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Aim: Documentation is a critical element in the function of the nursing team, and cannot be separated from high-quality, patient-centered care. The aim of this study was to compare the quality of nursing documentation in electronic and paper-based systems.Method: A retrospective descriptive study was designed to compare the quality of nursing documentation in electronic health records (EHR) versus paper-based documentation systems before and after the application of the electronic system.Results: Analysis of data found a significant difference in the quality of nursing documentation in the two hospitals both before and after the implementation of an EHR system (p < 0.001).Quality of nursing documentation in the electronic system was significantly better than that of paper-based documentation systems.Conclusion: Vocal-electronic systems help to improve quality of nursing documentation, suggesting this aspect may be essential to implementing a successful system in local settings. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that a disease outbreak may cause high stress among healthcare workers. However, the vast majority of those studies applied a variable-centered approach, in which relationships between the variables are believed to be identical across the studied population. The main purpose of this study was to identify latent profiles of healthcare workers with similar combinations of levels of various work-related stressors during the coronavirus disease 2019 (COVID-19) pandemic and to examine their predictors. Methods: A cross-sectional paper-and-pencil study was conducted among a convenience sample of 297 emergency department (ED) nurses and 219 emergency medical services (EMS) staff members working in 10 hospital EDs and 52 EMS centers in Ardabil province, Iran. Data were collected using the Health and Safety Executive Management Standards Indicator Tool (HSE-MS IT). Results: Using the latent profile analysis (LPA), five work-related stress profiles were identified: "high stress with a good understanding of one's job role" (11.1%), "moderate stress" (41.9%), "relatively high stress with average demands and a very low understanding of one's job role" (23.8%), "low stress" (18.0%), and "generally low stress but with very high job demands and relational conflicts" (5.2%). Age, marital status, service location, workplace, and the number of overtime hours significantly predicted profile membership. Conclusion: The results of the study suggest the importance of incorporating various sources of stress and using the person-centered approach when investigating the work-related stress of healthcare workers during disease outbreaks. Identifying sociodemographic and work-related predictors of profile membership may be useful for preparing interventions that will be better suited to healthcare workers' needs. [ABSTRACT FROM AUTHOR]

Objective: To augment the international scientific approach to raising public mental health through active lifestyle among adults, we added the evidence of the association between physical activity and subjective wellbeing in the Middle East and North Africa region by emphasizing the mediator—COVID-19. This study aimed to identify the correlations between active mobility and subjective wellbeing during the COVID-19 pandemic in a sample from Tabriz, Iran, which has not yet been tackled in previous study. Methods: We finalized an online survey (N = 603) from adults between 5 June and 15 July 2021. This group reported their individual and socio-economic characteristics and their perception features and location (e.g., home, work) during COVID-19. The paper developed three ordinal logistic regression (OLR) models to examine the association between active mobility types such as commute, non-commute, frequency of active travel to parks and services per week, and different subjective wellbeing including: 1- life satisfaction, 2- feeling energetic, and 3- peaceful mind while controlling for socio-economic variables (e.g., age, gender, education, job, and income) and objective commute distance. We also incorporated the most relevant objective (street length, land-use mix, number of intersections, and building and population density) and subjective (perceived distance to different services, perceived walking places, and perceived facilities attractiveness) factors. Results: Positive response relationships between four types of physical activity levels and subjective wellbeing scores were demonstrated in all of the three developed models (with significant levels of 0.05, and 0.1) with appropriate model fits, which confirmed the existing literature. However, these relationships showed different patterns (varied significant levels) for each type of subjective wellbeing. In addition, the factors including street length (p value: 0.004), perceived walkable places (p value: 0.021, 0.068, 0.017, and 0.025) (positively), population density, and perceived distance to shopping malls (p value: 0.076, <0.0001, and 0.059 (negatively) were associated with different indicators of subjective wellbeing. Conclusion: As for the implication of our study, special actions by urban authorities such as increasing mixed-use and creating attractive places will be required to enhance the walkability of the neighborhoods. Moreover, notifying the adults regarding the benefits of physical activity is much more needed. [ABSTRACT FROM AUTHOR]

Given the perennial imbalance and chronic scarcity between the demand for and supply of available organs, organ allocation is one of the most critical decisions in the management of organ transplantation networks. Organ allocation systems undergo rapid revisions for the sake of improved outcomes in terms of both equity and medical efficiency. This paper presents a Data Envelopment Analysis (DEA)-based model to evaluate the efficiency of possible patient-organ pairs for kidney allocation in order to enhance the fitness of organ allocation under inherent uncertainty in such problem. Eligible patient-kidney pairs are regarded as decision making units (DMUs) in a Credibility-based Fuzzy Common Weights DEA (CFCWDEA) approach and are ranked based on efficiency scores. Using a common set of weights for all DMUs ensures a high degree of fairness in the assessment and ranking of DMUs. The proposed model is also the first allocation method capable of coping with the vague and intervallic medical and nonmedical allocation factors by the aid of fuzzy programming. Verification and validation of the proposed approach are performed in two steps using a real case study from the Iranian kidney allocation system. First, the superiority of the proposed deterministic model in enhancing allocation outcomes is demonstrated and analyzed. Second, the applicability of the proposed fuzzy DEA method is demonstrated using a series of data realizations for different credibility levels. [ABSTRACT FROM AUTHOR]

Background: Long-term complications of stroke, persisting for more than 6 months after the initial event, substantially reduce the quality of life (QoL) in a significant percentage of stroke survivors. In this paper, we studied the prevalence of long-term urinary incontinence (UI) in post-stroke patients. In addition, we attempted to identify patient characteristics which were associated with higher UI prevalence, higher UI severity, and less UI-associated QoL. Methods: Medical records in a tertiary referral hospital were used to contact patients who had experienced a stroke between 6 to 32 months before the study date. The patients were given the International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI-SF) questionnaire for determining the presence of UI and its severity. UI-positive patients were then given the I-QOL questionnaire to determine their QoL. Results: The prevalence of UI in our study population (n = 189) was 31%. Older age at the time of stroke was associated with higher UI severity (r = 0.290) and lower QoL (r = -0.265). Furthermore, the presence of movement limitation was associated with higher UI prevalence (P < 0.001, OR = 3.89) and severity (P = 0.002, d = 1.05). Movement limitation also significantly impacted the psychological and social aspects of UI-associated QoL (P = 0.035, d = -0.74). Conversely, higher body mass indices (BMIs) were associated with lower UI severity (r = -0.346) and higher QoL (r = 0.281). Conclusion: In conclusion, UI continues to be prevalent in stroke survivors long after the cerebrovascular accident (CVA). As a result, these patients require continuous monitoring and UI prevention. [ABSTRACT FROM AUTHOR]

Purpose: Respect for human rights is one of the most important criteria for the delivery of medical care in hospitals. Ethical predictability is useful to identify human rights concerns in health-care organizations. The hospital environment and the flow of its processes make the topic of predictability much more sensitive and, at the same time, more difficult than other organizations. The purpose of this paper is to determine and compare the ethical predictive factors in selected hospitals in Mazandaran province. Design/methodology/approach: This cross-sectional survey using multilevel sampling (four hospitals, 938 patients, 186 staff) was conducted in the first half of 2017. The measurement instrument was a researcher-made questionnaire consisting of seven areas of service recipients' rights, patient safety, patient satisfaction, human resources, governance, organizational and financial commitments. The analysis of the collected data was performed through SPSS V. 22 and one-way ANOVA and post hoc Tukey's tests. Findings: Ethical predictability was higher in social security hospitals compared to private and public hospitals, and patient safety and patient rights showed higher magnitudes compared to other dimensions. Financial domain, patient satisfaction, governance and organizational commitment formed the middle priorities in ethical predictability, and human resources had the least average in ethical predictability in the selected hospitals in the province. Originality/value: Identifying the factors which influence ethical predictability, in addition to promoting service recipients' rights and patient satisfaction, is of great help to the managers and health service authorities, so that they can have a better understanding of these factors and, consequently, make appropriate micro and macro-decisions to provide better services. [ABSTRACT FROM AUTHOR]

Purpose: Health is one of the most basic human rights. Self-medication not only results in many risks, complications and mortalities but also remains a massive economic burden on governments' pharmaceutical budgets, insurance companies and the general population. The importance of self-medication as one of the worldwide health problems, this paper aims to investigate the extent of this problem and related factors in Sanandaj, Iran in 2018. Design/methodology/approach: This cross-sectional, descriptive study was conducted on 838 people who referred to pharmacies in Sanandaj, Iran in 2018. The subjects were selected in 10 pharmacies, 84 in each, randomly. A self-constructed questionnaire was used to collect information about demographic features, prevalence and reasons for self-medication. The data was analyzed statistically by SPSS software. Findings: The results show a high prevalence of self-medication, 73.70 per cent among people who referred to the pharmacies in Sanandaj during 2018. There was a significant correlation between self-medication and occupation, education level, age groups, chronic disease, smoking or reasons to refer to pharmacies (p < 0.05). Analgesics, antibiotics; non-steroid anti-inflammatory, cold and gastrointestinal medicines were the most commonly used medicines by the subjects. People with headache, cold, infection, stomach pain, toothache and dysmenorrhea were more likely to act self-medication than people with other complaints. Among people who do self-medication, (85.60 per cent) had already experienced satisfactory results after using medicines. Mild symptoms of the disease (74.11 per cent), availability of medicines (72.98 per cent) and easy access to medicine supplies in pharmacies (71.35 per cent) are other reasons for self-medication. Research limitations/implications: In general, the study had some limitations. One of the limitations was related to the research period i.e. spring and summer. So, it is suggested to conduct studies in other seasons, too. Furthermore, as the time of self-medication was the past three months, there was a probability of recall bias. Originality/value: The prevalence of self-medication in Sanandaj is high and alarming, implementing educational programs about this issue is extremely required. Health policymakers should take all necessary steps to tackle self-medication efficiently. [ABSTRACT FROM AUTHOR]

A systematic review was conducted to gain a more nuanced understanding of similarities and distinctions across countries in the development of executive functions (EF). The review includes 26 studies, with child and adolescent participants, that were published between 2006 and 2018. Both similarities and differences within developmental patterns of EF are identified across different countries. Across countries, bilingual children are shown to outperform their monolingual peers. Task improvement with age is not consistently reported in all studies, with no linear effects apparent in children from developing countries or regions. Gender differences on EF measures also vary between countries. Girls perform better than boys on EF tasks and parent and teacher ratings of EF in both Western and East Asian samples. Yet, in Iran and Tanzania, boys receive higher EF scores. From preschool age through adolescence, East Asians outperform Western counterparts on direct assessment measures of EF. However, strong discrepancies can be found between measures of direct EF assessment and parent and teacher ratings of children's EF. Chinese parents rate their children's EF as lower compared with parents from other countries. The role of contextual factors explaining differences in EF development is discussed. Highlights: This paper presents the first systematic review on the topic of cross‐national variation in children's EF development.A clearly defined conceptual framework regarding EF facets and analysis of a wide age span underpin this review.From preschool age through adolescence, East‐Asian children outperform their Western counterparts on direct assessment measures of EF. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Determination of remaining growth potential of patients is the most important factor in orthodontic treatment. Purpose: This study aimed to assess the correlation of clivus length and angle with age, gender, sagittal growth pattern of the jaws, and skeletal maturation using lateral cephalometry. Materials and Method: This cross-sectional study was conducted on 390 lateral cephalograms (Vatech, paX-i3D Green, South Korea) of patients aged 6 to 25 years. The patients were assigned to three groups of skeletal class I, II, III (n=130) with equal gender distribution. The clivus length and angle, Welcher angle, maxillary and mandibular effective length, sella turcica to Nasion (SN), and the angles between SN and point A (SNA), between SN and point B (SNB), and between NA and NB (ANB )were measured. Correlations of variables with age and gender, and cervical vertebral maturation stage (CVMS) were analyzed using the Pearson and Spearman’s correlation tests, independent t-test, and one-way ANOVA at 0.05 level of significance. Results: Clivus length had a significant correlation with SNA (r= 0.103, p= 0.042), SNB (r= 0.108, p= 0.033), maxillary (r= 0.547, p< 0.001) and mandibular (r= 0.589, p< 0.001) effective lengths, SN length (r= 0.586, p< 0.001), and CVMS (r= 0.697, p< 0.001). Clivus angle had a significant correlation with SNA (r= 0.105, p= 0.039), SNB (r= 0.155, p= 0.002), maxillary (r= 0.507, p< 0.001) and mandibular (r= 0.596, p= 0.001) effective lengths, SN length (r= 0.566, p< 0.001), and CVMS (r= 0.699, p< 0.001). The mean clivus length (p= 0.006) and angle (p= 0.002) were significantly higher in males, and had a significant correlation with age (r= 0.636 and r= 0.718, p< 0.001). The mean clivus length and angle were not significantly different in class I, II, III (p> 0.05). Conclusion: All parameters were greater in males, and increased with age (except Welcher angle). Clivus length and angle had significant correlations with position of both jaws but not with sagittal relationship. [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 & aims: Missed nursing care is a global challenge that can have many consequences and it's known as a common threat to the patient safety and quality of nursing care. The nurses' professional commitment plays the final role in the occurrence of this issue. This study aimed to investigate the relationship between nurses' professional commitment and missed nursing care in Iran. Materials & methods: This cross-sectional descriptive-analytical study was conducted on 270 nurses working in two hospitals affiliated to Tehran University of Medical Sciences (Sina & Shariati) from September to December 2023. The research community included all nurses working in medical-surgical wards in the designated hospitals. The research samples were included in a targeted and quota method after obtaining organizational permits, ethical approval and informed consent. Data collection was done using three questionnaires including demographic information form, Nursing Professional Commitment Scale, and MISSCARE Questionnaire. The collected data was analyzed in SPSS software, version 25. Results: The results of Pearson's correlation test showed that there is a significant negative relationship between nurses' professional commitment and missed nursing care scores (r=-0.23) (p < 0.001). The mean score of nurses' professional commitment was reported at a moderate to high level (83.72 ± 16.02) and the mean score of missed nursing care was reported at a low level (47.84 ± 16.48). Nurses over 40 years old, morning shift and employed nurses showed higher professional commitment. Also, nurses under 29 years old and male nurses had more missed nursing care other than their participants. No relationship was observed between other demographic variables with nurses' professional commitment and missed nursing care. Conclusion: The results of this study showed that higher nurses' professional commitment leads to higher quality of care and less missed nursing care. Based on findings of this research, it is recommended for health care providers and nursing managers to adopt programs to increase nurses' professional commitment and consequently reduce missed nursing care. [ABSTRACT FROM AUTHOR]

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]

Background: Brain and central nervous system (CNS) cancers make up about 3% of all cancers around the world and are more common among men than women. Present study aimed to evaluate the occurrence trend of brain and CNS cancers in Iran from 1990 to 2017. Methods: This study using global burden of disease (GBD) 1990 to 2017 data demonstrated the trend of incidence and mortality of brain and nervous system cancer in Iran. All-age, sex-based, age-standardized, age-specific (from 1990 to 2017), and age distribution of incidence and mortality rates of brain and nervous system cancer were estimated in Iran during 2017. Results: Both incidence and mortality rates of brain and nervous system cancer increased from 1990 to 2005 in Iran, Eastern Mediterranean Region, and global level. During 1990, incidence and mortality rates of brain and nervous system cancer were higher in women than men, but gradually both rates increased in men and exceeded women in Iran. From 1990 to 2017, the value of age-adjusted rate was higher than all-age rate of brain and nervous system cancer. The most incidence and mortality of brain and nervous system cancer from 1990 to 2017 occurred in age group of > 70 and the least values were seen in 15-49-year-old group in Iran. Conclusion: The brain tumor occurrence and mortality in Iran was higher than other Eastern Mediterranean Region countries. Incidence and mortality of this cancer has an increasing trend in Iran and this trend somewhat was independent from population aging. [ABSTRACT FROM AUTHOR]

Purpose: The Iranian patients' rights charter defines patient rights as a reflection of fundamental human rights in the field of medicine and incorporates all elements of patient rights accepted in international texts. The purpose of this paper is to study the way in which diabetes patients' rights are being exercised in everyday hospital practice in Birjand, Iran. Design/methodology/approach: A cross-sectional study design was used in 2014. The sample size was estimated 150 patients, out of which 108 diabetes patients completed questionnaire. The questionnaire of diabetes patients' perspectives on the patients' rights was used to collect data. The questionnaire consists of 22 questions. Data entry and analysis were carried out using SPSS software (version 22). Descriptive and inferential statistics were calculated with all survey items and total scores, as well as demographic data. Findings: The response rate was 72 percent. Overall, the mean score percentage of diabetes patients' perspectives on the patients' rights was 74.04± 8.4. Furthermore, statistical significant differences were found among diabetes patients in relation to patients' perspectives on the patients' rights according to highest level of education (F=16.52, p=0.002), their habitat(t=3.49, p=0.001), age groups (F=18.70, p=0.0001) and the duration of the disease (F=5.16, p=0.007). The results showed that no statistically significant differences were observed among diabetes patients in relation to diabetes patients' perspectives on the patients' rights according to their gender (F=1.57, p=0.12) and marital status (F=1.56, p=0.09). Originality/value: Clinicians can provide care based on patients' rights, and their knowledge of patients' rights needs to be evaluated. Educational courses, leaflets, booklets and posters can be helpful in this regard. In addition, professional organizations and the Ministry of Health need to be more sensitive to this issue. [ABSTRACT FROM AUTHOR]

Purpose Falling was distinguished as leading cause of fatal and non-fatal injuries among elderly; there is a lack of information regarding the falling risk factors in developing countries. The purpose of this paper is to investigate the falling risk and correlated factors in community-dwelling elderly.Design/methodology/approach This cross-sectional study was performed on 280 elderly using a multi-sectional questionnaire in Karaj, Iran. The simple stratified random sampling was used. Adult who were over the age of 60, living independently, able to ambulate independently and safely, no cognition problem and speaking in Persian entered in the study. Exclusion criteria were residing in assisted living facility or unwilling to participate. Several statistical tests including logistic regression analysis were used to analyse the data.Findings The mean age of participants was 69.55±8.82 and 51 per cent of them were female. The results showed that there are significant differences between low-, medium- and high-risk groups regarding age, marital status, diabetes, blood pressure and osteoarthritis (p<0.05). Due to finding, the main predictors to higher chance of falling were age (OR=1.61; 95% CI 1.025–1.097), marital status (OR=1.485; 95% CI 1.170–1.279), vision acuity (OR=1.603; 95% CI 1.297–2.223), activities of daily living (OR=2.10; 95% CI 1.047–3.859), heart disease (OR=1.448; 95% CI 1.268–1.728), osteoarthritis (OR=1.238; 95% CI 1.711–2.127), falling history (OR=1.026; 95% CI 1.015–1.089) and medication (OR=5.975; 95% CI 1.525–23.412).Practical implications Better understanding of falling risk factors can lead to the implementation of effective preventive intervention, thus reducing public health expenditure, and improving the quality of life.Originality/value This study was conducted for the first time to assess the risk of falling in older people in Iran. [ABSTRACT FROM AUTHOR]

Purpose Developing country workers mainly face important challenges when examining equality in health services utilization among the population and identifying influential factors. The purpose of this paper us to: understand health service use among households with different socio-economic status in Isfahan province; and to investigate probable inequality determinants in service utilization. Design/methodology/approach Almost 1,040 households living in Isfahan province participated in this cross-sectional study in 2013. Data were collected by a questionnaire with three sections: demographic characteristics; socio-economic status; and health services utilization. The concentration index was applied to measure inequality. Analysts used STATA 11. Findings Economic status, educational level, insurance coverage and household gender were the most influential factors on health services utilization. Those with a high socio-economic level were more likely to demand and use such services; although self-medication patterns showed an opposite trend. Practical implications Female-headed families face with more difficulties in access to basic human needs including health. Supportive policies are needed to meet their demands. Originality/value The authors used principle component analysis to assess households' economic situation, which reduced the variables into a single index. [ABSTRACT FROM AUTHOR]

Purpose Hospital responsiveness to the patient expectations of non-medical aspect of care can lead to patient satisfaction. The purpose of this paper is to investigate the relationship between the eight dimensions of responsiveness and overall patient satisfaction in public and private hospitals in Tehran, Iran. Design/methodology/approach This cross-sectional study was conducted in 2015. In all, 500 patients were selected by the convenient sampling method from two public and three private hospitals. All data were collected using a valid and reliable questionnaire consisted of 32 items to assess the responsiveness of hospitals across eight dimensions and four items to assess the level of overall patient satisfaction. Data analysis was performed using descriptive statistics and multivariate regression was performed by SPSS 18. Findings The mean score of hospital responsiveness and patient satisfaction was 3.48±0.69 and 3.54±0.97 out of 5, respectively. Based on the regression analysis, around 65 percent of the variance in overall satisfaction can be explained by dimensions of responsiveness. Seven independent variables had a positive impact on patient satisfaction; the quality of basic amenities and respect for human dignity were the most powerful factors influencing overall patient satisfaction. Originality/value Hospital responsiveness had a strong effect on overall patient satisfaction. Health care facilities should consider including efforts to responsiveness improvement in their strategic plans. It is recommended that patients should be involved in their treatment processes and have the right to choose their physician. [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: Adopting a healthy lifestyle and improvements in medical care have led to an increase in life expectancy. Thus, the development and implementation of techniques for assessing healthy lifestyles have garnered more attention recently. Finding and evaluating healthy lifestyle assessment tools across all demographics is the goal of this systematic review. Method: Using online databases PubMed, Scopus, Web of Science, and APA PsycINFO, a systematic literature review was carried out in accordance with Preferred Reporting Items for Systematic Review and Meta‐analyses. Registration DOI https://doi.org/10.17605/OSF.IO/ZD9XK for the review has been set on Open Science Framework (OSF). Using the quality standards proposed for measuring features of health status surveys, two independent reviewers evaluated the methodological quality ratings of the eligible studies. Results: From 7480 studies, 47 eligible instruments were identified and included in the review. Most of the studies followed the World Health Organization's definition of healthy lifestyle to develop the scales. The instruments are categorized into those used to assess general lifestyle or healthy lifestyle in general as well as in the clinical population. Physical activity, nutrition, tobacco use, alcohol use, and stress management were the most assessed modules of healthy lifestyle. Furthermore, validity, reliability, responsiveness, floor and ceiling effects, and interpretability were among the psychometric qualities that were frequently assessed. Conclusion: Lifestyle questionnaires can be used to identify specific risk factors in a variety of populations, as well as to plan community‐based intervention programs, by acting as a predictive diagnostic tool and preventive measure. The majority of the assessments of healthy lifestyles that are currently accessible require improvements. [ABSTRACT FROM AUTHOR]

Objective Work-related musculoskeletal disorders are one of dentists’ most common occupational health problems. Human error is considered one of the critical factors of medical error. Musculoskeletal abnormality due to inappropriate work postures and mental workload are two important causes of human error in dental operations. Hence, this study investigates dentists’ mental workload and the incidence of skeletal-muscular disorders. Materials & Methods A cross-sectional descriptive study was conducted in Shahid Shukri Dental Hospital in 2021. The sampling was done via the targeted sampling method and 42 individuals were included in the study. The NASA task load index and the Nordic questionnaire were used to collect the data. Data analysis was done using the SPSS software, version 26, at the significance level of 0.05. Results The average percentage of disorders were as follows: Neck area=30.1%, left shoulder=11.76%, right shoulder=13.74%, right elbow=9.23%, left elbow=6.56%, right wrist=28%, left-hand wrist=25.06%, upper back area=20.1%, waist=13.8%, hip and thigh=17.1%, knee=26% and ankle=23.46%. Age and work experience had a significant relationship with the prevalence of musculoskeletal disorders (P<0.05). The effort component with a Mean±SD of 74.95±22.16 received the highest score and discouragement with a Mean±SD of 49.92±26 got the lowest score compared to other components. The central sterilization department, with a mean of 67.41±24.86, exhibited a higher mental workload than other departments. In contrast, the admission department, with a mean of 50.72±26.59, reported a lower mental workload than other cases. Conclusion Musculoskeletal disorders are related to workload and work capacity. Creating suitable working conditions, providing more training programs to employees, and strengthening their mental workload capacity can help prevent occupational injuries in the workplace. [ABSTRACT FROM AUTHOR]

Background: The word-in-noise discrimination test evaluates the phonological aspect of speech based on the detection of the vowels. While word-in-noise perception (WINP) test is one of the speech perception exams and evaluates the ability to understand the meaning of words by discovering the consonants. Until now, all word-in-noise tests have assessed speech discrimination performance, and for the first time, the normal values of the WINP test for adults have been determined. Since the normal values of WINP scores in children have not been reported, our research aimed to determine the normal values of the WINP test in children aged 5 to 13 years. In this cross-sectional study, 120 Persian speaking Iranain children with normal hearing thresholds were evaluated from the beginning to the end of spring 2023. We divided them into 4 age groups (A = 5–7 < years, B = 7–9 < years, C = 9–11 < years, D = 11–13 < years). The evaluations included general audiology tests and WINP tests using homtonic-monosyllabic words (HMWs) at a signal-to-noise ratio of 5 dB. Results: Significant difference was observed between the mean scores of the WINP test in age group A (54%) compared to age group B (66%), (Pv = 0.04). Also, the differences between the mean scores of age group A compared to age groups C (70%) and D (69%) were significant (Pv = 0.01, Pv = 0.03). Conclusions: This article presented the norm values of WINP test scores for Persian speaking Iranian children aged 5 to 13 years. The norm values of WINP test scores in the age group of 5–7 years were lower than in the age groups of 7–13 years. The biggest change in the performance of speech perception in noise was observed in the age range of 7–9 years. [ABSTRACT FROM AUTHOR]

Background: There is a lack of quantitative studies that specifically measure the association between the experience of pregnancy and unintended pregnancy. The present study aims to address the prevalence of unintended pregnancy and identify its predictors. Additionally, the study explores whether unintended pregnancy is associated with pregnancy uplifts and hassles. Methods: This cross-sectional study was conducted on 488 pregnant women between 20 to 40 weeks' gestation at the comprehensive health center in Tabriz City from February 2022 to January 2023. A cluster sampling method was used for sampling, and data were collected using socio-demographic questionnaires and the Pregnancy Experience Scale (PES). Descriptive statistics were used to describe the socio-demographic characteristics and the prevalence of unintended pregnancy. Binary logistic regression was employed to identify the predictors of pregnancy desirability. To examine the relationship between unintended pregnancy and pregnancy experience, an independent t-test was used for bivariate analysis, and a general linear model (GLM) was utilized for multivariate analysis, with control for potential confounding variables. Results: The prevalence of unintended pregnancies was 30.7% (24.3% unwanted pregnancies, and 6.4% mistimed pregnancies). The results of the binary logistic regression indicated that the lower age of both the woman and her spouse were significant predictors for unintended pregnancy (P < 0.05). Based on an independent t-test, the mean score for uplifts in women with unintended pregnancy was significantly lower than in women with intended pregnancy (mean difference (MD): -4.99; 95% confidence interval (CI): -5.96 to -4.02; p < 0.001), While the mean score of hassles in women with unintended pregnancy was significantly higher than women with intended pregnancy (MD: 2.92; 95% CI: 2.03 to 3.80; p < 0.001). The results of GLM showed that women who had unintended pregnancies had significantly lower scores for uplifts (B = -4.99; 95% CI: -5.96 to -4.03; P < 0.001) and higher scores for hassles (B = 2.92; 95% CI: 2.06 to 3.78; P < 0.001). Conclusions: The high prevalence of unintended pregnancies in Tabriz highlights the importance of targeted interventions to address this issue, considering the policy framework and unique challenges faced by women. Future studies should focus on developing context-specific interventions that effectively meet the needs of women with unintended pregnancies. Plain Language Summary: An unintended pregnancy is a pregnancy that occurs either when the woman did not intend to get pregnant at all or when she intended to get pregnant but became pregnant at an inappropriate time. This type of pregnancy can have negative effects on the physical and mental health of women during pregnancy and after delivery. So far, no study has investigated the relationship between the experience of pregnancy and unintended pregnancy, and the existing studies, which are qualitative and based on interviews, have examined women's experiences of unintended pregnancy. For the first time, our study examined the relationship between pregnancy experience and unintended pregnancy in 488 women using a valid questionnaire, the Pregnancy Experience Scale, which includes two parts: uplifts and hassles specific to pregnancy. Our findings showed that women who have an unintended pregnancy have a worse pregnancy experience in both uplifts and hassles specific to pregnancy. Also, limited studies have investigated the prevalence of unintended pregnancy in Iran, especially in the city of Tabriz in recent years. Our study, found this prevalence to be 30.7% in Tabriz, with 24.3% of women having no intention of getting pregnant and 6.4% of women experiencing pregnancy at an inappropriate time. The recommendation is to implement strategies to reduce unintended pregnancy rates and improve women's knowledge of fertility, sexuality, and contraception. [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: 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. Granulomatous dermatoses, particularly on facial skin, pose a diagnostic challenge, as similar histologic patterns can be produced by different causes. Aim. To evaluate the correlation between clinical suspicion and histopathological findings in various facial granulomatous dermatoses. Materials and Methods. This retrospective, cross-sectional study included all patients with the histopathological diagnosis of facial granulomatous dermatoses from the years 2016 to 2021 in an academic hospital. Demographic, clinical, and histopathologic features were reviewed and analyzed. Results. In this study, 150 histopathological records with the diagnosis of facial granulomatous dermatoses from the years 2016 to 2021 were reviewed. The most common clinical diagnosis was rosacea 34 (23.6%), followed by sarcoidosis 27 (18.8%), leishmaniasis 15 (10.4%), and granulomatous rosacea 10 (6.9%). The frequency of clinical diagnosis of rosacea (70.6), sarcoidosis (66.7), foreign body G (62.5), TB (75), pseudolymphoma (75), acne agminata (66.7), and granulomatous rosacea (70) in female patients was higher than that in males (P value = 0.03). The effect of age on the type of both clinical and histopathological diagnosis was statistically significant (P value = 0.0001 and 0.004, respectively). Conclusion. Our study contributed significantly to the understanding of the clinicopathological aspects of facial granulomatous dermatoses and advocated for a multidisciplinary approach to the diagnosis and management of these complex skin conditions. [ABSTRACT FROM AUTHOR]

Objectives: Cerebral palsy (CP) can cause motor, sensory, cognitive, and communicative problems and poor feeding performances in children. Feeding problems could be lifethreatening and negatively affect cognitive and physical growth. This study investigates the frequency of response to oral motor skills, the frequency and severity of feeding problems, and the relationship between age and oral motor skills with feeding problems in children with CP aged 2 to 7 years. Methods: This was an observational and cross-sectional study. The participants were 60 children (26 girls and 34 boys) with CP with a mean age of 4.76±1.71 years. The screening tool for eating problems and oral motor assessment scale assessed participants' feeding and oral motor skills. The Spearman test determined the correlation between age and oral motor dysfunctions with feeding problems. Results: The present study revealed that 80% of participants indicated feeding problems in the screening tool of the eating problems test. Problems with feeding skills (51.5%) were the most frequent. Furthermore, the most frequent response of participants to "closing the lips while feeding with a spoon" was 46.7%, and "sucking with straw," equaled 55.0%," which was passive. For other items, the most frequent response of the examinees was "functional." Finally, the results showed no significant correlation (P<0.05) between age and mean scores of frequency and severity of feeding problems. A significant negative correlation was found between mean scores of oral motor skill with frequency (P<0.001, r=-0.476) and severity (P=0.001, r=-0.424) of feeding problems. Discussion: The majority of children with CP have problems with feeding and oral motor skills. Some skills in the fields of feeding and oral motor should be noticed more by speechlanguage pathologists and included in their therapeutic program, especially "feeding skills," "closing the lips while feeding with a spoon," and "sucking with straw." [ABSTRACT FROM AUTHOR]

Objectives: Since December 2019, COVID-19 spread worldwide. Patients with COVID-19 are at high hazard for dysphagia. This study investigates the incidence of dysphagia in COVID-19 patients admitted to the intensive care unit (ICU) and identifies predictors of dysphagia in COVID-19 patients. Methods: This prospective study analyzed 100 COVID-19 patients admitted to the ICU of Firoozgar Hospital in Tehran City, Iran. The demographic and clinical features of the eligible patients were collected. Dysphagia and cognition were evaluated according to the Persian version of functional oral intake (FOIS-P) status and the Rancho Los Amigos scale (RLAS). The qualitative variables are described in frequency and percentages and the quantitative variables are illustrated by Mean±SD. Also, univariate and multivariate cox regression was performed to predict possible relations between demographic and clinical variables with dysphagia. Results: A total of 100 COVID-19 patients (43.3±13.3 years, 55% were men) who were admitted to the ICUs were appraised by speech and language pathologists. Meanwhile, 70% of the subjects had at least one comorbidity, with the most common ones being diabetes, hypertension, and obesity. Also, 74% of patients were on invasive mechanical ventilation (60% through endotracheal tube and 40% through tracheostomy). In addition, 57% of patients presented dysphagia. Age (odd ratio (OR)=1.127; 95% confidence interval (CI), 1.019%, 1.247%; P=0.02) and level of consciousness (OR=0.393; 95% CI, 0.178%, 0.868%; P=0.021) were predictors of dysphagia. Discussion: Dysphagia was prevalent among COVID-19 patients predicted by age and level of consciousness. Early evaluation of suspected patients is required for timely and efficient interventions to avoid further problematic issues and progress their quality of life. [ABSTRACT FROM AUTHOR]

Background and Aim: Despite the abundance of literature about deaf children, few works specifically address the concept and practice of difficulties in parenting hearing-impaired children. The first interactions of the child are with his parents, and parents have the most important role in child improvements during early intervention programs. The main purpose of this paper was to investigate different aspects of parenting hearing-impaired children. Methods: In this article, we reviewed all aspects of parenting hearing-impaired children in papers from 1984-2009 in Medline, Scopus and Proquest and relative textbooks. The semi-professional role of parents of hearing-impaired children make them feel under excessive stress and this usually affects their other roles as fathers and mothers. Many factors including child age, type of hearing loss and parents' individual characteristics may influence the impact of child's hearing loss on parents. Conclusion: Parenting a hearing-impaired child is both similar and different to parenting any other child. Where there are differences, there are usually challenges too. Taking support and advice from professionals and other parents are necessary and invaluable for parents of hearing-impaired children. [ABSTRACT FROM AUTHOR]

Background and Objectives: Problem-solving is formed as one of the most important branches of life skills in the socialization process and several factors are effective in adopting its types. The purpose of the present study was to explain the sociological factors related to social problem-solving strategies in girls and boys ready for marriage who refer to Baharenko Counseling Center in Shiraz. Methods: The present study was based on the survey method, in which 912 ready-to-marry men and women referring to Baharenko pre-marital Education and Counseling Center were selected as a statistical sample by cluster random sampling. The research tool was a questionnaire whose validity was confirmed by experts and its reliability was assessed using Cronbach's alpha coefficient method. Data were analyzed using t-test, F-statistic, correlation coefficient, and stepwise regression. Results: There was a positive and significant relationship between logical problem-solving strategy and spiritual health (existential and religious). Also, all dimensions of social well-being (acceptance, adaptation, prosperity, cohesion, and contribution) had a significant and positive relationship with problem-solving. The results of stepwise regression also showed that spiritual health and social well-being can predict 0.21 of the logical problem-solving variable in couples ready for marriage. Conclusion: The social and spiritual health of individuals was an important explanatory factor in predicting the dependent variable. The more people value themselves and enjoy social and spiritual health, the more likely they are to be part of society and experience a more meaningful life, the more likely they are to use a rational problem-solving strategy. [ABSTRACT FROM AUTHOR]

Background: This paper presents the objectives, research design, methodology, and primary findings of the Isfahan Comprehensive O Elderly Study (ICES). Materials and Methods: In this cross-sectional study, 603 elderly persons (aged 60 and over) were selected by multistage cluster sampling method from Isfahan, Iran, in 2016 comprehensive questionnaires along with a detailed interview were used to collect information on personal, family, socioeconomic, health and social services characteristics, life styles, physical illnesses and chronic diseases, mental, emotional and cognition disorders, quality of life, disabilities, sleep quality, social supports, life satisfaction, self-efficacy, and of participants. Results: The mean ± standard deviation (SD) age of participants was 69.66 ± 6.31 years, consisting of 50.75% females. About 23% of elderly persons were at the risk of malnutrition and 4.5% were current smoker. Severe and mild depression were documented in 9.3% and 30.2% among included study subjects, respectively. About half of the participants had hypertension, and 26.8% suffered from cardiovascular disease. The mean ± SD of total score of Geriatric Depression Scale, Perceived Stress Scale, Older People's Quality of Life, Physical Activity Scale for the Elderly and Pittsburg Sleep Quality Index was 8.84 ± 6.79, 14.76 ± 5.92, 133.99 ± 10.55, 142.04 ± 120.53, and 6.17 ± 3.44, respectively. Elderly males had significantly higher life satisfaction and self-efficacy and better cognitive function than females (P < 0.01). Conclusion: The findings of current study provided a comprehensive overview of the current health status and lifestyle of older adults in Isfahan city. The ICES could help policy makers to design appropriate prevention and interventional programs and policies to cover the specific needs of the elderly population. [ABSTRACT FROM AUTHOR]

Iran is a developing country with low levels of economic development and globalization and is ruled by a theocratic government. To address the lack of national research on well-being in Iran, this retrospective observational study aims to examine life satisfaction and its main determinants among Iranian adults. Using World Gallup Poll data collected between 2006 and 2017, we examined life satisfaction as a cognitive aspect of subjective well-being in relation to various factors. Our results show that income is the strongest predictor of life satisfaction, followed by standard of living, gender, social support, age, negative affect, and education. In developing countries such as Iran, which face significant economic, political, and social challenges, individuals prioritize the satisfaction of basic needs by emphasizing factors such as the socioeconomic status. In contrast, developed countries with established welfare systems may emphasize other values such as social connections and healthy lifestyle behaviors as key factors in life satisfaction. This study contributes to a deeper understanding of the determinants of life satisfaction in Iran and provides insights for future research and policy making. [ABSTRACT FROM AUTHOR]

Background: The concurrence of acute myocardial infarction (AMI) with COVID-19 can complicate the clinical conditions of patients and affect the patterns of hospital resource utilization. This study aimed to investigate and analyze the direct treatment costs of AMI patients with concurrent COVID-19. Methods: This cross-sectional study collected and analyzed clinical data, including symptoms, readmission, and interventions, and treatment cost data for all patients at Tehran Heart Center using SPSS26 software. The mean medical costs of patients from January through May 2022 were also calculated. Results: The COVID-19 group was composed of 72.9% male and 27.1% female patients, whereas the non-COVID-19 group consisted of 67.3% male and 32.7% female patients. Most of the patients in the COVID-19 group (60%) were in the elderly age group (>65 y). The length of stay was 8.70±5.84 days for the COVID-19 group and 6.31±4.42 days for the non-COVID-19 group. The mortality rate in the COVID-19 group was 24%, higher than the 5% rate in the other group. Additionally, the average total treatment costs were $6384.54±$6760.13 in the COVID-19 group and $6362.49±$4343.07 in the non-COVID-19 group (P>0.78 and P>0.050). Conclusion: The study found that the COVID-19 group had a significantly higher in-hospital mortality rate than the non-COVID-19 group. During the follow-up period, the incidence of complications (chest pain and heart failure) was higher in the non-COVID-19 group. It also showed that longer hospital stays resulted in higher treatment costs. [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: 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]

Objective: This study aimed to evaluate the potential risk factors of lifetime urolithiasis occurrence on a nationwide scale in Iran. Methods: All data regarding urinary stone events were extracted from the cross-sectional Iran National Stone Survey (INSS) study, and the possible determinants of urolithiasis incidence were evaluated. Results: Our multivariable logistic regression suggested that while older age at presentation, male sex, and a positive family history of urolithiasis in either of the patient's parents or siblings were all significantly associated with an increased odds of lifetime urolithiasis occurrence (all P < .001), a positive family history in one's sister (odds ratio; OR = 5.56) or brother (OR = 4.70) were the most significant predictors. Moreover, belonging to Baluch ethnicity (i.e., an ethnical group indigenous to the south eastern regions of Iran) and residing in regions with higher water hardness (i.e., total concentration of dissolved minerals) were also associated with an increased odds of urolithiasis occurrence (P < .001 and P = .023, respectively). Conversely, living in regions with higher mean humidity decreased the chances of developing a urinary stone event during one's lifetime (OR = 0.62, P < .001). Conclusion: Our results indicated that a constellation of demographic, ecological, and familial risk factors are associated with an elevated risk of developing urinary stones during one's lifetime. These findings can assist in implementing novel regional healthcare policies, considering the specific demographic and ecological characteristics. They also support tailoring personalized preventive strategies, particularly for individuals with multiple nonmodifiable risk factors. [ABSTRACT FROM AUTHOR]

Women's health is the foundation of society's health and it can be achieved only by addressing all aspects of their health. The aim of this systematic review and meta-analysis is to investigate the prevalence of social health of Iranian women and related factors. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used for reporting; the terms "social health," "women," "Iran," and related keywords were searched in PubMed, Web of Science, Scopus, PsychoInfo, ProQuest and local databases, SID, Magiran, Irandoc, Elmnet, and Noormags up to August 2022. The published English or Persian quantitative primary studies which were conducted in Iran and reported social health or its dimensions among Iranian women were included. The studies were assessed by quality assessment tool for observational cohort and cross-sectional studies developed by National Heart, Lung, and Blood Institute. From the 786 studies retrieved, 22 studies were finally included surveying different groups of women. Age, marital status, education, employment, socioeconomic status, social support, social participation, social trust, social security, communication skills, and self-esteem were the factors affecting women's social health. Five studies entered meta-analysis and mean score of social health was 98.54 (95% CI: 87.56–109.51) and it was the lowest among women who were the head of households. Since women's social health has been less considered in the society and research studies, further policies, legislations, and capacity building in mentioned fields are necessary. As social health is an important aspect of health, it is necessary for governments to address the known determinants of women's social health in order to plan and promote the health of women, family, and finally society. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has limited hemodialysis patient's attendance in healthcare centers and receiving diet education. This study was conducted to investigate the effectiveness of distance learning on the nutrition quality of hemodialysis patients during the COVID-19 pandemic. Methods: In the single-blind randomized clinical trial, 60 patients undergoing hemodialysis were randomly divided into control (n = 30) and experimental (n = 30) groups. Before and after the intervention, Dialysis Malnutrition Score (DMS), Malnutrition-Inflammation Score (MIS) (primary outcome), albumin, the total iron-binding capacity of the blood (TIBC), and body mass index (BMI) (Secondary outcome) were investigated. The experimental group received educational content through social networks for three months, whereas the control group received routine care and training. Results: There was no significant difference between the two groups in terms of the mean of DMS, MIS, albumin, and TIBC before the intervention. Pre-test BMI had a confounding effect; therefore, an analysis of covariance was performed to eliminate that effect. This analysis showed significant differences in the post-test mean DMS, MIS, TIBC, and BMI between the two groups. In the control group, significant differences were observed in MIS and BMI toward deterioration. The results also indicated a significant relationship between education level and age with TIBC and between marital status and albumin index. Conclusion: Distance learning can be considered by healthcare managers and police makers as a suitable alternative to the classic face-to-face learning method to enhance hemodialysis patients' nutrition quality during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background Cleft lip and cleft palate are the most common congenital anomalies in the head and neck region, which are affected by environmental and genetic factors. These anomalies can cause serious problems such as physical deformity, nutritional problems, respiratory problems, and problems in social interactions for affected people. Objective The current study aims to investigate the prevalence of lip and palate clefts and the related factors in infants born from 2014 to 2019 in Karaj, Iran. Methods This descriptive-analytical study was conducted on the data of 91,563 babes born from 2014 to 2019 in Kamali, Imam Ali, Maryam, and Ghaem hospitals in Karaj, Iran. The data were collected and analyzed in SPSS software, version 24. Results Of 91,563 cases, 46 were identified with various types of clefts. The overall prevalence was 0.5 per 1000 live births; 26.08 had cleft lip, 52.17% had cleft palate, and 21.73% had cleft lip and palate (P=0.024). Also, 56.52% of babies were male (P=0.37), 76.08% had mothers aged 20-30 years with a mean age of 24.4 years, 58.69% had first-time pregnancy mothers, 13.03% had parents with cousin marriage (P<0.001), and 37% had mothers with blood type A (P=0.11). Conclusion The prevalence of lip and palate clefts in babies born in Karaj is lower than the global prevalence and the prevalence in other cities of Iran. [ABSTRACT FROM AUTHOR]

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

Introduction: Identifying patterns of human immunodeficiency viruses (HIV) transmission and factors affecting it can help to prevent and control the disease. The present study aimed to identify the latent classes of HIV risk factors in Iran. Material and methods: This cross-sectional study was conducted among 32,168 HIV patients. We fitted latent class analysis by considering 11 indicators. Models with 2 to 5 classes were fitted, and the best-fitted model was chosen based on Acaik information critical (AIC), Bayesian information criterion (BIC), entropy, and interpretability of the results. Additionally, multinomial logistic regression model was applied to assess relationships between the covariates and latent class membership. Results: We identified 3 latent classes, including low-risk (41.35%), high-risk (50.28%), and moderaterisk (8.37%) classes. The moderate-risk class was most likely prison history (69.09%) and addiction (67.37%). The high-risk class included addiction (99.68%), injection drugs users (IDUs) (99.06%), prison history (86.27%), and sharing needles (79.64%). Older age and being single increased the odds of membership in high-risk class (OR: 1.021, 95% CI: 1.017-1.024%; OR: 1.34, 95% CI: 1.20-1.50%), respectively, while older age increased the odds of membership in classes of moderaterisk (OR: 1.028, 95% CI: 1.023-1.033%) compared with low-risk group (p < 0.05). The odds of membership in classes of high-risk (OR: 0.011, 95% CI: 0.010-0.013%) and moderate-risk (OR: 0.113, 95% CI: 0.098-0.131%) were significantly lower in women than in men compared with low-risk group (p < 0.05). Conclusions: Injection drugs users, drug addiction, sharing needles, and prison history are related to HIV infection in Iran. Moreover, older age, female gender, low education, and being single increase the odds of membership in high-risk classes. These findings highlight the need for preventive interventions and harm reduction programs for people at risk. [ABSTRACT FROM AUTHOR]

BACKGROUND: Burnout is not only related to mental health but also to efficiency. Thus, recognizing effective coping strategies has a significant role in improving mental health, the efficiency and productivity of human resources, and making better the level of quality of service. OBJECTIVE: To determine burnout syndrome and examine related factors among the employees of Mashhad University of Medical Sciences. METHOD: This cross-sectional study was conducted among 600 employees at Mashhad University of Medical Sciences. They were selected by a stratified sampling method. The data collection tool was the demographic information and the Burnout Self-Test Maslach Burnout Inventory (MBI) questionnaire. Data were analyzed through SPSS software version 20, using descriptive statistics and independent samples t-tests, one-way ANOVA, and Pearson and Spearman regression. RESULTS: The findings showed that emotional exhaustion (EE) and depersonalization (DP) in the majority of employees were high and personal accomplishment (PA) was low at 88.33% of cases. All participants presented burnout. However, participants aged 35-40 years, those with professional and Ph.D. degrees, and research staff reported higher burnout levels. CONCLUSION: Job burnout and its subscale levels among the employees were high. Job burnout is associated with socioeconomic status that can be affected by individual, organizational, management, and environmental factors. Therefore, this study suggests that employees need to get out of EE and DP conditions for higher job performance. Additionally, further research is required to examine the long-term effects of workplace burnout. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) is a leading cause of cancer-related deaths among women worldwide, and its incidence has increased in Iran over recent years. Objectives: In this study, we aimed at assessing the completeness of BC pathology reports in the population-based cancer registration system and perform a spatial analysis of the incidence of this cancer in Iran in 2016 to help policymakers develop targeted interventions. Methods: We conducted a retrospective descriptive analysis, using secondary data from the Integrated Cancer Information Management System, and obtained 13789 BC pathology reports from all provinces in Iran in 2016. Pathology data, including tumor type, tumor site, tumor size, pathologic T stage, pathologic N stage, and tumor grade were examined for completeness by age group. Results: Pathology reports from 4000 women with BC in 2016 from across all provinces of Iran were selected for this study. The completeness of tumor type, tumor site, tumor size, pathologic T stage, pathologic N stage, and tumor grade increased with aging. In addition, the completeness of pathology reports varied across different variables. Accordingly, the tumor grade and pathologic T stage had the highest and lowest completeness rates (100 % versus 27.4%), respectively. Spatial analysis revealed significant high-risk areas for BC incidence, including Isfahan, Markazi, Chaharmahal and Bakhtiari, and Kohgiluyeh and Boyer-Ahmad provinces in central Iran. In contrast, North Khorasan was identified as a low-risk area. Conclusions: Considering the incompleteness of the pathology report in most of the tumor variables in the BC registry, we recognize the gaps to improve pathology data. To ensure effective interventions for BC control, tailored preventive measures are needed, particularly for high-risk areas. Continuous evaluation and data completion, including standard cellular pathology reports, are necessary for accurate BC control in Iran. [ABSTRACT FROM AUTHOR]

Background: Bladder cancer is one of the most common cancers worldwide and also in Iran. Understanding of bladder cancer epidemiology is of great value for policymakers and assists in the prevention and early detection of the disease. Objectives: The aim of the present study was to report national and subnational incidence trends of bladder cancer in Iran between 2003 and 2015. Methods: This study investigated the age-standardized incidence rates (ASIRs) per annum of bladder cancer from 2003 to 2015 in Iran using the data from the cancer registration system of the Ministry of Health and Medical Education of Iran. The crude incidence rates were calculated by dividing incident cases by the country and province population, which were provided by the Statistic Center of Iran. Age standardization was performed using the WHO standard population, and ASIRs were compared by age, sex, and province. Results: The ASIR of bladder cancer increased from 8.35 in 2003 to 13.57 in 2015 in men. The ASIR of bladder cancer also showed a mild increase in females, 2.12 in 2003 versus 2.86 in 2015. The province of Yazd had the highest rate of bladder cancer in men, and West Azerbaijan had the highest rate for women (15.13 and 7.79 per 100,000), while Sistan va Baluchestan and Ilam had the lowest ASIRs formen and women (3.01 and 0.96 per 100,000, respectively). Conclusions: The increasing trend of bladder cancer incidence in Iran, despite the clear decreasing global trend accompanying to ongoing aging of the population highlights the diseases as a potential health problem in the upcoming years in Iran. Therefore, it is necessary for health organizations to implement effective research and control programs in the country to prevent further increases in disease burden. [ABSTRACT FROM AUTHOR]

Objectives: Patient falls are highly prevalent in hospitals, and are considered a complicated challenge. Thus, the present research assessed the prevalence of the fall risk assessment and the correlated factors among elderly inpatients. Methods: The present analytical and cross-sectional research was conducted with 419 elderly patients meeting the inclusion criteria. The data collection instrument consisted of two parts including demographic information and the Johns Hopkins fall risk assessment tool (JHFRA). A convenience sampling method was used to select the elderly patients staying in the general wards of Allameh Bohlool Gonabadi Hospital, Gonabad City, Iran. The data analysis was done in SPSS software, version 23 using descriptive (frequency, Mean±SD) as well as inferential statistics (logistic linear regression analysis). Results: The Mean±SD of participants' age was 72.09±9.46 and the prevalence of the fall risk was 85.9%. Statistically significant correlations were found between the elderly inpatients' fall risk and their age (P=0.001), sex (P=0.012), and cardiovascular diseases (P=0.001). Discussion: Considering the high prevalence of fall risk among elderly inpatients, it is essential to plan for preventing and reducing the rate of elderly inpatients' falls. [ABSTRACT FROM AUTHOR]

Objectives: Limitations in the ability to perform manual functions decrease the individual's participation in activities of daily living (ADLs). Thus, it is required to study the relationship between manual skills and self-care activities in children. This study aims to investigate the relationship between manual ability and self-care in children with spastic cerebral palsy at the ages of 1 to 8 years. Methods: In this cross-sectional study, 125 children aged 1-8 years with spastic cerebral palsy who were chosen by the convenience sampling method from 8 occupational therapy clinics in Tehran City, Iran, in 2022 were studied. The evaluation tools were manual ability classification system (MACS), mini-manual ability classification system (Mini-MACS), pediatric evaluation of disability inventory (PEDI), and cognitive level form designed in the SPARCLE project. After collecting the data, Stata software, version 14 was used to analyze data using chi-square, Spearman correlation coefficient, Mann-Whitney, Kruskal-Wallis, and regression. Results: In this research, the mean age of the children was 54.2±15 months and 43.2% had a cognitive level >70. The mean self-care and mobility in children were 49.65±30.60 and 40.78±26.97, respectively. With increasing age, self-care and mobility of children showed a significant increase (P<0.001). No significant difference was observed between boys and girls in self-care and mobility (P<0.05). By changing the education level of the main caregiver, no significant difference was found in self-care and mobility (P<0.05). With the increase in children's cognitive ability level and MACS level, self-care and mobility improved significantly (P<0.001). Moreover, the level of MACS and mobility with the highest beta values (-0.530 and 0.512, respectively) showed a greater contribution to the prediction of self-care. Discussion: The results showed that with increasing age, cognitive ability level, and MACS level, self-care and mobility improve significantly in children with spastic cerebral palsy. Therefore, it is suggested to pay more attention to manual ability to improve self-care and mobility in these children. [ABSTRACT FROM AUTHOR]

Background: We aimed to determine the frequency of mutations in 3 common genes causing neonatal diabetes mellitus (NDM) in Isfahan. Methods: This study was performed on 15 patients with permanent NDM (PNDM). KCNJ11, INS, and ABCC8 gene mutations were examined in all patients. Other related gene mutations were also examined if the first three mentioned mutations were negative. The patients were classified into two groups based on the time of NDM diagnosis (before 6 and 6–12 months of age). Results: Patients with PNDM who were diagnosed before 6 months of age had more concomitant anomalies than those diagnosed between 6 and 19 months of age (p < 0.05). The genetic study did not show any mutation in ABCC8, KCNJ11, and INS genes. Evaluation of other gene mutations indicated that 3 patients (two boys and one girl) had a homozygous mutation in EIF2AK3, one patient (boy) had a homozygous mutation in PTF1A, and also one patient (boy) had a homozygous mutation in GLIS3 gene which are all considered as rare genes which could cause NDM. All of the patients with mutations were diagnosed before 6 months of age. Four out of the five patients were male and had parental consanguinity (2nd and 3rd degree). Conclusion: We found that mutations in KCNJ11, INS, and ABCC8 are not the common cause of PNDM in our population, and mutations in EIF2AK3, PTF1A, and GLIS3 genes are more frequent. The PNDM cases and their related reported mutation were related to the syndromic form of NDM, and all of them were diagnosed before 6 months of age. [ABSTRACT FROM AUTHOR]

Background. The outbreak of COVID-19 reduced social interactions and access to healthcare centers, affecting older people’s self-care ability and quality of life. Low quality of life was associated with a higher mortality rate in older people with COVID-19; thus, large measures should be taken in this field. Objectives. The present study aimed to determine the correlation between self-care at home and older people’s quality of life in Pol-e Dokhtar City during the COVID-19 pandemic. Material and methods. The present cross-sectional and descriptive study was conducted by random sampling on 300 older people in Pol-e Dokhtar City. Three questionnaires acquired the data: the demographic information questionnaire, the standard older people self-care questionnaire and the World Health Organization Quality of Life-BREF (WHOQoL-BREF) questionnaire, which were analyzed using SPSS 22 software. Results. The total self-care score was low, and older age was associated with decreased self-care and quality of life. An increased education level enhanced the levels of self-care and quality of life. The psychological and social self-care scores were directly associated with the rise in the quality of life score. The use of insurance increased self-care and quality of life. Retired older people had higher self-care, but employed older people had a higher quality of life. Conclusions. Variables such as psychological and social self-care could predict older people’s quality of life during the COVID-19 pandemic. Therefore, educational interventions, social-cultural and recreational sports activities and spiritual, material and emotional support should be done to improve older people’s self-care and quality of life. [ABSTRACT FROM AUTHOR]

Breast cancer (BC) was the most common cancer in Iran, accounting for 12.9% of all incident cancer, and was the 5th leading cause of cancer death in 2020. The latest age standardized incidence rate (ASIR) of breast cancer was 35.8 in Iran and is expected to increase to more than 70 per 100,000 by the end of 2030. Incidence of breast cancer had a clustering pattern in Iran, while central provinces had the highest ASIR (72 per 100,000 population), and South East provinces had the lowest ASIR (5-11 per 100,000 population). Numerous studies have shown that the peak incidence of breast cancer was occurred in the age group of 40-49 years in Iran. There has also been reported a rapid increase in the incidence in young women from different regions of the country. Known molecular and cellular processes involved in the development of breast cancer in Iranian BCs have been reported from various studies in recent decades, and the most wellknown and prominent genes susceptible to breast cancer were BRCA1 and BRCA2. They acted as tumor suppressor genes and inherited mutations leading to chromosomal instability. However, non-coding RNAs, epigenetic alterations, signaling pathways, immune responses, and antioxidant-related genes are the main molecular processes associated with the progression of breast cancer among Iranian patients. While we are facing a significant increase in the incidence of breast cancer, with a lower survival rate, breast cancer is currently considered as one of the major health problems in Iran, which emphasizes the importance of providing and designing prevention and early detection program of breast cancer. [ABSTRACT FROM AUTHOR]

Background: Quality of care is one of the most critical issues in nursing care today. Moreover, all health care employees are responsible for providing support and high‐quality, safe care. However, nurses caring for COVID‐19 patients face problems such as unfamiliar work environments, exposure to the disease, lack of experience in their new positions, and close public and media attention. This study aimed to investigate missed nursing care and the reasons for missed nursing care during the coronavirus disease 2019 (COVID‐19) pandemic in Iran. Methods: This cross‐sectional study included 135 nurses working in COVID‐19 units. Data were collected using the MISSCARE Survey. The significance level for the statistical tests was set at p < 0.05. Results: Most of the participants were women and had a bachelor's degree in nursing. There was a lack of supportive and necessary care more than any other form of care. According to nurses, the most common reasons for missed care were urgent patient situations, inadequate staff, and an unexpected rise in patient volume and/or patient acuity on the unit. Conclusion: Generally, the results showed that being positioned in a new situation and unfamiliarity with the disease had a significant impact—among nurses—on the amount of care provided. Managers can use this information to solve existing missed‐nursing‐care problems and contribute to improving the quality of care. These results can be helpful in controlling missed nursing care and finding a more optimal solution for this problem; thus, we can improve the quality of care delivery and increase the satisfaction of nurses and patients. Additionally, an understanding of the kind of missing nursing care during a pandemic can positively enhance the management of similar situations in the future. [ABSTRACT FROM AUTHOR]