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Quality of life is referred to as the trend of social issues such as consumption, income, education, housing, and health and medical care. However, this is less common in the lives of immigrants in the 21st century. We aimed to examine the quality of life from the participants' perspective based on the lived experiences of the refugees living in the UN camp in Sarvestan, Iran. In this qualitative content analysis study, in-depth and semi-structured interviews with 15 residents of the Afghan camp were performed. Data analysis yielded 415 open codes, and three issues appeared. Level 3 or the main challenges were achieved in 3 levels: quality of life, quality of services, and obstacles and shortcomings. Sub-topics related to the quality of life included health, security, tranquility, economic status, social acceptance, and education. Sub-issues related to service quality in various forms include comprehensiveness of service, accessibility, usefulness, and appropriateness. Sub-topics related to obstacles included financial deficiencies, social barriers, and cultural-ethnic problems. The immigrants' demands for improving the quality of life included providing services to high-risk groups of refugees, continuing the education of the youth and adolescents, providing necessary equipment and settings for health and culture, and improving the employment status.

Background This study aimed to identify and explain the strategies of faculty development based on their role and learning styles at Iranian Universities of Medical Sciences. Methods We conducted a qualitative content analysis study in 2021 using purposive, snowball sampling, with a maximum variation of age and experience levels of faculty members. Twenty four participants were enrolled in this study (eighteen faculty members and six medical sciences students); data collection consisted of two phases of semi-structured interviews and a brainstorming group technique. Data were categorized into two themes and six related subthemes, based on their similarities and differences after frequent summarization. Results The data analysis yielded two themes and eight categories. The first theme was to explain competencies based on role and task with two sub-themes: Tasks and capabilities and Development and excellence of personal qualities. The second theme was the best strategies for empowering the teacher with four sub-themes, including problem-based learning, integration of methods, evaluation-based education, and scholarship in education (PIES), which explains the strategies that can support the development of teachers in medical sciences. Conclusion From the perspective of faculty members, the importance of some strategies in education and empowering the teachers’ professional competence dimensions should be emphasized. PIES could explain the practical strategies that can support the development of teachers in medical sciences.

Reflectivity is one of the fundamental methods of education. This study aimed to investigate the relationship between reflectivity and self-regulated learning in MA medical education students of Shiraz University of Medical Sciences in 2018 and 2019.In this descriptive study, 34 full time and virtual MA students of medical education participated, using census method. Data were collected through the Pintrich and DeGroot self-regulated learning and the Kember et al.'s reflectivity questionnaires. Descriptive and inferential statistics were used for data analysis, through SPSS.The results showed that self-regulatory learning strategies in subjects with good reflectivity were significantly higher than those with poor reflectivity; also, the scores of cognitive strategies and motivational beliefs were significantly higher in the participants with good reflectivity. There was no significant relationship between reflectivity and subscales of self-regulated learning strategies and also between reflectivity and self-regulated learning strategies in the full time and virtual courses.It was found that there was a positive and meaningful relationship between reflectivity and self-regulated learning. Therefore, it is recommended that the managers and professors in medical universities should provide training programs in this field in order for the students to benefit from the advantages of reflectivity and self-regulated learning.

In this study, we aimed to explain the strategies of faculty development based on their role and learning styles at Shiraz University of Medical Sciences. We conducted a qualitative content analysis study in 2021 by purposive, snowball sampling, with a maximum variation of age and experience levels of faculty members. Eighteen participants were enrolled in this study, and data collection consisted of two phases of semi-structured interviews and brainstorming group technique. Data were categorized into two themes and six related subthemes, based on their similarities and differences after frequent summarization. The second theme was the best strategies in empowering the teacher with four sub-themes, including problem-based learning, integration of methods, evaluation-based education, and scholarship in education (PIES), which explains the strategies that can support the development of teachers in medical sciences. PIES could explain the practical strategies that can support the development of teachers in medical sciences.

The aim of this study was to compare a number of anthropometric indicators, blood pressure and level of happiness in athletic and non-athletic female staff members of universities of medical sciences in Fars Province. This is a cross-sectional descriptive study, in which 237 athletic women and 241 non-athletic women participated. The data included weight, waist circumference, waist-to-hip ratio, body mass index, and systolic and diastolic blood pressure.To calculate the level of happiness, the Oxford University Happiness Questionnaire was used. The data were analyzed using SPSS, version 13. The results showed that excess weight and obesity were prevalent among female staff members of the universities. The body mass index of athletic women was in a more normal range. The waist-to-hip ratio was lower in athletic women compared to non-athletic women. In happiness, athletic women were superior to non-athletic ones. However, no significant difference was observed between athletic and non-athletic women in their systolic and diastolic blood pressures. It appears that participating in physical exercise can be effective on psychological and physiological aspects of female staff members of universities of medical sciences.

Despite the increase in the women’s employment in universities, especially in medical fields in the recent decades, there is still some evidence indicating the lower number of academically higher rank females, especially in the full professor rank. Therefore, the present study aimed at investigating the gender differences in academic promotions in Shiraz University of Medical Sciences (SUMS). The present study aimed to compare the academic promotion of male and female academic staff in SUMS from 1992 to 2013. The statistical population of this study consisted of all the faculty members working in the faculties and research centers of SUMS. The data were collected through access to their files on the gender, age, school, department, the university where they were educated, and the maximum length of time passed before their promotion. The findings of the study revealed that during the study years about 300 faculty members had promoted to the associate professor rank and 104 members to full professorship rank. The mean of the years passed for promotion to associate professor and professor ranks was 9.97 years (M±SD= 92) and 6.22 years (M±SD=3.32), respectively. The results showed that there was a statistically significant difference in the number of the promoted male and female staff (P

The prevalence of hookah smoking in the Islamic Republic of Iran is increasing among females, especially in the southern cities.The aim of this study was to investigate the factors influencing hookah tobacco smoking among females in the Islamic Republic of Iran.In this qualitative study, 52 females who use hookah were selected (25-71 years old) from the cities of Evaz and Gerash and were interviewed. The participants were selected using purposive sampling and the data were gathered using semi-structured interviews. Data analysis was performed using the conventional approach of qualitative content analysis.Most participants were aged between 25 and 35 years old and 55.8% were married. Three main themes were identified from the qualitative data including: personal factors, family factors and social factors.The findings of this study indicate that the reasons for hookah smoking were based on complex interactions between individual, family, and social factors. In order to successfully reduce hookah smoking in females it is necessary to consider an approach that uses these social factors.العوامل المؤثّرة في تدخين تبغ الشيشة بين الإناث في جمهورية إيران الإسلامية: دراسة نوعيّة.محمد بذرافشان، أمير المنصوري، حامد دلام، بهنام مسموعی، نسرين شكربور.يتزايد معدّل انتشار تدخين الشيشة في جمهورية إيران الإسلامية بين الإناث، لا سيّما في المدن الجنوبية.هدفت هذه الدراسة إلى استقصاء العوامل التي تؤثّر على تدخين تبغ الشيشة بين الإناث في جمهورية إيران الإسلامية.في هذه الدراسة النوعيّة، اختيرت 52 امرأة يدخّن الشيشة (في عمر 25–71 عامًا) من مدينتي إيفاز وجيراش، وأُجريَت مقابلات معهن. واختيرت المشاركات عن طريق أخذ عيّنات هادفة، وجُعت البيانات بمقابلات شبه منظّمة. وحُلِّلت البيانات بالنهج التقليدي لتحليل المحتوى النوعي.تراوحت أعمار معظم المشاركات بين 25 و 35 عامًا، وكان ٪55.8 منهن متزوجات. وحُدّدت ثلاثة مواضيع رئيسية من البيانات النوعيّة اشتملت على: العوامل الشخصية، والعوامل العائلية، والعوامل الاجتماعية.تشير نتائج الدراسة إلى أن أسباب تدخين الشيشة اعتمد على تفاعلات معقّدة بين العوامل الفردية والأسرية والاجتماعية. ويستلزم النجاح في الحدّ من تدخين الشيشة لدى الإناث التفكير في نَجٍ يستخدم هذه العوامل الاجتماعية.Étude qualitative sur les facteurs influençant le tabagisme par houka chez les femmes en République islamique d’Iran.La prévalence du tabagisme par houka en République islamique d’Iran augmente chez les femmes, en particulier dans les villes du sud.l’objectif de la présente étude était d’étudier les facteurs influencant le tabagisme par houka chez les femmes en République islamique d’Iran.Dans cette étude qualitative, 52 femmes sélectionnées qui fumaient la houka (âgées de 25 à 71 ans) dans les villes d’Evaz et de Gerash ont été interrogées. Les participantes ont été sélectionnées sur la base d’un échantillonnage ciblé et les données ont été recueillies dans le cadre d’entretiens semi-structurés. L’analyse des données a été réalisée selon l’approche conventionnelle d’analyse qualitative du contenu.La plupart des femmes avaient entre 25 et 35 ans. En termes de statut marital, 55,8% étaient mariées. Trois thèmes principaux ont été identifiés à partir des données qualitatives, à savoir : les facteurs personnels, les facteurs familiaux et les facteurs sociaux.Les résultats de cette étude indiquent que les raisons de l’utilisation de la houka étaient les interactions complexes entre les facteurs individuels, familiaux et sociaux. Pour réussir à réduire le tabagisme par houka chez les femmes, il est nécessaire de tenir compte les facteurs sociaux.

Background: Iran is a disaster-prone country in which many natural and man-made disasters happen every year. Because the health sector is vital due to its nature of treatment and rehabilitation of the injured after the disasters, all health care providers, especially hospital nurses, should be prepared to provide the services they need. Objective: The present study aimed to determine the level of knowledge, attitude, and performance of nurses about disaster management in teaching hospitals affiliated to Iran, Shiraz University of Medical Sciences in 2019. Methods: This cross-sectional and descriptive-analytical study was conducted on a sample of 230 nurses working in the teaching hospitals of Iran, Shiraz University of Medical Sciences, who were selected using the stratified sampling proportional to size and simple random sampling methods. The data were collected using a valid and reliable questionnaire containing 20 questions in three dimensions of knowledge, attitude, and performance. Then, the collected data were analyzed using SPSS 25.0 through independent samples t-test, ANOVA and Tukey tests at the significance level of 5%. Results: The results showed that the highest and lowest mean scores were related to the attitude (2.38±0.19) and knowledge (1.70±0.50) of the nurses, respectively. However, all three dimensions were at a moderate level. The results showed significant relationships between the mean score of performance and the gender, marital status, age, and work experience of the nurses. In addition, statistically significant relationships were found between the mean score of knowledge and their age and work experience (p Conclusion: According to the findings, the following suggestions can be made to increase the knowledge and performance of the nurses for being prepared in critical situations: reducing the duration and increasing the quality of training classes and workshops on disaster preparedness; providing some incentives for nurses, especially female, married, older, and more experienced ones to attend these classes; and improving the methods of training materials related to disaster management.

The main aim of this study was to investigate the effects of inhaled lavender aromatherapy on depression and anxiety levels among postmenopausal women. A randomized clinical trial was performed in which 46 postmenopausal women received 2% inhaled lavender essence or distilled water 20 minutes nightly before bedtime for 4 successive weeks. Depression and anxiety mean scores decreased in the lavender group compared with controls, providing evidence that lavender aromatherapy may be an effective noninvasive treatment during the postmenopausal stage.

Background:Quality of services is one of the important factors affecting the success of service organizations. However, due to limited resources, organizations should identify the most important dimensions of service quality and take some measures to improve them.Objective:To identify and prioritize the factors affecting service quality from the viewpoints of all health care stakeholders in the teaching hospitals and the headquarters affiliated to Shiraz University of Medical Sciences.Methods:This is an applied, cross-sectional and descriptive-analytical study conducted in the teaching hospitals and the headquarters affiliated to Shiraz University of Medical Sciences. The study population consisted of all health care stakeholders, including patients, patients' families and relatives, general population, health care policymakers and managers, and health service providers such as matrons and supervisors. Six people of each studied stakeholder group were selected as the study sample using a purposive sampling method (n=30). A pair-wise comparison matrix designed based on the SERVQUAL dimensions was used for making pair-wise comparisons and collecting the required data. The collected pair-wise comparison data were analyzed through Fuzzy DEMATEL and ANP techniques using Super Decision 2.2 and Excel 2007.Results:The results showed that Access (NW=0.39018) and Tangibility (NW=0.05873) had the highest and lowest priorities.Conclusion:According to the results of the present study and from the studied health care stakeholders' viewpoint, access to care was the most affecting and most important dimension to be improved. Therefore, in order to improve patients' access to the health care services, some suggestions can be made such as providing appropriate facilities for patients' families and relatives, offering special discounts to the poor, providing easier access to the emergency entrance, providing parking and accommodation for patients and their relatives, employing and using the appropriate number of staff, and delivering 24-hour and high-quality health care services.

Parvin Etesami is one of the prominent and celebrated contemporary Iranian poetesses who enjoy a prominent place, particularly by dealing with certain issues such as women’s education throughout her poetry. Under the influence of her father, Yusuf Etesam al-Mulk, she successfully advanced her development and flourished in this field. Yusuf Etesam al-Mulk translated some books from Arabic into Persian, namely Qasim Amin Mesri's book entitled Tahrir al-Mar'a on women’s freedom and education, to be partly published in Iran under the title of Tarbiyate Niswan (Women’s Education). This study is an attempt to explore Qasim Amin Mesri's ideas on the freedom and education of women and the effect on Parvin Etesami's poems and views; therefore, by studying their lives and works, and comparing their views, the authors aimed to determine whether she was under his influence in her poetry or not, and if yes, determine to what extent she has been influence. Moreover, their approaches towards the necessity of educating women and Parvin’s particular attitude towards the capabilities of Iranian women without imitating Western women are investigated in this study.

Background and Purpose: One of the most important principles of training is the appropriate teaching method. The method used plays a key role in the process of teaching and learning and affects the students’ learning while knowledge of these methods and choosing the best of them lead to improvement in education. The aim of this study was to compare the effect of two lecturebased and multimedia-based training methods on learning, knowledge and remembrance of breast cancer topics in students of Shiraz University of Medical Sciences in 2016. Methods: In a quasi-experimental study, 42 midwifery students were assigned to two groups for training (25 students in multimedia-based method and 18 in lecture-based method). The students’ knowledge was measured using 20 multiple-choice questions designed by the researcher in three stages: pre-test, post-test and test-retest (2 months after the intervention). Then, the data were analyzed using SPSS, 19, at a significance level of 95%. Findings: There was no significant difference between the students’ mean age and their mean score in the course of women’s diseases in the two groups. No difference was observed in the mean scores in the two groups (p>0.05) before the intervention, but after the intervention the level of students’ knowledge in both groups increased (p=0.000). In the post-test stage, there was a significant difference between the scores in the multimedia-based and lecture-based groups (p=0.000). Results: The results indicated the effectiveness of multimedia knowledge and breast training method so that this method showed a more lasting knowledge after two months of training. Bangladesh Journal of Medical Science Vol.19(4) 2020 p.710-716

Background: Breast cancer ranks the first common cancer in women in Iran and is the fifth mostcommon cause of death. Peer education on the self-efficacy and mental adjustment of breastcancer patients undergoing chemotherapy can contribute to their easier adaptation to the disease.This study aimed to determine the improved mental adjustment and self-efficacy for womenundergoing chemotherapy through peer education. Study Design: This study was conductedusing pre- and post-test follow up and control design approach. 70 women with breast cancerwho underwent chemotherapy in Nemazi hospital participated in this study. Method: Usingconvenient sampling, the participant were selected and randomly assigned into two groups. Theexperimental group was randomly assigned to four groups and peer education was conductedone educational session per week for 6 weeks. To assess mental adjustment and self-efficacybefore and after the study, Mini-Mental Adjustment to Cancer Scale (Mini-MAC) and Self-Efficacy Scale for Self-Management of Breast Cancer (SESSM-B) questionnaires were used.Chi-square and t-test were used to analyze the data. Results: For the experimental group, theresults showed statistically significant improvement in self-efficacy (p

Background: Breast cancer is the most prominent cause of women's mortality due to cancer and is one of the most serious and commonly diagnosed cancers among Iranian women. Also, social support plays a vital role in breast cancer patients' lives and their diagnosis and treatment processes. This study aimed to determine the associations between social support status and the recurrence of breast cancer in women breast cancer referred to the Breast Diseases Research Center in Motahari Clinic in Shiraz, Iran in 2018. Methods: This was an applied and descriptive-analytic study on women with breast cancer referred to the Breast Diseases Research Center in Motahari Clinic in Shiraz, Iran in 2018. A sample of 221 patients in two groups of 117 non-recurrence patients and 44 patients with recurrence and metastasis were selected randomly. A localized standard questionnaire was used to collect the required data. The collected data were analyzed using SPSS 24.0. Results: Based on the results, there were significant differences between the two studied groups of patients with and without recurrence in terms of the means of social support and all of its dimensions (P-value Conclusion: The results showed that the breast cancer patients studied without recurrence had higher social support. Therefore, to improve the studied patients' health, we recommend providing the patients with a safe and secure environment, giving accurate and complete responses to the patients' questions, providing continuous psychological counseling, etc.

In the new era, many people seek their health-related information through the Internet due to the increasing access to this technology. Searching online health information can affect the health behavior. This study aimed to investigate the correlation between online health information-seeking behavior and a healthy lifestyle during pregnancy in a sample of Iranian pregnant women. This cross-sectional study was conducted among pregnant women admitted to health centers of Eghlid city, Fars province, Iran in 2019. A total of 193 women participated in the study. The required data were gathered using two validated questionnaires to measure the online health information-seeking behavior and the healthy lifestyle practices of the participants. The collected data were analyzed through descriptive statistics and Pearson correlation coefficient using SPSS version 22. Online health information experience and its subscales showed no statistical correlation with a healthy lifestyle. Age and education did not correlate with online health information-seeking behavior. Age had a statistical correlation with a healthy lifestyle, but education had the same correlation only with some subscales of a healthy lifestyle. The findings were surprising, suggesting that online health information-seeking behavior does not affect the lifestyle of pregnant women. These finding and probable explanations are discussed, but due to the limited literature on the subject, further studies are recommended to be conducted.

This is a quasi-experimental study conducted on 200 men smokers living in Fasa City, Iran, in 2016. The data gathering tools consisted of five parts: demographical information; questions related to...

Background: Today, the prevalence of psychological problems such as stress, anxiety, and depression in hemodialysis patients has increased and affected their quality of life. Objectives: Given the relationship between resilience interventions and psychological problems, this study aimed to investigate the effect of resilience training on stress, anxiety, depression, and quality of life in hemodialysis patients. Methods: This was a controlled clinical trial study on 57 hemodialysis patients referred to Fasa city hemodialysis centers from October to December 2019. Patients were selected using a simple sampling method and divided into two groups of intervention (n = 29) and control (n = 28) using the block randomization method. In 12 sessions of a 90-minute workshop, the intervention group was taught resilience skills by a clinical psychologist. Before and after the intervention, stress, anxiety, depression, and quality of life were measured using the Depression anxiety stress scale (DASS) 21 and SF-36 questionnaires. Data were analyzed with Statistical Package for the Social Sciences (SPSS) software version 20 using t-test, Kolmogorov-Smirnov, and chi-Square tests. Results: According to the paired t-test, the patients’ mean score of stress, anxiety, and quality of life significantly decreased in the intervention group (P < 0.001), whereas depression score did not significantly change after the intervention (P = 0.689). The difference in the mean scores of stress, anxiety, depression, and quality of patients' life was not significant in the intervention group before the intervention and in the control group before and after the intervention (P > 0.05). Conclusions: Resilience training reduced stress and anxiety in hemodialysis patients and improved their quality of life. Thus the use of resilience intervention programs along with other methods for hemodialysis patients' care and treatment programs is recommended as a non-invasive, non-pharmacological, inexpensive, and cost-effective method without complications.

Background The current corona virus pandemic is acting as a stressor or trauma, which not only threats physical health status, but also threats mental health status and well-being of people. Currently, COVID-19 pandemic is a life-threatening unpredictable condition accompanied with a large number of uncertainties. The present study has mainly aimed to assess mental health and the relevant social factors during this pandemic in Fars province. Methods This cross-sectional study was performed on 922 participants in Fars province, Iran, using internet-based data collection technique. All the included participants filled out the General Health Questionnaire (GHQ-28). Moreover, demographic variables and some social factors were evaluated by asking some questions. All the participants were ensured of the confidentiality of the collected data, and willingly completed the questionnaire. Results Among the participants, there were 629 women (68.2%) and 293 men (31.2%). The mean age of the participants was 36.98 ± 11.08 years old. Four hundred twenty-five subjects (46.1%) obtained GHQ-28 scores above the cut-off point, and accordingly, they were suspected of having poor mental health statuses. Women, in comparison to men (OR = 2.034, 95%:1.62–3.28), and individuals aged 50 years old (OR: 4.01 95%:2.15–7.50), have poorer mental health statuses. Trusting on media, health authorities, and cooperation with policy makers, as well as having uncertainty on information about Coronavirus pandemic were also shown to be associated with poor mental health condition (P Conclusion The present study revealed that the number of those people with suspected poor mental health in Fars province significantly increased compared to a previous study using the same questionnaire. Furthermore, the participants who had less trust in media and policymakers were more prone to mental health problems. Therefore, it can be concluded that supporting people in these life-threatening pandemic crises is of great importance, so the policy makers and media must present reliable and valid information to people as soon as possible.

Background: Procrastination is prevalent among university students and it affects different aspects of their personal and academic life. Objectives: This study aimed to determine the prevalence of academic procrastination among medical students and its relationship with their academic achievement. Methods: This is a cross-sectional correlational study of 317 medical students at Shiraz University of Medical Sciences. To collect the data, we used Solomon and Rothblum academic procrastination questionnaire (1984). The questionnaire’s validity and reliability were confirmed by experts. We used descriptive statistics and inferential statistics (Pearson correlation coefficient, Independent t-test, and one-way analysis of variance) to analyze the data by SPSS version 14. Results: The results showed that 29.25% of the students had academic procrastination (nearly always or always). Moreover, 47.9% of the students stated that academic procrastination at a moderate level had caused a lot of problems for them. There was a significant negative relationship between academic procrastination and academic achievement in medical students (P < 0.01). Male students and those living in the dormitory had higher levels of procrastination than females and those living at home (P < 0.01). Conclusions: The findings of the present study revealed that a considerable number of students had high levels of procrastination, leading to permanent problems and reduced academic achievement.

Background: Diabetes is a global epidemic with serious complication and there is a clear need for paying special attention to self-management as the cornerstone to optimal control of the disease. Objectives: This study aimed to assess the self-management status and its correlation to disease control indicators in people with diabetes. Methods: In a descriptive cross-sectional study, 220 patients were selected from the list of the referred patients available in Lamerd public health network from December 2014 to June 2015. In the first step, data about demographic information and disease control were collected from the patients’ records. In the second step, the self-management status of each patient was assessed by the Diabetes Self-Management Questionnaire developed by Schmitt et al. To analyze the data, independent sample t-test and Pearson correlation coefficient were used. Results: The mean age of the male and female participants was 56.43 ± 13.50 and 56.46 ± 10.49 years old, respectively. The mean duration of the disease was 6.67 ± 4.72 years for men and 7.07 ± 5.30 years for women. Twenty-one (25.9%) men and 60 (43.7%) women had a history of smoking. The results of the Pearson correlation coefficient showed that there was an inverse and statistically significant relationship between diabetes self-management status and weight, body mass index (BMI), waist circumference, glucose tolerance test (GTT), LDL, and cholesterol. The results of the t-test did not show significant differences between the level of HbA1C (HbA1C7) and self-management scores of the patients (P > 0.05). Conclusions: Patients with better self-management status were in a better disease control condition with respect to weight, BMI, waist circumference, GTT, LDL, and cholesterol levels. Special attention to the control and management of LDL, cholesterol, HbA1C, BMI, and blood pressure levels is recommended in planning for these patients.

Recognition of the factors affecting the medical students’ academic success is one of the most important challenges and concerns in medical schools. Hence, this study aimed to investigate the mediating effects of metacognitive learning strategies and learning-related emotions in the relationship between academic self-efficacy with academic performance in medical students.MethodsThe present study was carried out on 279 students of medicine studying at Shiraz University of Medical Sciences. The students filled out three questionnaires: academic emotions (AEQ), metacognitive learning strategies, and academic self-efficacy questionnaires. The data were analyzed using SPSS and Smart PLS3.ResultsThe results of structural equation modeling revealed that the students’ self-efficacy has an impact on their learning-related emotions and metacognitive learning strategies, and these, in turn, affect the students’ academic performance. Moreover, learning-related emotions influence the metacognitive learning strategies, which in turn mediate the effect of emotions on academic performance.DiscussionThe results of this study revealed that metacognitive strategies and learning-related emotions could play a mediating role in the relationship between students’ self-efficacy and academic performance.

This study aimed to develop and test a research model that examined 7effective factors on the effectiveness of laboratory information system (LIS) through strategic planning. This research was carried out on total laboratory staff, information technology staff, and laboratory managers in Shiraz (a city in the south of Iran) teaching hospitals by structural equation modeling approach in 2015. The results revealed that there was no significant positive relationship between decisions based on cost-benefit analysis and LIS functionality with LIS effectiveness, but there was a significant positive relationship between other factors and LIS effectiveness. As expected, high levels of strategic information system planning result in increasing LIS effectiveness. The results also showed that the relationship between cost-benefit analysis, LIS functionality, end-user involvement, and information technology-business alignment with strategic information system planning was significant and positive.

Background: Author and journal self-citation contributes to the overall citation count of an article and the impact factor (IF) of the journal in which it appears. However, little is known about the extent of self-citation in the general clinical medicine literature. This study aimed to determine the effect of self-citation (journal and author) on the IF of Iranian, American, and European English medical journals. Materials and Methods: IF, IF without self-citations (corrected IF), journal self-citation rate, and author self-citation rate for medical journals were investigated from 2014–2021 by reviewing the Journal Citation Report (JCR). Twenty Iranian medical journals (published in English) in the web of science indexed were selected and compared with 20 American and 20 European medical journals. The correlation between the journal self-citation and author self-citation with IF was obtained. We used Spearman’s correlation coefficient for the correlation of self-citation and IF. Results: The overall journal citations were higher in the American and European journals compared to the Iranian ones between 2014 and 2021. There was a significant relationship between journal self-citation rates and IF (P

Despite the increasing interest in the need to increase the students’ learning motivation, there have been few attempts to determine the relationship between the students’ motivation and their L2 writing skill.The present study aimed at investigating the effect of extrinsic and intrinsic motivation on Iranian medical students’ L2 writing. 100 EFL medical students (both males and females) who had enrolled in an English academic writing course held in English Language Department of Shiraz University of Medical Sciences participated in this study.We used a questionnaire to classify the students’ extrinsic/intrinsic motivation. The results showed that the students’ motivation has a positive effect on their writing. Moreover, students with intrinsic motivation were more successful than those with extrinsic motivation in L2 writing. This study can provide the instructors with an in-depth understanding of motivation as a key factor which can improve the students’ writing. Understanding different types of students’ motivation and what promotes their learning skill can assist the teachers in fostering positive and realistic beliefs to maximize their teaching in an educational setting.

It is expected that the number of people living with diabetes rise especially in low- and middle-income countries. In Iran, more than four million adults have diabetes mellitus, and self-management education is essential for effective diabetes self-care. This study aimed to investigate the effect of self-management education with telephone follow-up in diabetic patients of rural areas of Fars province in Lamerd city, Iran. In this experimental study, 64 participants were randomly assigned to intervention and control groups (32 patients for each group). In the intervention group, the participants attended four educational sessions, each lasting 90 minutes. The control group received the usual care. Outcome measures were clinical variables and the patients' scores in Diabetes Self-Management Questionnaire (DSMQ) in the preintervention and postintervention phases. Effects of the intervention were analyzed using Mann-Whitney U test and analysis of covariance. Data of 60 patients (30 in each group) were analyzed. There were significant differences between the two groups in fasting blood sugar after 3 months of intervention. There was a significant difference between the intervention and control groups in DSMQ sum scale after adjusting for baseline value. In subscales of DSMQ, there were significant differences between the intervention and control groups in glucose management, dietary control, and physical activity, whereas no significant difference was found in health care use between the intervention and control groups. Self-management education with telephone follow-up in diabetic patients in rural areas is effective, especially in improving fasting blood sugar level and increasing scores of patients based on DSMQ.

The prevalence of depression and anxiety is increasing among the elderly around the world. It is believed that lavender can stabilize the people's mood, so this study was designed to evaluate the effect of lavender on anxiety and depression of the elderly.This study was a single blind clinical trial with a control group. The participants in the study consisted of 60 elderly subjects (30 in each group) who referred to the Health Center of Larestan city in the south of Iran in 2019. The intervention consisted of using 2 g of lavender teabag, which was prescribed to be used 2 times as decoction in the morning and night. The duration of the intervention was 2 weeks. The eligible participants were randomly assigned to the intervention and control groups using balanced block randomization with a block size of ten. The control group did not receive any placebo. Data collection tools in this study included demographic information questionnaire, Beck Depression and Spiel Berger Anxiety Inventory. Chi-square test and independent t-test were used to analyze the data. The significance level was considered 5 %.The two groups were similar in terms of age, gender, educational level and marital status and there was no significant difference. The mean score of depression in the intervention group before and after drinking lavender herbal tea was 17.80 ± 1.49 and 16.33 ± 1.49, respectively. The mean score of depression between intervention and control groups after drinking herbal tea were 16.33 ± 1.49 and 18.33 ± 1.84, respectively. This indicated the effect of herbal tea on reducing depression (P 0.001). Also, mean difference of intervention and control groups after drinking herbal tea in terms of depression and anxiety (state and trait) were (-2.00, 95 % CI (-2.86, -1.13)), (-6.40, 95 % CI (-9.43, -3.36)) and (-4.13, 95 % CI (-7.66, -0.60)), respectively.The results of the present study showed that consumption of lavender herbal tea can reduce depression and anxiety scores and since it is inexpensive and accessible, it is suggested to be used as a complementary treatment in reducing anxiety and depression.

Recognition of the factors affecting the medical students’ academic success is one of the most important challenges and concerns in medical schools. Hence, this study aimed to investigate the mediating effect of metacognitive learning strategies in the relationship between learning-related emotions and academic self-efficacy with academic performance in medical students. Methods: The present study was carried out on 279 students of medicine studying in Shiraz University of Medical Sciences. The students filled out three questionnaires: academic emotions (AEQ), metacognitive learning strategies, and academic self-efficacy questionnaires. The data were analyzed using SPSS and Smart PLS3. Results: The results of structural equation modeling revealed that the students’ self-efficacy has an impact on their positive emotions and metacognitive learning strategies, and these in turn affect the students’ academic performance. Moreover, positive emotions influence the metacognitive learning strategies which in turn mediate the effect of positive emotions on the academic performance.Discussion: The results of this study revealed that metacognitive strategies can play a mediating role in the students’ self-efficacy, positive emotions, and academic performance. Therefore, in case we can strengthen the students’ self-efficacy and their positive academic emotions, their performance will improve. Keywords: Academic self-efficacy, learning related emotions, metacognitive strategies, academic performance, medical students

Hospital employees' turnover is one of the problems with which both public and private organizations have been faced for many years. Employees' turnover can cause many organization's investments in employees to be wasted and the stability and continuity of the organizational activities to be undermined. The present study aimed to investigate the effects of social support and mediating factors on the turnover intention of administrative and financial employees working in the teaching hospitals affiliated to Shiraz University of Medical Sciences, Iran, using structural equation modeling in 2017. This was an applied, cross-sectional, and descriptive-analytic study conducted on the administrative and financial employees working in the teaching hospitals affiliated to Shiraz University of Medical Sciences in 2017. The results showed that the proposed model remarkably explained "turnover intention," and the overall validity of the model was confirmed. Accordingly, 15 of 21 study hypotheses were supported. Moreover, the results showed that social support had an indirect significant association with the hospital employees' turnover intention and could decrease it through increasing the employees' organizational commitment, psychological empowerment, and core self-evaluation and reducing their job stress and job burnout (P < .05). To reduce the hospital employees' turnover intention in hospitals, employ suitable and qualified individuals for the positions, provide training courses such as stress management, improve better interactions and mutual cooperation among managers and employees, provide job security and job enrichment, and create a comfortable and relaxed working environment.

The status of public resources in health has a positive and direct impact on this sector's outcomes because of its effect on the increase of social services. The government's ability to manage health expenditures greatly depends on identifying the determinants of these expenditures. Therefore, this study aimed to determine factors affecting the government health expenditures and estimate the related function in Iran during 2006-2011 using panel data. This was a cross-sectional and time-series study that was conducted using panel data analysis. In this study, the data were collected and categorized separately for each province from documents in the Ministry of Health and the Statistical Center of Iran. The results showed that there were positive associations between health expenditures and some factors including age group of 20 to 39 years (P = .04), the number of women (P = .001), the number of physicians, the number of hospital beds, and annual budget (P < .001). According to the results, it seems that allocating a part of health subsidies for increasing the insurance coverage of the age group of 20 to 39 years and also starting saving accounts can have an important effect on reducing health expenditures of this age group.

The current discourse of today's world has focused on providing well-being for human, while peace of mind and happiness are not necessarily the product of one's well-being and well-being is consistent with human mental health. Meanwhile, social scientists and health researchers have acknowledged that a phenomenon called laziness is a common disease of our century that has left people feeling at ease. This descriptive-analytical and library-based research addresses only one factor (harm), namely "laziness", among the factors and areas that undermines human peace. The modern religion has discussed how to get out of laziness. The present study acknowledges that rituals such as prayer, fasting and hajj provide a profound definition of health to believers, reinforcing the principles and components of true "peace". Religious rituals, as a practical solution to this process of influence on the one hand by weakening factors encouraging laziness, and on the other by improving the necessary spiritual talents and capacities, such as a spirit of hope, self-esteem and confidence, a realistic view to oneself and others. ... and the restoration of his criticizing spirit and responsibility will be able to deal with laziness

Today, postgraduate students experience a variety of stresses and anxiety in different situations of academic cycle. Stress and anxiety have been defined as a syndrome shown by emotional exhaustion and reduced personal goal achievement. This article addresses the causes and different strategies of coping with this phenomena by PhD students at Iranian Universities of Medical Sciences. The study was conducted by a qualitative method using conventional content analysis approach. Through purposive sampling, 16 postgraduate medical sciences PhD students were selected on the basis of theoretical sampling. Data were gathered through semistructured interviews and field observations. Six hundred fifty-four initial codes were summarized and classified into 4 main categories and 11 subcategories on the thematic coding stage dependent on conceptual similarities and differences. The obtained codes were categorized under 4 themes including "thesis as a major source of stress," "supervisor relationship," "socioeconomic problem," and "coping with stress and anxiety." It was concluded that PhD students experience stress and anxiety from a variety of sources and apply different methods of coping in effective and ineffective ways. Purposeful supervision and guidance can reduce the cause of stress and anxiety; in addition, coping strategy must be in a thoughtful approach, as recommended in this study.

This study was undertaken to determine the effects of transformational leadership (TL) and mediating factors on organizational success (OS) from the administrative, financial, and support employees' perspective in teaching hospitals affiliated with Shiraz University of Medical Sciences using structural equation modeling. Three hundred administrative and financial employees were selected, using stratified sampling proportional to size and simple random sampling. Data were collected using 5 questionnaires and analyzed using SPSS 21.0 and Lisrel 8.5 through Pearson correlation coefficient and path analysis and confirmatory factor analysis methods. Results showed that TL had significant positive effects on the 3 mediating factors, including organizational culture (t = 15.31), organizational citizenship behavior (OCB) (t = 10.06), and social capital (t = 10.25). Also, the organizational culture (t = 2.26), OCB (t = 3.48), and social capital (t = 7.41) had significant positive effects on OS. According to the results, TL had an indirect effect on OS. Therefore, organizations can achieve more success by strengthening organizational culture, OCB, and social capital through using transformational leadership style. Therefore, in order to increase OS, the following recommendations are made: supporting and encouraging new ideas in the organization, promoting teamwork, strengthening intergroup and intragroup relationships, planning to strengthen and enrich the social and organizational culture, considering the promotion of social capital in the employee training, establishing a system to give rewards to the employees performing extra-role activities, providing a suitable environment for creative employees, and so on.

Background: The function of healthcare workers, particularly nursing staff, in taking care of coronavirus disease 2019 (COVID-19) patients, cannot be overemphasized. As the pandemic lasts, burnout among the nursing staff needs to be considered as an important challenge. This was aimed to assess the nurses’ burnout and factors affecting this variable. Materials and Methods: In this cross-sectional study, Maslach Burnout Inventory was completed by 261 nurses in Shiraz hospitals (Iran) in April 2020. This questionnaire addresses different aspects, including emotional exhaustion, personal achievement, and depersonalization, to determine the intensity of perceived burnout among nurses during the outbreak. Results: Our data demonstrated that the nurses’ burnout in Shiraz hospitals during the COVID-19 pandemic was high (64.6%). Emotional exhaustion and depersonalization were observed in 63.6 and 53.3 percent of the participants, respectively. Moreover, the rate of successful personal achievement among these nurses was >97%. Work experience

INTRODUCTION: Academic burnout is one of the issues involving the educational systems at all levels, which wastes the human resources and expenditures. Academic burnout refers to the sense of exhaustion due to educational requirements, the sense of cynicism and indifference, and the sense of lack of competence. Considering the fact that burnout has already been studied in different professions and in cultures different from that of ours, there is a need to identify these factors among the Iranian medical students and accordingly propose some strategies to reduce burnout symptoms among these students. With this end, this study aimed to identify and quantify the importance of possible factors causing burnout among medical students in the 2nd and 4th years of their studies in Mashahd University of Medical Sciences and provide some suggestions. METHODS: The present research is a cross-sectional study conducted in 2017. The participants included medical students who had entered Mashhad University of Medical Sciences in Iran in 2013 and 2015 and were in their 4th and 2nd year of their studies in the university. A questionnaire prepared and validated by Maslach et al. was used to collect the data and distributed among 195 participants who were selected randomly as the sample. RESULTS: The results showed that the mean scores given by 195 selected respondents regarding emotional exhaustion, indifference, and inefficiency were respectively 3.89, 3.87 and 4.12 out of 7. CONCLUSION: Based on the results, students had the highest level of academic burnout in personal inefficiency or incompetence component and the lowest level was observed in indifference. Therefore, burnout and its components were explicitly seen among medical students; the authorities are recommended to take measures to reduce academic burnout among the students.

BACKGROUND: Communication apprehension (CA) is the fear or anxiety about communicating. This study was designed to investigate the CA and its related factors in the medical students at Rafsanjan University of Medical Sciences (RUMS). MATERIALS AND METHODS: In this cross-sectional study, personal report of CA (PRCA-24) was administered to 340 medical and paramedical students to measure anxiety in four domains of large groups, small groups, public speaking, and dyadic interaction. Pearson's correlation and linear regression analysis were used to investigate the relationship between CA and the variables of birth order, number of siblings, and university entrance score. Data were analyzed using descriptive and inferential statistics (Chi-square and Kruskal–Wallis Test). RESULTS: CA in the dimension of public speaking was higher than the other dimensions. Evaluation of the economic stability and its relationship to CA indicated a significant difference among all the domains of the PRCA-24. There was a significant relationship between the scores of CA and the number of siblings (P = 0.001). Linear regression and Pearson's correlation tests indicated a significant correlation between the variables of birth order, number of siblings, and university entrance score. The correlation between the CA with dimensions of group discussion, interpersonal, speaking, and meeting was weak but significant (P < 0.01). CONCLUSION: Without communication, the materialization and development of the human community are not possible. This aspect is more evident and crucial in the healthcare industry. Based on the results of this study, the medical and paramedical students at RUMS have a medium-to-high level of CA. Therefore, it is of utmost importance to detect students with high CA to prevent further communication problems after graduation.

Wolcott-Rallison syndrome is a rare disease presenting with insulin-dependent diabetes mellitus (DM) before 6 months old, skeletal dysplasia after 6 months old, and liver failure. Other manifestations are renal failure, microcephaly, epilepsy, central hypothyroidism, neutropenia, and dental and dermal problems. The cases were 2 patients from 2 different states of Iran (Khoozestan and Fars) who had developed DM before 6 months old. The first one was a 7-month-old infant who was healthy; in the genetic study (screening), autosomal recessive pattern and novel deletion in EIF2AK3 were reported; her sister had died at 5.5 years old due to diabetic ketoacidosis (DKA) that was associated with liver and renal failure. The second patient had developed DKA at 45 days old, which was associated with mild acute tubular necrosis and abnormal coagulation tests at onset clinical presentation, which were then resolved. He was treated with insulin, and at follow-up, the laboratory data are normal; in the genetic study, EIF2AK3 nonsense homozygous mutation was diagnosed. Genetic study of patients with insulin-dependent DM before 6 months old, especially those with DKA and associated with or without other disorders; attention to novel deletion of in EIF2AK3 gene; screening for skeletal dysplasia after 1 year old; and renal, liver, pancreatic, and thyroid function tests are recommended.

Problem-based learning (PBL) has become a distinct approach in learning. To assess the effectiveness of PBL in teaching ethics to medical students and the effect it has on their ethical reasoning, we decided to hold a PBL ethics workshop and then evaluate them based on pretest and posttest. This quasi-experimental comparative study in Shiraz University of Medical Sciences was designed based on pretest-posttest nonequivalent groups. After obtaining their consent, 120 health care providers were randomly selected and assigned in 4 groups and then asked to attend the ethics workshop. For measuring the participants' ethical reasoning through pretesting and posttesting, a case study consisting of 21 multiple-choice questions (cognitive domain-apply level) was performed. Data were then collected using a questionnaire, which was completed by the participants and analyzed using SPSS software (version 17). The comparison between the participants' attitude and knowledge toward ethics before and after the workshop revealed that all indices in the cognitive domain were changed (P < .001). The scores of pretest and posttest were significantly different. As to the results of our study, the PBL groups showed a more positive learning attitude and higher motivation in comparison with the control group who were subjected to traditional-based method of learning. The result of our study suggests that PBL can and should be used as an alternative method in teaching ethics in medical students because it is more effective and motivates the students.

Malaysian learners are observed to be error-prone in terms of semantic functions of modal auxiliary verbs in English. ESL Malaysian learners’ challenges in terms of using modal auxiliary verbs suggest that there might be some inadequacies in the syllabus, which could have led to the problems encountered by these students. Thus, the semantic functions of four modal auxiliary verbs, can, could, may and might, used by and introduced to Malaysian learners in Forms 1–5 textbook corpus were the focus of this study. Apparently, the findings show that these textbooks offer a relatively one-sided picture, overemphasizing the minor semantic functions and overlooking the frequent functions used in the presentday English. It is also argued that although there are invaluable insights available in terms of modal auxiliary verb forms and their semantic functions in major corpus-based studies, this real-life language has not been well presented in Malaysian English language textbooks. The findings of this study contribute to the improvement of the pedagogical practices in the teaching of the modal system, and emphasize that the semantic functions of each core modal in the teaching materials should be given adequate importance.

Nurses are the largest group and an important part of the providers in the health care systems that who a key role in hospitals. Any defect and deficiency in their work can result in irreversible outcomes. This study aimed to determine the effect of supervisors' support and mediating factors on the job performance (JOBPER) of 400 nurses working in the teaching hospitals affiliated to Shiraz University of Medical Sciences, using structural equation modeling. The results showed that the supervisor's support had a significant negative effect on work-family conflict (t = -2.57) and a positive effect on organizational commitment (t = 4.03); Work-family conflict had a significant positive effect on job stress (t = 11.24) and a negative effect on organizational commitment (t = -3.35) and JOBPER (t = -2.29). Family-work conflict had a positive effect on job stress (t = 4.48) and a negative effect on organizational commitment (t = -2.54). Finally, job stress had a negative effect (t = -3.30), and organizational commitment showed a positive effect (t = 5.96) on the studied nurses' JOBPER. According to the results, supervisor's support could influence JOBPER through reducing work-family conflict and increasing organizational commitment. Therefore, to improve the nurses' JOBPER in the hospitals, some strategies are recommended.

Childbirth is a great moment in a woman's life and is inevitably influenced by emotional, social, and psychological stress. This study aimed to assess the anxiety and pain level of nulliparous women giving birth using physiological methods (without doula support) during labor and those women supported by a doula at Towhid Hospital of Jam, Bushehr, Iran in 2015. In this interventional study, 150 women were randomly assigned to either an intervention (with doula support) or a control group (with no doula support). The intrapartum, postpartum, and hidden anxiety levels were measured using Spielberger standard questionnaire used for assessing anxiety. The labor pain rate was evaluated using McGill questionnaire. Results showed that the average rate of obvious anxiety during labor was 57.76 ± 9.57 in physiological delivery (without doula) and 48.04 ± 9.61 in doula-supported delivery. The difference between mean scores of obvious anxiety during labor was significant. The mean anxiety of the control group (who did not receive doula support) was higher (P = .000). Also, the difference between the mean labor pain scores of the 2 groups was statistically significant. The results of the study showed that doula's presence has positive significant effects on labor pain and anxiety reduction; also, doula-supported mothers reported considerably lower pain and anxiety compared with those experiencing physiological delivery (without doula). Thus, the increased use of doula in hospitals all over the country is recommended.

Background: Suicidal attempts are common among adolescents around the world. Many countries have taken measures to reduce the high incidence of suicidal attempts and prevent people from killing themselves. They also provide care to accelerate the process of recovery among those who have attempted suicide. Objectives: The aim of this study was to qualitatively evaluate the protective factors against suicidal attempts among adolescents who recently did so. Methods: In this qualitative study, 18 single adolescents, with a mean age of 17.44±1.15, who were referred to 2 hospitals in Shiraz (southern Iran), were selected via convenient sampling procedure. Data were collected via semi-structured in-depth interviews and analyzed using conventional approaches to qualitative content analysis. Results: Three main categories and 10 sub-categories were extracted from the data. The main categories included: (a) individual factors (lack of mental conflict, religious beliefs, fear of death, thinking about family, hope for the future, spiritual counseling), (b) social factors (interaction with friends, social stigma of suicidal attempt, sense of family cohesion), and (c) professional advice and support (psychological counseling). Conclusions: The findings of this study can guide health professionals to take measures to prevent suicidal attempts, communicate with people who are at risk of attempted suicide, and prevent relapse of those who are in recovery period after an attempted suicide. © 2017, Shiraz E-Medical Journal.