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Abstract Background The existence of various ethical challenges, the inability to resolve ethical conflicts, and, as a result, the low quality of care and the occurrence of dissatisfaction in patients and nurses have been discussed for years. By creating new ethical challenges, the Covid-19pandemic has played an important role in making the process of care for these patients more difficult and complicated. This study was conducted with the aim of designing a prescriptive model to help provide ethical-care and resolve ethical conflicts during the Covid-19pandemic. Methods In this two-stage qualitative study, a grounded theory research method was used in the first stage, and data were collected through semi-structured interviews. Sampling started purposefully and continued theoretically. In the second step, the appropriate model was designed using the three-step method proposed by Walker and Avant. Results The core concept was “behavior based on faith in God”, based on which the grounded theory of “faithful nursing” and then “model of solving ethical challenges with nursing based on faith in God” were presented. The strategies of the model in three parts are strengthening the beliefs of nurse, strengthening environmental facilitators to help nurse, and strengthening situational analysis in duty diagnosis in nurse were presented. Conclusions According to this model, nurses’ beliefs play a key role, and the strengthening of environmental factors play a secondary role in ethical-care.

Background: Quality of life is an important concept that is related to working conditions and lifestyle behaviors of a person. Poor quality of life in critical care nurses can reduce the quality of care. Objectives: The purpose of this study was to investigate the relationship between lifestyle and quality of life in critical care nurses. Materials & Methods: This multicenter cross-sectional study was conducted on 360 nurses working in critical care units of hospitals affiliated to Iran University of Medical Sciences. Demographic characteristics form, World Health Organization (WHO) quality of life questionnaire (WHOQOL-BREF) and Miller-Smith lifestyle inventory were used to collect data. Results: The mean age of nurses was 38.65±9.89. In the regression analysis, the lifestyle score has an inverse significant relationship with the score of physical health, psychological health, social relationships and environment subscales (B=-0.166, B=-0.233, B=-0.540, B=-0.067, respectively). An increase in the number of night shifts was associated with a decrease in quality of life (P

Background: Treatment satisfaction is one of the main factors of assessing care quality in patients with chronic diseases. Some factors may influence treatment satisfaction and improve or impair clinical outcomes. This study aimed to determine the relationship between fear of hypoglycemia and satisfaction with treatment in patients with type 2 diabetes treated with oral antidiabetic drugs. Methods: This cross-sectional study was carried out in one of the hospitals of Qazvin Province, Iran, in 2021. The research sample was 390 patients with type 2 diabetes who used oral antidiabetic drugs, selected through convenience sampling. The data were collected using the hypoglycemic fear survey (HFS) and the diabetes medication satisfaction (DiabMedSat) questionnaire. Then, the obtained data were analyzed using the independent t-test, one-way analysis of variance, and multiple linear regression in SPSS software, version 26. Statistical significance was set at P

The transcription factor encoded by the PAX2 gene plays a significant role in the development of the urogenital tract, eyes, ears, and central nervous system. Heterozygous mutations in the PAX2 gene cause renal coloboma syndrome, a rare autosomal dominant disorder characterized by optic nerve coloboma and renal anomalies. In this study, two siblings with chronic kidney disease (CKD) receiving regular dialysis therapy were investigated. DNA sequencing was performed on blood samples from both patients, which revealed four novel heterozygous variations in the PAX2 gene in both patients. Sequencing analysis showed a C to G transversion at position c.352 of the PAX2 gene in a heterozygous state.

Abstract COVID-19 is a newly recognized illness with a predominantly respiratory presentation. Although initial analyses have identified groups of candidate gene biomarkers for the diagnosis of COVID-19, they have yet to identify clinically applicable biomarkers, so we need disease-specific diagnostic biomarkers in biofluid and differential diagnosis in comparison with other infectious diseases. This can further increase knowledge of pathogenesis and help guide treatment. Eight transcriptomic profiles of COVID-19 infected versus control samples from peripheral blood (PB), lung tissue, nasopharyngeal swab and bronchoalveolar lavage fluid (BALF) were considered. In order to find COVID-19 potential Specific Blood Differentially expressed genes (SpeBDs), we implemented a strategy based on finding shared pathways of peripheral blood and the most involved tissues in COVID-19 patients. This step was performed to filter blood DEGs with a role in the shared pathways. Furthermore, nine datasets of the three types of Influenza (H1N1, H3N2, and B) were used for the second step. Potential Differential Blood DEGs of COVID-19 versus Influenza (DifBDs) were found by extracting DEGs involved in only enriched pathways by SpeBDs and not by Influenza DEGs. Then in the third step, a machine learning method (a wrapper feature selection approach supervised by four classifiers of k-NN, Random Forest, SVM, Naïve Bayes) was utilized to narrow down the number of SpeBDs and DifBDs and find the most predictive combination of them to select COVID-19 potential Specific Blood Biomarker Signatures (SpeBBSs) and COVID-19 versus influenza Differential Blood Biomarker Signatures (DifBBSs), respectively. After that, models based on SpeBBSs and DifBBSs and the corresponding algorithms were built to assess their performance on an external dataset. Among all the extracted DEGs from the PB dataset (from common PB pathways with BALF, Lung and Swab), 108 unique SpeBD were obtained. Feature selection using Random Forest outperformed its counterparts and selected IGKC, IGLV3-16 and SRP9 among SpeBDs as SpeBBSs. Validation of the constructed model based on these genes and Random Forest on an external dataset resulted in 93.09% Accuracy. Eighty-three pathways enriched by SpeBDs and not by any of the influenza strains were identified, including 87 DifBDs. Using feature selection by Naive Bayes classifier on DifBDs, FMNL2, IGHV3-23, IGLV2-11 and RPL31 were selected as the most predictable DifBBSs. The constructed model based on these genes and Naive Bayes on an external dataset was validated with 87.2% accuracy. Our study identified several candidate blood biomarkers for a potential specific and differential diagnosis of COVID-19. The proposed biomarkers could be valuable targets for practical investigations to validate their potential.

Abstract Contamination of farmland soils by trace elements (TEs) has become an international issue concerning food safety and human health risks. In the present research, the concentrations of TEs including cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), manganese (Mn), nickel (Ni), lead (Pb), zinc (Zn) and iron (Fe) in soils of 16 farmlands were determined in Gonabad, Iran. In addition, the human health risks due to exposure to the TEs from the soils were assessed. Moreover, the soil contamination likelihood was evaluated based on various contamination indices including contamination factor $$(\mathrm{CF}$$ ( CF ), enrichment factor (EF), geo-accumulation index (Igeo), and pollution load index (PLI) calculations. The soil mean concentrations for Cd, Co, Cr, Cu, Mn, Ni, Pb, Zn and Fe ranges as 0.102, 6.968, 22.550, 29.263, 475.281, 34.234, 13.617, 54.482 and 19,683.6 mg/kg in farmland soils. The mean concentrations of the TEs decreased in the order of Fe > Mn > Zn > Ni > Cu > Cr > Pb > Co > As > Cd. Levels of all metals in this study were within the FAO/WHO and Iranian soil standards. The HQ values from investigated elements for adults and children in the studied farms were less than the limit of 1, indicating no health risks for the studied subpopulations. The results of the present research indicated no significant carcinogenic health hazards for both adults and children through ingestion, skin contact and inhalation exposure routes. $$\mathrm{CF}$$ CF values of Ni and Zn in 100% and 6.25% of farmlands were above 1, showing moderate contamination conditions. EF values of metals in farmlands were recorded as “no enrichment”, “minimal enrichment” and “moderate enrichment” classes. Furthermore, it can be concluded that the all farms were uncontaminated except Ni (moderately contaminated) based on Igeo. This is an indication that the selected TEs in the agricultural soils have no appreciable threat to human health.

Introduction: Clear cell renal cell carcinoma (ccRCC) is recognized as one of the leading causes of illness and death worldwide. Understanding the molecular mechanisms in ccRCC pathogenesis is crucial for discovering novel therapeutic targets and developing efficient drugs. With the application of a comprehensive in silico analysis of the ccRCC-related array sets, the main objective of this study was to discover the top molecules and pathways in the pathogenesis of this cancer. Methods: ccRCC microarray datasets were downloaded from the Gene Expression Omnibus database, and after quality checking, normalization, and analysis using the Limma algorithm, differentially expressed genes (DEGs) were identified, considering the adjusted p value

In this study, we use the robust optimization techniques to consider a class of multi-objective fractional programming problems in the presence of uncertain data in both of the objective function and the constraint functions. The components of the objective function vector are reported as ratios involving a convex non-negative function and a concave positive function. In addition, on applying a parametric approach, we establish ε-optimality conditions for robust weakly ε-efficient solution. Furthermore, we present some theorems to obtain a robust ε-saddle point for uncertain multi-objective fractional problem.

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

Introduction: Because health-promoting behavior is one of the major determinants of health, this study was conducted to determine whether social support predicts health-promoting behaviors in elderly people living in Tabriz, Iran. Methods: In this descriptive and cross-sectional study, 180 elderly people referring to the health complexes in Tabriz, Iran, were selected using a random cluster sampling method. Data were collected using demographic questionnaires, the Health-Promoting Lifestyle Profile II, and the Multidimensional Perceived Social Support Scale. Data were analyzed using stepwise multiple linear regression models. Results: The mean age of 180 elderly people who participated in the study was 66.9 ± 5.74 years. The results of multiple regression indicated that education (B = 8.98, P < 0.001) and perceived social support (B = 0.45, P < 0.014) explained ~29% of changes in health-promoting behaviors among the elderly. Conclusion: Given the predictive role of perceived social support in health-promoting behaviors, establishing or strengthening supportive social networks seems to be one of the effective factors in promoting the elderly's health.

Background and aims: Cardiopulmonary resuscitation (CPR) success rate is an important issue for all healthcare facilities. In the present study, success rate and related factors were assessed in a hospital in Iran. Methods: This descriptive-correlational study was conducted in 2017. By using the convenience sampling, 156 patients were selected. Variables based on the In-Hospital Utstein-Style were used, which included 3 categories: patients, cardiac arrest and follow-up. Data were analyzed by SPSS 22. Results: Of 156 participants, 92 were male and the average age was 61.4±5.5 years. Most cardiac arrest occurred in night shift (43.6%). The most common cause of cardiac arrest was cancer (33%). Of 156 patients, 102 died. Results showed a significant correlation between success rate, a patient’s sex, rhythm type and medication administered during resuscitation (P

Background and aims: Organizational support of family members of the patients admitted to intensive care units (ICUs) potentially reduces mental stresses and enables them to better comply with and support the patients. The current study aimed at evaluating the needs of families of the patients admitted to ICUs in teaching hospitals of Iran. Methods: This cross-sectional study was conducted in 2015 using convenience sampling method. The Critical Care Family Needs Inventory (CCFNI) in 5 factors was used as a main data collection tool. The study population included 235 family members of the patients. Results: Total score of CCFNI was 132.32±18.46. Needs of family members of ICU patients decreased 0.428 times following the increase of length of stay in ICU (P

In recent years urban development approaches based on public transport (Transit-Oriented Development) have attracted attentions. Despite the emphasis on the term ‘public transport’, rapid transport systems and their proximity alone is not enough. In this research complementary public transport principles and measures in these approaches are studied, including the changing attitudes in design, compactness, population density, mixture of uses, interconnected street networks, cycling networks, and pedestrian networks. Assessment methods based on these approaches and published by the International Institute for Transportation & Development Policy are then explained. Bearing in mind differences in the physical, economic, and social context of our case study with those of new approaches’ origin, original assessment measures are investigated. Also, to clarify the application of the proposed method in Kooy-e Nasr district, data related to each measure are collected from both the field studies and documents and then analysed. According to results, the district has scored less than half of the full score, and does not, therefore, enjoy desirable conditions. Despite the district having suitable compactness and population density, the quality of pedestrian and cycling network is way below desirable. The method used here can undergo a localisation of measures’ details and then be applied to other Iranian urban districts.

Background: Nursing as a clinical discipline is developing in the emergency wards. Health care systems should continuously assess and prioritize indicators of clinical competency in these wards. The lack of clear standards of clinical competency indicators challenges evaluation. The purpose of this study was to determine clinical competency indicators and its priority based on nurses' views in educational and therapeutic centers in Guilan. Materials and Methods: The Q methodology was conducted in three phases, that is, phase I (determining the clinical competency indicators), phase II (classifying clinical competency indicators by an expert panel), and phase III (prioritizing clinical competency indicators). The subjects were selected by convenience sampling among nurses working in the emergency wards of teaching hospitals affiliated to Guilan in 2013. Finally, clinical competency indicators were prioritized using exploratory factor analysis. Results: In the prioritizing phase, data were collected from 710 nurses over two months. Five factors with 30 general competencies were found in three domains: communication, professional maturity, and personality characteristics. Six factors with 37 specific competencies were also found in two domains: scientific and technical capabilities and basic clinical skills that can provide a structured instrument for assessing clinical competence in emergency nurses. Conclusions: Achieved competencies can be used as a reference for nursing education and practice in emergency. Further research on health care system is needed in order to achieve a reliable and valid instrument.

Objective: The aim of the present study was to investigate the effect of eight weeks selected sport trainings on perceptual- motor skills among typical obese girls and girls with Down syndrome (aged 7-13). Materials & Methods: In this quasi-experimental study with control group, 22 obese children with Down syndrome and 22 typical obese children who were selected purposefully participated in 24 purposeful sport training sessions. All groups were assessed with Bruininks-Oseretsky Test of Motor Proficiency before and after training sessions. Results: The findings showed that both groups of participants significantly developed in their gross motor skills (P

 Introduction  Religion is an effective factor in socialization process which has attracted the attention of many sociologists. It is an important factor affecting mental health. Religion transforms the world picture in an individual view and changes his perception of himself, creation and the events surrounding him. Such a person does not feel frustration and anxiety caused by difficulties. He is sure that God support him. Incidents and events are transient and patience will be rewarded by God. (Cruise, Abedi, 2008). Naturally, human beings are vulnerable to concerns and worries so they consistently have fought to overcome them. Religiously speaking, one of the objectives of creation of humankind was to bring peace and comfort in life and humans struggle to overcome despair and depression (Parcham and others, 2010). Quality of life has a significant relationship with hope and plays an important role in achieving social success (Snayder quoted in Mehrinejad and Moghaddam, 2011). The lack of hope causes a person to feel disabled and desperate and that he does not have enough self-esteem. We tolerate suffering and torment because we think in the future it changes to the good. Therefore, all our efforts are worthwhile. Hope enables us to resist the difficulties and problems of the present so the door will be opened to solve them (Snyder, 2000). Spiritual crisis is one of the consequences of despair even among some religious people. Appropriate goal setting is a key factor in this battle. It seems that one of the causes of failures and successive wanderings in humans is disappointment in reaching goals and lack of effort. Optimistic people, with more faith, and popularity have more adaptability with education, employment and sports. Also, they have more political and social achievements and happiness. They hope they can live with the challenges that may be encountered consistently. Hope is so important that in recent years a new approach has emerged in the field of psychology, which is known as positive psychology. Positive psychology is the scientific study of human abilities and strengths. One of the most important element of positive psychology is optimism. So this paper aims at considering the relationship between religiosity and social hopefulness.   Materials & Methods  This is an applied research. With regard to the type of study, it is a descriptive study and has used the survey method. The study population consists of all high school female students in Shiraz during the academic year of 1391 -92, whose total number is equal to 5637 individuals. 381 students were selected by use of cluster sampling method and Cochran formula. Data collection techniques in this study was a Likert type questionnaire and the data was analyzed by SPSS software.    Discussion of Results & Conclusions  In this study, emotional, religious, moral and ritual aspects of hope were measured. According to the results of previous research, a positive relationship between religious orientation and hopefulness was found. Likewise, hopelessness is associated with depression. Students who are religious and hopeful, have a higher tolerance threshold and are generally more successful in school.     Â

Background and Aim: Pre-hospital delay is an important cause of increasing mortality in acute myocardial Infarction. There are conflicting data regarding the relationship between sex and pre-hospital delay for patients with acute myocardial Infarction. The aim of the present study was to determine the relationship between pre-hospital delay and sex. Materials and Methods: This cross-sectional survey was conducted on 162 consecutive patients with acute myocardial Infarction admitted to Cardiac Care Unit (CCU) in Dr. Heshmat hospital in Rasht between May 2010 and September 2011. A convenient sampling method was used. All patients were interviewed within 7 days after admission by using a data collection form. Results: Mean of pre-hospital delay for women was more than men. Majority of men had chest pain. The women often experienced different and non specific symptoms compared to men. Regression analysis showed no significant relationship between patients' characteristics and pre-hospital delay in women; whilst, pre-hospital delay was significantly related to perceiving symptoms to be serious and interpreting symptoms to a cardiac origin in men. Conclusion: Results of the current study suggest that pre-hospital delay for women was longer than men with acute myocardial Infarction; as women often experienced no specific symptoms compared to men. Therefore, it recommended that clinicians educate public, particularly women, on acute myocardial infarction to enable them to recognize the signs and symptoms of acute myocardial infarction correctly and realize the benefits of early treatment.

Objective: Literature survey has shown that participation in social programs can promote the mental and social health among intellectually disabled individuals. One of these programs is the Special Olympics (SO) and the programs related to it. The aim of this study was to investigate the effect of SO programs on self-efficacy among Iranian Special Olympians with Down Syndrome (DS). Materials & Methods: In this quasi-experimental research, forty DS members of Iran's SO national team were selected as the intervention group and 37 DS non-athletes were selected as the control group. The SO group participated in 9 months of SO specific sport programs. The “Wheeler and Ladd's Children’s Self-Efficacy for Peer Interactions Scale” was used to collect data from the two groups before and after the 9-month long athletic programs. Data were analyzed by kolmogroff-Smirnoff, paired T and independent T tests. Results: The results showed that SO programs had significant effects on the self- efficacy of the experimental group. The SO athletes were significantly (P&le0.001) better than the control group in all sub-scales of self-efficacy. Conclusion: It seems that participation in social-sport aspects of the Special Olympics programs can promote self-efficacy among this population. Generalizing such programs for DS people can help them show their abilities and provide them with self-efficacy which is necessary for living independently.

Several researchers have considered similarities between Multi-Criteria Decision Making (MCDM) and Data Envelopment Analysis (DEA), as tools for solving decision making problems. As the preferences of decision- maker (DM) on alternatives are not considered in classical DEA, some researchers have tried to consider it in DEA. The UTA-STAR method is one of the techniques widely used in Multi Criteria Decision Analysis. In this technique, the preferences of decision maker on alternatives are considered and UTA-STAR tries to compute the most suitable weights for criteria and alternatives to obtain a utility function having a minimum deviation from the preferences. The goal of this paper is interpreting decision maker’s preferences in UTA-STAR method, in a new manner, using the common set of weights (CSW) in DEA.

Objective: The aim of this research was to compare the body image between disabled athletes with disabled and non-disabled non- athletes. Materials & Methods: In this cross sectional and comparative study, fifty disabled athletes from the handicapped sports club, fifty disabled non athletes from Kahrizak disabled rest house and fifty non athlete healthy persons from governmental administrations were selected randomly by classified clustered method and their body image were compared. Data collection tools included a personal information questionnaire and a physical self description questionnaire (PSDQ) which included 11 sub-scales such as power, endurance, coordination, general health, flexibility, self-esteem, athletic competence, fat, body appearance, body activity and the global physical. The statistical procedures used in this study comprised one way ANOVA and the Newman-keuls test. Results: Body image of disabled athletes in the sub-scales of power, endurance, coordination, flexibility, self-esteem, athletic competence, body activity were higher than disabled and non-disabled individuals who were not athletes (P&le0.001). In addition the sub-scales of the body fat (P=0.012), body appearance (P=0.002) and general health (P=0.001), the results showed that a higher significance for the disabled athletes, however, there wasn’t significant difference for the non-disabled athletes. Conclusion: Thus the result showed that the attitude of the disabled and non-disabled individual in due to their continuous physical activity in that the disabled athletes have got better body images as compared to the disabled and non-disabled individual who have not physical activity.

Objectives: The aim of the present study was to compare and contrastthe sub-scale of the body image of the athletes and nonathlete menopaused females. Methods & Materials: The subjects of the research comprise 60 individuals who were between 43-53 years old. In this study the personalinformation questionnaire and PSDQ test were used.The Personal information questionnaire included the sub-scales of power, endurance, coordination, general health, flexibility, self-esteem, athletic competence, body appearance and, body activity. The Kolmogrov-Smirnov and T test used to analys data . Results: The results showed that the body image of the athletes in all of the sub-scales such as power, endurance, coordination, general health, flexibility, self esteem, athletic competence, fat, body appearance, body activity and whole body was significantly better than individuals who were not athletes. Conclusion: It seems that participation in physical activity programs have a positive effect on menopausal negative side effects.