director of the nine affiliated faculties) of Mazandaran University of Medical Sciences with an approximate number of 45 people and in the quantitative part included the staff of Mazandaran health services and sub-faculties were in 2016. In the qualitative part, sampling was done by snowball sampling method and 20 people were selected and in the quantitative part, it was done by sampling multi-stage relative classes with Cochran's formula and 323 people. In this study, considering that the data collection method was a researcher-made questionnaire, which consisted of two parts, including general questions and specialized questions (including 95 items). Delphi technique was used to analyze the data in the qualitative part and the structural equation method (SEM) and AMOS software were used in the quantitative part. Results: The results showed that the direct standard coefficient of the servant leadership style variable on knowledge sharing was 0.57, t value was 5.220 and P-value was less than 0.05. There is a significant relationship between servant leadership style and knowledge sharing. The direct standard coefficient of the servant leadership style variable on social capital is equal to 0.55, the t value is equal to 4.731 and the P-value is less than 0.05, the result is that the relationship between the servant leadership style variable and social capital is meaning. The coefficient of direct standard of the social capital variable on knowledge sharing is equal to 0.39, the value of t is equal to 3.932 and the value of P-value is less than 0.05, therefore, the relationship between social capital and knowledge sharing, the relationship. The results also showed that the value of chi-square in the model 1450/4503, the degree of freedom of the model is equal to 3208, the result of their ratio is equal to 1.404, which is an acceptable value. On the other hand, the fit indices of the main model such as CFI and IFI are all in an acceptable and appropriate level and the SRMR index is 0.061. Conclusion: In general, the more widespread the service leadership in an organization, the greater the sharing of knowledge and social capital. Social capital also facilitates people's access to other resources inside and outside the organization, increases people's willingness to engage in two-way interaction, and improves the effectiveness of knowledge creation and sharing. The dimensions of social capital, especially trust, networks, relationships and cooperation, with the effective sharing of information, control of information change and reduction of executive and managerial costs, encourage people to participate and cooperate with each other, as well as create and share new knowledge. This, in turn, facilitates knowledge management processes in the organization. To create and share knowledge, there must be a high level of trust and optimism in the relationships of members of the organization with each other. In some organizations, rewards are set or employees are forced to pass on their knowledge to others in order to encourage employees to share knowledge. The danger that may arise is that employees, in order to be rewarded or to satisfy higher authorities, seem to share knowledge and do not transfer their real knowledge and only share some useless information with others. This is usually due to mistrust and lack of social capital among individuals. Indeed, improving an organization's social capital can enhance the acquisition, coding, and transfer of knowledge; Because by facilitating the combination and exchange of resources, it helps the organization's ability to create innovation. [ABSTRACT FROM AUTHOR]

Background & Aims: The goal of medical science, which is progressing on a daily basis, is not only to avoid diseases but also to increase the quality of life of people (1). Quality of life is an important indicator of health beyond physical health and includes the feeling of healthiness, some degree of satisfaction and the general sense of self-worth (2), namely a mental state of well-being that can be influenced by culture, value system and the stressful environment (3). According to WHO definition, the quality of life is people's understanding of their position in life in terms of culture, value system in which they live, their goals, expectations, standards and priorities (4), which is affected in different ways by social, economic, environmental and individual factors (5). In fact, economic, psychological, social and environmental factors (6), as well as age, health status, occupation (7), gender, culture, education along with general behavioral, job and adaptation elements can influence the quality of life (8). Failure to pay attention to quality of life can lead to disappointment, reduction in social, cultural, economic, and health activities, loss of work motivation, decreased job performance, occupational burnout and early retirement (8, 9). On the other hand, paying attention to quality of life increases efficiency and reduces psychological pressures (10). Quality of life is one of the most important aspects of human health, and improving the health of employees may reduce medical costs, disability and absenteeism, improve job satisfaction and increase productivity (9, 11). The operating room is a closed environment associated with risks and anomalies, which can be considered a unit with environmental factors of stress causing dissatisfaction with personal responsibilities and professional work of surgical technologists, which may lead to physical and mental disorders adversely affecting a person's health and quality of life (13). Because we need employees who enjoy their high quality of life in order to provide satisfactory health care (14), the physical, mental health and emotional management of staff should not be neglected (15). In the operating room, the common goal of the surgical team is to provide effective, systematic and safe care, and failure of each member to perform their role can have a serious impact on the success of the entire team, and on the other hand, the success of an individual as a member of the team creates personal satisfaction in him/her (16) because surgical technologists are responsible for maintaining safety and comfort for patients in the operating room (17). Any negligence on the part of technologists may endanger the life of patients. According to the search for sources on this issue in Iran and abroad, it was observed that there were limited studies on quality of life of surgical technologists. Therefore, the researcher decided to conduct the present study with the aim of determining the quality of life and its related factors among surgical technologists of the medical training hospitals affiliated with Iran University of Medical Sciences. Methods: In this cross-sectional study that was conducted in hospitals affiliated with Iran University of Medical Sciences hospitals, 125 surgical technologists were recruited. Inclusion criterion was holding an associate or bachelor degree in surgical technology. The cluster sampling method was used, in which each of the centers was considered a separate cluster. According to the number of staff in the center, the personnel IDs of individuals were written on small sheets of paper. Then, the IDs were randomly selected by a person outside the study, the number was matched with that in the staff list, the desired person was chosen and sampling completed. A total of 150 questionnaires was distributed among surgical technologists in hospitals. The data were collected using demographic information questionnaire (age, gender, marital status, work experience, type of shift work, level of education, income, night shift hours per month and employment status) as well as 26-item WHOQOL-BREF. After obtaining permission from Research Vice-Chancellor (ethics code IR.IUMS.REC 1395.9411101009), OR was visited to collect data. The research goal was explained to all the research units, and there was no compulsion to participate in the study. In all stages of the research, the utmost confidentiality was observed for personal information, and anonymous questionnaires were completed as self-reports by the research units themselves in presence of the researcher. The normal distribution of data was confirmed by Kolmogorov-Smirnov test in SPSS-22. The results of descriptive analysis for qualitative variables were reported using frequency (percentage). The values of variables related to different dimensions of quality of life in each level of the studied variables were reported using mean±SD. To examine the relationship between different dimensions of quality of life with the studied variables, independent t-test was used for two-level qualitative variables, and one-way ANOVA was employed for qualitative variables with more than two levels. Bonferroni's post hoc test was used for pairwise comparisons. To investigate the effect of each variable on different dimensions of quality of life by controlling the effect of other variables, we used linear regression analysis, so that the significant variables entered at 0.2 level in univariate analysis. P<0.05 was considered the significance level in the rest of tests. Results: The participants of this research were 125 surgical technologists. More than half of the research units (52%) were <30 years, 40.8% were 30-40 years and the rest >49 years. The majority of research units (79.2%) were women and the rest were men. The mean and standard deviation of the quality of life was 63.10 ± 18.57; quality-of-life score in dimension of physical health was 54.77 ± 18.87, social health 54.60 ± 18.07, mental health 54.40±14.19, and environmental health 48.27±12.25, which shows that the lowest quality of life score of research units was related to the environmental dimension. By controlling the effect of each of the dependent variables, the variables of marital status and time of night shift had a significant effect on the level of physical health, so that after controlling the effect of night shift variable, the physical health score of married people was on average 13.23 units higher than single people [B=13.23, SE=2.96, P=<0.001, 95%CI= (7.36, 19.09)]. Also, after controlling the effect of the variable of marital status, physical health score of people who had >36 hours of night shift per month was on average 8.73 points lower than those who had <12 hours of night shift per month [B=- 8.73, SE=4.01, P=0.031, 95% CI= (-16.66, -0.790)]. Conclusion: The quality of life of surgical technologists was at an average level, and it was lower than other dimensions in the environmental dimension. Married people had a higher quality of physical health than unmarried people, and physical health was lower in those who had >36 hours of night shift per month relative to people with <12 hours of night shift per month. [ABSTRACT FROM AUTHOR]