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Background Cancer survival largely depends on its early diagnosis. Therefore, assessing help-seeking behaviours among people with potential symptoms of cancer is essential. Aim This study aimed to analyse the concept of help-seeking behaviour for cancer symptoms. Methods This concept analysis was conducted using Rodger's evolutionary method. An online literature search was conducted in the PubMed, Scopus and Cochrane databases to find relevant articles published from 2000 to 2017 in English peer-reviewed journals. In total, ninety articles were included in the study. Through thematic analysis, the data were analysed for the definitions, attributes, antecedents and consequences of the concept of help-seeking behaviour for cancer symptoms. Results The concept of help-seeking behaviour for cancer symptoms includes a chain of behaviours and is defined as the process of informed decision-making for seeking medical help and using healthcare services after the detection of the first potential cancer symptoms. The attributes of the concept of help-seeking behaviour for cancer symptoms include process, problem-centeredness, intentional action and interpersonal interaction. Antecedents of the concept of help-seeking behaviour for cancer symptoms were broadly categorised as its facilitators and barriers, among which old age, young age, marriage, low education level, positive family history of cancer, fear over cancer, low perceived threat, symptom disclosure to significant others are both facilitator and barrier. The consequences of the concept of help-seeking behaviour for cancer symptoms were also broadly categorised in the two main categories of positive consequences and adverse consequences. Conclusions Help-seeking behaviour is a multidimensional time-dependent and context-bound concept which is usually defined based on the concept of time in order to facilitate its measurement. It is generally used for assessing patients' delay in seeking medical help. The findings of this study provide better understanding about the concept of help-seeking behaviour for cancer symptoms and its implications for research and practice.

In recent years, extensive studies have been conducted on the diagnosis of Alzheimer's disease (AD) using the non-invasive speech signal recognition method. In this study, Farsi speech signals were analyzed using the auditory model system (AMS) in order to recognize AD. For this purpose, after the pre-processing of the speech signals and utilizing AMS, 4D outputs as function of time, frequency, rate, and scale range were obtained. The AMS outcomes were averaged in term of time to analyze the rate-frequency-scale for both groups, Alzheimer's and healthy control subjects. Thereafter, the maximum of spectral and temporal modulation and frequency were extracted to classify by the support vector machine (SVM). The SVM achieves higher promising recognition accuracy with compare to prevalent approaches in the field of speech processing. The acceptable results demonstrate the applicability of the proposed algorithm in non-invasive and low-cost recognizing Alzheimer's only using the few extracted features of the speech signal.

Background and aims: Cardiopulmonary resuscitation (CPR) success rate is an important issue for all healthcare facilities. In the present study, success rate and related factors were assessed in a hospital in Iran. Methods: This descriptive-correlational study was conducted in 2017. By using the convenience sampling, 156 patients were selected. Variables based on the In-Hospital Utstein-Style were used, which included 3 categories: patients, cardiac arrest and follow-up. Data were analyzed by SPSS 22. Results: Of 156 participants, 92 were male and the average age was 61.4±5.5 years. Most cardiac arrest occurred in night shift (43.6%). The most common cause of cardiac arrest was cancer (33%). Of 156 patients, 102 died. Results showed a significant correlation between success rate, a patient’s sex, rhythm type and medication administered during resuscitation (P

Background:Disordered eating attitudes and behaviors have become an issue of worldwide concern.Aim:This research was designed to investigate the role of body image satisfaction in the relationship with eating attitudes among students of Qazvin University of Medical Sciences in Iran.Methods:In this cross-sectional study, 385 Qazvin university students of medical sciences were recruited by randomized stratified sampling in 2014. The students completed a three-part questionnaire (socio-demographic, Eating Attitudes Test and Body Shape Questionnaire) in their classrooms. We used hierarchical generalized linear models to identify variables significantly associated with Eating Attitudes Test scores.Results:The mean age of the students was 21.80 ± 2.98 years. Mean scores for the Eating Attitudes Test and Body Shape Questionnaire were 66.75 ± 29.8 and 11.86 ± 10.97 respectively; 18.5% of students had a score of 20 and above (≥ 20) that indicated disordered eating attitudes or as being at risk of eating disorders. In the multiple regression model, the Eating Attitudes Test was related to screening body image dissatisfaction (β = 0.122, P < 0.001). Body mass index was negatively related to the Eating Attitudes Test score (β= -0.488, P < 0.016), and diet was significantly correlated with an increased Eating Attitudes Test score (β = 5.803, P < 0.001).Conclusions:The risk of eating disorders is relatively high among Iranian university students. It can be a warning to health policy makers and should be the focus of special attention. In the present study, the most important factor related to abnormal eating attitudes was body image dissatisfaction. Regarding the complexity of the causes of eating disorders, various preventive and therapeutic interventions are necessary to avoid the dissemination in society of an idealized view of excessive thinness and further unfavorable outcomes in college students.

Background and aims: Organizational support of family members of the patients admitted to intensive care units (ICUs) potentially reduces mental stresses and enables them to better comply with and support the patients. The current study aimed at evaluating the needs of families of the patients admitted to ICUs in teaching hospitals of Iran. Methods: This cross-sectional study was conducted in 2015 using convenience sampling method. The Critical Care Family Needs Inventory (CCFNI) in 5 factors was used as a main data collection tool. The study population included 235 family members of the patients. Results: Total score of CCFNI was 132.32±18.46. Needs of family members of ICU patients decreased 0.428 times following the increase of length of stay in ICU (P

Loss of pregnancy is a major stressor which can cause mental disorders. In stressful conditions, spiritual intelligence can be used as a coping strategy to manage and cope with the stressor. It may also produce positive outcomes in spontaneous abortion. This study aimed to assess the relationship of spiritual intelligence with depression after spontaneous abortion. This cross-sectional descriptive-correlational study was done in 2015-2016 on 185 women with spontaneous abortion who were hospitalized in the postnatal care ward of Kowsar teaching hospital, Qazvin, Iran. Data collection was performed in two steps. In the first step, a demographic and obstetric characteristics questionnaire and the Spiritual Intelligence Self-Report Inventory were completed by participants during their hospital stay. In the second step, i.e., 7 days after spontaneous abortion, the Edinburgh Postnatal Depression Scale was completed for each participant over the phone. Variables which were found in univariate analysis to have a significant correlation with depression were entered into multiple logistic regression analysis to assess their roles in predicting depression. Most women were depressed (54%). Multiple logistic regression analysis revealed that the significant predictors of depression were women's educational status (OR 0.419; CI 0.18-0.93), gestational age at the time of abortion (OR 1.121; CI 1.02-1.22), and the personal meaning production dimension of spiritual intelligence (OR 0.82; CI 0.73-0.91). Spiritual intelligence is significantly correlated with post-abortion depression. Developing and following strategies for promoting spiritual intelligence can alleviate depression, stress, and anxiety after spontaneous abortion and also help manage complicated pregnancies.

It is more than a decade that amniotic membrane has been used as a wound dressing because of its anti-inflammatory, anti-microbial, anti-fibrotic, anti-scarring properties, as well as its pain relieving and epithelialization promoting features. However, amniotic membrane had limited applications because it needs to suture in surgery, is highly fragile, firmly adhere to the wound and may cause bleeding and pain when changing the bandage. This study investigated the possibility of development of a novel amniotic-based chitosan gel dressing as a potential wound repair substrate with marked efficacy. In this experiment, amniotic gel prepared based on chitosan/PVP gel containing human amniotic membrane extract (AME-Gel) was investigated in terms of wound-healing efficacy and scar preventive effects in a rat burn model. The levels of re-epithelialization and dermal regeneration were examined by histological assessment using H&E and Masson's trichrome staining. Also, we clarified the mechanism of healing and cytokine-releasing activities of AME as well as its effect on epithelization, angiogenesis, and fibroblast growth and migration. Our results revealed that AME-Gel induces epidermal and dermal regeneration at a shorter time through formation of granulation tissue, enhancement of fibroblast proliferation, and improvement of blood capillary formation concomitant with developing collagen bundles. Therefore, AME-Gel could be considered a simple and easy to be used as a biological dressing for any type of superficial burn wounds, without any adverse effects.

Background Limbal stem cell transplantation (LSCT) is the definitive treatment for total limbal stem cell deficiency (LSCD). This study evaluates the anatomical and visual outcomes of a surgical technique supplemented by amniotic membrane extract eye drop (AMEED) for in vivo cultivation of limbal stem cells (LSCs). Methods One small limbal block (2 × 1 mm) harvested from the contralateral healthy eye was transferred to the diseased eye, which had been already covered by cryopreserved amniotic membrane (N = 20). The patients were categorized into case and control groups. AMEED was administered postoperatively only for patients in the case group (N = 14). Sequential penetrating keratoplasty (PKP) was performed in 4 eyes of the case group for optical clarity. Visual acuity, epithelial healing, corneal clarity and regression of conjunctivalization/vascularization were evaluated after surgery. The corneal buttons of post-PKP eyes were evaluated for LSC markers. Results In the case group, the mean corrected distance visual acuity (CDVA) was 20/400 before surgery, which improved to 20/40 and 20/50 at the last follow-up in eyes with and without PKP, respectively. Epithelial defects healed in all eyes of the case group during 2 weeks after surgery. Corneal conjunctivalization/vascularization regressed dramatically in all patients of the case group 2–3 months after surgery. In PKP cases, all transplanted corneas were clear at the last follow-up. LSC markers were expressed on the surface of all trephined corneal buttons. All eyes in the control group developed persistent epithelial defect. Conclusion This study suggests that amniotic membrane extract may be helpful for in vivo cultivation of limbal stem cells.

Background: Nursing as a clinical discipline is developing in the emergency wards. Health care systems should continuously assess and prioritize indicators of clinical competency in these wards. The lack of clear standards of clinical competency indicators challenges evaluation. The purpose of this study was to determine clinical competency indicators and its priority based on nurses' views in educational and therapeutic centers in Guilan. Materials and Methods: The Q methodology was conducted in three phases, that is, phase I (determining the clinical competency indicators), phase II (classifying clinical competency indicators by an expert panel), and phase III (prioritizing clinical competency indicators). The subjects were selected by convenience sampling among nurses working in the emergency wards of teaching hospitals affiliated to Guilan in 2013. Finally, clinical competency indicators were prioritized using exploratory factor analysis. Results: In the prioritizing phase, data were collected from 710 nurses over two months. Five factors with 30 general competencies were found in three domains: communication, professional maturity, and personality characteristics. Six factors with 37 specific competencies were also found in two domains: scientific and technical capabilities and basic clinical skills that can provide a structured instrument for assessing clinical competence in emergency nurses. Conclusions: Achieved competencies can be used as a reference for nursing education and practice in emergency. Further research on health care system is needed in order to achieve a reliable and valid instrument.

Perinatal tissues possess numerous types of stem (stromal) cells, which are considered effective candidates for cell therapy. These tissues possess common characteristics of both embryonic and adult stem cells, and cell therapists have begun to use perinatal stem cells to treat several diseases. Despite their benefits, these cells are considered biological waste and usually discarded after delivery. This review highlights the characteristics and potential clinical applications in regenerative medicine of perinatal stem cell sources – cord blood hematopoietic stem cells, umbilical cord mesenchymal stem cells, amniotic membrane stem cells, amniotic fluid stem cells, amniotic epithelial cells and chorionic mesenchymal stem cells.

Background: Restless legs syndrome (RLS) is a type of movement disorder with strong importunate movement of legs during rest or inactivity. Twitching of muscle is experienced at night that disturbs patients’ sleep. This syndrome is more prevalent among patients with multiple sclerosis (MS). Hence, this study aimed to investigate the association between restless legs syndrome and sleep disturbances in patients suffering from MS. Methods: This cross-sectional study was conducted from May to September 2016 in Qazvin, Iran. Participants were 118 patients with MS referring to the multiple sclerosis association. Data were collected using a demographic questionnaire, expanded disability status scale (EDSS) to screen and assess the intensity of restless legs syndrome, and Pittsburgh sleep quality index to investigate sleep disturbance. Descriptive and inferential statistics including independent T test, 2 test, and stepwise logistic regression analysis were used for data analysis. Results: RLS was diagnosed in 56.8% of the participants. The score of sleep quality was above 6 indicating poor sleep quality in the patients. However, the mean score of PSQI was significantly higher in patients suffering from restless legs syndrome compared to the healthy people (14.43 ± 2.2 and 11.43 ± 2.2, respectively; P < 0.001). Conclusions: RLS is a prevalent disorder in MS patients leading to sleep disturbances. Therefore, the assessment, diagnosis, and implementation of appropriate interventions to improve patients’ sleep quality are required. Such interventions also can improve patients’ health status and quality of life.

Human amniotic membrane (HAM) has been used as a very promising biological-based product in health centers, especially for skin and cornea wound healing applications. The excellent properties of this membrane make it a potential candidate in treatment of various skin injuries such as bedsores, burn wounds and diabetic ulcers. Such properties are cytobiocompatibility, a structure very similar to normal skin composed of extracellular matrix (ECM) proteins, various growth factors involved in normal wound healing process and antibacterial agents. HAM contains epithelial cells, fibroblasts and mesenchymal stem cells. Therefore, the successful decellularization of HAM with minimal negative effects on its ECM components is very important to avoid graft rejection and shows improved performance. To date, several approaches have been conducted for decellularization of HAM, which is mainly based on enzyme-, detergent- or mechanical procedures with various ranges of success. Here, we describe a systematic detergent based decellularization protocol as main protocol. We also explain the enzyme- and mechanical based methods as the alternative protocols for decellularization of HAM., S.C.K. is supported by the European Union Framework Program for Research and InnovationHORIZON 2020 under grant agreement no 668983 — FoReCaST.