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Background: To achieve the highest possible level of health for individuals and societies involved in the crisis, a high level of individual and professional competency is needed in nurses for their active participation in the crisis. The acquisition of professional qualifications by nurses to provide care in the crisis is very important. The present study aimed to determine the effect of disaster and accident response training on the enhancement of professional competence of nurses in response to the crisis. Materials and Methods: This research was a quasi-experimental study with pre-test, post-test design. The statistical population consisted of all nurses working in Shahid Chamran Hospital in Saveh City, Iran, in 2017. In total, 80 nurses were selected through the convenience sampling method and were randomly divided into the intervention and control groups. The intervention group received training through lectures and workshops for 16 hours in 4 days. The samples completed a professional nursing competency assessment questionnaire before and one month after the intervention. The obtained data were analyzed by the Chi-squared test, Fisher's exact-test, Independent samples t-test, and Paired samples t-test in SPSS. Results: The findings revealed no significant difference between the two groups concerning demographic variables. After the intervention, the average improvement of professional competence of nurses in their ability to manage the accident scene increased from 63.3 to 74.07, teamwork skill from 56.7 to 74, individual specific abilities from 61.4 to 70, ethical performance from 67.8 to 76.9, and professional skills from 54 to 60. The Mean±SD pretest score of professional competency of nurses in the intervention and control groups were 163.5±28.6 and 155.73±34, respectively. After the intervention, these scores increased to 185.13±28.8 and 158.48±33.3 in the intervention and the control groups, respectively. The difference was statistically significant in the intervention group (P<0.001). Conclusion: The findings of this study indicated that the competence of nurses to provide care in crises was not at a desirable level. Thus, assessing the competence of nurses and identifying the gaps in their knowledge and skills before attending crises is essential. Also, the incident and disaster education can dramatically increase nurses' professional competence in responding to the crisis. Therefore, we suggest the method used in this study as a feasible, simple, low cost and effective method in this regard. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to evaluate a smartphone-based online electronic logbook used to assess the clinical skills of nurse anesthesia students in Iran. Methods: This randomized controlled study was conducted after tool development at Ahvaz Jundishapur University of Medical Sciences in Ahvaz, Iran from January 2022 to December 2022. The online electronic logbook involved in this study was an Android-compatible application used to evaluate the clinical skills of nurse anesthesia students. In the implementation phase, the online electronic logbook was piloted for 3 months in anesthesia training in comparison with a paper logbook. For this purpose, 49 second- and third-year anesthesia nursing students selected using the census method were assigned to intervention (online electronic logbook) and control (paper logbook) groups. The online electronic logbook and paper logbook were compared in terms of student satisfaction and learning outcomes. Results: A total of 39 students participated in the study. The mean satisfaction score of the intervention group was significantly higher than that of the control group (P=0.027). The mean score of learning outcomes was also significantly higher for the intervention than the control group (P=0.028). Conclusion: Smartphone technology can provide a platform for improving the evaluation of the clinical skills of nursing anesthesia students, leading to increased satisfaction and improved learning outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Nausea is one of the most important symptoms of patients undergoing chemotherapy. This study aims to determine the effects of aromatherapy with sour lemon on nausea in patients undergoing chemotherapy. Methods: A total of 50 patients undergoing chemotherapy were randomly assigned to experimental and placebo (control) groups. The two groups completed the visual analogue scale for nausea before and the first to the fourth week after starting the intervention. The intervention was performed during chemotherapy. Using a dropper, a paper towel was saturated with 3 drops of sour lemon essential oil; however, for the control group, 3 mL of water as a placebo was spread on a paper towel. The intervention in the experimental and control groups was performed once a week for 4 weeks during weekly chemotherapy sessions. Results: At the beginning of the study, no significant difference was observed between the mean score of nausea in the two groups (P>0.05). The first to the fourth week after starting the intervention, significant differences were observed between the mean score of nausea in the two groups (P<0.05). The results of the repeated measures analysis of variance indicated that the mean score of nausea changed over time in the experimental group, indicating a gradual decrease in the mean score of nausea (P<0.05). Discussion: Our findings indicated that aromatherapy with sour lemon can be effective in reducing nausea in patients undergoing chemotherapy. [ABSTRACT FROM AUTHOR]

Background: Most surgical specimen errors occur in the pre-analysis stage, which can be prevented. This study aims to identify errors related to surgical pathology specimens in one of the most comprehensive healthcare centers in Northeast Iran. Methods: The present study is descriptive and analytical research conducted cross-sectionally in 2021 at Ghaem healthcare center in the Mashhad University of Medical Sciences on the basis of a census sampling. We used a standard checklist to collect information. Professors and pathologists evaluated the validity and reliability of the checklist using Cronbach's alpha calculation method of 0.89. We analyzed the results using statistical indices, SPSS 21 software, and the chi-square test. Results: Out of 5617 pathology specimens studied, we detected 646 errors. The highest number of errors is the mismatch of the specimen with the label (219 cases; 3.9%) and the non-compliance of the patient's profile in the specimen sent with the label (129 cases; 2.3%), and the lowest errors are the inappropriate volume of the fixator(24 cases; 0.4%), and they accounted for insufficient sample size (25 cases; 0.4%). Based on Fisher's exact test results, there was a significant difference between the proportion of errors in different departments and months. Conclusion: Considering the frequency of labeling errors in the stage before the analysis in the pathology department, the use of barcode imprinted in specimen containers, the removal of the paper request for pathology, the use of radio frequency chip technology, the use of the rechecking system and improving communication in different departments can be effective in reducing these errors. [ABSTRACT FROM AUTHOR]

The functional classification system (FCS) of roads means categorizing roads based on their service characteristics. The two primary considerations in classifying highway and street networks are accessibility and mobility, where by increasing the role of one, the other's role is reduced. In this paper, besides the conventional variables such as geometric design characteristics, parking lots, land use features, and accessibility; the Sydney Coordinated Adaptive Traffic System (SCATS) data following the real-time traffic flow and average speed of vehicles collected by Location-Based Services (LBS) are considered as new variables for estimating the FCS. Linear regression is used to model the importance of the variables. The chi-square test compared the observational and predicted speeds in the five categories of roads in Tehran, the capital of Iran. Results show that on-street parking has the highest impact and the land use variable has the lowest impact on speed that changes the FCS. Moreover, the presented classification was one to two categories compared with the conventional FCS presented in manuals in the case of Tehran's transportation network as a developing city. [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: When nurses feel that the learning processes in their organization are fair and just, they are more likely to feel confident about sharing their knowledge, expressing their concerns, and contributing to the learning process. Conversely, suppose employees perceive a lack of organizational justice. In that case, they may be less likely to speak up and share their valuable input due to concerns about unfair treatment or possible negative consequences. Objective: Nurses' silence and organizational learning may have a connection yet to be thoroughly investigated. We are exploring whether organizational justice mediates this relationship by improving nurses' perception of it and reducing silence among them. Methods: A study was conducted in Ardabil, Iran, to analyze the correlation between organizational learning, organizational justice, and organizational silence among 319 healthcare professionals from five hospitals. The study utilized three assessment tools: the organizational learning questionnaire, the organizational justice scale, and the organizational silence scale. The collected data were analyzed using IBM SPSS Statistics, and a structural equation model (SEM) was developed using the bootstrap method in AMOS 24.0 to test the proposed model. Results: Our study found a strong positive relationship between organizational learning and organizational justice and a significant negative correlation between organizational learning and silence. Also, there was a significant negative relationship between organizational justice and silence. SEM showed that organizational learning indirectly affects organizational silence through organizational justice as a mediator, explaining 72.3% of all variance in organizational silence. Conclusion: Our findings indicated that organizational learning is positively associated with justice but negatively associated with silence. When nurses experience organizational justice, they are less likely to remain silent. Encouraging nurses to share their opinions and concerns reduces silence and improves working conditions, morale, and patient care. Further research is needed to understand the complex interplay between organizational learning, justice, and silence in nursing settings. [ABSTRACT FROM AUTHOR]

Objective After the COVID-19 pandemic, providing health care has changed and telehealth services have expanded rapidly. Telemedicine in most sciences, including speech therapy, has become more and more popular throughout the world. However, in Iran, many families still hesitate to use telepractice in speech. The purpose of this study was to design and psychometrically evaluate the satisfaction questionnaire of families of children with stuttering or speech sound disorders from telepractice in speech therapy services. Materials & Methods This study is a methodological tool-making study. The statistical population of the research consisted of 142 parents of children with stuttering and speech sound disorders who used telepractice in speech therapy services living in Tehran Province, Iran, in 2022. The samples were chosen by available sampling. The content validity of the questionnaire was assessed by 11 speech therapy professors and specialists, and the face validity was assessed by 10 families that used telepractice in speech therapy services. The structural validity and reliability (factor analysis) were evaluated based on a questionnaire completed by 142 parents of children with stuttering and speech sound disorders. Internal consistency and reproducibility were used to assess the reliability of the questionnaire. To check the reliability (reproducibility of the tool), 30 participants completed the questionnaire over a time interval of two weeks. Data analysis was done using SPSS software, version 24. Results The average content validity ratio (CVR) in accepted items was 0.903 and the average content validity index (CVI) in accepted items was 0.935. The result of the factor analysis showed 3 factors: Effectiveness, user-friendliness, responsibility and responsiveness of the therapist, which explained 57.1% of the total variance. The Cronbach a coefficient of the whole questionnaire was 0.94 and three factors exceeded 0.7. The intraclass correlation coefficient (ICC) value for all three factors and the entire questionnaire was >0.9. Conclusion The findings of this research indicate that the questionnaire on families' satisfaction with telepractice in speech therapy services is an acceptable questionnaire with good validity (face, content and structure) and reliability (internal consistency and repeatability). Speech therapists can use this questionnaire to evaluate families' satisfaction with children with stuttering or speech sound disorders. Also, families can use it to assess remote sessions more accurately. [ABSTRACT FROM AUTHOR]

Introduction: Endodontic treatment errors (EEs) can lead to complications and require additional follow- up care. This study aimed to investigate the prevalence of root canal treatment errors among dental students, identifying error types based on radiographic criteria, tooth type, location, and technical errors. Materials & Methods: A cross-sectional study analyzed data from 201 patients who underwent root canal treatment at Ilam University of Medical Sciences between 2021 and 2022. Inclusion criteria were confirmed root disease diagnosis, adherence to standard treatment protocol, availability of radiographs, and complete patient files. The protocol included rubber dam isolation, radiographic length determination, manual file canal preparation, irrigation, obturation with the lateral compression method, and temporary restoration. Two endodontists evaluated filling length, density, convergence, and technical errors such as floor perforation, broken instruments, transportation, ledge formation, and access cavity gouging. Results: The study included 89 male (44.3%) and 112 female (55.7%) dental students with a mean age of 25.36 years. Among the 201 patients (28.9% male, 71.1% female; mean age 35.24 years), 71.6% had fillings of appropriate length, 12.14% short, and 15.9% long. Appropriate density was observed in 67.6%, and convergence in 86.1%. Technical errors included ledge formation (8.5%), floor perforation (1%), access cavity gouging (1.5%), and broken instruments (0.5%). A significant relationship was found between density and tooth type (p<0.002) and convergence and tooth type (p < 0.009). Conclusion: Proper filling, convergence, and density were more frequent in anterior teeth. Maxillary teeth had higher rates of proper filling compared to mandibular teeth. The overall rate of treatment errors was low, likely due to professor supervision. [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]

Background: Patients diagnosed with gynecological cancers often face a range of complications that can impact their quality of life and increase their anxiety. Nursing models combined with mobile phone applications have the potential to improve outcomes for these patients. This study aimed to assess the impact of a continuous care model utilizing a smartphone application on quality of life and anxiety levels among gynecologic cancer patients. Methods: This study involved two phases: (1) mobile App development and (2) implementation of the intervention. The two-group randomized controlled trial included 70 participants with gynecological cancers referred to medical centers affiliated with Shahrekord University of Medical Sciences in 2023. The participants were randomized into control or intervention groups (n = 35 per group). Finally, 68 patients completed the trial. The intervention group received an 8-week intervention incorporating the continuous care model, whereas the control group received routine care (the standard support provided by nurses both during and after hospitalization). The participants completed the Spielberger state-trait anxiety and quality of life (QLQ-C30) questionnaires before, immediately after, and two months after the intervention. The data were analyzed via the chi-square test, independent samples t test, analysis of covariance, and repeated-measures ANOVA. Results: There were no significant differences in the baseline data between the two groups. However, after the intervention, the intervention group reported a significant increase in quality of life, with mean scores rising from 68.90 ± 17.50 to 73.78 ± 16.79 immediately after the intervention and to 80.61 ± 9.90 at the two-month follow-up. In contrast, the control group showed no significant improvement. Additionally, state anxiety significantly decreased in the intervention group from 51.64 ± 14.97 to 40.20 ± 11.70 at the follow-up, and trait anxiety scores in the intervention group decreased significantly from 49.91 ± 14.96 to 39.82 ± 10.28 at the follow-up, whereas the scores of the control group worsened. Conclusion: The intervention improved quality of life and reduced anxiety in patients with gynecological cancers. Given the scant attention given to mobile application-based follow-up in gynecologic cancer patients in previous studies, this approach can be incorporated into routine care to support patients, and it is recommended for nurses, health care providers, and physicians. Trial registration: The study was registered as a randomized controlled trial in the Clinical Trial Registration Center of Iran. Registration Date: 2024-02-14, Registration Number: IRCT20231107059977N1. [ABSTRACT FROM AUTHOR]

Objective: Compiling and designing short and practical psychometric tools are among the benefits and strengths of a good standard test. The Delirium-O-Meter questionnaire measures patients' delirium status. Accordingly, the main aim of this research was to check the reliability and validity of the Persian version of this questionnaire. Method: This exploratory psychometric study was conducted from 2021 to 2022 at the therapeutic research training centers of Tabriz University of Medical Sciences. The study population included patients diagnosed with delirium. Content and construct validity were assessed using exploratory factor analysis and confirmatory factor analysis. Exploratory factor analysis was performed using SPSS 18, which helped identify the underlying factor structure, while confirmatory factor analysis in Smart PLS was employed to confirm the structure's fit. Pearson correlation was used to evaluate the consistency between different raters, and Cronbach's alpha was calculated to assess internal consistency. These methods were selected for their robustness in evaluating the instrument's psychometric properties, ensuring the reliability and validity of the Persian version of the Delirium-O-Meter questionnaire. Results: The Persian version of the Delirium-O-Meter questionnaire, consisting of 11 items, demonstrated strong psychometric properties. The average impact factor was 3.24, indicating a high relevance of the items. The content validity ratio was 0.78, and the content validity index was 0.87, both above the acceptable thresholds, confirming the content validity of the questionnaire. Cronbach's alpha coefficient for the entire questionnaire was 0.77, reflecting good internal consistency. The Kaiser-Meyer-Olkin index was 0.88, and Bartlett's sphericity test was significant (χ² = 278.45, P < 0.001), indicating the appropriateness of the data for factor analysis. Exploratory factor analysis revealed two factors that explained 76.09% of the total variance, supporting the questionnaire's construct validity. Additionally, Pearson's correlation coefficient between the assessments of two nurses was 0.91, signifying inter-rater solid reliability. Conclusion: The Persian version of the Delirium-O-Meter questionnaire demonstrates acceptable reliability and validity, as confirmed by the comprehensive psychometric evaluation conducted in this study. The strong internal consistency, significant content and construct validity, and high inter-rater reliability underscore its effectiveness in assessing delirium in Persian-speaking patients. These findings highlight the questionnaire's suitability for clinical use, providing a reliable and valid instrument for accurately diagnosing and managing delirium in diverse healthcare settings. [ABSTRACT FROM AUTHOR]

Introduction: According to the conducted studies, breast cancer is one of the most common malignant tumors, and its incidence rate is increasing yearly. One of the measures to reduce the mentalities from breast cancer is early diagnosis of biomarkers, such as Leptin polymorphisms (rs7799039 and rs2167270), and timely treatment. Leptin is an adipocytokine made by fat cells, playing a crucial role in cell proliferation, survival, migration, and immune response. The present study aimed to assess the association between polymorphisms in the Leptin gene and breast cancer risk in Arak, Iran. Materials & Methods: Two SNPs of the Leptin gene (rs7799039 and rs2167270) were genotyped by PCR-RFLP method (polymerase chain reaction-restriction fragment length polymorphism) in a case-control study, including 80 breast cancer patients and 80 healthy controls. In this study, all statistical analyses were performed in SPSS software (version 26) using the Chi-Squared test at P˂ 0.05 significant level. Results: Based on the results, rs7799039 and rs2167270 showed no significant association with breast cancer risk (P=0.183 and P=0.86, respectively). In this study, the mean age in the patient group was 47 ( an age range of 28-79 years). Conclusion: As evidenced by the obtained results, Leptin gene polymorphisms (rs7799039 and rs2167270) did not increase the risk of breast cancer in the Arak population in Iran. Although based on the present study results, there was no significant association between Leptin gene polymorphisms and breast cancer risk, according to the prominent role of the Leptin gene, the polymorphisms of this gene could be used as biomarkers to predict breast cancer in other populations. [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]

Background: Having knowledge of the dental procedures that necessitate endocarditis prophylaxis is of high importance. Therefore, the aim of the present study was to determine the knowledge level and attitudes of general medical and dental practitioners, dental specialists, and cardiologists in Tehran and Hamadan about endocarditis. Methods: This cross-sectional study was carried out on 420 general medical and dental practitioners, dental specialists, and cardiologists in Tehran and Hamadan provinces in 2015. The questionnaire used in this research consisted of three parts as follows: part one: information on cardiac diseases; part two: dental procedures requiring endocarditis prophylaxis; part three: antibiotic diet in endocarditis prophylaxis. Independent t-test, one-way ANOVA, and chi-square tests were conducted to analyze the data. All the analyses were performed in SPSS version 16. Results: The results showed that 86.7 had a relatively favorable and 10.5% of subjects had a favorable level of knowledge about endocarditis. Also, 58.6% of subjects had a poor attitude toward endocarditis prophylaxis. There was a significant relationship between knowledge and attitude, age, gender, and work experience (P < 0.001). There was a significant relationship between knowledge and attitude, and job groups; dental specialists had a more favorable knowledge and positive attitude than others (P < 0.001). Conclusion: We recommended developing more practical training programs in dental schools on cardiac diseases, and dental procedures requiring endocarditis prophylaxis and antibiotic diets. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is often linked to chronic inflammation, which can be influenced by both lifestyle and dietary choices. However, the relationship between the inflammatory potential of diet and lifestyle factors and the risk of developing T2DM remains unclear. The present study aimed to investigate the associations of the empirical dietary inflammatory index (EDII), dietary inflammatory score (DIS), and lifestyle inflammatory score (LIS) with the risk of T2DM among Iranian adults. Methods: The current study was conducted on 5714 individuals from Yazd Health Study (YaHS) who were followed up for a mean period of six years. YaHS is a prospective cohort study which has been conducted since 2014. Dietary intakes were collected at baseline using the food frequency questionnaire. The relative risk (RR) of T2DM was calculated by Cox regression analysis across tertiles of EDII, DIS, and LIS, adjusted for potential confounders. Results: The mean ± SD for the age and body mass index of the study population were 47.0 ± 9.2 years and 26.7 ± 5.1 Kg.m2, respectively. A significant association between LIS and the risk of T2DM was observed (RR: 4.05, 95% CI: 2.61–6.27 P-trend < 0.001). Individuals in the highest compared to the lowest tertile of EDII-LIS (RR: 3.07, 95%CI: 2.01–4.68; P for trend < 0.001) and DIS-LIS (RR: 2.42, 95%CI: 1.69–3.49; P for trend < 0.001) had a higher risk of T2DM. However, no significant association was found between EDII and DIS scores and the risk of T2DM. Conclusion: Greater adherence to LIS, EDII-LIS, and DIS-LIS scores was associated with a higher risk of T2DM, while no significant association was found between EDII and DIS with T2DM risk. [ABSTRACT FROM AUTHOR]

Introduction: Knee osteoarthritis (KOA) is one of the most common and prevalent debilitating chronic diseases across the world with various adverse effects such as pain and movement limitations which impact the health status and quality of life of the patients in the long run. Objectives: This study aimed to investigate the effects of self-care education on pain, quality of life, and consequences of disease in patients with KOA in Southern Iran. Methods: This is a randomized controlled clinical trial using a pretest–posttest design. Eighty patients with KOA were enrolled in this study and randomly allocated to a control and an intervention group. The data collection instruments included VAS: Visual Analog Scale, the SF-36 quality of life scale, and the Knee Injury and Osteoarthritis Outcome Score. The collected data were analyzed through SPSS v. 22, using descriptive tests, paired t -tests, independent t -tests, Chi-square, and ANOVA. A P level of <.05 was considered as the significant level. Results: Before the self-care educational intervention, no statistically significant difference was found between the control and intervention groups in pain intensity, quality of life, and consequences of osteoarthritis. After the self-care educational intervention, the findings revealed a significant difference between the intervention group's mean ± standard deviation for pain intensity (41.25 ± 21.74), quality of life (49.87 ± 14.74), and consequences of KOA (39.06 ± 12.15), respectively (P <.05). However, in the control group, there was no significant difference. Conclusion: Based on the results of this study, the positive effect of self-care education on patients with osteoarthritis was shown as to their pain intensity, quality of their lives, and reduction of the disease consequences. Thus, healthcare managers are recommended to apply this type of intervention for patients with osteoarthritis. [ABSTRACT FROM AUTHOR]

Context: Advance Care Planning (ACP), as a process for expressing and recording patients' preferences about end-of-life care, has received increasing attention in recent years. However, implementing ACP has been challenging in Iran. Objectives: To assess the readiness for advance care planning and related factors in the general population of Iran. Methods: This cross-sectional study was conducted on the general population of Iran in 2022. The data was collected using demographic information questionnaire and The RACP Scale. The purpose and methodology of the research was explained to all participants, and upon their agreement an informed consent was obtained. Participants were invited to fill out the questionnaires wherever is more convenient for them, either alone or if needed, with the help of the researcher to protect their privacy. Chi-square, fisher exact test and multiple logistic Regression model were used to assess the effective factors on the RACP. The data were analyzed by SPSS software version 26. Results: A total of 641 people with an average age of 36.85 ± 12.05 years participated in this study. Of those, 377 (58.8%) had high RACP. The logistics model showed an association between the chance of readiness for receiving ACP with participants' education level, such that the chance of readiness in those with Master's or Ph.D. degrees was three times higher than those with a diploma (p = 0.00, OR:3.178(1.672, 6.043)). However, the chances of readiness in those with bachelor's degrees was not significantly different from those with a diploma (p = 0.936, OR: 0.984 (0.654, 1.479)). Moreover, the chance of readiness was 1.5 higher in participants over 40 years of age compared with participants under the age of 40 (P = 0.01, OR: 1.571(1.10, 2.23)). Conclusion: According to the findings of this study, it can be concluded that there is a relatively RACP among people in Iranian society. The readiness of individuals for ACP increases by their age and education level. Therefore, by holding appropriate training intervention, we can increase the readiness of the public for ACP to improve their end-of-life outcome. [ABSTRACT FROM AUTHOR]

Background: Smile esthetics can be subjective. This study aims to assess the effect of culture/geographic location on judging smile esthetics by comparing the perception of smile characteristics between American laypersons (Western culture) and Iranians (Eastern). Materials and Methods: One hundred residents from each country were recruited for this analytical cross-sectional study. A frontal picture of a posed smile with standard norms which are mentioned in the Contemporary Orthodontics textbook by William R. Proffit was selected. Adobe Photoshop 7 was used to alter midline diastema, gingival display (GD), maxillary midline-to-face discrepancy, buccal corridor (BC), and smile arc. Images were given to groups to determine the most attractive and acceptable smile. Data were analyzed by Chi-square, Mann–Whitney, and Spearman correlation coefficient in SPSS-22 (α =0.05). Results: Americans were less critical in judging diastema (P < 0.001), GD (P = 0.013), and BC (P = 0.004) for smile attractiveness than Iranians. No difference was between the two groups in choosing the acceptability threshold and determining the most attractive smile except for BC (P = 0.002). Conclusion: Overall, Americans were more tolerant of variations in smile characteristics than Iranians. Both groups agreed on most smiles. Therefore, it seems that it is reasonable to use similar standards for smile characteristics while considering the small differences. [ABSTRACT FROM AUTHOR]

Background: Pregnant women have poor knowledge of oral hygiene during pregnancy. One problem with the follow-up of dental caries in this group is zero accumulation in the decayed, missing, and filled teeth (DMFT) index, for which some models must be used to achieve valid results. The studied population may be heterogeneous in longitudinal studies, leading to biased estimates. We aimed to assess the impact of oral health education on dental caries in pregnant women using a suitable model in a longitudinal experimental study with heterogeneous random effects. Materials and Methods: This longitudinal, experimental research was carried out on pregnant women who visited medical centers in Tehran. The educational group (236 cases) received education for three sessions. The control group (200 cases) received only standard training. The DMFT index assessed oral and dental health at baseline, 6 months, and 24 months after delivery. The Chi-square test was used for comparing nominal variables and the Mann–Whitney U test for ordinal variables. The zero-inflated Poisson (ZIP) model was applied under heterogeneous and homogeneous random effects using R 4.2.1, SPSS 26, and SAS 9.4. The level of significance was set at 0.05. Results: Data from 436 women aged 15 years and older were analyzed. Zero accumulation in the DMFT was mainly related to the filled teeth (51%). The heterogeneous ZIP model fitted better to the data. On average, the intervention group exhibited a higher rate of change in filled teeth over time than the control group (P = 0.021). Conclusion: The proposed ZIP model is a suitable model for predicting filled teeth in pregnant women. An educational intervention during pregnancy can improve oral health in the long-term follow-up. [ABSTRACT FROM AUTHOR]

Purpose: The current study aims to investigate the effect of a comprehensive warm-up program on functional movement (FM) patterns and landing errors of young male wrestlers. Methods: For this purpose, 50 wrestlers from Karaj City, Iran were selected as available to participate in the research and then randomly divided into two... [ABSTRACT FROM AUTHOR]

Objective Auditory processing disorder (APD) tests, based on the deviation of results from standard benchmarks, can distinguish children suspected of having APD. Some of these tests directly relate to the ability to discriminate sound pitch, while others may be indirectly affected. Accordingly, this study investigates the impact of pitch discrimination-based rehabilitation on diagnostic indices of APD tests. Materials & Methods In this study, we selected 19 children suspected of APD who were identified based on tests of pitch pattern, dichotic digits, and monaural selective auditory attention as the intervention group. These children received pitch discrimination-based training, for about three months, two to three sessions a week, each session up to 1 h. After completing the rehabilitation phases, diagnostic tests were administered again. We also selected 26 children with similar diagnostic criteria for APD as the control group. No intervention was applied to this group, and after a comparable period to the intervention group, diagnostic tests were re-administered. The results before and after the interventions were compared within the intervention group and with the 26 children in the control group. Results The rehabilitation showed significant improvements in the pitch pattern and monaural selective auditory attention tests. In the monaural selective auditory attention test, significant improvements were observed in both ears (P=0.001). In the pitch pattern test, effective improvements were also observed for both ears (P=0.001). The effects were such that nearly 37% of children suspected of APD, based on the diagnostic criteria used in the study, no longer met the criteria for this disorder. Hence, if the same tests are re-administered to them, these children will be diagnosed as having no auditory processing disorder. Conclusion Discrimination-based rehabilitation impacts the results of APD tests. Accordingly, some children who are classified as suspected auditory processing disorder with such tests, are removed from this subgroup after the intervention. [ABSTRACT FROM AUTHOR]

Objective Postoperative rehabilitation protocols, such as immobilization and non-weight-bearing periods during the acute phase after anterior cruciate ligament (ACL) surgery vary depending on the surgeon or the institution and lack clear standardization. Weight bearing (WB) after ACL reconstruction (ACLR) is critical. This study compares the results of WB immediately after surgery and partial WB with a brace after ACLR. Materials & Methods In this randomized clinical trial, the block random sampling method was used to select 84 patients who were divided into two groups. Group 1 was allowed to have full WB after surgery and Group 2 was asked to use braces after surgery, and they were divided into partial WB for one month and then full WB. Meanwhile, demographic information was recorded. The Lachman test, anterior knee pain, and kneeling pain before and one month after the surgery were also recorded. Knee function was evaluated using the international knee documentation committee, knee injury and osteoarthritis out-come score, and Lysholm scales before surgery and 1, 3, and 6 months after surgery. The data were analyzed using the SPSS software, version 20, and the Fisher exact test, the chi-square test, the Friedman test, and repeated measures analysis of variance. Results Most of the patients were men under 30 years of age. There was no statistically significant difference in the demographic information of the patients in the two groups. Kneeling pain, anterior knee pain, and the Lachman test did not differ between the two groups one month after the surgery. There was no difference between the two groups in the scores using the international knee documentation committee, knee injury and osteoarthritis outcome score, and Lysholm score in the 6-month follow-up. All the examined indicators in each group improved over time. Conclusion WB immediately after surgery compared to partial WB at 1, 3, and 6 months after ACLR do not differ; therefore, patients can bear full weight if they tolerate it. [ABSTRACT FROM AUTHOR]

Introduction: Untreated canals represent the primary cause of treatment failure in molars and the second leading cause in other dental groups. This study determined the prevalence of untreated canals and their relationship with periapical periodontitis using cone-beam computed tomography (CBCT) images. Materials and Methods: 385 CBCT images with at least one treated canal were selected from the oral and maxillofacial radiology center. The number of roots and canals, presence, and size of periapical pathology, and presence of untreated canals were recorded. The study used descriptive statistics and Chi-square, Fisher's exact, and odds ratio tests to analyze data. Results: Of the 2053 teeth examined, 14.9% had at least one untreated canal. Untreated canals in teeth increase the chance of having a periapical lesion, raising the prevalence by 11 times. Of these, 91.8% had both untreated canals and periapical lesions. This was more than teeth without untreated canals (35.8%). Most untreated canals were in maxillary molars (65.3%), and mandibular molars (12.54%). There was a statistically significant relationship (P<0.001) between the number of roots, canals, expansion, destruction, and jaw type with the prevalence of untreated canals. The maxillary first molar (68.66%) and second mesiobuccal (MB2) canal (63.27%) had the highest percentages of untreated canals. Conclusions: The MB2 had the highest prevalence of untreated canals. The presence of untreated canals significantly increased the risk of expansion and/or destruction. Therefore, identifying these conditions can also be useful in diagnosing untreated canals. Dentists should assess the anatomy of the tooth and the structure of the root canal to minimize the possibility of an untreated canal. CBCT can assist in this process. [ABSTRACT FROM AUTHOR]

Introduction: Occupational burnout has been introduced as one of the most critical social problems. The present study aimed to evaluate occupational burnout among a group of Iranian endodontists. Material and Methods: Seventy-two Iranian endodontists participated in this cross-sectional study by completing the abbreviated Maslach Burnout Inventory (aMBI), consisting of one questionnaire in three domains. The data were analyzed with SPSS 21, using the chi-squared test, correlation test, and linear regression. Results: Concerning occupational burnout, 2.9% of the participants had severe emotional exhaustion, 4.2% exhibited an intense feeling of decreased accomplishment, 67.2% exhibited moderate occupational burnout, and 78.9% of the participants were satisfied with their job. Of all the variables, only the years elapsed since graduation had an inverse and significant correlation with occupational burnout among endodontists. Conclusion: The overall mean scores of endodontists showed a moderate rate of occupational burnout compared to the standard mean scores in this field. Recent graduates exhibited higher scores. [ABSTRACT FROM AUTHOR]

Introduction: Successful endodontic treatment depends on completely clearing, shaping, and filling the prepared canals. Knowledge of the common and aberrant varying pulp anatomies is essential for suitable root canal treatment. Since, this anatomy is complex and varies morphologically in different populations. This study aims to determine the number of roots, canals, and evaluation of mandibular premolars canals using cone-beam computed tomography (CBCT) images in one of Iran's northern provinces (Golestan). Materials and Methods: CBCT axial, coronal, and sagittal slices of two hundred and twelve mandibular premolars were analyzed to determine the number of roots and canals based on Vertucci type. The images were analyzed in a one-millimeter slice in mesiodistal and buccolingual dimensions based on gender. The data were analyzed using the Chi-score test to compare the components if the defaults were not established. A significance level of 0.05 was considered. Result: Of the two hundred twelve teeth evaluated, 130 (61.3%) were first premolars, and 82 (38.6%) were second premolars. Most first premolars (78.5%) and almost all second premolars (97.6%) had one root. Morphological types of root canals were identified based on Vertucci's classification types I, II, III, IV, V, or VIII, and type I was the most frequent. There were no significant associations between number of roots and sex (P>0.05). Conclusion: Mandibular premolars mostly had one root and type I Vertucci morphology. The frequency of two-canal premolars was higher in the male population. Although the abundance of two or three roots with different morphologies was also observed, the possibility of the presence of an additional root canal should be considered. [ABSTRACT FROM AUTHOR]

Introduction: Acute pain caused by kidney stones is considered one of the most prevalent reasons for referring to treatment centers or hospitals. One of the essential issues in this field, which still has many questions, is the probability of an increase in kidney stone formation during fasting. This study assessed the relationship between kidney stone pain and fasting during Ramadan. Methods: This study conducted a descriptive cross-sectional check on the patients who referred to 3 central urgencies named Imam Khomeini-Shahid Labafi Nejad and Baghiatallah due to Colic pain generated from kidney stones during three periods of time, including before, in, and after Ramadan. Results: The study indicates ureteral stones are more prevalent than kidney stones in patients with Kidney Colic Pain during three periods. Also, it was released that the most amount of Colic pain was experienced by males under 40 years during three periods of time, so there is a significant relevance between the male gender and Renal Colic (P<0.05). A noticeable change in diet and more usage of carbohydrate compounds in addition to high-protein diets was reported here, so there is a significant difference between more carbohydrates and Renal Colic before and after Ramadan (P=0.022). Conclusion: It is specified that factors such as male gender, age under 40, being overweight, high-calorie diet, and low physical activity are the risk factors associated with Renal Colic. Also, this study found that the reception of renal colic patients in Ramadan had no significant difference in another two months. [ABSTRACT FROM AUTHOR]

Introduction: Clearance with personal consent is a common problem in healthcare systems. Clearance with consent individuals increases mortality, disability, and disease exacerbation. This study investigates the extent and causes of discharge with personal consent in patients admitted to the emergency department of Baqiyatallah Hospital in Tehran. Methods: This study is a cross-sectional study that was conducted in 2019 in the emergency room of Baqiyatallah Hospital in Tehran was performed. The research community of all hospitalized patients discharged with personal consent in the summer and autumn of winter was from the emergency room. The research sample was selected by census. A checklist with confirmed validity and reliability was used to collect the data. Results: Based on the findings, the discharge rate with personal consent in the emergency room of Baqiyatallah Hospital in Tehran in the summer-autumn-winter of 2019 was equal to 1.82%. Most of the patients were male, employed, and native to Tehran. They were hospitalized in the acute care ward. Most have armed force insurance and are discharged on a night shift with an average age of 40 and a standard deviation of 62. This document was truncated here because it was created in the Evaluation Mode. Conclusion: The residence of patients discharged with personal satisfaction has a significant relationship with factors related to the patient. Also, the residence and life of patients discharged with personal satisfaction are significantly related to the patient's reason and the job. Patients discharged with personal satisfaction have a significant relationship with the factors related to the hospital condition. The insurance of patients discharged by personal satisfaction has a significant relationship with the factors related to the hospital. Also, the place of residence and emergency departments of patients discharged by personal satisfaction with related factors. It has a significant relationship with the hospital staff, the job, and the reason for hospitalization of discharged patients with personal satisfaction, which has a significant relationship with the factors related to the hospital's condition. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to determine the frequency of CT scan involvement due to COVID-19 pneumonia in different age groups of patients. Methods: Patients with COVID-19 were referred to Amir al-Momenin Hospital in Arak City from May 2020 to June 2021. Age, sex, history of underlying disease, and CT scan results were recorded. CT scan Scores on the 5th to 8th day for patients were determined. The prepared CT scan was evaluated, and the pattern of pulmonary involvement and the prevalence of involvement in the lobes were assessed separately (upper, lower, peripheral, and bronchovascular fairytale). Results: Overall, 349 patients were included. The mean age was 50.89 years. The most common involvement of the right lower lobe was 92% and the left lower lobe was 89.1%. Most patients had peripheral lung involvement. The average number of lobes involved was 4.14. GGO and GGO and Consolidation were correlated with younger patients. Higher Consolidations were observed in the age groups of 30 to 50 and 50 to 70. Crazy Paving is more common in the elderly and Halo was more common in young patients. The severity of lung involvement and the number of lobes involved were associated with high age. Conclusion: Different age groups have specific features in CT scans to assess COVID-19 patients. Crazy Paving Appearance, Subplural bands, GGO, and Consolidation were seen in the elderly and severe/critical patients. Also, the amount of involvement and the number of lobes involved in the lungs of patients increases in patients of high age. [ABSTRACT FROM AUTHOR]

Background: Breast cancer, the most prevalent cancer in women and the second leading cause of cancer-related deaths worldwide, is a complex and heterogeneous disease characterized by multiple tumor types with distinct tissue patterns, biological characteristics, and clinical behaviors. Given the critical role of histopathological and molecular characteristics in the treatment and management of breast cancer. Objectives: This study was undertaken to investigate the histopathological and molecular characteristics of malignant breast masses in the city of Sanandaj from 2019 to 2021. Methods: In this descriptive-analytical study, out of 1,631 pathology reports from breast tissue samples collected in Sanandaj, a city in northwest Iran, between 2019 and 2021, 597 (36%) malignant cases were examined for their pathological type and molecular characteristics. Data analysis was performed using SPSS 26 software, employing chi-square and Fisher's exact tests. Results: The mean age of the patients at diagnosis was 49.7 ± 11.9 years. The most prevalent molecular subtype was luminal A (56.4%), followed by triple-negative (16.7%), human epidermal growth factor receptor 2 (HER2)-positive/enriched (14.1%), and luminal B (14%). Invasive ductal carcinoma was the predominant histological type, accounting for 82.7% of cases, followed by lobular invasive carcinoma (8.2%). Papillary carcinoma accounted for 5.9% of cases, metaplastic carcinoma for 1.8%, and mucinous carcinoma for 1.3%. Higher grades at the time of diagnosis were associated with the metaplastic subtype (P < 0.001). The only biomarker that showed a significant association with pathological types of breast cancer was Ki-67. The percentage of cases positive for Ki-67 was higher in three types of breast cancer: Infiltrating ductal carcinoma, metaplastic, and papillary (intraductal) carcinoma, compared to the other types (P < 0.001). Conclusions: According to our data, infiltrating ductal carcinoma is the most prevalent pathological type, and luminal A is the most common molecular subtype among Kurdish women in Iran. It is recommended that future studies examine patient survival based on the pathological and molecular types of tumors, including the evaluation of additional biomarkers. Furthermore, comparing these results with those from other ethnic groups could provide valuable insights into the impact of ethnicity on breast cancer characteristics and outcomes. [ABSTRACT FROM AUTHOR]

Objectives: After the divorce of their parents, children face various behavioral problems, and the attachment styles of the parents and their parenting styles will affect these problems. This research assesses the mediating role of attachment styles in the relationship between parent-child relationships and parenting styles with children's behavioral problems after divorce. Methods: The investigation was classified as a descriptive-correlation type. The population consisted of mothers of children aged 6 to 10 years who had undergone divorce proceedings at the Shahid Bahonar Judicial Institute's Welfare Department in Tehran City, Iran, during the first half of 2022. A convenience sampling method was used to select 268 mothers based on a correlation plan. They completed the child behavior inventory (CBCL), parent-child relationships survey questionnaire (PCRS), parenting styles inventory (PSI), and revised attachment style survey (RAAS). The research hypotheses were tested using the smart partial least squares in structural equation modeling. Results: The assessment of the research tools' reliability was conducted via the Cronbach α method and the composite reliability coefficient, with all variables showing a coefficient of above 0.7, indicating acceptable reliability. The validity of the questionnaire was evaluated using the average variance extracted, which exceeded 0.4, indicating relatively acceptable validity. The assessment of the adequacy of the structural model involved analyzing important coefficients of Z, R2, and Q2, with the obtained results indicating an appropriate fit. The results displayed that the mediating role of anxious-ambivalent attachment style and avoidant attachment style is evident in the association between authoritarian and permissive parenting styles and the parent-child relationship, particularly concerning children's behavioral problems (β=0.184, P<0.05; β=0.019, P<0.01). Secure attachment style serves as a mediating role (partial role) in the association between authoritarian, authoritative, and permissive parenting style and parent-child relationship with children's behavioral problems (β=-0.364, P<0.05; β=-0.096, P<0.01; β=0.056, P<0.05). Discussion: Avoidant and secure attachment styles can mitigate the impact of permissive and authoritarian parenting styles by mediating roles in the association between parent-child relationships and parenting styles with children's behavioral problems after divorce. They also highlight the emphasis on maintaining positive parent-child relationships and implementing authoritative parenting styles to reduce children's behavioral problems following. Further research is needed to address and assess concerns regarding children's behavioral problems after divorce. [ABSTRACT FROM AUTHOR]

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Background and objectives: Every day, either by accident or illness, there are numerous situations in which the safety of individuals, families or communities is endangered. >2000 children worldwide die every day as a result of unintentional injuries. The majority of risks influencing a cardiac arrest in a school are related to physical activity, such as participating in sports or having an airway obstruction or trauma event. In the United States and Europe, one million people experience cardiac arrests annually. The aim of this study was to assess the basic school teachers' practices regarding cardiopulmonary resuscitation at basic schools in Erbil City. Methods: A cross suctional study was carried out. To assess the practices of basic school teachers regarding cardiopulmonary resuscitation. The study was conducted from January 20,2021 to May 15, 2022. This study was conducted in basic schools in Erbil city according to six municipalities. The sample size was 470 teachers. The observational check list technique was used to assess cardiopulmonary resuscitation performance. Results: The majority of them were female (74%), more than half of them have a diploma (52.3%), the majority of age group were between 37-48 years old which represents 51%, the mean age was (43.85±8.27), most of the teachers were married (86.4%), the majority of them did not a training course (86.4%). Several teachers use tradition at media (9.6%) and social media (44.7). A lot of barriers were faced teachers to prevent participation in training courses were not found in professional training course The majority of the schoolteachers had poor levels of practice (51.1%) regarding the performance of cardiopulmonary resuscitation. Conclusion: The majority of schoolteachers had poor levels of practice regarding cardiopulmonary resuscitation. There was a significant association between the performance of CPR and some socio-demographic variables like age group, gender, years of experience, and desire to attend CPR training course. [ABSTRACT FROM AUTHOR]

Background and Objective: Over half of medical researches in Iran are done by students of different levels as their thesis. In medical school, thesis is a 6 hours mandatory course. This study caried out to determine the publication of thesis in faculty of medical in Gorgan, located in North of Iran. Materials and Methods: This descriptive study was performed on all thesis and all faculty members who have been advisor of at least one thesis up to the time of this study. To collect data, we used a questionnaire which contained questions about the research, their output and any obstacles to publication. All data have been analyzed by SPSS-13 software and Chi-Square test. Results: According to the collected information, 322 thesis were directed by 43 faculty academic members of Gorgan Medical School. 87.6% and 12.4% thesis supervisors were clinical and basic science academic members respectively. The majority of 127 (39.4%) published papers have either been published by domestic medical journals or represented in medical seminars inside the country. Basic members have published 70% of their papers while only 35.1% of clinical faculty members have published their research findings. Experimental papers have been published more than other papers (48.5%). The most important publication barrier were lack of time and collaborator in this matter. Conclusion: This study showed that publication rate of medical student thesis is far from ideal. [ABSTRACT FROM AUTHOR]

Introduction: Strokes rank among the leading causes of death and disability worldwide, with acute ischemic stroke (AIS) on the rise in Iran. Thrombolytic drugs constitute a primary treatment for ischemic stroke. However, due to limited studies in Iran, there exists hesitation among physicians regarding their administration. This study aims to assess the efficacy of these drugs on AIS patients. Methods: In a clinical trial, 80 patients with ischemic stroke were divided into treatment and control groups. Both groups were assessed upon admission and 72 hours later using the National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (mRS) scores at discharge. The treatment group received Alteplase (0.9mg/kg), while the control group received standard care. Statistical analysis was performed using SPSS 20. Results: The mean NIHSS ± SD scores at admission and 72 hours later in the treatment group were 10.0±3.51 and 4.55±8.75, respectively, compared to 8.53±3.52 and 7.88±9.21 in the control group, showing a significant difference in favor of the treatment group (P < 0.001). Similarly, the mean mRS± SD score in the treatment group was 1.68±1.79, significantly lower than the control group's 3.15±1.61 (P < 0.001). Conclusion: Intravenous Alteplase administration proved effective in treating patients with ischemic stroke, significantly reducing neurological complications and disabilities compared to standard medical care. [ABSTRACT FROM AUTHOR]

Objective: Incidental findings (IFs) are newly discovered abnormal findings unrelated to the primary purpose of imaging. Brain computed tomography (CT) scan is one of the most essential and initial imaging evaluations for head trauma patients, which may also have nontraumatic IFs. We aim to investigate the prevalence and nature of IFs in brain CT scans of head trauma patients. Methods: We conducted a cross-sectional study to evaluate brain CT scans of 1006 head trauma patients over one year (April 2021 to March 2022), to identify incidental findings by consensus agreement of two radiologists. We categorized the incidental findings into four categories based on appropriate follow-up recommendations. Results: We included 1006 head trauma patients who underwent brain CT scan, of which 126 incidental findings were discovered in brain CT scan of 107 patients. The prevalence of incidental findings was 10.6% (107/1006). The most common incidental finding was brain atrophy (n=15, 11.9%). The mean age of patients with IFs was significantly higher than those without IFs, but there was no difference between the two groups regarding gender. Conclusion: The discovery rate of incidental findings of brain CT scans in head trauma patients was considerable. Serious medical findings that need immediate evaluation were found in 5.6% of patients, mostly over the age of 40. Therefore, patients who have clinically significant incidental findings need improved documentation and follow-up to evaluate the long-term outcomes and reliability of imaging results. [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]

Objective This study aimed to investigate the validity and reliability of the Persian version of the "resilience assessment questionnaire" in patients with multiple sclerosis. Materials & Methods The statistical population of the present study included all multiple sclerosis patients living in Tehran City in 2022. Of them, 250 people were selected through available sampling. The participants completed the questionnaires of Gromis et al. resilience and the hospital anxiety and depression scales. The validity of the questionnaire was investigated using the formal, content, construct, and predictor methods. Also, the reliability of the test was checked through the Cronbach α method and retesting. Data analysis was done using SPSS software, version 26. Results The face validity was confirmed by checking the content and solving the appearance problems. The content validity of the questionnaire was confirmed after correcting the questions. The results of exploratory factor analysis showed that the resilience questionnaire includes 5 components: Emotional and cognitive strategies, physical activity and diet, family and friends support, peer support, and spirituality. Also, the Cronbach α values of these components were 0.88, 0.79, 0.62, 0.76, 0.50, and 0.89, respectively. The eigenvalues of these components explained 47.49% of the variance. There was a significant relationship between the resilience and anxiety/depression questionnaire components. The correlation value between the first and second stages confirmed the retest validity of the resilience questionnaire. Conclusion The Persian version of the "multiple sclerosis resilience" scale is a valid and reliable tool for assessing resilience features in Iranian MS patients, which can be used in policymaking and research studies. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the risk factors of death caused by COVID-19 in Iran. Methods: This study was a retrospective cohort study from February 20, 2020, to August 22, 2022, in the hospitals in Isfahan, Iran. The data were collected through a researcher-made checklist. To determine the risk factors of the death, logistic regression and Cox regression models were used. For each variable, the odds ratio and 95% confidence interval were also reported. Results: 1 885 Patients were included. The age of deceased persons was significantly higher than that of the surviving persons. The risk of death for the age group above 60 years was about 14 times higher than that of people aged 19-35 years [95%CI: 14.41 (2.02-102.99), P<0.01]. Hypertension [95%CI: 1.92 (1.47-2.5), P<0.01], diabetes [95%CI: 1.62 (1.23-2.13), P<0.001], and chronic obstructive pulmonary disease [95%CI: 1.92 (1.47-2.50), P<0.01] were also risk factors of mortality. Conclusions: This study reveals that the mortality rate due to COVID-19 is associated with old age, longer hospitalization in the ICU, increased length of stay, and comorbidities of high blood pressure, diabetes, and chronic pulmonary disease. [ABSTRACT FROM AUTHOR]

Introduction: The process of aging is a gradual decrease in the function of the body's systems, including the heart and blood vessels, respiration, urinary-genital system, endocrine glands, and the body's immune system. This study aimed to assess the effect of Temperament based on Persian medicine on the thermal comfort of aging in sanatoriums in Mazandaran province in Iran. Methods: This cross-sectional study was conducted at Rasht Azad University from June 2022 to December 2023. In the field section, the living space (sanatoriums) of older people who are under actual conditions (without interfering with the temperature conditions) in the mild and humid plain climate of Iran was investigated. Ninety-six aging adults above 65 years old were included. Sex, age, temperament (Mizaj) based on Persian medicine, and thermal comfort in four seasons were assessed. Results: Ninety-five participants were included, and 54 (54.5%) were aging females. The distribution of Mizaj regarding sex was similar (P=0.647), and most of the participants, 49 (51.6%), had a cold temperament. There was a significant relationship between Temperament and thermal comfort (P<0.01). There was a significant relationship between gender and thermal comfort (P<0.01). Conclusion: The results showed that the Temperament and gender of aging adults can play a central role in determining the amount of coverage of people and their thermal comfort. More long-term studies are needed to investigate more precisely the effect of Temperament on people's thermal sensations. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus (T2DM) is prone to opportunistic infections, including toxoplasmosis, due to an immunodeficiency system. This study aimed to evaluate the serum of people with T2DM to determine the titer of anti-toxoplasma antibodies in patients and compare it with the control group. Materials and Methods: 720 blood samples have been carried out between October and the end of January 2017 in Sistan, and Baluchestan provinces in southeastern Iran, of these, 360 samples were related to healthy individuals (control), and 360 samples were related to T2DM individuals. The immunoglobulin (Ig) M and IgG enzyme-linked immunosorbent assay methods have been used to detect toxoplasmosis. The data were analyzed using SPSS-19, Chi-square, and Fisher's exact test to compare statistical parameters. Results: In this cross-sectional study, out of 360 samples of T2DM by ELISA method, 60% samples in diabetic patients and 48.1% in control group were IgG positive (P < 0.05). Nearly 2.5% samples in diabetic patients and 0.3% in control group were IgM positive (P < 0.05). Conclusion: Anti-toxoplasma antibodies including IgG and IgM were higher in diabetic patient in comparison to control group. [ABSTRACT FROM AUTHOR]

Background: Continuing professional development (CPD) is a life-long learning process for all health-care members including dentists to improve their knowledge and skills in their profession and provide the best quality services. This study aimed to assess the needs, priorities, and obstacles of attending dentists in these programs in Isfahan province, in 2020. Materials and Methods: This descriptive-analytical cross-sectional study was performed on general dentists in Isfahan province. Data were collected through a three-part questionnaire, online and on paper; it included demographic information, prioritization of seven disciplines, and scoring of 33 dental subfields, as well as obstacles limiting participation in the CPD programs. This questionnaire was developed and validated by researchers. Statistical analysis was carried out through Mann–Whitney, Kruskal–Wallis, and Chi-square tests, and a significance level of 0.05 was considered. Results: Of 326 dentists (90.5% response rate) participating in this study, 157 were (48.2%) female, and most of them were in the high work experience group (45.1%). The highest mean scores standard deviation related to the dentist's interest and needs, among the seven dental disciplines, belonged to practice management (6.68 [2.9]), oral and dental reconstruction (6.29 [2.55]), and pediatric dentistry (6.291 [2.87]). On the other hand, lack of time (70.6%), inefficient teaching methods and organization (65%), and irrelevant topics (58.6%) were the most common obstacles limiting dentists in the CPD programs. Conclusion: Based on the results of this study, dentists in Isfahan province reported more interest and need to participate in some fields of CPD courses including practice management, pediatric dentistry, and oral and dental reconstruction. Thus, a system for continuing education based on dentists' needs and preferences is highly suggested. [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]

Good resilience skills support effective and timely adjustment to demanding situations in the workplace. Existing tools are insufficient to develop and evaluate workplace interventions to improve employee's resilience skills. The aim of this study was to develop and validate a Resilience Skills Questionnaire (RSQ) using the key constructs of social cognitive theory—self-efficacy, self-regulation, and social support—as a theoretical framework. Following DeVellis' guidelines for scale development, first an expert panel of thirteen professors was recruited to support the item development stages and determine content validity. At this stage, the initial pool of 38 items was reduced to 25 items and CVR and CVI were calculated as 0.92 and 0.93, respectively, indicating good content validity. A second panel of ten health professionals confirmed face validity. An online survey comprised of the 25 developed items was then completed by 336 health professionals working in urban healthcare centers in Shiraz, Iran, in November 2021. The data were used to assess the psychometrics of the questionnaire according to its hypothesized three-dimensional structure. Confirmatory factor analysis yielded a final model of seventeen items in three dimensions, self-efficacy (six items), social support (six items), and self-regulation (five items), with good psychometric properties ( χ 2 / df = 2.44 (p < 0.001), RMSEA = 0.06 , GFI = 0.92 , AGFI = 0.90 , IFI = 0.93 , CFI = 0.93). All standardized factor loadings were significant (p < 0.001). Internal consistency, as measured by Cronbach's alpha, was very good: RSQ (0.90), self-efficacy (0.86), social support (0.83), and self-regulation (0.86). Based on these results, the RSQ can be used as a standard and valid measure to develop and evaluate the effect of educational intervention programs to improve resilience skills and reduce job stress. [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: Although acupressure is proposed to boost sleep quality and alleviate anxiety in various disorders, no trials have yet documented these consequences in burn victims. Considering the high importance of managing sleep quality and anxiety among burn patients utilizing adjunctive non-pharmacological measures, this study sought to investigate the impacts of acupressure on sleep quality and anxiety among a population of Iranian patients with burn injuries. Methods: This trial was performed on 72 patients with second- or third-degree burns, who were divided into two equal arms to receive routine care plus 10-minute acupressure on either real acupoints (i.e., Yintang and Shen men) or sham points for three consecutive nights. Sleep quality and anxiety were investigated at baseline (T1) and on the fourth day (T2) by using St. Mary's Hospital Sleep Questionnaire (SMHSQ) and Spielberger's State-Trait Anxiety Inventory for State Anxiety (STAI-S), respectively. Results: The mean scores of SMHSQ and STAI-S were significantly lower in the real acupressure arm at T2 (P < 0.001 in two cases), implying better sleep quality improvement and higher anxiety alleviation. Also, the reduction in mean changes of SMHSQ and STAI-S scores from T1 to T2 was significantly more in the real acupressure arm (P < 0.001 in two cases). Conclusion: Acupressure, as a low-cost complementary method, could be potentially helpful in enhancing sleep quality and decreasing the anxiety of burn patients. Additional long-term trials are required to identify the sustainability of the findings. Trial Registration No: IRCT20130424013110N13 (Registration date: 19/03/2021, https://www.irct.ir/trial/55076). [ABSTRACT FROM AUTHOR]

Introduction: Although different tools have been designed to measure mindfulness, none has comprehensively examined academic mindfulness. Therefore, the present study aimed to build a reliable and valid tool for academic mindfulness measurement in students. Method: The research was a descriptive-correlational study and a validation of the test. Participants included 420 students of Bu-Ali Sina University in the academic year of 2022-2023, selected by multistage cluster random sampling method and completed the Academic Mindfulness Questionnaire (AMQ-5), Fear of Self-compassion Scale, and Academic Engagement Questionnaire. Data were analyzed using exploratory and confirmatory factor analysis. Results: Examination of the data by exploratory factor analysis showed that all 20 items had acceptable factor loads and revealed five factors (self-compassion, accepting without judgment, presence in the moment, performing tasks with awareness, and listening with full attention). Moreover, according to the confirmatory factor analysis, the questionnaire had an acceptable fit (RMSEA=0.047, AGFI=0.91, NFI=0.96, CFI=0.98). The findings showed that academic mindfulness was significantly correlated with fear of self-compassion and academic engagement. Moreover, Cronbach's alpha coefficient was 0.89. Conclusion: According to the findings of the present study, it can be concluded that the academic mindfulness questionnaire has a good validity and reliability and can effectively measure academic mindfulness in the five factors mentioned. [ABSTRACT FROM AUTHOR]

Introduction: Nowadays, Instagram has become one of the most widely used social media platforms in Iran and around the world. This study aimed to examine the psychometric properties of the Persian version of the Instagram Addiction Test in Iran. Method: This cross-sectional study utilized an online survey methodology to assess Instagram usage patterns and addiction levels among Iranian users. The survey which was conducted in 2020, targeted a diverse population across various regions of Iran, providing a comprehensive overview of the national Instagram user demographic. The sample comprised 950 participants, selected through convenience sampling approach. Key instruments included the Instagram Addiction Test (1998), the Connor- Davidson Resilience Scale (2003), and the Addiction to Mobile Questionnaire Based on Social Networks (2015). To ensure psychometric analysis, we employed construct validity via exploratory factor analysis, divergent validity through correlation assessment between Instagram addiction and resilience subscales, and convergent validity by evaluating the correlation patterns within Instagram addiction constructs. All data was analyzed using SPSS- 25. Results: The reliability, indicated by a Cronbach's alpha of 0.706, surpasses the accepted benchmark (α > 0.7), confirming the internal consistency of the tool. Conclusion: This study had substantiated the validity and reliability of the Persian version of the Instagram Addiction Test, affirming its efficacy in measuring dependency levels on this social media platform. [ABSTRACT FROM AUTHOR]

Introduction: Complex Post-Traumatic Stress Disorder (CPTSD) has been recognized as a distinct disorder from Post-Traumatic Stress Disorder (PTSD) in the eleventh revision of the disease classification system (ICD-11). The international trauma Questionnaires have been developed to measure C-PTSD. This study was conducted to enhance the psychometric properties of the Persian version of the 18-item International Trauma Questionnaire (ITQ-18 Items). Method: This research followed a descriptive-evaluative approach. The last version of ITQ was translated and back-translated, and its content validity was assessed through measurement and obtained above 0.70. The statistical population consisted of non-clinical married middle-aged women in the age range of 30 to 40 years who were registered in the comprehensive health services center electronic system of Bushehr province in the year 2022-2023. They responded to the questionnaires over a two-month period using a multistage cluster sampling method. To assess concurrent validity, the hospital anxiety and depression questionnaire along with adverse childhood experiences were used. The data were analyzed employing confirmatory factor analysis and correlation coefficient analysis. Results: Findings indicated that, considering SRMR=0.56, RMSEA=0.61, TLI=0.943, CFI=0.959, and BIC=21879.875, the optimal fit was found in the second-order two-factor model. A statistically significant positive relationship was found between CPTSD and clinical anxiety and depression (p<0.01). Additionally, adverse childhood experiences showed a correlation (p<0.01). Conclusion: According to the findings of the present study, it can be stated that the Persian version of the ITQ-18 Items, by the ICD-11, exhibits appropriate psychometric properties. [ABSTRACT FROM AUTHOR]