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Abstract Background Abnormalities in biochemical parameters and changes in eating habits are considered complications of obesity. Oleoylethanolamide (OEA), an endocannabinoid-like compound, has been shown to have protective effects on many metabolic disorders. Given this evidence, the present study aimed to assess the effects of OEA on lipid profile parameters, fasting blood sugar (FBS), and dietary habits in healthy obese people. Methods In this randomized, double-blind, placebo-controlled clinical trial, which was carried out in 2016 in Tabriz, Iran, 60 obese people were enrolled in the study based on inclusion criteria. The intervention group consumed 125 mg of OEA capsules, and the placebo group received the same amount of starch twice for 8 weeks. Blood samples (5 mL) were taken at baseline and the end of the study in a fasting state. Serum concentrations of FBS, triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and total cholesterol (TC) were measured by enzymatic methods using commercial kits. The low-density lipoprotein cholesterol (LDL-C) concentration was obtained using the Friede-Wald formula. To assess dietary habits, a food frequency questionnaire (147 items) was used at baseline and the end of the study. A value less than 0.05). After adjusting for baseline values and demographic characteristics, the difference in TG between groups remained significant (p = 0.044). Changes in other biochemical parameters were not significant. There was no significant difference between or within groups in terms of food groups. Conclusion OEA, as a complementary agent, plays a protective role in TG regulation. However, future studies with longer durations are needed to explore the impact of OEA on regulating dietary habits and to identify the mechanisms related to metabolic abnormalities in obese people. Trial Registration The study was registered in the Iranian Registry of Clinical Trials (IRCT) center as IRCT201607132017N30 with URL. www.IRCT.IR in date 03/10/2016.

Abstract Background People with disabilities (PWD) have different health service needs and different factors affect the utilization of these services. Therefore, the aim of this present study was to identify determinants of inpatient healthcare utilization among PWDs in Iran. Methods This research was a secondary data analysis of a cross-sectional study. The present study used data gathered for 766 PWDs (aged 18 years and older) within the Iranian Society with Disabilities (ISD) between September and December 2020. Multiple logistic regression models calculated adjusted odds ratios (aOR) and 95% confidence intervals in order to identify determinants of inpatient healthcare utilization among PWDs. Results Data for 766 people with disabilities were analyzed. A large number of participants were over 28 years of age (70.94%), male (64.36%), and single (54.02%). In the present study, more than 71% of participants had no history of hospitalization during the last year. In this study, males [aOR 2.11(1.14–3.91), participants with Civil Servants health insurance coverage [aOR 3.44 (1.16 − 10.17)] and individuals in the 3th quartile of disability severity [aOR 2.13 (1.01 − 4.51)] had greater odds of inpatient healthcare utilization compared to the other groups. The value of the concentration index (C) for inpatient healthcare utilization was − 0.084 (P.value = 0.046). The decomposition analysis indicated that gender was the greatest contributor (21.92%) to the observed inequality in inpatient healthcare utilization among participants. Conclusion Our findings suggested that the likelihood of hospitalization among the study participants could be significantly influenced by factors such as gender, the health insurance scheme, and the degree of disability severity. These results underscore the imperative for enhanced access to outpatient services, affordable insurance coverage, and reduced healthcare expenditures for this vulnerable population. Addressing these issues has the potential to mitigate the burden of hospitalization and promote better health outcomes for disadvantaged individuals.

Abstract Dyslipidemia can increase the risk of heart attack and stroke due to the restriction of blood flow through the blood vessels. Dietary modification is an appropriate approach to reducing this phenomenon. This cross-sectional study aimed to evaluate major dietary patterns and the dietary inflammatory index (DII) in relation to dyslipidemia. 5954 participants in the Ravansar non-communicable diseases (RaNCD) cohort study were eligible for this study. Dyslipidemia was diagnosed based on the lipid profile under consideration of the RaNCD physician. Dietary patterns were assessed by principal component analysis. The three identified dietary patterns included (1) plant-based pattern; (2) high protein and sugar pattern; and (3) energy-dense dense pattern. DII was also calculated based on the dietary information from a validated semi-quantitative food frequency questionnaire (FFQ). We found that higher adherence to DII was significantly associated with increased odds of dyslipidemia after adjusting for age, sex, and physical activity (OR: 1.24; CI 95% 1.09–1.42). Additionally, higher adherence to the high protein and sugar diet and an energy-dense diet was significantly associated with higher odds for dyslipidemia (OR: 1.31; CI 95% 1.16–1.49) and (OR: 1.28; CI 95% 1.12–1.46). Nevertheless, according to our results, following plant-based diet had no association with dyslipidemia in both crude and adjusted models. Our findings revealed that greater adherence to DII, a high-protein, high-sugar diet, and an energy-dense diet can have undesirable effects on dyslipidemia.

Abstract One of the most significant consequences of the coronavirus disease (COVID-19) pandemic is the anxiety and stress it causes among the general population, which can be reduced by engaging in regular physical activity. The aim of this study was to estimate the levels of physical activity and mood state during the COVID-19 quarantine among the Kermanshah population. In this cross-sectional study, a total of 2471 subjects (1256 males and 1215 females) were selected in the population of Kermanshah in the west of Iran, using the convenience sampling method. Physical activity levels were assessed using the physical activity (PA) questionnaire short form (IPAQ-SF), and mood state was measured by the abbreviated form of the Iranian version of the standard POMS questionnaire (Bill Morgan 1979). Participants completed the online questionnaire between March 28th and May 20th, 2020. Descriptive statistics (mean, standard deviation, and percentage), and deductive (Chi-square and Spearman's correlation) were used for data analysis. our study found that the majority of participants reported decreased PA levels during the quarantine period. Specifically, 71.7% reported a decrease in moderate-intensity physical activity, 80.5% reported a decrease in high-intensity PA, and 71.3% reported a decrease in the total volume of PA. The results showed that there was a significant difference between the number of sessions (P=0.001), intensity (P=0.001), and duration of exercise (P=0.001) before and during the coronavirus. There was a significant positive relationship between low (r=0.93; P=0.001) and high (r=0.673; P=0.034) levels of PA and negative mood state. Additionally, there was a positive relationship between moderate PA level (r=0.82; P=0.001) and a positive mood states. The study suggests that the current quarantine has negatively affected the mood states of the participants. Overall, the study recommends regular PA to prevent COVID-19 while adhering to health and safety protocols.

Above-ground biomass (AGB) is considered an essential climate variable that underpins our knowledge and information about the role of forests in mitigating climate change. The availability of satellite-based AGB and AGB change (ΔAGB) products has increased in recent years. Here we assessed the past decade net ΔAGB derived from four recent global multi-date AGB maps: ESA-CCI maps, WRI-Flux model, JPL time series, and SMOS-LVOD time series. Our assessments explore and use different reference data sources with biomass re-measurements within the past decade. The reference data comprise National Forest Inventory (NFI) plot data, local ΔAGB maps from airborne LiDAR, and selected Forest Resource Assessment country data from countries with well-developed monitoring capacities. Map to reference data comparisons were performed at levels ranging from 100 m to 25 km spatial scale. The comparisons revealed that LiDAR data compared most reasonably with the maps, while the comparisons using NFI only showed some agreements at aggregation levels

Intended to examine the effects of altitude on flora, life forms and geographical distribution of herbaceous species, this study was conducted in Kabirkouh forests of Darreshahr, located in Ilam Province, Iran, by selecting an area (circa 300 ha) in this forest. The study area was divided into three elevational classes and 63 systematic random plots were sampled (21 in each of the elevational classes). In order to record the herbaceous cover, the surface area of the plots was determined using the minimal area method. Then the herbaceous species and their percent coverage were recorded based on the Van der Marel criterion. A total of 109 herbaceous species belonging to 92 genera and 24 families were identified in the study area. The most frequent species were in the Asteraceae (23 species) and Poaceae (16 species) families. The results showed that in all three elevational classes, therophytes were the dominant life form of the area. The frequency of the therophytes in the first altitude class was higher than in the other classes. The second predominant life form was hemicryptophytes, whose frequency in the third class was higher than the other classes. Other life forms observed in the region were cryptophytes and chamaephytes, respectively which made up the least proportion of the area’s plant population. In addition, the results indicated that within all of the elevational classes, a high percentage of the existing plants of the study area belonged to the Irano-Turanian floristic region. Generally, the altitude had a significant effect on the distribution of the flora of the study area.

Introduction: Depression as an emotional factor is one of the mental disorders that should be seriously considered. The aim of this study was to evaluate the effectiveness of cognitive-behavioral therapy (CBT) on the social anxiety, rumination, and psychological well-being of people with depression.Materials and Methods: The present study was a randomized clinical trial with a control group. The target population was people with depression who referred to the integrated health centers in Abadan, Iran. 30 people with depression who were willing to participate in the study were purposefully selected according to the study inclusion criteria and were randomly assigned to the experimental and control groups (each group consisted of 15 people). The volunteers were requested to fill the research questionnaires in the pretest stage. Then, the experimental group participated in 9 sessions of CBT and the control group was saved on the treatment waiting list. After the last treatment session for the experimental group, both groups filled the questionnaires again in the posttest and follow-up stages. Data were collected using Persian version of Beck Depression Inventory (BDI), Social Phobia Inventory (SPIN), Ruminative Response Scale ‎(RRS), and Psychological Well-Being (PWB) scales. Data analysis was performed using one-variable analysis of covariance (ANCOVA) and multivariate analysis of covariance (MANCOVA) test at the significance level of 0.05.Results: Group CBT had a significant effect on social anxiety (P ≤ 0.001), rumination (P ≤ 0.001), and quality of life (QOL) (P ≤ 0.001) of people with depression.Conclusion: Group CBT is effective on social anxiety, rumination, and psychological well-being of people with depression and this approach can be recommended to improve the psychological problems of people with depression.

Abstract Background Diabetes mellitus is a common chronic disease. Dyslipidemia and hypertension are two complications that may develop in diabetic patients if hyperglycemia, insulin resistance, and weight gain are not controlled. This study investigated the effects of melatonin supplementation on some cardiovascular disease risk factors and anthropometric indices in patients with type 2 diabetes mellitus (T2DM). Materials and methods In this double-blind, randomized, placebo-controlled trial, 50 T2DM patients were randomly allocated to intervention and control groups which received two tablets of either melatonin or placebo (250 mg) once a day for 8 weeks. Systolic blood pressure (SBP), mean arterial pressure (MAP), pulse pressure (PP), the atherogenic index of plasma (AIP), weight, body mass index (BMI), waist and hip circumference (WC, HC), a body shape index (ABSI), abdominal volume index (AVI), body adiposity index (BAI), lipid accumulation product (LAP), conicity index, and waist-to-height ratio (WHtR) were evaluated in all the patients pre- and post-intervention. Results Melatonin supplementation for 8 weeks significantly decreased the mean levels of SBP, MAP, PP, weight, BMI, WC, HC, BAI, AVI, conicity index, and WHtR post-intervention (p

Background & Objective: Blood pressure generally increases after menopause. Training modalities with a supplement can influence blood pressure indices. The present study aims at investigating the effect of eight-week resistance training with citrulline-malate consumption on blood pressure, Nitric Oxide (NO), and Vascular Endothelial Growth Factor (VEGF) in postmenopausal women with prehypertension Materials & Methods: The sample population is postmenopausal women with pre-hypertensive age ranging from 50 to 55 years old divided randomly into six groups, including “training + supplement”, “training + placebo”, “training”, “no training + supplement”, “supplement” and “placebo”. Resistance training was held 3 sessions per week in which the training intensity was 45% to 55% IRM. The supplement included citrulline-malate (8 g) an hour before each training session. Blood pressure, NO, and VEGE were measured using a barometer and kit before and after the training sessions. Two-way analysis of variance test and Tukey’s follow-up test were applied to analyze data. Results: The findings demonstrated that training leads to a decrease in systolic and diastolic blood pressures while an increase in NO and VEGF. The results showed that an eight-week period of citrulline-malate supplementation has decreased systolic and diastolic blood pressure. Besides, it was revealed that eight weeks of citrulline-malate administration made NO and VEGF increase. Also, the results indicated that the "exercise + supplement" group has had the greatest effect on increasing NO and VEGF and reducing systolic and diastolic blood pressure. Moreover, the findings proved that resistance training with citrulline-malate made systolic and diastolic blood pressures in menopausal women with prehypertension reduce. These effects are accompanied by rising levels of NO and VEGF. Conclusion: The findings revealed that the resistance training, which was applied in the present study, coupled with citrulline-malate supplementation, will improve blood pressure in postmenopausal women with hypertension.

Aim and Background: Diabetes is a factor of many physical and psychological disorders. Nowadays, the concept of adherence in diseases be attention and has been developed due to changing the illness pattern from acute to chronic, changing its ideology from cure to prevention, limited economical resource and shortening the Duration of hospitalization of patients. In order to, the aim of this study was to survey of effectiveness of acceptance and commitment therapy on health related beliefs among patients with type 2 diabetes. Methods and Materials: research method was semi experimental with pretest, posttest and control group design. From patients with type 2 diabetes who referred to Assaluyeh health centers, 30 subjects were selected purposely and were assigned in control and experimental groups randomly (15 subjects each group). To collect the data the Health Beliefs Questionnaire (HBQ) was used. The data analyzed using MANCOVA. Findings: Results of data analyzing showed that acceptance and commitment therapy on health related beliefs of patients with diabetes type 2 is effective (p

Aims: The purpose of this study was to investigate the effectiveness of acceptance and commitment therapy on perception of disease in patients with irritable bowel syndrome (IBS). Materials and Methods: The quasi-experimental research method was pretest and posttest with control group. The statistical population of this study included patients with irritable bowel syndrome (IBS) in Semirom city which were selected 30 of whom through purposive sampling and randomly assigned to two groups (Acceptance and commitment Therapy (ACT) and control group). Before and after the intervention, the individuals in all two groups were evaluated with the Disease Perception Scale. Then, there was a weekly session acceptance and commitment therapy based on treatment protocols for IBS for the experimental group, and the control group received no intervention. Results: The findings showed that acceptance and commitment therapy had significant effects on the components of illness sequences (P < 0.001), personal control (P < 0.001), nature of illness (P < 0.001), control through treatment (P < 0.001), worrying about illness (P = 0.002), and affectional respond to illness (P < 0.001). Conclusion: In according to findings, it can be concluded that the acceptance and commitment therapy as an effective treatment can be used in acute disease situations for people to promote positive perception of their illness.

Aim: This study aimed to investigate the effectiveness of acceptance and commitment therapy on self-care and adherence to treatment in patients with type 2 diabetes. Materials and Methods: This study was a quasi-experimental research with pretest–posttest-follow-up and control group design. The sample of the present study consisted of 30 patients with type 2 diabetes referred to the health network of Asaluyeh city in the first half of the year 2019. The perceived self-efficacy scale for self-care and adherence to treatment questionnaire were used for data collection. Results: The results of the data analysis showed that acceptance and commitment therapy is effective in the self-care and adherence to treatment of patients with type 2 diabetes. Conclusion: Based on obtained results, it can conclude that acceptance and commitment therapy as a short term therapy has effective influences on self-care and adherence to treatment of patients with type 2 diabetes.

Forest canopy cover (FCC) is one of the most important forest inventory parameters and plays a critical role in evaluating forest functions. This study examines the potential of integrating Sentinel-1 (S-1) and Sentinel-2 (S-2) data to map FCC in the heterogeneous Mediterranean oak forests of western Iran in different data densities (one-year datasets vs. three-year datasets). This study used very high-resolution satellite images from Google Earth, gridded points, and field inventory plots to generate a reference dataset. Based on it, four FCC classes were defined, namely non-forest, sparse forest (FCC = 1–30%), medium-density forest (FCC = 31–60%), and dense forest (FCC > 60%). In this study, three machine learning (ML) models, including Random Forest (RF), Support Vector Machine (SVM), and Classification and Regression Tree (CART), were used in the Google Earth Engine and their performance was compared for classification. Results showed that the SVM produced the highest accuracy on FCC mapping. The three-year time series increased the ability of all ML models to classify FCC classes, in particular the sparse forest class, which was not distinguished well by the one-year dataset. Class-level accuracy assessment results showed a remarkable increase in F-1 scores for sparse forest classification by integrating S-1 and S-2 (10.4% to 18.2% increased for the CART and SVM ML models, respectively). In conclusion, the synergetic use of S-1 and S-2 spectral temporal metrics improved the classification accuracy compared to that obtained using only S-2. The study relied on open data and freely available tools and can be integrated into national monitoring systems of FCC in Mediterranean oak forests of Iran and neighboring countries with similar forest attributes.

Accurate and real-time land use/land cover (LULC) maps are important to provide precise information for dynamic monitoring, planning, and management of the Earth. With the advent of cloud computing platforms, time series feature extraction techniques, and machine learning classifiers, new opportunities are arising in more accurate and large-scale LULC mapping. In this study, we aimed at finding out how two composition methods and spectral–temporal metrics extracted from satellite time series can affect the ability of a machine learning classifier to produce accurate LULC maps. We used the Google Earth Engine (GEE) cloud computing platform to create cloud-free Sentinel-2 (S-2) and Landsat-8 (L-8) time series over the Tehran Province (Iran) as of 2020. Two composition methods, namely, seasonal composites and percentiles metrics, were used to define four datasets based on satellite time series, vegetation indices, and topographic layers. The random forest classifier was used in LULC classification and for identifying the most important variables. Accuracy assessment results showed that the S-2 outperformed the L-8 spectral–temporal metrics at the overall and class level. Moreover, the comparison of composition methods indicated that seasonal composites outperformed percentile metrics in both S-2 and L-8 time series. At the class level, the improved performance of seasonal composites was related to their ability to provide better information about the phenological variation of different LULC classes. Finally, we conclude that this methodology can produce LULC maps based on cloud computing GEE in an accurate and fast way and can be used in large-scale LULC mapping.

Introduction: One of the most important factors affecting the future survival of organizations is identifying and meeting the increasing needs and demands of patients in order to provide high quality health care services. The aim of this study was to identify factors affecting the selection of Milad Hospital, Iran, by patients based on combined marketing factors. Methods: The present analytical and cross-sectional study was performed in the inpatient wards of Milad Hospital in 2013. Data collection was conducted using the Yaghoubi and et al. Questionnaire. The validity of the questionnaire was approved by specialists and its reliability was approved using Cronbach’s alpha (r = 0.85). The statistical population consisted of patients referring to inpatient wards of Milad Hospital. Using the formula for determining sample volume, a sample sized of 421 patients was determined. Sampling was performed using stratified random method. Data were analyzed using one-sample Kolmogorov Smirnov, independent-samples t-test, and ANOVA in SPSS software. Results: Among the seven dimensions of marketing, the service and process dimensions with mean scores of 18.58 and 6.27, respectively, were the most and the least important reasons for selecting a hospital. Moreover, specialization, appropriate quality of services, type of insurance coverage, skilled physicians, reputation of the hospital, recommendations of relatives and physicians, and sophisticated equipment played a leading role in hospital selection. Conclusion: Patients make different choices in different situations, but multiple competitive advantages can result in an increase in frequency of patient referral to a medical center.

Background and Aim: Organizations have to establish modern management systems to progress and to obtain maturity. One of the techniques which started in Europe in the last two decades and is considered in management area of country during recent years is the model of organizational promotion (EFQM). The purpose of this study was Performance Evaluation of Rajaei Hospital Based on «EFQM» Organizational Excellence Model.Materials and Methods: This cross-sectional study was conducted in year 2010 in Qazvin Rajai Hospital. Data collection tool, was EFQM organization Excellence Model questionnaire which was completed by all the managers. Validity and reliability of questionnaire was calculated. Results were analyzed using descriptive statistics.Results: Results indicated that this hospital has acquired 99.183 scores out of 500 in enablers factor(88.36 percent of optimum score). Also has gained 183.71 scores out of 500 (36/75 percent of optimum score). Overall, this hospital has obtained 366.7 scores out of 1000 as the total score in the model for performance evaluation in year 2010.Conclusion: Findings indicated that based on Excellence model criteria, this hospital is in a moderate level. Applying this model for Iranian hospitals which often meet serious problems in this area is informative and practical. Strong systematic view, paying attention to organizational process-based management and being result-oriented are advantageous of using this model.

The objective of this study was to compare the effectiveness of two group therapies, namely Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Cognitive Therapy (MBCT), on post-traumatic growth in patients with multiple sclerosis. The study followed an experimental-experimental design with a pre-test, post-test approach and included a control group. A total of 45 patients were purposefully selected and randomly assigned to either the experimental or control group, with each group comprising 15 individuals. Data was collected using post-traumatic growth inventory (Tedeschi and Calhoun, 1996). The findings revealed that both the group therapy based on Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Cognitive Therapy (MBCT) were effective in promoting post-traumatic growth. Furthermore, there was no significant difference in the effectiveness of the two therapies in improving post-traumatic growth in patients with multiple sclerosis (p > 0.05). These results have important implications for psychologists and counselors involved in the treatment and rehabilitation of individuals with multiple sclerosis.

Multiple sclerosis is a central nervous system disorder that presents significant psychological challenges for patients worldwide. In such cases, psychological interventions can offer valuable assistance. Therefore, one of the objectives of this study was to assess the impact of Acceptance and Commitment-Based Group Therapy (ACGT) on metacognitive beliefs and treatment adherence in individuals with multiple sclerosis residing in Ahvaz, Iran, in 2020. A purposive sampling method was employed, with 30 participants selected and randomly assigned to an experimental group and a control group, each consisting of 15 individuals. Data collection involved the use of the Metacognitive Beliefs questionnaire developed by Wells & Cartwright-Hatton (2004) and the Adherence to Treatment questionnaire by Seyyed Fatemi et al. (2018). This quasi-experimental study followed a pre-test, post-test, and follow-up design, including a control group. The experimental group participated in an eight-session, 90-minute Acceptance and Commitment-Based Group Therapy (ACGT), while the control group received no treatment. Data analysis was performed using analysis of covariance. The results demonstrated the effectiveness of acceptance and commitment-based group therapy (ACGT) in improving metacognitive beliefs and enhancing treatment adherence in individuals with multiple sclerosis (p < .01). Based on these findings, it can be concluded that this treatment approach can be beneficial for enhancing metacognitive beliefs and promoting treatment adherence in patients with multiple sclerosis.

Background: Childhood cancer is a grueling event that can affect the lives of patients and their parents both psychologically and physically. Playing is a way to reduce this problem in children with cancer. Objectives: The aim of this study was to evaluate the effectiveness of individual play therapy on hope, adjustment and pain response of hospitalized children with cancer. Methods: This quasi-experimental study was performed among 30 children with cancer aged 8 to 12 years. Subjects were randomly divided into experimental and control groups. In the experimental group, individual play therapy intervention was performed for two months (10 sessions). The study instruments included: Snyder’s Hope Scale, Pediatric Pain Response Questionnaire (Walker et al.), and Dokhanchi’s Adjustment Questionnaire (1998). In order to analyze the data, repeated measures analysis and Bonferroni post hoc test were performed in SPSS, version 16. Results: In this study, the mean age of participants in the experimental and control groups was 9.36±1.68 and 10.1±1.98 years, respectively. The results of this study showed that the difference between the three evaluation stages in all variables, except the post-test with the follow-up of hope variable, was significant in the experimental group (p≥0.001). But no significant difference was observed between the three evaluation stages in the control group (p≤0.001). Conclusion: It seems that play therapy intervention has an effect on the research variables. Given that the research was conducted on a small sample in a hospital, it is suggested that similar research be conducted to increase the external validity of the present study.

Background: One of the factors leading to anxiety in children with cancer is child hospitalization. This anxiety can be due to separation, sadness, as well as fear of a new environment, disability, and continuation of life. Objectives: The present study aimed to evaluate the effectiveness of group play therapy on anxiety in children with leukemia. Methods: The current research had an applied and quasi-experimental approach, with a pretest-posttest design and a control group. The statistical population of this study included all 8-12-year-old children with leukemia hospitalized in Dr. Afzalipour Hospital in Kerman in 2018. Among them, 30 children were selected by a convenient sampling method and were randomly assigned to the two experimental and control groups equally. The research tool was the Multidimensional Anxiety Scale for Children (MASC). Concerning the inferential analysis, the analysis of covariance (ANCOVA) method was used to compare quantitative variables between the three groups. Also, the ANCOVA model was used for modeling the difference between pretest and posttest measurements and adjusting for the effect of confounding variables such as gender and age. The analyses were performed using SPSS.22 software. Results: The results showed a significant reduction in anxiety scores between children who received group play therapy (mean anxiety=59.60) and those who did not receive any intervention (mean anxiety=60.60) (p>0.001). Based on the findings, the group play therapy intervention is effective in anxiety in children with leukemia. Conclusion: According to the findings of the present study, it can be concluded that group play therapy is effective in reducing anxiety in children with leukemia.

Background and Objective: Cancer as a negative stress factor will have a severe impact on patients' mental and physical health. The aim of this study was to investigate the causal relationship between perceived stress, perceived social support, and resilience with emotional adjustment mediated by life satisfaction among breast cancer patients. Materials and Methods: In this descriptive-correlational study, this study's statistical population was 420 patients with cancer patients referred to Tehran hospitals from October to December 2017. By purposeful sampling method, 200 people were selected as the sample through Cochran's formula. The instruments used in this study were the Perceived Stress Scale, Perceived Social Support, Resilience, Emotional Adjustment, and Life Satisfaction Questionnaire. The evaluation of the proposed model was performed using the path analysis method. Correlation tests such as the Pearson correlation coefficient and regression test were used to test the relationships. Correlation tests such as the Pearson correlation coefficient and structural equation modeling were used to test the relationships using SPSS software version 23 and AMOS software version 23. Results: With increasing perceived stress with a mean (SD) of 24.2 (8.7), emotional adjustment with a mean (SD) decreased by 14.9 (4.8), P

Background: The most common, costly, and debilitating functional gastrointestinal disorder is irritable bowel syndrome (IBS). This study aimed to determine the effectiveness of cognitive-behavioral therapy on metacognitive beliefs and pain problems in patients with irritable bowel syndrome. Methods: The study used a quasi-experimental design with pre-test, post-test and a three-month follow-up with the control group. All patients with irritable bowel syndrome at Tehran Shariatee Hospital were included in the statistical population. The sample consisted of 30 patients who were randomly assigned to experimental and control groups using the purposive sampling method. Before the intervention, the pre-test was held, after which the experimental group received cognitive-behavioral therapy in 8 sessions of 90 minutes, but the control group did not receive any intervention. Then, the post-test was administered and after three months of post-test implementation, the follow-up period was performed. The research tools included a metacognitive beliefs questionnaire and pain understanding. Data analysis was performed by SPSS.22 software and univariate variance analysis. Results: The experimental group was 33.6 (7.8) years old, while the control group was 35.9 (8.4) years old. Both groups were homogenous in terms of gender, age and marital status. The findings showed that cognitive-behavioral therapy was effective on metacognitive beliefs (P