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Aim: The present study aims at teaching the right citation models in scientific publications by top authors from Iranian universities of medical sciences in 2017, considering the relationship between moral development and self-control variables and model of "citation to multi-authored papers" in these articles. Background: Multi-authorship increases the amount of self-citation and also increases the likelihood of being cited by others. Methods: This study is of the applied scientometrics and correlation (model presentation) studies type. The research population in the first part of this study includes all the authors who had an H-index of 10 or more in the scientific databases of 2017. The sample size at this stage was 110, selected by systematic random sampling. The collected data were analyzed using SPSS 16.0. Results: The results of regression analysis based on the concurrent method indicated that the regression model is significant. The coefficient of determination is 0.096 and the F ratio is 5.650, which are significant at the level of p <0.001. In this regression model, the variables of the level of moral development (β = -5.801, p <0.001) and self-control (p < 0.001, β = -0.253) have significant predictive power and can be considered as predictors of behavioral modeling in citing "multi-authored papers". Conclusion: Based on the results, teaching how to avoid blindly citing the "multi-authored papers", which is regarded as a kind of "citation deviation", can, to some extent, lead to strengthening citation indexes. [ABSTRACT FROM AUTHOR]

Introduction: Journal clubs are known as the teaching methods in most of the medical training centers. In journal club (JC) participants discuss about articles in recent medical papers and finally, written scientific results are accepted or rejected. The aim of this study was to compare the traditional and evidence based medicine (EBM) type of JCs. Methods: The present study was conducted in Imam Reza Hospital, Tabriz University of medical sciences from January to March 2010. Forty participants were enrolled in our study: 16 stagers, 11 interns and 13 internal medicine residents. We held 3 journal clubs with 14 participants in the first session and 13 participants in the other sessions. Journal club was held at the end of each week. The first paper was presented by one of the attending physicians of rheumatology ward. The second paper was presented by another attendant of rheumatology ward who was a member of EBM group of Tabriz University of Medical Sciences. Then the results were compared. Results: The comparison of the sums of participants' scores didn't show any meaningful difference between traditional and EBM journal club in topic, purpose, and methods & material part of papers, but in the results section of the papers, the difference was remarkable. Conclusions: Our study showed that in the EBM journal clubs, participants learnt more about the results part of the papers.but in the results section of the papers. [ABSTRACT FROM AUTHOR]

Background: Mental disorders are one of the leading causes of illness and disability worldwide. According to the World Health Organization (WHO), one in four people in the world will be affected by mental or neurological disorders during their lifetime. Regular evaluation of mental health outcomes plays an important role in making decisions about timely treatment of the patient. Studies show that a medical record does not provide enough information about the diagnosis, current symptoms, psychiatric medications, and side effects of current medications and treatments for ongoing health care. In this study, the completeness of paper-based psychiatric records was investigated. Aim: The current study aimed to explore the completeness rate of paper-based psychiatric medical records (PMRs) and to investigate the factors effective on documentation status. Setting: The study was conducted in Ebnesina and Dr. Hejazi Psychiatric Hospital and Education Center. The case hospital is a psychiatric teaching hospital, which has 900 beds. Materials and Methods: The completeness rate of PMRs was determined using descriptive statistics. Fleiss' Kappa agreement and effective factors on PMRs' documentation status were assessed. Results: In total, 83.65% (n = 312) of the PMRs had at least one documentation defect. A significantly higher level of documentation completeness rate between different psychiatric wards was observed. Conclusion: Based on our results, it is suggested to conduct regular evaluation and provide feedback to the health-care providers, and conduct training courses. [ABSTRACT FROM AUTHOR]

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Statement of the Problem: Swelling of the surrounding tissue of surgical site is one of the most common, devastating effects after maxillofacial surgery and can have an effect on quality of life and the patients' satisfaction. Purpose: The purpose of this study was to investigate the effect of a custom-made appliance by the method of Computer-aided design/Computer-aided manufacturing (CAD/CAM) compared with conventional dressing for reducing facial swelling after maxillofacial surgery. Materials and Method: This clinical trial accomplished in 14 patients voluntarily referred to the Department of Oral and Maxillofacial Surgery at Bahonar hospital in Kerman. These patients were the candidate for surgical treatment of similar bilateral facial fractures (10 patients) and orthognathic surgery (4 patients). Facial computed tomography (CT) scans of the patients were taken to build up a custom-made appliance. Based on three-dimensional reconstruction from facial CT scan data, custom-made appliance was designed and built. Swelling on one side with custom-made appliance and on the opposite side with conventional dressing measured with paper tape graded before surgery, immediately after surgery, 24 hours, 48 hours, and 7 days later, we divided the patients into two groups of trauma and orthognathic surgical procedures Results: Based on the defined landmarks, all of the measurements were performed on both sides. Statistical analyses do not show any asymmetry before surgery (p= 0.48). In addition, there was no significant difference between two methods of dressing on the day of surgery and a day later (p= 0.084, p= 0.09), but there was a significant difference between two methods of dressing on second and seventh days. The swelling has decreased faster and further in our new method. Conclusion: Regarding the exact adaptation to the surgical site on facial skin, using custommade appliance by the method of CAD/CAM could be an effective tool that reduces swelling after maxillofacial surgery. [ABSTRACT FROM AUTHOR]

Background and Aim Fibromyalgia syndrome is a chronic disease that causes widespread musculoskeletal pain. It primarily affects women and negatively impacts many aspects of a person’s psychological and social life. This study aimed to compare the effectiveness of cognitive therapy based on mindfulness and compassion therapy on automatic negative thoughts, psychological symptoms, pain intensity, and quality of life in patients with fibromyalgia syndrome. Methods & Materials This research is a quasi-experimental study with a pre-test-post-test design with two experimental and one control group. The statistical study population consisted of all individuals with fibromyalgia syndrome referred to Mehregan Pain Clinic in Mirdamad (District 3), Seyed Khandan Clinic (District 4), and Taleghani Hospital Pain Clinic (District 1) in Tehran City, Iran. Of them, 30 patients were randomly selected and divided into three groups of experimental 1, experimental 2, and control; each group will include 10 people. The instruments used in this study included the World Health Organization quality of life questionnaire (WHOQOL BREF), pain intensity questionnaire (PIS), psychological symptoms questionnaire (Anxiety, Stress and Depression [DASS]), and automatic negative thoughts (QNS). Ethical Considerations This study was approved by the Research Ethics Committee of Arak Branch, Islamic Azad University (Code: IR.IAU.ARAK.REC.1400.005). Results The analysis of covariance showed the effectiveness of both cognitive therapies based on mindfulness and compassion therapy on four variables of pain intensity, psychological symptoms, automatic negative thoughts, and quality of life (P<0.05). Comparing the two intervention methods showed that both therapies had almost the same effect on pain intensity, psychological symptoms, and automatic negative thoughts (P<0.05) but the effectiveness of mindfulness intervention on the quality of life was significantly higher than compassion intervention (P<0.05). Conclusion The results indicate that cognitive therapy based on mindfulness and compassion therapy are suitable for people with fibromyalgia under appropriate treatment. [ABSTRACT FROM AUTHOR]

Background and objectives: The growing number of terminally ill patients has underscored the importance of equipping healthcare workers with adequate palliative care knowledge and self-efficacy. This study aimed to compare the palliative care knowledge and self-efficacy of nurses in intensive care units (ICUs) with those in general wards at hospitals affiliated with Kerman University of Medical Sciences in 2023. Methods: This descriptive-comparative cross-sectional study involved nurses from intensive care units and general wards of three hospitals affiliated with Kerman University of Medical Sciences, for a total sample size of 300 nurses (150 in each group). The samples were selected using convenience sampling. The data collection tools included a demographic information questionnaire, the Palliative Care Knowledge Test (PCKT), and the Palliative Care Self-Efficacy Scale (PCSES). Convenience Sampling method was used. The data were analyzed using SPSS 23. Descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test, Mann-Whitney U test and multivariate stepwise regression) were employed. Statistical significance was determined by a p-value of ≤ 0.05. Findings: The mean score for palliative care knowledge was 10.59 (± 2.10) for nurses in intensive care units and 10.43 (± 2.33) for nurses in general wards, with no significant difference between the two groups (P = 0.53). Similarly, the mean score for palliative care self-efficacy was 28.01 (± 10.29) for nurses in intensive care units and 27.98 (± 10.33) for nurses in general wards, with no significant difference between the groups (P = 0.98). Variables such as the history of caring for dying patients in the hospital (P = 0.004) or at home (P = 0.01), workplace (P = 0.002), and work experience (P = 0.03) were identified as the main predictors of palliative care knowledge and palliative care self-efficacy was affected by age (P < 0.001), history of participation in palliative care training courses (P = 0.008), and palliative care knowledge score (P = 0.01). Discussion and conclusion: This study revealed no significant difference in total scores of palliative care knowledge or self-efficacy between nurses in intensive care units and general wards It is suggested that more efforts be made to increase the knowledge and self-efficacy of all nurses, especially nurses in ICU departments, till providing a standard palliative care setting. [ABSTRACT FROM AUTHOR]

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic placed enormous pressure on healthcare systems around the world, but it also provided valuable insights for healthcare organizations during this challenging period. Objective: This study aimed to explore nurses' lived experiences of vulnerability in hospital nursing management during the COVID-19 pandemic, and reflect on the lessons learned. Methods: In this phenomenological study, 14 participants, including nurse managers at different levels and staff nurses, were selected by purposive sampling from one center university hospital. Data collection was done through in-depth individual semistructured interviews with participants and a review of weekly reports of crisis management meetings at the university hospital. Interviews were analyzed using Colaizzi's method in seven phases by MAXQDA software Version 10. Results: One overarching theme, four themes, and 15 subthemes were obtained from analyses of interviews. Four themes of "nurses' attrition," "distrust of society to the organization," "fragility in the organization's performance," and "intensified inequalities" were extracted as threats to nursing management at the hospital. Subsequently, the weekly reports of crisis management meetings at the university hospital were analyzed to extract the solutions and lessons. Conclusion: The unpreparedness of the healthcare system against a crisis can led to the loss of organizational assets, including medical staff and the credibility of the healthcare system. Limitations of the infrastructure at hospital became more obvious during the pandemic and caused serious threats to the healthcare system. Despite severe challenges along with the pandemic, it offered four valuable lessons in nursing management. [ABSTRACT FROM AUTHOR]

Introduction: Aging leads to declines in both physical and mental performance, resulting in major disorders such as frailty syndrome and anxiety. This study aimed to explore the relationship between frailty syndrome and anxiety among older adults hospitalized in educational hospitals in Ilam City in 2024. Materials & Methods: This cross-sectional study examined 240 older adults at educational hospitals in Ilam from May to July 2024. Data were collected using demographic questionnaires, the Mini-Mental Status Examination (MMSE), the Groningen Frailty Index (GFI), and the Geriatric Anxiety Index (GAI). Data analysis was performed using SPSS V.16, applying Kolmogorov-Smirnov, chi-square, Mann- Whitney, Kruskal-Wallis, simple linear regression, and descriptive statistics (mean, standard deviation, frequency) at a 5% significance level. Results: The participants had a mean age of 72.44 ± 5.19 years, with GFI and GAI scores of 11.04 ± 2.68 and 15.58 ± 2.55, respectively. Significant relationships were found between literacy level and reasons for hospitalization with the GFI, and marital status and daily care needs with the GAI. A significant positive relationship was observed between the physical dimension of the GFI and mild to moderate anxiety, the social dimension and severe to total anxiety, the psychological dimension and susceptibility to anxiety, and the total GFI score with severe and total anxiety. Conclusion: The study found that the physical, cognitive, and psychological dimensions of the GFI were related to varying levels of GAI, with specific correlations between the GAI and the social dimension of the GFI. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Healing of the inferior alveolar nerve injury during dental procedures is one of the biggest concerns of dentists. There are still debates on different treatment modalities. Purpose: This study aimed to compare the effect of 940nm and 810nm diode lasers on the repair of the inferior alveolar sensory nerve. Materials and Method: In this single-blinded randomized clinical trial, 39 patients with inferior alveolar nerve injury were divided into three groups: 1. 810nm laser irradiated, 2. 940nm laser irradiated, and 3. No laser irradiation (control group). All patients were treated in 12 sessions (3 days per week) and evaluated using a complete clinical neurosensory test (CNT), including brushstroke, 2-point discrimination, pinprick nociception, and thermal discrimination before and after treatment. Results: The mean dysesthesia of the patient treated with 810nm diode laser was significantly lower than the control group in all sessions (the 1st (p= 0.003), 3rd (p=0.008), 7th (p= 0.006), and 12th sessions (p= 0.005)). The 810nm laser resulted in more satisfaction in patients than the control group in almost all sessions (1st (p< 0.001), 7th (p= 0.028), and 12th (p= 0.006)). More patient satisfaction was seen in the 1st and 3rd sessions in the 810nm laser than in the 980nm laser (p< 0.001 and p= 0.003, respectively). Conclusion: 810nm diode laser can be better than 940nm in repairing inferior alveolar sensory nerve damage. [ABSTRACT FROM AUTHOR]

Introduction: 30 to 60% of patients admitted to non-psychiatric wards have at least one significant psychiatric illness. Objective: The aim of this study was to investigate the frequency, causes, and quality of psychiatric counseling requested. Materials and Methods: This descriptive study was carried out on all patients admitted to educational hospitals in Rasht, Iran from 2012 to 2014, for which psychiatric consultation was requested and their counseling sheets were available. Data were extracted based on the checklist. Assessment of the quality of the consultation request and the response quality of the counseling were done. Data were analyzed by SPSS21. Results: The frequency of psychiatric counseling application in this study was calculated to be 0/3%. A total of 905 counseling papers were reviewed. According to the data, 51/1% of patients were female and 48/9% were male, with the mean age of 45/7 years. For 54/7% of the patients, emergency counseling and for 45/3%, of them non-emergency counseling was requested. The most requesting counseling departments were surgery and internal medicine (14/6% and 12%, respectively). The lowest frequency of consultation requests was for anesthesiology department (0/1%). The most common reason for requesting psychiatric counseling was restlessness (26/75%) and then medication setting (14/45%). The most common diagnostic suspicion in response to counseling was delirium and the average duration for requesting counseling was 2.9 days after admission. Conclusion: Considering the relatively low frequency and quality of counseling in this study, more attention to the use of psychiatric counseling in medical patients and coherent training of assistants to improve the quality of counseling seem necessary. [ABSTRACT FROM AUTHOR]

Background & aims: Missed nursing care is a global challenge that can have many consequences and it's known as a common threat to the patient safety and quality of nursing care. The nurses' professional commitment plays the final role in the occurrence of this issue. This study aimed to investigate the relationship between nurses' professional commitment and missed nursing care in Iran. Materials & methods: This cross-sectional descriptive-analytical study was conducted on 270 nurses working in two hospitals affiliated to Tehran University of Medical Sciences (Sina & Shariati) from September to December 2023. The research community included all nurses working in medical-surgical wards in the designated hospitals. The research samples were included in a targeted and quota method after obtaining organizational permits, ethical approval and informed consent. Data collection was done using three questionnaires including demographic information form, Nursing Professional Commitment Scale, and MISSCARE Questionnaire. The collected data was analyzed in SPSS software, version 25. Results: The results of Pearson's correlation test showed that there is a significant negative relationship between nurses' professional commitment and missed nursing care scores (r=-0.23) (p < 0.001). The mean score of nurses' professional commitment was reported at a moderate to high level (83.72 ± 16.02) and the mean score of missed nursing care was reported at a low level (47.84 ± 16.48). Nurses over 40 years old, morning shift and employed nurses showed higher professional commitment. Also, nurses under 29 years old and male nurses had more missed nursing care other than their participants. No relationship was observed between other demographic variables with nurses' professional commitment and missed nursing care. Conclusion: The results of this study showed that higher nurses' professional commitment leads to higher quality of care and less missed nursing care. Based on findings of this research, it is recommended for health care providers and nursing managers to adopt programs to increase nurses' professional commitment and consequently reduce missed nursing care. [ABSTRACT FROM AUTHOR]

Introduction: Today, internet usage has become an integral part of daily life, but excessive use can harm sleep quality. This study aims to explore the relationship between internet addiction and sleep quality among students at Ilam University of Medical Sciences in 2023. Material & Methods: In 2023,400 students from Ilam University of Medical Sciences participated in this study. They were selected using simple random sampling and met the study criteria. Data were collected through Young's Internet Addiction Test (IAT) and the Pittsburgh Sleep Quality Index (PSQ1). Simple and multiple regression analyses were conducted with a significance level of a ≤ 0.05. Results: The findings showed that 320 (80%) of students exhibited mild to severe internet addiction, with an average total sleep quality falling within the poor range (6.30 ± 2.51). Subjective sleep quality was particularly poor (2.03 ± 0.662) compared to other dimensions (p > 0.05). Simple linear regression revealed significant associations between mild (coefficient = 1.03; p = 0.002) and moderate (coefficient = 2.05; p < 0.001) internet addiction and poor total sleep quality, compared to normal individuals. Additionally, graduate students had better sleep quality than undergraduates (coefficient = -1.03; p = 0.016). Multiple regression analysis, adjusted for educational level, confirmed the association between mild (coefficient = 0.98; p = 0.003) and moderate (coefficient = 1.97; p < 0.001) internet addiction and poor total sleep quality. Conclusion: Internet addiction is linked to poor sleep quality among Ilam University of Medical Sciences students, especially undergraduates. It underscores the need for interventions to raise awareness about internet addiction and its detrimental effects on sleep quality. [ABSTRACT FROM AUTHOR]

Background: Oral lichen planus (OLP) is a chronic inflammatory mucosal disease that is classified as a premalignant condition. Epithelial growth factor receptor (EGFR) is associated with tumorigenesis and tumor progression and is overexpressed in several oral malignant disorders. Despite the association of EGFR overexpression with oral potentially malignant lesions, few studies have analyzed its expression in OLP, showing controversial results. This study aimed to compare the expression of EGFR as a protein marker in Reticular and Erosive OLP. Methods: This descriptive-analytical cross-sectional was conducted on 15 paraffin blocks of reticular lichen planus lesions, 16 paraffin blocks of erosive OLP lesions, and 8 paraffin blocks of inflammatory fibrous hyperplasia lesions as the control group (39 in total). After immunohistochemical staining for EGFR, samples were simultaneously observed by two maxillofacial pathologist, and the percentage of stained cells, intensity of staining, pattern of staining, and the location of stained cells were obtained. Results: The Mann-Whitney-U test showed that there was no significant difference in the mean percentage of stained cells between erosive OLP and reticular OLP (P-value = 0.213) and between reticular OLP and control group (P-value = 0.137), but there was a significant difference between erosive OLP and control group (P-value = 0.035). Fisher's exact test showed that there was no significant difference between the frequency distribution of staining patterns in three types of lesions (P-value = 0.90). Kruskal-Wallis test showed that there was no significant difference between the intensity of staining in the three groups (P-value = 0.19) and also there was no significant difference between the location of stained cells in different layers of the epithelium in the three groups (P-value = 0.90). Conclusions: The results of this study showed that in comparison of reticular OLP, erosive OLP, and the control group there was a significant difference just between erosive OLP and control group in the percentage of stained cells. [ABSTRACT FROM AUTHOR]

Introduction: The preparedness of the healthcare system to address emergency situations is contingent on the inclination of healthcare personnel. Nursing students can serve as valuable resources to supplement the workforce during major incidents and disasters. This study investigated the facilitators and barriers of nursing students' willingness to respond to disasters at the Alborz University of Medical Sciences in 2022. Methods: In this cross-sectional descriptive study, 234 nursing students were recruited using convenience sampling. A deductive-inductive questionnaire was developed and distributed through an online self-administered survey comprising demographic information and questions on barriers, facilitators, various disaster scenarios, preferred activities, and reasons for pursuing a nursing career. Results: The mean willingness scores of nursing students in response to various disasters were as follows: 3.15 for natural disasters, 2.60 for man-made disasters, 2.94 for pandemics, and 3.32 overall. Among the disaster scenarios, the earthquake response obtained the highest willingness score, while infectious disease epidemics received the lowest score. The most and least willingness to perform activities during disaster response were related to bedside care and participation in patients' personal hygiene, respectively. Key determinants of participation included the possibility of immunization and concerns for family safety. Conclusion: The findings indicated that nursing students are generally willing to assist as members of the healthcare team during disasters. However, the willingness to respond to infectious disease epidemics and man-made disasters was below the norm. Concerns about family health and the risk of disease transmission were identified as primary barriers. Addressing these concerns is crucial to enhance nursing students' participation in disaster response. [ABSTRACT FROM AUTHOR]

Introduction: In recent decades, E-learning has gained widespread recognition globally as a vital application of information and communication technology. Objectives: The present study investigated the effectiveness of non-attendance triage training based on the ESI-IV system on the knowledge and ability of pre-hospital emergency staff. Patients and Methods: This study was a semi-experimental interventional study, and the study population consisted of the pre-hospital emergency staff of Ahvaz university of medical sciences academic hospitals in 2021. The study tool was a questionnaire on the awareness and performance of the triage system of hospital emergency (ESI). Initially, both questionnaires were completed, and submitted the triage training file to the intervention group. Two weeks after the first phase—completion of the questionnaire for the first time— and the study of the file by the subjects, the questionnaire was completed again by the intervention group, and the data of both groups were compared. Results: According to the results, the mean of awareness and decision-making in the control group before and after the intervention was (11.8, 10.85, and 13.82) and (7.51, 7.36, and 8.86) respectively. The results indicate that non-attendance triage training based on the ESI-IV system was effective in the knowledge and ability of the pre-hospital emergency personnel had a positive and significant impact, and remains at a good level. Conclusion: The present results of the research indicate that the use of non-attendance training as an effective method can improve interns’ knowledge and ability. [ABSTRACT FROM AUTHOR]

Background. Granulomatous dermatoses, particularly on facial skin, pose a diagnostic challenge, as similar histologic patterns can be produced by different causes. Aim. To evaluate the correlation between clinical suspicion and histopathological findings in various facial granulomatous dermatoses. Materials and Methods. This retrospective, cross-sectional study included all patients with the histopathological diagnosis of facial granulomatous dermatoses from the years 2016 to 2021 in an academic hospital. Demographic, clinical, and histopathologic features were reviewed and analyzed. Results. In this study, 150 histopathological records with the diagnosis of facial granulomatous dermatoses from the years 2016 to 2021 were reviewed. The most common clinical diagnosis was rosacea 34 (23.6%), followed by sarcoidosis 27 (18.8%), leishmaniasis 15 (10.4%), and granulomatous rosacea 10 (6.9%). The frequency of clinical diagnosis of rosacea (70.6), sarcoidosis (66.7), foreign body G (62.5), TB (75), pseudolymphoma (75), acne agminata (66.7), and granulomatous rosacea (70) in female patients was higher than that in males (P value = 0.03). The effect of age on the type of both clinical and histopathological diagnosis was statistically significant (P value = 0.0001 and 0.004, respectively). Conclusion. Our study contributed significantly to the understanding of the clinicopathological aspects of facial granulomatous dermatoses and advocated for a multidisciplinary approach to the diagnosis and management of these complex skin conditions. [ABSTRACT FROM AUTHOR]

Background: Enterococcus faecalis has been widely used as a valuable microbiological pathogen for in vitro studies due to its ability to successfully colonize the root canal in a biofilm-like style, invade dentinal tubules, and resist endodontic treatment procedures. The aim of this study was to compare the bactericidal efficacy of photodynamic therapy (PDT), 2% chlorhexidine, 2.5% NaOCl, and combination of PDT and 2.5% NaOCl against E. faecalis. Materials and Methods: Sixty single-rooted teeth had their canals contaminated with E. faecalis in brain heart infusion broth and were incubated for 48 hours. The canals were then subjected to 2% chlorhexidine, 2.5% NaOCl, PDT (red light emitting diode 625 nm+ Toludine Blue) and PDT + 2.5% NaOCl. Controls consisted of no treatment (positive control) and without inoculation of bacterium (negative control). Following treatment, the canal contents were sampled with sterile paper points. The samples were dispersed in transport medium, serially diluted, and cultured on blood agar to determine the number of colony forming units (CFU). Data were analyzed by Mann-Whitney U test at 5% significance level. The significance level for all analyses was set at P <.05. Results: Combination of PDT and 2.5% NaOCl achieved maximum reduction in recovered viable bacteria, no viable bacteria was observed after treatment of PDT + 2.5% NaOCl. Conclusion: Combination of PDT and 2.5% NaOCl simultaneously is effective in the elimination of E. faecalis from dentinal tubules under the conditions of this study. [ABSTRACT FROM AUTHOR]

Background and Aims: This study aimed to collect reports and HIS in a web-based system due to the problems of paper recording of student activities in practical courses, as well as the lack of computers in the departments for observing graphs and treatment plans. Materials and Methods: The initial graphic design of the website was done after the assessment of needs and the necessary planning for designing the website. The main template of the website was designed after consulting with the faculty and the designer company. A combination of HTML, CSS, JQuery, and Java script was used for static coding and what the user sees or interacts with. Then, the basic information entered the website and the content designer put the website in the designed layout. In the end, a sample hosting space was prepared and the website was fully provided to the professors and faculty officials to work with as an administrator and a user. They conveyed all their opinions and the corrections were made based on the feedback given. Results: The use of the internet and software with a central database played a significant role in monitoring and evaluating the long-term information of the student and the evaluation of the entire department, universities, and patients in each region up to macro-national evaluations. This could give the expansion and advancement of science in addition to the central registration of documents and radiographs, as well as their ease to access. Conclusion: The designed website was well received among the students and the attending staff. Introducing a web based logbook and HIS system can optimize the clinical teaching. These logbooks could help both students and staff saving time and resources, and to facilitate providing better personalized care for patients. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to conduct a systematic review and meta-analysis to estimate the prevalence of needle-stick injury among Iranian nurses. Methods: We conducted a systematic review and meta-analysis to estimate the prevalence of needle-stick injury among Iranian nurses. A comprehensive search of Web of Science, PubMed, Scopus, Scientific Information Database, and MagIran was performed, yielding 29 observational articles comprising 8842 nurses. The studies ranged from 2006 to 2023, with sample sizes varying from 68 to 1555 individuals. Methodological quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. The pooled prevalence was calculated using the random-effects model, and subgroup analyses were conducted based on hospital type and gender. The data was analyzed using Stata software version 16. Results: The pooled prevalence of needle-stick injury among Iranian nurses was found to be 46% (95% Confidence Interval [CI]: 39-53%). Subgroup analysis revealed significant difference in prevalence between teaching hospitals (47%; 95% CI: 39-54%) and military hospitals (38%; 95% CI: 31.1-44%). The prevalence of NSI in region 1 (Tehran and surrounding provinces) and other regions was 45.1% (95% CI: 37-54%) and 49.17% (95% CI: 36.5-61.7%). Gender-based analysis showed higher prevalence in women (58%; 95% CI: 44-71%) compared to men (55%; 95% CI: 43-66%). Conclusion: Needle stick injuries has a high prevalence among Iranian nurses, especially nurses working in teaching hospitals. Therefore, it seems necessary to use interventions to reduce it. [ABSTRACT FROM AUTHOR]

Introduction: Effective performance in online education increasingly impacts the quality of classes and, consequently, student learning outcomes. This study aims to compare satisfaction levels and learning rates between online and face-to-face methods of teaching medical physiology. Material & Methods: This cross-sectional descriptive-analytical study involved 79 medical students divided into two groups. The first group received instruction on heart physiology (5 weeks, one session per week) online via the Navid system, while the second group received face-to-face instruction. At the study's conclusion, both groups underwent the same test to assess learning outcomes, and satisfaction with the teaching methods was evaluated through a questionnaire. Data analysis was conducted using Stata 14 statistical software, employing logistic regression and linear regression models. Results: The two groups differed in terms of the course studied, student nativeness, and satisfaction levels with the educational method. Satisfaction with online education was reported at 69%, compared to 65% for the face-to-face method. The average learning score for students in the online group was 12.93±0.12, while in the face-to-face group, it was 13.48±0.47. However, the linear regression model revealed no significant relationship between students' scores and specific educational methods (p=0.32). Significant relationships were observed between age, nativeness, and dormitory accommodation with satisfaction levels in online education. Conversely, none of the variables showed a significant relationship with satisfaction levels in face-to-face education. Conclusion: Both e-learning and face-to-face methods demonstrated relatively similar effects on students' learning outcomes. However, satisfaction levels with online education appear to be influenced by variables such as age, nativeness, and dormitory accommodation. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome causes a decrease in sexual function and health-promoting behaviors. The present study compared the effectiveness of emotionally focused therapy and cognitive-behavioral therapy on sexual function and health-promoting behaviors in women with polycystic ovary syndrome. Method: This semi-experimental study was carried out on women with polycystic ovary syndrome referred to the infertility clinic of Afzalipur Hospital in Kerman, in 2022. For this purpose, 45 patients were selected using convenience sampling and were then randomly placed into two experimental groups and one control group (15 people in each group). The experimental groups were subjected to the interventions of emotionally focused therapy and cognitive-behavioral therapy. The questionnaires on sexual function and promoting lifestyle were used. Data were analyzed using SPSS21 software and variance analysis. Results: Findings revealed that the cognitive-behavioral therapy of emotionally focused therapy had significant effects on sexual function and health-promoting behaviors (P<0.05). The comparison of two therapies revealed that the effectiveness of cognitive-behavioral therapy on sexual function and health promoting behaviors is more than emotionally focused therapy. Moreover, there was no statistically significant difference between post-test and follow-up scores (P>0.05), which shows the lasting effect of the interventions on sexual function and health promoting behaviors in mothers with polycystic ovary syndrome. Conclusion: According to the results, the use of cognitive-behavioral therapy can be more effective on sexual function and health-promoting behaviors in women with polycystic ovary syndrome. [ABSTRACT FROM AUTHOR]

Introduction: The Quality of Life (QOL) of couples with infertility can be affected by Irrational Thoughts (IT) regarding childbearing and it might be influenced by Religious Teachings (RT) as a mediator. The purpose of this study was to investigate the relationship between QOL and IT of childbearing with the mediating role of RT in couples with infertility in Shahrekord City, Iran. Method: This analytical correlational study was conducted among 196 couples with infertility who were referred to Shahrekord Infertility Center, Iran selected by a convenient sampling method. Data were collected using the questionnaires on QOL provided by the World Health Organization (WHO), IT designed by Flex and Religious Teaching. Results: The mean score of QOL was 76.42± 20.137, IT 32.20± 9.019 and RT was 150.84± 40.97. A significant relationship was found between the mean scores of QOL and IT of childbearing with the mediating role of RT in couples with infertility (P=0.001). Moreover, mean scores of study concepts had no significant relationship with demographic variables (gender, education, and infertility duration) among the participants. Conclusion: Based on the findings, the QOL of couples with infertility can be improved by strengthening the RT and reducing the IT of childbearing. [ABSTRACT FROM AUTHOR]

Background: Cardiomyopathy, characterized by heart stiffness, can lead to heart failure. This study aimed to investigate aortic stiffness in children with dilated cardiomyopathy (DCM) to better understand its contribution to disease severity. Methods: This case-control study compared 48 children with DCM with 96 healthy children over a 10-year period starting in 2011. Aortic strain, aortic stiffness index, aortic distensibility, and pressure strain elastic modulus were measured. These parameters, along with several echocardiographic measures, were compared between the DCM and control groups. Statistical analyses were performed using SPSS 18, with a significance threshold set at a P value below 0.05. Results: The participants included 57.6% boys, with 58.3% in the DCM group and 57.35% in the control group (χ² =0.014, P=0.905). The age range was 2 to 18 years, with mean ages of 11.08±4.63 years for the DCM group and 10.77±2.82 years for the control group (P=0.691). Significant differences between groups were observed in aortic distensibility (P=0.004), aortic stiffness β index (P=0.001), and pressure strain elastic modulus (P=0.004). Post-treatment analyses based on ejection fraction and fractional shortening cutoffs indicated no changes in elasticity parameters except for the aortic stiffness β index, which varied according to the Ross classification. Conclusion: Children with DCM exhibited reduced aortic strain and aortic distensibility, as well as elevated aortic stiffness β index and pressure strain elastic modulus. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine postoperative cardiac and noncardiac complications and their association with the use of cardiopulmonary bypass (CPB), surgical outcomes (length of hospital and ICU stays), dependence on mechanical ventilation, and mortality. Methods: This retrospective cross-sectional study was conducted on pediatric patients aged 0 to 18 who underwent open or closed cardiac surgery over a 1-year period. The use of CPB support, CPB duration, cardiac surgery complexity according to the risk-adjusted classification for congenital heart surgery (RACHS-1), and demographics were examined as potential risk factors associated with an increased number of postoperative complications. The study was performed at the Children's Medical Center, a teaching hospital affiliated with Tehran University of Medical Sciences in Iran. Results: A total of 283 surgeries were included in our study. Seventy-six (26.9%) of the study population experienced at least 1 complication. Our analysis revealed that increased CPB durations were associated with higher odds of cardiac complications, with an odds ratio of 1.02 (P=0.002). Moreover, higher RACHS-1 levels were significantly associated with greater numbers of cardiac and noncardiac complications. Additionally, prolonged mechanical ventilation and open-heart surgery intensive care unit (OH-ICU) stays were significantly associated with cardiac and noncardiac complications. Our logistic regression analysis found no association between demographic and clinical risk factors, the number of complications, and mortality. Conclusion: Postoperative complications occurred in 27% of pediatric heart surgeries. Prolonged mechanical ventilation and OH-ICU stays were significantly associated with cardiac and noncardiac complications. However, no significant association was found between postoperative complications and mortality. [ABSTRACT FROM AUTHOR]

Objective: Hospitals play a vital role in disaster management and their function must be maintained during crises. Isfahan province is susceptible to major crises and disasters at any time of the year. The study aimed to investigate the hospital safety index (HSI) in hospitals in Isfahan province. Methods: This cross-sectional study was conducted using the HSI questionnaire of the world health organization. The safety of all 55 hospitals in Isfahan province was evaluated with the Persian version of the questionnaire from 2017 to 2022. In this study, all hospitals were evaluated by a group of experts from the emergency operations center (EOC) of Isfahan University of Medical Sciences, and the checklists were completed with the cooperation of the hospital disaster committee, visiting the hospitals, and interviewing the personnel. Results: The safety level of hospitals has improved from 2017 to 2022 so in 2022, 38 hospitals (69.09%) had a high safety level, and 17 hospitals (30.91%) had a medium safety level. This increase in safety has happened in all three components of safety (functional, non-structural, and structural safety). There was no significant difference in the overall hospital safety score between academic-educational, non-academic governmental, social security and military, and private and charity hospitals (P<0.05). Conclusion: Although the safety in the hospitals of Isfahan province has improved due to the continuous disaster prevention and preparedness activities, hospitals still need to improve to achieve higher levels of safety. The HSI shows how well a hospital can maintain its organization and performance during disasters. This index will be useful for decision-making and policy-making to prioritize administrative and civil interventions. [ABSTRACT FROM AUTHOR]

Aim: Our objective was to assess the efficacy and safety of adding alpha-pinene (a herbal terpenoid) to quadruple therapy compared to a placebo in improving symptoms and Helicobacter pylori (H. pylori) eradication rates in Functional dyspepsia (FD) patients. Background: FD is a prevalent upper gastrointestinal condition, and no definitive pharmacological treatment is available for its management. Methods: We conducted a randomized, double-blinded, placebo-controlled trial on FD patients diagnosed with H. pylori infection. We collected baseline demographic data and assessed FD symptoms in the participants. Patients were randomly allocated to receive either standard quadruple therapy with α-pinene capsules (0.25 mg/day) or quadruple therapy with a placebo for two weeks. We employed a validated questionnaire, the Short Form Leeds Dyspepsia Questionnaire (SF-LDQ), to evaluate FD symptoms. The eradication rate of H. pylori was compared between the two groups one month after completing the treatment regimens. Any reported adverse drug reactions (ADRs) were documented throughout the trial. Results: Over four months, a total of 66 patients completed the trial. Notably, there were no significant differences in baseline SFLDQ scores between the two groups (p=0.83); however, a significant divergence emerged at the trial's conclusion (p=0.03). The H. pylori eradication rates did not show notable differences between the two treatment arms (p=0.43). Importantly, there were no dropouts from the trial due to ADRs. Among reported ADRs, participants experienced abdominal pain, headache, diarrhea, and a metallic taste, with no significant variance in incidence rates observed between the two groups (p=0.62). Conclusion: These findings suggest that α-pinene could be an effective and safe agent for reducing FD symptoms. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the impact of two different aerobic exercise programs on the Body Mass Index (BMI) and progranulin (PGRN) levels of overweight or obese female students. Methods: In this quasi-experimental study, 36 overweight or obese female students from Kashan University of Medical Sciences and Islamic Azad University volunteered to participate. They were randomly divided into three groups: two groups underwent progressively increasing interval or continuous aerobic exercise programs, while the third group served as a control. The exercise programs lasted for 8 consecutive weeks, with blood samples collected before and after the intervention. Progranulin levels were measured using the ELISA technique with Human PGRN, and BMI was assessed at the beginning and end of the program. Results: The results of a one-way ANOVA test showed a significant decrease in progranulin levels (P=0.00) and BMI in both exercise groups compared to the control group (P=0.029). Conclusion: Both interval and continuous aerobic exercise programs were effective in reducing circulating progranulin levels and BMI in overweight or obese female college students. The exercise interventions led to a significant decrease in both variables. Further research is warranted to explore the effects of different aerobic exercise protocols on BMI and progranulin levels in normal adults. [ABSTRACT FROM AUTHOR]

Background: In 1995, teaching and public hospitals that are affiliated with the ministry of health and medical education (MOHME) in Iran were granted financial self-sufficiency to practice contract-based relations with insurance organizations. The so-called "hospital autonomy" policy involved giving authority to the insurance organizations to purchase health services. The policy aimed at improving hospitals' performance, hoping to reduce government's costs. However, the policy was never implemented as intended. This was because most participating hospitals gave up to implement autonomous financing and took other financing pathways. This paper analyses the reasons for the gap between the intended policy and its execution. The lessons learned from this analysis can inform, we envisage, the implementation of similar initiatives in other settings.Methods: We conducted semi-structured interviews with 28 national and 13 regional health policy experts. We also gathered a comprehensive and purposeful set of related documents and analyzed their content. The qualitative data were analyzed by thematic inductive-deductive approach.Results: We found a number of prerequisites and requirements that were not prepared prior to the implementing hospital autonomy policy and categorized them into policy content (sources of funds for the policy), implementation context (organization of insurance organizations, medical tariffs, hospitals' organization, feasibility of policy implementation, actors and stakeholders' support), and implementation approach (implementation method, blanket approach to the implementation and timing of implementation). These characteristics resulted in unsuitable platform for policy implementation and eventually led to policy failure.Conclusions: Autonomy of teaching hospitals and their exclusive financing through insurance organizations did not achieve the desired goals of purchaser-provider split in Iran. Unless contextual preparations are in place, hospital autonomy will not succeed and problematic financial relations between service providers and patients in autonomous hospitals may not be ceased as a result. [ABSTRACT FROM AUTHOR]

Background: Clinical advice may suggest discontinuing breastfeeding after the diagnosis of phenylketonuria in infants as the only effective way to monitor the newborn's intake and accurate measurement of phenylalanine (Phe). This study aims to investigate the prevalence and duration of breastfeeding, as well as its effect on serum Phe levels in infants with phenylketonuria at Education and Therapy Medical Center, Be'sat Hospital, Iran. Methods: We conducted a cross-sectional study of 34 children under two years old diagnosed with phenylketonuria between September 2018 and December 2022. Infants were categorized as breastfed and non-breastfed (bottle-fed) based on their feeding method after diagnosis. Data on age at diagnosis, medical records, demographic information, and anthropometric indices were collected, and infants with incomplete data or mixed feeding (formula + breast milk) were excluded from the study. Results: Of 94 infants managed in our hospital, 34 had complete medical records. Among the all patients 13 (38%) continued to be breastfed combined with phenylalanine-free amino acid-based protein substitute, while 21 (62%) were did not receive breast milk. The mean duration of breastfeeding was 2.57 ± 0.59 (1–3) months. The mean age at diagnosis was 22.6 ± 18.4 days. Phenylalanine concentrations at diagnosis were mean 10, SD 5.44; range 4–24 mg/dL [0.22–1.33 μmol/L] in the breastfed group and mean 14.3, SD 10.2; range 5–37 mg/dL [0.27–2.05 μmol/L] in the non-breastfed group.Non-breastfed infants had lower serum Phe levels than breastfed infants: mean 3.76, SD 2.10; range 1–7 mg/dL [0.05–0.38 μmol/L] and mean 4.89, SD 3.68; range 2–19 mg/dL [0.11–1.05 μmol/L], respectively, although not statistically significant [(t (34) = 118.0, P = 0.51]. Also we found no significant associations in body measurements for weight, height, and head circumference at birth and final assessment. Conclusions: In conclusion, during treatment, there were no statistically significant associations between breastfeeding and serum Phe levels with growth in children with phenylketonuria. [ABSTRACT FROM AUTHOR]

Background: Despite the widespread use of extracorporeal shock wave lithotripsy (ESWL) as a treatment for kidney stones, it is essential to apply methods to control pain and improve patient comfort during this procedure. Therefore, this study aimed to investigate the effect of acupressure at the Qiu point on pain intensity and physiological indices in patients undergoing ESWL. Methods: This randomized, sham-controlled clinical trial was conducted at the Shahid Beheshti Educational-medical Center in Hamadan City (western Iran) from May to August 2023. Seventy-four eligible patients were split into intervention (n = 37) and sham (n = 37) groups. Ten minutes before lithotripsy, the intervention group received acupressure at the Qiu point, while the sham group received touch at a neutral point. The primary outcomes were pain intensity measured by the Visual Analog Scale (VAS) and physiological indices such as blood pressure and heart rate at baseline, 1, 10, 20, 30, 40, and 50 min after the intervention. The secondary outcomes included lithotripsy success and satisfaction with acupressure application. Results: The analysis of 70 patients showed no significant differences in the demographic and clinical information of the patients across the two groups before the study (P > 0.05). Generalized estimating equations revealed that the interaction effects of time and group in pain and heart rate were significant at 30 and 40 min (P < 0.05). The results of this analysis for systolic blood pressure revealed a significant interaction at 30 min (P = 0.035). However, no significant interaction effects were found for diastolic blood pressure changes (P > 0.05). Conclusions: Acupressure at the Qiu point positively impacts pain in patients undergoing ESWL treatment and increases their satisfaction. However, these results for physiological indices require further studies. Thus, acupressure can be considered a simple, easy, and effective option for pain management in patients during this procedure. Trial registration: [https://en.irct.ir/trial/69117], identifier [IRCT20190524043687N4]. [ABSTRACT FROM AUTHOR]

Background: Ensuring patient safety is of paramount importance in healthcare services. Sleep disorders not only have detrimental effects on the health of healthcare students but also significantly impair their performance, leading to an increased risk of medication errors. These errors can pose a grave threat to the safety and well-being of patients. It is crucial to address and mitigate sleep disorders among internship healthcare students to safeguard the quality of care and minimize potential patient harm. Objectives: This study aimed to investigate the predictors of Patient Safety Competency (PSC) based on the sleep quality of internship healthcare students. Methods: A study was conducted on 331 students from the Ardabil School of Nursing and Midwifery at Ardabil University of Medical Sciences in northwest Iran from August to December 2022. The participants were selected by stratified random sampling. Data were collected using a demographic information form, the Pittsburgh Sleep Quality Index (PSQI), and the Health Professional Education in Patient Safety Survey (H-PEPSS). The collected data were analyzed using SPSS software version 22.0. Person correlation coefficients were used to examine the relationship between PSC level, its dimensions, and sleep quality, while multiple linear regression was conducted to identify the predictors of PSC. Results: The competency of nurses in patient safety was average in both classroom and clinical settings. However, their ability to work as a team with other healthcare professionals scored the lowest. In addition, the quality of sleep was found to be a predictor of patient safety competency among healthcare students during their internships. Conclusions: It is important to note that healthcare students tend to have moderate patient safety competence (PSC), which is positively correlated with their sleep quality. Therefore, it is vital to identify the key factors that directly affect PSC. This would enable nursing and midwifery faculty administrators to take preventive measures to enhance patient safety competence in both classroom and clinical settings. Additionally, organizing educational workshops that engage students and improve their sleep quality could improve patient care. Practical courses are recommended for health professionals and students in clinical settings to enhance patient safety competencies. Additionally, student internships should receive hands-on training to improve teamwork and rest conditions. [ABSTRACT FROM AUTHOR]

Background: Patients with Acute Coronary Syndrome (ACS) experience high levels of anxiety that may cause instability of hemodynamic indices, increased risk of ischemia, myocardial infarction and poor quality of life. Aromatherapy can affect patients' anxiety levels and improve hemodynamic indices. This study aimed to evaluate the efficacy of aromatherapy on anxiety and hemodynamic indices in ACS patients. Methods: This study was a double-blind, randomized clinical trial conducted on 154 ACS patients. The participants were classified into two equal groups of intervention and placebo through the block randomization method. The data collection tools consisted of demographic information, a shortened 6-item version of the Spielberger questionnaire and a form of hemodynamic indices. For two consecutive nights, the intervention group inhaled 7 drops of the chamomile essential oil (%10) and the placebo group inhaled 7 drops of the sesame oil poured on a sterile cotton ball. The hemodynamic indices were collected half an hour before, one and four hours after the intervention until the next morning. The Spielberger questionnaire was completed once before the intervention and once after the end of the intervention, by the researcher through an interview. The number of heart rate (HR) was counted for a full minute. Also, the blood pressure (BP) of all the samples was measured by the researcher. Data analysis was done using Chi-square, paired t-test, and analysis of variance (ANOVA) in SPSS22. Results: The mean and standard deviation of the age of patients were 58/2 ± 11.6 and 59.7% of them were female. The results of ANOVA showed a significantly lower anxiety score as well as systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR in the intervention group compared to those of the placebo group (P < 0.001). The decrease in anxiety score after the intervention, in the intervention and placebo groups was (5.2 ± 1.9) and (1 ± 1. 18) respectively. In the intervention group, the SBP and DBP after the intervention, was significant (P < 0.05). Also, the HR was significant (P < 0.001) after the intervention. Conclusions: Aromatherapy could reduce anxiety and improve hemodynamic indices in ACS patients. Trial registration: IRCT20080825001083N11. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization has introduced two sets of child growth standards for growth assessment. These reference values may not be suitable for use in other populations. Therefore, this study aimed to determine specific Z scores in the population covered by Mashhad University of Medical Sciences in Iran. Methods: This cross-sectional study was conducted on data obtained from the evaluation of height, weight, and head circumference of children aged from 0 to 18 months visiting the healthcare centers of Mashhad University of Medical Sciences from March 2018 to March 2021. A total data of 128,472 children were extracted from the Electronic Health Records (SinaEHR®) and included in the study. Finally, the collected data were analyzed using Minitab and SPSS software (version 16). Results: The L, M, and S parameters were used to calculate Z scores for weight, height, and head circumference. These Z scores were then compared to standard deviation values for each age from our study and international standards to determine any differences. Our study found that mean weight scores were 0.16 kg higher than the CDC standard and 0.34 kg higher than the WHO growth standard. Conclusion: The provision of this exclusive reference to children's growth indicators not only allows for a more accurate evaluation but also provides the possibility of comparison with other populations using their specific growth charts. It seems that one of the best plans is to compare growth charts with international populations and national growth charts, which due to the electronization of the entire processes of the health system, is more possible than ever. [ABSTRACT FROM AUTHOR]

Background: Obesity is considered a widespread concern internationally. Few studies have investigated the relationships between dairy consumption and hypertension and obesity. Therefore, this study examined the above concern in students. Methods: This cross-sectional study was conducted on 292 male students (18--30 y) living in the dormitories of Tabriz University of Medical Sciences. Students were selected via the multistage stratified random sampling method. Demographic information, anthropometric measurements, blood pressure (BP) readings, and a semi-quantitative validated questionnaire assessing dairy consumption (including a 24-hour dietary record covering 2 typical days and a holiday) were collected. After all the questionnaires were reviewed, they were coded and analyzed with Nutritionist IV software. Results: The average age of the subjects was 22.36 years. The mean±SD values of body mass index (BMI), waist circumference, waist-to-hip ratio, and waist circumference-to-standing height ratio were 22.68±2.58 kg/m², 80.95±7.81 cm, 0.85±0.04, and 0.46±0.04 among the studied population, respectively. The mean±SD values of systolic and diastolic blood pressure were 111.84±10 mm Hg and 70.99±8 mm Hg, respectively. Milk consumption was associated with a low waist circumference (95% credible interval, 1.005 to 4.580; P=0.046). The odds of hypertension (defined as BP>120/90 mm Hg) were 2.686 times higher in the overweight and obese group than in the normal BMI group. The risk of hypertension was 1.045 times higher for individuals with abdominal obesity than for those who did not consume dairy products. Conclusion: Milk consumption was associated with a low waist circumference. The correlations between systolic blood pressure and anthropometric factors were statistically significant. BMI, waist circumference, and waist-to-hip ratio were positively associated with systolic blood pressure. [ABSTRACT FROM AUTHOR]

Objective In recent years, the infant development and assessment programs have received attention by the health system of Iran. In this regard, the training of examiners for performing the Bayley tests has become one of the needs of the health system. This study aims to design and evaluate the validity and reliability of the Bayley-III examiner clinical performance scale. Materials & Methods In this study, participants were Bayley-III test examiners from medical universities in Iran, who were selected using a purposive sampling method. First, in focused group discussion sessions with 10 Bayley-III test experts, the items of instrument were formulated. Then, to evaluate the face validity, the questionnaire was sent to a panel of expert consisting of 8 Bayley-III experts and examiners and they were asked to rate the items from 1 to 5 in terms of importance. The items with an impact score of less than 1.5 were deleted, and other items were revised, if needed. To evaluate content validity, the questionnaire was sent to 10 Bayley-III test experts, and then the content validity ratio (CVR) and content validity index (CVI) were measured. The items with CVR <0.6 and CVI <0.7 were deleted. The reliability of the instrument was assessed by calculating the inter-rater reliability, test re-test reliability, and internal consistency. Quantitative data analysis was done in SPSS software, version 22. Results The instrument with 66 items, including 32 items for the cognitive domain, 22 items for the language domain (13 for receptive and 9 for expressive components), 12 items for the motor domain (9 for fine and 3 for gross motor skills), and 14 items for the general section, was assessed in stability and reliability. The intraclass correlation coefficient (ICC) for the test re-test reliability was obtained 0.83 for the specific section and 0.86 for the general section. The ICC for the inter-rater reliability was 0.80 (95% CI: 58-82). The highest correlation value was related to the cognitive scale (0.88), and the lowest value was for the gross motor skill subscale (0.76). The kappa coefficient for the inter-rater reliability of the general section was above 0.7. The kappa coefficient for the specific section ranged from 1 to 0.35. The Cronbach’s α for the internal consistency of the general section was 0.76. Conclusion The designed questionnaire is a valid and reliable tool to evaluate the clinical performance of Bayley-III test examiners in Iran. [ABSTRACT FROM AUTHOR]

Introduction: Due to the increasing incidence of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in the world, it is necessary to examine the level of knowledge among different parts of population, especially among students, in order to establish remedial preventive interventions. Therefore, the aim of this study was to determine the knowledge, attitude, and practice of dormitory students of Shahid Sadoughi University of Medical Sciences in Yazd towards HIV/AIDS. Material and methods: This descriptive, cross-sectional study was performed among 658 dormitory students of Shahid Sadoughi University of Medical Sciences in 2019, who were recruited through multistage sampling. A valid and reliable questionnaire was used to collect students' data. SPSS version 22 was employed to analyze the data. Results: In total, 59.9% of students had high knowledge level. There was a significant association between students' knowledge and gender, field of study, and grade point average of the last half year. Positive/neutral attitude was observed among 77.7% of the students. Age and sex had a significant association with attitude. A total of 32 students (4.9%) had experienced extra-marital sex, and 9.4% of them were condom ever users during sexual contacts. Conclusions: The results revealed relatively high knowledge and neutral to positive attitude about HIV/AIDS among dormitory students. However, preventive measures among participants with highrisk behaviors were not properly employed. [ABSTRACT FROM AUTHOR]

Introduction: Nurses who are at the forefront of the fight against Covid-19 have faced problems such as anxiety and stress due to the high contagiousness of this disease and the challenges of providing services to infected patients. Death anxiety and the resulting fear following the Covid-19 pandemic can affect caring behaviors and the quality of nursing care services. Objective: The present study was conducted with the aim of determining the association between caring behaviors and death anxiety among Iranian nurses working in COVID-19 wards. Methods: This cross-sectional study was conducted in 2021 in Tehran. The participants consisted of 233 nurses who were purposively selected from university hospitals in Iran. Data collection tools included Demographic Information Form, Death Anxiety Scale, and Caring Dimension Inventory (CDI-25). Data analysis was done using SPSS (version 16). Results: Most of the participants were female (79.4%), had less than 5 years of work experience (50.6%), and had bachelor's degree (88.8%). Based on the results, the level of death anxiety among nurses was moderate (7.05 ± 3.85) and their caring behavior was at optimal level (103.03 ± 13.15). Among the subscales of caring behavior, physical-technical behaviors with mean of 46.43 ± 6.20 got the highest score, and unnecessary behaviors with mean of 4.39 ± 0.73 got the lowest score compared to other subscales. Based on data analysis findings, caring behavior and its dimensions had no significant correlation with nurses' death anxiety (p = 0.111). Conclusions: Our results showed that despite having a moderate level of anxiety, nurses try to provide good care behaviors to patients with covid-19. However, reducing nurses' anxiety can improve caring behaviors. [ABSTRACT FROM AUTHOR]

Developing an anesthesia module in the operating room is one of the significant steps toward the implementation of electronic medical records (EMR) in health care centers. This study aimed to develop and evaluate the web based-anesthesia module of an electronic medical record Sciences, in the operating room of the Namazi Medical Training Center of Shiraz University of Medical Iran. This developmental and applied study was conducted in steps including determining the functional and non-functional requirements, designing and implementing the anesthesia module, and usability evaluation. 3 anesthesiologists, 3 anesthesiologist assistants, and 12 anesthetist nurses were included in the study as a research community. React.js, Node.js programming language to program this module, Mongo dB database, and Windows server for data management and USE standard questionnaire were used. In the anesthesia module, software quality features were determined as functional requirements and non-functional requirements included 286 data elements in 25 categories (demographic information, surgery information, laboratory results, patient graphs, consults, consent letter, physical examinations, medication history, family disease records, social record, past medical history, type of anesthesia, anesthesia induction method, airway management, monitoring, anesthesia chart, blood and fluids, blood gases, tourniquets and warmers, accessories, positions, neuromuscular reversal, transfer the patient from the operating room, complications of anesthesia and, seal/ signature). Also, after implementing the anesthesia module, results of the usability evaluation showed that 69.1% of the users agreed with the use of this module in the operating room and considered it user-friendly. [ABSTRACT FROM AUTHOR]

Introduction: The breast cancer burden is still increasing, both in developing and developed countries. The present study was conducted to determine the survival rate of breast cancer based on tumor biological subtypes in patients referring to three referral oncology centers at Mashhad University of Medical Sciences, Mashhad, Iran. Methods: The present population-based study was conducted at Imam Reza Hospital, Omid Hospital, and Reza Oncology Center, Mashhad University of Medical Sciences, Mashhad, Iran Demographic information, the status of biomarkers in immune-histochemical evaluation, clinical and pathological features of the tumor, type of therapy, recurrence, or death was recorded for each eligible patient. Results: In total, 247 patients were included in the study. The mean age of patients was 48.8 ± 1.3 years. The mean time of survival was 2.64±0.13 years. In detail, the survival rate from the first year to the fifth year was reported as 100%, 96%, 91%, 90%, and 89%, respectively. The survival rate of the luminal B subtype was higher than other subtypes but the difference was not significant (P=0.7). Only in terms of metastasis, there was a significant difference between the alive and dead patients (P=0.0001). Conclusion: Despite no significant relationship between biological markers, the breast cancer subtype, and its survival rate, the overall survival rate of the patients decreased lightly through five years. However, further studies are required to indicate more accurate data about the breast cancer survival rate in our region. [ABSTRACT FROM AUTHOR]

Hydatidosis, caused by Echinococcus granulosus is one of the most important zoonotic diseases, throughout most parts of the world. Hydatidosis is endemic in Iran and responsible for approximately 1% of admission to surgical wards. There are extensive genetic variations within E. granulosus and 10 different genotypes (G1-G10) within this parasite have been reported. Identification of strains is important for improvement of control and prevention of the disease. No new review article presented the situation of Echinococcus granulosus genotypes in Iran in the recent years; therefore in this paper we reviewed the different studies regarding Echinococcus granulosus genotypes in Iran. [ABSTRACT FROM AUTHOR]

Background: Residence characteristics can affect health of residents. This paper reports the development of an instrument assessing these aspects of neighborhoods. Materials and Methods: Literature search and focus group discussions with residents were carried out and relevant items were extracted. Five experts reviewed and commented on the items. An observation instrument with 54 items was composed and completed by two independent observers in 20 randomly selected locations. Due to lack of acceptable reliability in some items, the checklist was revised. The new 22-items checklist in four categories (general characteristics, public green area characteristics, access to services and undesirable features) was completed by two independent trained observers in 28 randomly selected locations. Results: The items in the final checklist had kappa statistics ranging from 0.63 to 1, with an exception of the item assessing “presence of beggars, homeless or working/street children”, with kappa as low as 0.27 due to variability of their presence in different times. Average Kappa statistics was 0.78 for general characteristics, 0.79 for public green area characteristics, 0.84 for access to services, and 0.54 for undesirable features. Conclusion: Neighborhood and health observation instrument seems to have good reliability in city of Tehran. It can probably be used in other large cities of Iran and similar cities elsewhere. [ABSTRACT FROM AUTHOR]

Purpose: Multiple sclerosis is an autoimmune disease with a very high prevalence all over the world in recent years. Therefore, this research intended to examine the impact of resistance and aerobic exercises on selected functional capacities and cognitive indicators in depressed women with multiple sclerosis (MS). Methods: The current study was semi-experimental with a pre-test and post-test design. In this survey, 30 women with MS (25-50 years old) with an expanded disability status scale range between 0-5.5, and depression among those who visited the neurology clinic at Guilan University of Medical Sciences (Bethat) were selected. The study included a control group (n=10) and two intervention groups: resistance (n=10) and aerobic (n=10) exercises. To evaluate the variables of stress, depression, fatigue, and functional capacities, the following questionnaires and tests were used: Perceived stress scale, Beck's depression inventory, fatigue severity scale, 10-meter walk test (10MWT), 6-minute walk test (6MWT), timed up and go (TUG), and 30-second chair stand (30 CST) tests. Exercises of aerobic were done at an intensity of 40_60% of the maximum rate of heart for 10-30 minutes. Home-based resistance training, including a hypertrophy phase (four weeks), and strength and power phase (four weeks) was conducted at an intensity of 0.5-1.5% of the subjects' body weight. The duration of the training for both groups was eight weeks. The data were analyzed by repeated-measures two-way ANOVA by SPSS software, version 26. The significance level was set at 0.05. Results: Both resistance and aerobic training had a significant intra-group impact on various factors (P=0.05). Specifically, perceived stress (P=0.01) and depression level (P=0.001), and 10- MWT (P=0.01), 6MWT (P=0.001), and 30 CST (P=0.001) results showed statistically notable improvements. Regarding the inter-group effect, notable dissimilarities were seen in depression and functional strength of lower limbs (30 CST) among the three groups (P=0.05). Noteworthy, variations were also found in fatigue and the timed up-and-go test. Conclusion: Both aerobic and resistance exercises can be considered effective interventions for improving depression, perceived stress, and functional capacity in individuals with MS. [ABSTRACT FROM AUTHOR]

Introduction: Prevention of acquired immune deficiency syndrome (AIDS) requires proper awareness and attitude towards the disease, and ways of transmission and prevention. This study aimed to investigate the awareness and attitude of students at Kurdistan University of Medical Sciences and University of Kurdistan towards AIDS in 2020. Material and methods: This was cross-sectional, descriptive-analytical study. The study population was students at Kurdistan University of Medical Sciences (MUK) and University of Kurdistan (UOK) in 2020. 369 students were selected based on relative sampling. Data collection tool was international AIDS questionnaire (IAQ). Independent t-test and analysis of variance were applied for analysis. Results: The total IAQ score among students of MUK (75.38 ± 7.66) was higher than that of UOK students (71.17 ± 8.52) (p = 0.023). Although the total score in men (74.04 ± 8.14) was slightly higher than women (72.71 ± 8.50), there was no significant difference (p = 0.13). The difference in the scores of students living in single house with students living with their parents (p = 0.002) and students living in dormitories (p = 0.006) was statistically significant. The average score of undergraduates was the lowest, and doctorates the highest (p = 0.035). Conclusions: In light of the need to increase the awareness of ways of AIDS transmission, and appropriate attitudes towards people living with HIV/AIDS, with a focus on non-medical students, schemes should be designed and implemented to raise awareness and attitudes among people. [ABSTRACT FROM AUTHOR]

Background: Nurses significantly contribute to the healthcare system, constituting the highest number of healthcare staff. A positive attitude or mindset at work increases the ability to carry out the organization's duties, tasks, and plans. This study investigates the relationship between work effectiveness and work engagement of nurses in the selected hospitals affiliated with Iran University of Medical Sciences (IUMS), Tehran City, Iran, in 2021. Methods: This descriptive cross-sectional study has employed a correlational design. A total of 255 nurses working in selected hospitals affiliated with IUMS were recruited through proportionate stratified sampling. The study data were collected using the utrecht work engagement scale (UWES) and conditions for work effectiveness questionnaire II (CWEQ-II). Statistical analyses involved descriptive statistics, the independent t-test, analysis of variance, the Pearson correlation, and regression in SPSS software, version 22. The significance level was set at P<0.05. Results: The Mean±SD work effectiveness among nurses was found to be 37.31±7.41, indicating their medium-to-high work effectiveness. Also, their Mean±SD work engagement was 68.96±15.48, indicating the high work engagement of nurses. There was also a significant positive relationship (r=0.656, P<0.001) between the total work effectiveness score and work engagement. The results showed that the "support" dimension of work effectiveness exhibited the highest correlation with work engagement (r=0.606, P<0.001). Also, the "absorption by work" dimension of work engagement had the highest correlation with work effectiveness (r=0.653, P<0.001). Conclusion: According to the study results, increasing the work effectiveness of nurses necessitates the creation of a positive attitude and perspective through managerial actions. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to investigate perception and engagement in unprofessional behavior of residents and medical interns and explore the factors affecting their engagement in unprofessional behavior. Method: This study has an explanatory (quantitative-qualitative) mixed-method design. This study was conducted at Shahid Sadoughi University of Medical Sciences in 2022–2023. Participants, including residents and medical interns (n = 169), were entered by stratified random sampling. A survey was conducted in the quantitative step. A by an unprofessional behavior in clinical practice questionnaire (29 items) was used. For each behavior, the participants were asked to report whether they (a) participated in the behavior and (b) stated that the behavior Is unprofessional. In the qualitative step, 17 participants contributed. The qualitative data were collected by semi-structured interviews and analyzed according to the conventional content analysis approach Graneheim and Lundman introduced. Results: The highest ratio of participants' engagement in unprofessional behavior was reported in 'failure to introduce yourself and nurses and physician assistants to the patient and his family' (n = 145 (85.8%)). The results showed the proportion of participants who engaged in unprofessional behavior more than those who did not participate. There were associations between participants' engagement in each behavior and their perception of that particular behavior as unprofessional. (p = 0.0001). In the following behaviors, although the participants acknowledged that these behaviors were unprofessional, those who participated in the unprofessional behaviors were significantly more than those who did not participate: failure to comply with clinic regulations and policy (p = 0.01), eating or drinking in the hallway of the clinic (p = 0.01), medical negligence in duties in the clinic setting (p = 0.04) and failure to perform duties in teamwork (p = 0.04). The qualitative results were explored in a theme entitled "internalized unprofessional culture," including three categories "encouraging contextual risk factors towards unprofessionalism," "suppressing of unprofessionalism reporting," and "disbelieving professionalism as a key responsibility." Conclusion: The results indicated that most participants engaged in unprofessional behaviors. The findings resulted from the internalized unprofessional culture in the workplace. The findings showed that engagement in unprofessional behaviors resulted from personal and systemic factors. The weakness of responsibility recognition and identity formation as a professional facilitated the engagement in unprofessional behaviors at the personal level. Furthermore, systemic factors including the contextual risk factors (such as deficiency of explicit and hidden curriculum), and the suppression of unprofessionalism reporting mechanism as a hidden factor played an important role in normalizing unprofessional behavior and promoting engagement in unprofessional behaviors among the participants. Recognition of the nature and extent of students' unprofessional behaviors facilitates educational discussion among teachers and students in this field. The results might assist to establish an assessment system and feedback mechanism to solve the problem of the "failure to fail" problem. In addition, these results provide medical educators insights into the development of professional courses that equip learners with adherence to professionalism and coping skills to deal with unprofessionalism in the healthcare system. [ABSTRACT FROM AUTHOR]

Introduction: Recurrent Pregnancy Loss and Recurrent Implantation Failure are major limiting factors in the establishment of pregnancy. Recurrent Pregnancy loss is defined as the failure of two or more clinically recognized pregnancies. A considerable proportion of infertile couples undergoing IVF treatment experiencing recurrent implantation failure (RIF) fail repeatedly to implant following at least three IVF cycles. MicroRNAs (miRNAs) can serve as reliable non-invasive diagnostic and prognostic biomarkers for pregnancy-related complications. Therefore, this study aimed to quantify miR-23a-3p expression level in the plasma of patients with idiopathic recurrent pregnancy loss (iRPL) and recurrent implantation failure compared to healthy subjects to evaluate its potential diagnostic value in iRPL and RIF patients. Material & Methods: This study is a cross-sectional descriptive study. A total of 120 plasma samples were obtained from 40 women with a history of at least two consecutive iRPL, 40 women with RIF, and 40 healthy women without a history of miscarriage to evaluate the expression level of the circulating miR-23a-3p by quantitative real-time polymerase chain reaction (qPCR) technique. All participants were recruited from Assisted Reproductive Technology (ART) and Stem Cell Research Center, Tabriz, Iran, September 2019-March 2020. Statistical analysis was performed using SPSS (version 22). Diagnostic efficiency of the circulating miRNAs was determined by Receiver Operatig Characteristic curve analysis using Graphpad Prism version 9.1.1. Findings: Our results showed that the miR-23a-3p expression level in plasma of iRPL patients was lower than those in healthy controls but without a statistically significant difference (P=0.113). We also found that miR-23a-3p plasma level in patients with RIF tended to be lower compared to healthy participants; however, it was not statistically significant (P=0.974). Discussion & Conclusion: The current study provides evidence indicating that downregulation of miR-23a-3p may be associated with iRPL and RIF. Therefore, further research is needed, such as using different geographic regions, large sample sizes, and other techniques (microarray). [ABSTRACT FROM AUTHOR]

Introduction: Squamous cell carcinoma accounts for about 90% of head and neck cancers. The present study aimed to investigate the epidemiology and anatomical involvement pattern of squamous cell carcinoma (SCC) in the head and neck region from 2013-2021 in Imam Khomeini Hospital, Kermanshah, Iran. Material & Methods: This descriptive cross-sectional study was conducted on all the patients with SCC of the head and neck treated at Imam Khomeini Medical Center in Kermanshah over a period of 10 years. Demographic and pathological information was extracted from the patients' medical records. Then, the obtained data was analyzed in SPSS software (version 23). Findings: Out of 299 patients identified with SCC, 236 (78.9%) were male, and the remaining were female. The majority of the patients (48.8%) fell within the age group of 55-72 years, with 57.9% reporting a history of smoking and 76.9% residing in urban areas. Among those studied, the most commonly affected site was the larynx, accounting for 49.5% (148) of cases. The highest incidence of head and neck cancers in both men and women was observed in 2019, with 15.9% and 15.7% of cases, respectively. Discussion & Conclusion: The results of this study showed that most patients were older men over 50, who mostly lived in the city and smoked. The most anatomical site of involvement was the larynx. Therefore, it is recommended to pay attention to these risk factors to prevent and control these cancers. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the psychometric properties of the Persian version of the Cambodian Nursing Care Quality Scale. Design: Methodological design. Methods: This study was carried out in several steps: a forward‐backward translation was done, face and construct validity was measured using exploratory and confirmatory factor analysis and the reliability was evaluated. A convenience sampling method was employed to recruit 350 nurses from May 2021 to March 2022. Results: The exploratory factor analysis extracted six factors that explained 60.76% of the total variance. The six‐factor model is supported by confirmatory factor analysis. The Cronbach's alpha and the intra‐class correlation coefficient were 0.94 and 0.85, respectively. Patient or Public Contribution: Evaluation of the quality of care can lead to the enhancement of the quality of nursing services and patient safety. This will subsequently increase the patients' and community satisfaction. [ABSTRACT FROM AUTHOR]