javad hedayati

 A patient experiences high pain and anxiety during laceration healing. One of the non-pharmacological methods of pain and anxiety relief is using music.

 This study was outlined to examine the impact of music therapy on the pain and anxiety levels of patients experiencing wound healing by suturing in the emergency wards.

 The study population for this randomized controlled clinical trial was all patients aged 18 - 65 years who were referred to the Emergency Ward of Imam Khomeini and Buali Sina hospitals, Sari, Iran, to suture the hand or foot. Thirty people were included from each group in the study. In the intervention group, traditional Iranian wordless music (Peyk Sahar track) was played with headphones from when the patient was placed on the bed for suturing to the end, and the duration was recorded. In the control group, sutures were made according to the usual procedure. The pain level was measured by a visual analog scale in two stages before washing and immediately after the anesthetic injection. Moreover, the anxiety level was assessed in three steps, before washing the wound, after the end of the anesthetic injection, and immediately after suturing. Data were analyzed by the SPSS software version 22. Descriptive statistics, including mean and standard deviation, and inferential statistics, such as Exact Fisher’s test, Mann-Whitney test, and Wilcoxon, were used to describe and analyze the variables.

 The mean pain before washing the wound (before music therapy) and after the end of the anesthetic injection was not significantly different between the intervention group (5.38 ± 1.31 and 3.71 ± 1.98, respectively) and the control group (5.31 ± 1.69 and 4.60 ± 2.31, respectively) (P = 0.27 and 0.057, respectively). The mean anxiety before washing the wound, after the end of anesthesia injection, and immediately after finishing the suture was 3.37 ± 0.89, 2.73 ± 1.23, and 1.27 ± 0.52in the intervention group, and 3.50 ± 0.97, 3.07 ± 1.33, and 2.07 ± 1.14 in the control group, respectively. The mean anxiety at all three times was significantly different between the two groups (P < 0.001).

 The study results indicated that music therapy lowered pain without a statistically significant difference. However, music therapy significantly reduced anxiety. Therefore, it is recommended to use music therapy to reduce pain and anxiety in patients.

Transmitting bad news is one of the difficult tasks of the care team. This situation is as stressful and costly for the healthcare team as it is tedious and expensive for the clients. Therefore, the present study was conducted to investigate the factors affecting the skill of presenting bad news to the patient and companions.

This study was a narrative review. In the present study, Persian studies were searched in Persian language databases such as Elm Net, Noormag, SID, Magiran, With The Keywords Bad News, Diagnosis Disclosure, Truth-Telling, Patient, Treatment Staff from 1385 to 1399. To search for studies in English, the keywords, breaking bad news, diagnosis disclosure, truth-telling, patient, medical staff in the database, Research gate, Elsevier, Science DirectPubmed, Scopus between 2009-2020 were used. The Google Scholar database was also searched in Persian and English. Inclusion criteria included complete Persian and English articles. Exclusion criteria included not having access to the full article. Review articles were also excluded from the study. After searching the databases, 208 articles were included in the study. The researchers examined 27 articles by applying inclusion and exclusion criteria and eliminating duplicates.

The findings showed that individual factors, communication factors and supportive factors are the factors affecting the bad news. Training in this area is insufficient. Therefore, according to the findings of the study, the role-playing method and multimedia tools can be used, the spikes protocol also plays an important role in improving communication skills.

According to the findings of the study, it is recommended that health policy makers and hospital managers by providing appropriate instructions to the cultural and social conditions of the country and also by holding bad news presentation skill classes, taking into account the mentioned effective factors. Try to improve bad news presentation skills.

The purpose of this study was to determine the relationship between literacy rate and Critical thinking of undergraduate students at Bu-Ali Sina University. This research is applied in terms of purpose and descriptive-correlation in terms of nature. The statistical population of the study were all students of Hamedan University of Bu Ali Sina who were studying in the academic year of 98-97. Based on the Karjesi and Morgan tables, 500 people were selected using a comparative stratified sampling method. Data collection was done by means of two questionnaires (Researcher-made Literacy Questionnaire and Rickets Critical Thinking Survey Questionnaire 2005). The content validity of the questionnaire was confirmed. The reliability of the questionnaires was also obtained by calculating the Cronbach's alpha coefficient as 0.74 and 0.85. To analyze the data, descriptive and inferential statistics- such as mean, percent, Kolmogrov-Smirnov test, single-group T test, Pearson correlation test and stepwise regression test- were used in the spss software environment. Based on the findings of the present study, the rate of literacy and critical thinking of undergraduate students at Bu-Ali Sina University is higher than the average (3). Also, the results of Pearson correlation tests and stepwise regression show that there is a direct correlation between literacy and students' critical thinking; in other words, the higher the level of Media Literacy, the more cognitive thinking will increase and if the level of literacy skills is lower, the student's critical thinking will be at a low level too, and it is obvious that all components of the Media Literacy can predict the student's critical thinking.

Deaths due to road traffic accidents (RTAs) are a major public health concern around the world. Developing countries are over-represented in these statistics. Punitive measures are traditionally employed to lower RTA related behavioural risk factors. These are, however, resource intensive and require infrastructure development. This is a randomised controlled study to investigate the effect of non-punitive behavioural intervention through peer-comparison feedback based on driver behaviour data gathered by an in-vehicle telematics device. Design, Setting, and Participants: A randomised controlled trial using repeated measures design conducted in Iran on the drivers of 112 public transport taxis in Tehran province and 1309 inter-city busses operating nationwide. Driving data is captured by an in-vehicle telematics device and sent to a centrally located data centre using a mobile network. The telematics device is installed in all vehicles. Participants are males aged above 20 who have had the device operating in their vehicles for at least 3 months prior to the start of the trial. Intervention: The study had three stages: 1- Driver performance was monitored for a 4-week period after which they were randomised into intervention and control groups. 2- Their performance was monitored for a 9-week period. At the end of each week, drivers in the intervention group received a scorecard and a note informing them of their weekly behaviour and ranking within their peer group. Drivers in the control group received no feedback via short messaging service (SMS). 3- Drivers did not receive further feedback and their behaviour was monitored for another 4 weeks. Primary and Secondary Outcome Measure: Primary outcome was changes in weekly driving score in intervention and control groups during stage 2 of intervention. Taxis and busses were analysed separately using generalised estimating equation analysis. Funding and Ethical Approval: This project was funded by the National Institute for Medical Research Development (Grant No.940576) and approved by its ethics committee (Code: IR.NIMAD.REC.1394.016). This trial was registered at www.irct.ir as IRCT20180708040391N1.

In the realistic manner، piles are similar to the slender columns that soil around them acts as a lateral support. The piles situated in the liquefiable soil layers، loss their lateral supports due to the liquefaction resulted from the seismic ground motion. In this case، pile has the potency of axial instability similar to the unsupported columns. This instability can lead to the lateral buckling of the piles in the eak direction and creating the plastic hinges in the pile’s badly. Many failures that acurr in the piles and their supported structures، due to the lique faction of soils after earthquakes has been reported. These piles ere designed based on the credictable codes such as JRA and NEHRP. So it seems that the behavior and analysis methods of piles are still unknown. This research attempts to predict the buckling capacity of the piles in layered liquefiable soils، using a numerical method in which Rayleigh-Ritz approach was employed to minimize total potential energy. Furthermore، a new practical approach has been presented to calculate effective buckling length of pile in liquefiable soils. By the means of this approach the buckling capacity of pile could be obtained while the stiffness of pile and soil are accessible. This method can be also applied to the extended pile shafts in the bridge piers