فهرست مطالب آسیه عشوری

Nurses are one of the most important elements of health care system that have been in a stressful situation during the Covid-19 pandemic. The aim of this study was to investigate the prevalence and sources of nurses' occupational stressand identify related factors during this period.

This cross-sectional study was performed on 392 nurses of Rasht educational and medical centers in January to March 2021 selected with stratified random method. Demographic and occupational stress data (by Expanded Nursing Stress Scale questionnaire) werecollected. Data analyses performed by descriptive statistics and multiple regression models with SPSS software version 26.

The mean age of nurses were 37.8±8.8 years old. Stress was mild in 62% of nurses, moderate in 20% and severe in 2%. Death and dying situation (1/78±0/74), uncertainty concerning treatments (1.71±0.72) and workload (1.69±0.68), expressed higher occupational stress. Working in the intensive care units or emergency ward, higher education, excessive hours of work and female gender were independently predictors of more occupational stress and these characteristics determined 15% of the variance of stress scores.

Stress related to the job during the Covid-19 pandemic is high, and stress in the workplace, especially in intensive care units and emergency ward, should be reduced and standard work shifts should be developed. Furthermore, training of stress management in situations of patients’ death and dying, high workload and uncertainty concerning treatment in pandemic conditions for at risk population of nurses should be done.

Manpower consider as the most valuable asset and resource organization in the world today. Job satisfaction is the main factor of employees’ job performance and it leads to increase productivity and satisfaction in individuals. Organizational managers in order to achieving ideal goal should present more comprehensive image of the jobs’ satisfaction employees. This study has been done to investigate Faculty members’ job satisfaction in GUMS.

This descriptive- cross sectional study has been done on 186 basic sciences and clinical faculty members of medicine, dentistry, pharmacy, nursing& midwifery  ,paramedical and health school in Guilan university of medical sciences in the years 2018 to 2019. Reaserch tool was standard job satisfaction questionnaire of smith, kendall & Hulin in two parts including: personal information and questionnaire with 45 questions in 6 domains: salary &benefits, upgrade opportunities and personal growth, how to supervise and connections, psychological conditions and job security, physical conditions and the nature of work. Data were analyzed by statistical indicators frequency (percent), Mean (standard deviation) and, kruskal- wallis ,pearson correlation coefficient and linear regression tests through SPSS.

Findings show that the Mean score of different domains of job satisfaction was between 1 to 5 as follow: the nature of work (3.9±0.8), management, how to supervise and connections (3.3±0.7), physical conditions and the nature of work (3.1±0.8) psychological conditions and job security (3.1±0.9), upgrade opportunities and personal growth (3.0±0.7) and salary &benefits (2.8±0.8). Satisfaction in all domains was on average Mean except nature of work domain was desirable. Results of Pearson correlation test show that among satisfaction level and different domains , the most positive correlation respectively related to psychological conditions and job security, job management aspect (how to supervise and connections), upgrade opportunities and personal growth, physical conditions and the workplace, nature of work , salary &benefits (correlation coefficient between 0.705 to 0.905).Totally age, total years of service, type of employment and educational groups of faculty members, explain satisfaction variance score (3 to 18) in different domains.

Satisfaction in all domains was moderate only in jobs’ nature was desirable. It is suggested in subsequent study the reasons of less satisfaction in young and junior faculties also in clinical faculties considered.

Given the importance of adolescents’ health, especially girls and the inadequacy of dairy consumption around the world, we examined the psychological factors associated with dairy consumption behavior. Therefore, this study was conducted on high school girls.

The present descriptive-analytical study was carried out on 385 female high school students in Shaft City during 2019 using the census method. The survey questionnaire consisted of demographic information, knowledge structure, perceived self-efficacy, and dairy consumption behavior completed by students. To analyze the results,  Chi- Square tests, Spearman correlation coefficient, and multiple logistic regression were used via SPSS 21 software.

In total, 221 people (57.7%) consumed less than 2 units and 162 people (42.3) consumed more than 2 units of dairy products per day. The average scores of self-efficacy and knowledge constructs were 23.20 ± 6.6 (average) and 19.1± 3.05, respectively (at a good level). No significant correlation was found between perceived self-efficacy and dairy consumption behavior r = 0. 199 (p <0.05). Furthermore, no significant correlation was observed between knowledge and behavior (p> 0.05, r =- 0.25). The results of multiple logistic regression showed the predictive power of the perceived self-efficacy structure in dairy consumption behavior with an odds ratio of 1.052 (with a confidence interval of 95%: 1.089-1.016).

Perceived self-efficacy predicted the behavior of dairy consumption in the studied students. So, educational interventions in schools should focus more on promoting the perceptions and nutritional attitudes.

Coronary artery disease is one of the major health problems worldwide. According to the World Health Organization, this disease is one of the leading causes of death in the world as well as in Iran. Therefore, the aim of this study was to determine the relationship between physical activity level and some risk factors for coronary heart disease in patients with heart attack.

This study was a cross-sectional study of the analytical descriptive type in which the study population included patients with myocardial infarction referred to Dr. Heshmat Educational and Medical Center in 1994. The sampling method was available and 180 patients with myocardial infarction were studied according to the entry criteria. Data were collected using data collection tools. The collection tools were: 1) Demographic information: age, sex and marital status, family history of heart disease, 2) Clinical trials, including cholesterol, triglycerides, etc. Upon arrival at the hospital and 3) Questionnaire Back level of physical activity.

66% of the studied units were men and the mean age of the patients was 62 years. The average score on the level of physical activity in the field of work and leisure time in Venice was significantly higher in men than in women (P <0.001). There was no significant relationship between body mass index, age, education, history of hypertension and underlying diseases and diabetes, as well as history of family members suffering from heart disease, with the level of physical activity of the research units (for all communications P <0.05> ).

It is recommended to include regular and correct physical activity in the treatment plan of these patients. Choosing an active lifestyle in addition to maintaining body mass index in the appropriate range and reducing excess fat, causes control and prevention of cardiovascular risk factors. By increasing the level of regular and correct physical activity for patients, it may be possible to prevent the risk of developing cardiovascular disease.

Many patients undergoing aggressive medical interventions, such as cardiac electrophysiology studies, experience anxiety on the operation day, which can affect patients' psychological and physiological issues. This study aimed to investigate the effect of guided imagery on anxiety and vital signs in patients undergoing cardiac electrophysiology studies.

This study was performed as a double blind randomized clinical trial study. The statistical population included 52 patients who were candidates for cardiac electrophysiology study in Rasht. They were divided into two groups of intervention (n=26) and control (n=26) through simple randomization. Before and after the intervention, the Spiel Berger state anxiety inventory questionnaire was completed and their vital signs were recorded. For the intervention group, one day before and one hour before the electrophysiology studies, a guided audio visualization CD was delivered through headphones for 18 minutes.

The results showed that there were no significant differences between the two groups in mean blood pressure score, respiratory rate, body temperature, and heart rate before and after the intervention (p >0.05). The severity of hidden anxiety score was significantly different between the two groups after the intervention.  No meaningful difference was observed between the two groups in regards to the other variables such as obvious anxiety score before and after intervention and the hidden anxiety score before intervention(p >0.05).

Guided visualization was effective in controlling both open and hidden anxiety in patients undergoing the electrophysiology studies but had no effect on patient's vital signs.

Beta-thalassemia major is a very severe blood disease, its Clinical signs are premature and appear from 3 to 6 months of age. It is one of the most common monogenic diseases in the world and in Iran, and if it is not diagnosed and treated during the first years of life, it will lead to death. In this study, to check the factors affecting the survival of patients with beta-thalassemia major the semi-parametric Cox and parametric Weibull models were used and their efficiency was compared.

In this longitudinal retrospective study, using the available sampling method, data from 300 patients with beta-thalassemia major referred to Zafar's thalassemia clinic in Tehran during the years 1994 to 2017 were used. To compare the models and select the best model, we used the Akaike information criterion (AIC). Data analysis was performed using Stata software version 13.

The values of the Akaike information criterion (AIC) for semi-parametric Cox model and the parametric Weibull model were 277.600 and 107.211, respectively. Based on both Cox and Weibull models, the variables of blood transfusion, age of desferal and iron deposition in the liver were significantly associated with the survival of patients. Based on Akaike's criterion, the efficiency of the Weibull model was better than the Cox model.

Considering the obtained values, the parametric Weibull model is more efficient than the semi-parametric Cox model for survival analysis of patients with beta-Thalassemia major

The lung cancer is the third cause of death and also one of the five common cancers in Iran. In this study, the efficiency of semi-parametric Cox models and Weibull parametric models in order to evaluate the effective factors of survival time of patients with lung cancer were investigated.
This study was a prospective-cohort study in which the total number of 228 patients with lung cancer followed up from 1991-2007 and necessary information such as age at the time of diagnosis, gender, place of residence, education, residence status smoking, family history of cancer, province were collected from Babol cancer registry center. Then, these added to Cox and Weibull models as demographic factors. Akaike information criterion (AIC) was used to compare the efficiency of competing models.
In this study, 75% of cases were men and only 8% of patients survived until the end of the study. The 1, 3, and 5- year survival rates were 13, 8 and 8% respectively. Among the factors studied in the Weibull model, the effect of smoking on survival time was significant (p0.05). However, AIC suggested higher efficiency for parametric Weibull model.
In spite of the importance of the Cox model is as a more common method by researchers, this study showed that the Weibull model is more efficient in survival data analysis. According to the results of this study smoking prevention is necessary to increase the longevity of patients with lung cancer.

Coronary artery disease (CAD), is a leading cause of mortality and morbidity in the world and more focused among the researchers. For this reason, novel risk factors for CAD, such as serum iron in the form of serum ferritin levels have been emphasized. Excessive serum iron can increase risk of CAD by the production of free radicals and incorporation into lipid peroxidation.
To investigate the relationship between serum ferritin level and severity of obstructive CAD.
This analytical cross-sectional study was conducted on 400 patients with CAD, referred to Rasht Heshmat Heart Hospital from September of 2014 to March of 2015. Demographic information, serum ferritin level with other blood markers was collected before angiography and the severity of vessel involvement was evaluated afterwards. Data analysis was done using Mann-Whitney, Kendall tau and Spearman correlation coefficient tests.
The median age of patients was 58 years and 56% were male. The median of serum ferritin level in women and men was 74 and 95 µg/dl, respectively (p.05 for all)
In this study, no significant relationship was observed between serum ferritin level and severity of obstructive CAD. Further investigations are needed to consolidate the finding.

Background and objectivesDrug resistance is a common cause of treatment failure in malignant disorders especially hematological malignancies. Overexpression of P-glycoprotein (pgp) is the most common cause of drug resistance. Studies on the importance of pgp are controversial that is attributed to the lack of a standard method for pgp assay and the lack of consistency with clinical data. The aim of this study is Multiple drug resistance (MDR) evaluation according to pgp expression in leukemic cells at the beginning of treatment, and prediction of responses to treatment, relapse or death. Materials and MethodsBetween June 2001 and May 2006, we studied 185 leukemic patients. Diagnosis was performed on each case via morphology, based on immunotypes, and by cytogenetic method; pgp expression was also evaluated by flowcytometry. For pgp evaluation, we collected peripheral blood or bone marrow samples in EDTA. Then, patients went under treatment by standard protocols and their responses to treatment were observed. Patient follow ups for response to treatment, complete remission, resistance to induction, relapse or death were conducted. Finally, clinical data were compared with laboratory results. Mann-Whitney, kruscal-valis, kaplan-meier, and chi-square tests were used for data analysis. ResultsFrom 185 patients with the median age of 28.5 years (within the age range of 11-76), 128 patients showed AML and 57 ALL. 62% were male and 38% female. Pgp expression showed no significant correlation with age, sex, type of leukemia, and white blood cells count. There was no significant association between pgp expression and AML subtype. Two-year Overall Survival (OS) and Disease Free Survival (DFS) were 63% and 42% respectively. DFS showed significant correlation with pgp in ALL and non-M3 subtype of AML (P=0.024). Conclusionsexpression of pgp would be a prognostic factor for relapse prediction and might be important in treatment planning.