Lubratex eye ointment with polyethylene cover significantly reduces corneal abrasion in ICU patients: a randomized controlled trial.

Corneal abrasion is a frequent complication in critically ill, intubated patients, potentially leading to visual impairment. This study compares the efficacy of three ocular care methods in preventing corneal abrasion among this vulnerable population. We conducted a randomized controlled trial involving 156 intubated adult patients admitted to the ICU. Participants were randomly allocated to one of three intervention groups (n = 52 per group): (1) polyethylene cover only, (2) polyethylene cover with artificial tear drops, and (3) polyethylene cover with Lubratex eye ointment. One eye per patient was randomly assigned as the control, receiving standard ICU eye care. Daily assessments over five days included a standardized dryness and corneal abrasion checklist, graded strip evaluation of eye dryness, and documentation of corneal abrasion incidence. Data were analyzed using descriptive and inferential statistics (SPSS-18). The incidence of corneal abrasion was significantly lower in the group receiving polyethylene cover with Lubratex eye ointment (4%) compared to the polyethylene cover with artificial tears group (36%, p < 0.001) and the polyethylene cover only group (60%, p < 0.001). The combined application of a polyethylene cover with Lubratex eye ointment effectively prevents corneal abrasion in intubated ICU patients. This method demonstrates superior efficacy compared to polyethylene covers used alone or with artificial tears. We recommend its implementation as standard practice for corneal abrasion prophylaxis in this high-risk population.Trial Registration. This study is registered with the Iranian Registry of Clinical Trials (IRCT201506294736N8) and can be accessed at www.IRCT.ir .

Risk factors for thrombosis in dialysis patients: A comprehensive systematic review and meta-analysis.

AIM: To identify the factors associated with thrombosis in dialysis patients. BACKGROUND: Thrombosis is a leading cause of vascular access failure in dialysis patients. Numerous risk factors contribute to thrombosis in this population. METHODS: A systematic search was conducted across international databases using standardized keywords. The quality of the selected studies was assessed using the STROBE and CONSORT checklists. The findings were summarized in a Garrard table. Meta-analysis was performed using CMA software. The study adhered to the guidelines outlined in the PRISMA statement. RESULTS: A total of 180 articles were reviewed. The odds ratio for thrombosis in patients with arteriovenous grafts compared to arteriovenous fistulas was 10.93 (95 % CI: 9.35-12.78), demonstrating statistical significance (P = 0.001). Similarly, hemodialysis patients had an odds ratio of thrombosis 3.60 times higher than non-hemodialysis patients (95 % CI: 3.54-4.19), with statistical significance (P = 0.001). Patients undergoing single-stage basilic vein transposition had a 1.89 times higher risk of thrombosis compared to those undergoing two-stage transposition (95 % CI: 1.04-3.46), also demonstrating statistical significance (P = 0.038). CONCLUSIONS: Thrombosis in patients with end-stage renal disease undergoing dialysis was significantly associated with various factors, including graft access, single-stage basilic vein transposition, and hemodialysis. Additional contributing factors to thrombosis included diabetes, elevated homocysteine levels, female gender, age over 50, access location, and low access blood flow velocity. The analysis revealed a higher incidence of thrombosis in end-stage renal disease patients undergoing hemodialysis compared to those not undergoing dialysis, as well as in patients with arteriovenous grafts compared to those with arteriovenous fistulas. These findings underscore the importance of recognizing and managing these risk factors to prevent thrombotic events and enhance patient care within the dialysis setting.

Exploring the lived experiences of adolescent girls affected by head lice infestation: a qualitative descriptive study.

BACKGROUND: Head lice infestation is a prevalent dermatological condition among adolescent girls, which has wide-ranging adverse physical, psychological, and emotional effects on their lives. However, these experiences have been sparsely documented. This study aimed to investigate the lived experiences of Iranian adolescent girls regarding head lice infestation. METHODS: In this phenomenological study, a purposive sampling technique was employed to select 15 adolescent girls who were experiencing head lice infestation. Collaboration was established with local schools to identify and recruit the participants. Subsequently, the purpose and nature of the study were explained to the identified participants and their guardians. Semi-structured in-depth interviews were conducted to gather the necessary data. The collected data underwent analysis using Colaizzi's seven-step method. To enhance the credibility of the findings, Lincoln and Guba's (2004) criteria were applied. The management of the data was facilitated through the utilization of MAXQDA software version 0.9.5. RESULTS: The average age of the participants, aged 12 to 17, was 14.5 (standard deviation = 1.7). In terms of education, the majority of them had completed upper secondary education (n = 8, 53.3%), followed by lower secondary education (n = 4, 26.6%). The participants' experiences were categorized into four main themes and 15 sub-themes. The main themes included living in the shadow of fear, torment of infestation, "struggling with head lice, and disturbing ramifications. The sub-themes encompassed social fear, fear of harm, fear of beauty decline, stigma, bullying behavior, self-blame, adversity, challenging struggle, effective coping, nonconforming behavior, family disruption, academic disruption, health threats, and confused mental state. CONCLUSION: During head lice infestation, adolescent girls endured negative experiences and extensive fears, considering it a significant ordeal. They encountered multiple challenges while dealing with lice and utilized both adaptive and maladaptive strategies to cope with the infestation. It is recommended to enhance public awareness regarding head lice infestation, and healthcare providers should offer emotional support and counseling services to affected girls and their families.

Prevalence and factors associated with poor sleep quality among nurses in COVID-19 wards.

The COVID-19 pandemic has significantly impacted the working conditions of nurses, leading to a detrimental effect on their sleep quality. This cross-sectional study aimed to investigate the prevalence of poor sleep quality and its associated factors among nurses working in COVID-19 wards in Kermanshah, Iran. A total of 97 nurses were selected through simple random sampling from COVID-19 wards. Data was collected using a demographic information sheet and the Pittsburgh Sleep Quality Index. Descriptive and inferential statistical methods, including chi-square and multiple logistic regression, were used for data analysis. The results showed that 74.2% (n = 72) of the nurses experienced poor sleep quality. Significant associations were found between poor sleep quality and work experience (p = 0.045) as well as the type of work shift (p = 0.001). However, no significant relationships were observed between poor sleep quality and factors such as age, sex, body mass index, overtime hours per month, physical activity, or underlying diseases. The high prevalence of poor sleep quality among nurses working in COVID-19 wards underscores the necessity of implementing targeted interventions to address this issue. In this regard, in addition to periodic shift schedule changes and reductions in working hours, it is necessary to adopt purposeful measures to improve working conditions and enhance the physical and mental health of nurses. These measures may include providing sufficient human resources to reduce the workload and fatigue of nurses, appropriate scheduling of working hours, and the implementation of stress management programs.

Epidemiology of Celiac Disease in Western Iran during 2019-2021.

Celiac disease is a growing global public health concern. This epidemiological study is aimed at determining the prevalence of celiac disease in Kermanshah, Western Iran, from 2019 to 2021, as well as the frequency of gastrointestinal and nongastrointestinal manifestations associated with the disease. In this cross-sectional study, the medical records of all patients with a confirmed diagnosis of celiac disease between 2019 and 2021 were reviewed. The average population during the study period was 2,058,545. A researcher-developed checklist was used as the data collection tool, and descriptive statistics were employed for data analysis. During the study period, there were 113 patients diagnosed with celiac disease, with a mean age of 29.1 ± 16.6 years. The three-year prevalence of celiac disease was 5.49 (95% CI: 5.17-5.82) per 100,000 population. Among these patients, 70% (n = 78) was female. The most common gastrointestinal manifestations of the disease were abdominal pain (77.8%), constipation (59.3%), and diarrhea (54.9%). Iron-deficiency anemia (64.6%) and vitamin D3 deficiency (46.1%) were the most common nongastrointestinal manifestations. Growth retardation was observed in 39.0% of patients. This study demonstrated a higher prevalence of celiac disease in Kermanshah compared to global statistics. Given the association of celiac disease with other conditions such as diabetes, irritable bowel syndrome, growth retardation, and iron-deficiency anemia, healthcare providers should consider screening patients for celiac disease. Furthermore, community-based education is crucial in raising awareness about the significance of adhering to a proper diet and reducing wheat consumption.

Cancer patients' experience with implanted venous ports: A qualitative descriptive study.

AIM: The aim of this study was to explore the experiences of cancer patients regarding venous access ports. BACKGROUND: The utilization of intravenous access ports for administering chemotherapy drugs is on the rise. Understanding patients' experiences with these devices can provide valuable insights for nursing managers and nurses. METHODS: A conventional qualitative content analysis approach was employed to explore the experiences of 14 patients who had venous access ports. The participants were selected from patients admitted to the oncology ward of a hospital affiliated with Kermanshah University of Medical Sciences. A purposive sampling method was used for participant selection. Semi-structured in-depth interviews were conducted as the data collection tool. MaxQda-10 software was utilized for data management. RESULTS: The data analysis yielded three main categories and ten sub-categories. The categories consisted of positive aspects of venous access ports, negative aspects of venous access ports, and barriers to accepting venous access ports. CONCLUSIONS: The participants highlighted both the positive and negative aspects of venous access ports, while also identifying insufficient knowledge and "fear and anxiety" as barriers to accepting these devices. Providing essential training and offering psychological support to newly hospitalized cancer patients could prove beneficial in this regard.

Exploring the lived experiences of women with multiple gestations in Iran: a phenomenological study.

BACKGROUND: Multiple gestations present numerous physical, psychological, social, and economic challenges for women. Understanding the problem-solving experiences of pregnant women carrying multiple can be invaluable. This study aimed to explore the experiences of Iranian women with multiple gestations. METHODS: This descriptive phenomenological study utilized purposive sampling and continued until data saturation. Data collection involved in-depth semi-structured interviews, with analysis performed using Colaizzi's 7-step method. MAXQDA software was employed for data management. RESULTS: This study involved 12 women with multiple gestations. The average age of the participants was 33.76 ± 6.22 years, and 9 were pregnant with triplets. The data were categorized into four primary themes: the paradox of emotions, the pregnancy prison, immersion in fear, and the crystallization of maternal love, encompassing 17 sub-themes. CONCLUSION: Pregnant women with multiple gestations undergo various changes and experience conflicting emotions. Enhancing their ability to adapt to and accept numerous pregnancies can be achieved through supportive, personalized, and family-centered care, along with improvements and revisions in care policies for multiple gestations.

Exploring nurses' experiences of recommended patient care: a descriptive phenomenological study.

BACKGROUND: Caring for recommended patients creates work and emotional challenges for nurses. Nurses are obligated to provide care regardless of the patient's situation. Therefore, knowing the experiences of nurses in dealing with recommended patients in order to provide quality and effective care can be the basis for increasing patient satisfaction. The present study was conducted aimed to explain nurses' experiences of caring for recommended patients. METHODS: This was a qualitative study with descriptive phenomenological approach. Participants were 12 nurses working in different wards of hospitals affiliated to Kermanshah University of Medical Sciences, selected by purposive sampling method with maximum diversity. The data collected using semi-structured interviews in face-to-face and audio-recorded methods. MAXQDA 2020 software was used for data management. The analysis of the data was done using the Colaizzi's 7-step method. In order to verify the trustworthiness of the data, Lincoln and Guba criteria were used. RESULTS: After continuous data analysis, 110 initial codes were extracted. These codes emerged in 18 sub-themes and 6 main themes including: catastrophe, be in decline, be in progress, discrimination, work overload, and poor prognosis. CONCLUSIONS: The results showed information about the presence of recommended patients in the hospital, which can have consequences for patients and nurses. Therefore, it is advised that nurses provide standard care and avoid any kind of discrimination against all patients regardless of whether the patient is recommended or not.

Comparing the effects of rosemary aromatherapy and music therapy on anxiety levels in patients undergoing general surgery: A randomized controlled clinical trial.

BACKGROUND: Preoperative anxiety is a prevalent concern among patients undergoing surgery, potentially elevating the risk of postoperative complications. This study aimed to compare the effectiveness of inhalation aromatherapy using rosemary essential oil and music therapy in reducing anxiety levels among general surgery patients. METHODS: This study employed a randomized controlled clinical trial design involving 236 patients scheduled for general surgery. The participants were randomly assigned to one of four groups: aromatherapy with Rosmarinus officinalis L. essential oil (n = 59), music therapy (n = 59), combined aromatherapy and music therapy (n = 59), and a control group (n = 59). Data collection instruments consisted of the Spielberger State Anxiety Inventory, a personal information form, a music player, and wireless headphones. In the aromatherapy group, patients were instructed to inhale three drops of 25% rosemary essential oil. The music therapy group listened to instrumental music through headphones, while the combined group received both inhalation aromatherapy with rosemary essential oil and music therapy. The control group received three drops of an aromatic placebo. The interventions were administered for a duration of 30 min, starting one hour before surgery. Inferential statistics, including the Kolmogorov-Smirnov test, chi-square test, paired t-test, one-way analysis of variance, and LSD post-hoc test, were employed for data analysis. RESULTS: The study findings demonstrated significant effectiveness in reducing anxiety among surgical patients for aromatherapy (P = 0.001), music therapy (P < 0.001), and combined aromatherapy and music therapy (P = 0.001). Aromatherapy showed the highest anxiety-reducing effect, whereas combined therapy exhibited the lowest effect. CONCLUSION: The results indicate that inhalation aromatherapy, music therapy, and combined aromatherapy and music therapy are all effective approaches for anxiety reduction in surgical patients. Hence, the implementation of these cost-effective and non-invasive interventions is recommended to alleviate anxiety among surgical patients.

Prevalence and factors related with venous thromboembolism in patients admitted to the critical care units: A systematic review and meta-analysis.

OBJECTIVE: Venous thromboembolism is one of the most common cardiovascular disorders in the any intensive care units (ICUs), which annually leads to death and imposes great costs on patients and society worldwide. The present study was conducted with the aim of determining the prevalence and factors related to venous thromboembolism in the ICUs as a systematic review and meta-analysis. METHODS: The current study was conducted in international databases, on all descriptive and analytical studies and clinical and semi-experimental trial studies, without time limit until November 2, 2021. The present study was designed and implemented based on PRISMA guideline. The quality of the studies was checked using STROBE checklist and meta-analysis was performed using CMA software. RESULTS: Among the 3204 articles found, after the evaluations, 189 articles entered the full text review phase, and as a result, 38 articles were included in the study. The reported prevalence of thromboembolism was 1-45%. The prevalence of venous thromboembolism was 12% in overall. The chance of venous thromboembolism was higher in ICUs patients >57 years old and ICUs patients with a history of venous thromboembolism. CONCLUSION: The results of this study showed that venous thromboembolism has a higher prevalence in ICUs patients in comparison to non-ICUs patients. It is recommended to nurses and healthcare staffs to provide accurate decision and care for prevention of venous thromboembolism and paying attention to the patient's warning signs, timely administration of anticoagulants, and monitor coagulation factors.

Physicians' attitudes towards the development of the nurse prescribing role in critical care and emergency departments.

BACKGROUND: The progression of the nurse prescribing role encounters numerous challenges, with physician resistance being a significant obstacle. This study aims to assess physicians' perspectives regarding the expansion of the nurse prescribing role within critical care and emergency departments. METHODS: This cross-sectional study employed convenience sampling to enroll 193 physicians. Data collection instruments included a demographic information form and a researcher-developed questionnaire. Descriptive and inferential statistics were used to analyze the data using SPSS-22 software. RESULTS: A total of 193 physicians participated in the survey, with a mean age of 41.9 ± 10.7 years. Among physicians from various age groups, genders, educational backgrounds, and clinical experiences, more than 60% acknowledged prescribing medicine as an essential component of their professional responsibilities. However, a significant majority of physicians in these categories agreed that in emergency situations, nurses should be allowed to prescribe medication to save patients' lives. It is worth noting that, unlike specialist and fellowship physicians, a majority of general practitioners (83.3%) held the view that nurse-prescribed medications do not contribute to the professional development of nursing. The nurse prescribing role encountered several predominant obstacles, namely legal consequences (78.8%), interference of duties between physicians and nurses (74.1%), and a legal vacuum (77.2%). CONCLUSION: The majority of physicians expressed a favorable attitude towards nurse prescribing in emergency and critical care departments. To facilitate the development of the nurse prescribing role, it is essential to ensure the acquisition of scientific qualifications and implement necessary changes in nursing curricula across bachelor's, master's, and doctoral programs.

Effects of auricular acupressure on test anxiety in medical students: a randomized parallel-group trial.

BACKGROUND: Test anxiety is a prevalent issue among students, including those in the medical field. The present study aims to examine the impact of auricular acupressure on reducing test anxiety specifically among medical students. METHODS: In this single-blind randomized parallel-group trial, a total of 114 medical students from Kermanshah, Iran, were allocated into two groups: intervention and control. Each group consisted of 57 students. The data collection instruments included a demographic information form and the Sarason Anxiety Inventory. In the intervention group, bilateral auricular acupressure was administered on the Shen Men point for a duration of 10 min. On the other hand, the control group received bilateral auricular acupressure on the Sham point, located in the earlobe, as a placebo, also for 10 min. RESULTS: The mean test anxiety scores in the Shen Men acupressure group exhibited a significant reduction from 18.4 ± 5.3 before the intervention to 13.3 ± 4.8 after the intervention (P = 0.001). Conversely, in the Sham acupressure group, the mean test anxiety scores showed no significant change, with values of 16.36 ± 6.4 before the intervention and 16.4 ± 6.1 after the intervention (P = 0.963). Prior to the intervention, the majority of participants in both the intervention group (87.7%) and control group (86.0%) exhibited moderate to severe levels of test anxiety. Following acupressure, a significant improvement was observed in the intervention group, with 52.6% of participants experiencing a reduction to mild anxiety levels (P = 0.001); however, no notable change in anxiety levels was observed in the control group. Furthermore, a statistically significant difference in anxiety intensity after the intervention was found between the two groups (P = 0.001). CONCLUSION: Shen Men auricular acupressure demonstrates efficacy in reducing test anxiety among medical students. However, to validate its effectiveness, further research using objective measures is warranted.

Predictors of care burden among caregivers of patients with COVID-19.

AIM: To explore predictors of care burden among the caregivers of patients with COVID-19. DESIGN: The findings of this cross-sectional study were presented in accordance with the guidelines outlined in the Strengthening the Reporting of Observational Studies in Epidemiology statement. METHODS: The samples included 172 caregivers in Imam Reza and Farabi Hospitals, located in Kermanshah, Iran, who were enrolled in the study using convenience sampling. A demographic information form and the Caregiver Burden Inventory were administered. The data were collected between 13 May 202 and 20 August 2021. RESULTS: Of the caregivers, 62.8% (n = 108) were male and 71.5% (n = 123) were over 40 years old. Furthermore, 66.3% (n = 114) of caregivers had severe and very severe care burden, with a mean care burden of 78.9 ± 20.4 out of 120. A statistically significant difference was found between care burden and the variables of monthly income, health status, number of patients under care and residence status (p < 0.05). CONCLUSION: The caregivers experienced a high care burden, which can have harmful effects on them. Therefore, it is necessary to provide them with various forms of economic, psychological and social support.

Emergency care utilization and patients' outcome before and after COVID-19 national lockdown in Iran: a cross-sectional study.

INTRODUCTION: COVID-19 rapidly spread throughout the world. Stay-at-home and social distance strategies accompanied by fear of contamination with COVID-19 caused significant disruptions in daily life. The study focused on the impact of the COVID-19 pandemic on emergency visit and patients' outcome in the emergency department (ED). METHOD: Administrative and clinical data of 25-hospital EDs in Kermanshah province of Iran from February 20, 2020, to February 18, 2021, were retrospectively analyzed with the comparable periods in the previous year. The incidence rate ratio (IRR) was used to compare the differences between the pandemic and the pre-pandemic period. RESULT: The number of ED visits decreased nearly 50% after the declaration of a national lockdown. Moreover, the proportion of patients triaged in ESI 1 and 2 levels increased by 40 and 52%, respectively. The ratio of patients admitted to intensive care units and discharged against medical advice also increased significantly. CONCLUSION: Despite the number of ED visits sharply declining, the ratio of patients who came to EDs with higher acuity significantly increased. So, health authorities must sensitize the public about life-threatening signs and symptoms in such conditions.

Prevalence and reasons for self-medication for prevention of COVID-19 among the adult population in Kermanshah-Iran.

AIM: To determine the prevalence of self-medication and reasons for self-medication (SM) for the prevention/treatment of COVID-19 among the adult population. DESIGN: Cross-sectional study. METHODS: This study was performed on 147 adults in Kermanshah, Iran. Data were collected by a researcher-made questionnaire and analysed by SPSS-18 software using descriptive and inferential statistics. RESULTS: The prevalence of SM in the participants was 69.4%. Vitamin D and vitamin B complex were the most commonly used drugs. The most common symptoms leading to SM were fatigue and rhinitis. Strengthening the immune system and prevention of COVID-19 (48%) were the main reasons for SM. Factors related to SM included marital status [OR = 8.04, 95% CI = (3.62, 17.83)], education [OR = 0.16, 95%CI = (0.08, 0.35)] and monthly income [OR = 0.09, 95%CI = (0.03, 0.26)]. PATIENT OR PUBLIC CONTRIBUTION: Yes.

Intention to leave the profession and related factors in nurses: A cross-sectional study in Kermanshah, Iran.

AIM: To investigate the intention to leave the profession and its related factors among nurses in Kermanshah, western Iran. DESIGN: Cross-sectional study. METHODS: A total of 377 nurses were enrolled in a stratified random sampling method. Data were collected by the Anticipated Turnover Scale and a sociodemographic information form. and analysed by descriptive and inferential statistics (logistic regression analysis). RESULTS: The results showed that 49.6% (n = 187) of nurses tended to leave the profession and the mean score of intention to leave was 36.6 ± 0.5 of 60. There were no statistically significant differences between nurses who intended to leave and those who did not in terms of age, marital status, gender, type of employment, type of shift and work experience. But a statistically significant association was found between workplace (p = 0.041, adjusted OR = 2.07) and job title (p = 0.016, adjusted OR = 0.58) and intention to leave the profession. PATIENT OR PUBLIC CONTRIBUTION: No.

Mortality rate and liver transplant in patients with mushroom poisoning: A systematic review & meta-analysis.

Background: Mushroom poisoning is raised as a poor food problem that can cause the death of patients or the need for a liver transplant. Objective: This study was conducted with the aim of assessment the mortality rate and liver transplantation in people suffering from mushroom poisoning through a systematic review and meta-analysis. Method: The study is designed and conducted based on the PRISMA statement. International databases have been checked for articles up to March 1, 2022. The results of the study are presented with the guidance of Garrard's statement. CMA software was used in meta-analysis. Results: Thirty-three articles were selected for this study. The mortality rate reported 0-40% and the results of the meta-analysis showed that the mortality rate was 2.87%. in other hand the mortality rate was 1.4% with studies that reported zero death. Overall, 16 patients had liver transplants, that only 2 died after liver transplants and 14 others survived. Conclusion: The death in patients with mushroom poisoning is significant. Patients with liver disorders and patients or kidney disorders are more likely to have a poor prognosis. Liver transplant can be lifesaving. Also, quick referral of patients in the early stages reduces the need for liver transplantation.

Violence against Emergency Nurses in Kermanshah-Iran: Prevalence and Associated Factors.

Background: Violence against emergency nurses is a global concern with undesirable physical and psychological consequences. This study was conducted to investigate the characteristics of physical and verbal violence against emergency nurses in Iran. Methods: In this cross-sectional study, 150 nurses working in seven hospitals affiliated to Kermanshah University of Medical Sciences were included in the study using the stratified random sampling method. The data collection tools included a personal information form and a researcher-made questionnaire. Violence-related characteristics were assessed using descriptive statistics. Logistic regression was used to identify factors related to physical and verbal violence. Results: The frequency rates of physical and verbal violence during the past 12 months were equal to 62% (n = 93) and 94.7% (n = 142), respectively. In both types of physical violence (49.5%, n = 46) and verbal violence (40.4%, n = 57), the nursing station was the most common place of violence. In both physical (n = 40, 43.0%) and verbal violence (n = 101, 71.1%), the most common perpetrator was the patient's family. Most physical violence (57.0%, n = 53) and verbal violence (35.2%, n = 50) occurred in the night shifts. No statistically significant relationship was found between physical and verbal violence and gender, age, marital status, type of employment, and work experience. Discussion. The results indicate the seriousness of workplace violence against nurses. It is necessary to adopt a global approach along with providing sufficient manpower and psychological empowerment of nurses. Further studies with a forward-looking approach are suggested.

Explanation of the internet addiction model based on academic performance, academic experience, and clinical self-efficacy in nursing students: A path analysis.

BACKGROUND: Internet addiction is a common disorder in nursing students, and this calls for a deeper investigation into this phenomenon and its dimensions. The aim of this study was to explain the internet addiction model based on academic performance, academic experience, and clinical self-efficacy in nursing students. MATERIALS AND METHODS: This study is a correlational and path analysis study that was conducted on 340 nursing students. Data collection tools included Yang's internet addiction questionnaire and self-efficacy in clinical performance scale. In this study, the academic grade point average was the measure of academic performance and the academic term was the measure of academic performance. Data were analyzed using SPSS-16 and AMOS-22 software, descriptive and analytical statistics, and structural equations. RESULTS: There was a significant negative correlation between clinical self-efficacy (r = -0.950, P ≤ 0.01), academic experience (r = -0.872, P ≤ 0.01), and academic performance (r = -0.654, P ≤ 0.01) with internet addiction. A negative and significant relationship was found between the internet addiction and variables of clinical self-efficacy (total effect = -0.743, P < 0.001). Model fit indices were good and acceptable. CONCLUSIONS: There was a negative and significant relationship between the variables of clinical self-efficacy, academic experience and academic performance, and the internet addiction. Meanwhile, the academic experience had a negative and significant effect on the internet addiction. This finding highlights the need to implement advisory and psychological interventions to reduce internet addiction, especially in students with less academic experiences.

Demographic, clinical, and laboratory findings of mushroom-poisoned patients in Kermanshah province, west of Iran.

BACKGROUND: Mushroom poisoning can cause gastrointestinal, renal, and hepatic symptoms and even death. This descriptive study examined the demographic, clinical, and laboratory findings of patients with fungal poisoning, a type of fungus causing the poisoning, and the incidence and mortality rates of fungal poisoning in Kermanshah province, western Iran, from 2014 to 2018. METHODS: The medical records of 193 patients with mushroom poisoning from 2014 to 2018 were evaluated. The liver and kidney function tests, electrolytes, abdominal and pelvic ultrasound, chest x-ray, coagulation tests, and coagulation factors (fibrinogen, prothrombin) were assessed. Data were collected from the medical records of patients admitted to the Poisoning Center of Imam Khomeini Hospital in Kermanshah, Iran using a researcher-made checklist. Data were analyzed by SPSS (version 16) using descriptive statistics, including mean, standard deviation, and frequency distribution tables. Trend analysis for proportion was done by chi-square statistics in STATA-14 software (ptrend command). RESULTS: Of cases, |51.3% were male, 92.6% were city dwellers, 38.3% were aged 21-40 years, and 92.5% were poisoned during the spring. The fungus that caused poisoning was Amanita virosa. The gastrointestinal, nervous, and visual systems were the most common systems involved. The most common gastrointestinal symptoms included nausea and vomiting (72.0%) and abdominal pain (71.0%). Vertigo (11.9%) and headache (9.3%) were the most common neurological symptoms. The most common visual manifestation was blurred vision (7.8%). Of cases, 23.7% had metabolic acidosis. The increased alkaline phosphatase level was the most common liver disorder in 98.7% of the cases. Increased blood urea nitrogen and creatinine levels were also reported in 21.0% and 17.7% of the cases, respectively. The serum lactic dehydrogenase and creatine phosphokinase levels also increased in 99.3% and 30.2% of the patients, respectively. The mortality rate was 1.6% (n = 3). CONCLUSION: The fungal poisoning diagnosis should always be considered in young patients referred to the emergency department with gastrointestinal complaints, a history of consuming wild self-picked mushrooms, and high liver and kidney test values. Since most fungal poisonings occur in the spring, it is necessary to inform the community of the dangers of consuming self-picked wild mushrooms, especially in this season.