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Aim: The present study aims at teaching the right citation models in scientific publications by top authors from Iranian universities of medical sciences in 2017, considering the relationship between moral development and self-control variables and model of "citation to multi-authored papers" in these articles. Background: Multi-authorship increases the amount of self-citation and also increases the likelihood of being cited by others. Methods: This study is of the applied scientometrics and correlation (model presentation) studies type. The research population in the first part of this study includes all the authors who had an H-index of 10 or more in the scientific databases of 2017. The sample size at this stage was 110, selected by systematic random sampling. The collected data were analyzed using SPSS 16.0. Results: The results of regression analysis based on the concurrent method indicated that the regression model is significant. The coefficient of determination is 0.096 and the F ratio is 5.650, which are significant at the level of p <0.001. In this regression model, the variables of the level of moral development (β = -5.801, p <0.001) and self-control (p < 0.001, β = -0.253) have significant predictive power and can be considered as predictors of behavioral modeling in citing "multi-authored papers". Conclusion: Based on the results, teaching how to avoid blindly citing the "multi-authored papers", which is regarded as a kind of "citation deviation", can, to some extent, lead to strengthening citation indexes. [ABSTRACT FROM AUTHOR]

Introduction: Journal clubs are known as the teaching methods in most of the medical training centers. In journal club (JC) participants discuss about articles in recent medical papers and finally, written scientific results are accepted or rejected. The aim of this study was to compare the traditional and evidence based medicine (EBM) type of JCs. Methods: The present study was conducted in Imam Reza Hospital, Tabriz University of medical sciences from January to March 2010. Forty participants were enrolled in our study: 16 stagers, 11 interns and 13 internal medicine residents. We held 3 journal clubs with 14 participants in the first session and 13 participants in the other sessions. Journal club was held at the end of each week. The first paper was presented by one of the attending physicians of rheumatology ward. The second paper was presented by another attendant of rheumatology ward who was a member of EBM group of Tabriz University of Medical Sciences. Then the results were compared. Results: The comparison of the sums of participants' scores didn't show any meaningful difference between traditional and EBM journal club in topic, purpose, and methods & material part of papers, but in the results section of the papers, the difference was remarkable. Conclusions: Our study showed that in the EBM journal clubs, participants learnt more about the results part of the papers.but in the results section of the papers. [ABSTRACT FROM AUTHOR]

Purpose: Strategic orientation is one of the critical principles affecting the marketing and strategy selection of an organization's activities, reflecting the strategic tendencies implemented by the organization to create behaviours, leading to organizational efficiency and better employee performance. Therefore, this paper aims to study the relationship between strategic orientation and performance in Qazvin teaching hospitals through green supply chain management (SCM) to improve employees' performance. Design/methodology/approach: This was a descriptive– analytical and cross-sectional study. The total number of employees in medical centres was 2,256 people. According to Morgan's table, the required number of samples was 328, including 10% of the sample loss. The questionnaire was given to 365 staff in different hospitals in proportion to the number of staff. Two statistical software, SPSS24 and AMOS23, were used to evaluate the results. Findings: All three variables were relatively moderate in the hospitals. The results of evaluating the structural model of the research showed that all the studied hypotheses were significant, except for the relationship between organizational performance and strategic orientation hypothesis. The results also show that this model had a good fit. Practical implications: The findings can lead to saving the environment, creating a better social image and reducing costs and profitability, allowing managers to know the strategic orientations rather than depending on institutional pressure issues and monitoring guidelines. Originality/value: Considering the significant relationship between the dimensions of green SCM and the hospitals' performance, the authors suggest: establishing multilateral co-operation in environmental issues, improving the environmental status of hospitals, reducing waste rates and paying attention to social responsibility of hospitals. In addition, the findings help hospital management to comprehensively understand the strategies for implementing green SCM procedures. [ABSTRACT FROM AUTHOR]

Background: Mental disorders are one of the leading causes of illness and disability worldwide. According to the World Health Organization (WHO), one in four people in the world will be affected by mental or neurological disorders during their lifetime. Regular evaluation of mental health outcomes plays an important role in making decisions about timely treatment of the patient. Studies show that a medical record does not provide enough information about the diagnosis, current symptoms, psychiatric medications, and side effects of current medications and treatments for ongoing health care. In this study, the completeness of paper-based psychiatric records was investigated. Aim: The current study aimed to explore the completeness rate of paper-based psychiatric medical records (PMRs) and to investigate the factors effective on documentation status. Setting: The study was conducted in Ebnesina and Dr. Hejazi Psychiatric Hospital and Education Center. The case hospital is a psychiatric teaching hospital, which has 900 beds. Materials and Methods: The completeness rate of PMRs was determined using descriptive statistics. Fleiss' Kappa agreement and effective factors on PMRs' documentation status were assessed. Results: In total, 83.65% (n = 312) of the PMRs had at least one documentation defect. A significantly higher level of documentation completeness rate between different psychiatric wards was observed. Conclusion: Based on our results, it is suggested to conduct regular evaluation and provide feedback to the health-care providers, and conduct training courses. [ABSTRACT FROM AUTHOR]

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Aims: This study aimed to evaluate whether stress communication and supportive dyadic coping moderate the effects of occupational stress on dyadic adjustment and the quality of work‐life of nurses. Background: Nurses are at higher risk for occupational stress, work–family conflict, and the challenge of balancing job and family roles. However, in recent studies, the impact of dyadic coping strategies in dealing with work–family stress in those couples has not received adequate attention. Design This study was a cross‐sectional study. Methods: The research sample comprised 591 nurses recruited through announcements in hospitals and health centres in Iran between May 2018 and February 2019. They completed the Expanded Nursing Stress Scale, the Dyadic Coping Inventory, the Dyadic Adjustment Scale, and the Quality of Nursing Work Life questionnaire. Hierarchical regression was utilized. Results: Results indicated that there was a negative relationship between occupational stress and dyadic adjustment, and quality of work‐life. Stress communication and supportive dyadic coping moderated the association between occupational stress and dyadic adjustment as well as the quality of work‐life. Conclusion: The current findings suggest that the nurses who use dyadic coping strategies to deal with occupational stress report a higher level of adjustment and quality of work‐life. Summary statement: What is already known about this topic? Nurses face much stress in their workplace.Occupational stress can negatively affect the quality of work‐life and marital adjustment of nurses.Coping strategies can reduce the negative effects of occupational stress on couples' life. What this paper adds? Negative associations between occupational stress and dyadic adjustment, and quality of work‐life were found.Stress communication and supportive dyadic coping moderated the association between occupational stress and dyadic adjustment.Stress communication and supportive dyadic coping moderated the association between occupational stress and the quality of work‐life. The implications of this paper: The results of the current study suggest the importance of adding teaching dyadic coping skills to the nursing curricula.This finding is relevant for clinical experts to consider training coping skills as a beneficial way to experience higher dyadic adjustment.Efforts towards increasing dyadic coping in nurses may influence the effects of work–family stress on dyadic adjustment. [ABSTRACT FROM AUTHOR]

Background and Aim: The aim of this study was to evaluate and compare the effect of curcumin and ibuprofen on pain control, in terms of pain intensity and duration of analgesia after extraction of the third molar of the mandible in the maxillofacial surgery department of the University School of Dentistry Islamic Azad Medical Sciences in the academic year 1400-1399. Material and Methods: The study was performed as a double-blind randomized clinical trial on 48 patients who were candidates for mandibular third molar surgery. they should also write their pain intensity one hour after taking the second dose of the drug after seeing the first symptoms of pain based on the VAS scale and the duration of their analgesia from the time of taking the drug (which was one hour before surgery for all patients) to the first signs of pain appeared on a piece of paper. Data analysis was performed using Two sample T test power analysis of PASS software version 22. Results: The results of our study showed that the duration of analgesia after Curcumin use is shorter compared to Ibuprofen (P<0.001). This difference was also statistically significant. Also, after taking the second dose of the drug, patients treated with ibuprofen reported less pain intensity, although this difference was not statistically significant (P=0.39) Conclusion: Ibuprofen compared to Curcumin further reduces patients' pain and also has a longer duration of pain for patients after extraction of the third molar of the mandible. [ABSTRACT FROM AUTHOR]

Background & aim: The purpose of this study was to evaluate the scientific outputs of Iranian dental researchers in the ISC citation database during the years 2010-2017. Material & Methods: This research is an applied research that has been done by using co-word analysis which is a kind of content analysis and scientometric methods. The statistical population of the study includes 1383 records in dentistry researches that indexed by Iranian researchers in the ISC during 2010-2017. Results: The findings showed that most dental papers were produced by researchers at Tehran University of Medical Sciences. Researchers in our country have also collaborated with US researchers in their papers. The survey of the most commonly used topics showed that the most focus of our researchers is on dental and oral Health. The topic of dental plaque has also been identified as an underdeveloped topic in the fields. Conclusion: According to the findings, it seems, scientific output of dentistry field in was ISC increased during 2010-2017. and Tehran Medical sciences, Shahid Beheshti medical sciences and Islamic azad university were applied as first to third scores. [ABSTRACT FROM AUTHOR]

Falling is one of the most common adverse events leading to patient injury. The purpose of this study (as part of a Ph.D. paper) was to investigate the effects of educational interventions on patients' self-efficacy and falls prevention knowledge. A sample of 176 participants were recruited at a university hospital in Iran. Each patient received an educational pamphlet on falls prevention. The questionnaire measured patient knowledge (scores ranged from 0 to 20) and falls prevention self-efficacy (scores ranged from 20 to 60) before and after the third day of the intervention. Overall, the mean knowledge score improved from 47.8% (9.57 ± 2.51) to 68.3 (13.68 ± 1.85), which was statistically significant (p < 0.001). For falls prevention self-efficacy, the pre-test mean was 41.0 ± 7.42 (range: 20–56; total: 60), but the post-test mean improved to 47.26 ± 9.12. 0.05. Our study suggests that the hospitalized patients have little knowledge of falls prevention and that educational interventions have improved their knowledge of falls prevention. Study participants were confident in implementing useful falls prophylaxis during hospitalization. [ABSTRACT FROM AUTHOR]

Transitional care is a designed plan to ensure the continuity of care received by patients as they transfer between different locations or levels of care. The aim of this paper is to explore nurses' experiences of transitional care in multiple chronic conditions. A qualitative method with a conventional content analysis approach was utilized. The study was conducted at university hospitals in 2 big cities (Isfahan and Tehran) of Iran. This study is performed from November 2018 to December 2019 using deep, semi-structured, and face-to-face interviews which are focused on nurses' experiences of transitional care. Data collection continued until saturation was reached. Finally, 15 nurses take part in this study. Data collection and data analysis were conducted concurrently. Data were analyzed using Graneheim and Lundman's techniques. Two main themes providing a descriptive summary of the major elements of transitional care identified: "threat to patient safety" and "Care breakdown". Findings showed an exclusive image of unsafe transitional care which was done unplanned without appropriate delegating care to family and threat patient safety. There is still a gap in the transition from hospital to home. Nursing managers can address this issue by creating a culture of teamwork, training competent nurses by continuum education, and more supervision of nursing care. Policymakers can ensure continuity of care by developing policies and programs about transitional care. [ABSTRACT FROM AUTHOR]

Background and Aim Fibromyalgia syndrome is a chronic disease that causes widespread musculoskeletal pain. It primarily affects women and negatively impacts many aspects of a person’s psychological and social life. This study aimed to compare the effectiveness of cognitive therapy based on mindfulness and compassion therapy on automatic negative thoughts, psychological symptoms, pain intensity, and quality of life in patients with fibromyalgia syndrome. Methods & Materials This research is a quasi-experimental study with a pre-test-post-test design with two experimental and one control group. The statistical study population consisted of all individuals with fibromyalgia syndrome referred to Mehregan Pain Clinic in Mirdamad (District 3), Seyed Khandan Clinic (District 4), and Taleghani Hospital Pain Clinic (District 1) in Tehran City, Iran. Of them, 30 patients were randomly selected and divided into three groups of experimental 1, experimental 2, and control; each group will include 10 people. The instruments used in this study included the World Health Organization quality of life questionnaire (WHOQOL BREF), pain intensity questionnaire (PIS), psychological symptoms questionnaire (Anxiety, Stress and Depression [DASS]), and automatic negative thoughts (QNS). Ethical Considerations This study was approved by the Research Ethics Committee of Arak Branch, Islamic Azad University (Code: IR.IAU.ARAK.REC.1400.005). Results The analysis of covariance showed the effectiveness of both cognitive therapies based on mindfulness and compassion therapy on four variables of pain intensity, psychological symptoms, automatic negative thoughts, and quality of life (P<0.05). Comparing the two intervention methods showed that both therapies had almost the same effect on pain intensity, psychological symptoms, and automatic negative thoughts (P<0.05) but the effectiveness of mindfulness intervention on the quality of life was significantly higher than compassion intervention (P<0.05). Conclusion The results indicate that cognitive therapy based on mindfulness and compassion therapy are suitable for people with fibromyalgia under appropriate treatment. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Swelling of the surrounding tissue of surgical site is one of the most common, devastating effects after maxillofacial surgery and can have an effect on quality of life and the patients' satisfaction. Purpose: The purpose of this study was to investigate the effect of a custom-made appliance by the method of Computer-aided design/Computer-aided manufacturing (CAD/CAM) compared with conventional dressing for reducing facial swelling after maxillofacial surgery. Materials and Method: This clinical trial accomplished in 14 patients voluntarily referred to the Department of Oral and Maxillofacial Surgery at Bahonar hospital in Kerman. These patients were the candidate for surgical treatment of similar bilateral facial fractures (10 patients) and orthognathic surgery (4 patients). Facial computed tomography (CT) scans of the patients were taken to build up a custom-made appliance. Based on three-dimensional reconstruction from facial CT scan data, custom-made appliance was designed and built. Swelling on one side with custom-made appliance and on the opposite side with conventional dressing measured with paper tape graded before surgery, immediately after surgery, 24 hours, 48 hours, and 7 days later, we divided the patients into two groups of trauma and orthognathic surgical procedures Results: Based on the defined landmarks, all of the measurements were performed on both sides. Statistical analyses do not show any asymmetry before surgery (p= 0.48). In addition, there was no significant difference between two methods of dressing on the day of surgery and a day later (p= 0.084, p= 0.09), but there was a significant difference between two methods of dressing on second and seventh days. The swelling has decreased faster and further in our new method. Conclusion: Regarding the exact adaptation to the surgical site on facial skin, using custommade appliance by the method of CAD/CAM could be an effective tool that reduces swelling after maxillofacial surgery. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Healing of the inferior alveolar nerve injury during dental procedures is one of the biggest concerns of dentists. There are still debates on different treatment modalities. Purpose: This study aimed to compare the effect of 940nm and 810nm diode lasers on the repair of the inferior alveolar sensory nerve. Materials and Method: In this single-blinded randomized clinical trial, 39 patients with inferior alveolar nerve injury were divided into three groups: 1. 810nm laser irradiated, 2. 940nm laser irradiated, and 3. No laser irradiation (control group). All patients were treated in 12 sessions (3 days per week) and evaluated using a complete clinical neurosensory test (CNT), including brushstroke, 2-point discrimination, pinprick nociception, and thermal discrimination before and after treatment. Results: The mean dysesthesia of the patient treated with 810nm diode laser was significantly lower than the control group in all sessions (the 1st (p= 0.003), 3rd (p=0.008), 7th (p= 0.006), and 12th sessions (p= 0.005)). The 810nm laser resulted in more satisfaction in patients than the control group in almost all sessions (1st (p< 0.001), 7th (p= 0.028), and 12th (p= 0.006)). More patient satisfaction was seen in the 1st and 3rd sessions in the 810nm laser than in the 980nm laser (p< 0.001 and p= 0.003, respectively). Conclusion: 810nm diode laser can be better than 940nm in repairing inferior alveolar sensory nerve damage. [ABSTRACT FROM AUTHOR]

Background & aims: Missed nursing care is a global challenge that can have many consequences and it's known as a common threat to the patient safety and quality of nursing care. The nurses' professional commitment plays the final role in the occurrence of this issue. This study aimed to investigate the relationship between nurses' professional commitment and missed nursing care in Iran. Materials & methods: This cross-sectional descriptive-analytical study was conducted on 270 nurses working in two hospitals affiliated to Tehran University of Medical Sciences (Sina & Shariati) from September to December 2023. The research community included all nurses working in medical-surgical wards in the designated hospitals. The research samples were included in a targeted and quota method after obtaining organizational permits, ethical approval and informed consent. Data collection was done using three questionnaires including demographic information form, Nursing Professional Commitment Scale, and MISSCARE Questionnaire. The collected data was analyzed in SPSS software, version 25. Results: The results of Pearson's correlation test showed that there is a significant negative relationship between nurses' professional commitment and missed nursing care scores (r=-0.23) (p < 0.001). The mean score of nurses' professional commitment was reported at a moderate to high level (83.72 ± 16.02) and the mean score of missed nursing care was reported at a low level (47.84 ± 16.48). Nurses over 40 years old, morning shift and employed nurses showed higher professional commitment. Also, nurses under 29 years old and male nurses had more missed nursing care other than their participants. No relationship was observed between other demographic variables with nurses' professional commitment and missed nursing care. Conclusion: The results of this study showed that higher nurses' professional commitment leads to higher quality of care and less missed nursing care. Based on findings of this research, it is recommended for health care providers and nursing managers to adopt programs to increase nurses' professional commitment and consequently reduce missed nursing care. [ABSTRACT FROM AUTHOR]

Purpose: The Iranian patients' rights charter defines patient rights as a reflection of fundamental human rights in the field of medicine and incorporates all elements of patient rights accepted in international texts. The purpose of this paper is to study the way in which diabetes patients' rights are being exercised in everyday hospital practice in Birjand, Iran. Design/methodology/approach: A cross-sectional study design was used in 2014. The sample size was estimated 150 patients, out of which 108 diabetes patients completed questionnaire. The questionnaire of diabetes patients' perspectives on the patients' rights was used to collect data. The questionnaire consists of 22 questions. Data entry and analysis were carried out using SPSS software (version 22). Descriptive and inferential statistics were calculated with all survey items and total scores, as well as demographic data. Findings: The response rate was 72 percent. Overall, the mean score percentage of diabetes patients' perspectives on the patients' rights was 74.04± 8.4. Furthermore, statistical significant differences were found among diabetes patients in relation to patients' perspectives on the patients' rights according to highest level of education (F=16.52, p=0.002), their habitat(t=3.49, p=0.001), age groups (F=18.70, p=0.0001) and the duration of the disease (F=5.16, p=0.007). The results showed that no statistically significant differences were observed among diabetes patients in relation to diabetes patients' perspectives on the patients' rights according to their gender (F=1.57, p=0.12) and marital status (F=1.56, p=0.09). Originality/value: Clinicians can provide care based on patients' rights, and their knowledge of patients' rights needs to be evaluated. Educational courses, leaflets, booklets and posters can be helpful in this regard. In addition, professional organizations and the Ministry of Health need to be more sensitive to this issue. [ABSTRACT FROM AUTHOR]

Introduction: 30 to 60% of patients admitted to non-psychiatric wards have at least one significant psychiatric illness. Objective: The aim of this study was to investigate the frequency, causes, and quality of psychiatric counseling requested. Materials and Methods: This descriptive study was carried out on all patients admitted to educational hospitals in Rasht, Iran from 2012 to 2014, for which psychiatric consultation was requested and their counseling sheets were available. Data were extracted based on the checklist. Assessment of the quality of the consultation request and the response quality of the counseling were done. Data were analyzed by SPSS21. Results: The frequency of psychiatric counseling application in this study was calculated to be 0/3%. A total of 905 counseling papers were reviewed. According to the data, 51/1% of patients were female and 48/9% were male, with the mean age of 45/7 years. For 54/7% of the patients, emergency counseling and for 45/3%, of them non-emergency counseling was requested. The most requesting counseling departments were surgery and internal medicine (14/6% and 12%, respectively). The lowest frequency of consultation requests was for anesthesiology department (0/1%). The most common reason for requesting psychiatric counseling was restlessness (26/75%) and then medication setting (14/45%). The most common diagnostic suspicion in response to counseling was delirium and the average duration for requesting counseling was 2.9 days after admission. Conclusion: Considering the relatively low frequency and quality of counseling in this study, more attention to the use of psychiatric counseling in medical patients and coherent training of assistants to improve the quality of counseling seem necessary. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to survey the prevalence of exposure to workplace violence (WPV) including physical violence, verbal abuse, bullying as well as its related factors among physicians and medical students attending teaching hospitals of Kurdistan University of Medical Sciences (KUMS).Design/methodology/approach This is a descriptive analytic as well as a cross-sectional study which was carried out on all physicians (general and specialists) and medical students attending teaching hospitals of KUMS in 2014. Overall, 400 participated in this study and data were gathered using a standard questionnaire. Then, data were analyzed using SPSS 20, χ2 and Fisher's exact tests as well as univariate and adjusted logistic regression.Findings The prevalence of physical violence, verbal abuse and bullying among medical students was reported 4.5, 59 and 0.8 percent, respectively. In addition, the prevalence of these violence among general practitioners was 6.9, 72.4 and 0 percent, respectively. Moreover, 11.5, 42.3 and 3.8 percent of specialists had experienced physical violence, verbal abuse and bullying, respectively. Patients and their relatives were the main sources of the violence. Based on the results of multivariate logistic regression, male sex (AOR=2.60, CI: 1.56–4.32) and having shift work (AOR=3.13, CI: 1.67–5.84) were the most significant risk factors for total WPV.Originality/value The WPV experienced by physicians and medical students attending teaching hospitals of MUK is high. Health sector authorities should develop and implement proper strategies and interventions aiming at reducing or preventing from incidence of WPV. [ABSTRACT FROM AUTHOR]

Purpose: Accreditation helps to ensure safe and high-quality services in hospitals. Different occupational groups have various hospital accreditation experiences. The purpose of this paper is to investigate nurses' accreditation experience and its effects on Iranian teaching hospital service quality.Design/methodology/approach: This was a qualitative study involving a phenomenological approach to studying nurses' hospital accreditation experience and understanding the effects on Iranian teaching hospital service quality. Data were collected using two focus groups in which nurses were selected using purposive sampling. Transcripts were analyzed using content analysis.Findings: Nurses' experiences showed that hospital administrators and nurses had greater role in implementing accreditation than other occupational groups. Accreditation improved patient-centeredness, patient safety, logistics and managerial processes and decision making. However, a weak incentive system, extra documentation and work stress were negative experiences.Practical Implications: Nurse experience, as the most important care team member, reveals accreditation's strengths and weaknesses and its effects on service quality.Originality/value: The author used a phenomenology approach to measure accreditation effects on service quality - a valuable tool for understanding a phenomenon among those that experience hospital accreditation processes. [ABSTRACT FROM AUTHOR]

Purpose: In this paper, we present the major curricular reform in MD program of Tehran University of Medical Sciences, the oldest and the largest medical university in Iran, initiated about a decade ago. Materials and methods: Following a comprehensive program evaluation, many of the basic challenges of the traditional curriculum were revealed, namely, lack of pre-defined competencies for graduates, over-reliance on teacher-centered teaching methods, over-emphasis on knowledge base in student assessments, and focusing solely on biomedical aspects of patient care. In 2010, a vision statement for reform was created and approved by the University Council. The new curriculum was launched in 2011. Results: The changes included: revising the content of the courses, assimilating horizontal and vertical integration, emphasizing clinical skills, encouraging active involvement in patient management, providing more opportunity for supervised practice, integrating behavioral and psychosocial topics into the curriculum, incorporating interactive teaching methods, assessing students’ higher levels of cognition, and strengthening workplace assessments. To evaluate the changes, data were continuously collected and analyzed from the beginning. Conclusions: Changing the curriculum of an MD program is a laborious task which should be planned and undertaken carefully and cautiously. It is an endless, yet invaluable and satisfying endeavor toward better future. [ABSTRACT FROM AUTHOR]

Background: At present, combined provision of direct composite restorations and dental bleaching has become increasingly popular to meet the esthetic demands of patients. This study aimed to assess the effect of internal bleaching on microtensile bond strength of composite to freshly veneered enamel. Methods: In this in vitro experimental study, 50 sound extracted human premolars were randomly divided into five groups (n=10). All teeth received composite veneers. Two groups underwent no further intervention and were subjected to measurement of microtensile bond strength of composite to enamel 24 hr and one week after the veneering. The remaining three groups underwent internal bleaching. Group 3 underwent bleaching one month after the veneering, and microtensile bond strength was measured after 24 hr. In groups 4 and 5, bleaching was performed immediately after the veneering. Microtensile bond strength was measured after 24 hr in group 4 and after one month in group 5. Data were analyzed using one-way ANOVA. Results: All the groups were not significantly different regarding the mean bond strength (p=0.110), but they were significantly different in terms of the mode of failure (p=0.01) such that the mode of failure was mainly adhesive in the three bleached groups. Conclusion: Internal bleaching after composite veneering has no significant effect on microtensile bond strength of composite to the enamel. [ABSTRACT FROM AUTHOR]

Introduction: Today, internet usage has become an integral part of daily life, but excessive use can harm sleep quality. This study aims to explore the relationship between internet addiction and sleep quality among students at Ilam University of Medical Sciences in 2023. Material & Methods: In 2023,400 students from Ilam University of Medical Sciences participated in this study. They were selected using simple random sampling and met the study criteria. Data were collected through Young's Internet Addiction Test (IAT) and the Pittsburgh Sleep Quality Index (PSQ1). Simple and multiple regression analyses were conducted with a significance level of a ≤ 0.05. Results: The findings showed that 320 (80%) of students exhibited mild to severe internet addiction, with an average total sleep quality falling within the poor range (6.30 ± 2.51). Subjective sleep quality was particularly poor (2.03 ± 0.662) compared to other dimensions (p > 0.05). Simple linear regression revealed significant associations between mild (coefficient = 1.03; p = 0.002) and moderate (coefficient = 2.05; p < 0.001) internet addiction and poor total sleep quality, compared to normal individuals. Additionally, graduate students had better sleep quality than undergraduates (coefficient = -1.03; p = 0.016). Multiple regression analysis, adjusted for educational level, confirmed the association between mild (coefficient = 0.98; p = 0.003) and moderate (coefficient = 1.97; p < 0.001) internet addiction and poor total sleep quality. Conclusion: Internet addiction is linked to poor sleep quality among Ilam University of Medical Sciences students, especially undergraduates. It underscores the need for interventions to raise awareness about internet addiction and its detrimental effects on sleep quality. [ABSTRACT FROM AUTHOR]

Background: Oral lichen planus (OLP) is a chronic inflammatory mucosal disease that is classified as a premalignant condition. Epithelial growth factor receptor (EGFR) is associated with tumorigenesis and tumor progression and is overexpressed in several oral malignant disorders. Despite the association of EGFR overexpression with oral potentially malignant lesions, few studies have analyzed its expression in OLP, showing controversial results. This study aimed to compare the expression of EGFR as a protein marker in Reticular and Erosive OLP. Methods: This descriptive-analytical cross-sectional was conducted on 15 paraffin blocks of reticular lichen planus lesions, 16 paraffin blocks of erosive OLP lesions, and 8 paraffin blocks of inflammatory fibrous hyperplasia lesions as the control group (39 in total). After immunohistochemical staining for EGFR, samples were simultaneously observed by two maxillofacial pathologist, and the percentage of stained cells, intensity of staining, pattern of staining, and the location of stained cells were obtained. Results: The Mann-Whitney-U test showed that there was no significant difference in the mean percentage of stained cells between erosive OLP and reticular OLP (P-value = 0.213) and between reticular OLP and control group (P-value = 0.137), but there was a significant difference between erosive OLP and control group (P-value = 0.035). Fisher's exact test showed that there was no significant difference between the frequency distribution of staining patterns in three types of lesions (P-value = 0.90). Kruskal-Wallis test showed that there was no significant difference between the intensity of staining in the three groups (P-value = 0.19) and also there was no significant difference between the location of stained cells in different layers of the epithelium in the three groups (P-value = 0.90). Conclusions: The results of this study showed that in comparison of reticular OLP, erosive OLP, and the control group there was a significant difference just between erosive OLP and control group in the percentage of stained cells. [ABSTRACT FROM AUTHOR]

Introduction: The preparedness of the healthcare system to address emergency situations is contingent on the inclination of healthcare personnel. Nursing students can serve as valuable resources to supplement the workforce during major incidents and disasters. This study investigated the facilitators and barriers of nursing students' willingness to respond to disasters at the Alborz University of Medical Sciences in 2022. Methods: In this cross-sectional descriptive study, 234 nursing students were recruited using convenience sampling. A deductive-inductive questionnaire was developed and distributed through an online self-administered survey comprising demographic information and questions on barriers, facilitators, various disaster scenarios, preferred activities, and reasons for pursuing a nursing career. Results: The mean willingness scores of nursing students in response to various disasters were as follows: 3.15 for natural disasters, 2.60 for man-made disasters, 2.94 for pandemics, and 3.32 overall. Among the disaster scenarios, the earthquake response obtained the highest willingness score, while infectious disease epidemics received the lowest score. The most and least willingness to perform activities during disaster response were related to bedside care and participation in patients' personal hygiene, respectively. Key determinants of participation included the possibility of immunization and concerns for family safety. Conclusion: The findings indicated that nursing students are generally willing to assist as members of the healthcare team during disasters. However, the willingness to respond to infectious disease epidemics and man-made disasters was below the norm. Concerns about family health and the risk of disease transmission were identified as primary barriers. Addressing these concerns is crucial to enhance nursing students' participation in disaster response. [ABSTRACT FROM AUTHOR]

Introduction: In recent decades, E-learning has gained widespread recognition globally as a vital application of information and communication technology. Objectives: The present study investigated the effectiveness of non-attendance triage training based on the ESI-IV system on the knowledge and ability of pre-hospital emergency staff. Patients and Methods: This study was a semi-experimental interventional study, and the study population consisted of the pre-hospital emergency staff of Ahvaz university of medical sciences academic hospitals in 2021. The study tool was a questionnaire on the awareness and performance of the triage system of hospital emergency (ESI). Initially, both questionnaires were completed, and submitted the triage training file to the intervention group. Two weeks after the first phase—completion of the questionnaire for the first time— and the study of the file by the subjects, the questionnaire was completed again by the intervention group, and the data of both groups were compared. Results: According to the results, the mean of awareness and decision-making in the control group before and after the intervention was (11.8, 10.85, and 13.82) and (7.51, 7.36, and 8.86) respectively. The results indicate that non-attendance triage training based on the ESI-IV system was effective in the knowledge and ability of the pre-hospital emergency personnel had a positive and significant impact, and remains at a good level. Conclusion: The present results of the research indicate that the use of non-attendance training as an effective method can improve interns’ knowledge and ability. [ABSTRACT FROM AUTHOR]

Background. Granulomatous dermatoses, particularly on facial skin, pose a diagnostic challenge, as similar histologic patterns can be produced by different causes. Aim. To evaluate the correlation between clinical suspicion and histopathological findings in various facial granulomatous dermatoses. Materials and Methods. This retrospective, cross-sectional study included all patients with the histopathological diagnosis of facial granulomatous dermatoses from the years 2016 to 2021 in an academic hospital. Demographic, clinical, and histopathologic features were reviewed and analyzed. Results. In this study, 150 histopathological records with the diagnosis of facial granulomatous dermatoses from the years 2016 to 2021 were reviewed. The most common clinical diagnosis was rosacea 34 (23.6%), followed by sarcoidosis 27 (18.8%), leishmaniasis 15 (10.4%), and granulomatous rosacea 10 (6.9%). The frequency of clinical diagnosis of rosacea (70.6), sarcoidosis (66.7), foreign body G (62.5), TB (75), pseudolymphoma (75), acne agminata (66.7), and granulomatous rosacea (70) in female patients was higher than that in males (P value = 0.03). The effect of age on the type of both clinical and histopathological diagnosis was statistically significant (P value = 0.0001 and 0.004, respectively). Conclusion. Our study contributed significantly to the understanding of the clinicopathological aspects of facial granulomatous dermatoses and advocated for a multidisciplinary approach to the diagnosis and management of these complex skin conditions. [ABSTRACT FROM AUTHOR]

Background: Enterococcus faecalis has been widely used as a valuable microbiological pathogen for in vitro studies due to its ability to successfully colonize the root canal in a biofilm-like style, invade dentinal tubules, and resist endodontic treatment procedures. The aim of this study was to compare the bactericidal efficacy of photodynamic therapy (PDT), 2% chlorhexidine, 2.5% NaOCl, and combination of PDT and 2.5% NaOCl against E. faecalis. Materials and Methods: Sixty single-rooted teeth had their canals contaminated with E. faecalis in brain heart infusion broth and were incubated for 48 hours. The canals were then subjected to 2% chlorhexidine, 2.5% NaOCl, PDT (red light emitting diode 625 nm+ Toludine Blue) and PDT + 2.5% NaOCl. Controls consisted of no treatment (positive control) and without inoculation of bacterium (negative control). Following treatment, the canal contents were sampled with sterile paper points. The samples were dispersed in transport medium, serially diluted, and cultured on blood agar to determine the number of colony forming units (CFU). Data were analyzed by Mann-Whitney U test at 5% significance level. The significance level for all analyses was set at P <.05. Results: Combination of PDT and 2.5% NaOCl achieved maximum reduction in recovered viable bacteria, no viable bacteria was observed after treatment of PDT + 2.5% NaOCl. Conclusion: Combination of PDT and 2.5% NaOCl simultaneously is effective in the elimination of E. faecalis from dentinal tubules under the conditions of this study. [ABSTRACT FROM AUTHOR]

Background and Aims: This study aimed to collect reports and HIS in a web-based system due to the problems of paper recording of student activities in practical courses, as well as the lack of computers in the departments for observing graphs and treatment plans. Materials and Methods: The initial graphic design of the website was done after the assessment of needs and the necessary planning for designing the website. The main template of the website was designed after consulting with the faculty and the designer company. A combination of HTML, CSS, JQuery, and Java script was used for static coding and what the user sees or interacts with. Then, the basic information entered the website and the content designer put the website in the designed layout. In the end, a sample hosting space was prepared and the website was fully provided to the professors and faculty officials to work with as an administrator and a user. They conveyed all their opinions and the corrections were made based on the feedback given. Results: The use of the internet and software with a central database played a significant role in monitoring and evaluating the long-term information of the student and the evaluation of the entire department, universities, and patients in each region up to macro-national evaluations. This could give the expansion and advancement of science in addition to the central registration of documents and radiographs, as well as their ease to access. Conclusion: The designed website was well received among the students and the attending staff. Introducing a web based logbook and HIS system can optimize the clinical teaching. These logbooks could help both students and staff saving time and resources, and to facilitate providing better personalized care for patients. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to conduct a systematic review and meta-analysis to estimate the prevalence of needle-stick injury among Iranian nurses. Methods: We conducted a systematic review and meta-analysis to estimate the prevalence of needle-stick injury among Iranian nurses. A comprehensive search of Web of Science, PubMed, Scopus, Scientific Information Database, and MagIran was performed, yielding 29 observational articles comprising 8842 nurses. The studies ranged from 2006 to 2023, with sample sizes varying from 68 to 1555 individuals. Methodological quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. The pooled prevalence was calculated using the random-effects model, and subgroup analyses were conducted based on hospital type and gender. The data was analyzed using Stata software version 16. Results: The pooled prevalence of needle-stick injury among Iranian nurses was found to be 46% (95% Confidence Interval [CI]: 39-53%). Subgroup analysis revealed significant difference in prevalence between teaching hospitals (47%; 95% CI: 39-54%) and military hospitals (38%; 95% CI: 31.1-44%). The prevalence of NSI in region 1 (Tehran and surrounding provinces) and other regions was 45.1% (95% CI: 37-54%) and 49.17% (95% CI: 36.5-61.7%). Gender-based analysis showed higher prevalence in women (58%; 95% CI: 44-71%) compared to men (55%; 95% CI: 43-66%). Conclusion: Needle stick injuries has a high prevalence among Iranian nurses, especially nurses working in teaching hospitals. Therefore, it seems necessary to use interventions to reduce it. [ABSTRACT FROM AUTHOR]

Background: Cardiomyopathy, characterized by heart stiffness, can lead to heart failure. This study aimed to investigate aortic stiffness in children with dilated cardiomyopathy (DCM) to better understand its contribution to disease severity. Methods: This case-control study compared 48 children with DCM with 96 healthy children over a 10-year period starting in 2011. Aortic strain, aortic stiffness index, aortic distensibility, and pressure strain elastic modulus were measured. These parameters, along with several echocardiographic measures, were compared between the DCM and control groups. Statistical analyses were performed using SPSS 18, with a significance threshold set at a P value below 0.05. Results: The participants included 57.6% boys, with 58.3% in the DCM group and 57.35% in the control group (χ² =0.014, P=0.905). The age range was 2 to 18 years, with mean ages of 11.08±4.63 years for the DCM group and 10.77±2.82 years for the control group (P=0.691). Significant differences between groups were observed in aortic distensibility (P=0.004), aortic stiffness β index (P=0.001), and pressure strain elastic modulus (P=0.004). Post-treatment analyses based on ejection fraction and fractional shortening cutoffs indicated no changes in elasticity parameters except for the aortic stiffness β index, which varied according to the Ross classification. Conclusion: Children with DCM exhibited reduced aortic strain and aortic distensibility, as well as elevated aortic stiffness β index and pressure strain elastic modulus. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine postoperative cardiac and noncardiac complications and their association with the use of cardiopulmonary bypass (CPB), surgical outcomes (length of hospital and ICU stays), dependence on mechanical ventilation, and mortality. Methods: This retrospective cross-sectional study was conducted on pediatric patients aged 0 to 18 who underwent open or closed cardiac surgery over a 1-year period. The use of CPB support, CPB duration, cardiac surgery complexity according to the risk-adjusted classification for congenital heart surgery (RACHS-1), and demographics were examined as potential risk factors associated with an increased number of postoperative complications. The study was performed at the Children's Medical Center, a teaching hospital affiliated with Tehran University of Medical Sciences in Iran. Results: A total of 283 surgeries were included in our study. Seventy-six (26.9%) of the study population experienced at least 1 complication. Our analysis revealed that increased CPB durations were associated with higher odds of cardiac complications, with an odds ratio of 1.02 (P=0.002). Moreover, higher RACHS-1 levels were significantly associated with greater numbers of cardiac and noncardiac complications. Additionally, prolonged mechanical ventilation and open-heart surgery intensive care unit (OH-ICU) stays were significantly associated with cardiac and noncardiac complications. Our logistic regression analysis found no association between demographic and clinical risk factors, the number of complications, and mortality. Conclusion: Postoperative complications occurred in 27% of pediatric heart surgeries. Prolonged mechanical ventilation and OH-ICU stays were significantly associated with cardiac and noncardiac complications. However, no significant association was found between postoperative complications and mortality. [ABSTRACT FROM AUTHOR]

Objective: Hospitals play a vital role in disaster management and their function must be maintained during crises. Isfahan province is susceptible to major crises and disasters at any time of the year. The study aimed to investigate the hospital safety index (HSI) in hospitals in Isfahan province. Methods: This cross-sectional study was conducted using the HSI questionnaire of the world health organization. The safety of all 55 hospitals in Isfahan province was evaluated with the Persian version of the questionnaire from 2017 to 2022. In this study, all hospitals were evaluated by a group of experts from the emergency operations center (EOC) of Isfahan University of Medical Sciences, and the checklists were completed with the cooperation of the hospital disaster committee, visiting the hospitals, and interviewing the personnel. Results: The safety level of hospitals has improved from 2017 to 2022 so in 2022, 38 hospitals (69.09%) had a high safety level, and 17 hospitals (30.91%) had a medium safety level. This increase in safety has happened in all three components of safety (functional, non-structural, and structural safety). There was no significant difference in the overall hospital safety score between academic-educational, non-academic governmental, social security and military, and private and charity hospitals (P<0.05). Conclusion: Although the safety in the hospitals of Isfahan province has improved due to the continuous disaster prevention and preparedness activities, hospitals still need to improve to achieve higher levels of safety. The HSI shows how well a hospital can maintain its organization and performance during disasters. This index will be useful for decision-making and policy-making to prioritize administrative and civil interventions. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the impact of two different aerobic exercise programs on the Body Mass Index (BMI) and progranulin (PGRN) levels of overweight or obese female students. Methods: In this quasi-experimental study, 36 overweight or obese female students from Kashan University of Medical Sciences and Islamic Azad University volunteered to participate. They were randomly divided into three groups: two groups underwent progressively increasing interval or continuous aerobic exercise programs, while the third group served as a control. The exercise programs lasted for 8 consecutive weeks, with blood samples collected before and after the intervention. Progranulin levels were measured using the ELISA technique with Human PGRN, and BMI was assessed at the beginning and end of the program. Results: The results of a one-way ANOVA test showed a significant decrease in progranulin levels (P=0.00) and BMI in both exercise groups compared to the control group (P=0.029). Conclusion: Both interval and continuous aerobic exercise programs were effective in reducing circulating progranulin levels and BMI in overweight or obese female college students. The exercise interventions led to a significant decrease in both variables. Further research is warranted to explore the effects of different aerobic exercise protocols on BMI and progranulin levels in normal adults. [ABSTRACT FROM AUTHOR]

Aim: Our objective was to assess the efficacy and safety of adding alpha-pinene (a herbal terpenoid) to quadruple therapy compared to a placebo in improving symptoms and Helicobacter pylori (H. pylori) eradication rates in Functional dyspepsia (FD) patients. Background: FD is a prevalent upper gastrointestinal condition, and no definitive pharmacological treatment is available for its management. Methods: We conducted a randomized, double-blinded, placebo-controlled trial on FD patients diagnosed with H. pylori infection. We collected baseline demographic data and assessed FD symptoms in the participants. Patients were randomly allocated to receive either standard quadruple therapy with α-pinene capsules (0.25 mg/day) or quadruple therapy with a placebo for two weeks. We employed a validated questionnaire, the Short Form Leeds Dyspepsia Questionnaire (SF-LDQ), to evaluate FD symptoms. The eradication rate of H. pylori was compared between the two groups one month after completing the treatment regimens. Any reported adverse drug reactions (ADRs) were documented throughout the trial. Results: Over four months, a total of 66 patients completed the trial. Notably, there were no significant differences in baseline SFLDQ scores between the two groups (p=0.83); however, a significant divergence emerged at the trial's conclusion (p=0.03). The H. pylori eradication rates did not show notable differences between the two treatment arms (p=0.43). Importantly, there were no dropouts from the trial due to ADRs. Among reported ADRs, participants experienced abdominal pain, headache, diarrhea, and a metallic taste, with no significant variance in incidence rates observed between the two groups (p=0.62). Conclusion: These findings suggest that α-pinene could be an effective and safe agent for reducing FD symptoms. [ABSTRACT FROM AUTHOR]

Background & Aim: Due to the increase in anxiety caused by corona in students, especially nursing students who deal with patients, it seems necessary to identify ways to deal with it. The purpose of the present study is to investigate the relationship between religious beliefs and anxiety of Corona among nursing students of Gonabad University of Medical Sciences. Materials & Methods: In this descriptive research, 159 nursing students who met the criteria for entering the study in 2019 were included in the study by stratified random sampling. The data was collected through the questionnaire of demographic information, corona anxiety and religious beliefs of George. Data analysis were analyzed using descriptive and analytical statistical methods (Kolmogorov-Smirnov, Mann-Whitney, Fisher, Chi-Square) at a significance level of P<0.05. Results: The results showed that the majority (79.2%) of weak corona anxiety research units had strong religious beliefs (73.6%), and Spearman's test showed that there is no significant relationship between corona anxiety and religious orientation (P<0.05). Conclusion: Acting on religious beliefs can reduce people's anxiety in difficult and critical situations, and in this study, because the majority of the research units had strong religious beliefs, they reported low corona anxiety. [ABSTRACT FROM AUTHOR]

Introduction: Effective performance in online education increasingly impacts the quality of classes and, consequently, student learning outcomes. This study aims to compare satisfaction levels and learning rates between online and face-to-face methods of teaching medical physiology. Material & Methods: This cross-sectional descriptive-analytical study involved 79 medical students divided into two groups. The first group received instruction on heart physiology (5 weeks, one session per week) online via the Navid system, while the second group received face-to-face instruction. At the study's conclusion, both groups underwent the same test to assess learning outcomes, and satisfaction with the teaching methods was evaluated through a questionnaire. Data analysis was conducted using Stata 14 statistical software, employing logistic regression and linear regression models. Results: The two groups differed in terms of the course studied, student nativeness, and satisfaction levels with the educational method. Satisfaction with online education was reported at 69%, compared to 65% for the face-to-face method. The average learning score for students in the online group was 12.93±0.12, while in the face-to-face group, it was 13.48±0.47. However, the linear regression model revealed no significant relationship between students' scores and specific educational methods (p=0.32). Significant relationships were observed between age, nativeness, and dormitory accommodation with satisfaction levels in online education. Conversely, none of the variables showed a significant relationship with satisfaction levels in face-to-face education. Conclusion: Both e-learning and face-to-face methods demonstrated relatively similar effects on students' learning outcomes. However, satisfaction levels with online education appear to be influenced by variables such as age, nativeness, and dormitory accommodation. [ABSTRACT FROM AUTHOR]

Introduction: The Quality of Life (QOL) of couples with infertility can be affected by Irrational Thoughts (IT) regarding childbearing and it might be influenced by Religious Teachings (RT) as a mediator. The purpose of this study was to investigate the relationship between QOL and IT of childbearing with the mediating role of RT in couples with infertility in Shahrekord City, Iran. Method: This analytical correlational study was conducted among 196 couples with infertility who were referred to Shahrekord Infertility Center, Iran selected by a convenient sampling method. Data were collected using the questionnaires on QOL provided by the World Health Organization (WHO), IT designed by Flex and Religious Teaching. Results: The mean score of QOL was 76.42± 20.137, IT 32.20± 9.019 and RT was 150.84± 40.97. A significant relationship was found between the mean scores of QOL and IT of childbearing with the mediating role of RT in couples with infertility (P=0.001). Moreover, mean scores of study concepts had no significant relationship with demographic variables (gender, education, and infertility duration) among the participants. Conclusion: Based on the findings, the QOL of couples with infertility can be improved by strengthening the RT and reducing the IT of childbearing. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome causes a decrease in sexual function and health-promoting behaviors. The present study compared the effectiveness of emotionally focused therapy and cognitive-behavioral therapy on sexual function and health-promoting behaviors in women with polycystic ovary syndrome. Method: This semi-experimental study was carried out on women with polycystic ovary syndrome referred to the infertility clinic of Afzalipur Hospital in Kerman, in 2022. For this purpose, 45 patients were selected using convenience sampling and were then randomly placed into two experimental groups and one control group (15 people in each group). The experimental groups were subjected to the interventions of emotionally focused therapy and cognitive-behavioral therapy. The questionnaires on sexual function and promoting lifestyle were used. Data were analyzed using SPSS21 software and variance analysis. Results: Findings revealed that the cognitive-behavioral therapy of emotionally focused therapy had significant effects on sexual function and health-promoting behaviors (P<0.05). The comparison of two therapies revealed that the effectiveness of cognitive-behavioral therapy on sexual function and health promoting behaviors is more than emotionally focused therapy. Moreover, there was no statistically significant difference between post-test and follow-up scores (P>0.05), which shows the lasting effect of the interventions on sexual function and health promoting behaviors in mothers with polycystic ovary syndrome. Conclusion: According to the results, the use of cognitive-behavioral therapy can be more effective on sexual function and health-promoting behaviors in women with polycystic ovary syndrome. [ABSTRACT FROM AUTHOR]

Background: Intensive and critical care nurses need to demonstrate ethical sensitivity especially in recognizing and dealing with ethical dilemmas particularly as they often care for patients living with life-threatening conditions. Theories suggest that there is a convergence between nurses' empathy and ethical sensitivity. Evidence in the literature indicates that nurses' emotional, demographic, and work characteristics are associated with their level of empathy and ethical sensitivity. Aim: To investigate the relationship between nurses' empathy and ethical sensitivity, considering their emotional states (depression, anxiety, and stress), demographic and work characteristics, and test an empirical model describing potential predictors of empathy (as a mediator) and ethical sensitivity using path analysis. Research design: Using a cross-sectional design, the philosophical theory of care ethics and empathy was extended and adopted as a conceptual framework for this study and tested by path analysis. Participants and research context: Data were collected from 347 intensive care nurses recruited by ten educational-medical hospitals in Iran using a questionnaire between February and March 2021. Ethical considerations: The study was reviewed by the Ethical Advisory Board in Iran and conducted according to the Declaration of Helsinki. Findings: Study participants demonstrated a mild level of stress, anxiety, and depression, alongside a relatively high level of empathy and ethical sensitivity. Nurses with good socioeconomic status had higher empathetic behavior with patients than those with weak status. Nurses aged over 40 who had received ethics training and had higher work experience were associated with higher ethical sensitivity compared to nurses under 20 years of age. Empathy directly affected ethical sensitivity; however, anxiety had an indirect effect on ethical sensitivity through empathy. Among demographic factors, age had a positive direct effect on ethical sensitivity. Conclusions: Less anxiety and a high level of empathy contribute to higher levels of ethical sensitivity among intensive and critical care nurses. [ABSTRACT FROM AUTHOR]

Background: Clinical advice may suggest discontinuing breastfeeding after the diagnosis of phenylketonuria in infants as the only effective way to monitor the newborn's intake and accurate measurement of phenylalanine (Phe). This study aims to investigate the prevalence and duration of breastfeeding, as well as its effect on serum Phe levels in infants with phenylketonuria at Education and Therapy Medical Center, Be'sat Hospital, Iran. Methods: We conducted a cross-sectional study of 34 children under two years old diagnosed with phenylketonuria between September 2018 and December 2022. Infants were categorized as breastfed and non-breastfed (bottle-fed) based on their feeding method after diagnosis. Data on age at diagnosis, medical records, demographic information, and anthropometric indices were collected, and infants with incomplete data or mixed feeding (formula + breast milk) were excluded from the study. Results: Of 94 infants managed in our hospital, 34 had complete medical records. Among the all patients 13 (38%) continued to be breastfed combined with phenylalanine-free amino acid-based protein substitute, while 21 (62%) were did not receive breast milk. The mean duration of breastfeeding was 2.57 ± 0.59 (1–3) months. The mean age at diagnosis was 22.6 ± 18.4 days. Phenylalanine concentrations at diagnosis were mean 10, SD 5.44; range 4–24 mg/dL [0.22–1.33 μmol/L] in the breastfed group and mean 14.3, SD 10.2; range 5–37 mg/dL [0.27–2.05 μmol/L] in the non-breastfed group.Non-breastfed infants had lower serum Phe levels than breastfed infants: mean 3.76, SD 2.10; range 1–7 mg/dL [0.05–0.38 μmol/L] and mean 4.89, SD 3.68; range 2–19 mg/dL [0.11–1.05 μmol/L], respectively, although not statistically significant [(t (34) = 118.0, P = 0.51]. Also we found no significant associations in body measurements for weight, height, and head circumference at birth and final assessment. Conclusions: In conclusion, during treatment, there were no statistically significant associations between breastfeeding and serum Phe levels with growth in children with phenylketonuria. [ABSTRACT FROM AUTHOR]

Background: In 1995, teaching and public hospitals that are affiliated with the ministry of health and medical education (MOHME) in Iran were granted financial self-sufficiency to practice contract-based relations with insurance organizations. The so-called "hospital autonomy" policy involved giving authority to the insurance organizations to purchase health services. The policy aimed at improving hospitals' performance, hoping to reduce government's costs. However, the policy was never implemented as intended. This was because most participating hospitals gave up to implement autonomous financing and took other financing pathways. This paper analyses the reasons for the gap between the intended policy and its execution. The lessons learned from this analysis can inform, we envisage, the implementation of similar initiatives in other settings.Methods: We conducted semi-structured interviews with 28 national and 13 regional health policy experts. We also gathered a comprehensive and purposeful set of related documents and analyzed their content. The qualitative data were analyzed by thematic inductive-deductive approach.Results: We found a number of prerequisites and requirements that were not prepared prior to the implementing hospital autonomy policy and categorized them into policy content (sources of funds for the policy), implementation context (organization of insurance organizations, medical tariffs, hospitals' organization, feasibility of policy implementation, actors and stakeholders' support), and implementation approach (implementation method, blanket approach to the implementation and timing of implementation). These characteristics resulted in unsuitable platform for policy implementation and eventually led to policy failure.Conclusions: Autonomy of teaching hospitals and their exclusive financing through insurance organizations did not achieve the desired goals of purchaser-provider split in Iran. Unless contextual preparations are in place, hospital autonomy will not succeed and problematic financial relations between service providers and patients in autonomous hospitals may not be ceased as a result. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to identify the main reasons for discharge against medical advice (DAMA) in the emergency department (ED) of a teaching hospital in Tehran, Iran.Design/methodology/approach: This cross-sectional study was conducted on all the patients who left the ED of a referral teaching hospital against medical advice (AMA) in 2008. A questionnaire was filled out for each patient to determine the reasons behind patient leaving AMA.Findings: In total, 12.8 percent of the patients left the hospital AMA. Dissatisfaction with being observed in the ED, having a feeling of recovery and hospital personnel encouraging patients to leave the hospital were the main reasons for leaving the hospital AMA.Practical Implications: Like many other centers, the results showed that poor communication skill and work overload were the main contributing factors to DAMA. The center managed to improve patient satisfaction and thus lowered DAMA rates following this study. Considering the similarities reported in the reports and that of other studies, it could be concluded that policy makers in other centers can also benefit from the results to adopt effective approaches to reduce DAMA rate.Originality/value: To the knowledge no study has evaluated the rate and the reasons behind DAMA in the Iranian EDs. [ABSTRACT FROM AUTHOR]

Background : The main purpose of the present paper is to examine the effectiveness of acceptance and commitment therapy on perceived stress, stress coping strategies and illness perception in women with Ulcerative Colitis. Materials and Methods: This is an experimental study performed as pretest and post-test. The population consists of woman suffering from Ulcerative Colitis in Isfahan. The sample includes 37 Colitis selected by multi-stage random sampling and randomly assigned to experiment and control groups (control=20, experimental=17). The acceptance and commitment therapy was performed in the experimental group within two months once a week. The tools applied by this study include Perceived Stress Scale, Brief Illness Perception Scale Stress Coping Strategies Scale and Brief Illness Perception Scale. Results: The results of this research showed that the means of coping strategies in experimental group has changed significantly in comparison with control group (p<0.05). Conclusion: Thus, the acceptance and commitment therapy could be used along with other methods of the treatment for the women with Ulcerative Colitis. [ABSTRACT FROM AUTHOR]

Background: Coronary heart diseases (CAD) and their risk factors are among the major causes of death in Iran. Since these risk factors begin to develop early in life, it is vital to diagnose those newborns at high risk of CAD. Objectives: The present study investigated the umbilical cord blood lipid profile of term and preterm neonates. Methods: In this cross-sectional study, the lipid profiles of 292 neonates, of which 276 were term and 16 preterm, were examined at a teaching hospital. Results: The lipid profile results of total cholesterol, triglycerides, high density lipoprotein, and low density lipoprotein were 69.8, 34.9, 23.6, and 31.5 in term neonates and 80.5, 25.5, 25.1, and 38 in preterm neonates, respectively. Conclusions: According to the current paper, the lipid profiles of eastern Iranian neonates were similar to those reported in global studies. Moreover, except for triglycerides in the female neonates, lipid profiles were significantly higher among the male neonates. [ABSTRACT FROM AUTHOR]

Background: Ensuring patient safety is of paramount importance in healthcare services. Sleep disorders not only have detrimental effects on the health of healthcare students but also significantly impair their performance, leading to an increased risk of medication errors. These errors can pose a grave threat to the safety and well-being of patients. It is crucial to address and mitigate sleep disorders among internship healthcare students to safeguard the quality of care and minimize potential patient harm. Objectives: This study aimed to investigate the predictors of Patient Safety Competency (PSC) based on the sleep quality of internship healthcare students. Methods: A study was conducted on 331 students from the Ardabil School of Nursing and Midwifery at Ardabil University of Medical Sciences in northwest Iran from August to December 2022. The participants were selected by stratified random sampling. Data were collected using a demographic information form, the Pittsburgh Sleep Quality Index (PSQI), and the Health Professional Education in Patient Safety Survey (H-PEPSS). The collected data were analyzed using SPSS software version 22.0. Person correlation coefficients were used to examine the relationship between PSC level, its dimensions, and sleep quality, while multiple linear regression was conducted to identify the predictors of PSC. Results: The competency of nurses in patient safety was average in both classroom and clinical settings. However, their ability to work as a team with other healthcare professionals scored the lowest. In addition, the quality of sleep was found to be a predictor of patient safety competency among healthcare students during their internships. Conclusions: It is important to note that healthcare students tend to have moderate patient safety competence (PSC), which is positively correlated with their sleep quality. Therefore, it is vital to identify the key factors that directly affect PSC. This would enable nursing and midwifery faculty administrators to take preventive measures to enhance patient safety competence in both classroom and clinical settings. Additionally, organizing educational workshops that engage students and improve their sleep quality could improve patient care. Practical courses are recommended for health professionals and students in clinical settings to enhance patient safety competencies. Additionally, student internships should receive hands-on training to improve teamwork and rest conditions. [ABSTRACT FROM AUTHOR]

Background: Despite the widespread use of extracorporeal shock wave lithotripsy (ESWL) as a treatment for kidney stones, it is essential to apply methods to control pain and improve patient comfort during this procedure. Therefore, this study aimed to investigate the effect of acupressure at the Qiu point on pain intensity and physiological indices in patients undergoing ESWL. Methods: This randomized, sham-controlled clinical trial was conducted at the Shahid Beheshti Educational-medical Center in Hamadan City (western Iran) from May to August 2023. Seventy-four eligible patients were split into intervention (n = 37) and sham (n = 37) groups. Ten minutes before lithotripsy, the intervention group received acupressure at the Qiu point, while the sham group received touch at a neutral point. The primary outcomes were pain intensity measured by the Visual Analog Scale (VAS) and physiological indices such as blood pressure and heart rate at baseline, 1, 10, 20, 30, 40, and 50 min after the intervention. The secondary outcomes included lithotripsy success and satisfaction with acupressure application. Results: The analysis of 70 patients showed no significant differences in the demographic and clinical information of the patients across the two groups before the study (P > 0.05). Generalized estimating equations revealed that the interaction effects of time and group in pain and heart rate were significant at 30 and 40 min (P < 0.05). The results of this analysis for systolic blood pressure revealed a significant interaction at 30 min (P = 0.035). However, no significant interaction effects were found for diastolic blood pressure changes (P > 0.05). Conclusions: Acupressure at the Qiu point positively impacts pain in patients undergoing ESWL treatment and increases their satisfaction. However, these results for physiological indices require further studies. Thus, acupressure can be considered a simple, easy, and effective option for pain management in patients during this procedure. Trial registration: [https://en.irct.ir/trial/69117], identifier [IRCT20190524043687N4]. [ABSTRACT FROM AUTHOR]

Background: Patients with Acute Coronary Syndrome (ACS) experience high levels of anxiety that may cause instability of hemodynamic indices, increased risk of ischemia, myocardial infarction and poor quality of life. Aromatherapy can affect patients' anxiety levels and improve hemodynamic indices. This study aimed to evaluate the efficacy of aromatherapy on anxiety and hemodynamic indices in ACS patients. Methods: This study was a double-blind, randomized clinical trial conducted on 154 ACS patients. The participants were classified into two equal groups of intervention and placebo through the block randomization method. The data collection tools consisted of demographic information, a shortened 6-item version of the Spielberger questionnaire and a form of hemodynamic indices. For two consecutive nights, the intervention group inhaled 7 drops of the chamomile essential oil (%10) and the placebo group inhaled 7 drops of the sesame oil poured on a sterile cotton ball. The hemodynamic indices were collected half an hour before, one and four hours after the intervention until the next morning. The Spielberger questionnaire was completed once before the intervention and once after the end of the intervention, by the researcher through an interview. The number of heart rate (HR) was counted for a full minute. Also, the blood pressure (BP) of all the samples was measured by the researcher. Data analysis was done using Chi-square, paired t-test, and analysis of variance (ANOVA) in SPSS22. Results: The mean and standard deviation of the age of patients were 58/2 ± 11.6 and 59.7% of them were female. The results of ANOVA showed a significantly lower anxiety score as well as systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR in the intervention group compared to those of the placebo group (P < 0.001). The decrease in anxiety score after the intervention, in the intervention and placebo groups was (5.2 ± 1.9) and (1 ± 1. 18) respectively. In the intervention group, the SBP and DBP after the intervention, was significant (P < 0.05). Also, the HR was significant (P < 0.001) after the intervention. Conclusions: Aromatherapy could reduce anxiety and improve hemodynamic indices in ACS patients. Trial registration: IRCT20080825001083N11. [ABSTRACT FROM AUTHOR]

Background: Sentinel lymph node biopsy (SLNB) is primarily performed to detect axillary lymph node involvement and determine the need for surgical axillary lymph node dissection (ALND). However, the procedure is expensive and necessitates the use of radio-labelled colloids that are not readily available to a large number of patients. It also carries the risk of producing occasional false negative results. Objectives: This study aimed to define highly specific ultrasound parameters to ascertain axillary lymph node involvement as an alternative or complementary method to SLNB in selected patients who require ALND. Patients and Methods: In this prospective cross-sectional study, 256 patients with confirmed breast cancer were selected through non-probability purposive sampling. The selected patients were referred to Omid Hospital, a tertiary educational oncology center in Mashhad, Iran, from 20I8 to 2022. This study identified highly specific cut-off points for ultrasound parameters to determine lymph node involvement in comparison with the histological diagnosis post-SLNB or ALND. Measurements were taken of the tumor size, the cortical thickness of the axillary lymph node, the short axis diameter of the node, and the count of lymph nodes with a cortical thickness of ≥ 3 mm. Results: Among 256 patients with a mean age of 46.41 ± 10.77 years, 202 (87.9%) had histologically confirmed metastatic adenopathy. The ultrasound cut-off values identified to define metastasis with high certainty were as follows: A tumor size > 50.5 mm (with 97% specificity), a difference in cortical thickness of ≥ 4.5 mm (with 100% specificity), a short axis diameter of the node > 12 mm (with 95% specificity), more than three lymph nodes with a cortical thickness of ≥ 3 mm (with 943% specificity), and a cortical thickness of ≥ 6 mm (with 95% specificity). Conclusion: Highly specific ultrasound findings can diagnose lymph node metastasis with a high degree of certainty and can used as an alternative method to SLNB. A difference of ≥ 45 mm between the cortical thickness of the suspected lymph node and the contralateral lymph node and a cortical thickness of ≥ 6 mm are ultrasound findings that can detect lymph nodes involvement, with a specificity ranging from 95% to 100%. [ABSTRACT FROM AUTHOR]

Background: Obesity is considered a widespread concern internationally. Few studies have investigated the relationships between dairy consumption and hypertension and obesity. Therefore, this study examined the above concern in students. Methods: This cross-sectional study was conducted on 292 male students (18--30 y) living in the dormitories of Tabriz University of Medical Sciences. Students were selected via the multistage stratified random sampling method. Demographic information, anthropometric measurements, blood pressure (BP) readings, and a semi-quantitative validated questionnaire assessing dairy consumption (including a 24-hour dietary record covering 2 typical days and a holiday) were collected. After all the questionnaires were reviewed, they were coded and analyzed with Nutritionist IV software. Results: The average age of the subjects was 22.36 years. The mean±SD values of body mass index (BMI), waist circumference, waist-to-hip ratio, and waist circumference-to-standing height ratio were 22.68±2.58 kg/m², 80.95±7.81 cm, 0.85±0.04, and 0.46±0.04 among the studied population, respectively. The mean±SD values of systolic and diastolic blood pressure were 111.84±10 mm Hg and 70.99±8 mm Hg, respectively. Milk consumption was associated with a low waist circumference (95% credible interval, 1.005 to 4.580; P=0.046). The odds of hypertension (defined as BP>120/90 mm Hg) were 2.686 times higher in the overweight and obese group than in the normal BMI group. The risk of hypertension was 1.045 times higher for individuals with abdominal obesity than for those who did not consume dairy products. Conclusion: Milk consumption was associated with a low waist circumference. The correlations between systolic blood pressure and anthropometric factors were statistically significant. BMI, waist circumference, and waist-to-hip ratio were positively associated with systolic blood pressure. [ABSTRACT FROM AUTHOR]

Objective In recent years, the infant development and assessment programs have received attention by the health system of Iran. In this regard, the training of examiners for performing the Bayley tests has become one of the needs of the health system. This study aims to design and evaluate the validity and reliability of the Bayley-III examiner clinical performance scale. Materials & Methods In this study, participants were Bayley-III test examiners from medical universities in Iran, who were selected using a purposive sampling method. First, in focused group discussion sessions with 10 Bayley-III test experts, the items of instrument were formulated. Then, to evaluate the face validity, the questionnaire was sent to a panel of expert consisting of 8 Bayley-III experts and examiners and they were asked to rate the items from 1 to 5 in terms of importance. The items with an impact score of less than 1.5 were deleted, and other items were revised, if needed. To evaluate content validity, the questionnaire was sent to 10 Bayley-III test experts, and then the content validity ratio (CVR) and content validity index (CVI) were measured. The items with CVR <0.6 and CVI <0.7 were deleted. The reliability of the instrument was assessed by calculating the inter-rater reliability, test re-test reliability, and internal consistency. Quantitative data analysis was done in SPSS software, version 22. Results The instrument with 66 items, including 32 items for the cognitive domain, 22 items for the language domain (13 for receptive and 9 for expressive components), 12 items for the motor domain (9 for fine and 3 for gross motor skills), and 14 items for the general section, was assessed in stability and reliability. The intraclass correlation coefficient (ICC) for the test re-test reliability was obtained 0.83 for the specific section and 0.86 for the general section. The ICC for the inter-rater reliability was 0.80 (95% CI: 58-82). The highest correlation value was related to the cognitive scale (0.88), and the lowest value was for the gross motor skill subscale (0.76). The kappa coefficient for the inter-rater reliability of the general section was above 0.7. The kappa coefficient for the specific section ranged from 1 to 0.35. The Cronbach’s α for the internal consistency of the general section was 0.76. Conclusion The designed questionnaire is a valid and reliable tool to evaluate the clinical performance of Bayley-III test examiners in Iran. [ABSTRACT FROM AUTHOR]