مجله علوم پزشکی رازی
سال بیست و نهم شماره 10 (پیاپی 224، دی 1401)

 Eating disorders are one of the most common mental / psychological disorders that cause many problems in physical health and mental function and also impair the quality of life of the sufferer and cause death. Eating disorders can cause eating disorders and threaten a person's health by altering their diet and receiving poor nutrients. Overeating disorder is an eating and eating disorder that is now officially recognized as a diagnosis. It affects approximately 2% of the world's population and can cause other health problems related to diets, such as high cholesterol and diabetes. Nutrition and eating disorders are not just about food, which is why they are known as mental disorders. People often use them as a way to deal with a deeper problem or other psychological condition such as anxiety or depression. People with anorexia nervosa may eat a lot of food in a short time, even if they are not hungry. Stress or emotional distress is often involved and may cause overeating. Lack of emotional regulation justifies overeating in various behaviors such as restricting food, valuing weight, shape, and negative emotions. Also, lack of emotion regulation has a strong relationship with overeating, so consuming too much food reduces the intensity of emotions. If emotion regulation fails, self-regulation in other areas, such as controlling eating behavior, can also fail; therefore, it seems likely that the models explaining overeating behavior in overeating disorder and overeating in obesity are related to failure in self-regulation due to intense emotions. Eating behavior is a complex phenomenon that involves the breadth and frequency of periods of eating and choosing daily foods and determines the amount of energy received by the individual and is the result of environmental, physiological, and psychological factors. Therefore, therapy can be effective in reducing eating disorders that can help the person in controlling his behavior and emotions. A meta-analytical look at the therapies used to treat eating disorders in the last decade shows that most research has focused on cognitive-behavioral therapy. The cognitive-behavioral approach of eating disorders focuses on cognitive distortions and attempts to change emotions and behaviors, and focuses on behavior. The therapist helps the patient identify their cognitive distortions and replace them with more positive and realistic ways of thinking. There is a vacuum of research in this area. Given the above, the present study seeks to answer the question of whether the effectiveness of cognitive-behavioral therapy on psychological distress, obesity, and emotion disorder in people with bulimia will be different?

Due to the nature of the subject of the present study, the method of the present study is quasi-experimental and is a pre-test-post-test design with a control group. The statistical population was considered as high school students. Therefore, the statistical population of the present study is all-female high school students in Kerman in District 2 of Education. The sample size was selected as a multi-stage cluster from 4 girls' high schools. First, through bulimia (bulimia nervosa) Gormali, Black, Duston, Radin (1982) questionnaire, and clinical interview, 45 students with bulimia nervosa were identified and selected and randomly assigned to three groups of 15. Inclusion criteria were having the conditions to participate in intervention sessions (availability), determining students' satisfaction with cooperation, not taking medical and psychiatric drugs, not having acute medical or metabolic disorders through screening tests and exit criteria these included not being able to attend intervention sessions (unavailability), student dissatisfaction, taking medications and psychiatry, and having an acute medical or metabolic disorder. The research instrument was Gormali, Black, Duston, Radin's (1982) Overeating Behaviors Scale (DAS). The experimental groups underwent cognitive-behavioral intervention. Data analysis was performed using an independent t-test.

The results of this test indicate that there is a significant difference between the depression subscale and the psychological distress variable of people with bulimia nervosa in the two post-test groups. Also, the effectiveness of cognitive-behavioral therapy on the rate of anxiety and depression in the post-test was not significantly significant.

The cognitive-behavioral approach of eating disorders is based on cognitive distortions and attempts to change emotions and behaviors and focuses on behavior. The therapist helps the patient identify their cognitive distortions and replace them with more positive and realistic ways of thinking. Explaining the result, it is stated that the disorder of emotions and feelings in students is one of the major problems in adolescence, which is a critical and sensitive period, which has unpleasant consequences, including bulimia nervosa. Is created. Adolescent students with bulimia nervosa develop unregulated emotions, feelings, and emotions. Emotional Dysregulation plays a significant role in the development and persistence of eating disorders. People with overeating disorders use inefficient and troublesome methods to deal with their emotions. These techniques may temporarily reduce arousal, but over time, not only do they intensify emotional coping, but they themselves become a problem, suggesting that overeating behaviors are in fact maladaptive ways to control emotion. Explaining the result also states that anxiety and worry is a good opportunity for common behavioral disorders such as anxiety, depression, and stress. Therefore, in these situations, restoring a sense of control and increasing self-confidence and a sense of self-efficacy can be an important factors in treatment and recovery. Cognitive-behavioral therapy is one of the treatment approaches that help to solve the problems caused by dysfunction in emotions, cognitions, and behavior using a systematic and purposeful method. In other words, it can be said that in cognitive behavioral therapy, the strengths of behavioral therapy and cognitive therapy approaches, ie objectivism, evaluation, and measurement on the one hand and the involvement of memory in cognitive reconstruction and information interpretation, on the other hand, are gathered. And in the form of a single body in the form of a new approach. People with binge eating disorders are often more obese than people with anorexia nervosa. Therefore, the primary focus of treatment in this study was weight loss, and clients were told that the primary priority in treatment was to eliminate overeating behaviors and develop good habits. Eat, to achieve this goal. Second, issues such as obesity, nutrition, and regular exercise were considered. There is no difference in the cognition of people with bulimia nervosa.

 Multiple sclerosis is an inflammatory disease that brings many physical and psychological complications, the chronic nature of which, the lack of definite prognosis and treatment, and the involvement of a person at a young age cause many psychological problems in patients, including psychological distress. Becomes According to the results of research, people with multiple sclerosis suffer from psychological distress due to their disease. So that the severity and catastrophizing of pain along with psychological distress is always considered a significant problem in multiple sclerosis patients. Psychological distress has negative and irreparable effects on physical, mental, and behavioral health, which is very costly for a person and will bring adverse consequences; for this reason, it is necessary to know the factors affecting it. Mindfulness can be one of the important and influential factors in people's psychological distress. Mindfulness is a person's clear awareness of what is happening inside and in interaction with the external environment in successive moments of perception, which can help free people from automatic thoughts, habits, and unhealthy behavior patterns. Mindfulness is paying attention in a special and purposeful way, in the present tense and without judgment and prejudice. Based on the background, if it is possible to deal with unpleasant emotions and symptoms of psychological distress by developing mindfulness skills, it can be expected that weakness in these skills will increase the possibility of a person suffering from psychological distress. Also, the research background has shown that mindfulness can play a role in the relationship between mental health and psychological distress, which indicates that mindfulness can reduce the negative consequences of psychological distress in people. In addition to mindfulness, which plays an important role in psychological distress, Zuckerman's alternative five-factor model personality traits are also a determining and important factor in predicting psychological distress. Human personality can be defined as a dynamic organization within a person consisting of biological-psychological and social systems, which are responsible for regulating and adapting to the changing environment. Clinical findings show that mental pressure caused by daily life events gradually affects the activity of different body systems, including the immune system, and can weaken and disturb patients with multiple sclerosis, and among them, personality traits can have this effect. Adjust or strengthen. On the other hand, people with multiple sclerosis show different reactions to this disease according to their personality traits, which can affect their quality of life. The quality of life is expressed from an objective point of view, while others express it from a subjective point of view. The objective view considers the quality of life as obvious and related to living standards, which include physical health, personal conditions, social relationships, or other social and economic factors. On the other hand, the subjective point of view considers the quality of life synonymous with the happiness or satisfaction of the individual and emphasizes cognitive factors in the evaluation of the quality of life. The research that has investigated the relationship of these variables by considering the mediating role of the quality of life-related to health in the form of a research model has been less investigated. Therefore, in this research, the question is answered whether psychological distress is predicted based on mindfulness and personality traits with a mediating role of health-related quality of life in patients with multiple sclerosis.

The statistical population of this descriptive-correlation study included all patients with multiple sclerosis who were referred to the MS Association of Tehran and were studying in 2020-2021, and 400 people were selected by the available non-random sampling method (online method). And they responded to Kessler et al.'s Psychological Distress Questionnaire (2003), Baer et al.'s Five Factor Mindfulness Questionnaire (2006), Zuckerman-Coleman Zuckerman Personality Questionnaire (2002), and World Health Quality of Life Questionnaire Short Version (2004). Then the proposed model was analyzed through the structural equation model.

The results showed that the direct paths of mindfulness, anxiety/neuroticism, sociability, activity, and aggression/hostility were significant for psychological distress. But the direct path of sensation seeking/impulsivity on psychological distress was not significant.
Also, the indirect effects of mindfulness, anxiety / neuroticism, sensationalism / impulsivity, and aggression / hostility through the mediating role of health-related quality of life on psychological distress were significant. However, the indirect effects of socialization and activity through the mediating role of health-related quality of life on psychological distress were not significant. The structural model of the research had a favorable fit.

In general, it can be said that psychological categories are important in patients with multiple sclerosis, and the results of this study are an important step toward knowing the factors affecting psychological distress in patients with multiple sclerosis. One of the limitations of the research was the data collection, and implementation of part of the research questionnaires offline, that is, by creating a link, placing the questionnaires in it, and sharing in virtual social media, which allows the researcher to directly monitor the response of the sample. There were no In using the results, it should be noted that the findings of this research were limited to patients with multiple sclerosis who referred to the MS Association of Tehran, so caution should be used in generalizing the results to other cities due to ethnic and cultural differences. Observed in the generalization of the results. Due to the spread of the coronavirus, the questionnaires were implemented online and the other part was face-to-face, this possibility was only available for multiple sclerosis patients who had access to the questionnaire link or were present in the association at the time of the research. Therefore, many other patients who did not have access to the online link or were not present in the forum at the time of the research did not have a chance to answer the questions of the questionnaires, which was beyond the control of the researcher. It is suggested that in the next research, all questionnaires should be administered in person, observing social distancing, so that the researcher can be a guide for sample people to answer if necessary.

 Urinary tract infections (UTIs) are among the most common bacterial and frequently recurring infection during childhood, especially in the ages of three months that can involve upper UTI (pyelonephritis) and lower UTI (cystitis). There are three forms of urinary tract infections include pyelonephritis, cystitis and bacteriuria without symptoms.  Approximately 10-30% of children experience a urinary tract infection in the early years of life. The prevalence of UTI has estimated 36.8% in some third world countries. Enterobacteriacea, especially Escherichia coli has been detected as the most common cause of UTI. The crucial criteria to diagnose of UTI are including: fever, pyuria, the growth of organism more than 105  colonies in culture medium. Nowadays, antibiotic resistance is a global concerning among pediatric patient with UTI. The other important issues are including, urine reflection and scar in the lining of the kidney tissue, failure in growth and function of kidney, chronic of kidney and eventually kidney graft and dialysis. So fast diagnostic and treatment of these patients to prevent of development is so important. Although DMSA scanning is a gold standard to detect of renal parenchymal tissue involvement but due to high cost, no accessible in all of the clinical centers and exposure to dangerous chemical substances of radioactive, it is used less. Some clinical symptoms, such as fever, stomachache, backache, nausea, anorexia and inflammatory markers such as white blood cell (WBC), Erythrocyte sedimentation rate (ESR),C_ Reactive Protein (CRP ) can be handy methods to detect of the site of urinary infectious, but it is not reliable method. So there is not a practical, fast and reliable method to separate of pyelonephritis and cystitis. Pyelonephritis can lead to scar and the next stages high blood pressure and kidney failure. The prevalence of kidney scars due to pyelonephritis had reported 26.5% to 49%.  Mean platelet volume (MPV) is an important index in detection of inflammatory. The aim of this study was to investigate the value of MPV in differentiation of pyelonephritis from cystitis in children with UTI.

In this analytical cross- sectional and diagnostic study which was approved by the Ethics Committee of Babol University of Medical Sciences, Babol, Iran, with the ethics code IR. MUBABOL1724132572, a total of 141 children (1 month to 18 years) with urinary tract infections hospitalized in pediatric Hospital of Amirkola, Babol were enrolled from 2015 to 2020. Inclusion criteria including positive urine culture and exclusion criteria including negative urine culture, lack of diagnosis of pyelonephritis and cystitis, lack of cooperative of patients and the history of blood disorder associated with abnormal platelets (Bernard-Soulier syndrome, gene mutation myh9, ITP).
Considering the inclusion and exclusion criteria, diagnosis of pyelonephritis and the result of positive culture, patients enrolled to this study. And then, whole blood specimens from patients were collected to detect of MPV, CRP, and ESR. According to traditional guidelines, chocolate/ blood agar (non selective medium) used for routine urine cultures.
MPV was investigated and compared between patients with pyelonephritis and cystitis. Diagnostic value of MPV by statistical indicators specificity, sensitivity and AUC were calculated and finally statistical analysis of data was carried out using the SPSS (v 16.0) software package.The statistical tests, such as chi- square test, independent t- test, Mann withney, Spearman rank correlation, ROC and Kolmogorov-Smirnov were used in this study. P-Value less than 0.05 were assumed as statistical significance. MPV was evaluated in patients with pyelonephritis and cystitis by independent t- test. Correlation analytical was used to detect of relationship between MPV, ESR, CRP and leucocytes among two groups of pyelonephritis and cystitis. ROC (Receiver Operating Characteristics Curve) was used to evaluate and comparison of sensitivity, specificity and the area under the curve for the MPV in patients with pyelonephritis and cystitis.

Among 141 patients with UTI, 63.8% with pyelonephritis and 36.2% with cystitis enrolled in this study. MPV in patients with reflux was detected 8.67± 0.95 fl and in patients without reflux was detected 8.66± 0.99 fl. This finding was no statistically significant difference between MPV and reflux (P= 0.96). In this study, according to two groups of patients with pyelonephritis and cystitis the frequency of bacteria was investigated. The most common pathogen among both groups of patients was detected Escherichia coli. There was no statistically significant between type of pathogen among two groups ( P= 0.167).  The result of laboratory variables investigation in both groups of pyelonephritis and cystitis were detected 8.7 fl and 8.5 fl, respectively. There was no statistically significant difference between two groups (P= 0.329). Although there was no statistically significant difference in platelet count (P= 0.374), leucocyte (P= 0.115) and lymphocyte (P= 0.073), but we found statistically significant differences in erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) between two groups, (P= 0.001). MPV comparison results between two groups (pyelonephritis and cystitis) showed there was no statistically significant difference between two groups.  There was no statistically significant between MPV and ESR, CRP and leucocyte, (P> 0.05).

According to the result of our study, the role of MPV in differentiating pyelonephritis from acute cystitis was detected. The evidence of this study showed MPV has low diagnostic value in differentiating pyelonephritis from acute cystitis in children with UTI.  So, detection of Mean platelet volume is not an appropriate method and it needs to more studies to find Para clinical factor in diagnostic is worth wealthy.

 Type 1 diabetes is one of the most common endocrine disorders in children (5), which affects approximately 1 child under the age of 18 out of every 300 to 500 people (1). Time trend evaluation studies have shown that the prevalence of type 1 diabetes in childhood is increasing in all parts of the world, and the average relative increase is 3 to 4 percent per year. Also, the age of onset of type 1 diabetes in children has decreased. It is believed that non-genetic factors are important for the development of type 1 diabetes and its increase, but scientific evidence is insufficient and the causes of this increase and the current epidemic are still unknown (6). This disease is strongly related to microvascular and macrovascular complications, whose pathophysiological mechanisms are diverse and sometimes unclear (7, 8). Improving blood sugar control in diabetic patients leads to a reduction in the incidence of chronic complications of the disease and, of course, the cost of the resulting treatment (9). The main treatment in type 1 diabetes is the use of insulin, and an important part of nursing education in these patients includes education related to diabetes management regarding glycemic control in these children (9). Carrying out regular wind activities and an active lifestyle as a non-pharmacological intervention method is effective in promoting public health and also reducing the complications of some chronic diseases (10-12). One of the positive effects of regular exercise is improving carbohydrate metabolism in metabolic disorders, which can prevent complications related to hyperglycemia (13-15). Due to the high cost of treatment, non-pharmacological methods such as regular physical activity can play an important role in glycemic control and complications caused by diabetes in these people (5). In fact, type 1 diabetes is a challenging problem to manage various physiological and behavioral symptoms. Despite the importance of regular exercise in these people, it is very difficult to manage different methods of physical activity, especially for people with type 1 diabetes, and to provide health care in these people. People with type 1 diabetes, as a part of inactive people from the general population with an unhealthy physical index, are not very willing to participate in physical activity (16). One of the factors related to the low level of physical fitness and reluctance to participate in physical activities in these people is due to the fear of hypoglycemia (5). Although regular exercise can improve the health and well-being of children with type 1 diabetes; However, there are several barriers to exercise for a person with diabetes, including fear of hypoglycemia, loss of glycemic control, and inadequate knowledge about exercise therapy; Therefore, providing an exercise program in accordance with scientific sports recommendations as well as the needs related to motor development for these people can be beneficial (16). Considering the prevalence of type 1 diabetes and its irreversible complications, especially in younger children, as well as the importance of hyperglycemia control, it is important to reduce diabetic complications in these patients (8). Although exercise can be effective in improving the health of children with type 1 diabetes; But due to the difference in research results, more research is needed to prescribe a suitable exercise program for these people, which justifies the necessity of the present research; Therefore, the current research was designed with the aim of investigating the effect of selected combined exercises on glycemic control of girls with type 1 diabetes.

In quasi-experimental study 20 female patients with type 1 diabetes (age: 11.17 ± 2.60 years, height: 138.41 ± 12.10 cm, weighs: 32.24 ± 8.28 kg) using random sampling and they were divided into two training and control groups. Exercise training was done for eight weeks, three sessions per week and each session consisted of 60-90 minutes of combined training. Blood sampling was performed before and after the intervention period. Paired-samples t-tests were used to investigate within groups changes and independent t-tests were used to examine between groups.

After the training period, the results a significant decrease in 2-Hour Plasma Glucose was observed in both exercise (P = 0.044) and control (P = 0.022) groups. There was also a significant decrease in fructosamine levels in the training group (P = 0.002). In the study of intergroup changes, fructosamine changes in the exercise group were significant compared to the control group (P = 0.038), but no difference was observed between level of fasting blood sugar (P = 0.201) and 2-Hour Plasma Glucose (P = 0.143) between exercise and control groups.

Regarding the relationship between physical activity and glycemic control in type 1 diabetes, it can be said that exercise in the training session can improve the sensitivity of insulin-sensitive cells such as muscle fibers like other people (27, 28); Admon et al showed in a study that a session of aerobic exercise can reduce blood glucose levels in patients with type 1 diabetes (29). In a meta-analysis, Burns et al stated that the combination of aerobic and resistance exercises can improve insulin sensitivity in children (30) and both types of exercises should be considered in designing exercises to improve insulin sensitivity. Among the effective mechanisms for improving insulin sensitivity after exercise, there are molecular mechanisms effective in insulin signaling, as well as a small increase in glucose membrane transporter-4 (GLUT4) after regular exercise in muscle cells, as well as an increase in GLUT4 accumulation. pointed out in the sarcoplasmic membrane (31-33). In this regard, Knudsen et al. showed that exercise increases GLUT4 in insulin-responsive storage vesicles and T tubules, and the accumulation of insulin-sensitive GLUT4 in sarcolemma and endosome membrane increases (34). Of course, in the present study, the level of muscle GLUT4 of the subjects was not checked due to the invasiveness of the muscle biopsy test, which is one of the limitations of the present study. Given that exercise can increase insulin sensitivity; In these people, during sports training and after training, it is necessary to consume smaller amounts of injectable insulin (5, 35). Considering that regular exercise can increase insulin sensitivity and reduce blood sugar levels during exercise as well as hours after exercise, in total, the cumulative effects of regular exercise along with drug treatment for patients with type 1 diabetes, It can prevent hyperglycemic damages such as glycosylation of proteins and cells of other body organs and prevent microvascular and macrovascular complications of diabetes in the long term (8, 36). Ghalavand et al showed in their research that regular exercise training increased insulin sensitivity and decreased 2-hour blood sugar (5). Although, in the present study, it was not possible to check glucose at different hours after exercise, and the fructosamine index was used as the average euglycemia of the subjects. Despite the positive benefits of fructosamine, including shorter life span and greater sensitivity to HbA1c and not being affected by factors related to hemoglobin changes, for a more accurate interpretation of fructosamine, it is necessary to check the amount of serum proteins (25), which was not measured in the present study. And it was one of the limitations of the present research. The findings of the present research showed that eight weeks of selected combined exercises improve glycemic control in the form of a decrease in serum fructosamine in girls with type 1 diabetes, and that exercise can play a positive role in the management of diabetes in these people.

 Despite the fact that researchers have recently turned their attention to the new style of video games with movement (exergames) and considering that these games have been recently accepted as a kind of sports activity with a wide range of people as audience of these games both male and female in various ages, the influence of gender in response to various parameters, including hemodynamic factors, has not been addressed. Therefore, the above study was conducted with the aim of comparing the effect of gender on hemodynamic factors and normetanephrine after video boxing game with movement, with and without blood flow restriction.

Fourteen healthy young people (Female: 8, Male: 6; Age: 30±10 years; BMI: 21±3 kg.m2) were divided into two groups of men and women and participated in two training sessions of boxing with Microsoft Kinect Xbox 360. Normetanephrine and some hemodynamic factors such as HR, SBP, DBP, RPP and MAP were measured before and after. At the beginning of each session, the subjects performed 5 minutes of warm-up exercises with stretching. Blood samples were taken from serum before training to test for serum Normetanephrine. A Cardiac Holter monitoring system was used to measure Heart Rate. All measurement instructions were followed in the measurement process; before the start of the game, the Avecinna My Patch Holter device with four cables were installed on the subjects' chests by f-55 SKINTACT chest leads made in Austria and poly-gel ultrasound gel to measure the heart rate. The selected exergame was boxing from Kinect Sports with Microsoft's Kinect X BOX360.
Subjects were two groups of men and women and competed against each other for 20 minutes, the separated groups of women and men were fighting against each other. In the first week, seven subjects with BFR, which was imposed by an Iranian-made inflatable cuff with 15 to 20% systolic blood pressure restriction by a sphygmomanometer, played against seven competitors without BFR. After seven days, the training session was repeated, but this time the two groups were changed regarding BFR. At intervals of 5, 10, 15, and 20 games, the cuffs were opened and closed again. The Rate of Perceived Exertion (RPE) was also recorded by the Borg 10-point scale at the minutes of 0, 5, 10, 15, and 20 minutes. Accordingly, the subjects were supposed to indicate the rate of perceived exertion by numbers when implementing the protocol. Blood samples were taken again by specialists present at the laboratory immediately after the game. Shapiro-Wilk test was used to evaluate the normality of data distribution. Independent t-test was used to compare before and after data of the two groups and the Analysis of variance with repeated measures was used to evaluate the data of RPE and the significance level was considered as p≤0.05 for all statistical analyses. Data were analyzed using SPSS software version 22.

Statistical analysis of the present study showed that boxing exergame in both protocols with and without BFR led to a significant increase in hemodynamic variables except DBP in both men and women, but comparing the increase between the two groups of women and Men did not show significant outcomes. The results showed that although the comparison of increase in SBP, MAP, HR, RPP indices during both protocols in both groups of men and women was not significant; Men showed a greater increase in SBP, HR, RPP in the protocol with BFR compared to without BFR, while in the group of women it was quite the opposite. The group of women in the protocol without BFR showed a greater increase in these parameters compared to the protocol with BFR.
Regarding MAP parameter, men in both protocols showed more increase than women. The results of the DBP data, showed an insignificant increase in both groups in the two protocols and no significant difference was observed between men and women.
Regarding normetanephrine, like other parameters, the comparison of increase in normetanephrine in women and men during both protocols was not significant and, like the MAP parameter, in men, the increase in both protocols was greater than in women. The results of independent t-test related to hemodynamic and normathephrine indices are presented in the table below.
Regarding the comparison of reported RPE, both groups of men and women reported significantly higher values ​​in the session with BFR, but the comparison of the values ​​reported in women and men did not show a significant difference in both protocols (without and with BFR, respectively F4,48=0.039, p=0.997; F4,48=1.426, p=0.240). However, in the protocol without BFR, women reported higher values ​​of RPE in all the above minutes. Conversely, in the protocol with BFR, men reported higher values ​​of PRE at different minutes.

In general, it can be concluded that a exergame session in both with and without restriction of blood flow in the arteries of the hand, could not cause significant results in increasing hemodynamic factors, normetanephrine and RPE in both men and women. However, there were differences in the responses of some factors between the two groups. The reason for this insignificancy can be due to various factors such as the type of game chosen, the duration of training protocols or the competitiveness of the game that caused excitement in both groups and the degree of obstruction of blood flow and opening and closing the cuffs during the protocol with BFR.  the comparison of hemodynamic responses of men and women in the proposed protocol in the combination of exergame with different training methods such as BFR that was presented in this study has recently come to many researchers attention, that proves the potential of this new style of games with sports activities that appeals to a wide range of audiences. Therefore a closer look at the effects of this proposed protocol on the cardiovascular system and hemodynamic factors in long-term protocols and the comparison of gender responses in other age groups is required.

 Family formation begins with the union of a man and a woman, and one of the manifestations of a successful married life is the establishment of constructive interactions between husband and wife (1) Marriage plays an important role in the mental health of individuals, and if married life does not meet the needs of couples, not only will mental health not be realized, but it will also have negative consequences (2) Evidence shows that dissatisfaction in marital relationships and emotional breakdown between couples leads them to divorce or divorce (3). The goal of couples participating in family and couple therapies is to improve exchanges, increase trust, resolve conflicts and strengthen intimacy between themselves despite the persistence of problems (8). When the family is considered as a system, the processes of this system such as communication, exchange patterns and boundaries, hierarchy, adaptation and family functioning are better understood. Families and couples change their growth path in response to stressful situations, and Olson's complex circular pattern can well illustrate these changes. The complex cyclical pattern of family and marital systems expanded to fill the gap between research, theory, and practice in systems theory. This model focuses on communication systems and integrates three dimensions of the family. These three dimensions have been repeatedly discussed in family therapy perspectives and models. These three dimensions include cohesion, adaptability, and communication (9). Consistency addresses the issue of how systems strike a balance between separation and coexistence (5, 6). Adaptability refers to the degree to which family members or couples are able to change relationships, plans, and rules (5). Communication The third dimension is a complex circular pattern that is considered as a facilitator dimension. Using positive communication skills helps couples and families change their levels of attachment and adaptability so that they can meet their situational and developmental needs (11).
Different theories and perspectives have been proposed on marital and family conflicts and the intervention methods have been developed based on these approaches, one of which is the structural family therapy approach. The emphasis of family therapy is on the family as a whole, which consists of subsystems within the family (12). The effectiveness of this approach has been shown in research in solving couples' problems (14, 15). Another approach to couple therapy is Guttman couple therapy (16,17). The effectiveness of Guttman couple therapy has been shown in several studies, including in solving couples' problems (23-25).
Given the importance of Olson's Circumplex Model, it seems necessary to use approaches that can bring the couple's cohesion, adaptability, and level of communication to a desirable level, Therefore, the aim of this study was to investigate the compare the effectiveness of Structural Family Therapy and Gottman Couple Therapy on the cohesion, adaptability and communication of incompatible couples.

The population of this study includes of non-adjustment couples referring to Behbahan Education Counseling Clinic in the first half of 1398, sample of 45 couples from this community was selected by available method and randomly divided into two experimental groups and one control group. The quasi-experimental research design was pre-test, post-test and follow-up with a control group. First, pre-test was taken from all three groups and then the experimental groups were exposed to Structural Family Therapy and Gottman Couple Therapy for 8 sessions and 90 minutes each session (one session per week). At the end of the sessions, all three groups underwent post-test and 1.5 months later underwent follow-up test. Participants completed the family adaptability and cohesion Evaluation Scale (FACES-III) and the Communication level subscale of the ENRICH Scale. Data were analyzed using univariate and multivariate covariance analysis.

The results showed that Structural Family Therapy and Gottman Couple Therapy significantly improved the cohesion, adaptability and communication of non-adjustment couples, Also, comparing the effectiveness of the two approaches shows a significant difference in favor of Gottman couple therapy group in the variables of cohesion and adaptability, and structural family therapy in the variable of communication. The results also showed that the effectiveness of these two approaches continued until the follow-up stage. The results were discussed in detail on the effectiveness of these approaches.

The results showed that both approaches improved the cohesion, adaptability and level of communication in the experimental group. The findings of this study were consistent with the results of Previous research (23،24،30). From the point of view of structural family therapy, changing the organization or structure of the family leads to better communication between family members and the construction of family boundaries, one of which is the pattern of marital communication, leads to healthy family functioning (13). Explaining the effect of structural family therapy on couple cohesion, adaptability and communication, we can say; Structural theory, by creating harmony between family members, especially the sub-system of marriage, creates a suitable structure and increases the closeness and cohesion of couples (13). This approach contributes to the health of couples and makes them feel better together by influencing family boundaries and making the boundaries within the family healthier. Structural family therapy helps couples to have a sense of individuality and a sense of belonging to the group by teaching them sufficient flexibility within clear boundaries and with proper functioning. In proper demarcation, the couple forms a stable system that helps them to show greater flexibility in making decisions and changing relationships and patterns.
On the other hand, the findings of this study were consistent with the results of Previous research that have proven the effectiveness of Guttman's approach in solving couples' problems. (23،24،30). Explaining the significance of the effectiveness of Guttman couple therapy on cohesion, adaptability and couple’s communication, it can be said that according to Guttman, expressing interest, admiration and respect helps couples to get closer to each other and to Perform joint activities together on a daily basis. In a lasting marriage, the couple usually compromises and gently resolves their issues in favor of the parties (31). Also, teaching couples common sense leads them to establish a relationship with each other and to support their spouse's rules and suggestions. The effect of Guttman couple therapy on couple’s communication can also be said; Communication is a vital and important dimension in a couple's functioning, training in positive communication skills helps couples to meet their developmental needs. One of the things that hurts a couple's positive relationship is conflict. Conflict is inevitable in marital relationships. Guttman's theory teaches how to resolve conflicts and targets negative emotions during conflicts. Also, the results of comparing the two approaches showed that Guttman couple therapy has a greater effect on couples' cohesion and adaptability than structural family therapy. This difference in effectiveness can be related to the nature of Guttman couple therapy approach. On the other hand, the results showed that structural family therapy has a greater effect on couples' communication than Guttman couple therapy, which is also due to the structural emphasis on concepts such as family structure, interactions between members and family reconstruction (12). The statistical population, available sampling, and the design of the present study present limitations on the generalizations and interpretations that need to be considered. According to the results, it seems that structural family therapy and Guttman couple therapy can help to improve the psychological and marital characteristics of couples seeking divorce.

 Human resources are the most important asset of an organization, and job satisfaction of employees is a vital issue and one of the signs of success of the organization (1). Job satisfaction refers to the sum of positive desires or feelings that people have about their job. That is, the more job satisfaction a person has, the more they love their job, the more they satisfy their needs through it, and the more they will have positive feelings about it (2). Various factors, such as the ability to work full time, personal independence while working, social status, job security, cooperation with staff, appreciation for work, as well as demographic factors such as age, gender, and educational degree, can affect job satisfaction (5-7). Job satisfaction can motivate employees to work more effectively, so that satisfied people will be more creative and productive than dissatisfied ones (6). Lack of job satisfaction reduces the morale of employees, and this will have adverse effects on the performance of the organization. Dissatisfaction with work can have a direct impact on the incidence of work accidents and unsafe behaviors (8). Overall, there is a strong relationship between employees' job satisfaction and their performance. In terms of the relationship between job satisfaction and performance, studies have shown that the performance of human resources in Iran in the last 10 to 20 years has decreased by about 25 percent (9). In addition to the importance of job satisfaction and organizational environments, in university centers, due to the presence of clients and students, job satisfaction is of special importance and a lack of it disrupts the work of clients as well as educational processes. University employees are involved in the education and training of trained forces in the community, and their job satisfaction affects their jobs and professions and will increase the productivity of the university system on a large scale (13). Therefore, considering the importance of job satisfaction for university staff in improving service provision, the present study was conducted at Iran University to determine the level of job satisfaction and the factors affecting it.

The current study used a cross-sectional (descriptive-analytical) design. The statistical population included all employees of different administrative departments of the Iran University of Medical Sciences in 2016.  Cochran's sample size estimate formula, a known number of statistical population (about 2000 people), and the score of work satisfaction and dissatisfaction in Miao et al, 2017 were used to establish the sample size (14). The formula yielded a sample size of 460 respondents. To eliminate errors, the total number of samples was decided to be 500 people from among employees with diverse characteristics in July, August, and September 2016, taking into consideration 8% of the additional samples picked using simple random sampling. Inclusion criteria included at least one year of job experience and a willingness to engage in the study, whereas exclusion criteria included a refusal to participate and less than one year of work experience. Data was obtained using the Demographic Information Form and the standard 20-item Minnesota Job Satisfaction Scale established by Weiss et al. (1967). (15). This questionnaire assesses internal contentment (feelings about the intrinsic nature of the job) and outward satisfaction (feelings about the side characteristics of the job). The products are rated on a 5-point Likert scale, ranging from one (totally unhappy) to five (very satisfied) (completely satisfied). The questionnaire yields a minimum score of 20 and a maximum score of 100. The total of the scores achieved in the two areas shows the individual's overall pleasure; a score of 20 to 47 indicates poor contentment, a score of 48 to 76 suggests moderate satisfaction, and a score of 77 to 100 indicates great happiness. The validity and reliability of the questionnaire were accepted in the research by Pouladi and Reishahri, 2006 (16); Martins & Proença, 2012. (17). The implementation process was such that after approving the plan and receiving the code of ethics, the necessary permits for data collection were obtained, and during the process, sufficient information about the research objectives and confidentiality of personal information was provided to participants, and they were given written consent to complete it in a self-reported manner. Finally, 500 questionnaires were sent back, and descriptive and analytical methods were utilized to examine them using SPSS software version 20.

Most respondents (51.8%) were between 31 and 40 years old. Women included 71.8% and men 28.2% of the study subjects. Most respondents were married (76%) and had a diploma (50.6%). 299 subjects (59.8%) were employed on a contract, and the work experience of 11 to 20 years, with 40.4%, had the highest frequency. Internal job satisfaction, with a mean and standard deviation of 6.02 ± 29.26 and internal-external job satisfaction, with a mean and standard deviation of 30.27 ± 6.64 were the average levels. Total satisfaction, with a mean and standard deviation of 59.54 ± 11.46 was an average level of satisfaction. There was a statistically significant negative relationship between age and job satisfaction (r = 0.578; p =-0.003), i.e., with increasing age, job satisfaction decreased. There was a significant relationship between the mean gender score and job satisfaction (p = 0.02), where the average satisfaction of women was higher than that of men. There was a statistically significant relationship between the two variables of education level and job satisfaction (p = 0.433; r = 0.001), i.e. with increasing education, job satisfaction increased. Job satisfaction of individuals was significantly different with respect to their employment status (p = 0.001) and the average satisfaction of subjects with formal employment status was higher than other groups. But there was no statistically significant relationship between marital status and work experience with regard to job satisfaction score (p> 0.05). 

Considering that employee work satisfaction was modest in the current study, promotional initiatives should be tailored to age, gender, degree of education, and employment position. It is important for universities of medical sciences and health services to keep people healthy, so the management system should be able to meet the needs of employees in terms of their health and comfort. This will not only improve job satisfaction but also improve service quality and organizational work efficiency.

 Dysphagia is defined as swallowing dysfunction which leads to difficulty of passing food or water from mouth to hypopharynx or esophagus. Neurogenic dysphagia can be seen in lesions in one or both cerebral hemisphere or involvement of motor nucleus of swallowing muscles in brain stem or their motor axons (3,4). As mentioned in literature, swallowing dysfunction is one of the most common complications in acute stroke occurring in 13-94% of cases which can directly affect patients’ short term and long-term prognosis (2). It might complicate the course of acute stroke by developing malnutrition, dehydration, dependency on others, and silent aspiration pneumonia which all can lead to prolongation of hospital stay (5,6,7).On the other hand, dysphagia is considered as an independent predictor of mortality in acute stroke patients (2,8). Additionally, as discussed in many studies, location of brain infarction can predict the occurrence of dysphagia in stroke patients. For instance, infarctions in peri-insular cortex, right opercular cortex, left basal ganglia or thalamus are the most common sites leading to dysphagia following acute stroke. There are other factors associated with the occurrence of dysphagia in acute stroke including size of the infarction, right or left side of the lesion, age and gender of the patient and pre-existing comorbidities such as hypertension or diabetes (20, 22). Furthermore, it is suggested to initiate oral feeding as soon as possible in stroke patients. Therefore, it seems that early identification of dysphagia in acute stroke patient would lead to appropriate swallowing treatments and decrease the risk of pneumonia and related complications following acute stroke (9,10). So, in this study we aimed to estimate the prevalence of dysphagia after acute ischemic stroke in patients referring to Rasool-Akram hospital, Tehran, Iran and revealing whether there is a correlation between incidence of dysphagia and stroke characteristics including vascular territory and right or left side of the stroke, demographic variables or pre-existing underlying diseases.

In this historical cohort study, 177 patients with acute ischemic stroke who were admitted to Rasool-Akram hospital were evaluated. The study was performed for a-six-month period. Patients with incomplete medical records or who were suffering from dysphagia prior to their admission were excluded. Ultimately, 137 patients were included in our study and their medical records were carefully studied and data such as presence or absence of dysphagia following stroke within 48 hours of admission, demographic data including age and sex, history of previous stroke, smoking, diabetes, hypertension, side of the brain infarction (right or left) and vascular territory of acute stroke were all evaluated. Data were analyzed using SPSS version 22 and analytical significance was considered as p-value<0.05.

From 137 patients, 60.6% were male and 39.4% female with median age of 65.41± 13.51 years old, (the oldest patients was 95 years old and the youngest, 31 years old). Diabetes and hypertension were in 35.8% and 66.4% of patients, respectively. 34 patients (24.8%) were smoker and 40 patients (29.2%) had history of previous stroke. Dysphagia was seen in 43 patients so, the prevalence of dysphagia following acute ischemic stroke was estimated 31.4%. The localization of the infarction was divided into ten groups including complete middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), striatocapsular infarction, peri-insular infarction, and centromsemiovale infarction, infarction in territory of internal carotid ICA, cerebellum, brain stem and diffuse small vessel diseases. Statistically significant, dysphagia was more common in middle cerebral artery infarctions (p-value= 0.017, OR= 2.75 CI (2.05-3.55)).  Regarding the side of the infarction, 43.8% of patients had cerebral infarction on the left side, 36.5% on the right, 2.2% bilaterally and 17.5% of patients had diffuse small vessel diseases. Interestingly, there was a significant correlation between the left side infarctions and dysphagia (p-value= 0.034). Also, there was a significant correlation between age and occurrence of dysphagia, so that the older age was associated with the higher risk of dysphagia. No significant correlation was revealed between dysphagia and other variables including patient’s gender, diabetes, hypertension, smoking and previous stroke in this study.

In this study, 31.4% of patients had dysphagia after acute ischemic stroke which was nearly similar to other studies (12,13,14). However, in a meta-analysis study published in 2021, the prevalence of dysphagia following intracerebral hemorrhage (ICH) has been estimated up to 63.6% (23) and up to 55% in stroke patients (24). Association between dysphagia and different vascular territory infarction or lesions pattern had been evaluated in many studies with inconclusive results and approximately all vascular territories had been associated with dysphagia in various studies including anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), and vertebrobasilar arteries (16,21,22). However, in some studies no statistical significance was explored and it was revealed that probably this is the size of stroke that has an association with dysphagia rather than vascular territory of infarction (14). In this study, there was a statistically significant correlation between dysphagia and MCA territory infarctions. The side of the brain lesion is another item that has been discussed in studies and it is proposed that dysphagia is more common in left side strokes, the same result revealed in our study. Though there was no association between patients’ gender, smoking or underlying diseases such as hypertension, diabetes, and dysphagia in this study, in one study, diabetes, female gender and older age was associated with higher risk of dysphagia (20). Nevertheless, more studies are required to evaluate association of these factors and risk of dysphagia more precisely. Currently, 2018 best stroke practice guidelines for the early management of patients with acute ischemic stroke from the American Heart Association/American Stroke Association, support early detection for screening dysphagia and recommend adherence to dysphagia screening in acute stroke centers by healthcare professionals, however practice remains diverse. A recent systematic review assessed the benefits of early detection for dysphagia with bed sides screening by a non-swallowing expert in adult stroke. This survey revealed that evidence from both experimental and observational studies showed a considerable protective benefit of dysphagia screening following adult acute stroke which decreases post stroke complications including pneumonia, dependency on others foe feeding, and length of hospital stay, and mortality compared with similar patients with no or relatively less precise early detection (24). Since it is highly recommended to start oral feeding as soon as possible in stroke patients, it is worth to screen every stroke patient for dysphagia several times during first days of stroke to evaluate patient’s swallowing function and initiate appropriate feeding method accordingly.
It seems that despite excellent strategies that have been developed during recent decades in acute stroke management or secondary prevention, dysphagia has been overlooked in practice and it appears that there are still some uncertainties regarding dysphagia screening benefit in patients with stroke and adequate comprehensive data is still lacking, especially in Iran. However, as explored in this study, dysphagia was a common consequence of stroke so that about one third of Iranian patients with acute ischemic stroke suffer from dysphagia which can result in unwanted complications or even death. This survey and similar ones, highlight the importance of early evaluation of dysphagia in acute stroke which can be easily performed by primary health care professionals in stroke institutions.

 Lack of physical activity is a worrying condition because it leads to major health problems such as obesity, high blood pressure and various metabolic disorders. Exercise is a lifestyle change suggested to reduce atherogenic markers in adults. Increased physical activity and fitness are clearly associated with a reduced risk of cardiovascular disease, but the optimal type, intensity, and amount of exercise to reduce the risk factors for various cardiovascular diseases are unknown. Due to seemingly contradictory information, confusion has arisen about what exercise recommendations should be made in order to confer the greatest health benefits. Dyslipidemia is one of the most important complications of obesity with a high incidence of cardiovascular events. Previous prospective epidemiological studies have demonstrated a close association between lipid profiles and morbidity and mortality of cardiovascular disease. Epidemiological evidence suggests that physically active people are 30 to 50 percent less likely to develop type 2 diabetes or cardiovascular disease than sedentary individuals. Exercise has shown improvements in lipid profile and fat loss, whether with or without dietary restrictions or with or without weight loss. However, it is not known which exercise is the best and most effective way to improve lipid profile. High blood pressure is another complication of a sedentary lifestyle that is one of the most common medical disorders with an increased incidence of all causes of death and mortality due to cardiovascular disease. Exercise remains a fundamental treatment for the primary prevention, control and treatment of hypertension. The optimal frequency, intensity, time and type of exercise need to be defined to optimize the antihypertensive capacity of exercise, especially in children, women and the elderly, and certain ethnic groups. Increased physical activity is generally associated with a reduction in the risk of cardiovascular disease, probably due to improvements in its risk factors, such as improvement in lipid profiles and lowering blood pressure. Despite the many studies that have been done in examining the effects of exercise on the risk factors for cardiovascular disease, how much and what type of exercise is needed to get the best response and the most effective exercise is still unknown. The aim of this study was to compare the effects of 8 weeks of aerobic and resistance training on lipid profile and blood pressure in obese sedentary women with hypertension

In this study, 44 obese sedentary women with hypertension participated. These patients were randomly assigned to one of four groups, A (those receiving moderate intensity of aerobic training and 3 days per week, n =11), B (those receiving moderate intensity of aerobic exercises and 5 days per week, n = 11), C (those receiving moderate intensity of resistance training, 3 days per week, n =11), and D (those receiving moderate intensity of resistance training and and 5 days per week, n = 11). The values of lipid profiles, systolic and diastolic blood pressure and mean arterial blood pressure were recorded in each group before and after the intervention, and the final data were compared in each group with baseline status and compared to the other groups at the end of the study.

In the present study, there was a significant improvement in body weight and BMI in all four groups. After intervention in all groups, except for group A, HDL significantly increased and LDL decreased. HDL in group A was significantly lower than group C and D. Total cholesterol in group B was significantly higher than group C and D. For triglyceride levels, only a significant decrease was observed in the mean values of triglyceride group D compared to group B. Also, the mean systolic blood pressure significantly decreased in all groups except for group D and diastolic blood pressure in all 4 groups. At the end of the study, systolic blood pressure was significantly lower in group B than in groups A, C and D. while, diastolic blood pressure in group A was lower than group C and D and group B than group C and D respectively.

All exercise protocols used in this study have shown a significant improvement in lipid profile and blood pressure systolic, diastolic and mean arterial blood pressure in sedentary overweight people with high blood pressure. But a remarkable point in this study was the observation of two different effects of aerobic and resistance training on two important risk factors for cardiovascular diseases, namely, dyslipidemia and high blood pressure. Although both exercises were effective in improving lipid profiles and blood pressure, high volume resistance exercises seemed to have the most effective in improving lipid profiles, while aerobic exercise showed the highest efficacy in improving high blood pressure. All exercise protocols used in this study showed a significant improvement in lipid profile and systolic, diastolic and mean arterial blood pressure in sedentary obese people with hypertension, but a significant point in this study Observing two different effects of aerobic and resistance training on two important risk factors for cardiovascular disease, namely dyslipidemia and hypertension. Although both groups of exercises were effective in improving lipid profile and blood pressure, high-volume resistance training seemed to be most effective in improving lipid profile, while high-volume aerobic exercise was most effective in improving high blood pressure. One of the limitations of this study was the small sample size. Therefore, conducting more comprehensive studies in a larger statistical population seems to lead to more accurate results. Another limitation of this study was the lack of attention to diet as well as the type of blood pressure medication used by patients, which may affect the results. On the other hand, considering that in some lipid and blood pressure parameters there were differences between the participating groups at the beginning of the study that did not allow us to draw a definite conclusion, it seems that the groups are matched in terms of these parameters to provide A definite conclusion is very important.

 Improving the level of health in society requires advancement in the level of education in universities of medical sciences. This improvement will only be achieved by removing the obstacles. One of the obstacles with which most of the students are encountered, and which has an unpleasant impact on learning and educational success, is called academic procrastination. Academic procrastination is considered as a common phenomenon due to the fact that it involves 70% of students. Academic procrastination means a delay in doing the assignments and completing the projects and preparing for exams. There are two types of procrastination in doing the assignments among students. The first type is purposeful procrastination. For instance, when students have to finish different assignments at the same time, they, therefore, prioritize the assignments. The second type is unreasonable procrastination, and we consider this type of  procrastination as academic procrastination. Procrastination has negative, irreparable impacts on medical students, for example, decrease in knowledge, and not learning the skills to take care of patients. At last, after entering the workplace, these people suffer from occupational anxiety and depression, medication errors, occupational burnout, lack of essential motivation to take care of patients and decrease in quality of providing services more than their other colleagues. According to the studies that were conducted, students of medical sciences are prone to mental disorders due to having certain study conditions, such as entering a large and stressful workplace, heavy study load, intense competition, educational period, uncertainty about future career. The students of today, will be the medical staff of future in health and medical field. Thus, in order to have a knowledgeable medical staff, we should take into account the consideration of students’ health at present. Despite the fact that there has been a large number of studies on the topic of influential factors on procrastination, there has not yet been shaped a clear insight on this topic. Given that academic procrastination is a common phenomenon among students, and has unpleasant effects, the researcher, thus, decided to conduct a reviewing study of the literature about procrastination incidence and the associated mental-social factors among students of medical sciences, so that a step is taken to be able to identify the dimensions of this issue and to develop approaches to decrease procrastination through the results obtained from this study.

This article is a review study which was conducted in 2020. It was done through a search in databases of SID, Iran Medex, Google Scholar, Magiran, Medline, Science Direct, Scopus, ProQuest, by using the key words “procrastination”, “student”, “medical sciences”, in Farsi and also with their English equivalents. Inclusion criteria included descriptive and analytic studies, or narrative or systematic review studies, which at least contained an abstract in Farsi or English, with a time limit from 2010 to 2020. And exclusion criteria also included studies whose full text was not available in Farsi or English, and they were omitted from the study. 3110 articles in total were extracted in the initial searching. After omitting the repeated articles, 57 articles were obtained, and they were screened in two stages. In the first stage of screening, the titles and a general summary of the articles which were obtained, were investigated. Those articles which had the inclusion criteria and could answer the research questions of the present study, were selected. 30 studies were excluded in this stage. In the second stage of screening, the full text of the articles which were included after the previous stage, were investigated and those articles which were not related to the purpose of the present study (n = 7) were excluded from the list of the study. In the end, 20 articles were used to write this review article.

This review study demonstrated that the prevalence of academic procrastination among students of medical sciences in Master’s degree and in Dentistry, and students who reside in dormitory, is higher. And each of the variables which were mentioned were categorized in two categories of mental factors and social factors. Out of the 20 articles that were studied in this research, 16 articles were in Farsi and 4 articles were in English. In addition, most of the studies were conduced in the years 2018 – 2019. Out of all the articles which were investigated, categorization of the studies was carried out based on the content; it was in such a way that eventually the results of the study were categorized in two categories of: A) the level of procrastination in students, and B) psycho-social factors. psycho-social factors included the following sets: 1) psychological factors were divided to three sub-categories of mental illnesses (such as anxiety and mood disorders), mental abilities (such as self-efficacy, self-esteem, mindfulness, emotional intelligence, and optimism), and personal characteristics (self-discipline, self-regulation, inefficient schema, attributional style and perfectionism), 2) social factors were divided into two subcategories of social media and educational associated factors. The diversity of these studies is an indication of the wide coverage of this study in the researches which were conducted before. In order to observe the ethical considerations in the research, the studies which were used are mentioned and correctly written in the reference section.

Review of different studies from all around the world indicates the high prevalence of academic procrastination among students of medical sciences. With regard to the above-mentioned impact and consequences of academic procrastination on students of medical sciences, and as a result, the incidence of these consequences in working environment of health and medical staff (the quality of caretaking and finally safety of the patient) which will have irreparable effects; it is, therefore, suggested to the managers of medical sciences that they plan strategy-training programs, such as holding workshops on improving motivation and academic achievement and positive psychology in order to reduce academic procrastination, specially in students who reside in dormitories, so that students can enjoy a better academic achievement. In addition to that, it is better to design and conduct an intervention study for determining the effectiveness of the techniques which were recommended.

 Patients who are diagnosed with diabetes are very susceptible to cardiovascular complications and cardiovascular diseases are considered the most important causes of death in these patients. The prevalence of cardiovascular disease in patients with type 2 diabetes is about 2-4 times that of non-diabetic people. Diabetic patients face endothelial damage and functional disorders. These disorders include functional changes of the endothelium, such as disorders in the regulation of vascular expansion and contraction and increased inflammatory activity, which is related to cardiovascular disease. Insulin is known as a direct and effective agent in the vascular endothelium, which affects the modulation of vascular tone. It exerts its effects on vascular tone through two pathways of nitric oxide release and endothelin-1. Endothelin-1 is a strong vasoconstrictor that is secreted by vascular endothelial cells. This substance is known as the strongest vasoconstrictor and its contraction effect is ten times more than angiotensin-2, vasopressin, and neuropeptide Y. Angiotensin II is the end product of the reaction catalyzed by the angiotensin-converting enzyme, a vascular activating peptide that causes the proliferation of smooth muscle cells of the vessel walls, Myocytes hypertrophy and the release of platelet-derived growth factor. All of these play a role in the occurrence of vascular disorders. To eliminate the undesirable redox state caused by estrogen deficiency, specific measures have been investigated, the most effective of which is hormone therapy; But at the same time, it increases the risk of coronary heart disease, pulmonary embolism, and breast, uterine, and ovarian cancer in consumers. Changing lifestyles and exercising can be effective in preventing menopause syndrome (8). Also, numerous types of research are conducted today to evaluate the effectiveness of compounds with antioxidant properties against cell damage caused by oxidant agents. Some research has shown that royal jelly reduces the complications of diabetes. Royal jelly can be considered a therapeutic method to prevent insulin resistance, which is associated with high blood pressure in patients with diabetes. Propolis is also a resinous substance that is collected by bees from different types of tree buds and is used to cover the parts of the hive and to seal the cracks and crevices of the pack. According to the issues raised and also considering that in the reviewed studies, no study was found that examined the effect of endurance training and royal jelly on menopause and its complications, so the present study seeks to find the answer to this question. The question is whether eight weeks of endurance training with royal jelly has a significant effect on the markers of angiotensin-2 and endothelin-1 in the heart tissue of Ovariectomized rats suffering from diabetes or not.

In this experimental study, 40 Ovariectomized rats with diabetes (40 mg/kg Streptozotocin) were randomly divided into (1) OVXD, (2) Sham, and (2) groups. 3) RJ, (4) Pr, (5) ET, (6) ET+RJ, (7) ET+Pr, and (8) ET+RJ+Pr were divided. To investigate the effect of Ovariectomy and diabetes, 6 rats were considered as a healthy control group. Endurance training groups ran for eight weeks, three sessions a week and each session was 60 minutes with an intensity of 55-75% VO2 max on the treadmill, especially for rats. The royal jelly and Propolis consumption groups received 100 mg/kg daily supplements as a peritoneal injections. To analyze the data, a one-way analysis of variance with Tukey's post hoc test was used.

The results showed that RJ and Pr decreased angiotensin-2 significantly less than the OVXD group (P≥0.05). In the ET+RJ group, the values of angiotensin-2 and endothelin-1 were significantly lower than in the OVXD group (P≥0.05). Also, in the ET+Pr group, the values of angiotensin-2 and endothelin-1 were significantly lower than in the OVXD group (P≥0.05). In the ET+RJ+Pr group, the values of angiotensin-2 and endothelin-1 were significantly lower than in the OVXD group (P≥0.05). The effect of exercise + royal jelly and also exercise + Propolis on the increase of angiotensin-2 and endothelin-1 was more favorable than the effect of ET, RJ, and Pr (P≥0.05).

It seems that endurance exercise and royal jelly supplement alone have improving effects on the condition of heart tissue in diabetic conditions; but these two interventions, combined, complement each other's effect to improve the risk factors of cardiovascular diseases in menopause and diabetes. The results of the present study showed that RJ values of MDA and angiotensin-2 were significantly lower than the OVXD group. Therefore, it seems that the use of antioxidant supplements such as royal jelly and Propolis can be effective in improving cardiovascular function through antioxidant pathways and reducing oxidative stress. Due to the increase of some antioxidants and the reduction of oxidative stress following sports training; it is suggested to use sports exercises similar to the present study to prevent the risk of a heart attack in menopause and diabetes. According to the interactive effects of endurance training with royal jelly on antioxidants, reducing oxidative stress is suggested in future studies to modulate oxidant-antioxidant and also reduce cardiovascular risk factors from the combination of these antioxidants along with sports activities.

 Optimal performance of sports skills is due to the complex interaction of physiological, anthropometric, psychological and biomotor factors. The most important factors for success in various sports include bodybuilding, tactical, technical skills, mental abilities and athletes' experience (2). The performance of elite athletes who are active in various sports can be generally attributed to two factors: one is related to the level of training of these athletes and the adaptations made by them, and the other is related to genetic factors and the potential talents are the individual. Among these, their individual (genetic) characteristics can be partially identified by examining anthropometric characteristics and functional adaptations resulting from exercise using functional tests. Sports coaches, on the other hand, are always looking for ways to bring athletes to the highest levels of athletic performance(3). Sports experts and coaches have acknowledged that optimal performance depends on a number of factors, including physical, psychological, and skill factors. Anthropometric characteristics and physical condition, although they may be only part of the factors influencing sports activities, but it is important for coaches to identify these characteristics and be able to understand its value in their athletes (4). However, due to little research in the field of improving selected biomechanical variables in adolescent athletics and also the lack of research on the effect of physical characteristics on the effectiveness of training and the lack of research on combined training on performance and performance factors of adolescent athletes, conduct research The present is necessary and it is hoped that this research can take an effective and small step to reduce the research gaps in the field of athletics as an Olympic-oriented sport. Therefore, the present study seeks to answer the main question whether eight weeks of combined training (plyometric and resistance) have a significant effect on selected biomechanical variables (flexibility, balance, power and speed) of ectomorphic and mesomorphic runners?

The method of the present study was quasi-experimental and was done with pre-test, post-test and control group. The statistical population of the study consisted of adolescent athletes aged 12 to 17 years. The sample consisted of 15 ectomorphic adolescents, 15 mesomorphic adolescents and 15 adolescents as a control group who participated in the adolescent training of active teams in Tehran province leagues and were purposefully invited to participate as a statistical sample. In this study, the training program consisted of 8 weeks of specific training for each of the experimental groups that performed combined exercises for 8 weeks. The Sargent test was used to evaluate the power, the 30 m sprint test was used to evaluate the speed, the Star Test Equilibrium test (SEBT) was used to evaluate the dynamic balance, and the Flex board test was used to evaluate the flexibility. In this study, the training program included 8 weeks of specific training for each group as follows. The control group performed normal exercises with evidence, and the experimental groups performed selected plyometric or resistance exercises for 30 minutes, including 10 minutes of warm-up, and 20 minutes of special exercises. Also, the selected resistance training program was in three periods with 12 repetitions in each period, during which the subjects performed the mentioned exercises with 60% of maximum strength. To increase the speed or speed of movement, a training load with a weight of about 60-30 should be Percentage of the athlete's maximum strength. One minute between periods and two minutes between stations, active rest (flexibility and stretching movements) was considered and included the following movements: foot press, knee extension, knee flexion, lifting on the toe with weights, squats and lifting the pair was performed with weights (15). The subjects then performed plyometric exercises for 30 minutes. The selected plyometric exercise program was designed based on the principle of overload and each movement was performed in three fixed repetitive winds in each period in all weeks, between each stage. A minute of rest was considered. The exercises offered included speed jump with one and two legs, jumping from a squat position, bending the knee with a jump, jumping with the open leg forward, scissor jumping, and so on To analyze the data along with descriptive statistics (mean and standard deviation, etc.), regression test, and analysis of covariance and Bonferroni post hoc test in SPSS software version 24 were used.

Covariance test showed that the value of F related to covariance in all four research variables was not statistically significant (P≤0.05), on the other hand, the value of F related to the group in all four variables of research was statistically significant (P≥0.05).That is, after removing the pre-test effect, there is a significant difference between the mean scores of the two groups in the post-test of selected biomechanical variables in the ectomorphic group, so eight weeks of combined training on selected biomechanical variables (flexibility, balance, power and speed) Ectomorphic work is impressive. The covariance test in Table 3 showed that the value of F related to covariance in all four research variables was not statistically significant (P≤0.05), on the other hand, the value of F related to the group in all four variables of research was statistically significant (P≥0.05). is significant. That is, after removing the pre-test effect, there is a significant difference between the mean scores of the two groups in the post-test of selected biomechanical variables in the ectomorphic group; Therefore, the null hypothesis that the mean difference between the two groups in the post-test is not significant is rejected after eliminating the possible effect of the pre-test. Therefore, eight weeks of combined training affects the selected biomechanical variables (flexibility, balance, power and speed) of Mesomorphic runners. By comparing the effect sizes (ETA coefficient) in both ectomorphic and mesomorphic hands, it is found that the ectomorphic measurements have better performance in all four biomechanical variables. The results of the present study showed that eight weeks of combined training (plyometric and resistance) had a significant effect on selected biomechanical variables (flexibility, balance, power and speed) of ectomorphic and mesomorphic athletics boys. These exercises also have a greater effect on selected biomechanical variables of ectomorphic boys than in mesomorphic athletes.

In this regard, it can be said that combined training improves muscle weakness and deficiency in ectomorphs in two ways, which first causes muscle hypertrophy through resistance training and as a result, plyometric training increases muscle well-being. However, mesomorphs have reached their optimal physical level due to adequate muscle volume and may require higher training volume and pressure to increase capabilities, so it can be concluded that the combination exercises used in the present study are suitable for ectomorphic individuals, but individuals Mesomorphs need more pressure and a higher volume of training to improve their physical performance, and this issue can be considered in the design of training and future research on this issue. Use combined exercises in athlete training programs.

 Today, repeated high intensity endurance training is an integral part of the preparation of most team and individual sports, which, if not accompanied by proper recovery during or after physical activity, does not create the necessary adaptations and may Is to harm the athlete's performance under the conditions of competition or training (1, 2). Due to intense repetitive training, if the return to the original state is not done properly, it may cause over-training and injury in the athlete (3). Buffer capacity can be affected by the type of recovery (13). Therefore, in addition to the effect of the type of recovery on physiological factors and tampon capacity, exercise performed by the athlete is also effective in preparing for re-homeostasis and return to pre-workout conditions. However, it has received less attention in various studies. The purpose of this study was to investigate the effect of 8 weeks of aerobic training on the buffering system response to three types of active, passive, and stretching recovery in inactive girls.

Thirty students of Farhangian University (age: 22.49±0.33 years, weight: 68.33±7.31 kg, height: 176.76±8.32 cm and BMI 23.12) performed three types of active, passive, and stretching recovery (n=10) during repeated high-intensity endurance test for one week in a crossover method. voluntarily divided into three groups of 10 to have a repetitive endurance test in a special recovery method including active recovery (running at 50% of maximum heart rate) at 5-minute break intervals between exercise protocols. , Passive (sleeping in an open arch) and stretching movements (upper body - lower body) participate (18). Before and immediately after the test, arterial blood samples were taken from the subjects and blood acidity, bicarbonate, carbon dioxide pressure and excess alkali were measured with a gas meter (Techno medica, GASTAT 700 series, Japan). To investigate the effect of different recovery methods between groups. Then, all subjects participated in 8 weeks of aerobic exercise (three sessions per week, 80-65% of maximum heart rate / week). At the end of 8 weeks, similar to the beginning of entering the design, the subjects again underwent a severe repetitive endurance test and participated in their specific restoration methods between stages of the test. Blood samples were taken again before and after the final intense repeated endurance test. At the beginning of the study, the health status and satisfaction of the subjects through a physical fitness questionnaire (22), the necessary conditions for participation in physical activity were examined and their health and readiness to cooperate with the research project was confirmed. During the field operation period, the subjects' food and drug consumption research was controlled as much as possible by presenting a specific and individual diet plan. 8-week endurance training: The first week of the independent variable application course was conducted to familiarize and prepare the subjects psychologically. Then the aerobic exercise program presented in Table 1 was performed for 8 weeks and three sessions per week. After getting acquainted with how to perform the training protocol, all the subjects performed a Repeated high intensity endurance training program including 60 meters running in 30 seconds with 30 seconds of rest 6 times in a row. Then, for 5 minutes, each subject participates in one of the recovery methods under review for 5 minutes. After 5 minutes, the intense endurance test was repeated and at the end of the exercise, the recovery program was performed again. This training program and recovery methods were performed for 4 times. After 8 weeks of endurance training, the same program of Repeated high intensity endurance test was performed in different groups.

Blood sampling was performed before and after the Repeated high intensity endurance test, at the beginning of the project and also after 8 weeks of endurance training. At each stage, 5 cc of arterial blood samples were taken by observing all necessary laboratory conditions, including impregnation of insulin syringe with heparin, and for analysis of blood gases in less than 15 minutes, it was transferred to a gasometer and then acidity. Blood, bicarbonate, carbon dioxide pressure, alkali excess and alkaline buffers were examined. It should be noted that all blood samples and tests were performed in the pre-test and post-test stages from 16:00 to 18:00.

Two-way ANOVA repeated measure showed that in the pre-test phase, there was no significant difference between the three types of recovery to pre-test for the study variables (P>0.05). In reference to pre-test, the changes in PH, HCO3-, PCO2 after eight weeks' endurance training showed a significant difference for active recovery(P<0.05). There was no significant difference in the effect of endurance training for the three types of recovery to O2-sat, BE and BB (P>0.05). 

The results of the present study showed that aerobic exercise improves the response of the tampon to three types of active recovery, inactive and stretching movements in inactive girls, among which the effect on active recovery is significant. During intense periodic activity in addition to H + Of lactic acid, most of the carbon dioxide produced by energy metabolism reacts with water to form carbonic acid under the influence of the enzyme carbonic anhydrase (CA). The result of this reaction is then decomposed into H + and -HCO3 and increases the extracellular H + concentration (23, 24). In summary, the present study showed that 8 weeks of intense aerobic exercise improved the tampon capacity of female students, which was more dramatic with active recovery. It seems that the type, intensity and duration of endurance training and types of recovery, as well as various methods of assessing tampon capacity are important in obtaining research results, while athletes enjoy the benefits of active recovery during intense repetitive training.. And this is while in untrained people, they give the same answers to different types of recovery. It seems that high aerobic fitness in trained people and finally strengthening the tampon device is a justification for the results of the present study. Future research by examining the effect of different types of recovery on novice and elite athletes as well as the synergy of sports and recovery exercises can provide more accurate information to coaches and athletes.

 Professional ethics is a branch of ethical knowledge that analyzes the ethical duties of a profession and its ethical issues. Professional ethics is a set of principles and standards of human behavior that determine the behavior of individuals and groups. The principles of professional ethics have a great burden and values, the observance of which plays a significant role in the observance of norms and the effectiveness of social interactions, and this requires basic and basic knowledge of the mentioned principles. Professional ethics is a rational thinking process that aims to determine the values ​​of the organization. Ethics in higher health education is a multi-dimensional concept and the origin of its effectiveness in it, for this reason, it has received the attention of many universities. The diversity of research in the field of professional ethics has confronted researchers and managers with many variables and dimensions in this regard. Higher health education is one of the subsets of science and technology systems, which is of particular importance due to the changing environment of health systems and the need for education to respond to this changing environment. The ethics of education in the university provides the benefits and individual and group well-being of students. Ignoring ethics in education harms students' ability to learn. Some of the ethical principles of university education include: respecting students as human beings, considering students as equals in counseling, teaching, and grading, and keeping students' grades confidential, so professors must observe the principles of professional ethics. (especially clinical professors) is of special value due to the effective role they have on the performance of learners and individuals. Faculty members as models and examples for students, besides their scientific role, also play a sensitive moral role. For this reason, in many universities and institutions of higher education, regulations with the title of ethical identifiers have been compiled. On the other hand, training and compliance with the principles of professional ethics in medical clinical fields are always the focus of attention. Clinical professional ethics means knowing and acting on the moral responsibilities that each person has towards others. In ancient Iranian medicine, the scholars of Iranian medicine, who were the Islamic Mujtahids of their era, believed in their monotheistic belief in virtue-based ethics between the doctor and the patient and considered attention to clinical ethics as the main condition for entering the medical field, along with medical services. Medical ethics is an interdisciplinary science whose subject is ethical issues in the field of medical sciences. Medical ethics tries to apply ethics in the field of practice of doctors and medical staff and the field of ethical decisions in medicine, and examines the obstacles to the observance of professional ethics; For example, these obstacles can be placed in the fields of management, environment, personal care and any factor that prevents the observance of professional ethics in clinical care. Therefore, according to the topics discussed in the medical community, the discussion of ethics has a special place due to the importance of the medical profession, so medical ethics has been assigned very serious and extensive scientific discussions. If the benefits of observing professional ethics are more comprehensive, the degree of commitment to its principles is of higher degree, and the more reasonable the restrictions imposed by the principles of professional ethics are, the more effective they are in the growth of the organization, the stronger the adherence will be. The interweaving of moral virtues with the medical profession has long given it sanctity and honor. Because the doctor is the trustee of the patient's life, wealth, and honor due to his profession. This principle of ethics in medicine has many examples, among them are trustworthiness towards public property (medical facilities and equipment) and human resources (doctors, nurses, workers in medical departments, students, and patients). Ethics in higher health education is a multi-dimensional concept, for this reason, it has been the focus of many universities. Education and compliance with the principles of professional ethics in medical clinical fields are always the focus of attention. Therefore, the present study is conducted to review professional ethics with the approach of higher health education.

In this systematic review, of articles published in domestic and foreign journals available in databases; SID, Iran Medex, Pubmed, Google scholar, Cochrane, Scopus, Web of Science Uptodate, Magiran, were used in the range of 2000-2020. The search for articles was mainly done using the keywords professional ethics, higher education, medical science education, health and their English equivalent quality of learning experiences, effective learning, learners, and University of Medical Sciences. The inclusion criteria included all studies in line with the approach of professional ethics and effective higher health education, and the exclusion criteria were studies not related to the title. Two researchers searched the articles simultaneously and evaluated the quality of the articles separately in order to increase the validity and reliability of the study. The articles were evaluated based on the inclusion and exclusion criteria. The selection of articles was done in such a way that at first, a list of titles and abstracts of all the articles available in the databases were prepared by the researcher and examined in order to determine and select relevant titles. Then related articles were entered into the research process independently of all cases. At the end of the search, 98 articles were obtained and finally, 14 articles that were of good quality were included in the systematic review.

It shows that the role of academic faculty members in universities is to improve moral education in universities. Some of the goals of professional ethics are: achieving prosperity and perfection, acquiring competencies and creating a foundation for guiding educators, medical errors and doctor's responsibility (confidentiality, truthfulness, confidentiality, etc.), ethics in education, research, ethical considerations for the development of ethics education Medicine based on Iranian-Islamic values ​​and holding a workshop on topics related to professional medical ethics for university faculty members.

Professional ethics is one of the basic necessities in the health education system, and in order to achieve professional ethics in the health education system, the approaches mentioned in the higher health education system should be implemented. The professional ethics working group seeks to implement the professional ethics enhancement package from the total transformation and innovation plan packages in medical science education, which aims to institutionalize the responsive education approach in the health system and institutionalize professional ethics and communication skills. Values ​​and ethical principles and professional behavior at the core of all educational programs and activities, including the main goals of the Ministry of Health in the field of ethics and role models of professors in this regard, have the greatest impact on the education of students. Professional ethics is one of the basic requirements in the health education system, and in order to achieve professional ethics in the health education system, the approaches mentioned in the higher health education system should be implemented.

 Marriage is one of the most important interpersonal relationships that many people experience and it is a social institution based on which a man and a woman decide to live together as a couple through a legal, religious and moral obligation. They get married based on specific goals and wish to experience a stable and satisfying life. But when couples live a stable and satisfying life, they also experience conflicts in their life together. Marital conflicts are one of the common problems of couples and is due to the inconsistency of the couple in the type of their desires and expectations. Communication beliefs are also one of the factors that affect couples' relationship and according to Beck (1970) when our irrational beliefs decrease and logical beliefs replace them, marital satisfaction and compatibility will also increase. As long as couples are not aware that these thoughts are irrational and are somehow accustomed to these beliefs, they downplay and ignore their role in creating marital problems.Also, one of the effective factors in women's mental health in the process of marital life is their satisfactory sexual desires and reactions, which include physiological, psychosocial, developmental and sexual response dimensions. Understanding this cognition is problematic due to the specific research limitations, but the durability and stability of an important part of the marital relationship according to the values and norms approved by society, depends on sexual intercourse (frequency and type) between men and women and the couple talk about sex , Sexual desires and preferences and the discovery of other sexual preferences, have a great impact on establishing a marital relationship. Self-expression, which means "the ability to express feelings, thoughts and beliefs, and to defend one's rights in logical ways," has three dimensions of the power to express emotions; The power to articulate good and bad beliefs and thoughts and to make strong and clear decisions is the power to stand up for one's rights and not allow others to harm or abuse one's personal weakness. Obviously, not expressing feelings and emotions, in many cases, causes long-term sexual problems.Therefore, one of the interventions that can be used and researched in the case of people with marital conflicts is the emotional security model. The results of a study showed that emotional security training has a significant effect on women's marital conflict and its dimensions. Other findings of this study showed that emotional security training affects both dimensions of will and mental well-being neuropathy. In addition, in the case of emotion-oriented couple therapy, which is a method that is close to and somewhat overlaps with the method of emotional security, the results of Davarnia et al.'s(2014)research showed that emotion-based couple therapy training has reduced women's marital burnout. In fact, emotional security training focuses on increasing effective feelings about attachment, moderating self-esteem, and relieving oneself of unpleasant emotions such as shame. Weber is effective in increasing the emotion of happiness and reducing marital conflict.Therefore, considering the effect of emotional security training on couples' emotions and attachment, the important role of women in the family and their impact on other family members and the importance that marital beliefs, expression and sexuality can play in women's marital conflicts. Researchers and psychotherapists in Iran have not paid much attention to these preventive methods, including teaching emotional security to couples, and these methods need more scientific study. As a result, the question of the present study is whether emotional security training has a significant effect on marital beliefs, expression and sexual activity in women with marital conflicts?

In this quasi-experimental study, 50 women with marital conflicts were selected by the purposive sampling method and randomly divided into experimental and control groups. Eight 90-minute sessions were held for the experimental group for 4 weeks and the control group did not receive any intervention during this period. Participants were measured by the Barati and Sanai (1996) Marital Conflict Questionnaire, the Idelson-Epstein (1982) Communication Beliefs, the Halbert Sexual Index (1992), and the Rosen et al. (2000) Sexual Performance Index.

The results of analysis of covariance, repeated measures test, and Bonferroni post hoc test showed that the scores of beliefs about Marital Relationship among the experimental group decreased significantly, but in the control group there was no significant decrease and the scores of Sexual Expressiveness and function among The experimental group had a significant increase, but in the control group there was no significant increase, so there is a significant difference between the experimental and control groups. The follow-up results also showed that the effect of educational intervention was still stable.

The results of this study showed that emotional safety training has a significant effect on beliefs about marital relationship,sexual expressiveness ,sexual function in the experimental group who received the educational intervention, compared with the control group who did not receive educational intervention Significant changes were experienced in the dependent variables and also the follow-up results showed that the effect of educational intervention in the experimental group was still stable. Therefore, the hypotheses were confirmed. As a result, based on the evidence of the present study, this educational program can be used to improve the beliefs about marital relationships and sexual expressiveness and function in women with marital conflicts. The Emotional safety training Training Program helps couples become aware of each other's perceptions by providing awareness of their beliefs and perceptions in the relationship. It then uses behavioral techniques (active listening and empathy) to create a healthier perception and clearer relationships.Teaching Behavioral Techniques Increases Positive Interactions such as Identifying and Expressing Emotions, Expressing Needs and Desires Instead of Expecting Mindfulness, Apologizing, and Forgiving When Angering, and Managing Conflict Instead of Withdrawing Couples' relationships become clearer, resulting in negative beliefs. Marital relationships are improved and marital conflicts are reduced.People also learn to increase their verbal and non-verbal interactions, to show sexual self-expression, including touching, hugging and kissing in relation to their spouse, and to express their thoughts and desires and be more physically close.Therefore, although these trainings do not deal directly with sexuality, but by promoting self-esteem, reducing negative emotions such as shame and increasing positive emotions and expressing them, the ground for increasing women's sexual activity is provided. The main limitation of this study is the taboo nature of sexual issues in society, and for this reason, some participants were cautious in their answers. Therefore, it is suggested that other researchers use this type of research with other effective intervention strategies on beliefs about Marital Relationship, Sexual Expressiveness and function in women with marital conflicts.

 Addiction is one of the most important social deviations, which is the basis of many harms and social problems at the level of society. The side effects of addiction at the psychological and individual level have been and continue to be harmful to the social sector and society as a whole. In this regard, health is one of the main foundations of human life and the necessary conditions for fulfilling his social roles, and addicted people whose health is at risk in some way can continue their individual and collective activities in a desirable way who feels healthy and in addition to the socio-economic status, other factors such as biological, interpersonal and psychological-behavioral factors are also improved in them. Meanwhile, improving psycho-behavioral factors or psychological characteristics such as resilience and irrational beliefs are of particular importance. Resiliency of addicts can be affected by addiction and related conditions. Resilience of addicts can be affected by addiction and related conditions. Historically, the majority of preventive researches and development of interventions aimed at problematic behaviors have been focused on identifying risk factors and high-risk populations; Resilience is more than simply recovering from turmoil. Resilience increases the ability to tolerate and adapt to life crises and overcome them.  Also, addiction can intensify irrational beliefs. Irrational beliefs can become mandatory and definite goals, which if not met, lead to confusion and anxiety. The basic assumption of cognitive theories is that dysfunctional thoughts are involved in the way a person interprets and evaluates reality, and also the behavioral responses that result from certain interpretations are involved in the persistence of substance abuse disorder.
 In this regard, any intervention that can affect the above variables and improve them, will create better conditions for the psychological condition of addicts. Research has shown that cognitive therapy training is effective in reducing the symptoms of irrational beliefs. Therefore, cognitive therapy based on mindfulness (MBCT), as an intervention can lead to improving resiliency and irrational beliefs in addicted people. In this type of treatment, mindfulness is non-judgmental and is based on the present. In fact, this type of treatment can help in releasing automatic thoughts, unhealthy habits and behavioral patterns, and therefore can play an important role in regulating behavior, including aggressive behaviors and increases the ability to tolerate and adapt to life crises and overcome them.
In Iran, extensive research has not been done on the effects of mindfulness-based cognitive therapy (MBCT) on improving the psychological characteristics of addicts. Therefore, investigating the effectiveness of this group of interventions on resilience and irrational beliefs of addicted people is of particular importance. So, the main application of the current research is regarding the effectiveness of cognitive therapy based on mindfulness (MBCT), because it can reduce the level of dependence addiction and have a positive effect on mental health indicators. Hence, in the present study, the effectiveness of mindfulness-based cognition has been measured and its effects on resiliency and irrational beliefs have been investigated.

The current research was semi-experimental and pre-test and post-test type with a heterogeneous control group. The statistical population in this research included all addicts who referred to addiction treatment clinics in Tehran with an age range between 18 and 65 years. The number of 40 people who met the criteria for entering the research, such as not suffering from chronic physical and mental illness, not taking certain drugs, and not attending the detoxification period, were selected as the sample group using the available non-random sampling method. Two groups (an experimental group and a control group) were randomly assigned. Then, the participants were randomly replaced in two groups. First, using Connor-Davidson Resilience Scale (2003) and Jones irrational beliefs questionnaire (1968), the pre-test was performed on both groups. Then the experimental group was exposed to 12 sessions (3 times a week for 90 minutes), of cognitive therapy based on mindfulness (MBCT). It was based on the protocol of Teasdale et al (2000), but the control group did not receive any treatment program after the pre-test. Finally, the post-test was conducted for both groups. The research data were analyzed using the statistical method of multivariate covariance analysis. The data of this research were analyzed using descriptive statistical methods such as mean, standard deviation and variance as well as the inferential statistical method of multivariate covariance analysis with the help of SPSS 20 statistical software.

The results show that in the resiliency and irrational belief, after removing the effect of the pre-test on the dependent variable, it is observed that between the adjusted averages of the scores of all the dependent variables in patients with addiction according to group membership (experimental and control groups) There is a significant difference in the post-test stage (P<0.001). Therefore, cognitive therapy based on mindfulness (MBCT), has had an effect on reducing the resiliency and irrational belief scores of addiction patients in the experimental group in the post-test. Therefore, cognitive therapy based on mindfulness has had an effect on increasing the resiliency and irrational belief scores of patients with addiction in the experimental groups in the post-test.

In explaining the results, it can be said that the goal of cognitive therapy based on mindfulness is to help people to experience their disturbing thoughts as a thought and to become aware of the dysfunctional nature of their thoughts and instead of responding to them, they only watch them. If they are in an addicted person, unusual issues become normal issues; Because of this, the addict basically has high expectations of situations. On the other hand, the addicted person not only always uses the projection mechanism, which is the basis of irrational beliefs, but also finds an irrational belief about addiction. In cognitive therapy based on mindfulness (MBCT), trainings such as letting go of negative thoughts and conceptualizing instead of self, strengthening the self-observer, accepting internal events instead of controlling them. In fact, the main goal of this treatment is to create psychological flexibility or resiliency; It means creating the ability to choose an action among different options that is more suitable, not that an action is performed or actually imposed on a person simply to avoid disturbing thoughts, feelings, memories or tendencies, such as drug addiction. With mindfulness in cognitive therapy, people are taught to live in the present and now and better deal with the challenges of addiction as well as the challenges after that.
Also, in accordance with the findings related to resilience, the application of this method has been able to provide a kind of positive attitude towards the surrounding environment to addicts and basically improve the knowledge of the environment and thus prevent relapse. In other words, the application of cognitive therapy based on mindfulness has been able to provide addicts with a positive attitude towards the surrounding environment and basically improve their knowledge of the environment. In this way, it can be acknowledged that cognitive-behavioral treatments can be considered as a useful treatment by psychologists and counselors and can have a complementary aspect to drug treatment in improving psychological problems associated with addiction.

Since 2020, the COVID-19 pandemic, triggered by SARS-CoV-2, represents the major global issue affecting the lifestyle of people around the world. Wuhan, China was the first city to detect the SARS-CoV-2 virus, but the virus soon spread around the world, forcing the World Health Organization to declare a global epidemic on March 11, 2020 (1). Previous pathological conditions or comorbidities such as old age are one of the main causes of premature death and increased morbidity and mortality due to COVID-19 (4). Inactivity due to hospitalization and bed rest and reduced physical activity due to constant quarantine and social distancing can reduce the ability of organ systems to resist viral infection and the risk of damage to the immune, respiratory, and Increase cardiovascular systems, musculoskeletal and nervous system (4). On the other hand, the health benefits of physical activity, from cardiovascular health to mental health, have been well established (5). Decreased physical activity and increased sedentary behaviors were reported during quarantine in several populations, including children and patients with a variety of medical conditions (6). In general, COVID-19 lifestyle changes have led to a decrease in physical activity and consequently more inactivity in different parts of the community, which can pose a risk to general or mental health, especially for certain populations. In this study, we have tried to review the neurological and psychological effects of COVID-19 and the resulting lifestyle changes, and specifically the role of exercise in relation to these effects.
Central nervous system (CNS) and peripheral nervous system (PNS) manifestations can occur during and after COVID-19, but the underlying mechanisms, symptomatology, and frequency of these complications are not well understood (7). Limited postmortem studies have shown signs of hypoxic brain damage and inflammatory neurological changes in the brainstem, while neuropathological data from the PNS are almost non-existent. Due to the cause, direct invasion of acute respiratory syndrome of COVID-19 virus to nerve tissue has been suggested in several cases, but autoimmune damage and neurological complications related to intensive care management can also be effective. The contribution of these mechanisms to the overall burden of CNS and PNS complications of COVID-19 is unknown (7). Follow-ups in Germany and the United Kingdom have shown that neuropsychological symptoms after COVID-19 in 20 to 70% of patients, even in young adults, last for months after the onset of respiratory symptoms, suggesting brain involvement persists (9). COVID-19, which enters through angiotensin-converting enzyme receptors, can damage endothelial cells, leading to inflammation, thrombosis, and brain damage. In addition, systemic inflammation leads to a decrease in monoamines and neurotrophic factors and activation of microglia, which leads to an increase in glutamate and N-methyl-d-aspartate-3 and excitatory toxicity, and these factors cause the onset or exacerbation of existing neuropsychiatric symptoms. They are already (9). However, the extent of damage caused by the COVID-19 pandemic strain is still speculated; it has recently been suggested that irregular neuro-endocrine-immune interactions may be behind psychiatric manifestations observed in quarantined individuals (12, 13). Persistent and increased stressful events can direct immune, endocrine, and nervous system responses primarily through hypothalamic-pituitary-adrenal (HPA) mediated dysfunction (12), and changes in the levels of systemic inflammatory mediators or the brain predispose individuals to pathological psychological conditions. It acts like anxiety and depression. In addition, stress can be a potential trigger for neuroinflammation, a term used to indicate an imbalance or intensification of immune signals in the brain that can lead to several disorders such as aggression, psychosis, depression, and anxiety disorders (12). Covid 19 has also been shown to alter nerve growth factors that may affect the neuropsychological effects of Covid-19 (16,17).
The current situation of the epidemic as a stressful situation has led to a decrease in physical activity in the general population. Considering that exercise training has been shown to be useful in a number of pathologies with which post-COVID-19 syndrome bears similarities in terms of symptoms and possible pathogenic mechanisms; therefore, it is necessary to consider the potential optimal effect that this has on the improvement or prevention of COVID-19 neuropsychiatric complications. Despite the benefits of exercise, there are limitations to sports activities for different people, which can endanger the neurological and mental health of different people, especially people with underlying diseases or people with special conditions such as patients, children and the elderly. A review of a study that specifically looked at the effect of exercise training on nerve function in patients with COVID-19 were not found; However, based on trials, general recommendations for exercise training in patients have been identified that may be beneficial to the neurocognitive effects of COVID-19 in both healthy individuals and those with COVID-19 syndrome.
There is ample evidence that appropriate, supervised exercise may be an effective multisystem therapy to reduce the neuropsychological effects of COVID-19 syndrome, which is commensurate with the variety of cases and symptoms. Further studies on the effects of exercise-based therapies on post-COVID-19 syndrome are needed to provide practical insights into what type of exercise training should preferably be prescribed, with an emphasis on weight management and adherence strategies. In addition, the effect of post-COVID-19 syndrome on neuropsychological complications of certain demographic groups such as children, adolescents or the elderly remains unknown; Even exercise training and rehabilitation programs for neuropsychiatric complications in these individuals are not known. Overall, a multidisciplinary and integrated approach, part of which is related to sports science, is essential to improve individuals' clinical conditions; nevertheless, neurological and psychological aspects must be integrated into the assessment, as well as the social impact that this pathology entails. Due to the limitations of studies, new proposals for long-term research into the disease in an effort to restore full function and return to previous life are recommended.

 As a social unit, the family includes the most, the deepest, and the most basic human relationships, which, in terms of their importance, role, and various applications, are of interest to religious and ethical scholars, education experts, sociology, and psychology. has taken (2). Therefore, the importance of recognizing and investigating the factors that cause the consistency and strength of this social institution can be a useful step in the direction of improving the level of society's culture (4). The tendency to marry is influenced by several factors. Among the various factors affecting marriage, social life is very important, and communication is one of the main skills of social life (6) and one of the factors that can weaken the effectiveness of a communication and cause a lack of understanding of the message sent. Or in other words, to decode it correctly, it is false beliefs, prejudices and negative attitudes (7). In fact, the farther the cognitive fields of the two elements of communication, i.e. the receiver and sender of the message, are from each other, the less effective the communication will be (8). A person's attitude towards marriage is his way of thinking and feeling about marriage (10). The attitude that a person has towards the future and the choice of a spouse can determine how to guide them in future relationships, and the lack of a positive attitude as a result of numerous individual and external reasons is considered to explain the lack of tendency of young people to marry (13).
The effectiveness of the L-Son model has been confirmed in many other studies, including Sepehari Shamlou et al. These researchers showed that the approach of pre-marital education has been effective in increasing awareness of expectations, improving communication beliefs and marital satisfaction of married women. But the question is whether this approach has an effect on the communication beliefs of the fear of marriage among students or not? Another pre-marriage training program is pre-marriage awareness and interpersonal choices program. This program was based on the communication attachment model. OneApp was developed as a model for examining close relationships. This theoretical model is a representation of communication links in a relationship. Overall, this program provides a comprehensive and thorough review of the salient areas for explaining romantic relationships and a comprehensive framework for understanding the pattern of closeness and intimacy in premarital relationships. In confirmation of this result, Rajabi and colleagues in a research confirmed the effectiveness of this educational strategy on improving communication beliefs and reducing ineffective beliefs.
According to the above, preparing for marriage is a relatively new approach to prevent dissatisfaction and failure in married life, and it is based on the view that boys and girls on the verge of marriage can learn how to have successful and stable marriages; Teaching pre-marital skills helps to strengthen and stabilize marriage, reduce divorce rate and improve the quality of marriage, and this doubles the tendency of researchers to follow up early and provide specialized intervention in order to have the best choice. However, the internal and external limitations in the constructs and dependent variables of the research are well indicative of the novelty of these trainings and the high prevalence of divorce and marital problems indicate the lack of sufficient attention of specialists to this important and vital training. Also, researchers still do not have a general opinion about the best consensus method. In this regard, the aim of the current research is to answer the question whether two premarital preparation strategies with Olson's approach and premarital education based on selection and awareness are effective on the fear of marriage of students on the verge of marriage? And which method is more effective?

To conduct the present semi-experimental research, which was pre-test-post-test and follow-up with the test and control group, 45 people were selected from among the students on the verge of marriage of Dezful University of Medical Sciences using the available sampling method and considering the entry and exit criteria. In the form of three groups of 15 people, the training was divided into the method of choice and awareness, Elson's approach and control, and after completing the consent form, Idelson-Wapstein's (1982) communication beliefs questionnaires and Richard et al.'s (2007) fear of marriage. completed in the pre-test. Then the experimental groups received 90 90-minute sessions of their respective intervention. Finally, all subjects completed the questionnaires again.
Finally, descriptive statistics (mean and standard deviation), Shapiro-Wilk tests, analysis of variance with repeated measures and Bonferroni's post hoc analysis were used to analyze the data using SPSS version 24 software.

The results showed that the difference between the mean scores of fear of marriage in three stages of the research is significant (P≥0.001). Also, the average scores of this variable in the two experimental and control groups also have a significant difference (P≥0.001). The results have shown that nearly 53% of the individual differences are related to the differences between the three groups. In addition, the interaction between research stages and group membership is also significant (P=0.001). The amount of this difference is about 0.916. That is, 91% of the variance or individual differences are related to the differences between the three stages of the test and group membership.
According to the results of the follow-up test, it was found that the difference between the pre-test, post-test and follow-up stages was significant and it was found that in the structure of fear of marriage, the difference between the two stages of pre-test and post-test (P=0.001), pre-test and follow-up (0.001) =P) is significant; But the difference between the post-test and the follow-up was not significant.

The results showed that the two methods of pre-marriage education, the method of choice and awareness and El Son's approach, have a significant effect on the communication beliefs of students' fear of marriage. In the explanation of the present research, it can be said that Elson's approach has four important features of an effective preventive approach, including the need to identify the factors that affect the success of marriage. The assessment of couples based on those factors considers the necessity of providing feedback and practice to couples in problem areas and emphasizing the training and practice of communication skills in conflict resolution (16) and these factors seem to be a reason for the findings of the present research.
On the other hand, premarital education program includes five components of recognition, trust, encouragement, commitment and contact. A composite of these five relationship links provides a picture of overall perception in a relationship and meaningful information about feelings of love, attachment, and closeness in the relationship. This program organizes the five components of communication in two parts, intellectual and heart knowledge. The part of intellectual knowledge refers to the knowledge and understanding obtained from the spouse or fiancee in the step of familiarity and romantic relationships narrowly and deeply (28).

 Motivation is one of the most important elements of learning and progress. Although intelligence and talent are important and determining factors of students' learning, other factors are also important and influential besides these factors. Among these factors, motivational beliefs can be mentioned. Academic motivation generally refers to the motivations, needs, and factors that cause a person to attend educational environments and obtain an educational certificate. Motivation is defined as a process by which goal-oriented activities are stimulated and maintained. In the theoretical and conceptual models of motivation, progress, beliefs, and expectations of people, the most important and main determinants of progress behavior are considered. These models include attribution theory, expectation-value theory, self-determination theory, goal theory, and self-efficacy theory. When learners have the necessary motivation to learn, the process of communication is facilitated, content becomes more fluent, anxiety is reduced, and creativity and learning are manifested. Also, motivated students have positive motivational effects on the teacher and as a result, they make education satisfactory for both the teacher and the students. Also, the study showed that students' motivation affects all classroom activities. The issue of academic motivation is an essential issue for teachers and education custodians of different countries. Increasing the motivation level of students requires a change in the factors that motivate a person, which is divided into two categories, internal and external. Motivational beliefs, the expectation of success, and perceived subjective value act as mediating variables about cognitive processes and progress behaviors. At the most general level, it is assumed that the socio-cultural environment acts as the main source of influence on the mental processes of the individual. This environment includes stereotypes related to gender and culture, behaviors and beliefs of socializers, talents, and previous development of the individual. Considering that the researchers of expectancy-value theory have emphasized the different roles of task value, ability-expectation beliefs, task difficulty understanding, source of control, and previous progress in subsequent progress, it can be said that expectation-value can influence It has positive and negative effects on students' academic motivation, therefore, in this research, we seek to answer the following question. Do psychological and situational gains and losses in the relationship between expectations and values ​​affect academic motivation?

The current research is of the correlation type, which examines the relationships between the variables of the proposed model using the structural equation modeling method. The statistical population of this research includes all secondary school girls and boys of Qorve city in the academic year 2020-2021, and the number of these students is reported to be 10,000 by the Ministry of Education. The sample size in this research was calculated using Cochran's pheromone equal to 384 people. The sampling method in this research is multi-stage cluster sampling. The city has two regions, north and south, and girls' and boys' schools, and one class from each school and each level were selected through virtual and in-person selection (according to the conditions of the corona disease and the strictness of the schools) and a questionnaire was provided to them. The main tool for collecting information in this research is a standard questionnaire (psychological gains and losses, expectations, academic motivation). In order to determine the presence or absence of a relationship or influence between the variables and to estimate and generalize the results obtained from the sample size to the statistical population from the Kolmogorov-Smiranov test, the simple correlation model with the obvious variable, the Pearson correlation coefficient test and the path model (mediator) to evaluate the hypotheses and data The research and the research conceptual model have been used. The tool for analyzing questionnaire data of this research is Spss statistical software and Amos structural equation modeling software.

According to the findings of this research, expectations have a positive effect on academic motivation. Expectations have a positive effect on psychological gains and losses. Psychological gains and losses play a mediating role in the relationship between expectations and academic motivation.

In general, it can be said that by creating expectations in students, it is possible to help increase academic motivation. Also, according to the relationship between expectations and psychological losses, it can be concluded that by increasing expectations, psychological losses in students can be increased. In the model of expectation and value, these structures are the two main predictors of behavior leading to progress, and it is assumed that expectation and value have a direct effect on progress behavior, and the amount of expectation and value is influenced by the perception of the social environment, cultural context. Therefore, motivation and engagement are powerful processes that can motivate students to learn new skills on the one hand and can lead to a lack of engagement and educational self-destruction on the other hand. (Positive or negative reactions towards the teacher, classmates, university, or school; the feeling of belonging to the individual, conformity with the school or its demands). The review of the research literature shows that the educational involvement of parents is accompanied by the educational involvement of students, especially the concern to do homework at home and a positive attitude towards school. Students' involvement in school activities leads to educational progress, positive expectations about academic ability, improvement of academic performance, and reduction of dropping out. One of the limitations of this study is the inability to generalize to other cities in the country because the results of the study were only for students in Qorve. Also, the unnecessary strictness of the school administrators in distributing the questionnaire among the students can be mentioned, as well as the very poor cooperation of some students in answering the questions of the questionnaire, which we convinced them to cooperate with great difficulty and convincing explanations.

 The immune system is affected by a variety of physiological and psychological pressures (1). Exercise has been shown to impair immune system function, which appears to depend on the intensity and duration of exercise and the secretion of stress hormones (2). Exercise in a high temperature environment has a synergistic effect on stress responses to exercise (3, 4). Acute stress (e.g., cortisol) and inflammatory responses (e.g., cytokines) after exercise at warm temperatures are greater than those seen at lower temperature conditions (5). Heat stress caused by high ambient temperatures can affect physical function; Tolerance to exercise in hot environments is lower than cold environments (6). There have been numerous reports of increased plasma cortisol responses (9, 10) and production of cytokines (4, 11) seeking to limit fluid intake during acute exercise. Recently, Costello et al. (2018) showed that acute exercise in a warm environment increases the levels of interleukin-6 (IL6) and plasma cortisol only in conditions of fluid restriction (12). Ignoring the increase in physical and psychological stress experienced while exercising in conditions of ambient heat and dehydration combined with improper recycling can increase the risk of various diseases (4, 13) and impair athletic performance (14). Caffeine is one of the most common dietary supplements in the world, which has been used as a factor to increase physical-mental functions and delay fatigue in athletes (15). Also, caffeine, with its energizing and anti-inflammatory properties, in addition to increasing athletic performance, can reduce the inflammatory responses caused by strenuous exercise (16, 17). In this regard, Fedor (2010) examined the acute use of two doses of 4 and 7 mg / kg body weight of caffeine and showed that only higher doses of caffeine can prevent proinflammatory cytokines caused by moderate-intensity endurance training (18). Jafari et al. (2014) showed that acute consumption of 6 and 9 mg / kg body weight of caffeine inhibits the increased response of serum tumor necrosis factor (TNFα) following a period of debilitating resistance activity (19). However, the lack of effect of acute caffeine consumption on the response to inflammatory markers following exercise has also been reported in some studies (20, 21).
consumption to possibly modulate the response to inflammatory parameters caused by exercise in conditions of ambient heat and dehydration has not been studied. Research findings also indicate a discrepancy between the results regarding acute caffeine consumption and the response to inflammatory markers following exercise; Considering the important role of caffeine supplementation along with exercise on physical function as well as reducing inflammation, it seems that the study of the effects of exercise and caffeine supplementation on inflammatory markers is of great importance, but according to studies, the findings are very limited in this regard. Therefore, the aim of this study was to investigate the effect of caffeine supplementation and exhausting exercise on inflammatory factors in hot environments.

In this experimental study, 30 male athletes with an average age of 26.6 ± 3.9 years in dehydrated conditions were selected in an accessible and targeted manner and divided into three groups of caffeine consumption (number = 10 people), placebo group (number = 10 people) and the control group (number = 10 people) were divided. Caffeine group consumed 6 mg / kg body weight of caffeine. 60 minutes later, the subjects performed a series of increasingly exhausting aerobic exercise. Data were analyzed using analysis of variance with repeated measures, One-way ANOVA and Tukey post hoc test at the P<0.05.

The results showed that immediately after exercise, the levels of IL1B, TNFα and IL6 were significantly higher than the control group (p≥0.001). The caffeine group experienced a greater increase in IL6 (p≥0.001) and IL1B (p≥0.05) and a smaller increase in TNFα compared to the sham group (p≥0.001). Also, hs-CRP levels were significantly higher than baseline in the exercise group (p≥0.001).

The results of this study indicate that maximal aerobic function increased following caffeine consumption. The findings of this study were consistent with the results of Previous research (26-28). In this study, we used the Bruce treadmill test, while in the study, the 20-meter shuttle test was used as the maximum aerobic test. In addition, the high ambient temperature and dehydration conditions present in the present study could be another reason for the differences in the present results with the study of Lamina and Musa (29). The results showed that acute exercise significantly increased plasma IL1β, IL6, TNFα and hs-CRP levels in caffeine and sham groups. Consistent with these findings, increased blood levels of inflammatory agents following acute exercise have been reported in many studies (27, 30). Consistent with the results of the present study, previous studies have shown that caffeine consumption increased the IL6 response after maximal aerobic activity (34, 35). One of the reasons for this observation is that more cytokine secretion through caffeine consumption is associated with higher power output and greater metabolic stress (further increase in adrenaline and plasma lactate after exercise) (34, 35). Therefore, it seems that caffeine consumption may not have a direct effect on IL6, but rather increases the IL-6 response by increasing potency and consequently the need for higher metabolism.

One of the important findings of the present study was that acute caffeine consumption did not affect basal inflammatory factors, because there was no difference between the mean levels of basal inflammatory factors in the study groups. This observation is consistent with the results of studies by Arsenault et al. (36) and Kempf et al. (37), but with the results of studies by Fletcher and Bishop (38) and Jafari et al. (19) that increase basal levels of inflammatory markers in response to Acute caffeine consumption has been reported to be inconsistent. One possible reason for this discrepancy may be related to the conditions of the subjects; The subjects in the present study were in dehydrated conditions and at ambient temperature, which may have increased the basal levels of inflammatory markers by increasing the secretion of stress hormones and, therefore, reduced the effect of caffeine on these factors. Because the secretion of stress hormones (epinephrine and cortisol) has been cited as one of the basic mechanisms for increasing basal levels of inflammatory markers due to caffeine consumption (38, 39).
 In the present study, acute caffeine consumption further increased plasma IL6 levels in response to exercise. Consistent with this finding, some previous studies in this field have reported higher increases in plasma IL6 levels following exercise in subjects who consumed caffeine (35, 40). This higher increase in IL6 levels following caffeine supplementation is mainly attributed to a decrease in IL6 clearance by the liver, which occurs due to decreased visceral blood flow due to increased adrenaline (30). Another finding of the present study was that acute caffeine consumption reduced the rate of exercise-induced increase in TNFα. Horrigan et al. (2004) showed that caffeine consumption suppresses the production of proinflammatory cytokine TNFα in human blood and this effect is mediated by modulating the cyclic AMP / protein kinase A signaling pathway (41). Caffeine and its metabolite, theophylline, have also been shown to directly activate the enzyme histodoniestylase, which also distills central histone and reduces the transcription of inflammatory genes (17). In the present study, elevated IL1β and TNFα levels returned to baseline levels during blood sampling 24 hours after exercise in subjects experiencing caffeine supplementation, but remained elevated in the sham group. There were some limitations in the present study, such as the lack of measurement of other inflammatory factors. Examining the effect of different doses of caffeine supplementation after exercise can also help to better explain and interpret the results. This is a research weakness suggested by future studies to measure these post-exercise indicators along with caffeine consumption in athletes. It seems that the maximal exercise in hot environments and dehydration status increases the release of inflammatory markers that appear to be moderated by caffeine consumption. Also, caffeine use is associated with faster recovery of inflammatory status.

 Intrinsic physical literacy is a reliable factor that, despite it, the skills, knowledge and attitude of children and teenagers develop in various activities and it causes balance and self-confidence in them to perform their activities (1). The term physical literacy refers to "motivation, confidence, physical strength, level of knowledge and perception that people seek to develop throughout their lives, in order to maintain physical activity at an appropriate level (2). Studies have shown that physical literacy is a part of human capacity that affects all stages of life and plays a significant role in perception, self-confidence and motivation (7). Quality physical education programs for the development of students' physical literacy are for them to be able to make active and healthy choices for the present and throughout their lives. However, due to the spread of the Covid-19 virus, the physical and movement activities of students have decreased in the current period. As mentioned earlier, physical literacy plays a significant role in perception, self-confidence, and motivation, and on the other hand, the spread of the corona virus can also affect people's confidence and mood (8). Therefore, apart from the other existing problems, in addition to the car life and the spread of apartment living, and as a result, the reduction of sports activities in the society, the Covid-19 virus has also affected the physical activity of the people in the society, especially the students, and these cases can cause irreparable damage. To import to the country in the future. Therefore, it is impossible not to consider the corona virus in the examination of physical literacy that is related to physical activity, in this particular age where there is a strong fear about sports activities (9). The Covid-19 virus has caused many problems in the field of sports (11); One of these cases can be seen as a decrease in motor activity and, as a result, physical literacy in students (12). According to the mentioned contents, the aim of the current research was to identify the indicators of physical literacy during the outbreak of the corona virus and to investigate the development of physical literacy of students.

The purpose of this research is fundamental and it is a type of qualitative and quantitative (mixed) research that is used in the qualitative part of foundational data theory (which is also known as data-driven theory, contextual theory, and fundamental theory) and the method Strauss and Corbin (1990) were used. Therefore, the researcher decided to extract the causal factors of the physical literacy development of students during the outbreak of the corona virus and provide a suggested model with a qualitative research. Considering the executive nature of the work, in order to conduct the interview, the researcher interviewed experts and experts in the field of sports management, movement behavior and sports psychology, which was considered in the qualitative part of the sampling method in a targeted manner. Finally, theoretical saturation was achieved with 14 interviews. In order to accurately measure each of the obtained indicators, it was necessary to prepare a tool to measure the obtained indicators and determine the amount of each of the indicators, so the questionnaire as a quantitative tool in this research was used. In fact, the indicators discovered from the interviews were considered in the form of central codes as dimensions of the questionnaire and open codes as items, and finally they were converted into a questionnaire in a preliminary study with 110 samples. Therefore, the sample should also be considered in the quantitative section. In fact, the purpose of measuring indicators is to compare the level of development of physical literacy in the centers of different provinces of the country. Due to the fact that the development is different in different provinces of the country, therefore, in this study, the provinces were divided into two categories, rich and poor (14), and therefore, the cities of Tehran, Mashhad, Isfahan as rich cities and Zahedan, Yasouj and Birjand were investigated as less privileged cities and physical education teachers were considered as the community. Therefore, in this research, in the quantitative part, two societies are considered. A wealthy society and a poor society with infrastructural facilities. The criterion for entering the research in the quantitative section was having at least five years of work experience and having a master's degree in physical education.
Therefore, the questionnaire was prepared and distributed online. All steps of the present research have been approved by the Ethics Committee of Ahvaz University (IR.IAU.AHVAZ.REC.1401.075). A sample size of 539 people was considered and descriptive methods of structural equations and hierarchical analysis were used in the quantitative part. SPSS version 26 software was used in this research.

The findings of the interview in order to identify the causal factors for the development of students' physical literacy during the outbreak of the corona virus are presented in Table No. 1. All the interviewees were faculty members in sports management, growth and movement learning, and sports psychology with experience between 5 and 20 years. As you can see, 38 signs or open codes are placed in the form of 6 core codes and 3 selective codes. In this part, the questionnaire's standardization indicators are presented, and in the next stage, a comparison is made between privileged and non-privileged cities. The result shows that 68.53% of the physical literacy development causal indicators questionnaire is explained by six factors, and considering that the model is implemented in SPSS software and does not present an error, it can be stated that the determinants of the matrix coefficients The anticorrelation is zero and therefore this assumption is also met. Also, the KMO indices and Bartlett's sphericity test were in the optimal range (Table 2).

The results of our research showed that the most important component was the environmental component. The environmental component overseeing culture building was the role of the media in the development of physical literacy, increasing the awareness of families and society. Also, the structural component was the second most important. Also, the hierarchical analysis showed that the software component is in the third rank and the management component is in the fourth rank. In the fifth category of hierarchical analysis, hardware facilities and in the sixth category were individual factors. These results show that an important step can be taken in maintaining the health of students by identifying the indicators of physical literacy during the outbreak of the Corona virus, and this requires comprehensive cooperation between the family, school and authorities, and with rational management and Allocating targeted programs can promote physical literacy and thus health-related goals in children and prevent the side effects of Covid-19 to some extent.

 Tourism is one of the most important industries to stabilize financial revenues worldwide (1). The use of tourism capacities to develop the financial issues of countries has led to extensive efforts by countries to develop tourism, which has paved the way for the development of tourism infrastructure (2). The tourism industry as an invisible export, if well planned and managed, is the most lucrative and most lucrative industry and contributes significantly to job creation due to the widespread dimensions of unemployment, wealth distribution, regional imbalances, poverty reduction. Improves the living standards and livelihoods of community members and plays positive cultural interactions (3). Tourism capacities have led to it being mentioned as a solution for the development of communities (4).
The importance of tourism is so great that various researches have been done in this field and different results have been obtained, including: Nathan et al. (2019) examined the role of mass media in the ecotourism industry and concluded that the expansion of mass media has led to the creation of a global village today, which has made it possible to market through these media. In order to expand the tourism industry, we will witness nature tourism (11). Barari et al. (2016) analyzed the economic effects of urban tourism from the perspective of citizens (Case study: Babolsar city) and found that there is a significant relationship between tourism and economic development variables (12).
So Considering the importance of tourism and especially health tourism on economic and regional development on the one hand and the importance of the role of information technology and especially e-business in the new era on the other hand and since the truth about the correct education model in the field E-business is not done The researcher is trying to answer the question whether education in e-business in the field of health tourism in Iran follows a suitable pattern or not?

The present study is one of the mixed researches that was conducted qualitatively and quantitatively. Considering that the qualitative part of the present research was carried out in the first stage and then the quantitative part, so the present research is one of the exploratory researches in the mixed part. In the qualitative part of the research, the qualitative method of directional content analysis was used. Also, the present research is field in terms of implementation. Given that the results of the present study will be used by e-businesses, so it was an applied research.
The statistical population of the present study in the qualitative part included experts in the field of health tourism and e-business and in the quantitative part of the statistical population included academic experts, business experts, owners of successful companies in the field of health tourism and specialists in the field of information and communication technology.
In the qualitative part by snowball method, 14 people and in the quantitative part by targeted sampling method, 130 people, including 40 academic experts, 30 business specialists, 30 owners of successful companies in the field of tourism. Health and 30 ICT specialists were selected as a statistical sample
In the qualitative part of the research, reliability (validity), transferability and verifiability were used to check the validity. Descriptive and inferential statistics were also used in the quantitative part of the research. In the descriptive statistics section, the mean and standard deviation were used and to validate the model and present the final model, the statistical method of structural equations was used. The whole process of data analysis was performed in SPSS and PLS software.

Open coding of education dimensions in the e-business model in the field of health tourism in Iran led to the identification of 16 primary indicators. After this stage, axial coding was performed and the categories of educational issues, idea generation, knowledge transfer and skill issues with unique features were extracted and educational dimensions were categorized in the form of these 4 categories. It was also found that all the relationships in the research model were confirmed (table 2). The results of the present study showed that all the identified dimensions have a significant role in the e-business model in the field of health tourism in Iran. Finally, the research model has a good fit.

The results of the present study showed that the identified model was categorized into 4 categories of educational issues, idea generation, knowledge transfer and skill issues. It was also found that the research model has a good fit. In this regard Taghizadeh et al. (2011) pointed out that the development of medical tourism requires attention to educational aspects and knowledge promotion in this field (8). In another study in this regard, Radovich and Nola (2018) also found that paying attention to educational aspects in order to promote businesses related to health tourism can lead to the promotion of these businesses and improve the position of health tourism in communities (14). These results are consistent with the findings of the present study. Also, in another study in this field, Abadi et al. (2018) in a study that was conducted with the aim of strategically examining the development of medical tourism using the SWOT method, found that the strategic situation of medical tourism development in Yazd is in an aggressive state. They pointed out that the growth of awareness about this type of tourism puts the strategic position of this type of tourism in an aggressive position (15). Wang (2016) in a study aimed at developing Internet marketing strategies in the use of medical tourism, showed that the use of Internet marketing methods to develop medical tourism, while improving awareness and familiarity with medical purposes, causes To the path of growth and development of this type of tourism with a higher intensity (16).
In general, the results of the present study showed that the four dimensions of educational issues, skills issues, idea generation and knowledge transfer in the field of education in e-business are effective in the Iranian tourism industry. On the other hand, it was found that the research model has a good fit, which all confirms the role of educational aspects in e-business in the field of health tourism. Therefore, paying attention to these dimensions is of special importance.

 Urinary tract infection (UTI) is a common infection during pregnancy and different age groups of children, including the neonatal period. It comprises 1/3 of bacterial infections in newborn infants, with a prevalence of 0.1-1% in term and 4-25% in preterm neonates. UTI occurs more commonly in male neonates (M/F: 2-6/1) for the higher incidence of structural abnormalities (1, 2). Urinary tract anomaly is found in about 20-50% of infants with UTI. UTI rarely occur during the first 3 days of life, and urine culture is not routinely recommended for the evaluation of early onset sepsis (3). Appropriate serum vitamin D level is important for the prevention of multiple infections during pregnancy, including UTI. Maternal serum vitamin D has a negative correlation with UTI (4, 5). The role of maternal vitamin D deficiency during pregnancy as a risk factor of neonatal UTI remains controversial.
This review study was performed to evaluate the correlation between maternal vitamin D deficiency during pregnancy and neonatal UTI for the early diagnosis and prevention of its complications.

Relevant articles from PubMed, Google Scholar, ISI web of knowledge and scopus databases were evaluated in this review article to investigate the correlation between reduced maternal vitamin D and neonatal UTI up to 2022. Diagnosis of UTI was made in neonates with clinical manifestations of fever, vomiting, poor feeding, jaundice, failure to thrive, weight loss, diarrhea, irritability, lethargy, apnea, bradycardia, or abdominal distention associated with urine white blood cells more than 5/hpf, and positive urine culture (any growth of a single pathogen in suprapubic urine aspiration, or more than 104 CFU/ml of a single pathogen from urine obtained by urethral catheterization, or more than 105/ml of urine bag sample), if possible. However, urinalysis has low specificity and sensitivity for diagnosis of UTI in neonates, and does not consider as a part of evaluation. Vitamin D measurement has been defined by the Institute of Medicine (IOM) as; severe vitamin D deficiency (less than 12 ng/mL), deficiency (12-20 ng/ml), vitamin D insufficiency (20-30 ng/mL), vitamin D sufficiency (more than 30 ng/mL), and more than 50 ng/ml as the cause for concern.

Maternal UTI is a common infection during pregnancy with several adverse maternal and perinatal complications such as pre-eclampsia, chrorioamnionitis, growth and developmental delay, low birth weight (prematurity, intrauterine growth retardation) and perinatal death (2, 6). Maternal UTI might contribute to the increased incidence of UTI during the neonatal period (1, 2, 7, 8). In Bilgin et al study on 230 neonates, maternal UTI was non-significantly associated with intrauterine growth retardation, preterm labor and low birth weight. However, neonatal UTI was significantly higher in neonates with maternal UTI, compared to the control group, which suggested maternal UTI as a risk factor of the neonatal UTI (2).  A significant correlation was found between prenatal maternal and neonatal UTI in Micle et al study, in which neonatal UTI was reported in about 30% of prenatal maternal UTI vs 6.8% without infection (6). Emamghorashi et al showed a significant relationship between maternal prenatal UTI and neonatal infection; in which 30% of neonates with UTI vs 6.8% without UTI had mothers with a history of UTI. They suggested a possible benefit of evaluating neonates with a history of maternal UTI during pregnancy (7). In Khalesi et al study, about 15% of neonates had a positive maternal history of UTI (4.4%, 6.1%, and 4.4% during the 1(st), 2(nd), and 3(rd) trimesters of pregnancy, respectively). Totally, maternal UTI increased 6 fold higher risk of neonatal UTI. They emphasized on more attention for the assessment and management of UTI among neonates for reducing the related complications (8). UTI has different presentations during the neonatal period. It usually remains asymptomatic in the majority of newborns, or presents with nonspecific symptoms such as failure to thrive or prolonged hyperbilirubinemia. However, other manifestations of a severe illnesses such as poor feeding, abdominal distension, vomiting, tachypnea, gastrointestinal manifestations, fever, irritability, lethargy, and cyanosis might be reported.Therefore, regular monitoring of at risk neonates is recommended for asymptomatic or nonspecific clinical manifestations (2,3,8).  Vitamin D is an important hormone during pregnancy, which is provided from dietary sources and skin synthesis by sunlight exposure (8). Previous studies have shown essential role of vitamin D in regulation of both innate and adaptive immune responses by increasing motility and phagocytic activity of neutrophils, producing antimicrobial peptides, regulating cytokine production, inhibiting inflammatory process and lowering the severity of infectious and autoimmune disorders. Vitamin D, is known to have an effect on urothelium, with immunomodulatory capacity against bacterial infection (5, 6, 9, 10). Increasing vitamin D level during pregnancy modulates the innate immune system for a protective response in infectious disorders. Vitamin D deficiency has been considered as the risk factor of UTI, especially in females. Maintenance of normal vitamin D level might reduce the occurance of UTI (4, 9, 10).  Some studies showed the importance of sufficient vitamin D level for the prevention of UTI by inhibiting the production of inflammatory factors such as IL-6 and TNF-@, and producting defensive antibacterial urinary tract peptides such as Cathelicidin and β-defensines. Cathelicidin is secreted by the immune cells and epithelial surfaces of multicellular organisms. It has a protective role against infection by increasing cytokine production, stimulating macrophage proliferation and up regulating macrophage vitamin-D receptor. β- defensin expresses on the epithelial cell surface, which attracts and increases white blood cells during kidney infection. Vitamin D deficiency increases the risk of UTI by decreased production of these substances (5, 10). Maternal vitamin D level has a negative correlation with the incidence of UTI, and the risk of UTI increases in pregnancy with low serum vitamin D level, which shows the etiologic correlation between serum vitamin D and potential risk of UTI (9, 10). In Yang et al study on 238 infants, serum 25(OH) D levels were significantly lower in cases with UTI (29.09 ± 9.56 ng/mL) than controls (38.59 ± 12.41 ng/mL). Infants with acute pyelonephritis had lower serum 25(OH) D than those with lower UTI. They showed that serum 25(OH) D <20 ng/mL was positively related to an increased odds of UTI, and vitamin D supplementation was associated with a lower risk of UTI (9). In a meta-analysis of 9 studies included 580 patients with UTI, vitamin D insufficiency was significantly associated with the increasing incidence of UTI, especially in childhood. A significant etiologic correlation was found between serum vitamin D level and increased risk of UTI (10). In a case-control study on 187 participants (97 pregnants with a symptomatic UTI and 90 matched healthy pregnant), mothers with serum vitamin D less than 10-20 ng/ml have a higher incidence of UTI during pregnancy than women with serum vitamin D more than 30 ng/ml in Haghdoost et al study. Pregnant women with acute pyelonephritis had significantly lower serum vitamin D level than those with acute cystitis (5). Vitamin D deficiency has been reported in breast fed infants secondary to low maternal sun exposure and insufficient vitamin D intake (9). Increasing serum vitamin D level by supplemental products during pregnancy increases the protective response of urinary tract system and prevents of further infections. Therefore, regular monitoring of newborns at risk of UTI is recommended during the neonatal period (2, 5, 9).

Multiple studies showed the protective effect of sufficient serum vitamin D level for the prevention of UTI. Based on the increased incidence of maternal UTI in cases with low serum vitamin D level, and correlation between maternal and neonatal UTI supplementation and maintenance of normal maternal vitamin D level is recommended for the prevention of neonatal UTI in all mothers during pregnancy.

 According to research, exercise is effective in various fields. Reports from international activities show that sports in areas such as personal development, health promotion and disease prevention, promotion of gender equality, social integration and social capital development, peace building and conflict prevention/prevention, post-disaster / injury relief and normalcy Life-building, economic development, communication, and social mobilization have had the greatest impact, and are also linked to the Millennium Development Goals. But it does not seem to be able to achieve these eight alone. These goals include; Eliminate extreme poverty and anxiety, achieving universal primary education, promoting gender equality and women's empowerment, reducing child mortality, improving maternal health, fighting AIDS, malaria, and other diseases, ensuring environmental stability, and ultimately creating a global partnership for development. Undoubtedly, sport is an important tool in the hands of governments and governments to guide people towards the planned goals, because the most important means of public education in the current contemporary society in industrialized countries is a sport. The lack of scientific evidence and the underlying theoretical framework for how exercise can be used for social change indicates a significant gap between theory and practice. The educational system of the country is one of the most important systems in the country and its management requires difficult and effective management due to the presence of nearly 15 million students, 1100,000 administrative and educational staff, 716 educational districts with wide and diverse goals and communication with all Iranian families. Education seeks to provide the necessary conditions and create the right environment and opportunities, to put all students in healthy educational situations, and by responding to their needs, programs to strengthen the body in line with the principles and stages of growth and in harmony with the development of the spirit of supply. Slowly, In addition, educational sports, due to benefit from the large volume of society, especially children and adolescents at basic ages, can be a powerful potential for improving the situation in the country in various dimensions such as social cohesion, physical and mental health, etc. and in turn effectively help Show the development and progress of the society. But in the meantime, there is no complete research in which the impact of various sports categories on the development and progress of the country has been comprehensively examined to determine the extent to which various institutions and organizations have used this powerful tool. Based on this, the researcher intends to measure the impact of exercise on the dimensions of health to: What is the role of exercise in the development of health with the presentation of the model?

The method of the present study is applied. In this research, there are two groups of statistical population: (a) Professors and faculty members of the university (physical education and doctoral studies) whose number is about 30 people and the number of participants This study was about 12-15 experts who collected data until the information was saturated. (B) Professors and sports instructors in several universities and schools, whose number was 81 people and due to the low number of participants, all 81 people were used to distribute and collect questionnaires and the number of participants in this study was about 12-15 experts from the organization. Data collection has been done until information saturation is reached. A researcher-made questionnaire was used to collect data.

To conduct the interview, the researcher communicated with 12 experts (fear of theoretical saturation) within ten days. By appointment, he had a meeting with each of the experts for about 30 minutes. In these sessions, the researcher has asked two questions in the field of research. The researcher recorded the words of the organizational experts during the interview. The interview was open and in it, the researcher tried to control the interview by asking two questions to achieve the research goal. After obtaining the open codes, in the next step, due to the axial coding, similar and different codes were identified and similar codes were merged. In the combined stage, the identified indicators are presented through a review of the research background and a model derived from the results of interviews with each other, which finally extract the main factors. The results showed that exercise has an effective role in the field of sports and health, disability and social cohesion in the field of health, performing correct movements under the supervision of sports experts and in the field of social cohesion, social development of pupils and students and in the field of lack of standard sports facilities for individuals. The disabled person has the most weight.

The findings of this study show that there is interest in sports and physical education among students, a long history of sports and physical education in schools and universities, the existence of sports at the university level, and the interest of some principals and experts to develop educational sports in schools. And Azad University is the most important strength of educational sports in the country. It should be noted that the most important weaknesses of educational sports are the inadequacy of physical education specialists in schools and universities, weak policy-making and macro-planning for educational sports, lack of effective communication with educational sports centers in the world, and improper and unplanned use of training hours. Physically pointed. About specialized manpower, according to management researchers, specialized and skilled manpower is the most important pillar and factor of development. Today, countries in the process of planning and formulating, and implementing strategies benchmark themselves and using real, self-made, and standard indicators and criteria, compare their country with other countries and their strategic planning based on achieving the desired situation. They are characterized by indicators and criteria, they direct. In Iran, due to the importance of managerial components such as planning, strategy, and managerial attitudes, and by correcting and improving them in the country's sports management, many weaknesses about educational sports in the country can be corrected and can become strengths for this sector. But the fact is that in many indicators of development, especially in the field of the disabled, the use of sports as a factor for social cohesion, livelihood, and economic issues has not performed well, and this is due to the lack of attention of some decision-makers to the basic contribution of physical education in school sports. And not paying enough attention to the fundamental importance of sports and physical education of universities in the national program. Neglect and lack of a detailed program in university and school sports and neglecting it can have disappointing results for sports, because all over the world, school and university sports to find talent and eliminate gender discrimination, creating a suitable environment to help people with disabilities. , Used to spread peace between ethnicities and nationalities. Because it is the basis of championship and professional sports. The limitations of the research are due to factors such as the structure of society, people's moods, political, social norms, and some other factors, and the achievements of this research should be used considering the limitations. And effective internal imposes constraints on the researcher that are uncontrollable. Hence, it can have a significant impact on the conclusion. Among the limitations that the present study faced, the following can be mentioned: Due to the limitations caused by the research tools (interview and questionnaire), this research also has problems such as not having enough time to respond, not providing personal opinions. Due to the lack of trust in the questioners. One of the limitations of the present research is that it is cross-sectional, because the research was conducted at a specific time, its results can not be generalized to all times and can be considered definitive for all conditions. Therefore, longitudinal research is recommended.

 The preconception and during pregnancy periods are now thought to be critical for the long-term effects on fetal development and postnatal growth and may predispose offspring to phenotypic changes and multi-diseases later in life. Moreover, physical activity and different kinds of stress during pregnancy are two important maternal behavioral lifestyles that can influence in health or disease of mothers and fetuses. While there are still many questions about the optimum intensity of maternal exercise, exercise during pregnancy has been considered as a positive environmental factor in the prevention of chronic diseases in the next generation. Several pieces of research have shown the positive effects of short-term and long-term exercise on the gene expression of offspring. High-intensity interval training is a form of cardiovascular exercise in which short periods of intense exercise with less-intense recovery periods. Animal model studies recently highlighted which pregnant mothers could tolerate this intensity during pregnancy. It has recently been determined that the Sirtuins family has a cardioprotective role in the heart. There is evidence that Sirt6 protects the heart from developing diseases through negative regulation of the insulin growth factor (IGF) signaling in the myocardial cells. Therefore, the present study aimed to investigate the role of high-intensity maternal exercise before and during pregnancy on the expression of cardiac genes Sirt6 and IGF2 as factors of cardiac health in adult female offspring.

Twenty-four female Wistar rats which never experienced a pregnancy, aged 8 weeks, were randomly divided into three maternal groups; mothers sedentary (control group, n = 8), mothers who exercised only before pregnancy (n = 8), and mothers who exercised before and during pregnancy (n = 8). High-intensity interval training consists of running on the treadmill with the speed of 18m/min at 10˚ inclination for 3 mins (85–95% ofVO2max), switching with active recovery, and the speed of 13m/min (65% of VO2max) at 0˚ inclination for 5 days/week which is in accordance with the overload principle; the duration and number of bouts were increased every week. High-intensity-interval training was performed in two parts, the first part included six weeks of HIIT prior to pregnancy and then 3 weeks of HIIT during pregnancy. Two females with one male were mated for two days. After pregnancy, the animals were kept individually per cage to notice the birth process, number, and birth weight of pups. Then the offspring were allocated to pup groups according to their mother groups at the end of the breastfeeding duration (3 weeks old). Ten-week-old rats were anesthetized with Xylazine (3 mg/kg) and Ketamine (30 mg/kg) and the left ventricle was separated after whole blood extraction. The Sirt6 gene expression and IGF-2 gene expression were measured by the RT-PCR method and the data were analyzed by the one-way ANOVA method.

The present study showed that there was no statistically significant in the sex birth weight (P = 0.246) of pup groups as previously published. Also, maternal HIIT did not lead to significant differences in the number of pups (P = 0.16) between different maternal groups. Maternal HIIT before and during pregnancy has effects on the Sirt6 gene expression (P=0.0001) in the heart of female offspring and has no significant effect on IGF-2 gene expression (P=0.268). 

The consequences of maternal exercise in offspring have been investigated as a positive maternal behavior during pregnancy. We have indicated in our previous study that maternal exercise before and during pregnancy has positive effects on the cardioprotective genes of male offspring’s hearts. In the present study, we broaden the investigation to determine the cardioprotective effect of maternal exercise in female offspring. Our finding indicated that maternal high-intensity interval training leads to an increase of Sirt6 mRNA in the female similar to male offspring. Scientific evidence supports a relationship between birth weight and postnatal health outcomes and mentions birth weight as a vital factor in adult multi-disease. Consistent with the previous study, our study showed that maternal high-intensity interval training did not affect the birth weight of offspring. The benefits of high-intensity interval training on the heart are the reduction of glucose consumption as a source of energy so high-intensity interval training compared to traditional moderate-intensity continuous training is a suitable way to promote heart health. It is well established that maternal exercise during pregnancy improves insulin sensitivity in adult offspring. One of the protective factors of maternal exercise is the decreased cardiac glucose uptake in offspring, but its molecular mechanism is not well understood. It is well-known that one of the important pathways of the cardioprotective effect of exercise is an activation of the Sirtuins family. It has been demonstrated that one of the intergenerational effects of exercise in cardiomyocytes is increasing Sirt6 in the neonatal heart. Therefore, one of the possible mechanisms to increase the expression of the SIRT6 gene observed in the present study to improve the cardiovascular health of offspring by maternal HIIT before and during pregnancy is to reduce glucose consumption as fuel and reduce metabolic pressure on the heart of offspring. Likewise, we indicated that maternal high-intensity training could increase Sirt6 in the heart of adult female offspring. Thus, the above findings suggest maternal high-intensity exercise is a positive maternal behavior before and during pregnancy, which can affect the health of the heart in the next generation.

 In the last two years, with the outbreak of the Covid-19 disease, various parts of higher education were affected, especially the education of medical students. With the spread of this disease, the involved countries inevitably changed their current educational methods and took measures in this field. The process of teaching and learning should continue and this view led to the emergence, discovery, and application of a wide range of online teaching-learning methods. Attendance in class is especially important when teaching medical sciences because learners are trained to solve problems, critically analyze, and make therapeutic recommendations, and absenteeism is a concern. Following the formulation of the comprehensive program in the field of education, to plan for the realization of the policies and strategies contained in those operational packages, operational plans, and annual projects are implemented based on them. Following the aim of higher education in the health system and the educational transformation and innovation plan in Iran's universities of medical sciences, twelve educational packages were placed as the basis of educational transformation and development. One of the most important packages of the transformation plan was the virtual education package. For the development of virtual education, 8 steps of training manpower, regulation of laws, encouragement, and motivation, production of electronic content, provision of infrastructure, production and dissemination of knowledge, development of virtualization, and novelty, and innovation were determined as the main strategies. With the emergence of the phenomenon of Covid-19 and its stability with new strains in the context of other effective factors and the forced movement of the education system at different stages towards virtual education as the dominant method and most fields as the only educational method, this question In the minds of the beneficiaries of the education process, especially the executors, it raises the question whether the virtual education methods as previously considered as a goal and ideal; Are they responsive to teaching and learning needs? Many things have been said and written about the problems of classrooms before the contemporary period. Now and in the new conditions, it seems that some of the previous problems have been strengthened. By default, advantages are also considered for virtual education, but of course, the question must also be answered which of these "Educational benefits" can only be accessed through virtual training and cannot be obtained in face-to-face training? It seems that now, despite the new experiences in the field of virtual education, there is an opportunity to move away from the past positive and current negative emotions and perceptions towards this type of education; The real place of virtual education in the cultural context of the country's education system should be determined and operational planning should be done free of unrealistic idealism to improve the quality of education and increase students' participation in this process. Although the corona pandemic caused many problems on all the indicators of society, including the health of the people, it led to the flourishing of some capabilities in the country, among which we can mention the spread and prosperity of virtual education throughout the country. It seems that virtual education has entered a new phase in our country and more attention has been paid to virtual education. On the other hand, those responsible for the matter have become more aware of the importance of distance education and e-learning-based education. Therefore, it is expected that with the development of the necessary infrastructure such as the development of the nationwide Internet network and increasing its speed, the production of interactive educational software, and the use of the experiences gained in this pandemic, we will witness the increasing prosperity of virtual education in the country, and even after the end of the Corona epidemic. , this type of training should continue alongside face-to-face training. In the field of medical education, the development of online simulators in field of medicine, the promotion of virtual hospitals and remote medicine (telemedicine), the presentation of virtual cases, and the holding of online tests can help in promoting virtual education. Critical thinking is a general term that is often used to refer to two very different concepts, ability, and desire. Ability refers to a person's ability to think critically, while willingness refers to a person's desire to think critically. The virtual approach will be a suitable field for the emergence of talents, creativity, and innovations. Also, with the continuous and low-cost expansion of the virtual education system and the reduction of the need for space, space and place, educational facilities and welfare facilities for this need and the dominance of information technology and communication technology and its influence on different levels of people's lives, the traditional concept The class has changed and ultimately increases the efficiency of the education process. Considering the importance of virtual education during the corona pandemic period and its role in the critical thinking of students of higher health education and the explanations provided, the question raised here is that the general perception of virtual education during the corona pandemic period and the critical thinking of students in How is the corona pandemic period and what are the requirements of this field?

This article is a review study conducted in 1400 by searching SID, PubMed, Google Scholar, Magiran, Springer, Wiley, Web of Science(ISI), Scopus, Science direct, and ProQuest databases and using the keywords " Critical thinking, virtual education, corona pandemic era" and their English equivalents were done. As a result of the search, 158 articles were found in the period from 2000 to 2022, 74 articles were selected in the screening stage, and at the end, 17 articles were subjected to content analysis.

This review study showed that virtual education during the Corona pandemic has a direct effect on critical thinking.

In general, it can be concluded that to improve the level of critical thinking, virtual education can be used alongside real education, and in this regard, educational goals can be achieved. Online learning as a paradigm shift in the framework of e-learning has gained special importance after the start of the Coronavirus and changes in the way universities teach from traditional to digital. With the sudden and immediate closure of universities, the corona pandemic has changed the educational and research structure. This critical situation has created many concerns, including the decline in the quality of education and an uncertain future for students. In Iran, in most parts of the world, since the early days of the Corona outbreak, the use of various electronic and virtual education methods as an alternative to face-to-face education has been on the agenda. Today, electronic learning and virtual education are considered new paradigms in teaching and learning mechanisms.

 In early January 2020, a new corona virus called corona was identified as an infectious agent by the World Health Organization and caused a viral pneumonia outbreak, the first of which was reported in Wuhan, China in December 2019. The virus has so far infected most countries in the world and has become a global problem. By this time in December 2021, about 265 million people in the world have been infected with this virus and 5 million 270 thousand people have died from this disease. According to the World Health Organization, the incidence of this disease is still increasing and will become the third leading cause of death in the world by 2030. This disease has a special complexity and has multiple dimensions and consequences that have caused many problems in the field of health, social and economic as well as psychological for people. The emergence of this disease is now a public health crisis. According to this research, exposure to news and restrictions caused by this disease can lead to many mental health problems. In fact, one of the situations that puts a lot of stress on people during the outbreak of covid 19 disease is the inability to predict and uncertainty about the control and end of the disease.
Mental health is defined as a harmonious and harmonious behavior with society, recognizing and accepting social realities, the power to adapt to them and meeting one's balanced needs and is an important factor for the health of society. The prevalence of the disease can also increase feelings of loneliness, decrease social support, feelings of fear and anxiety to clinical stress and anxiety, obsessive-compulsive disorder associated with the disease, and decreased life expectancy. One of the hopeful factors is health and the disease can cause despair, fear and even despair of the patient. The outbreak of a disease has a much deeper and wider impact and affects not only the affected community and relatives, but the entire community. Because everyone finds themselves at risk, and therefore people's feel of safe and healthy changes, and this situation causes people to despair. Hope is the capacity to imagine the ability to create paths to desirable goals and to imagine the motivation to move in those paths. Hope predicts physical and mental health such as positive response to medical interventions, mental health, effective getting along, and health-promoting behaviors. Covid 19 disease can also lead to psychological problems due to its infectious nature and unpredictable nature. In this regard, various researchers consider the implementation of public health policies, including areas related to individual and collective mental health in accordance with the different stages of the epidemic of this disease is very necessary. Mindfulness can be an effective tool for achieving peace of mind and body that helps people become aware of their current feelings. Mindfulness-based interventions are considered as one of the third generation or third wave cognitive-behavioral therapies. Mindfulness is a form of meditation rooted in Eastern religious teachings and rituals, especially Buddhism. Segal has defined mindfulness as paying attention to specific and purposeful ways, in the present time, without judgment or prejudice. Linhan stressed for the first time the need to pay attention to mindfulness as one of the essential components of psychological therapy. Mindfulness requires the development of three components: judgment avoidance, purposeful awareness, and focus on the present moment. Focusing on the present and processing all aspects of the above experience makes one aware of the daily activities and automatic functioning of the mind in the past and future world and he controls emotions, thoughts, and physical states through moment-to-moment awareness of thoughts. As a result, it is released from the everyday and automatic mind focused on the past and the future. Although general vaccination has reduced the virus in some countries, including Iran, and reduced the number of infected people, a large number of people are still infected with the virus on a daily basis. and the psychological effects of this situation have caused great concern on the part of the world health organization and the psychiatrists. Also, due to the fact that Covid 19 is a pandemic virus and its side effects are still unknown to the medical community around the world, a decrease in mental health and life expectancy has occurred in people infected with this virus. The information and research that exists about the covid 19 virus and most of the research that has been done has talked about the physical and psychological problems and consequences of this virus, and not much has been done to treat psychological problems. Therefore, considering the importance and necessity of this topic, the present study investigates the effectiveness of mindfulness-based cognitive therapy on mental health and life expectancy of patients with covid 19 disease.

The present study was is applied and the research project was one of the single-subject clinical trial and multiple baseline projects. In this type of project, the researcher studies the effect of one variable on another variable on one or more triable. Three people were randomly selected from a sample of patients with covid 19 disease who recovered from the disease and were consistent with the purpose of the study. The General Health Questionnaire (GHQ) was designed by Goldberg and Hiller. The questions in this questionnaire examine a person's mental state over the past month, including symptoms such as abnormal thoughts and feelings and aspects of observable behavior that emphasize the here and now situation. The Life Expectancy Questionnaire (HQ) was developed by Schneider et al In 1991 to measure hope. It has 12 items and is self-assessment. It has two subscales. In this study, clinical significance has been used to analyze the data. Clinical significance refers to the scientific value or significance of the effect of the intervention performed. Two major and widely used approaches in clinical significance are the reliable change index approach and the normative comparison approach. Reliable change index (RCI) was first introduced by Trax &   Jacobson . for analyzing the data obtained from single case designs. In this index, the post-test score is subtracted from the pre-test score and the result is divided by the standard error of the difference between the two scores. Also the clinical significance was calculated through a formula which was first developed by Blanchard & Schwarz . to analyze the single subject data. The percent recovery formula is one of the methods to measure clients' progress in reducing target problems. In this formula, the pre-test score is subtracted from the post-test score and the result is divided by pre-test score. To analyze the data and evaluate the performance, visual inspection or graphic diagram, and diagnostic improvement were used and the results from before and after the intervention are presented in the table below. After the treatment sessions, the data were scored and interpreted. The tables related to findings are explained below. In Table 1, the scores of the three subjects on post-traumatic stress scale in baseline, treatment and follow-up stages are shown (baseline three times, treatment three times and in follow-up three times) along with a reliable index and overall recovery percentage based on different stages of treatment.

The results of this study showed that mindfulness-based therapy has an effect on the mental health of patients with improved covid 19 and has increased the mental health of these people. The results of the present study showed that mindfulness-based therapy has an effect on the life expectancy of covid 19 disease patients and has increased life expectancy in these patients.

The aim of this study was to evaluate the effectiveness of mindfulness-based therapy on increasing mental health and life expectancy of undergraduate students of Lorestan University who had covid 19 disease and recovered from this disease. Mindfulness-base therapy has helped patients live in the present and become more aware and accepting of their current situation. Also, hope for the future and do not drown in negative thoughts. The results showed that mindfulness-based therapy increased mental health and life expectancy in patients recovering from covid 19.

 According to the World Health Organization, cardiovascular diseases account for approximately 30% of deaths worldwide. Obesity is one of the most important risk factors for developing cardiovascular diseases and other non-communicable diseases. Excessive obesity plays an important role in the development of cardiovascular risk factors such as hypertension, dyslipidemia, and diabete. Currently, body mass index and waist circumference are recommended for classification of overweight and obesity . Increased body mass index and waist circumference have been shown as a risk factor for cardiovascular disease . However, studies have shown that the discriminative capacity of BMI is questionable due to the inability to distinguish between adipose tissue and lean mass. This issue has led to the idea that by combining traditional anthropometric indices (such as height, weight, body mass index or waist circumference), a better physical index can be designed that considers and examines body shape Recently, Body Shape Index (BSI) has been proposed as a new body index. Krakower et al. (2012) reported a significant correlation between body shape index and visceral fat tissue and showed that premature deaths are more related to this index than waist circumference and body mass index. Body Roundness Index (BRI=BRI) is another new index proposed that based on waist circumference and height, can better predict the percentage of body fat and visceral fat compared to the traditional indices of body mass and circumference. Recently, several studies have shown that body circumference index can be used as an index of obesity to determine the presence of left ventricular hypertrophy, hyperthermia, cardiovascular disease and diabetes .The purpose of this study was to predict the relationship between physical activity and some new and traditional obesity indicators in women with cardiovascular disease and to determine the power of these indicators in the diagnosis of cardiovascular diseases.

This descriptive-correlation study was conducted on 334 women with CVD (middle: n=189, elderly: n=145) referring to a heart centers in Mashhad. The inclusion criteria included female patients in the age range of 40 to 75 years, myocardial infarction, heart attack, high blood pressure and cholesterol, and willingness to participate in the research. Cardiovascular disease factors were diagnosed by consulting a specialist doctor and reviewing medical records for each patient. To investigate the relationship between different factors, the study was conducted in different age groups. For this purpose, the subjects were divided into two groups: middle-aged (40-55 years, 189 people) and elderly (60-75 years, 145 people). Written informed consent was obtained from all study participants. The convenience sampling method was used. Physical activity level was measured with International Physical Activity Questionnaire (IPAQ). The body shape index (BSI), body roundness index (BRI), Waist circumference (WC), body mass index (BMI), Waist-Hip Ratio (WHR), fat mass percentage (%FM) were measured and calculated. Body shape index was calculated based on height (meters), body mass index and waist circumference (meters) using the formula. Body circumference index is based on height (meters) and waist circumference (meters). First, the irregularity (non-dimensional value) of the body (€) was determined using the formula. Irregularity measures the degree of ovality or roundness and ranges from zero (full circle) to one (vertical line).
Independent t test was used for show difference between middle age and elderly groups. To evaluate the possible correlations between obesity indices, Pearson and Spearman correlation coefficients were used. The Receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity and the best cut-off point of anthropometric indices.

The results showed that there is no significant difference for physical activity, body mass index, body roundness index, body shape index, waist circumference, waist-to-thigh ratio and body fat percentage between middle-aged and elderly groups. The results of the correlation coefficient showed that in both middle-aged and elderly groups, body roundness index has a positive relationship with waist circumference, body mass index, waist-to-thigh ratio and fat mass. In middle-aged people, the level of physical activity had no significant relationship with any of the variables, but in elderly patients, the level of physical activity had a negative relationship with body roundness index and body shape index. In the middle-aged group, the body roundness index had the largest area under the curve, and the body shape indices and waist-to-hip ratio are in the second place with a small difference. In the elderly, the waist circumference had the largest area under the curve and the body roundness index ranked second. The level of physical activity in both groups had the lowest area under the curve. The values ​​of the cut points using the highest sensitivity and the lowest specificity in the middle-aged group for the physical activity level is greater than 984.5, body roundness index is less than 5.41, body shape index is less than 0.0834, waist circumference is less than 89.7, Body mass index less than 26.3, body fat percentage less than 31.8 and waist to hip ratio less than 0.91 and in the elderly group, physical activity level more than 789.7, body roundness index less than 5.8, index Body shape was less than 0.0865, waist circumference was less than 91.5, body mass index was less than 28.03, body fat percentage was less than 30.46 and waist to hip ratio was less than 0.9.

Contrary to the initial hypothesis of the researchers, the research findings showed that the level of physical activity had the least ability to predict the presence of cardiovascular disease. According to the present research, there was a weak relationship between the level of physical activity and obesity indicators. Considering that prospective studies in adults have shown that low physical activity is closely related to the development of cardiovascular disease, however, it may be that if the amount of physical activity is low, its changes are not very reliable and cannot be a good predictor for the factors Cardiovascular risk. The level of physical activity in the present study was average (1135.7 meters/minute/week for the middle-aged group and 916.4 meters/minute/week for the elderly group) and the subjects were divided according to the International Physical Activity Questionnaire in terms of physical activity. According to Maisen et al.'s study (2011), the activity level is less than 600 met-minutes per week as inactive, between 600-1500 met-minutes per week as semi-active and more than 1500 met-minutes per week as active was considered. Among the possible reasons for the difference in the results of the mentioned studies, we can mention the physical fitness of the subjects, the disease and pathological conditions of the subjects, and gender. Body roundness index was created in order to predict body fat and visceral fat tissue percentage by using waist size in comparison with height, which makes it possible to estimate the body shape as an egg or oval. Body shape index independent of body size (height, weight and body mass index) creates a quantitative scale to estimate body shape. In preliminary studies, researchers have shown that BSI is a better predictor of premature mortality than BMI and WC in the general US population. According to the results of the study, BRI and WC are best indices for predicting the possibility of CVD in patient middle age and elderly women.

 Quality of life is a subjective and dynamic issue, that is, it is different at any time compared to another time, which is the position of each person in life about his goals, expectations, and individual concerns, not only under the influence of the type and extent of the created problem. Quality of life is considered a basic indicator of health, and since the quality of life includes many dimensions such as physical health, mental health, social relations, family life, emotions, physical functions, spirituality, and professional life of people, paying attention to it is of double importance. Among the intermediate periods of human life, "adolescence" is considered one of the most important periods of life. The conditions governing adolescence indicate the need for the adolescent for more mental peace, in addition to that, the adolescent needs to be understood by others; in adolescence, sports and games as leisure activities can play a decisive role in maintaining the physical and mental health of children and adolescents. Sports and physical activities are an important and inseparable part of teenagers' lives in the school environment and even outside of school. Students also form a large part of society and as future professionals, they will take on important responsibilities in society, so their health is of particular importance in all fields. The computer is one of the phenomena that cannot be ignored of the physical and psychological effects of its use. The computer sometimes fascinates and influences the younger ones more than the older ones. Computer games are a type of entertainment that is played with devices equipped with an electronic processor. Games, especially electronic games, can help maintain mental health due to their capabilities and functions. They are also considered one of the factors affecting the child's growth, personality, and socialization. The desire of young people to use computer games has led to the creation of an active and healthy lifestyle, especially at the school level. However, research on the use of computer-motion games in schools is limited and mostly laboratory research. The basis of the current research on the quality of life is a holistic approach. In this approach, physical health, mental health, social relations, and the quality of the living environment are among the constituents of the quality of life. Since, according to the review of related research backgrounds, no special research was observed about electronic games and non-electronic sports with the quality of life and their mutual effects, the present study seeks to answer the question of whether electronic sports and non-electronic sports affect the quality of life and related indicators. Does it affect physical fitness skills?

The statistical population of this research was made up of 900 female students in the twelfth grade of the second high school in the 2nd district of Ray city, of which 60 were randomly selected and classified into 4 groups according to the number of sports and electronic sports. Became Each group consisted of 15 people. The research method is descriptive and semi-experimental, which was implemented in the field. Standard quality of life questionnaire (SF-36) was used to measure the quality of life of the subjects and evaluate the effect of this study on it. To analyze the data, descriptive indices and statistical tests of analysis of covariance were used in SPSS software.

The results showed that there is no significant difference between the mental health of students of different groups in the mental health post-test. Regarding the variables of physical fitness, the results showed that there is a significant difference between the pre-test and the post-test variables of agility, ball throwing, reaction, shoulder raising, and bar fix.

Sports and physical activities are considered suitable options for improving the physical fitness factors in students, and by improving these factors, we can hope to improve their quality of life. In a general summary of the research results, it should be mentioned that achieving physical fitness and maintaining it affects all aspects of life, and besides strengthening health, it is also effective in increasing work efficiency. Prepared people have more energy, which affects work and intellectual efficiency, makes recreational and leisure activities useful, increases resistance to fatigue, and ultimately improves physical activity and sleep patterns. Therefore, sports and physical activities are considered suitable options for improving the physical fitness factors in students, and by improving these factors, we can hope to improve the quality of life in them, because a major part of the quality of life is physical health and the ability of people to do everyday things in a good way. Efficient and effective returns. However, many exercises can lead to the development of a person's physical fitness, and two types of these exercises are traditional sports exercises and sports exercises using electronic games, and it seems that electronic games if used correctly and Used in a limited period, it can be the basis for the development of physical fitness. But in general and according to the results obtained, it seems that the best form of training is the combination of two types of traditional sports training and electronic games because, in most of the findings, the results of the combined group were better than other groups, and therefore it is suggested that students To develop their physical fitness and improve their quality of life, Shahrari secondary schools should use combined exercise programs so that they can get the best possible results.

 Studies show that an unbalanced future outlook predicts delinquency, drug use, and high-risk sexual behaviors during adolescence. At the same time, having a hopeful mindset, having sufficient resources for purposeful thinking, and being familiar with the paths needed to achieve goals, lead to well-being in individuals. It also enhances a person's deep vision for the future, their learning activity, their longevity and their performance. Thus, the outlook for the future can affect a wide range of emotions, thoughts, and behaviors. The future perspective, which is defined as the current prediction of future goals, can be created by setting motivational goals in the future and creating long term behavioral projects to achieve these goals. The problem for many young people and adolescents is that they live with a relatively short-term outlook, and it is difficult for them to see the future right now. In the field of education and learning, the ability to tolerate delays in reward is very important. Students have to choose between immediate reward and short pleasure, or long-term reward and long pleasure, and here is the future perspective that gives him the power to evaluate the future. The purpose of this study is to investigate the determinants of future prospects in female high school students in Shiraz.

The statistical population of the study is all female high school students in Shiraz (10865 people) who were studying in the academic year 1399-1400. Among them, 346 students were selected as a sample by multi-stage cluster sampling method and participated in the study. The research tool was a standard questionnaire whose validity was confirmed by professors and experts and its reliability was confirmed by Cronbach's alpha coefficient.

The results of structural equation modeling showed that negative emotion regulation strategies have a positive effect on cognitive distortions, and positive emotion regulation strategies have a negative effect on cognitive distortions. Positive emotion regulation strategies have a positive effect on goal setting and cognitive distortions have a negative and significant effect on the future perspective and the effect of goal setting on the future perspective was positive. The results show that the strongest relationships in the model are related to the effect of negative emotion regulation strategies on cognitive distortions with a coefficient of 0.78 and then related to the effect of cognitive distortions on the future outlook with a coefficient of -0.55. The findings also show that apart from the relationship between negative emotion regulation strategies and rejected targeting (p <0.05), five other relationships have been confirmed in the model (p <0.05). If a person can manage and control his emotions, he will have more free space intellectually to focus on goals and goal setting. Cognitive distortions affect the future outlook (p <0.05) and the direction of the negative impact and the intensity of the impact is -0.55. Targeting has an effect on the future outlook (p <0.05) and the direction of the positive effect and the intensity of the effect is equal to 0.29. Therefore, the positive and negative strategies of the emotion regulation variable are the only external variable of the structural model of the research to which no one-way arrow is pointed. Finally, the existence of a significant positive causal relationship between goal setting and future perspective indicates that the more students expose themselves to goal setting or goal setting in the future, the more rapidly towards a future perspective. A more balanced and ideal future will move. In fact, by choosing goals in the desired area, the person is not only not bothered by the difficulty of the path, but also welcomes learning skills and doing difficult tasks to overcome obstacles in the way of his goal and pursues his goal. Acquires the necessary competence and avoids poor performance, and is more determined and does not doubt in its decision in the direction of the goal, and consequently, these measures tend to be more and more forward-looking. Will strengthen the more desirable in him.

Cognitive distortions have a negative and significant effect on the future outlook. The indirect and inverse effect of negative emotion regulation strategies, and the indirect and reinforcing effect of positive emotion regulation strategies on the future outlook in this study, reveal the need for planning to empower students in controlling and managing cognitive emotions.

 Anxiety during pregnancy and fear of childbirth is seen as common problems in Primiparous women. Anxiety and fear during pregnancy are sometimes considered a natural mechanism that prepares the expectant mother for pregnancy and the accompanying changes, but the intensification of worry and anxiety can take the form of illness and affect the mental health of pregnant women. More than 80 percent of women with low-risk pregnancies experience some degree of anxiety and fear of childbirth, and in 6 to 10 percent of cases, this anxiety and fear cause severe debilitating complications in pregnant women. There are several treatment methods to reduce the symptoms of anxiety and fear of childbirth. One of the effective treatment methods is behavioral activation therapy. This treatment method is one of the third-wave psychotherapy methods that increase the behaviors that increase the contact of the person with the reinforcing connections of the environment. In this treatment method, the patient is taught to use an alternative and adaptive coping model in dealing with annoying and frustrating environmental conditions and to react with an active behavior instead of avoidance. Research findings have shown that excessive activity of the inhibitory system leads to anxious personality traits, high sensitivity to threatening stimuli, and anxiety-related behaviors such as worry and fear. The results of some studies confirm the existence of a relationship between inhibition systems and psychiatric disorders such as depression, fear, and anxiety, but few studies have investigated the effect of this method on reducing anxiety and fear in Primiparous women. Another way to reduce fear and anxiety is to use a calm tone. Using a relaxed tone during pregnancy as a suitable method to calm the mind and mind, focus attention on the fetus, positive imagery towards pregnancy, and increase the relationship, and attachment of mother and fetus has been desired by the researchers. In relaxation training, by using breathing techniques, special verbal stimuli, and mental relaxation during the treatment of clients, people are helped to reduce their stress and achieve calmness in their bodies and mind. achieve Correctly performing relaxation exercises improves a person's blood circulation and reduces tension, anxiety, and depression by creating a positive attitude and improving brain function, and increasing people's cellular energy and confidence by relieving their anxiety. Relaxation methods are also known to be effective in many situations such as pain, childbirth, anxiety, and insomnia during pregnancy, and it causes a person to gain the power to control his emotions and behaviors. Considering the great importance of fear and anxiety and their effects on the mental health of Primiparous pregnant mothers, this research aims to determine and compare the effect of educational interventions on the effectiveness of behavioral activation and relaxation in reducing anxiety and fear of childbirth in women. Prenatal care was performed in the hospitals of Karaj city.

The current research was a semi-experimental study with a control group in terms of practical purpose and research design. The statistical population of the research included pregnant women with first births in Karaj in 1400. 144 Primiparous pregnant women referring to Shahid Madani Hospital in Karaj were randomly selected and placed in two groups of behavioral activation and relaxation technique (48 people in each group) and a control group (48). For the experimental group, a training session on behavioral activation and calm tone was implemented, and then a researcher-made questionnaire was used to collect data on the effectiveness of the training on the scores of anxiety and fear of childbirth. The reliability of the questionnaires was confirmed using Cronbach's alpha of 0.78 for anxiety and 0.71 for fear. Descriptive and inferential statistics were used for data analysis using SPSS version 21 software.

In this research, 144 Primiparous pregnant women were studied in two groups of behavioral activation and relaxation techniques (48 in each group) and the control group (48). The studied groups had no statistically significant differences in terms of the variables of gestational age and the interval between marriage and first pregnancy. The results showed that after the intervention, the anxiety and fear of childbirth of Primiparous pregnant women in the intervention groups decreased significantly, but no significant statistical difference was observed in the control group.

It seems that behavioral activation training and relaxation training can help Primiparous pregnant women to recognize, despite the automaticity of many bodily responses, they can identify them and reduce the anxiety and fear of childbirth. According to the results of relaxation and behavioral activation during pregnancy, it can be considered as a suitable method to reduce anxiety and fear of pregnancy. This study showed that the designed intervention has significant positive effects on reducing the anxiety and stress of pregnant women. Therefore, it is suggested that a series of training in the form of behavioral activation and relaxation should be included in the care programs of pregnant women. The method of reducing fear and anxiety based on calm tone and behavioral activation due to having conscious and non-judgmental techniques can have beneficial effects in improving fears and worries during pregnancy. Considering the simplicity and availability of training in behavioral activation techniques and body exercises, it is suggested the presence of a supportive person such as a life partner, female relatives, and a private midwife; by doing these interventions, they can increase the satisfaction of the birth experience and the feeling of comfort and reduce the fear and anxiety. Considering the limited number of people and the duration of the interventions in this research, it is suggested that this training be carried out with a longer duration and on a larger sample size of pregnant women. The effect of this research with the effect of other therapeutic and psychological methods on the dependent variables of this research should be compared and investigated in practice. Also, in order to evaluate the effect of the passage of time on the retention of educational achievements, it is suggested that researchers consider follow-up courses in future research. Considering that one of the limitations of the present study was the use of a questionnaire in the data collection process, it is suggested that another study be conducted with other tools (observation and interview) to investigate the level of anxiety and fear of childbirth in Primiparous women.

 Today, many thinkers consider the years before elementary school to be the most fruitful years for education and learning. They believe that a young child learns at a faster rate than he will be able to later and his early mental connections and associations are so stable that in the following years such it does not last. In most cases, preschool children's growth is unbalanced in different growth areas, so growth in one area may be faster than growth in other areas. In addition, children's growth is irregular in most cases. For example, a child may not make much progress in a relatively long period in the field of development, and after that, almost overnight, he will reach sufficient maturity in a series of skills or show more mature characteristics. Also, the growth of children is strongly influenced by the environment, and the settings in which children of this age live are very variable. Family, recreational and educational environments of young children are very different according to the values and characteristics that are strengthened in them; therefore, the skills, abilities, and characteristics that this group of children show may be caused by environmental influences before it is an indication of their abilities. All these factors contribute to the increase of individual differences between children, differences that specialists in the field of preschool and early childhood education acknowledge should be anticipated and considered valuable. The existence of these individual differences between children does not have much effect on the dissemination of standards that show similar expectations of children's development or are even designed to lead to more uniform outcomes in children. A child's growth begins before birth and continues throughout life. In the early years of development, the child's brain connections become very complicated, and the interference of these connections can have long-term effects on his development. At the beginning of birth, babies are actively involved in discovering and learning their surroundings due to adequate nutrition and a rich environment. The sensitive period for most human abilities ends before elementary school and reaches a lower sensitivity of brain neurons. Abilities such as vision, hearing, emotional control, and methods of responding to stimuli reach the lowest level of brain sensitivity at the end of early childhood. Other areas of development, such as language development, numerical and mathematical skills, and social skills, have the highest level of brain sensitivity in this period compared to other periods of life. Also, at birth, the size of a baby's brain is one-quarter of an adult's brain, but by the age of three, this size is three times. It becomes its initial size and this brain size growth is closely related to the amount and quality of its interactions with the environment and different experiences. By summarizing the results of research and studies, it can be concluded that physical-motor, cognitive, social-emotional, behavioral, and learning approaches are not separate from each other, and one should pay attention to all aspects of the child's development and consider the child's personality as a whole. Many environmental factors affect the child's development in the early years of life. Around the world, increasing attention is being paid to the importance of the early years of childhood, with an emphasis on the development and use of developmental and learning standards. Advanced countries develop accurate growth indicators for their children and use them for educational planning. The need for this category is also felt in our country. In our society, children are mostly screened in terms of development and by doctors, not in terms of evolution (cognitive growth and learning); Therefore, considering the importance and necessity of the existence of developmental standards for children to evaluate them in different developmental areas and to know their strengths and weaknesses to provide timely interventions to reach their maximum developmental potential, the purpose of this research is to validate developmental standards for children aged It is 3 to 4 years.

The research method was a descriptive-correlational research design and applied research in terms of purpose. The statistical population includes all 3-4 year old children in Tehran. The sample size in each growth area is 100 children aged 3 to 4 years and their teachers and parents, which was obtained through cluster and matrix sampling in kindergartens. The sample was selected from 5 geographical regions according to the economic, social, and cultural characteristics of Tehran, including northwest and east, southwest and east, and the center (regions 3, 5, 6, 14, 16). The data collection tool includes scales for measuring developmental capabilities in cognitive, language, and literacy domains, an approach to learning, physical-motor, and social-behavioral-emotional for 3 to 4-year-old children, which was developed using the standards available in different countries. These scales include the following: the developmental standards of different American states, including the developmental standards of Washington (2012), which has five areas of cognition, language, and literacy, an approach to learning, physical-motor, social-behavioral-emotional, and Nebraska developmental standards (2018). Which have seven fields science, mathematics, creativity, language, physical-motor, approach to learning, and social-emotional. Data analysis including descriptive statistics and validity assessment through content, formal and cultural validity, and validity check through the validity of assessors, internal consistency of the instrument, Cronbach's alpha, and retesting were determined by correlation method.

The findings of the research indicated that there is a positive and significant relationship between the cognition scale and the subscales of logic, arithmetic, science, and studies, between the physical-motor scale and the subscales of gross motor skills and fine motor skills, between the approach to learning scale and the subscales Curiosity and interest, stability of attention, contemplation and creativity between the language and literacy scale with the subscales of receptive or receptive language, expressive language, reading and writing and between the emotional-behavioral-social scale with the subscales of self-concept, self-regulation, interaction with peers and adults and with social behavior, which indicates the construct validity of the scale (of internal consistency). Also, the research findings show; The reliability of the cognitive scale is equal to 0.94, the reliability of the physical-motor scale is equal to 0.74, the reliability of the total approach to learning scale is equal to 0.85, the reliability of the language and literacy scale is equal to 0.93 and in the emotional-behavioral-social scale It was equal to 0.85, which indicates the optimal reliability of the scale.

In this research, the difficulty coefficient (the percentage of respondents to each question based on a three-level spectrum) is presented. The findings of the research indicate that the difficulty coefficient of the physical-motion scale (the percentage of answers to each question option) in the area of gross motor skills and fine motor skills is 29 at the yes level; therefore, the difficulty coefficient of the physical-motion scale questions shows the moderate to high ease of the questions. In questions about the approach to learning at the level of curiosity and interest, the questions are in the yes range. In the field of attention stability, the difficulty coefficient of most questions is at the yes level. The area of creativity and the area of contemplation is at the level of Yes; therefore, the difficulty coefficient of the approach to learning questions shows the medium to high ease of the questions. The difficulty coefficient of language and literacy scale questions, comprehension language, and expressive language questions is in the yes criterion. The reading difficulty coefficient is sometimes at the yes level and the questions of the writing area are at the yes level, except questions 50, 52, and 54. In general, it can be said that the difficulty coefficient of the language and literacy scale questions shows the average to high ease of the questions. In social-emotional questions in the behavioral domain of self-concept, self-management, and social behavior, the difficulty coefficient of most of the questions is at the yes level, therefore, the difficulty coefficient indicates the medium to high ease of the questions; Therefore, based on the findings of the research on the difficulty factor of the questions, the majority of the questions indicate the medium to high ease of the questions. In explaining the findings of the research, it can be stated that the list has high reliability in all areas, this proves the reproducibility of this list in society. It shows that it is consistent with similar foreign and domestic studies. Because reliability is a necessary condition for validity. In other words, if a measure does not have reliability, it cannot show the correct and real value of a phenomenon; Considering the appropriate validity and reliability of the list of cognitive, language and literacy, physical-motion, approach to learning, social-behavioral-emotional developmental skills, it is suggested that to evaluate the developmental skills of cognitive, language and literacy, physical-motor, approach to learning, social-behavioral-emotional children of 3-4 years old in different regions and cultures of Iran should use this list.

 One of the goals and tasks of the educational system is to create a foundation for the all-round development of a person and the education of healthy, efficient, and responsible people to play a role in personal and social life. Therefore, under the title of the fundamental pillar of the country's education system, students have a special role and position in achieving the goals of the education system, paying attention to this segment of society from the point of view of education and upbringing will lead to greater fertility and prosperity of the education system of the society. It will be since well-being is an important indicator for various educational outcomes, and also considering the centrality of school in the lives of teenagers, it is logical that it is important to investigate the educational well-being that shows the relationship between well-being and educational variables. To solve this problem and the damage caused by it, the academic and emotional functions were linked together, and based on this, the academic well-being structure was created to create a relationship between the emotional and academic functions, improving the relationship between the school learner and creating progressive parallel changes. It was investigated in the learner and the learning environment, in the community of students. The academic well-being of students is one of the important concepts in the research field of the education system because this concept is the key to understanding and recognizing a wide range of students' behaviors and has a significant impact on their academic success and performance. Studies have shown that people in the same conditions and environments do not have the same well-being and individual differences play an important role in this. In other words, well-being emerges from the interaction of several factors, including environment, individual, and personality. In recent years, in this field, new approaches with the influence of positive psychology emphasize the capabilities and functions, and individual characteristics of people, among which academic resilience can be mentioned. In general, resilience can be considered as adapting to the challenge and pressure and overcoming it, as well as being strengthened through the experiences of these challenges, which can increase a person's inner ability and social skills. Academic resilience refers to academic progress despite challenging conditions in the educational process. In educational environments, resilience is considered as a very high probability of success in school and other life successes despite environmental difficulties. On the other hand, one of the variables affecting academic well-being is academic support. The issue of academic support for students is multi-dimensional. The role of teachers, parents, and peers provide academic support, each of them alone and about each other, play an important role in the quality and quantity of students' academic activities. The support of teachers and peers has led to a positive perception of the school atmosphere, which is associated with a sense of security, justice, and academic well-being. Based on this, academic support for students is not only limited to the teacher's activities in the classroom but also the peer group, and each parent as a source of support can play a decisive role in academic support for students. Academic support improves students' performance because it provides expectations and values in the classroom for students and encourages students' efforts to achieve these values and expectations. While trying, the student has enough security and does not see himself under threat from the environment, and feels valuable. These feelings and performances are not achieved only by the type of teacher's behavior, but these cases are the result of a set of elements that interact with each other. To be based on this, the current research aimed to investigate the antecedent factors affecting academic well-being and its improvement, and sought to investigate and present a model for academic well-being based on academic support and academic resilience.

The present study was conducted on 540 male and female high school students in Shiraz in the academic year (2021-2022). The sample members were selected using the multi-stage cluster sampling method. First, four girls and four boys' schools were randomly selected from among all secondary schools, and in the second stage, two classes were selected from each school. They were randomly selected (16 classes) and completed the scales of academic support (Sands and Plunkett, 2005), academic resilience (Cassidy, 2016), and academic well-being (Tominin-Sweeney et al., 2012). After collecting the data, the evaluation of the proposed model was done with the method of structural equations and using the Imus program.

The results of the data analysis show that academic resilience plays a mediating role between academic support and academic well-being (p = 0.008, β = 0.09).

In general, it can be stated that academic support (parents, teachers, and peers) prepares students to acquire academic resilience and flexibility in the face of academic problems and challenges, and after acquiring this component Psychologically, students act enthusiastically toward education and learning and finally experience academic well-being. In the field of research limitations, it can be mentioned that due to the spread of the coronavirus and the increase in virtual education and teaching in all schools, caused limitations in data collection (such as sampling). In addition, considering that the tools and their completion were done by students in the virtual space, it is possible that the accuracy of the information has decreased, so the use of other methods of information collection such as interviews and observations as well as face-to-face implementation it can provide more complete information about research variables. In addition, the society and the sample of the present study consist of female and male students of Shiraz schools, so it is prudent to generalize the results to other communities such as students from other cities, students, and other community members. According to the results of this research in the field of application, the findings of this research can provide important information for educational officials. One of the findings of this research was the effect of academic support on resilience and academic well-being. Therefore, educational officials are expected to provide environments so that people can express their opinions easily and have sincere relationships with peers, parents, and teachers. This feature leads to the fact that people can create resilience and academic well-being in themselves. Considering the effect of academic resilience on academic well-being, it can be stated that in order for students to experience the well-being necessary for their studies and finally reach academic well-being, they need the educational environment to provide them with challenges to create the limit of their abilities so that they can experience academic resilience by dealing with those challenges. In the field of research proposals, it was also found that the test of other exogenous and intermediary variables in the form of the model tested in this research can expand and develop the existing knowledge about well-being. It should be noted that in the current research, individual and social characteristics have been discussed, and therefore, it is necessary to investigate other situational, cognitive, and emotional variables.

Today, many organizations are trying to become knowledge-based organizations (1-3). In this effort, the adaptation and implementation of knowledge management practices in any type of organization, both private and public, is considered useful and has the potential to play an important role in improving their performance (4,5). Evidence shows that effective and efficient knowledge management is considered a key success factor for organizations to gain a sustainable competitive advantage (8-10). Psychology is the foundation of knowledge management because knowledge management is all about people. The basic goal is to use all available knowledge to live a happier, healthier and more productive life. Knowledge management and psychology are similar because knowledge management can be used not only to improve people's lives. It can also help improve the communities we live in (11). What people share is their competencies, experiences, expertise, values, background information, and insights to create institutional frameworks for evaluating and combining new experiences and information (12,13).
In fact, knowledge is related to people and that human resource management disseminates it. Knowledge management is developed and strengthened under the cover of human resources management, therefore, in long-term knowledge-based organizations, success in competitive arenas can only be achieved through competent colleagues (15). In this regard, sports organizations also need to acquire, create, store and use knowledge, as one of the most important factors determining growth and development. So far, few researches have investigated the status of knowledge management and human resource management in sports organizations. In this regard, Zalaf et al. (2017) investigated the quality of sports human resource management in Padang using the sports development index and analyzing the availability of sports human resources. The results showed that the development of sports in Pandang depends on the quantitative and qualitative scale based on the human resource management index (16). Also, Huang and Zhang (2011) presented the management of sports events based on knowledge management, which is very important to improve the management skill of the event organization (19).
Despite the great research interest in knowledge sharing, there are still few studies that relate this behavior to human resource variables (training, growth, and performance). The influence of human variables on knowledge sharing has been widely neglected. According to the above, the current research intends to examine the question of whether knowledge management is related to education and development and human resources?

The research method was descriptive-correlation and practical in terms of purpose, and in terms of data collection, it is field-based. The statistical population of this research consists of the employees of Tehran Municipal Sports Organization (1600 employees), among whom 310 people were selected as a statistical sample by simple random and according to Morgan's table. In order to collect data, the field method and the standard human resources management questionnaire and the Knowledge Management (Lawson, 2003) were used. To check the relationship between the variables, Pearson's correlation test was performed using SPSS version 26 software.

The results showed that there is a significant positive relationship between knowledge management and human resource management in Tehran Municipality Sport Organization. There is a significant positive relationship between all knowledge management components (knowledge creation, knowledge sharing, knowledge application, knowledge storage) with all human resource management components (employee recruitment, training and development, performance evaluation, service compensation, working conditions). The highest correlation was obtained between knowledge storage and performance evaluation.

The findings of this research show that there is a significant positive relationship between knowledge management and education and development and human resources. The results of the present research are in line with the findings of Mohammadi et al. (2013) (18). Knowledge management should be analyzed as a factor that affects human resource management. Human resource management is a set of integrated human resource practices that support an organization's strategy, create a sustainable competitive advantage. Human capital (skills, knowledge, and behaviors) and organizational capital (routines, systems, tacit knowledge) are the most cited in the background of the resource-based view, which are acquired over time and make interpretation and imitation difficult for competitors (24). According to the results of Theriou and Chatzoglou (2014), organizations that follow the best human resource management practices, through the design of human resource practices that support knowledge management and, in turn, support the creation of organizational capabilities, achieve higher performance (26). Therefore, if human resource management is about the effective management of people and if the most valuable resource of people is knowledge, then human resource management and knowledge management are closely related to each other (27). Studies have long supported the claim that employees are the most important organizational asset, especially when it comes to achieving an effective knowledge management process (26-29). Employees are a vehicle for creating, sharing and implementing knowledge. Nilsson and Ellström (2012) emphasized that overall organizational success is increasingly related to identifying, recruiting, managing, and retaining high-performing or talented individuals to meet the current and future demands of an organization (28). Therefore, the main purpose of human resource performance is to develop, select and hire people, train and develop employees, evaluate their performance, reward them and create a learning culture to support and achieve the organization's strategy (30). Therefore, human resource management activities, such as recruitment and selection, training and education, performance management and reward systems, are necessary for the proper management of knowledge (31) and instrumentally help to improve the flow of knowledge, i.e., its acquisition, transfer and integration in the organization. they do. The results of our study show that there is a positive and significant relationship between knowledge management and the components of recruitment, training and development, performance evaluation, service compensation and working conditions in Tehran Municipal Sports Organization. The most valuable asset of any organization is its human force, and more importantly, the knowledge within the organization. In other words, spending money to improve knowledge or human capital is the most valuable and useful investment that any organization can make (32). There were also some limitations in the present research since the questionnaire only measures the attitude of the employees, therefore it is not considered an accurate tool to measure the reality. It is suggested to carry out this research in other situations and compare their results with each other.
In short, the results of the present research showed that there is a positive relationship between knowledge management, education and development and human resources in Tehran Municipal Sports Organization. Considering the positive relationship between knowledge management and training and development and human resources in Tehran Municipal Sports Organization, it is suggested that Tehran Municipal Sports Organization helps by establishing knowledge and training and development of staff.

 Obesity, as a serious metabolic syndrome, has many health and social effects disorder that is characterized by excessive accumulation of body fat. It’s also associated with a body mass index (BMI) of more than 30 kg/m2. Overeating, lack of physical activity, and genetic factors are the main reasons for obesity. Based on BMI analysis of the population of 200 countries, obesity will has exceeded 6% in men and 9% in women by 2025(1). Obese individuals are at risk of developing diseases such as type 2 diabetes, cardiovascular disease, non-alcoholic fatty liver disease, hypertension, hypercholesterolemia, immune dysfunction, rapid onset of infection, delayed wound healing, and certain types of cancers(2). The pathogenesis of these disorders has been linked to the health of the gut microbiota(3). The gut microbiota is considered an endocrine organ that has influenced on immunity, metabolism, neuroendocrine responses of the host, and synthesizes vitamins, amino acids, and enzymes(4). They can also produce important short-chain fatty acids (SCFA) and absorb dietary minerals(5). The microbiota composition is very different amongst people and is affected by several factors, such as antibiotic use, diet, lifestyle, genetic traits, and body mass index(6). It was demonstrated that a decrease in beneficial bacterial species in the gut microbiota is linked to obesity and metabolic disorders(7), so microbiota has been known as one of the principal causes of obesity(8, 9). In addition, recent findings have shown that Firmicutes and Bacteroidetes are two dominant phyla in human gut microbiota, and an increased Firmicutes/Bacteroidetes ratio is correlated with obesity(10). Some studies suggest that the consumption of probiotic substances and dietary fibers can beneficially alter the gut microbiome composition in a short time(11, 12).  Recently, a lot of attention has been paid to the use of natural products such as marine organisms with anti-obesity activities. Marine organisms, especially brown algae, are good dietary complements with prebiotics and anti-obesity potentials for those who want to lose weight.  They are widely used in the treatment of various diseases because of their several pharmacological activities(13). Consumption of marine seaweeds has risen considerably over the past decades because of their high nutritional compositions such as minerals, polyunsaturated fatty acids, and high dietary fibers(14). Brown algae have the potential anti-obesity agents such as fucoxanthin, phlorotannins, fucoidan, and alginates(13, 15). Alteration in lipid metabolism, suppression of inflammation, suppression of adipocyte differentiation and delay in gastric emptying are the ways that anti-obesity compounds from algae may involve(16). Besides, the potential benefits of brown seaweeds on the human body are related to dietary fibers that have prebiotic activities over the gastrointestinal tract (GIT) microbiota. Such fibers are non-digestible components that can selectively enhance beneficial microorganisms of the gut microbiota (17, 18). On the other hand, consumption of brown seaweeds can promote beneficial bacteria while reduce harmful species in the gut microbiota of rats(10). Brown seaweeds have a variety bioactive molecules such as, polysaccharides, polyunsaturated fatty acids, and polyphenolic compounds that play have the potential health benefits in regulating gut microbiota and therefore improving obesity(3). In fact, consumption of brown seaweed may exert an effective impact on gut health by acting as prebiotics, and promoting the growth of lactic acid bacteria that aid in the production of SCFA such as butyrate, propionate, and acetate(19). Kim et al (2018) showed that Laminaria japonica brown seaweed had a probiotic and anti-obesity effect on reducing of pathogenic bacteria level and increasing lactic acid bacteria level in gut-obese rats(20).  Regarding to these considerations, the objective of this study was to find the effects of hot water and ethanolic extracts of Persian Gulf brown algae, Padina pavonica and Cystoseira myrica on changing gut microbiota, some serum indices, food intake and weight loss in rats that fed with high-fat diet.

In this study, 100 male Wister rats in the weight range of 220±20 gr were selected and divided into 10 groups (8 treatment groups, one normal control group, and one obese control group). All animals except for normal group were fed with 60% cholesterol for 1 month. Each group was further treated with hot water (HW) and ethanolic (E) extracts of seaweeds for 8 weeks.  Then during the experiment, food intake and weight loss were measured weekly and daily, respectively, and at the end of period, we collected the stool samples (3 samples of each group), and analyzed the intestinal microorganisms through 16SrRNA sequencing in all groups.

Our results indicated that the consumption of Padina pavonica and Cystoseira myrica brown seaweeds can change obese rats' intestinal microbiota into normal individuals. The distribution ratio of intestinal microorganisms showed that Bacteroides and Firmicutes are as dominant phyla in the microbiota of all groups. Our result also revealed that hot water and ethanolic extracts of Padina pavonica and Cystoseira myrica were effective in changing intestinal microorganisms in obese rats. However, we found that all the extracts prepared from Cystoseira myrica were more efficient in diminishing the relative abundance of obesity-associated genera and increasing the leanness-associated genera in the treatment group compared with the control obese group. Clostridium and Lactobacillus were the dominant genera in all groups with pathogenic and lactic acid potentials. However, the anti-pathogenic effects of all Cystoseira myrica extracts were more effective than all Padina pavonica extracts.  Moreover, we also indicated that the extracts, especially those from hot water extracts of Padina pavonica and Cystoseira myrica were more effective in decreasing cholesterol, IL1 and TNF-α as well as liver enzymes such as ALP and AST in all treated groups.

Our findings supported that Cystoseira myrica could be a good choice for weight loss. The present study demonstrated that all the extracts could promote the growth of specific beneficial microbial populations, and reduce the abundance of both pathogenic bacteria and obesity-associated microbes. Furthermore, we showed that weight loss happened due to a decrease in food intake. Although, all the extracts from Padina pavonica and Cystoseira myrica resulted in lower level of cholesterol, inflammatory factors as well as liver enzymes, Cystoseira myrica was more effective than Padina pavonica. The best extract that could normalize all criteria was Cystoseira myrica. It seems that in vivo animal studies can be extended to humans as well, and therefore, we suggest that Cystoseira myrica may be used as a prebiotic material, with anti-obesity effects on human health.; however, it needs more investigation.

The higher education system as a social sub-system, although always with a delay, seeks to provide alternative services, change the organization of the teaching-learning process and transfer knowledge, skills and attitudes to its potential learners. This important task has been addressed to universities mainly based on the World Declaration on Higher Education at the UNESCO World Summit in Paris in 1998. With the advent of information and communication technology and the spread of COVID-19 around the world, this issue has gained more momentum and another form of education called virtual education (virtual university) and distance education has emerged. Since the beginning of the development of web-based virtual education or electronic education since the beginning of the 21st century, most of the important universities of the world have taken significant measures in the field of obtaining education in this way. The first virtual universities include Jahan Gostar Network Academy, American Virtual University, and Jones International University. The virtual university in Iran started its activity through the University of Tehran in 2010 and has made significant progress so far. The broad and comprehensive approach to electronic education is proof that this new educational system brings unique benefits for individuals, organizations and educational centers and offers clear horizons in the field of education. In order to avoid the waste of investment in electronic learning systems, users should be encouraged to use this system. The advantages of electronic education include low cost; wide distribution; easy accessbility; Up-to-date educational materials; the personal nature of learning; Education at any time and place; reducing costs related to teacher, classroom, student and travel salaries; direct student interaction with the content; Avoid wasting time and money; Having enough opportunity to study, facilitate and speed up the educational process; The possibility of choosing a favorite professor from among several professors; Revisiting educational programs and being student-centered, allowing a large number of learners to receive education at a convenient time and place; flexibility; increasing access to educational materials, efficiency; Comprehensive, dynamic and fast access to educational resources at any time and place, flexibility and convenience, increasing access and quick dissemination of information, time management. On the other hand, this type of education and its features make teaching and learning more attractive for a high percentage of students, increasing educational opportunities; creating a positive attitude towards the learning process; Helping the student in developing the required skills; Helping students in the field of critical thinking, self-centeredness, working in groups; Transforming the inactive role of the student into an active and autonomous role; turning the teacher's role into a supporting role; supporting various teaching and learning methods; increasing social power; Enthusiasm and motivation are widespread. Therefore, the aim of the research was to explain the model of virtual education dimensions in Lorestan University of Medical Sciences.

This research is descriptive-exploratory in nature and method. The statistical population is all the professors of Lorestan University of Medical Sciences and based on the table of Karjesi and Morgan, the sample size was 308 people and the cluster sampling method was used. The data collection tool in this research was a semi-structured interview, the result of which was a researcher-made questionnaire with 27 items. In quantitative method, factor analysis test, structural equation model, correlation coefficient (Pearson) and regression were used.

Rrsults: 

In this research, according to the importance of the satisfaction required by professors from the electronic system of Lorestan University of Medical Sciences, it was observed that there is a significant and direct relationship between professors' satisfaction with the system and the educational content component. On the other hand, the level of professors' satisfaction with electronic education and support and guidance in Lorestan University of Medical Sciences is lower than the desired average from the technical and infrastructural aspects of the system.

According to the obtained results, it was found that in general, the professors of this university were satisfied with the way of conducting virtual education and its effectiveness. Some professors stated that this method of teaching in non-emergency and normal conditions can also be used in general courses when the corona pandemic is over, because with this, the classes of students of the University of Medical Sciences become lighter and The work of teachers becomes easier. Also, according to the professors' opinions and existing concerns, the picture-in-picture feature should be used in the virtual space to establish face-to-face communication between the professor and the student and the possibility of transferring information from the professor to the student and vice versa in the best way. Did. It is appropriate to provide the financial and human basis for strengthening the hardware and software infrastructures. A working group consisting of experts should be used to design the educational system to improve the level of teacher-student interaction. Also, experts should be present in this working group regarding reflection and solving system problems. Because of the advantages and disadvantages of virtual education, it is necessary to combine it with traditional face-to-face education. In order to evaluate and verify the correct identity, attendance and exams should be held in person or in a newer method. In general, strengthening the technological infrastructure, such as increasing the speed and bandwidth of the Internet in universities conducting virtual education, and improving the quality and quantity of information banks and digital libraries of databases, especially the improvement and promotion of reliable databases. Science is required. Also, involving students and professors in researches and activities that lead to the compilation of educational content and its updating will be a solution to many weaknesses and limitations in this field.

Today, there are few countries in the world where the most important and one of the major problems is not the issue of drugs and addiction. The World Health Organization has considered the issue of drugs, including production, transfer, distribution, and consumption, along with three other global issues, namely, the accumulation of weapons of mass destruction, environmental pollution, poverty, and class divisions among the basic issues that affect human life in social dimensions. , economic, cultural, and political threats and challenges in the global arena. Drug addiction is a neurological-psychiatric disorder that is associated with unpleasant habits and a strong desire to consume among its users, and over the years, it has caused many sufferings and tragedies due to the emergence of health problems for its abusers. Substance abuse disorder can make many substance-dependent patients suffer from psychological conditions such as stress, anxiety, and depression. Among the many psychological problems that arise in these people, we can mention a lack of attachment to life, depression, and despair, etc. Also, one of the essential components in addicts and even in depressed patients is problems related to mental health. Among the important factors affecting mental health is the category of death. Facing death and anxiety caused by it is considered as one of the most important components of people's mental health. Death anxiety means constant, abnormal, and morbid fear of death or dying. According to the definition of the British National Health Service, death anxiety is a kind of feeling of panic, fear, or worry when thinking about the process of dying or disconnecting from the world or what happens after death. Considering the importance of addiction disease and its complications, many methods are used to treat it, which can be referred to as self-compassion and reality therapy. Reality therapy is a strategic approach to behavior change; therefore, to explain it, we must first describe the selection theory. In psychology, various approaches such as behavioral therapy, cognitive therapy, psychoanalysis, etc. Therapeutic reality is an approach like other psychological approaches to change the behavior of mental patients in the first place and then to help change the behavior of clients in the process of self-development. Self-compassion training is one of the new interventions in the field of therapy that can increase a person's social support by applying kindness to oneself and others and improving social adjustment. In addition, this approach is effective on people's stress and psychological health. This approach can lead to improvement of distress tolerance and reduction of psychological distress of people. Self-compassion includes three components: self-love vs. self-judgment, human commonality vs. isolation, and mindfulness vs. extreme assimilation. The combination of these three components characterizes a person who has self-compassion. Therefore, it is necessary to use treatment methods for the fear of death in addicts. Now, according to what was said and also the importance of the subject, in this research we intend to investigate the effectiveness of two approaches reality therapy and compassion therapy on the fear of death in drug addicts and compare the effects of these two record therapies. Therefore, the main question of the research is: Is there a significant difference between the effectiveness of the two approaches of reality therapy and self-compassion on the fear of death in drug addicts and the two-month follow-up of the treatment?

The statistical population of this semi-experimental study included all addicts who were referred to six addiction treatment clinics in Galougah city in 1400-1401. The sample of the present study included 45 people (15 people in the reality therapy group, 15 people in the compassion group, and 15 people in the control group). The research tools were Templer's fear of death questionnaire (1970) and Glaser's (2010) reality therapy protocols (60 minutes each session) and Gilbert's (2014) compassion therapy (90 minutes each session). Repeated measure variance analysis was used to analyze the data.

It shows that, on average, the death anxiety variable in the two therapeutic intervention groups (reality therapy and self-compassion) decreased compared to the control group in the post-test. In the follow-up test, the level of death anxiety in the two educational intervention groups increased slightly compared to the post-test and decreased slightly in the control group. On the other hand, it was found that reality therapy was more effective than compassion.

In general, it can be said that the fear of death in drug users can be improved by using reality therapy and compassion. In the current research, there were some limitations as follows: the available research sample cannot represent all addicts. The results of the present study can be generalized to the third group of drug users with demographic characteristics related to this research, and caution should be observed if the results are generalized to other women suffering from other types of addiction. In this research, it was not possible to control some variables such as family problems. Also, several questionnaires were completed at home, and the existing conditions may affect the way of answering. Considering the effectiveness of the two approaches of reality therapy and compassion therapy, it is suggested that these two approaches be used by therapists during the treatment and withdrawal of addiction so that the patients have more spirit in dealing with the withdrawal of the disease. Considering the effectiveness of these two psychotherapy approaches on mental disorders caused by addiction, it is suggested that therapists and mental health professionals, by holding reality therapy and compassion therapy, should take steps to change the level of mental health and follow-up treatment so that basic steps can be taken in to improve the process of leaving this disease and speeding up the recovery process of patients, it was harvested.

The target of Rapamycin is a 290 kDa protein that was created in the 1970s from the isolation of a yeast resistant to cell growth inhibitory properties. Each complex is phosphorylated by a different substrate and is known as the main controller of cell growth. MTOR exists in mammals in the form of Rapamycin, which is divided into two groups, MTORC1 and MTORC2. Each complex performs different tasks according to its location in the cell. This pathway is involved in the regulation of Lipogenesis, glucose metabolism, cytoskeletal activity, and apoptosis (programmed cell death). MTOR creates conditions in the human body that are very suitable for positive cell growth; For example, it is involved in gene expression and translation of various cell proteins (enzymes and contractile proteins), ribosome biogenesis, activation of the protein kinase C (PKC) synthesis pathway that causes muscle growth, and also the strength of the cell skeleton. To be On the other hand, it prevents apoptosis, protein burning (autophagy), and excessive turnover of nutrient carriers, including glucose and amino acids. Inhibition of FoxO proteins by AKT through transcriptional mechanisms increases cell survival. AKT stimulates cell growth and proliferation through mTORC1. It also increases VEGF secretion and eNOS phosphorylation mediates vasodilation and angiogenesis. AKT increases cellular metabolism through downstream targets such as GLUT4 and GSK3. One of the main drivers of mTOR pathway activation is the pressure and mechanical load applied to the muscle. Growth factors, nutrients, hormones, and cytokines are other stimuli of the mTOR pathway. After this stage, AKT improves the activity of two pathways, mTOR and glycogen synthase kinase 3 beta; which play a key role in skeletal muscle hypertrophy in response to strength training. After mTOR is phosphorylated, PV0s6k, which stimulates protein synthesis, is phosphorylated, on the other hand, muscle growth inhibitory factors such as 4e-bpi and eif2 are inhibited. Another importance of the AKT/mTOR pathway is the inhibition and inactivation of the FOXO or FKHR factor. FOXO is the main factor in the activation of the ubiquitin-protease system, which causes the breakdown of contractile proteins. In fact, the AKT/mTOR pathway prevents atrophy and breakdown of skeletal muscle proteins with its activity. Research shows that strength training inhibits FOXO and Atrogenin by activating the AKT/mTOR pathway and thus prevents muscle atrophy. Based on the research conducted on the relationship between mTOR/AKT pathway and sports activity, it can be said that this pathway is activated especially in strength training and for hypertrophy. Of course, it should be said that this route has other duties as well. But in general, it is an anabolic pathway; but how the duration, intensity, and type of exercise affect mTOR/AKT levels in humans is still unanswered. The activity of the mTOR/AKT pathway depends on the age, sex, type, and intensity of the performed activity, the type and rate of contraction speed (introverted-extroverted), and also the type of tar. Therefore, in the present study, the researcher intends to evaluate the expression of mTOR/AKT proteins by comparing a single eccentric and concentric session.

10 healthy men were randomly divided into two groups (concentric group of 5 people, eccentric group of 5 people). Isokinetic contraction included eccentric and concentric knee extension with maximal strength and speed. In order to equalize the workload in both protocols, it was considered the same and the round trip speed was 60°/s. The contractions included 12 sets of 10 repetitions for the right leg, the rest time between each set was 30 seconds. A biopsy was performed at the beginning and end of the study. Biopsy was performed in both distal and proximal directions of the vastus lateralis muscle. In order to check the expression of mTOR and AKT proteins in each group, the tissues were examined by immunocytochemistry technique. The dependent t statistical method and covariance test were used to analyze the data.

The results showed that the intragroup changes of mTOR and AKT proteins after one activity session were significant in the extrovert and introvert groups (p≤0.05). However, the inter-group changes of mTOR and AKT proteins showed no difference between the two groups.

Many adaptations, such as increasing strength and lean mass, are caused by repeated resistance training, and this is due to the high degree of plasticity of skeletal muscle in response to training pressure. Different training stimuli in resistance sports can create different molecular responses related to the special adaptations of skeletal muscle to the type of resistance training. Prescribing a resistance program should be done according to the manipulations done in the variables. Exercise variables include intensity, volume, and time under tension. Manipulation of each of these variables can affect the final result. Of course, it should be kept in mind that manipulating only one variable can make it impossible to study the effect of other variables in molecular responses. In total, the present study showed that a session of eccentric and concentric activity leads to changes in the factors involved in strength and hypertrophy. In addition, these changes are generally greater in eccentric than concentric contractions.

The role of exercise in human health is not hidden from anyone. Nowadays, sports and physical activities are extremely valuable tools. And as one of the ways of spending free time, they are the largest part of the free time of millions of people around the world. In this regard, due to the expansion of the scope of government services in recent years, the increase in public expenses and economic issues, and many other elements make it necessary to consider the improvement of the functioning of government organizations as a vital matter, and one of these organizations is government sports facilities. Therefore, government sports facilities are at a lower level than private facilities due to their low operational efficiency and financial performance, and they are not very popular among the people of the society. For this reason, most of the sports facilities and spaces that are completely owned by the government and are managed by the government are facing a lack of funds. This situation has caused the removal or reduction of services and events organized by these places. Therefore, the current research is trying to investigate the effect of handing over sports facilities to the private sector in the direction of the development of public health and public sports and the success and failure rate, and by clarifying its strengths and weaknesses, a strategic model for improving this phenomenon. Therefore, taking into account the above and providing a proposal and solution for the correct implementation of the additional articles, the results and consequences of the implementation of the transfer of sports facilities in Iran in the development of sports are based on the available information, which can well demonstrate the need for research. Make sure that taking advantage of the opinions and suggestions of the statistical community based on their records and experiences and summarizing them can help the researcher in providing solutions that include the effect of the correct implementation of the supplementary materials.

This research is a qualitative study that was conducted with the foundational data method (ground theory) and by using in-depth interviews among participants who are informed and knowledgeable about the research topic. The number of samples (participants) has been determined to reach data saturation. In the table below, a sufficient number based on theoretical saturation (17 people and 24 documents) was selected and asked for opinions in a purposeful and accessible (judgmental) way. Two tools of systematic library study and exploratory interviews were used to conduct this research. The extraction of components was done by examining the basics and background through the study of documents, books, and articles including domestic and foreign sources.

After coding the interviews, selecting the concepts and going from induction to analogy, and arriving at sub-categories and main categories, finally the central paradigm model of "state health-oriented sports" was chosen as the central phenomenon. What the researcher means by the central term health-oriented state sports is the emphasis and preference of the participants on the state and low-cost public sports services for the possibility of the general public, especially women and the elderly, using sports spaces, to improve the general health of the society and prevent various diseases. Cardiac, vascular, spine, etc. Because the existence of low-cost or free sports spaces provides a factor for the possibility of public use. This need is felt more than in villages, especially in cities where people have less mobility due to their urban lifestyle. According to the findings of this research, privatization in the field of public sports services is detrimental to the public health of society and the government should make it possible to use these services in this field of sports and recreational services by providing minimal facilities but extensive and comprehensive. To provide for all members of the society with any ability and economic class. Based on three-stage coding and data analysis, it is concluded that the phenomenon of health-oriented state sports was chosen as the central phenomenon in this research. The consequences of the phenomenon of health-oriented state sports are the increase in the level of public health and well-being, as well as the promotion and high productivity in outsourced professional sports.

The connection between the general health of society and the well-being of its people with their level of physical activity and exercise is not hidden from anyone. In addition to playing a prominent role in health, exercise and relaxation also make people happy and reduce depression and mental illnesses. Therefore, looking at public sports should be a trans-economic view and the government should support this sector by allocating funds and special facilities so that all sections of the society can have easy and cheap access to sports facilities and spaces, health, and vitality of body and mind. Provide for themselves Therefore, based on the findings of this research, outsourcing in the field of public sports, due to the high cost of these services, can reduce the use of these facilities by everyone. Therefore, according to the participants in the research, sports for all, as long as all people of any gender and age can easily access it (to the extent of using walking or cycling fields, equipment free sports, free play and entertainment spaces, low-cost or free swimming pools or clubs in some cases), can become a powerful arm in preventing the occurrence of mental and physical diseases, providing health and well-being to people society, make it cheap.