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Validity and reliability of Persian adaptation of MSLSS in the 12-18 years, middle and high school students (430 students in grades 6-12 in Bushehr port, Iran) using confirmatory factor analysis by means of LISREL statistical package were checked. Internal consistency reliability estimates (Cronbach's coefficient [alpha]) were all above the conventional criterion of 0.70 for all factors indicating adequate reliability of the factors. Cronbach's coefficient [alpha] of the total scale was 0.83. The pattern matrix appeared by and large to be consistent with previous investigations of the MSLSS using exploratory factor analytic methods. It seems this Persian adaptation of the MSLSS offers a reliable and valid means of assessing Iranian middle and high school students' life satisfaction. Using that as a screening tool in schools may help in discriminating between different domains responsible for child and youth problems.

Background: Cerebrovascular diseases are the second common cause of mortality worldwide. The onset of reperfusion in the first 3-4.5 hours is a predictive factor of treatment. Objective: The present study investigated barriers to receiving tissue plasminogen activator in patients with ischemic stroke. Methods: This cross-sectional study examined 191 patients with first-ever stroke referring to the emergency department of the Persian Gulf Martyrs Hospital of Bushehr City, Iran, in 2016. One checklist was completed which included demographic data, history of diseases, knowledge of stroke symptoms, and intervals regarding the onset of symptoms to informing emergency, informing emergency on arrival at the emergency department of the hospital, and making the diagnosis for the patients. The obtained data were analyzed in SPSS v. 19. Results: Mean±SD age of the patients was 65.92±12.48 years. The majority of patients under investigation (55.5%) were female, 63.4% were married, 56% were illiterate and 72.3% resided in other districts of Bushehr province. Mean duration between onset of symptoms and arrival at emergency department, onset of symptoms and call the emergency service, time of arrival at emergency department to perform brain Computer Tomography (CT) scan and also to be counseled by a neurologist were 699.66, 195.51, 45.11 and 423.62 minutes, respectively. Finally 14.6 percent of patients were qualified to be treated with tPA. Conclusion: The main barrier to timely therapy is a delay in golden time. Therefore, public education to promote public awareness could be of great benefit in reducing the referral delay time. [ABSTRACT FROM AUTHOR]

Objective: The assessing the effect of letrozole and medroxyprogesterone acetate on women with simple endometrial hyperplasia without atypia in reproductive age. Material and Methods: Eighty patients of Abolfazle clinic in Bushehr with abnormal uterine bleeding and simple endometrial hyperplasia enrolled in this study. The patients were randomized in 2 groups: group A included 40 patients who received 10 mg medroxyprogesterone acetate for 10 days in each month during 3 months and group B included 40 patient that received 2.5 mg letrozole for 3 months. Serial transvaginal sonography and estradiol were checked basically and repeated after 3 months of treatment. Main outcome measures were endometrial thickness and estradiol level in serum. Results: In 2 groups A & B, there were no significant differences in the base variables. The level of estradiol in groups A and B before treatment was similar in the 2 groups. Endometrial thickness in groups A and B was not statistically significant. The difference between these 2 groups from the endometrial thickness reduction viewpoint, is not significant (P value = 0.445). The level of decline estradiol in serum in the groups A&B was significant. Conclusion: Letrozole is an acceptable drug for treatment of simple endometrial hyperplasia especially in the patients who did not tolerate medroxyprogesterone. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is evaluate the effects of weight before and during pregnancy on maternal and neonatal complications. Materials and Methods: In this cohort study, the statistical population was pregnant women. After collecting all the primary information, the relationship between pre-pregnancy body mass index (BMI) and weight gain during pregnancy with preterm delivery and maternal complications such as diabetes and pre-eclampsia were studied. Results: From a total of 1400 pregnant women, who were recruited for this study, 897 were referred to Bushehr's Persian Gulf Martyrs Hospital; statistical analysis was performed on the participants. BMI before pregnancy had no significant relationship with the number of previous abortions (P = 0.3). No significant relationship was found between BMI before pregnancy and gestational diabetes during pregnancy (P = 0.53), preeclampsia (P = 0.26), or preterm delivery (P = 0.55). Weekly weight gain was significantly less in mothers without preterm birth than mothers with preterm birth (P = 0.002), but there was no significant difference in overall weight (P = 0.99). BMI had a significant impact on low birth weight (LBW) in infants (P = 0.003). The impact of pre-pregnancy BMI on Apgar scores was significant (P = 0.043). The mother's BMI and weekly weight gain (without adjusting for confounding variables) as well as weight gain after adjusting for confounding variables had no significant effect on the mother's risk of developing gestational diabetes. The mother's age was the only confused variable (adjusted odds ratio [OR] = 1.09, P = 0.004). Pre-pregnancy BMI had a significant impact on the chances of Small for gestational age (SGA) infants (P = 0.03), but no significant effect on the chance of large for gestational age (LGA) births (P >0.05). Conclusion: High BMI during pregnancy has an adverse outcome in pregnancy. [ABSTRACT FROM AUTHOR]

To correct poor quality of life due to the elderly’s limitations and cardiovascular disorders requires the identification of supporting resources, adaptation, and enhancement of the sense of coherence. While having the little evidence available, this clinical trial was performed on 96 elderly people with cardiovascular disease. The goal was to determine the effect of education based on a self-management empowerment model on the sense of coherence. The results indicate the effect of a five-step educational intervention on a total sense of coherence score in the experimental group and on its dimensions. The results can provide a framework to design nursing education for the empowerment of the elderly. [ABSTRACT FROM PUBLISHER]

Introduction: Critical thinking training is one of the most important missions of educational institutes. Hence, academic libraries as an inseparable operational unit of higher education must help their users to benefit from information resources and facilities providing them with the chance to develop and improve critical thinking capability. This study aimed to investigate significant barriers to and inhibitive factors on providing suitable environment for developing and improving critical thinking in university libraries from the viewpoints of students in Boushehr University of Medical Sciences and Persian Gulf University. Methods: In this descriptive survey, the barriers to critical thinking development in academic libraries was investigated according to the viewpoint of 793 students from Bushehr University of Medical Sciences and Persian Gulf University in 2013-14 academic years. Students were selected by stratified proportional sampling. Data was collected through a valid and reliable researcher-made questionnaire categorized using 5-point Likert scale. The questionnaire was validated using experts’ viewpoints and its reliability was approved through estimation of Chronbach’s Alpha (0.84). Data were analyzed using descriptive statistics, one-sample t-test, Mann Whitney Test, and Kruskal-Wallis. Results: Mean scores in areas of linguistic barriers (weighted mean: 3.59), users’ inherent barriers (weighted mean: 3.49), users’ social and psychological barriers (weighted mean: 3.38), and logical barriers (weighted mean: 3.34) were higher than cut-off point of 3 and placed in significancy level of (p=0.0001). These barriers were identified as most important ones from the viewpoints of students. Conclusion: By encouraging students to ask and seek and creating a suitable environment for sharing ideas, university libraries and librarians can help their users in improving their linguistic communication. Holding educational workshops to promote information literacy skills, ability to seek, analyze, evaluate and judge the value and validity of information, as well as conducting educational tours on how to use library facilities could eliminate major factors in developing critical thinking that are lack of ability in determining informational needs and different levels of identification and utilization of retrieved information. [ABSTRACT FROM AUTHOR]

Objective: Studies determining the relationship between serum vitamin D status and childhood asthma have yielded controversial results. Findings indicated that vitamin D deficiency is associated with asthma and airway hyper responsiveness. The aim of this study was to assess the relationship between serum vitamin D status and childhood asthma. Methods: Data were obtained from 200 asthmatic children (age 3-12 years) and 200 healthy controls. Serum levels of 25(OH) vitamin D, total IgE, calcium, phosphorus, parathormone (PTH) and eosinophil count were measured in both asthmatic children and healthy controls. Also, the mean values of 25(OH) vitamin D were compared with asthma symptom severities. Findings: There was a significant decrease in the concentration of serum 25(OH) vitamin D in the asthmatic patients as compared with the controls (20.34±2.8 vs 25.39±4.1 ng/mL, 95%CI: 1.46-3.86, P=0.01). Out of total asthmatic subjects, 40 (20%) were vitamin D sufficient, 48 (24%) were insufficient, and 112 (56%) were deficient. Total IgE concentration was also significantly higher in asthmatic patients having vitamin D deficiency (132.4±20.1 IU/ml, 95%CI: 1.38-3.75, P=0.03). Comparing asthmatic patients with healthy controls, odds of having vitamin D level less than 20ng/mL was 2.47. Conclusion: Our findings suggest that vitamin D deficiency or insufficiency may be positively related to the prevalence of asthma in children. [ABSTRACT FROM AUTHOR]

Background: Beta thalassemia major has a considerable impact on quality of life. The purpose of this study was to determine the life satisfaction of beta-thalassemic children and adolescents compared to healthy controls. Methods: This research, conducted in 2009, was a controlled, cross-sectional study in which beta-thalassemic patients, who were being followed-up by the Thalassemic Center in Bushehr, a city in southern Iran, were compared with a healthy control group. The Multi-dimensional Student Life Satisfaction Scale (MSLSS) was used to measure the participants' quality of life in five domains. The chi-squared test, t-test, Pearson's Product Moment Correlation, and multiple regression analysis were used for the statistical analyses. Results: The unadjusted mean scores of three of the domains, i.e., school, friends, and living environment, and the total score of five domains, i.e., school, friends, living environment, family, and self, were significantly higher in thalassemic patients than in the control group (P < 0.05). These significant differences were persistent after adjusting the mean scores of the three domains and the total score of the five domains for age, gender, and educational level. Conclusion: The thalassemic patients were more satisfied with life than the healthy controls in Bushehr. Many factors may be responsible for this finding. The results of this study suggest that the attitude of parents and society concerning assigning responsibility to patients should be assessed. The assessment should include comparing the satisfaction with life of thalassemic patients with that of their healthy siblings and conducting national studies on the quality of life of thalassemic patients and their satisfaction with life. [ABSTRACT FROM AUTHOR]

Background: Despite several recent innovations in phacoemulsification surgery, importance of pupil diameter in this surgery is becoming more evident. Purpose: To compare the effect of opioid agonist (fentanyl) versus opioid agonist-antagonist (buprenorphine) on pupil diameter in cataract surgery and to choose the best opioid in high-risk phacoemulsification surgery. Methods: In this randomized double-blinded clinical trial, 60 patients who were candidates for elective phacoemulsification surgery were randomly divided into two equal groups: experimental (buprenorphine, 0.3 μg/kg) and control (fentanyl, 1 μg/kg). Pupil diameter was measured preinjection and at several times postinjection. Blood pressure was recorded at several intervals, as well as shivering, nausea and vomiting, and recovery time. Results: Mean (SD) recovery time was significantly less in the control group (19.46±5.43) than in the experimental group (33.23±10.75) (P<0.0001). The constriction effect (ie, pupillary diameter in mm) was significantly lower in the experimental group (0.53±0.45) than in the control group (1.06±0.52) (P=0.0001). The percentages of constriction effect in experimentaland control groups were 7.68% and 15.07%, respectively. The eye was two times more constricted in the control group in comparison with the experimental group after induction of anesthesia. Conclusion: Buprenorphine is a better solution to decrease pupil constriction in comparison with fentanylinhigh-risk phacoemulsification surgery. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in which the authors discusses their study investigating the rate, timing and predictors of the early breastfeeding discontinuation for women who gave birth to a child in Bushehr and referred to university clinics for follow up.

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disease and associated with insulin resistance. CXC Ligand 5 (CXCL5) is a new cytokine which is secreted from white adipose tissue during obesity and by blocking insulin signaling pathway inhibits the activity of insulin and promotes insulin resistance. Objective: The aim of this study was to assess serum level of CXCL5 in PCOS women with normal body mass index. Materials and Methods: In this case-control study, 30 PCOS women with normal body mass index as the case group and 30 non-PCOS women as the controls were enrolled. Serum levels of CXCL5, insulin and other hormones factors related with PCOS were measured by ELISA method, also the biochemical parameters were measured by autoanalyzer. Results: Significant increases in serum insulin concentration, homeostasis model assessments of insulin resistance, luteinizing hormone, luteinizing hormone/folliclestimulating hormone, fasting blood sugar, testosterone, and prolactin were observed in the case group compared to the controls. were in the serum level of CXCL5, cholesterol, low-density lipoprotein-cholesterol, high-density lipoproteincholesterol, dehydroepiandrosterone-sulfate, creatinine, and homeostasis model assessment of beta cell function between these two groups. Conclusion: In this study, no significant change was observed in serum concentrations of CXCL5 in PCOS women with normal BMI. [ABSTRACT FROM AUTHOR]

Background: Clinical investigations have reported several anesthetic properties of intrathecal injections of meperidine. The purpose of this study was to investigate the effect of adding meperidine to intrathecal heavy lidocaine on hemodynamic changes and blood loss in patients undergoing elective suprapubic open prostatectomy. Methods: In a randomized double-blind clinical trial, 77 patients candidate for elective suprapubic open prostatectomy were allocated to two equal groups. All patients in the control and experimental groups received heavy lidocaine intrathecally. A low dose of meperidine was added to lidocaine in the experiment group. Changes in blood pressure and heart rate were measured and documented in several intervals. Blood loss, transfusion rate, shivering, nausea, vomiting, need to an analgesic drug, and transient neurologic symptoms were also recorded. Results: No significant difference was observed between the two groups in regards to blood pressure changes in operating room. Blood pressure increase was more prevalent among patients of the control group immediately in post-operating period .There were significantly (P<0.0001) less postoperative bleeding and need to transfusion in the experimental group. Conclusion: Adding low dose of meperidine to lidocaine induces minimal effect on blood pressure change in operating room, but prevent increasing of blood pressure in postoperative period with a reduction of bleeding. [ABSTRACT FROM AUTHOR]

Background: Although education is one of the most substantial needs of patients that should be taught by nurses and midwives, it is not clearly defined through the hidden curriculum in students' teaching programs. The aim of this study was to explore the patient education through the hidden curriculum in the perspectives of nursing and midwifery students., Materials and Methods: A qualitative, content analysis study was performed and twenty nursing and midwifery students were interviewed. Data were collected using face-to-face semi-structured interviews and analyzed using conventional content analysis approach., Results: Students' perception of the hidden curriculum in patient education emerged in three main themes concerning: (1) interactions, (2) teaching and learning opportunities, and (3) reflective evaluation., Conclusions: The hidden curriculum in patient education can be transferred as interactions between professors, students, nurses, doctors, and also patients who are rooted from paying attention to the human dimension of the patient, avoiding the materialistic treatment of the patient and treating the patient with dignity. Educational policies and students' assignments should be designed based on the patient's educational goals and the goal of evaluation has to be presented to the students clearly., Competing Interests: There are no conflicts of interest.

Background: Women and mothers are the most important educational audience to convey health teachings. This study was aimed to evaluate the knowledge level of different types of health violations of food production, distribution, sale centers and public places; and authorities investigating the violations among women referring to health care centers in Bushehr., Materials and Methods: In this descriptive-analytical study, which was done cross-sectionally, 600 women who were referred to health care centers affiliated to the Bushehr University of Medical Sciences was selected by convenience sampling. Two-part questionnaire was used to collect data: demographic information and a researcher-designed knowledge survey questionnaire consisted of 25 questions with Cronbach's alpha = 0.7. Data were analyzed with the software SPSS version 13; using Chi-square test and Phi and Cramer test. P ≤ 0.05 was considered to be statistically significant., Results: The findings showed that 56.9% and 26.5% of women had good and moderate knowledge levels regarding health violations, while the general knowledge level of authorities investigating health violations were at the moderate level among 57.3% and at the good level among 15.3% of women. Overall, there was a significant relationship between education level and the women's knowledge level of health violations (P < 0.0001). The relationship between the women's education level and authorities investigating health violations was not significant (P = 0.073)., Conclusion: Applying interventional methods of education in health violations to the women by health centers can elevate the level of health knowledge among them.

Background: Clinical investigations have reported several anesthetic properties of intrathecal injections of meperidine. The purpose of this study was to investigate the effect of adding meperidine to intrathecal heavy lidocaine on hemodynamic changes and blood loss in patients undergoing elective suprapubic open prostatectomy., Methods: In a randomized double-blind clinical trial, 77 patients candidate for elective suprapubic open prostatectomy were allocated to two equal groups. All patients in the control and experimental groups received heavy lidocaine intrathecally. A low dose of meperidine was added to lidocaine in the experiment group. Changes in blood pressure and heart rate were measured and documented in several intervals. Blood loss, transfusion rate, shivering, nausea, vomiting, need to an analgesic drug, and transient neurologic symptoms were also recorded., Results: No significant difference was observed between the two groups in regards to blood pressure changes in operating room. Blood pressure increase was more prevalent among patients of the control group immediately in post-operating period. There were significantly (P<0.0001) less post-operative bleeding and need to transfusion in the experimental group., Conclusion: Adding low dose of meperidine to lidocaine induces minimal effect on blood pressure change in operating room, but prevent increasing of blood pressure in post-operative period with a reduction of bleeding., Trial Registration Number: IRCT138903061936N2.