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Abstract Background There is a need to survey the quality of online education and the level of students’ academic satisfaction and evaluate their learning experience to improve the quality of online education, especially for graduate students. Therefore, the present study investigated relationship between information literacy and satisfaction with quality of virtual education in Iranian nursing students during the COVID-19. Methods This is a cross-sectional descriptive study that was conducted on 80 nursing master’s students who were enrolled in the study using convenience sampling. This study was conducted using data collection tools including four questionnaires of demographic information, quality of online education, academic satisfaction, and educational information literacy of the learning and study strategies inventory (LASSI). Results The mean score of the Iranian nursing students' information literacy was 63.78 ± 9.14, and that of their quality of virtual education was 151.72 ± 22.93. In addition, their mean score of satisfaction with virtual education was found to be 70.29 ± 25.77, respectively. The results showed that there was a direct correlation between information literacy on the one hand and quality of virtual education (r = 0.78, p

Abstract Background The present research aimed to investigate the relationship between electronic learning and emotional and cultural intelligence in Shiraz University of Medical Sciences nursing students who entered the university in the years 2021 and 2022. Methods This is a cross-sectional and correlational study conducted in the School of Nursing in Shiraz University of Medical Sciences. 172 nursing students who were studying in the academic year 2021–2022 participated in this study. 90 nursing students in 2021 and 82 in 2022 entered the university. Using Morgan’s sampling table, we selected 118 nursing students as the statistical sample. Due to the emergence of the Covid-19, available sampling was used. To collect the data, we used three emotional intelligence, cultural intelligence, and e-learning questionnaires. Pearson’s correlation coefficient and multiple linear regression tests were employed to analyze the data. Results It was shown that there was a significant relationship between emotional intelligence and e-learning with students’ cultural intelligence. In addition, there was a significant relationship between electronic learning and emotional intelligence dimensions. Also, there was a positive and significant relationship between e-learning and the dimensions of cultural intelligence. The optimism, strategic, and motivational components could predict electronic learning in students. Discussion and conclusion According to the findings of the research, e-learning is a new teaching method that was used in Iran following the conditions of the COVID-19 pandemic in the world and provides many educational opportunities for the educational system of the country. It exists, prompting experts and curriculum specialists to examine e-learning and its influencing factors seriously and comprehensively. When students are at a favorable level in terms of emotional intelligence and cultural intelligence, they can accept electronic learning and improve and develop it.

Introduction: The main element of being a student is learning and pursuing knowledge. A student is an individual who has a strong motivation for seeking knowledge and increasing his/her insight to increase the level of scientific information and deepen his understanding. This study was conducted to investigate the relationship between academic motivation and academic performance of medical students of Shiraz University of Medical Sciences (Shiraz, Iran).Methods: This research was an applied descriptive-analytical study. The study population was all the clinical medical students of Shiraz University of Medical Sciences (Shiraz, Iran). McInerney’s standard academic motivation questionnaire was used to collect the required data for the study. The study population was 293 clinical students who were selected as a sample.Results: Based on the results of this study, there was a significantly positive correlation between the level of academic performance of clinical medical students and the dimensions of academic motivation including the tendency to acquire ability (P=0.043, r=0.118), tendency to perform (P=0.013, r=0.146), and tendency towards external goals (P=0.034, r=0.124). The results of this study also showed that only the dimension of motivation for academic progress had no significant correlation with the academic performance of clinical students (P=0.096, r=0.098).Conclusion: In general, the findings of this research indicated that academic motivation in students was one of the factors influencing academic performance, and with the increase of a student’s motivation to progress, their academic performance also improves.

Abstract Introduction Motivation is a driving force behind man’s behavior which has led to many psychological studies throughout the world. Moreover, it is the fuel for successful learning. While intrinsic motives provide the internal rewards, extrinsic motivation supplies the required external rewards to keep the engine of learning running. Knowing the factors which impact intrinsic/extrinsic motivation helps educators target their efforts at a higher level and make more informed decisions. Method This study intends to examine how intrinsic vs. extrinsic motivation may be influenced by demographics including learners’ background factors of major, age, and occupation and to determine the relationships that may exist between intrinsic and extrinsic motivation. To this end, an explanatory sequential mixed-methods research was conducted at one of the public universities in Shiraz on the majors of Elementary Education, Educational Affairs, Social Studies and Theology, and the Arabic language which were selected through cluster sampling. These students were having their English courses at the university. Based on Krejcie and Morgan’s formula for sample size, a questionnaire was administered to 100 participants to collect quantitative data. Moreover, semi-structured interview sessions were conducted with one fourth of the participants. Results Using Multiple Analysis of Variance (MANOVA) and Pearson correlation, we found that learners’ background factors of age, field of study and professional status did not affect intrinsic nor extrinsic motivation. However, significant and positive relationships were found between intrinsic motivation and total motivation index, and between extrinsic motivation and total motivation index. Qualitative data obtained from the interviews were analyzed using a thematic analysis. The results of the interviews showed some new illuminating trends as revealed from the participants’ responses and it was found that most interviewees followed intrinsic motives and considered motivation as a factor of great significance. Conclusion In the English as a Foreign Language (EFL) context in which our study was conducted, instructors can follow more similar classroom motivational techniques and strategies since neither type of motivation was influenced by the variables of different major, age and occupation. Though many studies have shown that EFL learners are more extrinsically motivated in comparison with ESL ones, our study revealed that participants were more intrinsically motivated. Thus, this study may be replicated in other educational contexts such as an ESL context. The study can also be repeated in some universities in which other educational systems such as coed education is used to see the possible similarities and differences. Motivation is the important stimulant to impel the learners to achieve their learning goals; thus, it should receive sufficient attention in various educational settings.

Abstract Background Emergency medical services preparedness in mass casualty incidents is one of the most important concerns in emergency systems. A mass casualty incident is a sudden event with several injured individuals that overwhelms the local health care system. This study aimed to identify and validate the components of emergency medical services readiness in mass casualty incidents which ultimately led to designing a conceptual model. Methods This research was an explanatory mixed-method study conducted in five consecutive stages in Iran between November 2021 and September 2023. First, a systematic review was carried out to extract the components of emergency medical services preparedness in mass casualty incidents based on the PRISMA guideline. Second, a qualitative study was designed to explore the preparedness components through in-depth semi-structured interviews and analyzed using the content analysis approach. Third, the integration of the components extracted from the two stages of the systematic review and qualitative study was done by an expert panel. Fourth, the obtained components were validated using the Delphi technique. Two rounds were done in the Delphi phase. Finally, the conceptual model of emergency medical services preparedness in mass casualty incidents was designed by a panel of experts. Results 10 articles were included in the systematic review stage and sixteen main components were extracted and classified into four categories. In the second stage, thirteen components were extracted from the qualitative study and classified into five categories. Then, the components of the previous two phases were integrated into the panel of experts and 23 components were identified. After validation with the Delphi technique, 22 components were extracted. Lastly, the final components were examined by the panel of experts, and the conceptual schematic of the model was drawn. Conclusions It is necessary to have an integrated framework and model of emergency medical service readiness in the planning and management of mass casualty incidents. The components and the final model of this research were obtained after the systematic scientific steps, which can be used as a scheme to improve emergency medical service preparedness in response to mass casualty incidents.

Research conducted over the years has established that artificial light at night (ALAN), particularly short wavelengths in the blue region (~400–500 nm), can disrupt the circadian rhythm, cause sleep disturbances, and lead to metabolic dysregulation. With the increasing number of people spending considerable amounts of time at home or work staring at digital screens such as smartphones, tablets, and laptops, the negative impacts of blue light are becoming more apparent. While blue wavelengths during the day can enhance attention and reaction times, they are disruptive at night and are associated with a wide range of health problems such as poor sleep quality, mental health problems, and increased risk of some cancers. The growing global concern over the detrimental effects of ALAN on human health is supported by epidemiological and experimental studies, which suggest that exposure to ALAN is associated with disorders like type 2 diabetes, obesity, and increased risk of breast and prostate cancer. Moreover, several studies have reported a connection between ALAN, night-shift work, reduced cognitive performance, and a higher likelihood of human errors. The purpose of this paper is to review the biological impacts of blue light exposure on human cognitive functions and vision quality. Additionally, studies indicating a potential link between exposure to blue light from digital screens and increased risk of breast cancer are also reviewed. However, more research is needed to fully comprehend the relationship between blue light exposure and adverse health effects, such as the risk of breast cancer.

Abstract Background Teamwork has played a critical role in ensuring patients’ safety and preventing human errors in surgery. With advancements in educational technologies, including virtual reality, it is necessary to develop new teaching methods for interpersonal teamwork based on local needs assessments in countries with indigenous cultures. This study aimed to design and develop a new method of teaching teamwork in cesarean section surgery using virtual reality; we further evaluated the effects of this method on healthcare professionals’ knowledge and attitudes about teamwork. Methods This study was designed using the ADDIE instructional design model. The TeamSTEPPS Learning Benchmarks questionnaire was used to assess the educational needs of 85 participants who were members of the cesarean section surgery team. A specialized panel analyzed the extracted needs, and the scenario was compiled during the design stage. Finally, four virtual reality contents were created using 360-video H.265 format, which were prepared from specified scenarios in the development of the educational program. The TeamSTEPPS Learning Benchmarks questionnaire was used to measure knowledge, and the T-TAQ was used to measure the participants’ attitudes. Results Six micro- skills were identified as training needs, including briefing, debriefing, cross-monitoring, I'M SAFE checklist, call-out and check-back, and two-challenge rule. Intervention results showed that the virtual reality content improved teamwork competencies in an interprofessional team performing cesarean section surgery. A significant increase was observed in the mean score of knowledge and attitude after the intervention. Conclusion Through addressing the need for teamwork training, utilizing the TeamSTEPPS strategy, and incorporating new educational technologies like virtual reality, the collaboration among surgical team members can be enhanced.

Introduction: Medical education is beyond gaining a certain level of knowledge and mastering a specific set of skill. Medical students should try to improve the self and system, which necessitatespersonal growth and professional identity development. In this study, we aimed to investigate the factors which contribute to the formation of professional identity of medical students in basicsciences stage and finding out the significance of each factor.Methods: In this cross-sectional practical survey, semi-structured interviews were done with 10 medical students. The interview results yielded several items, which were used to make a 14-itemquestionnaire, the validity and reliability of which were verified. The contribution of the items to the factors was verified through factor analysis, the prerequisites of which were KMO and Bartletttest, which were done and approved. The significance of the factors obtained was evaluated and ranked through one sample t-test and Friedman test, respectively.Results: The result showed that professional identity development in the stage of basic sciences was influenced by several factors, including educational, socioeconomic, personal, and familial ones. Also, the personal factor ranked first, followed by socioeconomic, educational, and familial factors, respectively. Conclusion: In this study, it was concluded that the participants were more influenced by their own personal attitudes as compared to their familial, socioeconomic, or educational factors. Moreover, the factors which contributed to the professional identity of medical students were not at the same level of significance. To train physicians with high professional identity, medical education authorities are recommended to consider the above-mentioned factors.

Abstract Background Evidence suggests that menopause can be associated with a variety of negative psychological changes such as depression and anxiety, and improving the mental health status of women during menopause is one of the important priorities and challenges of the health system. The aim of this study was to determine the effect of saffron (Crocus sativus L., Iridaceae) herbal tea on happiness in postmenopausal women. Methods In this randomized clinical trial which was conducted in 2021, 72 postmenopausal women were enrolled and divided into intervention and control groups. The randomization blocks method was used for random allocation, and the Oxford Happiness Questionnaire was utilized to measure the scores. The intervention included the use of 30 mg of dried stigmas of the saffron plant, which was boiled once (in the morning, in 300 ml of boiling water for 10–15 min) and consumed with white rock candy as one cup of saffron tea daily. To compare the trend of changes and after removing the effect of other variables, generalized estimating equation (GEE) was used. Results There was no significant difference between the intervention and control groups in any of the quantitative and qualitative characteristics (p > 0.05). The results of paired samples t-test showed that the happiness mean score in the intervention group increased significantly (p

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

Abstract Background and Aims The reasons for the unfavorable performance of hospitals in providing care to Coronavirus Disease 2019 (COVID‐19) patients include the lack of preparation, knowledge, and relevant skills, making it necessary to evaluate the preparedness of nurses to respond to COVID‐19. Therefore, the present study aimed to investigate the preparedness of hospitals affiliated with Shahrekord University of Medical Sciences during the COVID‐19 pandemic in 2022. Methods In this analytical study, data were collected from 350 randomly selected nurses who worked in three hospitals affiliated with Shahrekord University of Medical Sciences; demographic information tools and the preparation of nurses for COVID‐19 patients were used to collect the data. We analyzed the data using SPSS software version 26. Results The mean and standard deviation of the total preparation score was 118.85 ± 0.98. The lowest (6.80 ± 0.18) and highest (23.35 ± 0.19) average values belonged to risk assessment and management and COVID‐19, respectively. The score of nurses' preparedness to deal with COVID‐19 was not statistically correlated with age, work experience, and so on. The average preparation score was significantly different in different treatment departments (operating room and COVID‐19). Conclusion The preparation of nurses was low in dealing with COVID‐19. Thus, managers of nursing services should design and implement educational programs to strengthen the nurses' weaknesses and ultimately increase their awareness and skills in dealing with disasters.

Abstract Background and Aims The effective response of emergency medical services in mass casualty incidents (MCIs) calls for sufficient preparation. The components of preparation must be determined first to achieve this goal. This study aimed to describe the elements of preparedness of emergency medical services for MCIs. Methods A qualitative study was carried out on emergency medical service systems in Iran (from April 2022 to mid‐March 2023), using in‐depth semistructured interviews with participants who were managers and members of the incident command team, experts, technicians, paramedics, and telecommunicators of emergency medical services. Interviews were carried out face‐to‐face and via telephone. The data were collected using voice recorder and transcript and analyzed by content analysis method. This study was conducted using the consolidated criteria for reporting qualitative research. Results Thirty‐six participants were included in the study. A total of 834 codes were analyzed. Thirteen components were extracted from the study and classified as five categories including “Strengthening management and organization,” “individual and group empowerment,” “capacity expansion,” “technology and infrastructure development,” and “operational response measures.” Conclusion Emergency medical service preparedness in response to MCIs is a critical issue. For improving preparedness, the main components must be identified. The study results described the elements of emergency medical service preparedness, which could be used as a framework for developing the national model of emergency medical service preparedness in MCIs.

Background: Faculty members are the main pillars of universities, and their performance has a vital role in the efficiency of universities. In the current era of the Covid-19 pandemic, students’ traditional evaluation method is not sufficient, and 360-degree evaluation is recommended, or multi-rater feedback is a means of providing evaluation from various stakeholders. The aim of this study was to compare the evaluation of faculty members’ teaching effectiveness in Larestan Medical School by 360 degrees and the evaluation done by the students in 2020 during the Covid-19 pandemic.Methods: This descriptive-analytic study compared the 360 degree evaluation and the students’ ratings on faculty members’ performance at Larestan University of Medical Sciences during 2020 -2021. The statistical population consisted of all full-time professors (N=28) selected by census method and students (N=280) chosen by random cluster sampling. The materials used were six valid and reliable questionnaires filled out by students, an expert in evaluation, heads of departments, deputies, peers, and self-assessment of faculty members. Data were analyzed through SPSS software (version 23) using the Friedman test (P

Abstract Background Continuing medical education is essential for nurses to provide quality patient care and upgrade their professional skills and competence. The need for continuing medical education (CME) has become more apparent in the face of advances in medical science, the ever-changing healthcare system, and nurses’ vital role in improving health care. It is, therefore, imperative to explore the nurses’ experience of CME courses and the extent to which such programs are effective. Objective The present qualitative study aimed to explore and describe nurses’ experiences of the effect of CE programs in promoting their competencies toward non-communicable diseases. Methods This qualitative content analysis study was conducted from December 2019 to April 2020 at various hospitals affiliated to Shiraz University of Medical Sciences (Shiraz, Iran) and based on the principles of conventional content analysis. The target population was nurses who actively worked in the chronic wards of these hospitals. The participants were selected using maximum variation sampling, including nine nursing managers, education and clinical supervisors, and staff nurses. Data were collected through individual, face-to-face, semi-structured interviews guided by an interview guide, and data collection continued until data saturation was achieved. Each interview took about 30–45 min. Follow up questions were used for clarification when needed. Data trustworthiness was assessed according to the criteria proposed by Guba and Lincoln. Results Analysis of the interview data resulted in 230 primary codes, based on 8 categories, and three themes were identified. The extracted themes were gaps in the planning of the CME program, problematic context, and training to improve professional skills and competency. The associated categories were gaps in the planning of the CME program, problematic context, and training to improve professional skills and competency. Conclusion Professional competence and performance of nurses can be improved through intrinsic motivation stimulation, planning, and implementation of training programs based on professional needs and effective assessment of the teaching/learning process.

Background: Citations are considered a measure of the scientific impact of research articles. CiteScore is a standard metric, based on the Scopus database, of the number of times articles in a given journal were cited during a given period relative to the number of articles published by that journal during that period.Objectives: To investigate the factors associated with CiteScores of journals on cardiology and cardiovascular diseases and indexed in Scopus in 2019.Methods: This cross-sectional, descriptive-analytical study examined 338 journals to analyse the correlation between CiteScore and such other variables and parameters as coverage by indexing services (databases), type of access, language, type of published articles, age of the journal (year of establishment), H-Index, Scimago Journal Rank, and the quartile of the journal.Results: CiteScore of a journal was positively correlated to the following variables or parameters: coverage by PubMed, Web of Science, and EMBASE (p < 0.001), articles in English (p < 0.001), age of the journal (p = 0.001), publishing review articles (p = 0.23), H-Index (p < 0.001), and Scimago Journal Rank (p < 0.001).Conclusion: Coverage of a journal in international databases, especially in PubMed, Web of Science, and EMBASE, is critical to increasing its visibility. Publishing review articles, which tend to be cited more often because they serve as comprehensive sources of information, can increase the CiteScore of a journal. Also, publishing more articles in English contributes to the number of times articles in a journal are cited.

BackgroundApplication of a Clinical Information System (CIS) like Electronic Patient Record (EPR), PACS system and CPOE has turned into one of the most important criteria of priorities of health care systems. The aims of the clinical information system include improving the physicians' efficiency level, integrating the caring process, and expanding the fuzzy quality of the services offered to patients. Achievement of these benefits in reality is not an easy task, and there are lots of plans in this field which are doomed to failure. About 50% of the implementation plans of clinical information systems in health care organizations have failed, and this trend is significantly affecting industrial countries. Proper implementation of hospital information systems lies in identifying and assessing the relationships among the most important risk factors of fuzzy. The present study aimed to provide an applicable model for identifying, ranking and evaluating the risk factors associated with projects of clinical information technology in hospitals of Shiraz University of Medical Sciences.MethodThis is an applied study which evaluates the risk factors associated with implementation of clinical information technology projects in hospitals of Shiraz Medical Sciences University. The participants consisted of professionals and senior experts of clinical information technology. Fuzzy logic was used in this study. We also applied ANP-DEMATEL combined model with fuzzy procedure to provide the analytic model of the study.ResultsAccording to the study findings, lack of top-executive supports, and unstable organizational environment were the two most important risk factors, while the main organizational factors and technology were also highly important. In addition, the factors associated with technology had the highest influence on the other studied risk factors.ConclusionHospital authorities can benefit from this proposed model to reduce the risk of implementing the projects of clinical information technology and improve the success coefficient of the risk of such projects.

Students’ incivility in higher education is a serious issue with undesirable impacts such as disturbed learning, interruption in the leaning and teaching environment, and stressful relationship between teacher and learners. It is basically defined as disruptive and unreasonable behaviors which cause psychological or physical distress, turning into threats if no action is taken to deal with them. It may further involve any behavior or verbal statement with negative impacts on teacher and students’ health, adversely affecting their occupational relationship, thereby disturbing the teaching and learning process. Educational weaknesses in dealing with virtual incivility can revolutionize the relationships and turn it into effective instruction if all stakeholders understand the nature of virtual communication and revisit their own roles in such an environment. University administrators may keep on evaluating such behaviors and provide instructors with constructive advice to enhance the quality of the course content and classes in virtual settings.

Abstract Background: Readability is one of the critical factors in choosing a suitable text to teach the students or ordinary people. Studies have shown that the readability of a text depends on the number of citations, type of article, journal impact factor, and journal scope. This study aimed at determining the readability in the most widely cited original English articles published in Iranian Medical Journals in 2018 and comparing them with the same type of articles in British and American Medical Journals; we also sought to determine the association between the level of readability of articles with the journal’s impact factor (IF) and the total number of citations. Methods: In this cross-sectional study, according to the search conducted in the database of the Iranian Journal of Medical Sciences, we searched different databases of ISI journals, and the results showed us 80 journals. We selected one American and one British journal for each Iranian journal, which was similar in terms of the journal’s scope and impact factor. Then, the most cited original article in the latest issue of 2018 in each journal was extracted for review. Afterwards, we recorded five indicators of Iranian, American, or English journals, Impact Factor, number of citations to the article, journal’s scope, and GFI score in a data collection form. The obtained data were analyzed using SPSS version 25. Results: Comparison of mean Impact Factor, number of citations to articles, and GFI score between the three Iranian, English, and American Journal groups was statistically significant (p-value

The articles submitted to ISI-Indexed journals receive various comments from peer reviewers. This study analyzes the text histories as well as peer reviewers' comments on 20 articles written by Iranian medical researchers published in ISI-indexed journals. Using Mungra and Webber's (2010) categorization of linguistic comments, this study aimed to investigate the amount and types of linguistic comments made by peer reviewers on these manuscripts. There was also an attempt to understand the reasons behind their linguistic problems through semi-structured interviews. The results revealed that fewer linguistic comments as compared to content comments are made on these manuscripts. Moreover, Mungra and Webber's (2010) categorization of linguistic comments was not found to cover all linguistic comments in our corpus and an additional category was used to make better categorization of linguistic issues. Personal attempts to improve the knowledge of English, attendance in various English classes, participation in academic research networks and, above all, extended use of English in researchers' university curricula are among the basic reasons for the researchers to develop their knowledge of English. Implications for holding English for Academic Purposes courses for medical researchers are also discussed.

Background and purpose: Metadiscourse markers (MDMs) play a significant role in academic witting. They act as a bridge between writers and readers and make a text more understandable. Therefore, this study aimed at investigating the use of MDMs in introduction, methods, results, and discussion (IMRaD) sections of English medical research articles (RAs) published in Iranian and American ISI journals. Materials and methods: In this cross-sectional study, performed in 2020, we selected 60 RAs published in Iranian medical journals and 60 RAs in American medical counterparts. Following Hyland’s taxonomy, MDMs were identified. Data analysis was done in SPSS V21 applying t-test. Results: The mean scores for MDMs were 5.40 and 5.78 in RAs published in Iranian and American journals, respectively that indicated no significant difference between MDMs used by Iranian and non-Iranian authors of medical RAs (P=0.377). Conclusion: Further trainings on the use of MDMs not only help authors to write more coherently and their intended meanings clear to their audience, but also enables readers to easily interpret the text. In fact, these markers improve the quality of writing and increase the comprehensibility of the text.

Background: Cost assessment with modern costing systems can be conducive to the efficiency of education. In this study, activitybased costing was applied to calculate the cost of in-person training for undergraduate nursing students, and to evaluate the adjustable cost in virtual education. Methods: It was a descriptive-applied research using cross-sectional economic analysis based on activity-based costing system. The statistical population included undergraduate nursing students in Lamerd, Iran. Data analysis was performed using the data obtained from a 4-year undergraduate program (2012 to 2016). The data were compiled in three categories, namely educational costs, support costs and cultural-welfare expenditure. The acquired data in face-to-face education were considered as the reference for comparison. Furthermore, the adjustable costs for the alternative e-learning approach were measured. Results: The total training cost at Lamerd Nursing School during the four-year study program stood at US$382,761. The per capita cost in this period was equal to US$13,693. It was measured at US$8,659 for educational activities, US$3,933 for support, and US$1,077 for welfare. Therefore, the highest per capita cost was in the area of education and the lowest cost was attributed to welfare. Furthermore, the curriculum cost in face-to-face training was calculated to be US$664. Finally, it was found that virtual education would reduce the total cost by US$156,199. Conclusion: Activity-based costing system is a new model that helps restructure the financial systems of universities. It enables the senior management in these institutions to make informed decisions on adjusting educational activities based on the information acquired. One of these decisions involves comparing the cost-effectiveness of in-person paramedical training with that of virtual training. This is especially important in adopting modern educational models.

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

Background and aims: Leishmaniasis is one of the most overlooked diseases in tropical areas, which can lead to many deaths and illnesses. The present study was designed to determine the trend of cutaneous leishmaniasis in the south of Fars Province (south of Iran) during 2007-2016. Methods: The population of this cross-sectional study consisted of all people with cutaneous leishmaniasis referring to the Center for Infectious Diseases in Larestan, Gerash, Evaz, and Khonj in the south of Fars Province during 2007-2016. The incidence of cutaneous leishmaniasis was analyzed using the Cochrane-Armitage trend test, and the significance level was considered 5%. Results: In general, 4602 cases of cutaneous leishmaniasis were reported from 2007 to 2016. The highest and lowest incidence rates (659.1 versus 88. 3 per 100000 people) were observed in 2008 and 2012, respectively. In addition, the incidence of the disease significantly reduced (P Trend=0.003). Finally, the 0-4 age group had the highest incidence of the disease (69.64 per 100000 people), and the hands were the most common organ affected by cutaneous leishmaniasis (37%). Conclusion: According to the research findings, the incidence rate of cutaneous leishmaniasis is declining although leishmaniasis is still one of the endemic diseases in the region. Therefore, preventive and controlling interventional programs can be effective in reducing new cases of the disease, including the education of individuals, especially children, environmental cleanup, and extermination and control of stray dogs and rodents in the suburbs.

Background: In December 2019, a series of pneumonia cases of unknown cause appeared in Wuhan, China, which was very similar to viral pneumonia. In late January 2020, the World Health Organization named this disease the sixth public health emergency of international concern due to an increase in the number of COVD-19 cases. This study was designed to determine different epidemiological and clinical aspects of COVID-19 worldwide. Methods: This is a review study. We searched for articles related to COVID-19 from December 20, 2019 to June 05, 2020. Two researchers performed the search separately, and finally articles containing information on coronavirus, its mortality and epidemiology and clinical characteristics of the patients were selected for review and extraction. Results: The results of various studies show that the most common symptoms of the disease include fever, cough and fatigue, and the most common respiratory symptom is Rhinorrhoea. Transmission occurs primarily when an infected person sneezes or coughs through respiratory droplets, such as the spread of influenza and other respiratory pathogens. Some studies have reported that the COVID-19 incubation period is an average of 4.6 days, ranging from 1.2 to 11.1 days and can potentially be asymptomatic. Conclusion: The significant increases in the morbidity and mortality necessitate prevention and control activities by educating people on important health issues such as staying at home, using clean masks and gloves, as well as performing proper and timely medical interventions.

Background: Suicide is a multi-factorial phenomenon whose patterns can vary even from one place to another in one country; the purpose of this study was to determine the causes of suicide attempt in a 6-year period in Larestan County in the period between 2012 and 2017. Methods: The present study was a descriptive-analytic cross-sectional study. In order to investigate the epidemiological condition of suicide attempters in Larestan, all files of suicide cases registered in the period between 2012 and 2017 in this city were investigated, and finally 723 cases were included in the study. For statistical analysis, independent t-test, chi-square and logistic regression models were used. A significance level of 5% was considered. Results: Of the total 723 suicide attempts recorded in the health network of Larestan, the mean age at suicide attempt was 26.08 ± 7.88 years and 3.73% of them had died as a result of suicide attempt. Drug abuse and poisoning were the most common methods of suicidal attempt. Based on the regression model, Increase in age, male sex, and physical problems were the most important factors in predicting suicide death (PConclusion: Various factors including age, male gender and physical problems contribute to suicide and deaths associated with it; therefore, the implementation of educational and counseling programs for these individuals, especially in adolescence and youth, and people with physical and psychological problems is essential.

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

Utilizing the scores obtained from a teacher entrance test used in an English language institute as a means of selection, the researchers selected 100 out of 121 female teacher candidates to participate in this study. Furthermore, a reading, writing, and listening test was administered to the candidates to exclude those candidates with low and high proficiency. Based on the results obtained from the tests, the number of participants decreased to 30 and they were requested to come in for oral interviews; they were those who were interviewed twice by two different groups of male and female raters. The results analyzed through correlational analysis and descriptive statistics indicated that the interview scores of the teacher candidates, as measured by the first group of female raters () was in high correlation with those in class performance (p ). However, there was no correlation both between the interview scores of the female teacher candidates (), assessed by the male raters and their in class performance (p ) and the () - () pair. It can be concluded that rater bias might have had an effect on the Iranian female teacher candidate's test scores. The subjects were also divided into attractive and unattractive groups and further assessed by the fourth and fifth group of female and male raters to indicate whether female sex appeal affects the test scores or not. The results showed that the mean differences between the AF-AM (attractive female-attractive male) pairs were significant although the mean differences between the NAF-NAM (nonattractive female-non-attractive male) (P=.05, t=1.131) were not significant.

Objective: Fars province in south Iran is an endemic focus of Leishmaniosis. This study was designed to evaluate the epidemiological status of cutaneous Leishmaniasis in Fars province, South Iran, from 2007 to 2016. Methods: This study was a retrospective-analytical cross-sectional study. The study population consisted of all people with Leishmaniasis, who referred to the infectious disease center in four cities of Larestan, south Fars province, from 2007 to 2016. Chi-square test and ANOVA were used in data analysis. The significance level was considered as 5%. Results: In the period 2007-2016, 4599 cases of cutaneous Leishmaniosis were registered. The highest number of cases occurred in 2008. The mean age in 2007 and 2016 was 17.7±17.1 and 12.9±16.5, respectively. Women were the majority of cases, from 2007 to 2012. Hand ulcers were the most prevalent part of the body in all these years, except 2016. In terms of seasonal distribution, most of the cases occurred in winter and the least in summer. Afghan and Pakistani immigrants produced the majority of cases. Conclusion: The trend of cutaneous Leishmaniosis has declined in Larestan city from 2007 to 2016. However, Leishmaniosis is still a major public health problem. Since the majority of cases were related to Afghan and Pakistani immigrants, it is necessary to ward off these people

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

Today, teaching Language for Medical Purposes (LMP) in higher education is a highly demanding conception of language pedagogy. LMP teaching and learning in real-life-like situations have plausible implications for using language in real-life healthcare settings. LMP skills can be considered a bridge between the instructional-learning context of medical higher education and therapeutic fields, enabling the students to keep their knowledge of tackling the emerging needs up to date (1). Parallel with the application of educational technology in medical higher education, the stakeholders’ interest in synthesizing the games is now revolving around the application of Science, Technology, Engineering, Art, and Mathematics (STEAM) approach; in the light of this, LMP learning is not a vicarious experience (2). Games have long been recognized as a vehicle for both language learning and therapy; however, the makeup of the new generations of games as educational-therapeutic LMP activities still resembles their prototypes. The novelty, driven in part by a host of educational technology and simulation tools, has made it easier than ever to introduce the games into LMP education.

Introduction: Emotional intelligence is a social skill thatcontrols stress and affects one’s ability to cope with the demandsand environmental pressures; it so can improve professionalcompetence in health care providers such as nursing students.Training on emotional intelligence increases the mental healthand influences the mutual relationships, stress, depression andaggression. This study aimed to determine the effect of emotionalintelligence skills training program on the stress and academicsuccess of nursing students in a higher education health complex.Methods: This study is a quasi-experimental study with aneducational intervention. The participants included 100 studentsof nursing selected by stratified random sampling from bothgenders. They were randomly categorized into two interventionand control groups including 50 subjects, respectively. We usedMeyer and Salvia model in Emotional Intelligence training in theintervention group. During the training sessions in the interventiongroup, the control group did not receive any intervention. Academicstress and professional competence in both groups were measuredbefore and two weeks after the experiment. SPSS version 21 wasused to analyze the data, using Paired t-test, independent t-test,Wilcoxon, Mann-Whitney and Chi-Square tests. Results: The mean age of the participants was 20±2.14 yearsold. According to the results, the mean difference of the changesin the professional competence (p(presponse (presponse (pcompared with the control group, showed no significant effect onthe other factors of academic stress such as frustration, conflict,academic pressure, changes and self-imposed stress.Conclusion: The education of emotional intelligence componentscan improve the efficiency of nursing care services and professionalcompetence due to deceased stress.

Background: Malaria is one of the major human health problems that have become increasingly important in recent decades. Objective: The present study aimed to identify the epidemiological status of malaria in the years 2006–2018 in the southern region of Fars province in southern Iran. Methods: This is a cross-sectional descriptive-analytical study. The study population consisted of all persons with malaria referred to the Center for Disease Control in the four cities of Larestan, Gerash, Evaz and Khonj in the south of Fars province, Southern Iran, between 2006 and 2018. Frequency (%) was used to report descriptive statistics and mean and standard deviation for quantitative variables. The trend of malaria incidence during these years was analyzed using the Cochran Armitage Test. The significance level was considered 5%. Findings: A total of 190 cases of malaria in the period of 2006 to 2018 occurred in the southern region of Fars province; 77.9% were men, more than 95% were Afghans, and most of them were workers. The incidence of malaria in one hundred thousand people per month showed that most of the new malaria cases were in the months of July to October. The peak incidence was in August, with 19.88 cases per 100,000 people. Cochran-Armitage test results showed that this trend was not statistically significant (P = 0.399), despite an almost upward trend in malaria incidence in the south of Fars province. Conclusion: The results of this study showed that the trend of malaria in the south of Fars province was ascending; therefore, increasing surveillance activities to prevent and control malaria in such area is of utmost importance.

This study aimed at investigating the applicability of teaching lexical bundles to the writing performance of medical students in an EFL context. Four components of the writing proficiency, namely Task Response (TR), Lexical Resource (LR), Grammatical Range and Accuracy (GRA) and Cohesion & Coherence (CC), were investigated with regard to the effect of teaching lexical bundles. Thirty medical students in the preclinical stage at Shiraz University of Medical Sciences participated and the study was performed through a two-phase procedure. In the first phase, paragraph and essay writing principles were taught after a pretest. The posttest was administered following the treatment. Data were analyzed through T test. The results of the first phase indicated that all components except GRA changed significantly. In the second phase, the students were introduced and exposed to four-word lexical bundles extracted from the medical corpus. Having access to the corpus analysis software, the students could explore the corpus and learn the lexical bundles contextually. They were also given the list of lexical bundles for explicit exposure and were guided to use them appropriately in their writing assignments. The essays assigned following the lexical bundle teaching were regarded as the posttest of the second phase while the posttest of the first phase was regarded as the pretest of the second phase. Data analysis revealed that LR changed significantly and the students were able to benefit from lexical bundles to improve their LR that enabled them to write more naturally and use collocations more appropriately. Students, writing instructors, syllabus designers, and material developers can best benefit from the findings of the present study.

Background: Nowadays, suicidal attempts of adolescents, which are done with different methods, have caused a great concern in communities. Thus, this study aimed at surveying the reasons of suicidal attempts leading to hospitalization. Methods: This was a case-control study conducted on 300 adolescents during 1 year. In this study, 150 adolescents younger than 18 years, who were hospitalized due to suicidal attempt and referred to Nemazi hospital, were selected. After the primary measures were done and the patients gained consciousness, they were asked to fill out a questionnaire on the factors affecting suicidal attempt. Another questionnaire containing similar questions was filled out by 150 age-matched adolescents, as the control group, who referred to Nemazi hospital for problems other than suicide. The patients with chronic or advanced disease were excluded. Data were analyzed in SPSS, Version 17, using t test, chi-square, and logistic regression tests. In this study, the role of religion and beliefs in suicidal attempts was investigated. Results: Comparison of the 2 groups revealed a significant relationship between suicidal attempt and factors such as sex (P value < 0.001), educational level (P value < 0.001), fathers’ addiction (P value < 0.001), and history of imprisonment (P value < 0.001), history of suicide in the friends and relatives (P value < 0.001), maternal marital status (P value < 0.02), religious beliefs (P value < 0.001), depression in parents (P value < 0.01) and in adolescents (< 0.001), place of living (P value < 0.001), and neonatal diseases (P value < 0.017). Odds ratio of factors with significant P values were as follows: Male gender: 4.7, history of imprisonment of the father: 2.86, history of addiction in the father and mother: 1.27 and 1.26, history of neonatal disease: 1.99, remarriage of the father and mother: 2.7 and 4.35, history of depression: 2.52, place of living: 2.02, and lack of belief in Islam decree about suicide: 1.85, and lack of religious belief: 3. 18. Conclusions: According to the results, special attention should be paid to family grounds. In this respect, the role of parents and instructors is highly important. Moreover, the preventive role of religion, especially Islam, in preventing suicide is essential.

Background: Among manuscripts submitted to biomedical journals, randomized controlled trials (RCTs) form the backbone of evidence-based medicine. Hence, their protocol should be designed rigorously and their results should be reported clearly. To improve the quality of RCT reporting, researchers developed the CONSORT Statement in 1996 and updated it in 2010. This study was designed to assess the quality of RCT reporting vis-à-vis adherence to CONSORT among articles published in Iranian medical journals (English, Persian, CONSORT-endorsing, and non-CONSORT-endorsing). Methods: In this cross-sectional study, all RCTs published in all Iranian medical journals from September 2012 to September 2013 were retrieved to evaluate their adherence to CONSORT. The journals’ instructions for authors were also reviewed to find out whether or not they endorsed CONSORT. The CONSORT 2010 Checklist was used. Microsoft Excel 2007 was applied to analyze the data, and MedCalc was employed to compare the groups. Results: Totally, 492 pharmacological RCTs that met our inclusion criteria were identified. Twenty-five items were reported in fewer than 50% of the articles. The differences between the articles published in Persian and English language journals were statistically significant in 17 items. The differences between the articles published in the CONSORT-endorsing and non-CONSORT-endorsing journals were significant in 8 items. Conclusion: Our findings showed very weak adherence to CONSORT. Authors, reviewers, and editors should be trained to use standards expressed by the CONSORT Group in reporting RCTs.

The demanding task of language learning necessitates great efforts on the part of the learners. In the process of learning, some learners are overawed by language anxiety via setting some unreasonable standards. Different factors influence a learner’s anxiety one of which is educational level of the learner. In this respect, this study sought to investigate the effects of educational level on learner anxiety. To this end, both learner’s educational qualifications and parents’ qualification were considered and their influences were measured on the learner anxiety. 150 students were involved who attended some language institutes in Shiraz, Iran. The participants were asked to fill in the Foreign Language Classroom Anxiety questionnaire. The statistical analysis applied in this study was Multivariate of Analysis (MANOVA) and the pertinent data were analyzed using SPSS version 22. It came to light that participants with different levels of education and different mother’s educational levels did not differ in their anxiety level. In other words, neither learner education nor his or her parents’ education had any significant effects on the learner anxiety. Delving into factors which may hamper successful language learning is not only worthwhile but also promising and learner anxiety is one of them.

Introduction: Non-verbal communication skills, also called sign language or silent language, include all behaviors performed in the presence of others or perceived either consciously or unconsciously. The main aim of this review article was to determine the effect of the teachers’ non-verbal communication on success in teaching using the findings of the studies conducted on the relationship between quality of teaching and the teachers’ use of non-verbal communication and also its impact on success in teaching. Methods: Considering the research method, i.e. a review article, we searched for all articles in this field using key words such as success in teaching, verbal communication and non-verbal communication. In this study, we did not encode the articles. Results: The results of this revealed that there was a strong relationship among the quality, amount and the method of using non-verbal communication by teachers while teaching. Based on the findings of the studies reviewed, it was found that the more the teachers used verbal and non-verbal communication, the more efficacious their education and the students’ academic progress were. Under non-verbal communication, some other patterns were used. For example, emotive, team work, supportive, imaginative, purposive, and balanced communication using speech, body, and pictures all have been effective in students’ learning and academic success. The teachers’ attention to the students’ non-verbal reactions and arranging the syllabus considering the students’ mood and readiness have been emphasized in the studies reviewed. Conclusion: It was concluded that if this skill is practiced by teachers, it will have a positive and profound effect on the students’ mood. Non-verbal communication is highly reliable in the communication process, so if the recipient of a message is between two contradictory verbal and nonverbal messages, logic dictates that we push him toward the non-verbal message and ask him to pay more attention to non-verbal than verbal messages because non-verbal cues frequently reveal the intention of the sender of the information and reflect his/her emotional reactions. Based on the obtained results of this study, it is recommended that attention to non-verbal communication skills can make a positive change in the future of a student’s life. It seems necessary for the teachers to practice and learn effective communication skills, especially for those who always interact with a large group of students. One of the factors contributing to the success Moror failure of students is the quality of the relationship and how the teacher builds this relationship with students. Especially, it is more effective for students who are more responsive to human relations and communication skills. Finally, it is recommended that the teachers should improve their communication skills to have better communication with their audience. The authorities are recommended to help improve the teachers’ level of communication skills through holding training courses.

Introduction: One of the aims of the family physician program (FPP) is to improve the maternal and child health indicators. this study aimed to comparison maternal and child health indicators in Shiraz rural areas before and after implementation of FPP during 2001 to 2012. Methods: This applicable study was conducted in Shiraz in the south west of Iran in 2014. The child and maternal health indicators before (2001 to 2005) and after FPP (from 2006 to 2012) were gathered from the Health Center (Enghelab and Shohadaye Valfajr). The instrument for data collection was a questionnaire consisted of 20 maternal and child health indicators. Descriptive statistics was used and for analyzing the data, Excel and Stata software and comparisons of rates and joint point regression tests were employed. Results: the results showed that The FPP lead to decrease in stillbirth, infant mortality and child under one-year mortality in the rural area. Also all the vital horoscope indicator (mortality under one month, mortality under one year, the frequency of the infants under one year, the percentage of stillbirths, crude death percentage, crude birth percentage, general fertility percentage, total fertility percentage) have improved after FPP in Health Center rather than Enghelab Health Center . Conclusion: the maternal and child health indicators had improvement after FPP implementation. Therefore, it is recommended to continue the program.

Appeal towards training translators as a sector in translation studies has had a dramatic increase throughout the past decade due to the needs for intercultural communication. Consequently, translator training institutes have multiplied and translation scholars’ concern for providing a sound educational basis is realizable. Having reviewed the several translation competences models proposed by translation scholars, it seems that the EMT (European Master’s in Translation) framework is known as the most successful. However, due to the criticisms of the EMT model encompassing the exclusion of the professional translators’ views and their real-world needs in the market, the present study seeks to report the professional translators’ insights on the compatibility of this framework with their needs. This study adopted a descriptive-survey approach using stratified sampling technique. The instrument for this study included a five-point likert-scale translation competences questionnaire. The participants of this study were selected through a list of the professional translators of Proz.com (the selection criteria was having more than five years of experience). A total number of 700 questionnaires were randomly distributed among which 456 respondents replied through the Limesurvey website. The findings revealed that the “language competence”, “thematic competence” and “intercultural competence” were the three highest ranks in the category followed by the “Translation service provision competence”, “Information mining competence” and “Technological competence”. Focusing on the most compatible competences, the educational systems for translator training can establish a link between educating the future translators and the perceived needs in the translation market. University training should concentrate on training the students who acquire a high level of linguistic competence, knowledge of the subject matter, and the cultural knowledge of both source and target language.

With respect to the prominence attached to motivation and its significant effect on learning in general and language learning in particular, the present study aimed at identifying the motivating factors affecting Iranian medical ESP learners using a checklist, interview, and questionnaire. To this end, ten students were interviewed from two different majors: nursing and medicine. A questionnaire with 30 items was developed using the responses from the interviews and distributed among one hundred and six ESP medical and nursing students. The results suggested that the students who studied medicinewere more motivated compared to those who studied nursing. Based on the results of the factor analysis, the medical school students found “Teacher characteristics & teaching material”; “Immigration & personal aspirations”; and “Instrumental motivation” motivating while “Intrinsic/integrative motivation” and “Learning environment” were motivating for the nursing school students. Further investigations using two-way-within-between subjects ANOVAs, and one way ANOVAs revealed that students of medicine had a higher level of motivation, but their opinion regarding the factors they found motivating did not differ much from those studying nursing.

This study aimed to investigate the effectiveness of Computer Assisted Language Learning (CALL) on Iranian EFL learners’ vocabulary learning. Furthermore, this study was an attempt to explore if there is any difference between the impact of CALL instruction on Iranian male and female EFL learners’ vocabulary learning. Therefore, 50 homogeneous male and female participants were selected. The instruments were the Quick Placement Test of Oxford University Press and University of Cambridge Local Examinations Syndicate, version 1 (2001) and two vocabulary achievement tests were administered as pre- and post-test. After the homogeneity test was employed, a pre-test was administered to participants of both groups. The experimental group underwent 12 sessions in six weeks of instruction using CALL. Finally, a post-test was given to both groups. Descriptive statistics, independents samples t-test, and paired samples t-test were run to find the effect of CALL instruction on Iranian EFL learners’ vocabulary learning. The results of paired samples t-test between pre-test and post-test of both groups of the study showed that the experimental group outperformed the control group. The results also indicated that there was no significant difference between male and female learners’ vocabulary learning using CALL instruction.

INTRODUCTION: Health-care workers in community service professions are the formerly candidate for occupation burnout. This study aimed to investigate the relationship between empowerment and job burnout among auxiliary health workers (behvarzan) at Fasa University of Medical Sciences. MATERIALS And METHODS: In this descriptive-analytical study, 120 auxiliary health workers were enrolled using the census. Spritzer's psychological empowerment and Maslach burnout inventory questionnaires were used to collect the data. Then, they were analyzed through the SPSS software, using descriptive analytical tests. RESULTS: The findings of this study revealed that the auxiliary health workers' empowerment was in the range of 22–75 with a mean ± standard deviation [SD] of 48.5 ± 9.71, which is in a fairly high level considering the highest score (75) in this scale. Moreover, with respect to burnout (mean ± SD of 58.03 ± 18.64), 36 participants (30%) had low level of burnout, 69 subjects (57.5%) were at the intermediate level, and 15 (12.5%) suffered high levels of job burnout. According to the results of this study, there were a high correlation and negative relationship (r = 0.406, P > 0.001) between psychological empowerment and job burnout among the auxiliary health workers. On the other hand, all empowerment components (competence, autonomy or independence, effectiveness, and trust) had a reverse and significant association with burnout. CONCLUSION: Based on the results of this study, the auxiliary health workers (behvarzan) were in a good range of empowerment; also, the dimensions of empowerment were correlated with job burnout in Fasa university-affiliated hospitals' health workers. On the other hand, demographic features had no association with these two factors. It is suggested that health authorities should take measures to empower the workers and identify and remove the effects of the various dimensions of job burnout among the health workers in these hospitals.

BACKGROUND: Given the relationship between positivity interventions and psychological problems, this study aimed to investigate the effect of positive thinking training on stress, anxiety, depression, and quality of life of hemodialysis patients. MATERIALS AND METHODS: This is a quasi-experimental and interventional study conducted on 70 hemodialysis patients referred to Fasa hemodialysis centers, Iran, between April 2019 and October 2019. Patients were selected using a simple sampling method and randomly divided into control (n = 35) and intervention (n = 35) groups. The intervention group was trained on positive thinking skills in eight sessions of a workshop. Before and after the intervention, stress, anxiety, depression, and quality of life in both the groups were measured using the Depression, Anxiety, and Stress Scale-21 and Short Form-36 Questionnaire. Data were analyzed using paired t-test, independent t-test, Kolmogorov–Smirnov, and Chi-square tests. RESULTS: There was no significant difference in the mean scores of stress, anxiety, depression, and quality of life in the two groups before the intervention.(P > 0.05), and in the control group, there was no statistically significant difference before and after the intervention (P = 0.092, P = 0.228, 0.280, respectively). In the intervention group, the mean score of stress and anxiety decreased from 23.65 ± 4.12 to 16.68 ± 4.41 (P < 0.001) and from 17.77 ± 5.15 to 14.57 ± 4.18 (P = 0.002), respectively, and that of the patients' quality of life also increased from 35.19 ± 10.07 to 55.98 ± 11.71 (P < 0.001). However, the mean score of depression did not change significantly after the intervention (P = 0.689). CONCLUSION: According to the results of this study, the use of positive thinking intervention programs with other methods for hemodialysis patients' care and treatment is recommended as a nonpharmacological, cost-effective, and uncomplicated method.

Introduction: In e-learning, people get involved in a process and create the content (product) and make it available for virtual learners. The present study was carried out in order to evaluate the first virtual master program in medical education at Shiraz University of Medical Sciences according to P3 Model. Methods: This is an evaluation research study with post single group design used to determine how effective this program was. All students 60 who participated more than one year in this virtual program and 21 experts including teachers and directors participated in this evaluation project. Based on the P3 e-learning model, an evaluation tool with 5-point Likert rating scale was designed and applied to collect the descriptive data. Results: Students reported storyboard and course design as the most desirable element of learning environment (2.30±0.76), but they declared technical support as the less desirable part (1.17±1.23). Conclusion: Presence of such framework in this regard and using it within the format of appropriate tools for evaluation of e-learning in universities and higher education institutes, which present e-learning curricula in the country, may contribute to implementation of the present and future e-learning curricula efficiently and guarantee its implementation in an appropriate way.

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

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