محبوبه رسولی

One of the reasons for leaving the job among nurses can be the lack of career adaptability, which refers to ability to cope with changes in working conditions. This study aims to determine the relationship between career adaptability and the intention to stay in job among nurses working in critical care units of teaching hospitals in Tehran, Iran.

This is a descriptive-correlational study with a cross-sectional design that was conducted in 2022-2023 in critical care units of seven hospitals affiliated to Iran University of Medical Sciences. Participants were 220 nurses working in these units with at least 6 months of work experience, who selected by a stratified sampling method from different working shifts. Data collection was done online using a demographic form, the career adapt-abilities scale (with four dimensions of concern, control, curiosity, confidence), and an intention to stay in job questionnaire (with three dimensions of adaptation, sacrifice, communication). Descriptive statistics (Mean±SD, frequency, percentage) were used to describe the data, while Pearson’s correlation test and regression analysis were used to assess the relationships between the study variables.

The mean total score of career adaptability was 2.98±0.98 and the mean total score of intention to stay was 3.02±1. Among the dimensions of career adaptability, the highest average was related to concern (3.05±1.14) and the lowest score was related to curiosity (2.92±1.09). Among the dimensions of intention to stay, the highest score was related to sacrifice (3.06±1.09) and the lowest score was related to adaptability (2.98±1.1). A positive and significant relationship was found between career adaptability and the intention to stay in job (r=0.43, P<0.05). 

Career adaptability, especially its curiosity dimension, has a significant relationship the intention to stay in job among nurses working in critical care units. By addressing different dimensions of career adaptability in nurses, hospital managers can be able to safeguard nurse retention in hospitals and mitigate nurse turnover.

In today's era, when the country is involved with the coronavirus disease and the recent incidents and events have increased the number of people visiting hospitals, and according to the results of the studies, nurses experience more work pressure and stress. Due to the nature of their work, they are more exposed to psychological harm, so it is necessary to examine their post-traumatic growth and by knowing this, we can promote the strengthening factors of nurses as much as possible. In this direction, we conducted a study regarding the assessment of post-traumatic growth in nurses caring for children with covid-19 disease.

This study was descriptive research. The research population was nurses working in children's departments of teaching hospitals affiliated with Iran University. The samples were selected using census sampling. The researcher attended the hospital in different shifts, introduced himself to the nurses, explained the research objectives, and asked if they were willing to participate in the study. The participants signed the consent form. The approximate duration of answering the questionnaires was 1 to 20 minutes. After collecting the data, it was analyzed using SPSS ver. 20.0 software. The significance level was considered 0.05.

In this study, 168 nurses, including 157 women and 11 men, were included. The mean score of the post-traumatic growth scale in nurses working in the children's department during the COVID-19 pandemic was 49±23.21, which is lower than the average of the tools used and shows that post-traumatic growth in nurses working in the pediatric department is low. Nurses received acceptable and lower scores in the dimensions of personal strength, spiritual change, and facilities, and they had the highest score in the dimension of valuing life. The results showed no statistically significant difference between the mean score of post-traumatic growth in different demographic variables; only the difference between the mean score of the component of spiritual change in the group of different ages and work histories was found to be statistically significant.

The present study's mean score is lower according to the distance between the post-traumatic growth score and the total score. This group is vulnerable and needs more comprehensive measures and investigations. Considering the continuity of contact with cases of illness, nursing managers must investigate and address this issue to promote and facilitate this phenomenon and develop counseling and psychological sessions to improve the mental health of nurses.

The most important factors for the development of any society are human resources. The intensive care units (ICUs) are the most important departments in the hospitals. Considering the importance of time management for patient care, lack of human resources in this profession, and the fact that nurses spend a lot of time on indirect and non-nursing works, this study aims to investigate the time and type of indirect patient care provided by nurses in the ICU of a hospital in Iran during the COVID-19 pandemic.

This is a descriptive, cross-sectional, and observational study that was conducted for 6 months. Participants were 42 nurses working in the ICU of Hafte Tir Hospital in Rey, Iran who were randomly selected from different shifts. Their activities were observed and their spent time was recorded by the researcher using the stopwatch mobile application. The data collection tool was the Persian version of the International Classification for Nursing Practice (ICNP) checklist with acceptable face and content validity according to opinions of a panel of experts (5 faculty members and 10 nurses). descriptive statistics (frequency, mean, standard deviation, minimum, and maximum) were used for data analysis by SPSS software, version 22. 

Most of nurses (60%) were in the age group of 30-39 years and 72% of them had a work experience of 11-20 years. Most of the nurses were female (85%) and married (80%). In each shift, nurses spent an average time of 247 minutes providing indirect care. The longest time in indirect care was related to writing nursing reports (34.9 ± 10.5 min per shift) and the shortest time were related to removing personal protective equipment (6.11±3.19 min per shift), consulting with a colleague, and wearing personal protective equipment (both with 7±3.55 min per shift).

Although patients need direct care and continuous presence of the nurse more during the COVID-19 pandemic and there are advanced equipment. To provide proper nursing care, it is important to increase the number of nurses and reduce their non-nursing activities.

Embryo donation, so to speak, is the transfer of the embryo resulting from the extrauterine insemination of the third couple's sperm into the applicant's womb, who for some reason is not capable of reproduction. Mutual respect is spoken, but an important issue such as the confidential relationship that is created as a result of this donation has remained silent, which can cause problems in the future. According to medical theories, the origin of the embryo is egg and sperm, so there is no doubt in assigning the donated embryo to the donor couple, but what is the subject of question and controversy is the relationship that the donated embryo has with the donor couple, or in other words, their biological parents. This article, which is written with a descriptive and analytical method, examines different theories and it is concluded that among the different jurisprudential and medical theories, the theory that the child is basically attributed to the donor couple, but in the case of the donor couple The recipient is in the status of a foster child in relation to the woman who owns the uterus and in the status of her godmother in relation to the husband of the woman who owns the womb; It is the most acceptable theory.

The research method is descriptive-analytical using library resources.

Ethical Considerations: 

In the upcoming research, it has been done by maintaining the originality of the content and respecting the principle of fairness and trustworthiness.

In this article, it can be seen that according to medical theories, the origin of the embryo is the egg and sperm. Therefore, there is no doubt in assigning the donated embryo to the donor couple, but what is the subject of question and dispute is the clarification of the legal position of the parties (donor and recipient) in this legal act and the legal relationship between the donor couple and the donor couple as a result of the legal act of donating the donated embryo. Or, in other words, the parents find their birth certificate, which recognizes the fetus as a gifted object, the one who gives the fetus is the donor and the one who receives the fetus is the one who receives the fetus.

Among the different jurisprudential and medical theories, this theory that basically the child is attributed to the donor couple, but in the case of the donor couple, the woman who owns the womb is considered as a foster child and the husband of the woman who owns the womb is considered as her foster child, among all the theories. This theory is the most acceptable theory.

Infant hospitalization in the intensive care unit is a psychological crisis for the family that causes stress and disability for the family. In critical situations, the knowledge of the healthcare team is devoted to patient care, while it is necessary to emphasize the needs of the family. This study aims to determine the impact of family-centered empowerment model on quality of life of premature infants parents’ were admitted to the neonatal intensive care unit.

This quasi-experimental controlled study was performed on 84 parents with preterm infants admitted to the intensive care unit. Samples were continuously targeted in both intervention and control groups. They received training sessions in four steps and 8 sessions. The ability of the subjects was also assessed by the competency questionnaire (including three dimensions; threat perception, self-efficacy and self-esteem). Demographic questionnaire, and WHOQOL-BREF quality of life questionnaire once at the beginning of the study and again one month after completion. Intervention sessions were completed and the data were analyzed using Chi-square, independent t-test, analysis of variance and Spearman and Shapiro-Wilk correlation coefficient using SPSS software.

There was no significant difference between the two groups in terms of demographic characteristics and baseline competency scores (self-efficacy, self-esteem, severity and sensitivity) and quality of life. Comparison of total quality of life score (P=0.041) in the intervention group was significantly higher than the control group. In-group comparison, empowerment scores [self-esteem, self-efficacy (P<0.001)] of both groups and intensity and sensitivity scores (P<0.001) showed a significant increase only in the intervention group. In terms of quality of life, in the psychological dimension (P=0.042), social (P=0.003), environmental and total scores (P<0.001) in the intervention group and in the total score dimension (P=0.41) There was a significant increase in environmental performance (P<0.001) in the control group.

 The family-centered empowerment model has improved some quality of life factors. , But further studies are needed to reach a definitive conclusion in this regard. It is suggested that future researchers strengthen the family-centered empowerment program in less effective dimensions. Further studies should also be performed on the use of family-centered empowerment program to empower pregnant women with the possibility of preterm delivery and its effectiveness after delivery.

Embryo donation, so to speak, is the transfer of the embryo resulting from the extrauterine insemination of the third couple's sperm into the applicant's womb, who for some reason is not capable of reproduction. Mutual respect is spoken, but an important issue such as the confidential relationship that is created as a result of this donation has remained silent, which can cause problems in the future. According to medical theories, the origin of the embryo is egg and sperm, so there is no doubt in assigning the donated embryo to the donor couple, but what is the subject of question and controversy is the relationship that the donated embryo has with the donor couple, or in other words, their biological parents. This article, which is written with a descriptive and analytical method, examines different theories and it is concluded that among the different jurisprudential and medical theories, the theory that the child is basically attributed to the donor couple, but in the case of the donor couple the recipient is in the status of a foster child in relation to the woman who owns the uterus and in the status of her godmother in relation to the husband of the woman who owns the womb; It is the most acceptable theory.

The research method is descriptive and analytical using library resources.

Ethical Considerations:

 In the upcoming research, it has been carried out by maintaining the originality of the content and respecting the principle of fairness and trustworthiness.

In this article, it can be seen that according to medical theories, the origin of the embryo is the egg and sperm, so there is no doubt in assigning the donated embryo to the donor couple. But what is the subject of question and controversy is the relationship that the donated embryo has with the donor couple, or in other words, their biological parents.

Among the different jurisprudential and medical theories, the theory that basically the child is attributed to the donor couple, but in the case of the donor couple, the woman who owns the womb is considered a foster child and the husband of the woman who owns the womb is considered an alien to him; It is the most acceptable theory.

This study aimed to determine the relationship between health literacy and self-care of hypertension among firefighters in Tehran.

This cross-sectional study, which conducted in among 360 male firefighters, age of 18-60 years, working in the Tehran Fire Department in year 2019 was performed by two-stage sampling method in cluster and simple random. Data were collected through demographic form, Health literacy for Iranian adult questionnaire (HELIA) and researcher-made self-care checklist for hypertensive disease. Data were analyzed in SPSS (version 22) using descriptive methods and, analytical tests.

57.5% of people were in the age group of 30-40. The mean score of health literacy was 73.96 with a standard deviation of 3.8. The highest mean score of health literacy was related to information perception and the lowest average score was related to reading skills. Among study sample, 44.2% had “good” and 26.7% had” very good” health literacy. Also, the mean score of self-care behaviors was 19.23 with a standard deviation of 3.4. About 14.4% of employees had a mean score of good self-care. There was a direct and significant correlation between health literacy and self-care (r= .36 [m1] , p <0.001[m2] ).

Health literacy and self-care behaviors weren’t favorable. There was a significan[93] t positive correlation between health literacy and self-care. Therefore, it is necessary to design an appropriate intervention.

Despite advances in health care in developed and developing countries, including Iran, there are still high rates of children suffering from diarrhea and serious complications. In this regard, mothers' self-efficacy in preventing, controlling, and treating diarrhea is very important. The aim of this study was to determine the self-efficacy of mothers of children aged one to five years in the field of diarrhea prevention in kindergartens in Qazvin in 1399.

In this cross-sectional descriptive study, 400 mothers with children aged 1-5 years in kindergartens in Qazvin were selected who met the inclusion criteria including minimum writing literacy, physical and mental health. sampling was done randomly- cluster and in two stages. A total of 20 kindergartens and then 20mothers were selected from every home. To collect data the form of demographic and The Maternal Self-Efficacy Scale for Preventing Early Childhood

 In this study, the average maternal self-efficacy score in the prevention of diarrhea in children was( 11/8)± 47/104, which was below the bottom range. there was no significant correlation between the age of the mother, the level of education, the economic situation and the number of children and mothers, and their self-efficacy score.

 The low self-efficacy of mothers of children in this study indicates the need for planning to implement educational programs for mothers.
it is suggested that this study should be done in other cities of the country to be able to reduce the incidence of diarrhea in high-risk age groups by developing a detailed atlas of mothers self - efficacy in the field of diarrhea.

Health literacy as one of the effective social components in community health needs special attention. This is especially important for mothers who are responsible for caring for their premature babies. Nurses, as the front line of communication with these mothers, are obliged to recognize and select effective methods to promote health literacy in this group. The aim of this study was to determine the effect of teach-back education on the health literacy level of mothers of premature neonates in the Neonatal Intensive Care Unit (NICU).

In this quasi-experimental study, 128 mothers with premature neonates who had referred to the NICU of hospitals affiliated to the Iran University of Medical Sciences were. Mothers were nonrandomly divided into experimental and control groups. In the experimental group, the educational needs of the mother were determined through the Parent Health Literacy Activities questionnaire. Then, education to the mothers was done in a teach-back approach. In the control group, mothers received routine care. Maternal health literacy levels in both groups were assessed before and three months after discharge.

There was no significant difference between the two groups in terms of demographic characteristics (P<0.05). There was no significant difference between the two groups in terms of health literacy score before the intervention (P=0.372). However, the health literacy score was higher in the experimental group compared to control group three months after the intervention (P<0.001). In addition, there was a significant difference in the health literacy score before and three months after the intervention in the experimental group (P<0.001). In the control group, there was no significant difference in terms of the health literacy score before and three months after the intervention (P=0.059).

This study showed that teach-back education improves the health literacy of mothers with premature neonates. Therefore, it is suggested that nurses use this educational method to improve the health literacy of mothers with premature neonates during discharge.

Congenital heart defects are one of the most common congenital anomalies and delay in their diagnosis causes a significant increase in mortality and complications. The aim of this study was to determine the frequency of congenital heart diseases using pulse oximetry in neonates born in hospitals of Golestan University of Medical Sciences.

In this cross-sectional descriptive study, 357 seemingly healthy infants born from June 2016 to September 2017 in hospitals affiliated to Golestan University of Medical Sciences underwent right hand and foot pulse oximetry. If the oxygen saturation level was less than 94% in the baby's right hand and foot, it was checked again one hour later and if the result was repeated, the baby was referred to a specialist for further testing. Correspondingly, neonates who exhibited positive results underwent a follow up 3 months after the primary pulse oximetry test. Findings were divided into descriptive sections (mean, standard deviation and frequency distribution table) and inferential including multivariate regression analysis then they were analyzed. The significance level was 0.05.

Out of 357 neonates, 341 had an oxygen saturation level above 94%. Among the 16 cases who had a blood oxygen saturation less than 94%, 14 cases exhibited an oxygen saturation level above 94% after a second examination. 2 cases had a saturation level of less than 94%. The results showed that from the 357 infantes both the cases that exhibited lower oxygen saturationhad (0.6%) suffered from mild ASD during the study and after the follow-up carried out after 3 months. There was also a significant and direct relationship between maternal non-smoking (P<0.005), absence of maternal heart disease (P<0.005) and maternal family, no history of maternal abortion (P = 0.005) and number of abortions (P = 0.011), Absence of stillbirth (P<0.005) and number of stillbirths (P<0.005) and absence of serious diseases of diabetes, thyroid and hypertension and having other minor diseases (P<0.005) with neonatal oxygen saturation level.

According to the results of the present study, which showed a significant and direct relationship between maternal variables and neonatal blood oxygen saturation, accurate history and clinical examination along with pulse oximetry can be considered as an important tool to identify congenital heart disease in infants.

Children and adolescents with cleft lip and / or palate (CL/P) need the long-term medical and rehabilitation services. They need services for solving problems related to their quality of life that was influenced by clefts. The aim of this study was to translate the quality of life adolescent cleft questionnaire and to assess its reliability and validity among Persian adolescents with cleft lip and / or palate.

In this descriptive-analytic study, 31 Persian – speaking adolescents with CL/P at the age range of 16 to 24 years and 31 age and sex matched healty adolescents, were participated. In this study the quality of life adolescent cleft (QoLAdoCleft) questionnaire was used. The QoLAdoCleft questionnaire was translated to Persian language and re-translated to English by two translators (forward/backward translation). The content validity and face validity were conducted.  Intraclass Correlation Coefficient (ICC) and Cronbach’s alpha were assessed for test-retest reliability and internal consistency, respectively.

The face validity of the quality of life adolescent cleft questionnaire and its content validity was good (CVI=0.74). Cronbach’s alpha coefficient was 0.95 that indicating good internal consistency, and ICC= 0.98 showed good test-retest reliability. There were statistically significant differeces between adolescents with clefts and healty adolescents in total scors of the QoLAdoCleft questionnaire (P= 0.001)

The comparison of the scores between study groups showed that the quality of life of adolescent with clefts was different from that of healty adolescents. The Persian version of the quality life of adolescent cleft questionnaire has acceptable validity and reliability.

The special role of health service providers in coping with the crisis is undeniable. However, there is lack of a research studying the crisis management of the operating rooms. The aim of this study was to evaluate the situation of crisis management in operating rooms of hospitals affiliated to Tehran University of Medical Sciences.

In this descriptive cross-sectional study, thirty –seven of operating rooms, affiliated to Tehran, Iran and Shahid Beheshti University of Medical Sciences were evaluated through observation and ask question based on WHO‏/PAHO standard checklist. All data were analyzed by SPSS software using descriptive and analytical statistical tests (Chi-square, Shapiro Wilk, and ANOVA).

According to the results of this study, the average score of structural status, non-structural factors and functional and managerial ability were 16.19± 3.49, 66.32± 15.98, 41.12 ±19.04, respectively, which reflect the medium level of preparedness for disaster management in the operating rooms of hospitals studied. The results of comparison between all three dimensions of crisis management showed that the highest average score of managerial safety and performance was related to operating room of hospitals affiliated to Shahid Beheshti University of Medical Sciences (P <0.05). There was not a significant difference in structural and non-structural dimensions among hospitals that were studied (P >0.05).

Based on the results of this study the disaster preparedness of operating rooms are moderate (medium) in structural, non-structural, and managerial-functional domains; thus necessary appropriate measures should be taken to enhance the preparedness of hospital operating rooms in these aspects of crisis management.

Improving the quality of education is based on recognizing the effective factors that require consideration of the views of the education authorities (professors and students).The purpose of this study was to explain and identify effective factors the quality of theoretical education of the Operating room from students and teachers viewpoints in Medical Sciences Universities of Tehran city.

The present study is a cross-sectional (descriptive-analytical) study. The statistical population includes students and faculty members of the operating room in Medical Sciences Universities of Tehran city.342 people were selected by census and stratified random sampling. A researcher-made questionnaire was used for data collection. Data were analyzed using Friedman tests,T-test and Mann-Whitney test in SPSS software.

In the ranking of the factors affecting the quality of theoretical education from the perspective of students and teachers, the highest average was related to the domain of teacher-related factors and the lowest to the domain of professional ethics and behavior. Among the components of each domain from the studentschr('39') point of view, the most important factor, properly evaluating the teaching and research activities of teachers and providing them with appropriate feedback And to Them, and from the Teacherschr('39') perspectives, interest and tendency toward field of study and ethics on the part of teachers and students. The mean scores of these components were significantly different between teachers and students (P<0.001).

The results show that from the perspective of students and teachers of the operating room, the role of teachers has a very significant effect on the quality of theoretical education.And It seems that to increase the quality of teaching in the operating room, it is necessary to consider the factors that lead to the improvement of the quality of the role of teachers. It also promoted the quality of the six fields discussed in this study.

Decades after the introduction of nanotechnology as a new field of research and production, the pace of development of this field has been remarkable. These advances have enabled nanomaterials to be used in various sectors and industries including electronics, optics, consumer goods, energy production and storage, soil and water conservation, as well as in medicine for therapeutic and diagnostic purposes. Worldwide sales of nanomaterials were $ 22.9 billion in 2013 and with annual growth of 19.8%, it is expected to reach US $ 64.2 billion by the end of 2019; Therefore, many economists consider the production and use of nanomaterials an integral part of future economic activities. These advances are due to the unique physico-chemical and biological properties of nanoscale materials. The large surface-to-volume ratio, size and surface characteristics of nanomaterials are the most important physico-chemical properties of them. The specific physico-chemical properties of nanomaterials have led them to show specific behaviors in interaction with biological systems; The most important of these behaviors are moving towards secondary target organs, poor clearance by macrophages, the ability to transmit through the axons of sensory neurons, and to reach intracellular structures such as mitochondria and the nucleus. These properties, in addition to their many applications, have also raised concerns about the potential effects of these substances on human health and the environment. These concerns have generated a large wave of research in the fields of nanomaterials safety, health and toxicology. Forecasts show that the number of staff exposed to nanomaterials will reach about 6 million by the end of 2020. Concerns are increasing day by day as the number of workers exposed to nanomaterials increases. In our country more than 200 companies are active in the field of production and using nanomaterials. These companies have received 517 nanoscale certification for their products, until January 2019. Their products are exported to 49 countries and 5 continents worldwide. The increasing growth of these activities in the country necessitates attention to the safety, health and environmental aspects of nanotechnology. According to what was said, this study aimed to investigate the relationship between the symptoms of employees of nanomaterials producing and consuming companies with chemical composition (as a factor affecting the type and severity of effects) and physical state (as an influencing factor on exposure) of the nanomaterials.

The present study is a descriptive cross-sectional study carried out in 2018 among employees of nanotechnology companies in Tehran. Specifications of the companies were provided by correspondence with the Ministry of Industry, Mine & Trade. Of the companies invited, 52 companies agreed to participate in the study. Staff symptoms were assessed using a nonspecific symptoms questionnaire. The questionnaire was designed and validated in a period of two months by a team of 19 experts in the fields of occupational health, occupational medicine, toxicology, medical nanotechnology and health education. The required information about the occupational characteristics, chemical composition and physical state of the nanomaterials used in the companies was also collected using the NanoTool method form. The questionnaire and the form were then emailed to staff exposed to nanomaterials. Staff inclusion criteria were "to have direct exposure to nanomaterials, that is, to produce or consume nanomaterials during their daily working processes" and "to have at least one year of experience". Of the 52 companies that agreed to participate in the study, 198 completed questionnaires and completed forms were received. Finally, data were analyzed using SPSS.22 software. Frequency distribution tables and Chi-squared test, Fisher exact test and Kruskal-Wallis test were used for this purpose.

The study of the characteristics of the subjects showed that their mean age was 33.76 (SD = 6.108) years; Their average work experience was 6.76 (SD = 5.217) years. Study participants were well educated, with 61.2% having a masterchr('39')s or doctorate degree. 49% (96) of the subjects were men and 51% (100) of them were women. Manufactured / consumed nanomaterials in companies were investigated in similar groups in terms of chemical composition (metal, metal oxide, carbonous and the others) and physical state (dry powder, suspension/ emulsion, paste/gel and the others). The results of investigating the frequency of symptoms of nanotechnology companies’ employees using nonspecific symptoms questionnaire showed that the frequency of some skin symptoms such as "redness", "itching" and "roughness" were 72.7%, 67.2% and 62.6%, respectively. the frequency of some respiratory symptoms were also high; "cough" (64.1%), "sneezing" (60.6%) and "sore throat" (60.1%). High-frequency ocular symptoms included "eye irritation" (66.2%), "itchy eyes" (28.3%), and "red eyes" (25.3%).Investigation of the correlation between the skin symptoms of the employees with the chemical composition and physical state of the nanomaterials used in the companies showed that the symptoms "skin roughness", "skin itching", "skin rash" and "hair loss" have significant correlation with the physical state of nanomaterials and "skin redness", " Skin darkness "and" skin rash" have significant relationship with the chemical composition of nanomaterials. Investigation of the relationship between employeeschr('39') gastrointestinal symptoms with the chemical composition and physical state of the nanomaterials used in the companies showed that the symptoms "appetite suppression", "thirst", "nausea/vomiting" and "darkness of stool color" have significant relationship with the physical state of nanomaterials and "thirst", "Nausea/vomiting" and "inability to detect taste" have significant relationship with the chemical composition of nanomaterials. Evaluation of the relationship between neurological symptoms of staff with the physical state and chemical composition of nanomaterials showed the significant relationship between "movement problems" and chemical composition of nanomaterials. Also, "dizziness" and "sleeplessness/wakefulness" were significantly associated with both the chemical composition and the physical state of the nanomaterials. Investigating the relationship between the chemical composition and physical state of the nanomaterials with the respiratory symptoms of staff revealed "shortness of breath", "wheezing", "chest heaviness", "difficult breathing", "increased phlegm" and "voice change" significantly correlated with Both the chemical composition and the physical state of the nanomaterials. "Cough" was also significantly associated with the chemical composition of the nanomaterials. Examination of the correlation between ophthalmic symptoms and chemical composition and physical state of nanomaterials indicated that the symptoms "blurred vision" and "visual impairment" were significantly correlated with the chemical composition of the nanomaterials. Also, "increased eye gum" and "red eyes" were significantly associated with both the chemical composition and the physical state of the nanomaterials.

Given the frequency of symptoms in staff exposed to nanomaterials, their statistical association with the chemical composition and physical state of nanomaterials, Staffchr('39')s attitude toward nanomaterials that are generally considered safe, inadequate and generally inappropriate use of personal protective equipment appropriate to work with nanomaterials and lack of education and training about the effects of nanomaterials on health and the environment, existing these problems among the employees of these companies are reasonable and that is an important issue. Therefore, the following are suggested to reduce occupational exposure to nanomaterials: Provide adequate training to the staff of these companies in the areas of basic concepts of nanosafety, standard work procedures when working with nanomaterials, appropriate personal protective equipment for working with nanomaterials and using them properly and waste management of nanomaterials.

Heart failure is a prevalent, chronic disease in developing country, and type II diabetes mellitus is considered to be a major cause of heart failure. An effective approach to the control of these diseases is the active participation of patients in self-care. However, the concurrence of heart failure and diabetes is associated with complex and difficult self-care behaviors. Therefore, it is essential to identify the influential factors in self-care behaviors. The present study aimed to assess the correlations between self-care behaviors and anxiety, family support, and disease state in patients with heart failure and type II diabetes. 

This descriptive-correlational study was conducted on 158 patients with heart failure and type II diabetes mellitus referring to Chamran Hospital in Isfahan, Iran in 2018. The patients were selected via continuous sampling. Data were collected using the European heart failure self-care behavior scale, Charlson comorbidity index, mini-mental state examination social support (family scale), Spielberger state-trait anxiety inventory, and a demographic questionnaire. Data analysis was performed in SPSS version 16 using descriptive statistics (frequency, frequency percentage, mean, and standard deviation) and inferential statistics (t-test and analysis of variance).

The majority of the patients (88.6%) had moderate self-care behaviors, with the mean score estimated at 38.37 ± 4.76. No significant correlations were observed between the demographic characteristics of the patients, their disease state, family support, and anxiety with self-care behaviors (P>0.05).

According to the results, investigations must continue on the influential factors in self-care behavior in order to change the attitudes of patients in this regard, so that heart failure and type II diabetes could be controlled and their complications could be prevented.

Nowadays, using nanomaterials is provided in various fields of science and technology due to their unique size and characteristics. On the other hand, these unique properties have created many concerns about the potential effects of nanomaterials on human and the environment. Occupational exposure is the most important way of human exposure with nanomaterials. Therefore, this study was conducted to investigate the symptoms of the workers of the nanotechnology companies in Tehran.

At first, a non-specific symptom questionnaire was designed and validated by a group of specialists. Then, nanotechnology companies were identified and questionnaires were provided to the employees of these companies. Finally, the data were analyzed using SPSS.22 software.

The results showed that the designed questionnaire had a good validity and reliability for the study. The average age of employees was less than 34 years and the average working experience was less than 7 years, indicating Newness of nanotechnology in the country. The results showed that the frequency of skin symptoms (such as roughness, itching and redness), respiratory symptoms (such as coughing, sneezing and sore throat) and ocular symptoms (such as burning, itching and redness) are relatively high among the workers of the nanotechnology companies.

Because the results indicated that the frequency of some of the symptoms were high among the workers of the companies under investigation, it is necessary to use control measures to reduce the exposure and contact of the workers with nanomaterial.

The aim of this study was to determine the relationship of family members’ health literacy and performance in face of myocardial infarction.

Myocardial infarction is one of the most important causes of death and disability in developed and developing countries. Proper performance of patients' attendance in early hours of myocardial infarction event plays an important role in reducing mortality and morbidity. Health literacy is also known as one of the major determinants of understanding information about health.

In this descriptive-correlational study, 286 family members of patients experiencing myocardial infarction that witnessed the vent were recruited in the study by convenience sampling method and based on inclusion criteria of reading and writing literacy and age over 18 years old. Data were collected using a demographic form, Iranian adult health literacy questionnaire (HELIA) and the questionnaire performance during myocardial infarction. Data were analyzed in SPSS version 22 using descriptive statistics (frequency distribution, mean, standard deviation) and inferential statistics (mean comparison, correlation and regression tests).

Health literacy mean score (61.49±21.05) showed an adequate level. “Assessment skills” and “decision making and application of health information” had, respectively, the lowest (52.68±25.30) and the highest (68.07±19.87) mean score among health literacy dimensions. There was a statistically significant relationship of health literacy with age, education and medical profession in the family (P≤0.0001). Only 17.98 percent of the participants had a good level of performance (Scores 6.8 to 10). The history of myocardial infarction in patient and the duration of the patient transition from the onset of pain to arrival to the hospital showed a statistically significant relationship with performance, meaning that family members of patients with a history of myocardial infarction were able to transfer their patient to the hospital in less than half an hour (P≤0.0001). A statistically significant relationship was found between health literacy and performance; those with higher level of health literacy had better performance. Of the health literacy domains, only understanding had a significant relationship with performance (P=0.004).

Although the mean score of health literacy was adequate, the participants hadn't good performance. Therefore, improving the performance of community and family members by health service providers including nurses, mass media, practitioners, and health promotion planners for educational interventions is recommended. Proper planning to increase specific health literacy can prevent adverse outcomes in this area.

The educational environment and family are of the most important factors in the growth and development of linguistic and verbal skills of a child. Certain conditions such as environment can influence the linguistic characteristics of the child. This study aimed to examine the syntax comprehension of Persian language speaking children among foster families and typically-developing children.

72 Persian speaking children living in orphanages between the ages 4 to 6 and 75 typically-developing 4 to 6 year-old children were assessed by the Persian syntax comprehension test. This test measures 24 syntactic constructs of Persian language in 96 items. Also, the Mann-Whitney Test was used to compare the groups. 

Given the results of the Persian syntax comprehension test, the mean syntax compression score of children living in orphanages were significantly lower than those of typically-developing children (P<0.05). 

The foster children should be more paid attention to, in order to particularly enhance their syntax comprehension.

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.

One method of autologous transfusion is acute normovolemic hemodilution (ANH) that involves withdrawal of whole blood shortly before surgery with infusion of fluids to maintain normovolemia.
A retrospective study was carried out during 2013-2014 at Tehran Blood Centre. The data regarded different cardiac surgery hospitals which performed acute normovolemic hemodilution in their operating room. We analyzed adverse events included arrhythmia (atrial fibrillation, premature ventricular contraction) and unstable hemodynamic from collecting blood to 30 minutes.
308 patients scheduled for acute normovolemic hemodilution during cardiac surgery and were evaluated adverse events. We assessed 266 (86.4%) Cardiopulmonary bypass graft patient, 20 (6.6%) patients mitral valve replacement and aorta valve replacement, two valves replacement concurrent in 3 (0.9%) patients (MVRŔ) (MVR TVR), 10 mitral valve replacement with CABG and, congenital heart disease in 7 (2.3%) patients and 2 (0.6%) Bental repair. No significant hemodynamic changes and arrhythmia were recorded.
In this survey, No patients didnt show any adverse events (arrhythmia and unstable hemodynamic) during and 30 minutes after phlebotomy. Acute normovolemic hemodilution safely could perform in cardiac surgery patients with CABG, valvular replacement.

Cesarean delivery is usually limited to cases where it is not possible through normal path, or is associated with serious risks for the fetus and mother, therefore it is expected, Caesarean section should be used in limited and specific cases and the rate of it does not exceed certain limits. Unfortunately,nowadays reported cesarean section rate is more than acceptable in the country. Lack of awareness of the complications of cesarean and negative attitude toward normal vaginal delivery was of the causes of the increased tendency of pregnant women to have cesarean. The aim of this study was to investigate the factors affecting on selection of the methods of delivery and attitude of pregnant women admitted to the civil hospitals Social Security Organization in 2013. This research was descriptive–analytical and cross–sectional. In this study of 2521 pregnant women in 67 civil hospitals Social Security Organization across the country had referred in the summer of 2013, using simple random sampling were examined. For data collection, a questionnaire including demographic characteristics, the questions about reasons for selection of cesarean, and attitude measurement toward vaginal delivery and cesareanwas prepared by voting of midwives and obstetricians and then,after final approval by test-ratest method,completed through interviews withpergenant mothers. For the data analysis were used of SPSS 22 software and chi-square and T-tests. The mean age mothers were 27.64±0.21 and also 57% of them had a higher education diploma. The cesarean rate was 50.7% in women in the study. 57% of women tend to be more moderate cesarean (p<0.001). Their main reasons for choosing cesarean were analgesia operating procedures, the lack of harm to the fetus, preventing tearing and deformed genitalia, do not require frequent examinations and suggestion of doctor or midwife. Significant statistically association was between current birth mothers with maternal age, spouse's age, age at marriage, level of Education, job, income, previous delivery,parity, stillbirth, infertility and miscarriage and a family history of cesarean section (p<0.001). There was significant relationship between level of knowledge and attitude toward cesarean delivery (p<0.001). But there was no found significant association between the attitude of the normal vaginal delivery with mother's level of knowledge (p=0.31). According to the survey results and the relationship between attitudes to caesarean and selection, it is essential to deal with the excessive increase in cesarean and achieve an acceptable limit this type of delivery (cesarean section), Necessary actions should be performed to raise the awareness of women about the benefits of normal vaginal delivery and disadvantages of cesarean section.

Pain is one of the most pro-blems after cesarean section that causes m-any physiological and psychological probl-ems for mother. Numerous actions have be-en used to alleviate the post operative pain of cesarean. However، there is no consensus about the best suitable analgesic method. Aim of this study was to compare the impa-cts of general and spinal anesthesia on the severity of pain and consequences of the cesarean operation. The present resea-rch was a double-blinded، randomized، cli-nical trial study، in which 110 pregnant wo-men aged 20-35 years undergoing cesarean (55 women in the spinal group and 55 wo-men in the general group) were assessed. Surgery technique was the same in both groups. All women received diclofenac so-dium as suppository. The post operation pain intensity (intolerable، sever، moderate، mild and no pain) were measured in groups by visual analog scale (VAS)، headache، nausea and vomiting frequency. Also، the analgesic dose were measured in two gro-ups then compared. The data was analyzed by the SPSS software، version 11 and the statistical tests، chi-square and fisher. 17. 3% of the participants had nau-sea and vomiting and 2. 7% had headache after cesarean operation. In the recovery ro-om before receiving the analgesics، 44. 5% had moderate pain، and after receiving of analgesics 59. 1% had mild pain. 47. 3% of the patients received two doses of diclo-fenac sodium for relief of pain. There was a significant relationship between anesthesia type and pain intensity after surgery (p<0. 05). There was no significant relation-ship between the anesthesia type and head-ache after pain. Discussion & The type of an-esthesia has a significant influence on the intensity of pain، headache، nausea، and vo-miting after cesarean section.

In survival analysis because are still unknown some of the important factors related to disease, it is too difficult or impossible measure all the appropriate factors and related diseases. Not consider these common unknown risk factors causes dependence among survival times, the results from Cox proportional hazard model and parametric models are not reliable. In this case, we use to confront the above problem of frailty models. The purpose of this study was to examine factors affecting survival of patients with gastric cancer using the log-logistic parametric model with gamma frailty and to compare these results with Cox model. This study includes Information of 110 cases with gastric cancer was collected from Babol cancer registry during 1990 through 1991, who were followed up for a period of 15 years by the year 2006. In order to explore factors affecting survival of patients, Cox model and also parametric model Log-logistic with gamma frailty were examined and the Akaike information criterion (AIC) was considered as a criterion to select the best model (s). For the statistical analysis, the statistical softwares SAS 9.1 and STATA 8.0 were used. All P<0.05 were defined as statistical significance. Sample of subjects encompassed 75.4% men and 24.6% women. The mean age at diagnosis was 60.2 yr for men and 57.5 yr for women. The median survival time reached 8.6 months, and survival rates in 1, 3, and 5 years following diagnosis were 25%, 18%, and 17%, respectively. Multivariate analysis showed that family history of cancer might increase significantly the risk of death from cancer according to Cox and parametric models by including and not including heterogeneity effect. According to AIC criterion and the nature of the data (hazard rate is non-monotonic), parametric model (with and without gamma frailty) had better performance when compared to Cox model. And among, log logistic model with gamma frailty seemed more appropriate. In this model, age and family history of cancer were significant predictors. Results indicated that early preventative care for patients with family history of cancer might be of importance to decrease the risk of death in patients with gastric cancer, and being younger, on the other hand, would cause a potential decline in the corresponding risk of death. According to our findings, based on the Akaike criterion and also the nature of the data (the hazard rate is hump-shaped), log logistic model with gamma frailty could be considered as a useful statistical model in survival analysis of patients with gastric cancer rather than Cox model.

Esophageal cancer is one of the eight common cancers in the world and the sixth cause of cancer death. The standard survival analysis, Cox proportional hazard model, is based on the assumption that all individuals in study experience the desired event; however, due to the nature of information and type of event, this assumption would be unrealistic. Naive use of Cox regression analysis can be misleading. In this study, we aimed to determine impact of risk factors and demographic factors on survival and cure fraction of patients with esophageal cancer using cure parametric models. Data were collected from the cancer registry of Babol affiliated to Tehran University of Medical Sciences, School of Public Health. A total of 359 patients were recruited to the study and were followed for a period of 15 years. Results showed that 62.7% of patients were men and 37.3% were women. The mean age was 60.0 year for men and 55.3 years for women. Estimated survival rates in one, three, and five years following diagnosis were 23%, 15%, and 13%, respectively. The median of survival time was 8.9 months. To assess the impact of personal factors on survival of patients, we used the mixture cure parametric (weibull and Log-normal). In both models, family history of patients was statistically significant. The results of this study suggest that screening of individuals who have family history of cancer (especially in men) can be an effective factor in reducing the risk of death in patients with esophageal cancer. Preventive programs and monitoring should be greatly considered. Since proportional hazards assumption is rejected in this study, log normal Mixture Cure Model with Logit link function could be used instead of Cox and Weibull models in survival analysis of patients with esophageal cancer.