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Abstract Background Benign prostatic hyperplasia (BPH) is common and presents as lower urinary tract symptoms (LUTS). Understanding patient concerns and treatment preferences is essential for effective management. This study aimed to investigate the attitudes, preferences, and expectations of Iranian patients with BPH, and compare them with those of urologists in addressing this condition. Methods A cohort of patients diagnosed with BPH underwent assessment during their initial visit. Before any counseling, their attitudes, concerns, and expectations regarding benign prostate enlargement were evaluated using semi-structured interviews. Patient responses were analyzed based on educational levels and age. Additionally, correspondence was initiated with thirty urologists who graduated within the past twelve years to assess their attitudes toward BPH, concerns, and treatment approaches. Interview questions were constructed using the Delphi method, and their validity was confirmed. Responses from both groups were analyzed and compared. Descriptive statistics, independent t-test, Chi-squared test, Mann-Whitney U, and principal component analysis (PCA) with varimax rotation were used for statistical analysis. Results The study comprised 261 patients and 30 urologists. Findings revealed that 86.2% of patients and 86.7% of urologists perceived a lack of sufficient patient knowledge about BPH. Patients across all educational levels and age groups expressed a desire for more information about their condition. Primary concerns among patients included exacerbation of urinary symptoms, potential malignancy, and sexual dysfunction. While patients generally preferred pharmacological treatments, those older than 75 years showed a significantly higher preference for surgical options. Conversely, urologists exhibited greater concern for long-term clinical complications associated with BPH. Results indicated significant parallels between the attitudes of urologists and patients in assessing the multifaceted impact of BPH on patient well-being. Conclusion This study enhances our understanding of patient attitudes and concerns regarding BPH, thereby facilitating more effective treatment strategies. Our findings encourage urologists to enhance patient perspectives by delivering comprehensive information. Furthermore, the comparison between patient and urologist attitudes towards BPH underscores the importance of tailored care and patient-centered approaches in optimizing outcomes for individuals with BPH.

Objectives: Down syndrome (DS) is a genetic disorder that causes many problems for the affected person and his or her family. The present study aimed to investigate the effect of resilience training on the stress of mothers of students with DS. Methods: This study is a non-randomized clinical trial conducted on 36 mothers of students with DS studying at Shahid Rajaieh School, Tehran. They were selected by a convenience sampling method and divided into the control and intervention groups. Resilience skill training intervention was performed in ten sessions for the intervention group. The instruments used in the present study included a demographic questionnaire and a parenting stress index. Data were analyzed using SPSS software, version 18. Results: Before training resilience skills, no significant difference was observed between the mean stress scores in mothers of the intervention and control groups. After the training program, there was a significant difference between the mean stress scores of the two groups. Discussion: Training resilience skills can reduce stress in mothers of children with DS. Coresponding author: Narges Arsalani, E-mail: nargesarsalani@gmail.com You can also search for this author in: PubMed, Google Scholar

Objectives The care transitions measure (CTM-15) is a reliable and valid tool to evaluate the transition of care. This study aims to assess the psychometric properties of the Persian version of CTM-15 in Iranian older people. Methods & Materials This is a psychometrics study. The questionnaire was first translated into Persian based on the international quality of life assessment protocol. Then, it was completed by 200 older people who were selected using a convenience sampling method based on the inclusion criteria. After completion, face validity, content validity, construct validity (using confirmatory factor analysis and exploratory factor analysis) and convergent validity were investigated. The reliability of the questionnaire was evaluated in terms of internal consistency (using Cronbach’s α) and test-retest reliability. Statistical analyses were done in SPSS software, version 26 and AMOS software, version 24. Results The content validity index (CVI) for the whole questionnaire was obtained as S-CVI=0.966. Following CFA, the 4-factor solution was not confirmed and did not show a good fit (P

Abstract: Articles 454 and 455 of the Civil Code are ambiguous in terms of the examples of the "right of rescission", the examples of "the implied condition of prohibition of the customer in the assignment" and the meaning of the word "void"; however, the supreme court decision as a unified judicial precedent No. 810 dated 24/06/2021is also vague and outside the scope of the lawsuits. A court has described the option of violation of the payment of installments and the delivery of the goods upon rescission as an implicit prohibition of the customer's assignment, and has ruled on the invalidity of the possessions and eviction. But in similar lawsuits, another court, from the terms of the same contract, did not describe such a concept, and with a different interpretation of the law, ruled against the seller. The supreme court emphasized the intent of the contracting parties in the case of the right to rescind the contract and return of goods sold, by commenting on an implicit matter, and did not comment on the legal status of the possession of the seller, and believes that the owner's right of priority does not invalidate the condition and the right of rescission against the return of the goods. While, according to the opinion of the majority of late and contemporary jurisprudents, deduced from Articles 454 and 455 of the Civil Code, the customer's right of assignment in the contractual right of rescission is dependent null. Thus, since the implicit matter of the return of goods sold and the request for eviction is based on the request for the cancellation of the assignment, the decision of the court is logically voidable.

Abstract: A healthy, clean, and secure environment is necessary for the hospital, one of the fundamental foundations of the nation's healthcare system, to function well and sustain the general well-being of society. Timely detection of contaminated surfaces and efficient and timely disinfection will be helpful in hospital infection control. For this purpose, the level of surface contamination of medical equipment in intensive care units was to be determined and compared as part of this research. Method: The present study was carried out descriptively, with a sample size of 400 cases on ten types of medical equipment, for one month, with two method Nano sensors color indicator and standard microbial Culture. Results: According to the results obtained, we saw 182 cases of contamination (45.5%) in the samples obtained with the Nanosensor and 176 points of contamination (44%) in the samples obtained with the microbial culture medium, in both bedside instruments and ventilators as The most contaminated surfaces were identified. Also, E. coli, at 55.68%, Staphylococcus aureus, at 28.9%, and Salmonella 23.86%, were recognized as the most common microorganisms. Conclusion: Both methods have the necessary precision to identify contamination reservoirs, And the contamination reported in both methods is similar to what was expected. So in cases where the goal is not to distinguish the type of microorganisms and only to identify the general contamination, Nanosensors can be used as a fast, accurate, and low-cost method.

Having creative and innovative employees is one of the characteristics of successful organizations in the contemporary world. Meanwhile, educational organizations have a wider capacity to simultaneously train and hire innovative staff. The aim of study was to compare innovative behavior models for use by planners and managers of educational organizations. The method of research was qualitative exploratory, research population includes all models of innovative behavior and data collection and analysis methods were documentary method and deductive content analysis respectively. The research findings indicate an upward trend in interest of study methods and factors affecting innovation among behavioral scientists and management researchers in both developed and developing countries. Awareness about complexity of recent models compared to previous models and the emphasis on the role of internal and external components of innovation is another research finding. Other findings of the study are that the component of "idea development" is present in ten models of innovation, while the two components of "initial assessment of the status of the organization" and “role of external factors on innovation" are mentioned in only three models. Therefore, the main similarity and difference among innovative behavior models can be seen in these three components. In addition, after the "idea development" component, the three components of idea production (in 8 models), product goods (in 8 models) and marketing (in 7 models) have caused the most similarity between innovation models. Based on these findings, it is suggested that in order to create and strengthen innovative behavior in educational organizations, a model be considered by policy makers and planners that has four main components namely production of new ideas, development of new ideas, production of goods based on new ideas and marketing for new products.

Introduction: Parkinson’s Disease (PD) associates with changes in sex hormones; however, it remains unknown whether this is either a cause for or a result of the disease. To further evaluate it, we investigated if the development of 6-Hydroxydopamine (6-OHDA)-induced Parkinsonism changes the serum levels of testosterone and prolactin or not. Methods: 6-OHDA was injected into the medial forebrain bundle using stereotaxic surgery. The development of Parkinsonism was evaluated by apomorphine-induced rotational test and the immunofluorescence labeling of Dopaminergic (DA) neurons in substantia nigra. The necessary blood samples were collected before the toxin and in the third and sixth weeks afterward. The hormones levels were determined using Enzyme-Linked Immunosorbent Assay (ELISA) kits. Results: The severity of rotations was different among 6-OHDA-treated rats; accordingly, they were divided into two subgroups of severe and mild parkinsonian rats. The degeneration of DA neurons was observed in both subgroups; however, it was significantly less in the mild group. In the sixth week after the toxin, testosterone level increased but only in the severe subgroup. Prolactin increased in both subgroups in the third week after the toxin but returned to normal in the sixth week. There was no association between the pre-toxin levels of these hormones and the intensity of Parkinsonism. Conclusion: Our findings indicated that the development of 6-OHDA-induced Parkinsonism increases the serum levels of testosterone and prolactin. Increased prolactin occurred earlier and was observed in rats with less DA neuronal loss. Therefore, prolactin levels can predict the death of DA neurons before the clinical signs of PD were revealed.

Objectives: Chronic Obstructive Pulmonary Disease (COPD) impacts the quality of life of the affected patients. The present study aimed to determine the effects of home-based self-care program follow-up on re-hospitalization frequency and quality of life in COPD patients. Methods: This quasi-experimental study was performed on 44 COPD patients at Masih Daneshvari Hospital in Tehran City, Iran, in 2018. For collecting the necessary data, we used demographic data checklist, COPD Assessment Test, and the St. George’s Quality of Life questionnaire. We used SPSS v. 22 for analyzing the obtained data. Results: The present study revealed that the highest age frequency was in the 61-70 years age group. Moreover, the male gender had the highest frequency and most research participants had elementary school education; the highest frequency regarding the disease duration was >5 years. Besides and the hospitalization frequency was once a year. The present study findings indicated that the provided self-care program follow-up reduced the re-hospitalization frequency and increased the quality of life of the explored COPD patients (P

Background: As the number of elderly people referred to hospitals increases, so does the number of discrimination reports in the care of the elderly, compared with younger people. This study aimed to investigate the status of ageism in caring for elderly patients from nurses’ perspective. Methods: It was a descriptive cross-sectional study that was conducted in three selected hospitals of Ardabil province, Iran, in 2019. A total of 482 nurses were recruited by convenience sampling. The data were collected using a demographics questionnaire and the Ageism Scale in Hospital Care and analyzed using descriptive (frequency, percentage, mean, and standard deviation) and inferential statistics (the Pearson correlation coefficient, independent t-test, one-way ANOVA, and Scheffe post hoc test) in SPSS V. 20. Results: The mean age of the participants was 33 years. Most nurses showed moderate ageism when providing care to older adults. The level of ageism was significantly associated with age (P=0.002), gender (P=0.001), work experience (P=0.032), and the ward in which the nurses worked (P=0.001) Conclusion: The findings revealed that the study hospitals suffered ageism. Also, the level of ageism was associated with the age, gender, admission ward, and work experience of the nurses. Thus, it is suggested to consider appropriate interventions to prevent ageism, when designing and planning care for older adults.

Background and Aim: International student satisfaction is a vital element in international universities and one of the promotion methods in the global ranking, and is considered as a competitive factor. Materials and Methods: The research method is mixed (quantitative-qualitative) of exploratory-confirmatory type. The statistical population includes experts, international department managers and foreign students(1352 people) in three universities of medical sciences in Tehran, Shahid Beheshti and Iran. The sampling method is qualitative, purposeful and the sample size is 21 professors. In a small part of the multi-stage cluster method, 450 international students were selected. The research tool was a semi-structured interview in the qualitative part of the interview and a researcher-made questionnaire in the quantitative part. Results: According to the research results, the most influential factor in the foreign studentschr('39') satisfaction model includes virtual services(0.84), loyalty(0.81), university reputation and rank (0.78), admission process(0.75), Research services(0.72), Staff and management services(0.71), International services(0.70), Educational services(0.68), Health services(0.67), Welfare services(0.65), Financial facilities(0.64), university infrastructure(0.63) and cultural services(0.61). Conclusion: In order to attract financial resources, international competition, improve regional and global ranking, universities should consider and plan the priorities of the proposed satisfaction model to improve the level of satisfaction of foreign students.

Purpose – This paper aims to clear ambiguities regarding the definition of intellectual capital and its components in the evaluation of rehabilitation organizations. Design/methodology/approach – A preliminary definition of intellectual capital and its three domains of human, relational and structural capital and separate lists of proposed components for each domain was developed based on the results of a previous study. Fourteen experts in rehabilitation, health management and management engaged in Delphi rounds to reach agreed-upon definitions. Their ideas on relevance and the measurements of each proposed component in the assessment of intellectual capital in rehabilitation organizations were gathered by a questionnaire. Findings – Intellectual capital was defined as “The capital that emerges from the interaction of human resources’ ‘ability to think’ and to ‘create ideas’ with ‘a favorable internal and external organizational environment’ (including the managerial, social, structural, and physical environment, as well as communication between the inside and outside of the organization).” This capital is expected to gradually increase with further education, skills training and the gaining of experience by staff and managers. Also, the further development of intra-organizational structures and inter-relations with the market will empower the organization to adapt to continually changing circumstances, leading to competitive value and profit. Finally, a list of 101 proposed components was agreed upon in the evaluation of intellectual capital in rehabilitation organizations. Originality/value – This paper may lead to the development of measurement tools and ultimately to planning effective programs to increase intellectual capital in rehabilitation organizations.

The purpose of this study was to identify the factors affecting the competencies of Information and Communication Technology (ICT) of faculty members of Islamic Azad University of Tehran in order to improve the status quo. The present study was applied in terms of data quality and in terms of research method of content analysis. Participants in this study were selected based on theoretical principle of saturation, including 16 faculty members, such as professors, managers and ICT specialists who were selected through purposeful and theoretical sampling. The data collection tool is a semi-structure interview. Data were analyzed using MAXQDA software in three stagesof open, axial and selective coding. Data validation was done using the verifiability method by the contributors. Based on research findings, effective factors on the development of ICT competencies of faculty members were identified and categorized in four categories including four environmental and technical factors, cultural factor, legal factor, technological factor, and nine dimensions and 37 indicators

ObjectivePostoperative nausea and vomiting is one of the most common side effects after anesthesia in surgeries, such as cesarean section. This study aimed to investigate the effect of ginger and metoclopramide in the prevention of nausea and vomiting during and after cesarean section.MethodsThis clinical trial was conducted on 180 patients aged 18–40 years who underwent cesarean section under spinal anesthesia. The first group received 10 mg of metoclopramide via intravenous injection (metoclopramide group), and the second group received 1 g of oral ginger (ginger group) half an hour before spinal anesthesia. The frequency and severity of nausea and vomiting during surgery and at 2, 6, 12, and 24 hours postoperatively were compared in both groups. To analyze the results, the t-test, chi-square test, and Mann-Whitney test were used.ResultsThere was no significant difference in the frequency of nausea and vomiting between the 2 groups during operation, 2 hours and 6 hours after surgery (P=0.182, 0.444 and 0.563 respectively). The severity of nausea and vomiting was also similar in the 2 groups (P=0.487 and 0.652 respectively); however, the metoclopramide group had a lower systolic blood pressure (P

Background: Adherence to rehabilitation regimens is a major issue in the treatment of stroke. Despite the agreement on the importance of adherence, there is still no clear definition of this concept in rehabilitation. The aim of this study was the concept analysis of the concept of adherence to rehabilitation regimens in stroke patients. Materials and Methods: This qualitative concept analysis was performed using Walker and Avant's method. English and Persian articles were searched using keywords such as “adherence”, “compliance”, “rehabilitation”, “stroke”, and other related keywords among articles published from 1997 to 2018 in PubMed, Scopus, Web of Science, Google Scholar, Iranmedex, Magiran, and Scientific Information Database (SID). Related textbooks were also searched and all articles containing definitions, attributes, antecedents, and consequences of the concept were included in the study. Results: The attributes of the concept included complex, multidimensional, and dynamic behavior in the treatment process, personal experience, and adaptive behavior in patients, changeable, situational, voluntary, and collaborative behavior, and active communication between the patient and the healthcare provider. Common antecedents of the concept of adherence to the rehabilitation regimen were classified into patient-related and environmental-related categories and the consequences were classified into the three categories of patient-related, healthcare professional-related, and healthcare system-related. Conclusions: This concept analysis can be useful in eliminating any ambiguity of the concept of adherence to rehabilitation regimens. It helps clarify the vague concepts used in nursing rehabilitation instead of adherence. The results of this study can be helpful for researchers for further studies in this context.

Abstract Background Emergency and disaster are on the rise in the world. One of the most important components of disaster risk management is the early warning system. Studies have shown divergent models of warning systems with different structures. However, since no systematic review of early warning systems in disasters has been conducted so far, a systematic review of the models, components, and structures of these systems is essential. This protocol is a systematic review study, which aims to evaluate the existing warning systems and their structure. Methodology This study attempts to comprehensively search the previous studies with terms and expressions including disaster, emergency model, early warning system, and their synonyms at MESH. To this end, English articles, which have been published from 1980 to 2019, will be assessed. Google Scholar, PubMed, Web of Science, and Scopus databases as well as relevant specialized websites will be searched. Studies will be evaluated by two individuals independently. Discussion To the best of our knowledge, no systematic review of models, structures, and components of the early warning system has been conducted so far. This study is the first attempt to comprehensively evaluate the models and components of early warning systems. Accordingly, this study will provide evidence of models, structures and elements of the early warning systems. Systematic review registration PROSPERO CRD42018116111

This research aimed to characterize and compare the properties of nanoliposome (NLP)-loaded Salep mucilage-based bionanocomposite films containing free and encapsulated Allium jesdianum Boiss. essential oil (AEO). The mean size of nanoliposome containing Allium jesdianum Boiss. essential oil (NLP/AEO) was around 125 nm, the zeta potential value was about −35 mV, and the entrapment effectiveness was over 70% based on an evaluation of NLP prepared using the thin-film hydration and ultrasonic approach. Morphological studies further corroborated the findings of the Zetasizer investigation. When NLP/AEO has added to Salep mucilage-based bionanocomposite films, the tensile strength (TS), water solubility (WS), water content (WC), and water vapor permeability (WVP) were found to decrease. In contrast, the contact angle and oxygen permeability (O2P) elongation at break (EAB) increased. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) images indicated that Salep mucilage-based bionanocomposite films added with NLP/AEO had a disordered inner network in the cross-section and a rough structure on the surface compared to the control film. Finally, an increase in antibacterial activity and a decrease in AEO release rate was observed for the Salep mucilage-based bionanocomposite films incorporated with NLP/AEO. Our results indicated that NLP/AEO, as an innovative sustained-release system, had the potential for using the developed antibacterial food packaging base on Salep mucilage for the shelf life extension of perishable food products.

Background: Penile fracture is a urological emergency requiring proper diagnosis and treatment. Limited studies conducted in Iran have reported high prevalence of this problem (9.9 per 100,000 male population). In this study, we also examined the causes and symptoms, as well as the type of treatment physicians choose so that in the future, we can use this data to educate physicians and other people in the community about this disease. Methods: First, all urologists across the country were contacted and informed about the project. Then, from February 2017 to February 2018, a pre-prepared questionnaire containing the required information was sent to them and they were asked to complete and send this questionnaire in case of a penile fracture. Then, every two weeks, we reconnected all urologists in different ways (email, phone call, virtual networks, etc.) and collected relevant data. Finally, all data were analyzed using SPSS software, version 19. Results: The incidence of penile fractures was estimated to be 2.5 per 100,000 men (from 0.38 in the age range of 69-60 years to 3.9 in the age range of 39-30 years). The most common causes of penile fractures were sexual intercourse (64.8%), followed by non-sexual trauma (16.9%) and masturbation (13.3%). Pain, edema and discoloration of the penis were the most common symptoms at the time of admission (83.6%) and most patients (84%) had referred to a physician within the first 24 hours after the accident. 78.9% of urologists believed in emergency surgical treatment, while 20.3% believed in delayed surgical treatment and 0.7% believed in supportive treatment. Conclusion: Because of the cultural diversity of Iran, the rate of penile fracture is very different in different parts of Iran, but its rate is much lower than previous studies.

ObjectiveDysmenorrhea is one of the most common problems for women, especially during their reproductive age. Various studies have examined the effects of vitamins D and E and ginger supplements. This study aimed to investigate the individual effects of each of these supplements on dysmenorrhea.MethodsThis single-blind clinical trial was conducted in 2016 on students aged 18 to 25 years who complained of mild to severe dysmenorrhea. The participants were randomly assigned into 4 groups: vitamin D, vitamin E, ginger, and placebo. The effects of the supplements on the severity of dysmenorrhea were evaluated in 2 successive cycles using the visual analog scale (VAS) and a questionnaire.ResultsInitially, 240 female students were enrolled in the study; thereafter, 40 students were excluded from the study owing to follow-up loss. The average VAS score for dysmenorrhea in the entire study population was 7.13±0.80 before the intervention; the mean VAS score after the first and second months of supplement use was 5.37±1.51 and 4.93±1.48, respectively. The highest reduction in pain severity was observed in the ginger group (F=74.54, P

Objective Teamwork is a fundamental part of medical rehabilitation. The purpose of rehabilitation teamwork programs aims to enhance the functional and mental capabilities of disabled people to improve their quality of life. One of the problems of providing rehabilitation services in Iran is teamwork. In fact, teamwork is a missing link in rehabilitation services, and teamwork between physicians and therapists in different areas of rehabilitation helps to provide quality rehabilitation services. Therefore, this study aimed to identify barriers to teamwork in providing rehabilitation services. Materials & Methods This study was conducted in a qualitative approach to identify the barriers of teamwork using conventional content analysis based on Graneheim method (2004) in Shiraz and Tehran in 2017. 32 participants were selected based on purposive sampling with maximum diversity and sampling until data saturation. Data were collected through semi-structured interviews. Before the interview, the purpose of the study was explained and informed consent was obtained from the participants. Interviews lasted between 20 and 60 minutes and MAXQDA 10 software was used for data analysis. In this study, four criteria of acceptability, reliability, transferability and verification capability of Guba and Lincoln were used to evaluate and validate the data. Results After conducting interviews and analyzing of data, 846 primary codes extracted by removing similar codes. The classes were identified from the indirect open coding process by reading the text several times and assigning related codes to them by continually comparing the codes with each other and ensuring the accuracy of the coding. The findings of this study showed that the barriers to teamwork in providing rehabilitation services included a core theme of "trustworthy of a missing link to rehabilitation teamwork", and six main categories including: "disorderly planning and planning", "poor communication and coordination", " Lack of financial resources, "inadequate education system", "false cultural beliefs", "inadequate knowledge and experience", as well as 20 subcategories.. Conclusion According to the findings, efficient rehabilitation teamwork requires a comprehensive understanding, considering the long-term in addressing the barriers. Identifying the barriers for providing rehabilitation teamwork can be the first action in the formation and advancement of teamwork at hospitals and rehabilitation centers. The "trustworthy of a missing link to rehabilitation teamwork" was the main barrier to teamwork. The results of this study can provide insights and extensive knowledge about teamwork to policy-makers, managers, providers, and rehabilitation staff for removing these barriers to order promotion of rehabilitation services. Therefore, it is vital for health policy-makers and managers to change their vision and focus on teamwork as a key part of health plans. Further research is suggested.

Objectives Locomotive Syndrome (LS) refers to reduced mobility due to the impairment of locomotive organs. LS results in movement limitation, loss of balance, pain sensation, muscle weakness, and ultimately increased demand for long-term nursing care. This study aimed to investigate LS in Iranian elderly and its risk factors. Methods & Materials This descriptive, cross-sectional study was conducted on randomly selected 320 community-dwelling elderly people in Qaem Shahr City, Iran, in 2018. The study was approved by the Ethics Committee of the University of Social Welfare. The study instruments were demographic form and geriatric locomotive function scale-25 Persian questionnaire. The obtained data were presented by descriptive statistics and logistic regression was used to investigate the correlation between the criterion and predictor variables. All analyses were done in SPSS-V23. Results The Mean±SD age of the participants was 69.85±7.7 years. About 58% of the participants were in the LS group. Variables of age (OR=1.05, increase per 1 year), female gender (OR=2.7), positive history of chronic disease (OR=3.4), and positive history of chronic pain (OR=4.04) were the predictors of LS among elders. Conclusion Regarding the high prevalence of LS and its relationship with demographic factors (age and sex) as well as chronic disease and, chronic pain, screening methods to identify those at risk for LS and taking preventive measures are highly recommended.

Objective The most effective and influential capital of any organization is its human resources. The promotion of financial and physical resources results from human resource development. Recognizing and identifying the factors affecting job performance is one of the important management tasks on the macro scale. Therefore, its related factors such as recruiting, training, educating, and maintaining employees, are planned and implemented in a better way by human resource management. If ethical values such as commitment to work, honesty, and integrity are observed, the organization's job performance and success will increase. The present study was conducted with the aim of explaining the relationship between work ethics and job performance of the administrative and medical staff of the University of Welfare and Rehabilitation Sciences and its affiliated centers in 2017. Materials & Methods This was a descriptive-analytic research study. The study population was the entire 1506 administrative and medical staff of the University of Social Welfare and Rehabilitation Sciences and its affiliated centers (Razi Psychiatric Hospital, Rofeideh Rehabilitation Hospital, and Mafi Rehabilitation Center) in 2017. Out of their staff, a total of 250 employees were selected by the straight randomized methodas the study sample. The research instrument consisted of a valid and reliable questionnaire with 15 questions about Patterson's job performance, 50 questions about Gregory's criterion work ethics that has 4 dimensions (attachment and interest, seriousness and perseverance, healthy relationships, and collective spirit and participation), and a demographic information questionnaire. To analyze the data, in the descriptive statistics section, indicators such as statistical tables, distribution indices, and percentage, and in the inferential statistics section (with regard to the abnormal distribution of data) non-parametric tests of Spearman's correlation coefficient and Mann-Whitney U test were used. Results The results showed a significant positive correlation between work ethics and its dimensions with the job performance of employees (P

Introduction: Mental disorders are the most prevalent health problems in the world. 23.6\% of Iranians have at least one psychological disorder. Men usually neglect their mental health issues, and their top priority mental health disorders should be determined for health planning. Methods: International databases including MedLine, Scopus, Web of Science, ProQuest, and SID national database were searched from 2015 to October 2020. The latest reported prevalence and percent of total DALY (Disability-adjusted life year), their difference between sexes as well as the expert panel’s opinion about mental disorders were gathered in a matrix based on the Three-Dimensional Combined Approach Matrix (3D-CAM). Each item got a rank and prioritization was made base on mean rank. Results: Eight studies were included. The most prevalent mental disorders among the Iranian male population were Major Anxiety Disorders (MADs, 12\%) and the highest burden belonged to Major depressive disorder (MDD) comprising 2.88\% of the total DALY. Considering all parameters, the highest priority was the Drug Use Disorders (DUD) followed by Alcohol Use disorders (AUDs), Conduct disorder, MADs, Bipolar disorder, MDD, and Schizophrenia, respectively. Conclusion: Men are extremely affected by drug and alcohol use disorders in Iran and also there is a lack of practical screening and effective interventional programs for these disorders in the primary health care system. More intensive harm reduction programs are needed for decreasing devastating consequences of any substance use disorders as well as improving mental health literacy and raising awareness toward risk perception for preventive and controlling purposes.

Introduction: Urethroplasty is one of the most common and important reconstructive procedures in the field of urology. In order to improve patient’s condition, medical man needs to be acquainted with this technique. We aimed to evaluate quality of life and satisfaction of patients with Urethroplasty in the reconstructive urology department of Shohada-e-Tajrish Hospital, during 1995-2016. Materials and Methods: This study was a retrospective cohort. Sampling was done by census method. The patients' demographic information, cause and duration of urethral stricture, type and frequency of procedures, daily fluid intake, urinary obstruction symptoms, the quality of marital relations, and the quality of life of patients before and after the surgery, were evaluated. Results: The mean age of the patients was 36.6 years. 46.4% of the patients had moderate and more than moderate marital satisfaction after surgery, while this preoperative satisfaction was 48.2% (P>0.05). Patients' quality of work life and job satisfaction was significantly higher than before surgery (P=0.05). In 90.3% of the patients, urination status had no or little negative impact on their daily life after surgery. Also, 86.9% of the patients did not have weak urinary flow during follow-up. 88% of the patients were satisfied with the outcome of their surgery. Patients' satisfaction with their physical health after surgery was 82.1%. Conclusion: In general, it is inferred that Urethroplasty is associated with a high success rate and patient satisfaction, and also improves their quality of life.

Introduction: Population aging is becoming a global challenge for developing countries. The aim of the present paper is to review the current literature on geriatric health and to propose possible research areas. Methods: By reviewing scientific databases, all published papers in geriatric health within the last 5 years (until 31 December, 2019) were extracted. Inclusion criteria were being about elderly health conducted on Iranian elderly population and published no longer than 5 years ago. Unrelated, foreign studies and qualitative, trend analysis, and case series were excluded. The keywords were classified into 5 macro domain of General, Biological, psychological, Social and Spiritual domains. Results: Until 31 December, 2019, 713 related studies were finally retrieved. 56.8% of keywords belonged to the Biological macro domain. Among which, neurologic disorders had the highest proportion of studies (n=108, 15.1%). The most prevalent subdomain was the “Sociological” (P=15.4%) and the most prevalent keyword was “Quality of life”. The lowest proportion of studies was belonged to Hematology and Otolaryngology (0.4% each). Among the top institutions in terms of publication output are University of Social welfare and Rehabilitation Sciences (11%), Shahid Beheshti University of Medical Sciences (9.7%), and Iran University of Medical Sciences (9%). Conclusion: Most of the literature concerning elderly`s health in Iran has focused on biologic aspect of health. There seems to be an urgent need to develop a research roadmap to cover all aspects of research among elderlies. Various prepositions to develop and promote context-based and innovative strategies are also provided.

Introduction: Andropause is a syndrome with a slow progression that is associated with androgen deficiency in older men. This study aimed to collect all scientific data about the factors that cause the occurrence of andropause in Iranian men as well as the aspects of life which can be affected by this disorder. Materials and Methods: Searching was conducted in international databases including MedLine, Scopus, Web of Science, ProQuest, and national database (SID) from inception until December 2019. Retrieved studies were reviewed by two researchers independently and selected studies were summarized in a table. Results: Finally, 21 related studies were included and summarized information showed that andropause can be negatively affected by age, lower testosterone levels, smoking, lower economic status, lower educational level, and poor employment status. Some studies have also implied that there is a significant correlation between andropause and quality of life, sleep quality, depression, anxiety, marital dissatisfaction, urinary incontinence, coronary heart disease, and metabolic syndrome. Conclusion: According to the collected data in this present study, Iranian studies have covered a wide variety of complications and related factors in the field of andropause but, we still lake some studies about other aspects of andropause such as musculoskeletal impairment, erectile dysfunction, memory and cognitive disorders, skin and hair disorders, decreased libido, and other mood disorders.

Introduction: Preeclampsia is a specific gestational syndrome that reduces organ perfusion due to vascular spasm and endothelial activation. Despite the use of magnesium sulfate, the patient's blood pressure sometimes remains uncontrolled, and therefore, it is necessary to use other medications, especially diuretics and Methyldopa. Hence, the aim of this study was to compare Lasix and Methyldopa in controlling postpartum hypertension in preeclampsia patients after magnesium sulfate treatment. Material and Methods: This double-blind randomized clinical trial was carried out on 100 women with preeclampsia referred to Akbar Abadi Hospital-Iran. In the first 24 hours after the termination of pregnancy, the participants’ blood pressure was measured and those with a blood pressure of 140/90 to 160/100 were divided into two groups. In the first and second 24 hours, and then one week after the intervention, systolic and diastolic blood pressure as well as diuresis and drug complications in the two groups were assessed and compared. The present study was registered in the Iranian Registry of Clinical Trials (IRCT) under the ID of IRCT20180114038349N1. Results: The mean age of individuals was 29.93 ± 6.65 in the Methyldopa group, and 32.35 ± 4.85 in the Lasix group (P = 0.479). Systolic and diastolic blood pressure had a substantial reduction in both groups, but there was no significant difference between the two groups (P> 0.05). Systolic blood pressure was reduced by 31 mmHg (reduction from 146 to 115) in the methyldopa group and 30 mmHg (reduction from 145 to 114) in the Lasix group. Furthermore, the reduction in diastolic blood pressure was 25 mmHg (from 95 to 70) in the methyldopa group, and 21 mmHg in the Lasix one (from 91 to 70). Conclusion: The present study showed that using Lasix and methyldopa was effective enough in changing blood pressure in patients with preeclampsia, and the effects observed in the two groups were the same. Therefore, it could have a great impact on the wellbeing of couples.

Background and aim: To find if intra-operative local injection of Mitomycin-C after internal Urethrotomy in patients with urethral stricture can improve the outcome of surgery. Materials and Methods: Seventy patients were allocated in two groups randomly and data were analyzed. The case group (n=35) was treated by internal Urethrotomy with intra-operative local injection of Mitomycin-C. The control group (n=35) was underwent standard internal Urethrotomy. The patients were followed after removing catheter and for 6 months after surgery by USS PROM questionnaire and uroflowmetry. Results: A significant difference was observed in terms of urodynamic indices like Q-max (p-value=0.006) and urine flow pattern (p-value=0.025) after internal Urethrotomy in the local injection of Mitomycin-C group and control group, six months after surgery. In the case group, in the six months after operation, only 2.9% of patients had Q-max less than 15 and no one had obstructive pattern, while in the control group, 25.7% of patients had Q- max less than 15 and 17.1% had obstructive pattern. However, the patient's satisfaction history did not show any significant difference in post-internal Urethrotomy voiding status in the local injection of Mitomycin-C group and control group, either immediately after removal of the urethral catheter (p-value=1) and six months after surgery (p-value=0.198). Also, no significant difference was observed in terms of urodynamic indices like Q-max (p-value=0.771) and urine flow pattern (p-value=1) after internal Urethrotomy in the local injection of Mitomycin-C group and control group, immediately after removal of the urethral catheter. Conclusions: Intra-operative local injection of Mitomycin-C after internal Urethrotomy can be regarded as a safe and efficient technique which has several advantages including lower cost. Lower recurrence rate of urethral stricture is the main effect of local Mitomycin-C application that is more prominent after six months follow up.

Background. Work-Family Conflict (WFC) is a form of interrole conflict in which an active participation in occupational activities causes strain and interferes with family roles of workers and vice versa. It is a major source of occupational stress among workers and personnel. Emergency Medical Technicians (EMTs) are an important part of the healthcare system that respond to emergencies. The EMTs experience high level of job stress, which may affect their ability to perform their family roles, and, on the other hand, actively performing their family responsibilities may interfere with the effective delivery of the already stressful activities at workplace. Objective. The aim of this study was to determine the prevalence of WFC among Emergency Medical Technicians in Iran and its relationship with time management skills. Methods. This was a descriptive study. In this study, 271 EMTs from the western part of Iran completed the questionnaire for the assessment of WFC. The Carlson Family-Conflict Questionnaire and the “Time Management Behaviors Scale” developed by Macan were used as evaluation instruments. The data were analyzed by SPSS software version 16. Appropriate statistical analysis such as mean and standard deviation, Pearson correlation, and Spearman rank correlation was applied for analyzing the data in SPSS. Results. The majority of the participants reported some degrees of WFC. Statistical analysis showed a significant inverse correlation between total WFC score and total “Time Management Behaviors scale” score (r = −0/381، p0.05). Conclusions. The findings of this study indicate that time management behaviors and skills can reduce WFC among Emergency Medical Technicians. Therefore, it is recommended that prehospital emergency authorities and policymakers plan and implement measures such as reducing the duration of shift-work schedules, decreasing shift-change restrictions, and organizing regular time management courses. Also, employment of local inhabitants is preferred to geographically distant individuals with similar qualification as this will reduce the distance between home and workplace.

Background and purpose: Women who develop preeclampsia are prone to post-traumatic stress disorder (PTSD). The major role of spiritual health is well understood in health contexts. On the other hand, the effects of stress, anxiety, and depression are known to influence the treatment process in women with preeclampsia experiences. So, this study aimed at comparing spiritual health and perceived stress levels in women with preeclampsia, affected and unaffected by PTSD. Materials and methods: This descriptive-analytic study was done in 278 multipara women with preeclampsia at 36-40 weeks gestation admitted to public hospitals in Mashhad, Iran 2017. The Perinatal Posttraumatic Stress Questionnaire (PPQ), the Post Traumatic Disorder Checklist (PCL), Depression Anxiety and Stress Scales (DASS 21), and the Spiritual Well-Being Scale were administered. Data were analyzed using SPSS V16 applying independent T-test, Mann Whitney, and Spearman's rank correlation coefficient. Results: Among the patients 68 (26%) developed postpartum PTSD. Significant relationships were found between the two groups of affected and unaffected by postpartum PTSD in spiritual well-being (P= 0.030), depression (P= 0.001), stress (P= 0.000), and anxiety (P=0.000). Conclusion: Low levels of spiritual health and high levels of depression, anxiety, and stress in postpartum women are amongst the main causes of developing PTSD in women with history of preeclampsia.

Introduction: Involving approximately 4% of malignancies in women, ovarian cancer remains one of the most fatal cancers. However, it is important to consider conditions which are not primary ovarian diseases, but mimic their behaviors. In the present study, the epidemiological characteristics of extra-ovarian conditions mimicking ovarian masses are evaluated. Methods: This cross-sectional study was conducted on patients with a primary diagnosis of ovarian mass who underwent surgery by gynecologists between January 2012 and March 2016. The surgeon’s primary diagnosis and the final histopathology assessment report were evaluated for each patient. In cases where the final histopathology report was not in the spectrum of gynecologic pathology, possible reasons for incompatibility were investigated. Results: Ultimately, 1876 patients with a mean age of 48.26±15.4 years underwent analysis. Among these patients, 27 (1.4%) had masses of a non-gynecologic origin. The final diagnoses were divided into four main categories: masses with a gastrointestinal origin (55.5%), infectious (18.5%), those with a retroperitoneal origin (18.5%), and embryologic-origin masses (7.4%). Conclusion: The results suggest that extra-ovarian diseases should be considered in differential diagnoses of patients with a primary diagnosis of ovarian cancer. Furthermore, it was found that metastases from gastrointestinal tract tumors and infectious diseases are the most common pathologies among extra-ovarian conditions.

Today, optimism is one of the important factors in organization success, positive managers increase their employee motivation. And with a brighter landscape, it provides a platform for the growth and excellence of the organization. Positive organizational behavior and positive thought, increases employee`s performance, efficiency and productivity improvements, satisfaction, social economic development and welfare level. The purpose of the study was determining the positivism factors in training group managers in the universities of the country. The study was a survey type. The research participants were composed of educational groups as studied cases Guilan province. Participation in this study were chosen by using census selected and it includes 150 training group managers from the Guilan province universities. Initially, 139 positive components were extracted through the literature review and limited to 69 components through Delphi process. Finally, after incorporation and removing repetitive cases, 49 extracted components were set in 8 dimensional format and the research questionnaire was set based on it. Then, the questionnaire was given to the educational training managers, after completing and collecting, they were analyzed based on Friedman test and Hierarchical Cluster Analysis (cluster). Finally, 8 components (hope, glow, quality of life, happiness, forgiveness, self efficacy, psychological capital, optimism) were identified and among given components, happiness, self efficacy and psychological capital that had the highest priority and effect on managers positivity were introduced.

Background: Family caregivers of individuals with chronic psychiatric disorders play an important role in the management of the patient’s conditions, which interferes with other activities of daily living, work, social and leisure activities. Objective: This study was conducted in an Iranian context to explore the perception of family caregivers about barriers of leisure in care of individuals with chronic psychiatric disorders. Methods: The current qualitative study was conducted on the basis of conventional content analysis. Participants were 15 family caregivers of individuals with chronic psychiatric disorders who were selected by Purposeful sampling method between July 2016 and March 2017 in Tehran, Iran. The data was collected via in-depth semi- structured interviews. The interviews were tape recorded, written and transcribed. Then, data were analyzed by inductive content analysis method. Results: Data analysis led to extraction of 3 main categories and 10 sub categories. Obstacles to leisure-time of family caregivers have been placed in three main categories which are patient-related factors (Resentment from psychological problems, Resentment from behavioral problems, Need for continuous monitoring and access), caregiver-related factors (Physical harm, Psychosocial harm, Temporal stress, Accumulation of responsibilities, Concerns), and community-related factors (Feeling of sympathy and rejection, Social stigma). Conclusion: Understanding the barriers of leisure in this group of family caregivers has contributed to understanding the family caregivers' perception in this area and regarding their leisure, it can provide a broader perspective to mental health therapists, rehabilitation managers and policy makers for understanding the needs, addressing the challenges and barriers of this group of family caregivers.

Methods: This study is Randomized control trials that all of the spinal cord injury, who referred to khatam-al Anbia Hospital in Tehran Iran in first 6 month of 1393, was our statistical research community. 40 patient were selected Based on inclusion criteria and purposive sampling method. They were randomly divided into two groups of experimental and control by using a table of random numbers. Experimental groups were performed intervention include exercise program for paraplegia spinal cord injury during twelve 45-60minutes sessions, twice a week. SPSS statistical software SPSS19 data using chi-square, independent t-test and paired T was performed. Results: Results showed that no different between two group of intervention and control about demographic characteristics. The mean visceral pain intensity Score was 5/12±0/87 in intervention group, and 4/76±0/65 in the control group before intervention, which respectively reached to 2/89±0/95 and 4/47±0/62 after implementation of the intervention and this difference was Significant in intervention group (p≤0/001). Conclusions: Results showed that regular exercise program can reduce visceral pain intensity after spinal cord injuries.

Background & Aim: Nurses due to sensitive nature of professional are constantly exposed to stress. Stress is a known component of modern nursing and has become a challenge for this profession. This study aimed to evaluate the mean score of job stress among nurses using systematic review and meta-analysis has been done. Materials & Methods: 11research papers were obtained using the key words “job stress, occupational stress, Workplace stress, nurse and their possible combination” through the nationally available databases of SID، Magiran, PubMed, Scopus and Science direct. Analysis of data was performed using meta-analysis (random effects model). Heterogeneity among studies was assessed using the I2 index. Results: The mean score of job stress with sample size of 2682 people in all the 11 papers estimated 96.56 (95% CI: 64-129). Highest prevalence of job stress was reported in correlational studies (114.54, 95% CI: 61.5-167.5). Conclusion: Given the high job stress score among nursing, stress reduction programs implementing seems necessary

Objectives: Hydrotherapy treatment is a type of complementary therapy which is administered in conjunction with other conventional modes of treatment for the treatment and rehabilitations of cerebral palsy patients. Though it has gained increasing popularity in many countries around the world, its application in Iran is still rare. The aim of this study was to perform an integrative review of the extant literature in the field of hydrotherapy and its applications for the improvement of ICF (International Classification of Functioning, Disability and Health) in spastic diplegia cerebral palsy patients. The review encompassed multifactorial analysis of the articles published between 2000 and 2016. Methods: All related articles published in Iran as well as other countries from across the world (during the last sixteen years) with the keywords: hydrotherapy, cerebral palsy, participation, play, motor function, body function and body structure, were extracted from databases such as Science direct, PEDro, CINAHL, PubMed, ProQuest, magiran. The articles thus obtained were selected for evaluation and analysis. Results: More than 33 papers were found from the literature search (as specified above). Of these, 18 articles were eliminated due to unrelated materials and addressing methods other than hydrotherapy rehabilitation. Of the remaining 15 papers that directly corresponded to the effect of hydrotherapy on improving ICF of spastic diplegia cerebral palsy patients, 11 articles were investigated in this review. The abstracts were evaluated first, followed by the full texts of the 11 articles that met the inclusion criteria. Discussion: The results of the review showed that hydrotherapy when applied along with other conventional methods of rehabilitation, exerts positive effects on all areas of ICF. Hydrotherapy can be used in children and adolescents with spastic diplegia cerebral palsy, but the exercises chosen must be in accordance with the physical and cognitive conditions of the patients. However, studies in some areas of ICF are limited and further studies in this field are felt.

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Introduction: Uterine septum is one of the most common congenital abnormalities in women that leads to numerous gynecological problems and adverse obstetrics outcomes. This study aimed to evaluate the effects of Hysteroscopic Resection on pregnancy outcomes in women undergone the surgery. Methods: In this quasi-experimental study, 90 women were included from April 2016 to June 2018 from patients attending to Rasoul Akram hospital of Tehran. The inclusion criteria included: the age lower than 35 years old, primary infertility, idiopathic recurrent spontaneous abortion, BMI between 19 and 30, and having informed consen. Septum was resected by scissor upward and lateral. After 10 months of follow-up in average, we assessed rate of live births, abortions, birth weight and presentation. Results: 82 individuals were assessed for occurrence of conception (response rate=91%). The mean age of patients was 30.01 ± 6.76 years and the mean BMI was 26.25 ± 4.88. Out of 82 patients, 36 patients were pregnant, of whom 16 (44.4%) had abortions. 5 (14.9%) of the pregnancies ended with preterm birth, and 6 (17%) ended with stillbirth. Conclusion: The present study showed that the infertile patients with uterine septum and with no other causes of infertility were more likely to be pregnant compared to other patients with idiopathic infertility. Our study showed that post-operation fertility following Hysteroscopic Resection was lower than that in previous reports. According to the findings of this study, scissors may be safe, effective and cost-effective method for removing uterine septa.

Objectives The aim of the study was to determine the effect of mindfulness program on the caregivers’ strain on elderly patients with Alzheimer’s disease who were referred to the Iran Alzheimer’s Association 2012. Methods & Materials This study was a quasi-experimental study with two groups and before and after design. The participants (n=60) were selected by convenience sampling method and then randomly allocated to intervention (n=30) and control (n=30) groups. The intervention group was trained with a mindfulness program for 6 weeks in two sessions (2 hours in each session per week). Data were collected through the caregiver’s strain questionnaires before and one week after the intervention. Results The mean of caregivers’ strain in the intervention group decreased from 36.96±6.72 to 30.63±6.37 (P0.05). Conclusion The results showed that the mindfulness program could reduce the caregivers’ strain on Alzheimer’s disease, and these findings can be applicable for all caregivers.

Background & Objective: Medical education is one of the most important challenges facing Iranian medical authorities Meanwhile Islamic Azad University as a nongovernmental authority for medical education has its own challenges and problems This study aimed to assess faculties perception to identify the challenges in this area to improve the achievement of educational goals and the quality of health care Methods: In this qualitative study in 2014 the conventional content analysis was done for 10 semistructured interviews with the faculty member of Islamic Azad University with experience interest and authority in medical school After implementation of interviews reviews were done several times The open coding system was used to generate initial categories for analysis Results: Analysis of data obtained from interviews with participants resulted seven themes including the public system abandoned the university despite the general acceptance ignoring students positive and negative characteristics problems of clinical faculty challenges of research area challenges in clinical education problems related to the field of interaction with the Ministry of Health and Medical Education and improving strategies Each theme consisted of several subcategories and described the specific aspects of the challenges in this area Conclusion: It is expected that the Ministry of Health and Medical Education in the Stewardship of Health and Medical Education consider the clinical education in Islamic Azad universities in terms of planning and policymaking Islamic Azad University officials also should consider strategies within the organization

Background: The safety of rehabilitation centers is of great importance to ensure the well-being of patients. The present study aimed to determine non-structural and functional vulnerability of state rehabilitation centers of Tehran City welfare organization in disasters using national standard instruments in 2014. Materials and Methods: This study has a descriptive and cross-sectional design. A total of 17 rehabilitation centers affiliated with Tehran welfare organization are investigated. The vulnerability of centers was measured using 2 checklists of non-structural and functional vulnerability of the World Health Organization. The reliabilities of the non-structural and functional vulnerability instuments were 0.79 and 0.91, respectively, using the Cronbach α. The data were collected through observation and interview with authorities of centers and their staffs. The data analysis was performed through descriptive statistics and 1-sample t-test using SPSS 16. Results: Among 17 rehabilitation centers, the mean functional safety of 11 centers (64.7%) was high and showed low vulnerability and safety of 6 centers (35.3%) was average and showed average vulnerability. With regard to non-structural safety level, 9 centers (53% of centers) had high safety level and showed low vulnerability. Eight centers (47% of centers) had average safety level and showed average vulnerability. The results of 1-sample t test showed that at the significance level of 0.05, there was no significant difference between functional and non-structural safety of centers. Conclusion: The functional and non-structural safety of state rehabilitation centers of Tehran welfare organization was above average and vulnerability of centers to disaster was average, too. We suggest that the required planning be performed to improve non-structural and functional safety quality of centers and reduce their vulnerability.

Background: The safety of rehabilitation centers is of great importance to ensure the well-being of patients. The present study aimed to determine non-structural and functional vulnerability of state rehabilitation centers of Tehran City welfare organization in disasters using national standard instruments in 2014. Materials and Methods: This study has a descriptive and cross-sectional design. A total of 17 rehabilitation centers affiliated with Tehran welfare organization are investigated. The vulnerability of centers was measured using 2 checklists of non-structural and functional vulnerability of the World Health Organization. The reliabilities of the non-structural and functional vulnerability instuments were 0.79 and 0.91, respectively, using the Cronbach α. The data were collected through observation and interview with authorities of centers and their staffs. The data analysis was performed through descriptive statistics and 1-sample t-test using SPSS 16. Results: Among 17 rehabilitation centers, the mean functional safety of 11 centers (64.7%) was high and showed low vulnerability and safety of 6 centers (35.3%) was average and showed average vulnerability. With regard to non-structural safety level, 9 centers (53% of centers) had high safety level and showed low vulnerability. Eight centers (47% of centers) had average safety level and showed average vulnerability. The results of 1-sample t test showed that at the significance level of 0.05, there was no significant difference between functional and non-structural safety of centers. Conclusion: The functional and non-structural safety of state rehabilitation centers of Tehran welfare organization was above average and vulnerability of centers to disaster was average, too. We suggest that the required planning be performed to improve non-structural and functional safety quality of centers and reduce their vulnerability.

Background and Objectives: Academic burnout leads to poor performance in students. On the other hand, motivation has direct relationship with academic performance of students. In this study, the relationship between motivation and academic burnout among nursing and paramedical students was investigated. Methods: This study was conducted as a cross-sectional study on nursing and paramedical students of Qom city in the second semester of 2014-2015. A total of 264 students were randomly selected from nursing and paramedical students. Data collection tools were demographic information form, academic burnout questionnaire, and academic motivation scale. Data were analyzed using regression and Pearson’s correlation coefficient. The significance level was considered p

Introduction: Due to the importance of holding effective scientific Olympiads for medical sciences students, this study aimed to evaluate experts’ viewpoints in regard to their necessity, costs, achievements, barriers and solutions. Methods: In this qualitative study, required data were collected using open-ended questions through self-development questionnaires, which were filled out by experts. Data were analyzed through content-analysis methods. To select participants, a purpose-based sampling method was applied up to the point of information saturation. Thus, this study was performed with 20 individuals. Results: The main necessity and philosophy of holding Olympiads expressed by the experts were: promoting health sector performance, extension of interrelationships between universities, development of scientific competition and incensement of students’ creativity. The majority of participants believed that the achievements of holding these Olympiads are negligible versus their costs. The most important barriers were: absence of appropriate relationships between universities, lack of proper support for holding these Olympiads, the low motivation of professors, noninterested students and the shortage of resources and facilities. Furthermore, the most important solutions included: performance evaluation of previous Olympiads, increasing incentives and motivations as well as suitable planning. Conclusion: According to experts’ viewpoints, although holding scientific Olympiads is necessary for medical students, during past years, the achievements of such Olympiads versus theirs costs seem negligible and there are lots of barriers in the path of achieving their goals and philosophy.

Objectives: The analysis of the concept of ageism will help us to achieve a similar, clear, and understandable definition of ageism in the care system. The aim of this study was clarification of the ageism in caring system. Methods & Materials: We utilized the Walker and Avant’s model in this study. In a review of literature from 1969 to September 2018, sources were included on the basis of the definition, functions, properties, premises, consequences, and empirical referents of the ageism concept. Results: According to our analysis, the main attribute of the concept of ageism is that the ageism is a discriminatory process towards the elders which can have a positive or negative aspect with a conscious and unconscious manifestation in the cognitive, affective, and behavioral components in three micro, meso and macro levels and can be self-directed or other-directed. Conclusion: Since the concept of ageism in our country is relatively new and unknown, this concept analysis by clarifying the ageism, with understanding this concept in the care system, can improve implementation of more extent studies and development of research tools for identification of its barriers and facilitators and its execution.

BACKGROUND: Breastfeeding is not only a perfect food for the infant but also is a living fluid with many features. It provides the infant's physical growth and is responsive to its emotional needs. Since determining the knowledge and attitude of girls in this period and promoting, it is considered as the main principle in motivating them for choosing this method in future. MATERIALS AND METHODS: This descriptive-correlational study was conducted to determine the knowledge and attitude of 630 high-school students on breastfeeding at a selected public high school in Tehran, Iran in 2018. A researcher-made questionnaire was administered to collect the data, to determine the validity of the tool; content validity was used and to determine its reliability, a test re-test method was applied. Data were analyzed by the nonparametric tests of Chi-square, multiple comparisons, and Spearman correlation coefficient. RESULTS: The results showed that 80.3% had moderate knowledge. The mean score of knowledge in the human sciences group was significantly higher than others. Furthermore, the attitude of 22.5% of girls was positive, 77.5% had no idea, none of them had negative attitudes. There was a statistically significant difference between the mean score of attitude of the students in groups of knowledge (good, moderate, and weak) (P < 0.01), and multiple comparison tests showed that the positive attitude score in the moderate knowledge group was more than the attitude score in weak and good knowledge. CONCLUSION: The results indicate that there is an unbiased attitude about the moderate knowledge of different aspects of breastfeeding among pre university students, although they have a moderate knowledge on a complete and successful breast feeding.

CONTEXT: Iran's health system has always faced many challenges in the field of disaster risk management. The establishment of early warning systems in countries has been identified as an important component of preparedness and risk reduction. AIMS: This study aims to extract the experiences of those involved in the field of risk management in relation to the challenges and problems of early warning system establishment in the Iran's health system. SUBJECTS AND METHODS: This was a qualitative study, which has been conducted using a content analysis method. Data were collected through semi-structured interviews with 16 individuals who had at least one disaster management experience at the emergency operation centers. Sampling was done purposefully. The data were then analyzed using the Grenheim method. RESULTS: Nine subcategories of data were analyzed that included legal vacancies, challenges related to protocols and guidelines, weaknesses in the prediction infrastructure, weaknesses in the communication infrastructure, poor coordination, scarcity of resources, inadequate education, information management challenge, and evaluation challenge, and three main categories were extracted that included policy challenges, infrastructure challenges, and management challenges that represented the issues experienced in establishing an early warning system in the Iranian health system. CONCLUSION: Policy-makers and managers of health system need to pay special attention to improve the legal framework and standard protocol, strengthening infrastructures, increasing management performance in the field of coordination, education, allocation of resources, flow of information, and evaluation system.

Introduction: Infertility affects an estimated 15% of couples globally and in Iran, a quarter of Introduction: One of the current debates regarding men’s reproductive health is the declining sperm count and the role of nutritional and environmental factors. This study aims to investigate the association between dairy product consumption and oligozoospermia, sperm count of 5 to 15 million per milliliter of semen, in adult men. Materials and Methods: This age-matched case-control study was conducted on 102 oligozoospermia and 306 healthy men (control group). Both groups were recruited from an infertility clinic in Tehran, the Royan Institute. Dietary intake of subjects was collected using a valid and reliable 168-item food frequency questionnaire. Odds ratios (OR), ex-tracted from conditional logistic regression, were used to compare the occurrence of oligozoospermia by tertiles of dairy intake. Results: After adjusting for potential confounding variables, the high intake of low-fat dairy products was inversely associated with the risk of oligozoospermia (OR: 0.48; 95%CI: 0.24 – 0.95), (P =0.046). The higher intake of high–fat dairy products [(OR: 2.44; 95%CI: 1.26 – 4.73), (P =0.008)], high–fat milk [(OR: 2.16; 95%CI: 1.09 – 4.30), (P =0.043)], and ice creams [(OR: 2.37; 95%CI: 1.25 – 4.50), (P =0.008)] were also positively associated with oligozo-ospermia. Conclusion: The high intake of low–fat dairy foods seems to have a protective effect on oligozoospermia. Higher intake of high – fat dairy products, high– fat milk, and ice creams were associated with an increased risk of oligozo-ospermia.

Introduction: Obstructive azoospermia is one of the causes of post-testicular infertility in men and previous studies have reported inconsistent levels of endothelial nitric oxide synthase (eNOS) enzyme in these patients. Accordingly, the present study aimed to provide further evidence on the expression of eNOS enzyme in patients with azoospermia. Materials and Methods: In this case-control study, 10 patients, who were diagnosed with azoospermia and were referred to the infertility center for treatment or diagnosis, and 7 healthy fertile men were recruited. An informed written consent was obtained from included subjects and they underwent testicular biopsies. Samples were assessed via immunohistochemical methods to determine their levels of eNOS expression. Results: Both leydig and sertoli cells were found to express eNOS, while this enzyme was not expressed in normal germinal cells. The only significant difference between the two groups was the level of eNOS expression in sertoli cells which was found to be higher in patients with obstructive azoospermia compared to the control group (P

Background: One of the main goals of nursing education is training them to provide proper medical services to patients as well as healthy people in the community and health centers using their knowledge and specific skills. This service requires nurses’ critical thinking and effective learning. The purpose of this study was to determine the impact of critical thinking skills on decision making styles of nursing management. Methods: This interventional study is of semi-experimental kind and conducted on 60 nursing managers (30 in each group of the samples). In the beginning of the study, California questionnaire of critical thinking scale was completed by the participants. The intervention group received critical thinking skills training for 8 sessions (4 theoretical sessions and 4 practical sessions). A week after the end of the last training session, the same questionnaires were completed by the participants. Results: Prior to conducting the study, 2 groups were not significantly different regarding demographic variables. The mean score of critical thinking and decision making style of the control group was the same before and after intervention, but in the intervention group, the mean score increased. Conclusion: Teaching critical thinking skills increases the level of critical thinking and the use of rational decision making style by nurses. Nurses’ cognitive ability, especially their ability to process information and make decisions, is a major component of their performance and requires possession of critical thinking. Thus, universities of medical sciences are suggested to provide necessary support to allow the development of professional competencies, decision making, problem-solving, and selfsufficiency skills, which are influenced by the ability for critical thinking.

Objective: The purpose of this study was to investigate the relationship between organizational citizenship behavior, organizational commitment and its dimensions on the Welfare staff in Tehran 2013. Materials & Methods: In this cross - sectional study, one hundred eight staff of Tehran Welfare were selected by random sample, and the sample size of the previous studies. Data were collected using two standard questionnaires OCB, and Organizational Commitment, which includes the three dimensions, affective commitment, normative commitment and continuance commitment and analyzed by statistical methods such as: Pearson correlation coefficient and ANOVA. Results: The finding showed Between OCB and organizational commitment there was significant and positive correlation (P&le0.01, r=0.325). Also the dimensions of organizational commitment: affective commitment and normative commitment have a significant positive relationship with OCB, but not significant relationship OCB with a continuous commitment. ANOVA results showed that the average OCB in age, type of employment and employee experience is different. And Continuous commitment in hiring employees is different and emotional commitment in Background employees is different. Conclusion: Based on the findings we conclude that the enhancement of organizational citizenship behavior, organizational commitment and staff of Tehran can be increased.