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The Effectiveness of Compassion-Focused Therapy on Social Isolation and Psychological Distress in People with Binge Eating Disorder
Seyyed Aliakbar Karimi Ah, Ghodrattollah Abbasi, Hoseinali Ghanadzadegan,
Volume 0, Issue 0 (3-2024)
Abstract
Background & Aims: Eating disorder is one of the worrisome issues in the field of public health, which is characterized by episodes of regular binge eating. During this disorder, people eat relatively large amounts of food and lose control over their eating behavior. The global prevalence of eating disorders in 2018-2020 is estimated at 0.6 (1.8 percent) in adult women and 0.3 (0.7 percent) in adult men. Eating disorders are usually associated with obesity and physical and mental illnesses. People with this disorder experience significant problems and impairments in the quality of life. (1) An eating disorder is a complex health problem resulting from a combination of causes and individual factors such as behavior and genetics. These behaviors can include lack of physical activity, inactivity, incorrect eating pattern, use of medication and others. Eating disorder is associated with poor mental health and reduced quality of life (2). Also, the main causes of death are eating disorders, diabetes, heart diseases, strokes and some types of cancer (3). Based on this, one of the factors of binge eating disorder is eating behavior, which may continue even after treatment (4). Among the things that can increase the incidence of this disorder are self-criticism (5), shame (6), guilt (7), social isolation (8) and psychological distress (9).
Among the factors that increase the prevalence and severity of eating disorder is social isolation (10). Social isolation means the lack of weakness of relationships between a person and other people, groups and society (11, 12), which also affects eating behaviors and causes eating disorders and related disorders (10).   A systematic review in this field showed that social isolation increases unhealthy eating behaviors and eating disorders (14).
Psychological distress is one of the problems that appear with eating disorders. Psychological distress includes unpleasant mental states including depression, anxiety and stress, all three of the mentioned disorders include symptoms of emotional and physiological conditions (16, 17). People with high mental distress complain more about the symptoms of physical illness and the frequency of physical illnesses is a strong predictor of the occurrence of damage in their physical, psychological and social functioning (18).   Psychological distress is common with eating disorders and can exacerbate the severity of the eating disorder (22).
Several interventions have been used to reduce the psychological problems of people with eating disorders. Among these interventions, one of the intervention treatments that has received less attention is the treatment focused on compassion (26). Compassion-focused therapy is a system of psychotherapy developed by Gilbert that integrates techniques from cognitive behavioral therapy with concepts from developmental psychology, social psychology, developmental psychology, Buddhist psychology, and neuroscience (27 (. The goal of compassion-focused therapy is to help people heal emotionally and psychologically by encouraging them to be compassionate with themselves and others. Many people believe that compassion, both with oneself and with others, is an emotional response and an important aspect of well-being. The advantage of promoting compassion is increasing emotional and mental health (28).   By using the compassionate approach, researchers were able to reduce the shame and self-criticism of people with eating disorders (32).
Therefore, considering the medical and psychological consequences of this disorder that can lead to the risk of suicide, the use of psychological interventions to prevent the consequences of this disorder is of great importance and necessity. The present study tries to answer the question of whether the treatment focused on compassion is effective on social isolation and psychological distress of people with eating disorders.
Methods: This was a semi-experimental study with a pre-test and post-test design and a follow-up phase with an experimental group and a control group. The statistical population of the research was women aged 18 to 40 years old in Tehran who had visited Hakim obesity clinic in 1401. In order to carry out the research, 30 people from the mentioned society were selected in the available way and randomly divided into experimental group and control group (15 people in each group). Therapeutic intervention was performed for 8 sessions on the experimental group and no training was provided to the control group. The tools used in this research are the 26-item EAT questionnaire (Garner and Kerfinkel, 1982) with 26 items for the eating disorder scale, the 21-item DASS questionnaire (DASS) of Lavibond with 21 items for the psychological distress scale, the questionnaire (Russell, Pilova and Cortona, 1980) It was with 20 items for the social isolation scale, which was completed in two phases: pre-test, post-test and follow-up. The experimental group received compassion-focused therapy training for 8 sessions of 60 minutes, and the control group received no intervention. The data was analyzed using the repeated measurement analysis method and spss.22 software.
Results: The average (standard deviation) age in the experimental group was 3 people (20%) from 18 to 25 years, 7 people (46.67%) from 26 to 33 years, and 5 people (33.33%) from 34 to 40 years and in the control group 4 people (26.67 percent) were 18 to 25 years old, 7 people (46.67 percent) were 26 to 33 years old, and 4 people (26.67 percent) were 34 to 40 years old. Also, in the experimental group, the mean (standard deviation) of psychological distress decreased from 49.20 (7.82) in the pre-test to 46.86 (7.79) in the post-test and to 47.13 (7.97) in the post-test. ) increased in the follow-up phase. (P < 0/001). The results of analysis of variance were significant for the within-group factor (time) and significant between groups. Also, the interaction of group and time was significant. The pairwise comparison of the groups showed that there is a significant difference between the pre-test and post-test and pre-test and follow-up stages in social isolation, that is, the scores decreased from the pre-test stage to the follow-up stage (p<0.001). Comparisons in the group under the educational intervention showed that there is a significant difference between the pre-test and post-test and pre-test and follow-up stages in reducing psychological distress. It means that the scores have increased from the pre-test stage to the follow-up stage. While there was no difference between the post-test and follow-up stages in reducing psychological distress (p>0.001).
Conclusion: The aim of this study was the effectiveness of compassion-based therapy on social isolation and psychological distress in women with eating disorders. The findings of this research showed that compassion-based therapy reduced social isolation and psychological distress in women with eating disorders in the training group.

Validity of Criteria for Bacterial Meningitis in Children with Fever 28 to 56 days
Dr Shabahang Jafarnejad, Dr Leila Erfani, Dr Hamidreza Khoshnezhad Ebrahimi, Mahdi Rezai, Somayeh Esmaeilian,
Volume 0, Issue 0 (3-2024)
Abstract
Introduction: Bacterial meningitis is an acute inflammatory phenomenon of the central nervous system, which is considered an emergency from the medical point of view, and if it is not diagnosed and treated, it will be associated with high mortality. It has been reported that it decreases with increasing age up to 25 years old. The complications of these diseases are relatively common and include blindness, deafness, neurological disorders, decreased level of consciousness, mental retardation, and paralysis. The death rate of bacterial meningitis is still high. Early diagnosis and treatment of bacterial meningitis can prevent serious complications. The diagnosis of bacterial meningitis is based on the combination of clinical and laboratory symptoms. Early treatment of bacterial meningitis can prevent serious complications such as hearing loss, memory problems, learning disorders, brain damage, seizures, and death. The diagnosis of bacterial meningitis is based on a combination of clinical and laboratory symptoms that indicate an inflammatory response in the cerebrospinal fluid. CSF).. Neonatal meningitis is divided into two categories, early and late, which are, respectively, due to the presence of signs of infection and isolation of the organism from cerebrospinal fluid culture in less than 72 hours or more than 72 hours of life. Analysis of cerebrospinal fluid through lumbar puncture is the most important laboratory diagnostic test. However, LP is invasive and painful and can pose challenges in its implementation and induce anxiety in the medical staff. This work is usually associated with side effects such as headache, back pain, and rarely with infection, brain herniation, and subdural, epidural, and spinal bleeding. The management of febrile infants aged 29 to 56 days in the emergency department has been discussed for decades. has taken. Although there is general agreement that these infants should have urine and blood tests, there is no such agreement for CSF testing. According to the said material, in this study we decided to take a step towards improving the sensitivity and specificity of diagnoses by examining and evaluating the accuracy of bacterial meningitis criteria in children who have undergone LP, which ultimately leads to more effective treatment and significant improvement. The quality of life of patients can be taken away.
Methods: In this descriptive-analytical study, the accuracy of bacterial meningitis criteria was investigated in low-risk children with fever of 28 to 56 days who underwent LP in the period of 2015 to 2019 at Hazrat Ali Asghar Hospital. After obtaining the necessary agreements, the approval of the ethics committee and permission to access the files were received from the hospital management. The information was completed through a checklist related to the criteria of bacterial meningitis and according to the files of the referring patients. The study questionnaire includes age, sex, gestational age, patient's appearance, history of chronic diseases and length of stay in NICU, history of antibiotic use in the last 72 hours, white blood cell count, tuberculosis band percentage, and LP test result. Completed questionnaires were randomly selected and analyzed from 73 checklists. It should be noted that the checklist was designed according to related articles and with the consultation and opinion of professors of Iran University of Medical Sciences. The implementation limitations of the plan included the time-consuming completion of the questionnaires and the incompleteness of the files and cases of loss to follow-up. After completing the data collection, the data were entered into SPSS and analyzed.
Examining  the accuracy of bacterial meningitis criteria: Using the central limit theorem and the finiteness of the mean and standard deviation, as well as the large number of observations, it was assumed that the data distribution was normal. Therefore, we no longer used common tests such as Kolmogorov-Smirnov, Anderson-Darling, etc. to check the normality of distributions. Because the predictor variables were quantitative or at least converted to quantitative and the response variable (LP) was also quantitative, we used multivariate regression design for data analysis. Of course, it is important that the linearity of the data was ensured before performing the regression method. This method was used to investigate the effect of LP on other mentioned cases with the aim of checking the accuracy of bacterial meningitis criteria in children with fever of 28 to 56 days who underwent LP in Hazrat Ali Asghar Hospital between 2015 and 2019. Considering that a suitable linear relationship was seen to express the relationship between the predictor variable and the response variables, we used linear regression transformations and obtained the results in a table. According to the obtained results, we found that the criteria for bacterial meningitis in febrile children can be defined under the components (38-week-old children, no long stay in NICU, negative AB, no evidence of infection on examination, normal CXR, no chronic medical problem, LP negative) modeled and obtained the optimal model.
Findings: SPSS version 22 software was used for statistical analysis of data. The results for quantitative variables were expressed as mean and standard deviation (Mean ± SD) and for categorical qualitative variables as percentage. Comparison between quantitative variables was done by t-test, and in case of non-normal distribution, using Mann-Whitney U test. Chi-Square Test and Fisher's Exact Test were used to check the relationship between qualitative variables. A significance level of less than 0.05 was considered.
In this study, among 84 patients, 57.14% of the patients studied were boys and 76.2% of the patients were born at a gestational age of more than 37 weeks. 88% of the patients had a happy appearance, and none of the patients had evidence of infection during the examination, and the results of the chest x-ray were reported to be normal in 98.8% of the patients. 81% of patients did not experience prolonged NICU stay and LP result was negative in all patients.
Conclusion: Considering that most of the patients looked happy and none of the patients had evidence of infection in the examination and these findings were consistent with the laboratory evidence, therefore, it is recommended not to perform LP in patients with this clinical picture.
Key words: Validity of Criteria  ، bacterial meningitis, fever, children aged 28 to 56 months


 
Investigating the effectiveness of the forgiveness-oriented schema therapy training package and comparing it with cognitive behavioral therapy on anger management of women with marital conflicts referring to family counseling centers in Shiraz.
Fareshteh Bagherizadeh Moghadam, Floor Khayatan, Zahra Yousefi,
Volume 0, Issue 0 (3-2024)
Abstract
Introduction
Violence as a problem has always attracted the attention of researchers and many efforts have been made by them to control and reduce this problem among different groups (1). Meanwhile, anger management as an important issue in married life plays an important role in the growth and excellence of families and can reduce interpersonal tensions. Anger management is often an individual issue, the solution can often involve a group effort. Anger management couples counseling is a way for you as a couple to approach the recurring issue of anger in your relationship (2).
Anger management skills is a cognitive behavioral intervention that focuses on anger as a driving force behind violence. Also, the skill of anger control includes various strategies to minimize violence in people's relationships, so that it does not interfere with doing daily tasks and activities, but instead causes motivation and progress (6).
Schema therapy is a new and integrated method, which is mainly based on the expansion of the concepts and methods of classical cognitive behavioral therapy. The therapeutic scheme has combined the principles and foundations of cognitive-behavioral, attachment, gestalt, object relations, structuralism, and psychoanalysis schools in the form of a therapeutic model and a valuable concept. Nevertheless, the therapeutic scheme is not an eclectic treatment that proceeds through trial and error, but is based on a coherent and integrated theory (8). 
Another method used in this study is cognitive behavioral therapy. This method is a type of psychotherapy that focuses on the influence of a person's beliefs, thoughts and attitudes on his feelings and behaviors. The goal of cognitive behavioral therapy is to teach you how to actively face and overcome various problems or events throughout your life. research gap regarding the effect of forgiveness-oriented schema therapy and cognitive behavioral therapy on anger management of women with marital conflicts; It has caused evidences regarding these treatment approaches to be unavailable today. In such a way that this issue has caused the scientific approach to deal with anger to not be understood as an important issue. Therefore, the researcher is trying to answer the question whether forgiveness-based schema therapy and cognitive behavioral therapy have an effect on anger management of women with marital conflicts referring to family counseling clinics in Shiraz or not?
Methods
This research was approved by the Ethics Committee of Isfahan Islamic Azad University (Khorasgan) with code IR.IAU.KHUISF.REC.1401.021. In order to carry out the current applied research, which was carried out in a semi-experimental way and with a pre-test-post-test design, among women with marital conflicts in the year 2019 in Shiraz city, who after completing the questionnaire of marital conflicts, obtained a high score in conflicts (111 and above). 45 people were purposefully selected and randomly divided into 3 groups of 15 people: cognitive behavioral therapy, forgiveness-oriented schema therapy, and control. Then the experimental groups received the desired interventions under the supervision of the researcher. It should be noted that before and after the interventions, all the subjects completed the Spielberger Anger Control Questionnaire. In order to analyze the data of the present research, descriptive statistics and analysis of covariance and Bonferroni post hoc tests were used to analyze the data. This analysis was done using SPSS software.
Results
As can be seen in table (3), based on the results of the covariance test, with the control of the pre-test score, there is a significant difference in anger management in the group of forgiveness-oriented schema therapy, cognitive-behavioral therapy and control (P<0.05, F=12.81 ).
The results of the pairwise comparison of the mean scores of anger management (Table 4) show that there is a significant difference between the forgiveness-oriented and cognitive-behavioral therapy (P < 0.001), as well as the package of forgiveness-oriented and cognitive-behavioral therapy, both on the anger management of women with Marital conflict was effective and had a significant difference in terms of average post-test scores with the control group (P<0.05). 
Discussion

The results of statistical analysis in the previous chapter showed that both schema therapy and cognitive-behavioral treatments were significantly effective in reducing the anger of women with marital conflicts, compared to the control group. In schema therapy, emotions and emotional regulation are completely related to the concept of schema state. This concept is the basic and most complex aspect of the theoretical model presented by Yang et al. (2007) (16). A mood is a dominant disordered emotional state that is thwarted by thought, emotional, and behavioral patterns based on a set of specific needs. Usually, states are activated by internal or external stimuli and may include both adaptive and maladaptive responses (16).
In particular, a dysfunctional state is manifested by maladaptive schemas or coping responses that manifest in uncomfortable emotions, avoidance responses, or self-destructive behaviors, and it affects a person's behavior and controls his emotional functioning. The basic concept of state theory in schema therapy is that different mental states have different goals and are related to different needs. The therapist's first goal in schema therapy is to understand and conceptualize the client's performance model. This work is done for simplification and helps the clients to understand their performance method. There are four macro classes of mode (17).
Schema therapy emphasizes moment-to-moment changes in awareness of emotions and feelings and helps clients to identify their negative emotions (including anger) and express them in the right way. In the meantime, the therapist also intervenes and defends the state of the vulnerable child and helps the clients to communicate with the damaged child through a healthy adult, and a dialogue is formed between them and helps the damaged child to understand the events that happened during Remember that they are related to this excitement and look at them with the perspective of a healthy adult (13). Therefore, it can be concluded that regulating emotions such as anger, through identifying and changing ineffective states and transforming them into efficient and healthy states, will reduce anger and manage it more.

Factors Affecting the Formation of Psychological and Sociological Identity of Women
Dr Reza Kavand, Mrs Tayyaba Esmaili,
Volume 0, Issue 0 (3-2024)
Abstract
Background and Aim: The contradiction between tradition and modernity has also challenged the Iranian woman's identity. On the one hand, the traditional values and on the other hand, the modern values have caused the Iranian woman to wander between choosing a traditional identity or a modern identity or a combination of both. The identification of women is effective. In this regard, this research has been conducted with the aim of investigating the sociological and psychological factors influencing the formation of the identity of women in Behbahan city. The issue of identity has always been discussed in Iranian society, because identity is both an important part of human existence and the feeling of belonging and solidarity to the society is possible through identity. Some theorists consider the interference in defining the identity of men and women to be the source of many human problems, what is important in the opinion of thinkers are the factors influencing the formation of identity. It can be said that the elements that make up women's identity consist of elements that create different forms of their identity in different societies. Some of the most important factors are gender, religion, family and other structural factors in society. By combining each of the mentioned elements, three types of patriarchal, patriarchal and human-oriented structures have been formed, and in each of these structures, the type of look and interaction with women is different. In recent decades, as a result of the expansion of modernization and the process of modernization of societies at the global level, there have been changes in the field of human life, which has caused the transformation of social roles and women's awareness of their position in society. The increase in education and employment among women, on the one hand, has led to a decrease in the desirability of the traditional female model, and on the other hand, it has caused a lack of harmony between traditional and new roles, and ultimately led to a crisis of women's identity.
Method: In this research, the library method was used to collect information related to theoretical foundations, and the quantitative method and survey approach were used to collect statistical data. The statistical population of the present study includes all women over the age of 18 in Behbahan city, which according to the statistics obtained from the civil registry office of Behbahan city, totals 53356 people. Considering that the most widely used technique in the survey method is the questionnaire, therefore, the collection tool in this research is the questionnaire. Standard and researcher-made indexing and items were also used to make the questionnaire. In this questionnaire, the questions are closed-ended, and information has been collected in person and electronically. Also, the Likert scale was used to measure the questions. In this study, this work has been done through the method of content validity and formal validity (that is, by referring to common sense and expert judges and related books and topics). In other words, the prepared questionnaire was delivered to various professors and experts in the fields of methodology, statistics and sociology (including supervisors and advisors) and the opinions and views of each of them regarding the indicators and indicators. And the research items were obtained and after summarizing them, the final questionnaire was compiled.
Results: The descriptive findings of the research show that more than half of the women's identity status and their attitude towards female identity is at an average level. The findings of the explanatory results show that the correlation between the independent and dependent variables is 0.37 and the variable of modern socialization has a greater influence on the identity of the studied women with 0.43. According to the analytical findings of multivariate regression, the independent variables of traditional socialization 0.38, religiosity 0.36, modern media use 0.29, modern religiosity 0.22, and traditional religiosity 0.17 influence women's identity, respectively.
Conclusion: From the conducted study, it can be concluded that the identity of the women under study is a modern identity rather than a traditional identity, and the women under study are affected by modern factors rather than being influenced by traditional factors in shaping their identity. This study showed that there is a significant relationship between the traditional socialization of women and the formation of their identity (traditional, modern and integrated). So that the higher the traditional socialization of women, the formation of female identity will be in a better condition. And on the contrary, the lower the level of traditional socialization of women, the lower will be the formation of female identity. The empirical findings of the research indicate that the correlation coefficient of traditional socialization and the formation of women's identity in Behbahan city is the size is 0.38 and traditional socialization can explain the formation of women's identity to the size of 0.38. In fact, there is a moderate correlation between traditional socialization and the formation of women's identity. The results of this research, confirming the fifth hypothesis, showed that traditional socialization will lead to the formation of women's identity.
 
Studying the Relationship between Marital Satisfaction and Induced Abortion among Suburban Women Living in the City of Bandar Abbas
Dr Serajeddin Mahmoudiani, Ms Fatemeh Rahmati,
Volume 0, Issue 0 (3-2024)
Abstract
Extended Abstract
Background: Abortion is one of the components of reproductive health among women. This action can occur spontaneously or be induced intentionally. Induced or intentional abortion refers to the unnatural loss of a fetus, which can be done by the woman herself or another person, using various methods (1). Abortion can pose risks and complications for the mother, such as bleeding, damage to the reproductive system, and even death, especially in cases of unsafe abortions. It is important to note that the consequences of unsafe abortion not only affect the individual but also have broader implications for the entire healthcare system (2). Marital satisfaction is a crucial indicator of life satisfaction and plays a significant role in women's health (13). It encompasses the satisfaction and pleasure experienced in various aspects of marital relations, including personality issues, communication with each other, conflict resolution, financial matters, sexual relations, and parenting (14). Marital satisfaction includes various topics, such as satisfaction with different roles in married life, conflict resolution strategies, satisfaction with sexual and emotional relationships, the level of satisfaction with family financial management, agreement about having children, and a realistic understanding of the impact of children on marital relationships (15). Due to unfavorable economic and social conditions, low quality of life, and a lack of suitable welfare and health services, especially for women, areas with low income and education levels tend to have a lower level of reproductive health than other urban groups (24). Therefore, this study was conducted with the aim of investigating the relationship between marital satisfaction and induced abortion among women with husbands of reproductive age (15 to 49 years) living in the suburbs of Bandar Abbas city.
Methods: The present study was conducted using a quantitative approach and a survey method. The statistical population of this study consisted of married women of reproductive age (15 to 49 years old) living in the suburbs of Bandar Abbas city. Based on Cochran's formula, 379 women from the statistical population were surveyed, and a multi-stage cluster method was employed for sampling. The data collection tool comprised a standard questionnaire, which included one part dedicated to capturing the demographic, social, and economic characteristics of the participants. Another section of the questionnaire addressed questions related to marital satisfaction. The measurement of marital satisfaction utilized the Kansas standard questionnaire (25). The validity of the questionnaire was assessed through content validity, with relevant experts evaluating and ultimately approving the questionnaire. Additionally, the reliability of the questionnaire was verified using Cronbach's alpha test, which yielded a value of 0.983 for the measure of marital satisfaction, indicating high reliability in the desired measure.
Results: The highest proportion of women (26.9%) were between 30 and 34 years old, with an average age of 32.8 years. The majority of women's husbands (50.9%) were between 30 and 39 years old, and the average age of the spouses was 37.1 years. Approximately 82% of housewives and over 92% of their husbands were employed. More than 48% of women considered themselves to belong to the middle class, while only 1.2% identified as belonging to the high socio-economic class. The study also found that more than 89% of the women belonged to the Fars ethnicity, and 94.5% were Shiites. The highest proportion of women (33.5%) and their spouses (35.4%) had a diploma. The majority of women (51.2%) had resided in the marginal areas for 1 to 10 years, with an average duration of 13.6 years. The average length of marriage for women was 12 years. Regarding marital satisfaction, the majority of women (64.6%) reported an average level of satisfaction. The research findings also indicated that about 3% of the surveyed women had a history of at least one induced abortion. Marital satisfaction was the only variable that demonstrated a statistically significant effect on the probability of induced abortion in this research. As marital satisfaction increased among women, the probability of abortion decreased. The coefficient of determination showed that the model used in this research can predict between 8.8% and 40.7% of the probability of induced abortion.
Conclusion: The findings of this research showed that none of the background variables and individual characteristics of women had a statistically significant effect on the probability of induced abortion. This result contradicted previous studies (5-12, 16) that demonstrated a significant relationship between economic, social, and demographic characteristics and the likelihood of induced abortion. Multivariable linear regression analysis revealed that marital satisfaction had a statistically significant effect on the probability of induced abortion. As marital satisfaction increased among women, the occurrence of abortion decreased. This finding aligns with the results of previous studies (16, 17, 19), each of which also found a significant impact of relationship and marital satisfaction on abortion. However, this finding was not confirmed in some other studies (18). Overall, the regression model used in this research was able to predict up to 40.7% of the possibility of induced abortion. Reducing induced abortion can lead to improved maternal health in society. Additionally, decreasing abortion rates can influence the current level of fertility in the country. Even in conditions of fertility below the replacement level, the influence of this factor, however small, can be significant. Based on the findings of this research and the aforementioned literature, it can be suggested that efforts to improve the quality of life and marital relations among couples can deter women from choosing induced abortion. Therefore, it is recommended that population policies, family support programs, and health policies pay serious attention to this important issue. Developing and implementing practical and operational programs before marriage to train women in managing marital conflicts can enhance the level of marital satisfaction. Furthermore, identifying couples with marital conflicts and providing counseling sessions can be other effective solutions in this domain.
 
The effectiveness of treatment based on acceptance and commitment on cognitive flexibility, resilience and perceived stress in women with depressive disorder
Ms. Mona Isvand, Mr. Hossein Baghooli, Mr. Hojjat Allah Javidi, Mr. Majid Barzegar,
Volume 0, Issue 0 (3-2024)
Abstract
Introduction: depression is one of the most common psychiatric disorders that its treatment imposes large amount of costs on the individual and consequently the family and society.
Depression is one of the most common psychiatric disorders, which destroys a person's innate capacity to grow and flourish, causing a disorder in a person's mental health [1] and as one of the major health problems, it is predicted that by 2030, it will be the only become the main cause of disease all over the world [2]. This serious mood disorder is accompanied by severe symptoms that affect a person's feelings, thoughts and daily life [3]. The prevalence rate of depression is higher than other mental disorders and is around 17%. In the Iranian population, the prevalence rate of depression varies between 5.69% and 73%, and among women it is reported to be 1.7 times more than men [4]. Depressed patients are part of the group of patients who do not receive adequate treatment and only half of them recover. It seems that the effective management of depression in patients requires more attention to their preferences, treatment needs, and finally the use of more comprehensive treatment packages to maximize patient participation and adequate use of the treatment method[5].
Objective: the study aimed to evaluate effectiveness acceptance and commitment therapy for cognitive flexibility, resilience and perceived stress among depressed women of Andimeshk.
Method: statistical population included all the women referring to psychiatric clinics of Andimeshk from March 2021 to March 2022. According to the inclusion criteria, 30 patients who were willing to participate in the research were randomly assigned into two groups (experiment group and control group, 15 people each). to Morrow’s questionnaire was used; for cognitive flexibility, Dennis and Vander Wal’s questionnaire and for resilience, Connor-Davidson Scale and for perceived stress, Cohen, Kamarck & Mermelstein were applied. To diagnose depression the clinical interview SCID5 was applied. The data were analyzed using analysis of covariance and evaluation of its assumptions.
Findings: the results indicated that acceptance and commitment therapy affected the depressed patients’ cognitive flexibility and perceived stress. Inferential findings showed that the treatment based on acceptance and commitment to reflection, cognitive flexibility, resilience and perceived stress of depressed patients had a significant effect. In order to align the obtained results with the research background, it can be said that the treatment based on acceptance and commitment, relying on its therapeutic principles, including the principle of acceptance, as the most basic principle of treatment, by increasing the patient's psychological acceptance of his thoughts and feelings, has been able to reduce ineffective control actions such as perceived stress are effective. Because during the above treatment method, a person learns to accept them without any internal or external reactions in order to eliminate the above reactions, then the above acceptance by the patient makes him able to act independently of such negative experiences. This has been able to lead to a reduction in and a more logical evaluation of stressful situations by the person, and this is how the perceived stress of patients has decreased. Also, by increasing the psychological and mental acceptance of the person, the above treatment has increased the patient's cognitive flexibility by actively and effectively confronting his thoughts and feelings and avoiding any avoidance.
Conclusion: the results emphasized the efficiency of this therapy for depressed patients and that it can be used as an effective interventional procedure. Treatment based on acceptance and commitment in depressed patients has resulted in their ability to use effective coping strategies. This ability causes people to have a more logical approach to the conditions of different life situations and when problems arise, they deal with them by solving the appropriate problem, and in this way, their resilience has increased. Treatment based on acceptance and commitment instead of changing cognitions increases the psychological connection of a person with his thoughts and feelings. It also increases the capacity to accept psychological experiences and commitment, meaningful, flexible, adaptive activities without considering the content of obvious experiences [60]. By clarifying values and paying them and determining the important goals of life, instead of dealing with symptoms and everyday issues, people including depressed patients learn to deal with values and what is more important in life instead of physical and mental responses. It causes a decrease in the attention and excessive sensitivity of the person to the complications of the disease.
 
The effectiveness of emotion-focused therapy (EFT) on the regret of choosing a spouse and the future anxiety of women with marital conflict
Leyla Mohammadi, Ghodratollah Abbasi, Rameza Hassanzadeh,
Volume 0, Issue 0 (3-2024)
Abstract
Background and purpose: The aim of the present study was to investigate the effectiveness of emotion-oriented therapy (EFT) on the regret of choosing a spouse and the future anxiety of women with marital conflict.
Method and Materials: This was a semi-experimental study with a pre-test and post-test design and a follow-up phase with two experimental groups and one control group. The statistical population included all the women who referred to the counseling center of multiple regions of Tehran, among whom 30 women with marital conflict were selected based on the criteria of entering and exiting the study and were randomly divided into an experimental group and a control group of each group. 15 people were placed. The participants completed the questionnaire of regret about choosing a spouse and future anxiety in three times: pre-test, post-test and follow-up. The experimental group received 10 sessions of emotion-focused therapy (EFT) and the control group received no intervention. The data was analyzed using the repeated measurement analysis method and spss.22 software.
Findings In the experimental group, the mean (standard deviation) of regretting the choice of spouse decreased from 21.18 (6.26) in the pre-test to 10.11 (3.78) in the post-test, but in the control group, the mean (standard deviation) the regret of choosing a spouse was 20/55 (5/19) in the pre-test and 20/61 (5/54) in the post-test, which was not different. Also, in the experimental group, the average (standard deviation) of future anxiety in the pre-test was equal to 76.56 (10.61), which decreased to 55.07 (9.77) in the post-test, but in the control group, the average (standard deviation) of anxiety The future score was 17/73 (10/62) in the pre-test and 49/72 (10/90) in the post-test.
Conclusion: Emotion-focused therapy (EFT) has been effective on the regret of choosing a spouse and the future anxiety of women with marital conflict.
 
The Effect Of Training Patient Communication Skills In Nursing Students By Role Playing Method
Shima Damman, Dr. Mohsen Faseleh Jahromi, Dr. Ali Dehghani,
Volume 0, Issue 0 (3-2024)
Abstract
Introduction: Professional communication skills training can be effective in developing learners' self-efficacy. More emphasis has been placed on active and student-oriented strategies such as role-playing in patient communication training. This research was conducted with the aim of the effect of training patient communication skills in nursing students by role playing method.
Materials and methods: This research is a semi-experimental study, the research population consisted of 42 third-year nursing students of Jahrom Nursing and Paramedical Faculty in 2019; who were selected by census method and 22 people were randomly assigned to the role-playing group; Communication skills training was held during 3 two-hour sessions during three weeks for both groups. Data were collected using the communication skills checklist, before and one month after the intervention, and analyzed using independent t, paired t, Mann-Whitney, Wilcoxon and chi-square tests and in spss version 21 software.
Findings: The difference in the mean score of patient communication skills in the groups of role playing (34.05±8.56) and lecture (33.67±7.9) before the intervention was not statistically significant; But after the intervention, the average score of communication skills with the patient increased in the students of the role playing training groups (67.38±8.71) (p=0.001).
Conclusion: Using the role-playing educational method compared to the traditional educational method can improve the communication skills of nurses.
Biosynthesis of silver and selenium nanoparticles using Lentinus edodes mushroom supernatant and structural characterization and evaluation of their antioxidant activity
Hamed Barabadi, Hossein Vahidi, Mahdieh Ameri Shah Reza, Maha Soltani, Kamyar Jounaki, Salar Sadeghian-Abadi, Maryam Babaei Sabet,
Volume 0, Issue 0 (3-2024)
Abstract
Background & Aims: Nanobiotechnology implicates the integration between biotechnology and nanotechnology. Biosynthesis of metal nanoparticles in the range of 1 to 100 nm is one of the topics of interest for researchers in nanotechnology due to the lack of environmental pollution and cost-effectiveness. Among different approaches for the biogenic fabrication of metal-based nanoparticles, the fungus-mediated fabrication of nanoparticles is of high interest. Some of the fungi are toxic and not safe for humans. Hence, exploring the new safe fungi that can fabricate metal nanoparticles with specific size distribution and morphology is a significant and promising aspect of the biosynthesis of nanoparticles. Lentinus edodes is a popular and medicinal edible mushroom in the global market with wide therapeutic properties. This study aimed to investigate the ability of extracellular synthesis of silver and selenium nanoparticles using the supernatant of Lentinus edodes. In the next step, the antioxidant properties of these mycosynthesized nanoparticles were compared.
Method: Initially, Lentinus edodes was cultured in Sabouraud Dextrose Broth (SDB) medium and the grown fungi were isolated from the culture medium. Then, 100 mL of 1 mM metal salt solution (silver and selenium) was added to 100 mL of supernatant and incubated at 28 °C for 48 hours. The fabrication of silver and selenium nanoparticles in the supernatant was investigated. In the next step, the biosynthesis of nanoparticles was investigated through macroscopic observations by the color change of the reaction system and the Tyndall effect. Then, the characteristics of biosynthesized nanoparticles were evaluated by employing Field emission scanning electron microscopy (FE-SEM), Dynamic light scattering (DLS), and Fourier-transform infrared spectroscopy (FT-IR). Finally, the antioxidant effect of the produced nanoparticles was evaluated by DPPH free radical scavenging assay.
Results: Initially, the color change to brown and orange confirmed the fabrication of silver and selenium nanoparticles, respectively. Then, the Tyndall effect confirmed the formation of a colloidal system. In the next step, the mycofabrication of nanoparticles was confirmed by employing DLS, FE-SEM, and FT-IR. Lentinus edodes was able to biosynthesize the silver and selenium nanoparticles with an average hydrodynamic diameter of 91.79 and 85.75 nm and a Polydispersity index (PdI) of 0.56 and 0.434 at pH value of 10, respectively. Based on FE-SEM images, nanoparticles were synthesized with a spherical morphology. The FT-IR analysis showed the presence of different functional groups on the surface of the synthesized nanoparticles. These functional groups are attributed to the conjugated biomolecules that surround the nanoparticles. These fungal biomolecules not only stabilize the colloidal system of nanoparticles, but also influence the biological performance of nanoparticles.  Furthermore, silver and selenium nanoparticles at the concentration of 0.5 mM inhibited 49.04±1.5 and 49.81±1.79% of DPPH free radicals, respectively.
Conclusion: This study showed that Lentinus edodes was able to synthesize silver and selenium nanoparticles extracellularly as a reducing agent by reducing silver and selenium ions. The mycosynthesized nanoparticles also showed significant antioxidant activity. Several parameters such as particle size, morphology, surface chemistry, and capping agents influence the biological properties of nanosized particles. Although these nanoparticles exhibited significant in vitro antioxidant performance, further in vivo studies are required to demonstrate the antioxidant properties of these nanoparticles. Moreover, future animal-based investigations should be conducted to determine the pharmacokinetics and pharmacodynamics of these nanoparticles.
 
The Role of Pulsed Dye Laser Treatment in Reducing Ecchymosis After Septorhinoplasty
Dr Reihaneh Heidari, Dr Behrooz Amirzargar, Dr Abbas Dehghani, Dr Babak Saedi, Dr Azadeh Goodarzi,
Volume 0, Issue 0 (3-2024)
Abstract
Introduction
Septorhinoplasty surgery is a common and popular procedure in Iran, known for its significant impact on improving the quality of life, self-confidence, and overall life satisfaction of patients. This surgical technique is well-established and precise, aiming to enhance both the aesthetic and functional aspects of the nose. However, a common challenge associated with septorhinoplasty is the development of ecchymosis, a condition characterized by swelling and bruising, which can be severe and, in some cases, even fatal. This postoperative complication often leads to patient dissatisfaction.
Recent years have witnessed a growing interest in the potential of PDL (Pulsed Dye Laser) treatment to mitigate ecchymosis following septorhinoplasty. Several studies have explored the efficacy of laser therapy in reducing the severity and duration of ecchymosis in the postoperative period. PDL laser treatment, with its targeted and non-invasive approach, has shown promise in effectively reducing bleeding and accelerating the natural healing process. This positive outcome is likely attributed to its ability to increase blood flow, promote lymph drainage, reduce inflammation, and enhance tissue generation. Consequently, PDL laser treatment appears to expedite the healing process for patients undergoing septorhinoplasty. Furthermore, the precision and controlled nature of laser therapy allow for specific treatment methods, thereby minimizing side effects and optimizing patient comfort. The non-invasive nature of this approach provides a favorable alternative to traditional methods, reducing the risk of further damage to delicate nasal tissues and ultimately facilitating a smoother recovery for patients.
Recovery outcomes vary among different articles due to the duration of the study and individual patient conditions. In future studies that provide more detailed insights, a clearer understanding of the types of lasers and the extent of improvement achievable with each can be obtained. This review aims to examine recent articles in this field to present the results, ultimately aiding in informed decision-making regarding the use of PDL laser therapy after septorhinoplasty.
Method
The process of investigating the role of PDL laser in reducing ecchymosis after septorhinoplasty commenced with a thorough research methodology. Keywords such as "laser," "ecchymosis," and "septorhinoplasty" were employed to search various academic databases, including Pubmed, Google Scholar, and the Cochrane Library, for relevant studies. Specific filters were applied to refine the search, including parameters related to publication date, study design, and subject relevance. Priority was given to peer-reviewed articles, clinical trials, systematic reviews, and comprehensive meta-analyses published within the past decade to ensure that the review encompassed current and relevant research. Additionally, the selection criteria focused on studies that specifically investigated the application of PDL laser therapy to reduce ecchymosis following septorhinoplasty.
The selected articles underwent meticulous evaluation, considering methodology, sample size, study design, and the results of laser treatment in managing ecchymosis. Particular attention was given to the quality of evidence, statistical significance, and the identification of any potential limitations or biases within the studies. Subsequently, a detailed analysis of key findings was conducted, emphasizing the mechanisms of action, efficacy, and potential challenges associated with the utilization of laser therapy to reduce ecchymosis after septorhinoplasty. This analysis aimed to ensure that the clinical outcomes related to the procedure were adequately addressed. By comprehensively analyzing the available information, the objective of this review is to provide an informed perspective on the role of laser therapy in managing ecchymosis after septorhinoplasty surgery, contributing to the advancement of knowledge and the enhancement of patient care in the field of septorhinoplasty.
Results
In the study conducted by Alegre-Sánchez et al., involving 34 patients aged between 28 and 79 years, ecchymosis resulting from various causes, including trauma, surgery, and cosmetic procedures, was investigated. The study aimed to assess the effectiveness of PDL laser treatment with varying parameters. The findings indicated that shorter pulses (0.5 ms) and higher fluences (8 j/cm2) were more effective in treating ecchymosis, particularly in cases of severe ecchymosis. Older, milder, and deeper ecchymoses exhibited a lower response rate.
DeFatta et al. conducted a study to explore the effectiveness of PDL laser (6 j/cm2, 6 ms) in reducing ecchymosis following cosmetic procedures in 20 patients. Their research revealed a 63% improvement in ecchymosis within 48 to 72 hours of laser treatment. Moreover, the rate of healing was higher when laser therapy was administered between days 5 and 10 after the onset of ecchymosis. Two other studies reported that the rate and speed of recovery from ecchymosis following PDL laser treatment were significantly higher than in control groups.
Discussion
Septorhinoplasty is widely recognized as an effective cosmetic procedure both in Iran and across the globe. Consequently, significant efforts have been devoted to addressing the challenges associated with this surgery in recent years. Among these challenges, ecchymosis stands out as a worrisome complication during the early postoperative phase. To mitigate these challenges, this study investigates the potential of laser therapy in rhinoplasty patients.
The application of lasers in this context generally contributes to a faster resolution of ecchymosis, providing a smoother path to recovery for patients. This positive outcome is attributed to the reduction of inflammation, improved blood circulation, and increased lymph drainage. Laser therapy allows for precise treatment methods, minimizing damage to sensitive nasal tissues during the healing process. However, it is important to note that further research is necessary to confirm the long-term efficacy and possible complications associated with laser therapy in this field.
The capability of laser therapy to expedite the resolution of bruising and promote rapid healing significantly enhances patient satisfaction and overall surgical outcomes. Recent studies have demonstrated the effectiveness of low-level laser therapy in various medical conditions, ranging from diabetic foot to androgenic alopecia, post-chemotherapy mucositis, wound healing, and inflammation.
Harsant et al. explored the effects of low-level laser therapy in facial plastic surgery, highlighting its impact on flap survival, wound healing, alopecia, and potential effects on skin aging. They recommended further comprehensive data in this field and considered the use of laser therapy as an adjuvant treatment. Moreover, Alegre Sanchez et al. and Fata et al. indicated the potential of low-level laser therapy in reducing ecchymosis. However, it's important to note that none of these studies were case-control studies. In another meta-analysis, Enwemeka et al. emphasized the highly effective role of laser phototherapy in tissue repair and pain reduction, positively impacting all three stages of tissue repair.
The potential effects of low-level laser therapy, as discussed in previous articles, encompass several key mechanisms: Reducing Edema and Inflammation, Restoring Damaged Tissue, Collagen Synthesis, Increasing Elasticity, Reducing Pain, Increasing Tissue Perfusion and Neovascularization, Increasing Cell Proliferation, and Especially Fibroblasts.
An accepted theory regarding the biological mechanism of photomodulation suggests that it involves the absorption of light by chromophores. These mechanisms, especially the recovery of damaged tissue and neovascularization, can effectively reduce edema and ecchymosis following rhinoplasty.
In a study conducted by Saedi et al., the Visual Analog Scale (VAS) scores in the laser-treated group were reported as better than those in the control group. However, it's worth noting that this difference was not statistically significant. Possible explanations for this inconsistency could include patients experiencing post-surgery stress or focusing on all parts of their face rather than just the area around the eyes. Additionally, if patients do not report a significant difference after laser surgery, the treatment may not fully serve its intended purpose. This discrepancy may also account for the differences in perceptions between the researchers and the patients involved. Nevertheless, the findings of this study demonstrated a positive effect of low-power laser therapy on ecchymosis that persisted for up to one month.
While the precise results may vary across different studies, there is a general consensus that the use of laser therapy is effective in reducing ecchymosis following surgery. Patients who undergo septorhinoplasty and receive laser treatment post-surgery tend to experience a swifter healing process. Moreover, certain studies have highlighted the benefits of laser treatment, such as the reduction of side effects and increased patient comfort compared to traditional treatment methods. The available data strongly support the notion that laser therapy plays a pivotal role in the management of ecchymosis following surgeries, including septorhinoplasty.
However, it's important to acknowledge a limitation of this treatment method, namely its cost, which may pose a barrier to its widespread adoption. Despite the positive results observed in this study, the extensive use of PDL in reducing ecchymosis after surgery necessitates longer-term follow-up and further studies with larger sample sizes and diverse intervention types to comprehensively evaluate its benefits and cost-effectiveness.
Comparison of the Effectiveness of Mindfulness Therapy, Biofeedback and Combined Method on Sexual Quality of Life in Men with Premature Ejaculation
Dr Mehdi Sarafraznasab, Dr Reza Ahmadi, Dr Ahmad Ghazanfari, Mrs Sarah Moghdisi,
Volume 0, Issue 0 (3-2024)
Abstract
Background & Aims: Premature ejaculation is the most common sexual problem that has many psychological effects on the relationship between spouses. Therefore, the present study aimed the effectiveness of mindfulness therapy, biofeedback and combined method on sexual quality of life in men with premature ejaculation.
Methods: The research method was semi-experimental, pre-test, post-test, follow-up with a control group. The studied population included all men 30 to 50 years with premature ejaculation who referred to the Nejat sexual disorders clinic in Tehran in 2022. Among them, 32 men with premature ejaculation were selected based on the inclusion criteria and by purposive sampling method. Then, they randomly assigned to experimentals and control groups (groups of 8 people each). The Sexual Quality of Life- Men (SQOL-M) was used to pre-test, post-test, follow-up. The first experimental group received mindfulness intervention in eight 90-minute sessions, the second experimental group received biofeedback intervention in eight 20-minute sessions, and the third experimental group received the combined method (The combination of mindfulness and biofeedback) in eight 90-minute sessions; While the control group was on the waiting list. The data were analyzed using repeated measure of covariance analysis and Bonferroni post hoc test. 
Results: No statistically significant differences were observed in the demographic variable of the groups. The findings showed that there was a significant difference between the experimental groups and control group; all three mindfulness therapy, biofeedback and combined method therapy interventions increased sexual quality of life (F= 50.93) in men with premature ejaculation and the effect of these therapeutic interventions in the follow-up phase has been stable (P <0.05). Also, the results of Bonferroni post hoc test showed that the effectiveness of combined method on sexual quality of life (IJ= 7.70) was higher than mindfulness therapy and biofeedback (P <0.05).    
Conclusion: According to the results of the present study, the of mindfulness therapy, biofeedback and combined method interventions can increase the sexual quality of life of men with premature ejaculation. It is suggested that therapists and counselors use these treatments in order to improve the sexual quality of life of men with premature ejaculation along with other therapeutic interventions.      
Effectiveness of unified transdiagnostic treatment on emotional distress, emotion regulation, in patients with history of suicide
Mis Afsaneh Amiri, Dr Maryam Izadi Mazidi, Dr Sahar Eshrati, Dr Amirhossein Jafari Mehdiabad,
Volume 0, Issue 0 (3-2024)
Abstract

Abstract:
Background: Suicide is a phenomenon which has plagued humans life throughout history from traditional relationships in the past to complex one s in modern life, so it has many consequences in different societies. Studies have shown that people who attempts to commit suicide are suffering deficiencies, emotional disturbance and difficulty in emotion regulation. According to these studies, ineffective emotion regulation strategies such as self-blame, rumination and catastrophizing have a stronger relationship with indicators of emotional problems such as suicide and aggression. As a result, the process of emotion regulation and its management is necessary in different situations. Emotional distress is a natural cognitive phenomenon that all people experience in certain situations of life. There are many evidences for this claim, but the intensity, frequency and controllability of this phenomenon are different in different people. [9]
Emotion regulation refers to an individual’s ability to be aware of and control the emotions they experience. It plays a significant role in preventing suicidal thoughts or actions. People unconsciously employ emotion regulation strategies throughout the day to cope with challenging situations. Many individuals use various strategies to regulate their emotions and adapt to environmental demands. Healthy strategies can moderate intense feelings and enhance understanding of the emotional experiences. Conversely, unhealthy strategies may leave lasting damage. Emotional regulation empowers individuals to better manage their emotional states. Unified transdiagnostic treatment is recognized as a novel psychological intervention with proven effectiveness for various emotional disorders.[14] In this study, we investigated the impact of unified transdiagnostic treatment on emotional dysregulation and difficulties in emotion regulation among patients with a history of suicide attempts. The core of this intervention is awareness, especially emotional and cognitive awareness, and identification and control of different emotions.
The main objective of this study is to examine the effectiveness the outcomes of unified transdiagnostic treatment for emotional disorders with those of emotion-focused transdiagnostic treatment in patients with a history of suicide attempts.
Method: The research method employed was a semi-experimental design with a pretest-posttest control group. For this study, 50 patients aged 18 to 40 years with at least one diagnosis of emotional disorders were purposefully selected from Baharloo and Roozbeh hospitals in the year 2023. During the course of the study, 6 individuals (4 from the experimental group and 2 from the control group) dropped out, resulting in a final sample of 44 participants divided into two groups of 22 each (experimental and control). In addition to standard interventions, the experimental group received an unified transdiagnostic treatment (Barlow et al., 2017) consisting of 8 sessions lasting 90 minutes each, while the control group received routine interventions during the same period. Data were collected using standardized questionnaires assessing emotion regulation difficulties (DERS) and emotional distress (DASS-21). Statistical analysis was performed using SPSS version 26.
Results: In the post-test phase, the unified transdiagnostic treatment group showed improvement in emotional dysregulation scores and difficulty in emotion regulation compared to the control group. Additionally, the analysis of Covariance revealed that the distribution of scores in both emotional dysregulation and difficulty in emotion regulation variables is normal. Furthermore, statistical analyses indicated that there is a significant difference between the post-test mean scores of the experimental and control groups in at least one of the emotional dysregulation and difficulty in emotion regulation variables. The results of the multivariate analysis of Covariance showed that the F value for the emotional dysregulation variable was 188.912, and for the difficulty in emotion regulation variable, it was 207.199, all of which are statistically significant (p < 0.05).
Conclusion: The results indicate that unified transdiagnostic treatment is effective in reducing emotional dysregulation and increasing emotional regulation in patients with a history of repeated suicide attempts referred to Tehran neurology and psychiatric hospitals. Transdiagnostic integrated treatment has been effective in reducing the level of emotional disturbance in patients with a history of suicide attempts. In general, the unified protocol for the transdiagnostic treatment of emotional disorders, using psychological training techniques, emotional awareness training, increasing cognitive flexibility and emotional exposure, deals with emotional disturbance and correcting emotional regulation habits of patients. The unified protocol teaches the nature of emotions and the main components of emotional experiences and helps patients to track their experiences of an emotion, that is, to identify the triggers of emotional experiences, their responses to these emotions and the messages of these responses.[34] This finding is consistent with the studies conducted by Izadi et al. (2019),[33] Ghasemzadeh et al. (2021),[36] Elah Dadian Flavarjani and Gerji (2021),[37] Sauer-Zavala et al. (2021),[27] Galehgirian et al. (2021),[24] and Ehrenreich et al. (2017) [39]. The role of emotion regulation can be highlighted in explaining this finding. The second module of the integrated protocol focuses on psychological education about the nature of emotions and the core components of emotional experiences. It assists patients in tracking their emotional experiences, identifying emotional triggers, their responses to these emotions, and the consequences of these responses. unified transdiagnostic treatment, through emotional awareness and emotion regulation training, helps reduce anxiety, depression, and stress in participants. This intervention fosters improvement in negative emotional experiences.
Furthermore, the results demonstrate that unified transdiagnostic treatment has an effect on reducing and improving emotional disorders and emotion regulation in patients with a history of suicide attempts in the experimental group compared to the control group.This finding is consistent with other studies, including Talkovsky et al. (2017),[42] Davoudi et al. (2018),[47] Fadaei et al. (2018),[48] Sakiris and Berle (2019),[21] To elaborate on this finding, It should be said that one of the mechanisms through which this treatment protocol creates change is emotion regulation. One of the most common emotion regulation strategies is the use of cognitive strategies,[52] the fifth module of the integrated protocol focuses on assessing and modifying cognitive evaluations. It helps patients gain greater awareness of how they interpret and evaluate situations and understand how thoughts impact emotional reactions. The goal of changing cognitive evaluations is to enhance flexibility in evaluative situations. This module assists patients in identifying maladaptive self-appraisals, recognizing the impact of these appraisals on their mood or emotions, and achieving greater flexibility in their thinking patterns.       


Investigating the Effectiveness of Neurofeedback Treatment on Depression and Comparing it with Other Treatments - A Systematic Review
Roshanak Chaychi, Leila Sadegh Marand, Mozhgan Ghafouri Shahmirzadi, Samin Shahhosseini, Faezeh Jamshidi Goharrizi,
Volume 0, Issue 0 (3-2024)
Abstract
Mental disorders are a group of disorders that affect the thinking, behavior, mind, psyche, mood, perception and awareness, causing discomfort for the affected person or causing disability in the functioning of the affected person. The causes of mental disorders are not well known, but what is certain is that genetic factors, various stresses, and the type of interaction a person has with others are effective in causing or causing them. The study shows that the rate of mental disorders in Iran is increasing, so that the rate of mental disorders in 2014 was reported as 22% in the general population and this rate in 2011 It has reached about 37%. Anxiety, somatization disorder, and depression, whose incidence rates were 40%, 30%, and 43% in the general population, respectively, are referred to as the most common mental disorders in Iranian society. Among mental disorders in Iran, depression is known as the most common mental disorder.
Depression is referred to as the common cold of mental disorders. According to the definition, depression is a mood disorder that causes a constant feeling of sadness or loss of interest in things that the affected person used to enjoy. Also, depression can interfere with memory, thinking, eating and sleeping. This disorder has a negative impact on a wide range of physical and mental health of affected people, so that the number of physical diseases such as cancer, heart diseases and even overweight is higher in people suffering from depression compared to normal people. Also, compared to normal people, depressed people not only have less psychological well-being, but also these people face a severe drop in academic and job performance. On the other hand, depression is known as the most common mental disorder in people with suicidal thoughts and behavior. Therefore, the importance of depression is not hidden from anyone and its treatment should be followed seriously.
One of the common treatment methods in depression is drug therapy, which fluoxetine, fluvoxamine, paroxetine, and sertraline are known as the most common antidepressant drugs, however, many patients may not respond significantly to drug therapy. And sometimes drug therapy may show less effectiveness than other treatments. Meanwhile, different types of psychotherapy such as cognitive behavioral therapy, emotional therapy, commitment and acceptance therapy, and schema therapy have also provided their treatment protocols to help depressed people. But another non-pharmacological intervention in depression, which has attracted the attention of therapists and researchers in recent years, is neurofeedback therapeutic intervention. Neurofeedback is a relatively new treatment for mental disorders and depression, using real-time scans to show how the patients' brains work and resolve these disorders .
Method
The method of the present study is descriptive and according to the implementation method, it is a systematic review article. Review studies are one of the important types of qualitative research that are used to study phenomena and evaluate important categories based on previous research sources. This method is used when the relevant previous studies related to the desired phenomenon are well covered. In this case, by using these studies, the underlying categories of the studied phenomenon can be evaluated, classified and identified.
The research community includes all articles with the English keywords Depressive Disorder, Major Depression, Mood Disorder, Depression along with Neurofeedback Training, , biofeedback, neurofeedback in foreign databases Scopus, Springer, Web of Science, Google-Scholar, Science Direct and keywords Neurofeedback, bioneurofeedback along with depression, depressive, mood disorder in the internal databases of SID, Normags, Magiran, Civilica, ISC, Google-Scholar, which were published between 1993 and 2023. In order to select relevant studies, the Prism guide for review studies was used. At first, 397 articles were selected using the above keywords in internal and external search engines. After that, 263 studies were excluded due to non-relevance, 71 studies due to duplicates in the search engines. From the remaining 63 studies, after fully reading the articles and applying the inclusion and exclusion criteria, 47 other studies were excluded and 16 studies were selected for the final sample selection.
Results
The results of this study showed that out of 16 selected studies, 8 studies were conducted in Iran, 3 studies were conducted in South Korea, and 1 study was conducted in China, Russia, Spain, Finland, and the United States. No studies were found in the continent of Africa and South America, and 1 study was selected for the continent of America, which indicates limited studies in this continent. Also, no studies related to before 20100 were found, 9 studies were between 2010 and 2018, and 7 studies were related to the last 5 years. Also, out of the 16 selected studies, most of the studies used the Beck depression questionnaire to measure depression (10 out of 16 studies). Among the conducted studies, only one study had a sample size of more than 50 people, which is because only interventional and therapeutic studies were selected and the sample size in experimental studies in each control and experimental group should be at least 8 people, so In no study, the number of their samples is not less than 16 people. It is also necessary to remember that master case studies or single-subject experimental designs were excluded from the study due to the small number of samples.
Discussion
The purpose of this study was to investigate the effectiveness of neurofeedback therapy and compare it with other treatment approaches on reducing depression. The results of this study showed that in all the studies conducted, neurofeedback therapy was able to significantly reduce depression in treatment groups. These results are in agreement with the studies of Chubforoshzadeh et al. (2015) who showed that neurofeedback treatment is effective in reducing the symptoms of depression in people with MS and also with the study of Hood et al. (2021), who showed that neurofeedback treatment has a significant effect on Reducing depression in people with generalized anxiety disorder is effective, it is consistent.
Conclusion
The results of this treatment showed that neurofeedback treatment was significantly effective in reducing depression symptoms, and this effectiveness when combined with other treatments is not only more effective, but the durability of the treatment is longer compared to a single treatment. We also need more studies to compare this treatment with other treatments. Considering the effectiveness of this treatment, it is suggested that mental health professionals combine this treatment with other treatments in order to reduce the symptoms of depression and improve the quality of life of depressed patients.
Investigating and Explaining the Factors Preventing and Promoting Physical Activities of the Elderly in Islamshahr City
Naimeh Khavoshi, Davood Shojaezadeh, Zahra Jalili,
Volume 0, Issue 0 (3-2024)
Abstract
In today's world, it is practically impossible to know the way of life and progress without stress, and it has become a law among human societies. The purpose of this research was to investigate and explain the inhibiting and facilitating factors in the physical activity of the elderly in Islamshahr city. From the point of view of the goal, the present PJ.Hash was of applied and exploratory type. The statistical population in the current study included researchers and experts from sports science, psychology, sociology, sports veterans, doctors and nurses, as well as members of organizations related to the field of geriatrics in Islamshahr city. The samples were purposefully selected for in-depth and semi-structured interviews and the interviews continued until the theoretical saturation stage, theoretical saturation was achieved after interviewing 25 people. Data analysis was done based on qualitative method. The results of the research showed that 23 open codes for challenges were defined in the form of 3 sub-codes, which included: cultural and lifestyle barriers, environmental and facility barriers, personal and personality barriers. Also, 41 open codes for strategies were defined in the form of 5 sub-codes, which included: educational and program measures, promotional measures, motivational measures, legal measures, infrastructure measures. According to the obtained results, it can be concluded that the inhibiting factors directly and indirectly reduce the participation of the elderly in sports, therefore, in order to achieve the goals of the sports of the elderly, attention should be paid to the basic and structural principles and measures, and to support the elderly with strategies such as: holding Special sports festivals for the elderly, training coaches and sports experts for the elderly, establishing sports houses for the elderly, diversifying the sports services for the elderly encouraged them to join sports participation.
 
Presenting a Model of the Influence of Leaders' Wisdom on Organizational Success with the Mediating Role of Perceived Organizational Reputation
Mr. Reza Abedi, Dr. Saeid Saffarian Hamedani, Dr. Taraneh Enayati,
Volume 0, Issue 0 (3-2024)
Abstract
Background and purpose: With the increasing complexity and increase in global competition, the need for flexibility and changeability in organizations has become more and more visible. The aim of the current research was to present a model of the influence of leaders' wisdom on organizational success with the mediating role of perceived organizational reputation.
Method: In the qualitative part, the opinions of experts were used with the Delphi technique, and in the quantitative part, a survey of statistical samples was used using structural equations. The statistical population of the research in the qualitative part included (experts and managers of the Center for Intellectual Development of Mazandaran Children and Adolescents in the field of policy-making) for consensus in the Delphi method, the sample size in the qualitative part was determined to be 17 people considering the saturation law In the quantitative part, the statistical population included 153 employees of the Center for Intellectual Development of Children and Adolescents of Mazandaran province. In the quantitative section, the sample size was determined to be 153 people using Cochran's formula. Sampling method was available in the quantitative section. The method of collecting information is library method, and the measurement tool in the qualitative part is a semi-structured interview and in the quantitative part it includes a researcher-made questionnaire, the questions of which were taken from the data obtained from the interview. Determining the validity of the questionnaire in this research was done by two methods: 1. Form and 2. Content. In the form method, the questionnaire was given to a group of experts, and in the content method, the calculations related to the AVE and CR coefficients related to the validity of the questionnaire items were confirmed. took Reliability coefficients were confirmed using Cronbach's alpha test. SPSS and LISREL software were used to analyze the data in the qualitative part of the Delphi technique and in the quantitative part of the structural equation modeling method.
Findings: The findings showed that leaders' wisdom has a positive and significant effect on organizational success with a mediating role of strategic flexibility and perceived organizational reputation. Also, the results showed that the elements and components and micro-sub-components of leaders with the mediating role of perceived organizational reputation are 75% effective. The power of the model in the sample size of 153 people has reached the value of one, which is higher than the value of 0.8. Therefore, the adequacy of the sample volume is confirmed. In other words, the results show that the sample size is sufficient to estimate the unknown values. The horizontal axis of the graph represents the sample size and the general axis represents the value corresponding to the power of the model. This graph shows that where the null hypothesis is accepted, the reason is not the lack of sample size and the validity of the results is confirmed. In order to determine the appropriate model for the identified dimensions, confirmatory factor analysis model has been used (15). Confirmatory factor analysis is used when the researcher has a lot of knowledge about the underlying construct. Based on theoretical knowledge, experimental research and previous studies, the researcher assumes that there is a relationship between the observed variables and the fundamental factors and then tests this assumption. In confirmatory factor analysis, the researcher seeks to prepare a model that is supposed to describe or explain the experimental data based on a few relatively few parameters. This model is also based on pre-experimental information about the data structure. The desired model can be based on: 1) a theory or hypothesis, 2) a certain classification scheme for the items or partial tests, 3) known experimental conditions, or 4) knowledge obtained from previous studies about the data. be wide (16). After specifying the pre-experimental factors, confirmatory factor analysis tests the optimal fit of the observed and theoretical factor structures to the data set by determining the fit of the determined factor model.
Conclusion: In explaining these results, it can be said that organizational reputation has attracted managers' attention to solve internal organizational problems. Employees want to cooperate with an organization that is sensitive to their issues, including the work environment and the environment outside the organization, such as air pollution and the environment

3D Printing Technology and Additive Manufacturing: a Review of Biomedical Application
Dr Sheida Esmaielzadeh, Dr Mahsa Vaghefi, Dr Banafsheh Esmaeilzadeh, Dr Mohammad Sadegh Tavallali,
Volume 0, Issue 0 (3-2024)
Abstract
Backgrounds & Aimes:
The difference in the clinical conditions and anatomy of each patient, on the one hand, and the the availability of the medical-digital data, on the other hand, enforce the daily expansion and progressive flourishing of the Additive Manufacturing (AM) technology (3D printing) applications in the medical world. The possibility of manufacturing patient-specific pieces with any geometrical complexities out of different materials )from a wide range of hard and soft materials( with a conventional cost is one of the advantages of this method, which has led various medical specialists to benefit from AM technology at different diagnostic and therapeutic levels. The rapid development of these applications is such that it is not far-fetched to estblish a separate AM unit in collaboration with physications of various specialties in hospitals (and in some medical centers this has already begun). Therefore, due to the significant expansion of the AM field in medicine, in this article, its advantages and disadvantages have been investigated, and the applications and development of AM technology in the customization of medical and rehabilitation equipments, implants and prostheses have been investigated.
Methods:
Standard search method was used in Persian and English databases, namely Science direct, Scopus, PubMed, Google Scholar and ISC.The evaluation and selection criterion was the articles that were placed in the field of biomedical application with additive manufacturing technology between 2015 and 2023, and finally 40 articles were studied and reviewed.
Results:
The results of the conducted studies showed that AM technology is used in the manufacturing of all kinds of advanced implants such as knee joint, lumbar vertebrae welder, sternum, spine, hip joint, knee joint bracket, as well as the production of prostheses such as ears, nose, teeth, hand and foot bones, which have favorable mechanical and physical properties and are fully compatible with the patient's body. Furthermore, 3D printing technology is used in  manufacturing rehabilitation equipments and various orthosis. The prominent role of this technology in medical education and orientation of the patients and their families should not be forgotten.
Conclusion
AM technology can provide the production of complex pieces with a variety of structures simpler and faster at a lower expenses compared to traditional methods. The use of this miraculous technology in the field of medical training, pharmaceuticals and drug delivery, tissue engineering and organ manufacturing, and the manufacture of medical tools and equipment will bring an excessive revolution in the field of medicine and biomedicine, which can save the lives of many patients. Many medical professionals use 3D printing in their diagnostic and therapeutic work.

Importance of Iodine during Pregnancy and Lactation, a Narrative Review
Dr. Fahimeh Ramezani Tehrani, Dr. Sima Nazarpour,
Volume 0, Issue 0 (3-2024)
Abstract
Background and Aim: Iodine is essential for the production of thyroid hormones, which regulate many bodily functions, including metabolism and growth.  Thyroid hormones are closely related to the growth, development of the nervous system, and the metabolism of substances throughout the body, thus managing various aspects of the body's metabolism.
Fetal development strongly depends on thyroid and iodine metabolism, especially during critical periods of brain development (from early pregnancy to early birth), nervous system development depends on thyroid hormones and can be compromised if their function is impaired. This narrative review focuses on the role and importance of iodine during pregnancy and lactation and explains various related issues.
Materials and Methods: In this narrative review, PubMed, Web of Science, and Scopus databases, as well as SID, Irandoc, and Magiran Persian databases, were searched with appropriate keywords for related articles, and 97 articles were used for this comparative review.
Results:
Iodine during pregnancy:
Thyroid hormone production in pregnant women increases by 50% in early pregnancy. On the other hand, the increase in the mother's blood volume during pregnancy may be associated with a decrease in the concentration of nutrients and, as a result, a decrease in their concentration in the urine. During pregnancy, maternal iodine is transferred to the fetus through the placenta and is the only source of iodine for the fetus during pregnancy, so the iodine status of pregnant women directly affects the growth and development of the fetus. Insufficient iodine intake during pregnancy can lead to a range of adverse reproductive outcomes, including increased risk of perinatal and infant mortality, and intellectual impairment in children. The most severe consequence of iodine deficiency is cretinism, a condition characterized by severe physical and mental developmental delays. Iodine deficiency during pregnancy can cause serious disorders in maternal and fetal thyroid function and lead to adverse consequences in pregnancy. Studies have shown that overt hypothyroidism due to severe iodine deficiency during pregnancy is associated with adverse outcomes including spontaneous abortion, gestational hypertension, preeclampsia, and gestational diabetes. Mother's thyroid hormone plays an important role in fetal brain development. The brain is especially sensitive to iodine deficiency during its formation in the early embryonic period and after birth. During pregnancy and early lactation, the iodine needed by children is completely taken from the mother. Insufficient iodine as well as excess may cause hypothyroidism. Indeed, iodine deficiency during pregnancy is the most important preventable cause of neurodevelopmental disorders worldwide and is an important global public health issue.
Pregnant and lactating women need more iodine than other adults. In general, pregnant women need a 50% increase in iodine to produce enough thyroid hormone to meet the needs of the fetus, as well as to meet the needs of increased production and placental transfer of thyroid hormone, which is necessary for optimal fetal growth. In areas where iodine is sufficient, the mother's thyroid gland increases its iodine absorption to maintain sufficient reserves inside the thyroid. However, in moderate to severe iodine deficiency, such adaptive mechanisms may fail to maintain adequate iodine stores (4). Accordingly, the daily requirement of iodine during pregnancy increases to 250 micrograms compared to 150 micrograms for non-pregnant women.
Iodine during Lactation:
Infants are more sensitive than other age groups to abnormal changes in iodine concentration because they have the highest iodine requirement per kilogram of body weight. The development of the brain and central nervous system takes place from the second trimester of pregnancy to the age of 3 years. Breastfed infants are solely dependent on the adequate supply of iodine in breast milk for the synthesis of thyroid hormones, and the concentration of iodine in breast milk depends on the mother's dietary intake. Therefore, low maternal iodine intake inevitably predisposes lactating women and their infants to iodine deficiency. Based on this, it is clear that during this period, the mother's iodine intake should be optimal to provide enough iodine for the developing fetus.
Recommendations
Most people get relatively small amounts of iodine in their diet, so an additional source is needed to provide them with enough iodine for their daily needs and to maintain normal thyroid hormone concentrations. Salt, enriched bread and water are the main sources of iodine. WHO recommends fortification of all dietary salt with iodine as an effective and safe strategy for the control and prevention of iodine deficiency disorders (IDD) for those living in iodine-deficient and iodine-sufficient areas. Adults need 150 micrograms of iodine per day, which varies from 90 to 290 micrograms per day based on the age and physiological status of the person. Pregnant and lactating women need more iodine than other adults. 220 to 250 micrograms per day during pregnancy and 250 to 290 micrograms per day during lactation are recommended.
Accordingly, iodine supplementation during pregnancy and lactation is widely and justifiably recommended to prevent the potentially damaging and irreversible consequences of iodine deficiency on child development.
Current WHO recommendations indicate that although iodine supplementation during pregnancy is safe, it may not be justified in pregnant women with mild iodine deficiency living in iodine-sufficient countries
The timing of iodine supplementation seems to be very important in relation to pregnancy. All the evidence shows that iodine supplementation is most effective (probably the only effective agent) in preventing fetal neurologic damage if it is started before conception or in the first and early second trimester of pregnancy and continues throughout pregnancy. Given the timing of thyroid hormone action on the developing fetal brain, it is reasonable to start iodine supplementation for women prone to iodine deficiency before conception, if possible, to ensure adequate thyroid iodine stores.
WHO, UNICEF, and ICCIDD/IGN recommend a daily dose of 250 mcg potassium iodide for lactating women. Alternatively, in countries where iodine deficiency is evident, and has not been corrected by a public iodized salt program, these authorities recommend an annual depot dose of 400 mg of iodized oil orally at 6-monthly intervals for the exclusive breastfeeding mother
Conclusion: In summary, adequate iodine intake during pregnancy and lactation is vital for the health and development of the child. Considering the necessity of sufficient iodine for the development of the nervous system of the fetus and newborn and the increased need for iodine in pregnant and lactating women compared to other adults, it is recommended to take iodine supplements or iodine-rich foods during pregnancy and lactating.
 
Comparing the effectiveness of positive parenting intervention program and cognitive therapy based on mindfulness on psychological fatigue in mothers of children with attention deficit/hyperactivity disorder in Kerman city.
Masoumeh Karimi, Mohammad Molayi Zarandi, Alireza Manzari Tavakoli,
Volume 0, Issue 0 (3-2024)
Abstract
Abstract
Parents of children with attention deficit-hyperactivity disorder experience more stress compared to parents of normal children. This can lead to mental health problems for parents, such as depression, parental stress, and increased parental problems. This psychological pressure is caused by Having a child with a disorder has a significant impact on parenting styles. Therefore, the purpose of this research was to compare the effectiveness of positive parenting intervention program and cognitive therapy based on mindfulness on psychological fatigue in mothers of children with attention deficit/hyperactivity disorder in 2014. This research is a semi-experimental project with a pre-test-post-test in the experimental group (positive parenting intervention program) and the comparison group (cognitive therapy based on mindfulness) with the control and follow-up group, the statistical population of all mothers of children with attention deficit disorder. The research sample includes 60 mothers of children with attention deficit/hyperactivity disorder in the 6 months of spring and summer of 1402 and has the criteria to enter the intervention by selection and sampling. Purposeful and simple random assignment of 20 participants to each group and implementation of interventions. The experimental group underwent positive parenting intervention and cognitive therapy based on mindfulness for a period of 12 sessions of 75 minutes, and the control group did not receive the intervention. The research tool was Smets (1996) Multidimensional Fatigue Questionnaire (MFI). The results of the covariance analysis showed that the averages of the psychological fatigue scores in the positive parenting intervention program group, the cognitive therapy group based on mindfulness, and the control group showed a significant difference. Therefore, it can be said that the positive parenting intervention program had a greater effect on psychological fatigue in mothers of children with attention deficit/hyperactivity disorder than cognitive therapy based on mindfulness.
Conclusion: The positive parenting intervention program can be used to reduce the psychological fatigue of mothers of children with attention deficit/hyperactivity disorder.
 
Evaluation of students' satisfaction and understanding of the learning environment during the integrated training course of practical semiology in the covid-19 pandemic at Iran University of Medical Sciences
Ali Tayebi, Shabahang Jafarnejad, Mahya Naderkhani, Ali Arjmand Tajoddini, Seyede Fateme Nouri Abhari, Faranak Olamaeian, Shahin Keshtkar Rajabi, Alireza Zakaryaei,
Volume 0, Issue 0 (3-2024)
Abstract
 Background:
An emerging disease surfaced in China in December 2019, manifesting as acute respiratory syndrome, rapidly evolving into a global pandemic (1-3). The cause was identified as the severe acute respiratory syndrome coronavirus (SARS-CoV-2), designated COVID-19 by the World Health Organization on January 30, 2020 (4). In response to its high fatality rate and contagiousness, countries worldwide implemented widespread closures, including Iran, where all administrative, commercial, and educational activities ceased. Consequently, virtual education gained prominence to mitigate academic setbacks and ensure continuity (5). This shift necessitated educators, many inexperienced in virtual teaching, to adapt quickly (6). Medical education also adapted to these conditions, with significant impacts on student learning in hospital settings. Face-to-face teaching in hospitals and clinics was curtailed due to the disease burden in Iran, leading to substantial changes in medical education (7, 8). Studies in Iran have yielded conflicting findings on the pandemic's effects on medical education, highlighting both the efficacy of online and virtual medical courses and varying outcomes (8-12). Recognizing the significance of the semiology course for medical students, crucial for learning clinical examinations and patient interaction skills before entering hospital departments, emphasizes the need for structured training in semiology. This foundational unit underpins medical and clinical education, playing a vital role in future patient care and healthcare management (13). The current research was designed with the aim of investigating the level of students' satisfaction and students' views on different aspects of practical semiology unit courses in two groups of students who completed the course in person and virtual.

Methods:
 This study was a meticulous examination conducted among medical students enrolled at Iran University of Medical Sciences (IUMS) in Tehran throughout the year 2022. To ensure ethical standards, the study commenced following approval from the IUMS Ethics and Research Committee (approval number: IR.IUMS.REC.1401.490).  Participants in this study were enrolled using convenience sampling into two groups: a virtual learning group and a face-to-face learning group, both meticulously matched in demographic characteristics such as age, gender, and academic semester. The sampling strategy employed convenience sampling, categorizing participants into two distinct groups: face-to-face and virtual learning environments. This stratification aimed to maintain demographic equilibrium concerning variables such as age, gender, and academic semester, thereby mitigating potential confounding factors. Adequate sample sizes were computed to uphold statistical power, mandating a minimum of 193 participants encompassing both groups: 65 in the virtual cohort and 128 in the face-to-face cohort. The practical semiology curriculum was tailored based on specific needs identified among students at Iran University of Medical Sciences (IUMS). For the virtual course, educational content included 57 carefully crafted instructional videos sourced from expert lectures and practical demonstrations. These resources were made available on the IUMS online platform prior to the course commencement, ensuring accessibility and preparation for virtual learners. Conversely, the face-to-face course was conducted in a spacious, well-ventilated facility equipped with 15 dedicated learning stations. Each station accommodated 5-9 students, an instructor, and occasionally a simulated patient actor when required. These stations were fully stocked with essential tools and educational aids, facilitating hands-on learning experiences under direct educator supervision. The curriculum spanned three intensive modules over 12 days, covering critical topics such as clinical history-taking, physical examinations, and technical competencies including surgical techniques and invasive procedures. Outcome measures centered on evaluating student perceptions of the learning environment and overall satisfaction levels. This assessment was conducted using the Dundee Ready Education Environment Measure (DREEM) (14) questionnaire, a validated tool designed to assess educational climate effectiveness across domains like learning, teaching quality, academic self-perception, educational atmosphere, and social conditions. The DREEM questionnaire assesses students' perceptions across several dimensions: learning, teachers, academic ability, educational atmosphere, and social conditions of education. Each component uses a 5-point Likert scale, with scores categorized into poor, moderate, and high levels based on predefined score ranges. Additionally, student satisfaction with the semiology course is evaluated through a separate 10-question online questionnaire, also using a 5-point Likert scale, with scores classified into poor, moderate, and high satisfaction levels. Statistical analysis of collected data utilized SPSS software, employing standard metrics such as mean ± standard deviation for continuous variables and percentages for categorical data. Comparative analysis included Mann-Whitney U tests, independent sample t-tests, and chi-square tests as appropriate, with significance set at P ≤ 0.05. These rigorous analytical approaches aimed to discern significant differences and draw robust conclusions regarding the efficacy of each educational modality in fostering student learning and satisfaction in semiology training at IUMS.

 Results:
A total of 325 medical students were included in this study. 22.8% of the students (n=74) had participated in virtual training and 77.2% of the students (n=251) had participated in the face-to-face semiology course. The average age of students was 22.65 ± 2.75 years and ranged from 20 to 38 years (P=0.8). 54.2% (n=176) were male students and 45.8% (n=149) were female students (P=0.01) (Table 1).
Table 1. Demographic Characteristics of the Participants by Type of Learning Groups.
Characteristics face-to-face learning group
(n=251)		 Virtual learning group
(n=74)		 P value[1]
Gender, n (%)
Male
Female 		 
127 (50.6%)
124 (49.4%)		  
49 (66.2%)
25 (33.8%)		 0.01
Age, years (SD)[2] 22.49 (2.4) 22.97 (2.9) 0.8

The relationship between the type of students' training course (face-to-face or virtual) and their level of satisfaction was investigated. Statistical analysis did not show a significant relationship between these two variables (P=0.1) (Table 2).
Table 2. Satisfaction of the Participants by Type of Learning Groups.
Characteristics face-to-face learning group
(n=251)		 Virtual learning group
(n=74)		 P value[3]
Satisfaction, n (%)
Poor
Moderate
High 		 
0 (0)
16 (6.4)
235 (93.6)		  
1 (1.3)
7 (9.5)
66 (89.2)		 0.1

 The dimensions of the DREEM questionnaire were examined, Overall, poor perception had a very low prevalence (0-1.4%). In contrast, high perception in students showed a prevalence of more than 90% in all dimensions in face-to-face education and between 77 and 91.9% in virtual education. Except for SPSCE, in other dimensions, the level of high perception was significantly higher in students with face-to-face education (P<0.05) (Table 3).
Table 3. Examining and Comparing the Dimensions of Students' Perception by Type of Learning Groups.
Characteristics face-to-face learning group
(n=251)		 Virtual learning group
(n=74)		 P value3
Students' perception of learning, n (%)
Poor
Moderate
High 		 
1 (0.4)
23 (9.2)
227 (90.4)		  
0 (0)
17 (23)
57 (77)		 0.006
Students' perception of teachers, n (%)
Poor
Moderate
High		  
0 (0.4)
12 (4.8)
239 (95.2)		  
0 (0)
14 (18.9)
60 (81.1)		 0.001>
Students' perception of their academic ability, n (%)
Poor
Moderate
High		  
0 (0)
13 (5.2)
238 (94.8)		  
1 (1.4)
11 (14.9)
62 (83.8)		 0.003
Students' perception of educational atmosphere, n (%)
Poor
Moderate
High		  
0 (0)
8 (3.2)
243 (96.8)		  
1 (1.4)
8 (10.8)
65 (87.8)		 0.005
Students' perception of the social conditions of education, n (%)
Poor
Moderate
High		  
0 (0)
14 (5.6)
237 (94.4)		  
0 (0)
6 (8.1)
68 (91.9)		 0.4

Conclusion:
In general, according to the DREEM index, the level of satisfaction with education in general and in all its dimensions was reported to be high and suitable for both learning groups. The overall score of satisfaction and perception with education based on DREEM, for a group of students who participated in face-to-face learning, in all dimensions including: SPL, SPT, SPAA, SPEA and SPSCE was more than the virtual group. This study showed that although virtual training has high satisfaction among students, the face-to-face training method caused higher academic satisfaction and perception. Therefore, considering the nature of the semiology course and its clinical importance, it is suggested that this course and, in general, courses that have a high clinical aspect, be taught face-to-face. It is recommended to compare the final test results of students in two face-to-face and virtual groups of semiology course in other studies.
 
 
[1] *P-values indicate differences between students by type of learning groups. P < 0.05 was considered statistically significant. 
 
[2] Abbreviation: SD, standard deviation.
 
[3] *P-values indicate differences between students by type of learning groups. P < 0.05 was considered statistically significant. 
 

Investigating the effectiveness of compassion-based therapy and emotion-oriented therapy on improving flexibility in people with psychoactive substance poisoning
Navid Shirmardi, Parviz Askari, Farshad Bahari,
Volume 0, Issue 0 (3-2024)
Abstract
Introduction
Nowadays, drug abuse has become one of the most important issues and problems related to mental health (1), drug addiction is a learned habit that includes psychological and physiological factors and leads a person to dependence and continued use (2).
Psychologists have found that stressful life factors can weaken people's mental health and their social functioning and lead to psychological damage in them. Some people go through stressful events without reducing their mental health and suffering from mental illness (6). An important concept that is presented in the direction of substance abuse is the perception of competence; Perception of competence is one of the components and concepts of self-concept, which refers to the process of a person becoming aware of his characteristics, the type of relationships with others, feedback from events, capacities and abilities, and focuses on various cognitive, physical and social fields (7).
The basic principle in therapeutic compassion refers to the issue that external soothing factors and behaviors should be internalized, in this way, as the human mind reacts to external issues, it also finds comfort in front of internal factors (13), to In addition, in this treatment, people learn not to suppress or avoid their painful feelings and experiences, so they can recognize their experience in the first step and feel compassion for it (14).
On the other hand, emotion-oriented therapy, which is a combination of experiential and systemic therapy, is offered; Emotion-oriented therapy is determined by three stages of connection and awareness, recall and discovery and emotional reconstruction in eight steps; These three stages overlap, and throughout the treatment, the client is viewed as an expert on his experience and the therapist as a guide and facilitator for the client's goals (18). In this treatment, it is believed that the way people organize and process their emotional experiences and the interaction patterns they create and strengthen have led to their helplessness (19), in other words, it can be called emotion-oriented therapy. By creating constructive interactions between people and identifying safe attachment patterns, it reduces cognitive distortions in people (20).
According to the presented materials and the negative impact of psychoactive substance poisoning on individual and social life on the one hand, the lack of general consensus regarding the choice of the best type of intervention to reduce the negative effects of these substances, the importance of the perception of competence in life, and since by reviewing the research Conducted inside and outside the country, no research was found in the field of the subject, so the researchers are trying to answer the question, is the therapy based on compassion and emotion therapy based on the perception of competence effective in people dependent on psychoactive substances?
Method
To carry out the present research, the present experiment was carried out with the pre-test-post-test-follow-up group with the control group among the people addicted to psychoactive substances who visited outpatient addiction treatment centers in Ahvaz and were admitted to these centers. 45 people were purposefully and randomly divided into experiment 1 (compassion-based therapy), experiment 2 (emotion-oriented therapy) and control groups. All the subjects completed the Parandin Social Competence Perception Questionnaire. The first group underwent 8 sessions of 60 minutes once a week under compassion-based therapy based on Gilbert's compassion-focused therapy protocol, and the second group underwent 12 60-minute sessions of emotion-oriented therapy based on Greenberg and Watson's emotion-oriented therapy protocol. The control group did not receive any intervention. Finally, to analyze the data from descriptive statistics (mean and standard deviation) and inferential statistics including mixed variance analysis with repeated measurement, Benferroni post hoc test using SPSS computer software version 27 was used at a significant level, 05/0 a=0 was used.
Results
As seen in Table 2; In the stages of pre-test, post-test and follow-up, the value of F is significant at the level of P=0.001. These findings show that there is a significant difference in the dependent variables in the pre-test, post-test and follow-up stages. Also; In the interaction between the group * measurement steps for the perception of competence, the value of F is significant at the level of P=0.001. These findings also show that in dependent variables, the interaction of group * measurement steps is significant. Also; In the groups of compassion-based therapy and emotion-oriented therapy, the F value is significant at the level of P=0.001 for the perception of competence. These findings show that there is a significant difference in the dependent variables between the groups of compassion-based therapy and emotion-oriented therapy.
As can be seen in Table 3, in the variable of competence perception, the treatment groups based on compassion and emotion-oriented treatment, in the post-test and follow-up phases, compared to the pre-test, is significant at the level of p>0.05. While in the control group, these differences are not significant (p<0.05). Also, in all three groups of compassion-based treatment, emotion-based treatment and the control group, there are no significant differences in the variable of competence perception in the follow-up stage compared to the post-test (p<0.05).
As seen in Table 4, in each variable of competence perception; In the pre-test stage, there is no significant difference between the groups of compassion-based therapy and emotion-based therapy compared to the control group (p<0.05). However, in the post-test and follow-up phases, the comparison between the emotion-oriented treatment group compared to the compassion-based and evidence-based treatment groups is significant at the p<0.05 level. Also, in the post-test and follow-up stages, the comparison of the two groups of compassion-based therapy and emotion-oriented therapy is not significant at the p<0.05 level.
Discussion
Considering the confirmation of the effectiveness of emotion-oriented therapy on improving the perception of competence, in explaining this finding, it can be argued that one of the goals of emotion-oriented therapy is to establish effective cognitive regulation skills. Emotion regulation is a pattern of organizing emotions in response to environmental conditions and is a basic principle in initiating, evaluating and organizing adaptive behavior as well as preventing negative emotions and maladaptive behaviors, and is considered one of the most important elements in the development of social-emotional skills and maintaining a relationship with It is the people around you. This treatment not only suppresses unwanted emotions, but also causes the person to always express his emotions in a calm situation.  Social-emotional learning helps people feel more competent and efficient in daily responsibilities and life challenges (8).
Regarding the confirmation of the effectiveness of compassion-based therapy on improving the perception of competence in explaining this research finding, it can be said that compassion-based therapy works like physical therapy of the mind, which neutralizes the threat system and activates the relief system; As a result of the transformation of this system, the perception of competence increases. People with self-compassion are better able to deal with distressing events; because they have a higher acceptance ability than other people; Therefore, the emotional turmoil in these people decreases and the tolerance of the turmoil increases, which finally realizes the ability to relieve and control oneself. This treatment with its techniques increases the self-esteem of a person, which improves their perception of competence (10).

 
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