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Abstract Objective Workplace violence (WPV) is an important issue in prehospital care, especially for emergency medical technicians ( EMTs) who are at increased risk of physical violence due to the nature of their work. This study aimed to shed light on the specific factors that contribute to the underlying causes of physical WPV in the prehospital context through direct experience and insight into the work of EMTs. Methods Sequential explanatory mixed methods were applied in five western provinces of Iran from 2022 to 2023. In total, 358 EMTs that met the criteria for the quantitative phase were selected using a multi-stage clustering method. In the quantitative phase, the researchers used a questionnaire on workplace violence in the healthcare sector. Based on the results of the quantitative phase, 21 technicians who had experienced physical violence in the past 12 months were invited for in-depth interviews in the qualitative phase. Results The average age of the EMTs was 33.96 ± 6.86 years, with an average work experience of 10.57 ± 6.80 years. More than half (53.6%) of the staff worked 24-hour shifts. In addition, most EMTs were located in urban bases (50.3%), and 78 (21.8%) reported having experienced physical violence. No significant correlations were found between the demographic characteristics of the technicians and the frequency of physical violence, except base location in the last 6 months. The qualitative study also created one theme (the complexity of WPV in the prehospital setting), four categories, and ten subcategories. Conclusion The study’s results emphasize the need for comprehensive WPV factors in the prehospital setting. These factors can lead to identifying and improving strategies such as organizational support, improving communication and collaboration between responders, and training in de-escalation techniques. In addition, it is crucial to address the root causes of WPV such as poverty and lack of education in the community to create a safer and more supportive environment for patients and staff.

Abstract Introduction This study aimed to evaluate the predictive accuracy of the prehospital rapid emergency medicine score (pREMS) for predicting the outcomes of hospitalized patients with traumatic brain injury (TBI) who died, were discharged, were admitted to the intensive care unit (ICU), or were admitted to the operating room (OR) within 72 h. Methods A retrospective cohort analysis was performed on a sample of 513 TBI patients admitted to the emergency department (ED) of Besat Hospital in 2023. Only patients of both sexes aged 18 years or older who were not pregnant and had adequate documentation of vital signs were included in the analysis. Patients who died during transport and patients who were transferred from other hospitals were excluded. The predictive power of the pREMS for each outcome was assessed by calculating the sensitivity and specificity curves and by analyzing the area under the receiver operating characteristic curve (AUROC). Results The mean pREMS scores for hospital discharge, death, ICU admission and OR admission were 11.97 ± 3.84, 6.32 ± 3.15, 8.24 ± 5.17 and 9.88 ± 2.02, respectively. pREMS accurately predicted hospital discharge and death (AOR = 1.62, P

There have been remarkable advancements in regenerative medicine for bone regeneration, tackling the worldwide health concern of tissue loss. Tissue engineering uses the body’s natural capabilities and applies biomaterials and bioactive molecules to replace damaged or lost tissues and restore their functionality. While synthetic ceramics have overcome some challenges associated with allografts and xenografts, they still need essential growth factors and biomolecules. Combining ceramics and bioactive molecules, such as peptides derived from biological motifs of vital proteins, is the most effective approach to achieve optimal bone regeneration. These bioactive peptides induce various cellular processes and modify scaffold properties by mimicking the function of natural osteogenic, angiogenic and antibacterial biomolecules. The present review aims to consolidate the latest and most pertinent information on the advancements in bioactive peptides, including angiogenic, osteogenic, antimicrobial, and self-assembling peptide nanofibers for bone tissue regeneration, elucidating their biological effects and potential clinical implications.

Abstract Background Emergency medical service providers are frequently exposed to a variety of stressors as a result of their work environment. These stressors can have detrimental effects on both the physical and mental well-being of individuals. This study was conducted with the aim of exploring stress management strategies in emergency medical service providers. Methods This study was conducted in 2023 using a qualitative approach and content analysis method. A purposive sampling method was used to include 16 emergency medical system providers from Hamadan city. Semi-structured interviews, with a duration of 45–60 min, were conducted for data collection. The Data were analyzed using Graneheim and Lundman’s conventional content analysis approach. Results The analysis of the interview data revealed three themes: readiness for the worst conditions, assistance based on supportive partnerships, and striving for balance. The six categories within these three themes were mental preparation, risk management, collaborations in emergency response, supportive communication, adaptive behaviors, and maladaptive responses. Conclusions The results of this study shed light on the various stress management strategies employed by emergency medical service providers. Understanding and implementing effective stress management strategies can not only enhance the well-being of emergency medical service providers but also improve the quality of patient care. Further research and action are essential to promote the resilience and mental health of these professionals, ensuring their overall well-being and job satisfaction.

Abstract Introduction Emergency medical services (EMS) providers encounter a variety of challenges due to the unpredictable, uncontrollable, and dynamic conditions in the pre-hospital field. This study explored the perceived professional challenges among EMS providers. Materials and methods This study was conducted using a qualitative research approach and the method of content analysis. Eighteen EMS providers were purposively selected from EMS stations in Hamadan, Iran. The collected data were then analyzed based on the Granheim and Lundman's method. Results Based on data analysis, five categories and one theme were identified. The extracted theme was professional challenges. The five categories were as follows: Ineffective policies; multicultural and multidisciplinary factors; ambulance dispatch route problems; legal issues; and abuse against the emergency medical services Conclusion In general, it has been found that EMS providers encounter numerous and complex professional challenges during their work. EMS managers can utilize the findings of the present study to develop strategies for reducing the professional challenges faced by EMS providers. By doing so, they can improve the quality of care in the prehospital field.

Abstract Introduction The unpredictability of prehospital emergencies combined with constantly changing circumstances can lead to increased stress and mental health issues among Emergency Medical Technicians (EMTs). To accurately determine the stress-inducing factors in the prehospital environment, it is important to first identify the stressful events that occur in this environment. Therefore, this study strives to provide a thorough analysis of the stressors in the prehospital environment. Methods Sequential explanatory mixed methods were conducted in Hamadan prehospital emergency centers in 2022. The study included 251 EMTs, who were selected through a method in the quantitative phase. The quantitative part used a questionnaire consisting of basic information and the Posttraumatic Stress Questionnaire (PCL-5). In the qualitative phase, 17 with extensive experience in dealing with prehospital stressors were selected based on their PCL-5 scores (above 33). The qualitative phase analysis was carried out using the contractual content method using the Graneheim and Ladman's approach. Statistical analyzes for the quantitative and qualitative phases were performed using SPSS 21 and maxqda 10, respectively. Results The study revealed that the EMTs had an average PTSD score of 21. 60 ± 11. 45. Multivariate linear regression analysis showed that the number of shifts had a statistically significant relationship with PTSD scores (t = 26.38, P

Habrobracon hebetor (Say) (Hymenoptera: Braconidae) is one of the most important biocontrol agents of insect pests in conducting IPM programs. In the present study, the effect of successive mass rearing by several generations on some biological parameters of H. hebetor was studied under laboratory conditions (28±2oC, R.H. 65±5 % & L:D (16:8)). The results of the analysis of variance showed that continuous rearing in different generations had a significant effect on all parameters (p

Introduction: Emergency medical services (EMS) are provided in the difficult and unpredictable conditions of prehospital settings. Therefore, EMS students need to receive quality education to acquire considerable knowledge and skills. This qualitative study aimed to explore the educational challenges in medical emergency students.Methods: This qualitative study was carried out in 2019 using qualitative content analysis. Participants were fourteen undergraduate EMS students purposively recruited from Hamadan University of Medical Sciences, Hamadan, Iran. Data collection was done through semi-structured interviews and continued up to data saturation. Data were analyzed using the conventional content analysis approach explained by Graneheim and Lundman.Results: The four main categories of the challenges of EMS education were shortcomings of the clinical education environment, lack of qualified EMS instructors, deficit of the curriculum, and theory-practice gap.Conclusion: During their university education, EMS students face different challenges. For effective training, more coordination is needed among the emergency medical board, faculty membersand EMS managers. It is also recommended that the curriculum should be revised.

Abstract Introduction Emergency medical services (EMS) providers are at continuous exposure to occupational stressors which negatively affect their health and professional practice. This study explored perceived occupational stressors among EMS providers. Methods This qualitative study was conducted from December 2019 to April 2020 using conventional content analysis. Sixteen EMS providers were purposively selected from EMS stations in Hamadan, Iran. Semi-structured interviews (with length of 45–60 min) were held for data collection. Data were analyzed through Graneheim and Lundman’s conventional content analysis approach. Findings Data analysis resulted in the development of two themes, namely critical conditions of EMS provision, and personal and professional conflicts. The six categories of these two themes were complexity of patients’ clinical conditions, interruption of EMS provision, health hazards, interpersonal problems, interprofessional interactions, and legal conflicts. Conclusion Besides the stress associated with emergency patient care, EMS providers face many different occupational stressors. EMS managers can use the findings of the present study to develop strategies for reducing occupational stress among EMS providers and thereby, improve their health and care quality.

Background and Objective: Aging is a critical period of life and attention to the issues and needs of this stage is a social necessity. In recent years, aging has become one of the most important public health issues. Therefore, the main purpose of the present study was to determine the effectiveness of Acceptance and Commitment Therapy on improving quality of life in elderly with cancer. Materials and Methods: The present study was a quasi-experimental study with pretest-posttest design. In this study, 30 people were selected by convenience sampling. Quality of life questionnaire and mental health questionnaire were used for data collection. After pre-test, the study sample received 8 training sessions. Analysis of the results of covariance analysis was performed in spss23 software. Results: The results showed that treatment of admission and commitment in elderly people significantly increased in comparison with the control group, quality of life and its dimensions (physical, psychological, environmental and social dimensions) (p

Background & Aim: Frustration is one of the important psychological consequences for the elderly in the nursing home. Spiritual care is a unique aspect of nursing care that can be a strong response to the dealing with frustration. The aim of this study was to determine the effect of spiritual care education on hope in the elderly residents of nursing homes. Methods & Materials: The present study was a before-and-after semi-experimental study, conducted in 2018 on 35 elderly residents of nursing homes in Hamadan, assigned into two groups of intervention (35 people) and control (35 people). At the beginning of the study, both groups completed the Schneider hope scale. For the intervention group, the intervention based on spiritual care was performed in three sessions. The post-test was performed for both groups after one month. Spearman correlation and Kruskal-Wallis tests were used to analyze the data through the SPSS software version 16. Results: There was no significant difference in overall hope score between the groups of intervention (22.94±9.80) and control (25.94±3.86) before the intervention (P=0.085); but after the intervention, there was a significant difference between the intervention (42.94±6.04) and control (23.80±4.09) groups (P

Anxiety and depression are the most common psychological disorders in old age. Reminiscence is a part of the normal life cycle in elderly that prepares them to face death, resolve past conflicts, gain existential integrity, and find the importance of positive life and self-esteem. Therefore, the present study aimed to determine the effect of structured group memory on reducing anxiety and depression in the elderly in Maragheh. It was a semi-experimental study with pretest-posttest design and control group. The statistical population of the study included all retirees of Maragheh Retirement Center who experienced anxiety and depression disorder. Participants included 46 elderly men (95-65 years) selected through convenience sampling according to inclusion criteria and were randomly assigned into two experimental and control groups (n=23). The experimental group received structured reminiscence sessions for eight sessions of 60 to 90 minutes once a week, but the control group did not receive any intervention. Participants responded to the Beck Anxiety Inventory and Beck Depression Inventory. The data were analyzed by one-way covariance analyses using SPSS 23 software. The results showed that structured memory significantly reduced anxiety and depression in the experimental group. Therefore, it is recommended that reminiscence training be used to reduce anxiety and depression in the elderly.

Background: Because of the complexity, stressfulness, and the threatening nature of the working environment of prehospital Emergency Medical Technicians (EMTs), they encounter many ethical challenges during making decisions and providing quick and accurate care to patients. The present study aimed to investigate the ethical challenges among prehospital EMTs. Materials and Methods: To review all published studies, we searched SID, Medlib, Iran Medex, Magiran, Web of Science, Medline, Google Scholar, CINAHL, PubMed, Ovid, and Scopus databases from 2000-18. The keywords were “ethical challenges”, “emergency medical technicians”, and “prehospital emergency”. Results: According to the evaluation of the studies, the ethical challenge regarding prehospital emergencies included decision over dispatching an ambulance to the scene, cardiopulmonary resuscitation, triage in crisis and disaster, irrational interventions of the patient or patient’s family, intervention in accordance with patient’s informed consent, and safe driving. Conclusion: Considering the unique conditions of prehospital caring, identifying, and discovering the ethical conflicts in this field of the health care system and providing the appropriate solution are very important.

One of the major challenges to the elderly in the modern world is loneliness. Feeling lonely is experienced in all age groups, though it is a stronger feeling at old ages. This study aimed to investigate the relationship between religious exposure and psychological well-being with loneliness in the elderly. The statistical population of the study included all elderly people covered by the Welfare Office and Imam Khomeini Relief Committee in Maragheh. According to Morgan's table and using a convenience sampling method, 168 individuals were selected accordingly. Golman religious coping questionnaire (2011), Russell's loneliness questionnaire (1966), and psychological well-being survey by Tabesei Zanjani (2004) were used for collecting data. The results were analyzed using Pearson correlation and simultaneous regression tests. Results showed an inverse and significant relationship between loneliness and subcategories of psychological well-being (p≤0.01). The results also reported that loneliness had an inverse and significant relationship with active coping subscales, passive coping and negative feelings toward God (p≤0.05). The results of simultaneous regression showed that psychological well-being and religious coping were both negative predictors for loneliness. Though, psychological well-being with a beta coefficient of -0.479 is a better predictor of loneliness. It was deduced from the results of the study that religious beliefs play an important role in preventing and reducing loneliness. In addition, a higher level of psychological well-being prevents loneliness occurring.

Background & Aim: Postpartum depression disorder is a common psychosocial disorder with negative consequences for the mother and child. On the other hand, attention training technique can be more effective than other techniques for intervention in the cognitive-attention syndrome. Therefore, the present study was conducted to determine the effectiveness of attention training technique on the symptoms of depression, anxiety and metacognitive beliefs in patients with postpartum depression. Methods & Materials: This study was conducted in a single-case experimental design using a multiple baseline design in eight sessions during one-, three- and six-month follow-ups on two patients, referred to the psychology and psychiatry unit of Tabriz Red Crescent in 2018. The Beck Depression Inventory, the Beck Anxiety Inventory and Metacognitive Beliefs Questionnaire were used to collect the data. Data analysis was performed using the Excel software as a graphical analysis and then based on the percentage of improvement, effect size and clinical significance. Results: At the end of treatment, a significant reduction was observed in the symptoms of depression (61% remission), anxiety (48% remission) and metacognitive beliefs (83% remission) in patients with postpartum depression. Conclusion: The results of this study showed that attention training technique can be effective in the treatment of patients with postpartum depression. However, further studies are needed in this area. Clinical trial registry: IRCT20171227038096N1

Background: Different psychological variables are effective in the continuation of substance abuse. This study aimed to investigate the relationship between metacognition and perfectionism with duration of methadone maintenance treatment in addicts referred to addiction treatment centers in Tabriz. Materials and Methods: This descriptive-correlational study was performed on 196 people referred to Shams, Sadra and Ehya clinics in Tabriz in 2017. The research instrument was a questionnaire of metacognitive with positive and negative perfectionism scales. Data were analyzed using multiple regression and Pearson correlation by SPSS ver.25 software. Results: The findings showed that there was a significant relationship between metacognition and duration of treatment (P

Systemic Lupus Erythematous (SLE) is a chronic autoimmune disorder with a relapsing- remitting course. Besides, SLE most commonly occurs in child-bearing-age women. Due to protean manifestations, the diagnosis may be challenging; however, a high index of suspicion, i.e. achieved by experience and perceptivity is the key to a correct decision. Here, we present an SLE patient; her initial symptoms resembled a malignant process, but important elements guided us to the underlying autoimmune process. A 34-year-old woman presented with a uterine mass, deep vein thrombosis, and significant thrombocytopenia. Our first impression was malignant processes; however, considering her age with thrombosis and thrombocytopenia as the key components of her presentation, we suspected antiphospholipid syndrome and SLE. Her abdominal mass was a benign leiomyoma. We treated her with glucocorticoids and anticoagulants. Accordingly, after improving cytopenia, we discharged her and the follow-up examination result was satisfactory.

Background: Prehospital emergency care services are one of the vital health services in many countries that provide first and immediate medical care to the patients and injured people at the scene and during transfer to healthcare centers. This study was conducted to investigate and compare the use of prehospital emergency services in urban and road emergency bases of Hamadan University of Medical Sciences. Materials and Methods: In a descriptive-analytic study, all missions (ambulance requests) conducted at urban and road emergency bases were studied and compared over three years. The study tool was a checklist compiled of questions from PCR (Patient Care Report). PCR contains written information about the patient's demographic characteristics, mission time, mission address, mission reasons, emergency base and mission code (ambulance identification code), and so on. Finally, the collected data were analyzed using descriptive (mean and variance) and inferential statistics (t test and Chi-square). Results: The results of the study indicated that every year, urban bases missions increased about 600 and rural bases missions about 450. Road traffic incidents, falls, cardiac emergencies and poisoning were the most common causes for ambulance call at urban and road emergency bases. In addition, urban and road bases missions were significantly different with regard to the cause of missions in all cases (except heat stroke) (P

Introduction: Acne is one of the most common skin diseases that affect nearly 85% of people in different periods of life. It can affect various individual and social aspects of personality, including self-concept, self-esteem and perfectionism. The purpose of this study was to investigate the relationship between self-concept, self-esteem and perfectionism with acne severity in adolescents. Materials and Methods: This descriptive cross-sectional study was carried out on junior high school and high school students in Jolfa city, western part of Iran (2013). In this study, 200 adolescents with acne were selected through purposeful method of sampling. The instrument used in the study included Saraswot self-concept questionnaire (1984), Rosenberg Self-Esteem Questionnaire (1965), and Hewet and Felt Multidimensional Perfectionism (1991). Data were analyzed using descriptive statistics, Pearson correlation and regression analysis. Results: The findings of the study showed that self-concept and self-esteem had a significant negative relationship with acne severity (r= -0.36, r= -0.83, P≤0.01 respectively). On the other hand, perfectionism has a significant positive relationship with the severity of acne (r= 0.58, P≤0.01). Also, the results showed that in predicting the severity of acne, self-esteem plays a very important role (β= -0.75, P≤0.01). Conclusion: According to the findings of the study, adolescents are vulnerable to the psychosocial effects of acne. On this basis, considering mental health care along with medical treatment is necessary in acne treatment.

Granulomatous mastitis is a pathological diagnosis with a variety of causes, and its treatment depends on the underlying cause. We report a case of granulomatous mastitis in a 25-year-old woman admitted with erythema nodosum and an unresponded acute inflammatory mastitis to treatment. It was challenging for us to make a definite diagnosis between sarcoidosis and idiopathic lobular granulomatous mastitis for her. In the end, our diagnosis was sarcoidosis because of dactylitis we found in her physical examination which responded dramatically to nonsteroidal anti-inflammatory drug treatment. We started therapy with corticosteroids and immunosuppressant drugs and offered her continuous follow-up.

Introduction: Heavy metals are found to be one of the major environmental hazardous contaminants, for human health, animal life, air quality and other components of environment. They can affect geochemical cycles and accumulate in animal tissues since physical processes are not able to remove them, so they are consistent in long term. The analysis of the total concentration of heavy metals in soil may provide information about soils enrichment but in general, it is widely used to determine the potential mobility of heavy metals in environmental behavior under chemical forms of metals in soils. Heavy metals existat several phases including water-soluble, exchangeable, bounded to organic matter, bounded to carbonates, bounded to Fe-Mn oxides, secondary clay minerals and residual fraction within primary minerals network. There is a dynamic equilibrium between different fractions of elements in soil. The main objectives of the present study were a) The analysis of the total concentration of heavy metals such as Fe, Mn, Ni, Cr, Co, Pb, Zn, Cd and Cu and b) The fractionations of heavy metals and identification of controlling factors to distribution and behavior of heavy metals in soils at different land uses. Materials and Methods: The study was performed at central area of Zanjan province (Iran). The study area was over 2000 km2 in coordinates 20´ 36° to 41´ 36° E and 19´ 48° to 53´ 48° N. The average altitudes were over 1500 meters above sea level. The major land uses of the study area included agriculture (AG), rangeland (RA) and urban (UR). Sample collection was done based on the random grid method in August 2011. Surface soil samples (0-10 cm depth) were taken from grid centers included 137, 77 and 27 samples from AG, RA and UR land uses, respectively. The samples were digested in Nitric acid 5 normal (Sposito et al., 1982) and total concentration of Pb, Zn, Ni, Mn, Cu, Cr, Fe and Co were measured by Perkin-Elmer: AA 200 atomic absorption instrument and cadmium was measured by atomic absorption equipped with Rayleigh: WF-1E graphite furnace. 75 soil samples were selected, DTPA-extraction and sequential extraction were performed and physiochemical characteristics of these samples analyzed. To extract the metals by DTPA, the method developed by Lindsay and Norvell, (1978) was used and sequential extraction was done by Tessier et al., (1979) method. All statistical parameters were calculated using SPSS 16.0 software, and mean comparison (mean separation) was carried out using Duncan test at probability level of 5%. Results and Discussion: The results indicated that heavy metals concentrations and patterns were evidently affected by different land uses. Co concentration was between 17.0 – 35.7 mg/kg and had the lowest total coefficient of variation (14%). The maximum total Cr and Ni values were measured in AG land use (26.1 and 52.6 mg/kg, respectively) and lowest was in UR land use (17.0 and 37.2 mg/kg, respectively). The highest total average value of Mn was found in RA (698.9 mg/kg) and the lowest in UR (629.1mg/kg) land use. The highest Fe concentrations were measured in AG and RA land uses (17.2 and 17.0 g/kg, respectively) and the lowest in UR land use (14.0 g/kg). The maximum Concentration of total Cd was observed in UR land use (2.47 mg/kg) and its minimum values were found in RA and AG (0.83 and 0.75 mg/kg, respectively) in the study area. In UR land use, Cu and Zn were more significant than AG and RA land uses. Pb variation was the same as Zn so that its increased concentration was found in urban land use (90.2 to 1357.5 on average 220.1 mg/kg). The highest Pb values were measured in UR land use (220 mg/kg) while the lowest concentrations were found in RA and AG land uses (80.6 and 69.0 mg/kg, respectively). Different elements showed various fractional distribution in different land uses. The highest Co percentage was related to residual fraction at all land uses, with values up to 48.4%, 54.0% and 48.1% in AG, RA and UR land uses, respectively. Ni fractionation had approximately the same pattern with Co in all factions and land uses, except exchangeable fraction of Ni that showed the lowest percentage in all land uses. The dominant fraction of Cu was residual fraction with the amounts of 73.3% 76.0% and 61.9% in AG, RA and UR land uses, respectively. The second dominant fraction in UR and AG land uses was related to that was bounded to OM, with 16.5% and 10.1%, respectively. Zn distribution in the AG and RA land uses had the same trend: Residual>bounded to Fe-Mn oxides>bounded to OM>bounded to carbonate>exchangeable fraction. Whereas, Zn distribution showed different trend in UR land use as bounded to Fe-Mn oxides>residual>bounded to carbonate>bounded to OM>exchangeable fraction. Pb distribution was different in each land use. Pb showed similar distribution to Zn in UR. In AG and RA land uses residual fraction of Pb was measured as highest value while other fractions of Pb had these distributions: Pb bounded to carbonate>bounded to Fe-Mn oxides>exchangeable >bounded to OM fraction in AG land use and Pb bounded to Fe-Mn oxides>bounded to OM>bounded to carbonate>exchangeable fraction in RA land use. Conclusion: Based on the results of this study, Cr, Co, Ni, Mn and Fe magnitudes are uneven in soils. The total heavy metal concentrations fractionation can provide information on the contaminant metals sources. High levels of exchangeable fractions, acid soluble and easily reducible perhaps indicates anthropogenic activities. Naturally, Chemicals are associated to resistant soil fractions such as oxy hydroxides, organic matter and sulfides. In soil fractionation, the contribution of each fraction in soil was a function of metal type and land uses. Those metals were affected by anthropogenic activities such as lead, zinc, and partly copper, showed the highest percentage in the fraction that influenced by external input sources. Those were characterized by lithogenic origin (cobalt and nickel) was mainly found to be highest in residual fraction. However, in all metals, those fractions affected by anthropogenic activities (non-resistant fractions) were much more in urban land use than agriculture and rangeland ones.

Background: To assess patient' reaction towards bedside teaching in the nephrology ward of Imam Khomeini Hospital Complex (Tehran) and to identify the factors that may influence it. Methods: A cross-sectional study was conducted in the nephrology ward of Imam Khomeini Hospital Complex from march to September, 2014. All inpatients present on the day of the study were interviewed using a structured questionnaire. Results: 146 patients were examined in this study that 62 patients (42.5%) were women and 84 cases (57.5%) were men. 112 (76.7%) of patients had a good feeling about the training to physicians. The behavior of students was evaluated respectful by 132 individuals (90.4% of patients). Total number of 106 individuals (72.6% of patients) had trusted to the health care team and 120 people (82.2% of patients) knew that the physicians’ behaviors are associated with the respect to their religious beliefs. Not being same sex of the examiners was important for 47 individuals (32.2% of patients). The number of 123 cases (84.2% of patients) evaluated the physicians' behavior with respect to their privacy. The number of 119 individuals (81.5% of patients) received their responses from the examiners. Statistical tests indicate a significant relationship between the respectful behavior of students with patient and good feeling about training to physicians, so that the 95.5% of people who have seen the respectful behavior of students to oneself had a good feeling about training to physicians (P˂0.001). The relationship between the presence of teacher with students and good feeling on training to physicians was significant (P=0.013). Positive feeling about practicing physicians was associated with patient age. So the age average of people who feel good about practicing physicians was significantly lower than the other people (47.2±17 versus 55.6±18 and P=0.028). Conclusion: The relationship between respectful behavior and presence of teacher with students and age and good feeling on training to physicians was significant.

Elderly, which refers to the age group above 65 years, appears to be a substantial period of life. Nowadays, due to the increase of life expectancy and the decrease of birth rates in developed and developing countries, the phenomenon of elderly has been attracting attention more than ever. Consequently, the aim of this study was to predict the elderly’s life satisfaction based on the health-promoting lifestyle. The method of the present study was of correlational type. The statistical population included all the elderly people aged 60 to 75 years referring to the elderly care centers in Tabriz, Iran in 2020. The statistical sample included 183 people selected using convenience sampling method. Used to collect data were Health-Promoting lifestyle and life satisfaction questionnaires. Data were analyzed using Multiple Regression Analysis of stepwise model. The results showed that there is a significant relationship between all factors of the health-promoting lifestyle and life satisfaction in the elderly and the predictor variables explain 34% of the variance of elderly’s life satisfaction. Physical activity (β=0.344), spiritual growth (β=0.187), interpersonal relationships (β=0.161) and health responsibility (β=0.133) can predict the elderly’s life satisfaction in a positive way, respectively. Therefore, based on the findings, it seems that taking advantages of teaching of health-promoting lifestyle, specifically the components of physical activity and spiritual growth, we can improve the elderly’s life satisfaction.

Introduction: Infrequency and low exposure to critically ill patients requiring airway management will lead to reduction in the skills and performance of the Emergency Medical Technicians (EMTs) over time. The present study was conducted primarily aiming to evaluate airway management in stationary ambulance simulations and identify the factors affecting Endotracheal Intubation (ETI) success rate. Method: This is a simulation study. The study population comprised of active EMTs in prehospital emergency bases in Hamadan province. The participants were placed at the back of an ambulance to perform the airway management scenario, which had already been prepared. To investigate the factors affecting the success (≤3 attempts) or failure rate of intubation, both unadjusted and adjusted odds ratios (95% confidence intervals) for univariate and multivariate regressions were reported. Results: 184 subjects with the mean age of 33.91+6.25 years and the median work experience of 8 years were studied (54.3% with a history of training in the past year). The median number of previous intubations performed by technicians in the last year was 7 times (IQR 4-9). The total success rate at ventilation, intubation and back-up airway were 50.67%, 53.29%, and 50.0%, respectively. Out of the total 552 attempts for ETI placement, 58.2% of the technicians were able to perform ETI within 3 attempts. Univariate analysis showed that age (OR=1.06, P=0.022), previous number of ETIs (OR=2.49, P

Biological and demographic parameters of the mealybug ladybird, Cryptolaemus montrouzieri (Mulsant) were evaluated on citrus mealybug, Planococcus citri (Risso) and obscure mealybug, Pseudococcus viburni (Signoret) under 24 ± 2 ºC, 80 ± 5% relative humidity and a photoperiod of 16:8 (L: D) h. The mealybugs had a significant effect on developmental time and reproductive and demographic parameters of the ladybird. Life span (egg to adult death) was obtained 220.85 ± 5.78 and 119.44 ± 2.1 days when fed on Pl. citri and Ps. viburni, respectively. However, mean number of eggs per female (fecundity) and mean percent of egg hatching were significantly higher on Ps. viburni than on Pl. citri. In addition, values of intrinsic rate of increase (rm), finite rate of increase (λ) andnet reproductive rate (R0) were significantly higher on Ps. viburni than on Pl. citri.The values of intrinsic rate of increase were estimated 0.081and 0.094 day-1 on Pl. citri and Ps. viburni, respectively. Results of this study suggested that the obscure mealybug is a more suitable prey than the citrus mealybug as the ladybird displayed shorter developmental time, and higher fecundity and growth rate when fed with obscure mealybug.

The list of forty one subgenera of the genus Andrena from Iran is given. The list provided here is based on a detailed study of all available published data. Four subgenera and five species are recorded for the first time from Iran, including Andrena (Cnemidandrena) fuscipes (Kirby, 1802), Andrena (Lepidandrena) curvungula (Thomson, 1870), Andrena (Lepidandrena) pandellei (Pérez, 1895), Andrena (Parandrena) sericata (Imhoff, 1868) and Andrena (Platygalandrena) tecta (Radoszkowski, 1876). Ecological notes on the newly recorded species are briefly discussed.

Pseudoparasitus talebii Nemati, Malekshah-koohi & Afshari n. sp. is described and illustrated based on female specimens collected from soil in Golestan province, Gorgan region, Iran. The definition of Pseudoparasitus oudemans is revised and new definition is presented.

We present the results of a survey of the andrenid bee fauna of Gorgan County, Golestan province, Iran between 2014 and 2015. The survey led to the identification of twenty-three species of the genus Andrena Fabricius and Melitturga Latreille belonging to subgenera Campylogaster (1 species), Chlorandrena (1 species), Holandrena (2 species), Hoplandrena (1 species), Melanapis (1 species), Melandrena (4 species), Micrandrena (4 species), Nobandrena (1 species), Notandrena (1 species), Plastandrena (2 species), Simandrena (1 species), Truncandrena (1 species), Zonandrena (2) and Melitturga (1 species). Of these, eight and six species are new to the fauna of Iran and Asia, respectively.

In a faunistic study, eviphidoid mites (Acari: Mesostigmata) in Nowshahr county (western Mazandaran province) during 2009-2010, a total of 23 species from superfamily Eviphidoidea belonging to eight genera and three families were collected and identified from different soil and manure habitats. Five species of Pachylaelaps insularis (Berlese), Olopachys compositus (Koroleva), Olopachys caucasicus (Koroleva), Onchodellus cf alpinus (Willmann), Gamasholaspis incisus Petrova and the genus Gamasholaspis Berlese were new records from Iran. Among collected families, Macrochelidae had the highest relative frequency (55.77 percent), and the families Pachylaelapidae and Parholaspididae with frequencies of 30.21 and 14.02 percents were in next ranks, respectively. No specimen of Eviphididae was collected in this study. The most frequent species of the first three families were Glyptholaspis americana (Berlese) (8.52 percent), Olopachys caucasicus (Koroleva) (9.3 percent), and Holaspina alstoni Evans (13.25 percent).

Despite the existence of a large variety of competency frameworks for medical graduates, there is no agreement on a single set of outcomes. Different countries have attempted to define their own set of competencies to respond to their local situations. This article reports the process of developing medical graduates' competency framework as the first step in the curriculum reform in Tehran University of Medical Sciences (TUMS). A participatory approach was applied to develop a competency framework in Tehran University of Medical Sciences (TUMS). Following literature review, nominal group meetings with students and faculty members were held to generate the initial list of expectations, and 9 domains was proposed. Then, domains were reviewed, and one of the domains was removed. The competency framework was sent to Curriculum Reform Committee for consideration and approval, where it was decided to distribute electronic and paper forms among all faculty members and ask them for their comments. Following incorporating some of the modifications, the document was approved by the committee. The TUMS competency framework consists of 8 domains: Clinical skills; Communication skills; Patient management; Health promotion and disease prevention; Personal development; Professionalism, medical ethics and law; Decision making, reasoning and problem-solving; and Health system and the corresponding role of physicians. Development of a competency framework through a participatory approach was the first step towards curriculum reform in TUMS, aligned with local needs and conditions. The lessons learned through the process may be useful for similar projects in the future.

In this paper, we introduce a new method and new motion variables to study kinematics and dynamics of a 6 d.o.f cabledriven robot. Using these new variables and Lagrange equations, we achieve new equations of motion which are different in appearance and several aspects from conventional equations usually used to study 6 d.o.f cable robots. Then, we introduce a new Jacobian matrix which expresses kinematical relations of the robot via a new approach and is basically different from the conventional Jacobian matrix. One of the important characteristics of the new method is computational efficiency in comparison with the conventional method. It is demonstrated that using the new method instead of the conventional one, significantly reduces the computation time required to determine workspace of the robot as well as the time required to solve the equations of motion.

In this paper, we introduce a new method and new motion variables to study kinematics and dynamics of a 6 d.o.f cable-driven robot. Using these new variables and Lagrange equations, we achieve new equations of motion which are different in appearance and several aspects from conventional equations usually used to study 6 d.o.f cable robots. Then, we introduce a new Jacobian matrix which expresses kinematical relations of the robot via a new approach and is basically different from the conventional Jacobian matrix. One of the important characteristics of the new method is computational efficiency in comparison with the conventional method. It is demonstrated that using the new method instead of the conventional one, significantly reduces the computation time required to determine workspace of the robot as well as the time required to solve the equations of motion.