anooshiravan kazemnejad

The engagement of learning and academic achievement is the expectation of instructors and students of the teaching-learning process, which can be influenced by various factors, such as the characteristics of the teacher and his management style in the classroom. Determining which classroom management styles are more relevant to students' engagement and academic achievement can help the instructor in choosing a better classroom management approach. The aim of this study was to determine the relationship between classroom management style and engagement to learning and academic achievement in nursing students.
This descriptive-analytical and cross-sectional study was conducted in 1394 at Nursing and Midwifery School of Tehran University of Medical Sciences. The sample consisted of 23 teachers and 177 students who selected by counting all method. Data collection tools included modified PCMSA and UWES-S questionnaires and demographic data forms. After translating and redefining, both of their factual validity tools were confirmed by 4 experienced teaching nurses. In order to calculate the reliability of the classroom management practices questionnaire, the Kappa computational formula was used simultaneously for two observers, which was at least 0.92. The reliability of the desire to learning questionnaire by calculating the Cronbach's alpha coefficient was 0.87. The data was analyzed using spss16 software and analyzed by descriptive statistics (frequency, mean and standard deviation) and inferential statistics (ANOVA and Gabriel, Spearman and Chi-square correlation coefficient).
Most teachers use 65.2% non-interactive, 13% intermediate and 21.7% interactive in classroom management. There was no significant relationship between classroom management practices and students engagement to learning (P = 0.331), but there was a significant relationship between classroom management practices and students' academic achievement (P < 0.001). There was also a significant, but weak, relationship between the engagement to learning and academic achievement in the interactive classroom management (r = 0.33, P < 0.001).
According to the results, considering that the interactive management method has a significant relationship with the academic success of the students and has a meaningful but weak relationship with enthusiasm for studying, it is therefore proposed to use as a selective method with caution (due to the low volume Sample) to be used.

Self-efficacy is a key psychological source in adapting to chronic diseases and plays a crucial role in how patients adapt to the challenges of cancer as a chronic disease. Promoting self-efficacy in patients with breast cancer leads to better Compatibility with the diagnosis and treatment of cancer, reducing cancer symptoms, improving mental image, and improving the communication of patients with therapeutic personnel. The purpose of this study was to investigate the effect of education and telephone counseling on the self-efficacy of women with breast cancer undergoing radiotherapy.

In This Randomized Clinical Trial Study, 64 patients who were scheduled for the Breast Cancer Radiotherapy and Referring To Cancer Institute of Imam Khomeini , Tehran University Of Medical Sciences, were recruited using the convenience sampling method. Participants were randomly assigned into Two Groups of Test (N = 32) And Control (N = 32). Before The Start Of Radiotherapy, Chronic Disease Self-Efficacy Scale Was Completed By Research Samples In The Studied Groups. Patient's Self-Efficacy Was Evaluated Again 1 Month And 3 Months After Education and Telephone Counseling, And Data Were Analyzed Using SPSS-22 Software.

Before The Intervention, There Was No Significant Difference Between The Mean Score Of Self – Efficacy Of The Two Groups. However, 1 Month And 3 Month After The Beginning Of Intervention, The Mean Score Of Self-Efficacy In The Experimental Group Was Significantly Higher Than In The Control Group (P

According To The Results Of This Study, The Use Of Education And Telephone Counseling To Promote Self-Efficacy Of Women With Breast Cancer Under Radiotherapy Is Emphasized.

Fatigue is a common complication in patients undergoing hemodialysis. Among the measures that could be used as a nursing intervention to reduce fatigue, is reflexology. This study was conducted to Compar foot and hand Reflexology on fatigue in patients undergoing hemodialysis.
This study was a randomized clinical trial and single-blind, in three-group on 90 hemodialysis patients. Data collected included demographic questionnaire and a questionnaire fatigue severity. Fatigue questionnaire before and after the intervention of the third week and the fifth week of the intervention was completed by all three groups.
Findings from this study showed before and after the start of the third week foot and hand reflexology there was not statistically significant difference between the control and intervention groups exist (p=0.346 pre-intervention) (p=0.813 third week of intervention) But fifth weeks, significant difference was observed between control and intervention groups (p=0.002).
Based on the findings of this study in seem reflexology as a part of alternative medicine, is an effective way to reduce fatigue. It is recommended due to its low cost, and ease of its lack of side effects in patients with hemodialysis are used to reduce fatigue.

Caring for child with asthma brings about a lot of tension for the parents. As well, this chronic illness has main effects on family function and quality of life of the patients. Thus, the purpose of this study is to investigate effect of family-centered empowerment model on quality of life of the parents of children with asthma. This is a Quasi-experimental study with 60 parents of children with asthma classified in two case and control groups based on random allocation. The seven sessions of educational program based on educational needs of parents in case group done for four months. After four months of program done measured parent quality of life questionnaire in case and control groups. Data analysis was performed using statistical methods including, t-test, paired t-test and Fisher`s Exact test. There was no significant difference in the mean knowledge, self-efficacy, self-esteem and quality of life scores in case and control groups before intervention. whereas the difference was significant after intervention (P<0.001). thus, there was significant difference in the mean knowledge, self-efficacy, self-esteem and quality of life scores of parents in the case group after intervention and four mounts after that (P<0.001). This study shows the effect of family-centered empowerment model on quality of life of the parents of children with asthma and it is suggested that such a model be implemented in much more study population.

Relative and absolute reliability are psychometric properties of the test that many clinical decisions are based on them. In many cases، only relative reliability takes into consideration while the absolute reliability is also very important. 11 community-dwelling older adults 65 years and older aged (69. 64±3. 585) and 20 healthy young in the age range 20 to 35 years (28. 80±4. 15) using three versions of Timed Up and Go test were evaluated twice with an interval of 2 to 5 days. Generally، the non- homogeneity of the study population was stratified to increase the Intraclass Correlation Coefficient (ICC); this coefficient in elderly people is greater than young people and with a secondary task is reduced. In This study، absolute reliability indices using different data sources and equations lead to in more or less similar results. At general، in test –retest situations، the elderly more than the young people must be changed to be interpreted as a real change، not random. The random error contribution is slightly greater in elderly than young and with a secondary task is increased. It seems، heterogeneity leads to moderation in absolute reliability indices. In relative reliability studies، researchers and clinicians should pay attention to factors such as homogeneity of population and etc. As well as، absolute reliability beside relative reliability is needed and necessary in clinical decision making.

Dietary notifications have been introduced recently for Alzheimer Disease (AD). In Iranian old medical manuscripts, there are some nutritional recommendations related to Nesyan (AD equivalent). The aim of this article was to compare dietary recommendations of Iranian traditional medicine (ITM) with novel medical outcomes. 1) Searching for dietary recommendations and abstinences described in ITM credible manuscripts; 2) Extracting fatty components of ITM diet according to the database of the Department of Agriculture of the USA; 3) Statistical analysis of fatty elements of traditionally recommended foods via Mann-Whitney Test in comparison with elements of the abstinent ones; 4) Searching for AD dietary recommendations and abstinences which currently published in medical journals; 5) Comparing traditional and new dietary suggestions with each other. 1) Traditionally recommended foods are fattier than abstinent ones (P<0.001). There are meaningful differences between unsaturated fatty acids (UFAs) (P<0.001), saturated fatty acids (P<0.001), and cholesterol (P<0.05) of recommended foods and abstinent ones. 2) Traditionally recommended diet is also fattier than the abstinent diet (4.5 times); UFAs of the recommended diet is 11 times more than that of the abstinent one; it is the same story for cholesterol (1.4 times); 3) Recent studies show that diets with high amounts of UFAs have positive effects on AD; a considerable number of papers emphasizes on probable positive role of cholesterol on AD; 4) Traditional recommended diet is in agreement with recent studies. ITM recommended diet which is full of unsaturated fatty acids and cholesterol can be utilized for complementary treatment of AD.

Air pollution is the major problem in industrial cities. It seriously threatens the inhabitants'' health، especially high-risk people like pregnant women’s. Spontaneous abortion could happen as a consequence of carbon monoxide in this situation. This study was aimed to examining the effect of environmental carbon monoxide concentration on the rate of spontaneous abortion. This study was conducted on 148 pregnant women who had spontaneous abortion (case group) and 148 pregnant women without abortion (control group). They were collected randomly from 10 hospitals in different area of Tehran between June 2010 to February 2011 and the correlation between spontaneous abortion and environmental carbon monoxide was investigated. Two groups were matched by their age، their husbands'' age، age at the first childbirth، educational level، average of family income، previous delivery type، interval between deliveries، history of previous abortion، body mass index، parity، duration of residence in Tehran and the amount of time spent at work and outside of the home (P>0. 05). The study revealed that the mean of environmental carbon monoxide concentration in case group (4. 09±2. 09PPM) was significantly higher than control group (2. 81±1/07PPM) (P<0. 001) and the rate of abortion was 1. 98 times higher in highly concentrated areas (CI95% 1. 55-2. 53). There was also a negative relationship between gestational age and carbon monoxide concentration. The results of the study showed that there was a significant relationship between the occurrence of spontaneous abortion and the environmental carbon monoxide concentration.

This research was designed to evaluate the developmental status of children aged 4–60 months in Tehran city by two developmental screening tests, Denver Developmental Screening Test II (DDST II) and Ages and Stages Questionnaires (ASQ) and also to determine the consistency coefficient between these two tests.

In this cross–sectional study, DDST II and ASQ were performed on 197 children (104 boys, 93 girls), aged 4–60 months (Mean=23.5 months), at four health centers in Tehran city. Evaluation of 15% of children was repeated by Developmental Pediatricians who were blinded to the screening results.

Developmental disorders were observed in 37% and 18% of children who were examined by DDST II and ASQ tests, respectively. Considering those children who were healthy but their parents were concerned about their developmental status, these figures changed to 38% and 43%, respectively. The estimated consistency coefficient between DDST II and ASQ was 0.21 which is weak (P=0.002) (for gross motor 0.24, language 0.18, personal-social 0.06 and fine motor 0.05). The consistency coefficient between the physicians’ examination with DDST II and ASQ were 0.17 (P=0.099) and 0.47 (P=0.003), respectively.

A weak consistency coefficient was found between DDST II and ASQ tests. Therefore, the results of these two screening tools should be compared with a developmental diagnostic test in order to choose an appropriate screening tool.

Sometimes it is impossible to directly measure the effect of intervention (medicine or therapeutic methods) in medical researches. That is because of high costs, long time, the aggressiveness of therapeutic methods, lack of clinical responses, and etc. In such cases, the effect of intervention on surrogate variables is measured. Many statistical studies have been accomplished for measuring the validity of surrogates and introducing a criterion for testing. The first criterion was established based on hypothesis testing. Other criterions were introduced over time. Then by using the classic methods, the Likelihood Ratio Factor was introduced. After that, the Bayesian Likelihood Ratio Factor developed and published. This article aims to introduce the Bayesian Likelihood Ratio Factor based on time dependent data. The illness under study is lung disease in victims of chemical weapons. The surrogate therapy method uses the forced expiratory volume at fist second.

Colorectal cancer is the most common cancer of digestive system and also fourth cause for death of cancer around the world. Different studies indicate that survival of patients suffering from colorectal cancer has recently developed in some areas of the world. However, it is not clear which factors involve in this improvement. This study aims at investigating some clinical and pathologic factors in prognosis of these patients with colon and rectum cancers separately. Data recorded from 1194 patients with colorectal cancer in Cancer Record Center of Research Center for Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences (Tehran, Iran) was used in this study. Data analysis was performed using competing risks model. Software used for data analysis was STATA, 11 version, and significance level was regarded as 0.05. Body mass index, alcohol consumption, tumor site, inflammatory bowel disease, metastasis to lymph nodes and metastasis to other organs had significant effect on death of colon cancer, while body mass index, metastasis to other organs and kind of the first treatment had significant effect (P<0.05) on rectum cancer. Median survival was 7.75±1.118 and 3.917±0.26 years for patients with colon cancer and rectum cancer respectively. Also, 1, 2, 3, 4 and 5 years of survival rates for colon cancer were 88.7%, 77.9%, 68.5%, 61.4% and 56.8%, respectively, while they were 89.1%, 74.2%, 60.7%, 47.1% and 41.9% for rectum cancer, respectively. According to the results of this study, some variables may have different impacts on colon and rectum carcinoma; therefore it is needed that the effects of the factors on different parts of the large bowel be considered separately in the future studies.

Preterm delivery is the birth of an infant before 37 gestational weeks. In prior studies, relationship between body mass index (BMI) and preterm delivery before pregnancy and weight again during pregnancy has been inconsistently reported. This study was done to determine the association of the above two factors with preterm labor. This research was done on 502 pregnant women age range between 18 - 35 years and gestational age between 14 - 18 weeks of pregnancy. Gestational age determined by last menstrual period (LMP) and ultrasound imaging of the first trimester pregnancy. BMI was measured based on pre-pregnancy weight. The medical history and midwifery questionnaires, completed and their weight gain during pregnancy and the occurrence of preterm delivery were studied. Participants in the study, divided into three groups based on pre-pregnancy BMI and three other groups based on weight again during pregnancy; then each group of BMI divided into three subgroups based on pregnancy weight. In this study, the incidence of preterm labor in women with higher and lower BMI was higher than pregnant women with normal BM (p = 0.002). Statistical analysis did not show any statistical significant difference between weight again during pregnancy and preterm delivery (p = 0.82). Survey of both pre-pregnancy BMI and weight again during was apparently significant (p = 0.04) but it was only due to the effect of BMI. This study showed that there is an association between abnormal BMI and preterm deliver. Therefore, education programs and consultation with a specialist in nutrition are suggested for women in reproductive aged

This study aims to investigate some clinical and pathologic factors associated with the prognosis of patients with colon and rectum cancers separately. Colorectal cancer is the most common cancer of the digestive system and also the fourth cause of cancer-related deaths around the world. Different studies indicate that survival of patients with colorectal cancer has improved in some areas of the world. However, it remains unclear which factors are involved in this improvement.Patients and Data for 1194 patients with colorectal cancer registered in the Cancer Registry Center of the Research Center of Gastroenterology and Liver Disease, Shahid Beheshti University of Medical Sciences were used in this study. Data analysis was performed using competing risks model. Software used for data analysis included STATA, Version11, and significance level was regarded as p.

In this study, a SYBR Green real-time RT-PCR assay for quantification of HIV-1 viral RNA was developed. This assay was performed based on amplification of the pol region of HIV-1 and product analysis by an ABI 7500 system. We quantified HIV-1 viral load in 26 seropositive patients by this system and the data were subsequently compared with results obtained with a reference technique represented by COBAS AMPLICOR HIV-1 Monitor test. The results demonstrated that this technique could detecte up to 500 HIV-1 RNA copies/ml of plasma. The linearity of this approach was conserved over a wide range of HIV-1 copy numbers (5×102-5×109). Since no positive signal was observed in seronegative volunteers, the specificity of the test was calculated as 100%. Comparison of the results with those obtained by the reference quantification method, revealed a significant correlation between the results (R2= 0.95). On the basis of the most recent recorded cases for HIV-1 infection and AIDS in Iran, the prevalence of this disease is rising rapidly and the situation has been called to be alarming by national health representatives. Determination of HIV-1 viral load in plasma has been considered as the most effective single prediction tool of clinical outcome. Indeed, the development and stabilization of HIV-1 RNA assays have given physicians a unique tool for monitoring HIV-1 patients treated with antiviral drugs. In this study, we have developed a SYBR-Green Real Time RT-PCR assay for quantitative analysis of HIV-1 in infected patients. Since a synthetic RNA standard was used in this assay, the upper limit of detection was detected to be higher than the standard test (5×10 9 versus 7.5×10 5). This can be important in patients with acute high viral load infections. Reproducibility was assessed by Intra assay and Inter assay analysis. Coefficient of variations Ct, in reproducibility tests for Intra assay and Inter assay variability were less than

Asthma affects an estimated 300 million people worldwide. Poor compliance with the prescribed medication leads to increased mortality and morbidity. Various determinants of compliance have been described. The purpose of this study was to determine factors that can influence patients'' compliance with prescribed Metered Dose Inhaler drugs.179 patients with diagnosis of asthma were selected from two asthma clinics in Tehran. 160 of them met the inclusion criteria. Collected data consisted of patients'' demographic data, asthma symptoms and severity, medical history of patients and their attitude towards asthma control and using drugs. Compliance was assessed by four questions regarding using Metered Dose Inhaler drugs.There was a significant correlation between compliance and patient''s literacy level, attitude about using drugs, and their knowledge about asthma (p=0.012, p=0.0001, p=0.001 respectively). However there was significant negative correlation between symptom control score and compliance (r =-0.270, p=0.004). Other factors including sex, patients'' attitude about asthma control and severity of asthma did not show any significant relation.There are four major factors influencing the patients'' compliance: level of literacy, attitude towards asthma management, knowledge about asthma, and symptom control. The negative relation between compliance and symptom control may be caused by patients'' inadequate knowledge towards continuing treatment after improvement in their conditions. The study emphasizes on the importance of enhancing the patients'' compliance. This could be done by providing patients with adequate information about their disease and treatment.

In assessment orthodontic treatment need, for the same group of people, dentists usually have different ideas with respect to a gold standard. The most common way of determining validity of the assessments is computing coefficients of agreement like Kappa and Weighted Kappa. In this article we first present shortcomings of the coefficients and then propose a more appropriate alternative method for evaluating of agreement. Methods & Materials: This analytic cross-sectional investigation has been done with the Index of Orthodontic Treatment Need (IOTN). This index which independently was measured on 51 study models by an expert dentist (as gold standard) and 10 other dentists (as raters), has 5 ordinal levels (no need, little/mild need, moderate/borderline need, severe need, extreme need). Diagonal parameter model and uniform association model were used for modeling agreement to evaluate validity of the assessments.

In 6 cases, diagonal parameter model (with significance level at least 0.34) and in 4 other cases, uniform association model (with significance level at least 0.36) were appropriate to the relevant data. The best assessments belong to the dentists for whom uniform association model was fitted and the worst of them to the dentists for whom diagonal parameter model was fitted.

All of the dentists tended to rate casts higher than the gold standard, so that local odds ratio for dentist who had the least(most) tendency to rate casts higher than the gold standard was 6.4(121.5), So all of them needed to be further educated to assess the index.

Nutrition is an important factor that influences immunity, and nutritional deficiencies can impair resistance to infections. Malnutrition is the most common cause of immunodeficiency worldwide. Trace elements such as zinc, selenium, iron, and copper can influence several components of immunity. Primary antibody deficiency disorders are a group of disorders characterized by an unusual susceptibility to infections and malnutrition. Impaired nutritional status has been reported in immunodeficient patients. The aim of this study was to determine anthropometric indices and trace elements status in these patients. Thirty-eight children (28 males, 10 females, aged 2-18 years) with primary antibody deficiency referring to Children’s Medical Center of Tehran University of Medical Science were enrolled in this research. Primary immunodeficiency disorders consisting of CVID, XLA, IgA deficiency, IgG subclass deficiency, and hyper IgM were assessed. Anthropometric indices, comprised of height, weight that were measured and body mass index (BMI) was calculated. Height-for-age (HAZ), weight-for-height (WHZ) and weight-for-age (WAZ) were determined according to Z-score to study mild, moderate and severe malnutrition. Serum copper, zinc, selenium and iron levels were measured by an atomic absorption spectrometer. The most common disorders were CVID 52.5% and X-linked agammaglobulinaemia 27.5%. Based on BMI measurements 21.1% of patients had malnutrition. According to HAZ, 13.2%, 13.2% and 36.8% had severe, moderate and mild malnutrition, respectively. According to WAZ, 10.5%, 18.4% and 28.6% had severe, moderate and mild malnutrition, respectively. Regarding to WHZ, 14.3% and 28.6% had moderate and mild malnutrition, respectively. Low selenium levels and high copper levels were observed in 37.5% and 70.3%, respectively. Anthropometric data showed that the frequency of malnutrition in these patients was higher than the CDC standard. Low serum selenium levels and high serum copper levels were observed, suggesting further research is needed on these parameters. Most of the patients had serum zinc and iron levels within the normal range. It is recommeded that clinical immunologists and nutritionists should make a collective effort to provide these patients with standard or specialized diets so as to decrease the risk of infection.