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Extended Abstract Background: The coefficient of hydraulic roughness of rivers is one of the most important factors in the planning, design, operation, and maintenance of water resources projects in river engineering studies. The value of the hydraulic roughness coefficient varies in diverse and complex conditions of rivers and is affected by various factors, usually in hydraulic models the roughness coefficient shows the most sensitivity compared to other parameters. A correct estimate of the roughness coefficient improves the understanding of flow hydraulics and river conditions. Despite many efforts, the inability to accurately estimate the roughness coefficient and the use of Manning's constant value (n) are the main error factors in flood simulation and flow depth calculation. The flow roughness coefficient is typically not constant and changes dynamically as the flow depth changes. The best way to determine the roughness is to measure the flow rate and calculate Manning's n through the inverse solving of Manning's equation. The present study mainly aims to determine more precisely the roughness coefficient of the Sanij River upstream of the Faizabad hydrometric station. Methods: The studied area in the current research is the Sanij watershed, 30 km from Yazd city in Taft city, Yazd province. This basin has an area of 153,173 square kilometers. To achieve the objectives of the research, after conducting field studies, the Faizabad hydrometric station at the outlet of the Sanij watershed was used to collect the required flood discharge and ash-flow data in the study area; Therefore, the hydraulic radius and the value of Manning's roughness coefficient were estimated through the inverse solving of the corresponding equations and the determination of other hydraulic parameters such as velocity and slope. The slope was measured with an inclinometer and a leveler. Results: The lowest value of the n is equal to 0.034, corresponding to a discharge of 180 m3s-1 , while the highest value of the Manningʼs roughness coefficient is equal to 0.119, corresponding to a discharge of 2.083 m3s-1 . As the discharge decreases, the roughness coefficient increases. The function of the roughness coefficient in relation to the discharge (with R2 = 0.80) indicates their inverse and significant relationship. The function of the hydraulic radius in relation to the discharge (with R2 = 0.944) indicates that the discharge and hydraulic radius have a direct and significant relationship. The roughness coefficient has an inverse lower less-significant relationship with the hydraulic radius. Every flood creates different roughness levels with different sedimentation rates; therefore, Manning's roughness coefficient will vary depending on variations in particle diameter. Usually, the channels or rivers of dry areas are temporary, in the descending branch of the hydrograph and at the end of the flood, larger parts remain on the surface of the bed, and it causes errors in the estimation of Manning's roughness coefficient based on experiments and local visits. The apparent error is caused by the larger diameter particles remaining on the surface of the bed and the carrying of fine particles by the flow. On the other hand, during the flow, the orientation of the sediments is generally in line with the direction of the flood, which creates the least hydraulic roughness; But with the reduction of flood intensity and the remaining of coarse-grained particles, in addition to the increase of hydraulic roughness, the random roughness of particles, which plays an effective role in Manning's roughness coefficient, increases. In flows where the flow depth is lower than D90, or smaller than the diameter of large pebbles in the bed, Manning's roughness coefficient reaches its highest value under static-hydraulic conditions, and inflows with greater depth From D90 due to special hydrodynamic conditions, the lowest value of Manning's roughness coefficient was observed. In other words, at high flow rates, the relationship of the roughness coefficient on the entire flow is reduced; therefore, with the increase of the flow depth, the value of n decreases and the hydraulic radius increases. This phenomenon is mostly seen in rocky channels and rivers. The current research showed that in the rivers of dry and rocky areas, we usually encounter overestimated values of Manning's roughness coefficient due to the presence of large pebbles in the bottom of the dry bed. This phenomenon can be seen especially in floods with lower discharge and the cause of this can be related to the reduction of hydraulic roughness in the bed during the flood flow. This phenomenon can be effective in overestimating or underestimating the roughness coefficient. Conclusion: The results show that the roughness coefficient changes from 0.034 to 0.119 in the study range and has an inverse and significant relationship with discharge (R2 = 0.8). Moreover, the roughness coefficient has an inverse relationship with the hydraulic radius (R2 = 0.59). The roughness coefficient is not constant and changes in different flood events. Discharges with a depth less than D90 are those in which Manning's roughness coefficient reaches its maximum value of 0.11. In this study, the lowest Manning's roughness coefficient was observed in discharges with a depth greater than D90 and a flood height greater than 50 cm, as in the discharge of 115m3s-1 , the roughness coefficient “n” decreased to a limit of 0.034. The roughness coefficient is unstable in different events, because during the passage of the current or in the ascending and descending branches of the flood hydrograph, depending on the speed and power of the flow, the bed granularity is dynamically changing, and Manning's roughness coefficient (n) is instantaneous. It changes. During the peak flow, it is difficult to understand the hydrodynamic roughness coefficient and it can lead to overestimation or underestimation of the roughness coefficient; Therefore, it is better to consider this case to achieve more accurate values of roughness coefficient in river engineering studies

Background: Frailty is accompanied by serious health complications in the elderly, especially during hospitalization. Visual scales have been designed for quick and easy evaluation of frailty in different cultures and settings. Therefore, this study aimed to define the accuracy of the Pictorial Fit Frail Scale (PFFS) for frailty screening in the hospitalized elderly in Iran. Methods: This cross-sectional study was conducted on 304 hospitalized participants, aged 65-85 years old admitted at Ziaeian Hospital (Tehran) were enrolled through the inclusion criteria from August to December 2019. All participants were evaluated based on the Minimum Data Set-Home Care, the Pictorial Fit Frail Scale, and the Quality-of-Life instrument, through face-to-face interviews by a trained nurse at the admission time. Spearman’s correlation coefficient, and ROC analysis were performed using SPSS at p

Investigations of the growth, interaction, and coalescence of cracks are important because they help to provide tools for the more realistic modeling of rock masses containing low persistence discontinuities and better estimations of the strength and stiffness of a rock material. Understanding the coalescence mechanism is useful for justifying the mechanism of continental crustal deformation, evaluating the structural failure of slopes with rock bridges, and analyzing the stability of tunnels when a mode I or mix mode failure mechanism is involved. The evaluation of crack growth can provide valuable information about the mechanism for the formation of new geological structures, and the formation, evolution, and growth of faults. This paper reports the results of diametrical compression tests on rock-like disk-shaped specimens. Each specimen contained two pre-existing open or closed flaws. The growth, interaction, and coalescence of the pre-existing flaws were investigated both physically and numerically. A hybrid bonded particle-finite element system was used in the numerical simulation. The results of the physical and numerical studies were in good agreement. In particular, the induced crack patterns showed close agreement in the physical and numerical tests. Digital microscope image processing was used in the physical tests to study the dislocations along the initial flaws. It was shown that wing crack formation was responsible for the failure of the specimen when flaws were inclined with respect to the loading direction. The crack growth and linkage were shown to be affected by the friction between faces of the flaws. In addition, the slip distributions at the flaws surfaces were illustrated and examined to understand the crack propagation mechanism. The effects of the flaws on the disk failure loads were assessed both numerically and experimentally as well.

Global spread of a disease causes fear that can lead to discrimination against the people infected with the disease. On December 2019, COVID-19 emerged in Wuhan, China, and has spread throughout the world. In this descriptive and analytic study Perceived discrimination of the patients admitted to COVID-19 wards was measured in medical settings. Data was collected of 176 patients discharged in March and April 2020. Discrimination scale was used to collect data in medical settings. Overall mean score of the scale was 11.51 ± 3.883 indicating low level of perceived discrimination. The highest level of discrimination belonged to refusal of physicians and nurses to physically examine the patients (0.992 ± 3.49). Low level of perceived discrimination was reported in this study, which necessitated taking useful measures to identify discrimination, determines causes and prevent discriminatory behaviors in medical settings to improve the hospitalization experience and disease outcomes.

Introduction: Diabetes is a disease whose control requires effective self-care and patient education. Multimedia Messaging Service-based (MMS) education is one of the new methods for education. The purpose of this study was to investigate the effect of two types of in-person and MMS-based education in the Telegram application on self-care and weekly fasting blood sugar levels in patients with insulin-dependent diabetes. Methods: In this clinical trial, a sample of 66 patients with diabetes who referred to the Sina hospital in Tabriz, were randomly assigned into two groups: in person and MMSM-based education. Data gathering tools included a demographic form, Toobert’s self-care activities questionnaire (as primary outcome), and a checklist to record fasting blood sugar weekly measured by a glucometer. Data were analyzed using independent and paired sample t-tests, chi-square, and repeated measures ANOVA. Results: After the education the mean scores of self-care in terms of diet, exercise, foot care, and blood sugar testing activity significantly increased in both groups (P0.05). Reduction in the fasting weekly blood sugar levels over a 12-week period were statistically significant in both groups (P 0.05). Conclusion: MMS-based education same as in-person, improves self-care in patients with diabetes. Given the disadvantages of in-person education, this new educational strategy can be used to facilitate the patient education process and improve its quality.

In the Coronavirus disease 2019 (COVID-19) pandemic, underlying diseases such as cardiovascular disease, respiratory illness, liver and kidney disease or malignancies, have a critical prognostic role for these patients. Due to the increased risk of mortality in patients with established or new-onset comorbidities, we decided to conduct a study to further investigate the possible comorbidities and treatment recommendations of COVID-19. All articles published by March 25, 2020, on the new coronavirus infection were reviewed and for cutaneous manifestation as a new emerging concern, by April 25, 2020. ScienceDirect, Google Scholar, Scopus, PubMed databases were searched, and keywords such as "COVID-19", "2019-nCoV", "Coronavirus2019", "SARS-CoV-2”, and "comorbidity" have been used. The most important comorbidity in elderly patients with confirmedCOVID-19 was cardiovascular disease, followed by diabetes and chronic respiratory disease, respectively, and on the other hand, COVID-19 itself could cause acute heart, lung, liver, kidney, and skin disease. Also, the prevalence of underlying diseases in dead patients or patients with severe COVID-19 is higher than the others. Considering treatment, drug interactions, and careful drug adjustment based on hepatic and renal metabolism are essential. The results of this study showed that the mortality rate and ICU admission in people with the underlying disease is higher than in other people. Also, we must pay attention to the possible multi-organ damages and comorbidities for the protection and successful treatment of COVID-19. There are some comorbidities like primary cutaneous manifestations that may have diagnostic or prognostic values in the COVID-19 course.

Background & Objective: Dementia is associated with serious effects on memory, cognition and ability to carry out daily activities. There is evidence that impairment in activity of daily living (ADL) is even reported among elder patients who suffer from mild cognitive disorders. Therefore, we aimed to determine the status of ADL and instrumental activity of daily living (IADL) in healthy and cognitive impaired elderlies (MCI, Mild, and Moderate dementia). Methods: In this cross-sectional study which was conducted in 2016, 300 elderlies (60 years and above) were selected using a classified cluster sampling in four groups (each group of 75 individuals). These groups comprised of healthy old people and elderlies with mild cognitive impairment (MCI) and mild to moderate dementia that were residing in rural areas of Isfahan and Tehran and were classified between stages of 1 to 5 according to the Global Deterioration Scale (GDS). All individuals in four groups were assessed by ADL and IADL evaluation tools. The geriatric depression scale (GDS-15) and DSM-IV scale were performed on healthy elderlies by a physician to confirm the lack of mild dementia or depression. Data were analyzed by SPSS 20 software and using descriptive statistics, analysis of variance and independent samples T-test. Results: According to the cognitive impairment screening results by GDS, 76 elderlies were healthy, 75 were in MCI group, 72 individuals were diagnosed with mild dementia and 77 were suffering from moderate dementia. The mean scores of ADL tool on the basis of different cognitive stages of elderlies were statistically significant (p

Background: In today's transforming world, increased productivity and efficient use of existing facilities are practically beyond a choice and become a necessity. In this line, attention to change and transformation is one of the affecting factors on the growth of productivity in organizations, especially in hospitals. Aim: To examine the effect of transformational leadership on the productivity of employees in teaching hospitals affiliated to Iran University of Medical Sciences. Methods: This cross-sectional study was conducted on 254 participants from educational and medical centers affiliated to Iran University of Medical Sciences (Tehran, Iran) in 2016. The standard questionnaires of Bass & Avolio and of Hersi & Goldsmith were used to respectively assess transformational leadership and level of productivity. The research assumptions were tested in a significance level of 0.05 by applying descriptive statistics and structural equations modeling (SEM) using SPSS 19 and Amos 24. Results: Results of the fitting indicators of the assessing model after amending includes Chi-square two to degrees of freedom of 2.756, CFI indicator 0.95, IFI indicator 0.92, Root mean square error of approximation (RMSEA) indicator 0.10. These results indicate that the assessing model is well fitting after the amendment. Also, analysis of the model's assumptions and the final model of the research reveals the effect of transformational leadership on employees’ productivity with a significance level of 0.83 (p=0.001). Conclusion: This research indicates that the more the leadership and decision-making style in hospitals lean towards transformational mode, the more positive outcomes it brings among employees and the organization due to increased productivity. Therefore, it is essential to pay focused attention to training/educational programs in organizations to create and encourage transformational leadership behaviors which hopefully lead to more productive employees.

Introduction: The intention of this study was to identifying and prioritizing challenges in research in Tabriz University of Medical Sciences (TUMS), Iran, and giving exact solutions to remove those challenges from the perspective of stakeholders (the members of faculty board, students, administrators, and research staff of the university). Methods: This mix-method study (quantitative-qualitative) conducted in summer-2014 in TUMS. The participants of this study included 139 of the members of faculty board, 349 of the students, and 39 of administrators and research staff (in total, 525 individuals). The data collection tool in the qualitative section was an open-ended questionnaires (3 questions), and in the quantitative section it consists close question questionnaires (26 questions). For prioritizing these challenges, it was used by prioritization matrix that it had four criteria: Importance, the ability to solve, cost-effectiveness and immediacy. Results: The important challenges from the perspective of participant included: Lack of co-operations of administrative centers with researchers, the existence of cumbersome rules, lack of motivation in researchers from authorities, being non-economic of doing a research to the professors and students, The lack of research result in decision-making, the low capacity and ability of members of faculty board, students, and staff on issues related to research procedures, and lack of attention to the quality of research. Conclusion: Lack of attention to the quality of research, and the existence of cumbersome rules in research area have the most priority in challenging research in TUMS, which they need more attention and planning to resolve these challenges of the authorities and managers of this university.

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Background: The elderly population following the improvement in health status and life expectancy in developing countries is increasing. Malnutrition causes decreased quality of life and increased mortality in elderly. This study aimed to review systematically and meta-analysis of studies assessing the prevalence of malnutrition among Iranian elderly people over 60 yr of age using Mini Nutritional Assessment (MNA). Methods: This systematic review and meta-analysis was conducted in 2016 to estimate the overall malnutrition prevalence. Data were collected using the following keywords: prevalence, elderly, aging, malnutrition, nutrition, nutritional assessment, nutritional status, health status, mini nutritional assessment, MNA and Iran in PubMed, Scopus, Google Scholar, Iranmedex, Magiran, and SID. Computer software CMA: Two were applied to estimate the overall prevalence of malnutrition. Results: Seventeen of 811 articles were included in our analyses. The overall estimated prevalence of malnutrition among elderly based on the random effect model was 12.2% (95% CI 8-18.5). In subgroups, the prevalence of malnutrition among elderly living in home based on the fixed effect model was 9.2% (95% CI 7.1-11.9) and prevalence of malnutrition among elderly residents of nursing homes based on the random effect model was 21.6% (95% CI 12-38.6). Conclusion: Given the increase in the elderly population in future and the prevalence rate of malnutrition among them as well as the higher prevalence of malnutrition in elderly care centers, more attention to this population group is a matter of necessity.

Background: Validation study of Barthel Index for elderly patients being attended in outpatient and rehabilitation clinics in Iran. Methods: Face-to-face interview with 395 out patients geriatric 60+ years was done in a cross-sectional study. The internal consistency Barthel-ADL was used to approve reliability. Criterion validity and factor analysis were used to verify validity. Results: Reliability the Iranian version BI was significant at 0.938. In criterion validity analysis, the high correlation tools included Functional Ambulation Category (FAC) and Foot and Ankle Ability Measure (FAAM-subscales ADL) at 0.947 and –0.945, respectively. In factor analyses, two domains obtained, the variance of 10 items achieved 69.79%; also, the Item Total Correlation (ITC) of each item was measured. Conclusions: The Barthel Index shows a good validity and reliability, and recommended to use in the Iranian geriatric outpatients in evaluating physical ability.

Background: The aim was to determine validity, reliability, and cutoff of full-mini nutritional assessment (MNA) and MNA-short form (SF) also which one was better for the screening of malnutrition in the Iranian hospitalized elderly. Methods: In this cross-sectional validation study, 96 hospitalized elderly ≥60 years selected from two hospitals in Tehran. Anthropometric measures (body mass index [BMI], mid-arm circumference [MAC], calf circumference [CC], abdomen, and waist skinfold thickness) and laboratory tests (albumin and hemoglobin levels, and red blood cell count were performed. Nutrition tools (full-MNA and MNA-SF), cognition tool (mini-mental state examination, depression scale (Geriatric Depression Scale15 and activities of daily living (ADL) index (Modified Barthel-ADL) were administered. Results: The full-MNA scores were significantly correlated to measures of MAC, BMI, waist, and CC. The MNS-SF scores were significantly related to measures of MAC, waist, and CC. Serum albumin showed a poor correlation with both tools. At cutoff 24 in full-MNA had a sensitivity 75% and specificity 77.8% and the MNA-SF considered 62.5% sensitivity and 65.3% specificity at cutoff 10.50 to detect well-nourished from malnourished subjects. The internal consistencies of both tools were >90%. In exploratory factor analysis, six components found for full-MNA and two components for MNA-SF. Known group validity of full-MNA was reflected significant differences between geriatric patients with expected higher full-MNA scores and patients with expected lower scores (BMI ≥24 vs. BMI

Objectives: the present study describes assessing mental health status (anxiety, depression, and psychological wellbeing) of old people in different age groups in tehran metropolitan city. The outcomes of this study could help to health policy makers to develop of better health policy in gerontology field by determine of priorities of mental care in different age groups of old people. Methods & Materials: this was a cross sectional study in 2010. The participants were (n=402) aged 60 years old and over which have underrepresented from Shahid Beheshti University. The survey methods were via face-to-face interviews, and just in a few cases as telephone interviews. The instrument to data collection included demographic questionnaire, k6 and yeild tools. Data analyzed by Stata and SPSS ver.15 through t-test, one-way anova. Regression models applied as well. Results: based on results in the past 4 weeks,10.9% of elderly had sever anxiety or depression symptoms and about half of them (46.5%) had moderate psychological distress. The rate of psychological distress increased with age growing, specifically in 60- 79 years old however, this rate declined from age of 80 years and over. Psychological distress levels among elderly women were more than old men in all age groups, except of 60-69 years old people. Regarding psychological wellbeing, feeling of tireless, lone less, and depression are the most common complain of house dowelling old people in tehran metropolitan area. As the results show 43.1% elderly participants were in moderate level and 17% of them were in the bad level of psychological wellbeing. Based on regression model, sex (P=0.012), housing (P=0.004), and retirement salary (P=0.048) were significant variables that effect on psychological distress. The income rate was only important component that effect on psychological wellbeing of elderly participants. There was no significant different between aged groups 60-64 and 65-69 in psychological distress. All disorders or chronic disease in elderly had effect on anxiety and depression symptoms in old people however, only musculoskeletal disease, pain, and tireless had significant impact on psychological wellbeing in elderly Conclusion: the important components that effect on mental health of elderly related to fragile elderly from aspect of socio economic factors. Based on the results of this study old women, homeless elderly or old people that living in renting home or in other wise have not enough income to alive, low educated elderly and also alone old people had more psychosocial distress symptoms and less psychological wellbeing. Meanwhile, the rate of income had the most important role to have a happiness feeling among old people in participants.

Objective (s): To determine the pattern of incidence and survival rates of cancers in elderly adult in the period of five years to obligate the screening and therapeutic aged care services to old people.Methods: This is a historical cohort study based on the data analysis years (2001 to 2005) and cancer registries reporting survival rates for these cancers in people aged 60 years and older. Collecting data was through observation and data gathering Cancer Research Center, Shaheed Beheshti University of Medical Sciences. The inclusion criteria were cancer patients 60+ years registered through the annual reports of cancer cases and survival patients followed. To compare the survival and separation of sex Kaplan Meier coax method was used. The death and death of the relative risks of various cancers were calculated by regression model.Results: Based on data 33.5% of women surveyed aged 60 years and older and 66.5% were elderly men. The mean age was 71.2 years. Mean survival in this study was 88.2 years. The highest incidence of skin cancer was 5 years old. The geographical distribution of incidence was bladder cancer among elderly in Kermanshah province. Yazd province was the highest prevalence of common cancers in elderly. The average of five-year survival in Lorestan province was the highest and the Ardabil province had the lowest. The relationships between sex and death from cancers were (0.84 to 0.95), and the relationships between the relative risks of death from cancers (1.03 to 1.09) which were significant.Conclusion: The risks of cancer death among nine provinces were varied comparision to Tehran metropolitan. In oderwords survival rate of cancers in the nine provinces significantly were less than Tehran province.

Background: Discharge against Medical Advice (DAMA) is a problem for hospitals which may result in increasing readmissions, morbidities, inabilities, deaths and health care costs. This study, aimed to investigate the rate and causes of DAMA in Iranian hospitals. Methods: A systematic review and meta-analysis study was conducted in 2014. Required data were collected through searching for key words included: "Discharge Against Medical Advice", "Leaving against medical advice", "causes*", "hospital" and their Persian equivalents, over databases including PubMed, OVID, Google Scholar, Embase, Scopus, Magiran, scientific information database (SID). The reference lists of the articles, certain relevant journals and web sites in this field were also searched. Results: Out of 913 articles initially retrieved, finally 17 articles were incorporated into the study. There were 244858 individuals studied in the articles. Using a random effects model, the rate of DAMA in Iranian hospitals was estimated at 7.9% (6.3%-9.8%). While the highest rate of DAMA was associated with patients in departments of psychiatry (12%), the lowest rate was related to patients in departments of pediatrics (3.7). DAMA was in men more than women (P

Objectives: The aim of the study was to achieve the health status of the Iranian elderly migrants in Australia. Methods & Materials: This study was done as a cross sectional survey carried out in 2005-2007 on 302 Iranian immigrant aged 65 yrs and over who had lived in Sydney Metropolitan area for at least 6 months. Results: The majority of the Iranian elderly had a moderate level of anxiety and depression (44%) and more than half of them (58%) were experiencing average level of psychological wellbeing. From aspect of physical function (41%) Iranian elderly had moderate level of physical function as well as without limitation. With respect to daily living activity, the great part of the elderly participants (56%) were independent. The predictor variables of Socio-demographic and acculturation were strong significant variables in physical and mental health status of the Iranian elderly. Conclusion: Chronic medical conditions, Physical and social activity, and also accessing information and awareness of aged care services predicted both mental and physical health status of Iranian elderly respondents in this study (P≤0.001).