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Introduction: Chronic pain is one of the most common diseases in today's world, which has a serious influence on the quality of life. Low back pain (LBP) is very common in developed and developing countries. This study aimed to investigate anxiety & depression as a disability factor in chronic LBP in patients referred to the Orthopedic Clinic of Touba Clinic in Sari, Iran in 2018. Material and Methods: The Ronald-Morris Disability Questionnaire was used to assess disability, the Beck Anxiety Questionnaire was used to assess anxiety, the Beck Depression Questionnaire was used to assess depression, the SF-36 was used to assess quality of life, and the Visual Analog Scale was used to assess pain. Results: In this study, 100 patients were studied. Seventy were female and 30 were male. The mean age of patients was 45.05 ± 11.45 years. Sixty five patients suffered from depression and 35 patients had normal depression. The mean score for disability was 14.05, and the mean and standard deviation from the pain score of patients was 36.2 ± 2.7. Conclusion: Depression is one of the disability factors in people with chronic LBP in patients referring to the orthopedic clinic of Touba Clinic in Sari city in 2018.

Background For decades, child labor has been an important global issue associated with inadequate educational opportunities, poverty and gender inequality. In order to make effective policies to reduce child labor it is important to understand the specific factors that affect it. We aimed to investigate the main factors affecting child labor n Iran. Materials and Methods There are authoritative websites on the topic of working children in Iran, including the WHO, UNFPA, UNDP, Web of Science, ProQuest, Medline, Scopus, and CINAHL databases for reviewing studies conducted in Iran. Articles from internal dissertations and Google's databases, SID, Magiran, and Iran Doc during the period 1985 to June 2019 were included. Quality of studies was reviewed by the STROBE checklist. Information was extracted by two blind researchers. Results A total of 9 studies were identified (including 17, 219 on child labor), the majority of which were cross-sectional. Affecting factors on child labor and Street children were grouped into four categories such as "Family problems", "Urbanization", "Social and Cultural", and "Personality". Conclusion In the contemporary Iranian society, many children, for some reasons including personal, family, social and cultural, and urbanization problems, are involved with important social damages such a child labor. These factors make children vulnerable and endanger the health of the community.

Background: Today, an increasing trend to methadone as an alternative maintenance treatment for opiate dependence in adults is observed; children for both intentional and accidental reasons are exposed to serious and fetal effects of methadone. We aimed to investigate effects of methadone on children and sexual functioning among adults in Iranian population. Materials and Methods: An extensive search was done in databases of Medline, EMBASE, Scopus, Cochrane, and Web of Science until August 2018. Two independent researchers screened articles, and categorized them based on the evaluated outcomes and overall effect size was presented. After excluding the duplicated, irrelevant and low-quality articles, eligible ones were enrolled in the meta-analysis. Finally, pooled effect size was presented as standardized mean difference (SMD) or pooled prevalence with 95% confidence interval (95% CI). Results: Methadone was found to be more effective than morphine on neonatal abstinence syndrome. The first four most common symptoms of methadone poisoning were loss of consciousness (81%), sleepiness (72%), meiotic pupils (76%), vomiting (56%), and Apnea (48%). The overall prevalence rate of sexual disorders and erectile dysfunction was 66.3% and 77.5%, respectively. The subjects in methadone group were over 2.5-fold more likely to use condom during intercourse (p Conclusion: Evidence suggests a positive impact of methadone maintenance treatment on risky sexual behaviors. Regarding the methadone poisoning effect on children, people should be informed by health care providers about serious and fetal effects on children.

BACKGROUND Chronic obstructive pulmonary disease (COPD) increases susceptibility to sleep disturbances. This study aimed to evaluate the association between COPD severity criteria with sleep quality. METHODS One hundred fifty-eight patients in Rasul Akram Hospital of Iran University of Medical Sciences, Tehran, Iran, from April 2019 to March 2021 diagnosed with COPD were examined using the Pittsburgh Sleep Quality Index (PSQI), COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnoea scale, spirometry and pulse oximetry. RESULTS Of 158 subjects, 125 patients were male (79%), and 33 were female (21%). The mean subject's age and FEV1/FVC ratio were 62.6 ± 11.5 and 65.6 ± 14.9%, respectively. The mean CAT scoring and Spo2 saturation reported 16.2 ± 7 and 91.5 ± 10.8%, respectively. The mean PSQI score was 8.2 ± 3.8. The association between PSQI score with FEV1 and FEV1/FVC ratio was not statistically significant (p = 0.64 and 0.58, respectively), whereas the association between PSQI scores with CAT score (p ˂ 0.0001, r2 = 0.51) and dyspnoea severity (p ˂ 0.0001, r2 = 0.29) were statistically significant. The patients with higher CAT score demonstrated poor sleep quality, particularly in longer sleep latency (p = 0.001, r2 = 0.056), bad subjective sleep quality (p ˂ 0.0001, r2 = 0.286), lower sleep efficiency (p = 0.002, r2 = 0.077), higher sleep disturbance (p ˂ 0.0001, r2 = 0.225), daytime dysfunction (p ˂ 0.0001, r2 = 0.259) and sleep medication intake times a week (p = 0.01, r2 = 0.069). Dyspnoea severity was attributed to bad subjective sleep quality (p ˂ 0.0001, r2 = 0.069), higher sleep disturbances (p = 0.005, r2 = 0.08), and daytime dysfunction (p ˂ 0.0001, r2 = 0.108). CONCLUSION The PSQI has a significant association with the CAT and mMRC for COPD patients and is linked to the disease's severity.

Introduction: Depression is considered as the most common psychological problem in societies. Depression, anxiety disorders, and substance abuse are more common in patients with pain compared to the general population. In this study, the state of depression in patients with upper limb pain with radiculopathy or without paraclinical signs of radiculopathy has been investigated. Material and Methods: We conducted the depression status in patients with upper limb pain with and without radiculopathy in a descriptive cross-sectional study in Sari in 2017. Beck Depression Inventory (BDI-II), Short Form (36) Health Survey (SF-36), short-form McGill pain questionnaire was used to evaluate the status of major depressive disorder, health status and quality of life, and severity of pain in them, respectively. The data was analyzed by SPSS 22. Results: From 120 patients with the mean age 44.97±9.77 years, 19% had mild depression, 18% moderate depression and 11% severe depression. The mean score of SF36 was 29.94±6.86. The mean scores of McGill pain scale was 13.31±6.02. The mean depression score had a significant difference between the two groups studied (P=0.04). The McGill pain score had also a significant difference between the two study groups (P=0.012). The mean score of SF36 had no significant difference in both groups (P=0.41).Conclusion: The depression score and the prevalence of moderate and severe depression were also higher in patients with chronic upper limb pain with cervical radiculopathy than in patients without cervical radiculopathy.

Objectives: We aimed to develop a scale and evaluate this scale's validity and reliability to measure factors affecting people's knowledge and attitudes toward the pandemic breaking transmission chain.Methods: This exploratory mixed-method study was carried out in two phases: (1) item generation using literature reviews and interviews and, (2) item reduction by psychometric assessments of the developed scale. The face, content, construct (exploratory and confirmatory factor analysis), convergent, and discriminant validity of the scale were assessed in the Iranian population (n = 500) from March to June 2020. The Composite Reliability (CR) and the internal consistency correlation coefficient were estimated.Results: The Knowledge and Attitude Scale Toward COVID-19 Pandemic Breaking Transmission Chain (KA-C) among the Iranian population included 18 items. Two factors with a whole variance of 66.05% were identified by exploratory factor analysis. Factors were labeled as “health literacy” and “home health empowerment.” The confirmatory factor analysis showed the goodness of fit. The CR of the scale for first and second factors were 0.965 and 0.833 receptively. The scale's internal consistency correlation coefficient was acceptable (Cronbach's alpha = 0.960 and 0.823, average interitem correlation = 0.643 and 0.635, McDonald's omega = 0.963 and 0.829, for the first and second factor, receptively).Conclusion: The KA-C scale can be exerted to screen the people's knowledge and attitude about the COVID-19 pandemic breaking the transmission chain as a valid and reliable scale for further policymaking, health care providers, and for a multi-dimensional psychosocial assessment of the pandemic period.

Introduction: This study was carried out to determine the extent of prostitution and its causes among Iranian children at risk of social harm. Material and Methods: The authoritative websites on the topic of childhood prostitution performed in Iran during the period 1985 to 2019 were searched in WHO, UNFPA, UNDP, ISI, ProQuest, Medline, Scopus, CINAHL, and Google Scholar databases for reviewing studies conducted in Iran. Articles from internal dissertations and Google's databases, SID, Magiran, Google Scholar, Iran Medex and Iran Doc search engines. Upon leaving unrelated and unqualified articles, finally, seven studies were selected. Information by 2blind researchers in the form of the article title, the first author, year of research, sample size, age was included in the Excel program. Results: The search yielded a total of 1256 records. After removing duplicates, 45 documents were retained for further examination. After screening the titles and abstracts, seven papers were retained for full-text review. Based on pre-defined inclusion criteria, seven records were included in the systemic review. Many reasons for prostitution were: running away from home, sexual harassment, forced sex, presence of a child among prostitutes including family members or friends, and other reasons including the history of addiction of parents, the history of detention and imprisonment before prostitution and the responsibility of supplying them (sponsorship) gifts and prices, membership in sex offending gangs, sex trade, and sex sales. Conclusion: Violence, sexual abuse, and sexually transmitted infections, pregnancy, mental illness, involvement in child trafficking networks and substance abuse are the consequence of the experiences of these children in prostitution, therefore, it is very important that specialists and authorities should first consider heavy penalties for adults seeking sexual contact with children and key measures should be taken for the use of these children by social services.

Introduction The Pittsburgh Sleep Quality Questionnaire is capable of covering different stages of sleep, and it is regarded as one of the best ones available, and checking for its validity and reliability among depressed patients is a step in this direction. The aim of this study was to evaluate the reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) questionnaires in patients with depression. Methods In this study, 93 depressed patients were in the study group, and 100 patients were in the control group. The Persian translation of the PSQI and ESS questionnaires and the Beck Depression Inventory (BDI) were at the disposal of both validity and reliability of PSQI and ESS, and its correlation with BDI scores were analyzed. Results In our study, Cronbach's alpha coefficient of the PSQI questionnaire was 0.821. According to the PSQI and BDI-II scores, the results between the PSQI and ESS scores were significantly correlated. Conclusion Using the Persian PSQI and ESS questionnaires to evaluate sleep quality and daytime sleepiness in patients with depression provides a reliable and valid measure for subjective sleep quality in clinical practice and research.

Introduction A considerable segment of the elderly population in Iran is illiterate, and it seems the existing neuropsychological screening tests are not very useful for detecting dementia in illiterate participants. The purpose of this study was to develop and validate a tool called Persian test of Elderly for Assessment of Cognition and Executive function (PEACE) for detecting dementia in both illiterate and literate participants. Methods First, in order to design some of the cognitive aspects of the PEACE assay, we considered other prevalent neuropsychological instruments, such as the General Practitioner assessment of Cognition (GPCOG), Functional Assessment Staging (FAST), Mini Mental State Examination (MMSE), and Wechsler Memory scale. The other domains of PEACE were designed according to our clinical proficiencies and the culture of the society. In the next step, the participants were classified into three distinct groups, i.e., the control group (n=33), the Mild Cognitive Impairment (MCI) group (n=30), and the Alzheimer's group (n=38). All of the participants in each group were divided according to their educational level, i.e., illiterate, semi-literate, and literate. Results We developed PEACE consisting of 14 items, each of which represents a specific cognitive function, with a maximum score of 91. The 14 items are Orientation, Praxis, Attention and Concentration, Attention and Calculation, Memory, Similarity, Abstract Thinking, General Information, Language, Judgment, Gnosis, Planning (Sequencing), Problem Solving, and Animal Naming. PEACE scores are highly correlated with those of the MMSE (r=0.78). The optimal cut-off point of PEACE chosen for diagnosis of Alzheimer's disease was 67.5 (sensitivity: 75.8%, specificity: 97.4%). The PEACE scores showed a significant difference between Participants with Alzheimer's disease and the control group (p=0.0000) and the MCI group (p=0.003). In addition, there was no significant difference between illiterate and literate participants in the Alzheimer's group. However, the PEACE scores differed significantly (p=0.0000) between illiterate and literate participants in the control group. Conclusion The PEACE addresses the limitations of existing tests and is appropriate for use in countries that have high rates of illiteracy. It is a valid screening mechanism for the detection of dementia in both illiterate and literate participants.