Medical Journal of Mashhad University of Medical Sciences
Year:2020 | Volume:63 | Issue:2|Papers Count:27

Introduction: Congenital heart disease could have effect on life expectancy and may be associated with other anomalies causing hemodynamic abnormality which regress after resolving the shunt. The purpose of this study was to investigate the change in the mitral valve prolapse after defect closure in patients with atrial septal defect. Materials and Methods: This study including all patients with atrial septal defect (ASD) who referred to Ghaem and Imam Reza Hospital in Mashhad from September 2017 to September 2018, and had been candidates for atrial septal defect closure. Demographic data were collected. Two-dimensional echocardiography was done before and after defect closure procedure. Exclusion criteria including patients with suboptimal echocardiography view and post procedure residual shunt. Results: The results of this study showed in patients with atrial septal defect, the prevalence of mitral valve prolapse was 51. 2%. Also, 19. 05% of patients with mitral valve prolapse before the defect closure procedure, did not have any prolapse after the procedure. On the other hand, the mean and standard deviation of right ventricle and right atrium size and pulmonary artery pressure after the procedure were significantly lower than values before the procedure. Conclusion: The results of this study indicated, in the presence of ASD, right ventricular (RV) volume overload by effect on left ventricle, could cause mitral valve structural abnormality. This abnormality could be regress after ASD closure and resolving of shunt effect on RV.

Introduction: Colistin is an old antibacterial agent, which is using for multiple drug resistant (MDR) infections. Due to increased rate of MDR infections, the use of this agent is rising worldwide. The aim of this study was to identify colistin utilization patterns in a teaching hospital.  Materials and Methods: This prospective study performed on 43 patients admitted to Imam Reza Hospital at Mashhad from March 2018 until February 2019 who received more than three doses of Colistin. At the beginning oof the study, demographic characteristics, Colistin doses, laboratory findings, culture results and the response to treatment bwere recorded. Finally, Data were analyzed by SPSS v. 16 software and the frequency of errors in Colistin indication, dose, dose intervals, and dose adjustments were evaluated, also for drug interactions.  Results: Out of 43 patients who received colistin, burning (39. 53%) was the main indication for Colistin prescription. Colistin was prescribed based on microbiological findings for 20. 93% of cases, only. Colistin was administered prior to culture response for 39. 53% of cases, and for 39. 53% of cases no specimen for culture was sent. In 81. 25% of cases the received dose was correct and in 18. 75% the dose was more than standard. Dose adjustment based on creatinine monitoring was not performed properly in 71. 43% of cases. A total of 541 Colistin vials were administered without indication and a cost of 90. 347. 000 Rials was imposed on the Health system.  Conclusion: The results of this study indicate that there is a pressing need for physicians' training programs and appropriate strategies for prescribing Colistin in the treatment protocols.

Introduction: one of the problems of general medical education is that students are not interested in practical and practical training as they seek to assist and participate in the assistive exam. Along with this, there are a variety of classes that most students use and even unethical methods, such as buying questions, sometimes is common. Despite these issues, we always see a significant number of assistants dropping off after acceptance. So, we decided to find and evaluate the causes of the withdrawal of assistants from education. Materials and Methods: This cross sectional study that was conducted on all of the Assistant during the last 5 years in the first half of the 1397. In this study, a researcher-made questionnaire was used. Results: In this study, 62 specialized assistants who had withdrawn from 1992 to 1996 were enrolled to the study. 48 (%77. 4) of subjects were married. 39(%62. 9) were free quota and 19(%30. 6) were deprived areas quota and the rest of the population included other quotas. Most of the withdrawals were related to emergency medicine and then children. Lack of personal interest, family problems and duty in assistants were the most common reasons for withdrawal. About 70% of them willing to attend exam again and radiology and skin was the most favorite fields. Conclusion: The results of this study can provide achievements for associate Policymakers, especially those from medical science universities.

Introduction: Morphine as a basic opioid is a full agonist of brain receptors exerts its activity. Initial symptoms of morphine abuse are respiratory depression through direct central nervous system depression and can ultimately lead to apnea or complete respiratory arrest. Toxic dose of morphine suppresses the central nervous system and can cause coma. For the analysis of drugs abuse, often examples such as blood, liver, bile and urine are used. Materials and Methods: In this study, urine and bile samples of 635 unknown samples were tested for morphine and codeine using thin layer chromatography and to biologic samples were compared. Results: Meanwhile, aside from the negative examples and statistical analysis was performed between positive samples. The results showed that morphine levels in bile are many times more than in the other samples. In cases that a drug or its metabolites in the blood and other samples cannot be detected, it can be detected in the bile. Conclusion: Considering the results of this study, it can be concluded that bile samples as a supplement along with other samples such as urine can be used in detection and documentation of morphine and codeine.

Introduction: In this retrospective study, we compared odontoid fractures type two patients treated with two methods of anterior and posterior surgery. Materials and Methods: In this cross-sectional retrospective study, 39 patients under 65 years old with odontoid fractures type two and its subtypes witch had anterior and posterior surgery were included in the study. Necessuray experiments and information included open mouth radiography, AP, letral and CT scan if needed, and also demographic information, mechanism of injury, occurrence of neurologic symptoms at the time of admission, the length of hospital and ICU stay, and length of surgery were completed. Finally, the data were analyzed by SPSS software. Results: Among 39 pateints, 25(64. 1%) were male and 14(35. 9%) were female. The length of ICU stay and surgery in posterior group were significantly higher than anterior group (p<0. 05). Any complications such as: displacement, loosening, CSF fistula, esophageal rupture, hypoglossal nerve rupture were not not created or exacerbated. Fusion rate in 12 month was sinnificantly higher in posterior group but after 24 month there was not any significant changes between two groups. Conclusion: According to the results, posterior surgery is the standard and selective method for the treatment of these odontoid type two fractures which have good clinical results and fewer complications.

Introduction: Faculty members are the most important asset of any higher education institution. Empowerment of faculty members in the fields of teaching, research, and leadership will also lead to the performance of the mission of the educational institution. A needs assessment has long been considered as one of the important components in many areas that deal with planning to achieve certain goals and objectives. Effective management of university education requires managerial skills. This study was conducted to assess the managerial skills of managers of educational departments of Mashhad University of Medical Sciences. Materials and Methods: In this cross-sectional study, 70 managers of the educational departments of the faculties of Mashhad University of Medical Sciences entered the study in the census. The instrument was self-reported questionnaire that was sent to participants. This was including 68 items that were measured technical skills (32 items), conceptual skills (15 items) and human skills (21 items). The questionnaire was designed based on Katz's theory of management skills and the validity of the questionnaire was measured by content validity and its reliability was measured by Cronbach's alpha (α = 0. 80 and test-retest (r = 0. 83). Answer the questions based on the Likert scale (very high, high, low, rarely) that the scoring 4 to 1. The questionnaire was sent to each faculty member via e-mail. Data were analyzed using SPSS software version 20 and descriptive and inferential statistics (analysis of variance). Results: The results showed that the mean age of the subjects was 38. 4 04 8. 04. The technical skills of managers about with the duties of 93. 8% are too high compactness. In human skills Participatory system, with emphasis on the reform proposals and also the ability to modify their behavior and attitudes in the 75 percent needs managers is very high or high. Perceptual skills and familiarity with the strategy based on the 68. 8 percent estimate is high and very high compactness. Conclusion: In cases of technical skills, human skills, perception skills of training managers and the results should be reinforced in training programs.

Introduction: The aim of this study was the investigating rational use of opioid and non-opioid injectable analgesics in patients admitted to surgery and emergency wards of Imam Sajjad general hospital, Ramsar, Iran. Materials and Methods: This descriptive and retrospective study was performed between July to August 2016 on 1181 files of patients receiving injectable analgesics and admitted to surgery and emergency wards of Imam Sajjad general hospital. Different information including indication, dose of administered drug and duration of treatment were recorded and compared to the AHFS guideline. Results: Among 1181 subjects, 675 patients were admitted to surgery and 506 patients to emergency wards. The main indications of injectable analgesic administration were trauma, cancer pain, chest pain and lumbar neuropathic pain, respectively. Of the 1181 patients, 568 cases received opioids, 341 cases received non-opioids and 272 cases received both opioid and non-opioids. Among the opioids, morphine was the most prescribed and among the non-opioids ketorolac was the most. Mostly encountered adverse effects were nausea and vomiting, hypotension and headache. Overall, 23. 62% of the prescriptions were in accordance with guideline and 76. 37% of them weren’ t compatible. Conclusion: Because of high inconsistency with guideline, it seems to need more attention on promoting medical staff information about prescription and rational use of injectable analgesic drugs.

Introduction: New advances in the world of technology have made smartphones a way for people to communicate. Despite the benefits of a smartphone, addiction to the use of this technology can lead to many personal, social and cultural harms. The aim of the present study is to investigate the factors affecting smartphone addiction in high school adolescents in Semnan. Materials and Methods: In terms of method, the present study is descriptive and survey. The method of data collection in this field research and data collection tool is the standard questionnaire. The statistical population is the students of Semnan girls 'and boys' high schools. Out of 200 distributed questionnaires, 189 valid and measurable questionnaires were collected and finally analyzed and analyzed by structural equation method. Results: The results of this study show that the mediating variable of intention to use on the hypotheses of intellectual anxiety on smartphone addiction, attitude on smartphone addiction and mental disorder affect smartphone addiction and the moderating role of social impact on intention Use in smartphone addiction has not been effective and the role of moderation of use stress has not been effective in intention to use in smartphone addiction. Conclusion: Based on the results of this study, intellectual rumination, attitude and feeling of deprivation of security with the mediating role of intention to use addiction to smartphone use is effective in high school teenagers in Semnan.

Introduction: Staphylococcus aureus is a Gram-positive cocci which is one of the main infection causes. 20-30% of healthy people carry staphylococcus in their nasal cavities. Staphylococci resistant to beta-lactam is called MRSA. Regarding the presence of MRSA in the therapeutic environment. The sample was taken by swapping from nose secretion of emergency department staff at Ghaem Hospital. This study aims staphylococcus resistant to antibiotics. Materials and Methods: In this study, 100 emergency medical personnel of Ghaem Hospital in Mashhad were sampled from nasal secretions from Farvrdin to Aban 1397. Samples were taken by two sterile wet swabs from nasal secretions and by chemical test, staph coccus was detected and antibiotic susceptibility test was done by Kirby Bayer method. Results: From a total of 100 employees in emergency departments of Ghaem Hospital, 68 samples revealed Staphylococcus aureus (68%), while 21 samples of Staphylococcus aureus were found to be beta-lactamase positive. Resistance to antibiotics was observed, 100% of samples were resistant to penicillin and the highest sensitivity to cefotaxime was 100%. It was notable that one sample was resistant to vancomycin (3. 5%). Conclusion: If an employee has MRSA in nose secretion, they shouldn’ t have direct contact with patients. More caution is needed in hospital occupations.

Introduction: The purpose of this study was to determine the cognitive-behavioral hypnotherapy, drug therapy on psychological Hardiness, and state-trait anxiety in panic disorder. Materials and Methods: The statistical population consisted of all persons referring to Ebnsina Specialty Hospital in Tehran in the year 2018-2019. Forty-five patients were selected by simple random sampling and were replaced in 3 groups of 15 persons (two experimental and one control group). Participants were assessed with Kiomarsi, Najarian, and Mehrabi Zadeh Honarmand Psychological Hardiness (1998), Spielberger State-Trait Anxiety (1970). Participants were then trained for five sessions, received drug therapy under the supervision of a drug specialist, and the control group received no training. Results: Data were analyzed using multivariate analysis of covariance. The results showed that there were significant differences between the variables of psychological hardiness and trait anxiety post-test hypnotherapy with a post-test control group and drug treatment group. In the case of state anxiety variable, treatment had no significant effect. The post-test showed that the level of psychological hardiness in the hypnotherapy group was significantly higher than the control and drug treatment groups. Also, trait anxiety in the hypnotherapy group was considerably lower than the control and drug treatment groups. Conclusion: Given the significant impact of cognitivebehavioral hypnotherapy on psychological hardiness and state-trait anxiety in panic disorder are suggested to be used to improve the mental health of these patients.

Introduction: Major depressive disorder is the third and obsessive-compulsive disorder is the fourth most common mental disorder. These disorders have devastating effects on a person's job, education, and social functioning. The aim of this study was to compare the personality traits of depressed, obsessive-compulsive patients. Materials and Methods: The research method was based on causalcomparative method and its statistical population was the clients of psychological and psychiatric centers of Sari city in 1397. Thirty people were randomly selected and randomly assigned to two groups of 15 obsessive-compulsive patients and depressed patients. The tools used included a five-factor personality questionnaire (NEO) (McCray and Costa, 1985) and Beck Depression (Beck, 1961). In order to analyze the results, a variance analysis test with a significant level (α = 0. 05) was used. Results: The results showed that people with depression and obsessive-compulsive disorder in the characteristics of Nowruz (P <0. 001), extroversion (P <0. 018), empiricism (P <0. 003), consensus (P <0. 004), conscientiousness (P <0. 042 were different from people with obsessive-compulsive disorder. Conclusion: Based on the findings of this study, it can be said that due to the differences in different groups of patients in terms of personality, these characteristics may be different in creating and continuing and the effect of these variables on various mental disorders and problems.

Introduction: Diabetes is a metabolic disorder in the body that is impaired by the ability to produce insulin hormone. The main purpose of the present study is to discover the hidden knowledge in the data of diabetic patients, which can assist clinicians in clustering new patients and prescribing appropriate medication according to each cluster. Materials and Methods: In this paper, we use MR-VDBSCAN algorithm. The implementation of this algorithm is based on the map-reduce framework of Hadoop. The main idea of the research is to use local density to find the density of each point. This strategy can prevent clusters from joining at different densities. Results: The algorithm is based on the selected dataset, tested and evaluated, and the results show high accuracy and efficiency. The results were compared with the results of k-Means clustering, The MR-VDBSCAN algorithm has a higher execution speed than that of the algorithm and has the ability to detect clusters with different density of superiority of this algorithm than the comparable algorithm. The results show that the MRVDBSCAN algorithm can provide better performance than other algorithms. In particular, the similarity of the proposed algorithm is 97% for the diabetes set. Conclusion: The results show that the MR-VDBSCAN algorithm performs better clustering than the K-means algorithm and can place patients into subgroups that assist physicians in prescribing.

Introduction: The purpose of this study was to investigate the demographic factors and self-esteem among women victims of spouse abuse and its necessity to review it legally. Materials and Methods: The statistical population of the study was all women who suffered from spouse abuse in Mashhad in 1395. The sample consisted of 200 women suffering from domestic violence that via convenience sampling and volunteers were selected. To collect information from the checklist of demographic factors, a questionnaire measuring violence against Haj Yahya women and Cooper Smith's self-esteem was used. Data were analyzed using Pearson Correlation and multiple hierarchical regressions by SPSS software version 19. The data were analyzed using SPSS software. Results: The results showed that there was a significant relationship between demographic indicators and spousal abuse, so that variables such as low level of education in the couple and the number of children in the negative direction and addiction in the couple in the positive direction predicted spousal abuse, but self-esteem was not able to predict spouse abuse. Conclusion: identifying the effective factors in the occurrence of spousal abuse with government intervention and formulating policies for coping can help to design more targeted programs to reduce and prevent this phenomenon by taking measures to reduce spouse abuse, which is the same as primary prevention.

Introduction: The chronic physiologic diseases such as diabetes cause psychological damages such as depression in the patients suffering from them. Therefore the present study was conducted aiming to investigate the effectiveness of emotion-based therapy on the anxiety and psychological wellbeing of the patients suffering from type 2 diabetes. Materials and Methods: The research method of the present study was quasi-experimental in pretest, posttest type with control group and sixmonth follow-up stage. The statistical population of the study included all the patients with type 2 diabetes who referred to the physicians specialized in diabetes 2 in the city of Shiraz in 2019. 60 patients with type 2 diabetes were selected through purposive sampling method and they were randomly accommodated into experimental and control groups (each group of 30 patients). The patients in the experimental group received 14 emotion-based therapy sessions during three-and-a-half months. Anxiety questionnaire (Beck, 1988) and the questionnaire of psychological wellbeing (Ryff, 1996) were used in the present study. The data from the study were analyzed through repeated measurement ANOVA via SPSS23 statistical software. Results: The results showed that the emotion-based therapy has significant effect on the anxiety and psychological wellbeing of the patients with type 2 diabetes (p<0. 001) in a way that this therapy succeeded in leading to the decrease of anxiety and the improvement of psychological wellbeing in these patients. Conclusion: Considering the results of the present study, emotion-based therapy can be considered as an efficient therapy to decrease the depression of the patients with type 2 diabetes through concentrating on awareness and emotion management and the people’ s awareness of emotional processes.

ntroduction: Attention to the psychological, emotional and educational components of students is becoming more and more common. according to this the purpose of this study was to predicting academic buoyancy based on family emotional climate, academic engagement, and academic selfefficacy. Materials and Methods: The research method was descriptive correlational. The statistical population consisted of all high school female students in Saveh city in the academic year of 2018-2019 that 347 students were selected through cluster sampling. The tools used included the Rio and Tsing' academic engagement (2011), Morgan & Jinks academic self-efficacy (1999), Hillburn's family emotional climate (1964), Dehghanizadeh and Husseinchari academic buoyancy questionnaires (2012). Pearson correlation coefficient and multiple regression were used for data analysis Using SPSS 23 software. Results: Pearson correlation results showed that there is a positive and significant relationship between family emotional climate, academic engagement, and academic self-efficacy with academic buoyancy (p <0. 01). The results of multiple regression analysis also showed that family emotional climate, academic engagement and academic self-efficacy were able to predict 12% of the variance of academic buoyancy. Academic selfefficacy with beta coefficient (β = 0. 15), academic engagement with beta coefficient (β = 0. 19) and family emotional climate with beta coefficient (β = 0. 12) had significant role in predicting of academic buoyancy. Conclusion: The results support the ability of academic involvement, academic self-efficacy and family emotional climate in predicting students' academic buoyancy.

Introduction: Now a day, there is a crucial need for a quick and effective disinfectant to prevent nosocomial infections in hospitals. Meanwhile evaluation and validation of disinfectants are important. hospital surfaces, instruments, and rooms. the aim of this study was to evaluate the effect, quality and disinfectant activity of the Quick spray (Virobac Spray). Materials and Methods: Antibacterial activity of Quick spray (Virobac Spray) was evaluated on four different gram-positive and gram-negative bacterial strain including Staphylococcus aureus (ATCC 29737), Pseudomonas aeruginosa (ATCC 28753), Escherichia coli (ATCC 25922) and Enterococcus faecalis (ATCC 1237. The antimicrobial solution was examined in ½ , ¼ , and 1/8 dilutions, and the antibacterial effect was determined after the exposure time such as 45, 60, 90, and 120 seconds. Results: Quick spray (Virobac Spray) show a powerful antibacterial activity even in ½ dilution, also we demonstrate that the antibacterial activity of this solution will be enhanced with increased time of exposure. Conclusion: the result of this study demonstrated that Quick spray (Virobac Spray) is a broad-spectrum and effective disinfectant and are able to inhibit the growth of a wide range of bacteria including grampositive and gram-negative bacteria.

Introduction: Subcutaneous emphysema is a clinical condition that occurs when air enters the soft tissues under the skin. The condition may occur in any part of the body depending on the pathology. The aim of this study was to evaluate the sensitivity and specificity of the history and physical examination of subcutaneous emphysema in blunt trauma patients. Materials and Methods: This is a descriptive-analytical study. All patients with blunt trauma referred to the emergency department were evaluated for the mechanism of injury, major complaints, vital signs, and oxygen saturation. History and physical examination were performed according to Barbara Bates' reference. Emphysema was diagnosed based on chest X-ray results. The results were analyzed using ROC curves in SPSS software. Results: Emphysema was detected in 3 cases of 99 patients with mean age of 33. 4 19 19 43. 43. AUC analysis of heart rate was significant (P = 0. 032). A heart rate above 98. 5 was associated with a sensitivity of 17. 6% and a specificity of 66. 7% with emphysema. In other tests, pneumothorax had the highest sensitivity and specificity (100%). An interesting finding was the sensitivity of 100% rib fracture to emphysema. After that, pulmonary contusion, pulmonary noise reduction, and chest scratching were 66. 7%, followed by pain, shortness of breath, and hemothorax with 33. 3%. Conclusion: Proper physical examination and history taking can help to diagnose emphysema with high sensitivity and specificity. The purpose of this study was to demonstrate the importance of this topic.

Introduction: Paying attention to the subject of mental health and psychological well-being in old age became a necessity and in order to achieve a comprehensive and effective program to promote psychological well-being in the elderly, it was necessary to research, study and find effective and related factors. The aim of this study was to determine the mediating role of self-care and spiritual experiences in the relationship between psychological well-being and social support of the elderly. Materials and Methods: The present research method was correlation with path analysis method. From the community of all elderly people in private and public centers of Tehran in 1997-96, 300 elderly people (76 men, 224 women) were selected by military sampling method. The research tools included Reef's Psychological Welfare Questionnaire, Social Support Questionnaire, Self-Care Scale, and Spiritual Experience Questionnaire. In this study, Sobel test, path analysis and structural equation modeling were used to analyze the research findings. Results: The results showed that the variable of social support indirectly had a significant relationship with psychological well-being through self-care and spiritual experiences (p≤ 0 / 005). Conclusion: The model of predicting the psychological well-being of the elderly based on social support with self-care mediation and spiritual experiences has a favorable fit.

Introduction: Klebsiella pneumonia, a gram-negative bacterium, is one of the leading causes of nosocomial infections, especially in the urinary tract. The current study aimed to determine K1 and K2 capsule serotypes in samples collected from hospitals in Kermanshah. Materials and Methods: This study was descriptive cross-sectional research. The samples were collected from patients with urinary tract infections or wounds caused by burns between the first 4 months of 2016. The serotype of samples was determined using the polymerase chain reaction (PCR) method with primers for magA and wzy genes which belong to the CPS gene cluster and are necessary for the biosynthesis of K1 and K2 capsular polysaccharides, respectively, after approving bacteria by the phenotypic method. Results: The findings showed that out of 60 samples approved in phenotypic studies with a 1: 1 ratio of urine and wound samples, 37 (61. 67%) samples belonged to K1 and 23 (38. 33%) samples to K2 serotype. Moreover, among the urine samples of patients, 22 (73. 33%) samples had K1 serotype. On the other hand, out of the samples belonging to wounds caused by burns, 21(70%) and 9(30%) samples had K1 and K2 serotype, respectively. Conclusion: As evidenced by the obtained results, the prevalence of K1 serotype was higher in both urine and burn samples in the study population.

Introduction: Irritable Bowel Syndrome can influence the patients’ cognitive, emotional and psychological processes in addition to the physical problems that appropriate cognitive therapies should be applied to decrease these damages. therefore the present study was conducted aiming to investigate the dialectic behavior therapy on pain anxiety and depression in the people with Irritable Bowel Syndrome. Materials and Methods: it was a quasi-experimental study with pretest, posttest with control group. The statistical population of the current study was men and women with Irritable Bowel Syndrome referring to circulatory specialists in the city of Hamedan in the second quarter of 2019. 30 patients with Irritable Bowel Syndrome were selected through available sampling method and they were randomly accommodated into experimental and control groups (each group of 15). The experimental group received dialectic behavior therapy intervention (Linhan, 2004) during two-and-a-half months in ten seventy-five-minute sessions. The applied questionnaires in this study included pain anxiety (Mc Cracken, et. al., 1992) and depression (Beck et. al., 1996). The data from the study were analyzed through MANCOVA method. Results: the results showed that the dialectic behavior therapy has significant effect on pain anxiety and depression in the people with Irritable Bowel Syndrome (p<0. 001). Conclusion: according to the findings of the present study it can be concluded that the dialectic behavior therapy can be used as an efficient method to decrease pain anxiety and depression in the people with Irritable Bowel Syndrome employing techniques of bearing distress, acceptance and emotional self-regulation.

Introduction: Asthma is one of the most common chronic diseases and many psychological factors are involved in the onset and severity of the disease. The purpose of this study was to the effectiveness of schema therapy on cognitive emotion regulation and quality of life in asthmatic individuals. Methods: The research method used was quasi-experimental research with pretest-posttest design and control group. The statistical population of this study included all asthmatic individuals who referred to asthma and allergy clinics in Bushehr in year 2019, using a voluntary sampling method, 40 of them were selected and randomly assigned to experimental group and control group (each group of 20 person). The mean age of the samples was 29. 5 ± 6. 32 years. To collect data cognitive emotion regulation questionnaire of Garnefski & Kraaij and quality of life in adults with Asthma Mark & et al (1992) were used. This quasi-experimental study was conducted with a pretest-posttest design with control group. The experimental group underwent schema therapy (8 sessions 90 minutes) but the control group received no treatments. Data were analysed using Covariance Analysis. Results: The results showed that schema therapy was effective to increase cognitive emotion regulation and quality of life in asthmatic individuals (p≤ 0. 05) Conclusion: According to the results, this treatment can be used to increase cognitive emotion regulation and quality of life in asthmatic individuals.

Introduction: E-services have advantages such as increasing speed, increasing access and reducing costs, and non-electronic insurance services lead to a decrease in the speed of service delivery and will lead to dissatisfaction of the insured. Also, in the current context in which coronary heart disease has grown in the world and it will take years to eradicate it, we need to move more towards providing more e-services. Methods: The purpose of this study is to identify the obstacles to the establishment of electronic insurance services in Ahwaz health insurance. The research method is applied in terms of purpose, and in terms of nature, it falls into the category of mixed research (qualitative and quantitative). In the first stage, a questionnaire was provided to the experts using the Delphi method, and finally 8 barriers were identified as barriers to the establishment of the electronic insurance services system: process barriers, infrastructure barriers, support barriers, cultural barriers, knowledge barriers, financial barriers, manpower barriers. Human, executive barriers. In the second phase of the research, a questionnaire was designed based on the identified barriers and provided to the staff of health insurance branches. Results: The results showed that the identified barriers, including process, infrastructure, cultural, manpower, financial, knowledge, support and executive barriers, had a significant impact on the establishment of the electronic insurance services system, respectively. Conclusion: In order to establish an electronic insurance services system, the desired barriers should be identified in order of priority and addressed according to the barrier model.

Introduction: Research has shown that patients with irritable bowel syndrome have difficulty regulating their emotions; Thus the aim of this study was to evaluate the effectiveness of treatment based on acceptance and commitment and compare it with cognitive-behavioral therapy on the cognitive regulatory strategies of excitement of patients with irritable bowel syndrome. Materials and Methods: The research method was quasi-experimental pretest-post-test and follow-up with experimental and control groups. The statistical population of the present study includes patients with irritable bowel syndrome referred to the private offices of physicians in Semirom. The sample size was 45 people with irritable bowel syndrome who were selected by purposive sampling method and randomly assigned to three research groups (two treatment groups treated with CBT, ACT and control group). The data were collected by analysis of covariance and repeated measures analysis of variance and LSD post hoc test. Results: The research results showed that cognitive-behavioral therapy has a significant effect on all aspects of cognitive emotion regulation (P<0. 001). Acceptance and commitment-based therapy also has a significant effect on all aspects of cognitive emotion regulation, except for the components of acceptance, ruminant, perspective, and catastrophe (P<0. 001). There was no significant difference between the effectiveness of cognitive-behavioral therapies and acceptance-based therapy and commitment to cognitiveregulatory emotion strategies (P>0. 001). Conclusion: It seems that both approaches can play an important role in the treatment of cognitive emotion regulation in patients with irritable bowel syndrome.

Introduction: Research has shown that emotion regulation plays an important role in adaptation skills and social problem solving in children also and different aspects of life such as adapting to life changes and stressful events. Preschool children have many problems in areas such as social problem solving, emotional knowledge, and emotion regulation before entering school. The purpose of this study was to investigate the effect of emotion regulation training on social problem solving, emotional knowledge and emotion regulation in preschool children. Methods: The statistical population consisted of all preschool children in Shahrood in the academic year. A sample of 30 children was selected by convenience sampling method and divided into two groups of 15 experimental and control groups. The variables were Grass and John (2003), Izard et al. (2003), and Garnefsky and Craig (2001) children's emotion regulation scales. Pre-test was performed in both groups before the intervention and the experimental group received 8 sessions of 45 minutes of behavioral therapy based on one session per week for the experimental group. The control group did not receive any psychological treatment. At the end of eight training sessions, both groups were re-tested with post-test. To analyze the data, univariate covariance analysis and multivariate analysis of covariance was used. Results: The data obtained through univariate and multivariate analysis of covariance showed that emotional adjustment training program was effective on social problem solving, emotional knowledge and emotional regulation of preschool children (p<0. 001). Conclusion: Therefore, it seems that emotion regulation training through behavior therapy is effective on social problem solving, emotional knowledge and emotional regulation and can be useful.

Introduction: The present study was conducted with the aim of identifying and ranking the factors affecting the social responsibility of schools. Methods: The statistical population of the present study Human resource management and training management formed. Statistical samples of the research were selected for in-depth interviews with experts, managers, deputy managers and formal and contract experts in the education departments of Iran. In this study, the researcher collected the required data by conducting indepth and semi-structured interviews with 15 members of the community. Participants in the present study include three spectrums. In this research, three spectrums of university professors and experts, senior managers and deputies of the general departments of education and official and contractual experts of the education departments were interviewed. And then the data obtained through open coding, pivotal It was selected and analyzed. Thematic analysis technique (theme) was used to analyze the data and the validity of the research findings was guaranteed by the members using review methods, peer review, and participatory research. Results: The results showed effective factors. Social responsibility includes legal responsibilities (paying attention to human rights, paying attention to social laws, intellectual property, adhering to the law) and moral responsibilities (paying attention to transparency, accountability, respect for values and norms). Conclusion: Social responsibility includes legal responsibilities (paying attention to human rights, paying attention to social laws, intellectual property, adhering to the law) and moral responsibilities (paying attention to transparency, accountability, respect for values and norms).

Introduction: Research has shown that positivism affects many variables, including behavior; Therefore, the aim of this study was to identify the components and factors affecting positivity in the organizational behavior of employees of sports organizations during the outbreak of Covid-19. Methods: The present study is applied in terms of purpose and in terms of qualitative method. The data theory method of Strauss and Corbin's systematic approach was used. The statistical population included experts and informants of sports organizations. In this section, sampling was performed by the method of maximum diversity and the total number of participants was 15. In this section, after each interview, the collected data was reviewed and according to the surveys conducted, the next interview was conducted; This process continued until theoretical saturation was reached. Semi-structured interviews were used to collect data. In order to evaluate the quality and validation of qualitative results in the present study, Lincoln and GABA (1985) evaluation criteria including validity, transferability, reliability and verification criteria were used. Results: The findings showed that the central phenomenon in this study is a combination of sub-categories of self-efficacy, resilience, realistic optimism and hope. Causal factors affecting positivism also included organizational support, organizational justice, transformational leadership, and genuine leadership. Underlying factors influencing positivism strategies included organizational culture, organizational self-esteem, and psychological ownership. Interfering factors influencing positivism strategies included role ambiguity, job characteristics, and individual differences. Strategies affecting positivity included positivity training, career adaptability, and personality competencies. Conclusion: Finally, the consequences of applying positivist strategies included increasing employees' job motivation, strengthening attitudes, strengthening organizational citizenship behavior, improving and developing individual development, improving organizational performance, creating social capital and organizational virtue.