mehdi rezaee

The burden of psychological disorders and its financial burden has increased in the world and in Iran. Usually, these patients need financial support to improve their mental health. Sometimes basic insurance organizations hesitate to include psychological counseling services in the insurance package. The assistance of the Welfare Organization and the Ministry of Health is not enough.

It is a descriptive study with financial calculations. Using the data of the Iranian Statistics Center, demographic information until 2031 and using the data of the mental health survey reports of the Ministry of Health in 2011 and 2021, the annual growth for the 90s was calculated. Then, with the discount formula, the growth of prevalence of disorders, different severity of disorders, the number of referrals to different centers, the number of referrals was estimated up to 2031. Assuming an annual tariff growth rate of 20%; The insurer's share is 30%, 50%, and 70%; 50% and 10% annual growth in the number of clients after providing insurance coverage, the estimate was completed

The financial burden of insurance organizations for psychological counseling was estimated from 708.2 million tomans (insurance share 30% in 2024, fixed rate of clients) to 23,534 million tomans (insurance share 70%, annual growth of 10% clients in 2031).

Psychological counseling is both necessary and cost-effective to be covered by insurance organizations. By developing a right service package, psychological counseling can be covered according to the severity of the disorder, the location of the service provision, and the different shahres of the insurance organizations. It would be wise that some disorders, considered important, be covered by basic insurance organizations, for other cases supplementary insurance along with other supportive and welfare services such as subsidies would be rational.

 Equity in access to health resources is a fundamental goal of health systems worldwide.

 This study aims to assess the distribution of essential health resources necessary for healthcare provision in Bushehr Province.

 This cross-sectional study spans ten years and utilizes several widely recognized indices in health resource distribution equity and equality, including the Gini Coefficient, Concentration Index, Horizontal Inequity, Robin Hood Index, Theil Index, Atkinson Index, and Quantile Ratio. These indices were calculated based on both the population level and the proposed resource allocation model (PRAM) using Excel Software 2018 and Stata version 18.

 The findings indicate a degree of inequality in the distribution of all health resources examined, with special beds exhibiting much higher levels of inequality than others. The sensitivity of the studied indices varied across the distributed resources. Moreover, the trend of inequality generally decreased for all examined resources. The PRAM results suggest that adopting a different approach to resource distribution can significantly reduce inequality levels.

 Despite a downward trend in the inequality of health resource distribution, significant disparities persist. Altering the resource distribution system from the conventional geographical division could aid in achieving equity and equality in healthcare. Such changes could also reduce the costs associated with the health system.

Indicators for predicting the quality and vigor of fruit tree seedlings can be worthwhile if they are conveniently and visually assessable in various climatic regions. Since allometric relationships exist between plum seedling vigor index and morphological traits, this study evaluated morphological features in plum seedlings while determining their quality and vigor. The samples were of major commercial varieties from several regions of Iran, and the assessments followed path analysis and multiple linear regression. Plum seedlings of 8 commercial cultivars were harvested in three replicates from 11 nurseries in four provinces. Morphological indicators included seedling height, diameter above the graft line (DAGL) and at root-collar (RCD), root length, number of roots and branches, seedling vigor, dry weights of aerial parts and roots (ADW and RDW, respectively), and ratio of height to DAGL and seedling height to ADW. Simple correlations among these variables appeared diverse, and the correlation coefficients broke down into direct and indirect effects through path analysis, with vigor as the dependent variable. This variable increased with some of its components, including DAGL and dry weight. However, the ratio of height to DAGL decreased when the accumulated growing degree-days (AGDD) increased from 2700 to about 4500 °C per day in the various regions. Average vigor values of certified and uncertified seedlings were 11.7 and 19.2, respectively. Among the visually assessable traits in the nursery, DAGL showed a higher correlation with the vigor variable and other morphological features, thus making it the most important index for plum seedling evaluation.

This study explored the concept of ‘life balance’ during physical isolation due to COVID-19 in Iran in 2020.
In a cross-sectional design, 403 participants completed the internet-based "Life Balance Inventory (LBI)”, which includes five subscales: health, relationship, identity, challenging/interesting activity, and daily activities. The data were analyzed using SPSS 21, and a significant level of less than 0.05 was considered. Descriptive statistics, t-tests, and one-way ANOVA were utilized in the analysis.
The total mean score of LBI was 1.51+_0.38(unbalanced). The scores were distributed among the participants as follows: 52.6%  of participants scored between 0.6 and 1.5 (very unbalanced);  37.7% of participants scored between 1 and 1.5 (unbalanced); 8% of participants scored between 2 and 2.5 (moderately balanced); and finally, 1.7% of participants scored between 2.5 and 3 ( very balanced). Significant relationships were found between LBI and gender (P=0.001), chronic comorbidity (P-value =0.029), and Job (P-value=0.044). The health subscale showed no statistical difference according to the demographic factors. Males demonstrated more life balance in their daily activities, including driving and social transportation (p=0/001). Married participants and those older than 40 exhibited more balance in the relationship subscale (p-value=0/001). Teachers and faculty members showed more balance in identity (p=0.014) and relationship (p=0.001). Higher-income participants revealed more life balance in the challenge/interesting subscale (p=0.033).
The results suggested that participants experienced an unbalanced lifestyle during the early phase of COVID-19 isolation.

Global reimbursement is a hospital payment method. In some global surgeries, the billing cost of treatment differs from the tariff set by the Supreme Council of Insurance, leading to financial losses for hospitals or insurance companies. This study compares the billing costs of childbirth services with the approved tariffs.

This descriptive-analytical study examined the billing costs of all childbirth cases (natural and cesarean section) covered by health insurance at three specialized maternity hospitals (A, B, C) in Tehran province in 1400. Data were sourced from health insurance company dashboards, compiled in Excel, and analyzed using SPSS software.

The study evaluated 3,742 childbirth cases, with 35% being natural births and 65% cesarean sections. The comparison between billing costs and approved tariffs showed that Hospital A's costs for both natural and cesarean childbirths exceeded the set tariffs. However, the billing costs in the other two hospitals were below the approved tariffs. Additionally, the actual hospitalization days for cesarean sections were shorter than those covered by the tariff in all three hospitals.

This study highlights variations in childbirth billing costs compared to the approved global tariffs across different hospitals. These findings underline the necessity of cost control in hospitals and suggest a need to revise the approved tariffs to align with the actual hospitalization duration for patients.

Anesthesiologists and surgeons strive as a team to minimize postoperative patient reported pain scores by using modern multimodal pain management protocols. This study was designed to examine the effects of adding different doses of adjuvant tramadol to bupivacaine solution in interscalene block (ISB) in patients undergoing shoulder arthroscopic surgery.

In this prospective controlled randomized double-blinded trial, 60 consecutive eligible subjects candidate for arthroscopic shoulder surgery were assigned randomly into 3 groups. The patients were assigned to receive one of the specific doses of tramadol in bupivacaine mixture in their preoperative ultrasound-guided ISB. In the control group (T0), the ISB was performed with 30 ml solution of perineural 0.25% bupivacaine and epinephrine. The block was performed with the same solution mixed with 100 or 200 mg of adjuvant tramadol with a total volume of 30 ml in patient in T100 and T200 groups, respectively. The required postoperative duration of analgesia, 24 hours postoperative analgesic consumption, observational and patient-reported pain scores, and side effects were recorded in the recovery room and up to 24 hours.

Mean postoperative analgesia duration was significantly longer in group T200 (681 ± 270 min) than in Group T100 (501 ± 298 min) and Group T0 (402 +/- 223 min) (P =0.006). A statistically significant difference was found in the first 24 hour postoperative cumulative opioid consumption among groups T200 (5.5 +/- 3.2 mg), T100 (9.0 +/- 4.5 mg) and T0 (9.30+/- 4.78 mg) (P=0.009).  There was no intergroup difference in intraoperative analgesic consumption, postoperative sedation score, and complications due to ISB or tramadol adverse effects.

There is a dose-dependent prolongation of ISB with adjuvant tramadol for arthroscopic shoulder surgeries.

The hospital autonomy plan, the biggest decentralization plan to reform the administration structure of public hospitals, has been implemented for about three decades in Iran. In this study, we aimed to examine the effects of the plan on the financial indicators of autonomous public hospitals.

This descriptive cross-sectional study used revenue and cost data associated with all public hospitals affiliated to Bushehr University of Medical Sciences in 2021. The relevant data was extracted from two big databases including health information system (HIS) and accounting system, and after the data quality control, specific financial self-sufficiency balance (the ratio of specific income to the specific cost of the same hospital) and total financial balance (the ratio of specific income to the total cost of the same hospital) were calculated using Excel software.

Results demonstrated that the specific financial self-sufficiency balance and the total financial balance were 61% and 27%, respectively. The highest and the lowest values of the specific financial self- sufficiency index pertained to the Heart Hospital (the only single specialty heart hospital in the province) and Imam Hossein Hospital (a hospital with 29 active beds in Tangestan county with a population of 82502) as 74% and 45%, respectively. The gap index between the specific cost and revenue of each ac-tive bed showed that on average, the cost of each bed was nearly 215 million Tomans higher than its own income in 2021.

The hospital autonomy plan had different effects on the financial indices of public hospitals studied in this research, denoting it is not possible to cover all hospital-specific expenses through its own earned revenues. Accordingly, government subsidies to autonomous hospitals are necessary.

Daroyar project was implemented with the aim of regulating fair and sustainable access of people to medicines and increasing insurance coverage. This study investigated the effect of the plan on the number of prescriptions and the cost of the health insurance organization.

This study is a cross-sectional retrospective study. The research community is the outpatient electronic prescription of drugs of Iranian health insurance organization in the second 6 months of 1400 and 1401. In this study, the number of drug prescriptions, the cost paid by the insurance organization, and the number of service-providing pharmacies were extracted from the prescription dashboards of the Health Insurance Organization's electronic system. Data analysis was done using Excel 2019 software.

The number of prescriptions increased by 71% and costs by 251% in 1401. The average cost increased by 105%, but the average number of prescriptions, excluding preferred currency, decreased by 12%. The preferred currency share of the total cost paid by the organization for electronic drug prescription was 57%. The highest cost paid by the organization was to Tehran province (13%). The amount of preferred currency has been increasing from October to March.

The Daroyar project has led to the improvement of people's access to pharmaceutical services. The decrease in the average net share of the organization per prescription is a sign of the coverage of cheap drugs. The significant share of the preferred currency indicates the success of the project in providing domestically produced drugs.

Exercise training is an important intervention in the pulmonary rehabilitation of adults with chronic respiratory diseases. High-intensity exercise is challenging for these patients. Thus, interval exercise has received much attention as a suitable option for optimizing a tolerable load during exercise. This study aimed to investigate the effects of high-intensity interval training (HIIT) on peak power, peak oxygen uptake, functional capacity, and health-related quality of life in people with chronic respiratory diseases.

In this study, the related studies were collected and examined from Google Scholar, PubMed, and Science Direct databases.

A total of 14 randomized controlled trials were selected based on the study subject. The results demonstrated that HIIT and continuous training in adults with chronic obstructive pulmonary disease (COPD) led to significant improvement in peak power, peak oxygen uptake, and 6-minute walk test (6MWT) or 12-minute walk test (12MWT) distance and health-related quality of life and there was no significant difference between the two groups. And HIIT, compared to no exercise training, showed greater significant changes. Few studies have examined HIIT in patients with cystic fibrosis, with different results. We found no studies investigating the effect of HIIT on non-cystic fibrosis bronchiectasis and interstitial lung diseases. Conclusion studies confirm the positive effect of HIIT on cardiorespiratory fitness, exercise capacity, functional capacity, and health-related quality of life in people with COPD. In other respiratory diseases, more studies are needed to investigate the effects of HIIT.

Applying the Dickson quality index (DQI) is an efficient but destructive and time-consuming method for predicting sapling quality in nurseries.Fast and low-cost prediction of the quality, establishment, and growing strength of fruit tree saplings in the orchard through the identification of morphological characteristics, which are so highly correlated with this index, is necessary for different stages of sapling production.To evaluate the relationship between the morphological characteristics in peach and nectarine saplings, bare-root saplings of 16 commercial cultivars with three replicates from 10 nurseries, located in four provinces, were studied. The samples provided from two types of non-certified sapling, grafted on the seedling rootstocks, and certified sapling on the vegetative rootstocks during the transplanting seasons of 2020-2021. Sapling height, diameter above grafting line (DAGL), root length, number of roots and branches, shoot and root fresh and dry weights, height to diameter ratio, and DQI were evaluated, and simple correlations between them were estimated. The correlation coefficients were broken down into direct and indirect effects through path analysis, with DQI as the dependent variable.The results showed that the average DQI for non-certified saplings, produced in different climates, was 14. The higher values were observed in areas with more than 3100 AGDD. In certified saplings, DQI reached to 47. Based on the results of the path analysis for DQI evaluation, the highest direct effect was related to the DAGL.DAGL is the most efficient index in the quality assessment of the saplings, due to having the highest correlation with the DQI and most of the morphological traits.

Water is one of the most important needs of plants and drought stress is one of the most important stresses for plant growth. Given the global water shortage, provide solutions to save water consumption in agriculture, such as choosing the appropriate irrigation method, irrigation time management, providing methods to reduce and control the negative effects of water shortage on plants and the use of more resistant varieties to water shortage and The use of different techniques to reduce the effects of water scarcity is important and should be a priority for research. Paclobutrazole is a group of plant growth regulators of triazole that prevents the production of a wide range of gibberellic acid and has many applications in agriculture. Paclobutrazole reduces the negative effects of abiotic stress on plant growth by regulating the levels of hormones, enzymatic and non-enzymatic antioxidants and osmolytes. A group of beneficial soil bacteria that increase plant growth are called plant growth promoting bacteria and are among the most important types of biofertilizers. PGPRs by lat out of volatile organic compounds (VOC) increase biomass, plant tolerance to abiotic stresses and disease resistance.

This research was conducted as a factorial split plot in the form of a randomized complete block design with three replications in Qom and Hamedan regions (Hamedan is a cold and mountainous region with mild summer and Qom is a dry and desert region with hot and dry summers). Experimental factors include irrigation regime with three levels 1- (irrigation at 40% of available plant moisture discharge during the growing season (optimal irrigation), 2- optimal irrigation up to pollination stage and irrigation at 60% of available plant moisture discharge until the end of the growing season 3- Irrigation in 40% of available plant moisture discharge up to pollination stage and cessation of irrigation until the end of growing season), foliar application of paclobutrazole at three levels (zero, 50 and 100 ppm in two stages of stem and spike) and invoice The third included five levels of growth-promoting bacteria (non-consumption, Mycobacterium, Azotobacter, Azospirillium, and a combination of three bacteria). Irrigation regimen factors and paclobutrazol in the main plots and growth-promoting bacteria in the subplots. The traits evaluated in this experiment included parameters related to leaf chlorophyll fluorescence and Rubisco activity.

The results showed that the interaction effect of irrigation regime on paclobutrazol was significant for biological yield and grain yield, so that at the third irrigation level, the use of paclobutrazol at a concentration of 100 ppm increased grain yield and biological yield. Also, according to the analysis of variance table, the interaction effect of irrigation regime in bacteria for biological yield and grain yield was significant, so that in the third level of irrigation regime, two levels of combination of three bacteria and Azotobacter with 19.05 and 17.95 tons, respectively. Hectares had the highest biological yield.

In general, the results showed that in more difficult conditions of irrigation regime, the use of paclobutrazol can cause less decline and improve grain yield and biological yield. It can also be inferred that the use of growth-promoting bacteria increases grain yield and biological yield and improves morphological traits, and the combination treatment of Mycobacterium, Azotobacter and Azospirillium had the highest yield.

The presence of a blind child in the family puts a lot of pressure on the caregivers, especially the mother. Therefore, the mother’s mental and emotional condition is affected and disturbs her ability to balance time. By knowing the pattern of time use in mothers of blind children, it is possible to help improve the health and quality of life of these mothers. This study aims to evaluate the time use in mothers of children with blindness compared to the mothers of healthy children.

This is a descriptive and cross-sectional study. Ninety mothers of blind and healthy children aged 6-14 years participated in this study. Mothers were selected from among those whose children were in exceptional schools of Shahid Mohebi, Narjes, and Khazaeili and normal schools in West of Tehran, Iran using a convenience sampling method. Mothers’ time use for different activities was evaluated by the Persian version of the Mothers’ time Use questionnaire. The collected data were analyzed in SPSS software versio 21 using independent t-test and Mann-Whitney U test.

Mothers of children with blindness spent more time on household chores and childcare and less time on sleeping/resting compared to the mothers of healthy children (50.0≥P).

The presence of a blind child in the family affects the ability of mothers in balancing the time and the quality of the time spent by them on daily activities. Therefore, there is a need to pay attention to balance of time as a variable of health and quality of life.

 Outsourcing as an efficiency-oriented approach was introduced to elevate productivity in the public sector. This strategy as a public-private partnership (PPP) arrangement was coined to increase efficiency and quality in public organizations.

 In this study, we aimed to investigate the quantity of applying common outsourcing models at Bushehr University of Medical Sciences (BUMS).

 This descriptive and cross-sectional study was conducted in 2020 at BUMS. The research population was all BUMS deputies, hospitals, and health networks. This study was carried out in three stages, including a literature review, the construction of a checklist and finally the quality assurance of gathered data. Descriptive indices were calculated using excel software version 2016.

 Results showed a total of seven various outsourcing models on which 189 cases of services had been outsourced. Of the 189 cases, 108 were clinical, and the rest were non-clinical. Among the outsourcing models, the service purchasing model was the most typically used, and leases and divestitures were the two least used models.

 Although various outsourcing models are available, they have been disproportionately utilized, showing that to spread the domain of penetration of this strategy, we need to tackle the obstacles ahead of its successful implementation. Increasing the knowledge of managers could be an effective solution. Furthermore, capacity–building toward raising the number of private healthcare providers could facilitate the implementation of an outsourcing policy.

The significant and rapid growth of the aging population is one of the most important phenomena of the current century. According to the main component of the World Health Organization, the concern over aging can be operationalized through informal contributions such as social and leisure activities.

The current study mainly aimed to review the factors associated with the participation of community-dwelling older adults in activities related to leisure and social participation.
Data Source:In this study, based on PRISMA guidelines, articles investigating factors associated with the participation of community-dwelling older adults in activities related to leisure and social participation and published from 2005 to 2022 in Google Scholar, PubMed, Scopus, and EMBASE databases were screened. Inclusion criteria consisted of articles having been published in peer-reviewed journals between 2005 and 2022 and reaching I, II, III, and IV AOTA levels of evidence. To complete the study, a total of 651 articles were retrieved. Finally, 29 articles were reviewed.

Out of 29 articles, three articles were at evidence level I, 12 were at evidence level II, one was at evidence level III, and 13 were at evidence level IV. The social participation of the elderly was discussed in all 29 articles; however, the activities related to leisure of the elderly, in addition to the social participation, was discussed in only 11 articles. Levels of education and disability were the most relevant individual factors affecting the social participation and leisure activities of elders, respectively; the social networks with families, friends, etc., on the other hand, were the most relevant environmental factors influencing both social participation and leisure activities.

Since the levels of education and disability were the most relevant individual factors affecting the participation of the elderly in activities related to social participation and leisure, respectively, and because it was difficult to make interventions in these factors, it was suggested that occupational therapists and other geriatric specialists should make advocacy-based interventions in the social networks which was recognized as the most relevant environmental factors contributing to leisure and the social participation.

Appropriate information about the ability of patients with Parkinson disease (PD) to perform cognitive instrumental activities of daily living (IADL) is necessary. The present study aimed to assess the psychometric properties of the Persian version of the Penn Parkinson daily activities questionnaire-15 (PDAQ-15).

A total of 165 knowledgeable informants of PD patients completed the PDAQ-15. The clinical dementia rating scale, Hoehn and Yahr staging, hospital anxiety and depression scale (HADS), and Lawton IADL scale were used in the study. Internal consistency and test-retest reliability were evaluated by the Cronbach α coefficient and intraclass correlation coefficient (ICC), respectively. To examine the dimensionality of the questionnaire, exploratory factor analysis was used. The construct validity was assessed using the Spearman rank correlation test. To assess the discriminative validity, PDAQ-15 scores were compared across cognitive stages.

The PDAQ-15 showed strong internal consistency (the Cronbach α=0.99) and test-retest reliability (ICC= 0.99). Only one dimension was identified for the PDAQ-15 in the factor analysis. There was a strong correlation between PDAQ-15 with the depression domain of the HADS scale and the Lawton IADL scale (rs=|0.71–0.95|). The correlation of PDAQ-15 with the anxiety domain of the HADS scale was moderate (rs=0.66). Discriminative validity analysis showed that the PDAQ-15 has significant power to discriminate between PD patients across cognitive stages.

These results suggest that the PDAQ-15 is a valid and reliable PD-specific instrument and can be useful in clinical and research settings.

 Work-life balance refers to a person’s ability to effectively manage multiple responsibilities at work. Quality of life (QOL) is a person’s satisfaction with values in which they live. This study aims to investigate the relationship between work-life balance and QOL in dormitory and non-dormitory students

 This cross-sectional study was conducted on 230 students (dormitory and non-dormitory) of Shahid Beheshti University of Medical Sciences, Tehran, Iran, who were selected by a simple random sampling method. They completed the Life Balance Inventory and short form health survey (SF-36) questionnaire. The collected data were analyzed in SPSS v.18 software.

 The work-life imbalance in dormitory students (34.2%) was higher than in non-dormitory students (20.4%). The mean scores of physical health and mental health summary measures in non-dormitory students were higher than in dormitory students. There was a significant correlation between some domains of work-life balance and QOL (P<0.05).

Work-life balance, physical health, and mental health of non-dormitory students are higher than dormitory students. Given the relationship between work-life balance and QOL, educational and welfare planning should be made in universities to help improve the QOL of students.

Upper limb function can be correlated with the self-assessment of children with hemiplegic cerebral palsy.

This study aimed to determine the correlation between fine motor skills and occupational self-assessment in children with hemiplegic cerebral palsy.

Fifty patients aged 8 - 13 with hemiplegic cerebral palsy, who had 1 of 3 levels (I to III) of hand skills based on the manual ability classification system (MACS), were selected. The Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) Questionnaire for the motor skills and Child Occupational Self-Assessment (COSA) Questionnaire were given to participants. The Spearman correlation coefficient at a significance level of 0.05 was used to determine the relationship between the variables.

The mean and SD of occupational self-assessment and its subscales (i.e., occupational value and competence) at different levels of hand dysfunction (I - III) were 115.68 ± 14.04, 54.70 ± 8.83, and 60.98 ± 5.69, respectively. The mean and SD of fine motor skills and its subscales (i.e., visual-motor control, response speed, and upper-limb speed) and dexterity at different levels of hand dysfunction were 70.44 ± 14.76, 4.04 ± 2.44, 33.70 ± 6.19, and 32.70 ± 7.07, respectively. The spearman correlation showed a significant relationship between fine motor skills of hand and its subscales with occupational self-assessment and its subscales (P < 0.05).

The findings showed that to improve occupational self-assessment of cerebral palsy children, special attention should be paid to progress the function of the upper extremity through occupational therapy interventions. It can lead to improved quality of life, strong sense of self-efficacy, and greater independence.

Button mushroom (Agaricus bisporus) is approved in the global food market, with regards for 30% of total mushroom production in the world, and high content of bioactive constituents including vitamins, minerals, essential amino acids as well as valuable source of polysaccharide (Meng et al., 2012). The market for sliced fresh mushrooms is increasing rapidly due to consumer demand for prepared ready-to-use vegetables and convenience foods. Button mushroom was considered as a highly perishable food due to high respiration rate, and actually no natural physical barrier on its surface to protect it, which leading to texture softening, moisture loss and browning during postharvest (Brennan et al., 2000). For sliced fresh mushrooms, the shelf life is even shorter because of the effects of the washing and cutting processes. Melatonin (N-acetly-5-methoxytryptamine) is an endogenously beneficial indole amine synthesized by all cellular organisms, which can reduce the physiological detrimental effect of abiotic stresses in plants (Zhang et al., 2018). With this regard, melatonin can play prominent roles, as a highly efficient antioxidant, scavenging molecule, and as a signaling molecule in regulating or adjusting ROS scavenging enzyme activities (Zhang et al., 2018). Recently, numerous studies reported that exogenous melatonin treatment besides storage at low temperature has been improved postharvest preservation of several fruit and vegetables (Hu et al., 2018). Since there is no information about the response of fresh-cut button mushrooms to oxidative stress following exogenous melatonin treatment during postharvest cold storage, we evaluated the effects of exogenous melatonin on qualitative attributes of fresh-cut button mushroom with regard to cap browning, weight loss, membrane permeability indicators and phenol metabolism during postharvest low temperature storage.

Button mushrooms were selected on the basis of the uniformity of maturity and size and any mechanical wounded, and were then hand sliced using a sharp knife (4 mm wide). The sliced fresh mushrooms were immersed in 0, 1, 10, 100 and 1000 µmol/L of melatonin solution for 5 minutes at 20 °C, then removed from melatonin solution and air dried at room temperature for 1 hr. After that, sliced mushrooms of each replication were packed in 500g pet plastic mushroom box (40 sliced mushrooms per box) and stored in darkness at 4 °C with 90-95% relative humidity. During storage period (5, 10 and 15 days) sliced mushroom caps per replication of each treatment were used for estimating of traits. The button mushroom weight loss was determined during storage period. To calculate the browning index (BI), photographs of edible mushroom samples were taken on sampling days and L, a and b were calculated in Photoshop software environment. Weight loss was measured according to the method of Nasiri et al (2017). A spectrophotometric procedure described by Terada et al (1978) used for the determination of ascorbic acid content. Total phenolics was measured with using the Folin–Ciocalteu reagent by Singleton and Rossi (1965) method. The texture of the mushroom cap was used to measure electrolyte leakage content and determined essentially as described by Meng et al (2012). Malondialdehyde accumulation was measured with using the thiobarbitoric acid reagent according to the method of Hodges et al (1999). DPPH radical was used to measure of scavenging activity according to the method of Dokhanieh and Aghdam (2016). The extraction and activity of PAL were determined using method described by Nguyen et al (2003). PPO was extracted with acetone according to Nguyen et al. (2003). One-way analysis of variance and Duncan’s multiple range test at P<0.05 were used for multiple mean comparisons with SAS software.

Our results showed that weight loss and cap browning index of fresh cut mushrooms following exogenous melatonin treatment (10 µM), was significantly declined to lower amount than the control during cold storage at 4 °C for 15 days. According to our results, exogenous melatonin treatment significantly slowed process of senescence in strawberry fruit as exhibited by reduced weight loss and cap browning softening of during storage (Liu et al., 2018). At the end of storage, application of endogenous melatonin at 100 µmol/L led to an increase in total phenol and ascorbic acid in fresh cut button mushrooms. Similar enhancements in total phenol and ascorbic acid along with quality retention have also been reported in exogenous melatonin treated of peach and strawberry fruit during storage time (GAO et al., 2016; Aghdam & Fard, 2017). In this study, exogenous melatonin treatment obviously declined the increasing rate of electrolyte leakage rate as well as MDA contents compared to the control, demonstrating that the effect of melatonin in reduction of membrane oxidative damage might lead to slow down browning and senescence in fresh cut mushrooms. In agreement with this suggestion, suppression of oxidative stress due to retarded senescence and quality deterioration has been described in melatonin treated cassava root and strawberry and pomegranate fruit (Ma et al., 2106; Liu et al., 2018). DPPH scavenging capacity of melatonin treated fresh cut mushrooms steadily remained higher than the control during cold storage. Higher phenylpropanoid pathway activity in response to exogenous melatonin treatment during storage, might lead to accumulation of phenolic compounds which in result provided free radical scavenging capacity up-regulation (Zheng et al., 2019). As shown in this study, higher PAL and lower PPO enzymes activity in fresh cut mushrooms followed by exogenous melatonin treatment, may be associated with molecular signaling of H2O2 pool due to enhanced NADPH oxidase enzyme activity, result in triggering phenylpropanoid pathway might lead to higher total phenol content and higher total antioxidant scavenging activity, as well membrane lipids protection from peroxidation which indicated by enhanced PAL/PPO enzymes activity accompanying with lowering cap browning (Rastegar et al., 2020).

In summary, results of this study revealed the functional effects of postharvest exogenous melatonin application at 10 µM in preserving fresh cut mushrooms quality by retarding senescence process in A.bisporus as demonstrated by attenuating weight loss and cap browning during cold storage at 4 °C for 15 days. Bioactive constituents such as ascorbic acid and total phenolics notably enhanced in response to exogenous melatonin, which is accompanied with higher PAL and lower PPO activities in melatonin treated fresh cut mushrooms during storage time. Melatonin application maintained cell membrane stability as exhibited by lowering electrolyte leakage, MDA values as well as enhancing total antioxidant activity. In general, our result showed exogenous melatonin treatment can be used as a safe and beneficial method to maintain button mushrooms quality, reduce the cap browning and prolong postharvest life the mushrooms.

Nurses job satisfaction is one of the effective factors in improving the quality of nursing care. The aim of this study was to determine the factors affecting job satisfaction of nurses who working in emergency departments in public hospitals, affiliated to Tehran University of Medical Sciences.

This study was a cross-sectional study conducted in the emergency departments of 14 hospitals that affiliated to Tehran University of Medical Sciences. The data collection tool, including a demographic questionnaire and a Herzberg Worksheet Satisfaction Questionnaire. The study sample consisted of 665 nurses working in the emergency department who entered the study by census method. The obtained data were analyzed using descriptive and analytical statistical tests (Mean ±SD and Chi square) and Version 18 SPSS software.

The Mean ±SD of job satisfaction in nurses (141.58±36.831) was moderate to low and the highest level of satisfaction in two dimensions, respectively, communication with colleagues and patients (48.3درصد) and job status (27.7%) and the lowest level of satisfaction were in two dimensions, salary and benefits (62.4درصد) and work situation (49.3%), respectively.

In all organizations, job satisfaction has been identified as an important factor in creating employee motivation, efficiency and responsibility. Job satisfaction in nurses, improve the quality of nursing care and reduce their retirement.

The use of growth-promoting bacteria increases vegetative growth, and with it, timely consumption with appropriate concentrations of growth retardant can play a role in the distribution of nutrients to the shoots and roots, and thus improve dehydration tolerance. For this purpose, in this study, the reaction of the new super wheat cultivar SHS022 under the conditions of irrigation regime with the use of growth-promoting bacteria and the application of growth retardant paclobutrazol were investigated. This research was conducted as a factorial split plot in the form of a randomized complete block design with three replications in Qom and Hamedan in the 2018-19 crop year. The first factor includes the amount of irrigation with three levels (irrigation at 40% of available moisture discharge throughout the growing season (control), normal irrigation up to pollination stage and irrigation at 60% available moisture discharge until seed maturity, irrigation at 40% Moisture release available up to pollination stage and cessation of irrigation until the end of the growing season) and the second factor includes foliar application of paclobutrazol at three levels (0, 50 and 100 ppm) and the third factor including growth-promoting bacteria at five levels (control, Mycobacterium, Azotobacter and Azospirillium and combination). According to the results of analysis of variance, the main effects on chlorophyll fluorescence parameters, flag leaf relative moisture content, flag leaf chlorophyll content and Rubisco activity were significant. According to the results of comparing the mean in the first level of irrigation regime, there was no significant difference between paclobutrazol levels, but in the second level of irrigation regime, the highest percentage of relative leaf moisture was obtained at a concentration of 100 ppm paclobutrazol (66.23%), so that two levels Control and 50 ppm were in a lower statistical group (52.95 and 56.63%, respectively), but in the third level of irrigation regime, the highest trait was obtained at a concentration of 100 ppm paclobutrazol with 55.36% and The lowest was evident at the control level with 38.24%. The interaction effect of irrigation regime on paclobutrazol on Rubisco activity was significant so that in the first level of irrigation regime there was no significant difference between levels of paclobutrazol, but in the second and third levels of irrigation regime the highest amount of rubisco was 100 ppm paclobutrazol. They belonged to 37.63 and 29.27 units, respectively, and the lowest amount of trait was in the control factor.

Surgery wards account for a significant portion of hospital costs, followed by patient costs. Improving surgery wards' performance plays a major role in enhancing the accountability and efficiency of the hospital. This study aimed to evaluate the performance of inpatient surgical wards at the hospitals affiliated with Tehran University of Medical Sciences(TUMS).

A descriptive, cross-sectional, retrospective study was performed at all hospitals affiliated with TUMS in 2018. To measure the efficiency of these wards, three indicators have been considered; bed occupancy rate, the average length of stay, and bed turnover. Data have been analyzed using Excel software based on the Pabon Lasso model .

Among the 15 active surgical departments, 5 (33.31 %) were categorized in quadrant three, including ophthalmology, obstetrics and gynecology, vascular and trauma surgery, plastic surgery, and infertility department. The oral and maxillofacial surgery and general surgery departments were the poorest in their performance and located in quadrant one. Ten surgical wards out of 38 (26.33 %) have reported a satisfactory performance.

Understanding and comparing the performance of clinical departments is also useful in making decisions for standardizing the patterns of health services delivery, evidence-based management in health care centers, and enhancing accountability in the health system. It is suggested that managers revise the departments in the inefficient area to reduce the number of inefficient departments or attract more patients by marketing, diversifying services, and increasing the quality of services.

One of the main problems of crop production in our country is the difference between the actual grain yield of farmers and the achievable grain yield or the yield gap. In order to investigate the management factors affecting the reduction of wheat yield in Mahdasht of Karaj, a field experiment was conducted in the crop year 2017-18 in the farms of Mahdasht which was previously selected by the researcher. In this study, using stepwise regression, the contribution of all management factors that may play a role in reducing yield has been investigated. The results of correlation between different factors showed a positive and significant correlation between grain yield with the number of irrigations, nitrogen application in the second stage, total nitrogen consumption during the growing period and micronutrient consumption at a probability level of 1%, and there was a positive and significant correlation with the area under cultivation at the 5% probability level. According to the recorded wheat grain yield values, the average actual wheat grain yield was 4775 kg.ha-1 and factors affecting yield reduction in this area including the number of irrigations (42%), area under cultivation (9%), previously cultivated crop (6%) and total nitrogen consumption (5%) were determined. Other management factors had little effect on grain yield reduction. Potential grain yield in Mahdasht of Karaj according to the regression model can be raised to 7630 kg.ha-1, and the grain yield gap in this area is 2860 kg.ha-1.

The COVID-19 pandemic has caused a lot of changes on an individual and societal level. The current study was designed to investigate the impact of the isolation/ social distancing period on people’s sense of Being, Belonging and Becoming in the early stages of the COVID-19 measures.

A cross sectional survey study design was employed using a researcher-developed questionnaire with items developed based on the Model of Occupational Wholeness to investigate the changes that may have happened to what people have been doing during the COVID-19 measures compared to the time before. A sample of 1206, using snowball sampling, responded to the online questionnaire.

Findings indicated that participants at the early stage of the COVID-19 pandemic had changed the pattern of their Doings. The change of pattern, which was considered positive, was in relation to people valuing their health, having more time to take care of themselves, and doing activities which they had never had enough time to do before.

While these findings are not generalizable, they provide some insights into how the post-pandemic lifestyle of many people does not permit doing a lot of activities that could help with their health and well-being. While enforced isolation may have negative consequences, it is also clear that the pre COVID-19 pandemic lifestyle did not fully support healthy living. Reflecting on the COVID-19 lockdown experience provides an opportunity to review what are the essential personal and societal elements for living a healthy life.

 Family-centered services are collections for children with special needs and their families. These services consider families as expert about childrenchr('39')s needs. The essence of this approach is involvement of family in decision making, cooperation, and mutual communication (family and therapist), mutual respect, acceptance of family choice, family support, flexibility of service, and effort to empower families. These services have become a basic foundation of many early intervention programs and are especially useful in rehabilitation services. MPOC-20 is one of the questionnaires used to evaluate these services. This questionnaire consists 20 questions divided into 5 areas, the areas include the following: 1) enabling and partnership, 2) providing general information, 3) providing specific information about the child, 4) coordinated and comprehensive care for child and family, and 5) respectful and supportive care. This tool has been translated and validated in several countries and specifically in several diseases. In this study, the validity and reliability of this tool have been investigated.

 This study was a descriptive-analytical and in order to measure the validity and reliability of MPOC-20, content validity, correlation coefficient and reliability of the test-retest were done. To determine the content validity, 14 occupational therapists were asked and the result was calculated by measuring the content validity index and content validity Ratio. Then, an MPOC-20 questionnaire along with a form of demographic information and a consent form were given to 340 parents of children (children under 18 years and with different diagnosis) in clinics of Tehran. The articipants consisted of 142 girls patients (42%) and 198 boys (58%) randomly selected from public and private rehabilitation centers in different regions of Tehran. A large percentage of respondents were mothers (314 people were 92.4%). After 2 weeks, the questionnaire was again distributed among 30 of them, and the ICC coefficients were calculated. In order to determine the internal consistency, Cronbachchr('39')s alpha was calculated.

 The content validity index and content validity Ratio for all items were acceptable and no items were deleted. Cronbachchr('39')s alpha was 0.81 which indicates a high correlation between items in the questionnaire. The highest Cronbachchr('39')s alpha coefficient is related to the field of providing general information about the child (α=0.77). Also, in this section, the p-value was significant for all fields at the level of 0.001. In the reliability of the test-retest, the scores of the Intra-class correlation coefficient of all domains were higher than 0/6 which indicates a medium to good reliability of the questionnaire. Reliability in the field of supportive care had a high coefficient and good reliability. In other areas, the reliability was moderate.

 Considering the importance of evaluation in improvement of family-centered services provision, a strong tool is needed and MPOC-20 is well known in this regard. The results of this study showed that the Persian version of "MPOC-20" questionnaire has a good validity and reliability in children under the age of 18, and it can be used to assess family-centered services in both research studies and as clinical tool.