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Abstract Background The rapid growth of technology forced enormous changes in the provision of healthcare services. Different strategies are used to keep nurses up to date with rapid changes in health systems. Microlearning is one of the new methods of teaching professional skills to health workers. This method is effective in care settings that have many limitations in terms of time and place. However, it is very important to test the acceptability of this method among nurses before practical measures are taken for its widespread use. This study aimed to determine nurses’ acceptance rate of quick response code as a microlearning tool in workplace. Method This is a cross-sectional study was conducted in medical and surgical wards in hospitals affiliated to Guilan University of Medical Sciences. 185 nurses participated in the study. A number of selected medical devices were labeled with quick response codes containing educational content. The eligible nurses were instructed how to use the QR codes. After two months, they were asked to complete a questionnaire adapted from the technology acceptance model 3. SPSS 21 software was used to analyze the data. Results 166 nurses and 19 head nurses with mean age of 34.26 ± 8.17 years and mean work experience of 10.46 ± 7.64 years completed the questionnaires. Most participants were female, married, with a bachelor’s degree, worked on rotating shifts, in medical wards. The findings showed that the acceptance of the quick response code as a learning tool was at a moderate level (M = 66.1, SD = 16.6). Statistically, there was no significant relationship between nurses’ demographic characteristics and the total acceptance rate (P > 0.05). However, the analyses at the multivariate level, using multiple linear regression, showed a significant superiority of the total acceptance score in head nurses compared to nurses (b = 7.97, P = 0.047) and in nurses who had previous experience of using quick response codes, compared to colleagues without such experience (b = 5.18, P = 0.036). Based on the coefficient of determination, only 6.1% of the changes in the total acceptance score of quick response codes of nurses are explained by their personal-occupational characteristics (R 2 = 0.061). Conclusions The provision of QR code requirements such as necessary infrastructure and training by the health authorities could increase the acceptance of this tool as a microlearning measure.

Introduction: Esophageal varices (EVs) carry a significant risk of rupture and subsequent life-threatening bleeding. While previous research has investigated the effectiveness of the platelet count to spleen diameter ratio (PC/SD) as a non-invasive predictor of EVs in various populations, this study specifically focuses on the Iranian population to assess the applicability and effectiveness of this parameter in this region. Materials and Methods: Upper gastrointestinal endoscopy was performed on 147 cirrhotic patients to screen for EVs. Biochemical tests and ultrasonography were done to measure spleen diameter (SD) and calculate the PC/SD ratio. ROC analysis was done to determine the predictive performance of the parameters. Results: Among the patients, 73% had EVs. The analysis showed the following: platelet count (PC) had an AUC of 0.695 with 78.7% sensitivity and 56.4% specificity; SD had an AUC of 0.750 with 49.1% sensitivity and 89.7% specificity; and the PC/SD ratio had an AUC of 0.734 with 60.2% sensitivity and 79.5% specificity. The PC/SD ratio exhibited a high positive predictive value of 93% but a low negative predictive value of 41.9%. Optimal cutoff values were determined as follows: PC≤ 100,000, SD< 163, and PC/SD ratio≤ 523. Conclusion: By identifying high-risk patients who may benefit from targeted endoscopic screening, this non-invasive method could contribute to improving overall patient care and reducing the need for invasive procedures. However, due to suboptimal performance results, it is crucial to use this approach with caution, as endoscopic screening remains the standard practice for the diagnosis and management of esophageal varices.

Background: Numerous studies have yielded conflicting results concerning the disparities in verbal (semantic and letter) fluency between monolingual and bilingual individuals. Given the linguistic variations among bilinguals and the influence of cultural differences on language, this study examined verbal fluency in Kurdish and Azari bilinguals and compared it with that of Farsi monolinguals.Methods: This cross-sectional study involved 30 Farsi monolingual students, 28 Kurdish-Farsi bilinguals, and 29 Azari-Farsi bilinguals. The study utilized semantic (fruits and animals) and letter fluency tasks (/f/, /a/, and /s/). Each bilingual participant was instructed to perform the verbal fluency tasks twice: once in their native language and once in Farsi.Results: In both fluency tasks, bilinguals demonstrated superior performance in Farsi compared to their mother languages (Azari and Kurdish) (P

Abstract Introduction There is a relationship between excess body weight and the risk of a number of infectious diseases, including urinary tract infections (UTIs). This study aimed to investigate the correlation between body mass index (BMI) and UTIs among Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study (PGCS) population. Methods This cross‐sectional study was conducted on 10,520 individuals aged 35–70 years from PGCS. The demographical data and clinical characteristics of the participants were recorded. Microscopic examination of the urine samples was performed to detect the presence of bacteria or white blood cells (WBC) as indicators of infection. UTI was defined as the presence of bacteria in the urine (Few, moderate, and many) and a value of ≥10 WBC/high power field (HPF) by light microscopy. Results The prevalence of UTIs in this study was 8.8%, with a higher incidence in females compared to males (12.2% vs. 4.7%, p

Abstract Background Clinical education plays an essential role in shaping the nursing identity and is one of the central elements in the education of nursing students. Today, with the advancement of novel technologies, utilizing mobile phone-based technologies in the education of medical sciences is inevitable. Therefore, this study was conducted with the aim of investigating the impact of the urology educational application on nursing students’ cognitive-functional criteria and satisfaction during the internship period. Methods This experimental educational intervention study was conducted during nursing students’ urology internship course at Shahid Beheshti School of Nursing and Midwifery in Rasht. The data collection tools included a demographic characteristics questionnaire, cognitive skills scale, functional skills scale, and satisfaction scale (Stokes, 2001). The data were analyzed using SPSS software version 16, and a significance level was set at 0.05. Results Out of 48 studied students, 28 (58.3%) were males. The mean age of the students was 20.34 (SD = 1.51) years. In the application group, the mean of students’ cognitive skills after the intervention significantly increased by 2.33 units (95% CI: 1.73 to 2.9) (t(23) = 7.97, P

Objective: This study was conducted to investigate the treatment seeking behavior for COVID-19 symptoms among northern Iranian population and its related factors. Materials and Methods: This hospital-based cross-sectional study was conducted to investigate the treatment seeking behavior for COVID-19 symptoms and its related factors in 602 confirmed COVID-19 cases for a period of 2 months between March and May 2020 in Guilan at the onset of the corona epidemic in Iran. Results: Professional treatment-seeking was observed in 18.6% of patients and most of patient reported home remedies (50.3%) and self-medication (31.1%) as first reaction to COVID-19 symptoms. The most prevalent symptoms of COVID-19 in the study population were anosmia (98.3%) and fever (70.1%). The multivariate logistic regression analyses revealed that patients with breathing difficulties symptom and history of respiratory disease had greater odds professional treatment of seeking respectively (adjusted odds ratio (OR) =1.6, P=0.03, (OR) =3.3, P =0.001). Conclusion: Roughly half of symptomatic COVID-19 patient reported home remedies as first treatment-seeking behaviors and only breathing difficulties symptom and past history of respiratory disease were identified as an independent predictor of professional treatment–seeking. We will certainly face pandemics in the future. However, the world must obviously prepare for future pandemics in light of the lessons learnt from the COVID-19 pandemic. We hope that the results of this study can be a lesson for the future.

Background: Myometrial thickness has been expected to be a prognosticator for lower uterine segment function. Anabnormal function of the uterine muscle layer can cause common and important reproductive problems. This studyaimed to evaluate the relationship between the baseline myometrial thickness and assisted reproductive technologies(ART) outcomes.Materials and Methods: In this prospective cohort study, 453 infertile women undergoing ART cycles without anyobvious uterine pathology, participated in this prospective cohort study from February 2013 to May 2015. In order tomeasure the myometrial thickness in the anterior and posterior of the uterine, trans-vaginal ultrasounds were conducted ondays 2-4 of the cycle (menstrual phase) preceding ovarian stimulation and the day of human chorionic gonadotropin(hCG) injection. We defined three groups based on the baseline myometrial thickness in the anterior and posterior, including(A)

Background Maternal education is often linked to improved awareness. This study aimed to determine the impact of complementary feeding education for mothers using mobile phone applications on the anthropometric indices of Iranian infants. Methods This quasi-experiment study involved 86 eligible women divided into two groups—intervention ( n = 43) and control ( n = 43)—using a multistage sampling method. A researcher-designed questionnaire collected demographic data from parents and infants. Education was delivered through a mobile phone application. Infant anthropometric indices (weight-for-age, length-for-age, and weight-for-length) were measured before and 3 months after the intervention. Statistical analysis included independent t -tests, paired t -tests, chi-square tests (or Cochran–Armitage tests), and analysis of covariance. Results The mean weight-for-age Z -scores of the infants in the intervention group were significantly different before (0.07 ± 0.52) and after the intervention (0.37 ± 0.53) ( p

Abstract Background Novice nurses providing care in acute conditions should have satisfactory performance. Accurate and appropriate evaluation of the performance of novice nurses in providing care in acute situations is essential for planning interventions to improve the quality of patient care. This study was conducted to translate and evaluate the psychometric properties of the Persian version of the Perception to Care in Acute Situations (PCAS-P) scale in novice nurses. Methods In this methodological study, 236 novice nurses were selected by the convenience sampling method. 17-item scale PCAS-P was translated into Persian by the forward-backward process. Then, this version was used for psychometric evaluation. For this purpose, face validity, content validity, and construct validity were assessed using confirmatory factor analysis. Internal consistency and stability reliability were calculated. The data were analyzed using SPSS and AMOS software. Results The PCAS-P scale maintained the meaning of the original English version and was clear, explicit, and understandable for novice nurses. Confirmatory factor analysis showed that this Persian version is consistent with the proposed model and confirmed the fit of the three-factor model. The values of Cronbach’s alpha coefficient, McDonald’s omega, Coefficient H, and average inter-item correlation were excellent for the overall scale and its dimensions, and the three latent factors had good convergent and discriminant validity. Additionally, the average measurement size was 0.944 ICC (95% CI 0.909 to 0.969). Conclusion The PCAS-P scale is valid and reliable for measuring novice nurses’ perception of acute situations.

Abstract Although hematuria is not life-threatening, some could be the result of a more severe condition. Our objectives are to report on the prevalence and risk factors of asymptomatic microscopic hematuria (AMH) in the prospective epidemiological research studies of the Iranian adults (PERSIAN) Guilan cohort study (PGCS) population. This cross-sectional study was conducted from 2014 to 2017 and consisted of 10,520 individuals aged 35–70. Data collection was conducted using a questionnaire during a face-to-face interview. The urine analyses (UA) were done up to 2 h after sample collection. Based on a urine microscopy evaluation, AMH is defined as 3 or more red blood cells per high power field (HPF). Simple and multiple logistic regression analysis was conducted to explore factors associated with AMH. The prevalence of AMH in this study was 34.1% and was more prevalent in participants of older ages and female gender as well as those with low educational level, underweight-body mass index (BMI), high physical activity, smoking, alcohol consumption, and kidney stone disease. On the other hand, obesity, opium, and diabetes decreased the likelihood of AMH. The results of the present study shed light on the prevalence and risk factors of AMH and suggested that a significant portion of the study population is affected by AMH. Considering the lack of consensus on a definite clinical guideline for AMH in our country, the results of the present study could be used to design a unit algorithm for screening and therapy of AMH.

Abstract Background This study aimed to investigate the frequency of colorectal lesions in the first-degree relatives of patients with colorectal lesions among the Prospective Epidemiological Research Studies in Iran (PERSIAN )Guilan Cohort Study (PGCS) population. Methods In this cross-sectional study, 162 first-degree relatives with a history of colorectal lesions were randomly selected from 52 participants in PGCS. All subjects underwent total colonoscopy by a gastroenterologist, and a pathologist evaluated colorectal biopsies. Also, individuals’ demographic information, clinical data, and dietary habits were recorded. Results The mean age of the participants was 56.55 ± 7.04. Of 86 colon polyps, 52 neoplastic and 34 non-neoplastic polyps were observed in 56 patients (34.6%). Individuals with age > 60 years had 3.29-fold increased odds of developing colorectal polyps (OR = 3.29, 95% CI: 1.13–9.56, P = 0.029). The smokers were 2.73 times more susceptible to developing colorectal polyps than non-smokers (OR = 2.73, 95% CI: 1.24–6.02, P = 0.013). Moreover, consumption of vegetables more than three times per day was associated with decreased OR of colorectal polyp development (OR = 0.43, CI: 0.19–0.98, P = 0.045). Conclusions Considering the high prevalence of neoplastic colorectal polyps among the first-degree relatives of patients with colorectal lesions, early screening is recommended for individuals with a family history of colorectal lesions.

Background: Thyroid disorders, particularly hypothyroidism, can affect the movement of the digestive system. The aim of this study was to investigate the association between hypothyroidism and constipation. Methods: In this cross-sectional study that was conducted on the PERSIAN Guilan Cohort Study (PGCS), all individuals between the ages of 35 and 70 years, irrespective of gender, were included. The questionnaires were completed using dedicated online software that included demographic data, clinical characteristics, and nutritional information. Hypothyroidism was defined based on taking levothyroxine medicine as stated by the patient and diagnosis of chronic constipation was based on self-report. Individuals were divided into two groups based on their constipation status and compared with respect to the desired variables. The relationship between hypothyroidism and constipation was examined using logistic regression analysis. Odds ratio (OR) and 95% confidence interval (CI) were calculated. Results: The prevalence of hypothyroidism and constipation were 5.1% and 4.4% respectively, and both were more common in women than in men. In unadjusted model, there was no significant association between hypothyroidism and constipation (OR=1.28, 95% CI: 0.88–1.87, P=0.201). Similar result was obtained in fully adjusted model (OR=1.03, 95% CI: 0.70–1.53, P=0.875). Conclusion: There was no significant association between hypothyroidism and constipation in this study. Since nutrition and the type of fruits and vegetables and the type of substances consumed have an effective role in eliminating constipation, we recommend that these items be considered in future studies.

Background: Cardiovascular care units are among the most crucial departments in any healthcare system. In these units, nurses play the most pivotal roles, and the quality of nursing care is essential; missing certain aspects of care can have irreversible adverse effects on patient health. This qualitative study aims to investigate the factors influencing Missed Nursing Care (MNCs) based on the experiences of nurses and patients in cardiovascular care units. Materials and Methods: This qualitative study utilized the conventional content analysis approach to explore the factors affecting MNCs in cardiovascular care units. Data were collected between December 2021 and September 2022 through in-depth, semi-structured individual interviews with 11 participants selected through purposive sampling. Data analysis followed the five-step method proposed by Graneheim and Lundman. Results: The analysis revealed five main themes: nurse's job characteristics, work–life conflict, nurse's professional competence, the cardiac work environment atmosphere, and organizational management. Conclusions: The findings of this study suggest that authorities should consider factors such as understanding the occupational characteristics of nurses when assigning them to cardiovascular care units, providing solutions to mitigate work–life conflicts for nurses, enhancing nurses' professional competence, improving the working environment for nurses, and enhancing the performance and skills of organizational managers.

Objective: The purpose of this study is to evaluate the association between elevated serum liver enzymes and Metabolic Syndrome (MetS) in Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study (PGCS) population. Methods: This cross-sectional study involved 10,519 individuals between the ages of 35 and 70 enrolled in the PGCS. The gathered data encompassed demographic information, anthropometric measurements, blood pressure, and biochemical indicators. MetS was defined by the National Cholesterol Education Program–Adult Treatment Panel III criteria (NCEP-ATP III). The associations between elevated liver enzymes and MetS were examined using logistic regression analysis. Odds ratio (OR) and 95 % confidence interval (CI) were calculated. Results: The prevalence of MetS was 41.8 %, and the prevalence of elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and alkaline phosphatase (ALP) were 19.4, 4.6, 11.6, and 5.1 %, respectively. In the unadjusted model, elevated ALT, AST, and GGT were associated with increased odds of MetS (OR = 1.55, 95 % CI: 1.41–1.71; OR = 1.29, 95 % CI: 1.07–1.55, and OR = 1.90, 95 % CI: 1.69–2.14, respectively). These associations remained significant for ALT and GGT after adjustment for some demographic and clinical characteristics (aOR = 1.31, 95 % CI: 1.17–1.46 and aOR = 1.30, 95 % CI: 1.14–1.49, respectively). In addition, the odds of MetS increased with the number of elevated liver enzymes, up to almost 1.32-fold among subjects with three/four elevated liver enzymes. Conclusion: The higher incidence of elevated liver enzymes was associated with an increased likelihood of MetS. Including liver markers in diagnosing and predicting MetS holds promise and is considered a possible approach.

Introduction Colonic polyps and diverticulosis are common colon findings on colonoscopy. One of the risk factors of colorectal polyps and diverticulosis is the anthropometric index. Therefore, we aimed to investigate the association between the anthropometric index and colorectal findings.

Abstract Background and objective Observance of preventive behaviors is one of the main ways to break the coronavirus disease 2019 (COVID-19) chain of transmission. Therefore, the present study was conducted to determine the knowledge and behaviors of prevention of COVID-19 and the related factors in the rural population of Rasht city. Methods In this cross-sectional study, 344 people of the population referred to health centers in Rasht city were included through multi-stage cluster random sampling. The data were collected using a three-part researcher-made questionnaire including individual-social factors, knowledge about the prevention of COVID-19, and the preventive behaviors against COVID-19. Data analysis was performed using the Kolmogorov-Smirnov and Shapiro-Wilk tests, Spearman’s correlation coefficient, and multiple logistic regression analysis, by SPSS software version 16 at a significance level

BACKGROUND: Fear of childbirth (FOC) is one of the common reasons for choosing cesarean delivery without medical indications. The present study aimed to assess the effect of childbirth scenario-based educational intervention on FOC in primiparous women. MATERIALS AND METHODS: This study was conducted on 72 primiparous women attending comprehensive health care centers in Qazvin, Iran, in 2021. Participants were randomly placed in the control group (n = 38) and the intervention group (n = 34). The participants in the intervention group read the booklet of childbirth scenarios once a week for eight weeks. Data were collected using the demographic-fertility questionnaire and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) before the intervention, eight weeks after the intervention, and the first week after delivery. Data analysis was carried out using independent t-test, Chi-square, Fisher’s exact, repeated measures analysis of variance (ANOVA), and analysis of covariance (ANCOVA). RESULTS: By controlling the FOC scores before the intervention, the mean total FOC scores eight weeks after the intervention and in the first week after delivery in the intervention group were significantly 34 units (95% CI: 27.3–40.7) and 22.9 units (95% CI: 14.6–31.1) lower than the control group respectively (P < 0.001). CONCLUSION: Based on the results, childbirth scenario-based intervention can effectively reduce FOC among primiparous women. Healthcare providers, especially midwives, can benefit from applying childbirth scenario-based intervention in prenatal care to reduce the FOC of pregnant women.

BACKGROUND: Flatulence is one of the gastrointestinal complaints after a cesarean section (C-section). A host of treatments have been used to reduce this symptom in hospitals, and most of them are based on chemical drugs. It is considered that herbal drugs may have fewer side effects than chemical drugs, and it seems that fennel can reduce flatulence through stimulation of bowel movements. This study compared the efficacy of fennel and dimethicone capsules on the flatulence rate in post-cesarean birth women. MATERIALS AND METHODS: This study was a parallel double-blind randomized controlled trial, conducted in a teaching hospital. Eligible women who underwent a C-section and had the sensation of flatulence were randomly block allocated to the fennel and dimethicone groups (1:1). Each group received drugs every 6 hours for four doses after restarting oral feeding. Flatulence rate was the main variable measured before and one hour after taking each dose by the visual analog scale (VAS). Data were analyzed by statistical tests including repeated-measures analysis of covariance (ANCOVA) based on the intention-to-treat method in Statistical Package for the Social Sciences (SPSS) version 16.0. RESULTS: The dimethicone group showed a significant reduction in flatulence (F (7,245) =198.5, P < 0.001, η2p = 0.850). The same trend was also obtained for the fennel group (F (7,266) =215.0, P < 0.001, η2p = 0.849). However, there was no difference between groups on the flatulence level after adjusting for the baseline level of flatulence (F (1,72) =0.27, P = 0.607, η2p = 0.004). The same result was also obtained one hour after taking capsule 4 (F (1,72) =0.63, P = 0.430, η2p = 0.009). CONCLUSION: Both fennel and dimethicone capsules can reduce flatulence rate after C-section, although there was no significant difference among them.

Introduction: Termination of pregnancy through curettage in the first trimester requires cervical ripening (CR) which can be induced by medicinal or mechanical methods. In the pharmaceutical method, vaginal administration of misoprostol, as well as vaginal trinitroglycerin (TNG), has been shown to induce effective CR. This study was conducted with the aim of comparing vaginal misoprostol and vaginal TNG in the CR of women candidates for the first-trimester curettage. Materials and Methods: This double-blind clinical trial study was conducted on 168 pregnant women with a gestational age of less than 14 weeks who were candidates for curettage. Participants were randomly divided into two groups receiving vaginally either TNG (400 µgr)(n=87) or misoprostol (400 µgr) (n=81). Then, the state of CR and the need for mechanical dilatation were compared between the two groups. Also, the presence of any side effects caused by drug use was determined. Results: The percentage of CR in the misoprostol group (67.9%) was significantly higher than in the TNG group (32.2%) (P0.001). Generally, the rate of complications in the TNG group (35.6%) was significantly higher compared with the misoprostol group (13.6%) (P>0.001). Conclusion: Vaginally Misoprostol is more effective than vaginally TNG on CR of first-trimester curettage as well as it significantly reduces the need for mechanical dilatation of the cervix.

Abstract Background Postpartum hemorrhage, anemia, and iron deficiency are important health problems. Using safe, cheap, and available methods to reduce the amount of hemorrhage after childbirth can be effective for the mother's health during this period. Therefore, this study was conducted to determine the effect of date fruit consumption on the amount of hemorrhage after natural childbirth. Methods This randomized clinical trial was conducted on 98 women referred to the maternity ward of Al-Zahra Hospital in Rasht using the available sampling method. The primary outcome was postpartum hemorrhage, measured using the Pictorial Blood Loss Assessment Chart (PBLAC). Two hours after delivery, 100 g of date fruits were given to the intervention group, and the amount of hemorrhage was recorded during the first 24 h. Comparison between the two groups was done with the Mann–Whitney test with the Hodges–Lehmann estimator and corresponding exact conditional nonparametric confidence interval (CI) as effect estimate. A P

Abstract Introduction Sex education supports the development of suitable sexual behaviors in children. However, due to the limitations of sexual issues in Iran, parents may have different sex education styles. This study aimed to assess the styles of mothers in the sex education process of children and the related factors. Methods In a cross-sectional study, from March to May 2021, 306 mothers with a 4–12-year-old child who were referred to the comprehensive health service centers in Rasht city were entered into the study by a convenience sampling method. The tool was a questionnaire of parents' sex education styles. Data analysis was performed with independent t-tests, one-way ANOVA, Pearson's correlation coefficient, and the multiple linear regression model using SPSS software version 16. Results The majority of the mothers had a mean age of 36.2 ± 6.4 years. The score of the authoritarian sex education style was significantly higher than the other styles (P

Background: One of the necessary features to confront the COVID-19 pandemic is performance and resilience which causes nursing managers to have a wider perspective based on preventing preparation and reaction to the disaster. This study aims to evaluate the nursing perspectives on nursing management during the COVID-19 Pandemic. Materials and Methods: One hundred eighty-nine Iranian nurses working in a Corona Center hospital took part in this cross-sectional study. This hospital is the main center for curing COVID-19 patients in Guilan province, Iran. The data were collected using a questionnaire consisting of demographic features and disaster-managing surveys based on seven engineering approaches in hospitals by enumeration sampling from June to October 2021. Results: Findings showed the Mean±SD score of the nursing managers’ functions was 141.77±26.12 based on resilience approaches during the COVID-19 pandemic, and 73.2% of the participants believed that the managers’ performance during the pandemic was at a medium level. The Mean±SD scores of resilience principles in the nursing managers’ performance with detachment consisted of the commitment of the senior management at 29.34±5.90, the culture of fallibility at 18.34±3.84, the culture of learning at 11.81±2.77, awareness 6.62±1.61, preparation 9.56±4.03, flexibility 48.42±10.31, and transparency 17.35±4.03. There was a great statistical difference between the nursing managers’ performance and the employment type. Conclusion: The nursing managers’ performance level was at a medium level based on the resilience principles during the COVID-19 pandemic. The desirable performance of the nursing managers caused a reduction in burnout, increased job satisfaction, and ultimately reduced the nurses’ taking leaves. Therefore, designing and performing effective interventions to improve the nursing managers’ performance in a disaster is necessary. The trauma caused by COVID-19 has increased the nursing managers’ responsibility to create safe environments and perform the nurses’ protection policy. These activities and strategies can be performed at different levels.

Introduction:Tinnitus can be associated with many auditory and non-auditory factors, and its prevalence varies widely in the literature. There is no large sample of published data on tinnitus prevalence and its associated factors in Iran. Here, we analyzed the PERSIAN Guilan Cohort Study (PGCS) data and reported the prevalence of tinnitus and some of the risk factors related to tinnitus in the Iranian population. Materials and Methods:This cross-sectional study was conducted on 10520 men and women between 35 and 70 years old. The prevalence of tinnitus and associations between tinnitus and age, sex, habitat, marital status, employment status, socioeconomic status, educational level, lifestyle habits, and comorbid diseases were examined using simple and multiple logistic regression analyses.Results:The prevalence of tinnitus was 6.4% in this study. Based on the adjusted analysis, only older age (odds ratio: 2.60, 95% confidence interval: 1.88 – 3.60), residency in a rural area (odds ratio: 1.22, 95% confidence interval: 1.03 – 1.44), cigarette smoking (odds ratio:1.33, 95% confidence interval: 1.04 – 1.72), and having other comorbidities (odds ratio: 2.75, 95% confidence interval: 2.19 – 3.44) were related to tinnitus. In addition, the results of subgroup analyses by sex were mostly consistent with the overall analysis.Conclusions:Our results revealed that the prevalence of tinnitus in the north of Iran is comparable with other communities. Age and other comorbidities were among the most related factors to tinnitus.

Abstract Background Diabetes mellitus (DM) is known as one of the most prevalent non communicable diseases with high cost of health services in the world. Present study was conducted to assess the frequency of high risk people for diabetes mellitus based on American Diabetes Association (ADA) risk score among Iranian people. Methods Present study was a cross sectional study on non-diabetic subjects aged 35–70 years from 10,520 PERSIAN Guilan Cohort Study (PGCS). ADA risk score was calculated for every individual through an online calculator. Receiver operating characteristic (ROC) curves was used to assess diagnostic accuracy of the anthropometric indices to identify individuals with high risk ADA score for developing DM, represented by the area under the curve (AUC). Results From 7989 study subjects, ADA risk score found 3874 (48.5%) and 1912 (23%) at risk for developing PreDM and DM, respectively. The results of ROC curve analyses showed the highest diagnostic value was related to waist circumference (WC) in total population and Waist to Height Ratio in both sex (0.695 total, 0.743 female, 0.744 male). The cut-points of WC in total population to identifying high risk group were 97 cm. Conclusions A considerable number of populations were classified as high ADA risk for developing DM and PreDM that provide the importance of prevention strategies. Present study showed WC and Waist to Height Ratio have the highest diagnostic value to identify high risk people for DM.

Background and objectives: During health crises like COVID-19, people with different health conditions turn to traditional/herbal remedies, which can affect their health status. This study aimed to determine medicinal plant consumption and its association with health literacy during the COVID-19 pandemic in Iran. Methods: This web-based cross-sectional study involved 1242 Iranians aged 18 to 65. Data were collected using the Iranian Health Literacy Questionnaire (IHLQ), COVID-19-related variables, and a socio-demographic information questionnaire, analyzed by simple and multiple logistic regression analyses using SPSS 16.0. Results: It was found that 51.4% (n=638) of participants had used medicinal plants and herbal products, with a mean Health Literacy (HL) score of 76.16. Thyme (50.6%), ginger (34.9%), and cinnamon (24.4%) were the most commonly used plants; the most popular methods were infusion (78.3%) and decoction (32.2%). According to the adjusted analysis, the use of medicinal plants was significantly associated with being older (odds ratio (OR)=1.85, 95% confidence interval (CI):1.14-3.00), having contact with suspected/confirmed COVID-19 cases (OR=1.94, 95% CI:1.39-2.71), and having family members, friends, and/or relatives infected with COVID-19 (OR=1.37, 95% CI:1.00-1.88). Also, people who consulted with a physician or pharmacist before using medicinal plants had statistically higher mean HL scores than those who did not (p

Objectives: Premature infants in the neonatal intensive care unit (NICU) are exposed to environmental risks that may cause developmental problems i. The present study aimed to investigate the predictive effect of individual and environmental factors on the motor performance of low birth weight preterm infants. Methods: This cross-sectional study was performed in the neonatal clinic of Shahid Akbarabadi Hospital in Tehran City, Iran. A group of 90 low birth weight infants were enrolled in the study by non-probabilistic method and according to the inclusion criteria. Test of infant motor performance (TIMP), sensory profile2 (infant section), affordance in the home environment for motor development (AHEMD), and a demographic questionnaire were used to evaluate motor performance, sensory status, home environment, and other factors (birth weight, corrected age, parent’s education, etc.), respectively. Results: TIMP elicited score was positively correlated with the infant’s age (r=0.390, P

Introduction: This systematic review and meta-analysis aimed to summarize the evidence regarding the impact of needle direction and distance of arteriovenous fistula (AVF) cannulation on KT/V (where k is the dialyzer urea clearance, t, the duration of dialysis, and V, the volume of distribution of urea) and access recirculation (AR) as hemodialysis (HD) adequacy criteria. Methods: A comprehensive systematic search was performed on international and domestic electronic databases from the earliest to June 4, 2022 using keywords. Analysis was performed in STATA software v.14. Results: Three randomized control trials (RCTs) and four non-RCT articles were included in the final review. Six studies reported the effects of direction, while four mentioned the effects of distances of AVF cannulation on outcomes of HD adequacy based on KT/V or AR. Results of three non-RCT studies showed that retrograde direction decreased KT/V more than antegrade direction (ES: 0.44, 95% CI: -0.38 to 1.27). Two non-RCT studies showed that antegrade decreased AR compared to the retrograde direction (ES: -0.64, 95%CI: -1.94 to 0.67). However, the results of two RCTs indicated uncertainty about this issue. Two of the four studies suggested that a distance of 5 cm or more in arterial and venous needles had greater adequacy than a distance of less than 5 cm. However, other studies did not confirm this finding. Conclusion: Overall comparison of the results qualitatively and quantitatively indicated uncertainty about the effects of direction and distance of AVF cannulation on HD adequacy outcomes. More studies with high-quality designs, such as RCTs, are required to better understand and adjudicate the effects of needle direction and distance of AVF cannulation on HD adequacy outcomes.

Abstract Background Based on previous studies, it has been hypothesized that tube sterilization may be associated with a lower risk of breast cancer. This study aims to investigate the relationship between tubal ligation and the risk of breast cancer through a systematic review and meta-analysis. Methods In this systematic review and meta-analysis, PubMed/Medline, Web of Science, Scopus, and Google Scholar were searched for relevant non randomized studies published up to November 2020. Then, we screened the papers to include the eligible papers in the meta-analysis. Finally, we pooled the extracted results of individual studies to estimate the summary effect size. All analyses were done using Stata software version 13 (Stata Corp, College Station, TX). Results Four hundred sixty-four papers were retrieved from PubMed/Medline (160), Scopus (165), and Web of Science (139), and 21 papers from Google Scholar and manual search of references in selected full texts. After the removal of duplicates and screening of the papers, 11 articles (6 cohort and 5 case-control study) were included in the final analysis. The results of cohort (RR = 0.99, 95% CI = 0.97–1.0, I 2 = 21.1%) and case control studies (OR = 0.87, 95% CI = 0.62–1.12, I 2 = 88.9%) revealed that tubal ligation was not significantly associated with breast cancer risk. Conclusion According to our findings, tubal ligation cannot be considered as a risk factor associated with breast cancer risk.

Background and purpose: The spread of COVID-19 can cause anxiety and depression and lead to adverse outcomes in perinatal period. This study aimed to evaluate anxiety and depression symptoms and associated factors in pregnant and breast feeding women during the COVID-19 pandemic. Materials and methods: This cross-sectional study included 450 pregnant and breast feeding women in Rasht, Iran during the second and third wave of COVID-19 (June-November 2020). Data were collected using convenience and multi-stage sampling in a teaching hospital and six healthcare centers. Anxiety and depression were evaluated by Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9, respectively. Descriptive statistics and analytical statistics, including independent t-test, Chi-square test, and logistic regression were used to analyze the data. Results: Generalized anxiety was seen in 16.9% of pregnant women and 10.7% of breast feeding women (P=0.057). Expectant mothers were 6.64 times more likely to have depressive symptoms compared with breast feeding women (ORAdj=6.64, 95% CI: 2.08-21.15). Comorbid anxiety-depressive symptoms were higher in pregnant women than breast feeding women (6.2% vs. 0.9%, P=0.002). Anxiety was found to be significantly associated with an unemployed husband, having chronic diseases, thinking about COVID-19, and high-risk individuals in the family (P

This study aimed to evaluate the clinical features of COVID-19 patients diagnosed with acute coronary syndrome (ACS). After obtaining patients’ demographic and clinical data, ECG and transthoracic echocardiography were performed for all 228 patients. On average, patients aged 63.23 years. The most common underlying disease was hypertension (59.2%). The most common ECG abnormalities in COVID-19 patients with ACS were ST-T changes and pathological Q wave, and 12.3% experienced atrial fibrillation. According to the Multiple logistic regression analysis, a significant relationship between on admission tachycardia and left ventricular ejection fraction with in-hospital mortality was found (OR = 24.06, 95% CI: 4.63–125.11, OR = 0.92, 95% CI: 0.087–0.98).

Abstract Objectives Limited studies were found to investigate the occupational performance of autistic children and their parents’ quality of life. Therefore, this study aimed to investigate occupational performance of children with Autism Spectrum Disorder (ASD) and QoL of their mothers. Results In this study, 88 participants were selected from autism centers in Arak, Iran, 2020. The Canadian Occupational Performance Measure (COPM) and the parent version of Quality of Life in Autism Questionnaire (QoLA-P) were used to assess the occupational performance of ASD children and their mothers QoL. QoLA-P consists of parts A which is related to the quality of life and part-B related to the problems that these children have and are related to the parents or their caregivers. Regarding occupational performance, the first priority of mothers is self-care with frequency 64.8%. The finding suggested a significant correlation between total function score of COPM and the score of part-A (r = 0.227, p = 0.033) of QoLA-P. Also, the results revealed a significant correlation between the total satisfaction score of COPM and the score of part-A (r = 0.236, p = 0.026) and part-B of QoLA-P questionnaire (r = 0.231, p = 0.030). The mothers’ first priority is self-care and, the total satisfaction and function score of COPM showed a significant correlation with mothers’ QoL.

Background: Coping strategies to minimize the psychological impact of diseases and epidemics on the medical staff is essential. This study aims to investigate the psychological impacts of COVID-19 and the coping strategies of frontline medical staff in the fight against this disease. Methods: This analytical cross-sectional study was conducted in 2020 in Rasht, Iran 0.248 Medical Staff participated through convenience sampling and an online questionnaire. The questionnaires included two sections: Demographic characteristics and Coping strategies and the emotional impacts consisting of five dimensions and 67 questions (Scores 0–3). The two-sample t-test was used to compare the responses between gender, age, and Medical staff groups. Data were analyzed using SPSS software version 16. Results: The most critical item for the staff in the ‘emotion’ dimension was expecting a decrease in their relationship with the individuals who were not exposed to the disease (p

Objectives: COVID-19 pandemic and its consequences highlighted the importance of using telerehabilitation systems and affected the professional’s attitude toward it. This study aimed to investigate the feasibility, satisfaction, and attitude of rehabilitation professionals toward telerehabilitation during the COVID-19 pandemic in Iran. Methods: A web-based cross-sectional study was conducted to assess the feasibility, satisfaction, and attitude of rehabilitation professionals toward virtual training and telerehabilitation during the COVID-19 pandemic. A total of 118 occupational therapists, speech therapists, audiologists, psychologists, and educators completed the study questionnaires. Results: The findings indicate that the correlations among satisfaction, feasibility, advantages, and compatibility were significant (r ranging from 0.418 to 0.717). There were significant but weak positive correlations between years of working experience and scores of feasibility and advantages. In addition, the mean scores of feasibility, advantages, compatibility, and complexity in participants who provided telerehabilitation before the COVID-19 pandemic were higher than other respondents. Discussion: Because of the positive role of telerehabilitation in a situation such as the COVID-19 pandemic, health care systems should create mechanisms for its optimal use, protocol preparation, health professionals training, and infrastructure acquisition.

Objectives: Phonemic and semantic fluency tasks are used for verbal fluency (VF) evaluation. The present study aimed to select the most appropriate semantic categories and the most frequent phonemes of Persian as items for the VF test. Then, we determine the test results in differentiation between cognitively intact people and those with Mild Cognitive Impairment (MCI) and Alzheimer Disease (AD). Methods: A cross-sectional study was conducted on 120 people (60 cognitively intact, 30 with AD, and 30 with MCI) in two phases. In phase one, linguists determine the most frequent phonemes at the beginning of Persian words and the most frequent semantic categories based on a survey. In phase two, the verbal fluency test was administered to cognitively intact people and those with cognitive impairment (patients with AD and MCI). One-way ANOVA and multiple linear regression were used for statistical analysis. Results: The normal subjects scored significantly higher in all phonemic and semantic fluency tasks than the patients with AD and people with MCI (P

Background and Objective: In the current COVID-19 pandemic, disease diagnosis is essential for optimal management and timely isolation of infected cases in order to prevent further spread. The aim of this study is to assess of predictors of mortality among COVID-19 patients. Material and Methods: In a retrospective study, 522 COVID-19 patients were enrolled in Razi hospital, Guilan Province, Iran. This hospital was the main center for the treatment of COVID-19 patients in Guilan province. Data gathering was performed by census sampling from March to August 2020. Simple and Multiple logistic regression analysis was applied to assess the relationships of clinical and demographic characteristics with in-hospital mortality. Results: Multiple logistic regression showed that older age (aOR=1.04, 95%CI: 1.02 to 1.06, P

Background: Hematuria is one of the most common symptoms in nephrology and urology. Due to the lack of extensive meta-analysis studies on the epidemiology of hematuria in Iran, this study was conducted to determine the epidemiological status of hematuria in Iran. Methods: In Sep 2020, researchers studied six international databases such as PubMed, ISI/WOS, ProQuest, Embase, Scopus, and Google Scholar for English papers and Iranian databases (SID and MagIran) for Persian papers. Joanna Briggs Institute (JBI) checklist was used to review and control the quality of articles. Heterogeneity between studies was assessed by Cochran's test and its composition using I2 statistics. Results: After several screening phase, the number of 25 article included to the final analysis. The prevalence of hematuria in the general population and children, in Iran were estimated at 16.4% (95% CI, - 0.05-37.9) and 1.6% (95% CI, 0.9-2.3) respectively. The odds ratio (OR) of women to men in the prevalence of hematuria in the general population 1.74, 95% CI: 1.20-2.52, P=0.003, patients with beta-thalassemia major 2.02, 95% CI: 1.11-3.65, P=0.020, children 2.61, 95% CI: 1.19-5.71, P=0.016, the elderly 1.50, 95% CI: 1.15-1.94, P=0.002, and taxi drivers 3.73, 95% CI: 2.58-5.38, P

Introduction: This study aimed to determine the communication profile of parents of children with autism spectrum disorders (ASD) and parents of typically developing children (TDC). Materials and Methods: Broad autism phenotype and communication skills were measured using the broad autism phenotype questionnaire (BAPQ) and the Queendom communication skill test (QCST) in parents of children with ASD and parents of TDC. Participants included 346 parents of children with ASD and parents of TDC. In the ASD group, participants included 172 parents (76 fathers and 96 mothers) of children diagnosed with ASD. The TDC parent group included parents 174 (85 fathers and 89 mothers). In the autism group, at least one child had autism and in the opposite group, the child had no psychological problems. Two-way analysis of variance (ANOVA) was performed to examine the effects of group (TDC, ASD) and gender (male, female) on study variables. Results: A significant group-gender interaction was observed for BAPQ total scores (F(1,342)=4.28, P=0.039); Mothers of children with ASD reported higher BAPQ total scores than mothers of TDC (P=0.006), and mothers of TDC reported lower BAPQ total scores than fathers of TDC (P

Objectives: Musculoskeletal disorders in children with Cerebral Palsy (CP) affect the general health of the mouth and teeth. This study aimed to determine periodontal and dental diseases in children with CP based on gross motor function level, manual ability level, and subtypes of CP. Methods: This research was a cross-sectional study performed on 123 children (3-18 years old) with CP referred to dentistry and rehabilitation centers supervised by Tehran University of Medical Sciences in 2019-2020. They were selected by the convenience sampling method. The children were classified according to the gross motor function classification system: expanded and revised (GMFCS-E&R) for their gross motor function level, according to the manual ability function classification system (MACS) and mini-MACS for the functioning of their hands in handling objects, and according to the quality and topographical pattern of motor impairment for subtypes of CP. The periodontal status of children with CP was evaluated according to the recommendation of the World Health Organization using the community periodontal index and for caries according to the decayed, missing, filled index. All statistical analyses were done by SPSS v. 16. Results: The results showed significant differences between periodontal disease and sex, age, GMFCS-E&R, MACS, mini-MACS levels, and subtypes of CP (P0.05). Discussion: Periodontal disease and decayed, missing, filled teeth are common problems in CP children, and the conditions worsen with age and level IV and V of GMFCS-E&R and MACS.

Introduction: Various tools are utilized for determining auditory comprehension levels, one of which is the auditory comprehension token test. Since there’s no Persian equivalent for this widely used screening test, in this paper we have adapted it to create a Persian auditory comprehension test. Aim: The purpose of this research was creating an adapted Persian auditory comprehension test and determining its psychometric properties. Method: In the initial phase which was conducted in 2017, a preliminary Persian test was created and its content validity evaluated. To determine the internal stability of results; 188 adults (59 males and 129 females) from Tehran, aged 18-80 were selected. This sampling was conducted using cluster based random selection and each individual was assessed with Persian auditory comprehension tests, mini mental state examination and Wechsler numerical memory subtest. In order to determine the test’s stability, 10 people were reevaluated after a one-week interval. A poisson regression with 0 accumulation was used to investigate the effects of age and education on an individual's performance in the Persian auditory comprehension test. Results: The Persian auditory comprehension test was created with 36 questions and a total score of 36. Content validity based on Lawshe and test-retest reliability of the test were respectively calculated as 1 and 0.96 (with P

Abstract Background The persistence of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) RNA in the body fluids of patients with the novel coronavirus disease 2019 (COVID-19) may increase the potential risk of viral transmission. There is still uncertainty on whether the recommended quarantine duration is sufficient to reduce the risk of transmission. This study aimed to investigate the persistence of SARS-CoV-2 RNA in the nasopharyngeal, blood, urine, and stool samples of patients with COVID-19. Methods In this hospital-based longitudinal study, 100 confirmed cases of COVID-19 were recruited between March 2020 and August 2020 in Guilan Province, north of Iran. Nasopharyngeal, blood, urine, and stool samples were obtained from each participant at the time of hospital admission, upon discharge, 1 week after discharge, and every 2 weeks until all samples were negative for SARS-CoV-2 RNA by reverse transcription-polymerase chain reaction (RT-PCR) assay. A survival analysis was also performed to identify the duration of viral persistence. Results The median duration of viral RNA persistence in the nasopharyngeal samples was 8 days from the first positive RT-PCR result upon admission (95% CI 6.91–9.09); the maximum duration of viral shedding was 25 days from admission. Positive blood, urine, and stool RT-PCR results were detected in 24%, 7%, and 6% of the patients, respectively. The median duration of viral persistence in the blood, urine, and stool samples was 7 days (95% CI 6.07–7.93), 6 days (95% CI 4.16–8.41), and 13 days (95% CI 6.96–19.4), respectively. Also, the maximum duration of viral persistence in the blood, urine, and stool samples was 17, 11, and 42 days from admission, respectively. Conclusion According to the present results, immediately after the hospitalized patients were discharged, no evidence of viral genetic materials was found. Therefore, appropriate treatments were selected for the patients at this hospital. However, we recommend further investigations on a larger sample size in multi-center and prospective randomized controlled trials (RCTs) to evaluate the effects of different drugs on the shedding of the virus through body secretions.

Many studies have been conducted on related factors of missed nursing care (MNC) around the world. The differences have been due to the variation in the health systems. This review aimed to explain the factors affecting MNCs. A qualitative scoping review was undertaken. The databases including MEDLINE, ProQuest, Scopus, PubMed, ScienceDirect, and Google Scholar were searched for studies on MNC and its related factors. Screening on the studies was done in four stages and the final studies were selected based on the inclusion and exclusion criteria. Editorial, letter, and commentary studies were not considered. Finally, 34 studies were reviewed and eight main themes were obtained, including personal and job characteristics of nurses, nurses' workload, job satisfaction, available resources, professional communication and teamwork, work environment, management performance, and technology in caregiving. A wide range of organizational and individual factors contribute to MNC formation. The information obtained from this study can be beneficial for nurse managers to control the level of MNC and its consequences.

This study aimed to assess the information-seeking behavior about COVID-19 among older adults in northern Iran. Two hundred-fifty three older adults living in Rasht, northern Iran, were enrolled in a cross-sectional study. Most older adults obtained information about COVID-19 from television, friends, and acquaintances. They relied less on special patient associations and the Ministry of Health telephone system. The use of social networks, the Ministry of Health telephone system, the Ministry of Health text message system, and friends and acquaintances for obtaining information about COVID-19 were significantly higher in people aged 60 to 70 years than in people aged >70 years. The use of newspapers/magazines to get information about COVID-19 was significantly higher in men than women. The use of websites, social networks, physicians, other health care workers, friends and acquaintances, newspapers/magazines, and special patients’ associations for obtaining information about COVID-19 was significantly higher in people with tertiary education than in others. Older adults were more satisfied receiving information about COVID-19 from nurses and physicians. Therefore, it is recommended that policymakers and health managers pay special attention to developing health programs and social media programing to educate older adults about COVID-19 and access to the right media for accurate information.

Background: In vitro fertilization (IVF) is a useful assisted reproductive technology to achieve pregnancy in infertilecouples. However, it is very important to optimize the success rate after IVF by controlling for its influencing factors.This study aims to classify successful deliveries after IVF according to couples’ characteristics and available data onoocytes, sperm, and embryos using several classification methods.Materials and Methods: This historical cohort study was conducted in a referral infertility centre located inTehran, Iran. The patients’ demographic and clinical variables for 6071 cycles during March 21, 2011 to March20, 2014 were collected. We used six different machine learning approaches including support vector machine(SVM), extreme gradient boosting (XGBoost), logistic regression (LR), random forest (RF), naïve Bayes (NB),and linear discriminant analysis (LDA) to predict successful delivery. The results of the performed methods werecompared using accuracy tools.Results: The rate of successful delivery was 81.2% among 4930 cycles. The total accuracy of the results exposed RFhad the best performance among the six approaches (ACC=0.81). Regarding the importance of variables, total numberof embryos, number of injected oocytes, cause of infertility, female age, and polycystic ovary syndrome (PCOS) werethe most important factors predicting successful delivery.Conclusion: A successful delivery following IVF in infertile individuals is considerably affected by the number ofembryos, number of injected oocytes, cause of infertility, female age, and PCOS.

Background: Sexual self-concept has a considerable impact on mental and sexual health. However, the relationship between sexual self-concept and infertility is unknown. This study aimed to compare sexual self-concept betweenfertile and infertile women.Materials and Methods: This cross-sectional study was conducted on a sample of 250 fertile and 250 infertilewomen who had referred to 9 health centers affiliated to Medical universities in Tehran and Royan infertility treatmentclinics in Tehran, Iran in 2017. Sexual self-concept was measured using the Multidimensional Sexual Self-ConceptQuestionnaire (MSSCQ) consisting of 20 subscales. Analysis of covariance (ANCOVA) was performed to comparesexual self-concept between the two groups.Results: The mean age of fertile and infertile women was 34 ± 5.62 and 29.74 ± 5.29 years, respectively. The highestscore in both groups was for the sexual self-schemata subscale (mean score for fertile=3.21 ± 0.68 and for infertile=3.42 ± 0.62). The lowest score was for sexual-depression subscale (mean score for fertile=0.59 ± 0.81 and forinfertile=0.61 ± 0.76). After adjustment for the age of each subject, the husband's age, duration of marriage, and women’seducation, we analyzed the sexual-satisfaction, the power-other sexual control, and the fear-of-sex subscales,which were found to be significantly lower in infertile women (p

Objectives: Stuttering and phonological processing are mutually related. Emotion is an effective factor in fluency and language processing; however, its underlying neural mechanism remains unclear. Event-Related Potential (ERP) is a non-invasive highly-beneficial method with high time resolution for language processing. The present study aimed to explore phonological processing in emotional words in Children Who Stutter (CWS), compared to Typically-Developing Children (TDC). Methods: Ten Persian-speaking CWS (3 girls, 7 boys), aged 7-10 years (Mean±SD = 8.9±0.11) and 10 TDC who are matched in age (Mean±SD = 8.7±0.12) and gender were given 120 emotional words (high-valence low-valence) and neutral words to read. Phonological processing was measured by the aloud reading task, while ERP was simultaneously recorded. The collected results were analyzed as behavioral (reaction time and reading accuracy) and electrophysiological (amplitude and topography). Repeated-measures Analysis of Variance (ANOVA) and Independent Samples t-test were used for between-group comparisons. Results: The obtained behavioral data included Reaction Time (RT) and accuracy. There were no significant differences between the explored CWS and TDC in RT and accuracy (P>0.05). The mean value of amplitudes presented significant differences between CWS and TDC in language processing areas (P

Background & Objectives: Aphasia is one of the most common consequences of a stroke; thus, screening tests for early diagnosis of the problem are necessary when dealing with aphasia patients. One of these screening tests is the Language Screening Test (LAST). The purpose of this study was to translate, validate, and utilize this test in the Persian language for patients after stroke. Methods: The original version of LAST was translated into Persian, and then administrated on 100 patients in the acute phase by two examiners at the patient’s bedside in order to check the inter-rater reliability. To assess the agreement between the two forms (a and b) of the LAST, Concordance Correlation Coefficient (CCC), weighted Kappa, and Intraclass Correlation Coefficient (ICC) were used. Also, the Persian version of LAST and the Western Aphasia Battery (WAB) were performed at the chronic phase with two independent examiners with blind scoring. Results: Inter-rater reliability between Rater 1 and Rater 2 on LAST-a and LAST-b score were very good for both phases. The CCC for LAST-a and LAST-b, respectively, were 0.874 and 0.865 for the acute phase and 0.923 and 0.927 for the chronic phase. The weighted Kappa for LAST-a and LAST-b, respectively, were 0.750 and 0.740 for the acute phase, and 0.822 and 0.846 for the chronic phase. Conclusion: The obtained results showed that LAST is a very simple, fast, and valid test and can be used as a reliable tool in stroke patients. Lack of cultural and language dependency are the advantages of using this test.

Background & Objectives: Aphasia is an acquired language disorder that affects daily communication and quality of life. Early diagnosis and the treatment of aphasia are important. In this regard, one of the screening tests is the Aphasia Rapid Test (ART). This study aimed to investigate the validity and reliability of this test and extend the use of ART in the acute phase for patients with aphasia. Methods: The original version of ART was translated to Persian and 100 acute stroke patients were evaluated by ART. Besides, all the patients were assessed again after eight days by two independent raters to evaluate inter-rater reliability. Also, 70 patients were chosen to examine ART’s predictive ability; they were assessed using the Persian version of Western Aphasia Battery, after three months. Results: On day eight of the study, the Mean±SD ART was 11.26±2.03 for rater 1 and 11.44±2.04 for rater 2. Inter-rater reliability was good with the concordance correlation coefficient of 0.959 (95% CI: 0.939-0.972). Also, the Bland-Altman plot showed good agreement between raters without any significant trend/bias. Conclusion: The ART is a test that includes features, such as reproducibility, predictability, and inter-rater reliability. This test is short and can be used in the acute phase of aphasia in patients with stroke.

Background: The most common mental disorders in infertile patients are depression and anxiety. The four-itemPatient Health Questionnaire-4 (PHQ-4) is a widely used tool that consists of the PHQ-2 depression and GeneralizedAnxiety Disorder-2 (GAD-2) scales. Given that PHQ-4 has not been validated in infertile patients, this study aimed toexamine its reliability and validity in this population.Materials and Methods: Participants in this cross-sectional study consisted of 539 infertile patients from a referralfertility centre in Tehran, Iran. The PHQ-4, Hospital Anxiety and Depression Scale (HADS), World Health Organisation-Five Well-Being Index (WHO-5), Penn State Worry Questionnaire (PSWQ) and demographic/infertility questionnaireswere administered to all participants. Factor structure and internal consistency of PHQ-4 were evaluatedvia confirmatory factor analysis (CFA) and Cronbach’s alpha, respectively. The convergent validity of this scale wasexamined by its relationship with HADS, WHO-5 and PSWQ.Results: CFA results provided support for a two-factor model of PHQ-4. Internal consistency of the PHQ-4 and its subscalesboth were elevated with Cronbach’s alpha coefficients of 0.767 (PHQ-4), 0.780 (PHQ-2) and 0.814 (GAD-2). Inter-itemcorrelations were between 0.386 and 0.639, and corrected item-total correlations were between 0.576 and 0.687. PHQ-4,PHQ-2 and GAD-2 showed positive correlations with measures of HADS-anxiety, HADS-depression, and PSWQ and negativecorrelations with WHO-5, which confirmed convergent validity. Among demographic/fertility variables, we observedthat gender, infertility duration, and failure in previous treatment were correlated with PHQ-4 and its subscales scores.Conclusion: The PHQ-4 is a reliable and valid ultra-brief screening instrument for measuring both anxiety and depressivesymptoms in infertile patients.

Abstract Background Cognitive strategies play an important role in the prevention of psychological disorders. The aim of this study was to examine the relationships of cognitive emotion regulation with anxiety and depression symptoms in a sample of infertile women in Iran. Results According to correlation analysis, all adaptive strategies (i.e., acceptance, positive refocusing, refocus on planning, positive reappraisal, and putting into perspective), except for Acceptance strategy, were indirectly related to both anxiety and depression symptoms. Conversely, four maladaptive strategies (i.e., self-blame, rumination, catastrophizing, and other-blame) were positively related to anxiety and depression symptoms. After controlling for demographic/infertility information, hierarchical regression analyses indicated that acceptance, rumination, and positive refocusing subscales were significantly associated with anxiety; and refocus of planning was related to depression. Conclusion In sum, cognitive emotion regulation strategies appeared to be related to anxiety and depression symptoms in women suffering from infertility. These results suggest the use of cognitive therapy to reduce the anxiety and depression in these women.