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Objective(s): Knowledge about self-care behaviors and compliance with them in patients with chronic diseases is very important. The purpose of the present study was to investigate the behavior of patients with cardiac insufficiency through transcriptase and meta-analytic methods in Iran. Methods: Electronic databases including Magiran، Iran medex، Scopus ، Pub Med, Cochrane ،Web of Science were searched using the keywords self-care, self-care index, and self-care components (self-care maintenance, self-care management and self-care confidence) between 2009 and 2018. To investigate heterogeneity, I2 was used. Results: A total of 23 studies were entered into the final analysis. The mean score (CI 95%) of self-care behaviors was 34.33 (33.49-35.18). The meta-regression findings showed that in the studies conducted in recent years, the average score of self-care behavior of patients with heart failure increased, but this value decreased significantly in studies with large sample sizes. Conclusion: Considering the importance of self-care in the prevention and control of the disease, it is recommended to increase self-care behaviors among patients with heart failure.

Background. The birth of a premature baby needing to be hospitalized in the neonatal intensive care unit (NICU) endangers the initial mother-baby relationship, affecting mother-baby attachment. Therefore, it seems necessary to provide mothers of premature babies with appropriate nursing support. In the present study, we aimed to investigate the effects of spiritual self-care training on the mother-baby attachment of mothers giving birth to premature babies hospitalized in the NICU. Methods. This was a semi-experimental study with pre-test/post-test design conducted on 60 mothers with babies admitted to the NICU of Taleghani Hospital of Ilam (30 participants in each of the intervention and control groups).Two questionnaires were used for data collection, including a demographic information questionnaire and the Maternal Postnatal Attachment Scale (MPAS). Five self-care training sessions (45 minutes each) were held for mothers of the intervention group according to a self-care booklet prepared by the researcher. The attachment questionnaire was again completed after one week of the last training sessions by all participants, and the data were analyzed using SPSS version 22 software. Descriptive statistics were used to present quantitative (mean ±SD) and qualitative (frequency, %) variables. The normality of the data was checked using the Kolmogorov Smirnov test, and the MANOVA and univariate analysis of covariance (ANCOVA) tests were used to investigate the effects of the training on mother-baby attachment. The statistical significance level was considered P

Abstract Background Case-based learning (CBL) is an effective teaching–learning strategy that provides a learning environment similar to actual practice. The aim of the present study was to determine the nursing student's satisfaction with two methods of CBL and lecture-based learning. Methods This descriptive observational study was conducted in 2019 in School of Nursing and Midwifery in Ilam. All 128 undergraduate nursing students in the 3rd, 4th, and 5th semesters of nursing were enrolled in the study to compare students' satisfaction with CBL and lecture-based learning. Data collection tools included a demographic information questionnaire and a researcher-made questionnaire consisting of 20 questions based on the Likert scale. Data analysis was performed using SPSS Statistics 22. Results More than two thirds of the students (81.3%) found the CBL method was better than lectures. 60% of male students and 62% of female students stated that the CBL method increased their self-confidence compared to the traditional lecture-based learning (p 0.05). However, 4th semester students were more satisfied than other students (P = 0.02). Conclusion The results show that CBL, as a teaching–learning technique in specialized nursing courses, increases students' satisfaction and self-confidence compared to lecture.

Abstract Background: Menopause is a stage in woman's life that some women experience in middle age and some at a younger age (premature menopause). Low levels of ovarian hormones, during menopause can lead to various complications. Menopause is one of the factors that can affect a woman's sexual function. Objective: The present study was conducted to compare the effect of licorice vaginal cream and estrogen vaginal cream on the sexual function of postmenopausal women. Materials and Methods: In this randomized clinical trial study, 82 postmenopausal women who were referred to health centers in Ilam, Iran from July to November 2020 were randomly divided into 2 groups (n = 41/each). One group was given estrogen vaginal cream 2%, and the other vaginal licorice cream 2%. Participants used the 2 medications for 14-day periods each. We used the finite randomization method. Data collection questionnaires, including a demographic information questionnaire before treatment and a female sexual function index questionnaire were completed before, one month after the medication, and 2 months after using the medication. Results: The mean score of sexual function in the licorice group was 17.86 ± 4.37 and increased to 20.31 ± 4.63 at the end of the study. The mean score of sexual function in the estrogen group was 17.14 ± 3.99 and increased to 22.97 ± 5.09 at the end of the study (p = 0.015). Conclusion: The effect of estrogen vaginal cream on the sexual function of postmenopausal women was greater than licorice vaginal cream.

Background & Objective: Soon after the outbreak of COVID-19, Universities of medical sciences was forced to shift from face-to-face education toward online educational activities according to WHO recommendation to observe physical distancing. Therefore, the present study was conducted to determine the quality of virtual education classes from the perspective of students and professors at Ilam University of Medical Sciences. Materials & Methods: This cross-sectional study was conducted in five faculties of Ilam University of Medical Sciences in 2020. Thirty professors and 370 students participated in the study by convenience sampling. Data were collected using a researcher-made questionnaire based on the viewpoint of university professors and students about the quality of virtual classes. The questionnaire included 30 questions in four sections: the ability to use the educational system, feelings and attitudes towards the virtual class, learning and educational environment, interactive learning and perceived effectiveness, plus five questions addressing satisfaction with the training course. The data were analyzed using independent t-test at a significance level of P

Abstract Background Nurse preceptorship is a new concept emerging in the Iranian health care system. The purpose of this research was to assess preceptor nurses’ perceived benefits, rewards, support, and commitment to the role in a new nurse preceptorship program in Iran and to examine the relationships between these concepts. Methods A descriptive correlational study was employed, and using total population sampling method, 45 preceptor nurses were recruited from a tertiary referral teaching hospital in Iran. Data were collected using the Preceptor’s Perception of Benefits and Rewards Scale, the Preceptor’s Perception of Support Scale, and the Commitment to the Preceptor Role Scale. Descriptive statistics and correlational analysis were used to analyse data. Results Preceptors’ commitment to their role was positively and moderately associated with their perceived benefits and rewards (r = 0.503, p = 0.001) and perceived support (r = 0.430, p = 0.003). None of the examined demographic and practice variables showed statistically significant association with commitment to the preceptor role. Conclusions Commitment to the preceptor role was associated with benefits, rewards and support that preceptor nurses perceive in relation to their role. To optimise the effectiveness of nurse preceptorship programs, benefits, rewards, recognition, and support should be integral to planning of these programs.

The aim of this study was investigating the effect of cerebellar transcranial direct current stimulation (tDCS) on static and dynamic balance of inactive older adults. Twenty-four older adults participated in this study. All participants underwent static and dynamic balance tests. In the Experimental group, anode electrode was positioned at the O point in the cerebellum and cathode electrode was positioned on the left eye socket (FP1). In the control group, the anode and cathode electrodes were positioned at O and FP1 points, respectively, but the current stimulation was stopped after 30 s. Then, the posttest was performed. Data analysis was done using MANCOVA. There was a significant difference between the Experimental and control groups in static balance ( p = .12) and dynamic balance ( p = .18) and the performance was better in the experimental group. It can be concluded that tDCS can improve static and dynamic balance in inactive older adults.

Background: As the population ages, the impact of age-related diseases on health is becoming more apparent. Frailty is one of the most important issues faced by older adults. Objectives: This study aimed to determine the prevalence of frailty and the factors affecting it among older adults admitted to teaching hospitals in Ilam in 2020. Methods: This cross-sectional study was performed on 270 older adults admitted to teaching hospitals in Ilam. Participants were selected through consecutive sampling. Data were collected using the Tilburg Frailty Indicator and analyzed by the Chi-square test and logistic regression analysis. Results: The mean age of the older adults participating in the study was 71.97 ± 8.42 years. Overall, 18.1% of older adults were frail, and frailty was significantly associated with having a chronic disease, being accompanied by a close relative, hospitalization, age, sex, marital status, and education level (P < 0.05). The most important predictors of frailty in older adults were age, sex, history of stroke, and being accompanied by a close relative (P < 0.05). Conclusion: About one-fifth of the older adults participating in this study were frail. The prevalence of frailty was higher among women, those with chronic diseases or a history of stroke, single people, and those with low education levels. Therefore, these people need special attention.

IntroductionHealth Care Workers (HCWs) use Personal Protective Equipment (PPE) during the COVID-19 pandemic to protect themselves and prevent the transmission of the disease. The use of PPE, especially respiratory masks, has adverse consequences, including headaches, which have been secondary and unusual. The aim of the present systematic review and meta-analysis study was to investigate the prevalence of PPE-associated headaches in HCWs during COVID-19 pandemic.MethodsThe present review study was performed based on the PRISMA guideline. The protocol of the present study was registered in PROSPERO with the code CRD42022304437. Valid data resources such as Scopus, PubMed, Web of Science, Science Direct, Google Scholar, Embase were used to identify and extract relevant studies. The searches were conducted between the beginning of 2020 and the end of January 2022. A random effects model was used for meta-analysis and I2 index was used to investigate between-study heterogeneity. Data were analyzed using STATA ver. 14.ResultsA total of 539 articles were first identified through initial search and finally 26 final studies were selected to undergo the meta-analysis phase. According to the results of meta-analysis, the prevalence of headache after and before the use of PPE was 48.27% (95% CI: 40.20–56.34, I2 = 99.3%, p = 0 < 001) and 30.47% (95% CI: 20.47–40.47, I2 = 97.3%, p = 0 < 001), respectively.ConclusionThe results of the present study showed that the prevalence of PPE-associated headache in HCWs was relatively high, so, the use of PPE during COVID-19 pandemic can be considered as one of the causes of headache. Therefore, management strategies such as regular screening of HCWs for headaches and regular rest periods without the use of PPE can be effective in reducing the prevalence of headaches.

Introduction: There is no agreement on how the hands are positioned in cardiopulmonary resuscitation (CPR). In this study, the effects of two methods of positioning the hands during basic and advanced cardiovascular life support on the chest compression depth are compared. Methods: In this observational simulation, the samples included 62 nursing students and emergency medicine students trained in CPR. Each student performed two interventions in both basic and advanced situations on manikins and two positions of dominant hand on non-dominant hand, and vice versa, within four weeks. At each compression, the chest compression depth was numerically expressed in centimeter. Each student was assessed individually and without feedback. Results: The highest mean chest compression depth was related to Basic Cardiovascular Life Support (BCLS) and the position of the dominant hand on non-dominant hand (5.50 ± 0.6) and (P = 0.04). There was no statistically significant difference in the basic and advanced regression variables in men and women except in the case of Advanced Cardiovascular Life Support (ACLS) with dominant hand on non-dominant hand (P = 0.018). There was no significant difference in mean chest compression during basic and advanced cardiovascular life support in left- and right-handed individuals (P = 0.09). Conclusion: When the dominant hand is on the non-dominant hand, more pressure with greater depth is applied.

Abstract Background Urinary tract infection (UTI) is a common clinical problem in pregnant women. Bacteriuria in pregnancy without antibiotic treatment could result in complications. This study aims to investigate the etiology and prevalence of UTI and asymptomatic bacteriuria (ASB) in pregnant women in Iran. Method This meta-analysis follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. To avoid bias, all steps of the study were carried out independently by two researchers. We conducted a comprehensive search on all the related literature in national databases, including IranDoc, SID, Barakat Knowledge Network System, RICST, Magiran, Iranian National Library and international databases, including Scopus, Embase, Science Direct, PubMed/ Medline, Cochrane Library, Web of Sciences, EBSCO, as well as Google Scholar search engine until June 2018. After considering the inclusion/exclusion criteria and qualitative evaluation, studies were analyzed based on random effects model using Comprehensive Meta-Analysis Software Version 2. Results In 31 studies with a sample size of 20,309, the prevalence of ASB in pregnant Iranian women was estimated to be 8.7% (95%CI: 7.2–10.4). The lowest and highest prevalence of ASB were observed in the third trimester (6.1% [95%CI: 2.1–16.4]) and first trimester (11.7% [95%CI: 7.9–16.9]), respectively. Subgroup analysis of the prevalence of ASB based on geographical region (P = 0.002) and province (P

Background: The association between anemia and postpartum depression (PPD) has been reported to be controversial in different studies. Therefore, this study aimed to provide a comprehensive assessment of anemia and PPD. Methods: This review study was conducted according to the MOOSE protocol and results have been reported according to the PRISMA guideline. We searched epidemiologic studies published until January 2018 in nine English databases including Scopus, PubMed/Medline, Science Direct, Embase, Web of Science, CINAHL, Cochrane Library, EBSCO and Google Scholar using English MeSH keywords. The heterogeneity of the studies was assessed using the Cochran’s Q test and I2 index. Data were analyzed using a random effects model and comprehensive meta-analysis (CMA) software version 2. Results: In the 10 studies, the association between postpartum anemia and PPD was significant (heterogeneity test: P

Background and aim: Health risk behaviors are major and threatening problems of societies. The aim of this study was to determine and compare health behaviors among students of Iranian medical and human sciences universities. Methods: In this cross-sectional study, 570 senior medical and human sciences students of Ilam universities (Ilam, Iran) were selected during the period between October 2015 and October 2016, using the stratified random sampling method. The research tool was the self-assessment health questionnaire which consists of personal information, understanding the concept of health and health behaviors. Descriptive statistics and Mann-Whitney U, independent samples t-test and Pearson product-moment correlation tests were used in SPSS version 16. Results: The scores obtained by both groups of medical sciences and human sciences students were low. There was no significant relationship between field of study and the score of understanding the concept of health (p=0.289); but the relationship between field of study and the score on health behaviors (p=0.001) and between health behaviors and understanding the concept of health were significant for both the students of medicine (r=0.259, p=0.01) and the students of human sciences (r=0.493, p=0.001). Conclusion: Students’ health behaviors were not at a desirable level. Conducting interventions in the form of research projects have been recommended.

Objectives: Among different micronutrient deficiencies, vitamin D deficiency (VDD) is nowadays considered pandemic. Therefore, the present study aims to investigate vitamin D status in the population referred to the laboratories of Ilam from 2014 to 2015. Materials and Methods: This cross-sectional population-based survey was conducted among the patients who referred to five laboratories of Ilam from July 2014 to July 2015. The samples were selected by a random procedure. 25-hydroxyvitamin D [25OHD] levels were determined by enzyme-linked immunosorbent assay (ELISA) method. Cut-off points for serum levels of 25OHD were defined as normal (>30 ng/mL), vitamin D insufficiency (VDI) (10-30 ng/mL) and VDD (

Introduction: Professionalism is one of the fundamental concepts in nursing and the result of the interaction with the environment and others. Nursing professionalism impact on quality of care and affected by several factors. This study aimed to determine the attitude of nurses to professionalism and the factors affecting it. Methods: In this descriptive study, the attitude among nurses to professionalism has been measured by using the questionnaire Hall, in five dimensions "membership in professional organizations", "public service", "a sense of calling", "self-regulation"," autonomy" and a researcher made questionnaire about effective factors. 185 nurses working in health centers under the supervision of Tabriz University of Medical Sciences, using stratified random sampling participated in the study. Data using SPSS software, descriptive and inferential statistics, were analyzed. Results: The results showed that the nurse's attitude to professionalism is the average level. Among the five dimensions, the scores from highest to lowest consist of "membership in professional organizations", "a sense of calling", "self-regulation", "autonomy" and "public service". The relationship between nurses attitudes toward professionalism and variables of work experience and participation in training courses for individual empowerment was statistically significant (P

Introduction: The staffs' attitudes, beliefs, ideologies and dutifulness, along with their individual characteristics particularly their personality traits are among the factors that are known to affect their performance. The aim of this study was to determine the effect of individual contributions to the process of intraprofessional collaboration among Iranian nurses. Methods: Twenty-three nurses from three different areas, namely Tehran, Tabriz and Ilam hospitals participated in this qualitative study. The participants were selected through purposive sampling. Data were collected using deep and unstructured interviews. Interviews were simultaneously analyzed using conventional content analysis method after being transcribed. Results: Several essential factors contributing to the process of effective collaboration among Iranian nurses were identified: (a) nurses’ perspectives and beliefs, (b) personal experiences, (c) individual characteristics and, (d) personal problems. Conclusion: The findings indicate that the features and characteristics of individual contributions are very important and effective on nurses' intraprofessional collaboration. Thus, attention must be paid to these factors in order to overcome problems and obstacles that are encountered on the way of achieving effective collaboration.

Background: The clinical consequences of hypothyroidism and hypothyroxinemia during pregnancy such as preterm birth are not still clear. Objective: The aim of this meta-analysis was to estimate the relation of clinical and subclinical hypothyroidism and hypothyroxinemia during pregnancy and preterm birth. Materials and Methods: In this meta-analysis, Preferred Reporting Items for Systematic review and Meta-Analysis were utilized. Searching the 83Tcohort studies83T were done by two researchers independently without any restrictions on Scopus, PubMed, Science Direct, Embase, Web of Science, CINAHL, Cochrane, EBSCO and Google Scholar databases up to 2017. The heterogeneity of the studies was checked by the Cochran's Q test and IP2P index. Both random and fixed-effects models were used for combining the relative risk and 95% confidence intervals. Data were analyzed using Comprehensive Meta-Analysis software version 2. Results: Twenty-three studies were included in the meta-analysis. The relative risks of the clinical hypothyroidism, subclinical hypothyroidism and hypothyroxinemia during pregnancy on preterm birth was estimated 1.30 (95% CI: 1.05-1.61, p=0.013, involving 20079 cases and 2452817 controls), 1.36 (95% CI: 1.09-1.68, p=0.005, involving 3580 cases and 64885 controls) and 1.31 (95% CI: 1.04-1.66, p=0.020, involving 1078 cases and 44377 controls), respectively. Conclusion: The incidence of preterm birth was higher among mothers with clinical and subclinical hypothyroidism or hypothyroxinemia during pregnancy compared to euthyroid mothers, and these relations were significant. Therefore, 83Tgynecologists and endocrinologists83T should manage these patients to control the incidence of 83Tadverse pregnancy outcomes83T such as preterm birth.

Background: Hearing disorders are reported in thalassemia patients treated with deferoxamine. This study aimed to assess hearing loss in Iranian thalassemia major patients treated with deferoxamine. Methods: This review article was designed based on PRISMA guidelines. To review the literature, two researchers studied national and international databases including Iranmedex, Magiran, Medlib, SID, Scopus, PubMed, Science Direct, Web of Science and Google Scholar without time limit until May 2017. Cochran's Q test and I2 index were used to assess the heterogeneity of the studies. The data were analyzed using Comprehensive Meta-Analysis software version 2 and p

Introduction: Pregnant women and newborns are at risk of vitamin D deficiency (VDD). VDD during pregnancy can lead to several maternal and fetal complications. This study was performed with aim to determine the mean concentration of 25-hydroxyvitamin D [25(OH)D] in pregnant women and newborns in Iran. Methods: This meta-analysis study was performed without time limitation up to August 2016 based on the protocol of systematic review and meta-analysis studies (PRISMA). To access relevant studies, databases of Magiran, Iranmedex, SID, Medlib, IranDoc, Scopus, PubMed, Science Direct, Cochrane, Web of Science, CINAHL and Google Scholar were independently searched by two researchers. Search was performed using MeSH keywords. Pooled estimator was calculated according to significant I2 index based on the random effects model. Data were analyzed using Review Manager software version 5.3.5. Results: Among 19 studies, 4,829 pregnant women and 1,195 newborns were enrolled. The mean age of pregnant women was 27.01±0.31 years. Mean concentration of vitamin D in pregnant women was 15.02 ng/ml (95% CI: 13.68-16.35). This rate in newborns of 6 studies was calculated 14.59 ng/ml (95% CI: 9.94-19.23). The standardized mean difference (SMD) of 25(OH)D concentration was significant in pregnant women at third-trimester and their newborns (P=0.001). Conclusion: Mean concentration of vitamin D in pregnant women and newborns in Iran is very low and there is a direct relationship between maternal concentrations of vitamin D at third-trimester and newborn. Therefore, addressing VDD in Iranian pregnant women and newborns should be considered as a health priority.

BackgroundMultiple sclerosis (MS) is one of the most common neurological disorders and is one of the main causes of disability. The prevalence and incidence of MS in Iran is reported to range from 5.3 to 89/ 100,000and 7 to 148.1/ 100,000, respectively. There are no systematic and meta-analysis studies on MS in Iran. Therefore, this study was conducted to investigate the prevalence and incidence of MS in Iran using meta-analysis.MethodA systematic review of the present study focused on MS epidemiology in Iran based on PRISMA guidelines for systematic review and meta-analysis. We searched eight international databases including Scopus, PubMed, Science Direct, Cochrane Library, Web of Science, EMBASE, PsycINFO, Google Scholar search engine and six Persian databases for peer-reviewed studies published without time limit until May 2018. Data were analyzed using Comprehensive meta-analysis ver. 2 software. The review protocol has been registered in PROSPERO with ID: CRD42018114491.ResultsAccording to searching on different databases, 39 (15%) articles finalized. The prevalence of MS in Iran was estimated 29.3/ 100,000 (95%CI: 25.6-33.5) based on random effects model. The prevalence of MS in men and women was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and 44.8/ 100,000 (95%CI: 36.3-61.6), respectively. The incidence of MS in Iran was estimated to be 3.4/ 100,000 (95%CI: 1.8-6.2) based on random effects model. The incidence of MS in men was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and the incidence of MS in women was 44.8/ 100,000 (95%CI: 36.3-61.6). The meta-regression model for prevalence and incidence of MS was significantly higher in terms of year of study (pConclusionsThe results of this study can provide a general picture of MS epidemiology in Iran. The current meta-analysis showed that the prevalence and incidence of MS in Iran is high and is rising over time.

[This corrects the article DOI: 10.1371/journal.pone.0214738.].

Arbitrary Use of Insulin and Its Consequence

Introduction: The first and most critical stage in nursing profession is when an individual enters the educational or apprenticeship environment as a nursing student. Therefore, the students’ professional attitudes and behaviours are very important during the courses. Aim: To determine the professional attitude in Iranian Nursing Students. Materials and Methods: This descriptive cross-sectional study was conducted from October 2015 to October 2016 at Ilam University of Medical Sciences. One hundred fourteen nursing students who studied in fourth to eighth semesters were randomly selected through proportionate stratified random sampling. Data collection tools consisted of a demographic information form and the Inventory to Measure Professional Attitudes in Student Nurses. Data analysis was performed using descriptive and inferential statistics through SPSS 18, while p

Introduction: Professional autonomy plays an important role in nurses’ job satisfaction and the outcomes of patient care. A review of literature shows the presence of nurses’ dissatisfaction in regard to their professional autonomy. Aim: To assess the Iranian nurses’ perspectives of their professional autonomy. Materials and Methods: In this cross-sectional study, 150 nurses with bachelor or higher academic degrees and clinical experiences participated. The professional autonomy questionnaire by Blegen MA, composed of the domains of decision-making for ward’s affairs and decision-making for patient care, were used for data collection. The data was collected from November 2015 to April 2016 and analysed using descriptive and inferential statistics. Results: The mean (SD) of professional autonomy was 152.06 (28.181). Also, the means of professional autonomy in the domains of decision-making for ward’s affairs and decisionmaking for patient care were 71.91 (17.687) and 80.15 (13.088), respectively. The majority of the nurses (66.7%) stated that they had high levels of professional autonomy. There were statistically significance relationships between the nurses’ age, work experience, and educational level and nurses’ professional autonomy (p

Introduction: Medication administration is a key responsibility of nurses. If this duty is not properly accomplished, it can cause serious threats to the health and safety of patients. Aim: To explore factors affecting the frequency of medication errors from the perspective of nurses in educational hospitals of Ilam, Iran. Materials and Methods: The present descriptive analytical study was conducted on 120 nurses randomly selected from teaching hospitals of Ilam. A two part standard questionnaire was used. Its first part was on the participants demographic information. The second part consisted of three domains including 11 questions on the factors associated with nursing, seven questions on the factors associated with wards, and four questions on the factors associated with nursing management. Data analysis was performed using the SPSS software, version 19.0. The significant p-value was considered less than 0.05. A total of 120 completely filled questionnaires were obtained and this formed the study data. Results: The participants included 50 (42%) males and 70 (58%) females. In all the three domains, the most frequent factors resulting in the incidence of medication errors included: occupational fatigue exhaustion (58.5%), nurses personal neglect (56%), heavy workload in wards (65.6%), and inadequate staffing and high nurse/patient ratios (69.7%), respectively. Conclusion: Fatigue, personal carelessness, heavy workload, inadequate staffing and high nurse/patient ratios are the important and effective factors causing medication errors. Reducing the number of nurse's shifts during the month and increasing the number of personnel per shift are recommended.

Introduction: People in various professions may face discrimination. In the nursing field, discrimination among nurses in the workplace, regardless of race, gender or religion have not been studied; a problem that leads to a reduction in the quality of nursing care and nurse turnover. Discovery of the concerns of nurses about inter-professional collaboration is the purpose of this study. Methods: The present study is conducted by using a qualitative content analysis. The data collection process included 22 unstructured and in-depth interviews with nurses between April 2012 and February 2013 in the medical teaching centers of Iran. A purposive sampling method was used. All interviews were recorded, typed, and analyzed simultaneously. Results: The category obtained from explaining nurses' experiences of inter-professional collaboration was "discrimination" that included two subcategories, namely (1) lack of perspective towards equality in authorities, and (2) professional respect and value deficit.Conclusion: Nurses' experiences are indicating their perception of discrimination that influences the collaboration between nurses, which should be taken into account by managers. The findings of the present study help to managers about decision making on how to deal with staff and can be helpful in preventing nurse turnover and providing better services by nurses.

Introduction: Caring behaviors of clinical teachers is one of the most important and influential factors in the process of clinical instruction, so far has not been paid enough attention. In other words, there has been so little research done in this area, so that the researchers couldn't present the clear image of caring dimensions. Therefore, the present study was conducted to determine nursing students’ perception of instructors’ caring behavior. Methods: This descriptive study was performed on 240 nursing students in Tabriz University of Medical Sciences, Iran. The participants were selected through stratified random sampling method. The data were collected using Wade’s inventory for nursing students’ perception of instructor caring (NSPIC). Data were analyzed using descriptive statistics in SPSS13 software. Results: The level of nursing instructors' caring behavior during teaching students was medium to high with the mean and standard deviation of 4.65 (0.93), as the highest level belonged to the respectful sharing, and then respectively, instill confidence through caring, appreciation of life meanings, supportive learning climate, and control versus flexibility.Conclusion: The results obtained in this study demonstrate that there is a gap in some dimension in order to achieve optimum about instructors' caring behaviors. Examining and identifying the influential factors in this regard, and applying effective strategies by relevant authorities will be effective in qualitative promotion of clinical teaching.

Background: Many causes can lead to childhood rickets. We aimed to investigate the biochemical symptoms of childhood rickets with systematic review and meta-analysis. Materials and Methods: Seven articles published from 1975 to 2018 were recruited. The literature search was performed in the Scientific Information Database, Google Scholar, PubMed, and Elsevier databases using related keywords. For meta-analysis, the results of the studies were pooled using the random-effects model. The heterogeneity between the studies was checked using Q test and I2 index. Results: The total sample population consisted of 933 children with biochemical symptoms of rickets (133 participants per article). According to our findings, the mean serum levels of PO4, Ca, and alkaline phosphatase in children with rickets were 4.18 (95% confidence interval [CI]: 3.75–4.61, I2 = 98.3%,P

Introduction: Different problems might lead to reduction in the efficiency of nursing students' apprenticeship education and solving those problems. Aim: This study was conducted to determine nursing internship problems from the perspective of trainers and students. Materials and Methods: In this descriptive cross-sectional study, 20 trainers and 43 senior students of nursing were selected using census method. A researcher-made questionnaire was used to collect data. Total internal consistency (α) of the questionnaire was 0.88 and had proper convergent validity. SPSS was used to analyse data with applying descriptive and inferential statistics. Results: More than 50% considered their course relatively weak or weak in helping intern nurses to acquire comprehensive view of the nursing profession that takes a social perspective into account, skills required for the processes of nursing and instructing patients. Problems such as insufficient access to welfare and educational facilities, lack of co-operation among clinical team and scattering of internship sessions during a course were mentioned by nurses and their trainers. They believed that changes must take place in the way internship courses are carried out. Conclusion: Although the internship courses seem to achieve their aim of improving students' skills and independence in providing different nursing services to students and their trainers generally have a positive attitude towards such courses, there are still problems in effective exercise of the training.

Background: In recent decades, several medical and scientific studies on yoga proved it to be very useful in the treatment of some diseases. This study was conducted to investigate the effects of yoga on stress, anxiety, and depression in women living in Ilam, Iran. Methods: This study is a quasi-experimental study with pre-post test. To collect data, the questionnaire of DASS-21 (Depression Anxiety Stress Scale-21) was used. For eligible samples, hatha yoga exercises and training sessions were held for 4 weeks (3 time/weeks; 60-70 min each) by a specialist. Data were analyzed using SPSS version 20. Results: 52 women with a mean age of 33.5 ± 6.5 were included for analysis. Depression, anxiety, and stress decreased significantly in women after 12 sessions of regular hatha yoga practice (P < 0.001). Conclusions: Yoga has an effective role in reducing stress, anxiety, and depression. Thus, it can be used as complementary medicine.

Background: There is not enough studies to determine the frequency of using the prophylaxis against deep venous thrombosis (DVT) based on the American College of Chest Physician's (ACCP) guidelines in Iran. Thus, providing such statistics is essential to improve thromboprophylaxis in hospital. The present study aimed to determine the frequency of using the prophylaxis against DVT based on ACCP guidelines in patients hospitalized in surgical wards in one of teaching hospital in Ilam, Iran. Methods: In a cross-sectional, the samples were selected among medical records of patients who were hospitalized and underwent surgery in surgical wards of the hospital from April 2012 to September 2013. Type of prophylaxis was determined based on ACCP guidelines. After reviewing inclusion and exclusion criteria, patients' data were extracted from medical records based on required variables. Results: In reviewing 169 qualified samples, 46.2% (78 patients) were women. Of these, 132 patients were at risk of DVT and needed prophylaxis, only 39 patients (29.5%) received prophylaxis. Thromboprophylaxis based on ACCP guidelines had been fully implemented only in 30 cases (22.7%) of patients with the risk of DVT. The highest thromboprophylaxis was in the intensive care unit (46.6%) and neurosurgery (37.5%), and the least rate was in urology (0%). Conclusions: As the results of this study, there are differences between clinical practice and the ACCP guidelines recommendation in prophylaxis against DVT. Thromboprophylaxis has not been implemented based on ACCP guidelines in more than 75% of patients with the risk of DVT. Thus, new strategies are needed to implement thromboprophylaxis against DVT in Iranian hospitals.