Medical Journal of Mashhad University of Medical Sciences
Year:2021 | Volume:63 | Issue:6|Papers Count:32

Introduction: Pneumonia is one of the most common nosocomial infections in intensive care units. In the treatment of healthcare-related infections, antibiotics account for a significant portion of the cost of medication in the intensive care unit (ICU). The aim of this study was to investigate the changes in antibiotic use in terms of frequency and cost of nosocomial infection in ICU at Imam Reza 1000 Bed Referal Hospital in Mashhad. Methods: The present study is a descriptive and cross-sectional on the records of hospitalized patients with nosocomial pneumonia in Internal and Surgical ICU in Imam Reza hospital in 2016. The population was surveyed in full. Refer to patient records, identify antibiotics consumed Based on the prescribed dose for all patients studied, separation was confirmed for each hospitalization day. Then calculations were performed for the mean frequency of each drug item and its cost per day for one patient for the periods before, during and after pneumonia. Results: The results showed that the average cost of antibiotics per day for each patient during the period of nosocomial infection was 538431 million Rials and 343979 million Rials in the previous period. That is a 57 percent increase compared to the pre-pneumonia period. There was also a 33 percent increase in the incidence of pneumonia during the period. Conclusion: Over 50% increase in the volume of prescribed antibiotics during pneumonia nosocomial infection is important both in terms of health care costs and microbial resistance. The findings of the present study can be used to evaluate strategies to reduce this infection through cost-effectiveness studies.

Introduction: The importance of human papillomavirus (HPV) is in high prevalence and clinical manifestations of asymptomatic infection, genital warts (condyloma acuminata), dysplastic lesions, invasive anal cancer, cervix, anus, rectum and a group of oral cancers. This study aimed to determine knowledge and attitude of medical students Islamic Azad University of Mashhad about human papillomavirus. Materials and Methods: In this cross-sectional study, 280 medical students were selected by completing the questionnaire consisting of two parts of knowledge (36 questions) and attitude (9 questions). Data were analyzed by IBM-SPSS24 software. Results: Mean age of the subjects was 24. 84 ±,2. 55 years and 75% of them were females. The mean score of knowledge was 20. 35 ±,3. 54, indicating a relatively low level of awareness in medical students and was significantly correlated with age, level and passing of infectious part, but there was no significant correlation with gender, history of infection and marital status. The mean score of attitude was 13. 56 ±,3. 07, which indicates low level of attitude. Also, the score of awareness was inversely related to the attitude score. Conclusion: Considering the low scores of medical students' knowledge and attitude about human papillomavirus, more attention be paid on education of this disease.

Introduction: Despite the improvement in postoperative outcomes, delirium is a common neurological complication after cardiac surgery. Therefore, the present study was conducted to investigate the relationship between STS risk score and postoperative delirium in ICU in coronary artery bypass graft surgery. Materials and Methods: 150 patients between the ages of 18 and 75 who underwent elective off-pump CABG surgery were evaluated for STS risk score during the operation, the anesthesia protocol was the same, the patient's blood pressure was kept in the optimal range (map: 60-80). Delirium in the patient was assessed with a CAM ICU checklist by a trained nurse after extubation. After the operation, the care protocol was the same in the ICU and in the ICU after extubation, the rate of delirium was assessed by the trained nurse. Results: Frequency male and female was 57 and 93 respectively. STS, was no significant difference between the two groups. The number of grafts and the length of hospital stay in the group was significantly. No significant differences were observed between the two groups. There was a significant correlation between age and weight and STS. Weight, height and body mass index had a significant correlation with STS. The number of pixels received during operation with STS has a significant correlation. The number of platelets received during operation with EF before surgery and duration of operation had a significant negative and positive correlation, respectively. Conclusion: The presence or absence of delirium did not show a significant difference with STS score.

Introduction: Cancer cause many personal and social problems in all aspects of life and increases the support needs in people. This study was performed with aim to investigate the related factors with social support in cancer patients. Material and Methods: This cross-sectional analytic study was performed on 300 cancer patients referred to the health centers of Kerman,the samples were selected using systematic sampling method. Data were collected through the Social Support Self-Made Questionnaire and demographic variables questionnaire. Validity and reliability of the questionnaire were measured through face validity and internal consistency and were analyzed by Pearson correlation, T-Test, variance analysis and Tukey test. Results: The service-practical support component has the highest mean than other components. The mean of social support for cancer patients was different based on gender and was not different based on marital status. There was significant relationship between some variables include the employment, location, exact name and duration of illness with social support of cancer patients. While there was no significant statistical relationship between age, education level and income with cancer patients social support. Conclusion: It can be concluded that social support in the life cycle of cancer patients is influenced by contextual and demographic variables (gender, type of employment, place of residence, exact name of the disease and duration of the disease).

Introduction: Prostate cancer is the most common visceral cancer recognized in men. Considering the incidence of prostatic cancer in our country, evaluation of anatomical location of prostatic cancer and frequency of extraprostatic extension (EPE) and seminal vesicle invasion (SVI) as important prognostic factors, could be of great importance. Material and Methods: Patients suspected of prostatic cancer were subjected to transrectal systemic needle biopsy. 12 to 14 samples from different prostate anatomical regions were prepared. In pathology lab Based on morphology or if necessary with the help of immunohistochemical methods, 68 Patients with prostate cancer as well as extra-prostatic involvement in the sample, received the criteria for entering the study. Pathologist determined the anatomical location of prostate conflict. Data and statistical analysis were used to find out the relation between anatomical location of prostate cancer and EPE and SVI. Results: Patient’, s mean age was 73. 82 year. 29 patients (42. 6%) had seminal vesicle invasion. In 41 patients (60. 3%) all 12 biopsies were involved. In 90% cases involvement of the base region were seen. Also, the average rate of involvement of various margins was 10. 97 out of 12 biopsies. In 97. 05% of patients half and more than half of biopsies were involved. The mean serum PSA level before surgery in patients was 53. 64 ng/dL. Conclusion: There was no significant relationship between anatomic region of prostate cancer and extraprostatic extension(EPE) or seminal vesicle invasion(SVI). Also as our study showed more biopsies involved with cancer, more EPE and SVI were seen. Patients with EPE and SVI had higher mean age.

Introduction: Parents' relationship with children with conduct disorder can cause problems with their children. Therefore this study was done aimed to evaluation the effectiveness of Triple P-Positive Parenting Program on parent-child relationship and symptoms of disorder in adolescents with conduct disorder. Materials and Methods: Design of this study was semi-experimental type as pretest-posttest with control group. Statistical population consisted of all mothers of high school boy student with conduct disorder in district 4 of Tehran in 2019. The sample studied were all 34 mothers of children with conduct disorder who were selected through convenience sampling method and were divided randomly into two groups of experimental and control groups. For collection data was used from Parent Child Relationship Scale (PCRS) and Child Symptom Inventory (CSI-4). Data analyzing was conducted with ANCOVA and SPSS-22. Results: The results showed that Triple P have significant effect on parentchild relationship (F= 9. 70, p<. 05) and symptoms of conduct disorder (F= 12. 52, p<. 05). Conclusion: According to the findings this study, Triple P can be an effective educational method to improve the parent-child relationship and symptoms of disorder in adolescents with conduct disorder.

Introduction: The aim of this study is to present the future approach of marketing research of water pools according to the health status in the postcorona period. Material and Methods: This study was conducted with an integrated approach. In the first step, by examining the thematic literature and using futuristic research technique, the initial conceptual model was extracted with a deductive (quantitative) approach and then inductively (qualitatively) the model was obtained and completed. Finally, the designed model was tested using Mick Mac analysis. In the qualitative section, based on the content analysis of the studies, 23 drivers were finally identified for the future of Tehran pool water marketing research. In order to identify and classify the identified indicators, Mick Mac analysis in MICMAC software was used. The study population was sports management experts and managers of Tehran water pools. 20 people were identified as a sample by snowball technique. Results: A set of drivers (23 drivers) in the dimensions of personnel, customer, children, elderly, physical services, planning services, special services, location, environment, shower and locker room, health, direct advertising, strategy, ticket, political, economic, social, Culture, construction and rent, competitors, laws, championships and subsidies were recognized as effective studies. Conclusion: Based on Mick Mac analysis or in other words, Mick Mac analysis, economic drivers-economic-laws-subsidies-construction and rentenvironmental-health were identified as influential variables. Based on this, the scenario of financing and policy-making in order to increase the quality of existing pools, attracting financial support was proposed.

Introduction: Headache is one of the most common complaints in neurological clinics caused by traction, displacement, inflammation, vasospasm or dilation of pain-sensitive structures in the head or neck. The aim of this study was to evaluate the effectiveness of treatment. Metacognitive is emotional burnout and stress reduction in patients with migraine. Material and methods: The research method was quasi-experimental with a pretest-posttest design with a control group. The statistical population included patients with migraine headache referred to specialized clinics and neurological clinics in Zahedan in 1998. 30 of these patients were selected non-randomly and finally randomly divided into two groups, metacognitive treatment of 15 patients., And a control group of 15 people were included. Emotional Dysfunction Questionnaire (1996) and Depression, Anxiety and Stress Scale (DASS): Intellectual (1991) were administered to both groups before treatment. The control group did not receive any intervention. Follow-up evaluation was also performed three months after treatment. done. Analysis of variance with repeated measures was used to analyze the data. And SPSS 22 software was used. Results: Data analysis showed that in the post-test phase, the amount of stress in the experimental group was significantly reduced compared to the control group (p <0. 7). The findings also show that metacognitive therapy had a great effect on reducing stress symptoms and thus improving headache and relapse (P> 0. 05). Conclusion: Based on the results of the present study, group training on stress reduction based on metacognitive therapy can be effective in controlling stress and anxiety and reducing stress in patients with migraine and metacognitive therapy is both statistically and clinically significant. Dari reduced the metacognitive beliefs of patients with migraine headache in and after treatment.

Introduction: The purpose of the present study was to determine the role of Alexithymia, interpersonal forgiveness, and marital dissatisfaction on the emotional divorce of women referred to family counseling centers. Method: This study was an applied and correlational research design. All women referred to psychological clinics and counseling centers approved by the Tehran Psychological and Counseling Organization were selected from the statistical population by random cluster sampling method. Data were collected using Gutman Emotional Divorce Scale (2008), Alexithymia of Begby et al. (1994), Interpersonal Forgiveness, Pollard et al. (1998), and Enrich Marital Satisfaction (1989). Data were analyzed using Pearson and OLS models. Results: The results showed that Alexithymia (t = 4. 77 and P≤, 0/001) directly and interpersonal forgiveness (t = 8. 06 and P≤, 0/001) and marital satisfaction (t = 9. 30 and P≤, 0/001) can predict inversely emotionally divorce. Conclusion: Alexithymia, interpersonal forgiveness, and marital dissatisfaction have Basic role in predicting of emotional divorce, so improving their functioning can improve family functioning and quality of life.

Introduction: the presence of intimacy and adjustment between the couples causes the family stability and the couples’,and children’, s health. Therefore, the present study was conducted with the aim of investigating the effectiveness of the treatment through self-differentiation on the couples’,marital intimacy and adjustment. Method: it was an applied study in case of purpose and quasi-experimental in case of data collection method with pretest, posttest, control group and two-month follow-up design. The statistical population of the study included all the couples who referred to Healthy Family Consultation Center in the city of Qom in 2017. 16 couples (8 women and 8 men) who were willing to participate in the study were selected through convenient method and accommodated into experimental and control groups (each group of 8). The experimental group underwent 10 sessions of self-differentiation treatment during two-and-a-half months, while the control group didn’, t receive the aforementioned interventions. The applied questionnaires included marital conflict questionnaire (Barati and Sanaei, 1998), marital intimacy questionnaire (Bagarouzi, 2001) and marital adaptation questionnaire (Spinner, 1976). The data from the study were analyzed through repeated measurement ANOVA method. Results: the results showed that the treatment through self-differentiation method has significant effect on the couples’,marital intimacy and adaptation (p<0. 001) such that it succeeded in the improvement of the couples’,marital intimacy (effect size 66%) and adaptation (effect size 66%). Conclusion: the findings of the present study indicated that the treatment through self-differentiation can be applied as an efficient method to improve the couples’,marital intimacy and adaptation through utilizing techniques such as fusion, making the couples aware of triangulation, explaining familial projection and the concept of affective cut.

Introduction: Educational failure can influence the students’,cognitive and emotional process in addition to making problems in their educational process that applying appropriate psychological treatments to decrease these damages is necessary. therefore the present study was conducted aiming to investigate the effectiveness of training mindfulness-based stress decrease on the academic self-efficacy and academic burnout in the female students with Low academic performance in the secondary high school. Method: The present study was quasi-experimental with pretest, posttest, control group and two-month follow-up design. The statistical population of the study included female secondary high school students with Low academic performance in the city of Yazd in academic year 2018-19. 30 female students with Low academic performance were selected through clustered random sampling and they were accommodated in the experimental and control groups. The experimental group received mindfulness-based stress decrease (Cabat Zin, 2003) in ten ninety-minute sessions during two and a half months. The applied questionnaires in this study included academic self-efficacy questionnaire (Jing and Morgan, 1999) and academic burnout (Shaofley et. al, 2002). The data from the study were analyzed through repeated measurement ANOVA method. Results: The results showed that training mindfulness-based stress decrease has significant effect on the academic self-efficacy and academic burnout in the female secondary high school students (P˂, 0. 001). Conclusion: According to the findings of the present study it can be concluded that training mindfulness-based stress decrease can be applied as a useful method to improve academic self-efficacy and decrease of academic burnout in female students with Low academic performance.

Introduction: Oppositional Defiant Disorder (ODD) can bring about numerous psychological, emotional and academic damages for the students. therefore the present study was conducted aiming to investigate the effectiveness of the therapy based on self-compassion on the aggression and the ODD. Method: It was a quasi-experimental study with pretest, posttest with control group. The statistical population of the current study was the female students with ODD in the city of Tehran in the academic year 2018-19. 30 female students with ODD were selected through clustered random sampling method and they were randomly accommodated into experimental and control groups (each group 15 students). The experimental group received the intervention of the therapy based on self-compassion during two-and-ahalf months in ten seventy-five-minute sessions. The applied questionnaires in this study included the children and adolescents’,mental health evaluation questionnaire and resilience questionnaire. The data from the study were analyzed through MANCOVA method. Results: The results showed that the therapy based on self-compassion has significant effect on the aggression and resilience of female students with ODD (p<0. 001). Thus, this treatment has been able to reduce aggression and increase the resilience of female students with Oppositional Defiant Disorder. Conclusion: Findings of the present study reveal that the therapy based on selfcompassion can be used as an efficient therapy to decrease aggression and improve resilience in the students with ODD employing techniques such as training awareness of positive and negative experiences, creating positive experiences through mental imagination, training expressing compassion and behavior modification through environmental reinforcers.

Introduction: New research has acknowledged the effectiveness of technology in education,Especially with unforeseen circumstances such as the Covid-19 epidemic, its use has become a necessity,The purpose of this study is to provide a model of elementary learning mathematics curriculum for mobile learning approach. Methods: The research method is a sequential exploratory mix (classification formulation model). To identify the factors of elementary school mathematics curriculum model with mobile learning approach using data-theory theorysystematic design and conducting interviews based on purposeful theoretical sampling, various factors in elementary school mathematics curriculum with mobile learning approach have been identified. A statistical sample was selected from the faculty members of the curriculum, teachers and curriculum planners and researchers in the field of education and planning in Tehran. Results: The results showed that the research model consisted of a comprehensive theme, 3 organizing themes and 10 basic themes. Organizer theme, mobile learning perspective includes basic themes of learning planning, culture improvement, attitude and goals, organizer theme of mobile education enrichment includes basic themes of learning enrichment, performance and implementation of learning, teachers' competence, tools and Methods are the interaction of people involved in training and performance appraisal includes the basic themes of evaluation and improvement of physical condition and evaluation and quality improvement. Conclusion: It seems that the model can be effective in advancing the goals of education in the field of mathematics with an emphasis on mobile learning.

Introduction: Today, many efforts are made to increase the capabilities and reduce the problems of migraine sufferers through treatment programs. The aim of this study was to compare and evaluate mindfulness-based stress reduction training and the combination of mindfulness-based stress reduction and electrical cranial brain stimulation in the quality of life of migraine sufferers. Method: This research was applied in terms of purpose and in terms of how to collect quasi-experimental data with pre-test, post-test and follow-up with a control group. The statistical population of this study was all migraine patients aged 18 to 60 years who referred to Imam Khomeini Hospital in 2009. Finally, 45 subjects in three groups, respectively, the first group of stress reduction training based on mindfulness, the second group combined stress reduction based method On mindfulness with electrical stimulation of the brain from the skull using direct electric current and the control group as a comparison group received a non-structured training program such as time management and review of their daily and weekly tasks. Before the pre-test research, the follow-up stage was performed at the end of the post-test and one month after the end of the test, and subjects answered the quality of life questionnaire. Results: The results obtained from this study using repeated measures analysis statistical method showed that the training method of reducing stress based on mindfulness and combining stress reduction based on mindfulness and electrical stimulation of the brain from the skull compared to the control group increased quality of life. Were. However, the combination of mindfulness-based stress reduction and cranial electrical stimulation of the brain was stronger in improving quality of life compared with mindfulness-based stress reduction training alone. Conclusion: Therefore, it can be said that mindfulness-based stress reduction training methods and a combination of mindfulness-based stress reduction and electrical stimulation of the brain from the skull can be used to increase the quality of life and reduce psychological problems in migraine sufferers. Keywords: Reduce stress based on mindfulness, electrical stimulation of the brain from the skull, quality of life, migraine.

Introduction: The aim of this study was to investigate the role of emotional fatigue caused by virtual teaching and job stress in predicting burnout of young and middle-aged teachers. Methods: The research method is descriptive and co relational and the statistical population of this study consist of all primary school teachers in Khoy in 1378. According to Krejcie and Morgan (1970) table, 300 people based on stratified random sampling Were selected as a sample. Data were collected using Chen et al. (2019) Emotional Fatigue Questionnaire, Job Stress Questionnaire (HSE) and Brain Burnout Questionnaire and analyzed using multiple regression and independent t-tests. Results: The results showed that the emotional fatigue caused by virtual teaching with (r = 0. 58) at a significant level (p <0. 01) predicts burnout and teachers' job stress during the corona pandemic with (r = 0. 68) at a significant level (p <0. 01) predicts burnout in teachers. There was also a difference between job stress and emotional fatigue caused by virtual teaching between young and middle-aged teachers. Between the excitement of virtual teaching between young and middle-aged teachers. Therefore, all research hypotheses were confirmed. Conclusion: Emotional fatigue seems to have adverse effects on teachers' condition, especially on burnout, during the Covid-19 period.

Introduction: Studies have shown that children with cancer, in addition to physical problems, have psychological problems such as maladaptation. The aim of this study was to determine and compare the effectiveness of FRIENDS program training and play therapy on the adjustment of children with cancer. Method: The research method was applied in terms of purpose and quasiexperimental in terms of implementation method with pre-test-post-test design with two experimental groups and a control group. From 7 to 12year-old children with cancer referred to Loghman Hospital in Tehran, using the available method, 45 of them were selected as a research sample and randomly assigned to three groups of FRIENDS program, play therapy and control. The research tool was the Tobacco Children Adaptation Questionnaire. After collecting the research data, the method of covariance and Bonferroni post hoc test were used for analysis. Results: The results of covariance showed that both FRIENDS and play therapy methods are effective in increasing the adaptation of children with cancer (p˂, 0. 001, F=33/396). Bonferroni post hoc test showed that the FRIENDS method was more effective than the play therapy method on the adaptation of children with cancer (p˂, 0. 001). Conclusion: Both FRIENDS and play therapy methods affect the adaptation of children with cancer,But FRIENDS method was more than cognitivebehavioral play therapy.

Introduction: Due to the changes and developments that have taken place inside and outside the organizations, the organization's need for creativity, innovation, is felt more in this regard, the use of the team in the organization helps us in this important. The present study aimed to investigate and prioritize the drivers of team-based organizations with an organizational innovation approach during the outbreak of Covid 19. Methods: The research method is a combination of quantitative and qualitative and exploratory in terms of purpose. The statistical population is all employees of growth centers and science and technology parks in Khorasan Razavi, which according to Cochran's formula, 105 people have been selected as a sample. The data collection tools in the qualitative part included a semi-structured interview and in the quantitative part, a researchermade questionnaire. Results: The general results of the research indicate that in the model of team-based organization with organizational innovation approach, the dimensions of team-based organization include team processes, team results, organizational, behavioral and environmental context and dimensions of organizational innovation include office innovation, production innovation, new Process innovation, managerial innovation, marketing innovation, structural innovation, individual innovation, technical innovation, service innovation, and exploratory innovation. Also, prioritizing the dimensions of team-based organization with team-based approach, behavioral dimension is in the first place. Then the organizational context and team processes and team results are in the second to fourth ranks, respectively. Conclusion: It can be said that organizational innovation, structural innovation in terms of importance in the first priority and then production innovation in the second priority.

Introduction: infertility is phenomenon which seriously damages infertile women’, s mental health and causes psychological distress in them. Therefore, the present study was conducted aiming to investigate the role of metacognitive beliefs and experiential avoidance in predicting psychological distress with the mediation of adaptation to infertility in infertile women Materials and Methods: the research method was descriptive from correlational and structural equations type. The statistical population of the current study was infertile women who referred to Royan infertility center in the city of Tehran in the third quarter of 2018. The sample of the present study which included 350 infertile women who were selected through convenient method. The applied questionnaires in this study included the questionnaire of metacognitive beliefs (Wales and Kateraight-Hawton, 2004), the questionnaire of acceptance and action (Bond, et. la, 2011), the scale of mental-social adaptation to disease (Derogits and Derogits, 1990) and the questionnaire of psychological distress (Kesler, et. al, 2002). After collecting the questionnaires, the analysis of data was conducted through Pearson correlation method and structural equation. Results: the results showed that there is a significant relationship between variables (p<0. 001). In addition, the mediating role of adaptation to infertility was confirmed in the relationship of metacognitive beliefs and experiential avoidance with psychological distress in infertile women. Conclusion: considering the significant role of adaptation to infertility, it is a necessity to provide and use the training package of adaptation to infertility for infertile women to improve metacognitive beliefs and decrease experiential avoidance and psychological distress of infertile women.

Introduction: Today, observing environmental considerations in medical centers and hospitals is a requirement. Considering that no study has been done in the country on the design and construction aspects of such spaces from an environmental point of view, this study has been conducted with the aim of compiling effective indicators on the design and construction of a green hospital in the country. The type of research is survey and analytical. Methods: Methodology: In the first stage, using theoretical foundations, effective indicators were developed on the design and construction of hospitals and medical centers. Then, the indicators were reviewed and approved using the Delphi panel. Kolmogorov-Smirnov test was used to check the normality of the data. In the next step, by weighting the effective indicators, the indicators were prioritized through the Hierarchical Analysis Process (AHP) technique. Results: The results showed 7 main indicators and 30 sub-indices that had an abnormal distribution. A pairwise comparison of influential factors showed that the "Energy Management" index with 0. 567 has the highest weight and then the "pollution control" index with a weight of 0. 512. The lowest weight of the indicators belongs to the "landscape" factor with a score of 0. 331. The sub-indices were weighed based on two parameters of technical importance and priority of execution time, which were found to have the highest score under the subheading "Compliance with LEED standards" and the sub-index "No use of pesticides, dyes and other toxic chemical derivatives". Conclusion: In the study and construction phase, it is necessary to pay attention to the indicators and sub-indicators of Green Hospital in order to reduce environmental costs and increase the safety level of staff and patients while reducing the costs of the operation phase.

Introduction: The most significant factor in the family breakdown is a damage called divorce which destroys the individual, the family and the society,therefore, the present study was conducted aiming to investigate the effectiveness of couple therapy through ACT method on hope in life and self-compassion in the couples asking for divorce. Materials and Methods: In this study, a single experimental design of clinical type was used. The research community included all couples referring to Malayer city counseling centers in 1398. The research sample consisted of 6 couples (12 people) seeking divorce, who were selected using targeted sampling method and randomly assigned to two groups (3 pairs per group). ACT protocol (arianfar, rasooly, 1398), was administered in three stages of baseline, twelve-session intervention, and two-month follow-up and the subjects answered the questionnaires of Life expectancy (Schneider, et. al. 1991) and self-compassion(Neff, 2003) three times before treatment, three times in the middle of the treatment and twice at the end of the present research. The data from the study were analyzed through visual drawing, reliable change index, and improvement percentage formula. Results: The results showed that the ACT-based couple therapy has had significant effect on the hope in life and self-compassion of the couples asking for divorce,as this therapy has been able to lead to the increase in the scores of hope in life and self-compassion in the couples asking for divorce in therapy and follow-up stages. Conclusion: According to t، he findings of the present study it can be concluded that ACT-based couple therapy can be used as an efficient therapy to improve hope in life and self-compassion in the couples asking for divorce through employing alternatives such as mental techniques, selfobservation as the background, cognitive fusion techniques, stipulating the values and committed action.

Introduction: The aim of this study was to compare the effectiveness of cognitive-behavioral therapy with emotion regulation approach in improving symptoms of premenstrual dysphoric disorder. Method: The study was quasi-experimental with pretest-posttest control group design, and statistical population of the research was women with premenstrual dysphoric disorder of Karaj. Twenty-four female with premenstrual dysphoric disorder were selected using convenience sampling, and randomly assigned into two experimental groups and one control group. One of the experimental groups received 8 session of emotion regulation intervention, and the other group received 8 sessions of cognitive-behavioral therapy. All groups were assessed by the premenstrual symptoms screening tool (2003) in pre-test and post-test stages, and after one-month follow-up. Results: The results of ANOVA indicated that premenstrual dysphoric disorder symptoms reduced significantly in experimental groups in comparison with control group, and these results lasted after one-month follow-up. Furthermore, there was a significant difference between emotion regulation intervention and cognitive-behavioral therapy in improving premenstrual dysphoric disorder symptoms. Conclusion: Both cognitive behavioral and emotion regulation methods are applicable to premenstrual dysfunction but emotion regulation method is more effective.

Introduction: The purpose of this research was to present a practical model about the factors affecting sports success with an emphasis on mental and psychological factors. Methods: This research was done by MAXQDA method and through the data theory design of the foundation. The participants included 11 football experts and university professors who were selected through a combination of theoretical sampling and snowball methods for semi-structured in-depth interviews. The interviews continued until theoretical saturation was reached. The validity of the findings was done through the use of knowledgeable people and written sources, transferability of research results, maximum extraction and non-duplication of data. To analyze the data, open, axial and selective coding was used by MAXQDA 18 software. Results: The results show that there are 140 conceptual codes with 7 subcategories and 2 main categories in the format of 6 dimensions including: causal factors (5), background factors (3), central category (3), strategies (8), intervening conditions (5)., the results (6) were extracted. The integration of the categories based on the existing relationships between them around the factors affecting the success of the highest scoring national football player is a paradigm model. Conclusion: According to the results obtained from the research, it can be said that strategies such as intrapersonal factors and extrapersonal factors have consequences such as improving social status, reputation, popularity and success.

Introduction: Financing is one of the most important challenges for entrepreneurs and businesses to start and continue their activities. The crowdfunding method is an innovative approach to attract micro capital in various projects including health. The current research seeks to provide a model of factors affecting the success of crowdfunding in the health field. Methods: The current research has an applied nature in terms of orientation and its methodology is quantitative. The theoretical population of the research is financing experts in the health field and crowdfunding experts. The sampling method was done in a judgmental manner according to the expertise of experts in the fields of financing and crowdfunding in health projects. The sample size in this study was equal to 10 people. Research factors were extracted through literature review and interviews with experts. In the following, two questionnaires of expert evaluation and effect evaluation were used to screen and analyze the effects of factors, respectively. These questionnaires were analyzed with two methods fuzzy Delphi and fuzzy Dematel. Results: 22 factors were extracted through literature review and interviews with experts. Among the research factors, 10 factors had defuzzy values higher than 0. 6 and were selected for the final analysis. The effectiveness of the remaining factors was evaluated with fuzzy Dematel. According to the net effect index, the factors of specialized consultations to entrepreneurs in the field of health, entrepreneur's education and expertise, entrepreneur's previous experiences in the field of health, environmental effects of the project and defined project quality respectively had the highest effect. Conclusion: The practical proposals of the research were presented according to the most effective factors. The practical proposals of the research were: using the capacity of growth centers, science and technology parks and accelerators and FinTechs to increase the capabilities of entrepreneurs, entrepreneurs' attention to specialized knowledge in the field of health and related projects, entrepreneurs' focus in advertising on previous experiences, attention to social, cultural and environmental dimensions along with economic factors for project evaluation, and definition and analysis of quality improvement indicators for health projects.

Introduction: The cardiovascular system is one of the most important parts of exercise design, and the range of effect of exercise can range from the aerobic threshold to the anaerobic threshold. Therefore, this study aimed to determine the effectiveness of exercise based on the heart rate function curve in active young men. Material and Methods: For this purpose, 20 young and active boys with an average age of 20 to 25 years were selected as subjects and performed the helpless test of running on a treadmill. Heart rate and blood lactic acid level equivalent to aerobic and anaerobic thresholds were determined using the Dmax method and lactate measuring device, respectively. Simultaneously with the use of a respiratory gas analysis system, changes in the volume of oxygen consumption and carbon dioxide production were measured. In this study, to analyze the data, descriptive statistical methods such as categorizing information and converting them into frequency tables, adjusting the frequency and average percentage and standard deviation of variables were used. Integration operations were also used to calculate the area under the curve. Results: The results showed that to determine the aerobic and anaerobic threshold, the method based on the maximum distance from the heart rate function curve as well as the level of oxygen consumption and blood lactate can be used. The heart rate function curve is also effective in determining the effective range of exercise, the area under the curve, and the step speed equivalent to the aerobic and anaerobic thresholds. Conclusion: Therefore, it can be concluded that using the heart rate function curve model, the range of effectiveness of exercise can be determined and used as a new method in presenting exercise programs.

Introduction: The suicide attempt is one of the crucial public health problems. The present study investigated the epidemiological and geographical pattern of suicide attempts in Mashhad in 2016. Methods: In this cross-sectional study, pre-hospital information was collected from the emergency medical management centers (115) of Mashhad and other information was obtained from the medical records department of Imam Reza Hospital as the only reference hospital. Conventional statistical methods were used in the statistical analysis of data. Spatial analysis was used in Arc GIS software to investigate the geographical distribution of suicide attempts. Results: There were 2, 785 cases of suicide attempts, 64. 7% (1801) of whom were women. The highest frequency of suicide attempts was in the age groups of 15 to 24 years (N=799, 39. 1%) and 25 to 34 years (N=720, 35. 2%). In general, married people (N=1635, 58. 7%), high school literacy level (N=821, 29. 5%), and homemakers (N=1186, 42. 6%) had the highest percentage of suicide attempts. The most common method of suicide was drug poisoning (N=1736 84. 9%). The geographical distribution of suicide attempts showed that the highest suicide attempts were reported in the northeastern and suburbs of Mashhad. Conclusion: The results of present study showed that the incidence of suicide attempts was higher in young age groups and women. On the other hand, the incidence of suicide attempts was different in total and also separately for men and women in different geographical areas of Mashhad.

Introduction: Breast cancer is followed by various psychological, emotional and interactive damages for the infected women that applying appropriate psychological therapies to decrease these damages is necessary. Therefore, the present study was conducted to investigate the effectiveness of ACT on Psychological distress and sleep problems in the women with breast cancer. Material and Methods: The present study was quasi-experimental with pretest, posttest design and control group and two-month follow-up stage. The statistical population included women suffering from breast cancer who referred to Ala’,cancer control and prevention center in Isfahan in the six months of summer and autumn of 2019 and 2020. 30 women with breast cancer were selected through convenient sampling method and they were randomly replaced into experimental and control groups (each group of 15 women). After decreasing the numbers, 25 women remained (12 women in the experimental group and 13 women in the control group). The experimental group received ten ninety-minute sessions of ACT (Hays and Steroshell, 2010) during two-and-a-half months. The applied questionnaires in this study included Psychological distress questionnaire (Kessler et. al, 1995) and sleep problems (Buysse et. al, 2005). The data from the study were analyzed through repeated measurement ANOVA. Results: The results showed that ACT has significant effect on Psychological distress and sleep problems in the women with breast cancer (P<0. 001) and it was able to lead to the decrease of Psychological distress and sleep problems in these women. Conclusion: According to the findings of the present study it can be concluded that ACT can be applied as an efficient therapy to decrease Psychological distress and sleep problems in the women with breast cancer through employing techniques such as applying mental techniques, observing oneself as the background, cognitive fusion techniques, stipulating values and committed actions.

Introduction: Marital satisfaction can be influenced by various factors, both individual and interpersonal. Self-differentiation, forgiveness, and alexitymia can be among these factors. The aim of this study was to compare the self-differentiation, interpersonal forgiveness and alexithymia in female teachers with high and low marital satisfaction. Material and Methods: This research is causal-comparative. The statistical society included all female teachers in the elementary school of Arvand Free Zone who were engaged in the academic year of 2017, 200 subjects were selected as sample groups through available sampling method and responded to the interpersonal forgiveness (2010), the differentiation of self (1998), Alexithymia scale (1994) and marital satisfaction questionnaire (1989). Results: The results showed that there is a significant difference between two groups of female teachers with high and low marital satisfaction in terms of their differentiation (F= 7. 88, p< 0. 01), interpersonal forgiveness (F= 49. 53, p< 0. 01) and Alexithymia (F= 15. 68, p< 0. 01). Conclusion: According to the findings of this study, women have a higher level of differentiation and forgiveness, as well as lower alexithymia, a significant effect on improving the marital satisfaction of married female teachers.

Introduction: Today, eating disorders are a popular issue in society and are considered as the most important mental disorders that are rooted in biological, psychological, social and cultural issues. The aim of this study was to evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) on self-concept and depression in people with binge eating disorder. Material and Methods: The present study is a quasi-experimental study with a pretest-posttest design with a control group. The statistical population of this study was all people with binge eating disorder in Tehran, from which 30 people were selected by purposive sampling and then assigned to experimental and control groups. Self-concept, depression and binge eating disorder questionnaires were used to collect data. Results: with respect to F / 700/166 =. In the self-concept variable and F = 997/587 in the depression variable, it can be said that there are significant changes between the experimental and control groups in the post-test. Which shows that Acceptance and Commitment Therapy (ACT) has improved selfconcept, reduced depression and significantly reduced the symptoms of overeating in the experimental group compared to the control group. Conclusion: The results of this study showed that acceptance and commitment based therapy (ACT) is effective in improving self-concept and reducing depression and symptoms of overeating and the use of this treatment seems to be beneficial.

Introduction: The need to recognize and use emotional intelligence in social media in complex environmental conditions is essential in making rational purchasing behavior decisions,Therefore, the present study presents a model by identifying and measuring the components, and indicators of social media and emotional intelligence influencing purchasing behavior decision making. Material and Methods: The research method is a combination with a simultaneous / consecutive chain heuristic approach with grounded theory design. The statistical population was 30 academic experts and domestic and foreign experts and the sample size was a little 400. model of validityconstruct and validity-convergent measurement, and to estimate the reliability coefficients of the concepts of measurement tools from Cronbach's alpha using SPSS software and also to prepare statistical reports with the above software LISREL was used. Results: In qualitative data from in-depth structured virtual purposeful interviews with 30 experts with theoretical saturation and open coding with 81 categories, axial coding with 7 indicators and selective coding with 2 categories of factors, components Or indices that were influential in measuring social media and emotional intelligence on purchasing behavior decision were extracted. Quantitative studies using three experimental studies at regular intervals, from the collection of survey / applied data from emotional intelligence with five components (15 subscales), social media with 7 components and purchasing behavior decision making with 2 Component (five subscales) was performed. Conclusion: The qualitative part of the data with theoretical saturation and the quantitative part using the conversion of qualitative data to quantitative, the relationship between components, identifying and presenting the model and measuring the effects Variables were approved.

Introduction: The purpose of this study was to determine the effectiveness of Training based on mind theory and TEACCH's method on improving communication skills and social interaction of children with autism spectrum. Material and Methods: The research method is quasi-experimental (pre-testpost-test and control). The statistical population of the study consisted of all autistic children in Bushehr in 1397. Samples were selected by convenience sampling method and 45 subjects were randomly assigned into two experimental and one control groups. In this study, components of Giliam Autism Rating Scale (GARS) was used. Data were analyzed using SPSS-20 software and covariance analysis. Results: The results of the data analysis showed that the effectiveness based on the theory of mind was effective on improving communication skills (F = 34. 29, P≤, 0. 001) and social interaction (F = 92/21, P≤, 0. 001). The effectiveness of TEACCH's method was also effective on improving communication skills (F = 25. 01, P≤, 0. 001) and social interaction (F = 92/21, P≤, 0. 001), and there was no significant difference between the two experimental groups. Conclusion: TEACCH's method and mind theory can be effective in improving the social interaction of children on the autism spectrum. It is suggested that in order to increase the level of social interactions in children, the theory of mind and the TEACCH's method be used more than before.

Introduction: Infertility is among the most important challenges in the modern life that some of the couples are entangled with and their psychological and emotional health is damaged as the result of it. Therefore, the present study was investigated aiming to investigate the efficacy of Cognitive-Behavioral Therapy and infertility stress and depression on the infertile women. Material and Methods: The present study was quasi-experimental with pretest-posttest and control group design. The statistical population of the study included infertile couples who referred to the department of wellbeing in the city of Bandar Abbas in the winter of 2019. 30 infertile couples were selected through voluntary method and they were randomly accommodated in the experimental and control groups (each group of 15 couples). The experimental group received eight ninety-minute sessions of Cognitive-Behavioral Therapy intervention (Halfourd, 2005). The applied questionnaires in this study included depression questionnaire (Beck, et. al, 1996) and infertility stress (Newton et. al, 1999). The data were analyzed through MANCOVA method. Results: The results MANCOVA showed that Cognitive-Behavioral Therapy on infertility stress and depression have been effective in infertile couples, as this therapy succeeded in the decrease of infertility stress and depression in these couples. Conclusion: According to the findings of the present study it can be concluded that Cognitive-Behavioral Therapy can be applied as an Pursuit of automatic thoughts to identify fundamental beliefs, teach behavioral methods and cognitive errors and negative thoughts.

Introduction: Teachers 'teaching methods play an irreplaceable role in students' learning process. Accordingly, the present study aims to determine the components and framework of teaching pattern of primary school based on the teaching content to develop the lesson study model and estimate its internal validity. Material and Methods: The research method was mixed exploratory. In qualitative phase, the inductive content analysis was used to obtain the teaching pattern, and in the quantitative phase, the survey method was utilized for estimating internal validity. The statistical population of the qualitative phase comprised written resources and the teaching videos of selected projects of lesson study planning and the quantitative phase comprised experts and professors of lesson study and teaching method of primary school books. In both phases, samples were selected purposefully. In qualitative phase, 124 selected videos of teaching the lesson study project in a four year interval ( from 2015 to 2016 and from 2018 to 2019) were analyzed. In quantitative phase, 34 experts and professors of teaching method of textbooks and teaching method in universities were selected. The qualitative data were collected by analyzing the content of resources and selected videos and the quantitative data were collected by the research-made questionnaire. Results: The result of content analysis revealed seven types of content and the conceptual pattern was proposed and the videos were classified accordingly. Following content analysis and code extraction, components were extracted and presented in form of pattern of teaching steps appropriate for various content. Conclusion: Results from internal validation revealed that the proposed teaching pattern has high internal validity and is appropriate for teaching primary school students.