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Background: Depression is one of the most common mental disorders that leads to anxiety, sleep disturbances, and suicidal thoughts. Due to the high cost of treatment and the reluctance of many patients to seek medical help, major depressive disorder (MDD) is becoming more prevalent. Therefore, alternative methods like smartphone applications can help prevent and improve depression symptoms. The present study aimed to determine the effect of the newly developed Yara smartphone application on anxiety, sleep quality, and suicidal thoughts in patients with MDD. Methods: This randomized controlled trial with a pretest-posttest design was conducted on Iranian patients with MDD in 2022. Sixty-four patients were recruited using convenience sampling and randomly assigned to two control and intervention groups. The intervention was conducted using the Yara smartphone application for three months. Data were collected using the Spielberger State-Trait Anxiety Inventory (STAI), Pittsburgh Sleep Quality Index (PSQI), and Beck Scale for Suicidal Ideation (BSSI). Data were first entered into IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, N.Y., USA) and then analyzed using descriptive and analytical statistics. Results: There was no statistically significant difference in the mean score of anxiety and sleep quality between the intervention and control groups before the intervention (p ≥.05). However, this difference in the mean score of anxiety and sleep quality was statistically significant in the two groups after the intervention (p <.05). The results showed no statistically significant difference in the mean score of suicidal thoughts between the two groups before and after the intervention (p ≥.05). The use of the Yara smartphone application had a significant positive effect on anxiety and sleep quality in depressed patients (p <.001). At the same time, it had no significant effect on suicidal thoughts (p ≥.05). Conclusion: Considering the positive effect of using the Yara smartphone application on reducing anxiety and improving sleep quality in depressed patients, this application can help alleviate the problems of depressed patients alongside existing treatment methods. Thus, this application is recommended for this group of patients in psychiatric clinics and departments. The Yara application's effectiveness was not approved on suicidal thoughts in this study so that further investigation would be necessary. Trial Registration: Iranian Registry of Clinical Trial approval code (IRCT# IRCT20131112015390N7). [ABSTRACT FROM AUTHOR]

Background: Although acupressure is proposed to boost sleep quality and alleviate anxiety in various disorders, no trials have yet documented these consequences in burn victims. Considering the high importance of managing sleep quality and anxiety among burn patients utilizing adjunctive non-pharmacological measures, this study sought to investigate the impacts of acupressure on sleep quality and anxiety among a population of Iranian patients with burn injuries. Methods: This trial was performed on 72 patients with second- or third-degree burns, who were divided into two equal arms to receive routine care plus 10-minute acupressure on either real acupoints (i.e., Yintang and Shen men) or sham points for three consecutive nights. Sleep quality and anxiety were investigated at baseline (T1) and on the fourth day (T2) by using St. Mary's Hospital Sleep Questionnaire (SMHSQ) and Spielberger's State-Trait Anxiety Inventory for State Anxiety (STAI-S), respectively. Results: The mean scores of SMHSQ and STAI-S were significantly lower in the real acupressure arm at T2 (P < 0.001 in two cases), implying better sleep quality improvement and higher anxiety alleviation. Also, the reduction in mean changes of SMHSQ and STAI-S scores from T1 to T2 was significantly more in the real acupressure arm (P < 0.001 in two cases). Conclusion: Acupressure, as a low-cost complementary method, could be potentially helpful in enhancing sleep quality and decreasing the anxiety of burn patients. Additional long-term trials are required to identify the sustainability of the findings. Trial Registration No: IRCT20130424013110N13 (Registration date: 19/03/2021, https://www.irct.ir/trial/55076). [ABSTRACT FROM AUTHOR]

Background: Health literacy and e‐health literacy are important factors helping people shape awareness of health behaviours in different aspects, including sleep hygiene behaviours. Good sleep hygiene behaviours promote sleep quality and are beneficial to overall mental wellbeing. Objective: We aimed to examine if sleep hygiene behaviours may mediate the association between health literacy/e‐health literacy and mental wellbeing. Methods: Adult Iranian subjects (n = 9775; mean [SD] age = 36.44 [11.97] years; 67.3% females) completed the Health Literacy Instrument for Adults, eHealth Literacy Scale, three items on sleep hygiene behaviour that have been used in prior research and the Short Warwick Edinburgh Mental Wellbeing Scale. Data were then subjected to structural equation modelling (SEM) including 500 bootstrapping resampling to examine whether sleep hygiene is a mediator in the relationship between health literacy/e‐health literacy and mental wellbeing. Findings: Both health literacy and e‐health literacy were significantly associated with mental wellbeing (r =.63 for health literacy and.39 for e‐health literacy; p <.001) and sleep hygiene behaviours (r =.58 for health literacy and.36 for e‐health literacy; p <.001). Sleep hygiene behaviours were significantly associated with mental wellbeing (r =.42; p <.001). Moreover, SEM that incorporated bootstrapping approaches indicated that sleep hygiene behaviours were significant mediators in the association between health literacy/e‐health literacy and mental wellbeing. Conclusions: We conclude that health literacy and e‐health literacy are associated with mental health wellbeing in the Iranian population. Additionally, the association could be mediated via sleep hygiene behaviours. Patient or Public Contribution: The study was co‐designed with healthcare providers from the vice‐Chancellor's Office for Health Affairs of Qazvin University of Medical Sciences as equal partners. Moreover, the women's health volunteers were involved in the design of the study. [ABSTRACT FROM AUTHOR]

Background: Sleep quality is one of the most important factors to improve the quality of life in older adults and physical and mental health plays an essential role in better sleep quality. This study aimed to determine the impact of social support, and physical and psychological performance on sleep outcomes in Iranian older adults. Methods: In this case-control study, 400 elder people, who were exposed to sleep problems, and 400 people without sleep problems were randomly selected during 2016–2017 in Amirkola, Iran. Subjects in the case and control groups were matched in terms of gender and age. The demographic characteristics, Duke Social Support Questionnaire (DSSI), Physical Activity Scale for the Elderly (PASE), Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), Mini-Mental State Examination (MMSE), and Pittsburgh Sleep Quality Questionnaire (PSQI) questionnaires were used to collect data. T-test, Chi-square, Pearson Correlation coefficient, and multiple Logistic regression were used for data analysis. Results: The mean score of DSSI and its domains including social interaction (DSSI.Int) and social satisfaction (DSSI.Sat) were 28.15 ± 3.55, 9.31 ± 1.23, and 18.84 ± 2.88 in the case group and 28.87 ± 3.20, 9.48 ± 1.10, and 19.83 ± 2.44 in the control group, respectively. In this study, the mean scores of MMSE, PASE, ADL, and IADL were 25.36 ± 3.95, 101.71 ± 56.99, 13/97 ± 0.37, 20.59 ± 2/79; respectively. There was a significant inverse correlation between poor sleep quality with DSSI score (rho = -0.165, P < 0.0001), DSSI.Int (rho = -0.113, P < 0.001), DSSI.Sat (rho = -0.160, P < 0.0001), PASE (rho=-0.160, P < 0.0001), and IADL (rho = -0.112, P < 0.001) score. Therefore, more social support and physical activity improved the quality of sleep. There was a significant negative relationship between DSSI, and its domains with sleep quality in terms of gender. DSSI (rho = 0.25, P < 0.0001), DSSI.Int (P < 0.0001, rho=-0.18), and DSSI.Sat (P < 0.0001, rho=-0.22) was significant in men but not in women. The results of the adjusted logistic regression revealed a significant association between sleep quality problems and DSSI (p < 0.045, OR = 1.40), the use of hypnotic drugs (p < 0.0001, OR = 7.56), and occupation (p <0.03, OR= 12.66). Conclusions: The results of the present study suggest that low social support and all its domains, PASE, IADL, and using hypnotic drugs may play a role in the development of sleep problems. It can be used as an effective, safe, and low-cost strategy for promoting sleep quality in older adults. [ABSTRACT FROM AUTHOR]

Background: Diabetes type 2 is a chronic metabolic disease with major physical and health problems that is on the rise. The aim of this study was to evaluate the factors affecting sleep quality in patients with type 2 diabetes in Iran. This cross-sectional study was conducted on 160 patients with type 2 diabetes referred to the diabetes clinic of Kosar Hospital of Semnan city (Iran) in 2018. The sampling was convenient. The data collection tools were four questionnaires including demographic-clinical variables, Pittsburgh Sleep Quality Index (PSQI) questionnaire, Epworth Sleepiness Scale (ESS), and Beck depression inventory II questionnaire. The data was analyzed by STATA 14 and the crude and adjusted coefficient regression (β) with a 95% confidence interval (CI) were reported. Results: The mean (± S.D) of age was 58.70 (± 12.16) years and 60% were female. The multivariate linear regression model showed depression (β = 0.11; 95% CI 0.07–0.16) and sex (β = 1.24; 95% CI 0.17–2.30) are the most important predictors of sleep quality in diabetic patients. However, only underlying disease (β = 1.73; 95% CI 0.33–3.12) was the most important predictors of daily sleep disorder in diabetic patients. Conclusions: Depression and sex were the most important predictors of sleep quality in diabetic patients; therefore, it seems necessary to pay attention to these factors in the design of sleep disorder prevention and control programs. [ABSTRACT FROM AUTHOR]

Introduction: Sleep disorders are the most common behavioral complaints in children. Therefore, this study was conducted to determine the sleep habits of children admitted to Amirkabir Hospital, Arak, Iran. Material & Methods: In this descriptive cross-sectional study, children aged 4 to 12 years admitted to Amirkabir Hospital clinic in 2021 were randomly studied. Data obtained from the Children's Sleep Habits Questionnaire were analyzed using SPSS24.0 software. Findings: A total of 295 children with a mean age of 7.26±2.27 years were studied. The prevalence of the disorder in sleep habits was 67.4%. Among the children with disturbed sleep habits, 193 (96.9%) had poor sleep habits and 6 (3.1%) had average sleep habits. The total sleep habits score was significantly higher in girls, unwanted children, and children with divorced parents, low parental education level, and incompatible parents (P<0.05). However, there was no significant association between the total sleep habits score and children's age (P>0.05). Discussion & Conclusion:In this study, most children showed disturbed sleep habits. Considering that children's poor sleep habits may be a contributing factor for stress, pressure, and tension in the family, mass education and psychiatric intervention are needed in this regard. [ABSTRACT FROM AUTHOR]

Objectives: Sleep is one of the issues that attracted the attention of researchers during the COVID-19 pandemic. Researchers focused their studies on the prevalence of sleep disorders, sleep quality, and sleep duration. Sleep hygiene is a set of guidelines that play an important role in the sleep quality, the present study sought to evaluate the amount of sleep hygiene and sleep quality in Iranian adolescents and their relationship during the COVID-19 pandemic. Methods: The present study was conducted using a cross-sectional design. The research population consisted of all adolescents living in Kermanshah (western Iran) in 2021. The participants were a sample of 610 adolescents. They completed the Pittsburgh Sleep Quality Inventory and Adolescent Sleep Hygiene Scale. Results: The mean sleep quality score for the participants was 7.14 ± 2.47, indicating the high frequency of sleep problems affecting the participants. There were significant correlations between all components of sleep hygiene and sleep quality. There was also a significant correlation (r = − 0.46 between sleep hygiene and sleep quality (p < 0.001). No significant difference was observed in sleep hygiene and sleep quality between the male and female adolescents. The results showed that sleep hygiene subscales can predict sleep quality (R = 0.53, F = 39.20, p <.01). Conclusions: The data in this study confirmed the poor observance of sleep hygiene in adolescents during the COVID-19 pandemic and reported frequent sleep problems among the participants. The results also indicated a moderate relationship between sleep hygiene and sleep quality in adolescents. Thus, sleep hygiene components can be related to sleep quality. [ABSTRACT FROM AUTHOR]

The aim of the present study was to explore the potential relationships between menopausal symptoms, sleep quality, hot flash, and depressive symptoms in postmenopausal women. A cross-sectional study was designed with 150 healthy postmenopausal women (45–60 years of age) who had referred to the menopausal clinic in Babol. The participants completed the following instruments throughout the study: the Beck Depression Inventory for depressive symptoms, the Modified Blatt-Kupperman Menopausal Index for measuring menopausal symptoms, and the NEO-FFI for identifying the personality traits. After controlling all the covariates, high depressive symptoms were found to be associated with moderate/sever menopausal symptoms, poor sleep quality, and the average and high level of neuroticism. The results also demonstrated that the risk of depressive symptoms was lower in menopausal women with high level extroversion, high level agreeableness, and the average and high level of conscientiousness. The findings of the present study indicated that personality traits, menopausal symptoms, and poor sleep quality in particular can partially account for depression in Iranian menopausal women. It is highly imperative that effective health education or implement appropriate strategies to improve the quality of life for these women. [ABSTRACT FROM AUTHOR]

Introduction: Sleep disorders in hemodialysis patients are of high prevalence affecting the lives of these patients. Objective: The present study was conducted to investigate the effect of family-centered and peer-centered education on the sleep quality of hemodialysis patients. Methods: In this controlled clinical trial, 90 patients were randomly assigned to three groups (control, family-centered, and peer-centered). All three groups completed Pittsburgh Sleep Quality Index before the intervention. The intervention included five training sessions conducted by the researcher according to the patients' needs to improve their sleep quality. Routine ward interventions were performed for the control group. At the end of the study, the Pittsburgh Sleep Quality Index was completed by all three groups once again. Data were collected and analyzed using SPSS version 24 software and statistical tests. Results: No significant difference was found between the two intervention and control groups regarding demographic variables and variables related to sleep quality before the intervention (p <.05). However, based on the results of the Wilcoxon test, there was a statistically significant difference between the mean rank of sleep quality in the intervention and control groups after the intervention (p -value =.008), indicating that sleep hygiene education was effective in the two intervention groups. Conclusion: According to the findings, the mean rank of sleep quality in the two intervention groups was significant after the training, indicating the effectiveness of family-centered and peer-centered education. Accordingly, medical healthcare managers, policymakers, and planners, including nurses, are recommended to employ these convenient, safe, and cost-free training methods and provide better sleep quality and more comfort to patients by spending a short period of time for training. [ABSTRACT FROM AUTHOR]

Myo-inositol, a glial marker which plays a critical role in some brain regions, can supposedly affect sleep processes. The purpose of randomized controlled trial was to evaluate the impact of myo-inositol supplementation on sleep quality of pregnant women. The study enrolled 60 women with low risk singleton pregnancies, with a gestational age of at least 14 weeks, in Iran. The participants were block randomized to receive myo-inositol supplementation powder containing 2000 mg of myo-inositol and 200 μg of folic acid or placebo (400 μg of folic acid) for 10 weeks from the gestational age of 14–24. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). The primary outcome was the change in sleep quality from the first trimester to the second trimester (24–28 weeks). The ANCOVA with adjusted covariate variables in the first trimester was conducted to estimate the sleep quality between the two groups. The results of ANCOVA boot strapped showed that the mean difference of the total sleep quality score between the two groups was −1.537; 95% CI: −3.050 to −0.024, p =.047) in the second trimester at immediately post-intervention. Also, there were significant differences between the two groups in terms of subjective sleep quality (MD: −0.427; 95% CI: −0.725 to −0.128, p =.006, sleep duration (MD: −0.670; 95% CI: −1.240 to −0.101; p =.022) and habitual sleep efficiency (MD: −0.561; 95% CI: −1.038 to −0.085, p =.022). The research confirmed that myo-inositol supplementation can improve global sleep quality, subjective sleep quality, and sleep duration during pregnancy. Therefore, these findings applied to minimize the rate of poor sleep quality in pregnant women. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the exposure rate of Hepatitis A and Hepatitis E viruses in urban solid waste collectors/sweepers in the south of Iran. The 385 samples (serums) were collected from Shiraz Municipality waste sweepers.. A questionnaire was used to gather data on their demographic and occupational characteristics, as well as their awareness of viral hepatitis disease. The viral seroprevalence was determined by commercial IgG ELISA kit. All participants were male, mean age of 41 ± 8 years. ELISA assay showed that all of them were positive for anti-HAV IgG. Also, 62 out of 385 individuals were positive for anti-HEV IgG. The statistical analysis showed that the frequency of HEV IgG antibody among age groups 20–30, 31–40, 41–50 and >50 years old had an increasing trend, 4.5%, 10.1%, 17.4%, and 36.7%, respectively, indicating age factor significance (p =.001). Based on some investigated factors including the duration of work experience, current and previous jobs, habitation, personal hygiene status, and knowledge on viral hepatitis diseasees/their transmission, there was no statistically significant difference between anti-HEV IgG positive versus negative sweepers. The results indicated a slighty higher frequency of anti-HAV and anti-HEV IgG among sweepers compared to other pre-investigated population. It doesn't seem that garbage collecting/sweeping could be a significant risk factor for HAV and HEV infection. [ABSTRACT FROM AUTHOR]

Background: Prevalence of short and long sleep duration varies in different countries and changes over time. There are limited studies on Iranians' sleep duration, and we aimed to evaluate the prevalence of short and long sleep duration and associated factors among people living in Kermanshah, Iran.Methods: This population-based cross-sectional study was conducted between November 2014 and February 2017. Data was collected from 10,025 adults aged 35 to 65 years using census sampling, and we evaluated the short and long sleep duration (≤ 6 and ≥ 9 h, respectively) and its relation with the socio-demographic factors and health-related status of the participants.Results: Mean age of participants was 48.1 years (standard deviation = 8.2), and 47.4% of participants were male. Of our participants, 11.6% had short, and 21.9% had long sleep duration. Age ≥ 50 years, female gender, being single, mobile use for longer than 8 h per day, working in night shifts, moderate and good levels of physical activity, BMI ≥ 30, past smoking, and alcohol use were associated with short sleep duration (P < 0.05). Female gender and living in rural areas were associated with long sleep duration (P < 0.05).Conclusion: In the Ravansar population, short and long sleep duration are prevalent, with long sleep duration having higher prevalence. People at risk, such as night shift workers, as well as modifiable factors, such as mobile phone use, can be targeted with interventions to improve sleep hygiene. [ABSTRACT FROM AUTHOR]

Background: Sleep quality and depression in late adulthood, especially in patients with diabetes mellitus (DM), may affect quality of life and active ageing. Objectives: This research aimed to examine the association between sleep quality, depression, and DM in older adults. Methods: This case-control study is performed on people aged 60 years and over living in Amirkola, north of Iran. Participants were divided into two equal groups randomly, based on DM's status. Sleep quality was assessed using the Pittsburgh sleep quality index, and depression was evaluated using the Geriatric Depression Scale. Results: Totally, 800 older adults were examined. The results showed that in both groups, with or without DM, people with depression had poorer sleep quality (P < 0.001). Logistic regression analysis revealed the significant effect of female gender (OR = 2.36; 95% CI: 1.70 - 3.27) and depression (OR = 1.85; 95% CI: 1.37 - 2.51) on sleep quality of older adults (P < 0.001). Conclusions: Older people with or without diabetes were more likely to present poor sleep if they had depression, and DM didn't significantly affect sleep quality. [ABSTRACT FROM AUTHOR]

Sleep characteristics vary between populations. Detrimental sleep habits have cognitive consequences leading to daytime functioning debilitation. Until now no study has been done to investigate sleep characteristics in Iran thoroughly. In this study, we aimed to evaluate Iranians' sleep characteristics and their association with daytime functioning. We conducted a population-based study from January 2017 to May 2019 on people more than 18 years old who lived in 11 urban destricts and 3 rural areas of Tehran, Iran. We randomly selected the participants using a multistage random stratified clustered sampling method. We obtained the participants' demographic and anthropometric characteristics and details of bedtime, sleep duration, sleep onset latency, wake-up time and sleep impact on daytime functioning. Logistic regression model was used to assess the relationship between sleep characteristics) and daytime functioning. In total, 1830 people with a mean age of 40.83 years participated in the study. The gender distribution of the participants was even, and 70.98% of them were married. After adjusting for age and sex, the following three factors had a significant impact on daytime functioning: bedtime, sleep onset latency, and sleep duration. (OR = 1.12, P < 0.038, OR = 1.01, P < 0.011, and OR = 0.99, P = 0.01, respectively). We also found that longer sleep onset latency (P = 0.004) and shorter sleep durations (P = 0.029) significantly interfere with daytime functioning. Iranians' sleep characteristics, especially their sleep duration and sleep onset latency, are associated with their daytime function. Interventions on people's sleep hygiene are warranted to promote healthier sleep behaviors among Iranians, considering the high impact of current sleep characteristics on their daily lives. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the validity and reliability of a sleep hygiene index for the elderly. Subjects and methods: A total of 598 elderly people (mean age 68.34 years) were selected through cluster sampling, and the validity and reliability of the sleep hygiene index were measured. Confirmatory factor analysis was used to determine the structure validity, internal consistency and reliability of the questionnaire. To this end, Cronbach's alpha coefficient was used. In addition, concurrent validities with indicators such as sleep quality, Epworth sleepiness, insomnia severity, overall sleepiness measurement and the Berlin Questionnaire were studied. Results: The confirmatory factor analysis indexes of the structural equation model showed that the model fitted well with the data. The χ2/df ratio for the three-factor structure of sleep hygiene was 4.65, and the goodness of fit indices for this structural model (RMSEA = 0.064, CFI =0.9, TLI = 0.9, NFI = 0.9, GFI = 0.9) were good. The Cronbach's alpha coefficient of the whole scale was 0.78, and the re-test coefficient was 0.87. Conclusion: The Persian version of the Sleep Hygiene Index can be used as a reliable and valid tool for assessing sleep hygiene in the population of non-clinical elderly. [ABSTRACT FROM AUTHOR]

The present research was carried out to investigate the prevalence of head lice and related effective features among students in primary schools of Ahvaz County; Iran; to suitable training programs via improve the health promotion of the students in this county during winter 2016 and spring 2017. The sample size was 5930 students that was determined by using a single population proportion formula. In this analytical–descriptive study, samples were selected by a multistep, classification random sampling strategy. The data was collected in two parts, a carefully visual examination of the hair and scalp with head lice comb, and an interview to complete a questionnaire about epidemiologic factors. The collected data was evaluated using SPSS software, version 22. These data were compared using a Chi-square analysis, and a p value of less than 0.05 was considered to be significant. The overall head lice infestation rate in the studied population was 26.3%. The prevalence rate was 15.2% in the boys and 37.9% in the girls, while the rate of infestation was 25.1% in the urban areas and 36.9% in the villages. Also, a statistical significant relationship was observed between Pediculosis capitis and gender, geographical area, type of home, access to tap water, hygiene bath at home, bath times per week, the number of family individuals, sleeping in the common bedroom, use common bedding, daily comb, use common comb, use common towel, use common scarf, history of infestation, presence health educator in school, access to primary health services, knowledge about head lice, infestation in the family, performing personal hygiene, itching on the head and hair style, length, density, and color. The high prevalence of head lice among students in the majority of primary schools in Ahvaz County is attributable to inadequate access to health educators, sanitation facilities, inattention to personal health, and other related factors. The controlling program must be done more efficiently to prevent the prevalence of head lice infestation. It is suggested that the people's knowledge and attitude about biology, clinical presentation, prevention, and treatment strategies of pediculosis capitis should be improved. [ABSTRACT FROM AUTHOR]

Background: Coronavirus 2019 is a new infectious disease that has been declared by the World Health Organization as a global pandemic. This pandemic may have psychological effects on populations. Objectives: This study aimed to investigate the quality of sleep and depression in the Iranian community during COVID-19 pandemic. Methods: This nationwide cross-sectional web-based study was conducted from April 19 to May 12, 2020 in Iran. The data collection tools were the Pittsburgh Sleep Quality Index and Depression Center for Epidemiologic Studies' Depression Scale questionnaires. Each province in Iran was assumed as a cluster, and generalized estimating equations models were used to determine the demographic variables that were related to depression symptoms and sleep quality during COVID-19 outbreak. Results: In this study, 73.5% and 41.4% of the participants had poor sleep quality and had depression symptoms, respectively. Perceived income, hours spent outdoors, the number of people with COVID-19 that were acquainted with, and a history of depression significantly were related to sleep quality. Also, gender, age, having a child, education level, economic status, and a history of depression were significantly associated with having depression symptoms. Conclusions: Most participants had poor sleep quality, and less than half had depressionsymptomsduring the COVID-19 pandemic. These problems can disturb daily routines, cut social ties, and increase worries and fears of the future. Interventions are necessary to reduce psychological problems in Iran. [ABSTRACT FROM AUTHOR]

Background: Among nurses, sleep quality is an important factor which can be associated with many other factors, including job satisfaction, Morning-Evening (ME) chronotypes, and shift schedule. Besides, poor sleep quality can cause some problems for nurses and negatively affect the quality of nursing care. Therefore, the present study aimed to determine the predictive power of sleep quality by ME chronotypes, job satisfaction, and shift schedule in nurses working in Urmia teaching hospitals in 2019. Materials and Methods: A total of 327 nurses working in teaching hospitals affiliated to Urmia University of Medical Sciences were recruited using stratified sampling. Data were collected using the demographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Minnesota Satisfaction Questionnaire (MSQ), and the Composite Scale of Morningness (CSM). Data were analyzed using linear regression analysis and Pearson correlation coefficient. Results: The results of the Pearson correlation coefficient and linear regression analysis showed that the ME chronotypes (R2 = 0.51, p = 0.006), job satisfaction (R2 = 0.51, p = 0.001), and shift schedule (R2 = 0.51, p = 0.005) are significantly correlated with the sleep quality among nurses. Conclusions: We concluded that the sleep quality was correlated with ME chronotypes, job satisfaction, and shift schedule, so that increased job satisfaction was associated with improved sleep quality, and the shift to the morning chronotype was associated with decreased sleep quality. Rotating shifts were also associated with higher sleep quality. [ABSTRACT FROM AUTHOR]

BACKGROUND: Numerous studies have investigated the effect of lavender and damask rose aromatherapy on sleep quality. There is, however, little research to compare the impact of them over each other. The aim of current study was to compare the effect of aromatherapy with lavender and damask rose on sleep quality in patients after coronary artery bypass graft (CABG) surgery in Guilan Province, Iran, in 2017-2018. METHODS: In this randomized clinical trial (RCT) study, 97 patients undergoing CABG were randomly assigned to intervention or control groups. In the intervention groups, the patients were asked by the researcher to inhale the lavender or damask rose randomly every night for 5 consecutive nights at 22:00. The control group received routine nursing care in compliance with the hospital procedure. Data were obtained by demographic-clinical and Beck Depression Inventory (BDI) questionnaires. To analyze the data, chi-square test, t-test, Kruskal-Wallis test, and Wilcoxon test were used. RESULTS: During the 5-night intervention period, despite a relative improvement of sleep quality in intervention groups compared to the control group, none of the two aromatherapies had a statistically significant effect on any of delayed sleep (P = 0.514), sleep duration (P = 0.839), sleep efficiency (P = 0.067), sleep disturbances (P = 0.061), and daily functional disorders (P = 0.114) except for subjective sleep quality (P = 0.016) and use of sleep medications (P = 0.031). CONCLUSION: Using both aromatherapies with lavender and damask rose indicated positive effects on sleep quality of the CABG patients, but we could not find a superiority over each other. [ABSTRACT FROM AUTHOR]

Due to the increasing use of the internet in Iranian society, especially among students, and the importance of sleep quality (SQ) and quality of life (QOL), the present study examined the relationship between QOL, SQ, and internet addiction (IA) among medical science students. In the present descriptive-analytical study, the sample comprised Saveh University of Medical Sciences students who were studying in 2019. The survey included demographic information (i.e., age, gender, place of residence, field of study, semester, marital status, smoking status, daily exercise) and the 20-item Internet Addiction Test. From 285 distributed questionnaires, 279 individuals with a mean age of 21.01 years (SD ± 3.17) completed the survey. Findings indicated that students with IA had higher mean scores on (i) all physical dimensions concerning QOL (except for the physical pain) and (ii) all psychological dimensions of QOL. The findings will help national health authorities and planners in Iran design appropriate and effective interventions to improve student health and prevent IA. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Work Ability Index (WAI) is a suitable and valid instrument, which provides a general view of workers' abilities and functional capacities. OBJECTIVE: This study aimed to evaluate the effect of work-related and sociodemographic factors on work ability among employees of a company in Iran. METHODS: This cross-sectional study was conducted on 167 employees. Work ability was measured by the Persian version of WAI. A questionnaire was also developed to assess work-related and sociodemographic factors. The data were analyzed using univariate analysis of variance (ANOVA), independent t-test, and Pearson's correlation. RESULTS: The mean (SD) score of WAI was 38.4 (6.4). WAI mean score (p < 0.05) was associated with age, gender, sleep quality, smoking, work schedule, the conflict between the work and individual, family, and social lives, work injuries, and job satisfaction. CONCLUSIONS: To improve the workers' work ability, interventional programs should be concentrated on changing work schedules, improving sleep quality, limiting work hours, and not scheduling sensitive individuals to night shifts, those whose circadian rhythm stability and circadian rhythm amplitude is rigid type and languid type, respectively. [ABSTRACT FROM AUTHOR]

Background: Sleep quality is one of the main human factors related to urban road traffic crashes. This study aimed at determining the relationship between sleep quality and road traffic crashes in urban drivers. Methods: This correlational study was conducted in Hamadan, a city located in the western part of Iran. The study samples consisted of 309 Hamadan drivers (i.e., 103 with road traffic crashes (RTCs) and 206 without RTCs), who were referred to police centers to change or renew their driving licenses. The data collection tool was a two-part questionnaire including demographic information and the Pittsburgh Sleep Quality Index (PSQI). The questionnaire was filled out in a self-administered manner. Statistical analysis was done using the SPSS-16 software and applying logistic regression, Fisher's exact test, and Chi-square test. Results: The comparison of sleep quality scores between two groups, using the adjusted logistic regression test, showed a statistically significant difference between them (P = 0.019). This means that the sleep quality of drivers without RTCs was 1.8 times better than drivers with RTCS (OR=1.8; 95% CI, 1.1 - 3.07). Conclusions: There was a significant association between poor sleep quality and the occurrence of RTCs in urban drivers. As a result, it is recommended paying more attention to the sleep quality of urban drivers to prevent and control RTCs. [ABSTRACT FROM AUTHOR]

Background: "Partnership Care Model (PCM)", which is the first partnership conceptual framework founded on the Iranian culture to control chronic diseases, has been recently used in different fields of nursing research with no levels of valid evidence to support its application. Therefore, this systematic review and meta-analysis sought to clarify the impacts of interventions developed based on PCM on quality of life (QoL), sleep quality, anxiety, and depression among adults and children with chronic diseases., Methods: International data sources (e.g., PubMed, Web of Science, Scopus) and national databases (e.g., SID, MagIran, IranDoc, IRCT) were searched from 2001 to September 23, 2023, to find Randomized Controlled Trials (RCTs) on PCM-driven interventions for the experimental groups versus no intervention or standard care groups. The studies' methodological quality and evidence quality were rated utilizing the Cochrane risk of bias instruction and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Data were pooled by a random-effects approach employing STATA (vers. 11.2)., Result: Eighteen RCTs, reported in 22 publications, were qualified. The PCM compared to the standard care significantly improved the QoL among both adults (10 effect sizes [ESs], mean difference [MD]: 3.17, P < 0.001) and children (4 ESs, MD: 4.45, P < 0.001). Likewise, the intervention enhanced adults' sleep quality (3 ESs, MD: 7.15, P < 0.001). The anxiety of adults and children was also significantly lower in the PCM group (4 ESs, MD: -4.52, P = 0.001; 2 ESs, MD: -4.04, P < 0.001, respectively). However, regarding depression, a significant effect of PCM was found only among children (3 ESs, MD: -7.99, P = 0.011). The methodological quality of the studies and the evidence quality were undesirable., Conclusion: The PCM had a promising influence on the caring of adults and children suffering from chronic diseases. However, additional high-quality RCTs are needed to generate a higher quality of evidence concerning the clinical benefits of the PCM., Prospero No: CRD42021253790., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Inc.)

Epidemiological studies have shown a close correlation between exercises and sleep quality which affects the quality of life especially in elderly people. Thus, the purpose of this study was to investigate the relationship between sport participation and sleep quality of aged male and female populations. 384 elderly persons aged 60 years were selected by simple random sampling method in recreational parks of Tehran City. The correlation was measured between Pittsburgh Sleep Quality Index (PSQI) and quality of sleep. The physical activity level of participants was measured using the Global Physical Activity Questionnaire. Data analysis was carried out independent t test and using Pearson correlation at the significance level of p<0.05. The findings suggested that there was a significant relationship between sport participation with subjective sleep quality, sleep duration, habitual sleep efficiency, sleep disturbances and daytime dysfunction (p<0.05), while no significant relationship was found between sport participation with sleep latency and use of sleeping medication (P>0.05). The aged populations are highly recommended to do sport participation with the aim of improving quality of sleep. As shown, the higher levels of physical activity, the more quality of sleep occurs. [ABSTRACT FROM AUTHOR]

This descriptive correlational study was aimed at determining the relationship of hemodialysis shift with sleep quality and depression in 310 hemodialysis patients. Demographic and Clinical Questionnaires, the Pittsburgh sleep quality index, and Beck's Depression Inventory were used to ascertain the aforementioned relationship. Among the patients, 59.6% reported poor sleep quality and 44.8% reported experiencing depression. Results show that these conditions were significantly related to many factors. Although dialysis shift was not significantly related to sleep quality and depression, sleep quality was found significantly associated with age, female gender, illiteracy, unemployment, residence in rural areas, diabetes, addiction to sedatives, and phosphorus levels. A significant relationship was also found between depression and phosphorus levels. Logistic regression predicted age, gender, illiteracy, unemployment, residence in rural areas, and addiction to sedatives as factors for poor sleep quality. A body mass index (BMI) above 30, decreased urea, and increased phosphorus were predicted as factors for increased depression. [ABSTRACT FROM AUTHOR]

Purpose: Sleep apnea disorder brings about negative effects to the quality of life of the people involved. Debilitation of cognitive functioning is one of the consequences of this condition. However, scant researches have been carried out to explore the efficacy of cognitive therapy in mitigating the clinical symptoms and cognitive functions of the brain. Combining cognitive method and medical treatment, this research aims at comparing the effectiveness of continuous positive air pressure (CPAP) therapy and cognitive-behavioral treatment (CBT) in improving mental cognitive functions among patients with sleep apnea disorder. Methods: The study population included all patients who referred to the sleep disorders clinic in Tehran. Our sample consisted of 45 subjects who were randomly allocated into three groups of 15 individuals (CPAP, combined treatment, and control). All three groups were psychologically assessed prior to the intervention. Next, individuals in the cognitive-behavioral group underwent CPAP and 12 sessions of cognitive training, progressive muscle relaxation, mental visualization, and sleep hygiene. The other group went through CPAP therapy and the third group was also assessed. After the intervention, all groups were again psychologically assessed. Data collection instruments included Wisconsin cognitive software, semantic and complex Stroop, continuous performance, and polysomnography and CPAP devices. Results: The results indicated that both types of intervention can enhance cognitive functioning; however, a greater efficacy is obtained by combining the two methods compared with the exclusive application of medical treatment. Conclusion: This research proposes cognitive-behavioral therapy as a complement to medical treatment. [ABSTRACT FROM AUTHOR]

Background: Working at height has always been considered as one of the most dangerous industrial activities. Workers' fitness including their physical and psychological ability plays a key role in prevention of occupational accidents. This research was conducted to investigate the physical and mental fitness of telecommunication tower climbers as well as their job stress. Methods: This cross-sectional study was conducted among employees of a contracting company which worked in the field of telecommunication tower installation in Iran during 2016. Sixty out of 93 workers voluntarily participated in this study. Data collection tools were the Persian version of the Work Ability Index (WAI), the Persian version of the Health and Safety Executive (HSE) Stress Indicator Tool and an author-developed measure to assess socio-demographic characteristics. Data was analyzed through statistical tests such as independent t-test, univariate analyses of variance (ANOVAs), Pearson's correlation coefficient, and multivariate linear regression; using SPSS 1 9 software. Results: Workers' mean ± SD WAI score was 29.17± 10.33 and for work-related stress was 3.08 ± 1.80. There was a significant relation between WAI and educational level, job tenure, hours of sleep per day, regular exercise, and second job. The repression modeling explained 67.4% of the total variance (adjusted R2) 0f the WAI score. Among the dimensions of work related stress, control (β = 0.21) and changes (β = -0. 40) were significant predictors of the WAI score. Conclusions: To improve the worker's work ability, intervention programs should focus on promoting level of job control, sleep quality and exercise. Additionally, implementing a comprehensive macroergonomics and participatory program for increase involvement the workers in organization changes should be considered. [ABSTRACT FROM AUTHOR]

Introduction: Poor sleep quality can result in poor academic performance and damage to students' physical or mental health. Therefore, this study was performed with the main aim of investigating the relationship between metacognitions and students' sleep quality. Methods: The study design was descriptive of a correctional type. All the students of Mohaghegh Ardabili University constituted the statistical population. The study sample was included 230 male and female students who were picked out using the random cluster sampling method. Sleep quality index and metacognition questionnaire were used for data collection and Spearman's correlation coefficient and multivariate linear regression for the exploring of relationships between the variables. Results: The results revealed that more than 58% of the students had poor sleep quality scores. The results also indicated that the correlation coefficients of age, gender, education, metacognition total score and some subscales of metacognition with the students' sleep quality problems were significant. Meanwhile, the academic level could predict the students' sleep quality negatively (p<0.05, β=-0.214), and smoking (p<0.05, β=0.132) and negative beliefs toward the danger of thoughts (p<0.01, β=0.244) did it positively. Conclusion: Metacognitive beliefs can improve students' sleep quality through restricting students' ability in choosing and performing negative cognitive strategies. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study was conducted to investigate the sleep symptoms and polysomnographic patterns of obstructive sleep apnea in overweight and obese children. MATERIALS & METHODS: Overweight or obese children aging 6-18 yr old referred during 2010 to Endocrinology Clinic of Ghods Hospital in Ghazvin, central Iran were enrolled in the study. Polysomnography was done for the diagnosis of obstructive sleep apnea and the BEARS and Children's Sleep Habits questionnaires were used to survey sleep behaviors. RESULTS: We enrolled 30 children (14 males, 16 females). Twenty-one cases had body mass index (BMI) >95% and 9 had 85% CONCLUSION: Prevalence of obstructive sleep apnea is high among overweight and obese children. Physicians should be familiar with its manifestations and consider polysomnography as an invaluable diagnostic test. There was no relation between the degree of obesity and severity of obstructive sleep apnea. [ABSTRACT FROM AUTHOR]

Purpose: Although aromatherapy with damask rose can reduce anxiety and improve sleep quality in different conditions, no study has yet addressed its effects among operating room (OR) personnel. Considering the high level of workload among Iranian OR personnel during the COVID-19 pandemic which can affect their anxiety and sleep quality, this study evaluated the effects of damask rose aromatherapy on state anxiety and sleep quality among a population of Iranian OR personnel during the COVID-19 pandemic., Design: A randomized, nonblinded, parallel-group controlled trial., Methods: Eighty OR personnel were divided into the two groups of damask rose and placebo (paraffin oil) using the stratified randomization method. In the first aromatherapy session, the participants inhaled two drops of either damask rose oil or paraffin oil for 10 minutes at the beginning of their morning shift. Then, they attached an absorbent cloth napkin impregnated with 5 drops of products to the side of their pillow for 30 consecutive nights. The Spielberger state anxiety inventory (SAI) and the Pittsburgh sleep quality index (PSQI) were completed before random allocation (T1) and on the 31st day of the study (T3). Also, the SAI was completed 90 minutes after the end of the first aromatherapy session (T2)., Findings: The mean changes in the SAI score were significant compared to T1 both at T2 and T3 in favor of the damask rose group (P < .001 in two cases). Similarly, the mean change in PSQI score was significant compared to T1 at T3 in favor of the damask rose group (P < .001)., Conclusions: Damask rose can be effective in reducing state anxiety and improving sleep quality of OR personnel. Further studies are needed to determine the generalizability of the findings., (Copyright © 2021 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.)

Introduction: This research aimed to compare medical and psychological interventions to improve chronic insomnia among adult women who sought advice from a sleep clinic in the city of Tehran. Method: The study population included all of the clients in a sleep clinic in the city of Tehran suffering from chronic insomnia. The sample for this study included 26 clients, who were randomly divided into two groups with 13 clients in each group. Psychological intervention group subjects were given instructions for progressive muscle relaxation, guided imagery, relaxing music, and sleep hygiene in 4 sessions. Subjects in medical intervention group used hypnotic drugs in 4 weeks. All participants were examined after 4 weeks. The tools for obtaining information consisted of Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, Berlin Questionnaire for Sleep Apnea, and Beck Depression Inventory. Results: The analysis of data showed that both psychological and medical interventions could improve sleep quality and insomnia. Comparison between the two kinds of interventions showed that psychological interventions are more effective than medical intervention. Conclusion: According to the results, we may suggest that psychological interventions are a more proper remedy for insomnia. [ABSTRACT FROM AUTHOR]

Fresh leafy (FL) and ready-to-eat (RTE) vegetables are recognized as an important source of foodborne disease outbreaks worldwide. Currently, there are no data available for the prevalnce of bacterial foodborne pathogens (FBPs) in raw vegetables consumed in Iran. Here, we evalated the presence of common bacterial FBPs among 366 samples of raw vegetables including 274 FL and 92 RTE collected from 21 districts of Tehran. The presence of FBPs were screened using conventional microbiological culture methods and real-time PCR assays. Overall, a higher rate of bacterial contamination was detected in FL compared to RTE samples using both detection methods. The results obtained by microbiological methods showed that Staphylococcus aureus (134/366, 36.6%), followed by Escherichia coli (85/366, 23.2%) and Clostridium perfringens (66/366, 18%) were detetcted as the most prevalent pathogens in this study. Vibrio cholerae was not detected in any of the samples either by microbiological methods or by the real-time PCR assays. There was a noticeable reduction in the proportion of Campylobacter positive samples using conventional microbiological methods (3.5%) compared to the real-time PCR assay (20.7%). The proportion of FL and RTE positive samples obtained by conventional microbiological methods was significantly different (P < 0.05) for C. perfringens, Campylobacter spp. and S. aureus. The proportion of positive samples in FL and RTE vegetables obtained by the real-time PCR assays was significantly different (P < 0.05) for C. perfringens, S. aureus, Helicobacter pylori and STEC/EHEC, the last one was found more frequently in RTE than in FL samples. Our findings indicated a contamination of FL and RTE vegetables in Iran with a range of well-known and emerging FBPs. Positivity and the distribution of bacterial species from the current data indicated different contamination sources, and overall a lack of effective decontamination steps during the production chain. Moreover, further information about the quality of the water, the hygiene measures implemented during the processing, storage and marketing are required to better identify the critical points and define the proper measures. [ABSTRACT FROM AUTHOR]

Background: School closure is one of the main policies of global health care strategies performed worldwide. Despite all benefits, there might be some threats for younger groups spending their time in quarantine. This study aims to determine the impacts of lockdown and school closure on children's major lifestyle aspects, especially their leisure and sleep pattern during the COVID-19 pandemic., Methods: For the purpose of this study, an online questionnaire was distributed from 14th to 31st of March 2020 among the schools and students from the first grade to the 12th grade (before university) in Fars province, southern Iran. The questionnaire consisted of five sections which included data regarding the students' general information, activity priorities, adherence to quarantine, attitude toward school closure, and sleep patterns., Results: In our study, 20,697 filled questionnaires were received from the participants with an average age of 13.76 years; 29.7% of them were male, 80.6% were from urban areas, and 83.3% were from public schools. The overall first preference of students during school closure was mobile and computer games (30.1%), followed by studying (26.6%) and watching television (13.8%). Our results demonstrated that the majority of students adhered to social distancing and there was also a significant correlation among education levels and desire for schools to be closed till the end of the semester (P = 0.015). Also, regarding sleep patterns, the majority (53.5%) had above 12 h of sleep throughout the day., Conclusion: It seems that lockdown following COVID-19 pandemic has changed various aspects of the students' lifestyle remarkably, especially by increasing screen time and even sleep duration and pattern. We believe that certain strategies should be implemented by the Health and Educational Ministry to control not only the visible side effects of the quarantine period, but also the collateral consequences on their psychological and mental health.

Background: This study aimed to predict the quality of life (QOL) in patients with Painful Diabetic Neuropathy (PDN) based on pain severity, pain catastrophizing, pain acceptance, depression, anxiety, and sleep disturbance. Also, this study was aimed to assess the prevalence of psychiatric symptoms in Iranian patients with PDN., Method: 1120 patients (mean age, 53.6 ± 12.6 years) participated in the research. Data were collected by the Quality of life questionnaire (NeuroQoL); Beck Depression Inventory, Beck Anxiety Inventory, the visual analog scale for pain severity, Pain Catastrophizing Scale (PCS), Chronic Pain Acceptance Questionnaire (CPAQ) and Pittsburgh Sleep Quality Index (PSQI). Finally, the data were analyzed using SPSS-26 by multiple regression analysis., Results: The results showed the regression models' significance, and the dependent variables predicted 42% of total changes in the QOL. The most significant predicting factors were depression, pain catastrophizing, pain acceptance, pain severity, sleep disturbance, and anxiety in order. In patients with PDN, the prevalence of sleep disturbances, depression, and anxiety were 85.5%, 68.2%, and 62.1%, respectively. Also, comorbid depression and anxiety were found in 47% of patients., Conclusion: Results demonstrated a significant relationship between pain-related and psychiatric dimensions with QOL. Thus, it is suggested to design more specific psychological-based rehabilitation interventions in which these variables are considered. They should focus on more significant variables (such as depression and pain catastrophizing) to reach better treatment outcomes. Furthermore, this research shows a high level of anxiety, depression, and sleep disturbance in Iranian patients with PDN. Thus, experts and clinicians are suggested to focus on reducing these psychiatric symptoms.

Background: This study translated the Adolescent Sleep Hygiene Scale-revised (ASHSr) into Persian and aimed to validate its psychometric properties using classical test theory and Rasch analyses., Methods: Adolescents aged 14-18 (n = 389; 199 males) and their parents in Iran participated in the study. Each adolescent wore a wrist actigraphy device during sleep time and completed the ASHSr, the Depression Anxiety Stress Scale (DASS), the General Health Questionnaire (GHQ), the Pediatric Daytime Sleepiness Scale (PDSS), and the Pittsburgh Sleep Quality Index (PSQI). A parent of each adolescent completed the Sleep Disturbance Scale for Children (SDSC)., Results: The construct validity of the ASHSr was supported by both classical test theory (factor loadings from confirmatory factor analysis [CFA] = 0.64 to 0.88; corrected item-total correlations = 0.70 to 0.92; test-retest reliability = 0.72 to 0.90) and Rasch analyses (infit mean square = 0.73 to 1.30; outfit mean square = 0.74 to 1.32). ASHSr had significantly negative associations with DASS subscales (β = -0.15 to -0.42, ps < 0.001) and GHQ (β = -0.663, p < 0.001). Known-group validity was demonstrated by the significant differences between poor and good sleep hygiene based on ASHSr in the actigraphy measure and scores of PDSS, PSQI, and SDSC. The multigroup CFA and differential item functioning in Rasch analyses suggested that all the participants interpreted the ASHSr similarly, regardless of their gender or living in a private room., Conclusions: The Persian ASHSr demonstrated good reliability and validity in assessing sleep hygiene among Iranian adolescents. Healthcare providers may use it to assess the effectiveness of sleep hygiene programs., (Copyright © 2018 Elsevier B.V. All rights reserved.)