رمضان فلاح

Improving the self-management of hypertension treatment in patients with Transient Ischemic Attack (TIA) is effective in reducing the incidence of stroke in these patients. The aim of the present study was to investigate the effect of education based on the health belief model on improving self-management behaviors of high blood pressure in patients suffering from transient ischemic attack.

In this semi-experimental study conducted as a pre-test-post-test with intervention and control groups, 54 eligible patients were selected by convenient sampling method and randomly assigned to intervention and control groups. Self-management educational interventions based on the health belief model were conducted for the interventional group during three sessions. The control group received routine interventions. Data were collected using self-management and health belief standard questionnaires before and three months after the intervention. Data were analyzed by SPSS version 16 statistical software.

The results of the study in relation to demographic and background characteristics showed that before the intervention, both intervention and control groups were homogeneous in relation to all variables except body mass index. Also, the results showed that after the intervention, the mean scores of self-management and health belief between the intervention and control groups had a significant difference (p<0.001). Also, the findings showed that despite the fact that the average blood pressure reduction in the intervention group was more than the control group, there was no statistically significant difference between these two reductions.

Based on the findings of the research, education based on the health belief model is an effective educational method in improving self-management of blood pressure in TIA patients. Therefore, it is recommended to implement education based on the health belief model to strengthen self-management behaviors in these patients.

The COVID-19 pandemic has caused numerous psychological problems, especially anxiety, in patients with diabetes as a group with increased risk of contracting COVID-19. Patient education in this area can be a good way to reduce the psychological burden of these patients. This study aimed to determine the effect of patient education through social media on the COVID-19-related anxiety in patients with diabetes.

This is a single-blind clinical trial, in which 113 patients with diabetes were recruited using convenience sampling and then divided into two groups of experimental (n = 58) and control (n = 55) using simple random allocation. Data were collected using a demographic questionnaire and Corona Disease Anxiety Scale (CDAS). COVID-19-related patient education was provided for the intervention group at a two-week period, while the control group only received routine care. Data were entered into SPSS software version 26 and then analyzed using descriptive and inferential statistics.

There was no statistically significant difference in terms of demographic characteristics and the mean score of COVID-19-related anxiety between the two groups before the intervention (p > .05). This difference in the mean score of COVID-19-related anxiety was not found to be significant between the two groups after the intervention (p > .05). There was also a statistically significant difference between the mean score of COVID-19-related anxiety at measurement points of before and after the intervention in the experimental group (p < .05).

Educational intervention through social network leads to a slight reduction in COVID-19-related anxiety in diabetic patients. Therefore, social media is suggested as a suitable and accessible method for COVID-19-related patient education.

In today's world, with the advancement of technology, hand tools that required the physical strength of the body have given way to electric and pneumatic tools. Despite all the advantages that these tools have, there are many limitations and problems due to their use for people, including sound and vibration. Most different machines and tools produce vibrations in varying proportions, the forces and effects of which are transmitted to the body through the hands called hand-arm vibration (HAV) 1. These vibrations can cause cardiovascular, neurological, or skeletal disorders in the upper extremities. Hand-transmitted vibration (HTV) 2 can also lead to peripheral neuropathy syndrome, whose symptoms include numbness, impaired sensory perception (tremor, cold, heat, pain), and loss of hand skills. Another complication of hand-arm vibration is blood vessel spasm, which is a clinical manifestation of the white finger phenomenon and varies depending on the intensity and duration of hand contact and the amount of hand-arm vibration. This study was performed in heavy machine puncture workshops. In punctures, workers use an Impact wrench to unscrew and tighten the machine wheel bolts. Using this wrench exposes operators to sound and vibration. The aim of this study was to Evaluation of workers' exposure to hand-arm vibration of impact wrench in heavy vehicles puncture shops and providing control

This study was conducted with the participation of 20 employees of heavy vehicles puncture workshops who worked in different workshops with different Impact wrenches and were randomly selected. At first, the personal Demographic of the employees such as age, work experience, height, weight and level of education and the characteristics of the Impact wrench including weight, power, function life and manufacturer were recorded. Hand-arm vibration measurement GA2003 HARM VIBRATION METER made by CASTEL with a piezo electric T-shaped sensor was used to measure hand-arm vibration. Measurements were performed on the X, Y and Z axes according to ISO 5349-1. The effective vibration acceleration was measured in RMS mode and using a HARM filter. Then the effective total value vibration acceleration was calculated using Equation 1.Equation(1) ahv: total value effective vibration acceleration ( (   ahwx: X-axis effective vibration acceleration ( (  ahwy: Y-axis effective vibration acceleration (  ahwz:  Z -axis effective vibration acceleration ( ( 1. Hand Arm Vibration    2. Hand Transmission Vibration Image (1).  Pneumatic wrench on the left, a worker using it on the right There are about 10 screws in each wheel of heavy machinery, considering that the time required to open and close the screws of a wheel is 3 minutes, and considering the average number of wheels that can be opened and closed by one person during a day ( 20 wheels per day) The average exposure time was calculated as 1 hour, then using Equation No. 2, the effective acceleration equivalent to 8 hours of exposure per person was calculated and the results were compared with the allowable occupational exposure threshold of the country. Equation (2) A (8): the amount of effective vibration acceleration is equivalent to daily exposure  ahv: the total value effective vibration acceleration T: the vibration exposure time T0: the base time which is 8 hours per day.

Mean personal Demographic including age, work experience, weight and height were 36  8.97 years, 10.55  7.52 years, 10.86 kg and 175  4.9 cm, respectively. The mean characteristics of pneumatic wrenches including torque (power), weight and function life were 2750 N/M, 13.7  2.04 Kg and 1.45  1.05 years, respectively. 50% of the wrenches belonged to Genius Company, 25% to TAITIAN Company and 25% to other companies. The maximum effective acceleration measured in the front handle of the Impact wrench was 20.35  on the Z axis. The mean effective acceleration of vibration in the front handle on the X, Y and Z axes was 16.95  8.98 , 18.35  6.93  and 20.35  10.39 , respectively. Also, the total value of the effective vibration acceleration for the front handle was 32.34 14.88 . Measurements performed on the rear handle of the Impact wrench showed that the total value of effective vibration acceleration for the rear handle was 45.22  21.99 and the maximum effective acceleration measured was 28 on the Z axis. The mean effective acceleration of hand-arm vibration in the rear handle of the Impact wrench in the X, Y and Z axes was 22.85  12.79 , 25.2  8.78 and 28 15.9 , respectively.The mean effective vibration acceleration obtained after using felt in the tool handle on X, Y and Z axes was 7.1  1.33 , 8.25  1.69  and 7.2 ± 2.1 , respectively. The Vibration total value of effective acceleration of three-way vibration after using felt was 13.27  2.57 . The maximum vibration reduction was related to the Z axis. The mean effective vibration acceleration obtained after using elastomer in the Impact wrench category in X, Y and Z axes was 14.45  6.06 , 17.15   6.68 , 14.45  6.06 , respectively. The mean Vibration total value of effective three- axes vibration acceleration after elastomer use was 29.21  10.76 .The mean vibration acceleration of the 8-hour exposure of the Impact wrench with the exposure time of 1 hour per day is 16.38  7.58 and is higher than the allowable occupational exposure limit (5 ). The mean effective vibration acceleration of the 8-hour exposure after using felt whit Exposure time of 1 hour per day was 4.67  0.887 which is less than the allowable daily exposure limit and more than the action limit (2.5 ). The mean effective vibration acceleration of exposure 8 hours after elastomer use was 10.18  3.78, which is higher than the occupational exposure limit. effective vibration acceleration is equivalent to 8 hours of exposure  Comparison of the means of the three modes of the total value of effective vibration acceleration of Impact wrench vibration, the total value of effective vibration acceleration after felt application and the total value effective vibration acceleration after elastomer application in Impact wrench handle, showed that the reduction of effective hand-arm vibration acceleration by using felt and elastomer in Impact wrench is significant (P <0.05). Also, according to the obtained results, felt is more efficient than elastomer and reduces the effective acceleration of hand-arm vibration to a greater extent, which is also a significant reduction of vibration (P <0.05). Graph of changes in mean effective vibration acceleration Evaluation of the relationship between Impact wrench vibration total value with power (torque), weight and function life variables showed that there is a significant relationship between power (torque), Impact wrench and hand-arm vibration total value (p <0.05) and As the power increases, the vibration rate increases. But there was no significant relationship between the variables of Impact wrench weight and function life with the total value of effective acceleration of hand-arm vibration caused by Impact wrench.

The aim of this study was to evaluate the exposure of heavy machinery puncture workshop workers to hand-arm vibration caused by Impact wrenches and to provide control strategies. According to the results, the amount of hand-arm vibration caused by the Impact wrench is more than the allowable occupational exposure limit of the country and the highest vibration is in the rear handle of the Impact wrench and in the z axis (28). It is effective and increases the amount of hand-arm vibration by increasing it. The use of felt and elastomer in the Impact wrench category significantly reduced hand-arm vibration.The most effective acceleration of the hand-arm vibration was in the rear and front handles of the Impact wrench in the Z axis. The Z direction is along the length of the hand (from the fingertips to the arm) and when working with an Impact wrench is the maximum force and pressure applied to the back, i.e. in the direction of the hand. Therefore, most of the vibration is in the Z direction and in the same direction as the force generated by the Impact wrench.The maximum reduction in hand-arm vibration was by using felt on the Z axis and the maximum reduction was by using elastomer on the Y axis. Felt reduced by 70% and elastomer reduced by 43% the effective acceleration of hand-arm vibration caused by the Impact wrench. Although the results of repeated measures statistical tests showed that both coatings used in the Impact wrench handle significantly reduce hand-arm vibration caused by the Impact wrench, but the use of felt due to higher efficiency and the greatest reduction in hand - arm vibration in the Z axis (the maximum amount of vibration is caused by the Impact wrench in this axis) Can have a greater effect in reducing hand-arm vibration.According to the obtained results, the power or torque of the Impact wrench affects the vibration of the Impact wrench and with increasing torque, the amount of hand-arm vibration also increases. Statistical analysis by linear regression method also showed a significant relationship between Impact wrench strength and effective vibration acceleration (P <0.05), but there was no significant relationship between vibration and two variables of weight and function life. The amount of use of the Impact wrench during its function life is important and with the increase of the operating time of the Impact wrench, its power decreases so that in some cases it does not have the necessary efficiency to open and close the screws and employees are forced to change their Impact wrench. On the other hand, it is possible to increase the vibration rate by increasing the function life of the Impact wrench and the Depreciation of its parts. It seems that these two issues, i.e. increasing the Depreciation of parts and decreasing the power of the Impact wrench, neutralize the effect of each other on the resulting vibration. As a result, increasing the function life of the Impact wrench does not have a significant effect on hand-arm vibration.

In heavy machine puncture workshops, the level of daily occupational exposure of employees with hand-arm vibration caused by Impact wrenches is higher than the allowable occupational exposure of the country. The use of felt in the handle of the Impact wrench reduced by 70% and the elastomer reduced the vibration of the hand-arm by 43%, so the use of elastomer coatings and especially felt in the tool handle can be a good way to control the effective acceleration of hand-arm vibration.

Bus drivers, like other drivers, are prone to unsafe behaviors. Accidents are related to driver misbehavior. Because traffic accidents in intra-city and intercity routes are different, at least part of it may be related to driver behavior. The aim of this study was to compare the dangerous driving behavior intra-city and intercity bus drivers.

This descriptive-analytical study was performed on 107 intra-city bus drivers and 99 intercity bus drivers in the city of Zanjan using demographic characteristics questionnaire and Dula Dangerous Driving Index. Finally, after data collection from tests t-test, chi-square and multiple linear regression were used in SPSS19 environment at a significance level of 0.05 for statistical analysis.

The average weekly working hours of intra-city bus drivers are significantly higher than intercity bus drivers (p < 0.05). Also, the average of dangerous driving index and its factors, except for aggressive driving, were higher in intra-city bus drivers than intercity bus drivers (p < 0.05). In addition, the variable of weekly working hours had a negative effect on the score of RD in the intra-city drivers. Whereas it has a positive effect on NCED and DD in the intercity bus drivers (p < 0.05).

despite the lower number of fines and deaths on intra-city routes, it is necessary to take more serious control measures for risky behavior driving. These measures can include developing intervention programs to manage bus driverschr working hours to reduce fatigue, as well as raising driverschr  awareness for less risky driving behaviors.

Respect for patientschr('39') privacy is especially important in the emergency department. The present study was conducted to determine the relationship between the moral intelligence of emergency personnel with the level of respect for patient privacy in the emergency departments of hospitals affiliated to Zanjan University of Medical Sciences, Iran.

In this cross-sectional study, 154 patients and 77 emergency department staff participated by convenience sampling method. Demographic, moral intelligence and patient privacy questionnaires were used to collect data. Data were analyses by SPSS software version 16.

The mean age of employees was 34.04±7.6 years (range 24-54 years old), and the mean age of patients was 38.8±13.4 years (range of 18-76 years old). Employeeschr('39') moral intelligence was 76.96±8.42 and was in a good category. Also, the level of respect for patient privacy in the emergency departments was 85.63±13.88 and was in the moderate category. There was a significant and inverse relationship between employees’ moral intelligence with patientschr('39') physical privacy (r=-0.226) (p=0.048).

Considering the moderate level of respect to patient privacy in the emergency departments in the present study, it seems that in addition to the lack of staff information in this regard, the factors affecting it needs to be studied and paid special attention.

This study investigated the effect of perceived social support on the happiness of the wives of Zanjan physical veterans.

This is a descriptive correlational study. 188 wives of physical veterans with a percentage of 40% and above were selected by simple random sampling. Data were collected through Oxford and Zimet questionnaires and analyzed by multivariate regression in SPSS 25 software.

The age group of 45 to 54 years, with 60.6%, had the highest frequency. 55.9% of veteranschr('39') wives’ happiness level was high, 41% moderate, and 3.2% low. Among the happiness components, the lowest mean was related to the aesthetic (1.85) and the highest to self-efficacy (2.27). 78.72% of veteranschr('39') wives reported high perceived social support, 15.50% moderate, and 5.85% low. The highest averages were obtained from family (4.02), community (3.92), and friends (2.91), respectively. There was a significant relationship between the components of happiness and perceived social support (p<0.05). The results showed that the correlation coefficient of social support components with happiness (MR=0.443 and RS=0.96) was significant (p<0.00), and 19.6% of the variance of happiness is explained by the dimensions of perceived social support Among the three types of social support, only family support was predictive of happiness (p<0.00).

Family support plays a major role in the happiness of physical veterans’ wives.

Depression has been assumed as a prevalent disorder of the era. Depression cannot be attributed to a particular social class. Factors such as incompatible situations may lead to mental disorders and affect physical immunity. This study was carried out to investigate the prevalence of depression among the staff of Zanjan University of Medical Sciences.

This study was of cross-sectional type study whereby 693 subjects were selected through classified randomized sampling. The rate of depression incidence was obtained using Standard Beck Questionnaires. The data was analyzed by Chi-2 tests and cohesion indexes of Kramer and Gama were also used.

According to the results of this study 40% of the personnel were suffering from depression. They were identified as 23% with low depression, 13% with moderate depression, and 4% with severe depression. A significant correlation was found between depression and education level, type of settlement, and city where they worked.

Regarding the widespread prevalence of depression among the staff, planning and organization of consultation sessions by the authorities is suggested.