Factor V Leiden, MTHFR, and FXIIIVal34Leu gene polymorphisms and their association with clinical features and risk of diabetic retinopathy in patients with type 2 diabetes.

Background: Diabetic retinopathy (DR) is expanding to epidemic levels globally due to the progressing prevalence of diabetes mellitus (DM). In this study, the association between factor V Leiden (FVL), MTHFRC677T, and FXIIIVal34Leu polymorphisms and diabetic retinopathy was investigated in Eastern Iran. Methods: This case-control study enlisted the participation of 300 people (diabetic patients=100, diabetic retinopathy patients=100, healthy controls=100), and polymorphisms were examined by Tetra primer ARMS-PCR. Results: The frequency of FVL (p=0.294) and FXIIIVal34Leu (P=0.349) polymorphism showed no significant results between the genotype frequency in the mentioned groups. In contrast, MTHFRC677T SNP was significantly different in diabetic patients and controls (P=0.008). The MTHFRC677T polymorphism was found to be connected with increased systolic blood pressure in patients who had the TT genotype (130.96±11.92mm/Hg; P=0.011). Conclusion: Our study recommended that the MTHFRC677T polymorphism may offer to DR development. Studies with larger sample sizes and a wider spectrum of populations are authorized to verify this finding.

Which risk factor best predicts coronary artery disease using artificial neural network method?

BACKGROUND: Coronary artery disease (CAD) is recognized as the leading cause of death worldwide. This study analyses CAD risk factors using an artificial neural network (ANN) to predict CAD. METHODS: The research data were obtained from a multi-center study, namely the Iran-premature coronary artery disease (I-PAD). The current study used the medical records of 415 patients with CAD hospitalized in Razi Hospital, Birjand, Iran, between May 2016 and June 2019. A total of 43 variables that affect CAD were selected, and the relevant data was extracted. Once the data were cleaned and normalized, they were imported into SPSS (V26) for analysis. The present study used the ANN technique. RESULTS: The study revealed that 48% of the study population had a history of CAD, including 9.4% with premature CAD and 38.8% with CAD. The variables of age, sex, occupation, smoking, opium use, pesticide exposure, anxiety, sexual activity, and high fasting blood sugar were found to be significantly different among the three groups of CAD, premature CAD, and non-CAD individuals. The neural network achieved success with five hidden fitted layers and an accuracy of 81% in non-CAD diagnosis, 79% in premature diagnosis, and 78% in CAD diagnosis. Anxiety, acceptance, eduction and gender were the four most important factors in the ANN model. CONCLUSIONS: The current study shows that anxiety is a high-prevalence risk factor for CAD in the hospitalized population. There is a need to implement measures to increase awareness about the psychological factors that can be managed in individuals at high risk for future CAD.

Etiology, consequences, and solutions of working women's work-life conflict: a qualitative study.

INTRODUCTION: Work-life conflict (WLC) is important in organizational behavior research and human resource management. The present research aimed to investigate the underlying causes, consequences, and solutions to WLC in Iranian working women. MATERIALS AND METHODS: The present qualitative study was conducted through a content analysis method among 19 working married women in Birjand, a city in the east of Iran, from December 2021 to February 2022. To collect the data, semi-structured interviews were held. The average interview time was 45 minutes, and all interviews were recorded upon the participants' consent. Finally, after coding, the information was analyzed with MAXQDA software. FINDINGS: The causes of conflict included 4 main categories of individual, interpersonal, organizational, and cultural factors, with seven subcategories: the pressure of the mother's role at home, personality traits, lack of individual skills, insufficient support, work characteristics, organizational policies, and the traditional role of women in society. The consequences of conflict included 2 main categories, Decreasing quality of life and work problems with 4 subcategories: physical and mental illnesses, forgetting one's role towards others, limiting social communication, and reducing productivity. Conflict resolution methods included 3 main classes of individual-oriented, other-oriented, and organization-oriented with 8 subclasses: program-oriented, meaning-oriented, emotion-oriented, avoidance, emotional support, instrumental and work support, support work policies, and correct management views. CONCLUSION: To solve the problem of conflict, different aspects should be considered and help to solve this challenge by influencing each dimension.

Addressing food insecurity: An exploration of wheat production expansion.

Wheat plays a crucial role in global food security, serving as a vital food crop that feeds billions of people worldwide. Currently, Russia and Ukraine are responsible for exporting approximately 25% of the world's wheat, making any issues in these regions a cause for concern regarding global wheat supply. The problems faced in these areas have led to a surge in wheat prices worldwide. Consequently, it becomes necessary to explore alternative regions that can compensate for the decline in wheat production and supply. This study focuses on wheat production and yield in major producing countries, utilizing the GYGA (Global Yield Gap Atlas) protocol for predictions. The findings reveal a global wheat production gap of 270,378,793 tons. Notably, the largest gap in irrigated wheat production exists in countries like China, India, Pakistan, Turkey, Iran, Afghanistan, Uzbekistan, Egypt, and Azerbaijan. Additionally, the rainfed wheat production gap on a global scale amounts to 545,215,692 tons, with Russia, the USA, Kazakhstan, Australia, Ukraine, China, Turkey, Canada, India, and France having the most significant production gaps. Through boundary line analysis, specific criteria were identified for suitable areas of irrigated and rainfed wheat cultivation. For irrigated conditions, the temperature range of 3000 to 7000 GDD (Growing Degree Days) and a temperature seasonality of 3 were determined as favorable. Under rainfed conditions, the suitable areas encompass a temperature range of 2000 to 4000 GDD, an aridity index exceeding 600, and a temperature seasonality of 2. Thirteen countries possess extensive agricultural land within the climatic codes favorable for irrigated wheat cultivation. Approximately 50% of the agricultural lands within these countries, corresponding to the total arable area for irrigated wheat, fall within the climatic codes 3403, 5403, 5303, 4303, 5503, 5203, 3503, 3303, and 4103. China, the United States, Ukraine, Russia, and Iran are the top five countries with favorable lands for irrigated wheat cultivation. Similarly, fourteen countries have significant agricultural lands within the favorable climatic codes for rainfed wheat cultivation. Around 52% of the agricultural lands within these countries are within the climatic codes 3702, 2702, 2802, and 4602. France, Germany, Britain, Poland, and Denmark possess the highest potential to expand rainfed wheat cultivation areas within these favorable climate codes, with respective areas of 2.7, 2.6, 1.6, and 0.9 million hectares. According to the study, the North China Plain emerges as a primary region for increasing irrigated wheat production, both in terms of cultivated area and yield potential. For rainfed conditions, the European continent stands out as a significant region to enhance wheat production.

Changes in symptoms and characteristics of COVID-19 patients across different variants: two years study using neural network analysis.

BACKGROUND: Considering the fact that COVID-19 has undergone various changes over time, its symptoms have also varied. The aim of this study is to describe and compare the changes in personal characteristics, symptoms, and underlying conditions of individuals infected with different strains of COVID-19. METHODS: This descriptive-analytical study was conducted on 46,747 patients who underwent PCR testing during a two-year period from February 22, 2020 to February 23, 2022, in South Khorasan province, Iran. Patient characteristics and symptoms were extracted based on self-report and the information system. The data were analyzed using logistic regression and artificial neural network approaches. The R software was used for analysis and a significance level of 0.05 was considered for the tests. RESULTS: Among the 46,747 cases analyzed, 23,239 (49.7%) were male, and the mean age was 51.48 ± 21.41 years. There was a significant difference in symptoms among different variants of the disease (p < 0.001). The factors with a significant positive association were myalgia (OR: 2.04; 95% CI, 1.76 - 2.36), cough (OR: 1.93; 95% CI, 1.68-2.22), and taste or smell disorder (OR: 2.62; 95% CI, 2.1 - 3.28). Additionally, aging was found to increase the likelihood of testing positive across the six periods. CONCLUSION: We found that older age, myalgia, cough and taste/smell disorder are better factors compared to dyspnea or high body temperature, for identifying a COVID-19 patient. As the disease evolved, chills and diarrhea, demonstrated prognostic strength as in Omicron.

Global insight into understanding wheat yield and production through Agro-Ecological Zoning.

Global food security requires food production to be increased in the future decades. Agro-Ecological Zones (AEZ) methodology is a successful approach used in land evaluation studies to support sustainable agricultural development. This approach can facilitate finding suitable areas for wheat production on a global scale. This study was conducted based on a climate zone map, soil data, wheat cultivation area, yield, and production under irrigated and rainfed conditions, worldwide. The results for irrigated wheat indicated that there is an area of 59.5 Mha with an average yield of 4.02 t/ha which leads to the production of about 239.6 Mt of grain yield. Furthermore, climate zones (CZs) of 8002, 5203, 5302, 5403, and 8102 have the highest wheat production with an average of 20.7, 14.2, 13.3, 11.8, 11.5 Mt, respectively. The highest amount of irrigated wheat production has been achieved in soil type code 17 (Loam LF120), which has a cultivation area of around 23.6 Mha and a production of about 106.8 Mt. Rainfed wheat production is 410 Mt, and the cultivation area is 160.2 Mha. The highest rainfed wheat production with an average of 17 Mt was related to the 3702 CZ, followed by the other CZs (3802, 1303, 1203, 3602, 4602, etc.). The soil codes 11 (Loam HF120), 10 (Loam HF180), and 14 (Loam MF120) showed the highest rainfed wheat production. The findings of this study can be useful for agricultural scientists, authorities, and decision-makers around the world to find suitable lands to expand wheat cultivation and also to find new locations for increasing global wheat production to feed the increasing population in the world.

Genetic predisposition to nonalcoholic fatty liver disease: insights from ANGPTL8 gene variants in Iranian adults.

Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver disease with a global prevalence, and modulation of ANGPTL8 expression has emerged as a promising predictor of NAFLD susceptibility. This research was conducted to scrutinize ANGPTL8 protein expression in NAFLD patients and elucidate the interplay between ANGPTL8 gene polymorphisms and their lipid profiles, thus shedding new light on the pathophysiology of this complex disease. The study comprised 423 unrelated participants, including 222 healthy controls and 201 individuals with NAFLD, screened using FibroScan/ultrasonography and laboratory tests. The main goal focused on the genotype and allele frequency distribution in the ANGPTL8 gene, specifically analyzing two genetic variations: rs737337 (T/C) and rs2278426 (C/T). The participants diagnosed with NAFLD were slightly younger (P ≥ 0.05) and had a higher body mass index (BMI) than the individuals in the control group. Notably, there was a significant difference in the occurrence of the rs737337 polymorphism between the NAFLD and control groups, with a lower frequency observed in the NAFLD group. Our results indicated that individuals with the TC + CC genotype and C allele of rs737337 (T/C) had a decreased risk of higher levels of ALT and AST. Conversely, those with the CT, CT + TT genotype, and T allele of rs2278426 (C/T) exhibited an increased risk of higher levels of ALT and AST. The results imply that the rs2278426 (C/T) variant of the ANGPTL8 gene is more strongly linked to an increased risk of NAFLD compared to the rs737337 polymorphism. However, additional research is needed to understand the specific molecular mechanisms responsible for the upregulation of ANGPTL8 in individuals with NAFLD.

Is the Theory of Planned Behavior a good model for predicting salt consumption behavior in pregnant women? A structural equation modeling approach.

BACKGROUND: Non-communicable illnesses are the leading reason for wide-reaching death. Reducing the burden of these illnesses is one of the significant objectives of the World Health Organization's action plan. In this respect, reducing salt consumption is one of the most cost-effective public health interventions. The present study aimed to adjust the Theory of Planned Behavior (TPB) in expecting salt consumption behavior in pregnant women visiting the health centers in Birjand. MATERIALS AND METHODS: In this cross-sectional study, 273 pregnant women who visited the health centers in Birjand were selected through Quota sampling method. The data were collected using a self-administered questionnaire based on the TPB constructs. The data analysis was done in SPSS 19 and AMOS 24. RESULTS: The mean age of participants was 27.33 ± 5.77 years, and their mean gestational age was 12.67 ± 4.11 weeks. The mean score of attitude construct was 86.54 ± 8.50, subjective norm construct 36.59 ± 4.47, perceived behavioral control construct 41.63 ± 7.01, intention construct 16.01 ± 2.65 and behavior construct 19.86 ± 2.57. There was a statistically significant relationship between attitude construct (p < 0.001), perceived behavioral control (p < 0.001), and intention (p < 0.001) with salt consumption behavior (p < 0.05). The goodness of fit indices showed a proper fit of data (χ2/df = 1.94, PNFI = 0.6, TLI = 0.9, CFI = 0.9 and RMSE = 0.06). CONCLUSION: The results of this study showed that the TPB is an appropriate model for reviewing the behavior of salt consumption. Hence, this model offers a suitable basis for designing an educational intervention to regulate the quantity of salt consumed by pregnant women and; thus, its usage in health promotion programs is suggested.

The Relationship Between Attitudes Towards Caring for Dying Patients and Self Compassion in ICU Nurses.

The study aims to investigate the relationship between ICU nurses' attitudes towards caring for dying patients and self compassion.This cross-sectional study (Aug-Oct 2022) was conducted with the volunteer participation of 219 ICU nurses in Isfahan University of Medical Sciences, Iran. Data were collected through the Socio-demographic Form, the Frommelt Attitude toward Care of Dying Scale (FATCOD), and the Self-Compassion Scale (SCS).The mean score of attitude of end-of-life care and self-compassion were 92.77 ± 21.5 and 47.83 ± 7.69 respectively. A statistically significant difference was found between nurses' education level and attitudes of end-of-life care (p < 0.001) and self-compassion. (p < 0.04) A significant difference was found between end of life care training experience and self-compassion (p < 0.03). A positive, statistically significant relationship was found between the attitudes of end-of-life care total score and self-compassion total score (p < 0.001). A significant relationship between the self-compassion and attitude toward caring for dying patients is an important finding for quality of care in ICU nurses.

Effect of crocin and losartan on biochemical parameters and genes expression of FRMD3 and BMP7 in diabetic rats.

BACKGROUND: Diabetes is a multifactorial and growing disease, one of the severe complications of which is diabetic nephropathy (DN), which is the most common cause of chronic renal failure. FERM domain containing 3 (FRMD3) is responsible for maintaining the shape and integrity of nephron cells, and bone morphogenetic protein 7 (BMP7) helps maintain function and reduce kidney damage. This study aimed to evaluate the effect of crocin and losartan on biochemical parameters and the expression of FRMD3 and BMP7 genes in streptozotocin (STZ)-induced diabetic rats. METHODS: Forty male Wistar rats were randomly divided into five experimental groups as healthy, diabetic control (D), crocin, losartan, and diabetic rats treated with losartan-crocin (n = 8). A single dose of STZ (50 mg/kg intraperitoneally injection) was used to induce diabetes. Four weeks after induction of diabetes, rats received crocin (50 mg/kg) and losartan (25 mg/kg) daily for four weeks orally. Rats were sacrificed at the end of the intervention, and blood samples were taken to determine serum levels of glucose, urea, creatinine (Cr), malondialdehyde (MDA), and thiol. Real-time polymerase chain reaction (PCR) was used to assess the expression of the FRMD3 and BMP7 genes in the kidney samples. RESULTS: Diabetes induction increased serum levels of glucose, Cr, urea, MDA, and thiol, but decreased BMP7 and FRMD3 genes expression. Treatment with crocin and losartan decreased these biochemical parameters and increased the expression of the BMP7 and FRMD3 genes. DISCUSSION: Crocin may be a promising therapeutic agent for preventing and improving diabetes-related kidney disease due to its antidiabetic and antioxidant properties.

Effect of motivational interviewing on treatment adherence and self-efficacy of adolescents with asthma: A randomized controlled trial.

AIMS: This study examined the short-term effect of motivational interviewing on treatment adherence and self-efficacy of adolescents with asthma. DESIGN: The randomized controlled trial. METHOD: In this study, 72 adolescents with asthma were recruited and assigned to experimental and control groups randomly. In the experimental group, the motivational interviewing was performed for five weekly sessions lasting 80-90 min. The treatment adherence and self-efficacy questionnaires were completed before the intervention, 2 weeks and 3 months after the intervention in both groups. Data were analysed by Chi-Square test, independent samples T-test, repeated measures of Wilcoxon and generalized estimating equation. RESULTS: The treatment adherence was found to be significantly higher 2 weeks (p = 0.006) and 3 months after the intervention (p = 0.04) in the experimental group than the control group. In addition, the degree of self-efficacy was significantly more in the experimental group 2 weeks (p < 0.001) and 3 months later (p < 0.001) than the control group. The result of generalized estimating equation showed that the intervention group had an average of 14.44 more self-efficacy points than the control group (p < 0.001). Also, treatment adherence in the intervention group was significantly higher than the control group (ß = 6.14, p = 0.05(. CONCLUSION: This study adds to the evidence for the effectiveness of motivational interviewing in treatment of adolescents with asthma.

Experimental validation of in silico analysis estimated the reverse effect of upregulated hsa-miR-106a-5p and hsa-miR-223-3p on SLC4A4 gene expression in Iranian patients with colorectal adenocarcinoma by RT-qPCR.

BACKGROUND AND METHODS: Colorectal cancer (CRC) is considered one of the most common malignancies worldwide. The diagnosis and prognosis of the patients are very poor. In this study, we used in-silico analysis and experimental techniques to investigate novel co-expression genes and their associated miRNA networks in CRC. For this purpose, we conducted a comprehensive transcriptome analysis using online bulk and single-cell RNA-seq datasets. We then validated the results on tissue samples from cancerous and adjacent normal tissues from CRC patients by RT-qPCR. RESULTS: Using a weighted gene co-expression network algorithm, we identified SLC4A4 as a significantly downregulated hub gene in the CRC. The single-cell analysis indicated that the expression level of SLC4A4 in Paneth cells is higher than in other cell populations. Further computational analysis suggested hsa-miR-223-3p and hsa-miR-106a-5p as two specific hub-miRNAs for the SLC4A4 gene. RT-qPCR analysis showed a 2.60-fold downregulation of SLC4A4. Moreover, hsa-miR-223-3p and hsa-miR-106a-5p showed an increased expression level of 5.58-fold and 9.66-fold in CRC samples, respectively. Based on the marginal model analysis, by increasing the expression of hsa-miR-106a-5p, the average expression of the SLC4A4 gene significantly decreased by 103 units. Furthermore, ROC curves analysis indicated statistically significant for diagnostic ability of SLC4A4 (AUC: 0.94, Sensitivity: 95.5%, Specificity: 95.5%) and hsa-miR-106a-5p (AUC: 0.72, Sensitivity: 72.7%, Specificity: 100%). CONCLUSION: This study provides a framework of co-expression gene modules and miRNAs of CRC, which identifies some important biomarkers for CRC pathogenicity and diagnosis. Further experimental evidence will be required to support this study and validate the precise molecular pathways.

Effects of doxorubicin and apigenin on chronic myeloid leukemia cells (K562) in vitro: anti-proliferative and apoptosis induction assessments.

In this study, we aimed to investigate the effect of the co-treatment with apigenin and doxorubicin (DOX) on K562 cells. Our results show that apigenin (0, 40, 60, 80 ,100 µM) and DOX (0-10 µM) as single therapy, could decrease K562 cell viability (after 24 h of treatment) in a dose-dependent manner. Additionally, the co-treatment with apigenin (60, 80 µM) and 10 µM of DOX led to a greater reduction in cell growth (CI: 0.92 and 0.97) after 24 h of treatment compared to the single DOX treatment (p < 0.05). Consequently, apigenin and DOX, either as single or as co-treatment (24 h of treatment), were indicated to induce apoptosis in K562 cells through morphological studies, RT-qPCR, and western-blot analysis. Eventually, the expressions of Caspase 3, 6, 7, and 9 genes in the single treatment with DOX had higher alteration compared to the co-treatment with DOX and apigenin (p < 0.05).

Improving the mental health of working women with work-life conflict: A protocol development for an explanatory mixed method study.

BACKGROUND: Today, one problem facing working women is the conflict between work and life, and the resultant stress has a great impact on their mental health. A well-known model for stress management is Lazarus and Folkman's model. The primary goal of the present study is to improve working women's mental health through stress management. MATERIALS AND METHODS: The present study employs a mixed approach and is conducted in 4 phases. The target population is women working in Birjand University (South Khorasan province/Eastern Iran). The first step is to describe the research population of a cross-sectional study. The measurement instrument used is Carlson's standard work-life conflict measurement questionnaire. The sample size in this step is 319. The second step is to conduct a qualitative study by interviewing working women with work and life conflict. The sampling will continue until data saturation and then the data will be analyzed through a content analysis. The third step will be the development of a questionnaire based on Lazarus and Folkman's model using the information obtained from the qualitative step. This questionnaire will be then validated in the target research population. Moreover, an exploratory factor analysis, a confirmatory factor analysis and a reliability test will be run. The last step is to carry out an educational intervention to measure the effect of the intervention on stress management and general health in working women with work and life conflict. The measurement instruments used in this step are Cohen's Perceived Stress Questionnaire, General Health Questionnaire, and a researcher-made stress management questionnaire. CONCLUSION: It seems that the educational intervention of stress management with educational content designed based on the needs of the audience, can be effective in controlling and managing the stress caused by women's work-life conflict. TRIAL REGISTRATION: IRCT (IRCT20210918052508N1) from the Iranian Registry of Clinical Trials in 2021-09-21.

Factors affecting childbearing intention in women employees in Birjand: Application of the theory of planned behavior.

BACKGROUND: Childbearing is one of the most important determinants of population fluctuations. Identifying factors affecting childbearing is necessary for the proper implementation of population programs. This study aimed to determine the factors affecting childbearing intention among women employees in Birjand based on the theory of planned behavior. MATERIALS AND METHODS: In this descriptive-correlational study, 405 women employees in the offices of Birjand city in 2022 were selected by stratified random sampling and completed a two-part questionnaire including demographic information and questions related to the theory of planned behavior. The data were analyzed using SPSS v19 and Pearson's correlation, logistic regression, independent t-test, and ANOVA. RESULTS: The mean age of the participants in the study was 37.82 ± 6.39 years and the mean number of current children was 1.77 ± 0.92. The mean score of childbearing intention was 8.80 ± 3.06, the attitude was 66.04 ± 11.50, the subjective norm was 27.03 ± 6.95, and perceived behavioral control was 32.90 ± 7.80. Also, there was a significant negative and direct relationship between all the constructs of the theory of planned behavior and childbearing intention (P < 0.01). The variables of age, the number of current children, and the ideal number of children were predictors of childbearing intention. According to the standardized beta coefficients, the strongest predictor of intention was the number of current children (ß = -0.464). CONCLUSION: The findings showed that various demographic factors are efficient in childbearing intention. The findings of this study can provide a picture of the current situation of factors affecting childbearing intention in society and be used as a guide for policymakers in fertility planning.

The effect of planned presence of the family at the time of weaning on the length of weaning from mechanical ventilation in patients with brain injury admitted to intensive care units.

BACKGROUND: Weaning the patient from mechanical ventilation (MV) is one of the common treatments in intensive care units (ICU). Among the factors that can complicate the weaning process are psychological problems caused by a lack of family visits. OBJECTIVE: This study aimed to evaluate the effect of scheduled visiting on weaning from mechanical ventilation in patients with brain injury admitted to ICUs. METHODS: This quasi-experimental study was performed on 60 patients with brain injury referred to one of the hospitals in Central Province, Iran in 2020. The selection of samples based on inclusion criteria and random allocation to the two groups of intervention and control by permuted block randomization was done. The first-degree relatives of the patients at the time of weaning in the intervention group were present at the patient's bedside twice a day at 10:00 AM and 3:00 PM for 30-45 min and performed what they had been trained to do. Participants in the control group visited patients from the area outside the patient room. Length of weaning, length of mechanical ventilation, and length of stay in the ICU were recorded and measured using a researcher-conducted checklist. The results were analyzed using descriptive and inferential statistics and chi-square and independent t-tests in SPSS16. RESULTS: The study results showed that the number of patients weaned from mechanical ventilation in the intervention group was significantly higher than that of the control group (P ≤ 0.05). The mean length of weaning in the intervention and control groups was not statistically significant, but it was clinically significant in the intervention group (P > 0.05). In addition, the length of mechanical ventilation and the length of stay of the intervention group in the ICU were significantly shorter than that of the control group (P ≤ 0.05). CONCLUSION: According to the study results, scheduled visiting resulted in faster weaning from mechanical ventilation. As a result, nurse managers are suggested to make arrangements for family members to be present at the patient's bedside in order for patients to be weaned off the mechanical ventilator more easily.

Online assessment in two consequent semesters during COVID-19 pandemic: K-means clustering using data mining approach.

BACKGROUND: Education and assessment have changed during the COVID-19 pandemic so that online courses replaced face-to-face classes to observe the social distance. The quality of online assessments conducted during the pandemic is an important subject to be addressed. In this study, the quality of online assessments held in two consecutive semesters was investigated. MATERIALS AND METHODS: One thousand two hundred and sixty-nine multiple-choice online examinations held in the first (n = 535) and second (n = 734) semesters in Birjand University of Medical Sciences during 2020-2021 were examined. Mean, standard deviation, number of questions, skewness, kurtosis, difficulty, and discrimination index of tests were calculated. Data mining was applied using the k-means clustering approach to classify the tests. RESULTS: The mean percentage of answers to all tests was 69.97 ± 19.16, and the number of questions was 34.48 ± 18.75. In two semesters, there was no significant difference between the difficulty of examinations (P = 0.84). However, there was a significant difference in the discrimination index, skewness, and kurtosis of tests (P < 0.001). Moreover, according to the results of the clustering analysis in the first semester, 43% of the tests were very hard, 16% hard, and 7% moderate. In the second semester, 43% were hard, 16% moderate, and 41% easy. CONCLUSION: To evaluate the tests' quality, calculating difficulty and discrimination indices is not sufficient; many factors can affect the quality of tests. Furthermore, the experience of the first semester had changed characteristics of the second-semester examinations. To enhance the quality of online tests, establishing appropriate rules to hold the examinations and using questions with higher taxonomy are recommended.

Status of Iranian schools' psycho-social environment: cultural adaptation and validation of the Persian version of the W.H.O profile to create Child-Friendly Schools.

BACKGROUND: Creating an environment for emotional and social well-being is an important responsibility of Health-Promoting and Child-Friendly Schools. Thus, the present study aimed to assess cultural adaptation and validation of the Persian version of the Psycho-Social Environment (PSE) Profile. The second purpose of this study was to survey the psycho-social environment of schools among a local sample of Iranian school staff. METHODS: This study was conducted in two phases, including cultural adaptation and validation of a culturally adapted scale. The cultural adaptation process followed the procedure suggested by Beaton et al. Then, the culturally adapted scale was administered to a local sample of Iranian school staff including managers (21.9%), teachers (57.4%), support staff (4%), and other school staff (16.7%) in a cross-sectional study. The participants' mean age was 39.98 ± 8.11 years and they were mostly female (62.8%). The psychometric properties of the culturally adapted version of the questionnaire were tested using a confirmatory factor analysis (n = 265), and a test of internal consistency. Finally, the status of schools' psycho-social environment was assessed using descriptive and analytical statistics. RESULTS: Confirmatory factor analysis indicated an overall good fit for the 7-factor profile (χ2/df: 1.906, PNFI: 0.62, TLI: 0.78, CFI: 0.79, RMSE: 0.059). The test of internal consistency showed an acceptable reliability (α = 0. 98). CONCLUSIONS: The Persian version of the PSE profile was culturally adapted for use in Iranian schools. Certainly, this culturally adapted version of PSE profile could be useful to determine the school psycho-social environment and to make any changes that can promote a friendly school climate for all participants, and to enhance learning and development.

The relationship between aggressive behaviors of preschool children and the violence against Iranian women in the COVID-19 pandemic.

BACKGROUND: During epidemics, supports are limited and individual and collective vulnerabilities as well as domestic violence are increased. Therefore, various groups in society, especially children and their mothers, are extremely vulnerable. This study aimed to assess the relationship between aggressive behaviors of preschool children and the violence against Iranian women during the COVID-19 pandemic. METHODS: This descriptive-correlational study was conducted in October-November 2020. Stratified random sampling was performed among preschool children in Kerman. Data were collected using the Violence toward Women Inventory and the Aggression scale for preschoolers Scale. Data were analyzed using SPSS25, ANOVA, independent t-test, and Pearson correlation test. RESULTS: The results showed that the total mean scores of violence against women and preschoolers' aggression were 54.43 ± 10.6 and 88.44 ± 6.5, respectively. The results showed a statistically significant difference in aggressive behaviors of preschool children, mother's job, number of children, mother's education, income, and age. A positive and significant relationship was also found between the subscales of violence against women and aggression in preschool children. CONCLUSIONS: The results showed a positive and significant relationship between violence against women and aggression of preschool children. Therefore, it is recommended that parents identify and eliminate the risk factors for domestic violence during the COVID-19 in order to protect their children. Parents also must learn coping strategies for stress and resilience in the epidemic crises.