Search

Abstract Aims This study evaluates both financial and non-financial preferences of nursing students to choose a hospital for work in future. Background In Iran’s healthcare system, the persistent shortage and uneven distribution of nurses have been significant challenges. Addressing such issues requires attention to nurses’ preferences, which can be instrumental in designing effective interventions. Methods In this cross-sectional study, 500 nursing students from Kermanshah University of Medical Sciences (KUMS) were surveyed using a convenience sampling method to determine their preferences for selecting the type of hospital in which they wish to work in the future. The study was conducted during the second half of 2023 using a discrete choice experiment (DCE) approach. To identify the most influential components on future nurses’ preferences, conditional logistic regression analysis was employed. Results The study revealed that an ideal and preferred hospital for nursing students is one that offers a high monthly salary, is located close to their homes, provides Rasmi contracts, has adequate facilities and equipment, has a low workload, and requires less than three years for career advancement. Additionally, the results indicated that the highest willingness to pay (WTP) was associated with the type of employment in the hospital, with nursing students willing to reduce their monthly salary by 27,303,610 IRR to change their employment status from Gharardadi to Rasmi. Conclusions The study confirmed that both financial and non-financial factors significantly influence nursing students’ choices regarding their future workplace. This research can serve as a valuable reference for future studies in this area. The findings can significantly aid in designing and implementing effective interventions aimed at retaining nurses in hospitals and attracting and keeping nursing staff in underserved areas.

Abstract Introduction Coronary artery disease (CAD) is a leading cause of global mortality and a prevalent health issue in Iran. Assessing the empowerment of CAD patients during treatment and care is essential. However, no scale is available to measure empowerment in CAD patients in Iran. Therefore, this study aimed to evaluate the validity and reliability of the Persian version of the "Coronary Artery Disease Empowerment Scale" (CADES). Method This methodological and cross-sectional study was conducted on patients with CAD from June 2022 to April 2023 in Kermanshah City, Iran. The scale was translated using the forward–backward translation method. Construct validity was examined using Exploratory Factor Analysis (EFA) with 190 samples and Confirmatory Factor Analysis (CFA) with 344 samples, both selected through convenience sampling. Internal consistency was assessed using Cronbach's alpha coefficient, and reliability was evaluated using the test–retest method. SPSS version 27 and LISREL version 8 software were utilized for data analysis. Results The EFA and CFA results confirmed the instrument with three factors and 25 items. The model's main indicators in factor analysis were all above 0.9, indicating a good fit for the model. The Pearson correlation coefficient between the items and subscales with the main scale showed a direct and significant relationship. Additionally, Cronbach's alpha coefficient (0.813) and test–retest reliability (0.763) confirmed the reliability of the Persian version of the CADES. Discussion The study's results suggest that the Persian version of CADES is both practical and acceptable for evaluating the empowerment of CAD patients. This tool can be relied upon as a valid and reliable method for assessing these patients' empowerment.

Abstract Background Sleep disorders can be harmful to our health and treating them can also be expensive. Due to the widespread occurrence and impact of sleep disorders, it is valuable to investigate and study them from an epidemiological perspective. Therefore, this study aimed to determine the prevalence of sleep disorders among Iranian adults in 2022. Method This is a cross-sectional study that examines the prevalence of sleep disorders and problems in Iranian society. The participants were selected using a mixed sampling approach (utilizing virtual space and cluster sampling). A two-part package was used for evaluating participants sleep problems, which included a demographic profile form and the Holland Sleep Disorders Questionnaire. After collecting the data, appropriate statistical tests in SPSS version 25 were utilized for analysis. Results A total of 6013 questionnaires were fully filled out for this research, with participants answering the specific questions. The participants’ score on sleep disorders was 1.94, which means 44.1% of them suffer from sleep disorders. The results indicated that the prevalence of sleep disorders in this study was as follows: insomnia (35%), parasomnia (35.3%), circadian rhythm sleep disorder (38.4%), hypersomnia and excessive daytime sleepiness (39%), restless leg syndrome and leg movements during sleep (43%), and breathing disorders related to sleep (38.4%). The prevalence of sleep disorders among the study participants demonstrated a significant relationship with most of their demographic variables (P

Abstract Background Several preliminary studies have been conducted in the field of the prevalence of depression, anxiety, and stress in the elderly population. These studies have examined the prevalence in limited geographic areas with small sample sizes. Also, there are many limitations in the meta-analysis studies. The objective of the present study was to synthesize the global prevalence statistics of depression, anxiety, and stress in the elderly population through a systematic review and meta-analysis. Methods The present systematic review included retrieval of primary studies from the oldest relevant study up to 2023. To find the relevant studies, international databases such as Scopus, Embase, PubMed, and Web of Science (WoS) were systematically searched. Also, a manual search was performed through the Google Scholar search engine and a review of the sources of related articles. The qualitative assessment of the studies was conducted using the Joanna Briggs Institute (JBI) checklist. Due to a high heterogeneity among the study results, a Random Effects model was chosen. Results A total of 42 articles on depression, 47 articles on anxiety and 13 articles on stress were included in the meta-analysis. The overall estimates for prevalence based on a random-effects model were as follows: depression, 19.2% (95% CI: 13.0 − 27.5%); anxiety, 16.5% (95% CI: 11.1 − 22.8%); and stress, 13.9% (95% CI: 5.5 − 30.9%). The highest prevalence of depression and anxiety was recorded in Africa. The prevalence of depression was higher in nursing homes, and stress was more prevalent in individuals with COVID-19 compared to other populations. Conclusion The findings revealed a high prevalence of depression, anxiety, and stress in the elderly population. Therefore, it is recommended that healthcare professionals and policymakers pay more attention to the prevention and management of these disorders in the elderly population.

Abstract Background Motivation is a critical factor in the success of nursing students, as it significantly influences their ability to acquire the necessary knowledge and skills for the nursing profession. Insufficient motivation can result in a lack of engagement with learning activities, thereby impeding the development of essential competencies. Aim This study aimed to translate the Motivation for Nursing Student Scale (MNSS) into Persian and evaluate its psychometric properties within the context of nursing students in Iran. Method This methodological cross-sectional study involved a sample of 542 nursing students selected through convenience sampling. The MNSS was translated into Persian following the guidelines recommended by the World Health Organization. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of internal consistency were conducted to evaluate the validity and reliability of the instrument. Results The EFA and CFA validated the structure of the instrument, identifying four factors and 20 items, which explained 58.68% of the total variance. The CFA results indicated a well-fitting model with the following indices: CFI = 0.91, GFI = 0.93, IFI = 0.946, TLI = 0.92, RMSEA = 0.061, and SRMR = 0.049. The Cronbach’s alpha coefficient and Intraclass Correlation Coefficient (ICC) for the scale were 0.882 and 0.802, respectively. Conclusion The Persian version of the MNSS demonstrates satisfactory reliability and validity, making it a dependable instrument for measuring the academic motivation of nursing students. This tool can be effectively used to assess the motivation of nursing students in Iran.

Abstract Background The clinical readiness of newly graduated nurses is crucial in meeting the growing demand for health services. Consequently, it is essential to develop a scale that accurately evaluates the clinical readiness of these novice nurses. Aim This study aimed to translate and psychometrically evaluate the Persian version of the Nursing Practice Readiness Scale (NPRS) for new graduate nurses. Methods This methodological and cross-sectional study was conducted on new graduate nurses from June to November 2023 in Kermanshah City, Iran. The translation of the scale was performed using the forward–backward translation method. Construct validity was assessed using Exploratory Factor Analysis (EFA) with a sample of 180 participants and Confirmatory Factor Analysis (CFA) with a sample of 318 participants, both employing the convenience sampling method. The internal consistency of the tool was measured using Cronbach’s alpha coefficient. Additionally, the tool’s reliability was evaluated using the intraclass correlation coefficient (ICC). The analyses were conducted using SPSS version 27 and LISREL version 8 software. Results The results of EFA and CFA confirmed the tool’s structure, comprising five factors and 35 items. The CFA results showed a well-fitting model (CFI = 0.96, NNFI = 0.96, GFI = 0.893, RMSEA = 0.062, SRMR = 0.049). Pearson’s correlation coefficient indicated a significant relationship between the items, subscales, and the main scale. Additionally, the Cronbach's alpha coefficient of the tool was 0.932, and the intraclass correlation coefficient (ICC) was 0.891(0.724–0.957). Conclusion The Persian version of the Nursing Practice Readiness Scale (NPRS) is a valid and reliable tool, comprising 35 items and five factors. This scale can be effectively used to evaluate the clinical readiness of newly graduated nurses within the Iranian community.

Abstract Background Premenstrual syndrome affects many women in their reproductive years and often disrupts their social connections and work. This study aimed to compare the effects of positive psychology and physical activity on depression, anxiety, and stress among students with premenstrual syndrome. Methods In this four-group parallel clinical trial with blinded data analysis, 120 eligible students who experienced premenstrual syndrome were recruited based on inclusion/exclusion criteria and randomly allocated to four groups (n = 30) including three experiment groups as positive psychology, physical activity, and positive psychology, physical activity, and control group, using a simple randomization method. All four groups completed premenstrual syndrome screening and the DASS-21 questionnaire before the intervention. Then, the positive psychology intervention group received eight sessions of 70–90 min weekly intervention, the second group received eight weeks of aerobic physical activity intervention, and the third group received positive psychology and physical activity intervention for eight weeks. The control group did not receive any interventions. The DASS-21 was completed immediately after the intervention and two months later by all four groups. In this study, the participants and investigators were not blinded; however, the analysts were. The recruitment process took place from September 2018 to March 2019. One hundred twenty participants fulfilled the study. The Data were collected and analyzed using SPSS (v18). Results Before and immediately after the intervention, there was no statistically significant difference in depression, anxiety, and stress mean scores among the positive psychology, physical activity, positive psychology, and physical activity and control groups (p ≥ 0.05). However, two months after the intervention, a significant difference was observed between the four groups so there was a difference between the scores of the three intervention groups and the control group (p

Introduction The competency of a nurse in integrating knowledge, skills, attitudes, and values in various healthcare areas depends on their ability to apply these elements. It is a basic indicator of performance in nursing, and its assessment is a necessity among nursing students. Objective The present study was conducted to determine the psychometric properties of the Persian version of the nursing competence tool for Iranian nursing students in 2023. Methods This is a methodological study in which the Nursing Student Competence Scale (NSCS) was translated into Persian using the forward–backward translation method. A total of 321 nursing students were selected for construct validity by the exploratory factor analysis (EFA) (the first 190 nursing students) and confirmatory factor analysis (CFA) by convenience sampling method. Cronbach's alpha coefficient was used to evaluate the internal consistency, and the test–retest method was used to check the instrument's reliability. Results The results of EFA and CFA confirmed the instrument with six factors and 28 items. The results showed that the fit indices of the model in CFA included (CFI = .91, NNFI = .90, goodness of fit index = .83, root mean square error of approximation = .075, standardized root mean square residual = .047). Pearson's correlation coefficient between items and subscales showed a direct and significant relationship with the main scale. Also, Cronbach's alpha coefficient (0.9) and test–retest (0.88) confirmed the reliability of the Persian version of (NSCS). Conclusion Generally, the Persian version of the NSCS with 28 items and six factors is a valid and reliable scale. This instrument has good internal consistency, validity, and reliability, which can be used to evaluate nursing students’ competence in bachelor training.

Abstract Background Multiple gestations present numerous physical, psychological, social, and economic challenges for women. Understanding the problem-solving experiences of pregnant women carrying multiple can be invaluable. This study aimed to explore the experiences of Iranian women with multiple gestations. Methods This descriptive phenomenological study utilized purposive sampling and continued until data saturation. Data collection involved in-depth semi-structured interviews, with analysis performed using Colaizzi’s 7-step method. MAXQDA software was employed for data management. Results This study involved 12 women with multiple gestations. The average age of the participants was 33.76 ± 6.22 years, and 9 were pregnant with triplets. The data were categorized into four primary themes: the paradox of emotions, the pregnancy prison, immersion in fear, and the crystallization of maternal love, encompassing 17 sub-themes. Conclusion Pregnant women with multiple gestations undergo various changes and experience conflicting emotions. Enhancing their ability to adapt to and accept numerous pregnancies can be achieved through supportive, personalized, and family-centered care, along with improvements and revisions in care policies for multiple gestations.

Abstract Aim The present study aimed to evaluate the psychometric properties of the Persian version of the ‘Intensive Care Unit Dignified Care Questionnaire (IDCQ)’ among Iranian nurses. Design A methodological and psychometric study was conducted in 2022, involving nurses from six teaching hospitals in Kermanshah, Western Iran. Methods The IDCQ was translated into Persian using a forward‐backward translation method. Construct validity was assessed through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), employing a stratified sampling method with 455 critical care nurses. Internal consistency was gauged using Cronbach's alpha coefficient, while reliability was determined through the test–retest method. Analyses were performed using SPSS version 26 and Lisrel version 8 software. Results EFA and CFA validated the instrument's two‐factor, 17‐item structure. The CFA indicated a well‐fitting model with fit indices: CFI = 0.93, NNFI = 0.92, GFI = 0.861, RMSEA = 0.051 and SRMR = 0.046. Pearson's correlation coefficient substantiated a significant relationship between the items, subscales and the overall scale. The instrument's reliability was confirmed by a Cronbach's α coefficient of 0.88 and a test–retest reliability of 0.86. Conclusion The Persian version of the IDCQ, comprising two factors and 17 items, has been validated as a reliable and applicable tool for use within the Iranian nursing community.

Abstract Background Caring for recommended patients creates work and emotional challenges for nurses. Nurses are obligated to provide care regardless of the patient’s situation. Therefore, knowing the experiences of nurses in dealing with recommended patients in order to provide quality and effective care can be the basis for increasing patient satisfaction. The present study was conducted aimed to explain nurses’ experiences of caring for recommended patients. Methods This was a qualitative study with descriptive phenomenological approach. Participants were 12 nurses working in different wards of hospitals affiliated to Kermanshah University of Medical Sciences, selected by purposive sampling method with maximum diversity. The data collected using semi-structured interviews in face-to-face and audio-recorded methods. MAXQDA 2020 software was used for data management. The analysis of the data was done using the Colaizzi’s 7-step method. In order to verify the trustworthiness of the data, Lincoln and Guba criteria were used. Results After continuous data analysis, 110 initial codes were extracted. These codes emerged in 18 sub-themes and 6 main themes including: catastrophe, be in decline, be in progress, discrimination, work overload, and poor prognosis. Conclusions The results showed information about the presence of recommended patients in the hospital, which can have consequences for patients and nurses. Therefore, it is advised that nurses provide standard care and avoid any kind of discrimination against all patients regardless of whether the patient is recommended or not.

Purpose: The present research aims to develop a model for automatically inferring the relationships between terms in the Thesaurus of Islamic Sciences using Graph Convolutional Networks (GCN). By employing new algorithms in the field of deep learning, the research seeks to enhance the efficiency of information retrieval in the Thesaurus of Islamic Sciences. To enhance accuracy and comprehensiveness, reduce costs, and improve relationships between terms. Method: The current research employed used of convolutional networks method, networks, is are one of the crucial techniques methods in the field of learning. This method is capable of leveraging from the relationship patterns in the while also focusing on to the characteristics of each node. The dataset under study comprises all the terms from the thesaurus of Islamic sciences generated between 1994 and the early 2022, which are represented as a graph. The vertices represent the terms, and the edges represent the relationships between the terms in the graph. This graph is provided as input to the convolutional network, which then generates a model for the automatic inference of connections. And in order to analyze the obtained outputs, AP and ROC standards have been used. Findings: The revealed showed the model achieved the average accuracy 75% and a Roc score of 72% obtained for the data. It is noteworthy to accept the results considering that this method was used for the first time in the field of Islamic sciences and thesauruses. Conclusion: Despite shift in preference opinion thesauri thesauruses to ontologies, the use thesauri remains still of particularly especially in Iran. Compared to previous research, the method used to construct the thesaurus is different, resulting in more reliable outcomes. Consequently, we can expect improved results for various purposes, such as automatic indexing. New advancements in natural language processing and deep learning also give us hope for improvements in information retrieval and automatic indexing.

Background and Aim: The coronavirus pandemic has had a negative impact on the health and well-being of communities and individuals around the world. One of the concerns about the COVID-19 epidemic is the impact of social isolation due to social distancing on the mental health of older adults. This study aimed to investigate the relationship between mental health and loneliness among seniors during the COVID-19 pandemic. Materials and Methods: In this cross-sectional study, 211 retirees of Kermanshah University of Medical Sciences were selected by available sampling method in 2021. Data were collected through the Demographic, Mental Health Questionnaire (GHQ-28) and the Adult Social and Emotional Feeling Questionnaire (SELSA-S). Data were analyzed using paired t-test, one-way analysis of variance, covariance, and chi-squared tests. The significance level was considered 0.05. Results: The mean age of participants was 71.26 years and the results showed a significant relationship between feeling lonely and mental health (r = 0.535, p = 0.001). There were statistically significant relationships between mental health and social functioning (r = −0.204, p ≥ 0.001) and depression (r = 0.501, p = 0.001) and also between mental health and three subscales of loneliness: romantic loneliness (r = 0.001, p = 0.001), social loneliness (r = 0.493, p = 0.001), and family loneliness (r = 0.289, p = 0.001). Conclusion: Feeling lonely during the coronavirus disease pandemic has a negative effect on the mental health of older adults; therefore, it is necessary for mental health professionals to improve the mental health of the elderly with proper planning and interventions.

Aerial manipulators have seen a rapid uptake for multiple applications, including inspection tasks and aerial robot–human interaction in building and construction. Whilst single degree of freedom (DoF) and multiple DoF rigid link manipulators (RLMs) have been extensively discussed in the aerial manipulation literature, continuum manipulators (CMs), often referred to as continuum robots (CRs), have not received the same attention. This survey seeks to summarise the existing works on continuum manipulator-based aerial manipulation research and the most prevalent designs of continuous backbone tendon-driven continuum robots (TDCRs) and multi-link backbone TDCRs, thereby providing a structured set of guidelines for fabricating continuum robots for aerial manipulation. With a history spanning over three decades, dominated by medical applications, CRs are now increasingly being used in other domains like industrial machinery and system inspection, also gaining popularity in aerial manipulation. Fuelled by diverse applications and their associated challenges, researchers have proposed a plethora of design solutions, primarily falling within the realms of concentric tube (CT) designs or tendon-driven designs. Leveraging research works published in the past decade, we place emphasis on the preparation of backbones, support structures, tendons, stiffness control, test procedures, and error considerations. We also present our perspectives and recommendations addressing essential design and fabrication aspects of TDCRs in the context of aerial manipulation, and provide valuable guidance for future research and development endeavours in this dynamic field.

Background: Anemia in older adults is a natural consequence of aging and its symptoms and side effects are mostly neglected, which leads to negative effects on the quality of life in older adults. This study is an attempt to determine the prevalence of anemia in older adults through a systematic and meta-analysis study. Materials and Methods: This meta-analysis and systematic review was carried out in a time period from 1989 to 2022. To find articles pertinent to the topic of the study, Google Scholar, SID, MagIran, WoS, Scopus, and Embase databases were searched using keywords validated in MeSh/Emtree. Heterogeneity of studies was examined using the I2 index. Results: The search yielded 14,999 articles and eventually, 44 articles with a total sample size of 127,978 participants met the inclusion criteria of the study. The prevalence of anemia in older adults was estimated equal to 24.6 % (CI = 95 %; 19.1–31.1 %). The highest prevalence of anemia in older adults was in Africa (45.5 %; CI = 95 %; 3.9–94.5 %) and older adults living in nursing homes (53.7 %; CI = 95 %; 27.9–77.9 %). There was no significant difference between women and men in terms of the prevalence of anemia (P > 0.05). Conclusion: The findings indicated that the prevalence of anemia in older adults was high mostly in Africa. This finding requires more attention from experts, officials, and health policy makers.

Abstract Background Nursing education in Iran is one of the disciplines of medical sciences and it needs a design tailored to the community needs in terms of theoretical and clinical approaches. This system is currently faced with various challenges. This study aims to explore the challenges of Iranian nursing education system to address community needs. Methods A study was carried out through an exploratory descriptive qualitative design with content analysis method. In-depth semi-structured interviews were conducted with 21 participants from the nursing society, selected through purposive sampling. The interviews were continued until data saturation. Data analysis was performed simultaneous with data collection by using Graneheim & Lundman approach. Results Based on the interviews and simultaneous analyses, a total of 471 codes, 14 subcategories, six main categories, and two themes were extracted. The first theme, “system structure," consisted of three categories: "the need for ongoing revision of curriculum," "the need to recruit qualified students," and "the need for a proportionate educational environment." The second theme was “the education process” with three categories "the need for purposive educational design," "the need for purposive monitoring and feedback," and "the need for appropriate and early interaction with the community." The participants emphasized the continuous revision of the educational curriculum based on the current needs of the community and community-based nursing education. Conclusions In general, the results showed that Iranian nursing education system is faced with many challenges in the educational system structure and processes. It is necessary to make appropriate plans to enhance the status of the educational system structure and develop educational designs to address community needs using a hospital/community-based approach.

IntroductionSocial accountability is a new paradigm in dental education and a sort of cultural change. This study is an attempt to elaborate on the process of social accountability in the Iranian dentistry education system.Materials and methodsThis study was carried out as a qualitative work based on a grounded theory approach. The participants were selected through purposive sampling and took part in deep semi-structured interviews, and data saturation was achieved with 14 interviews. The main interviews were private, and face-to-face interviews were held on different occasions (morning and afternoon) in a quiet and decent environment. The interviews were held by the author and voice-recorded with the permission of the interviewees. Data analyses were performed through the Strauss–Corbin method along with the interviews.ResultsThe results indicated that the process of social accountability featured three stages: antecedents, mechanisms, and outcomes consisting of 619 codes, 16 subcategories, and 7 categories. Updating the curriculum, qualified students, appropriate educational environment, appropriate educational technology, monitoring and feedback throughout educational activities, proper interaction with society, and accountability to society's needs were the main categories in the study. The concept of proper interaction with society was the core variable.ConclusionThe results indicated that the process of social accountability has major and effective requirements in the antecedent, mechanism, and outcome stages, and it has a good performance in fulfilling the current needs of society for dentistry services. However, to meet potential needs, it needs special attention and programming.

Introduction: The risk factors for the metallothionein (MT) polymorphism in concentrations of heavy metals, especially mercury, in the blood are subject to several confounding factors, including differences in the ethnicity of the population analyzed, the sample size, and the type of the studied environment heavy metals to which population is exposed. This study aimed to investigate the effects of the MT1A (A>G) and MT1A (C>G) single nucleotide polymorphisms (SNPs) on blood mercury levels in the city of Ahvaz (located in southwest Iran). Materials and Methods: 300 unexposed (control group) and 150 exposed (case group) were included. DNA extraction, PCR-RFLP and DNA sequencing were performed, and blood mercury levels were determined by AAS method with DMA-80. Results: Blood mercury levels in the case group were higher than those in the control group (p-value G), with MT1A (C>G) polymorphism and P-values ​​of blood mercury levels of 0.69, 0.44, and 0.59. 0.56 for the case and control groups, respectively. Results showed that these two SNPs were not associated with mercury-induced toxicity in the case group despite high blood mercury levels and exposure. Conclusion: In conclusion, this takes look shows that MT1A (A>G) and MT1A (C>G) polymorphisms aren't related to susceptibility to excessive blood mercury attention in individuals.

Objective: The relationship between parents’ sleep quality and sleep hygiene and preschool children’s sleep habits was examined. Material and Methods: The study population consisted of the parents of all preschool children at daycare centers located in Kermanshah Province. Through cluster sampling, 153 parents from 26 daycare centers were selected. In order to assess the quality of sleep and sleep health of parents, Pittsburg sleep quality index (PSQI) and sleep hygiene index (SHI) were used. As to the status of childrens sleep habits (CSH), the parents also completed child sleep habit questionnaire (CSHQ). Data analysis was performed in SPSS version 25. The non-parametric tests like U Mann-Whitney test, Kruskal-Wallis’s test, Spearman’s rho, and regression test were used. Results: The mean score of CSHQ from the parents’ viewpoint was 56.34±7.96, which meant a relatively improper sleep habits in the children. The CSH was significantly and directly related to parents’ sleep quality and all of its subscales except two sub-scales (SSQ and HSE). In addition, CSH was directly and significantly related to the parents’ sleep hygiene and its three subscales. The results of multiple linear regression showed that the impact coeffcient of parents’ sleep quality (B=1.02), given the t-value, predicted changes in CSH with 0.99 confidence. Conclusion: In general, the results showed that CSH was in a relatively bad state, while it had a direct relationship with parents’ sleep quality and hygiene. To improve CSH, it is possible to improve parents’ sleep quality through implementing proper programs and motivating parents to observe sleep hygiene.

Background and Aim: Bismuth and its related compounds such as bismuth oxide nanoparticles (Bi2O3 NPs) are widely used in the medical field of science for drug delivery, cancer therapy, bio imaging, and fighting against pathogenic microorganisms. Most of the chemical compounds used in the synthesis of nanoparticles are toxic to human health and the environment, for this reason, recently considerable interest has been focused on the green synthesis of non-toxic and environmentally friendly nanoparticles (NPs). In the biosynthesis procedure, chemicals reducing agents are replaced by cell extract of organisms that contain bio-reductive compounds as stabilizing and capping agent for NPs. Methods: In this study, bismuth oxide nanoparticles (Bi2O3 NPs) were prepared using green synthesis by cyanobacterial cell extract of Spirulina platensis. The physico-chemical properties of the Bi2O3 NPs characterized by X-ray diffraction (XRD), energy dispersive X‒ray (EDX) analysis, Fourier-transform infrared (FT-IR) spectroscopy, scanning and transmission electron microscopy (SEM). The apoptotic properties of biosynthesized nanoparticles on MCF-7 and MCF-10a cell lines were determined using the effect of the Bi2O3 NPs on the expression of BAX and BCL2 genes by real-time polymerase chain reaction. Results: The size, shape, and morphology of Bi2O3 NPs are suitable for penetrating into the cancer cells and affecting their vital activities. In the MCF-7 cell line, the ratio of BAX/BCL2 expression was significantly higher than that of in MCF-10a cell line treated with the Bi2O3 NPs. Conclusion: The results revealed the stimulation of apoptosis in breast cancer cell line by green synthesized Bi2O3 NPs through an increase in apoptosis regulator genes expression.

Background: The venom peptides from the scorpion fauna of Iran have been poorly characterized so far. Objectives: In this study, we identified a cDNA encoding of an anionic cysteine-free antimicrobial peptide from the Iranian yellow scorpion odontobuthus doriae (O.doriae). Methods: The cDNA sequence of an anionic antimicrobial-peptide (AMP) was determined from the venom gland cDNA library of Iranian yellow scorpion O.doriae and was named ODAMP5. This sequence was characterized by a software. Then, the structure and function of its putative peptide were predicted in a bioinformatics manner. The library was constructed from 6 scorpion venom glands. The cDNA related to ODAMP5 was isolated from one positive clone of the library. Results: The analysis of ODAMP5 reveals a 51-residue mature peptide with an anionic property that was stable in physiological states. ODAMP5 was similar to anionic peptide Aba-2 from Androctonus bicolor and according to its structure, it can be a member of helical structure AMPs with a new type of putative conserved domain. Putative ODAMP5 has a small size which makes it convenient for synthesis. Conclusion: Furthermore, we created a framework to express the ODAMP5 peptide for future biomedical and pharmacological studies. ODAMP5 may be a new suitable therapeutic strategy for bacterial infection among a few recognized scorpion venom peptides without disulfide bridges.

Abstract Here, the improved efficacy of a novel composite of iron oxide (Fe3O4) magnetic nanoparticles (MNPs) functionalized by glutamic acid (Glu) and conjugated with thiosemicarbazide (TSC), evaluated on the expression of norB efflux pump gene in S. aureus strains. The proper synthesis of Fe3O4@Glu–TSC NP was confirmed and characterized by Fourier transform infrared spectroscopy (FTIR), scanning and transmission electron microscopy, Brunauer–Emmett–Teller (BET), energy dispersive X‐Ray spectroscopy (EDX), X‐ray diffraction (XRD), and UV–vis spectroscopy. The effect of NP on the expression of norB gene was studied using quantitative reverse transcription polymerase chain reaction (qRT‐PCR). The physical analysis of NP revealed proper synthesis, dispersion, and stability, as well as the spherical/cubic morphology with a mean size of 35–60 nm. The minimum inhibitory concentration (MIC) value of the functionalized nanoparticle decreased by two folds towards each respected strain in contrast with the Fe3O4 NP (alone). Additionally, in the presence of NP, the norB gene expression was reduced by up to 50% in comparison with the control group. In conclusion, the functionalized NP can be considered as a promising inhibitor of bacterial efflux pump genes against antibiotic‐resistant bacteria. However, further studies should be conducted to determine the safety of these nanoparticles for medicinal applications.

Abstract Background Universities are in charge of training, educating, and preparing students for their future. Teaching and learning methods have a profound role in fulfilling this responsibility by universities. Examining teaching–learning experiences needs a proper tool to collect the information needed. The aim of this study was to collect validity evidence of the modified experiences of teaching–learning questionnaire (ETLQ) in Iranian nursing students. Methods The validation process was started by securing the required permissions from the designer of the tool. Then the tool was translated into Farsi using forward–backward method. After preparing a Farsi version of the tool, the content, response process, and internal structure assessment were checked and supported using qualified methods. To examine internal structure, Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were conducted for three sections of the scale with the participation of 278 nursing students. To examine the reliability of the tool, test–retest method was used and internal correlation was examined using Cronbach’s alpha. Results The EFA and CFA results confirmed the tool with three domains, seven factors and 33 items. The R2-index of the model was obtained equal to 0.99, which indicates that 99% of the changes in teaching–learning experiences are explained by the tool (33 items). The main indices in CFA were higher than 0.9, which indicates the goodness of fit of the model. Pearson correlation between the items and the subscales was significantly and directly related to the whole scale. Moreover, with Cronbach’s alpha equal to 0.944 and test–retest result equal to 0.88, reliability of the Farsi version of modified ETLQ was supported. Conclusion The results showed that the Farsi version of modified ETLQ had acceptable and applied indices to measure teaching–learning experiences in nursing students. The tool can be used as a valid tool in different fields of education in medical sciences.

Introduction: Maintaining endotracheal tube intracuff pressure (ETTICP) within an optimal range is crucial for effective ventilation and prevention of aspiration. This study aimed to determine the effect of changing body position on ETTICP in patients under mechanical ventilation. Methods: In the current single-group study, each patient was taken as his/her own control. Thirty patients who met the inclusion criteria were selected as the study sample. First, the patients were placed in a supine (flat) position, head of the bed was raised to 30 degrees, and ETTICP was set at 25 cmH2 O as the baseline. Then, the ETTICP changes in the three positions (left lateral, right lateral, and semi-fowler) were compared with the baseline. Interventions were made on a random basis among the patients. Data were analyzed by repeated-measures ANOVA using SPSS version 13. Results: There was a significant difference among ETTICP means in three different body positions, so that ETTICP was higher in the left lateral position compared to other positions. Moreover, there was a significant difference among ETTICP means 0, 15, 45, and 90 minutes after changing the body position. ETTICP means after 0 and 15 minutes were significantly higher than other times compared to the baseline. Conclusion: ETTICP changes were affected by different body positions and the passage of time. Thus, regular monitoring and adjusting of ETTICP after any body positioning is essential, especially immediately and 15 minutes after repositioning.

The emergence and outbreak of the deadly novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019, become a global health problem in the last two years. SARS-CoV-2 is an enveloped virus with a non-segmented single-strand positive-sense RNA. It has some similarities with other coronaviruses, especially the SARS-CoV. However, the specific features of this virus have changed its pathogenicity and transmissibility compared to other coronaviruses. The distinctive structural differences of the SARS-CoV-2 spike protein have a key role in the kinetics of viral load and a broad range of virus tissue tropism. Because of these differences, SARS-CoV-2 has a greater affinity for binding host cell receptor angiotensin-converting enzyme 2 than SARS-CoV. Since its emergence, the SARS-CoV-2 genome has undergone several mutations. However, a small number can alter the virus antigenicity and clinical features of the disease, leading to the formation of different SARS-CoV-2 variants. Some of these variants have higher transmissibility, severity, and impact on host immunity than the original SARS-CoV-2. Although there are currently no specific therapeutic interventions for coronavirus disease 2019 (COVID-19), manufacturers are working to make and update vaccines by continuously monitoring antigenic and genetic changes in the SARS-CoV-2 population worldwide. Some of these vaccines are very effective against different variants of the virus, therefore in some countries, with widespread vaccination and compliance with health protocols, people have largely returned to normal living conditions. To better understand SARS-CoV-2, in this article, we reviewed its classification, genome organization, structure, and life cycle. In addition, an overview of the mutations occurring in the spike protein and the characteristics of the different variants is given here. Finally, vaccines produced against this coronavirus were briefly introduced.

Objective: This study was performed with the aims of screening the previous studies on breaking bad news in all medical wards. Methods: Eligible observational studies were selected. The quality of the studies was assessed using the STROBE checklist. The findings were reported using Garrard's table. All the stages of the present study were performed in terms of the PRISMA statement. Results: Totally, 40 articles were included in the study and 96 items were extracted. The results show that breaking bad news is a recipient-centered process. Respect, empathy, and support were reported. The news presenters are better to use guidelines based on evidence-based findings. It is suggested that the presenter should use simple and understandable content. Moreover, suitable time and space are important to present the news. The results show the importance of paying enough attention to the emotions of the recipient and the need to provide support after breaking bad news. Conclusion: The recipient must be the center of the programs. It is necessary to pay attention to the characteristics of the news presenter, the news content, and finally the support.Practice Implication: Understand the recipient, trained presenter, and use of the evidence-based results, improve the breaking bad news outcome.

IntroductionFamily members are the caregivers to patients with mental disorders at home, and the mental and spiritual pressures caused by this responsibility necessitate physical, mental, and perceived social support for these families. The present mixed method study is an attempt to elaborate on the perceived social support by Iranian families of patients with chronic mental disorders.Materials and methodsUsing a sequential mixed method explanatory study (quantitative and qualitative), 200 family members of patients with chronic mental disorders were selected through convenient sampling (quantitative phase). Data gathering was started using a demographics form and Stewart and Sherburne's perceived social support scale. The qualitative phase included 10 participants who obtained low scores in the quantitative phase and took part in private, face-to-face, in-depth, and semi-structured interviews. The data obtained in the quantitative phase were analyzed using statistical tests, and the interviews were analyzed using qualitative content analysis.FindingsThe perceived social support by the participants was at a moderate level in different fields of tangible support, information and emotional support, kindness, and positive social interactions. The results of the qualitative phase revealed social support status in 15 subcategories, 6 categories, and 2 themes of support and acceptance by family, relatives, and friends, with support and being understood by society. The results of the qualitative and quantitative sections emphasized the needs of the patient's family members (who acted as caregivers for patients) for support in family, social, and emotional areas.ConclusionThe family members of patients with chronic mental disorders have different needs in the area of perceived social support. Such needs are more tangible in family members such as children with mentally ill parents or parents with mentally ill children. The results of this study can be used for educational and supportive planning for caregivers of patients, most of whom are family members.

Introduction: It has been reported internationally that doctors have a limited understanding of the legal standard that applies to decision making capacity (DMC). No research on this has been conducted in Ireland to date. We sought to assess the understanding of legal principles relating to capacity and consent among Irish general practitioners (GPs), alongside how DMC assessments are conducted.Methods: This study utilised a cross-sectional cohort model circulating online questionnaires to Irish GPs associated with a university research network. Data were analysed using SPSS to conduct a variety of statistical tests.Results: There were 64 participants, with 50% aged 35-44 years and 60.9% being female. Of these, 62.5% found DMC assessments time-consuming. Only 10.9% of participants felt extremely confident in their abilities; most participants (59.4%) felt ‘somewhat confident’ in their ability to assess DMC. Also, 90.6% of GPs routinely engaged with families when assessing capacity. GPs felt their medical training did not prepare them for DMC assessment (undergraduate 90.6%, non-consultant hospital doctor 78.1%, GP training 65.6%). 70.3% felt guidelines relating to DMC would be helpful and 65.6% felt they needed additional training.Discussion and Conclusions: Most GPs recognise the importance of DMC assessment, and it is not considered a complex or burdensome task. There was limited knowledge of the legal instruments relevant to DMC. GPs felt there should be extra support available to assist them with DMC assessment; specific guidelines for different categories of patients was found to be the most popular resource requested.

Objective: The purpose of this study was to assess the psychometric properties of the social and personal identity scale (SPIS) among Iraqi-Kurdish medical students. Methods: Before starting the study, an approval letter was obtained from the developer and founder of the tool. The tool was translated from English to Kurdish by bilinguals using a forward-backward method. The construct validity of the scale was determined using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) with the participation of 301 and 423 medical science students, respectively. The reliability of the tools was verified using the correlation coefficient. Finally, the reliability of the scales was calculated using Cronbach's alpha. Results: The EFA and CFA results revealed two factors and 16 items. The EFA supported the correlation among the 16 items of the scale (KMO = 0.846, Chi-square = 2205.49 and P

BackgroundSubstance use disorder (SUD) and its related problems take a toll on the individual, family, and society. This study was conducted to determine the psychometric properties of the self-stigma scale in the families of persons who use drugs (PWUDs) in Iran.MethodsThis was a methodological and psychometric study. The study population consisted of 311 family members of PWUDs visiting outpatient and inpatient addiction treatment centers in Kermanshah who were selected using convenience sampling. The 14-item Self-Stigma Inventory for Families (SSI-F), which was developed by Yildiz et al. in 2019 using interviews and scales connected with stigma, was applied. The ten steps developed by Wilde et al. were used in this study for cultural validation. The exploratory factor analysis (EFA) (140 samples) and confirmatory factor analysis (CFA) (311 subjects) were used to confirm the construct validity, and the test-retest method was used to confirm the reliability of the tools. Cronbach's alpha was also used to test the internal consistency of the tools.FindingsThe results of EFA and CFA scales in families of PWUDs were confirmed with three factors and 14 items. The reliability degree of the tools was confirmed as 0.891 and the Cronbach's alpha was confirmed as 0.879 using the test-retest method. Pearson's correlation coefficient indicated a positive and significant status between the scale's items/factors and the scale itself.ConclusionGenerally, the results showed that the PWUDs SSI-F scale in Iranian families was valid and reliable with three factors and 14 items, and it can be used to conduct relevant studies.

Abstract Background One of the main elements that help students in research projects and composing dissertations is the student-supervisor relationship. A valid and reliable tool to measure this seems essential and it is the objective of the present study to validate and assess the psychometric properties of a questionnaire on supervisor-doctoral student interaction (QSDI) in Iran. Methods Before starting the study, a permission from the developer of the tool was secured. Then the tool was forward-backward translated. After preparing the Farsi version of the tool, content validity was confirmed through qualitative and quantitative methods. To examine construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted with participation of 218 and 410 MD, MSc, and PhD students of medical sciences, respectively. To check reliability of the tool, correlation coefficient was used. To examine internal consistency of the tool, Cronbach’s alpha was used. Data analyses were done in SPSS (v.25) and LISREL (v.8). Results The EFA and CFA results revealed eight factors and 39 items. The value of R-square for the model was equal to 0.99, which means 99% of changes in the dependent variable (supervisor-student interaction) is attributed to the independent variable (41 items). That is, 99% of the dependent variable changes is due to the independent variables. The main indices of the model based on factor analyses were supported (0.9

Traditional aerial manipulation systems were usually composed of rigid-link manipulators attached to an aerial platform, arising several rigidity-related issues such as difficulties of reach, compliant motion, adaptability to object’s shape and pose uncertainties, and safety of human-manipulator interactions, especially in unstructured and confined environments. To address these issues, partially compliant manipulators, composed of rigid links and compliant/flexible joints, were proposed; however, they still suffer from insufficient dexterity and maneuverability. In this article, a new set of compliant aerial manipulators is suggested. For this purpose, the concept of aerial continuum manipulation system (ACMS) is introduced, several conceptual configurations are proposed, and the functionalities of ACMSs for different applications are discussed. Then, the performances of proposed aerial manipulators are compared with conventional aerial manipulators by implementing available benchmarks in the literature. To enhance the comparison, new features with related benchmarks are presented and used for evaluation purposes. In this study, the advantages of ACMSs over their rigid-link counterparts are illustrated and the potential applications of ACMSs are suggested. The open problems such as those related to dynamic coupling and control of ACMSs are also highlighted.

Objectives: Sleep deprivation and insomnia have negative impacts on mental and physical health in adolescents. In order to examine the problems caused by insomnia, we need tools with acceptable validity and reliability for the target population. The aim of this study was to evaluate the psychometric properties of Insomnia Severity Index (ISI) in Iranian adolescent population. Material and Methods: The study was carried out as a descriptive-analytic normalization. Study group consisted of 701 adolescents aged 12 to 19, who were selected through cluster sampling. The participants completed ISI, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Inventory (PSQI), Adolescent sleep hygiene scale (ASHS) and global sleep assessment questionnaire (GSAQ). In addition, SPSS ver.22 and AMOSS ver.10 were used to analyze the data. Results: The reliability of the test was obtained equal to 0.77 based on Cronbach’s alpha and a good reliability (0.84) was obtained through test/retest method. Exploratory and confirmatory factor analyses with seven items were computed. The models fitness indexes were suitable for the structural model (CFI=0.99%, NFI=0.98%, GFI=0.99%, TLI=0.98%, RMSEA=0.049%). Moreover, there was a direct and significant correlation between the ISI index and the total score of other indexes. As to gender-based reliability, Cronbach’s alpha was 0.78 in female adolescents and 0.85 in male adolescents. Conclusion: The results indicated that the Persian version of the insomnia severity index can be used as a reliable and valid tool for assessing the severity of insomnia in Persianspeaking adolescents.

Background and Purpose: The importance of evaluating the performance indices of the emergency department as one of the most important hospital wards is obvious to everyone. Therefore, in the present study, we determined emergency performance indices in emergency centers of educational hospitals of Zanjan University of Medical Sciences. Methods: This is a cross-sectional descriptive study. In this study, data related to performance indices of emergency center in educational hospitals of Gilan University of Medical Sciences were collected during one full week in Ayatollah Moosavi and Valiasr hospitals by simple random sampling of the Poisson model in a continuous and gradual manner and we recorded the data. In this study, in total, 1341 samples were evaluated in relation to the variable of indices. Finally, the data were analyzed using proper descriptive and inferential statistics and SPSS Ver. 22. The instrument was a questionnaire which included the underlying profile (age, gender, marital status, insurance status, place of residence and degree of education) of the referrals to the emergency department and data of performance indices. Given that the questionnaire used is a checklist related to the standard performance indices recommended by the Ministry of Health of the country, it is reliable and valid. Results: Emergency performance indices in Zanjanchr(chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))39chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39'))))s educational centers was at a favorable level in comparison with other studies; except in cases when there is a triage time interval up to the first physicianchr(chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))39chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39'))))s visit that is suggested that by doing provisions on the physical environment and ease in the process of patient admission, reduce this time interval and to reduce the long-term stay of patients in emergency departments we can mention strategies such as preventing multiple services, making the number of counseling purposeful and restricting them to essential counseling and ultimately, following up on the treatment as soon as possible by the relevant services. Conclusion: Emergency performance indices in Zanjan educational and treatment centers is at a favorable level in comparison with other studies; except in cases when there is a triage time interval up to the first physicianchr(chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39')))39chr(chr(chr('39')39chr('39'))39chr(chr('39')39chr('39'))))s visit that is suggested that by doing provisions on the physical environment and ease in the process of patient admission, reduce this time interval and to reduce the long-term stay of patients in emergency departments we can mention strategies such as preventing multiple services, making the number of counseling purposeful and restricting them to essential counseling and ultimately, following up on the treatment as soon as possible by the relevant services.

This article provides a tutorial on the dynamic modeling of continuum robots. Continuum robots (CRs) have gained popularity in recent years due to their flexible backbone structure. Modeling and control of CRs motivate accurate and efficient dynamic models. Such models will enable simulation of dynamic behavior, improved structural design, and the development of dynamics-based control systems for CRs. As a unified underlying approach, the Cosserat rod-based modeling of tendon-driven CRs is used as the basis of the modeling techniques discussed in this paper. In addition to conventional continuum robot assemblies, new and emerging assemblies such as tendon-bent concentric tube and co-operative robots are also considered. The governing equations of motion for conventional CRs are first summarized and then extended for other tendon-driven CRs. This tutorial also contributes to developing a MATLAB code package for simulation of the dynamic response of these robots. The presented method and codes provide a useful and compact resource for readers and can be used for further development of tendon-driven continuum robots.

Background & Objective: There are a variety of virulence factors that allow Uropathogenic E. coli (UPEC) to cause infection in the urinary tract among which biofilm production ability plays the most important role. This study aimed to investigate the possibility of a link between biofilm formation and the flu and csgA virulence genes in this bacterium. Materials & Methods: The 45 UPEC isolates were collected from patients with the urinary tract infection in Rasht and following the biochemical and microbiological standard tests, the presence of flu and csgA virulence genes in confirmed isolates was investigated by polymerase chain reaction (PCR). Antibiotic sensitivity of the isolates was studied with antibiogram testing to determine its relationship with biofilm formation ability. Result: The highest antibiotic resistance profile was seen against chloramphenicol and tetracycline. Based on PCR test results, 60% and 82% of isolates have flu and csgA virulence genes, respectively and both genes were present in 55.5% of isolates. Four isolates with low, 10 isolates with strong and 11 isolates with moderate biofilm formation abilities were found to have both flu and csgA genes. Conclusion: The results showed a significant association between the presence of flu and csgA genes and biofilm production abilities in UPEC strains. Therefore, these genes can be further investigated as a suitable target for therapeutic interventions. In addition, due to the high resistance of these isolates to chloramphenicol and tetracycline antibiotics, these antibiotics are not recommended for the treatment of patients with urinary tract infections.

Abstract Background In addition to physical, mental, and social condition, ESRD and hemodialysis affect the quality of life of patients as well. Psychotherapy and non-pharmaceutical interventions are effective measures to add meaning to life, create a goal and motivation in life, and improve the quality of life in chronic patients. The effect of educational and supportive group therapy on the quality of life (QOL) of hemodialysis patients was examined. Methods The study was carried out as an interventional quasi-experimental study with the participation of 64 patients who were selected through convenience sampling and based on the patient’s hemodialysis days (Saturday, Monday, and Wednesday patients as an experimental group and Sunday, Tuesday, and Thursday patients as a control group). There were 32 patients in each group. The experimental group received eight 50 min sessions including two sessions per week. The control group received the normal interventions. The participants were assessed using a demographics form and Kidney Disease Quality of Life Short Form before, immediately after, and 1 month after the intervention. The collected data was analyzed using SPSS (v.24). Results The mean QOL scores of the experimental group before, immediately after, and 4 weeks after the intervention were 36.99, 43.3, and 44.9 respectively. Those of the control group were 36.39, 37.2, and 37.1 respectively. There was no significant difference between the two groups before the intervention (P > 0.05); however, the difference between the two groups was significant immediately after and 4 weeks after the intervention (P = 0.0001). The trend of score change in the experimental group was also significant (p

Abstract Background Organ donation following brain death has become an important way of supplying organs for transplantation in many countries. This practice is less common in Iran for different reasons. Therefore, this study aims to explore the obstacles to organ donation following brain death in Iran. Methods This qualitative research was conducted following the conventional content analysis method. The study population consisted of individuals with a history of brain death among their blood relatives who refused to donate the organs. Snowball sampling was employed to select the participants. In-depth semi-structured interviews were conducted for data gathering. Theoretical saturation was achieved through 20 interviews. Data analysis was done following the steps proposed by Graneheim and Lundman. Lincoln and Guba’s criteria were used to ensure data rigor and transferability of the study. Results Data analyses revealed 185 codes, 23 categories, and seven themes including, poor knowledge about brain death and organ transplantation from a dead body, cultural beliefs, religious beliefs, deficiencies of requesting process, fear and concerns, inability to make a decision, and social learning. Conclusion There were several factors in families’ reluctance to donate organs of a brain-dead patient. Through improving knowledge and changing cultural beliefs in society, it is possible to take large steps towards promoting organ donation from brain-dead patients.

Introduction: Busulfan drug for cancer treatment, due to the oxidation properties and free radicals production, causes disturbance on male fertility parameters, and leaves water spinach plant have antioxidant features. The current study was aimed to evaluate the effect of water spinach leaf on recovery of male genital injuries caused by Busulfan. Methods: This randomized controlled clinical trial was performed on 48 male rats of Wistar race in 2019. The specimens were divided into 8 groups including; normal saline, Busulfan, water spinach leaf extract with doses of 250, 500, and 1000 mg/kg, extract + Busulfan. Daily treatment for 2 months was administered intraperitoneally. Sperm parameters by colorimetric techniques and light microscopy, level of testis malondialdehyde by spectrophotometry, total antioxidant capacity and testosterone by ELISA method, and height of germinal layer through optical microscopy and Motic software were evaluated. Data analysis was applied by SPSS software (version 20) and Tukey post-hoc test. P< 0.05 were considered statistically significant. Results:The values of sperm parameters, testosterone hormone, and total antioxidant capacity were significantly decreased in negative control group than positive control (P < 0.01). Treatment by extract and extract + Busulfan in all doses significantly increased whole mentioned parameters compared to the negative control group (P < 0.01). In evaluated parameters in extract group alone, no significant changes were observed compared to the positive control group (P > 0.05). Conclusion: Leaf extract of water spinach plant increases the sperm quality and improves the Busulfan-induced adverse effects on male reproductive parameters.

Abstract Objective Social support is a key factor in the treatment and rehabilitation process of persons who use drug (PWUD). This highlights the need for a valid and reliable tool for assessing social support. The cultural and psychometric properties of community assessment inventory (CAI) in PWUDs under methadone therapy were examined in Iran in 2019. Methods The study was carried out as a validation and methodological study. At first, the original tool was translated into Farsi using forward-backward method. After ensuring face validity and content validity, construct reliability of the tool was supported using explorative and confirmatory factor analysis (EFA & CFA) using a sample group of 392 participants. The participants were selected through convenient-quota sampling from 24 drug clinics. Reliability of the questionnaire was supported using Pearson correlation coefficient and internal consistency based on Cronbach’s alpha. Results To determine content validity of the tool, CVI and CVR of it were obtained, which were on average equal to 0.79 and 0.59 respectively. The EFA supported correlation of the 37itmes of the tool (KMO = 0.975, Chi-square = 15,051.6, Pvalue=0.0001). The main indices of the model, based on CFA were higher than 0.9, which support goodness of fit of the model (χ2/DF = 2.98, CFI = 0.91, NFI, TLI = 0.905 GF = 0.92, REMSEA = 0.07, R2 = 0.99). Reliability of the tool based on internal consistency (Cronbach’s alpha) for the subscales were in 0.8–0.95 interval and equal to 0.85 for the whole tool. Conclusion As the results showed, CAI had acceptable indices for Iranian PWUDs under methadone therapy. The tool can be used for assessing social support level in the study population. It is a reliable and valid tool for studies in pertinent fields.

Abstract Introduction Drug dependence and the resultant problems notably decrease the quality of life (QOL). Measuring the QOL in persons who use drugs (PWUDs) and planning to improve it can be helpful for rehabilitation programs. Given the absence of a standard tool to measure the quality of life of PWUD, the present study is an attempt to validate psychometric and cultural characteristics of non-injection drug users’ QOL scale. Method The study was carried out as a validation and methodological work. The study population consisted of 273 PWUDs in Kermanshah-based drug clinics including outgoing and hospitalized patients. The participants were selected through convenient-quota sampling. After securing the required permission from the copyright owner of the tool, it was forward/backward translated. Face validity and content validity were determined quantitatively and qualitatively. To examine construct validity of the tool, explorative factor analysis and confirmatory factor analysis were used. Internal consistency was measured using Cronbach’s alpha and statistical analyses were performed using SPSS (v.25) and LISREL (v.8). Results Explorative factor analysis (EFA) and confirmatory factor analysis (CFA) results supported the tool with one factor and 22 items. The R2 index in the model was equal to 0.99, which means that 99% of the variation of dependent variable (total score of QOL) is attributed to independent variable (22 statements). In other words, 99% of the variation of dependent variable is due to the independent variables in the model. The main indices of the model based on CFA all were higher than 0.9, which indicates goodness of fit of the model (χ2/DF = 2.18, CFI, NFI, TLI = 0.93 GF = 0.84, REMSEA = 0.066, R2 = 0.99). The correlative coefficient was significant (p

Purpose- Food security (FS) is defined as sustainable access to safe and nutritious food for a healthy and active life. The present study was designed to investigate and determine FS status of rural households and the relevant influential factors. It was conducted on 432 rural households in six subdistricts of two districts of Sarpolzahab, West of Iran, in 2016. Design/methodology/approach- The samples were selected using random cluster sampling, and FS status was assessed using United States Department of Agriculture (USDA) household FS questionnaire. Therefore, both socio-economic questionnaire and the household FS questionnaire were completed during a face to face interview. Data were analyzed using the statistical software package SPSS-22. Chi-square, Mann-Whitney, Kruskal-Wallis, and forward multiple logistic regression were used for data analysis. Findings- Prevalence of food insecurity (FI) in all of the surveyed households was 65.3%, and household FS status between the subdistricts had a significant difference (P< 0.01). The results of the study showed that the prevalence of FI in the subdistricts of Posht-Tang and Sarab (83.3% and 76.4%, respectively) was higher than other subdistricts. Number of household’s members, land ownership, education of household’s head, activity status, and household’s income had significantly relationship with household FI (P< 0.01). Practical implications- The high prevalence of FI is a major threat to the abnormal utilization of environmental resources in this realm. Therefore, given the impact of horticultural activities and diverse cultivation on household FS, macro and regional policies should be provided to increase the diversity of products through agroforestry and intercropping. Original/value- This research presents the basic information on the FS status of rural households in Sarpolzahab and some related socio-economic factors the results of which can help planners and managers to implement interventions to improve the FS and welfare of rural households.

Abstract Background Persons who use drug need family and society’s support in the process of treatment and rehabilitation. Therefore, it is imperative to determine the psychological, social, and motivational factors that can help them in the treatment process. The present study was an attempt to determine the relationship between psychological, social, and motivational factors and the demographics of persons who use drugs (PWUD). Methods An analytical cross-sectional study was carried out. TCU psychological functioning and motivation scales for the PWUD was first translated into Farsi and validated after securing permission from the copyright holder of the tool. Participants were 250 PWUDs under methadone therapy who were selected through convenient sampling. Before analyzing the collected data, validity and reliability of the tool were confirmed using confirmatory and exploratory factor analyses. Given the scale of demographical data, descriptive and analytic statistics were used to analyze the relationship between demographical variables and psychological, social, and motivational factors. Results The results of exploratory and confirmatory factor analyses showed that out of 83 statements in the original questionnaire, 55 statements categorized into 11 aspects were usable for Iranian population. The results showed that gender, income, and marital status affect psychological functioning of the PWUD (P 0.05). There was a significant relationship between age, number of children, and history of using drug and psychological functioning of the participants (P

Objective: The purpose of this study is to determine the validity and reliability of the Persian version of the Pittsburgh Sleep Quality Index in the elderly population. Material and Methods: A methodological study was conducted as a confirmatory factor analysis. Totally, 598 elderly people were selected through cluster sampling. In addition to analyzing the three-factor structure of PSQI, internal consistency reliability, structural validity, and its concurrent validity were examined. The structural credibility of PSQI was examined using other similar tools such as Sleep Health, Epworth Sleepiness, Insomnia Severity, Global Sleep Assessment, and Berlin indices. Finally, the concurrent criterion validity of PSQI was evaluated through multivariable regression analysis and all statistical analyzes were performed using SPSS and AMOS software. Results: The reliability of the test according to Cronbach’s alpha was 0.81. Confirmatory factor analysis indicators supported goodness of fit of the structural equation model. The confirmatory factor analysis showed that the ratio of χ2 / DF was 2.66 for the three-factor structure of PSQI and the goodness of fit indices of model were acceptable for this structural model (RMSEA=0.053, CFI=0.98, TLI=0.96, NFI=0.97, GFI=0.99). In addition, the internal consistency of the PSQI was 0.81 and the scales correlation score ranged from 0.48 to 0.71. Conclusion: The results indicated that Persian version of Pittsburgh Sleep Quality Index had the required validity and reliability for the elderly population of Iran and it can be used as a useful tool by other studies.

Background. Family-centered intervention can be used as a therapeutic intervention to improve the quality of life (QOL) in clients with ostomy. This study aimed to determine the effects of family-centered intervention on the QOL in ostomy clients. Methods. A quasi-experimental study was carried out with participation of 70 clients with colostomy and 70 caregivers (family members). The participants were selected through convenient sampling and randomly allocated into the experimental and control groups. The experimental group received family-centered education. The education program included four sessions, 50–60 min each, that were implemented in two weeks at hospital wards or clients’ houses for the clients’ companions. Afterwards, the caregivers implemented the care at home for one month. The subjects in the control group received routine care before being discharged. The QOL of the clients in both groups was measured using the city of hope-QOL-ostomy questionnaire before and one month after the intervention. Results. The mean scores of the QOL after family-centered intervention in the experimental and control groups increased from 197.97 to 207.49 and from 195.2 to 199.03, respectively. The paired t-test showed a significant change in the experimental and control groups after the intervention at a confidence level of 95% (p=0.0001; p=0.002). In addition, after the intervention, however, there was a significant difference between the two groups in all these areas except for social aspects (p=0.007). Conclusion. Family-centered intervention can be used as a therapeutic intervention to improve the QOL in clients with ostomy. The intervention was effective in the physical, spiritual, psychological, and social health of these clients.

Background: Undesirable effects Negative feelings among women with unintended pregnancies may have undesirable effects on pregnancy. However, little is known about the effect of positive feelings and protective factors on prenatal mental health of pregnant women. The aim of the present study was to determine the effect of positive psychology-based interventions (PPI) on the happiness of women with unintended pregnancies. Methods: This randomized controlled trial that included 40 women with unintended pregnancies was conducted between March and July 2017. The subjects were randomly assigned to receive 10 weekly training sessions based on positive psychology (PPI) (N = 20) or routine prenatal care (N = 20). All subjects received usual prenatal care. The level of happiness and its five domains were measured in three time points: at baseline, immediately after completing the intervention, and 45 days after the end of the intervention. The happiness was assessed using the Oxford Happiness Inventory (OHI). Results: In the intervention group, the mean total OHI score increased from 31.3 (at baseline) to 42.5 (after completing ten sessions of PPI), and the increase remained statistically significant at a 45-day follow-up (39.8); P = 0.001. However, the total OHI score did not change significantly during the follow-up (P = 0.339). Satisfaction with life, self-esteem, and subjective well-being improved significantly after the interventions, whereas the increases observed in the scores of positive mood and self-efficacy dimensions were not significant. Conclusion: PPIs can improve happiness and its dimensions among women with unintended pregnancies. It is suggested that healthcare planners help women with unplanned pregnancies adapt by formulating strategies to hold training courses with a positive psychology approach and recognize and promote their positive aspects and strengths.

Ipomoea aquatica (IA) with antioxidant properties is used in therapeutic trends. An organophosphate, dichlorvos (Dich), is a common insecticide with various side effects on living tissues. This study examines the role of IA on Dich-induced hepatotoxicity in male rats. Sixty-four male rats were divided into eight groups including sham, Dich (4 mg/kg/day, intraperitoneally), IA 1, 2, and 3 (250, 500, and 1000 mg/kg/day, respectively, orally), and Dich + IA 1, 2, and 3. All treatments were applied daily for 60 days. At the end of the treatment, the animals were sacrificed. The histopathological changes, leukocyte infiltration, and apoptosis were assessed by light and fluorescent microscopy. The serum levels of hepatic enzymes, nitrite oxide (NO), and total antioxidant capacity (TAC) were evaluated biochemically. Dich statistically significantly increased the NO level, hepatic enzyme activity, apoptosis, leukocyte infiltration, the mean diameter of hepatocytes (DHs), and central hepatic vein diameter (CHVD) and also decreased the TAC, mean weight of liver, and the total weight of rats compared to the sham group (P < 0.01). In all IA and Dich + IA groups, a statistically significant decrease was detected in apoptosis, leukocyte infiltration, hepatic enzyme activity, NO level, mean DH, and CHVD, whereas an increase in TAC level, mean liver weight, and total weight was detected compared to the Dich group (P < 0.01). IA, due to the antioxidant property, recovers the Dich-related catastrophic changes in liver.

Abstract Background The rate of attempting suicide is growing due to the increasing social and economic problems and a variety of stresses taken by individuals in their lives. Helping people, boosting hope, and improving resilience to life hardships might be helpful in this area. This paper is an attempt to determine the effects of group reminiscence on hope and resilience in care-seekers who have attempted suicide. Method The study was carried out as a quasi-experimental interventional study. The participants were 57 care-seekers with a history of attempting suicide who met the inclusion criteria. The sampling was done through convenience sampling and the participants were grouped into control (n = 29) and experimental (n = 28) groups randomly. The experimental group received integrated reminiscence sessions (eight sessions; 60–90 min). Hope and resilience of the subjects were measured using Schneider's Hope Scale and Connor and Davidson’s Resilience Scale. The scales were filled out by the subjects before, immediately after, and 4 weeks after the intervention. Results The mean scores of hope in the experimental and control groups were 34.60 and 38.04, respectively, before the intervention. These figures immediately after the intervention were 44.07 and 35.96 in the experimental and control groups, respectively. 4 weeks after the intervention, the mean scores of hope in the experimental and control groups were 44.39 and 35.79, respectively, which is a statistically significant difference (p

Introduction: Spiritual health is the newest dimension of health that lies alongside other aspects of health. Since few studies have been conducted on the various effects of spirituality on nurses' clinical competence, this study aimed to determine the relationship between spiritual health and clinical competency of nurses. Methods: This study is a cross-sectional study. The samples consisted of 135 nurses working in intensive care units affiliated to Iran University of Medical Sciences. According to the number of nursing staff in each ward, the share of each ward was determined, and then nurses selected by random sampling. Data were collected using the Spiritual Well-Being questionnaire and the Critical Care Nursing Competence Scale. After referring to the wards, the questionnaires were compiled by the researchers, and finally, it was analyzed using the Pearson correlation coefficient test. The significance level was considered to be 5%. Results: The mean age of nurses was 35±6.6 years, their mean clinical experience was 11±7 years and the mean of nurses' work experience was 6.95±5 years. The mean score of spiritual well-being was 79.29±4.33 (medium level), the mean score of clinical competence was 378.53±4.90 (excellent condition) and the mean score of professional competence was 310.95±3.14 (excellent condition). Correlation test results showed no significant statistical relationship between spiritual health and clinical competency dimensions (P value>0.05).There was also no significant relationship between dimensions of spiritual health (existential health and religious health) and nurses' clinical competency (P-value>0.05). Conclusion: Nurses in ICUs have a relatively high and acceptable level of spiritual health and clinical competence, but nurses' clinical competence is not directly related to their spiritual health.