مجله علوم پزشکی رازی
سال سی‌ام شماره 5 (پیاپی 231، امرداد 1402)

Unintended pregnancy is considered a concern based on human rights and public health approaches. In the program of action of the International Conference on Population and Development in Cairo in 1994, it was emphasized that couples and individuals have a basic right to make free and responsible decisions about the number and spacing of children (1). Unintended pregnancy is an important public health concern in both developing and developed countries, because it has many social and health consequences (2). Global estimates of the incidence of unintended pregnancy and its consequences were first published in 1995. Based on those estimates, it was estimated that 38% of all pregnancies were unintended, and more than half of them, i.e. 22% of all pregnancies, ended in abortion (3). Some previous studies (26, 27) have found a relationship between women’s fertility knowledge and unintended pregnancy. Therefore, fertility knowledge should be considered as one of the most important variables affecting unintended pregnancy. Fertility knowledge is defined as a process during which men and women become aware of their potential for childbearing (28). Accurate knowledge and understanding about fertility facts is essential for women and couples in making appropriate decisions about whether, when and how to get pregnant (29). Several studies (30-36) that have been conducted among various samples have shown the low level of fertility knowledge among the investigated samples. The few studies conducted in Iran (37-39) have also shown insufficient fertility knowledge among men and women. No study was found that specifically examined the relationship between fertility knowledge and unintended pregnancy, so this research is an attempt to study the effect of fertility knowledge on the incidence of unintended pregnancy among married women of reproductive age.

The present quantitative study was carried out with survey method in 2022. The statistical population of the present study was all married women aged 15 to 49 attending the health centers of Zarrin-shahr city in Isfahan province. For this purpose, 400 women of the statistical community were randomly surveyed. Zarrin-Shahr city had 6 health centers, and by referring to all 6 centers, a total of 400 eligible women surveyed. A questionnaire was used to collect data. The questionnaire consisted of two parts: the first part included individual questions as well as questions related to fertility, and the second part included the measurement of fertility knowledge, which was used from the standard questionnaire (40). The aforementioned questionnaire consists of 9 multiple-choice questions, one of which is the correct answer. If all 9 items are answered correctly, the score will be 9, and if all the questions are answered incorrectly, the score will be zero, so the range of women’s fertility knowledge scores based on this scale fluctuates between zero and 9. In this study, for a better understanding of women’s fertility knowledge, the final score of each respondent has been converted into a range of scores from zero to 100. The age of the spouses, the place of birth of the women, the years of education of the spouses, the employment status of the spouses, the duration of marriage, the household monthly income and the class identity of the women were the independent variables. Unintended pregnancy of women was also a dependent variable.

The results showed that 52.3 percent of women, that is, more than half of them, had low fertility knowledge, while 13.8 percent of them had a lot of this knowledge. The results showed that 25% of the studied women had a history of at least one unintended pregnancy. There was a positive and significant correlation between fertility knowledge and unintended pregnancy. An increase in the level of fertility knowledge was correlated with a decrease in unintended pregnancy. The increase in age of women and their husbands was associated with an increase in unintended pregnancy, that is, they recorded a positive and significant correlation. The findings also showed that increasing the duration of marriage is associated with a significant increase in unintended pregnancies. This means that the correlation between the duration of marriage and unintended pregnancy is positive and significant. The increase in the level of education of women and their husbands was related to the reduction of unintended pregnancies. The mentioned positive correlation was statistically significant. The variables of employment status of women and husbands, place of birth of women, class identity of women and household monthly income of women had no significant correlation with unintended pregnancy. The results of the regression analysis showed that fertility knowledge is the only variable that has a statistically significant effect on the odds of unintended pregnancy. Increasing fertility knowledge had led to a decrease in the incidence of unintended pregnancy. Age, spouse’s age, spouse’s education, duration of marriage are variables that had significant bivariate relationships with unintended pregnancy, which lost their significance after controlling other research variables. The odds ratio showed that increasing one unit of fertility knowledge can reduce the odds of unintended pregnancy by 1.6%. The coefficients of determination showed that the used regression model is able to predict between 7.9% and 11.7% of the odds of unintended pregnancy.

Based on the findings of this research and considering the relatively low score of women in fertility knowledge, it can be said that the promotion and improvement of women’s fertility knowledge should be given serious attention in health and population programs. The low knowledge of women’s fertility in the discussion of infertility also confirms the importance of addressing this issue at the macro level. If women’s knowledge of the factors affecting infertility increases, it may affect the level of fertility and decrease the childlessness ratio of the population. Improving fertility knowledge, according to the evidence reviewed in this research, can lead to a reduction in unintended pregnancies and subsequently to a reduction in induced abortions. Reducing induced abortions can also increase the health level of mothers and even reduce maternal mortality. Therefore, in general, it can be said that the promotion of fertility knowledge can affect the quality of women’s and mothers’ health on the one hand, and even the population’s size on the other hand.

The coronavirus 2019 first spread from Wuhan, Hubei Province, China, and became a global epidemic in just two months, according to the World Health Organization. As of March 23, 2020, the unknown virus has spread rapidly worldwide, infecting more than 187 countries and killing a significant number of people worldwide. COVID-19 is an acute respiratory infectious disease characterized by the main symptoms of fever, cough, and shortness of breath. With the outbreak of COVID-19 and subsequent changes such as the closure of high-risk jobs and the implementation of emergency public health measures and home quarantine, social and economic relations and the way people lived were severely affected. During the spread of the virus, strict measures such as social distancing and mask-wearing were taken to control the spread of the disease in different parts of the world. One of the measures taken to curb COVID-19 was establishing home quarantine, which in turn can have a variety of consequences, including increased anxiety and stress. Patients with or suspected of COVID-19 are often afraid of the aftermath of the deadly virus, such as long-term health effects or death. People in quarantine may also experience fatigue, loneliness, depression, and anger. Additionally, common symptoms of COVID-19 such as fever, body aches, loss of taste and smell, hypoxia, cough, and dry throat can increase COVID-19 anxiety in patients, which may cause psychological distress. High levels of fatigue and anxiety resulting from quarantine conditions significantly increase the need for extreme care, but due to the unknown nature of coronavirus 2019 and the lack of definitive treatment, individuals may have difficulty responding to this need. This intensifies fear, anxiety, and depression in people. Another variable that can be associated with pandemic diseases, such as COVID-19, is coping styles and types of symptoms in high-stress patients. Since the beginning of the COVID-19 epidemic, there has been a wave of stress and anxiety, first among Chinese citizens and then around the world. People must use appropriate and effective coping strategies to control and reduce the stress caused by these conditions. Overall, COVID-19 anxiety, specifically health anxiety, can lead to cognitive errors, threat-related distortion, immunosuppressive behaviors, and destructive behaviors in healthy individuals who develop high levels of COVID-19 anxiety. In this regard, the present study aimed to compare psychological distress and coping styles in students with different levels of COVID-19 anxiety.

The research design was descriptive and causal-comparative. The statistical population of the study included undergraduate, graduate, and Ph.D. students of the University of Tehran, Iran, in the second semester of 2020-2021. In the present study, 200 students (100 students with high levels of COVID-19 anxiety and 100 students with low levels of COVID-19 anxiety) participated in the study through an online survey conducted via WhatsApp and Instagram. Inclusion criteria included belonging to the research community, having internet access, being between 18 and 30 years of age, and reporting personal satisfaction with their current living situation. The omission of questions was also considered as a criterion for leaving the research. Due to the epidemic of COVID-19, the closure of universities and educational institutions, and to prevent the spread of COVID-19, samples of this study were collected online. Participants were assessed using the COVID-19 Anxiety Inventory, psychological distress, and coping styles and then grouped. To identify students with COVID-19 anxiety, 338 questionnaires were distributed among the participants. Individuals who obtained a standard deviation above the mean COVID-19 anxiety scale were included in the analysis as a group with high levels of COVID-19 anxiety. Finally, data analysis was performed using multivariate and univariate variance with SPSS software version 24. It should be noted that in the present study, ethical considerations based on Helsinki ethics were observed.

The results of the Eta squared analysis show that the difference between the two groups in the studied variables is significant, with an Eta squared value of 0.71. This means that 71% of the variance related to the difference between the two groups is due to the interaction of COVID-19 anxiety and the studied variables. The results of multivariate analysis of variance showed that stress (68.55), anxiety (79.77), depression (94.17), Emotion-oriented Coping (98.81), Problem-oriented Coping (102.74), and Avoidance-oriented coping (114/48) were all significant at the level of 0.01. These findings indicate that there is a significant difference between the two groups in these variables (P<0.01). This means that students with different levels of COVID-19 anxiety differ in their use of psychological distress and coping styles. Specifically, students with high levels of COVID-19 anxiety had higher levels of psychological distress, emotion-oriented coping, and avoidance-oriented coping than students with low COVID-19 anxiety.

Findings from this study showed that students with high levels of COVID-19 anxiety have more depression, anxiety, and stress than other students. As a result, students with high levels of COVID-19 anxiety may become more sensitive to physical signs and symptoms, which can lead to increased levels of COVID-19 anxiety. On the other hand, the results of this study indicate that people with high levels of COVID-19 anxiety are less inclined to use problem-solving coping styles and are more likely to use emotion-oriented and avoidance-oriented coping styles. However, problem-solving coping styles can further reduce the harms of experiencing COVID-19 and the stress that results from it. Although stressors play an important role in exacerbating chronic and pandemic diseases, it should be borne in mind that how people deal with stressful situations plays an important role in their health. Therefore, psychologists and counselors need to pay more attention to these areas to reduce the severity of anxiety in students.

The aim of this current research was investigating the effectiveness of painting therapy in a scientific rather than traditional way on anxiety and learning disabilities in single-supervisor children.

The research method was a quasi-experimental design with pre- and post-test with control group. The statistical population of this research is consisted of male and female single-supervisors students in the second to fifth grades of elementary school. and the studied sample was including 30 students in the experimental and control groups which were matched based on gender and educational bases. The research instrument was the revised “Colorado Learning Disabilities Questionnaire (CLDQ) (Colorado Willcutt et al., 2011) and protocol of Painting Therapy (Case, 2020) includes 12 painting and language training sessions, which were held online due to the closure of schools in the Corona crisis.

Resullts: 

Analysis of pre- and post-test results showed that therapeutic painting reduces the disabilities of social anxiety, reading, problem and social recognition, perception of Spatial, and math, of students in experimental group.In general explanation of the findings of this study, it can be said that painting is a child’s language.The students with social anxiety and learning disabilities were able to connect with their inner and outer worlds with the simplest possible means beyond the pleasure they created for themselves.they revealed themselves verbally figuratively. Many single parent families have many problems due to disability and lack of family support, and parental care for their children’s social activities outside of school is very limited.In most single-parent families, prent-child relationships cannot be as well established as in normal families.Single Parents students often suffer from high levels of anxiety; these students often have lower academic status, more communication problems, and poor social skills.Excessive absenteeism from school leads to maladaptation and the formation of social anxiety and learning difficulties in them.Students with socil anxiety disorder also become anxious about simple tasks such as buttoning their clothes or ordering food in front of others. They think that if they ask a question, they may look stupid, afraid to eat in public, throw food on the floor, or if they enter a room, their feet will get stuck and they will fall to the ground and be clumsy.They become more anxious in the presence of peers with higher social status. Social anxiety makes learning difficult for these students and affects their abilities.Single Prents student with social anxiety and learning disabilities had many problems in their relationships, they were usually alone and had no friends, they dhd not even have any activities in online classes and did not participate in conversations, some of these students did not show any fear or anxiety in their appearance behaviors, but they had an avoidance mechanism that is a sign of social anxiety. Some students manifested widespread social anxiety and distress for no apparent reason, and finally another group immediately expressed the anxieties and fears they faced on a daily basis with great anxiety (Haberty, 2016). Painting Therapy with Single-Parents students has become one of the best Art Therapy methods for early intervention in emotional issues, and their adaptation.Students with social anxiety and learning disabilities did not have the means to express themselves, and painting spoke in their place through codes such as Sun, Tree, House, Man, etc…,Without any conditions. Based on their dvawings, the children ejected the killers of love and their painful problems were made possible.Whether children’s painting is called a code language, a cry of love, or a creative catcher, it as a projection of the children’s world, revealed  their whole personality. Painting and making, with  expressive expression, brout a fundamental change in the child, which led them to a higher understanding of themselves. Art activities and productions and considered not because of their aesthetic appeal but brcause of their analytical and therapeutic role. Psychological refinement enabled these students to actively seek solutions to life’s problems by creating creative and spontaneous activities. Psychological refinement causes obivious barriers to transformation and dissolution, and their morbid symptoms are alleviated (Case & Dally,2020).Therapeutic Painting not onhy identified the cause of many of the students emotional,and psychological problems, but also was effective in preventing disorders students mental health through early interventions.Therapeutic Painting enhances uditory, visual, attentional, motor coordination, memory enhancement, and communication between the right and left hemispheres of the brain in solving behavioral problems by promoting creativity and enabling perceptual- motor development resulting from fine eye-hand coordination. Psychology and expression of unconsciousness were effective in the verbal expression and caused a positive transformation and improvement of morbid symptoms of students with social anxiety and learning disabilities and solving their problems.

The results of the follow-up test were confirmed after 8 weeks with the stability of the positive changes.

The concern about the quality of life of the elderly living in resident at home and nursing homes has been one of the controversial issues. Some studies believe that if the mental health of the elderly is provided and a suitable atmosphere is created in the nursing homes, better health care and treatment can be provided to the elderly and their life expectancy can be increased; But on the other hand, some studies believe that caring for the elderly at home and with other family members can have an effective role on their psychological health; so that the results of some studies indicate that this group of elderly people have a higher life expectancy; But on the other hand, it can threaten their physical health and make them prone to other chronic diseases and malnutrition. Admission to a nursing home evokes emotional consequences, including feelings of rejection, psychological tension, depression, instability, loss of home and the chance to contact family and friends. Research shows that the living environment of the elderly plays a very important role in their psychological health. It has been shown in various researches that the level of quality of life and mental health, happiness and social health in the elderly living in nursing homes is lower than that of the elderly living at home; Based on this, it can be concluded that there is a relationship between living in a nursing home and the psychological state of the elderly, but it cannot be said with certainty that the low mental health of the elderly indicates living in a nursing home; Because some studies have shown that the diseases and disabilities of elderly people living in nursing homes are more than other elderly people, and disabilities lead them to care centers; Maybe this factor also has an effective role in reducing their mental health. Based on this, the implementation of a comparative study in the elderly with high performance and control of physical disabilities will clarify the role of living in a nursing home in the state of mental health of the elderly, which is addressed in the present study. Also, some studies indicate that the stay of the elderly in the nursing home is associated with the feeling of exclusion and their feeling of loneliness plays an effective role. Also, the research showed that the elderly living in the nursing home experienced a feeling of insecurity and rejection and described their transition from home to the nursing home as painful; In other words, living in a nursing home can have an effective role in reducing the mental health of the elderly. Elderly people who have a high level of rejection feel that they are of no use to themselves and those around them and cannot be effective; Also, the results of this study showed that the feeling of rejection, due to its high relationship with social incompetence, has an effective role in increasing depression symptoms in these elderly people; Based on this, it can be concluded that living in a nursing home, rejection and depression are closely related. In this regard, the results of some studies show that the elderly living in nursing homes have far more symptoms of depression, anxiety and stress and report less satisfaction with life. Nowadays, due to the increase in the number of elderly people and the shrinking of families, caring for the elderly is a very important issue, and detailed and comprehensive programs for the care of this sensitive age group should be provided by conducting field research and formulating detailed care policies. Compared to younger people, older people with depression usually have multiple co-occurring medical and cognitive disorders, and depression that occurs in older patients is often underdiagnosed or undertreated. Also, previous studies have shown that inactivity and disability are factors affecting the feeling of exclusion of the elderly; which, if accompanied by family rejection, can lead to an increase in psychological distress in the elderly. Considering the importance of this topic, the present study compared the perception of rejection and depression symptoms in elderly people living in nursing homes and resident at home.

The current research was descriptive and based on causal-comparative method. The statistical population of this research includes two groups of elderly people in Rasht city in 2020 who were living in nursing homes or living with their families. The sample size was calculated using G*Power software. From each group, 120 elderly people participated in a targeted manner and answered the Perceived Rejection Scale: PRS and the Geriatric Depression Scale: GDS-15. For both groups, the age gap is between 65 and 90 years, having minimum physical health to communicate and answer the questions of the questionnaire, not suffering from cognitive impairment diseases such as (Alzheimer, stroke and dementia), not being engaged in economic activity. And retirement from governmental and non-governmental institutions and having informed consent and willingness to participate in the research were considered as entry criteria. Also, failure to answer at least 10% of the questionnaire questions, fatigue and unwillingness to complete the questionnaire were considered as exit criteria. Data analysis was performed using SPSS-24 statistical software and multivariate analysis of variance.

The results of multivariate analysis of variance showed that the perception of rejection (F = 14.25, P = 0.001) and depressive syndrome (F = 17.280, P = 0.001) in the elderly living in nursing homes were significantly higher than the elderly were in the control group (P <0.001).

Overall, the results of this study showed that the perception of rejection and depression symptoms in elderly people living in nursing homes is more than that of elderly people living at home; But this difference cannot be attributed to the presence of the elderly in the nursing home. But in general, it can be concluded that elderly people living in nursing homes are more in need of appropriate interventions and educational programs to reduce the feeling of rejection and depression symptoms than the elderly people living at home. Therefore, it is suggested to provide educational and therapeutic programs to improve the psychological condition of these elderly people.

The aim of this study was to evaluate the effectiveness of group nutrition training based on play therapy on anxiety and tendency to food diversity in preschool children with avoidance- restriction of food.

The design of this study was a quasi-experimental pretest-posttest with a control group and a follow-up stage. The study population, available preschool children (3 to 5 years) had one of the eating disorders. By purposive sampling, 20 children with clinical symptoms of avoidance disorder / food restriction living in Sanandaj were selected; Which were randomly assigned to experimental and control groups. At first, a 3-hour group training session was held for the mothers of the children in the experimental group on parenting style, child nutrition and introduction of games. Subsequently, the experimental group received 120 minutes of 120 minutes of group nutrition training through play therapy, to collect data from the Wardell, Guthrie, Sanderson, and Rapaport (2001) Children's Eating Behavior Questionnaire and the Revised Child Anxiety Anxiety Scale (CMAS). Reynolds and Richmond (1987). To describe the data, tables and graphs were used frequently, as well as central indices and scatter indices such as mean and standard deviation. To answer the questions, repeated measures analysis of variance and multivariate covariance were used. Data were analyzed using SPSS software version 24.

An educational and treatment package to reduce avoidance- restrictive eating disorder was developed by a therapist who was validated by child clinical psychologists and nutrition and education experts. Findings showed that the significance level of anxiety and tendency to food diversity variables is less than 0.05. As a result, it can be said that there is a significant difference between the mean scores of these variables in the pre-test, post-test and follow-up stages. Considering the significance of the interaction of the stages * of the group, it is concluded that the rate of change in the variables of anxiety and tendency to food diversity during the pre-test, post-test and follow-up stages were not the same in the experimental and control groups; That is, treatment based on group nutrition education of preschool children with avoidance / restriction disorder based on play-therapy has been effective in reducing anxiety and tendency to food diversity. There is a difference between pre-test and post-test stages; That is, the intervention was effective in reducing anxiety and promoting dietary diversity. There is also a difference between the pre-test and follow-up stages and the significance level of 1.00 shows that there is no difference between the means between the post-test and follow-up stages; That is, the effectiveness of the intervention in the follow-up phase has shown that it has remained stable. It can be said that there is a difference between the children in the experimental group who received the intervention and the children in the control group in at least one of the variables of anxiety. The difference is 44% in the post-test and 78% in the follow-up. The level of significance obtained also shows that there is a difference between the children in the experimental group who received the intervention and the children in the control group at least in terms of one of the variables of the tendency to food diversity. The difference is 92% in post-test and 96% in follow-up. In the post-test, the level of significance of the components of physiological symptoms and anxiety is significant at the level of 0.05; That is, the intervention had an effect on reducing the physiological symptoms of anxiety and worry in children in the experimental group; However, the significance level of 0.102 obtained by Mankova test in the third component (social anxiety) shows that the intervention was not effective in reducing children's social anxiety in the post-test stage. In the follow-up stage, the level of significance of the components of physiological symptoms, anxiety and social anxiety is significant at the level of 0.05; That is, the intervention had an effect on reducing the physiological symptoms of anxiety, worry and social anxiety in children in the experimental group, and the rate of this effect in the component of physiological symptoms was 51%, anxiety 67% and social anxiety 42%. Also, the level of significance of the components of food pleasure, desire to drink, emotional overeating, excuse about food and emotional undereating is significant at the level of 0.05; That is, the intervention had an effect on the mentioned components in the post-test stage of the experimental group. The extent of this effect was in the components of food enjoyment (82%), desire to drink (72%), emotional overeating (82%), food excuses (42%) and emotional undereating (56%); However, the significance level of 0.183 and 0.433 obtained by Mancoa test in the fourth and fifth components (satiety responses and slow eating) shows that the mentioned intervention was not effective on these components in the post-test stage. In the follow-up stage, the significance level of all components is significant at the 0.05 level; That is, the intervention had an effect on the tendency to food diversity in children in the experimental group and the extent of this effect on the components of food enjoyment (90%), desire to drink (81%), emotional overeating (90%), satiety responses (35%), There were slow eating (51%), food excuses (57%) and emotional undereating (70%).

According to the findings and the effect of the treatment package developed in this study on dependent variables, its use in therapeutic settings for children with avoidance / restriction of food is recommended to reduce anxiety and expand their dietary diversity. Also, considering that the subject of this study was to reduce children's social anxiety, satiety responses and slow eating; It has not been effective, so researchers can look into this in future research.

Patent ductus arteriosus (PDA) is one of the congenital disorders in premature neonates, which is strongly associated with increased mortality in them. Currently, echocardiography is the method of choice for detecting PDA, and due to the high cost of this method and its lack of easy access, finding a suitable and low-cost alternative method, including the use of clinical parameters to quickly detect PDA in premature neonates and determine the cases in need Treatment is very important. Therefore, in this study, we decided to investigate the sensitivity and specificity of clinical criteria in the diagnosis of PDA in comparison with the echocardiography method.Preterm neonates refer to neonates who are born before 37 weeks from the first day of the last menstrual period (1) due to developmental delay and also weakness in the immune system, these neonates are about 40 times more than neonates with normal weight at risk ofmortality (2). The ductus arteriosus is a vein that connects the pulmonary artery to the aorta. This duct is the fetal vascular connection between the pulmonary artery and the aorta artery, which diverts blood from the pulmonary bed to the systemic circulation during the fetal period (3). In the uterus, blood is shunted from the lungs due to the high pressure in the lungs. Therefore, the blood leaves the right ventricle, enters the ductus arteriosus, and from there enters the aorta (4). The ductus arteriosus contracts after birth and usually closes within 72 hours after birth. If this active contraction does not occur after birth, the ductus arteriosus will remain open. Usually, within 10 to 15 hours after birth, this contraction causes the functional closure of the ductus arteriosus, which starts from the side of the pulmonary artery and finally progresses to the end of the aorta (5). Therefore, keeping this duct open causes the oxygen-rich blood in the aorta to mix with the deoxygenated blood flowing in the pulmonary artery. Therefore, a lot of blood is transferred to the lungs, which increases the pressure on the heart, increases the blood pressure in the pulmonary veins, and also impairs the ventilation of the lungs (6). A large blood shunt from the ductus arteriosus increases pulmonary blood flow and also decreases systemic blood flow (7). Neonates with reduced systemic blood circulation are exposed to dangerous complications such as increased systolic and diastolic pressure, increased oxygen demand, pulmonary edema, tachycardia, active pericardium, heart failure, intracerebral hemorrhage, pulmonary hemorrhage, and necrotizing enterocolitis (8).

This cross-sectional study was conducted on preterm neonates with PDA and preterm neonates without PDA who were admitted to the NICU department of Akbarabadi Hospital in Tehran during 2017 and 2018. In this study, 124 preterm neonates with a gestational age of 25 to 37 weeks were included in the study. Preterm neonates with convulsions, life-threatening infections, clinical or radiographic evidence of necrotizing enterocolitis, evidence of hemorrhage, congenital neurological disorders, metabolic and genetic syndromes, pulmonary hypoplasia syndrome, congenital heart anomalies, and other fatal abnormalities. , were excluded from the study. Also, a checklist was provided in which case and demographic information related to preterm neonates was recorded. Parameters such as birth age, height and weight, gender, duration of hospitalization in NICU, duration of mechanical ventilation, history of any underlying or congenital disease (such as heart and lung disease, sepsis, other infectious diseases, diseases respiratory, history of cardiac arrest, etc.), neurological diseases, type of birth (NVD or cesarean section), gestational age, mothers' age were also recorded. After initial examinations and selection of patients based on inclusion and exclusion criteria, various clinical parameters in newborns including heart rate, peripheral pulse status, precordial pulse status, heart murmur status, cardiothoracic ratio, first minute Apgar score and Fifth, the deterioration of the respiratory condition was investigated in terms of physical and clinical examinations. A heart rate less than 160 was given a score of zero, a heart rate between 160 and 180 was given a score of 1, and a heart rate greater than 180 was given a score of 2. Cardiothoracic ratio less than 0.6, 0.6 to 0.65 and more than 0.65 were determined with zero, 1 and 2 scores, respectively. The status without murmur, systolic murmur and diastolic murmur were defined with 0, 1 and 2 scores, respectively. Normal peripheral pulse score zero, brachial banding score 1, brachial and dorsalis pedis banding score 2, precordial pulse not visible and not palpable with score 0, palpable precordial pulse with score 1 and visible precordial pulse with score 2.  The scores of each of the clinical criteria were added together and a score equal to or greater than 3 was considered to be associated with the incidence of hemodynamically significant PDA. Then echocardiography was performed in the examined neonates by an experienced pediatric cardiologist. The results of this research were analyzed by SPSS software. In this study, p value equal to or less than 0.05 was considered statistically significant. To determine the sensitivity and specificity of clinical factors in determining PDA requiring treatment, the ROC diagram and the area under the ROC curve were used. The results related to the sensitivity and specificity of each of the physical and clinical examinations as a factor in the diagnosis of active PDA in need of treatment were compared with echocardiography results.

Based on statistical analysis and ROC curve performed in this study, the relationship between scores calculated based on Clinical criteria were demonstrated with PDA. Based on this, it can be said that by measuring clinical criteria and calculating the score can be detected PDA.  Also based on the ROC curve analysis at point (score) 3, the sensitivity value is 65% and the specificity value is 95%, and at point (score) 2 the sensitivity value is 90% and the specificity value is 87%.

AUC = 0.94 for the diagnosis of hs-PDA indicates the fact that the definition of the score parameter based on the clinical criteria presented in this research can help in the diagnosis of PDA without echo. Only the difference between the pre-ductal and post-ductal oxygen saturation and the intensity of the dorsalis pedis pulse should be taken into account. Also, since the level of sensitivity is higher in the score of two, and this means that the false negative cases are less in the score of two, therefore, the score of two can be a more appropriate score for detecting cases that need treatment. According to the ROC curve of 5 clinical criteria for the diagnosis of hemodynamically PDA, the order of effectiveness of these 5 criteria are CTR, precordial pulse, heart murmur, heart rate and peripheral pulse respectively.

Academic success is one of the most important criteria for the evaluation of educational systems. Academic progress is a term used to refer to the results of the individual’s performance in mental areas that are taught in school, college and university and is considered as a very important indicator for predicting his or her personal and social prosperity (Spinath, 2012). The multidimensional nature of academic performance requires that further research be conducted to identify the relevant factors. In addition, the early 2020 was marked by the outbreak and pandemic of a novel viral disease known as COVID-19. To control the spread of the disease and reduce the resulting cross-infections, governments decided to switch to online mode of teaching. Although the online learning method was promising in maintaining the educational courses and minimizing the disruptions imposed to learning routines, it created more challenges for the learners; one of the most important challenges was an increase in teachers and parents’ complaints regarding a decline in the academic performance of the learners. Therefore, it is of particular importance to examine the predictor variables of academic performance under the special conditions caused by Covid-19. An important variable related to academic performance is personality traits. Based on the results of various studies, the personality traits of the learners, as a psychological factor, affect the learners’ academic progress (De Baca et al., 2010). The results of former research shows that agreeableness and conscientiousness are positive predictors and emotionality is a negativepredictor of high academic performance. In most studies, the role of extroversion and openness to experience in predicting academic performance was positive but weak (Gulam et al., 2021).Another psychological structure that is likely to predict students' academic performance is resilience. The findings of different studies show that resilience increases students' effort and persistence in pursuing issues and completing challenging assignments, therebyfacilitating the possibility of achieving high-level learning outcomes. On the contrary, people with low resilience against the difficulties of assignments and possible problems give up very quickly during the learning process and fail to achieve the expected academic results (Novotný & Křeménková, 2016). Another factor that influences students' academic performance is self-efficacy (cited by Talsma, Robertson, Thomas, & Norris, 2022). It seems that self-efficacy increases the learner’s hope of success in a specific field through increasing motivation, and thus increases his or her persistence in doing assignments (Honicke & Broadbent, 2016). In addition, high self-efficacy by declining anxiety plays an essential role in a person's academic success (Maier et al., 2021). On the other hand, the results of a few other studies (including those by Baker, Caswell & Eccles, 2018; Li, Han, Wang, Sun, & Cheng, 2018; Comfort & Wernicke, 2016; Iglesia, Stover, & Lipris, 2014) indicate a relationship between social support and academic performance. It seems that the student's perception of social support strengthens the individual's psychological capital: a concept that includes positive variables such as hope, resilience, self-efficacy and optimism.Previous studies, focusing on a number of these variables, have shown their relationship with each other and their effect on academic performance. In fact, the simultaneous examining of these variables can determine their relative efficiency in predicting academic performance. In the current study, the researcher, inspired by multivariable phenomena, has attempted to compile and experimentally test a comprehensive theoretical model including the most important predictor variables of academic performance among female students at senior high school.

The research method was correlational with a structural equation modeling. The statistical population of the present study included all the female students of senior high schools in District 2 of Tehran in the academic year of 2021-2022, from which a sample of 400 students were selected using a multi-stage cluster sampling method. After entering the data in SPSS software, the data were analyzed using the structural equation modeling method with AMOS software. Data collection tools included McCree and Costa’s (2008) five-factor NEO-FFI-R questionnaire, the Multidimensional Perceived Social Support Scale by Zimmet, Dahlem, Zimet and Farley (1988), Scherer et al.’s (1982) general self-efficacy scale, Connor and Davidson's (2003) Resilience Scale and Pham and Taylor's (1999) Standard Academic Performance Questionnaire.

With regard to the findings, the fit indices such as the ratio of chi-square to the degree of freedom (df/χ²) with a value of 4.24, the incremental fit index (IFI) with a value of 0.96, the comparative fit index (CFI) with a value of 0.95 , goodness of fit index (GFI) with a value of 0.93, Tucker-Lewis index (TLI) of0.91, adjusted goodness of fit index (AGFI = 0.90), and root mean square error of approximation (RMSEA) with a value of 0.07 indicates a good fit of the proposed model with the data. The coefficients of the direct path and their direction have been determined. These coefficients are significant at the level (χ² ≥ 0.05) and the direct hypotheses related to them have been confirmed. It should be noted that in the figure representing the proposed model (Figure 1), the predictor variables explain a sum of 74% of the variance of the dependent variable (academic performance).It should be noted that in the present study, indirect hypotheses were investigated through the mediating variables of self-efficacy and resilience with the bootstrap method. The results showed:- Personality traits have a significant indirect relationship with academic performance through resilience (the lower limit of the confidence interval is 0.0282 and the upper limit is 0.0950).The indirect relationship of personality traits with academic performance is not significant through self-efficacy (the lower limit of the confidence interval is -0.0231 and the upper limit is 0.0727).Social support has a significant indirect relationship with academic performance through resilience (the lower limit of the confidence interval is 0.0304 and the upper limit is 0.1308). The indirect relationship of social support with academic performance is significant through self-efficacy (the lower limit of the confidence interval is 0.0431 and the upper limit is 0.1131).

The findings of the present study showed that the proposed model of students' academic performance based on personality traits and perceived social support mediated by resilience and self-efficacy under covid-19 conditions had a good fit with the data. In general, the predictor variables have explained about 74% of the variance of the dependent variable (academic performance) in the current study. To explain the model, it can be said that the variables of personality traits and social support have a causal relationship with academic performance. Also, these variables affect students' academic performance through the mediating variables of resilience and self-efficacy. By clarifying some of the predictor variables of academic performance, this study highlights the important roles of parents, school personnel, and social media: Firstly, by creating peace in families, schools, and the community, they should improve the adaptive personality traits of children and adolescents. Secondly, by providing all kinds of necessary support and showing healthy role models, they should set the foundation for for the formation of self-confidence and resilience in students. It should be noted that due to the nature of the current research (correlation), one should be very cautious in inferring the causal relationships between the variables of personality traits, social support, self-efficacy, resilience and academic performance.

Schizophrenia is a mental disorder with frequent psychosis, whose symptoms include delusions, hallucinations, disordered speech or behavior, and impaired cognitive ability. The cause of this disease becoming a debilitating disorder for patients and their families is its early onset and chronic course, which affects one percent of the population. Antipsychotic drugs are only effective in treating half of the patients, and the pathological mechanism of schizophrenia is not fully understood. In addition, these drugs improve generally positive symptoms (such as hallucinations and thought disorders that are at the core of the disease), but negative (such as social isolation) and cognitive symptoms (such as learning and attention disorders) remain untreated. On the other hand, these drugs have severe neurological and metabolic side effects and may lead to sexual dysfunction. Schizophrenia is a multifactorial disorder that involves the interaction of several genes, environmental factors, and epigenetic processes. Over the past ten years, genetic research has yielded new findings that have given rise to hope for the biological origins of schizophrenia. The genetic role is caused by a large number of alleles, including alleles with small effects that can be identified by GWAS studies. The drug treatments that are available for schizophrenia have poor efficacy for many patients in which the mentioned genetic factors are very effective.  Identifying the causes of this disease is an important step in the field of improving the treatment for this disorder, which is estimated to be half to one third of the genetic factors influencing the development of schizophrenia by common alleles reported in GWAS studies. Thus, GWAS studies are potentially an important tool for understanding the biological process of schizophrenia. GWAS Catalog is a complete collection of all published studies at the genome level, which makes it possible to investigate and identify the cause, understand the mechanism of the disease, and identify new treatment methods in this disease. In recent years, many efforts have been made to identify biomarkers in the diagnosis, prevention and treatment of schizophrenia, each of which introduces specific genes and pathways that overlap with other mental disorders. In this study, in order to investigate important genes and biological pathways in the development of schizophrenia, the genes reported in the GWAS catalog bioinformatics database were examined so that in the future, with more studies, it can help to treat and diagnose these patients more accurately.

In the present study, using the GWAS catalog database and searching for the word Schizophrenia, a list of 3344 SNPs was extracted from 80 research articles. In the next step, the SNPs that cause schizophrenia and other related diseases were extracted (1165 SNPs that were the result of 19 studies). Then, among the SNPs obtained in the previous steps, those with lower and equal p-values were 5*10^-8, isolated and checked using ensemble.org in the BioMart section, in order to find the closest genes. Then, the results of BioMart were sorted and collected based on the obtained genes, and the duplicates were removed (removal of duplicate genes) and finally 336 genes were obtained. (In general, for 554 SNPs, the gene was identified, and for the other 574 SNPs, the gene name was not found, which are extragenic.) In the next step, the above list was entered in BioMart and the names of the desired genes were obtained. (Part of Ensemble genes 107; NCBI gene (formerly Entrezgene) accession) which resulted in a total of 339 genes.
In the last step, the genes obtained from the previous step were checked using the Enrich R site, and through this site, the pathways that were related to the studied genes were extracted and compared with the results of different articles.

In this study, after entering the results in Biomart, 339 genes were obtained. Also, after entering the above list in the Enrich R site, the important pathways in which these genes are active were obtained. Pathways which Adjusted-P value was below 0.05 were considered as reliable results.

This study was conducted on schizophrenia by analyzing the data of GWAS catalog database to identify the mechanism of the disease and the pathways involved as well as the main and important genes of drug candidates. One of the important pathways in this study was Glucuronidation, which was one of the first pathways obtained from Wiki Pathway studies, which is often involved in the metabolism of substances such as drugs, pollutants, bilirubin, androgens, estrogens, mineralocorticoids, glucocorticoids, fatty acid derivatives, retinoids. and bile acids play a role. This pathway is mainly carried out in the liver, although the enzyme responsible for its catalysis. UGTs are widely expressed in the brain, but at lower levels than in the liver. Brain UGTs are inducible or inhibitable that affect drug release in the central nervous system. UGTs, cytochrome P450s, and transporters act together to influence the pharmacokinetics of drugs in the brain. After glucuronidation, many drugs have the ability to cross the blood-brain barrier. Another pathway is ascorbate metabolism. Ascorbate (vitamin C) is a vital antioxidant molecule in the brain. However, it has several other important functions, participating as a cofactor in several enzymatic reactions, including catecholamine synthesis, collagen production, and HIF-1α regulation. Ascorbate is transported to the brain and neurons through the sodium-dependent vitamin C transporter (SVCT2), which causes the accumulation of ascorbate in cells against a concentration gradient. The highest concentrations of ascorbate in the body are found in the brain and neuroendocrine tissues such as the adrenals, although the brain is the hardest organ to deplete ascorbate. Together with the regional asymmetry in the distribution of ascorbate in different regions of the brain, this shows the important role of ascorbate in the brain. The next pathway was the porphyrin metabolism pathway, which disruption in this pathway can cause neurological symptoms, neuropathy and a wide range of psychiatric symptoms in addition to specific diseases, until in 1939, Waldenstrn reported that schizophrenia in families with Acute intermittent porphyria (AIP) is very common, but no statistics were provided. Another study found that 5 of 40 AIP probands had hallucinations, suggesting a possible link between psychosis and AIP. A study in Sweden found that people with AIP were four times more likely to develop schizophrenia or bipolar disorder. In addition, first-degree relatives of these people are twice as likely to be diagnosed with schizophrenia and bipolar disorder. The other pathway was the pathway of retinoid metabolism, the first evidence linking this pathway to schizophrenia is that retinoid toxicity or deficiency frequently leads to the manifestation of symptoms that, although more severe in scope, are similar to those of schizophrenia. For example, mental disorder, mental defect, large ventricles, microcephaly and various major and minor congenital anomalies, among which cranial anomalies are prominent. Such deficits have been reported frequently among schizophrenic samples. With the increasing documentation of the prominent role of retinoids in the development of the central nervous system, the possibility of retinoid involvement in schizophrenia is strengthened. Another important pathway was drug metabolism, which drugs that are widely used today in the treatment of mental disorders, including depression, psychosis, and mood stabilizers, in many cases are associated with many side effects, and only a small number of patients respond appropriately to These drugs show Many factors, including genetic factors, are effective in the effectiveness of drugs, which are of interest today. According to the present study, it can be concluded that genetics and especially polymorphisms play a very important role in the development of schizophrenia and that these genes can be used in the diagnosis and treatment of this disease. In the future, the genes of these pathways can be studied more reliably in schizophrenia for diagnostic and therapeutic purposes. The genes obtained in this research can be suitable and new options for future studies on schizophrenia and optimization of treatment methods.

Job burnout is a psychological syndrome involving the three axes of emotional exhaustion, depersonalization, and personal accomplishment, and it occurs when a person in the workplace is subjected to prolonged stress with severe psychological and physical consequences (2). Burnout will lead to a low quality of work, customer or clients’ dissatisfaction, psychological consequences such as depression, and even physical illnesses. Since job burnout is a disabling condition that decreases the quality of services in workplaces, it is necessary to identify the underlying psychosocial risk factors involved in this condition. A growing body of literature has documented that various psychosocial risk factors can cause burnout including job motivation, lack of adequate support from managers, high workload and stress, and psychological or physical disorders (6). High workload and stressful work environment considered as important factors that contributed to the job burnout, but all people working at a stressful work environment dos not suffer from job burnout (15). It seems that some personal risk factors make people susceptible to job burnout. Psychological and personality factors considered as important personal risk factors that may play a decisive role in the development or maintenance of job burnout (17). Job burnout is one of the most disabling conditions that threaten the mental and physical health of workers in medical settings. While job burnout has been studies in different medical settings (3) there is a dearth of research in the dentistry settings and further research is needed. Dentists are one of the medical groups that are at high risk of burnout due to different environmental risk factors causing stress at work (5). Limited studies have been done on the role of psychological and personality factors involved in job burnout among dentists. This study aimed to explore the relationship between pathological personality traits and psychological distress (depression, anxiety and stress) with job burnout among dentists.

The method of this research was a descriptive-correlational study. The statistical population included all general and specialist dentists working in public clinics and private offices. Using a convenience sampling method study questionnaires were distributed electronically among channels and groups of dentists. Inclusion criteria include having work experience more than 2 years in the dentistry settings, current employment, being between 31 to 70 years old, not having a history of severe psychiatric illness and willingness to participate in research. The tools used in this study included the Maslach Burnout Inventory (MBI), Personality Inventory for DSM-5 (PID-5) and Depression, Anxiety and Stress-21 (DASS-21). After distributing the questionnaires, 758 completed questionnaires were received from the participants, of which 641 valid questionnaires were separated for analysis and the rest that were incompletely or uniformly completed were discarded. In order to analyze the data of the present study, descriptive indices, t-test, and Pearson’s correlation was used. All statistical analyses were conducted using IBM Statistical Package for the Social Sciences (SPSS) for Windows, Version 22.

The results showed that pathological personality traits and psychological components, as well as demographic characteristics (such as age, gender, marital status) and job-related variables (such as working hours, work history), affect job burnout in dentists. In terms of job burnout dimensions, in terms of emotional exhaustion, depersonalization, and lack of personal accomplishment, 0.5%, 7.8%, and 21.8% of respondents were in a high burnout state, respectively. There was a significant relationship between all three dimensions of job burnout and gender, and emotional exhaustion was more in men than women, and depersonalization and lack of personal success were more in women than men. Moreover, there was a significant relationship between all three dimensions of job burnout and marital status, so that emotional exhaustion and depersonalization were more in single people than in married people, and the lack of personal success was more in married people than in single people. There was a significant relationship between emotional exhaustion and education level, and it was more common among general dentists than specialist. There was a significant and direct correlation between the job burnout dimensions of working hours per week and the lack of personal success. Depersonalization was also higher in people with more than 40 hours of work per week. There was a significant and inverse correlation between work experience and depersonalization, and the intensity of the correlation was also weak.

In general, in addition to demographic variables (age, gender, marital status) and job-related variables (education and working hours), personality traits and mood states such as depression, anxiety and stress can explain job burnout among dentists. How job burnout can affect the five areas of personality is due to the fact that work is one of the issues that humans deal with on a daily basis and the tensions and pressures that cause job burnout can chronically affect the psychological structure of a person and affect the five areas of personality. On the other hand, personality traits affect the type of facing problems, pressures and tensions from the work environment. The results can have theoretical and practical implications in providing appropriate psychological interventions for dentists suffering from job burnout. At the theoretical level, the results of this research can help to better understand personal factors that aggravate and maintain burnout among dentists. At the practical level, the results can have practical implications in providing suitable psychological interventions for dentists suffering from job burnout. These results provide further support for the development of new treatments that target individual factors in burnout and teach skills to help develop individual skills. Nevertheless, the findings must be interpreted in the context of its limitations. The cross-sectional nature of our study impedes any inferences about causality or temporality of associations among the variables investigated. Therefore, longitudinal experimental studies are encouraged to explore whether the associations reported here actually resemble predictions and mediations in prospective designs in which causal relationships and temporal ordering of variables can be statistically detected. Only self-report measures were used in this research, which could introduce biases such as social desirability. Conducting experimental studies with more objective measurement tools on dentists with job burnout can be beneficial for finding better results. Despite these limitations present findings can pave the way for the future research and updated critical literature. This study adds to the growing literature on the field and remediate the dearth of studies in this area.

The experience of mourning leads to many emotions in people. As a result, learning emotion regulation strategies affects the experience of bereavement in bereaved people and is a kind of moderator of the experience of bereavement. People use strategies called emotion regulation to change emotional triggers, situations of emotional experience, amount and intensity, duration and way of experiencing emotion internally or externally. In the cognitive strategies of emotion regulation, the focus is on thoughts and cognition in anxiety management. Using emotion regulation strategies in any form and manner has an important role in all periods of life. Effective emotion regulation strategies are related to high self-confidence, positive emotions, how to deal with various types of stress and more constructive social and personal interactions. People with the ability to regulate emotions are able to control their impulses, feeling sad and hopeless, anxiety, adapting to problems and accepting themselves and the conditions, which leads to reducing psychological damage in them. Therefore, strengthening and learning these strategies in people, especially teenagers, is effective and one of the necessary skills to manage the bereavement experience. Considering the importance of variables of coping styles and cognitive emotion regulation strategies in the experience of normal bereavement and exit from the experience of abnormal bereavement, it is necessary and necessary to use appropriate therapeutic approaches to promote them. One of the therapeutic approaches that has received much attention in recent years is schema therapy. In cognitive psychology, schema is defined as an organized pattern of thinking and behavior and as a mental framework of pre-formed ideas. In the form of a schema, a person perceives the world and the world around him and organizes his new information. These strongly affect our thoughts and emotions, and if they are ineffective, they can cause emotional problems. In schema therapy, attempts are made to adjust these schemas using various experimental, behavioral and cognitive techniques to reduce the invocation of incompatible emotions. Some researchers say that in abnormal grief as a chronic problem and coexisting with other disorders, one should focus on schemas and consider targeting schemas as an effective factor in treatment. Schema therapy is designed as a cognitive-behavioral therapy targeting maladaptive schemas with the aim of treating long-lasting and chronic disorders. Therefore, it can be effective as an efficient method to help experience normal mourning and go through the natural period of mourning. The review of these studies shows that despite the importance of the role of dysfunctional schemas in abnormal grief and ineffective emotional regulation strategies, these two therapeutic methods have been used very little with the aim of intervention in abnormal grief, and these interventions have been very few in relation to abnormal grief in adolescents. Is. In addition to this, there was no research on intervention in abnormal grief caused by Corona, and the researches were only limited to investigating the symptoms of grief caused by Corona, screening tools in this regard, and people's lived experiences in this regard. Therefore, applying schema therapy and checking its effectiveness can be a way to find the most effective treatment methods for teenagers with bereavement caused by Corona. Meanwhile, few studies have investigated this method of treatment for grief, especially grief caused by corona in teenagers. Based on this, the question of the current research is whether schema therapy is effective on coping styles and cognitive emotion regulation strategies of students with abnormal grief caused by Corona?

In this research, the statistical population was first and second high school students with grief disorder caused by Corona in Yazd city in 2021 and 2022. The sample included 30 people (15 people in the experimental group with schema therapy method, 15 people in the control group) who were selected purposefully. The tools of the current research included the stress coping strategies questionnaire (Andler and Parker, 1999) and the cognitive emotion regulation questionnaire (Granfsky and Kraich, 2001). Schema therapy intervention based on Yang's schema therapy was implemented in 10 consecutive one-hour sessions on the experimental group. No intervention was done on the control group. Multivariate covariance analysis was used to analyze the data.

The findings showed that schema therapy was effective on positive and negative emotional regulation strategies and emotion-oriented and avoidant coping style in the sample group.

According to the present finding, it is necessary to use this treatment method to reduce the injuries and symptoms of abnormal grief by focusing on emotional regulation strategies and coping style of people. One of the limitations of the present study is that only the effectiveness of schema therapy in teenagers with abnormal grief caused by Corona has been investigated, and its generalization to other societies should be done with caution. Also, there is no exact assurance of the absence of coexistence with other disorders, which also affects the generalizability. Researches with a follow-up period can provide more complete findings related to the effectiveness of schema therapy.

Studying the role of gender and birth order in developmental standards has a great role in decisions and judgments about children. The most important period of a child's brain development is the first two years of life, which has a great role on the child's mental, physical, psychological, and social functioning. Recognizing that children's development is holistic is one of the basic principles of using developmental statements in the early years. All-round growth is the recognition of physical, cognitive, linguistic, emotional and social growth, which are interconnected, inseparable and dependent on each other. Gender differences in language and social-emotional skills appear to exist right after birth. For example, newborn boys make fewer rhythmic and early tongue movements during sucking. On the other hand, baby girls respond more to formula with a reflexive "smile" and show greater auditory sensitivity. Differences in later months include sensitivity to pain, responsiveness to mother's vocalizations, and discrimination of emotional expressions. However, even in the early stages of development, differences do not favor one gender group. For example, some studies show that boys show more happiness, look at their mothers for longer, and make more movements to be picked up. Additionally, some studies find no differences in infant eye contact, in contagious crying, or in response to the mother's face. One of the viewpoints related to learning is the viewpoint of behaviorism. In this perspective, learning is examined based on two basic principles of classical and active conditioning. Classical conditioning is a type of learning that is based on creating an association between a stimulus that does not normally cause a reaction and a learning stimulus that causes a specific reaction, and operant conditioning is another type of learning that is based on reinforcing or punishing behavior for increasing or decreasing the probability of its output; However, unlike behaviorists who did not deal with mental processes, cognitivists emphasize the unobservable mental processes that people use to learn and remember new information and skills. to be Among the theories of cognitive learning, we can mention Bandura's social-cognitive learning theory and information processing theory. Based on Bandura's social-cognitive theory, a lot of human learning happens in a social environment. Through observing others, we learn knowledge, rules, skills, strategies, opinions and attitudes, and by observing and using patterns, we learn the usefulness and appropriateness of behaviors. According to this theory, most of our learning is through modeling and observing the behavior of others and observing the consequences of the behavior that others do. According to Bandura's opinion, new behaviors are learned through two types of active learning and observational learning. Active learning allows people to acquire complex behavioral patterns through direct experience, by thinking about the consequences of their behavior and evaluating them, and observational learning, the main element of which is imitation by observing appropriate activities, correctly encoding the event for representation in memory, Doing the behavior and having sufficient motivation is facilitated. The aim of the present study was to investigate the role of gender and birth order in children's cognitive, physical-motor, language, learning and social-behavioral-emotional skills.

The statistical population included all children aged 1-2 and their parents in Tehran. The sampling method is cluster and matrix and the samples were selected from five geographical regions. The sample size included 500 children aged 1-2 years; 100 children were considered for each area. The data collection tool is a researcher-made tool that uses the developmental standards of several American states, such as the developmental standards of Washington (2012), the developmental standards of Nebraska (2018), and studies conducted in Iran.

The results showed that birth order has a significant role in cognitive skills, emotional-behavioral-social characteristics and language and literacy of girls and boys; But gender did not play a significant role.

This study was conducted with the aim of investigating the role of demographic characteristics in cognitive, physical-motor, language, learning and social-behavioral and emotional skills of 1-2 year old children in Tehran. Motor skills, the ability to control and coordinate large movements of the legs and arms (such as jumping, throwing) and fine movements of the fingers. Fine motor skills focus on using small muscles such as hands and fingers for activities. Gross motor skills involve coordinating the body's larger muscle groups, such as the legs and trunk, in activities. Cognition is a cumulative learning process that includes mastering new skills while improving existing skills. The processes or abilities by which knowledge is acquired and manipulated, including abilities such as memory, problem solving, and analytical skills. Social-emotional skills include the emergence of emotional self-regulation, showing empathy, developing skills to talk about feelings, engaging in positive social interactions with peers and adults, cooperating with others, and social independence. Well-developed social-emotional skills in early childhood are known to reduce behavioral problems. Regulation of emotional responses and social interactions, which is a function of mood and self-regulation, including behavioral problems, social competence and emotional competence, language, the ability to understand and express verbal communication. Learning approaches are behaviors related to how children engage in learning experiences, such as the ability to stay focused, interested, and engaged in activities. This study showed that the birth order of children has a significant role in cognitive, emotional, social behavior and language scales. Various theories and hypotheses have been proposed about birth order and the effects of family size. The research findings can be used in making decisions and judging children.

Background &

The experience of mourning leads to many emotions in people. As a result, learning emotion regulation strategies affects the experience of bereavement in bereaved people and is a kind of moderator of the experience of bereavement. People use strategies called emotion regulation to change emotional triggers, situations of emotional experience, amount and intensity, duration, and way of experiencing emotion internally or externally. In the cognitive strategies of emotion regulation, the focus is on thoughts and cognition in anxiety management. Using emotion regulation strategies in any form and manner has an important role in all periods of life. Effective emotion regulation strategies are related to high self-confidence, positive emotions, how to deal with various types of stress, and more constructive social and personal interactions. People with the ability to regulate emotions can control their impulses, feeling sad and hopeless, anxiety, adapt to problems, and accept themselves and the conditions, which leads to reducing psychological damage. Therefore, strengthening and learning these strategies in people, especially teenagers, is effective and one of the necessary skills to manage the bereavement experience. Considering the importance of variables of coping styles and cognitive emotion regulation strategies in the experience of normal bereavement and exit from the experience of abnormal bereavement, it is necessary and necessary to use appropriate therapeutic approaches to promote them. One of the therapeutic approaches that has received much attention in recent years is schema therapy. In cognitive psychology, schema is defined as an organized pattern of thinking and behavior and as a mental framework of pre-formed ideas. In the form of a schema, a person perceives the world and the world around him and organizes his new information. These strongly affect our thoughts and emotions, and if they are ineffective, they can cause emotional problems. In schema therapy, attempts are made to adjust these schemas using various experimental, behavioral, and cognitive techniques to reduce the invocation of incompatible emotions. Some researchers say that abnormal grief is a chronic problem and coexisting with other disorders, one should focus on schemas and consider targeting schemas as an effective factor in treatment. Schema therapy is designed as a cognitive-behavioral therapy targeting maladaptive schemas to treat long-lasting and chronic disorders. Therefore, it can be effective as an efficient method to help experience normal mourning and go through the natural period of mourning. The review of these studies shows that despite the importance of the role of dysfunctional schemas in abnormal grief and ineffective emotional regulation strategies, these two therapeutic methods have been used very little with the aim of intervention in abnormal grief, and these interventions have been very few about abnormal grief in adolescents. Is. In addition to this, there was no research on intervention in abnormal grief caused by Corona, and the researches were only limited to investigating the symptoms of grief caused by Corona, screening tools in this regard, and people's lived experiences in this regard. Therefore, applying schema therapy and checking its effectiveness can be a way to find the most effective treatment methods for teenagers with bereavement caused by Corona. Meanwhile, few studies have investigated this method of treatment for grief, especially grief caused by corona in teenagers. Based on this, the question of the current research is whether schema therapy is effective in coping styles and cognitive emotion regulation strategies of students with abnormal grief caused by Corona.

In this research, the statistical population was first and second high school students with grief disorder caused by Corona in Yazd city in 2021 and 2022. The sample included 30 people (15 people in the experimental group with the schema therapy method, and 15 people in the control group) who were selected purposefully. The tools of the current research included the stress coping strategies questionnaire (Andler and Parker, 1999) and the cognitive emotion regulation questionnaire (Granfsky and Kraich, 2001). Schema therapy intervention based on Yang's schema therapy was implemented in 10 consecutive one-hour sessions in the experimental group. No intervention was done in the control group. Multivariate covariance analysis was used to analyze the data.

The findings showed that schema therapy was effective in positive and negative emotional regulation strategies and emotion-oriented and avoidant coping styles in the sample group.

According to the present finding, it is necessary to use this treatment method to reduce the injuries and symptoms of abnormal grief by focusing on emotional regulation strategies and coping styles of people. One of the limitations of the present study is that only the effectiveness of schema therapy in teenagers with abnormal grief caused by Corona has been investigated, and its generalization to other societies should be done with caution. Also, there is no exact assurance of the absence of coexistence with other disorders, which also affects the generalizability. Research with a follow-up period can provide more complete findings related to the effectiveness of schema therapy.

Background &

Learning disability is one of the important constructs in exceptional education. One of the goals of educational systems is to raise the level of students' ability to increase the academic efficiency of learners. According to the Statistical Manual of Mental Disorders, a learning disability has been renamed to a specific learning disability, and reading disorder, writing disorder, and math disorder, each of which was once a distinct and independent disorder, are now considered to specify a specific learning disorder. A neurodevelopmental disorder in children that is caused by genetic and environmental factors and affects brain function in the areas of understanding and processing verbal and non-verbal information; in a way that lasts at least 6 months. This disorder leads to problems in learning and using academic skills in the form of carelessness, poor comprehension, slow reading, difficulty in spelling, problems in written expression, problems in mastering the meaning of numbers or calculations, and problems in mathematical reasoning. These problems are not related to mental retardation, developmental delay, uncorrected vision or hearing problems, or motor or neurological disorders, they are specifically meant in this way. In the education and treatment of learning disorders, one of the most important methods introduced is the sensory integration method. Sensory integration refers to processes whose information enters the brain through the eyes, ears, mouth, nose, skin, muscles, joints, and sense of balance. Ayres presented a theory called sensory integration to relate behavior and neural function, especially sensory information, which examines the specific connections of neural function, sensorimotor behavior, and academic learning in a hypothetical framework, and aims to find specific patterns of dysfunction. In children with learning and sensory problems special treatment methods for these groups. The method of sensory integration is a neurological flow that receives and organizes sensory information from the body and the environment of a person and uses it to function more effectively and better in the environment. This method leads to the improvement of excellent brain functions and the abstract levels of the brain from which mathematics is applied; it increases and thus improves the educational efficiency of these students. This intervention engages the child's senses with exercises in the form of a game, and this situation helps coordination and precision in the functioning of the child's senses. Agent concentration is important in maintaining integrity and improving learning performance, so it can play an effective role in improving reading and writing disorders. The basic assumption of this educational method is that children with learning disorders have problems in these sensory pathways. Much research has been conducted and its effectiveness has been confirmed regarding the effectiveness of this educational method in children with learning disabilities. Learning disorder affects brain function in the areas of understanding and processing verbal and non-verbal information; therefore, it is important to identify decisive intervention methods in this field. The purpose of this study was to investigate the effectiveness of the central nervous system reorganization method on explicit and implicit memory, mental retention ability, and visual-spatial skills of students with special learning disabilities.

The statistical population of this research included all students with specific learning disabilities who referred to the learning disabilities centers of Rafsanjan city in the academic year of 2019-2020, 90 of whom were selected randomly in three groups of sensory integration using the purposeful sampling method. , reorganization of the central nervous system, and the control group were replaced. Research tools included Bogard and Roos's (1991) mental fluid retention task, Snodgrass and Vanderwaart's (1980) manifest and latent memory questionnaire, and Kornoldi's (1998) visual-spatial memory test. Data analysis was done using repeated measurement with mixed design and multivariate analysis of variance using SPSS-24 software.

The Results showed that the effect of the group in the component of mental maintenance (p < 0.01 and F = 70.99), explicit memory (p < 0.01 and F = 293.26 (162 and 2)), hidden memory (p < 0.01 and F = (162, 2) 65.17) and visual-spatial skills of children are significant, so there is an obvious difference between mental retention, overt and hidden memory, and visual-spatial skills. There are three groups and between the effectiveness of educational methods considering learning disorders. Also, sensory integration training has been effective in increasing mental retention, explicit and implicit memory, and visual-spatial skills of students with specific learning disorders. On the other hand, the difference between the two groups of sensory integration and the nerve reorganization method showed that the effects of the sensory integration group on increasing mental retention, explicit and implicit memory, and visual-spatial skills of students are more than the central nervous reorganization group.

It was concluded that the methods of sensory integration and reorganization of nerves are effective in increasing mental retention, explicit and implicit memory, and visuospatial skills of students with specific learning disorders, and this effectiveness in the training of the sensory integration group compared to Reorganization of the nerves in the ability to maintain a higher and greater mental capacity.

Background &

Systemic sclerosis is an autoimmune disease of unknown cause and is very difficult to treat. Scleroderma, or systemic sclerosis (SSc), is a multifocal systemic disorder characterized by overactive immune system, systemic inflammation, vascular damage, and tissue fibrosis. The pathogenesis of the disease is mainly based on autoimmune inflammatory processes, systemic vasculopathy and collagen deposition in the skin and internal organs, which leads to tissue fibrosis with severe functional disorders and can be one of the major causes of mortality in these patients. SSc-associated interstitial lung disease (ILD) is a common complication of SSc, which can lead to significant morbidity and mortality. As with other pulmonary fibrotic diseases, damage to epithelial cells, activation of innate and acquired immunity, and activation of fibroblasts may lead to overproduction of the matrix and ulceration of the SSc-ILD. New studies speculate that differentiation and proliferation Myofibroblasts are a key pathological mechanism that increases fibrosis in SSc-ILD. According to EULAR recommendations, cyclophosphamide is the first choice for the treatment of SSc-ILD. Cyclophosphamide acts as a cytotoxic immunosuppressive agent by modulating lymphocyte function, reducing suppression of the inflammatory response and fibrosis. Cyclophosphamide (CYC) is an immunosuppressive alkalizing drug that inhibits the function of lymphocytes in the cellular environment. Moreover, bronchoalveolar lavage and pulmonary function testing are shown. Systemic and intravenous injection of immunosuppressive drugs may be associated with more potential systemic complications. A study published in the New England Journal of Medicine in 2006 found that treatment with cyclophosphamide for one year resulted in significant improvement in lung function and symptoms in patients with SSc-ILD. However, the use of cyclophosphamide is associated with potential side effects, such as increased risk of infection and cancer, and its use should be carefully evaluated on a case-by-case basis.Therefore, choosing the best method of drug administration with the aim of improving the symptoms and skin involvement in patients with systemic sclerosis can be very important and vital. In this study, the effects and immunotherapy of oral cyclophosphamide in the treatment of skin lesions and interstitial lung disease were studied.

The type of study is quasi-experimental, and 21 patients who received cyclophosphamide and had a follow-up of 12 months were included in the study.Twenty-one selected patients included in this retrospective cohort were treated with oral CYC (up to 2 mg/kg/day). Additionally, they received an additional low dose of prednisolone (≤10 mg) for 6 months. Skin score, forced vital capacity (FVC) and diffusion lung capacity for carbon monoxide (DLCO) were assessed as outcome measures. At entry and after 12 months Modified Rodnan Skin Score (MRSS), pulmonary function tests and DLCO have been evaluated. Inclusion criteria include the following: 1- Treatment with cyclophosphamide 2- Follow-up for at least one year from the start of the first dose of the drug 3- The use of oral cyclophosphamide for at least six months 4- Filling the diagnostic criteria of ACR (American College of Rheumatology) 5. Existence Documents related to High-resolution computed tomography (HRCT), PFT and DLCO at the beginning of treatment and 12 months after treatment. Exclusion criteria also included the following: Patients who, in addition to ILD, had pulmonary artery hypertension (PAH) or severe left ventricular failure (EF <50%) were excluded from the study. Patients with normal HRCT and FEV <20% were also excluded from the study, provided that the volume reduction was due to thickening of the skin. The patients received cyclophosphamide at a maximum dose of 2 mg/kg/day (50-100 mg/day) for 12 months. In addition, prednisolone 10-15 mg / day was initially administered for 2 months and then for 10 months at a dose of 5 mg / day. GhRh agonist and oocyte cryopreservation were used for 4 and 8 in 16 patients under 45 years of age, respectively. The major limitations of our study were the small population, and the retrospective nature of the study, which inevitably renders the study unblinded with selection biases. Other limitations included the lack of a comparative control group and the short follow-up period. An advantage of the present study is that all patients completed 1 year of treatment. We also presented all clinical and serological variables in detail, providing sufficient data for future comparative studies. The study was conducted after approval by the Ethics Committee of the University of Iran with the ethics code IRIUMS.FMD.REC.1396.9511288002.

The patients’ age at the time of ILD need to treatment/months median (IQR) were 34.0 (29.6–48.5) years, 18 (85%) had female gender, and 8 (38%) had a diffuse subtype of the disease. The mean (SD) FVC percentages obtained at baseline 59.5 ±10.7 and post-treatment 63.1 ± 16.2 with mean difference 2.9 ± 11.5, p=0.19. DLCO% in CYC treated patients at base was 67.7 ± 27.5 and post treatment was 60.0 ±22.9 with a mean difference of −8.0 ± 23.7 (p = 0.12). Following 12 months of treatment mean difference of changes in MRSS was −1.4 ± 4.5 in CYC-treated patients. In the twelfth month, 5 out of 21 patients showed improvement, while 14 patients had stable FVC. Among the patients, only one patient showed improvement in DLCO and 14 patients had stable DLCO. The non-significance of P indicates no change in the parameters and prevention of deterioration of the patient's condition in terms of the investigated parameters following the intervention. After one year of treatment with CYC, two patients showed symptoms of leukopenia, which led to a temporary reduction in the dose of the received drug to improve the condition.

Based on our findings, the use of cyclophosphamide as an immunosuppressive drug can prevent the deterioration of patients with SSc-ILD in terms of FVC, DLCO, and MRSS factors.

Background &

One of the most common chronic developmental disorders is attention deficit hyperactivity disorder, which affects about 7% of school children and 5% of adolescents and adults. Attention Deficit Hyperactivity Disorder is the most common Neuro-behavioral disorder that is seen in the clients of child and adolescent psychiatric clinics. Although in the past years, there was a false belief that this disorder improves from the years after adolescence, today the fact has become clear that this disorder will continue into adulthood in more than 50 to 75 percent of cases. The age of onset of this disorder has been determined before 5 or 7 years old. This disorder refers to people who show a level of inattention, hyperactivity, or impulsiveness and have problems at home, school, or in some social situations. Attention deficit/hyperactivity disorder is also related to learning disorder and low intelligence; many children with attention deficit hyperactivity disorder have other disorders. Emotional problems, anxiety, and depression are also seen in them. Attention-deficit/hyperactivity disorder is associated with reduced academic performance and academic progress, social exclusion, and in adults, with poorer performance, progress, and job attendance, higher probability of unemployment, and high interpersonal conflict. This disorder is noticeably disruptive in severe cases and affects social, family, and academic/occupational adaptation. Mindfulness means paying attention to specific and purposeful ways in the present and free from judgment. The conscious mind focuses on the process of continuous attention, to the content being paid attention to. Although the main goal of mindfulness is not relaxation, non-judgmental observation of negative internal events or physiological arousal causes this state to occur. Therefore, considering the many behavioral aspects of attention deficit hyperactivity disorder can lead to mothers' depression, anxiety, and limited parental role, feelings of inadequacy and inadequacy in child rearing, weak emotional attachment between child and parent, negative relationships. These children's relationship with their brothers and sisters leads to an increase in tension in the family, a higher rate of divorce, and the breakdown of family relationships. Therefore, according to the stated content and the lack of research related to mindfulness interventions based on stress reduction in the community of parents with hyperactive-attention-deficit children, the purpose of this research is to answer the question of whether mindfulness interventions based on stress reduction effectively on improving parent-child tension in parents of ADHD children.

The current research method was quasi-experimental with a pre-test and post-test design with a control group. The statistical population of this study was made up of all mothers with children with attention-deficit/hyperactivity disorder who were referred to Mashhad psychotherapy clinics in 2016-2017. From this population, 30 mothers of children with attention-deficit/hyperactivity disorder were selected purposefully and voluntarily and were randomly replaced in the experimental group and the control group (15 people in each group). Baumrind (1972) and Barry and Jones (1995) parent stress scale questionnaire answered (pre-test), then the experimental group underwent 9 sessions of mindfulness-based on Kabat and Zain (2004) stress reduction, and the control group did not receive any intervention. In the end, both groups responded to the research tools (post-test). The collected data were analyzed with spss-25 software and multivariate covariance analysis.

The results showed that mindfulness interventions based on stress reduction have a positive effect on parent-child tension in parents of ADHD children.

Mindfulness techniques effectively increase muscle relaxation and reduce worry, stress, and anxiety. This program increases mental awareness, and well-being, and reduces stress and its physical and psychological symptoms. Time spent in formal meditative practices such as yoga is also associated with improved mindfulness and well-being. Therefore, mindfulness can be considered a mediating factor for increasing psychological performance and reducing stress symptoms resulting from meditation exercises. Mindfulness-based stress reduction requires the use of special behavioral, cognitive, and metacognitive strategies to focus the attention process, which in turn prevents the downward spiral of negative mood, negative thinking, tendency to problematic responses, and the development of perspective. It leads to new and the emergence of pleasant thoughts and emotions. Therefore, it can be concluded that mindfulness interventions based on stress reduction affect improving parenting styles and parent-child tension in parents of ADHD children. The limitations of this research include the lack of a follow-up period and the special and difficult conditions of children with attention deficit hyperactivity disorder, and it is suggested that the results of this research be used as a field for future studies in the field of knowledge of educational programs. Effective on the child's parental stress and parenting styles, parents with attention deficit hyperactivity disorder should be used. It is also suggested that the officials and those involved plan a comprehensive treatment for these patients and their parents.

Background &

The health excellence program of education management tries to provide conditions for all the effective factors in school management while identifying internal and external capacities and abilities, by adopting a program-oriented approach to determine the goals and design of the operational plan of the school, and with a sharp and critical eye, continuously evaluate the performance of the school in relation to the roadmap or program Measure operations and intended goals. In addition, the education management excellence program gives the management the opportunity to identify and optimally use the available resources and capacities by using an intelligent and efficient system, making possible the continuous improvement and excellence of the educational process. In this way, all management processes are on the path of transformation, and continuous improvement thinking is institutionalized as a principle and value in education. On the other hand, education and training need continuous improvement of their performance in order to progress, and human resources are considered basic capital and the origin of any transformation and innovation in them. The job performance of education managers is one of the important variables in productivity and efficiency, and it is the most essential factor for creating a favorable position in the realization of educational goals. Therefore, the project of excellence in management will lead education towards an educational system based on the program and the practice of more accountability and attention to the needs of society. The accurate implementation of self-evaluation and external evaluation based on the defined definitions and indicators gives an opportunity to education management by using a smart and efficient system to identify and optimally use existing resources and capacities, continuous improvement and It makes possible the excellence of the educational process. Therefore, one of the variables that can affect the excellence of education management is the job performance of the managers, job performance is one of the basic and important issues that the managers and those involved in the organizations seek to increase. Job performance is actually a set of activities that are carried out by employees in order to achieve the predetermined goals of the organization, and it consists of several indicators such as job satisfaction, skills, abilities, etc. Some belief that meaning of the word performance; is the result of the work and efficiency of the organization, and some people also use performance to mean the process of doing work and how to perform tasks (without considering the result). In evaluating the performance of human resources, both the obtained results and the work process can be emphasized. In other words, performance means the result of human resource activities in terms of the implementation of assigned tasks after a certain time, which can have the aspect of productivity and efficiency. The education management excellence program can theoretically include many effects and benefits, the result of which can be counted as improving the existing conditions of schools and education as a whole. But a look at the research shows that in recent years, despite the implementation of this program at the school level, little research has been done in the field of the effects of the implementation of these programs on schools, teachers, and administrators. In this regard, this research evaluates the role and impact of the health excellence program of education management on the job performance of managers by looking at the previous research and the lack of research that has been done.

The research method was a combination of exploratory mixed research design (qualitative-quantitative). The research participants in the qualitative part, including the selected experts of Mazandaran Education Organization with management and policy-making experience, were determined to be 20 people taking into account the saturation law. In the quantitative part, the statistical population included employees of education departments of 32 regions and cities of Mazandaran province. In the quantitative section, the sample size was determined to be 320 people using the Karjesi and Morgan table. The measurement tool in the qualitative part was a semi-structured interview and in the quantitative part it included a researcher-made questionnaire. In order to analyze the data, the structural equation modeling method of SPSS and LISREL software was used.

The findings of the research according to results of the qualitative and quantitative part of the research showed that 82% of job performance is related to the dimensions of the education management excellence plan, which includes (1. care and attention, 2. rules and regulations, 3. criteria, 4. instrumental, 5. efficiency, 6. independent) is dependent.

The results of this research showed that the dimensions of the education management excellence plan have a positive and significant effect on the job performance of education workers in Mazandaran province. Therefore, some suggestions are given in this regard: 1- Holding in-service training in the form of various workshops in order to train the job performance of the employees. 2- Managers, and assistants should be fully informed about management excellence and its impact on the job performance of employees, and most of them should be given attention. 3- Paying attention to the mechanisms of management excellence and job performance by providing continuous evaluation research workshops. Based on the statement of the problem as well as the analysis presented in this research, the following can be presented as recommendations for conducting future research related to the subject of the current research: Similar research should be conducted in other organizations and the results Ready to compare. Research is conducted with the aim of determining the infrastructure needed to implement the proposed model of the dimensions of the teacher management excellence plan on the academic performance of students with the role of mediator of educational justice. A research with the aim of investigating the effectiveness of the dimensions of the management excellence plan on the job performance of employees, in the assistants and principals of schools.

Background &

Infertility makes people susceptible to mental illnesses such as depression and anxiety (3). Failure to pay attention to mental disorders and their symptoms such as interpersonal relationship problems, marital dissatisfaction, and decreased sexual desire creates a vicious cycle that reduces the possibility of infertility treatment and also leads to divorce (4). In societies where cultural norms value women more than the role of motherhood, infertility causes instability in cohabitation, domestic violence, and isolation (5). Infertility, because it causes a woman's inability to achieve the desired social role, is often associated with psychological distress (6) and affects their psychological, physical, social well-being and life expectancy (5).
But among the various factors, one of the most important variables in infertile women is psychological distress. In a general definition, psychological distress is emotional suffering that may have a negative impact on people's social functions and daily life (7) and is characterized by symptoms of depression and anxiety (8). Another important variable in the society of infertile women is infertility self-efficacy (9). Infertility self-efficacy means infertile people's perception of their abilities to use behavioral, emotional and cognitive capabilities in facing the diagnosis and medical treatment of infertility (11).
Finally, the quality of life is a broad concept that includes different areas of human life, including health (12). Quality of life is people's sense of their abilities regarding physical, emotional and social functions, and today it is considered as one of the indicators of development, which is very important to improve (14).
Due to the importance of infertility and the negative consequences of infertility in women, many interventions with different approaches have been formulated to reduce the psychological problems of infertile women. One of the therapeutic approaches that can be effective in psychological distress, infertility self-efficacy and also the quality of life of infertile women is schema therapy (15). Schema therapy is one of the most widely used third wave treatments, which was proposed by Jeffrey Young (16). The basis of schema theory is the principle of coordination. People are motivated to perpetuate their self-consistent view of the world and themselves and tend to interpret situations in such a way that their schemas are confirmed (17).
Another treatment approach that seems to be effective in psychological distress, infertility self-efficacy, and also the quality of life of infertile women, is the treatment based on acceptance and commitment (13). Treatment based on acceptance and commitment is one of the treatments of the third wave of the cognitive-behavioral approach, whose primary goal is to increase the quality of life by reducing the effect of ineffective control strategies and supporting behavioral change based on values (22). According to the above material, the researcher is trying to answer the question whether the effectiveness of treatment based on schema therapy has an effect on psychological distress, infertility self-efficacy and the quality of life of infertile women in Tehran.

The current research was semi-experimental with a pre-test-post-test-follow-up design with a control group for this purpose among infertile women who had referred to the infertility treatment centers of districts 1 to 5 of Tehran in 1401. With the coordination of the director of the infertility centers of regions 1 to 5, the health and care officer of the center provided the files of the infertile people to the researcher and while contacting the infertile women, they were given explanations about the working method. Based on this, 30 people were selected as a sample using the available sampling method and were randomly divided into two control and experimental groups.
In the first session and before the beginning of the treatment sessions, a pre-test and at the end of the last session, a post-test was conducted in both groups. A follow-up meeting was held in the same place after three months. The experimental group participated in schema therapy group sessions twice a week for ten 2-hour sessions. This treatment protocol with the opinion of clinical experts and the use of reliable sources (16) is presented by sessions in Table 1.

The results showed that there is a significant difference between the average scores of psychological distress in pre-test, post-test and follow-up. Also, the interaction effect between time and group is significant, which shows that the mean scores of psychological distress of infertile women are different at different times according to the variable levels of the group. That is, there is a significant difference between the two groups (the second experimental group and the control group) in the reduction of the psychological distress scores of infertile women from the pre-test stage to the follow-up. Also, the significance of the group factor on the psychological distress scores of infertile women indicates that regardless of the measurement time, there is a significant difference between the mean psychological distress scores of the experimental and control groups (P=0.001).
Another finding showed that there is a significant difference between the mean infertility self-efficacy scores in pre-test, post-test and follow-up. Also, the interaction effect between time and group is also significant, which shows that the mean infertility self-efficacy scores of infertile women are different at different times according to the variable levels of the group. That is, there is a significant difference between the two groups (the second experimental group and the control group) in the increase in infertility self-efficacy scores of infertile women from the pre-test stage to follow-up. Also, the significance of the group factor on the infertility self-efficacy scores of infertile women indicates that regardless of the measurement time, there is a significant difference between the mean infertility self-efficacy scores of the experimental and control groups (P=0.002). (Table 3).
As can be seen in Table 4, there is a significant difference between the mean scores of the quality of life in the pre-test, post-test and follow-up. It was also found that the quality of life scores of infertile women are different at different times according to the variable levels of the group. That is, there is a significant difference between the two groups (the second experimental group and the control group) in the increase in the quality of life scores of infertile women from the pre-examination stage to the follow-up. Also, the significance of the group factor on the quality of life scores of infertile women indicates that regardless of the measurement time, there is a significant difference between the mean quality of life scores of the experimental and control groups (P=0.002).

Schema therapy by emphasizing the change of maladaptive coping styles and maladaptive schemas formed in childhood and explaining how they are effective in processing and facing life events in therapy instead of ineffective coping styles and strategies provides an opportunity for the patient to stop negative evaluation and avoidance. and instead use normal and adaptive coping strategies (27).
Schema therapy is used to change processes and activities such as negative rumination, threat monitoring, focusing on danger, selling thoughts and behaviors such as behavioral, cognitive, and emotional avoidance that people prone to depression use to deal with the perceived inconsistency and regulate the resulting negative emotions. they give, it pays, and in this way it reduces the feeling of helplessness and inefficiency in a person (30).
This approach is effective by challenging incompatible schemas and ineffective responses and replacing them with inappropriate and healthier thoughts and responses. Schema therapy, with the ability to improve some basic and destructive components such as negative emotions and thoughts, depression, anxiety, personality abnormalities, etc., seems to be able to improve the omponents of the quality of life in people (28).

Background &

Polycystic ovary syndrome is one of the common endocrine diseases that affects 5-10% of women of reproductive age. The purpose of this research was to explain the effect of Tabata training in water on TSP-1 and TIMP-3 and insulin resistance in obese women with polycystic ovary syndrome.

To conduct this semi-experimental research, 30 women with a BMI greater than 29.9 in Isfahan city were selected and randomly divided into two experimental groups (metformin + Tabata exercise) (15 people) and control (metformin) (15 people). The Tabata training program consisted of 3 sessions per week for 40 minutes (10 minutes of warm-up, 20 minutes of exercise and 10 minutes of cooling down) consisting of 4-minute periods (20 seconds of activity and 10 seconds of rest) for 12 weeks. Subjects also took 500 mg metformin twice a day after breakfast and dinner. To measure the research variables, blood was taken after 12 to 14 hours of fasting and in two stages before and 48 hours after the last training session. To analyze the data, Shapiro-Wilk tests, one-way analysis of variance and Tukey's post hoc tests were used. People with endocrine diseases, untreated thyroid, Cushing's syndrome (a type of metabolic syndrome in which high levels of glucocorticoids lead to insulin resistance in muscle tissue, liver and fat tissue), congenital adrenal hyperplasia, suspected ovarian or adrenal tumor , heart patients, use of oral contraceptive pills, progestin and hormone induction (Inplanol), use of hormone therapy or herbal medicines during the last 2 months, use of acupuncture during the last 2 months, exercise during Last 2 months, pregnancy, history of abortion or childbirth in the last 6 weeks, history of breastfeeding in the last 4 months, having bariatric surgery in the last 12 months, unwillingness to fill out the consent form to enter the study, patients with or with a history of Cervical, endometrial, or breast cancer were excluded from the study.
After selecting the sample, the subjects completed the personal information questionnaire and blood was drawn after 12 hours of overnight fasting to determine the level of insulin resistance factors, TSP-1 and TIMP-3. Then the experimental group did the training program including 12 weeks, 3 sessions per week and each session lasted 40 minutes and also used metformin. But the control group only took metformin. The exercise protocol consisted of 10 minutes of walking forwards, backwards, sideways, and jogging in the shallow part of the pool (where the water level is below the neck) and then doing stretching exercises. Then, Tabata training was performed with a special training song for 20 minutes and 10 minutes of stretching and cooling down. 48 hours after the last training session, blood was drawn again from all subjects. Also, in order to comply with ethical considerations at the end of the research, the treatment protocols in the form of manuals were provided to the control group so that they can use it if they wish. Similar to protocols on land, in water intensity interval training programs, participants complete "very hard" bouts with "easy" recovery periods, and due to the higher viscosity and density of water, large movements with increased speed will have greater resistance to water flow. He said that this leads to the creation of an ideal environment for increasing work efficiency and energy consumption. Also, metformin is a biguanide drug and is sensitive to insulin. This drug is able to limit the secretion of insulin and its increase. It also reduces the amount of androgen secretion that is secreted from the ovary and adrenal gland. Therefore, metformin seems to be an effective drug in patients with PCOS, especially in those who are resistant to clomiphene. Metformin improves the menstrual cycle in patients with the syndrome and causes an increase in the sensitivity of the response of drugs effective in stimulating ovulation, especially in women with PCOS resistant to clomiphene citrate, and leads to a decrease in obesity.

The results showed that exercise caused a significant decrease in insulin resistance and a significant increase in TSP-1 and TIMP-3 in the experimental group. The results showed that 12 weeks of Tabata training in water has a significant effect on insulin resistance in obese women with polycystic ovary syndrome (P=0.0001, f3.59=11.097). Also, the results of Tukey's post hoc test showed that there is a significant difference between the pre-test of the water training group and the control post-test group and the post-test of the water training group with test control group , but does not have there is a significant difference between the other groups.
In this study, it was found that 12 weeks of Tabata training in water has a significant effect on TIMP-3 in obese women with polycystic ovary syndrome (P=0.0001, f3,59=20/270). Also, the results of Tukey's post hoc test showed that there is a significant difference between the pre-test of the water exercise group and the post-test of the water exercise group and between the post-test of the water exercise group and the control but  pre-test and the control post-test, There is no significant difference between the other groups.
In the present study, it was found that 12 weeks of Tabata training in water has a significant effect on TSP-1 in obese women with polycystic ovary syndrome (P=0.0001, f3,59=111/20). Also, the results of Tukey's post hoc test showed that there is a significant difference between the pre-test of the water exercise group and the post-test of the water exercise group and between the post-test of the water exercise group and the control.but pre-test and the control post-test, There is no significant difference between the other groups.

The results of the present study confirm the effect of Tabata exercise in water along with metformin on the factors involved in angiogenesis and insulin resistance in women with polycystic ovary syndrome.

Background &

Job performance is one of the most important variables in industrial and organizational psychology, and its importance is clear for both individuals and organizations, in other words, all major activities in industrial and organizational psychology focus on improving performance. Job is focused. Job performance is the amount of productivity that is obtained from the employment of an individual in the organization. Job performance shows how employees perform in their jobs, initiative, problem-solving, and ways of using resources. Job performance in the field of education is an important factor in the development and advancement of organizational goals; therefore, educational organizations should always try to identify, develop and maintain human capital. Psychological capital is one of the branches of positive psychology, which emphasizes a person's belief in his abilities to achieve success, to be persistent in pursuing goals, to create positive documents about himself, and to endure difficulties. This capital has characteristics such as having confidence in making the necessary efforts for success in challenging tasks (self-efficacy); Creating a positive document about current and future success (optimism); Being steadfast in the path of the goals and if necessary changing the paths to achieve the goals and achieve success (hope) and try harder to achieve success when surrounded by problems and hardships or even positive events, progress and More responsibility (resilience). Psychological capital in teachers as a guide and facilitator of the academic performance of teachers, by providing a human and moral perspective for schools, and also, by relying on the strengths and positive aspects of the organization's members and human resources, and relying on Ethical behaviors provide teachers with a performance beyond expectations, and by changing the conventional views and perspectives towards the school system, tasks, and roles, communication, the behavior of organization members (administrators, teachers, students, and employees). Therefore, teachers with high psychological capital create and create a positive atmosphere based on self-efficacy, hope, optimism, and resilience in themselves and their students. Considering that the education organization is considered one of the most important educational and service institutions of a country that has an important place in the improvement and prosperity of the society, increasing attention to the role of psychological capital in various ways can lead to improve the performance of employees (teachers). Therefore, according to the presented materials, the present research seeks to answer the question: What is the effect of psychological capital on improving the professional performance of teachers in Alborz province in order to present a model?

The purpose of this research is practical, which was carried out with a mixed approach (qualitative and quantitative) with an exploratory design and was approved by the Code of Ethics Commission of the Islamic Azad University of Sari branch with the code IR.IAU.SARI.REC.1401.194. The statistical population studied in the qualitative section included senior managers and education experts of Alborz province who had doctorate degrees and management experience of more than 10 years, and 20 people were identified and their opinions were used in the qualitative section. The statistical population studied in the quantitative section included all official and contract teachers of Alborz province (public sector) in the number of 25,402 people, and their opinions were used in the quantitative section. In the qualitative section, 10 people were selected as a statistical sample using the purposeful sampling method and considering the saturation law. In the quantitative part, based on Cochran's formula, 378 people were selected by stratified random sampling method. To collect data in the qualitative part of this research from semi-structured interviews in the form of a Delphi design and the quantitative part based on the criteria extracted from the qualitative stage, a researcher-made psychological capital questionnaire, and a job performance questionnaire were used. Patterson (1990) was used to collect the required data. The researcher-made psychological capital questionnaire had 51 questions and 2 "individual and organizational" dimensions and 8 components (spirituality, creativity, critical thinking, self-confidence, flexibility, responsibility, successful experiences, and organizational trust). Which was designed in the range of 5 Likert options (very low, low, medium, high, and very high) and was scored from 1 to 5 respectively. Job Performance Questionnaire was designed by Patterson in 1990 this questionnaire has 15 questions and was designed on a 4-point Likert scale (rarely, often, sometimes, and always) and scored from 1 to 4 respectively. To collect data, a researcher-made psychological capital questionnaire and Patterson's occupational performance questionnaire (1990) were used. Data analysis was done using SPSS21 and PLS software.

The results showed that there is a factor load of 0.683 between the variable of psychological capital and the promotion of job performance based on path coefficients, so the effect of psychological capital on the promotion of job performance of teachers in Alborz province is significant at the level of 0.99.

In general, it can be said that psychological capital is one of the influencing factors in the formation of job performance, therefore, by strengthening cognitive capital among employees, it is possible to provide the basis for more effective work in the organizational environment. One of the limitations of this study is the problem of communicating with some specialists, experts, and experts in the field of academic entrepreneurship and determining the time required to conduct interviews, as well as the low interest of some samples to participate in the research process and complete the questionnaires. A little research indicated. According to the results of the study, it is suggested to identify the causes of the ineffectiveness of educational centers regarding not entering the field of psychological capital and trying to increase it as much as possible, especially in in-service classes, which in turn can increase the performance level of teachers. Also, due to the educational nature of psychological capital, it can be considered in different training courses among the employees of different organizations and benefit from its material and non-material benefits.

Background &

: In general, among the effective methods in improving academic resilience, academic resilience, and emotional self-awareness can be mentioned as educational methods that include cognition, behavior, affection, and interactions at the same time. Resilience is a kind of returning to the initial balance or reaching a higher level of balance in threatening conditions and provides the means for successful adaptation in life. In the field of people's resilience, two categories of risk factors and protective factors can be separated, the risk factor prevents the effective performance of the individual. However, the protective factor is the resources that help people avoid the effects of looking at the importance of the family in hardships and crises. Resilience is not a one-dimensional structure, but a multi-dimensional phenomenon, it is understood in its context and context, and a complex interactive model is needed to fully understand it. On the other hand, in students, academic resilience means achieving good educational results despite adverse conditions and challenges through changing existing behaviors or creating new behaviors, such as discipline, practice, or planning. The resilience process is not just a biological or psychological fact. But at the same time, it also has social dimensions and nature. In other words, students who are resilient in one situation may face problems in another situation. Students who have academic resilience, even in the presence of stressful events and conditions that can put them at risk of poor performance and eventually dropping out of school, have high motivation and good performance. In other words, resilient students maintain a high level of motivation and progress despite stressful events and conditions, which requires the acquisition of appropriate self-awareness in different cognitive, behavioral, and even emotional fields. The purpose of this research was to compare the effectiveness of teaching self-directed learning strategies and brain-based learning on the academic resilience of high school students.

The research method was a semi-experimental pre-test-post-test type with an unequal control group. The statistical population of the current research is made up of all 387 female students of the first secondary school of the ninth grade of public schools in the city of Northern Swadkoh in the academic year of 2022-2023. A number of 45 people were selected based on the criteria for entering the research and were randomly replaced into two experimental groups of 15 people and a control group of 15 people. Samuels (2004) academic resilience questionnaire was used to collect data. The summary of self-directed learning strategies training sessions taken by Densero et al. (1979) in 8 60-minute sessions and the summary of brain-based learning training sessions taken by Cain et al. (2005) in 90-minute sessions were conducted on the experimental group. There was no intervention for the control group. Repeated measurement variance analysis was used with SPSS18 software to analyze the data.

The findings showed that teaching self-directed learning strategies and teaching brain-based learning affects the academic resilience of secondary school students. Brain-based learning training was more effective than brain-based learning training on academic resilience. The findings of this research can provide practical implications for consultants.

Brain-based learning helps students improve their cognitive skills. These skills include attention, memory, critical thinking, and problem-solving, which are effective in academic resilience and achieving better performance in various subjects. Teaching brain-based learning helps students strengthen their concentration power compared to teaching self-directed learning strategies. This focus helps students in learning and problem-solving and increases academic resilience. The limitation of the research to the first secondary school students of the ninth grade limits the generalization of its findings to other students and other grades, therefore caution should be observed in generalization. Since the gender of the participants was female, generalization to male students is limited. The data collection tool was a questionnaire, and questionnaires, despite their usefulness, may cause the respondents to respond under the influence of social desirability. Because the research was conducted in the northern city of Swadekoh, it may be limited in generalizing its results to other places due to the specific socio-cultural context of this city. The brain-based learning teaching method is an effective method for improving academic resilience, and the findings of this research can provide practical implications in the field of improving the performance of psychological factors to academic advisors and teachers using the brain-based learning teaching method. According to the results of the article, the hypothesis that there is a difference between the effectiveness of self-directed learning strategies and brain-based learning on academic resilience in high school students was confirmed. However brain-based learning training was more effective than self-directed learning strategies on academic resilience.

Background &

The effort of scientists to control and treat diseases opens new horizons for human society every day. The cloning that has been successful in the case of plants and animals, on the one hand, has fueled enormous challenges and fundamental questions about human cloning, and on the other hand, it has promised to cure many diseases. The goal of cloning therapy is to create stem cells that are similar to the patient's stem cells. The purpose of this will not be the production of a human being, but it is meant to restore life and full health to a person, to be allowed to achieve it. In this context, prominent statements and their opponents and supporters have explained their views. Therapeutic simulation is one of the challenging issues of the contemporary world, but no comprehensive and extensive research has been done on this issue. Cloning, which is another name, comes from the root of clone, which is a Greek word, and its literal meaning is "sprouting and multiplying". Cloning in biological science means "reproduction of a living organism without sexual intercourse" and currently refers to the act of implanting an embryo in the womb that was first produced in a laboratory. The cell is a French word that means that living organisms, despite the differences in shape and characteristics, are all made of small elements called cells, whose structure is almost the same in animals and plants. The meaning of cell in Farsi is "cell" which means a living organism despite the difference in shape and appearance. The process of asexual production of a group of cells, molecules, or living organisms that are all genetically similar is called "simulation" or "cloning". The different uses of this word indicate a common element, which is: the creation and production of a creature similar to the original animal without the involvement of the sexual element. Hence, cloning can be translated into asexual reproduction. Cloning means the steps that are taken to produce several copies of a single gene, and this term is used to mean the physical separation of a single cell and its multiplication in the culture medium to produce a population of those cells. In short, the production of an individual or a group of individuals that are genetically identical to what has been reproduced is called cloning. The most complete form of simulation is somatic cell nuclear transfer through which simulation takes place. By using this technique, the nuclear materials of the human somatic cell or the donor are transferred into an egg that has already been deactivated. Finally, it stimulates the formed egg cell to start its growth and development stages, and as a result, a cloned embryo is obtained. On the other hand, one of the new legal issues is the issue of simulation. This technique is one of the achievements and challenging issues of the contemporary world, but it has also been faced by scholars of jurisprudence, lawyers, and authors of legal texts. Accordingly, this article was conducted with the aim of investigating and analyzing simulation techniques in medical sciences with a legal approach.

This descriptive-analytical study analyzed and described its sayings and ideas with the method of documentary studies. In this method, the simulation process is carried out by splitting the embryo. Explanation that one or more cells are taken from the fertilized embryo and placed in a suitable environment such as the uterus or a laboratory tube. Each of these cells has the ability to turn into a new embryo, the result of which, if placed in a suitable space, is an embryo like the original embryo. This method is the same way that happens in nature, and identical twins or multiple twins are considered to be a manifestation of it. This method has been successfully used on many animals such as sheep, cows, mice and monkeys.

The results of the research indicate that the therapeutic simulation of the dual process is carried out by the method of embryo derivation and nuclear transfer, and healthy cells are replaced by defective and unhealthy cells, the purpose of which is the possibility of restoring life and health to a person, on the other hand, techniques Infertility treatment such as in vitro fertilization, sperm injection into the uterus is one of the methods commonly known as assisted reproductive methods. From the point of view of its goals, simulation is classified into two types: human or reproductive (first paragraph) and research or therapeutic (second paragraph). In other words, simulation is done for two

creating a perfect human (human simulation); Creating different organs of the human body (therapeutic simulation). The realization of the second goal is in such a way that every potential cell has the ability to become all the cells of the organs, so the growth can be stopped in the laboratory and only a specific cell, such as the heart, nerve or kidney, etc., can be allowed to grow. gave There are many disagreements and oppositions regarding human cloning due to its negative consequences, but there is no disagreement among scientists regarding therapeutic simulation, and even because of its widespread use and its many and important benefits in medicine, it is welcomed because of the treatment of chronic diseases.

In this paper, the simulation technique, which is considered one of the new human achievements, was discussed, and in this regard, the desired approach was expressed from the perspective of the jurists of the Imamiyya school and Iranian law writers. And it is the subject of controversy in the contemporary world, which has entered into the field of writing with the aim of researching, examining, and explaining the jurisprudence and legal ruling of therapeutic simulation technique, and the writer has tried to analyze and describe the material using the library method. The findings of the research indicate that, first, its therapeutic application is to create stem cells that are similar to the patient's stem cells, in this type of simulation, healthy cells are replaced by defective and unhealthy cells; in the continuation of the discussion, we concluded that the simulation phenomenon takes place during the dual process by two methods of embryo derivation and nuclear transfer. In addition, infertility treatment techniques such as in vitro fertilization, sperm injection into the uterus, and other methods are commonly known as assisted reproductive methods. The results of the research show that from the point of view of its goals, simulation is divided into two types of human or reproduction or reproduction (first paragraph) and research or therapeutic (second paragraph) and with the two goals of creating a complete human (human simulation) and creating different organs of the human body (therapeutic simulation) is done that in the legal discussion of this issue, we can pay attention to the following: abortion has a customary meaning and the custom of destroying laboratory embryos is not considered abortion. Also, the analogy of "Mustanbat al-Ala" is not valid in Imami jurisprudence, and the ruling on abortion and the destruction of the fetus outside the womb cannot be considered the same. On the other hand, the similarity of the principle of innocence, if we have doubts about whether something is haram, we rule that it is not haram. The rule of Daraa also stipulates that in case of doubt, punishment cannot be carried out. Therefore, there is no reason to prohibit the destruction of the simulated embryo, and it seems that extracting and using stem cells from it is without problems.

Background &

: Adolescence is a period in which many healthy and unhealthy habits are formed and spread to the next periods of life, and since during this period, health-threatening behaviors increase, adolescents are at risk of many health-threatening behaviors including increased food intake, decreased physical activity, and increased developmental vulnerability. Therefore, a health-promoting lifestyle in teenagers is one of the best ways that they can maintain and improve their health. Health-promoting behaviors are part of daily life activities that create a set of individual happiness, values, and well-being. A healthy lifestyle is a balanced life in which a person consciously makes healthy choices in different areas. Health promotion includes behaviors during which a person should have proper nutrition, exercise regularly, avoid harmful behaviors, protect against accidents, detect signs of illness in time in the physical dimension, control emotions, feelings, and thoughts, and cope with It deals with stress and problems in the mental dimension, independence, adaptability and modification of interpersonal relationships in the social dimension. Therefore, the type of interpersonal relationships and, as a result, the emotional system that governs the family structure and interpersonal relationships, affects the mental health of a person, because this emotional system is the ability to separate and differentiate oneself from others on a cognitive and emotional level. The purpose of the present study was to present a structural model for predicting health-promoting lifestyle in teenage girls based on self-differentiation and interpersonal sensitivity with the mediating role of social support.

The research method was descriptive and correlation type using structural equations. The statistical population in this research was made up of all high school female students in Yazd who were studying in theoretical fields (humanities, experimental sciences and mathematics) in the academic year of 1402-1401. 4 schools from district one and 4 schools from district two of Yazd city (8 schools in total) and from each school three classes from among mathematics, experimental and humanitarian fields (24 classes in total) were selected and in each class the questionnaire was randomly distributed to 15 students were given to complete. Finally, due to the non-response of a number of participants and the missing questionnaires, the analyzes were performed on 340 samples. The measurement tools in this research were Walker's health-promoting lifestyle (1987), perceived social support by Zammit et al. (1988), self-differentiation by Skowron and Smith (2003), and Boyce and Parker's (1989) interpersonal sensitivity. Data analysis was done using Pearson correlation and path analysis to investigate causal relationships between variables.

The results of the fit of the proposed model indicated a good fit of the model with the data. The direct coefficients of the model showed that self-differentiation (P<0.001, β=0.203) and perceived social support (P<0.001, β=0.259) have a significant positive effect on health-promoting lifestyle, and interpersonal sensitivity on style Health-promoting life has a significant negative effect (P<0.001, β=-0.309). Also, with the inclusion of perceived social support variable into the model, the indirect effect of self-differentiation and interpersonal sensitivity on health-promoting lifestyle became -0.0814 and -0.0335, respectively.

In explaining this finding, it can be stated that interpersonal sensitivity (emotional and social) is the skill of evaluating others' abilities, states, and traits through their non-verbal signs, and people who have these characteristics are disturbed in interpersonal relationships, regardless of real criticism or not. They are sensitive to accepting and changing their behavior to follow others' expectations, and as a result, they experience dysfunctional interpersonal relationships to a greater extent. Interpersonal sensitivity can cause individual isolation and increase the feeling of social loneliness because people with high interpersonal sensitivity suffer more from pessimism, mistrust, and a hostile view of the world, and as a result, experience social isolation and reduced benefits from social support. On the other hand, they are radically changing their behavior to suit others to minimize the risk of criticism and rejection. Therefore, teenagers in stressful situations may use it as a tool to reduce their mental pressure, which leads to a decrease in their desirable lifestyle. As a result, if teenagers have characteristics that can receive the necessary social support, this support will make them reduce the number of weaknesses caused by separation anxiety and fragile self-esteem and adjust their interpersonal relationships according to their needs. These relationships further satisfy the need for approval and minimize the fear of rejection and criticism, and during a cycle, this model can strengthen the possibility of promoting a desirable lifestyle. In general, people with differentiation and interpersonal sensitivity problems have difficulty in relating to others and maintaining intimate relationships and tend to cut off communication with others, as a result, they probably receive less social support from others. On the other hand, social support can improve problems related to Psychological disorders, and problems play a moderating role. As a result, a person who has high social support is not easily involved in the process of social comparison in the process of non-differentiation, interpersonal sensitivity, or sensitivity to rejection, and it seems that social support can play a mediating role in the relationship between self-differentiation and interpersonal sensitivity with health-related lifestyle.Therefore, adolescents with differentiation and interpersonal sensitivity problems have difficulty in maintaining intimate relationships with others and tend to cut off communication with others, as a result of which they receive less social support from others and the lack of social support causes maladaptive behaviors and Health decreases in these teenagers.

Background &

Today, human resources are considered the most valuable and important organizational resources that can lead to strengthening the competitive advantage of the organization compared to other organizations. In today's world, which is accompanied by rapid changes and transformations, effective human resources are one of the most important intangible assets in the organization, and the economic growth of the organization depends on empowering them. Managers of organizations want more than anything to gain a competitive advantage over other organizations and it should be known that to achieve this, making the right decision based on what is for the good of the organization and the environment and also creating an environment where mutual relations and effective among employees is one of the duties of management that can only come from a wise manager. On the other hand, in today's competitive world, an organization has a chance to survive if it can continuously adapt to the environmental changes around it. Environmental changes have forced organizations to continuously seek the best solutions and procedures to adapt to their environment and thus achieve a competitive advantage. As business environments become more complex and uncertainty about their future increases, it becomes more difficult to choose strategies that will lead organizations to success; Because gaining competitive advantage requires a commitment to resources and abilities that are in harmony with market conditions and difficult to return and imitate. The fruits of these commitments are borne over time and must be based on beliefs about the future. Working in turbulent business environments requires increasing organizational flexibility.The meaning of strategic flexibility is the ability of a company to respond to uncertainties by adapting goals to changing conditions or taking active action to create change using the organization's knowledge and capabilities. In a stable environment, the concept of traditional management helps organizations achieve success. But this management approach faces limitations in preparing organizations to face environmental uncertainty. For this reason, new management theories have focused on the development of organizational strategic flexibility as a substitute approach for traditional management. Flexibility can be considered as an organizational feature that reduces the organization's vulnerability to unpredictable external changes or puts the organization in a better position to respond successfully to changes. Since organizational success can be examined from various aspects, in this research, considering the importance of the topic of micro leaders in organizations, especially cultural organizations, we aim to identify the factors affecting strategic flexibility in the center of the intellectual development of children and adolescents that It has been active in the cultural field for more than half a century, and as an all-encompassing government body at the national level, it has been in communication and interaction with a wide range of people, especially children, teenagers and parents, and has a recognized position and records at the international level.

The research method was a mixed exploratory (qualitative-quantitative) research design. The statistical population of the research in the qualitative part included (experts and managers of the Center for Intellectual Development of Mazandaran Children and Adolescents in the field of policy-making) in order to reach consensus in the Delphi method, the sample size in the qualitative part was determined to be 17 people considering the law of saturation. And in a small part, the statistical population included the employees of the Center for Intellectual Development of Children and Adolescents in Mazandaran province. In the quantitative section, the sample size was determined to be 153 using Cochran's formula. The sampling method in the quantitative part was a multi-stage cluster design. The method of collecting information is the library method, and the measurement tool in the qualitative part is a semi-structured interview in the quantitative part, it includes a researcher-made questionnaire, the questions of which were taken from the data obtained from the interview. In order to analyze the data, the Delphi technique was used in the qualitative part and the structural equation modeling method was used in the quantitative part. SPSS and LISREL software was used.

The findings showed that the variable "strategic flexibility" has three dimensions: 1. organizational compatibility, 2. organizational value, and 3. organizational competition.

According to the qualitative stages of the research resulting from the answers of research experts in the Delphi technique in four stages. Also, according to the quantitative part of the research, the reliability of the internal consistency method for each dimension, convergent and diagnostic validity (differentiation of extracted structures based on the final model) was confirmed, and also according to the coefficients obtained for the dimensions of the research model, the questionnaire The compiled results of these dimensions had high reliability. Finally, the "strategic flexibility" variable has three dimensions: 1. Organizational compatibility, 2. Organizational value, 3. Organizational competition. It should be mentioned that the Center for Intellectual Education of Children and Adolescents should act step by step and gradually according to a road map and long-term strategic plan, and in order to implement it, it is necessary to develop an operational letter. Of course, these variables are not among linear variables, therefore, in the field of presenting a comprehensive model, this issue has been investigated, and the model presented by experts in the field of management, such categories are distantly related, and the model presented by experts in the field Management and training have a direct relationship with the organization's citizenship, in some cases, it is necessary, in other places it may have an indirect effect on the organization's citizenship behavior due to the variable of leadership. In some cases, in some concepts, these variables may overlap.