Comparison of the effectiveness of virtual reality-based education and conventional teaching methods in dental education: a systematic review.

BACKGROUND AND OBJECTIVES: Virtual reality dental simulators as an educational tool may create specific training conditions for dental students, allowing them to practice dental skills in a safe and controlled condition. This study aimed to investigate the effectiveness of virtual reality-based education in dental education compared to traditional education approaches. METHODS: In this systematic review, four databases (PubMed, Scopus, Web of Science, and Science Direct) were searched until 2023 following PRISMA guidelines. The Quality assessment and risk of bias were assessed by the Cochrane Collaboration Tool for RCTs and GRADE, respectively. Inclusion criteria were restricted to randomized or quasi-randomized trials about virtual reality efficacy in dental education. Two authors independently evaluated the data and reviewed the overall risk of bias for all selected studies. Study design, sample size, hardware, onset time of intervention, duration, and number of procedures performed were among the data extracted. RESULTS: From the 703 titles, 48 full texts were chosen for review, yielding 14 articles for final inclusion. The review of these articles indicated the effective role of virtual reality dental simulators in improving students' knowledge and practical skills. CONCLUSIONS: Based on our findings, adding haptic technology to virtual reality can improve students' practical skills, hand skills, theoretical knowledge, self-confidence, and learning environment. Although a fair amount of research needs to be done, notably on cost-effectiveness, student satisfaction, and other potentially adverse effects, virtual reality is a growing phenomenon with immense potential.

Investigating the Effect of Religious Intervention on Mental Vitality and Sense of Loneliness Among the Elderly Referring to Community Healthcare Centers.

The growth of elderly population is among the most important issues in the world, and religious interventions can help them to keep their health. For this reason, this study was conducted with the aim of determining the effect of religious intervention on subjective vitality and sense of loneliness of the elderly referring to healthcare centers. This semi-experimental study was conducted on 88 elderlies referring to community healthcare centers of Ilam City. The elderlies were randomly assigned into test and control groups, and subjective vitality and sense of loneliness questionnaire was distributed to them. For the elderly in the test group, twelve 30-45-min sessions of religious intervention were held. Then, at intervals of immediately, 1 month, and 2 months after the study, the studied questionnaires were redistributed again among the elderly, and the data were analyzed using SPSS 16 and through descriptive statistics as well as repeated measures of analysis of variance. Before intervention, there was no difference between mental vitality and fear of loneliness in the elderly, but after intervention, the amount of mental vitality increased and fear of loneliness decreased. Since in this study, implementation of religious intervention resulted in improved subjective vitality and diminished sense of loneliness among the elderly, it is suggested that this effective intervention be also used in other studies.

Relationship Between Praying and Self-Care in Elderly with Heart Failure: A Cross-Sectional Study in West of Iran.

Given the prevalence of Heart Failure (HF), the current study was conducted, aiming to determine the relationship between praying and self-care in the patients with HF in Iran in 2018. The type of the study is descriptive-analytical, which has been conducted in patient group of more than 65, suffering HF. The population of study has consisted of HF patients, referring to Shahid Mostafa Khomeini Hospital of Ilam province. Therefore, the patients, referring to this hospital for medical treatments, were included in this study. The study data were analyzed using software SPSS16. The findings showed there was a significant relationship between the severity of prayer and the demographic variables, such as gender (p < 0.004), education (p < 0.03), and duration of the disease (p < 0.001). The findings also showed that there was a relationship between self-care and gender (p < 0.001), education (p < 0.004), and duration of disease (p < 0.001). Also, the findings showed that there is a relationship between self-care and prayer (r = 727), so that increasing the amount of prayer will increase self-care. The mean (SD) of total prayer is 167.33 (10.49) and total self-care is 35.86 (10.60). With the increase in the rate of praying, their self-care increased. Based upon this, religious interventions are recommended to be held for this group of patients, focusing on praying.

Relationship Between Spiritual Health and Pain Self-Efficacy in patients with Chronic Pain: A Cross-Sectional Study in West of Iran.

In recent years, the prevalence of chronic diseases has had a growing trend, which has resulted in many health problems. Level of belief in God is effective on people's attitudes to life concepts, social deviations and psychological disorders, and improves them. Therefore, the present research was conducted with the aim of determining the relationship between spiritual health (SH) and pain self-efficacy (PSE) in Ilam City in 2018. This study was a descriptive cross-sectional study in the group of patients with chronic pain (CP). In this study, the study population was patients with CP in Ilam City and the study sample was 150 patients with CP referring to public and private health centers in Ilam, which had all the criteria for participation in the study. The findings showed mean (SD) of the total score of SH variables was 65.16 (9.88), and PSE was 34.48 (4.08). According to Pearson statistical analysis, there is a significant relationship between SH and PSE (r = 0.442, P = 0.000). Also, the standard beta and non-standard beta coefficients for SH variables in PSE show that the non-standard beta coefficient in SH is equal to 0.183. The results of this study showed that SH is a predictor of pain acceptance, so that patients who were more religious were more likely to tolerate CP. For this reason, it is suggested that religious interventions be performed to reduce pain in patients with CP, in order to provide the necessary context for pain reduction in this group of patients.

Investigating the Relationship between Religious Beliefs with Care Burden, Stress, Anxiety, and Depression in Caregivers of Patients with Spinal Cord Injuries.

Spinal cord injury (SCI) is one of the most severe diseases associated with the central nervous system of the individuals, which can lead to disability in the patient. The aim of the present study was to determine the relationship between religious beliefs with CG, depression, anxiety and stress (DAS) in caregivers of patients with SCI in the city of Ilam, Iran. This is a descriptive-analytic article, and the study population were caregivers of patients with SCI. A sample size of 150 patients was selected according to previous studies. The questionnaires used for data collection included Religious Coping Questionnaire (RC), Caregiver Questionnaire (CG), and Depression, Anxiety and Stress Scale-21 (DASS-21) Items. In this study, caregivers of patients with SCI were included in the study using convenience sampling method in Ilam city. The researchers identified patient caregivers who met the inclusion criteria. The research objectives were described for caregivers, and the questioners were initiated if caregivers were willing to participate in the study. Literate caregivers completed questionnaires through interviews, and trained questioners completed for illiterate caregivers in the same way (interviewing). Data were analyzed using spss 16 statistical software, and descriptive and analytical methods were used for statistical analysis. According to the findings, the mean (SD) of RC is 18.41 (2.73), negative RC is 7.05 (2.06), positive RC is 11.36 (1.89), stress is 10.78 (6.27), anxiety is 10.12 (5.58), depression is 10.50 (3.08), and CG is 78.16 (27.09). There is a significant relationship between RC levels with stress (P = 0.000, F = 40.565), anxiety (P = 0.000, F = 45.300), and CG (P = 0.000, F = 37.332), but there was no relationship between the RC level with depression status (P = 0.42, F = 0.634). Considering that religion can affect the level of CG, stress, and anxiety of the caregivers of the patients, it is suggested to provide necessary conditions to improve the health status of caregivers of patients with SCI by improving the religion status in patients and performing appropriate interventions in this regard.

Assessment of Mental Health Elderly with Chronic Pain Based on Quranic Components.

Considering the presence of mental disorders during illness or old age, it is necessary to pay attention to the mental health of the elderly. A modeling of the God's attributes means that one understands God's perception of his/her existential poverty; and on the other hand, one endeavors to work in the human domain in order to replicate and utilize the names and attributes of God the Almighty. For this reason, this study aims to determine the mental health (MH) assessment of elderly people with chronic pain (CP) based on Quranic components. The study is a descriptive cross-sectional study. A total of 138 elderly people who are aged over 65 years and had history of CP were enrolled. Data were collected using Islamic Questionnaire of Identifying God's Traits in the same, and analysis was performed using SPSS ver. 16. The mean (SD) of age in elderly is 81.00 (12.07), and as the age increased, the God's Traits score of the elderly increased (p = 0.003, R = 0.34). The mean overall God's Traits score was 234.68 (3.61). In the elderly who lived with their spouse and had higher social support, the score of God's Traits was higher (p > 0.05), but there was no relationship between other demographic characteristics and status of God's Traits (p > 0.05). This study is the first study to evaluate the MH status of chronic patients based on Quranic components, and their MH status has been high. It is suggested that the relationship between MH based on Quranic components and variables related to health be measured.

Do Religious Coping and Attachment to God Affect Perceived Pain? Study of the Elderly with Chronic Back Pain in Iran.

Religious Coping (RC) refers to the individual's ability to understand and cope with the stress in life. Attachment is a God relatively stable emotional bond that forms through continuous communication and requires interaction, pleasure and relaxation. Considering the increasing population of the elderly and the role of pain in their health status, the present study was conducted aimed to determine the relationship between RC and attachment to God with perceived pain in the elderly with chronic low back pain (CLBP) in Ilam in Iran. The present study is a descriptive cross-sectional one in the elderly group with chronic low back pain in 2018. A total of 300 elderly patients with chronic low back pain were enrolled using convenience sampling. The tools used included demographic characteristics form, religious coping questionnaire, attachment to God's questionnaire and perceived pain intensity questionnaire. The findings indicated that the mean (SD) of the total score of attachment to God variables was 65.71 (2.64), religious coping was 20.67 (2.59), chronic pain acceptance was 17.29 (6.66), and perceived pain was 5.81 (2.65). Also, there was a meaningful correlation between the intensity of the pain and the level of attachment to God and religious coping. Therefore, it is suggested that appropriate religious interventions for elderly patients with chronic pain should be undertaken to reduce their pain status in order to help improve their quality of life.

The Impact of Spiritual Care Education on Anxiety in Family Caregivers of Patients with Heart Failure.

Heart failure (HF) has been emerging as a general health problem over recent decades. Spiritual care is a type of support service provided to patients suffering from HF. Spiritual care intervention in nursing is a unique aspect of care, which cannot be replaced by psychosocial care. Considering the importance of anxiety for caregivers of patients with HF, the present study aimed to examine the effect of spiritual intervention on anxiety in caregivers of patients with HF in Ilam, Iran. This research is a semi-experimental study, 71 caregivers of patients with HF were randomly assigned to experimental group (n = 34) and control (n = 37) group. Beck Anxiety Inventory, which consisted of 21 items and scored based on a 4-point Likert scale ranging from zero to three, was employed to collect data. The scores range from zero to 63 with the higher scores indicating the higher level of anxiety. The experimental group received spiritual intervention over six 45-minute sessions in a period of 2 weeks (14 days; three times a week; every other day). Data were analyzed using descriptive and inferential statistics run in the SPSS software version 16. The result showed a difference between the level of anxiety in two groups after the intervention (P = 0.001). Anxiety level in the experimental group three weeks after intervention (27.88 ± 7.10) was significant in comparison with before intervention (45.06 ± 5.79) (P = 0.001). According to the results, the spiritual intervention reduced the anxiety level in the caregivers of patients with HF. Nurses are recommended to provide such necessary training to caregivers in order to provide the grounds for reducing their anxiety.

The Effect of Religion Intervention on Life Satisfaction and Depression in Elderly with Heart Failure.

The elderly suffering from heart failure is facing with some problems such as lowering of life satisfaction and depression. Regarding a lack of information in this issue, the current study was conducted to determine the effect of religion intervention on life satisfaction and depression in the elderly with heart failure, in Ilam-Iran. In a clinical trial study conducted on the elderly with heart failure disease in Ilam-Iran, the patients were randomly allocated into two experimental (46) and control (47) groups. The used instruments were a demographic checklist, life satisfaction questionnaire of LSI-Z and Beck depression inventory. The intervention done for test group was a religion-spiritual program designed based on the Richards and Bergin model, and according to Islam and Shia regulations and conducted during six sessions, each 30-45 min. The tools were completed before and after intervention. Gathered data were entered into SPSS software and analyzed by descriptive (mean and standard deviation) and inferential (independent t test and ANOVA) statistics. The results showed that there was no significant difference between the mean (SD) of life satisfaction in the experimental group [5.47 (3.37)] and control [5.85 (3.92)] before the intervention (P = 0.62) but after the intervention. The mean (SD) of life satisfaction of the test group [8.08 (4.36)] was higher than that of the control group [5.55 (3.96)] (P = 0.006). Also, no significant difference between the mean (SD) of depression in the experimental group [47.80 (10.48)] and control [49.87 (11.40)] before the intervention (P = 0.62) but after the intervention. The mean (SD) of depression of the test group [28.28 (14.78)] was lower than that of the control group [50.44 (14.02)] (P = 0.006). Regarding the positive effect of religion-spiritual program in depression and life satisfaction of the elderly with heart failure, it is suggested this program will be educated to these patients by health-care workers.

Investigating psychological problems in caregiver of pediatrics with cancer: A systematic review.

PURPOSE: Cancer is a type of chronic illness that causes many issues for patients and their caregivers, including a wide range of psychological problems. This study was conducted to determine the status and psychological problems of caregivers of pediatric patients with cancer who live in Iran. METHODS: All articles from 2000 to March 2019 related to the psychological of caregivers and their child's cancer were included in the search. Domestic websites in Iran and international databases were searched. Keywords of the search included child, cancer, malignancy, care burden, stress, anxiety, depression, coping strategies, psychological hardiness, posttraumatic stress, parents, father, mother, and pediatric. The search, data extraction, quality assessment and screening were conducted independently by two researchers. RESULTS: In the initial search, 345 articles were extracted regarding the psychological problems of caregivers. After final screening 15 articles were selected; from these four referred to care burden, four articles for coping skills, three articles for posttraumatic stress disorder (PTSD) and four articles for stress, anxiety, and depression among carers of children with cancer. CONCLUSION: Considering the existence of psychological problems such as caregiver burden, PTSD, stress, anxiety, and depression in caregivers of children with cancer, it is necessary to provide nursing interventions for this group of parents; particularly interventions that provide the necessary ground for reducing psychological problems and improving caregivers' mental health.

Investigating relationship between religious commitment and moral sensitivity in nurses working in ICU.

OBJECTIVES: This study aimed at determining the relationship between religious commitment and moral sensitivity among nurses working in the ICU sections in the west of Iran. The present study was a cross-sectional descriptive-analytic study carried out on nurses working in ICU wards of two western cities in Iran. The instrument used includes a demographic questionnaire, religious commitment questionnaire and moral sensitivity questionnaire in nurses. First, the researchers referred to the ICU wards of the hospitals in the cities after receiving permission from the relevant authorities by referring to three shifts in the morning, evening and night shifts and holidays. The researchers, while explaining the research goals for the nurses participating in the study, obtained their informed consent to participate in this study. RESULTS: According to the findings, mean (SD) of the overall score of religious commitment was equal to 36.38 (4.58) and mean (SD) of MS score of nurses was 59.21 (12.65). Also, 91 nurses (82.7%) had average MS, 7 (6.4%) had low MS and 12 (10.9%) had high MS.

The effect of educational intervention on the knowledge and attitude of intensive care nurses in the prevention of pressure ulcers.

BACKGROUND: Pressure ulcers can cause disability, which can lead to a default in patients' safety and results in frequent complications for patients. OBJECTIVES: This study aimed to determine the effect of educational intervention on nurses' knowledge and attitude in preventing pressure ulcers. METHODS: In this study, 67 nurses of ICU wards at Ilam University of Medical Sciences were randomly assigned to the experimental or control group. Data collection tools included the demographic characteristics questionnaire, the Pieper Pressure Ulcer Knowledge test (PUKT) and the Attitude toward Pressure Ulcer tool (APuP). In the experimental group, the nurses were allocated into groups of four-five persons and for each group four face-to-face training sessions and two virtual training sessions by means of educational videos on bed sores were performed. Gathered data were analyzed using SPSS software version 16, and descriptive and analytical tests were performed. RESULTS: PUKT questionnaire score in the experimental group improved from 15.68 (3.42) to 29.75 (12.33) (P = 0.000), while in the control group it was 16.40 (3.13) and 17.54 (6.62) before intervention, which was not significant (P > 0.05). Furthermore, the APUP questionnaire score in the experimental group improved from 27.12 (2.13) to 39.37 (3.21) (P = 0.000), while in the control group it was 27.65 (1.71) and 28.37 (5.00) before intervention, which was not significant (P > 0.05). CONCLUSIONS: Since educational intervention improved the knowledge and attitude of nurses in preventing pressure ulcers, it is required to conduct appropriate educational interventions to improve their knowledge and attitude.

Investigating the relationship between Islamic lifestyle and general health in adolescents.

INTRODUCTION: Islamic lifestyle refers to a way of life, whose main source is extracted from the divine book and is done in accordance with the divine rules. Therefore, the present study was conducted to determine the relationship between lifestyle and general health of adolescents. MATERIALS AND METHODS: This cross-sectional descriptive study was conducted in 2016 on 416 secondary school students in the city of Ilam. Sampling method was that Ilam city was divided into five clusters based on geographic area and two schools were included in the study from each cluster. Data were collected using an Islamic life style questionnaire and a general health questionnaire and they were analyzed using descriptive statistics tests and SPSS16 software. RESULTS: The findings showed that the mean SD of total score of Islamic lifestyle and general health was 162.48 (30.54) and 25.55 (11.13), respectively. In the classification of general health scores of adolescents, it was shown that 249 (59.9%) students had desirable general health; 165 (39.7%) of them had good general health and 2 (0.5%) of them had unfavorable general health. There was also a positive and significant relationship between Islamic lifestyle and general health (p < 0.001). CONCLUSION: Considering the existence of the relationship between Islamic lifestyle and general health of adolescents, it is necessary to provide the needed context to increase their general health by maintaining and improving the Islamic lifestyle of adolescents.

Prevalence of elder abuse in Iran: a Systematic review and meta-analysis.

BACKGROUND: In the past century, elder abuse has become an important health issue and a stressful event that negatively affects the physical and mental health of the elders. AIMS: Therefore, the present study aimed to determine the prevalence of elder abuse in Iran through systematic review and meta-analysis. METHODS: All articles about elderly abuse in Iran since 2005-2017 were searched using the Google Scholar search engine, four Iranian databases (Magiran, IranMedex, SID) and six international English language databases(Web of Science, Cochrane, Scopus, Pubmed, Science Direct-Embase) with keywords of Elder Abuse, Elder Mistreatment, Elder Neglect, Abuse and a combination of these keywords. After examining the entry and exit criteria and qualitative evaluation of the articles, Data was analyzed by comprehensive meta-analysis (CMA) software. FINDINGS: In a systematic review, 15 articles on elders in Iran were included in the study. The overall prevalence of elder abuse was 48.3% (with 95% confidence interval: 28.6-68.6) and the highest prevalence of elder abuse was related to the care neglect dimensionat the prevalence rate of 38.4% (with 95% confidence interval: 21.7-51.6) and the lowest prevalence rate of elder abuse was related to the rejection atthe prevalence rate of 11% (with 95% confidence interval: 6.9-17.1). CONCLUSION: The prevalence of elder abuse among elders was high in Iran. Considering the growing elderly population in Iran, preventive measures should be considered in this regard. For this reason, community health nurses are required to provide the elderly, family and community with necessary preventive interventions in this regard.

The Effects of Reflexology on Fatigue Severity of Patients with Cancer

Introduction: Breast cancer is a major threat to women's health and a common factor that can reduce their life expectancy. Complementary medicine such as reflexology is known to reduce fatigue severity in cancer patients. The present study aimed to cultivate the effect of reflexology on fatigue severity of patients with breast cancer. Methods: The present pre-post clinical trial recruited 57 patients with breast cancer and involved an experimental and a control group. All patients were livening in Ilam, Iran. Patients were randomly assigned to two groups of experimental (N=27) and control (N=30). The experimental group received reflexology for 4 sessions. Data were collected using Fatigue severity scale (FSS) and demographic information questionnaire. FSS was completed by the patients twice; before the intervention and 2 months after the intervention. Data were analyzed using SPSS and running t-test and ANOVA. Results: Results showed no significant difference in fatigue severity between experimental (45.44±5.30) and control (43.66±7.68) groups prior to the intervention (p>0.05). However, after conducting the intervention, a significant difference in fatigue severity was seen between the experimental (20.66±4.54) and control (40.36±9.58) groups (p=0.000). Conclusion: The present study showed that reflexology decrease fatigue severity in patients with breast cancer and community health nursing can to use of these complementary medicine to increase patients health conditions.

The association between metabolic syndrome and polycystic ovary syndrome: A systematic review and meta-analysis.

BACKGROUND: One of the most frequently encountered endocrinopathy in women of reproductive age is polycystic ovary syndrome (PCOS). Recent studies have reported varied prevalence of metabolic syndrome (MetS) in women with PCOS. The aim of this study is to determine if the women with PCOS are at a higher risk of MetS. METHOD: The present systematic review and meta-analysis was conducted according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. To collect articles, we searched online databases of PubMed/Medline, Scopus, Web of Science, Science Direct, Embase, CINAHL, Cochrane Library, EBSCO and Google scholar search engine and the reference list of the retrieved articles using MeSH keywords of "metabolic syndrome", "woman" and "polycystic ovary syndrome" without time limit until October 2018. Cochran's Q test and I2 Index were used to evaluate the heterogeneity among studies and the random effects model was used for combining the results. Data analysis was performed in STATA software version 11.1. RESULT: Finally, 72 studies involving 10075 PCOS patients with an average age of 26.2 ±â€¯5.01 years were included in the meta-analysis. The heterogeneity rate was high (I2 = 76.5%; p < 0.001) and the pooled estimate of the association between MetS and PCOS was significant (OR = 2.57, 95% CI: 2.18-3.02; P < 0.001). CONCLUSION: According to the results, there is higher risk of MetS in women with PCOS. Therefore, diagnosis and treatment of MetS in women with PCOS may have a significant impact on this patients health and reduce the rate of mortality and morbidity.

Efficacy of Implementing Home Care Using Eye Movement Desensitization and Reprocessing in Reducing Stress of Patients with Gastrointestinal Cancer.

Background: Gastrointestinal cancer is the third most common types of cancer in the world which leads to a lot of stress among sufferers. Pharmacological and non-pharmacological approaches are used to treat stress induced by serious diseases. Eye movement desensitization and reprocessing (EMDR) technique is considered as one of non-pharmacological method for decreasing patient's stress. Objective: This study was conducted to determine the effect of home care using EMDR technique on the stress of patients with gastrointestinal cancer. Materials and Methods: The current semi-experimental study was performed on patients with gastrointestinal cancer residing in Ilam, Iran. The patients were randomly divided into two groups of intervention (n=30) and control (n=30). Home care was provided for intervention group in patients' homes which included 2 sessions (a total of 60 sessions for all patients). Each session lasted for 45 to 60 minutes according to EMDR protocol. The data were analyzed using SPSS (version 16). Results: The findings of this study showed that most of patients were male (36, 60%), had diploma degrees (44, 73.3%), had a monthly income less than 500 thousand (38, 63.3%), were married (39, 65 %). The mean age of the patients was 69.18 ± 11.58 years. No statistically significant difference was observed between two groups before the intervention in terms of patients' perceived stress (P>0.05). However, efficacy and perceived distress of the intervention group significantly was decreased following the intervention (P<0.05). Conclusions: According to the findings regarding the impact of home care using EMDR technique on reducing stress in patients with gastrointestinal cancer, the implementation of this intervention and provision of education for patients are recommended to expand the nursing duty to community health wards as well as to improve the health status of patients.

Effect of Self-Management Program on Pain and Disability Index in Elderly Men with Osteoarthritis.

BACKGROUND: Osteoarthritis (OA) is a progressive disease of the joints, leading to decreased function and disability. OBJECTIVES: The study aimed to investigate the effect of self-management (SM) program on disability index and pain in aging men with knee OA. METHODS: The study included an SM group and a control group. Given the sample size of the previous studies, 83 patients were recruited. The study tools included a demographic profile questionnaire, visual analogue scale (VAS), and HAQ 8-item DI. The intervention included 10 SM sessions for patients in the SM group (8 sessions of in-person intervention and 2 sessions of telephone intervention). Patients were placed in groups of 7, and the sessions were held weekly each for a period of 45 to 60 minutes. Data were analyzed using descriptive and analytical tests by SPSS V. 16 software. RESULTS: The two groups(SM and control group) were homogeneous in terms of demographic characteristics (P > 0.05). The mean (SD) disability score was 19.12 (1.92) in the SM group before the intervention, which reduced to 14.70 (1.63) after the intervention (P = 0.000, T = 10.02). The mean (SD) pain score, was 9.19 (0.71) in the SM group before the intervention, which reduced to 6.48 (0.84) after the intervention (P = 0.000, T = 18.15). CONCLUSIONS: Training can help patients perform SM measures and improve their health status by enhancing the information needed for the disease.

The prevalence of neuropathy among type 1 diabetic adolescents in Iran: a systematic review and meta-analysis.

INTRODUCTION: Neuropathy is one of the most common complications of diabetes, which causes many problems for diabetic patients. Thus, the aim of the present study was to investigate the prevalence of neuropathy among type 1 diabetic adolescents by systematic review and meta-analysis. MATERIALS AND METHODS: This study is a systematic review and meta-analysis, which reviewed articles published from 2001 to September 1, 2018. The search process was carried out in the Google Scholar search engine and domestic and international databases such as Magiran, SID, Iranmedex, IranDoc, Medlib, PubMed, Scopus, Science Direct, Springer, Wiley Online Library, Web of Science, Ebsco and Cochrane using Persian and English keywords based on MESH conformity. All the research steps were carried out by two members of the research team who were familiar with systematic reviews and meta-analysis data, using the software CMA. Analysis of meta-regression and the use of a random effects model were introduced and analyzed. FINDINGS: When a systematic search was carried out on the reviewed articles, five of them were included in the meta-analysis phase. The sample size was 484, and the prevalence of diabetic peripheral neuropathy (DPN) in type 1 diabetic patients was 28.2% [confidence interval (CI) = 19.5-39.1]. The findings of the meta-regression analysis showed that the DPN prevalence rate decreased with increasing age (Q = 5.77 p = 0.016), and the results of more recent studies showed an increase in the DPN incidence rate (Q = 20.62, p < 0.001). CONCLUSION: The findings of the present study revealed that although the prevalence of neuropathy in diabetic adolescents was not high, the prevalence was significant. Considering the increasing prevalence of diabetes and its impact on the health status of patients, appropriate interventions should be conducted to prevent diabetes and subsequent diabetic neuropathy.

Effectiveness of acupressure on anxiety of children undergoing anesthesia.

BACKGROUND AND OBJECTIVES: Tonsillectomy is one of the most commonly used pediatric surgeries with high stress levels for children and their parents. The present study was designed and implemented regarding the fact that limited studies have ever been carried out about the effects of complementary therapies such as acupressure on the preoperative anxiety levels in children throughout the world. MATERIALS AND METHODS: Present study was a randomized clinical trial that was done in three groups with 144 children aged 5-12 years undergoing tonsillectomy. In present study, the children were allocated in three groups: intervention, control and sham. In the intervention group, the acupressure was applied on the Yintang point and in the sham group, was applied at a sham acupoint. No intervention was performed in the control group. Before and after intervention, the pediatric anxiety levels were measured using instruments. The results were analyzed using descriptive and inferential statistics such as the Kruskal-Wallis and Wilcoxon tests, chi-square (χ2) and analysis of variance (ANOVA) test. The significance level was considered p < 0.05. RESULTS: The total anxiety score in children was (70.39 ± 20.93) in the control group, (67.83 ± 16.78) in the intervention group and (71.40 ± 21.82) in the sham group, not significant difference (p > 0.05). The different in the overall anxiety score among children before intervention compare to after intervention was as following: Control group (-3 ± 17.46), intervention group (8.42 ± 32.98) and sham group (-4.32 ± 24.47). CONCLUSION: Like other surgical procedures, the tonsillectomy has serious stress for children. Our study demonstrates that the acupressure has a significant effect on the level of preoperative anxiety in children undergoing surgery. Therefore, nurses can use this technique to reduce the pediatric anxiety.