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Do environmental factors lead to obesity? آیا عوامل محیطی منجر به چاقی می شود؟ 2 1 چکیده ندارد. 2 Weight gain is one of the problems that many people face and is unfortunately the fifth leading cause of death worldwide. Overweight is caused by many factors, such as the environment, family and genetic history, metabolism, unhealthy eating behavior or habits. Factors like family history are unchanging, but other factors, such as your habits, lifestyle and environmental factors can change (1). In the following article, a number of factors affecting overweight, such as Exposure to environmental toxins, Changes in the Microbiome, Chronic stress and cortisol and… will be discussed. 183 184 2020/05/17 1399/2/28 2021/03/20 1399/12/30 آمنه مرزبان ameneh marzban Department of Human Ecology, School of Public Health, Shahid Sadoughi University of Medical Sciences,Yazd, Iran Iran amenemarzban@yahoo.com Obesity Overweight Environmental factors چاقی اضافه وزن عوامل محیطی Longo M, Junior FV, Cansian K, et al. Environmental factors that influence milk production of Pantaneiro ewes and the weight gain of their lambs during the pre-weaning period. Tropical animal health and production. 2018;50(7):1493-7.##Paciência I, Cavaleiro Rufo J, et al. Exposure to indoor endocrine‐disrupting chemicals and childhood asthma and obesity. Allergy. 2019;74(7):1277-91.##Singh UP, Singh NP, Murphy EA, et al. Adipose T cell microRNAs influence the T cell expansion, microbiome and macrophage function during obesity. Am Assoc Immnol; 2018;200(1)##John GK, Mullin GE. The gut microbiome and obesity. Current oncology reports. 2016;18(7):45.##Herhaus B, Ullmann E, Chrousos G, et al. High/low cortisol reactivity and food intake in people with obesity and healthy weight. Translational Psychiatry. 2020;10(1):1-8.##Hewagalamulage SD, Lee T, Clarke I, et al. Stress, cortisol, and obesity: a role for cortisol responsiveness in identifying individuals prone to obesity. Domestic animal endocrinology. 2016;56:S112-S20.## Haihong W, Qiao C, Hao M, et al. Relationship between sleep duration, screen viewing time, and the prevalence of overweight/obesity among primary school students in Xuzhou. Chinese Journal of Health Management. 2018;12(5):431-6.##Jantaratnotai N, Mosikanon K, Lee Y, et al. The interface of depression and obesity. Obesity research & clinical practice. 2017;11(1):1-10. Brault JJ, Dohm GL, Houmard JA. 22 Skeletal Muscle Metabolism and Obesity. Handbook of Obesity, Two-Volume Set. 2019:249.##Geeraerts X, Bolli E, Fendt S-M, et al. Macrophage metabolism as therapeutic target for cancer, atherosclerosis, and obesity. Frontiers in immunology. 2017;8:289.##Geeraerts X, Bolli E, Fendt S-M, et al. Macrophage metabolism as therapeutic target for cancer, atherosclerosis, and obesity. Frontiers in immunology. 2017;8:289## ##

The prediction of divorce adjustment through emotional adjustment with emphasis on gender considerations پیش بینی سازگاری پس از طلاق از طریق سازگاری عاطفی با تاکید بر تفاوت های جنسیتی 2 1 مقدمه: با توجه به افزایش روز افزون طلاق در ایران ، مطالعه حاضر با هدف بررسی پیش بینی سازگاری با طلاق از طریق سازگاری هیجانی و تأکید بر ملاحظات جنسیتی انجام شد. روش ها: این مطالعه از نوع همبستگی بوده و داده ها از طریق پرسشنامه جمع آوری شد. جامعه آماری کلیه زنان و مردان مطلقه شهر تهران در سال 2017 و روش نمونه گیری هدفمند بوده است. نمونه شامل 112 زن مطلقه و 134 مرد مطلقه با محدوده سنی 20 تا 40 سال بود. برای جمع آوری داده ها از مقیاس تعدیل طلاق فیشر (FDAS) (1) و اندازه گیری تعدیل عاطفی (EMA) (2) استفاده شد. برای تجزیه و تحلیل داده ها از ضریب همبستگی پیرسون، رگرسیون چند متغیره و تحلیل واریانس چند متغیره استفاده شد. یافته ها: نتایج نشان داد که بین سازگاری هیجانی  و سازگاری با طلاق همبستگی مثبت و معنی داری وجود دارد (01 / 0p <، r=0/29) و مردان در این عوامل نمرات بالاتری نسبت به زنان دارند. همچنین، سازگاری هیجانی پیش بینی کننده مهمی برای سازگاری با طلاق بود (720/0=  β ، 01 / 0p <). نتیجه گیری: نتایج این مطالعه مجموعه ای از بحران های پس از طلاق را نشان می دهد که نیاز به مدیریت و ترمیم توسط افراد مطلقه دارد. اگرچه چالش های زندگی پس از طلاق بر هر دو جنس تأثیر می گذارد، اما زنان به دلیل موانع جنسیتی در زمان پس از طلاق با آسیب بیشتری روبرو هستند. بنابراین ، برنامه هایی برای افزایش سازگاری هیجانی پس از طلاق توصیه می شود. همچنین برای روشن شدن طلاق بهتر است این پدیده از جنبه های مختلف مورد توجه قرار گیرد. 2 Introduction: In the growing number of divorces in Iran, the present study aimed to investigate the prediction of divorce adjustment through an emotional adjustment emphasizing gender considerations. Methods: The present study was a correlation study, and data were collected through questionnaires, field study, and library. The statistical population was all divorced women and men in Tehran city in 2017, and the sampling method was purposeful. The sample included 112 divorced women and 134 divorced men with an age range of 20-40 years. For data collection, the Fisher Divorce Adjustment Scale (FDAS) (1) and Emotional Adjustment Measure (EMA) (2) were used. Pearson correlation coefficient, multivariate regression, and multivariate analysis of variance method were used for data analysis. Results: The results showed that there is a positive and significant correlation between emotional adjustment and divorce adjustment (p<0.01, r=.29), and men have higher scores than women in these factors; also, emotional adjustment was a significant predictor of divorce adjustment (β=0.720, p<0.01). Conclusion: The results of this study reveal a series of post-divorce crises requiring management and restoration by divorced subjects. Although the challenges of life after divorce affect both sexes, women are faced with more harm in post-divorce time due to gender barriers. Therefore, programs to help increase emotional compatibility after divorce is recommended. Also, clarification of the divorce phenomenon is better to be considered from different aspects.   185 194 2020/05/172018/09/6 1397/6/15 2021/03/202021/07/19 1400/4/28 آسیه افتخاری asie eftekhari Department of Clinical Psychology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Iran asie.eftrkhari@gmail.com Divorce adjustment Emotional Gender طلاق سازگاری عاطفی جنسیت 1. Akavan Takhti, M. Divorce consequences in transition of its stages. Women’ study.2005 ;1(3): 125-152. [Persian]##2. Allerstein, S.; Kelly, B. Surviving the breakup: How children and parents cope with divorce. 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Investigating the effectiveness of group training based on reforming schema in improving individual and social health of mothers with parenting problems بررسی اثربخشی آموزش گروهی مبتنی بر اصلاح طرحواره‌ در بهبود سلامت روانی فردی و اجتماعی مادران دارای مشکل فرزندپروری 2 1 چکیده مقدمه و هدف: با توجه به اهمیت نقش مادر در خانواده، شناسایی طرحواره‌های ناسازگار اولیه آن‌ها می‌‌‌تواند به ما کمک کند تا مشکلاتی که منجر به روش‌های‌ تربیتی ناسالم می‌‌‌شود را شناسایی کرده و با آموزش‌های لازم در جهت بهبود آن‌ها، اقدامات لازم را انجام دهیم. پژوهش حاضر با هدف بررسی اثربخشی آموزش گروهی مبتنی بر طرحواره در بهبود سلامت روان مادران دارای مشکل فرزندپروری انجام گردیده است.  روش کار: در این پژوهش از روش شبه‌آزمایشی (پیش‌آزمون، پس‌آزمون با گروه کنترل) استفاده شده است. جامعه‌ی آماری عبارت است از، کلیه‌ی مادرانی که با مشکل فرزندپروری در دو سال اخیر به مرکز پیشگیری از آسیب‌های اجتماعی مراجعه کرده‌اند. روش نمونه‌گیری در این پژوهش از نوع  غیر تصادفی بود. در این پژوهش 100 نفر از مادران مراجعه‌کننده به مرکز پیشگیری از آسیب‌های اجتماعی، از طریق روش غیر تصادفی در دسترس انتخاب ‌شدند ‌و پرسشنامه‌ی سلامت عمومی (GHQ)، به عنوان پیش‌آزمون روی آنها اجرا گردید. سپس 24 نفر از کسانی که کمترین نمره را به دست آورده‌اند به صورت تصادفی در دو گروه 12 نفره آزمایش و کنترل جایگزین شدند. گروه آزمایش، آموزش اصلاح طرحواره را در 10 جلسه 90 دقیقه‌ای دریافت کرد، در حالیکه گروه کنترل هیچ‌گونه آموزشی دریافت نکرد. سپس از هر دو گروه پس‌آزمون گرفته شد و نتایج دو گروه با هم مقایسه شد. نتایج: برای آزمون فرضیه‌ها از آزمون تحلیل کوواریانس استفاده شد. نتایج نشان داد که بین گروه آزمایش و کنترل در هر دو متغیر سلامت روانی فردی و سلامت روانی اجتماعی تفاوت معناداری وجود دارد(001/0 > p). بنابراین فرضیه های 1 و 2  در این پژوهش تایید می شوند. به عبارت دیگر، مقایسه میانگین های دو متغیر، در پس آزمون گروه های آزمایش و گواه نشان می دهد. گروه مادرانی که آموزش گروهی مبتنی بر اصلاح طرحواره‌  داشته اند در پس آزمون،  سلامت روانی فردی و اجتماعی بهتری داشته اند. یافته‌ها نشان داد که با 95 درصد اطمینان می‌‌‌توان گفت آموزش اصلاح طرحواره بر افزایش سلامت روانی فردی و اجتماعی مادران دارای مشکل فرزندپروری مؤثر می‌باشد. 2 Introduction: Due to the important role of the mothers in the families, identifying their early maladaptive schema can help us identify the problems that lead to unhealthy life education and provide the necessary and appropriate training programs to improve them. This study uses group training to reform schema in improving mothers' individual and social mental health who consulted the social damage prevention center. The purpose of the study was to determine the effectiveness of reforming schema on a mothers' problems. Methods: In this study, the quasi-experimental method was used. The study population was all the mothers who had parenting problems in the last two years and have consulted the social damage prevention center.  Nonrandom sampling was used for our statistical census. Therefore, 100 mothers at hand were selected nonrandomly, and the General Health Questionnaire (GHQ) was conducted on them as a pre-test. Then, 24 mothers who obtained the lowest scores were randomly divided into two groups: experimental and control, in each of which there were 12 participants. The experimental group received training in 10 sections for 90 minutes, while the control group did not receive any training.  Afterward, a post-test was conducted for each group, and the results of the two groups were compared. Results:  A covariance analysis test was used to test the hyper hypotheses. The results showed a significant difference between the experimental and control groups in the individual's mental health and social mental health variables (p < 0.001). Thus, hypotheses 1 and 2 were approved in our study. In other words, the comparison of the average in two variables after the post-test of experimental and control groups showed that mothers trained according to reforming schem, had better social and mental health. With approximately 90%, it can be said that the training based on reforming schema effectively increases the social and individual health of the mothers challenging with parenting problems. 195 204 2020/05/172018/09/62020/11/28 1399/9/8 2021/03/202021/07/192021/07/19 1400/4/28 رضا جعفری ندوشن Rzea Jafari Nodoushan Department of Health, Safety and Environment Mangment, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran jafarinodoushan@gmail.com ویدا سادات انوشه vida sadat anoosheh Department of Occupational Health and Ergonomics, School of Health, Shiraz University of Medical Sciences, Shiraz , Iran Iran anooshehvida@gmail.com مهدیه شفیعی زاده بافقی Mahdieh Shafiezadeh Bafghi Occupational Health Research Center, Department of Health, Safety and Environment, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran محمد علی برزگر Mohammad Ali Barzegari BSc of Occupational Health Engineering, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran علی جعفری Ali Jafari Department of Psychology of Islamic Azad University, Ashkezar Branch, Ashkezar, Yazd, Iran Iran حجت دمیری Hojat Damiri Department of Psychology of Islamic Azad University, Ashkezar Branch, Ashkezar, Yazd, Iran Iran anoosehvida@gmail.com اعظم حسینی هنزایی Azam Hosseini Hanzaei MSc Student of Clinical Psychology, Faculty of Psychology and Educational Sciences, Islamic Azad University od Yazd, Yzad, Iran Iran anooshehvida@gmail.com : Reforming schema Mental health Mothers' problems اصلاح طرحواره سلامت روان مادران دارای مشکل فرزندپروری 1. 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Factors Impacting Why Women Stay in Marital Life with Substance dependent Husbands: A Grounded Theory Study عوامل مؤثر بر ماندگاری همسران افراد معتاد در ازدواج: مطالعه داده بنیاد 2 1 چکیده مقدمه: سوء مصرف مواد یکی از عوامل اصلی منجر به طلاق در ایران است. بنابراین ، این مطالعه با هدف ارائه مدلی کیفی از عوامل  موثر بر ماندگاری در ازدواج زنان با همسران وابسته به مواد انجام شد. روش ها: از نظریه داده بنیاد در پارادایم کیفی استفاده شد. 20 نفر (10 زن و 10 متخصص) بر اساس اشباع نظری ، نمونه گیری هدفمند و گلوله برفی و مصاحبه عمیق نیمه ساختار یافته مصاحبه شدند. مصاحبه ها با استفاده از روش مقایسه ای دایم مورد تجزیه و تحلیل قرار گرفت. یافته ها: میانگین سن شرکت کنندگان برای زنان( M=35.2, SD=7.40, n=10 )، و برای متخصصان (M= 37.3, SD= 7.42, n=10) بود. نیمی از متخصصین  مرد و نیمی زن بودند. نتایج نشان داد که شرایط علّی شامل این موارد بود: فرزند به عنوان مانعی برای ترک رابطه ؛ احساس رضایت از رابطه زناشویی ؛ نگرش ها ، انتظارات و احساسات همسران ؛ رفتارهای امیدوار کننده شوهر ؛ وابستگی مالی به شوهر و میزان اختلال مربوط به مواد. شرایط مداخله گرشامل نقش خانواده مبدا بود. راهبردهای بقاء زنان در زندگی زناشویی شامل استفاده از منابع حمایتی ، افزایش آگاهی و استفاده از رفتارهای سازنده بود. شرایط زمینه ای عوامل اجتماعی و حقوقی بودند. پیامدهای مقوله اصلی (سفری با ترس و امید) ، احساسات و تجربیات مطلوب و نامطلوب بود. نتیجه گیری: نتایج نشان داد که همسران شوهران وابسته به مواد ، نه تنها به دلیل موانعی مانند عوامل خانوادگی ، اجتماعی ، حقوقی و مالی ، بلکه به دلیل منابع حمایتی ، رضایت زناشویی و داشتن خانواده با همسر و فرزندان ، در ازدواج خود باقی می مانند.   کلیدواژه ها: وابستگی به مواد ، همسران ، ازدواج ، نظریه داده بنیاد ، تحقیقات کیفی 2 Abstract Introduction: Substance abuse is one of the major factors leading to divorce in Iran. Therefore, this study aimed to present a qualitative model of factors affecting women to stay married with substance-dependent husbands. Methods: The grounded theory in the qualitative paradigm was used. Twenty participants (10 women and 10 experts) were interviewed based on theoretical saturation, purposeful, and snowball sampling, and semi-structured in-depth interviews. The interviews were analyzed using the constant comparative method. Results: The participants’ mean age for women was (M=35.2, SD=7.40, n=10) and for experts was (M= 37. 3, SD= 7.42, n=10), half of whom were men and half were women for experts.  The results indicated that causal conditions consisted of the child as a barrier to leaving the marital relationship; feeling satisfied with the marital relationship; the attitudes, expectations, and feelings of the spouses; promising behaviors of the husband; financial dependency on the husband, and level of substance-related disorder. The intervening condition was the family of origin’s role. The women's survival strategies in marital life include the use of supportive resources, increasing awareness, and the use of constructive behaviors. The contextual conditions were social and legal factors. Consequences of the core category (A journey with fear and hope), were desirable and undesirable emotions and experiences. Conclusion: The results indicated that spouses of substance-dependent husbands stay in the marriage, not just due to obstacles like familial, social, legal, and financial factors, but also due to resourceful supports, marital satisfaction, and enjoy having a family with husband and children.   Keywords: Substance Dependency, Wives, Marriage, Grounded Theory, Qualitative Research 205 217 2020/05/172018/09/62020/11/282020/05/11 1399/2/22 2021/03/202021/07/192021/07/192021/07/19 1400/4/28 فرحناز رستمی farahnaz Rostami Department of Psychology, North Tehran Branch, Islamic Azad University, Tehran, Iran ایران farahnazrostami97@gmail.com الهام فتحی Elham Fathi Department of counseling, Hazrat-e Masoumeh University, Qom, Iran ایران fathielham@ymail.com ابوالفضل حاتمی ورزنه Abolfazl Hatami Varzaneh Department of counseling, Hazrat-e Masoumeh University, Qom, Iran ایران abolfazlhatami@yahoo.com منیژه دانشپور Manijeh Daneshpour Department of couple and family therapy, Alliant International University, California, USA امریکا mdaneshpour@alliant.edu Substance Dependency Wives Marriage Grounded Theory Qualitative Research همسران افراد معتاد ماندن در ازدواج نظریه داده بنیاد مطالعه کیفی 1. 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The Effect of Acceptance and Commitment Therapy on Hypochondria and Cognitive Emotion Regulation among Divorced Women اثربخشی درمان مبتنی بر تعهد و پذیرش بر اضطراب سلامت و تنظیم شناختی هیجان در زنان مطلقه 2 1 چکیده مقدمه: اضطراب سلامت یکی از ا اختلالات روانی است که کیفیت زندگی و سلامت روان زنان مطلقه را تحت تاثیر قرار میدهد. پژوهش حاضر با هدف بررسی اثربخشی درمان مبتنی بر تعهد و پذیرش بر اضطراب سلامت و تنظیم شناختی هیجان زنان مطلقه انجام شد. روش: روش پژوهش حاضر از نوع آزمایشی، با طرح پیش¬آزمون و پس‌‌آزمون با یک گروه آزمایش و یک گروه کنترل بود. جامعه آماری شامل زنان مطلقه ای بودکه تحت تاثیر مشکلات روانی ناشی از طلاق، در سال 1397به مراکز مشاوره شهر تهران مراجعه کردند. نمونه پژوهش شامل 30 نفر بود که به روش نمونه گیری هدفمند انتخاب و بصورت تصادفی در دو گروه آزمایش و کنترل گمارده شدند (هر گروه 15 نفر). ابزار پژوهش شامل پرسشنامه اضطراب سلامت و پرسشنامه تنظیم شناختی هیجان بود. گروه آزمایش تحت مداخله درمان مبتنی بر تعهد و پذیرش (ACT) (10 جلسه 90 دقیقه‌ای) قرار گرفتند؛ اما گروه کنترل هیچ‌گونه مداخله ای دریافت نکردند.  برای تجزیه و تحلیل داده ها از ضریب همبستگی پیرسون، آزمون لوین، آزمون شاپیرو ویلک و تحلیل کوواریانس چند متغیره MANCOVA) استفاده شد. سطح معنی داری مطالعه 0.05 در نظر گرفته شد. نتایج: میانگین و انحراف معیار  نمرات پس آزمون اضطراب سلامت در گروه آزمایش و کنترل به ترتیب 35.13±1.92 و 37.33±3.07 بود. نتایج نشان داد مداخله درمان مبتنی بر تعهد و پذیرش (ATC) بر کاهش اضطراب سلامت در زنان مطلقه تاثیر معنی دار داشت (P=0.04). همچنین رویکرد مداخله درمان در افزایش تنظیم هیجان مثبت در زنان مطلقه اثربخش بود( (P=0.01 نتیجه گیری: مداخله درمان مبتنی بر تعهد و پذیرش ضمن کاهش اضطراب و افزایش تنظیم هیجان در شرایط دشوار سازگاری روانی و اجتماعی را افزایش میدهد. همچنین آموزش ACT در کاهش مشکلات اجتماعی، تعاملی و اضطراب زنان مطلقه مفید می باشد. 2 Abstract Introduction: Hypochondriasis is a psychological disorder that affects divorced women's quality of life and mental health. The aim of this study was to investigate the effectiveness of acceptance and commitment therapy (ACT) on hypochondria and cognitive emotion regulation among divorced Women in Tehran. Methods: The method was experimental with a pre-test, post-test design, and a control group. In the present study, the research population includes divorced women who have been affected by divorce-related psychological problems and were referred to Tehran consultation centers in 2018. In this study, The sample consisted of 30 divorced women selected by purposive sampling and randomly divided into experimental and control groups (n= 15 each). The research tools included the Health Anxiety Inventory (HAI) and the Cognitive Emotion Regulation Questionnaire (CERQ). The ACT intervention was performed on the experimental group for ten 90-minute sessions. Pearson's correlation coefficient, Levene's test, Shapiro-Wilk test, and multivariate analysis of covariance (MANCOVA) were used to analyze the data. The significance level of the study was considered to be α=0.05. Results: The mean and standard deviation (SD) of hypochondria post-test scores in the experimental and control groups were 35.13±1.92 and 37.33±3.07, respectively. The results indicated that ACT decreased hypochondria in the women (P=0.04). Also, the intervention effectively increased positive emotion regulation in the women (P=0.01). Conclusion: In addition to decreasing anxiety and increasing emotion regulation ability under difficult situations, ACT can increase social and psychological adaptability. Also, ACT can effectively decrease interactive and stress and anxiety in divorced women. 218 225 2020/05/172018/09/62020/11/282020/05/112020/06/11 1399/3/22 2021/03/202021/07/192021/07/192021/07/192021/07/19 1400/4/28 حمیده ایری Hamideh Iri Department of Health Psychology, Khorramshahr International Branch, Islamic Azad University, Khorramshahr, Iran Iran irihamidh@gmail.com بهنام مکوندی Behnam Makvandi Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran Iran makvandi203@gmail.com سعید بختارپور Saeed Bakhtiarpour Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran Iran bakhtiyarpours@gmail.com فریبا حافظی Fariba Hafezi Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran Iran fhaffezi@gmail.com Anxiety Acceptance and Commitment Therapy Cognitive Emotion Divorce Hypochondriasis Women درمان اضطراب پذیرش و تعهد شناختی احساسات طلاق هیپوکندریازیس زنان 1. Amato PR. 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Effectiveness of Self-differentiation Training Based on Bowen’s Approach on Positive Feeling Towards Spouse in Married Women in Isfahan in 2019 اثر بخشی آموزش تفکیک خویشتن بر اساس رویکرد بوئن بر «احساسات مثبت نسبت به همسر» در زنان متأهل شهر اصفهان درسال1398 2 1 مقدمه: همچنان که تفکیک خویشتن فرایندی است که نشان دهنده استقلال فرد در بعد عاطفی و عقلانی می باشد و طی آن فرد یاد می گیرد به صورت مستقل تصمیم گیری نماید وبه صورت عقلانی عشق، احساس مثبت و صمیمیت داشته باشد، لذا هدف از پژوهش حاضر بررسی اثر بخشی آموزش تفکیک خویشتن  بوئن بر «احساسات مثبت نسبت به همسر» زنان شهر اصفهان می باشد. مواد و روش ها: این پژوهش، شبه آزمایشی با طرح پیش آزمون– پس آزمون با گروه کنترل و جامعه آماری شامل زنان متأهل مراجعه کننده به مراکز مشاوره شهر اصفهان در سال 1398بودند. نمونه گیری از نوع داوطلبانه بود. 30 زن انتخاب و به صورت تصادفی در دو گروه آزمایش و کنترل قرار گرفتند. هر دو گروه به پرسشنامه های اطلاعات دموگرافیک، احساسات مثبت نسبت به همسر (PFQ) پاسخ دادند. سپس آموزش تفکیک خویشتن بوئن به مدت 8 جلسه برای گروه آزمایش اجرا گردید. برای تجزیه و تحلیل داده ها از روش های آمار توصیفی و استنباطی(تحلیل کوواریانس) در سطح خطای (05/0) و نرم افزار 24 SPSS- استفاده شد. یافته ها: نتایج نشان داد آموزش تفکیک خویشتن بوئن براحساسات مثبت نسبت به همسر در زنان تأثیردارد (05/0P<)، به این معنی که آموزش تفکیک خویشتن باعث افزایش احساسات مثبت نسبت به همسر می شود. نتیجه گیری: با توجه به نتایج می توان گفت آموزش تفکیک خویشتن بوئن باعث افزایش احساسات مثبت نسبت به همسر در زنان شود؛ بنابراین می توان این آموزش را به عنوان روش مناسبی جهت مشکلات و مسائل زناشویی در نظر گرفت. 2 Introduction: As self-differentiation is a process that reflects one’s independence in the emotional and rational dimension, in which one learns to make independent decisions and to have a rational love, affection, and intimacy. This research aimed to study the effectiveness of self-differentiation training based on Bowen’s approach on positive feelings toward spouse in Married women in Isfahan. Methods: The research method was quasi-experimental with a pretest-posttest design conducted on the control group. The statistical population consisted of counseling applicant women in the city of Isfahan in 2019. Sampling was voluntary. The announcement was installed at counseling centers, and 30 women were randomly placed into control and experiment groups. All participants filled out demographic and Positive Feeling (PFQ) questionnaires. Then, participants of the experiment group were trained in Bowen’s self-differentiation in eight sessions. Data analysis was carried out using descriptive (Mean and standard deviation) and inferential statistical methods (analysis of covariance) at the error level of 0.05 and SPSS-24 software. Results: The results indicated that teaching Bowen’s self-differentiation significantly affected women’s positive feelings towards the spouse (p<0.05), which means that the differentiation training increases the positive feeling towards the spouse. Conclusion: According to the results, teaching Bowen’s self-differentiation can increase positive feelings towards spouses in women. Therefore, this technique can be considered a marital problem.   226 234 2020/05/172018/09/62020/11/282020/05/112020/06/112020/08/4 1399/5/14 2021/03/202021/07/192021/07/192021/07/192021/07/192021/07/19 1400/4/28 فریبا سعادت مهر Fariba Saadat mehr Department of Psychology, KhomeiniShahr Branch, Islamic Azad University, KhomeiniShahr, Isfahan ,Iran Iran faribasaadatmehr@gmail.com سحر خانجانی وشکی sahar khanjani Veshki Department of Counseling, Faculty of Humanities, Arak University, Arak, Iran Iran s-khanjani@araku.ac.ir Self-differentiation Bowen’s approach Positive Feeling Towards Spouse Married Women تفکیک خویشتن رویکرد بوئن احساسات مثبت نسبت به همسر زنان متأهل 1. Yannai A, Gonczarowski A, Nisan N, et al. A stable marriage requires communication. Games and Economic Behavior. 2019; 1(119):1-32##2. Ahmadi, S. Investigating the necessity and importance of marriage and family formation. 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Most Frequently Affected Body parts in Road Traffic Accidents Reporting to the Accident and Emergency Department of the Largest Tertiary Care hospital of Karachi in 2019 2 1 there is no abstract 2 Introduction Injuries sustained during Road Traffic Accidents (RTAs) amounts to a serious public health crisis. The aim of the study was to determine the body parts most likely affected in an RTA in patients brought to Accident and Emergency (A&E) department of Jinnah Postgraduate Medical Centre (JPMC), the largest tertiary care hospital of Karachi. Method A descriptive cross-sectional study was done in January-March 2019 among 371 respondents aged 15-65 years. Study participants were recruited through non-probability convenience sampling. A structured questionnaire was used to collect data on sociodemographic variables and type, severity and nature of injury. Chi Square test was used to determine the significant difference between using safety precautions with body parts affected. All analysis was performed on SPSS version 20. Results Out of 371 study participants, 64.4% (n=239) were between 15-35 years with 91.9% (n=338) males. In 77.1% (n=286) cases, emergency medical services responded in less than one hour and first aid was provided by doctor to 95.7% (n=355) at hospital. In 82.5% (n=306) cases, private vehicles were involved, with 46.1% (n=171) motorcycles. In 79.8% (n=296) cases, bone injury was prevalent, with 57.1% (n=212) leg injuries, which was the most frequently affected body part. Majority, 56.2% of the study participants who did not wear seat belts had chest area affected (p=0.006).  Conclusion It is concluded that males of 15-35 years who were motorcyclists were more prone to RTAs with lower limbs more frequently being affected. 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The Relationship between Body Image Dissatisfaction and New Anthropometric Indices in Women Referred to the Nutrition Clinic in Northwest of Iran, Ardabil City, 2019 ارتباط بین نارضایتی از تصویر بدنی و شاخص‌های تن‌سنجی جدید در زنان مراجعه کننده به کلینیک تغذیه در شمال غرب ایران، شهر اردبیل، 1398 2 1 چکیده اهداف: پژوهش­های اخیر، شیوع بالای نارضایتی از تصویر بدنی را در زنان نشان داده است. هدف مطالعه حاضر، بررسی رابطه بین عدم رضایت از تصویر بدنی و شاخص­های تن­سنجی جدید در زنان بود. روش کار: یک مطالعه مقطعی روی 384 زن  مراجعه کننده به کلینیک تغذیه در شهر اردبیل در سال 98 به روش نمونه­گیری در دسترس انجام شد. داده­ها از طریق تکمیل پرسشنامه­های چند بعدی نگرش فرد در مورد تصویر بدنی خود و اندازه­گیری­های تن­سنجی جمع آوری شد. این پرسشنامه 69 سوالی یک ارزیابی نگرشی از تصویر بدنی است که پاسخ-ها در قالب لیکرت 5 گزینه­ای موافق- مخالف جمع آوری می­شود. برای بررسی رابطه بین متغیرها از ضریب همبستگی پیرسون استفاده شد. یافته ­ها: میانگین سنی و نمایه توده بدنی زنان مورد مطالعه به ترتیب 20/7±01/30 (سال) و 17/5±21/30 ( کیلوگرم بر متر مربع) بود. تحلیل همبستگی نشان داد که یک رابطه معنی­دار مثبت بین همه شاخص­های تن­سنجی با خرده مقیاس­های وزن ذهنی و دل­مشغولی با اضافه وزن وجود داشت. بزرگترین رابطه خرده مقیاس وزن ذهنی به ترتیب با نمایه توده بدنی، دور کمر و نسبت دور کمر به قد (85/0 r= و 001/0>p) و شـــاخص حجـــم شـــکمی (82/0 r= و 001/0>p) به دست آمد. بزرگترین رابطه خرده مقیاس دل­مشغولی با اضافه وزن به ترتیب با دور کمر (44/0 r= و 001/0>p)، شـــاخص حجـــم شـــکمی و وزن(42/0 r= و 001/0>p)، و نسبت دور کمر به قد (41/0 r= و 001/0>p) وجود داشت. نتیجه­ گیری: نارضایتی از تصویر بدنی با شاخص­های تن سنجی ارتباط داشت. این نتایج نیاز به مداخلات و اجرای برنامه هایی را برای بهبود شاخص­های تن سنجی و در نتیجه نارضایتی از تصویر بدنی نشان می­دهند. 2 Abstract Introduction: Recent studies have shown a high prevalence of body image dissatisfaction in women. This study purposed to examine the relationship between body image dissatisfaction and new anthropometric indices in women. Methods: A cross-sectional study was done among 384 women referred to the nutrition clinic in Ardabil city in 2019, using convenience sampling method. Data were collected through multidimensional body self-relations questionnaires and anthropometric measurements. This questionnaire is an attitudinal assessment of body image, using a 5-point disagrees–agree Likert scale to collect responses. Data was analyzed using SPSS software (version 21). The Pearson correlation coefficient was used to investigate the relation between body image dissatisfaction and anthropometric indices. The significance level was less than 0.05. Results: The mean age and body mass index (BMI) of the women under study were 30.01±7.20 years and 30.21±5.17kg/m2, respectively. Correlation analysis presented that a significant positive relationship was between all anthropometric indices and the subjective weight and overweight preoccupation subscales. The highest relationship of subjective weight subscale was found with BMI, waist circumference, and waist-to-height ratio (WHtR) (r=0.85, p<0.001) followed by abdominal volume index (AVI) (r=0.82, p<0.001). The highest relationship of the overweight preoccupation subscale was obtained with waist circumference (r=0.44, p<0.001) followed by AVI and weight (r=0.42, p<0.001) and WHtR (r=0.41, p<0.001). Conclusion: Body image dissatisfaction was associated with anthropometric indices. The findings indicated the need for interventions designed to improve anthropometric indices and, consequently, body image dissatisfaction 243 250 2020/05/172018/09/62020/11/282020/05/112020/06/112020/08/42020/08/102020/08/26 1399/6/5 2021/03/202021/07/192021/07/192021/07/192021/07/192021/07/192021/07/192021/07/19 1400/4/28 فاطمه قنادی اصل Fatemeh Ghannadiasl Department of Food Sciences and Technology, Faculty of Agriculture and Natural Resources, University of Mohaghegh Ardabili, Ardabil, Iran ایران ghannadiasl@uma.ac.ir ندا حسینی Neda Hoseini Department of Food Sciences and Technology, Faculty of Agriculture and Natural Resources, University of Mohaghegh Ardabili, Ardabil, Iran ایران nedahoseini.student@gmail.com Anthropometric Indices Body Image Dissatisfaction Women شاخص‌های تن‌سنجی نارضایتی از تصویر بدنی زنان 1. Weinberger NA, Kersting A, Riedel-Heller SG, et al. Body dissatisfaction in individuals with obesity compared to normal-weight individuals: a systematic review and meta-analysis. Obesity Facts. 2016; 9(6): 424-41.##2. Pole M, Crowther JH, Schell J. Body dissatisfaction in married women: The role of spousal influence and marital communication patterns. Body Image. 2004; 1(3): 267-78.##3. Pinho LD, Brito MF, Silva RR, et al. Perception of body image and nutritional status in adolescents of public schools. Revista Brasileira de Enfermagem. 2019; 72: 229-35.##4. Zarshenas S, Houshvar P, Tahmasebi A. The effect of short-term aerobic exercise on depression and body image in Iranian women. Depression Research and Treatment. 2013.##5. Figueiredo RA, Simola-Ström S, Isomaa R, et al. Body dissatisfaction and disordered eating symptoms in Finnish preadolescents. Eating Disorders. 2019; 27(1):34-51.##6. Bahreynian M, Qorbani M, Motlagh ME, et al. Association of perceived weight status versus body mass index on adherence to weight-modifying plan among Iranian children and adolescents: The CASPIAN-IV study. Indian Pediatrics. 2015; 52(10):857-63.##7. Adetunji OJ, Olusola AI. Body image: A global health concerns among girls and women in developing countries. European Journal of Physical Education and Sport Science. 2018; 4(11): 76-86.##8. Tariq M, Ijaz T. Development of Body Dissatisfaction Scale for university students. Pakistan Journal of Psychological Research. 2015; 30(2): 305-22.##9. Quittkat HL, Hartmann AS, Düsing R, et al. Body dissatisfaction, importance of appearance, and body appreciation in men and women over the lifespan. Front Psychiatry. 2019;10:864##10. Fiske L, Fallon EA, Blissmer B, et al. Prevalence of body dissatisfaction among United States adults: Review and recommendations for future research. Eating Behaviors. 2014; 15(3):357-65.##11. Mintem GC, Horta BL, Domingues MR, et al. Body size dissatisfaction among young adults from the 1982 Pelotas birth cohort. European Journal of Clinical Nutrition. 2015; 69(1): 55-61.##12. Shoraka H, Amirkafi A, Garrusi B. Review of Body Image and some of Contributing Factors in Iranian Population. International Journal of Preventive Medicine. 2019;10:19. ##13. Ryding FC, Kuss DJ. The use of social networking sites, body image dissatisfaction, and body dysmorphic disorder: A systematic review of psychological research. Psychology of Popular Media. 2020: 9(4): 412–35.##14. Soohinda G, Sampath H, Mishra D, et al. Body image dissatisfaction in young Indian Men: Prevalence, psychosocial correlates, and the impact of sociocultural pressure. Indian Journal of Social Psychiatry. 2020; 36(2), 130.##15. ‌Green SP, Pritchard ME. Predictors of body image dissatisfaction in adult men and women. Social Behavior and Personality: An International Journal. 2003; 31(3): 215-22.‌##16. Nikniaz Z, Mahdavi R, Amiri S, et al. Factors associated with body image dissatisfaction and distortion among Iranian women. Eating Behaviors. 2016; 22: 5-9.‌##17. Pelegrini A, Sacomori C, Santos MC, Sperandio FF, et al. Body image perception in women: prevalence and association with anthropometric indicators. Revista Brasileira de Cineantropometria a Desempenho Humano. 2014; 16(1):58-65.##18. Legey S, Lamego MK, Lattari E, et al. Relationship among body image, anthropometric parameters and mental health in physical education students. Clinical Practice and Epidemiology in Mental Health. 2016; 12:177-87.##19. Pop CL. Association between Body Mass Index and Self Body Image Perception. Iranian Journal of Public Health. 2017; 46(12):1744-5.##20. Chen G, He J, Zhang B, et al. Body weight and body dissatisfaction among Chinese adolescents: Mediating and moderating roles of weight-related teasing. Current Psychology. 2019:1-9.##21. Morais ND, Miranda VP, Priore SE. Imagem corporal de adolescentes do sexo feminino e sua associação à composição corporal e ao comportamento sedentário. Ciência and Saúde Coletiva. 2018; 23: 2693-703.##22. Ribeiro-Silva RD, Fiaccone RL, Conceição-Machado ME, Ruiz AS, Barreto ML, Santana ML. Body image dissatisfaction and dietary patterns according to nutritional status in adolescents. Jornal de Pediatria. 2018; 94(2):155-61.##23. Silva D, Ferriani L, Viana MC. Depression, anthropometric parameters, and body image in adults: a systematic review. Revista da Associação Médica Brasileira. 2019; 65(5):731-8.##24. Ghannadiasl F. Assessing Anthropometric Changes during 8 Weeks Individualized Balanced Low Calorie Diet in Obese Women. Journal of Ardabil University of Medical Sciences. 2018; 18(3):310-7.##25. Rahati A. Evolutionary Study of body image and its relationship with self-esteem based on comparison between adolescent, middle age and old people. Tehran: Shahed University; 2004 (Dissertation).##26. 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Effect of Fall on Medical Costs among Elderly Inpatients; A Case-Study in Iran تاثیر سقوط بر هزینه خدمات درمانی سالمندان بستری:یک مطالعه موردی در ایران 2 1 چکیده: زمینه و هدف: سقوط عمده ترین و اصلی ترین علت آسیب های کشنده و غیرکشنده در سالمندان است. وقوع بالای سقوط در بیمارستان باعث ایجاد صدمات جدی، مصرف بالای خدمات پزشکی و تحمیل هزینه های بالا به بیمارستان و سیستم بهداشت و درمان میشود. این پژوهش با هدف بررسی تاثیر سقوط در سالمندان بستری در بیمارستان بر هزینه های خدمات پزشکی انجام گرفته است. روش بررسی: این مطالعه مقطعی و گذشته نگر بصورت مورد-شاهد در بیمارستان بوعلی سینا قزوین (سانترقلب) صورت گرفته است. پرونده 79 سالمند که در سالهای 1397-1394 دچار سقوط شدند به عنوان مورد و پرونده 79 سالمند با ویژگی های مشابه و بدون سقوط به عنوان شاهد در نظر گرفته شد. اطلاعات شامل سن، جنس، ویژگی های سقوط و هزینه های مرتبط با سقوط توسط فرم گزارش حوادث بیمارستانی، یرونده بیماران، گزارش پرسناری و سوابق بیماران گردآوری شد.  جهت مشاهده ارتباط بین متغیرها از آزمونc2 ، نرم افزار SPSS نسخه 22 جهت تحلیل داده ها و آزمون اماری paired sample t tes جهت تعیین تاثیر سقوط بر هزینه خدمات پزشکی، استفاده شد. یافته ها: هزینه کلیه خدمات دریافتی گروه مورد 458/030/453 تومان (1$=4250 Toman, year:2019) محاسبه شد که ازاین میزان، مبلغ 125/546/36 (06/8% ازهزینه کل) مربوط به خدمات دریافتی ناشی از صدمات سقوط بود. بیشترین مبالغ را به ترتیب خدمات درمانی (375/485/14 تومان- 63/39%)، تشخیصی (معادل 585/017/12تومان- 9/32%)، ویزیت (معادل863/496/7تومان- 51/20%) و مشاوره (معادل 302/546/2 تومان-7/6%) به خود اختصاص داده اند. اختلاف مبلغ میان دو گروه مورد وشاهد معادل150/065/31 تومان محاسبه شد. مقایسه مبالغ میان دو گروه مورد و شاهد نشان داد که سقوط سالمندانبه طور معناداری( p≤0.01 ) سبب افزایش هزینه های بیمارستان میشود. نتیجه گیری: نتایج پژوهش حاکی از آن است که آسیب های ناشی از سقوط درسالمندان بستری در بیمارستان سبب تحمیل اقدامات پزشکی،  افزایش طول مدت اقامت و در نتیجه افزایش هزینه های بیمارستان میشود 2 Objective: Falls are the main cause of injuries and death among the elderly and lead to using medical services. This study aimed to assess the effect of falls on medical costs among elderly inpatients. Methods: This retrospective cross-sectional study was done in a public hospital (heart center) in Qazvin, Iran. In this study, 79 medical records of the elderly who had experienced in-hospital falls and 79 medical records in control group with similar characteristics who had not experienced in- hospital falls during 2016-2019. The data, including the elderly age, sex, fall characteristics, and all hospital costs related to falls were gathered from hospital accident forms, medical records, nursing reports, and official data banks. The overall costs of services provided for fallen elderly were compared with the control group. The data were analyzed by SPSS software, version 22, using Chi-square and paired sample t-test. P<0.05 was considered statistically significant. Results: Total cost of all services provided for the elderly during their hospitalization was 106.596$ (base year: 2019, $1=42500 IRR), of this amount 8.600$ (8.06%) was related to the services due to in-hospital falls. The highest costs were related to treatment services (40%), diagnostic services (33%), visits (21%) and consultation (6%). The difference between the case and control groups was 7.310$. The elderly falls significantly increased medical costs by 8.06% (P≤0.01). Conclusions: Even falls that do not lead to serious injuries waste medical services and increase hospital costs by making changes in treatment methods and increasing the length of hospital stay.   251 263 2020/05/172018/09/62020/11/282020/05/112020/06/112020/08/42020/08/102020/08/262020/10/7 1399/7/16 2021/03/202021/07/192021/07/192021/07/192021/07/192021/07/192021/07/192021/07/192021/07/19 1400/4/28 افسانه فلاحی afsaneh fallahi Department of Health Services Administration, Science and Research Branch, Islamic Azad University, Tehran, Iran Iran Afsaneh.fallahi@srbiau.ac.ir لیلا ریاحی leila riahi Department of Health Services Administration, Science and Research Branch, Islamic Azad University, Tehran, Iran ایران l.riahi@srbiau.ac.ir انیسه نیک روان aniseh nikravan Department of Health Services Administration, Science and Research Branch, Islamic Azad University, Tehran, Iran ایران a.nikravan@srbiau.ac.ir Elderly fall Cost Medical services سالمندی سقوط هزینه خدمات پزشکی بستری مورد- شاهد 1. Salminen MJ, Vahlberg TJ, Salonoja MT, Aarnio PT, Kivelä SL. Effect of a risk‐based multifactorial fall prevention program on the incidence of falls. Journal of the American Geriatrics Society. 2009 Apr;57(4):612-9..##2. Tromp AM, Pluijm SM, Smit JH, Deeg DJ, Bouter LM, Lips PT. Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. Journal of clinical epidemiology. 2001 Aug 1;54(8):837-44.##3. Stevens JA, Ballesteros MF, Mack KA, Rudd RA, DeCaro E, Adler G. Gender differences in seeking care for falls in the aged Medicare population. American journal of preventive medicine. 2012 Jul 1;43(1):59-62.##4. Azadi A, Bastami M, Mmalek M. Effect of Fall-Preventive Program on Fear of Falling, Falling Frequency, and Quality of Life in the Elderly Living in Nursing Homes. Iranian Journal of Nursing Research. 2017 Oct 10;12(4):68-75.##5. NHS Improvement. The incidence and costs of inpatient falls in hospitals. London: NHS Improvement; 2017. Available from: https://improvement.nhs.uk/documents/1471/Falls_report_July2017.v2.pdf.##6. Worapanwisit T, Prabpai S, Rosenberg E. Correlates of falls among community-dwelling elderly in Thailand. Journal of aging research. 2018 May 24;2018.##7. Statistical Center of Iran. Population and Housing Censuses. Tehran: Statistical Center of Iran. Available from: https://www.amar.org.ir/english/Population-and-Housing-Censuses##8. World Health Organization. WHO global report on falls prevention in older age. Geneva: World Health Organization; 2008. Available from: https://apps.who.int/iris/handle/10665/43811##9. Najafi Ghezlcheh T, Ariapour S, Jafari Oori M. Epidemiology and relationship of fall and fear of falling in the elderly residing at Kamrani nursing home, Tehran, Iran. Iranian Journal of Ageing. 2016 Jan 10;10(4):152-61. ##10. King T. Helping baccalaureate nursing students care for the wellbeing of older adults. International journal of nursing education scholarship. 2005 Jun 29;2(1).##11. Fields J, Alturkistani T, Kumar N, Kanuri A, Salem DN, Munn S, Blazey-Martin D. Prevalence and cost of imaging in inpatient falls: the rising cost of falling. ClinicoEconomics and outcomes research: CEOR. 2015;7:281. ##12. Currie L. Fall and injury prevention. 2008. In: Patient Safety and Quality: An Evidence-Based Handbook for Nurses (Internet). Rockville, Maryland: Agency for Healthcare Research and Quality (US). Available from: https://www.ncbi.nlm.nih.gov/books/NBK2653/.##13. Hitcho EB, Krauss MJ, Birge S, Claiborne Dunagan W, Fischer I, Johnson S, Nast PA, Costantinou E, Fraser VJ. Characteristics and circumstances of falls in a hospital setting: a prospective analysis. Journal of general internal medicine. 2004 Jul;19(7):732-9. ##14. Tian Y, Thompson J, Buck D, et al. Exploring the System-Wide Costs of Falls in Older People in Torbay. London: The King's Fund; 2013. ##15. Florence CS, Bergen G, Atherly A, Burns E, Stevens J, Drake C. Medical costs of fatal and nonfatal falls in older adults. Journal of the American Geriatrics Society. 2018 Apr;66(4):693-8. ##16. Homann B, Plaschg A, Grundner M, Haubenhofer A, Griedl T, Ivanic G, Hofer E, Fazekas F, Homann CN. The impact of neurological disorders on the risk for falls in the community dwelling elderly: a case-controlled study. BMJ open. 2013 Nov 1;3(11).##17. Carroll NV, Slattum PW, Cox FM. The cost of falls among the community-dwelling elderly. Journal of Managed Care Pharmacy. 2005 May;11(4):307-16.##18. Wu S, Keeler EB, Rubenstein LZ, Maglione MA, Shekelle PG. A cost-effectiveness analysis of a proposed national falls prevention program. Clinics in geriatric medicine. 2010 Nov 1;26(4):751-66. ##19. Stolze H, Klebe S, Zechlin C, Baecker C, Friege L, Deuschl G. Falls in frequent neurological diseases. Journal of neurology. 2004 Jan 1;251(1):79-84.##20. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and non-fatal falls among older adults. Injury prevention. 2006 Oct 1;12(5):290-5. ##21. Alekna V, Stukas R, Tamulaitytė-Morozovienė I, Šurkienė G, Tamulaitienė M. Self-reported consequences and healthcare costs of falls among elderly women. Medicina. 2015 Feb;51(1):57-62. ##22. Hartholt KA, Polinder S, Van der Cammen TJ, Panneman MJ, Van der Velde N, Van Lieshout EM, Patka P, Van Beeck EF. Costs of falls in an ageing population: a nationwide study from the Netherlands (2007–2009). Injury. 2012 Jul 1;43(7):1199-203.##23. Morello RT, Barker AL, Watts JJ, Haines T, Zavarsek SS, Hill KD, Brand C, Sherrington C, Wolfe R, Bohensky MA, Stoelwinder JU. The extra resource burden of in‐hospital falls: a cost of falls study. Medical journal of Australia. 2015 Nov;203(9):367. ##24. Fu D. Health service impacts and costs of falls in older age. Geneva: World Health Organization. Available from: http://www.who.int/entity/ageing/projects/4%20Health%20service%20impacts%20and%20costs%20of%20falls2.pdf.##25. Verma SK, Willetts JL, Corns HL, Marucci-Wellman HR, Lombardi DA, Courtney TK. Falls and fall-related injuries among community-dwelling adults in the United States. PLoS one. 2016 Mar 15;11(3):e0150939. ##26. Watson WL, Clapperton AJ, Mitchell RJ. The cost of fall-related injuries among older people in NSW, 2006–07. New South Wales public health bulletin. 2011 Jun 23;22(4):55-9. ##27. Paliwal Y, Slattum PW, Ratliff SM. Chronic health conditions as a risk factor for falls among the community-dwelling US older adults: a zero-inflated regression modeling approach. BioMed research international. 2017 Mar 28;2017.##28. Kelsey JL, Berry SD, Procter‐Gray E, Quach L, Nguyen US, Li W, Kiel DP, Lipsitz LA, Hannan MT. Indoor and outdoor falls in older adults are different: the maintenance of balance, independent living, intellect, and Zest in the Elderly of Boston Study. Journal of the American Geriatrics Society. 2010 Nov;58(11):2135-41. ##29. Torkaman Gholami J, Mohamadi Shahbolaghi F, Norouzi K. The Relationship between Fear of falling and Activity Limitations among Seniors of Ghaem Shahr City in 2013. Iranian Journal of Rehabilitation Research. 2015 Oct 10;2(1):45-52. ##30. Iran SCo. Population and Housing Census Results Year 2016: Institute for Scientific Research; 2016. Available from: http://www.sci.org##31. Chang NT, Chi LY, Yang NP, Chou P. The impact of falls and fear of falling on health-related quality of life in Taiwanese elderly. Journal of community health nursing. 2010 Apr 28;27(2):84-95. ##32. Scuffham P, Chaplin S, Legood R. Incidence and costs of unintentional falls in older people in the United Kingdom. Journal of Epidemiology & Community Health. 2003 Sep 1;57(9):740-4. ##33. Araújo E, Martins K, Lima R, et al. Concern with falls in elderly people attended in an Integral Attention Center. Rev Eletr Enf. 2016;18:e1186.##34. 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Appreciation by migrants of the health care assistance provided by apulian family doctors 2 2 Introduction: Health promotion is the highest level of human sensitivity directed to break down differences and produce equal opportunities for unselected people to enjoy the best health care potential. This study aimed to evaluate the quality of the assistance provided to immigrants by Italian general practitioners (GPs), the level of satisfaction declared by migrants, and the perception of GPs about the needs of migrants. Methods: A survey was conducted. Both immigrant patients (regular and illegal) and some Italian GPs filled a questionnaire. Ten GPs were selected among those available to perform the study by a convenience sampling method; the immigrants were consecutively included among those attending the medical offices. Results: Over 90% (n = 66) of immigrants declared to be fully satisfied with the overall assistance provided with easy access to care. GPs declared no problems in assisting even illegal immigrants and suggested the accurate evaluation of patients’ needs to provide successful care. Conclusions: These findings indicate the importance of promoting health and education as provided by Italian GPs. The satisfaction declared by the interviewed immigrants is mainly attributable to the model of assistance provided in Apulia, which includes interventions for any health problem 264 269 2020/05/172018/09/62020/11/282020/05/112020/06/112020/08/42020/08/102020/08/262020/10/72020/06/10 1399/3/21 2021/03/202021/07/192021/07/192021/07/192021/07/192021/07/192021/07/192021/07/192021/07/192021/07/19 1400/4/28 Ignazio Grattagliano Ignazio Grattagliano Italian College of General Practitioners, Bari, Italy Family Medicine and General Practice, English Medical Curriculum, University of Bari, Italy Italia studiomedico@grattagliano.it Filippo Anelli Filippo Anelli Italian College of General Practitioners, Bari, Italy Italian Federation of Doctors’ and Dentists’ Orders Italia anellif@gmail.com Family doctors Migrants Primary care Italian health service جامعه پزشکان عمومی مهاجران مراقبت های اولیه پوگی. 1. Delvino N. European Cities and Migrants with Irregular Status: Municipal initiatives for the inclusion of irregular migrants in the provision of services. Oxford: COMPAS 2017, available at: www.compas.ox.ac.uk/2017/european-cities- and-migrants-with-irregular-status/ ##2. Spencer S, Hughes V. Outside and In: Legal Entitlements to Health Care and Education for Migrants with Irregular Status in Europe. Oxford: COMPAS 2015. Available at: https://www.compas.ox.ac.uk/wp-content/uploads/PR- 2015-Outside_In_Mapping.pdf. The Annex to the report provides information on the entitlements in each Member State.##3. Kraus R. Different forms, reasons and motivations for return migration of persons who voluntarily decide to return to their countries of origin International migration (Geneva, Switzerland).1986; 24(1):49-59.##4. Baroudi M, Nkulu Kalengayi F, Goicolea I, et al Access of Migrant Youths in Sweden to Sexual and Reproductive Healthcare: A Cross-sectional Survey. International Journal of Health Policy and Management. 2020. ##5. Regione Puglia. Rules for the reception, civil coexistence and integration of immigrants in Puglia. Bollettino Ufficiale Regione Puglia 2009;196(32):1-19. https://www.isfol.it/sistema-documentale/banche-dati/normative/archivio/legge-4-dicembre-2009n.32/Puglia_Leggen.32del041209.pdf##6. WHO. Report of an International Conference on Health Promotion. Ottawa, Ontario, Canada. Health Promotion: An International Journal, 1986; 1(4i–v):405–460. https://bsahely.com/2018/09/ 12/the-ottawa-charter-for-health-promotion-who-1986/##7. Bil JP, Zuure FR, Alvarez-Del Arco D et al. Disparities in access to and use of HIV-related health services in the Netherlands by migrant status and sexual orientation: a cross-sectional study among people recently diagnosed with HIV infection. BMC Infect Dis. 2019;19(1):906. ##8. P Klein Asylum seekers and the healthcare situation. Internist (Berl). 2016;57(5):402-8.##9. Ponce-Blandón JA, Mérida-Martín T, Del Mar Jiménez-Lasserrotte M et al. Analysis of Prehospital Care of Migrants Who Arrive Intermittently at the Coasts of Southern Spain. International journal of environmental research and public health. 2020;17(6):1964 . ##10. Lazarus JV, Baker L, Cascio M et al Novel health systems service design checklist to improve healthcare access for marginalized, underserved communities in Europe. BMJ Open. 2020;10(4):e035621.## ##

Effect of ambient temperature on spread of COVID-19: A Systematic Review تأثیر دمای محیط بر گسترش COVID-19: یک مرور سیستماتیک 2 1 چکیده  مقدمه: تاکنون تعداد زیادی از افراد در سراسر جهان به بیماری کرونا مبتلا شده اند و تقریباً همه کشورها موارد ابتلا و موارد مرگ را گزارش کرده اند. برخی مطالعات نشان داده اند که ویروس کرونا به دمای هوا حساس است و در دمای بالا گسترش بیماری کاهش می یابد. این مطالعه با  انجام مرور نظام مند به بررسی تاثیر دما بر انتشار COVID-19 می پردازد. روش کار: در این مطالعه ، جستجو در سه پایگاه داده الکترونیکی علمی اصلی ، از جمله Scopus ، PubMed ، Web of Science و همچنین Scholar Google در 14 آوریل 2020 برای یافتن مطالعات مرتبط با کووید-19 و گسترش آن در دماهای مختلف محیط انجام شد. یافته ها: در مجموع 588 مقاله برای غربالگری و 27 مقاله برای استخراج داده ها انتخاب شد. نتیجه برخی از این مطالعات نشان داد که تغییرات آب و هوایی می تواند بر انتقال ویروس کرونا تأثیر بگذارد. دمای پایین و رطوبت کم ممکن است عوامل اساسی برای بقای ویروس کرونا باشند. ممکن است  این ویروس در دمای 4 درجه سانتی گراد شرایط  ایده آلی برای ادامه حیات داشته باشد و به دمای 70 درجه سانتی گراد نیز حساس باشد. بر اساس یافته های برخی از این مقاله های بررسی شده ، افزایش دمای سطوح فولاد ضد زنگ، چوب، پارچه ها و فلزات می تواند در از بین بردن کروناویروس ها موثر باشد. نتیجه گیری: این مطالعه مروری نتوانست تأثیردقیق دما یا رطوبت را برای جلوگیری از گسترش و انتقال ویروس گزارش دهد. لازم است مطالعات بیشتری در این زمینه با داده های بیشتری انجام شود تا الگوی دقیق انتقال با بررسی شرایط ویروس در شرایط مختلف آب و هوایی معرفی شود.     2 Abstract Introduction: So far, the so many people has been infected by novel coronavirus (SARS-CoV-2) in the worldwide and almost all the countries have reported infected and death cases. Some studies have shown that coronaviruses are sensitive to air temperature and in warm temperature the rate of spread decreases. This study aimed to review the literature whether or not the temperature can affect the spread rate of COVID-19.   Methods: In this study, three main scientific electronic databases, including Scopus, PubMed, Web of Science and also Google Scholar were searched on April 14, 2020 to find relevant studies on COVID-19 and its spread in different ambient temperature. Results: Totally 588 articles were found for screening and 27 articles were selected for data extraction. The result of some of these studies showed that weather variations can affect transmission of coronavirus. Low temperature and low humidity may be essential factors for survival of coronaviruses. A temperature of 4°C is ideal for the life of this virus and it may be sensitive to 70°C temperature. The increase in temperature of stainless steel, wood, fabrics, and metal can eliminate and remove coronaviruses according to the findings of some of these reviewed articles. Conclusion: This review study failed to precisely report the effect of temperature or humidity to stop the virus from spreading and transmitting. It is required to conduct more studies in this regard to introduce the exact pattern of transmission by examining the conditions of virus transmission in different climatic conditions. 270 280 2020/05/172018/09/62020/11/282020/05/112020/06/112020/08/42020/08/102020/08/262020/10/72020/06/102020/05/27 1399/3/7 2021/03/202021/07/192021/07/192021/07/192021/07/192021/07/192021/07/192021/07/192021/07/192021/07/192021/07/19 1400/4/28 احد حیدری Ahad Heyari Department of Health in Disaster and Emergencies, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran ایران heydariahad@gmail.com سعید فلاح Saeed Fallah-aliabadi Department of Health in Emergencies and Disasters, School of Public Health, Shahid Sadoughi University of Medical Science, Yazd, Iran Environmental Science and Technology Research Center, Department of Environmental Health Engineering, Shahid ایران sd.fallah@gmail.com پیمانه حبیبی Peymaneh Habibi Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran ایران Keywords: Systematic Review Coronavirus Temperature Environmental Factors بررسی نظام مند کرونا ویروس دما فاکتورهای محیطی 1. 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Moghadami M, Hassanzadeh M, Hedayati A, et al. Modeling for Corona Virus Outbreak in IRAN. medRxiv. 2020.##29. Ma Y, Zhao Y, Liu J, et al. Effects of temperature variation and humidity on the death of COVID-19 in Wuhan, China. Science of The Total Environment 2020;724:138226##30. Jamil T, Alam I, Gojobori T, et al. No Evidence for Temperature-Dependence of the COVID-19 Epidemic. 2020;8:436 ##31. Bannister-Tyrrell M, Meyer A, Faverjon C, et al. Preliminary evidence that higher temperatures are associated with lower incidence of COVID-19, for cases reported globally up to 29th February 2020. medRxiv. 2020.##32. Harbert RS, Cunningham SW, Tessler M. Spatial modeling cannot currently differentiate SARS-CoV-2 coronavirus and human distributions on the basis of climate in the United States. medRxiv. 2020.##33. Chin A, Chu J, Perera M, et al. Stability of SARS-CoV-2 in different environmental conditions. medRxiv. 2020.##34. Baker RE, Yang W, Vecchi GA, et al. 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An experimental study of the survival of turkey coronavirus at room temperature and+ 4° C. Avian pathology. 2013;42(3):248-52.##48. Altamimi A, Ahmed AE. Climate factors and incidence of Middle East respiratory syndrome coronavirus. Journal of Infection and Public Health. 2020;13(5):704-8##49. Simmering JE, Polgreen LA, et al. Weather-dependent risk for Legionnaires’ disease, United States. Emerging infectious diseases. 2017;23(11):1843.##50. Alghamdi IG, Hussain II, Almalki SS, et al. The pattern of Middle East respiratory syndrome coronavirus in Saudi Arabia: a descriptive epidemiological analysis of data from the Saudi Ministry of Health. International journal of general medicine. 2014;7:417.##51. van der Lans AA, Boon MR, Haks MC, et al. Cold acclimation affects immune composition in skeletal muscle of healthy lean subjects. Physiological reports. 2015;3(7):e12394.## ##