مجله علوم پزشکی رازی
سال بیست و نهم شماره 8 (پیاپی 222، آبان 1401)

Vesicoureteral Reflux (VUR) is a common urinary tract disorder among pediatric population and defined as the retrograde flow of urine from the bladder into the ureters and renal collecting systems due to a failure in the ureterovesical valve function (1). Identifying children with VUR at an early age provides an opportunity to prevent episodes of acute pyelonephritis and the consequent renal scarring (2) . Voiding cystourethrography (VCUG) is the modality of choice for diagnosis and grading of VUR (3). In VCUG, the child is catheterized and radiocontrast material is injected through the catheter to fill the bladder (3). Disadvantages of this procedure are catheterization discomfort, complications and considerable radiation exposure of the children who are relatively more vulnerable to the adverse effects of ionizing radiation. In addition, the risk of carcinogenesis is higher in children as they have a longer life expectancy following the procedure than adults (4). Considering the mentioned disadvantages of VCUG, many attempts have been made to find a non-invasive alternative modality with adequate accuracy to detect VUR. Ultrasound (US) is a proper modality for evaluation pediatric urinary tract system due to its accuracy, accessibility and non-invasiveness (5, 6). However, there is controversy among clinicians regarding the accuracy of US for diagnosis of VUR. VCUG allows grading of VUR using the five-level International Reflux Scale (IRS). Grade of VUR is strongly associated with the outcomes such as spontaneous resolution, recurrence of UTI and renal scarring (7). Recent guidelines recommend clinical decision-making based on the grade of VUR on VCUG, including observation (without medical therapy) for selected children with grade I or II VUR But higher grades of VUR need medical or surgical interventions (7, 8). The diagnostic accuracy of VCUG for diagnosing reflux is very high and nearly 100% for high-grades of reflux (grade III -V) (9).The objective of our study was to determine the accuracy of ultrasound for detecting VUR in comparison with VCUG in children with UTI.

In this cross-sectional study, the total numbers of 540 children younger than  8 years old with UTI referred to Ali-Asghar children’s hospital, a pediatric center in Tehran, Iran were enrolled, from April 2017 to May 2019. All patients underwent US and VCUG to detect VUR.All patients with obstructive nephropathy were excluded from the study. US was performed immediately after diagnosis, and VCUG were performed after the resolution of fever and confirmation of a negative urine culture.US was performed by a single radiologist using a Philips Affiniti 50 ultrasound machine  with 4–7 MHz convex  and  7-10 MHZ linear transducers with the bladder being both full and empty. The most important ultrasonographic findings related to VUR, were dilatation of the renal pelvis or the ureter. Additionally, changes in kidneys size and cortical echogenicity, reduction in the thickness of renal parenchyma, irregularity of the kidneys margin, and increase of urothelial thickening were also noted.Grading system for VUR on VCUG is according to the International Reflux Study Committee:o   Grade I: reflux into the ureter;o   Grade II: reflux into the ureter and renal pelvis without dilatation;o   Grade III: reflux with mild dilatation;o   Grade IV: reflux with moderate dilatation, rounded fornices;o   Grade V: gross dilatation of the ureter, ureter tortuosity, papillary obliteration.Grades I and II were classified as low grade and grades III, IV, and V as high grade reflux (7).We used the mean and standard deviation and percent for reporting the descriptive statistics of quantitative and qualitative variables, respectively. Qualitativevariables were compared using the Chi square test and one way analysis of variance (One-way ANOVA) was used to compare the mean of quantitative variables. We used the sensitivity, specificity, positive predictive value, negative predictive value, overall accuracy and kappa agreement coefficient to investigate the efficacy of US for prediction of VUR based on the actual presence or absence of VUR confirmed by VCUG. Data was analyzed using Stata software, version 12 (StataCorp, TX) and p-value <0.05 was considered as the level of significant.

Among 572 patients evaluated for VUR, 540 patients entered our study. A total of 269 (49.8%) were boys and 271(50.2%) were girls. All patients underwent VCUG and US. Mean age of children who had VUR was 2.5 years old. Fifty-three cases (37%) had low-grades and 90 cases (63%) had high-grades of VUR. US was abnormal in 97 of 143 patients (67.8%) with confirmed VUR on VCUG and in 163 of 397 cases (41%) without VUR on VCUG.The overall sensitivity and NPV of US for detecting VUR were 67.83% and 37.31%, respectively. Among 90 children with high-grade VUR (grade III–V) on VCUG, 72 (80%) had abnormal findings on US and sensitivity and NPV of US among these cases, were 88% and 93.6 % respectively. All cases of grade V and 83.9% of grade IV VURs had abnormal US findings.

There is considerable interest in prompt and early detection of VUR as it is linked to recurrent UTIs, renal scarring and renal insufficiency. VCUG is the modality of choice for detecting VUR (10, 11). However, owing to some disadvantages such as bladder catheterization and pediatric radiation exposure, there is a growing interest in finding alternative and less invasive methods with acceptable accuracy to detect VUR (12). In this study, we evaluated the accuracy of US in predicting VUR among children hospitalized with UTI. Several studies have evaluated the efficacy of US in diagnosis of VUR and their results have been conflicting with some reporting unreliability of ultrasound in evaluation of VUR.Mehnat and colleagues showed that the sensitivity and specificity of US for detecting VUR were 40% and 76%, respectively and demonstrated that renal US was neither sensitive nor specific for detection of VUR in children with a first-time UTI (11). In another investigation, Adibi and colleagues demonstrated the sensitivity, specificity; NPV and PPV of US in diagnosis of VUR were 70.9%, 51.4%, 69.6% and 52.9% respectively. They suggested that US is a sensitive but not specific method in diagnosis of VUR (12). In a review article in 2016, Shaikh N. and colleaguesconcluded that US could not replace VCUG in detecting VUR.On the other hand, some studies reported that US is a reliable modality for evaluation of VUR (3). Hey-young Lee and colleagues demonstrated that 95.3% of high grade VUR cases could be detected by US . However, they also stated that the diagnosis of VUR by US had some limitations in cases of low-grad VUR and detection ratio of these cases was only 62.5% (13).Similar to other investigations, we found that sensitivity and specificity  of US to detect low-grade VURs are low (respectively 67.83% and 58.94%). However for high-grade VURs, the sensitivity (88%) and NPV (93.6 %) of US are acceptable. Regarding high frequency of spontaneous resolution of low grade VUR whilechildren grow up, it can be recommended that VCUG be performed only in children with abnormal findings on US, avoiding many unnecessary VCUG procedures.Although ultrasound is not sufficiently accurate to detect all grades of VUR, but has enough sensitivity and NPV for ruling out high-grade VUR. So avoiding unnecessary VCUG in children with normal ultrasound finding is recommended.

Autism is one of the neurological diseases that lead to changes in hormone levels. Therefore, the aim of this study was to the effect of a swimming exercise course on glucose and insulin in mice with autism. Scientific research has shown that people with autism have behavioral disorders including anxiety and depression. These patients are mostly isolated from social activities. The causes of this disease are not fully known, however, research by scientists in the last two decades has shown that accidents or the use of certain chemical drugs during fetal and early life can increase the risk of developing this disease in children. Clinical and animal evidence has shown the relationship between increased inflammation in the brain and autism. However, which brain area is involved in this disease is not completely clear. Although extensive research has been conducted on pharmacological and behavioral treatments, the response to these treatments has been largely unsuccessful. One method that has attracted researchers' attention in recent years is the use of sports protocols from adolescence to adulthood to reduce neurobehavioral disorders in adulthood. In addition, exercise has been confirmed as a factor in lowering inflammatory levels in the body and brain. Also, recent studies have shown that sports activities can reduce behavioral disorders including anxiety and depression, and increase social behaviors. Therefore, in this study, we decided to investigate the therapeutic effects of swimming in an animal model of autism on behavioral disorders, including anxiety, depression, and social behaviors, as well as the level of inflammation in the hippocampus and prefrontal brain regions, which are involved in these neurological disorders.

The present study was approved by the code of ethics IR.PNU.REC.1400.269 in the Code of Ethics Commission of Payam Noor University. C57BL6 female and male mice with an approximate age of 80-90 days and a weight of 20-22 grams were maintained under light conditions of 12 hours of light and 12 hours of darkness and a temperature of 23 ± 1 degrees Celsius, with sufficient water and food at their disposal. was placed After two weeks of adaptation to the environment, each male and female animal was placed in a cage for mating, then the next morning the vaginal plaque was checked as an indicator of pregnancy. In order to cause autism disease in mice, the animals were divided into control and autism groups on the 12th day of pregnancy (each group of pregnant mice included 10 heads). In the autism group, pregnant rats received a dose of 600 mg/kg intraperitoneally with sodium valproate. After that, children were allowed to be born. At the age of 21 days, the children were separated from the mother by gender and kept in groups of 5 in each separate cage. On the 28th day after birth (one week after separation from the mother), the juvenile animals were divided into 4 groups of 10 as follows: the control group that does not exercise, the control group that exercises, the autism group that They don't exercise, the autism group who exercise. The animals were subjected to swimming exercise for 8 weeks (56 days) from the age of 28 days to the age of 56 days. The training was done 5 days a week, and in this protocol, the animals rested 2 days a week. The results were subjected to a one-way analysis of variance using SPSS-26 software, and the significance level was considered less than 0.05.

The results of the one-way analysis of variance test showed that there is no significant difference in the weight of mice of different research groups. Also, the results of the one-way analysis of variance showed that there is a statistically significant difference in the level of glucose in the mice of the research groups. The results of Tukey's post hoc test showed that the glucose level in the autism group with exercise has a significant decrease compared to the control group without exercise and also compared to the autism group without exercise (P value is equal to P ≥ 0.000 and P ≥ 0.016 respectively), also the glucose level in the autism group without exercise was significantly lower than in the control group without exercise (P ≥ 0.001). Also, the results of the one-way analysis of variance test showed that there is a statistically significant difference in insulin levels in the mice of the research groups (P<0.001). The results of Tukey's post hoc test showed that the insulin level in the autism group with exercise has a significant increase compared to the control group without exercise and also compared to the autism group without exercise (P value is equal to P ≥ 0.001 and P ≥ 0.000 respectively).

Exercise decreased glucose and insulin in autistic mice, so it is suggested to use the swimming training protocol to improve the physical and hormonal condition of autistic patients. Scientific research has shown that people with autism have behavioral disorders including anxiety and depression. These patients are mostly isolated from social activities. The causes of this disease are not fully known, however, research by scientists in the last two decades has shown that accidents or the use of certain chemical drugs during fetal and early life can increase the risk of developing this disease in children Clinical and animal evidence has shown the relationship between increased inflammation in the brain and autism. However, which brain area is involved in this disease is not completely clear. Although extensive research has been conducted on pharmacological and behavioral treatments, the response to these treatments has been largely unsuccessful. One method that has attracted researchers' attention in recent years is the use of sports protocols from adolescence to adulthood to reduce neurobehavioral disorders in adulthood. In addition, exercise has been confirmed as a factor in lowering inflammatory levels in the body and brain. Also, recent studies have shown that sports activities can reduce behavioral disorders including anxiety and depression, and increase social behaviors. Therefore, in this study, we decided to investigate the therapeutic effects of swimming in an animal model of autism on behavioral disorders, including anxiety, depression, and social behaviors, as well as the level of inflammation in the hippocampus and prefrontal brain regions, which are involved in these neurological disorders.

Most teens use the Internet as a tool to build and maintain relationships with their peers. This rich culture strongly influences the technology, skills and interests of young people and adolescents. Students are among the most users of virtual networks due to their literacy. Students are one of the most used users of virtual networks due to their extracurricular activities. However, the negative effects of the use of communication technologies and social networks in the form of violence are undeniable. Anger, violence and aggression are in fact a kind of emotion and behavior in conflict with civilization. Civilization is a quality of social behavior in which there is a kind of consensus on the boundaries of privacy. Undoubtedly, young people, especially students, are more prone to civilization than violence. Despite their risks, social media can bring benefits if used properly. Social violence Unfortunately, today it affects a wide range of young people in our society, and this is worrying for our society in transition, which needs a healthy youth force and wants to leave its future in the hands of these young people. Iran has a young age structure, so the study of youth issues and problems is one of the research priorities. One of the most important issues in relation to young people at all levels of society (government, education, family, etc.) is the issue of behavioral disorders of young people in the form of violence. Among the youth anomalies, aggression is more pronounced and its frequency is higher and in terms of increasing the age of aggression in underdeveloped societies such as Iran, is one of the most important social issues of peripheral countries, especially peripheral countries with young age structure. Numerous reports in journals and researches indicate the frequency of aggression and its increase and spread among young people and the increasing and increasing issue of youth aggression. Aggressive behavioral patterns are becoming more prevalent among young people and even girls. In the current situation, the society in transition in Iran is facing many social, intellectual and cultural problems, and the student youth are an important part of the human capital of the society. Understanding the role of these networks in reducing violence and improving mental health in society can be explored, given the two-way and reciprocal approach between student users and social networks. The answer is yes. Violence and mental health are related to each other. The existence of violence is one of the social harms that has harmful physical and psychological effects and the role of cyberspace on it is not known; Therefore, the present study was conducted with the aim of the therapeutic role of virtual social networks on mental health and violence in young people.

This descriptive-analytical study was conducted with a mixed approach. The statistical population of the study was the qualitative section of the experts of the university complex of the province and in the quantitative section, the students of the Islamic Azad University, Central Tehran Branch and Allameh Tabatabai University. Using Cochran's formula, 384 people were selected as a statistical sample and selected by available random sampling method. Data collection tools were semi-structured interview and researcher-made questionnaire. Data analysis was performed using LISREL and SPSS20 software.

The results showed that control of social networks leads to improved levels of violence and mental health in young people (p <0.05).

In general, it can be said that the correct use of social networks is effective in reducing violence and increasing mental health among adolescents and young students; Therefore, it is necessary to provide the necessary training to young people and families on the proper use of virtual social networks. The phenomenon of violence is pervasive and does not belong to a particular community, although its extent varies from country to country or from city to city; Nevertheless, it can be said that most societies suffer from it. Violence is a new and common injury in society. Violent children try to dominate other children through physical or verbal violence. But given the dire consequences of aggression, it must be prevented. Of course, it should be noted that in order to control aggression, one should not punish the aggressive child. Rather, proper guidance of punishment in certain circumstances by parents, educators, and the police can lead to the correction of aggressive behavior, in which case punishment is applied in a controlled manner. But the best way to control aggression seems to be for children to learn how to control their anger and to better manage their actions and manage opportunities for aggression based on the social behaviors of others. Knowing the characteristics of each stage of development, Strengthening children's social behaviors such as: cooperating, participating, expressing empathy and empathy, warning of the possible consequences of aggressive behavior, gently punishing the aggressor, punishing aggression patterns, keeping the aggressor away from the place of aggression Strengthen anti-aggression behaviors, provide a set of arguments about the dangers and consequences of aggression with the aggressor or victims of aggression. Virtual society will never replace real society; Rather, it will act as a facilitator of social experiences. Communication facilities allow us to connect with communities of common interest in new ways globally and remotely. As a result, by joining these "remote communities" we will be able to build better social relationships with neighbors, colleagues and other citizens in the real world in the real world. Each social network has its own communication culture, that is, it has chosen a special and unique character and speech. Of course, one can find networks that have adopted an imitative communication culture. By joining any social network, a person becomes involved in a certain type of communication culture, which includes: attitude, reliance on words, special terms, behavior, personality and appearance type, and so on. Undoubtedly, the degree to which a person is affected by this environment will not be absolute zero. So each social network promotes its desired identity. For example, on sites such as Facebook, FriendFeed, and Twitter, the user not only joins the large community of the site in question, but also joins smaller groups and social networks. Each of these groups has its own affiliation and, consequently, a specific communication culture. Thus, in being influenced by the communication culture of these groups, one finds it necessary to change one's communication identity, that is, the style and identity of one's general actions in relation to others; Although this change of identity is temporary and limited to a specific time and place; But without a doubt, it will not be ineffective in the real identity of the person. According to the research results, it is suggested that the necessary training be given to young people and families in the field of proper use of virtual social networks, as well as the production and construction of programs and software for familiarity and free training on how to use the network. Social activities and increase motivation among young people to participate in associations and group organizations and institutional relationships.

With the change in the development paradigm from economic development to sustainable development, the role and function of the higher education system have undergone fundamental changes. Universities play a key role in transforming society into a sustainable society; Because they have the power to educate world leaders and empower them to carry out research activities to create a sustainable future. Sustainable universities have different organizational cultures that value "inclusion" and seek to promote it. Therefore, these universities play an important role in changing society and educating the new generation of citizens and leaders. Considering that universities of medical sciences play an essential role in promoting the health of society, therefore, it is recommended that to evaluate the sustainability of the university, careful planning should be done by the managers and practitioners of the higher health education system. From this point of view, the higher education system needs universities that, in terms of organizational structure, human capital, educational and research processes, etc., are the foundation for the realization of sustainable higher education in particular and sustainable development in general; A university with such characteristics is called a sustainable university. To take the first important step in the process of becoming a sustainable university, the theorists and practitioners of the university environment emphasize conducting an assessment of the sustainability situation in the university. In this context, the transformation and innovation package in medical science education has been implemented by the Ministry of Health, Treatment, and Medical Education. One of the packages deals with the discussion of moving toward the fourth universities, which refers to three general policies of institutionalizing the intellectual capital approach in the health system; Presence in the regional and global educational arenas, and the production and localization of valid scientific evidence for the promotion of higher health education. It can be said that a sustainable university is a university whose philosophy is based on essential rationality and systemic thinking, and by taking advantage of an interdisciplinary approach in education and research, it identifies and solves problems affecting human societies in a transactional manner, and its ultimate goal is the realization of sustainable development for current and future generations. The immediate and future benefits of the current research are identifying the dimensions of the sustainable university in macro medical sciences universities of region one, creating relative awareness of the concept of sustainable university, presenting a model of the impact of sustainable university with the fourth generation approach on developing critical thinking skills. Also, carrying out short-term planning in the university based on the findings of the research to promote the sustainable university program and develop critical thinking skills, helping the officials and managers of the universities of medical sciences in the first region to develop long-term sustainable university strategies is one of the practical consequences of this. It is research. Therefore, considering the importance and role of educational and academic organizations, including the records of universities of medical sciences and their impressive impact on the progress of the country, the field of higher education management must have a national determination and a realistic view with hope for the future and move forward in the path The implementation of the statement of transformation and innovation packages has been taken. Therefore, according to the presented materials, the main question of the current research is: What is the impact of the sustainable university with the fourth-generation approach on intellectual capital and the development of critical thinking skills in the macro medical sciences universities of Region 1 to provide a model?

The present research was conducted with a mixed approach. The statistical population in the qualitative section was 23 professors of the universities of macro-medical sciences in the first region who had the academic rank of associate professor and above, and in the quantitative section, there were 1851 professors of the academic staff of the macro-medical sciences universities in the first region of the country's health sector. In the qualitative section, 17 people were selected using the purposeful sampling method, and in the quantitative section, 320 people were selected as a statistical sample based on Cochran's formula. To collect data, the questionnaire made by the researcher of University and Rajaei's critical thinking skills questionnaire (2013) was used.

According to R2 values and path coefficients, it can be concluded that the relationship between the sustainable university and critical thinking (with a path coefficient of 0.371 and R2 value equal to 0.138 and T-statistic of 6.227) is positive and significant.

In general, it can be said that the relationship of a sustainable university with critical thinking is positive and meaningful, that is, it not only provides a platform for setting goals and activities but also translates sustainability issues into a language that is understandable for the decision makers of higher schools and universities. This audit can be used as a means of celebrating and raising awareness about past achievements as well as a commitment to improving the future. Among the limitations of the present study, are the difficulty of communicating with some university professors and determining the time required to conduct interviews and the low accuracy of some of the subjects in studying the questions and answering them. From there, one of the most important factors in promoting such a program is the existence of organizational rules and regulations, so it is suggested that universities formulate a charter and guidelines for the implementation of such a method. By analyzing and investigating, various issues and issues of educational, research, and professional development are identified and measures are taken to resolve them through the use of a sustainable university. To foster critical thinking, the educational system can be developed through the development of the text curriculum. The horse will take care of this. The goals of the curriculum play a role by providing a suitable platform and directing educational activities and resources. In cultivating critical thinking, the content and the process should be considered together, and it should not be enough to transfer some information in textbooks. Using diverse resources and organizing textbooks richly can help to develop students' critical thinking.

Considering the changes in fertility in Iran and reaching below the replacement level, the study of infertility is of great importance. intentional childlessness refers to women who are of childbearing age but do not intend to have children. Women who are referred to as "voluntary" or "voluntary childless" women are confronted with women who do not currently have children but will experience childbearing in the future and are called "temporary childless." Those who want to have children but cannot have children due to fertility problems are called involuntary children (1). Childlessness at the end of the reproductive years, or in other words, the same percentage of childless women in the age groups of 40-44 or 49-45, is called permanent or lifelong childlessness (2). Social changes in the educational and occupational status of women are among the most important causes of voluntary and involuntary childlessness (3). In general, on the one hand, relatively few studies have been conducted on childlessness in Iran, and on the other hand, few studies have been conducted on a significant sample of the population. In addition, studies have emphasized individual characteristics while individuals are at higher social levels and are also influenced by macro-social conditions and structures. The present study seeks to use the micro-level data from the 2016 census to examine permanent childlessness among women aged 40 to 49 years and to cover the above study gap to some extent. For this purpose, two categories of variables will be considered in explaining childlessness. Individual characteristics and variables that indicate the health, demographic, and economic status of the provinces of the country.

In the present study, a quantitative approach, a secondary data analysis method, and a multi-level analysis technique have been used. The main difference between this article and other previous articles is the use of two-level analysis method. With this method, the effect of individual and macro variables can be examined simultaneously. The statistical population includes all Iranian women aged 40 to 49 years, and the sample includes 85,799 of the mentioned women, which is available in the raw data of 2% of the 2016 census. To study permanent childlessness, it has been suggested that women aged 45 to 49 years or even 40 to 44 years should be considered. The 49-year-old childless person is considered a permanent childless person. In the present study, the first level units, i.e., the people within the second level units or provinces, are nested. The above model shows how the variables at one level affect other levels. Childlessness (code 0-having a child, code 1-childless) is a dependent variable that is made using the variable of the total number of live children born to women. Women between the ages of 40 and 49 who had no live children were defined as childless, and women with at least one live child were defined as having children. Age, place of residence, educational status, and employment status are the first level independent variables. General marriage rate (per thousand), general divorce rate (per thousand), urbanization as macro-population variables, total economic participation rate of 15 years and older, total unemployment rate of 15 years and above, Gini coefficient in urban areas and total inflation rate as macroeconomic variables and finally the ratio of the number of active hospitals to the population (number to one hundred thousand people), the ratio of the number of beds in hospital wards to the population (number to ten thousand people), the penetration rate of health insurance (percentage) And social insurance penetration rate (percentage) are considered as major health variables.

The findings of this study showed that the childlessness rate in the provinces of the country fluctuates between 3 and about 6%. North Khorasan province has the lowest proportion of childless women, while Bushehr province has the highest proportion of childless women. This ratio shows that childlessness in Iran is not yet at a worrying level, but nevertheless, finding a way to reduce these ratios and preventing their increase can prevent a sharp decline in the current level of fertility in the future. Statistical tests show that the probability of childlessness increases with age. The effect of age on childlessness has been confirmed in some previous studies (10). Rural women are less likely to have childlessness than urban women. Unemployed women are also less likely to have permanent childlessness than employed women. Women with a high school diploma and a university degree are less likely to have childlessness than women with a university degree. The effect of residence, employment status, and education on childlessness has also been shown in other studies (3, 5, 6, 7, 8, 9, 10). The research findings also showed that with the increase in the general rate of marriage, the probability of permanent childlessness for women in the provinces decreases. Increasing urbanization significantly reduces the possibility of permanent childlessness for women in the provinces. Increasing the economic participation rate of the population of the province significantly reduces the probability of permanent childlessness, and in contrast to increasing the unemployment rate of the population of the province, significantly increases the probability of permanent childlessness of women in those provinces. Considering the significant relationships that were mentioned in the findings section, it can be concluded that macro-demographic and economic variables are more important in predicting the likelihood of permanent childlessness in women. Health variables had no statistically significant effect on the status of permanent childlessness of women living in those provinces. This does not mean that this group of variables is not important, but it can be due to the fact that the health status of the provinces has a high degree of convergence and relative similarity, and therefore they have not had a significant impact.

Improving the economic situation, reducing the unemployment rate, providing a ground for marriage and trying to reduce the divorce rate can reduce permanent childlessness. Reducing the unemployment rate means improving the welfare and economic status of families; providing a ground for marriage means people entering into relationships that could potentially lead to childbearing; and reducing divorce rates means increasing the chances of having children among the population. Therefore, in general and as for policy proposals based on the results of the present study, it can be said that job creation at the macro level, which can reduce both unemployment and relative well-being for families, efforts to provide the basic requirements of marriage and prevent the increase in the age of marriage by providing suitable housing and facilities to solve this problem in society, as well as planning to strengthen family and marital ties and reduce the divorce rate, such as holding counseling classes for couples on the verge of divorce, can prevent an increase in the proportion of permanent childlessness in the future.

Soccer is a very dynamic and fast team game with a richness of movement, which is in the group of multi-structured sports games; Soccer is a sport characterized by numerous, complex, and dynamic kinematics activities with rotational or non-rotational movements (1). In this sport, a high level of points can be achieved only in planned training conditions (2). Sports scientists have focused on approximate explanations for excellent athletic performance; or they are looking for factors that affect the athlete's interaction with their environment (for example, diet, and exercise). By understanding these factors, environmental conditions can be manipulated to optimize athletic performance (4). Nutrition strategies are one of the most popular and accessible ways to improve performance, recovery and improve physiological changes in certain sports such as Soccer (5, 7). Despite a correct understanding of the physiological demands of Soccer, and the relationship between preparation and nutritional performance, the eating habits of soccer players are often associated with a lack of training and a lack of knowledge of the scientific methods of sports nutrition (8). The characteristics of contemporary professional Soccer increase the physical demands during the game as well as more matches per season. Now more than ever, aspects of optimizing athletic performance have received much attention from Soccer players and coaches. In this, nutrition plays a special role; because most elite teams try to provide adequate nutrition to ensure maximum performance while ensuring faster recovery from competitions and training. In addition to regular nutrition based on nutritional recommendations, sensible use of dietary supplements may also play a role in optimizing Soccer performance (9). Nutrition of Soccer players is an important issue and its knowledge can help increase the quality of this popular game and prevent possible health problems and injuries in players (10); which shows the importance of applied research on the effect of nutrition on the level of health and athletic performance of soccer players. In view of the above, the purpose of this study was to review the role of sports nutrition in the sports performance of soccer players with emphasis on the role of carbohydrates as one of the macronutrients applied to the sports performance of soccer players.

In the present systematic review study by searching the information obtained from the databases of Google Scholar, Pabmad, etc. from 2000 to 2022, studies that examined the effect of carbohydrates on the physical performance and physical fitness of footba soccer players. Were searched with the keywords Soccer, sports nutrition, macronutrients, carbohydrates and sports performance. The selected studies were reviewed by 3 authors and out of 124 selected articles, 35 articles that met the entry requirements were selected and used.

The importance of carbohydrates increases with increasing intensity of exercise, but due to the limited carbohydrate reserves in the body, the reduction of liver and muscle glycogen with intense exercise for a long time is a determining factor (24) in the performance of team sports such as Soccer. . Proper glycogen content plays a major role in athletic performance. As shown by physiological measurements performed in a Soccer match, the bioenergy of this particular sport is quite comprehensive and includes high oxidative capacity, high glycolytic capacity as well as high dependence on the degradation and re-synthesis pathway of ATP and phosphocreatine. Is (25). Due to the high glycolytic component, the content of muscle glycogen is important in Soccer. Proper carbohydrate intake is a key element in dealing with a lot of exercise among professional athletes. Consumed carbohydrates, which are stored as glycogen, are the source of muscle energy during exercise. Carbohydrates stored as glycogen in the liver and skeletal muscle are an important source of energy, both in competition and in training, where carbohydrate availability is a limiting factor during long-term physical activity. Can be effective in athletic performance. Based on the analysis of Soccer matches, the intensity of players' activity is at the level of 70-80 VO2max. Long-term effort at this level is mostly based on glycogen as a substrate for energy metabolism. Adequate carbohydrate intake before, during and after exercise helps maintain and restore glycogen stores, which can affect muscle fatigue and exercise performance (9). During a Soccer season, athletes tend to play intense and light competitions such as crucial and qualifying games. Muscle glycogen stores are a determinant of performance during exercise, and manipulating carbohydrates during the Soccer season to increase muscle glycogen stores can improve the performance of top Soccer players (26). Consumption of carbohydrate courses, depending on the intensity of training and competitions, should include more carbohydrates when competitions or workouts need more intensity and less carbohydrates when they need less intensity. The day before the game (MD-1) is one of the most important times to load up on carbs. Assuming that players have properly loaded muscle glycogen on the day of the match, the role of the pre-game meal should primarily be to promote pre-game hepatic glycogen storage, a goal that is more important for late morning or lunch. In fact, hepatic glycogen may be reduced by up to 50% after one night of fasting and may not fully recover by early evening depending on the frequency and dose of CHO (41). It is wise to allow players to consume the carbohydrate sources they enjoy during MD-1, as long as there are sufficient amounts to reach 6 g/kg (44). From a practical point of view, it is recommended to consume water during and after food before the game until reaching the competition site. Consumption of carbohydrate drinks should be prohibited after meals and re-consumed only after reheating and 5 to 10 minutes before the start of the race. This strategy is to reduce the likelihood of recurrent hypoglycemia in the first 10-15 minutes of the race (44). Carbohydrate nutrition during exercise is likely to improve the performance elements of the race day if fed at 30 to 60 grams per hour (45). Such feeding rates improve the physical aspects of performance such as total running distance, sprinting distance as well as technical performance such as passing, dribbling and shooting (46-49). Taking into account the warm-up time (for example, 20 to 30 minutes) and the game itself (for example, 90 to 95 minutes), this amount corresponds to the absolute dose of CHO equal to 60 to 120 grams per game. Due to the practical problems of refueling during the game and the extent of CHO exogenous oxidation depends on the CHO feeding pattern (50). In this regard, Anderson et al. Suggested that players may consume CHO at the beginning (20-30 g) and end of the warm-up period (20-30 g), between breaks in two halves (20-40 g) as an opportunity to consume Higher doses of CHO will benefit due to the increase in steady-state consumption time and, if possible, the second half (20-30 g) (39). However, such a diet (and indeed the CHO strategy of the optimal race day) has not been experimentally tested. Regarding muscle glycogen re-synthesis, the general consensus is that consumption of 1.2 g / kg / h CHO with a high glycemic index for 3 to 4 hours is optimal to facilitate short-term glycogen re-synthesis (64). The important point is that post-match feeding should start immediately after the game (ie in the locker room) because this is when muscle is most receptive to glucose uptake and glycogen synthesis (39). Due to the time required to complete muscle glycogen (24 to 72 hours), there is also a need to consume enough CHO in the day (s) after the race, often referred to MD + 1.

Given the role of CHO as an important substrate for glycolytic and aerobic systems in Soccer, the aim of this study was to provide an overview and theoretical framework of CHO consumption strategies in Soccer. According to research, CHO consumption plays an important role in the quality of training and also the performance of soccer players on the day of the match, which varies according to the physical condition of the athlete, the athlete's position and also the level of competition. CHO intake should be adjusted according to the athlete's training schedule and season. Also, for optimal muscle and liver glycogen stores for athletes' performance, it is necessary to observe nutrition before, during and after competitions and training according to the intervals between competitions and training of athletes. However, nutritional recommendations for athletes of the opposite gender and lower age groups, such as adolescents with developmental needs, may require nutritional revisions, which require further research due to limited information. . Given that Soccer competitions are different according to the level of competition and also the metabolic needs of Soccer according to the conditions of Soccer players (gender, age and position of the player), it shows different physiological needs of these athletes; which indicates the need for further research in this regard.

Public health as a key variable has caused most of the international activities and planning to focus on itself. Such a way that improving people's general health level has always been considered a concern. Researchers have found that improving public health can have positive effects in all individual and group areas and ultimately lead to improved people performance. The functions of public health have caused the improvement of its level to be taken seriously as an important issue. However, there are also problems in the way of improving public health, which has caused the development process of public health not to be taken seriously. One of the things that have always attracted the attention of researchers and doctors about health and are used as a method to overcome problems and diseases and raise the level of health is improving the way of thinking and using the mind (mindfulness). Mindfulness is highlighting the importance of mental and intellectual work. The importance of mental training is so much that cognitive scientists consider the achievement of people in special abilities through mind training based on a theory and changes in brain function, mental health, and future professional behavior. On the other hand, the mind includes a wide range of stories, hopes, fears, expectations, desires, imaginations, etc., and three of these states are the main ones in how to interpret and predict people's behavior. These three are desire (which specifies one's goals), belief (based on which we predict what a person believes to be the true state of the world), and pretense (because people do not always act as they are). But to what extent mindfulness affects public health and entrepreneurs who are constantly facing stress and work pressures is a question that needs more research. Another thing that seems to be related to the mindset and problems of entrepreneurs is creativity. Creativity is one of the important and basic key concepts in psychology. In today's world, the ability to adapt and manage changes is the main element of success and survival of every individual, and acquiring these abilities requires people to pay attention to creativity and variety. Successful people are people whose creativity and creativity form the arrowhead of their movement. Improving creativity as one of the key factors in people's success has caused it to seriously affect people's performance. The effort to improve creativity as a necessity in educational systems has always been considered and the process of developing creativity as an important issue has started from a young age. Creativity is one of the characteristics of a human being who can create many things with divine talent. If we remove creativity and innovation from the scene of human life, we have shot a blank arrow at the movement, dynamism, survival, and vitality of human life because stagnation and humiliating repetition of life is equal to death and destruction. Efforts to improve creativity cause innovative activities to be created, and as a result, while enjoying the benefits of innovation; lead to improving the mental state of individuals and groups. Although the effort to improve creativity and public health has been considered an important issue, there is a need for variables that influence the process of improving creativity and public health; Examined. Mindfulness, as one of the key variables, plays an important role in the process of improving people's mental performance, and this mental performance can provide the basis for improving creativity and general health. Cultivating the mind is one of the important issues that cause the proper mental preparation to be formed in people, which leads to improving the functional status of people. Although mindfulness plays an important role in improving the mental state of people, the lack of comprehensive research on its functions in some areas, including creativity and public health, has led to insufficient scientific evidence regarding the role of mindfulness in creativity and the general health of entrepreneurs. Not be On the other hand, this research gap has caused executive activities to improve creativity and public health as an important issue not to be taken seriously. This issue has led to the formation of a research gap in this field. According to the above material, the researcher is trying to answer the question, does mindfulness affect the creativity and general health of entrepreneurs?

The statistical population of the current user research and survey was formed by the entrepreneurs of Golestan province, whose exact number was not available. According to the selection available according to Cochran's sample size formula, 384 people were identified as the research sample in the conditions of uncertainty of the population. To collect data, a 28-question general health questionnaire (4 components of physical symptoms, anxiety, insomnia, insufficient social activity, and depression), a 30-question creativity questionnaire by Rendsip (1979) (4 components of mental persuasion, ideal influence, inspirational motivation, and individual consideration) and the 15-question questionnaire of Anasori et al.'s (2020) whose reliability was obtained as 0.81, 0.83 and 0.86, respectively, were distributed among the sample, and finally, 351 questionnaires were collected.

The results showed that mindfulness has a 0.597 effect on general health and a 0.761 effect on creativity.

Improving mindfulness by improving the level of creativity and general health can have positive effects. According to the results of the present research, it is suggested that holding training courses to improve the skills of entrepreneurs regarding mental cultivation, while increasing the level of their mental cultivation, will lead to the improvement of public health and creativity of these people. According to the results of the present research, it is suggested to hold brainstorming sessions, while increasing the level of creativity of entrepreneurs, to promote the general health and creativity of these people. Finally, because the exact statistics of the number of entrepreneurs were not available, it is not possible to generalize the obtained results to society. Also, the mental condition of the subjects could not be controlled when completing the questionnaires, which is one of the limitations of the present research. In general, the results of this research showed that mindfulness has a significant effect on the general health and creativity of entrepreneurs. Considering the role of the two components of health and creativity in the work progress of entrepreneurs on the one hand and the effect of mindfulness on these components, on the other hand, it is recommended that the officials and those involved in raising the level of general health and creativity of entrepreneurs to mind. To have visa attention.

Intimacy is one of the most basic elements in a couple's relationship. Intimacy is a dynamic concept in human relationships, especially in marital relationships, which means openness and non-inhibition in relationships and the closeness of two or more people in various emotional, logical and functional dimensions. Couples who experience a higher degree of intimacy, apart from socioeconomic status, report significantly fewer adjustment problems in their marital relationship (1).Given the importance of intimacy, identifying effective intervention and educational approaches to increase couple intimacy to improve couple relationships will be very useful. One of these approaches is motivational interviewing, which is a combination of principles and techniques derived from a very wide range of models of psychotherapy and behavior change (4).In addition, given that many marital problems have emotional roots, the recent approach to meta-diagnostic treatment to resolve couples' problems has come into focus; Because this treatment emphasizes emotions and maladaptive emotion regulation strategies, emotional experience and response to emotion is the main basis in the meta-diagnostic approach (12). But it is not clear which intervention is more effective. On the other hand, it is not clear whether these interventions affect intimacy or not, and which intervention is more effective is also in a state of ambiguity.

In order to conduct applied and quasi-experimental research with pre-test and post-test design, from couples referring to counseling centers in Shahrekord in 1399-1400 (1250 couples), by purposive sampling method and provided entry conditions For the study (with at least a third grade of middle school, age range 25 to 45 years, no disabling physical or mental illness) 60 couples were selected and randomly divided into three groups of motivational interview, meta-diagnostic treatment and witness. Before, immediately after and 45-day follow-up, the subjects completed the Wonden Brook and Bertman (1995) intimacy questionnaire, and the experimental groups each received 8 sessions of 90-minute intervention.Finally, from descriptive statistics (mean and standard deviation) and Kalmogorov-Smirnov tests, analysis of variance with repeated measures and Bonferroni post hoc using SPSS software version 25 at a significance level of 0.05 for statistical analysis of data used.

The results showed that the meta-diagnostic therapy group and motivational interviewing could lead to a change in the mean scores of the couple's intimacy (intimacy, agreement, honesty, love and commitment) in the post-test and follow-up stages. In order to be effective, the meta-diagnostic therapy and motivational interview therapy group was able to increase the mean scores of the couple's intimacy (intimacy, agreement, honesty, interest and love and commitment) in the post-test and follow-up stages. On the other hand, it was found that there were no significant changes between the pre-test scores.The results showed that the mean scores of the couple's intimacy variable, regardless of the effect of grouping, changed significantly during the post-test and follow-up stages, which is a significant difference compared to the pre-test (p = 0.001). On the other hand, it was found that the variable of grouping (post-diagnostic treatment group therapy) regardless of stages (pre-test, post-test and follow-up) had a significant effect on the intimacy variable of couples. This means that meta-diagnostic treatment was a significant effect compared to the control group (p = 0.001). Finally, the results indicate that meta-diagnostic treatment with the interaction of stages also had a significant effect on the test stages (pre-test, post-test and follow-up) of the couple intimacy variable (p = 0.001).The results of post hoc test (Table 3) show that the difference between the mean scores of pre-test and post-test is significant by following the variable of couple intimacy. However, there is no significant difference between the mean of the post-test andthe follow-up of this variable. This means that the mean scores of couples intimacy in the follow-up phase did not change significantly compared to the post-test, but due to the lack of follow-up scores compared to the post-test and a significant change in follow-up scores compared to the pre-test shows that the effectiveness of meta-diagnostic treatment on intimacy over time Preserved.On the other hand, it was found that the difference between the mean scores of intimate couples in the experimental group of meta-diagnostic therapy and the experimental group of motivational interviews was not significant and this finding means that the effectiveness of meta-diagnostic treatment and motivational interviews on the intimacy of couples was not significant. However, the difference between the experimental groups (meta-diagnostic therapy and motivational interview) with the control group was significant. In a summary, it can be stated as follows: Transdiagnostic treatment intervention and motivational interview have a significant effect on the level of intimacy of couples; However, the effectiveness of meta-diagnostic treatment and motivational interviewing on the level of intimacy of couples are not significantly different (Table 4).

In explaining the effectiveness of motivational interview on couples intimacy, it should be noted that the therapist's goal in motivational interview is to create a safe environment to express problems and then, strengthen the desire to change to improve relationships in the client, which leads to increased intrinsic motivation. . Since intimacy is a feature that is not a fixed feature and changes when the couple is faced with stressful situations. Therefore, motivational interviewing, by increasing the couple's inner motivation to maintain intimacy in difficult life situations, causes the couple to communicate with each other emotionally (increase interest), then plan with interest to improve their relationship (reduce boredom) and from this Satisfy and enjoy your action (increase intimacy) (9).In explaining this finding, it may be pointed out that couples are more likely to not be able to use positive emotions effectively in times of conflict, and on the contrary, they have a lot of negative emotions, which causes other problems such as negative perception. Concerns about their relationship with their spouse and improper marital functioning become a reason for their intimacy to be disrupted. However, emotional awareness training in meta-diagnostic therapy makes them aware of the existence of negative emotions and their negative impact on themselves, or try to recover emotions in different situations to keep the emotion healthy, and thus, the rate of marital problems is reduced and in The result is marital intimacy (14).

One of the areas that has undergone change in Iran is childbearing. Statistical data show a decrease in the fertility rate in the last few decades; To the extent that in recent years the number of children of a mother is less than the required index in replacing generations (1/2 children) (1). This downward change in fertility rate indicates a change in the fertility of Iranian families and their desire for one child. On the other hand, having one child is the result of any factor or factors, creating a fundamental change not only in the demographic structure and socialization of the family, but also in various aspects of school performance and all aspects of the individual's personality in the future. There are many treatments for psychological disorders today. Each of these therapies may be stronger and more specialized than the other. Third wave therapies focus more on families and proper communication, because human beings are social beings and the type of communication style they have with others has a great impact on their mental health and that of their families (3). Among the important therapies for the component of marital satisfaction in families, especially mothers, is the Boeing therapy and the new ACT therapy, which largely complements cognitive-behavioral therapy. These treatments can increase family cohesion and raise children properly. Among these therapeutic interventions is Bowen's treatment, whose approach is family therapy. Bowen's family therapy approach deals with the family as an emotional unit and a network of intertwined relationships that must be analyzed from a different context or historical perspective to better understand it. Bowen believes that the whole family system is an emotional unit that cannot be separated from each other or successfully (5). In other words, the foundation of this theory is based on the concept of separation. Bowen family therapists believe that all the problems in family functioning, including marital dissatisfaction in the couple, which has a negative effect on the children and causes emotional divorce, arise from inappropriate family systems. Accordingly, the main goal of Bowen's therapies is to reduce chronic anxiety by being aware of the family's emotional system, focusing on changing oneself rather than trying to change others (6). On the other hand, ACT therapy is rooted in a philosophical theory called functional contextualism and is based on a research program on language and cognition called the theory of the framework of mental relationships (7). Despite the many studies on the effectiveness of ACT therapy on anxiety, depression, heart disease, marital conflict, marital satisfaction and many more; However, no research has been conducted on the effectiveness of ACT therapy on cognitive emotion regulation; Research has also been conducted on other variables in the field of Boeing family therapy; But so far little research has been done on marital satisfaction. Therefore, considering the significant effects of cognitive emotion regulation on many aspects of a person's development and interpersonal relationships, the need for such research and the application of its results is clearly understood. In order to compare the effectiveness of Boeing family therapy and ACT treatment on differentiation, the following hypotheses are proposed.

This research was conducted by quasi-experimental method and using a pre-test-post-test design with two experimental groups and a control group. The independent variables of the study were Boeing family therapy and ACT treatment method and the dependent variable was marital satisfaction. The dependent variable scale was collected in two stages: pre-test and post-test. The statistical population of this study was all single mothers of preschool children in Kermanshah in the spring of 1399. The sampling method was simple by using random sampling and assignment. Forty-five mothers of preschool children were randomly selected and due to the prevalence of coronary heart disease in online sessions, intervention sessions were held for them through online sessions. The subjects' marital satisfaction scale was measured using the Enrich Marital Satisfaction Questionnaire for every 45 people (pre-test). Then, by simple random sampling, individuals were assigned to three groups of 15 people (two experimental groups and one control group). The experimental group members separately participated in eight 1.5-hour weekly sessions of the Boeing Family Therapy and ACT, conducted by a trained therapist, and the control group was placed on a waiting list. Meetings were held at Setareh Preschool Center on a weekly basis for two months. Participants in the sessions expressed their willingness to cooperate to receive intervention and participate in the research. Analysis of covariance and Bonferroni post hoc test were used to analyze the data.

The Benferoni post hoc test is performed to compare between the control group, ACT and Bowen. As can be seen in Table 5, there is no significant difference in marital satisfaction scores between the ACT and Bowen groups, and therefore Bowen-based therapy and ACT-based therapy have the same effect on marital satisfaction.

The aim of this study was to compare the effect of Boeing family therapy and ACT treatment on cognitive emotion regulation of single mothers in preschool centers in Kermanshah.
Stable and meaningful. Also, Bonferroni post hoc test showed that due to the differences in the comparison of these two interventional methods, the effectiveness of Buenie family therapy and ACT treatment on marital satisfaction is the same. The findings of the present study on the effectiveness of Boeing family therapy interventions on marital satisfaction are not unexpected and are consistent with the results of a large number of previous studies. The results showed that there was no significant difference between pre-test and post-test scores in the Boeing family therapy method and the ACT method on marital satisfaction. Couples in Buenos Aires believe that the phenomenon of marriage requires a high degree of adaptability. None of the couples feel safe and caring if there is no normal and acceptable level of adaptation in the marriage. In addition, marital intimacy requires a strong sense of self-awareness and self-differentiation. Couples with low levels of differentiation and high fusion are not able to understand their desires in the relationship, therefore, this process has a negative effect on their life satisfaction, when these couples with factors the change of role that reduces satisfaction, they face, they feel failure. Couples who are able to accredit themselves instead of seeking approval have a better working spirit in marriage.

Between 5% and 15% of patients with low back pain suffer from lumbar disc herniation, so intervertebral disc disease is one of the most common causes of low back pain. Surgical intervention for lumbar disc herniation is recommended in patients with severe symptoms and has hopeful results. Although surgery can reduce pain and improve physical function in the short term, its long-term effect is debatable. Recurrence of disc herniation is one of the complications of primary surgery. The reported rate of recurrent disc herniation is 5 to 15% according to the evidence in the literature. Although there are different surgical methods for the treatment of recurrent disc herniation, there is a difference of opinion among surgeons in choosing the surgical method. Lumbar intervertebral disc herniation is a major disease of the spine. Surgical treatment is recommended in cases where patients have irreversible symptoms due to this disease. However, other techniques, such as fusion surgery, laminectomy, and percutaneous endoscopic lumbar discectomy, also apply new tools in line with minimally invasive spinal surgery techniques. Gathering information about various factors influencing the recurrence of the disease, such as individual demographic variables and the type of surgical procedure, helps in better planning for the treatment of intervertebral disc herniation. Numerous studies have been performed to determine the causes of recurrence of lumbar disc herniation, and various risk factors have been suggested, including disc herniation, trauma, age, smoking, gender, and obesity. The aim of this study was to determine the frequency of recurrence of lumbar intervertebral disc herniation in both hemilaminectomy and partial laminectomy.

This study is analytical and retrospective. This study was performed on patients who have had at least 6 months since surgery for the treatment of lumbar intervertebral disc herniation and have obtained informed consent. 400 patients who were candidates for lumbar intervertebral disc herniation surgery in Mortaz Hospital in Yazd from 2016 to 2019 were divided into two groups in terms of the type of surgery, hemilaminectomy and partial laminectomy, and were evaluated and compared during six-month to three-year follow-up. Patients who were candidates for lumbar intervertebral disc herniation based on diagnosis and imaging results were used as the inclusion criteria. Patients with spinal canal stenosis, lumbar spine slippage, and dissatisfaction to participate in this study were excluded. Data included age, gender, body mass index, smoking, type of occupation (light or heavy), type of disc herniation (extruded or non-extruded), diabetes status, recurrence time, and type of surgery (partial laminectomy or hemilaminectomy). In the follow-up and review of the treatment process, information on recurrence of disc herniation was referred to. In addition to assessing the relationship between the type of surgery and recurrence of disc herniation, other possible risk factors for recurrence of disc herniation in terms of its impact on the type of surgery were studied.

The frequency of the first group consists of patients who underwent partial laminectomy and includes 338 patients (84.5%) and the second group of patients who underwent hemilaminectomy surgery which includes 62 patients (15.5%). The overall risk of recurrence, regardless of the surgical procedure, was 35 in 8.8%. In the group of 338 patients who underwent partial laminectomy, 26 patients (7.7%) had a recurrence of lumbar intervertebral disc herniation. In the group of patients who underwent hemilaminectomy, 9 out of 62 patients had a recurrence of disc herniation, which is equivalent to 14.5% of patients. In this study, no significant difference was found between the recurrence rate of lumbar intervertebral disc herniation in two methods of hemilaminectomy and partial laminectomy, which was evaluated by the Chi-square test (P = 0.08). The mean age of the samples was 47. 0.8 with a range of 15 to 79 years. In 338 patients who underwent partial laminectomy, the mean age was 47.98 years and in 62 patients who underwent hemilaminectomy, the mean age was 47.25, which was not significantly different from p = 0.689. Also, the mean duration of recurrence after partial laminectomy was approximately 6 months and in hemilaminectomy was 9 months. This relationship was evaluated by T-Test and was not significant with p = 0.135. The results of this study showed that in the sex variable, there was no difference in the recurrence rate of lumbar intervertebral disc herniation in both surgical methods of hemi laminectomy and partial laminectomy in males, but was significant in females with P = 0.036 In this study, diabetic and non-diabetic patients had no difference in recurrence rate in partial laminectomy and hemilaminectomy (p = 0.261). According to the results, there is no significant difference in the recurrence rate of lumbar intervertebral disc herniation in hemilaminectomy (P = 0.170) and partial laminectomy (P = 0.251) according to the type of disc herniation. According to the results of this study, the risk of recurrence of lumbar intervertebral disc herniation in people with light occupations in partial laminectomy surgery is lower than in hemilaminectomy surgery. Also, the risk of recurrence in non-smokers in partial laminectomy and hemilaminectomy was 7.2 and 17.3, respectively, and was significant with p = 0.030. The risk of recurrence of lumbar intervertebral disc herniation in the age range of 54-45 years was less in partial laminectomy than in hemi laminectomy. Regarding body mass index, none of the intervals had an effect on the risk of disease recurrence.

Based on the results of this study, there is no statistically significant difference in the recurrence of intervertebral disc herniation in both surgical methods of hemi laminectomy and partial laminectomy. However, the factors influencing the recurrence of intervertebral disc herniation were identified in this study, which made a difference between hemi laminectomy and partial laminectomy in the studied patients. According to these factors, risk factors can be determined to prevent the recurrence of disc herniation after surgery. Factors such as gender, age range, smoking, and type of occupation were identified in this study. Depending on the type of occupation, a suitable intervention for disc herniation surgery can be selected with fewer possible complications. In the present study, body mass index and weight were calculated on the outcome of surgery and hernia recurrence without any effect. However, due to the effectiveness of this risk factor, similar studies are needed to be more certain. To confirm the findings obtained in this study and also to compare them, it is suggested that other studies be performed with a higher number of samples and multicenter sampling.

One of the important goals of development programs in any country is to reduce social harms, and achieving this goal requires recognizing the effective factors that cause it in society. Nowadays, researchers consider social capital as one of the underlying and effective factors in social health and reducing risk in society .Students in a society constitute a large segment of the active population of a country, which various factors such as internal stimuli and external stressors, can endanger their social and mental health and are exposed to various social harms. And put at risk . Many efforts have been made in countries around the world to identify environmental and individual factors that predispose to risk. Among these efforts, attention to the social dimension is possible. Social capital is the result of the "social capital" of health, which is the study of phenomena such as mutual trust, social interaction, social groups, a sense of collective identity, a sense of a shared vision of the future and teamwork with effective interpersonal and group interactions. It can provide risk prevention and many social harms such as violence, drug use, alcohol and high-risk sexual behaviors. Studies have shown that youth and adolescents' access to social capital can reduce social and behavioral problems, so by providing the basis for social interaction, social skills and teamwork can reduce the rate of social harm and risk. They provided opportunities for academic advancement and health promotion. The purpose of this study was to present a model of social capital communication model and high-risk behaviors of social identity in students of Kermanshah University of Medical Sciences.

The present study is descriptive-correlational in terms of applied purpose and in terms of data collection method. n terms of applied purpose, the present study is descriptive-correlational in terms of data collection method because no manipulation has been done on variables and factors and based on the research approach, it is small. The statistical population of the present study will be selected from all students studying medicine in Kermanshah (2000 people in total) in the academic year 1399-1398 using Morgan table and available sampling method of 322 people to compensate for the possibility of falling sample size. 350 people were considered who will eventually be removed after completing the questionnaires by the volunteers of the distorted questionnaire and the relevant data of 322 people were analyzed. To measure high-risk behaviors, the High-Risk Behaviors Scale (YRBSS) was used. The adaptation of the High Disease Behavior Questionnaire of the US Centers for Disease Control and Prevention (CDC) was designed and developed in 2010 (15). The reliability of the high-risk behaviors questionnaire by Brenner et al. (2002, quoted by Mohammadi, Refahi and Samani, 2013) was evaluated through a test-retest and the results of the items ranged from 14.5 to 91.1 kappa. (1998) has three structural, communication and cognitive dimensions that examine the seven subscales of networks, trust, cooperation, mutual understanding, relationships, values, and commitment, and are arranged in 28 items based on a five-scale scale. Likert (I strongly agree = 5, I agree = 4, I have no opinion = 3, I disagree = 2 and I strongly disagree = 1). The reliability coefficient of this questionnaire in Sardari, Silavio Silavi (2016) research was 0.89 (16) and the Ethical Identity Questionnaire is a self-report scale that was developed and validated by Ako Bino and Reid (2002) and has two subscales of internalization from questions 1 to 5. (The degree to which moral identity is centralized in the individual's self-concept) and symbolism from questions 6 to 10 (the degree to which each subject shows moral identity in their appearance) (17). The answer to this questionnaire is in the range of 1 (strongly agree) to 5 (strongly agree) in each of the questions. The scoring of two items 4 and 7 is done in reverse. First, the person is asked to pay attention to the moral traits written at the top of the questionnaire, and then 10 questions about these traits are asked of the subjects to determine the extent to which these traits are important to the person. Cronbach reported these two dimensions as 0.77 and 0.76, respectively.

In order to analyze the data, descriptive statistics indicators (frequency, mean, standard deviation, graphs) and inferential statistics were used. In order to determine the validity and reliability of the research instrument, Cronbach's alpha statistical methods and confirmatory factor analysis were used to evaluate the normality of data distribution, skewness and elongation indices, and path analysis was used to examine the relationships between variables. SPSS and Smart PLS software were used to perform these tests.The results of the present study showed that moral identity and social capital have a significant effect on high-risk behaviors of students of Kermanshah University of Medical Sciences.

Laying the groundwork for improving and increasing the social capital of young people both at the family level and at the community level by increasing the sense of social trust, social solidarity, social awareness, providing the necessary social support and youth participation in social and cultural affairs. It seems that according to the theories and backgrounds and the results of the present study, the existence of a significant amount of social capital facilitates social actions and paves the way for achieving certain goals and Subsequently, it can act as a shield against social problems and harms, such as the occurrence of risky behaviors of young people.Universities and institutions of higher education should design and implement special training courses or classes in the form of extracurricular activities in order to educate and familiarize students with the field of social identity and social capital and high-risk behaviors with its constituent components.

One of the most important skills in preschool is social skills. In other words, social skills are concerned with empathy, self-efficacy, responsibility and social interaction, psychological adjustment, effective communication with others, and individual abilities. It is very important to learn social skills in childhood. By strengthening social skills in this period, we can see the strengthening of educational status, communication and language and verbal skills of children. Gersham et al. (2011) consider the dimensions of social skills including empathy, cooperation and interaction, assertiveness and self-control and psychological adjustment, effective communication with others, and individual abilities. Lynch and Simpson (2010) also identified important elements of social skills including empathy, participation in group activities, helping each other, communicating with others, and problem solving. One of the effective factors on strengthening children's social skills is play. Maria Montessori (1909) considers play to be a great school in which the child is educated and his physical, mental and social strength develops and he is prepared to live in any way. Below the game, there are 3 educational games. Educational game includes a set of organized educational activities in the form of individual and group games that pursue a specific educational goal. During games, children gain access to new mental concepts and acquire more and better skills. With the help of the game, they get acquainted with different colors, different shapes and different directions and gain valuable experiences. During the game, the learning materials are learned without pressure and with desire. The purpose of the present research was to determine the impact of educational games on the development of social skills on the preschool children in the city of Tehran. Regarding the necessity of the present issue, it can be said that research on the effect of play therapy on children with behavioral disorders shows a positive effect and improvement of children's skills problems and is used in almost all diagnostic classes. Research conducted in Iran on the effect of play therapy on maladapted children shows positive results. But special research in preschool is relatively small and has created a research gap. Therefore, conducting the present study on preschool children seems to be able to add to the existing set of knowledge. According to the above, the main purpose of this study is to investigate the effectiveness of therapeutic games on mental adjustment, effective communication with others and individual abilities of preschool children in Tehran.

The present study was an applied research in terms of purpose and a semi-experimental study of pre-test-post-test design with a control group. The statistical population includes all preschool children of the district 6 of the city of Tehran in the school year of 2018-2019, among which 30 students were selected through purposive and random sampling (n=30). The students were divided into 2 groups of 15, i.e. a control group and an experimental group (n=15 in each). The data were collected through the Social Skills Questionnaire by Akers (1992). The participants in the experimental group received a package of educational games for 10 sessions and 25 minutes per session. The control group received no games. The data were analyzed through the analysis of multi-variable covariance using SPSS24 software.

The results of the covariance analysis test indicated that in these two groups, i.e. control and experimental, there were significant relationship among the variables of the effective communication (P<0.001, F=134.2), cooperation (P<0.001, F=69.8), individual abilities (P<0.001, F=159.4). Besides, the control variable (pre-test) had a significant impact on all four variables.

it can be concluded that the educational games can have a positive impact on developing social skills of the preschool children. Therefore, in the education program of this age group this issue must be taking into consideration by the planning authorities in the macrolevel and by the teachers in the micro level. As shown, educational games have a significant effect on mental adjustment, effective communication with others and individual abilities of preschool children; However, in terms of the generalizability of the results, the present study has limitations such as limited educational sessions and differences in the family, economic and social problems of the subjects, lack of control over some intervening variables, lack of confidence in the use of all instructional methods. Therefore, it is suggested that other studies be conducted in the provinces of the country to get a clearer picture of the use of educational games in psychological adjustment, effective communication with others and individual abilities. The present study focused on the preschool level and the effect of using educational games on learning different subjects and the skills and social development of primary school students should be studied in other elementary grades.

Due to the rapid and rapid transformation of human knowledge and information, everything is changing rapidly. Organizations interact with the environment as an open system and need to respond to environmental changes in order to survive. Since human resources are the most important factor and axis of organizations, preparing these resources to face changes and update their knowledge is of particular importance. Medical education with the aim of maintaining and promoting human health is very important in order to train human resources specialized in this field. However, medical education is an endless process because medical sciences are advancing at a high speed and on the other hand, due to the escape of knowledge from human memory, its recall is considered necessary for various medical professionals. Continuing education of the medical team is a key element in increasing the knowledge, skills, quality and effectiveness of the health care system and promoting professional competence. The main purpose of continuing medical education is to maintain the skills and professional development of the medical community so that they can meet the needs of patients and the health system and improve the health system. Continuing medical education is a continuous learning process aimed at updating professional competence. This concept is a comprehensive approach to the continuous development of the profession. On the other hand, according to statistical estimates, the number of detainees has tripled since the beginning of the law. Also, the total number of types of continuing education programs (seminar, conference, congress, short-term vocational, codified, conference, workshop and self-study) has increased from 6 programs in 1369 to 9039 programs in 1391, which clearly indicates increasing growth and progress. It will rise in the coming years. In addition, the wide distribution of learners in the country, which according to Article 1 of the Law on Continuing Education includes all medical graduates, as well as the variety of educational topics, necessitates comprehensive and accurate planning, the management of which requires regular information. It is correct and up to date. On the importance of continuing medical education and learning in medical universities, it can be stated that one of the approaches emphasized by international organizations such as UNESCO in the 21st century is the inseparability of continuous learning from human life, which is a collective rethinking. In sensitive professions such as medicine. Education and development: Education, unlike development, can be measured objectively. Rapid changes in all pillars of organizations have severely limited the function of the training tool. For this reason, the scope of the concept of education has been considered. With the expansion and development of the concept of education, the objectivity and measurability of education faces many problems. Today, with the development of the concept of education, in addition to familiarity with skills and techniques, the way of thinking correctly and the system of thinking and analysis of the individual is also targeted and the word development is used instead of the word education. Roger Cartwright (2004) argues that "development is a process in which learning occurs through experience, where learning outcomes affect not only one's work skills but also one's attitudes". The aim of this study was to provide a model of continuing education at Ahwaz Jundishapur University based on a review of studies conducted in this field.

The statistical population of this study was 90 employees of Ahvaz University of Medical Sciences that 74 people were selected as a sample using Cochran sampling method. Data collection tools were a standard 100-item questionnaire with 7 components including management of education and technical support, technology and design, pedagogical, institutional, ethical, evaluation and feedback, and combined learning templates. The reliability of the questionnaire was confirmed by Cronbach's alpha of 0.8 and its validity was confirmed by face validity with the opinion of experts. SPSS software was used to analyze the data.

The results showed that the factors of education management and technical support, technology and design, pedagogical, institutional, ethical, evaluation and feedback and combined learning forms have a significant effect on the development of continuing medical education.

In general, it can be acknowledged that each educational content should have quality characteristics that meet the goals and strategies of education and in order to continuously develop medical education, education management and technical support factors, technology and design, pedagogical, institutional, Ethics, evaluation and feedback, and forms of blended learning are considered. There are two main approaches to educational design: a systems perspective, and a constructivist perspective. The systematic view of educational design considers education as a process consisting of input, process, and output. In this approach, which is based on the epistemological views of positivism and the psychological views of behaviorism and epistemology, one of its most important underlying assumptions is the acceptance of the existence of knowledge separately and independently outside the all-encompassing mind. As a result of the most important work done in educational design, a very complete and accurate analysis of the subject of education into its components and the classification of these components based on one of the classifications of educational objectives and then determine How to provide training for each of the objectives. Outputs or learning outcomes are first stated very clearly, followed by methods for teaching-learning activities so that students can achieve the desired goals (outcomes) by doing so. . In the constructivist view, which results from postmodern epistemology, knowledge is the product of the process of constructing meaning in the all-encompassing mind. Constructivism is a discourse in the field of learning and psychology that believes that knowledge by means of The person is made. In other words, it is the individual who, according to his previous experiences and knowledge, interprets the new situation and, as a result, forms an interaction with his new knowledge environment. In the first process, new information is added to the cognitive structure, and in the second case, the cognitive structure is changed in order to absorb the new information. In the continuing education programs, it was tried to observe all the above points in a desirable way. For this purpose, a study guide was developed for each program so that the audience or study it is familiar with the program objectives, matching the subject of the program with their needs and interests, duration of scientific validity of the program, evaluation method, cost, continuing education score and program authors.

The liver, as the largest gland in the body, can manufacture, store, change and secrete a large number of metabolic substances the body. The liver receives blood rich in nutrients from the digestive and esophageal tracts, then stores them or changes them into chemical substances that are used elsewhere in the body for metabolic needs. This tissue is especially important in regulating glucose and protein metabolism. The liver makes and secretes bile, which plays a major role in the digestion and absorption of fats in the digestive system. On the other hand, the lack of physical activity and the decrease in cardio-respiratory fitness related to it is related to the increase in diseases. Among obese individuals, sedentary individuals have an increased risk of developing fatty liver compared to physically active individuals of similar weight. These data support the hypothesis that increasing physical activity through exercise, which is defined as a planned, structured, and repetitive physical activity with specific intensity and duration, has beneficial effects on liver diseases. On the other hand, in the liver tissue, a large number of targeted proteins are connected to specific enzymes and cell structures and scaffolding proteins, which collect enzyme intermediates. Insulin increases the accumulation of glycogen by phosphorylating these enzymes and as a result, activates glycogen synthase and deactivates glycogen Desynthase. The DARPP-32 gene, which is also known as PPP1R1B regulatory subunit, is a strong inhibitor of protein phosphatase-1 (PP1). It is phosphorylated at Thr34 by cAMP. DARPP-32 shows a significant regional distribution in the brain, which is almost similar to dopamine innervation. Molecular studies of DARPP-32 have shown that its regulation and function are more complex. DARPP-32 protein is phosphorylated by stimulation of D1 and D2 dopamine receptors and is coded by the PPP1R1B gene. DARPP-32 is a small, unstructured protein of about 202 amino acids. Since the mid-1980s, DARPP-32 has been recognized as a critical mediator of dopamine's biochemical, electrophysiological, transcriptional, and behavioral effects. It has been shown that the phosphorylation state of DARPP-32 provides a mechanism to integrate information received by dopamine neurons and in different brain regions through a variety of neurotransmitters, neuromodulators, neuropeptides, and steroid hormones. Most studies have investigated the effect of endurance training on hormones and factors secreted from liver tissue. However, in none of the studies has it been determined which intensity of exercise can have a greater effect on the expression of the DARPP-32 gene. Therefore, in this study, we seek to investigate and answer the question of whether there is a significant difference between different intensities of aerobic exercise on the expression of Darpp32 markers in the liver of male Wistar rats.

The present research was experimental, for this purpose, 32 8-week-old male Wistar rats with an average weight of 237 ± 33 grams were purchased from Pasteur Institute. After being transferred to the animal laboratory environment, these animals were kept in groups of 8 mice in transparent polycarbonate cages in an environment with a temperature of 22 ± 1.4 degrees Celsius, a humidity of 45 to 55%, and a light-dark cycle of 12:12. The animals were randomly divided into 4 groups and each group had 8 heads including a control group, moderate-intensity aerobic training (MIT), high-intensity aerobic training (HIT) and high-intensity interval aerobic training (HIIT). Animal care was carried out in accordance with the guidelines of the International Institute of Health and the protocols of this study, following the principles of the Declaration of Helsinki and the rules of medical ethics. Also, this study was approved by the Ethics Committee of Payam Noor University with code IR.PNU.REC.1398.040. During the research period, the food made by Behparvor company was given to the animals in the form of pellets and according to the weekly weighing at the rate of 10 grams per 100 grams of body weight. The water needed by the animal was also freely available. In order to get acquainted with the conditions of the laboratory and the treadmill, the animals ran on the treadmill for 2 weeks, 5 days per week and for 10 to 15 minutes each day at a speed of 5 to 15 m/min. Rats were active for 8 weeks after warming up for 5 minutes (at a speed of 5 m/min). The number of sessions per week was 5 sessions. The MIT exercise protocol consisted of running at 65% of maximum oxygen consumption for a total time of 47 minutes. The exercise consisted of 5 minutes of warm-up and 5 minutes of cool-down and 37 minutes of the main body of the exercise at 65% of maximal oxygen consumption. The HIT exercise protocol included running at a speed of 20 meters per minute for 40 minutes with an increasing incline of the treadmill. The exercise consisted of 5 minutes of warm-up and 5 minutes of cooling down and 30 minutes of the main body of the exercise at 65% of maximal oxygen consumption. The incline of the treadmill was zero in the first week and 2% was added every 2 weeks until it reached 8% in the eighth week. The HIIT training protocol included 4 high-intensity intervals with 4 minutes of running at an intensity of 90 to 100% of maximum oxygen consumption and 4 low-intensity intervals with 3 minutes of running at 50 to 60% of maximum oxygen consumption, which lasted a total of 38 minutes. It consisted of 10 minutes of warm-up and 28 minutes of the main body of the exercise (16). In order to ensure the isolation of exercise in all 4 groups, the exercises were performed according to the method of Rokenmo et al. (2004). Based on this method, the net training time in each group was calculated and equalized based on the time, intensity, and repetition of the work. After finishing the training period, the mice were anesthetized, blood was taken and tissue was separated, and the data obtained by PCR-Real time device were measured and analyzed.

The results obtained from the implementation of this test showed that there is a significant difference between the research groups in the expression values of the Darpp32 protein gene. Comparison between groups showed that there is a significant difference in the expression of the Darpp32 protein gene of Wistar rats between control training groups (P ≥ 0.001). Comparison between groups was done with Tukey's test and the results showed that there is a significant difference in the expression of the DARPP32 gene in male Wistar rats between the HIIT group compared to the MIT, HIT, and control groups (P ≥ 0.001). So in the MIT group, they decreased by 0.021 units, in the HIT group by 0.011 units, and in the control group by 0.030 units compared to the HIIT group. On the other hand, a significant difference was also observed between the HIT and control groups compared to the MIT group (P ≥ 0.001), so that in the HIT group it increased by 0.010 units compared to the MIT group, and in the group, The control also decreased by 0.008 units compared to the MIT group. Also, the follow-up test in the training groups showed that there is a significant difference in the expression of the DARPP32 gene between the HIT and control exercise training groups (P ≥ 0.001), so in the HIT group it was 0.019 The unit has increased compared to the control group.

In general, it can be concluded that sports training produces favorable changes in the metabolic system of the liver - these effects were seen in aerobic exercise with high intensity. Aerobic exercise with high intensity for 8 weeks can increase the expression of the Darpp-32 protein gene. The results of the present study can be concluded that 8 weeks of aerobic exercise improves the function of genes involved in glucose metabolism. Among the limitations of the present study, we can point out the lack of control over the number of calories consumed by rats and the lack of control over physical activity outside of the animal research program. Despite this, the research background on the effect of the exercise protocols of the present research on Darpp-32 in liver tissue is very limited and needs more investigations.

World population growth and increasing expectations for effective treatments and a generally better quality of life are putting increasing pressure on healthcare Therefore, health care is still one of the most important social and economic challenges worldwide and requires new and more advanced solutions from science and technology (1, 2). In response to such needs, since the early 1990s, information and communication technologies (ICT) have had a positive impact on the accessibility, efficiency, and quality of almost every health care-related process (3). Hence, the term eHealth, which refers to the application of information and communication technology in health care, has come into common use. Indeed, eHealth has attracted a great deal of public and private interest and has fueled unprecedented levels of investment in both research efforts and funding (4). On the other hand, health continuity includes the areas of disease prevention, diagnosis and management. Over the past decade, a rapidly growing group of more than 1,200 companies focused exclusively on digital health have received $33 billion in investment. These companies provide products and services with regard to every aspect of the health chain. For example, their digital health products and services promise scale, efficiency, accessibility, convenience, and greater patient engagement (5). Which can indicate the importance of business related to the health industry in different sections of the society. Support services add value to a business's core services, provide points of differentiation, and create a competitive advantage over competitors. Fitness clubs offer a number of support services, including opportunities to participate in exercise. Fitness tests are a common support service (11). On the other hand, some of the clients of medical clinics need sports and physical fitness services. For example, heart patients who need rehabilitation; Obese people who are looking for fitness; Patients with metabolic disorders such as type 2 and type 1 diabetes or people with alcoholic fatty liver who are clients of health clinics or fitness clubs, which can indicate the importance of planning and strategizing to provide services related to the health industry and market. Work in this field.According to the mentioned contents, the aim of the present research was to design a model for the implementation of business strategies for marketing health-related products in social networks.

The present research was conducted with the approach of exploratory design of tool development, based on this plan, first the qualitative aspect of the research was conducted using the data theory analysis method based on Glazer's approach (1978) and then the research was conducted quantitatively and finally the qualitative and quantitative results were interpreted. It happened at the same time. In fact, in this project, first, based on qualitative studies, the structures or components of the desired theory were described and analyzed. In this way, the framework and factors of those structures and components are extracted and indexes are developed for it, and finally, using quantitative data, the credibility and evaluation of the constructed theory is investigated (Hakimzadeh and Abdulmaleki, 89). This plan can be seen below. The statistical population was used in the quantitative stage in the discussion of the screening of criteria from the point of view of 20 experts. It should be noted that considering that the criteria of the screening questionnaire should be set in such a way that the experts participate in the research; Therefore, qualitative experts were used in this research. In the criteria validation section, which was used with the confirmatory factor analysis approach, the statistical population was made up of all stakeholders and stakeholders and various experts in the discussion of sports business (N=2874). In order to estimate the sample size from SP sample size determination software. S. S sample power was used, taking into account the maximum independent variable influencing the dependent variables involved in the regression models of the research and the error percentage of 0.05, the power is higher than 0.85 and the effect size is 0.05, the sample size is 370. People were estimated. First, Delphi questionnaire was used to screen the identified criteria from the qualitative part of the research. And in the second stage, a questionnaire was used to measure the factorial validity of the identified criteria in the form of the desired constructs. The scoring basis for screening questionnaire criteria was based on a five-point Likert scale and the range of scores was from very low to very high. Delphi analysis method was used in the quantitative part. Confirmatory factor analysis and structural equation model were used to check the questionnaire. Coding of the qualitative part was done manually. In order to perform calculations in this chapter of the research, Excel version 10, SPSS software version 25, Amos software version 23 and SmartPLS version 2,3 were used.

The results showed that innovation strategy has a positive and significant effect on product strategy (α = 0.144, P = 0.001). Promotion strategy has a positive and significant effect on product strategy (α = 0.065, P = 0.001). Service strategy has a positive and significant effect on product strategy (α = 0.239, P = 0.001). Pricing strategy has a positive and significant effect on product strategy (α = 0.471, P = 0.001). Expert manpower strategy has a positive and significant effect on development strategy (α = 0.638, P = 0.001). Customer relationship strategy has a significant and negative effect on product strategy (α = -0.141, P = 0.001). Infrastructure strategy has a positive and significant effect on product strategy (α = 0.092, P = 0.001). Product strategy has a positive and significant effect on expert human resources strategy (α = 0.461, P = 0.001). It was also found that the innovation strategy indirectly has a positive and significant effect on the development strategy (α = 0.042, P = 0.001). Finally, it was found that the infrastructure strategy indirectly has a positive and significant effect on the development strategy (α = 0.027, P = 0.001).

According to the results of this research, it can be said that the business of marketing sports products related to health as a part of the health industry in social networks should be done by making timely decisions and with sufficient knowledge of consumers and market needs. By offering a good product, at a reasonable price, using optimal distribution methods, using informative advertisements using a process defined by efficient and responsible human resources in a suitable place (one of the most popular social networks). The customer's destiny is to increase their market share and keep their customers with creativity, initiative, flexibility and adapting resources to the needs and demands of customers in addition to increasing their market share.

The novel coronavirus disease 2019 or Covid-19 is an acute respiratory disease that is closely related to the Sars virus. Although all medical personnel is exposed to corona disease, emergency medical personnel are more exposed to this type of disease due to the special nature of their job. The uncertainty and low predictability of this disease not only threaten the physical health of people but also affects the mental health of emergency medical personnel in terms of emotions and cognition. Long-term negative emotions reduce people's immune function and destroy the balance of their normal defense mechanisms. So people may overreact to any illness, which can lead to destructive behaviors, worry, anger, and fear. According to the review of the sources, it can be stated that the occurrence of a sudden and life-threatening illness can create extraordinary pressure on the medical staff. Medical staff is particularly vulnerable to psychological and mental health problems such as aggression, anxiety, and depression, and their quality of life is affected. Depression, as one of the mental disorders, includes a wide range of emotional and mental states, from sadness and low self-esteem to emotional and physical disability. Anxiety is an unpleasant emotion that is usually described with words such as worry, anxiety, tension, and fear; Emotions that everyone experiences with different intensity. New studies have also shown that anxiety can increase or decrease the level of people's functions. Aggression is often a response to a person's expectations not being met or a response to behaviors that are considered unacceptable to the person. From a psychological point of view, aggression is defined as behavior aimed at hurting, annoying, or harming another person. The increase in psychological and physical problems observed in the life of medical workers leads to the configuration of a large volume of studies on how to increase the health level of this group of people. Measures should be taken to prevent and treat these cases. Among the treatments that can be used in this regard are the treatment focused on compassion and the treatment of acceptance and commitment. In acceptance and commitment therapy, the main goal is to create psychological flexibility. Acceptance and commitment therapy focuses less on reducing symptoms and more on increasing quality of life. On the other hand, some experts believe that the core of helping people is based on a sense of compassion. In compassion-based therapy, people learn not to avoid or suppress their painful feelings, so they can first recognize their experience and feel compassion for it. This plays a significant role in calming the mind and reducing stress and negative spontaneous thoughts. Additionally, self-compassion requires active and patient acceptance of difficult feelings. Due to being on the first line of dealing with this disease, emergency medical workers are more likely than others to be exposed to psychological disorders and extreme fluctuations in physical indicators. A cross-sectional study conducted on medical personnel in China during the outbreak of Covid- 19 has shown that among 512 personnel, about 164 had direct contact with an infected patient. Among them, the prevalence of anxiety was about 12.5%, of which 10.35% experienced mild anxiety, 1.36% experienced moderate anxiety, and about 0.78% experienced severe anxiety. The importance of conducting this research is because the more the number of psychological treatments including compassion-focused therapy and acceptance and commitment therapy increases, the more likely psychological indicators will decrease, including anxiety, stress, aggression, and the level of quality of life-related to their health. It is created and people can do their treatment tasks with more confidence.

  The current research was of a semi-experimental type with a pre-test, post-test, and follow-up plan with a control group, which was conducted on 60 medical emergency workers infected with Corona in Mashhad in the year 1400 and the form of three groups (two experimental groups and one control group) was done. The treatment groups were compassion-focused therapy and acceptance and commitment therapy. The list of symptoms of mental disorders and the quality of life questionnaire were used to collect information. The interventions of the two groups were implemented as a group in the Skyroom software, and no intervention was done for the control group. Both experimental groups were exposed to treatment for 8 sessions of 90 minutes, but the control group was placed on the waiting list. After the end of the treatment, the post-test was performed for all three groups, and after three months after the last group meeting, the follow-up was done. After scoring, the obtained data were analyzed using SPSS-26 statistical software.

  Based on the results of this study, there was a significant difference between the three stages of pre-test, post-test, and follow-up related to psychological indicators and quality of life in the experimental groups of treatment focused on compassion, treatment of acceptance and commitment, and the control group (P<0.05 ).

The results of the present study indicated that the treatment focused on compassion and the treatment of acceptance and commitment improve psychological indicators and quality of life. It is suggested that in future comparative studies, the effectiveness of two treatment approaches focused on compassion and acceptance and commitment therapy on physiological characteristics (heart rate and blood pressure) and other psychological outcomes of patients with corona should be studied. The findings of this research were about emergency medical workers in Mashhad, so the generalization of the findings with other samples and statistical societies should be done with caution. The self-reporting of the tools used and the purposeful sampling method are other limitations of this research that must be taken into account.

There are many factors that lead to progress in the academic environment. Factors such as motivational and environmental characteristics are important, but it is widely assumed that motivation is one of the main elements of progress in the educational environment. One of the important topics in the field of motivation is goal orientation. The theory of goal orientation mainly examines why people choose a specific goal, how they approach the desired goal and engage with the task related to it. One of the dimensions of goal orientation that has been examined in this research is mastery goal orientation, which has a direct relationship with people's learning and performance. Mastery goal orientation is known as a person's unconscious approach to a learning task. In general, the mastery goal orientation directs the academic behavior and is able to explain the relationship between the student's beliefs about academic success and being involved and continuing to complete a task, which has an effective role in the academic progress of students. Self-efficacy is another important factor that is of interest to researchers and administrators in the field of education. Bandura investigated the effects of self-efficacy on academic performance and named this construct as academic self-efficacy. He believes that self-efficacy beliefs play a role in academic success more than ability, knowledge and previous success. Academic self-efficacy emphasizes students' beliefs about their ability to succeed in academic subjects, curricular areas, and self-regulation in learning and study activities. Cognitive-motivational intervention is the process of monitoring, reviewing and directing behavior that reduces aimlessness and inconsistency between motivation and effort and leads a person on the path of effort and achieving efficiency. Studies have shown that teaching self-regulation components in Martin's theory can; affect the level of students' motivation, for example, sustainability in Martin's approach is one of the factors that is known as an effective factor and can lead to more self-efficacy and increase academic motivation in students. Persistence means that a person continues in his work despite the difficulty of the work and the challenges that exist. Due to the fact that training motivated, purposeful and efficient learners is one of the requirements for achieving academic success and the concept of motivation has always been the focus of researchers and education specialists. Therefore, cognitive motivational multidimensional intervention can be useful in the field of education. Considering the importance of this approach, the research question is: Is cognitive motivational multidimensional intervention effective on students' academic self-efficacy and mastery goal orientation?

The present study was a semi-experimental study with a pre-test, post-test and follow-up design with experimental and control groups. The statistical population of the research was all the fifth-grade students of Nahavand primary school, a sample of 30 people (15 in the experimental group and 15 in the control group) was selected through cluster sampling. The research tools included the academic self-efficacy questionnaires of Zajakova et al. (2005) and the goal orientation of Midgley et al. (1998). After the pre-test, the experimental group was trained in cognitive motivational intervention during 9 sessions of 45 minutes, and the control group did not receive any intervention. After the completion of the experimental intervention, the post-test and after one month, the follow-up test was performed. To analyze the data, Mixed analysis of variance was used in SPSS-23 software.

The results showed that cognitive motivational intervention has an effect on academic self-efficacy and mastery goal orientation (p<0.01).

Considering the impact of cognitive motivational intervention on increasing academic self-efficacy and the goal orientation of students' mastery, this method can be used to increase their academic progress. It is important to mention that the data presented in this study is self-reported. Although this method of data collection is a reasonable and defensible method, it would be useful to conduct research that examines similar constructs using data obtained from other sources such as teachers and parents. The current research, like other experimental designs, also had limitations, one of which was the small sample size, which reduces the generalizability of the findings; To solve this limitation, it seems necessary to conduct a study with a larger sample size in order to reach more stable results. Another limitation of this study was not considering the academic progress of the students. Considering the academic progress can affect children's self-efficacy, therefore, the results may have been integrated with the effects of academic progress, which should be cautious in generalizing the results, and it is suggested to control the educational progress and the level of children's motivation in future studies. According to the results of the current research and previous studies, it can be said that the cognitive motivational multidimensional intervention is effective and can be used, but schools are facing problems in the field of implementation, and the implementation of this approach requires planning and policy making in educational programs.

Antibodies, well-known as immunoglobulins (Igs), are produced by B lymphocytes and specifically defend against pathogens. Igs are glycoproteins and have high diagnostic value in several diseases including infections (1). Igs are composed of light and heavy chains (2, 3). Each chain is comprised of about 110-120 amino acid residues which create immunoglobulin folds named domains (4, 5).  Domains play an important role in Igs biological functions. Every domain is included of two anti-parallel β-sheets. B-sheets play an important role in epitope formation because most of the epitopes are located in B-sheets (6, 7).  Epitope/ antigenic determinant is a part of antigen recognized by antibody (8).  For precise detections of Igs, diagnostic tools such as Igs- epitope specific monoclonal antibodies (MAbs) are needed (11). Therefore B-sheets are valuable tools in detection of proteins epitopes.IgG is the highest Ig in serum and has vital role in defense against infections (12). For optimizing current IgG diagnostic tests, accurate determination of IgG-specific epitopes is extremely important (18). Immunoinformatic is a branch of immunology uses a large amount of computer-generated biological information to solve immunological problems and diagnosis of diseases faster and more accurate (19-21). Immunoinformatic has spread to almost all areas of immunology and has exceedingly facilitated understanding of immune responses and their role in disease and health. Accordingly immunoinformatic has provided novel research opportunities to study the molecular mechanisms of immunological processes and related diseases and thus provide more effective diagnostic and treatment strategies (24-26). As B-sheets play an important role in epitope formation (6, 7) and immunogenic epitopes are very useful tools for production of specific monoclonal antibodies against a molecule (11), we conducted this research for recognition of human IgG B-sheets with immunoinformatic method and study their compatibility with IgG epitopes.

The confirmed amino acid sequence of reference human IgG was determined with PDB data bank in http://www.rcsb.org/pdb/home/home.do web site. The second structure of human IgG was obtained with Phyre2 (Protein Homology/analogy Recognition Engine V 2.0) software available on the http://www.sbg.bio.ic.ac.uk/phyre website. The location of B-sheets and epitopes in IgG was determined by the IEDB (Immune Epitope Database) at www.immuneepitope.org. Website.

Figures 1 and 2 show the second structure of light and heavy chains of the human IgG molecule, respectively, obtained by phyre2 software. The IgG light and heavy chains second structure consists of alpha spirals and B-sheets.
Figures 3 and 4 show the location of B-sheets in light and heavy chains of the human IgG molecule obtained by IEDB software.Most of  the  B-sheets in IgG molecules were located in 150 - 175 amino acid sequences of light chains and in 130-140, 160-170, 190-200, 220-245, 375-410 and 420-425 amino acid sequences of heavy chains respectively as was determined by IEDB software.Three epitopes sited to constant domain of IgG light chain (CL) were predicted. These epitopes were located at 150-175 and 180-205 amino acid sequences of light chain. Also three epitopes situated to second and third constant domains of IgG heavy chain (CH2 and CH3) were predicted. These epitopes were located at 200-270, 290-360 and 380-400 amino acid sequences of heavy chain.Based on the results of present study, 66% of human IgG light chain epitopes and 66% of human IgG heavy chain epitopes are situated at the IgG B-sheets locations. Also in present study, 91% of the amino acids forming B-sheets sited in the heavy chains of IgG molecule were located in the CH2 and CH3 domains and 100% of the human IgG heavy chain epitopes were located in the CH2 and CH3 domains

According to the results of this study, most of human IgG epitopes are located in regions of the molecule where B-sheets are most likely situated, indicating a relatively high compatibility of B-sheets with IgG epitopes.Given that the B-sheets present in the second structure of proteins play an important role in epitope formation (6, 7), the occurrence of most human IgG epitopes (66%) at the location of B-sheets seems evident.Moreover, according to the findings of the present study, a total of 91% of the amino acids forming B-sheets sited in the heavy chains of IgG molecule were located in the CH2 and CH3 domains and 100% of the human IgG heavy chain epitopes were located in the CH2 and CH3 domains. This again indicates the high compatibility of B-sheets with epitopes located on the heavy chain of the human IgG molecule.The findings of our study are confirmed by Hajighasemi et al. study (31). In study of Hajighasemi et al. (31), about 91% of the linear epitopes located on the heavy chains of the IgG molecule, were situated in the CH2 and CH3 domains. Similarly, in our study 100%  of human IgG heavy chain  epitopes located on CH2 and CH3 domains.Also the results of present study are confirmed by another research (36) in which all (100% ) of spatial epitopes on fragment of crystallizable [Fc] component (part of heavy chains)  of the human IgG molecule were located in CH3 and CH2 domains as were  identified by DiscoTope and ElliPro  immunoinformatic softwares. Similarly in the present study, 100%  of IgG heavy chain  epitopes were located in the CH2 and CH3 domains.Moreover the results of another study performed by Rohani et al. (37) support the findings of current study. Rohani et al., reported that most of the areas with highest surface accessibility, hydrophilicity and flexibility, were situated in CH2 and CH3 domains of  human IgG heavy chains. (37). According to our results, most of  B-sheets are located in the CH2 and CH3 domains of  human IgG heavy chains. As B-sheets are regions with high accessibility, hydrophilicity and flexibility (6), presence of most B-sheets in the CH2 and CH3 domains  which are reported to be  highly accessible, hydrophilic and flexible ( 37), is reasonable.Furthermore, the high immunogenicity of B-sheets (39), once again confirms results of the present study. As immunogenicity plays an important role in epitope development, the high adaptation between the location of B-sheets and epitopes ( shown in our study) which both are highly immunogenic, seems logical.Besides since B-sheets play an important role in epitope formation(6, 7),  the high compatibility between location of B-sheets and IgG epitopes ( shown in present study) seems sensible.Overall, presence the most of B-sheets and IgG epitopes in CL, CH2 and CH3 domains of human IgG, shows the high compatibility between location of B-sheets and epitopes in human IgG. These findings are precious tools not only for prediction of IgGimmunogenic epitopes in order to producing specific monoclonal anti IgG antibodies to optimize current human IgG diagnostic kits but also for more exact detection of IgG functions. Moreover our results are helpful in producing of similar proteins for diagnostic and therapeutic aims, structure- function relationships and phylogenic studies.

Eating disorders are one of the most common mental/psycho-physical disorders that cause many problems in physical health and cognitive functioning, and also disrupt the quality of life of the affected person and cause death. Binge eating disorder is an eating disorder that is now recognized as an official diagnosis. It affects approximately 2% of the world's population and can cause other diet-related health problems, such as high cholesterol levels and diabetes. Nutrition and eating disorders are not only related to food, that's why they are known as mental disorders. People usually use them to deal with deeper issues or other psychological conditions such as anxiety or depression. People with binge eating disorder may eat a lot of food in a short period, even if they are not hungry. Stress or emotional distress often plays a role and may cause overeating. Binge eating involves consuming large amounts of food very quickly, even when you are not hungry, and is somewhat uncomfortable. Almost everyone overeats once in a while, but it can also become a disorder. In the psychopathology of eating disorders, it has been found that people with eating disorders report more Dysregulation of emotions than healthy people. These eating disorders lead to obesity in people. A meta-analytical look at the treatments used to treat eating disorders in the last decade shows that most of the research has been focused on psychological treatments. At the same time, the level of knowledge and awareness of people regarding physical activity should also be investigated because Childhood to adolescence is one of the most sensitive and important periods of human development. Physical activity is an approach that can empower a person to improve their health status, and the culture of physical activity constitutes the consumption process of performing targeted movements to ensure and develop health and sports skills. Today, combating the problem of obesity or overweight is one of the most important goals of the medical community and those involved in health, and increasing the level of physical activity of people is known as one of the beneficial solutions to reduce the amount of obesity and related diseases among the society. Various studies show that various factors such as misleading advertisements, availability of fast and convenient foods, lifestyle and low nutritional knowledge, and physical activity have put teenagers at risk. Not having the necessary physical activity, in addition to having an inappropriate effect on the body mass index and causing the risks of diseases such as diabetes and obesity, causes a decrease in general physical fitness and a decrease in their health and hygiene. Physical activity and the desire for physical activity help people to get rid of unhealthy emotional thoughts, habits, and patterns, so they can play an important role in regulating emotions. Since culture does not determine the nature and frequency of biological stimuli such as physical activity, but it influences them, sometimes it has a significant effect on the time and sometimes on how these stimuli affect. Culture affects not only our preferences but also our decision-making methods and even our perception of the surrounding environment. There is a gap in the research done in this field (14). Therefore, this study aimed to investigate the relationship between the desire for physical activity and stress and depression in neurotic obese students.

This descriptive-correlation study was conducted on overweight and obese male students of the first secondary school (7th grade) in the academic year of 2020-2021 Since the disorder considered in this study were people suffering from neuropathic obesity, Gormali et al.'s (1982) binge eating questionnaire was distributed among the statistical population and after checking the scores, it was determined that 80 people had a score above the cut-off point of the scale. The number of the statistical sample was considered equal to the number of the statistical population. Then Lavibond and Lavibond's mental disorders questionnaire (1995), and Shahlai's desire for physical activity (2019) were distributed among the subjects. Data were analyzed using Pearson's correlation coefficient and regression.

The results showed that there is a significant relationship between the desire for physical activity and the reduction of stress and depression levels. It is also possible to predict stress and depression by using a passion for physical activity.

In general, it can be concluded that the use of physical activity in resume activities reduces the level of stress and depression in students suffering from obesity, so the use of physical activity along with the use of material and spiritual incentives reduces the level of stress. And depression becomes nervous in obese students. The current research, like any other research, has limitations that can clarify the findings and suggestions of the research and help future researchers to adopt effective measures to deal with the threat of internal and external validity of research projects. to give The fundamental limitations of the current research are as follows: the bias of people towards answering the questions of the questionnaires, which reduces the accuracy of the results to some extent, the presence of unwanted variables that affect the results of the research, and the lack of use of other research tools such as observation and interview. It has been associated with the subjects and only using the questionnaire. This research was conducted only on the population of 7th-grade male students in Qom city, and caution should be observed in generalizing the results to other regions and cities. The level of honesty of the respondents to the questions in the questionnaires is one of the uncontrollable limitations. According to the results of this study, it is suggested that at the beginning of the academic year, by referring to the students' files, identify the people who have obesity and overeating disorders, and with the cooperation of the director and vice president of education, to introduce them to sports centers and Or sports teachers should take action. Encouraging and persuading students towards physical education and sports activities (physical and mental) should be done regularly and continuously by educational coaches and parents.

Creating suitable conditions for more mobility (recreational sports and leisure) which on the one hand entertains and fills the leisure time of the elderly and on the other hand eliminates their urgent need for mobility, is one of the most essential these are just some of the goal setting shareware that you can use. Therefore, due to the importance of this issue, the purpose of this study was a comparative study of recreational sports activities for the elderly in Germany and Iran based on the Brady model.There is virtually no planned evaluation of sports offers. Suggestions and criticisms are discussed irregularly in conversations between coaches and adult athletes. The results of the discussion are rarely recorded and are primarily related only to the quality of the coach. Theoretically, some possibilities have been shown for how service quality can be evaluated and improved. Unfortunately, these methods are not fully applicable in the elderly. On the one hand, this is because older people only want to give verbal feedback and sports providers do not have the resources to install a quality management system. However, there are ways to do the evaluation with relatively little effort. So the question is, how should sports and recreational activities be planned to attract older people? The necessity of conducting this study is determined by the demographic transition and the unpreparedness of the society to face the sudden increase of the elderly population, which is related to the specific characteristics of population transfer. Along with all the issues, it seems that the changes caused by the population transition in Iran have caused the new social structures to be unable to meet the needs and requirements of the elderly. The aging of the Iranian population and addressing the issue of the elderly, including sports and physical activity in their spare time, is an inevitable necessity. Therefore, it is hoped that the possible results of the research can help planners and policy makers to encourage participation in sports and physical activity of the elderly. Managers and policy makers can increase the level of participation in sports activities in the elderly community by considering the factors raised in the research and providing conditions for the implementation of programs according to the factors raised and removing barriers to participation in sports activities.

This was a qualitative-applied research with Brady four stages of a comparative approach. The statistical population of the research consists of existing domestic and foreign documents, sources and reference books in the field of Iranian and German elderly. Checklist related to the comparative comparison of sports and recreational activities of the elderly in Iran and Germany, which was in all five dimensions of planning, facilities, manpower, structure and demographic characteristics. The studied variables in each dimension were selected by a survey of supervisors and consultants as well as a study of the present theoretical foundations on the research topic.

Based on the results of research on comparing all five dimensions of planning, manpower, facilities, structure and medical characteristics of Iran and Germany, it was found that there are many differences between Iran and Germany. The structure of the Iranian model was based more on the prominent role of planning and financial issues, and the main concern of the Iranian elderly was livelihood, while in the German model, more emphasis was on manpower. Planning in sports and recreational activities in Iran and Germany was reviewed and compared: Comparison of planning approaches in recreational sports activities for the elderly in Iran and Germany in 12 Variables Was categorized: Poverty of the elderly, Elderly care volunteers, Daily schedule of life in a nursing home, Planning, Guardian of Aging Sports, Type of sports activity, Type of recreational activity, life style, Alone in old age, Type of activities, Media, Hiring the elderly. Comparison of facilities in recreational sports activities for the elderly in Iran and Germany in 6 Variables Was categorized: Elderly recreational sports centers, Access to sports venues, Existence of sports facilities for the elderly, standard facilities, urban environment, Sports services for the elderly. Comparison of manpower in recreational sports activities for the elderly in Iran and Germany in 4 Variables Was categorized: Manpower training, Characteristics of manpower, Manpower services, Duties of manpower. Comparison of structure in recreational sports activities for the elderly in Iran and Germany in 4 Variables Was categorized: Pension system, pension fund, German sports structure, Family structure. Comparison of demographic characteristics in recreational sports activities for the elderly in Iran and Germany in 4 Variables Was categorized:  Life expectancy, marital status, Job, Income, Insurance status.

The structure of sports and recreational activities in Iran and Germany was examined and compared, the results of which showed that there are differences between Iran and Germany in the dimensions of the pension system, pension fund, German sports structure and family structure. The structure of German sports is very similar to the federal structure that characterizes the Federal Republic of Germany. This feature makes German sports have an independent structure. Since the merger of the German National Olympic Committee Duster Sport Bando in May 2006 and the establishment of the German Olympic Confederation, it has become the only German umbrella organization. At the German macro level, both the federal government (through the Ministry of the Interior) and the 16 state governments (for example, through the Ministry of the Interior or the Ministry of Culture of the state government) are responsible for policy-making in the sport of the region under their control. As a result, there is no independent ministry called the Ministry of Sports in Germany. But in the Iranian state system, there is the Ministry of Sports and Youth. The industrial, economic and political structures of society in today's world are interrelated with sport; On the other hand, the industrial and economic development of Germany has affected the promotion of sports quality in society as a whole and even sports for the elderly, and in return, attention to sports at the educational, public, championship and professional levels Industrial, economic and social prosperity. At the same time, when young people and adults join sports and participate in sports programs, this participation can continue into old age and help the development of old sports. According to the results suggested that in the future planning of public sports in the country, special attention should be paid to sports for the elderly and rules and regulations should be developed to support sports for the elderly, as well as training specialized and trained sports coaches for public sports programs. According to the results of the research on the difference between planning approaches in recreational sports activities for the elderly in Iran and Germany, it is suggested to reduce sports costs by paying subsidies to institutions that deal with sports and community health. Since most seniors do not include any monthly expenses for exercise in the household budget, it is necessary to plan for short-term and long-term education of seniors and their families about the positive benefits of exercise for the elderly and the need to do it under any circumstances. The results also showed that the facilities of recreational sports activities for the elderly in Iran and Germany are different, so that sports managers and officials have made special planning and investment on this factor and by providing sports programs and facilities to the elderly, the level of motivation Increase them to participate in physical activity. Also, considering that most sports services are provided by private sports clubs, strengthening these clubs in various ways, as well as supporting them, can play an important role in the success of public sports programs. The results of the present study showed that the dimensions of manpower in recreational sports activities for the elderly in Iran and Germany are different. Also, by creating and developing volunteer centers and training them, provide the ground for the development of efficient human resources in this field, and at the end of the present study showed that the structure is different in recreational sports activities for the elderly in Iran and Germany, accordingly. It is suggested that in the future planning of public sports in the country, special attention be paid to sports for the elderly and rules and regulations be developed to support sports for the elderly, as well as the training of specialized and trained sports coaches for public sports programs.

Uncertainty is a state in which the knowledge of a person or persons is limited and full knowledge of the state or result that has been achieved or is not possible. Macroeconomic uncertainties create an uncertain environment for investors and make it impossible for investors to make decisions about future investments more efficiently and with more confidence, and they may suffer huge losses. Among the major indicators of economic uncertainty, we can mention inflation uncertainty, oil price uncertainty, exchange rate uncertainty, and gold price uncertainty. Uncertainty has attracted an important part of modern research in economics and has been proven to be an important factor for any economy. Uncertainty is a situation in which the possible events that will happen in the future are not clear and known. If they are known, the probability of their occurrence or the probability distribution function is unclear. In such a situation, making decisions about the future becomes complicated, and it is said that an "uncertain atmosphere" has dominated the decisions. One of the most important signs of uncertainty in an economic system is high and severe fluctuations in economic variables. In developing countries, including Iran, one of the reasons why the private sector is less willing to enter the economy is the fluctuations of economic variables. Such fluctuations lead to uncertainty in investment both in terms of profitability and investment costs. Uncertainty is a phenomenon that is not pleasant for the economy. Economic policymakers in every country should seek to reduce the atmosphere of uncertainty and increase the predictability of economic variables, because the uncertainty hurts the economic decision-making of households, companies, and investors, and as a result, reduces economic growth. On the other hand, a solid banking system is the foundation of sustainable economic growth, because banks are at the center of the financial intermediation process between savers and investors. One of the concepts raised in banking is the concept of financial health in the banking system. The concept of financial health as the concept of profitability and continuity of activity and proper performance of banks is of great importance in all economic sectors. All economic trustees tend to monitor the financial health of these units because the economic situation is generally affected by the way banks operate and their health. On the one hand, as an economic unit that can be deposited and collects the liquidity of society members and pays it in the form of facilities to various groups of economic units, and is the driving factor of the economic cycle, and on the other hand, deciding on the rate of deposits and facilities to change behavior It leads to economic reactions. According to the existing literature, political and economic uncertainty can affect the risk and stability of the banking sector from internal and external aspects. From the intra-systemic point of view, uncertainty leads to more conservative decisions of managers through the reduction of risk-taking behavior. In addition, it affects banks' risk through uncertainty and increases information asymmetry in the banking sector. Considering the importance of the banking sector in Iran's bank-oriented economy, in this research, an attempt is made to examine the economic uncertainty index on the stability of the country's financial banking system.

In this regard, inflation uncertainty as an economic uncertainty index and tax revenue uncertainty as uncertainty indices were calculated using generalized autoregressive and conditional heterogeneity variance models. In the following, the effect of these indicators on the health stability of the financial system was examined.

The results of this research show a negative and significant relationship between inflation uncertainty and exchange rate uncertainty with financial system health stability, however, the uncertainty coefficient of tax revenues is not statistically significant.

Economic uncertainty can be mentioned among the factors affecting the stability of the health of the financial system. Considering the importance of the issue in the country, in this research, an attempt was made to examine the stability of the health of the financial system from the perspective of the impact of uncertainty indicators on it. The results of the final estimation of the model show that economic uncertainty (inflation uncertainty index) has had a negative and significant impact on the health stability of the financial system, and with the increase of economic uncertainty, the vulnerability of the banking sector increases. This result shows the influence of the financial health of the country's banking system on macroeconomic stability. In general, it can be concluded that the experience of the financial crisis and the destructive effects caused by the transfer of the crisis from the monetary sector to the real sector of the economy, global efforts in the field of improving the quality of monitoring the financial health system and being on the path of financial health, addressing the issue of health indicators Financial systems and its influence on the efficiency of financial systems are of great importance. In examining the health of financial systems, choosing and determining indicators is one of the key steps. low stability or instability of the health of the financial system and bankruptcy, a sharp decrease in the supply of financial resources that provide capital, credits, and pressure on companies and households to adjust their financial balances, a decrease in customer confidence (and in other words, a decrease in the amount of savings) and finally, it leads to a decrease in production volume, income and wealth. Therefore, examining the stability of the health of the financial system and the factors affecting it in the economy of any country or region (both developed and developing) to help reduce the aforementioned costs and, first, improve economic growth and development inside the country is very important.

Citizenship competencies are one of the most important necessities in today's complex society. An effective and efficient education system is a system that is in line with the real goals and needs of society and has the ability to prepare the young generation and develop skills, including citizenship skills, to achieve the desired goals. Citizenship competencies are one of the most important necessities in today's complex society. Citizenship merit refers to knowing how to interact with each other in a democratic society. The Citizenship Competency Program seeks to develop cognitive, communicative, and emotional competencies along with the acquisition of knowledge about government and society. It has to do more with norms and mechanisms for living together. To this end, civic education should be based on activities, not just ideas. The development of citizenship competencies is considered as an educational goal and a good citizen is a person who has characteristics such as; (a) having the ability to evaluate and critique different perspectives, (b) thinking about issues such as justice and equality, (c) participating and (d) accept social responsibility. Universities, as educational and service-oriented organizations, are no exception to this rule of influencing students. In other words, achieving purely educational goals depends on the optimal use of human, financial, and equipment resources, but the dynamism of the university system depends on various factors, including having qualified employees, having a high professional commitment, and a committed heart. It is up to them to take steps in a dynamic and healthy environment by using all their power for the greater and better efficiency of this scientific and cultural organization. Therefore, the professional competence and commitment of all university staff and professors due to their important role in advancing the educational situation of the university is very important and will prepare the ground for performance improvement and productivity. Therefore, this study seeks to answer the question of what is the role of professors 'professional abilities on students' self-efficacy and competence?

In terms of purpose, this research is an applied research that was approved by the ethics committee of Islamic Azad University, Sari branch, with the ethics code IR.IAU.SARI.REC.1400.093. The combined research method and research design are also of the type of mixed exploratory research design (qualitative-quantitative). The statistical population of the research in the qualitative section includes (faculty and guest professors and managers of the department of Mazandaran University) to agree on the Delphi method. Also, the statistical population in a small part includes faculty members, visiting professors and teaching staff, and administrative staff of Mazandaran University in 1400 to 1487 people, who were selected by available sampling method. Sample size and sampling method in the qualitative section, according to the research method used in this study, the number of specific samples was not specified at first and sampling was available until 20 after the Theoretical saturation interview was obtained. The statistical sample size in the quantitative part was determined using Cochran's formula of 153 people. A semi-structured interview was used to collect information in the qualitative part and a researcher-made questionnaire was used in the quantitative part. In order to analyze the data in the qualitative part, the Delphi technique and in the quantitative part of the structural equation modeling method, SPSS, and LISREL software were used.

Based on the results of the structural model, the variable of teachers' professional abilities on self-efficacy is significant. Considering the significance and positiveness of these coefficients, it can be said that the professional abilities of teachers have a positive and significant effect on self-efficacy. Also, the effect of teachers' professional competencies on citizenship competence has been shown by estimating the standard coefficients of paths (value t) along with the factor load of each variable, and as it is known, all factor loads are in good condition and the capability they measure dimensions.

The results of the present study showed that the professional abilities of teachers have a significant effect on self-efficacy and citizenship competence. The university is an effective channel for transmitting a set of specific social knowledge, skills, values , and beliefs. The university should provide opportunities for learners to test different values and beliefs from different perspectives, to enable citizens to be aware of and respect their role, and to take an active part in the national interest. To be. Citizenship is not something that happens after graduating from university, but is learned and practiced in daily behaviors and interactions, and is the best place to practice citizenship, university, and school. In other words, the main responsibility for fostering, strengthening, and developing the values and skills of citizenship falls on these two places, which must be practiced and in the course of students' relations with each other and with other individuals and groups. Make them active and responsible citizens. What can justify the main mission and philosophy of the formation and development of universities in the current era is citizenship education and the development of citizenship skills. In order for universities to be able to develop citizenship competencies as one of the basic goals of the educational institution in students, they must be effective, because the most important factor that can indicate the achievement of goals is the effectiveness of the university. Among the various pillars of educational institutions, professors as the main pillar of education in universities have a decisive role in the effectiveness of the university and the development of students' competencies. Therefore, professors 'views on the effectiveness of the university as well as the extent to which students have citizenship competencies can help explain the role of the university and their effectiveness in developing students' competencies, especially citizenship competencies and self-efficacy. Numerous factors, such as parents, friends, the media, society and education, and higher education institutions, play a role in learning and developing citizenship skills. The family can be mentioned as an important resource for learning citizenship skills. But the school and the university play a major role in learning students' citizenship competencies. The university influences students' citizenship competencies through the subjects of the curriculum for citizenship education, the methods used to teach the topics, and the methods, rules, and regulations used throughout the university. Because the effectiveness of professors is focused on the achievement of educational goals and objectives, the development of citizenship competencies as one of the goals of the educational institution is better achieved in effective universities. Teachers' effectiveness indicates performance and progress in achieving educational goals. In general, it can be acknowledged that students should have the necessary abilities and skills such as competence and self-efficacy in today's society, which in order to improve their abilities, the professional capabilities of professors play a role and universities and higher education institutions not only for training Expert human beings, but also for expanding the frontiers of knowledge and from the perspectives of personal, national and international development, and the professional capabilities of professors play an important role in the development of educational goals. One of the limitations of the present study was the difficulty of coordinating and communicating with the participants in the qualitative part, which was time-consuming. Considering the effect of professors' professional abilities on students' self-efficacy and competence, it is suggested that in-service training be held in the form of various workshops in order to train professors' professional abilities. Managers, assistants should be fully informed about the impact of the effect of teachers 'professional abilities on students' self-efficacy and competence, and most of them should be considered.

Empowerment is the most important challenge for managers in this era. Because organizations are subject to rapid and unpredictable changes. Among the most important factors of these changes, we can mention the increasing global competition, the development and expansion of information technology, and changes in the characteristics and demands of customers. The change in the conditions of today's organizations has led to a change in their attitude towards human resources. In this situation, the employees of the organization have become the main operators of the workflow and partners of the organization. Empowerment, as one of the approaches to human resources development in the last few decades, has become the basis for many positive developments in the implementation of the work activities of employees. In today's changing conditions, organizations have no choice but to make proper use of human resources. Based on this, the only factor that creates balance in the organization will be employee empowerment. Empowerment is a tool that aligns individual goals with organizational goals and creates the belief that the progress of the organization will bring benefits to the employees. Empowering people means encouraging people to participate more in decisions that are effective in their activities, that is, providing a space for people to be able to create good ideas and bring them to life. Empowerment is a vital element of business in the new world. Goals such as getting closer to the customer, improving services, continuously providing innovation, increasing productivity, and taking control of the field will be achieved for organizations that have found new ways to empower their employees. Empowerment is a new stimulus for growing organizational environments that leads to employee mobility and creativity. On the other hand, due to the rapid growth of technology and the change in work, as well as the replacement of computers, robots, and fully automatic devices in jobs, important strategic empowerment for the development of various organizations to adapt to external changes and one It is one of the main issues of organizations. On the other hand, the main feature of empowering employees is aligning individual and organizational goals. In any case, empowerment can be seen as including a set of measures and methods that change the behavior of employees and make them more ready to take better decisions according to the conditions of the organization and by presenting Khalatit, in demanding team activities, should lead the organization in the direction of productivity. On the other hand, one of the effective factors of organizational effectiveness in sports environments is skilled and efficient human resources. The findings showed that there is a relationship between employee empowerment and job satisfaction. Also, empowered employees are likely to increase their motivational feelings, which helps them to gain the necessary power and control and acquire the necessary knowledge and skills to address the needs of customers. obtain It seems that the psychological approach is one of the other effective components of organizational empowerment mechanisms, and according to past studies, the psychological approach is also influenced by the human spirit and its dimensions; Therefore, in this research, an attempt is made to identify the organizational empowering dimensions of employees with a psychological approach.

The research method was a combination of exploratory mixed research (qualitative-quantitative). The statistical population of the research in the qualitative part included the selected experts of Mazandaran Education Organization with experience in management and policy-making, to reach a consensus in the Delphi method, the sample size in the qualitative part was determined by taking into account the law of saturation to the number of 20 people. And in the quantitative part, the statistical population included the employees of education departments of 32 districts and cities of Mazandaran province. In the quantitative section, the sample size was determined to be 320 using the Karjesi and Morgan table. The sampling method in the quantitative part was random. The method of collecting information is the library method, and the measurement tool in the qualitative part is a semi-structured interview in the quantitative part, it includes a researcher-made questionnaire, the questions of which were taken from the data obtained from the interview. Determining the validity of the present research questionnaire was carried out by two

1. Formal and 2. Content. In the formal method, the questionnaire was given to a group of experts. To analyze the data, the Delphi technique was used in the qualitative part and the Friedman test was used in the quantitative part.

The findings showed that in terms of prioritization, the dimensions of organizational empowerment of employees are as follows. 1) Decision making 2) Citizenship skills 3) Individual characteristics 4) Cooperation.

Empowering employees is a new method that is used by managers to increase productivity by increasing employees' commitment to the organization and vice versa. Empowerment is a different way for people to work with each other, and its main goal is to change the management structure from a traditional and pyramidal form to a cooperative structure. Empowerment is not only a kind of internal work motivation but also an active motivational tendency. Empowerment, as a new way of creating motivation, has become one of the hottest topics in management today. The existence of rapid changes, technological advances, and open and hidden competition in the world has made the importance and necessity of empowerment more obvious. Empowerment is achieved through internal and external challenges of the organization. External challenges include increasing the acceleration of changes, a competitive environment, new expectations of customers, and new market conditions. Internal challenges emphasize the maintenance of existing human resources, increasing the level of motivation, growth, and flourishing of talent and skills of employees. Empowerment is widely used in different ways. Many managers in the workplace talk about empowerment, and writers and experts recommend empowerment management as a solution to many organizational problems. Empowerment has been used for years in areas such as social work, urban redevelopment, and foreign development.

The aging of the population has caused an increase in the number of elderly people who receive treatment for cardiovascular disease. The prevalence of coronary artery disease is higher in the elderly, and on the other hand, complications after cardiac events are worse in the elderly. The most common cause of death in the elderly is cardiovascular disease. Rapid restoration of blood flow can lead to myocardial survival, preservation of cardiac function, and prolongation of the patient's life, and many clinical trial studies have been conducted to investigate the effect of Thrombolytics, and their results showed that Thrombolytics preserve ventricular function. Primary coronary angioplasty was defined as the primary revascularization strategy for acute myocardial infarction without or with prior thrombolytic therapy. In the last two decades, it has been shown that the complications of coronary artery syndrome have decreased with the development of therapeutic strategies such as revascularization, medical treatment, and risk factors in follow-up after discharge. Data from many cardiovascular centers have shown that angioplasty not only leads to a significant reduction in mortality but also in coronary ischemic events. Elderly people who have concurrent diseases such as lung diseases, kidney diseases, and cerebrovascular accidents and suffer from coronary accidents accept angioplasty with caution. This is even though in symptomatic patients with chronic coronary disease, revascularization leads to the resolution of symptoms and improvement of the patient's life expectancy. Despite the effects of coronary artery disease on the quality of life, morbidity, and mortality of the elderly, in the majority of cardiovascular studies, the elderly 75 years and older were significantly less expressed and directly due to advanced age, and complex co-morbidities, and significant physical and cognitive disabilities., fatigue, living in a nursing home, and decline in daily functioning were excluded from the study. Therefore, recent guidelines cannot provide evidence-based recommendations for the diagnosis and treatment of coronary diseases in the elderly. Choosing the correct treatment strategy for the elderly with acute coronary artery disease is due to the importance of the burden of care from the economic, social, and family points of view. Also, few studies are comparing the effect of medical treatment with revascularization in the elderly 75 years and older. The aim of the study is to determine whether elderly people benefit from primary angioplasty compared to medical treatment alone and the side effects of each of these treatments in the elderly.

The present study is a prospective cohort type, which was approved by the ethical code IR.TUMS.MEDICINE.REC.1397.934 in the ethical code commission of the Faculty of Medicine of Tehran University of Medical Sciences and 97 samples were taken in 9 months from June 2018 to the end of March. were collected and then for 24 hours and 30 days after the treatment (medical/angioplasty), the elderly (mostly 60 years old) with acute coronary artery disease were followed up in terms of the effectiveness and side effects of the treatments. All elderly people diagnosed with acute coronary syndrome hospitalized in two teaching hospitals of Tehran University of Medical Sciences were included in the study and evaluated in two groups. The first group of the interventional treatment group: was patients who were diagnosed with acute coronary syndrome and were treated with angioplasty from the beginning, and the second group, the optimal medical treatment group: patients who were treated with standard medical treatment from the beginning (including Thrombolytics, oral beta blockers, intravenous nitrates, antiplatelet Duals such as aspirin and Clopidogrel, intravenous anticoagulants such as heparin or enoxaparin, statin and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers 2) were included according to the latest guidelines. In this prospective cohort study, all patients aged 60 years and older with the acute coronary syndrome were collected by face-to-face interview and case evaluation from two teaching hospitals, Tehran University of Medical Sciences from 2018, and they were divided into two primary and medical angioplasty groups in terms of complications., mortality and efficacy of 24 hours and 30 days were compared.

Out of 120 patients with an average age of 71.2±8.2 years, 52 and 68 patients received primary angioplasty and medical treatment, respectively. The majority of patients in the primary angioplasty group were male (57.7%) and female (57.4%) in the medical group (p=0.07). In the first 24 hours, comparing the two groups with the logistic regression method, atrial fibrillation was significantly 11 times higher in the medical group (p=0.016) and improvement of angina in the primary angioplasty group was 3.8 times higher (p=0.04). The 30-day mortality rate was significantly higher in the medical group (p=0.006).

These results indicate that we overestimate the risks associated with revascularization in the elderly and deprive people of useful treatments. With increasing age, despite the significant reduction of hospital and short-term mortality by about 5 times, increasing the rate of angina recovery and fewer complications in angioplasty, this treatment method is less often chosen in elderly patients, and elderly people are less likely to choose this method due to their age. They are denied treatment. There are sufficient reasons for the elderly and very elderly with good tolerance to angioplasty. The success rate of immediate angioplasty and the survival rate without complications are similar to young patients, so old age is not a contraindication for angioplasty. Also, old age is not an independent risk factor for poor prognosis. In addition, complete revascularization in very elderly patients may improve prognosis and reduce the incidence of cardiac events. This study included limitations. Collecting samples from two different hospitals, one of these hospitals was not able to perform angioplasty in patients with angioplasty indication due to the lack of an angiography department, and the patients were forced to undergo medical treatment, which also led to a decrease in the number of The samples included in the angioplasty group and the bias in the selection of patients with real indications for medical treatment. On the other hand, it also leads to an increase in complications. The low sample size and the age of the patients included in the study were among the limitations of this study.

Multiple sclerosis (MS) is a chronic and neurological disease that causes various physical and mental disorders such as anxiety, depression, weakness, diplopia, blurred vision, decreased muscle strength, tremors, forgetfulness, lack of concentration, disorder of understanding feelings, etc. This disease is an inflammatory disease with a degenerative nature related to the central nervous system with a vast etiology. MS causes the myelin of the central nervous system (brain and spinal cord) to be destroyed, and the destruction of myelin determines the symptoms of the disease. This disease is common between the ages of 18 and 40. According to statistics, approximately 2.5 million people in the world have MS. The prevalence of this disease (MS), according to the statistics recorded by the World Health Organization, is 20 to 60 cases per 100,000 people, and statistics show that the ratio of women to men is higher. The clinical course of MS is diverse and can vary from a completely benign course to a progressive and debilitating course. Stress is a term that refers to a set of physical, mental, emotional, and tension factors in a person. Being exposed to stress in everyday life is an integral part of life, some of these stresses can have a positive effect on increasing arousal, and in this case, it prepares a person for activity. On the other hand, exposure to stress can be harmful. Stress occurs for a person when the environmental facilities are more than the person's resources for adaptation. Perceived stress is defined as the degree to which environmental situations in a person's life are evaluated as stressful. The studies conducted about perceived stress indicate that stress and its effect on mental health are determined to some extent by a person's subjective evaluation of life events. People suffering from chronic diseases, if they cannot control the perceived stress of the disease, will affect their mental health. Therefore, it is very important to control and manage stress so that the patient can deal with it efficiently. One of the unpleasant consequences of stress in chronic patients such as MS is the unfavorable quality of life of these patients, which shows that it is important to investigate and evaluate the quality of life in clinical research, that knowledge about the quality of life of patients will help the health team to Move the care to improve their quality of life. Every person's dream in life has always been to have a good life. In the present century, there have been many changes in people's views on life, and every person tries to live a quality life and strives to improve the quality of his life. For this reason, the evaluation of the quality of life has gained a lot of value in recent years. The concept of quality of life in the lives of healthy or sick people is affected by different conditions and changes. The concept of quality of life depends on physical, mental, and social health, which is influenced by people's opinions and expectations. Another variable that is theoretically related to the structure of perceived stress is willpower. Regarding the controlling factors of human behavior, behaviorist psychologists consider the controlling factor of a person to be the external environment of a person, and cognitive psychologists consider the internal system of a person, including his willpower and decision, to be effective in this field. They consider from the point of view of today's psychologists, the concept of willpower is synonymous with the relative strength of motivations, and in fact, they consider the study of self-control and motivation to be effective and useful in this field. In general, the problem of the present research is to what extent the components of quality of life and components of willpower can predict the perceived stress in patients with MS and the contribution of each of these variables. How much is it in predicting the perceived stress of patients with MS?

The current research design is a descriptive design of the correlation type, in which the components of quality of life and the components of willpower are predictor variables and perceived stress is the criterion variable. The statistical population of this research was patients with MS from Imam Khomeini Hospital in Tehran, and the sample of this research is 118 people, including 64 women, which is equivalent to 54.2 percent of the total sample size, and 54 men, which is equivalent to 45.8. The tools used in this research included Cohen's Perceived Stress Scale, the World Health Organization's Quality of Life Scale, and Godrezi's Willpower Scale. Data analysis was done using SPSS-23 software. To check the correlation of the dimensions of the variables, Pearson's correlation coefficient was analyzed using the simultaneous regression method.

The results showed that the components of physical health and mental health from the quality of life scale and the components of independence and courage from the willpower scale significantly predict perceived stress. The value of the standardized regression coefficient was -0.360 for physical health, -0.249 for mental health, and -0.333 for independence and courage.

Physical health, mental health, independence, and courage can affect psychological well-being and increase the problems caused by stress by affecting the perceived stress of MS disease and his avoidance of MS stress. Therefore, it is necessary to consider these factors in the management and treatment of these patients. Multiple sclerosis patients struggle with stress due to facing and fighting this chronic disease. It is important and necessary that their perceived stress from the disease is not high enough to be able to cope with the disease. Since some subscales of quality of life and willpower are related to perceived stress, it is useful to pay attention to them in patients. The higher the level of quality of life and willpower, the less stress a person feels.

Mental health is one of the most important components of a healthy life. Mental health seeks to reduce negative emotions such as anxiety, depression, and hopelessness and to prevent the occurrence of morbid symptoms in people. During the last few decades, the issue of mental health has been considered as one of the important aspects of health. Risk factors for mental health problems include family history, stressful life conditions, chronic illness, history of trauma, drug use, neglect or abuse in childhood, and lack of social support. The importance of mental health is due to its close connection with physical health. Mental health plays an important role in people's ability to maintain physical health. Mental illnesses such as depression and anxiety affect people's ability to participate in health-promoting behaviors. In turn, physical health problems such as chronic diseases can have a serious impact on mental health and reduce people's ability to participate in treatment and recovery. Specialists and researchers are looking for factors that can affect mental health. Meanwhile, marital satisfaction and self-efficacy are among the factors affecting the mental health of cancer patients, and the need for more investigations in this field is felt. The psychological effects caused by this diagnosis and the physical effects caused by its treatments are accompanied by many side effects, and due to the changes, sometimes self-confidence is jeopardized. Personal communication is disrupted due to uncertainty about the future. The previous adaptation mechanisms seem insufficient and being admitted to the hospital may induce a feeling of loneliness. It should be noted that chronic diseases, including cancer, can have destructive effects and affect the satisfaction of couples. Marital satisfaction is the most important component of marriage. It seems that mental health as a component of individual characteristics is related to marital satisfaction. The perception of self-efficacy is also a cognitive mechanism that creates the ability to control fearful things in a person and enables him to face problems. Understanding the ability makes a person avoid behaviors. People who have a clear, defined, harmonious, and almost stable sense of self-efficacy have more psychological health. These people have reached a clear view of themselves and are less influenced by daily events and evaluations of these events. Therefore, the present study aims to investigate the role of marital satisfaction and self-efficacy in the mental health of these patients.

For this purpose, 135 cancer patients undergoing chemotherapy in Shiraz city who were referred to chemotherapy centers in Shiraz in 2013 were selected. In this study, Goldberg's general health (1972), Fores and Elson's (1989) marital satisfaction, and Sherer et al.'s (1982) general self-efficacy questionnaires were used. The data were analyzed using multiple regression analysis methods.

The results of these analyzes showed that marital satisfaction and self-efficacy predict mental health in cancer patients undergoing chemotherapy.

In a general summary and according to the results of the present study, it can be stated that marital satisfaction and self-efficacy predict the level of mental health in cancer patients undergoing chemotherapy, so the attention of patients and Caregivers of these patients are important to the categories of marital satisfaction and self-efficacy. Just as every research has its limitations, this research also has limitations in several areas due to the special physical and mental conditions of these patients. The current research has been conducted on a special group of people (cancer patients) who may have many problems with attention and concentration, which may have affected their answers to the questions in the questionnaires. The small number of subjects may also be one of the other limitations of this research. Another limitation of this research is the non-uniformity of the sample group in terms of gender, type of cancer, and benign and malignant disease, which may have affected variables related to mental health. Using the available sampling method and collecting data using a self-report questionnaire by patients is another limitation of the present study. Considering that the statistical population studied in this research are cancer patients undergoing chemotherapy and a lot of psychological pressure is imposed on these patients, it is suggested that the role of other predictive variables in the mental health of this group of patients Review. Considering the importance of the concept of mental health and because this construct is relatively new and few types of research related to it have been done in our country, it is suggested to investigate it in different chronic and clinical patients to validate the results of this research. Also, considering the limitations of the current research in evaluating mediating and moderating variables, it is suggested that in future research, the role of these variables should be controlled and investigated, and various researchers in different formats (descriptive, experimental, longitudinal, etc.) to be done in connection with it. This research should also be done in single patients because the stress and type and amount of support in these patients are different. Also, regarding the effect of self-efficacy in cancer patients, this research is still in its development period and the need for more research in this field is felt.

Toxoplasmosis is a globally distributed disease caused by a parasitic protozoan called Toxoplasma gondii (T. gondii) in humans and animals that often develops asymptomatic acquired infections but the important aspect of this parasitic infection is the possible risk of congenital transmission and its severe effects on the fetus such as hydrocephalus, microcephaly, deafness and abortion up to milder abnormalities such as psychomotor retardation, mental disability, hearing loss, slow growth, chorioretinitis, cryptogenic epilepsy and autism disorders in infants. The infection appears to be associated with neuropsychiatric disorders such as anxiety, schizophrenia, depression, weight loss, autoimmune thyroid disease, violence, and suicide attempts. The term Mental Disorders is used to refer to mental disorders that have behavioural or psychological symptoms which affect various aspects of life and cause anxiety. In this article, the possible association between this parasite and the major categories of disorders (based on the Diagnostic and Statistical Manual of Mental Disorders or DSM) is described. 1- Neurodevelopmental Disorders. The association of global developmental delay and communication disorders with toxoplasmosis has not been investigated nor the author has not found an article in this regard but some studies consider T. gondii to be an effective or ineffective factor in intellectual disability, autism spectrum disorder, attention-deficit hyperactivity disorder. 2- Bipolar and Related Disorders which seems people who were evaluated immediately after the onset of these mental disorders were more likely to be exposed to T. gondii. 3- Anxiety Disorders. In this group of diseases, toxoplasmosis association has not been investigated or the author has not found an article in this regard except in some studies which consider T. gondii to be an effective or ineffective factor in generalized anxiety disorder. Latent toxoplasmosis exacerbates anxiety and depression and can be a risk factor for mental illness, on the other hand, the results are varied for depression but the genetic background is important for the response to latent toxoplasmosis. 4- Trauma and Stressor-Related Disorders er. Toxoplasmosis association has not been investigated in this group nor the author has not found an article in this regard although there are studies that consider T. gondii to be an effective or ineffective factor in post-traumatic stress disorder. 5- Dissociative Disorders The association with toxoplasmosis has not been investigated or the author has not found an article on these subjects. 6- Somatic Symptom and Related Disorders include somatic symptom disorder, illness anxiety disorder, conversion disorder and factitious disorder which none of them has been studied concerning toxoplasmosis, or the author has not found an article on these subjects. 7- Feeding and Eating Disorder include anorexia nervosa, bulimia nervosa, rumination disorder, pica and binge-eating disorder which none of which has been studied with toxoplasmosis, or the author has not found an article about them. 8- Sleep-Wake Disorders include narcolepsy, insomnia disorder, hypersomnolence disorder, breathing-related sleep disorders, parasomnias and restless legs syndrome. Except for hypersomnolence disorder, and breathing-related sleep disorders which can be partly related to parasite infection, the rest of the diseases were not studied nor the author has not found an article about them. 9- Disruptive, Impulse-Control, and Conduct Disorders include kleptomania, pyromania, intermittent explosive disorder, conduct disorder and oppositional defiant disorder. Except for intermittent explosive disorder which can be partly related to parasite infection, the rest of the diseases were not studied nor the author has not found an article on these subjects. 10- Depressive Disorders. Except for major depressive disorder and persistent depressive disorder (dysthymia) which can be partly related to parasite infection, the rest of the diseases were not studied nor the author has not found an article on these subjects. 11- Substance-Related and Addictive Disorders. The association of this disease with toxoplasmosis has not been investigated nor the author has not found an article in this regard. 12- Neurocognitive Disorders include delirium and major and mild neurocognitive disorders. Apart from delirium, many articles have been published on the relationship between this parasite and major and mild neurocognitive disorders. 13- Schizophrenia Disorders include delusions, hallucinations and disorganized speech. Statistical analysis showed that among patients with schizophrenia and the incidence of latent toxoplasmosis may be a connection in incidence and latent toxoplasmosis appears to be a risk factor, especially for schizophrenia and anxiety. It seems that both schizophrenia and latent toxoplasmosis can inhibit neurotransmission, increase the production of L-quinoline and its neurotransmitters, hormonal imbalances, alter tissue regeneration processes, lack of fear, impair human cognition and reduce grey matter density. 14- Obsessive-Compulsive and Related Disorders Toxoplasmosis association has not been investigated in this group nor the author has not found an article in this regard although there are studies that consider T. gondii to be an effective or ineffective factor in OCD. 15- Personality Disorders include antisocial personality disorder, avoidant personality disorder, borderline personality disorder, dependent personality disorder, histrionic personality disorder, narcissistic personality disorder, obsessive-compulsive personality disorder, paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder which none of them has been studied with toxoplasmosis, or the author has not found an article on these subjects. It seems that T. gondii can increase or cause some mental disorders and many articles have discussed the effect or lack of effect of this parasite also, the association of this parasite with a large number of diseases has not yet been worked out or needs further study. How and why this parasite affects the brain and nerves is still unknown to science that needs further investigation although it seems that infection with this protozoa may cause an increase or occurrence of some mental disorders.

Osteoporosis is a systemic skeletal disease associated with decreased bone mass and loss of bone tissue structure, resulting in increased susceptibility to fractures. Depending on the etiological factors, the disease may occur in primary (menopausal and aging) and secondary forms. One of the important etiologies of this disease is estrogen deficiency, in which estrogen deficiency is considered the main determinant of bone destruction in postmenopausal women. One of the major causes of this disease is estrogen deficiency, in which estrogen deficiency is considered the main cause of bone destruction in postmenopausal women (1, 2). The flax plant, with the scientific name of Linum usitatissimum, is an annual plant of the genus Linaceae that grows like a plant in the climatic conditions of Iran (10). Flaxseed is rich in phytoestrogenic compounds. Flaxseed phytoestrogens reduce post-menopausal complications in women by increasing sex hormone-binding globulin (SHBG) (11). Flaxseed is also a rich source of various phenols such as lignans, phenolic acids, flavonoids, phenylpropanoids, and tannins, known as a rich source of natural antioxidants (12). Regular exercise and physical activity can prevent diseases such as sarcopenia, obesity, and mitochondrial dysfunction, which are the main drivers of oxidative stress and inflammation in aging (13). It has also been suggested that exercise is a safe and effective way to prevent bone destruction in postmenopausal women (14). Given that ovariectomized rats have many similarities in the pathophysiological mechanisms of this complication with the human model, it is a suitable model for studying human osteoporosis (2, 16). On the other hand, since flaxseed has antioxidant and phytoestrogenic properties and exercise also leads to the prevention and treatment of osteoporosis complications, this study aimed to investigate the effect of aerobic exercise and flaxseed extract on osteoporosis index parameters in ovariectomized rats.

The present study is an experimental intervention. For the study, 36 adult female Wistar rats with an average weight of 250 ±20 prepared from the Laboratory Animal Breeding Center of the Faculty of Veterinary Medicine, Islamic Azad University, Tabriz Branch, were used. Rats were randomly divided into 6 equal groups, including control, sham (only opening and closing the abdomen), ovariectomy (Ovx), ovariectomy + Flaxseed extract (Ovx + Flaxseed), ovariectomy + aerobic exercise (Ovx + Exercise), and ovariectomy + aerobic exercise + flaxseed extract groups (Ovx + Flaxseed + Exercise) were divided. The treatment protocol was started after ovariectomy surgery on the study groups and ten days postoperative recovery (17). The ovariectomy + Flaxseed extract and ovariectomy + aerobic exercise + flaxseed extract groups received 400 mg/kg of flaxseed extract daily by gavage. Rats in the control group and the ovariectomized group received the same volume of normal saline by gavage. In the exercise groups, aerobic exercise was performed on a treadmill for five days each week for eight weeks. The training process was incremental. Groups that did not practice were placed on the treadmill for the same amount of time as the exercise groups while the machine was off (18). After sacrificing and taking blood samples from rats, the serum was immediately separated by centrifugation (4°C) at 1500 rpm for 15 minutes. The serum was transferred to a freezer at 20 ° C and stored. Serum alkaline phosphatase (ALP) levels were measured using an automated analyzer. Serum calcium concentration was measured using the modified atomic absorption method of 180-80 Ziman using a spectrophotometric device. Serum osteocalcin was measured using a Radioimmunoassay kit, and parathormone (PTH) was measured using an ELISA kit. Data were analyzed by one-way ANOVA followed by Tukey test at the level of p<0.05 by GraphPad software.

Serum calcium and PTH concentrations in ovariectomy mice were significantly lower than controls (p<0.05). Also, serum concentrations of osteocalcin and ALP in mice in the ovariectomy group were significantly higher than in the control group (p<0.05). Serum concentrations of parathyroid hormone and osteocalcin decreased significantly, and alkaline phosphatase and calcium in the treated groups increased significantly compared to the ovariectomized group (p<0.05). The best results were obtained in the Ovx + Flaxseed + Exercise group.One of the sites of the effect of PTH is bone tissue, which increases the uptake of calcium and phosphorus from bone tissue (22). A study has shown that ovariectomized rats have a high aerobic capacity and are also more resistant to disease, and have a reduced response to adverse environmental conditions (22). Xiaoli et al. showed that ovariectomy significantly increased osteocalcin compared to the sham group (23). These results are consistent with the results of the present study. In another study, Qi and Zheng stated that ovariectomy in rats resulted in a significant increase in serum osteocalcin levels, which was consistent with the results of our study (24). The researchers also said that treating osteoporotic rats after ovariectomy with phytoestrogens such as genistein and silicon would improve osteocalcin factor, which is consistent with the present study (24). In the present study, decreased osteocalcin levels after ovariectomy improved after treatment with flaxseed extract due to its phytoestrogenic properties. A study by jian feng et al. showed that the serum concentration of ALP enzyme in the ovariectomy group increased significantly. ALP is produced by osteoblasts and is essential for bone mineralization, which is consistent with our study (21). In another study, Qi and Zheng stated that ovariectomy significantly increased serum ALP levels, which was in line with the results of our study. Also, treatment with phytoestrogens will improve the ALP factor, which is in line with the present study (24). In the present study, elevated ALP improved after ovariectomy after treatment with flaxseed extract. Lihui et al. found that exercise in ovariectomized rats increased bone density by reducing bone resorption and increased bone formation (26). Decreased serum concentrations of PTH and osteocalcin and increased serum concentrations of calcium and ALP in the treated groups compared to the ovariectomy group showed an improvement in the condition in the treated groups compared to the ovariectomy group.

According to the results of the present study, it can be concluded that the combination of aerobic exercise and flaxseed extract has improved the complications of ovariectomy and estrogen deficiency in the studied rats. However, more research is needed to generalize the results in humans and to find the effective composition in the extract.

Adopted children usually have a range of experiences of abuse, such as physical abuse and neglect by biological parents before adoption, which negatively affects their adjustment. Most adopted children have the experience of living in an institution that is associated with a variety of alternative problems. In this regard, tips for informing families and society about this phenomenon and creating appropriate conditions to help decision-making families who are willing to do so are important and effective issues in improving the situation of adopted children and families. It is child-friendly and another important issue is to help reduce the problems and challenges after adoption and adoption. Because each family has a unique emotional state and atmosphere and their management method and type of operations are different from each other. Therefore, family performance is one of the most important factors that play an effective role in successful adoption. Family performance is one of the important indicators and guarantees the quality of life and mental health of the family and its members, and their negative relationships are considered one of the most important factors in creating and maintaining mental and emotional disorders. Therefore, finding a way to improve family functioning can be fruitful, and in the meantime, parental empowerment is one of the factors that can lead to good family functioning. When parents have the necessary abilities to adopt and raise a child, they can help improve their family functioning and ultimately communicate effectively with the adopted child. Empowerment is essential to create the right connection and this lasting and needed trust and to prevent wasting time and manpower. Empowerment leads to changes in parents' attitudes, behaviors, and behaviors, and these changes are a good platform for improving the situation of families. Because the parents' view of the situation and conditions and behavior of their children is different and he finds more and better awareness of them, and he also changes their attitude and behavior towards this awareness, and in contrast, children who behave calmly and firmly in At the same time, they observe the parents decisively and seriously and take action to change themselves, because if they do not change their behavior, they will see that the consequence will only be felt by themselves. Therefore, if immediate action is not taken today to empower parents and children (especially adolescents), irreparable damage will be done to the family body, then the importance of this empowerment process will become clear. In this regard, the researcher seeks to answer the question of whether the empowerment program for parents of adopted families has an impact on family performance components.

The present study is an applied and quasi-experimental study that was conducted with a pretest-posttest design with a control group. For this purpose and to conduct this research, among all families with adopted children in Tehran Welfare in 1399, 30 parents with adopted children who were eligible to enter the study were selected as a sample by the available sampling method and randomly divided into two control groups. With an average age of 46.87 90 5.90 and experiments with a mean age of 44.60 6 6.23. Then, all subjects completed the Family Performance Questionnaire by Nathan B. Epstein et al. (1983). Then, the subjects in the experimental group received 8 sessions of parental empowerment training. Finally, the findings were analyzed using descriptive statistics (tables and graphs) and inferential statistics including Shapirovilk and multivariate covariance (MANCOVA) tests using SPSSV19 software.

Before the analysis of covariance, the assumptions of this test were examined and the results showed that all the assumptions of this test were observed. The results of the multivariate analysis of covariance showed a significant difference in family performance scores of the two groups (P = 0.018, F =3.53, Pilay effect = 0.626). The results indicate that there is a significant difference between the experimental and control groups in the family performance variable. In order to determine this difference, univariate analysis of covariance was used and the results showed that a significant difference was observed between the groups in all components of family functioning. Also, by observing the averages of family performance components, it can be acknowledged that the parental empowerment program of families with adopted children was effective in family performance.

The purpose of this study was to the effectiveness of parental empowerment programs for adopted families on family performance components. The results of this study showed that the parental empowerment program has made a significant difference between all groups on all components of family functioning. Therefore, the parental empowerment program of families with adopted children was effective on family performance, in other words, the experimental group received higher scores on family performance after receiving parental empowerment intervention. In justifying the results of this study, it can be said that family performance is one of the important indicators and guarantees the quality of life and mental health of the family and its members, and their negative relationships as one of the most important factors causing and maintaining mental disorders and People's emotions are raised. Family functioning is an important aspect of the family environment that affects the physical, social, and emotional health of children. What happens within the family and how it works can be a key factor in creating flexibility and reducing current and future risks associated with unfortunate events and unfavorable conditions. Enabling and nurturing environments enable children to learn and develop. Conversely, poor family environments can be very detrimental to many aspects of children's development and their positive transition to adulthood. Therefore, empowering parents to improve family performance is one of the methods used today. When parents take action to empower themselves, they are instilled with the fact that they are a helpful and effective factor in improving family functioning, more interested in participation, and more supportive. Therefore, by empowering parents with adopted children, it is possible to help these families improve their performance so that they can show better performance with their adopted children. Having said that, and considering parental empowerment and recognizing it as one of the most important and influential factors that individuals can experience and also as an effective and interfering factor in the quality of family functions, parents can Acquire knowledge in the field of empowerment and transmitting it to their children, while having a positive effect on their growth and personality, improve the performance of family and children.

In general, personality includes characteristics that enable a person to communicate and adapt to others and facilitate the realization of self-esteem, and if he has a disorder, he always has problems with cognitive, mood, communication and identity problems (1-3 Among the types of disorders, borderline personality disorder has a high prevalence. In people with this disorder, there is a special pattern of behavior that is characterized by frequent and impulsive responses to emotional stimuli. Emotional vulnerability also causes the patient with borderline personality disorder to be often emotionally aroused, and the result of this high arousal is instability in behavior and poor control over emotion and physiological arousal, and facial and body language manifestations and the relationship between Is individual. (10) For this reason, various methods have been used to treat this disorder since ancient times. One of the new methods is emotion regulation, which can be fruitful in order to improve people by examining different emotions (15). In this regard, various researches have been done and contradictory results have been obtained (25-29).Reality therapy is another new method of counseling and psychotherapy, which is based on internal selection and control, and considers the cause of psychological problems in peoplechr('39')s choices and the irresponsibility of the individual in meeting his needs; In this treatment, efforts are made to enable people to meet their basic needs through better choices (31).Given the above, therefore, unfortunately, there is no general consensus among experts on choosing the best treatment method. On the other hand, reviewing research conducted in and outside the country, no research was found that compared the effectiveness of group therapy of emotion regulation and reality therapy on borderline personality disorder.

For the present quasi-experimental and applied research, among women aged 18 to 40 years with borderline personality disorder who referred to Tohid Clinic in Isfahan, 27 people were purposefully selected and randomly divided into 3 control groups (9 people) emotion regulation (9 people). And reality therapy (9 patients) were divided. The Leishner Nig Borderline Personality Questionnaire (BPI) was then completed by the subjects to assess and evaluate the borderline personality, the Jackson and Claridge Borderline Personality Scale (STB), and the experimental groups completed their own program under the supervision of the researcher for 8 years. The session and each session lasted 2 hours according to Tables 1 and 2. Both groups completed the questionnaires again. Finally, descriptive statistics, repeated measures analysis of variance and Bonferroni post hoc test were used to analyze the data.

The results showed that the scores of all borderline personality disorder variables in both experimental and post-test groups were relatively the same and less than the control group. Identity confusion and frustration are also significant in both groups, but emotion regulation therapy is more effective. On the other hand, it was found that both experimental groups have an effect on fear of intimacy and impulsivity, but reality therapy is more effective. However, fear of intimacy differed significantly only in the reality-based treatment group. Finally, the dissociative symptoms of borderline personality disorder did not differ significantly from the control group in any of the treatments and at different stages.

The results showed that Gross model emotion regulation therapy and reality therapy are effective in reducing most of the symptoms of borderline personality disorder in women. Evidence growing over the past decades has identified emotion regulation and reality therapy as contributing to mental health. In all of these studies, emotion regulation and reality therapy have been performed to improve and reduce the symptoms of the disorder in this area. For example, Hopkins (2018) studied the effectiveness of metacognitive education for patients with borderline personality disorder and behavioral imitation and loneliness in borderline personality disorder, which showed the effectiveness of this method in reducing patientschr('39') symptoms. Johnson and Howard (2018) investigated the relationship between non-suicidal injuries and borderline personality traits in adults, and the results showed that this method was effective in reducing patientschr('39') symptoms. Which confirm the results of the present study.