جواد رسولی

 Psychological distress refers to the general concept of maladaptive psychological functioning in response to specific stressful life events that can cause permanent or temporary harm to the individual. Determining psychological distress in individuals allows for early diagnosis of mental problems. Therefore, this study was conducted to determine psychological distress and its relationship with some demographic characteristics in adults referring to Urmia's comprehensive urban health service centers in 2024.

 In this descriptive cross-sectional-correlational study, 350 adults referring to Urmia's comprehensive urban health service centers who met the inclusion criteria were selected through multistage sampling and data were collected using Kessler's demographic characteristics and psychological distress questionnaires. For descriptive results, central tendency and frequency indices (percentages) were used, and for analytical results, a t-test, one-way analysis of variance, and linear regression were used to examine the relationship between variables and make prediction.

Based on the results of this study, the average total psychological distress score among participants was 11.19 out of 40. Psychological distress among participants had statistically significant differences in terms of demographic variables such as gender, employment status, income status, marital status, and history of psychiatric medication use. Also, employment status, housing status, and marital status were able to predict psychological distress and explained 67 percent of the psychological distress score.

Given the higher level of psychological distress in the studied women, unemployed individuals, individuals with lower income levels, and divorced individuals, it is recommended that health policymakers develop plans to improve psychological status and prevent the occurrence of serious mental disorders in these groups.

Problem statement: 

The initial phase of design is a complex, crucial, and ambiguous stage. Researchers suggest that designers rely on very simplistic thoughts at the onset of design to narrow down the chain of possible solutions, referred to as primary generators. Primary generators have various sources, one of which is cross-disciplinary references; cinema, in particular, provides a vast array of unexplored spaces. Therefore, the question of this study is: how can cinematic works be considered a source for the formation of primary generators?

This study aims to explore the role of cinema as a formative source of primary generators, thus establishing a credible resource to facilitate the initial design step, which often faces numerous complexities.

The present study first elucidates the concept of primary generators based on existing theoretical discussions in library sources. It then employs qualitative research methods and content analysis of sequences from selected cinematic works to assess the potential of cinema as a source of primary generators.

After gaining insight into the concept of primary generators, a categorization was provided, along with theoretical evidence from cinematic texts for each category. Four distinct viewpoints were adopted based on this categorization, including existential (human life), metaphorical-philosophical, environmental, and formal aspects, with examples from cinematic works presented for each. These findings demonstrate that cinema is a significant source of primary generators and can inspire a wide range of primary generators.

Cinema has been constantly interacting with architecture since the early days of its formation. One of the fields of this interrelation is the exploration of concepts that exist in the theories of cinema and can betraced in the realm of architecture. The “distancing effect” concept, also known as estrangement oralienation effects, and V-effect (Verfremdungseffekt in German) which has influenced many theorists of cinema and filmmakers is one of them. This concept can be defined through an example. While watching a drama, individuals experience sensory and emotional tensions,identify themselves with the actors, and perceive everything as reality. However, this process is disturbed by the “distancing effect”. They become aware that they are watching a performance, and therefore they are separated from the belief that the events are real, viewing the work with a distant and analytical perspective, away from emotional conflicts. In this way, imaginations and illusions dissipate, and the audience remains fully alert with a seeking and active mind,ready to think. The “Distancing effect” has been developed in many art forms to break simple immersion and identification,provokig self-awareness, social awareness, and reflection. The focus of the present article is to explore “distancing effect” concept in architecture, with the aim of interpreting its manifestations in architectural works. The research method is qualitative, based on theoretical discussions in library resources, where “distancing effect” concept has been explained. Cinema has been employed as an intermediary domain for a better explanation of “distancing effect” approaches, allowing architectural instances  be identifiedmore easily. The contents of  sequences from selected cinematographic works have been analyzed. By adapting them to the world of architecture, examples of this concept have been illustrated in architectural works. In this article, five categories of insideness and outsideness, main narrative and sub-narrative, objectivity and spatiality, parallel narrative, and anachronism are summarized, which can lead to the “distancing effect” in both architecture and cinema. In conclusion, it became clear that the “distancing effect” concept is not solely dedicated to literature or dramatic arts, but it can also be revealed in the field of architecture. various works of cinema and architecture from a wide geographical range are presented as instances of the “distancing effect”. As demonstrated, different famous filmmakers such as Antonioni, Tarkovsky, Kiarostami, Wajda, Wenders, von Trier, Mankiewicz, Bertolucci, and others used the “distancing effect” in their works. Notebly, Brecht theorized his concept in the twentieth century, yet many of the buildings discussed in this research belong to an earlier historical period. This indicates that many architects have (un)consciously used this concept in their works as they want to invite individuals to think, explore, be active, interpret, and be aware of what they are observing. Ultimately, it can be articulated  that the work of architecture plays a more significant role, it is not merely a space to provoke our sensations, but also a universe for deep contemplation and thought.

The COVID-19 pandemic has raised concerns about the possibility of reinfection, which could undermine global efforts to control the spread of the virus. Various factors are effective in the occurrence of re-infection of Covid-19 and studies have published different results in this regard. Therefore, the present study has been conducted in this direction and to compare the outcome of patients with re-infection & primary infection of COVID-19 and influencing factors.

The present study was conducted as a retrospective cohort. All the patients from the beginning of the epidemic until the End of June 2021, who were registered in the system of registering cases of COVID-19 in this province, were extracted. And finally, 18,401 patients with primary and recurrent infections were included in the study.

The results showed that women were more likely to get re-infection. It was also found that the age groups of 18-59 years and 0-4 years had the highest percentage of infections in patients with primary and reinfections, respectively. On the other hand, there is a significant relationship between people with primary infection and re-infection in terms of having a history of heart disease, kidney disease, and high blood pressure.

The results of this study showed that there is a statistically significant difference between the two groups of patients with primary infection and reinfection in terms of demographic variables, some risk factors, and clinical symptoms.

Colorectal and gastric cancers are among the most common types of cancers. Understanding the relationship between dietary factors and these cancers is crucial for preventing malnutrition and managing it in patients. This study aimed to conduct a comparative investigation into the nutritional intake and anthropometric indices of patients with non-metastatic colorectal and gastric cancer compared to a healthy control group.

In this descriptive, cross-sectional study, 167 participants, including gastric cancer patients (51 individuals), colorectal cancer patients (58 individuals), and a control group (58 individuals), were evaluated. Anthropometric parameters were measured using standard methods, and dietary intakes were assessed using a 24-hour dietary recall questionnaire. Subsequently, statistical analyses were performed using SPSS-21 software.

The study findings indicated that the body mass index, waist circumference, and waist-to-hip ratio were significantly higher in the control group (p< 0.01). Moreover, colorectal cancer patients exhibited higher ratios compared to gastric cancer patients (p < 0.01). Evaluation of dietary intakes in all three groups revealed a significantly lower intake of carbohydrates, proteins, fats, and energy in the gastric cancer group compared to the colorectal cancer group (p < 0.01). Additionally, in the gastric cancer group, the intake of energy, carbohydrates, proteins, and fats was significantly lower than in the other two groups (p < 0.05).

According to the results of this study, it appears that cancer patients exhibit significant differences in anthropometric indices and dietary intakes compared to non-afflicted individuals. It is recommended to involve specialized nutrition therapy groups to enhance their health status.

COVID-19 is an infectious disease that emerged as a pandemic in a short period. Pandemics are accompanied by high transmission rates and significant mortality. From a medical perspective, during all pandemics, the examination of individuals at risk due to chronic drug use or the presence of any underlying disease is crucial. The aim of this analytical-descriptive study was to investigate the relationship between demographic characteristics and underlying diseases with the discharge status of the patients with COVID-19 in the Intensive Care Unit.

In this study, the records of 430 patients with confirmed positive PCR tests, who were hospitalized in the Intensive Care Unit of Imam Khomeini Hospital from March 2020 to March 2021were included using a census method. Incomplete or inaccessible records were excluded. Demographic data (gender, age, marital status, etc.) and the history of underlying diseases (blood pressure, diabetes, heart conditions, etc.) were extracted from the records. The data were analyzed using descriptive statistics and hypothesis testing (t-test, chi-square) in SPSS software version 22.

Out of 430 affected patients, 257 individuals (59.8%) were male, and 173 individuals (40.2%) were female. Among the deceased, 173 individuals (63.8%) were male, and 98 individuals (36.2%) were female, and this relationship was statistically significant (P=0.016). Furthermore, the association between hypertension and diabetes with mortality was found to be statistically significant based on the test results (P<0.001).

The present study demonstrated that being male, as well as having hypertension and diabetes, are among the risk factors for both contracting and experiencing mortality due to COVID-19 infection.

Increased intra-abdominal pressure, which is often hidden in the evaluating of patients, causes critical and complete-rest patients with irreparable consequences. Numerous and consecutive position changes can be effective in creating conditions to increase intra-abdominal pressure. The present study aimed to investigate the effect of position changes on intra-abdominal pressure in mechanically ventilated patients.

The present study was a clinical trial in which 68 patients were randomly selected and enrolled. Intra-abdominal pressure was measured by intrablader method using water manometer. Other hemodynamic and respiratory parameters were measured by BENNETT 840 ventilator and SAADAT hemodynamic monitoring device. Data were entered into a checklist and analyzed using SPSS software version 22 and parametric and non-parametric statistical tests. In this study, a significance level of P < 0.05 was considered significant.

The mean intra-abdominal pressure of patients in different conditions had statistically significant differences. Patients in the 15° and 45° positions had the lowest and in the 30° position to the right side, the patients had the highest intra-abdominal pressure (P<0.001). Mean arterial pressure and abdominal perfusion pressure were the lowest in the position of 30° to the right side, and the highest values were in the position of 15° and 45°. The highest values of airway pressure were observed in the position of 30° to the right side.

Changing of position for mechanically ventilated patients in Intensive Care Units can be associated with significant respiratory and hemodynamic consequences.

Cervical cancer is the fourth most frequently diagnosed cancer in women. Colposcopy is a worldwide accepted method for detection of early carcinoma of cervix. This study was conducted to investigate the correlation between colposcopic examination results with histopathological findings and its diagnostic value in cervical biopsy.

This study was a cross-sectional comparative study performed on 436 women with abnormal Pap smear test results, referring to Urmia Motahari Hospital during March 2021 to March 2022. Colposcopy and histopathologic findings of individuals with abnormal Pap smear results were extracted from the patient records. The data were analyzed using descriptive and analytic statistics (Chi-square test) using SPSS 21 (SPSS Inc., Chicago, IL.,USA). The sensitivity, specificity, and positive and negative predictive values of various diagnostic methods were calculated. A probability of P<0.05 was accepted as significant.

The mean age of the participants was 37.3 ± 9.60. The most common finding in colposcopy and histopathology results were acetowhite lesions and cervicitis, respectively. According to the comparison, the agreement percentage of colposcopy and histopathology findings in noninvasive malignant neoplasia in the case of CINIII, CINII, CINI were 4%, 57.1%, and 37%, respectively. Sensitivity, specificity, and positive and negative predictive values for colposcopy in cervical intraepithelial neoplasia were reported as 57.3%, 51.8%, 23.3%, and 82.5%, respectively.

This study showed an acceptable correlation between colposcopic examination and histopathologic findings. Thus colposcopy can be used as a tool for early diagnosis of precancerous cervical lesions as a screening method alongside the pap smear. The correlation between the experience of examiner and accuracy of colposcopy results were not meaningful.

Microlithiasis is a common increasing disorder, especially in infants and young children, defined as sonographic detection of hyperechogenic deposits in the pelvic area of the ureter and calyces which are less than 3 mm in diameter. Potassium citrate is one of the drugs used in nephrolithiasis. Citrate prevents the formation of calcium deposits. It also inhibits calcium oxalate crystals, which can be the nidus for kidney stones. The aim of this study was to compare the effect of potassium polycitrate versus no treatment in the infants with microlithiasis.

In this descriptive-retrospective study, 112 patients referred to a pediatric nephrology clinic were enrolled. Children less than two years old with microlithiasis in kidneys or urinary tract confirmed by ultrasonography imaging were included in the study. Patients were randomly divided into two groups: the first group received potassium citrate solution of 1-2 mEq/kg of body weight daily for two months, and the second group did not receive any specific medication. Follow-up was performed every two months for six months using ultrasound by a skilled radiologist with a fixed ultrasound device. To minimize drug side effects and treatment response, the allergic responses were measured once every two months, and the physician decided drug will or will not continue. Data analysis was done by SPSS 19. The P values <0.05 were considered significant.

The mean age of the study population was 4.13 ± 2.27 months. The mean weight in the total study population was 6.62±1.36 kg and the mean birth weight in the total study population was 3±0.41 kg. According to the results of the study, the decrease in the size or number of stones in one or both kidneys was more in the recipients of polycitrate solution and the increase in the size or number of stones in one or both kidneys was more in the infants not receiving polycitrate (P<0.001).

Factors such as age, sex, current weight, birth weight and type of nutrition have no effect on improving and/or reducing the size and number of renal stones. However, in the group receiving potassium polycitrate solution, there was a significant reduction in the size and number of stones compared to the non-receiving group.

Kawasaki disease is a systemic vasculitis of unknown etiology that is common in the pediatric patients. The primary therapeutic strategy includes aspirin and Intravenous Immunoglobulin. The present study aimed to investigate the Neutrophil to Lymphocyte Ratio (NLR) in the patients with Kawasaki and its relationship with the resistance to IVIg therapy.

The present study included the patients presenting to the Motahari Hospital, Urmia, Iran, whom diagnosed with Kawasaki disease and received IVIg during 2008-2019. The authors collected the data from the patients' medical records and re-assessed the patients' data for meeting the diagnostic criteria for Kawasaki. Afterward, the data of eligible patients entered the analysis.

The data from 460 patients were obtained and assessed for meeting the diagnostic criteria for Kawasaki. Of 460 patients, 241 met the eligibility criteria, and the data for other patients that meet exclusion criteria were excluded from the study. According to the results of our study, response to IVIg therapy had a significant relationship with the variables of blood and urinary leukocyte counts (p=0.013 and p=0.01, respectively). However, we didn’t find any significant relationship between the response to IVIg therapy and the variables of age, gender, NLR, neutrophil count, lymphocyte count, C-Reactive Protein (CRP), serum albumin level, ALT, hemoglobin, platelet count, and the interval between onset of symptoms and treatment initiation.

High blood leukocyte count along with low urinary leukocyte count can predict the response to IVIg treatment and subsequent prognosis in the patients affected by the Kawasaki disease. However, the NLR did not show clinical relevance.

Early diagnosis of gestational diabetes and subsequent treatment plays a vital role in preventing the consequences of pregnancy. According to the results of previous studies about the increase in amniotic fluid glucose levels following gestational diabetes, this study aimed to determine the relationship between amniotic fluid glucose level and maternal BMI, fetal birth weight, and maternal blood glucose in mothers undergoing second-trimester genetic amniocentesis.

This study is a prospective cohort design performed on 115 pregnant women who underwent amniocentesis in the second-trimester of pregnancy at Kowsar Obstetrics and Gynecology Center. Data were collected using a checklist that assesses the initial demographic characteristics of individuals, including maternal age, severity, parity, gestational age, maternal weight and height, BMI, macrosomic birth history, history of preterm delivery, and abortion. The validity and reliability of the checklist were previously confirmed by the professors of the obstetrics and gynecology and Cronbach's alpha coefficient.

 The results of the present study showed that amniotic fluid glucose has a positive and significant correlation with age, fasting blood sugar, amniotic fluid volume, and birth weight of the fetus. Also, pregnant mothers with gestational diabetes had higher fasting blood sugar, fetal birth weight, amniotic fluid volume, and amniotic fluid glucose and had a significant difference with non-patients.

 With all the limitations of the present study, the results showed that amniotic fluid glucose could be used as a factor in the follow-up and consideration of pregnant mothers for gestational diabetes and fetal birth weight.

In pregnancies complicated by preeclampsia, it seems that failure of trophoblast invasion and induction of placental inflammation can lead to the production of biomarkers, one of which is CA-125. The aim of this study is to investigate serum CA-125 levels in non-severe and severe preeclampsia and compare it with normal pregnancy.

This retrospective case-control study was conducted on 30 women with normal pregnancy, 27 women with mild preeclampsia and 30 women with severe preeclampsia referring to the midwifery clinic of Shahid Motahari Hospital in Urmia who met the inclusion criteria. The data evaluated in this study included gestational age, systolic and diastolic blood pressure, platelet, AST, ALT, serum creatinine, serum uric acid, serum CA-125 levels, urinary protein level and birth weight. Venous blood samples were collected at delivery for complete blood count, creatinine, uric acid and CA-125 concentration from all participants. Then the results were compared.

The results of the present study showed that the mean CA-125 of women in the control group was 17.83±5.37 u/ml, in the mild preeclampsia group was 40.64±12.40 and in the severe preeclampsia group was 71.73±48.90, which indicates that this value is high in mild preeclampsia compared to the control group as well as severe preeclampsia compared to the other two groups. Statistical comparisons showed that there is a significant relationship between serum CA-125 levels in women with normal pregnancy and non-severe and severe preeclampsia (p<0.001).

The results of the present study showed that CA-125 is associated with the occurrence of preeclampsia (mild and severe) and can be helpful as a marker in the diagnosis of preeclampsia, especially its severe type. Moreover, due to the relationship between this marker and a wide range of other variables, paying attention to its serum level along with other paraclinical variables can be helpful in better diagnosis and management of patients.

Complications of exposure to second-hand smoke (SHS) are known to affect the health of pregnant women and fetus and it requires designing interventions to reduce the exposure of pregnant women to smoke. This study, therefore, aimed to examine the effect of couples' motivational interview in pregnancy on men's smoking at home.

The present study is a clinical trial study. 112 couples (56 non-smoking pregnant women with smoking spouses) enrolled in the study. Sampling was performed in several steps. First, according to the social, economic, and cultural conditions of the city, Urmia was divided into three sections, and two comprehensive health centers were randomly selected from each section. Blocked randomization method was used for random allocation in control and intervention groups. The motivational interview was conducted in 5 sessions of 60 minutes twice a week for intervention group. Individuals in both groups completed a demographic and smoking behavior questionnaire. The control group received routine prenatal care. Post-test was performed in the control and intervention groups 7 days and 30 days after the intervention. Data were analyzed by parametric and non-parametric tests and repeated measures in SPSS software version 20.

One hundred two couples completed the study. Mean smoking in the last week by the spouse, before, one week, and one month after the intervention were (70-172/5) 110, (40-135/5) 70, and (46-122/5)69.50 cigarettes, respectively. The results showed that these changes were statistically significant (p <0.001).

Couples' motivational interviews can be used to reduce smoking by the spouse, and ultimately this behavior change reduces the pregnant mother's exposure to secondhand smoke.

Colonoscopy is performed in order to examine the gastrointestinal tract. It can be used to evaluate the patients who suffer from certain medical conditions including chronic diarrhea of unknown etiology, occult bleeding, and anemia. The first essential step in performing an effective colonoscopy is adequate bowel preparation.

The present study was a descriptive cross-sectional study that involved 180 patients who underwent colonoscopy and were referred to the colonoscopy unit of Imam Khomeini Hospital in Urmia. It was conducted in a three-month period of time. The samples of the study were selected randomly. The demographic information questionnaire and the Boston preparation scale were used to collect the data. The data were analyzed using SPSS 16 software.

The quality of the patients’ bowel preparation was assessed based on the Boston bowel preparation scale. The obtained results showed that 26.1% of the subjects had inadequate bowel preparation. Moreover, based on the results of the study, the lowest frequency of referral to hospital for colonoscopy was related to the weight loss. On the other hand, the highest frequency of these referrals was related to positive occult blood test. Furthermore, the analysis of the results showed that the mean bowel preparation score in all of the samples was 6.4 with a standard deviation of 2.61. Finally, the left colon had the highest mean preparation score (2.33) and the right colon had the lowest mean preparation score (1.86).

According to the findings of this study, it can be concluded that bowel preparation is affected by various factors that influence the quality and the results of colonoscopy, cause misdiagnosis, and increase the treatment costs for the patients and health system. Therefore, considering the importance of the issue, educating patients, and using up-to-date knowledge about the patients’ bowel preparation can play an important role in the provision of solutions to these problems.

The issue of trauma in modern and industrial societies today is one of the most important issues and problems that have been considered in most countries. Because pre-hospital care is the first component of a trauma care system, doing it right can reduce the problems of long-term disability as well as deaths from trauma. Therefore, the present study was conducted to determine the effect of training based on a modified team-based learning method on trauma patient management skills by Urmia emergency medical personnel in 2020.

The present study was a before and after clinical trial study in two groups during which 98 technicians of Urmia Emergency Center were selected by stratified random sampling method. Sample members were randomly divided into intervention and control groups. In the intervention group, trauma patient management skills were taught by a modified team-based learning method. The tools used to collect information included two sections: demographic information and a trauma assessment skills checklist. The results were analyzed using SPSS software version 17.

The results of analysis of variance test with repeated measures showed a significant difference between intervention and control groups in learning trauma patient management skills (p <0.001) which was determined by examining the effect of test repetition and the effect of interaction. The changes of the studied variable in TBL groups were significantly more than the control group (p <0.001).

The results of the current study showed that training based on a modified team-based learning method is effective and improves personnel readiness in this field.

The particular condition of retirement causes the elderly to experience it as a stressful life event of individual and social characteristics. One of the main challenges in retirement is the issue of quality of life (QOL). Therefore, the purpose of this article was to determine the predictive components of QOL among retired men in Urmia.

In this descriptive-analytical study, 140 retired men living in Urmia were selected by cluster sampling method. The instrument used in this study was the Lipid quality of life questionnaire. Data were analyzed using SPSS v.21 statistical software and descriptive and analytical statistical tests (mean and standard deviation, frequency and percentage, Pearson correlation coefficients, one-way ANOVA, and multiple linear regression) at the significance level of p <0.05.

According to the results of this study, the mean and SD of total QOL was 71.21±10.27. Also backward multiple linear regression model revealed that variables of life satisfaction, marital status, retirement length, and sleep disorder predicted 28.8% of the variance of QOL. Moreover, age, marital duration, childchr('39')s number, and education level were removed from the regression model.

According to the results of the present study and other similar studies, it can be concluded that the negative factors in reducing the QOL among retired adults should be carefully identified and policymakers should try to develop appropriate programs to improve the QOL of retired older adults.

Hemodialysis is the most common treatment for patients with chronic renal failure and one of the problems reported in these patients is their non-adherence to diet and fluid restriction. This study aimed to determine the effect of teach back method training on dietary adherence and fluid restriction in hemodialysis patients.

In this study, 60 patients undergoing hemodialysis referred to Urmia teaching hospitals in 1399 were randomly assigned to the control and intervention groups. In the intervention group, in addition to routine training, the patient was given feedback-based training in two areas of diet and fluid restriction during 3 sessions for 45 to 60 minutes. The control group received only the usual training in the ward. Data collection using demographic questionnaire and adherence to treatment of patients with end-stage renal disease (ESRD-AQ) subscale of diet and fluid restriction in three stages: pre-test, post-test (7 days after intervention) and follow-up (30 days Was performed after the intervention. Data were collected using SPSS software version 16, Chi-square, independent t-test, repeated measures analysis of variance tests.

There was a significant difference between the intervention and control groups in the mean score of fluid restriction (P <0.001). This means that at first the means of both groups were almost the same. In the control group, the means were almost similar during the following times and did not change significantly with each other, but in the intervention group in the following times, the mean score of fluid restriction increased and also the mean scores of compliance with fluid restriction in each intervention group. The two stages of post-test and follow-up were significantly higher than the control group (p = 0.001). There was no significant difference in the mean score of diet adherence between the intervention and control groups (P <0.01).

The present study showed that teach back method education has a significant effect on adherence to fluid restriction in patients undergoing hemodialysis, but has no effect on adherence to the diet of these patients. It is suggested that nurses working in hemodialysis wards increase patientschr('39') perception of their disease by increasing the number of teach back-oriented training sessions and as a result can play an important role in self-care of hemodialysis patients and their adherence to diet and fluid restriction.

Nurses are the largest group of health care providers and their decisions play a very important role in the clinical fate of patients. Due to the importance of nurseschr('39') decisions, this study was conducted to investigate the clinical decision-making ability of hemodialysis nurses in Urmia hospitals.

The present study is a descriptive cross-sectional study performed on 60 nurses working in hemodialysis wards of hospitals affiliated with the Urmia University Medical Sciences. The samples were selected by counting. Data were collected from the Demographic Information Questionnaire and the Lauri and Salantra Clinical Decision Questionnaire. Data were analyzed using SPSS-17 software and descriptive and inferential tests.

The average score of nurseschr('39') overall clinical decision-making was 8.62 ±93.53, of which 57.5% of nurses had intuitive decisions, 22.5% had analytical-intuitive decisions, and 20% had analytical decisions.

The research findings showed that with increasing age and clinical history, nurseschr('39') decision-making progresses towards analytical decision-making, while younger and less experienced nursechr('39')s benefit more from intuitive decision-making.

Lymphadenitis is a type of inflammatory lymphadenopathy that is caused by the infiltration of inflammatory cells that can occur with or without the formation of abscesses inside the lymph node. Infectious acute lymphadenitis causes are mostly associated with acute viral and bacterial infection. The purpose of this study was to provide a more comprehensive description of the causes and evaluations performed and the effective treatment for patients referred to Shahid Motahari Hospital with cervical infectious lymphadenitis.

This retrospective study was performed on 191 children aged 3 months to 14 years admitted to Urmia Shahid Motahari Hospital who were diagnosed with cervical lymphadenitis between 2013 and 2018. Disease records, biological information, type of antibiotic treatment, aggressive procedure, contrast-enhanced CT scan information, treatment duration, and clinical symptoms were collected and a checklist was filled out.

107 patients (56%) were male and 84 patients (44%) were female. The mean age of patients was 46.65±35.05 months (range 3–168 months). Mean hospitalization duration was 5.54±3.19 days (range 1–22). The most common clinical symptom of the patients referred to the hospital was fever, which was present in 151 patients (79.1%). In 135 patients (70.7%) no aggressive procedure was taken. Abscess drainage was performed in 40 patients (20.9%), mass biopsy in 14 patients (7.3%), and surgery in 2 patients (1%). Thirty-nine patients (20.4%) had cultures that reported negative results in all cases.

The most common diagnosis in children is acute inflammatory lymphadenitis and occurs usually in spring and urban children. It is common in boys under 5 years of age. The most commonly used antibiotic is clindamycin. In cases of abscess, surgical drainage is performed for treatment.

Pregnancy is sweet experience in a womanchr('39')s life; however, a pregnancy loss can be a fatal story. About a quarter of all pregnancies end in miscarriage. One of the most beneficial things that can have a protective effect on these parents, especially mothers, is the existence of a strong support network from the family. The aim of this study was to determine the effect of individual advocacy counseling on the perceived social support from the family in mothers with pregnancy loss.

This quasi-experimental study with control group was conducted in 2018 in Urmia. A total of 100 women with pregnancy loss participated in the study. Sampling was done via randomization manner by blocking method. The intervention group received 4 sessions of educational support intervention while the control group received the usual care. Data were collected using demographic information and social support for family scale in two stages (pre-test and post-test) and analyzed by SPSS-22 software and statistical tests with significance level of 0.05.

The participants in two groups were well matched except for having a live child (p=0.03). The mean social support scores in the intervention and control group were 10.88 ± 2.73 and 10.28±2.89, respectively. This difference was not statistically significant (p=0.28) at start of the intervention. After intervention, the mean scores in the intervention and control group were 16.4±1.38 and 10.56±2.82, respectively which was statistically significant (p<0.001).

Individual advocacy counseling in women with pregnancy loss will increase their understanding from social support, and this can facilitate the process of adaptation in these mothers.

Grief counseling in the parents with pregnancy loss can lead to feelings of support and security when experiencing painful feelings and can pave the way for completing the grief process. The present study aimed to determine the effect of an intervention based on Warden's principles on the severity of grief in the mothers with pregnancy loss.

In this clinical trial we used availability sampling method and 100 mothers who had lost their pregnancy in Urmia in 2018 were entered into the study. The participants were divided into intervention and control groups by randomized block design. The intervention group attended 6 sessions of intervention based on Warden's counseling principles and the control group received usual care. Data were collected using Perinatal Grief Scale in two stages (pre-test and post-test) and were introduced into SPSS-22 software. Chi-square, Fisher exact test, paired t-test and independent t-test were used for data analysis. Significance level was considered less than 0.05.

There were no significant differences between the two groups in regard to the mean scores of total Perinatal Grief Scale and all of its different aspects before intervention. But the results of the Post-test of the intervention group revealed a significantly lower score compared to the scores of the control group and also pretest scores of the intervention group.

Intervention based on Warden's counseling principles in women with early and late pregnancy loss reduces the severity of mourning and relieves its symptoms more rapidly and can facilitate the process of adjustment in these mothers.

Cancer is the second leading cause of death in the United States and the third leading cause of death in Iran. The aim of this study was to determine the effect of peer-to-peer self-care training based on gastrointestinal complications in cancer patients.

The present study is a clinical trial. This was done with the participation of 80 cancer patients using the available sampling method and random sampling in two groups of tests and controls (40 people in each group). In addition to the usual training of the center, the members of the intervention group were provided with self-care training in the field of tolls and how to manage tolls. The control group received only routine training from the center, ie training by a physician and a hospital nurse, and training through posters and pamphlets at the center. The data collection tool was a questionnaire for the management of chemotherapy complications. Data were collected at the beginning of the study and during the first course of chemotherapy. Finally, the data were analyzed by descriptive and inferential statistical tests and SPSS software version 16.

After the intervention, there was a significant difference between the two groups in terms of the mean score of gastrointestinal complications due to chemotherapy and treatment, and the mean score of the intervention group was lower (Kay Square, p <0.05). The mean score of self-care behavior after intervention also showed a significant difference between the two groups and the mean score of the intervention group was higher (independent t, p <0.05).

Peer-to-peer training promotes behavioral management of chemotherapy, so the use of this training method is recommended for cancer patients undergoing chemotherapy along with other training methods.

Colonoscopy is the most important diagnostic and therapeutic method for colorectal diseases. Patients' satisfaction with such aggressive procedures is an important criterion for assessing the quality of health care. The purpose of this study was to determine the effect of compilation education through video tutorials and visual aids on satisfaction in patients undergoing colonoscopy.

This quasi-experimental study was performed on 180 outpatient colonoscopy candidates referred to Imam Khomeini Hospital in Urmia in 2018. The participants were selected by convenience sampling method and they were randomly assigned to control and intervention groups. Training videos and educational charts on colonoscopy before colonoscopy and on colonoscopy day were screened for the candidates of the colonoscopy, and the additional information and patient questions were provided. Patients' satisfaction after intervention was assessed by GHAA-9 questionnaire. SPSS software version 16 was utilized and descriptive and inferential methods were used for data analysis.

The mean score of satisfaction was 46.07 ± 5.03 in the intervention group and 24.72 ± 7.94 in the control group. The independent t-test results showed that there was a significant difference between the two groups after the intervention (p <0.0001).

The combination of education through educational videos and video cards significantly increased patient satisfaction, therefore the colonoscopy unit staff are recommended to improve the quality of care and patient satisfaction by using such methods.

More than 382 million people in the world live with diabetes, 80% of whom live in low-income and developing countries. Today, it is quite clear that improving metabolic control in diabetic patients can reduce the complications of the disease. The purpose of this study was to evaluate the quality of care associated with diabetic patients under the coverage of Urmia rural family physician program in 2017. In this cross-sectional (descriptive-analytical) study, 257 rural diabetic patients under the coverage of Urmia city health center were selected through simple random sampling among the existing patients. Optimal blood glucose control was considered as The hemoglobin A1C less than 7% and three criteria of the American Diabetes Association was used to assess the patient's care status, SPSS version 21software was used to analyze the chi-square and logistic regression tests to determine the relationship between optimal blood glucose control and independent variables.
The The mean age and duration of the patients were 59.1 and 6.7 years, respectively, and 66% of the participants were female. A total of 10% of patients mentioned the hospitalization history due to illness during a recent year, and 9.7% of participants had at least one of the complications of diabetes. The mean of Hemoglobin A1C was 7.08 ± 1.37, the mean lower lipid (LDL) was 35.8 ± 112.8 and the mean systolic blood pressure in patients was 124 ± 14.7. In terms of optimal glucose control (A1C <7%), 50.6% of patients had favorable conditions for glucose control and in general, 17.1% of participants in this study achieved three criteria of optimal diabetes care (HBA1C <7%, LDL <100mg / dl, BP <140mm / Hg). In multivariate analysis with logistic regression, after adjusting the effect of confounding variables, there was a statistically significant relationship between duration of diabetes, insulin consumption, referral history to private physician of clinic, visit by a clinician and body mass index with optimal blood glucose control. In general, metabolic control in rural diabetic patients covered by Urmia Health Center was satisfactory. This study showed that the regular referral of diabetic patients for testing hemoglobin A1C (at least twice a year) from rural health centers for patients under coverage could be effective in promoting their care.

Premarital education and counselling programs are considered as an important factor to promote the quality of married life. This study was performed to determine satisfaction of premarital couples about the quality of the premarital education and counselling program provided by Urmia health centers.
This descriptive analytical cross sectional study was performed on 50 couples referring to health centers in Urmia during 3 months. The data gathering tool was a questionnaire containing 2 parts. The first part included demographic questions and the second part included 22 questions related to dimensions of satisfaction of quality containing tangibility, reliability, responsiveness, assurance, and empathy. The data were analysed by the path analysis method by Mplus-5 software.
Mean age of marriage for men was 26.48.55 and 21.91.29 for women. The results indicated that education level (β2 = -0.292), location (β2 = -0.075), and sex (β2 = -0.106) had indirectly a negative effect on the satisfaction of couples. It also showed that responsiveness (β1 = 0.404), assurance (β1=0.316), reliability (β1= 0.312), and tangibility (β1=0.0207) had a direct and positive effect on the satisfaction of pre -marriage couples about the quality of premarital education and counselling program respectively.
According to the results, couple’s viewpoints should be considered in designing the premarital program. It is also recommended that all dimensions of quality of the premarital counseling and training program particularly empathy dimension should be identified and improved.