Background: Empathy is foundation of the positive physician and patient connection. Physician empathy and the patients' perceived of the physician's empathy can lead to a more positive clinical outcome. Empathy has identified as a main goal of instruct. Materials and Methods: A cross-sectional study employing a convenience sample of interns and their patients in hospitals in Kashan, Iran, 2018. The Jefferson Scale of Physician Empathy was completed by interns and their patients evaluated by completing the Jefferson Scale of Patient Perceptions of Physician Empathy. Results: The mean score of interns' empathy and the perception of patients' empathy was 72.65 ± 7.99, and 18 ± 3.07, that the mean score of interns' empathy is very low. The gender of interns had no significant effects on their empathy (P = 0.236), and there was no significant relationship between patient's perceived empathy with age (P = 0.3), sex (P = 0.651), and marital status. Statistically significant correlation was found between scores of interns' empathy and patients' perceived empathy (r = 0.49, P = 0.001). According to questionnaire (self-reported), the interns' empathy in surgical ward was significantly higher than the internal medicine wards (P = 0.01). However, according to self-assessment, the interns' empathy in wards was alike (0.08). There was no significant relationship between patients perceived empathy with different wards (0.92). Conclusion: Due to the low empathy score of interns, medical students should be trained on value-based curriculum. Also because the patients' empathy perception in the different wards was alike, the difference of interns' empathy is unimportant. Hence, in the future studies, perceived empathy by patients is more accurate.

Aims: Mental disorders such as depression, anxiety, and stress are important factors in determining the life quality as well as many social and economic problems in workers' life. The purpose of this study was to determine the frequency of psychological symptoms (depression, anxiety, and stress) among the examined workers in the periodic examinations of the medical centers of Kashan County during the 4-month period in 2018–2019. Materials and Methods: This cross-sectional study was conducted randomly on 154 workers examined in different industrial towns of Kashan County (5 areas). Data were collected using a DASS-42 questionnaire. Data were analyzed using SPSS 16 software, using Chi-square and Fisher's exact tests for qualitative variables and t-test and ANOVA test for data analysis of quantitative variables. Results: The symptoms of depression, anxiety, and stress were 18.83%, 33.12%, and 18.74%, respectively, in the present study. Moreover, the comparison of depression, anxiety, and stress with demographic variables showed a significant relationship between education level, employment type, and sex (P < 0.050). Conclusion: According to the results, workers' anxiety symptoms were more than depression and stress. Hence, it is essential to plan to identify such disorders in the workers to implement educational interventions and empowerment of these worthy people to increase mental health in the workplace.

Aims: Understanding students' attitudes and perceptions toward virtual education is important in successful development of e-learning in higher education. The purpose of this research is to investigate the tendency towards virtual education among students of Payame Noor University. Materials and Methods: This cross-sectional study was conducted in 2017 with the objective to find out perception of students about effective factors on their tendency towards virtual education. By applying Cochran formula for finite populations, sample size was calculated 92 students. Data were collected by a reliable and valid virtual education tendency questionnaire. Data was analyzed using SPSS software. Results: The results showed that the majority of respondents were in the age range of 20–29 years old and 53% of them were females. The majority of students (67%) believed that reducing visual communication was effective on the tendency toward virtual education. A lower percentage (30%), believed that the increase in students' academic level wasn't an effective factor in trend toward virtual education. overall 57% of students disagreed with the effect of reduction of costs on tendency towards virtual education. Conclusion: Most of the students stated that their tendency towards virtual education was due to the increase in their scientific level, it is suggested that the university authorities strengthen scientific foundations of the university. If so, more students are expected to enter virtual universities.

Aim: Psoriasis is a prevalent chronic skin disease, and evidence shows that psoriasis is considered as a risk factor for increased cardiovascular diseases. Consequently, this study purpose is an assessment of the relationship between psoriasis and carotid intima–media thickness (CIMT). Materials and Methods: The case–control study was conducted on 31 patients developed psoriasis, referred to the skin health-care centers of Kashan in 2016, and 31 healthy controls. Demographic data, disease duration, Psoriasis Area and Severity Index, and Carotid Artery Intima–Media Thickness were measured in each group of patients and compared. Data were entered into SPSS 16 software and analyzed using Chi-square, “Kolmogorov–Simonov” “Leven t-test,” univariate analysis of variance, and Pearson correlation tests. Results: The patients aged in case group was 10 ± 33 and in control group was 10 ± 32. CIMT values were obtained higher in patient group than in control group, but the difference was not significant (P = 0.44). CIMT results showed a significant increase in male than female patients (P = 0.02). In the present study, no relationship between CIMT and age of disease development and PASI index was observed which indicated the disease severity. Conclusion: In this study, according to the Pearson's correlation, a positive correlation was observed between the mean CIMT and age and also duration of the disease in patient group. Any correlation between psoriasis and CIMT and also between the CIMT and age of onset of the disease and PASI score was not found.

Aim: This study was conducted to observe the effectiveness of emotion regulation instruction on interpersonal problems among 10^th-grade female students in 2016–2017. Methodology: We used the quasi-experimental method and conducted pretests and posttests on the control group. Statistical population of this study is comprised of all 10^th-grade female students of Neyshabur (Khorasan Razavi Province). In this study, 30 female students were selected by multistage randomized cluster sampling. Then, they were randomly placed in the central and experimental groups (15 students in each group). Inventory of interpersonal problem questionnaire was used to measure the level of interpersonal problems among the students. The results of this questionnaire were confirmed and its Cronbach's alpha value was 0.88. We performed our emotion regulation instruction for the experimental group during 8 sessions that each lasted 90 min; these instruction sessions were held once a week, and the control group was also included in the list. At the end of these sessions, both the groups were reassessed. Results: The results of this study showed that there is a significant difference (P < 0.001) between the experimental and the control groups in the level of their interpersonal problems. Considering the level of emotion regulation effectiveness, we can allegedly claim that 87.6% of changes in interpersonal problems are a result of emotion regulation instruction. Conclusion: It seems that by instructing emotion regulation in schools, the level of interpersonal problems among students can be reduced. The emotion regulation as a model of behavior triggers social support for adolescents. Social support can lead to solve interpersonal problems. Implications of emotion regulation model for basic and clinical research on close relationships are discussed.

Aim: This study aimed to investigate the effectiveness of acceptance and commitment therapy on self-care and adherence to treatment in patients with type 2 diabetes. Materials and Methods: This study was a quasi-experimental research with pretest–posttest-follow-up and control group design. The sample of the present study consisted of 30 patients with type 2 diabetes referred to the health network of Asaluyeh city in the first half of the year 2019. The perceived self-efficacy scale for self-care and adherence to treatment questionnaire were used for data collection. Results: The results of the data analysis showed that acceptance and commitment therapy is effective in the self-care and adherence to treatment of patients with type 2 diabetes. Conclusion: Based on obtained results, it can conclude that acceptance and commitment therapy as a short term therapy has effective influences on self-care and adherence to treatment of patients with type 2 diabetes.

Background: Prolonged exposure to crystalline silica (CS) (SiO₂) dust enhances the production of reactive oxygen species. In many studies, oxidative stress has been measured in the serum of workers exposed to SiO₂dust. Aims: We investigated the body fluids such as urine, saliva, and serum, which can provide very good results for assessing the health status of workers' exposures to SiO₂dust. Materials and Methods: The oxidative stress biomarkers were evaluated in serum, urine, and saliva of 21 workers who were exposed to SiO₂silica crushing factories in the Hamadan city at the west of Iran as a case group and 28 controls. Results: The level of malondialdehyde in serum, urine, and saliva was significantly higher than that in case group compared to controls (22.19 ± 8.70, 9.86 ± 5.43, and 9.41 ± 7.31 nmol/L vs. 7.30 ± 2.22, 6.79 ± 3.21, and 3.93 ± 3.73 nmol/L, respectively). In addition, the total antioxidant capacity in urine (0.23 ± 0.06 vs. 0.29 ± 0.08 mmol/L), as well as catalase in the serum and saliva of case group was lower than that compared to control group (5.46 ± 1.56 and 1.32 ± 0.55 IU/L vs. 12.55 ± 5.72 and 2.32 ± 1.53 IU/L, respectively). Conclusions: The current study indicated that chronic exposure to SiO₂affects significantly on the oxidative stress biomarker levels in serum, urine, and saliva in persons exposed. Furthermore, SiO₂leads to the induction of oxidative stress and decreases the activity of the antioxidant enzyme.

Aim: Nowadays, in the industrial areas, there is a problem of simultaneous contamination of soil with heavy metals and lack of organic matter that can impede the growth of plants. Thus, this study was done to investigate the effect of organic amendments on decreases plant abiotic stress in a soil cocontaminated with lead (Pb) and cadmium (Cd) under ornamental sunflower cultivation. Materials and Methods: Treatments consisted of applying vermicompost (0, 15, and 30 t/ha) and soil polluted with Cd (0, 5, 10, and 15 mg/kg soil) and Pb (0, 400, and 600 mg/kg soil), and the plant used in this experiment was ornamental sunflower. After 8 weeks of the experiment, plants were harvested, and soil and plant Zn and Fe were measured using the atomic absorption spectroscopy. In addition, the ascorbate peroxidase (APX) and peroxidase (POX) of the plant were measured. Results: The application of 15 and 30 t/ha vermicompost significantly depressed the APX and POX activity by 12.1% and 14.6%, respectively. While the plant Fe and Zn concentration was significantly increased by 11.1% and 13.6%, respectively. Increasing soil pollution to Cd to 15 mg/kg soil significantly increased the APX and POX enzyme activities of the sunflower by 14.6% and 13.3%, respectively. Conclusion: It can be concluded that the interaction effect of Fe and Zn with heavy metal can help to decrease the plant abiotic stress that is a positive point in the environmental research. However, the role of organic amendments in decreasing heavy metals availability cannot be ignored.

Aims: The aim of the present study was to investigate the mediating role of emotion regulation and intolerance of uncertainty (IU) in the relationship between childhood maltreatment and nonsuicidal self-injury (NSSI) in adolescents. Materials and Methods: In this descriptive correlational study, 700 high school students studying in 2018–2019 from Kashmar were selected by multistage cluster sampling. The final analysis was performed on the 292 students who have at least once engaged in NSSI. Research tools include Deliberate Self-Harm Inventory, Child Abuse of Self-Report Scale, Difficulties in Emotion Regulation Scale, and Intolerance of Uncertainty Scale. Data were analyzed by structural equation modeling. Results: The findings showed that emotion regulation and IU mediate the relationship between childhood maltreatment and NSSI. Conclusions: The findings confirmed the mediating role of emotion regulation and IU in the relationship between childhood maltreatment and NSSI. As a result, it is crucial that specialists and therapists take these variables into account when dealing with adolescent students in counseling and treatment centers.

Aims: Psychological stress at workplace plays an important role in employees' well-being and performance. The prevalence of suspected employees suffering from psychological stress and factors influencing it was studied at a major regional manufacturer of tiles in Kashan, Central Iran, where employees often struggled with the harsh working conditions. Materials and Methods: This cross-sectional study was conducted on all 263 male employees of a major regional manufacturer of tiles in Kashan using both General Health Questionnaire-28 and demographic questionnaires. SPSS software (version 16) was used to analyze the data corresponding to descriptive and analytical statistic tests. Results: The frequencies of mental disorder, sleep disorder and anxiety, social function disorder, as well as depression and physical symptoms were found to be 52.3%, 52.8%, 75.7%, 12.8%, and 48.3%, respectively. There was a significant relationship between anxiety with work tenure and work shift, depression with income level, and general mental health with work shift and income. Conclusion: The results show that psychiatric disorders in this industry are significant, so implementation of prevention and treatment programs is of great importance for improving production and performance of workers, especially in high-risk groups.

Methylphenidate (MTP) is a first-line treatment for attention-deficit hyperactivity disorder (ADHD) in children and adults and as a second-line treatment for narcolepsy in adults. We report a case of a young adult male who presented with abnormal orofacial movements after MTP use for the management of ADHD. Laboratory tests were within normal limits. His family history was unremarkable and negative for neurological diseases. A dose of MTP was given during the neurological examination, and abnormal facial movements suggestive of oromandibular dystonia (DTN) were observed. MTP was withdrawn and the symptoms recovered. The oromandibular DTN secondary to MTP probably occurs due to influences in the dopaminergic pathway, and these dyskinetic movements may be associated with a disbalance state of the dopamine, in which an increase or decrease of this neurotransmitter could lead to abnormal movements.