BackgroundTransgender youth face multiple ethical and social challenges that significantly impact their mental health, dignity, and overall well-being. These challenges are influenced by social, cultural, and religious norms in a middle eastern country, and little is known about the ethical dimensions of their lived experiences.Research question/aim/objectivesThis study aimed to explore the ethical challenges and human vulnerability experienced by transgender youth in a middle eastern country, focusing on care, dignity, and social justice.Research designA qualitative study employing conventional content analysis was conducted to capture in-depth insights from participants' lived experiences.Participants and research contextEighteen transgender youth from the western region of the study setting participated in semi-structured, in-depth interviews. Participants were recruited via purposeful and snowball sampling, and interviews were conducted in private settings, lasting approximately 45 min each.Ethical considerationsThe ethical approval was obtained from the relevant institutional ethics committee. Confidentiality was ensured, written informed consent was obtained, and participants were free to withdraw at any time without consequences.Findings/resultsParticipants reported pervasive experiences of physical and sexual abuse, social rejection, discrimination in education and employment, stigma, rumination, anxiety about the future, family rejection, poverty, engagement in high-risk behaviours including substance use and criminality, and limited access to psychological, sexual health, and therapeutic counselling. These factors significantly affected their mental health, social integration, and overall quality of life, highlighting ethical concerns regarding care, vulnerability, and social justice.ConclusionsTransgender youth in a middle eastern country experience significant ethical and psychosocial challenges that threaten their mental health and well-being. There is an urgent need for culturally sensitive interventions, inclusive policies, and comprehensive counselling services to promote dignity, social justice, and mental health support for transgender individuals.

Introduction: The phenomenon of fear of infection is a significant challenge for healthcare systems, particularly among personnel working on the front lines. Pre-hospital emergency personnel, as a crucial part of the frontline healthcare workforce, experience the highest level of fear of infection among all healthcare workers worldwide. Investigating the fear of infection and its related occupational factors can be effective in managing this challenge. Objective: This study aims to assess the level of fear of infection and related occupational factors among personnel working in pre-hospital emergency operations. Methods: This cross-sectional study was conducted in Iran in 2024. The sample size consisted of 270 pre-hospital emergency operational staff selected through random sampling. Data collection tools included a demographic questionnaire and the Fear of Infection Evaluation Questionnaire (adult version of the Fear of Infection and Virus Evaluation - FIVE). SPSS software version 23 was used for data analysis. Results: The findings showed that the mean fear of infection score was 69, which is considered moderate. The Kruskal-Wallis statistical test revealed significant relationships between fear of infection and variables such as exposure to blood and secretions, the number of needlestick injuries, and participation in mental health and infection control courses (P < 0.05). In other words, Needlestick injury frequency was significantly associated with fear of infection, with the highest fear levels observed in those with 6-10 injuries. Additionally, participation in mental health and infection control courses was associated with higher mean fear scores. No significant relationships were found between fear of infection and place of service (urban or roadside base), adherence to personal protection principles, work experience, or educational level. Conclusion: Assessing the fear of infection and its related factors can help in planning to reduce occupational challenges among these personnel, which may ultimately lead to improved community health outcomes.

This is the first bottom-up review of the lived experience of persons who attempt suicide. The study has been co-designed, co-conducted and co-written by experts by experience and academics, focusing on first-person narratives within and outside the medical field. The lived world of individuals who attempt suicide is characterized by experiences related to the attempt itself ("contemplating suicide as a deliberate death", "contemplating suicide as an escape route", "looking for online answers about suicide", "planning suicide", "finding rest between the suicidal decision and the final act", "changing one's mind during the suicide attempt", "acting on suicidal impulses"); experiences related to the self and time ("feeling unworthy", "feeling detached from oneself or the world and lacking a sense of agency", "splitting the self between the decision to live or die", "perceiving an abortive and doomed future"); and experience of emotions and the body ("feeling overwhelmed by hopelessness and despair", "feeling empty and drained of energy", "feeling alone"). The lived experience of individuals who attempt suicide is also described in terms of the social and cultural context, including the experience of others ("feeling that no one cares", "feeling like a burden to others", "facing others' difficulty in understanding"); cultural, gender and age differences ("experiencing geographical, cultural and religious taboos about suicide", "feeling inadequate in relation to gender stereotypes", "feeling abandoned in old age"); and the perception of stigma ("facing social stigma", "experiencing a stigmatized self", "silencing suicidal behaviors"). The lived experience of persons after an attempted suicide is characterized as a complex process of self-acceptance and rediscovery ("living with suicidal thoughts", "navigating the challenges of recovery", "gaining new perspectives during recovery", "restoring interpersonal relationships to recover"). Finally, the lived experience of individuals who attempt suicide is described with respect to their access to general health care ("seeking help before the suicide attempt", "feeling abandoned after a suicide attempt") and mental health care ("experiencing shame as a barrier to care", "fearing mental disorder label", "feeling accepted and listened to", "facing economic difficulties in accessing support", "coping with distress during hospitalization"). The experiences described in this paper hold educational and social value, informing medical and psychological practices and research, public health approaches, and promotion of social change. This research overcomes embarrassment, fear and stigma, and helps us to understand the fragile nature of our emotions and feelings, our immersion in the social world, and our sense of meaning in life.

Introduction: Bipolar disorder (BD) is a recurrent psychiatric disorder with episodes of mania and depression. The severe and recurrent symptoms of BD can considerably influence patients' significant others and alter their lives and thereby, influence family functioning (FF). Aim: This study aimed at exploring the influential factors on the FF of patients with BD. Methods: This qualitative study was undertaken in 2021-2022 with the conventional content analysis method, adhering to the COREQ checklist. Data were collected through semi-structured interviews with 22 family members of BD patients and three healthcare providers, all purposefully selected from a psychiatric hospital in Hamadan, Iran. Data analysis was performed through Graneheim and Lundman's conventional content analysis. Results: Participants' experiences of the influential factors on their FF came into 20 categories and six main themes, namely family interaction, struggle for adaptation, role challenges, sexual behaviour challenges, financial problems and cultural backgrounds and conflicts. Discussion: Different personal, financial and sociocultural factors influence the sociocultural, financial, relational, sexual and role-related aspects of FF among the families of patients with BD. Implications for Practice: Given the critical role of FF in the prevention, early diagnosis and effective treatment and rehabilitation of patients with BD, healthcare authorities and providers need to carefully consider these influential factors when planning care. Relevance Statement: This study offers valuable insight into the role of influential factors on the FF of patients with BD. The findings equip mental health nurses with a deeper understanding of these factors, enabling them to provide better support to relatives. Psychiatric nurses can adopt a participatory care approach that actively involves family members and provides stronger support for family caregivers.

Treatment response remains one of the key challenges in managing patients with obsessive-compulsive disorder (OCD). This study aimed to investigate the efficacy of combining neurofeedback with pharmacotherapy in treating OCD. We conducted a single-blind, randomized clinical trial at Farschian Hospital in Hamadan, Iran. Forty-five patients with OCD were randomly assigned to three groups (n = 15 per group): experimental, placebo, and control. The experimental group received 25 neurofeedback sessions (three 45-minute sessions per week) alongside pharmacotherapy. The placebo group followed a similar protocol but without actual neurofeedback administration. The control group received pharmacotherapy alone. Data were analyzed using SPSS-22. The results demonstrated a significant improvement in the mean total obsession score, including both thought and compulsion subscales (p < 0.01). The experimental group showed significantly greater improvement in all outcome measures compared to both control groups (p < 0.05). No significant difference was observed between the placebo and control groups (p > 0.05). These findings suggest that combining neurofeedback with pharmacotherapy significantly reduces OCD symptom severity compared to either treatment alone. Neurofeedback may serve as an effective, novel, and non-invasive complementary therapy for OCD when combined with standard pharmacological treatment. Trial registration The trial was registered at the Iranian registry of clinical trials ( www.irct.ir ; registration number: IRCT2015030321313N1).

Background and Objectives: Autism in children has a profound effect on the life and mental and social health of the family, especially parents. Therefore, the present study aimed to determine the effect of desensitization with eye movement and reprocessing on depression of parents of children with autism. Materials and Methods: The present clinical trial was performed on 60 parents of autistic children referred to the Autism Center of Hamadan (Iran) in 2021. The samples were randomly located in the study groups. The intervention was performed for three consecutive 45-minute sessions once a week with desensitization treatment with eye movement and reprocessing. Data were collected using Demographics and the Beck Depression Questionnaire. Data analysis was performed using descriptive and inferential statistics in the SPSS (version 24) software. Results: There was a significant difference between the mean depression immediately after the intervention in the experimental (3.77±2.487) and control (17.15±4.49) groups (P<0.001). This difference between the two groups was also significant one month after the intervention (P<0.001). Conclusion: The results indicated that the intervention method of desensitization with eye movements and reprocessing significantly reduces the depression of parents of autistic children. Therefore, this method of treatment is recommended to healthcare providers for the prevention and treatment of psychological symptoms caused by the presence of an autistic child in the family.

Background: Although electroconvulsive therapy is a proven and secure treatment, it may induce anxiety and fear among patients and their families. Therefore, this study aimed to determine the impact of video-based education on the fear and anxiety of patients with bipolar disorders who are candidates for electroconvulsive therapy. Materials and Methods: This clinical trial was conducted on 72 individuals with bipolar disorders who were candidates for electroconvulsive therapy in Hamadan in 2021. In addition to routine care, the intervention group received educational materials through instructional videos by a Masters-level researcher. Data was collected using questionnaires assessing demographic and clinical characteristics, the Spielberger Anxiety Inventory, and a two-part questionnaire to investigate phobias. The collected data were entered into SPSS-24 software and underwent statistical analysis, with a significance level of less than 0.05 considered. Results: There was no statistically significant difference in the average anxiety and fear scores between the two groups before the intervention (P > 0.05). However, after implementing the educational intervention in both the intervention and control groups, there was a significant disparity in the average anxiety scores between the different study stages. Notably, the intervention group exhibited a more substantial reduction in anxiety (P < 0.001). After the educational intervention, the intervention group was the only one to show a significant decrease in average fear scores between the study stages (P < 0.001). Conclusion: This approach effectively alleviates anxiety and fear in bipolar disorder patients undergoing electroconvulsive therapy. Psychiatric department nurses should incorporate video-based education into their practices to enhance treatment outcomes.

BACKGROUND & OBJECTIVE:Identifying the care needs of parents of children with epilepsy using a reliable tool can help improve the quality of life for both parents and children, enhance care provision, and facilitate disease management. This study aimed to design and psychometrically evaluate the Needs of Parents Caring for Children with Epilepsy Questionnaire (NPCEQ). METHODS:This study employed a two-stage exploratory sequential mixed-methods design. In the first stage, 13 semi-structured interviews were conducted to clarify the concept of "parental care needs for children with epilepsy." A conventional content analysis of the interview transcripts was performed to identify subscales and items for inclusion in the instrument. In the second stage, the psychometric properties of the questionnaire were evaluated. The NPCEQ utilizes a 5-point Likert scale. Face validity was assessed by 20 parents, and content validity was evaluated by 35 faculty members. Reliability was tested in a random sample of 331 caregivers. RESULTS:The final NPCEQ consists of five dimensions with 31 items, accounting for 59.07 % of the total variance. The overall CVR was 0.853, and CVI was 0.877, both indicating very good levels. Internal consistency was assessed using Cronbach's alpha (0.761). Internal stability was evaluated using the intraclass correlation coefficient (ICC), which was found to be adequate (ICC = 0.62-0.86). The NPCEQ demonstrated evidence of content validity, construct validity, internal consistency, and stability. CONCLUSION:The NPCEQ demonstrated evidence of content validity, construct validity, internal consistency, and stability. The statistical analysis of the NPCEQ provided an objective tool for assessing the care needs of parents of children with epilepsy in clinical and domestic contexts.

Background:: Individuals with mental disorders are subject to stigma from society. Some patients accept and internalize this stigma, while others suffer from loneliness and reduced quality of life. Objective:: This study aimed to investigate the relationship between internalized stigma, feelings of loneliness, and quality of life in patients with mental disorders. Methods:: In 2023, a descriptive study was conducted on 250 patients with psychological disorders who were referred to Sina Hospital (Farshchian) in Hamadan. The patients were selected using a convenience sampling method. Data were collected through face-to-face interviews using four questionnaires: demographic information, the internalized stigma of mental illness, Russell's loneliness scale, and the World Health Organization's 26-item quality of life questionnaire. The data were analyzed using descriptive and inferential statistical tests in SPSS-22 software. Results:: There was a significant positive correlation between internal stigma and loneliness (p < 0.001, r = 0.817) and a significant negative correlation between internal stigma and quality of life (p < 0.001, r = -0.777). Additionally, loneliness and quality of life had a significant negative correlation (p < 0.001, r = -0.838). Conclusion:: The results generally indicate that approximately half of the patients with internalized stigma experience moderate to severe distress. As internalized stigma increases, patients are more likely to experience feelings of loneliness and decrease their quality of life. Therefore, it is recommended that measures be taken to reduce internalized stigma in patients with psychiatric disorders to alleviate feelings of loneliness and improve their quality of life.

The care needs of epileptic children are a multidimensional concept that varies based on the experience and understanding of family caregivers. This study aimed to analyze the concept of parental care needs for children with epilepsy. This study was conducted using the hybrid method in three phases. In the theoretical phase, a systematic literature review was performed. In the fieldwork phase with a qualitative approach, 13 parents caring for epileptic children were investigated with individual and semi-structured interviews at the Besat Teaching-Treatment Center (Hamadan, Iran) in 2024. In the final phase, the concept of parental care needs was defined based on the findings of the theoretical and fieldwork phases. The common antecedents identified in both the theoretical and fieldwork phases included low education levels and poor economic status. Additionally, the fieldwork phase highlighted the role of ineffective support systems. The common consequences were care quality improvement, financial burden reduction, care knowledge acquisition, and psychosocial status improvement, and the consequence of increasing stability in the family structure appeared in the fieldwork phase. The care needs of epileptic children’s parents included comprehensive support, therapeutic needs, and psychological needs, while financial constraints and inadequate care knowledge were identified as major challenges. These needs are influenced by factors such as low socioeconomic status and limited education, and their fulfillment leads to an improved quality of life and more effective disease management. Concentration on parental care needs and provision of appropriate support through education, financial resources, and social support can help reduce psychosocial pressures on families.

Background: Obsessive-compulsive disorder (OCD) is a potentially serious mental disorder that affects 1-2% of the world population. The OCD patients experience uncontrollable, and recurring thoughts (obsessions), and may feel a need to repeat behaviors (compulsions). In EEG studies, many different features have been investigated regarding their OCD diagnosis capability. However, there is no OCD study evaluating different EEG features with the same conditions and data. Methods: To address the problem, we employed six popular resting-state EEG features, including absolute and relative power, Phase locking value (PLV), Weighted phase lag index (WPLI), approximate entropy, and Higuchi's fractal dimension, to find out which feature can better discriminate OCDs from healthy controls (CON) under the same conditions and data. All the generated features were normalized using mean and standard deviation of values, calculated from 233 Iranian healthy people. After that, the most informative EEG features, discriminating 39 OCD individuals from age, handedness, and gender-matched, 39 CON were selected and entered into the classification process. In addition, an independent EEG dataset including 23 OCDs and 23 CONs was also used to investigate the consistency of the results. Results: As expected, most of the significant differences were observed at the high frequency bands in Beta I-IV, and Gamma bands. The highest classification accuracies were achieved using the support vector machine applied on the PLV features of the main (94.8 %) and independent dataset (100 %) Conclusions: These findings indicate that functional connectivity-based (PLV) features have a good potential to be used as a biomarker of OCD.

Background: Understanding the care needs of parents with epileptic children is crucial, as they experience unique challenges affecting their mental and physical health. Objectives: This study aims to investigate the needs of parents caring for children with epilepsy. Methods: This is a systematic review study. A search was conducted in databases such as PubMed, Web of Science, and Scopus for related articles published from 1975 to 2023, using keywords “epilepsy”, “children”, “parents”, “caregivers”, “care needs”, and “unmet needs”. The review followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Finally, 30 articles were selected for review after quality appraisal using the critical appraisal skills program (CASP) and strengthening the reporting of observational studies in epidemiology (STROBE) checklists. Results: The care needs were identified as psychological, educational, supportive, economic, social, and unmet needs. Parents expressed their supportive, economic, and social needs to reduce the burden of caregiving; their educational needs to cope with epilepsy; their psychological needs to reduce stress and anxiety; and their unmet needs to reduce emotional distress. Conclusions: To improve the health status of children with epilepsy, their parents' care needs should first be considered. The healthcare providers should provide health care services to the parents of epileptic children tailored to the identified needs.

Background and Objectives: Students, as the builders of tomorrow's society, can be the foundation of many changes and developments. The present study was conducted with the aim of investigating the relationship of emotional intelligence with hope and self-concept among nursing students of Hamedan University of Medical Sciences. Materials and Methods: This descriptive correlational study was conducted on 486 nursing students of Hamedan University of Medical Sciences in 2022-23 who met the inclusion criteria. The samples were selected by census method. The data were collected using a demographic information form, the Schutte Self-Report Emotional Intelligence Test, Miller's Hope Questionnaire, and Beck's Self-Concept Questionnaire. Data analysis was done in SPSS 20 software using Pearson's correlation tests, one-way analysis of variance, t-test for two independent samples, and linear regression. Results: In this research, 50.40% of the participants were male and 49.60% were female. Most of the participants (13%) were studying in the first and third semesters. The mean and standard deviation of study variables were obtained at 129.58±10.76 for emotional intelligence, 41.64±4.79 for hope, and 86.68±8.82 for self-concept. With the exception of the relationship between the emotion regulation component and the deviant expression component (P=0.548), other components of the emotional intelligence variable showed a significant direct statistical relationship with all the components of hope and also the total hope score (P<0.001). Regarding the strength of the relationships, the strongest relationship was observed between the emotional regulation component and the agency thinking component (Pearson correlation coefficient=0.431). The component of evaluating emotions in oneself and others only showed a statistically significant direct relationship with the job effectiveness component (Pearson correlation coefficient=0.114, P=0.012) and with total self-esteem score (Pearson correlation coefficient=0.031, P=0.031). Moreover, a statistically significant direct relationship was found between total emotional intelligence score and job effectiveness component (Pearson correlation coefficient=0.154, P=0.001), as well as total self-esteem score (Pearson correlation coefficient=0.103, P=0.023). Conclusion: The study indicates a positive relationship between emotional intelligence, hope, and self-concept among nursing students. The results of this study showed that improving emotional intelligence can enhance the skills and performance of nursing students, and it is proposed as an effective strategy for improving patient care in the nursing field.

Introduction One of the most important duties of the members of the treatment team is to pay attention to the mental, psychological, and social aspects of burn patients. One of the concerns of these patients during their stay in the hospital is the fear of rejection. The objective of this research is to examine the concept of 'fear of rejection' among patients hospitalized with burn injuries. Method This study was conducted between January 2023 and March 2024 in Hamadan, Iran, employing a qualitative content-analysis approach. The study enrolled sixteen patients, and data were collected through deep and semi-structured interviews. The data were then analyzed using the conventional content-analysis approach developed by Graneheim and Lundman. Results A group of 16 patients, comprising an equal number of men and women, were interviewed for this study. Based on the data obtained from these interviews, negative brainstorming, frustration, fear of permanent physical disabilities, occupational and financial challenges were identified as categories; visualization of a foggy future and inability in performance of roles emerged as the two themes. Conclusion Based on the results of this study, it can be said that the fear of social rejection, characterized by an inability to perform roles and the visualization of a foggy future, significantly affects the psychological and physical health of burn patients, potentially delaying their recovery. Assisting these patients in reaching their fullest potential to contribute to society post-discharge, and fostering optimism for a promising future, constitute a paramount aspect of daily care and ongoing support.

Accessible Summary What is known on the subject? Taking care of an autistic child at home can be tough for parents. They struggle to balance caring for their child and other tasks. This can affect their emotional well‐being and cause guilt and other psychological problems. What does the paper add to existing knowledge? Eye movement desensitization and reprocessing with finger movements can reduce guilt in parents of autistic children. Eye movement desensitization and reprocessing with Elite mobile health software movements can reduce guilt in parents of autistic children. The bilateral eye stimulation method using finger movements has a more sustained impact than the Elite app's bilateral stimulation method. What are the implications for practice? Healthcare providers are encouraged to learn Eye Movements Desensitization and Reprocessing. Healthcare providers are encouraged to use these methods to help with psychological issues in children with autism. Psychiatric nurses are encouraged to utilize this treatment approach for parents of children with autism, as well as to help alleviate feelings of guilt more broadly. Abstract Introduction Caring for an autistic child at home can be challenging for parents, as it can make it difficult to balance their responsibilities. This imbalance can negatively affect the emotional well‐being of the caregiver and lead to feelings of guilt. While this is a known issue, there may be gaps in knowledge specific to Iran. In this study, a new method was introduced to address this issue. Aim This study aimed to examine the impact of desensitization with eye movements and reprocessing (EMDR) on reducing parental guilt among autistic children's families. We aim to examine the effectiveness of two different treatment methods. Methods This study involved 90 parents (60 mothers, 30 fathers) of autistic children randomly assigned to either an experimental or control group. The two experimental groups received a 45‐min intervention session once a week for 3 weeks, while the control group did not receive any intervention. Data on feelings of guilt was collected using a questionnaire. After 30 days, both groups took a follow‐up test. The data were analysed using statistical software. Results This study found that there were significant differences in guilt feelings among different groups of EMDR therapy and a control group. Specifically, no significant differences were observed in the mean guilt scores between the experimental and control groups at the pre‐intervention stage ( p > .05). However, the experimental groups exhibited significantly lower mean guilt scores immediately after the intervention and 1 month later than the control group ( p < .05). Immediately after the intervention and 1 month later, no significant differences were observed between the two experimental groups ( p > .05). Conclusions The findings of this study demonstrate the efficacy of desensitization treatment using eye movements and reprocessing in reducing feelings of guilt among autistic children's parents. In the follow‐up phase, it seems that the two‐way stimulation method with finger movements is more effective than Elite software in terms of the continuity of the effect. Healthcare providers are encouraged to learn and use these methods to help prevent and treat psychological issues in autistic children.

ObjectivesThe aim of this study was to explore the voices of the family members of Bipolar Disorder (BD) patients about the challenges ahead of them. MethodsIn this qualitative study, 22 participants shared their experiences of sexual challenges of patients with BD through in-depth, face-to-face, semi-structured interviews. Qualitative content analysis was used for data analysis. ResultsAn overarching theme entitled "Unheard voices" reflected this experience. It comprised four main categories include sexual promiscuity, a change in sexual patterns, sexual support, and sexual indifference. The results revealed that the families of patients with BD have to deal with sexual promiscuity and change in sexual patterns in their family, and the family system attempts to respond to these changes by sexual support mechanisms and sexual indifference. ConclusionsGiven the significant impact of healthy sexual behaviors on the quality of life of both the individual and the family, therapists and family support systems are advised to strengthen and educate families to support their patients' sexual health and needs and protect their sexual existence; they should also address the sexual challenges faced by these families as a diagnostic and therapeutic priority, and early sexual health interventions should be provided to these families.

Stability of the brain functional network is directly linked to organization of synchronous and anti-synchronous activities. Nevertheless, impact of arrangement of positive and negative links called links topology requires to be well understood. In this study, we investigated how topology of the functional links reduce balance-energy of the brain network in obsessive-compulsive disorder (OCD) and push the network to a more stable state as compared to healthy controls. Therefore, functional associations between the regions were measured using the phase synchrony between the EEG activities. Subsequently, balance-energy of the brain functional network was estimated based on the quality of triadic interactions. Occurrence rates of four different types of triadic interactions including weak and strong balanced, and unbalanced interactions were compared. In addition, impact of the links topology was also investigated by looking at the tendency of positive and negative links to making hubs. Our results showed although the number of positive and negative links were not statistically different between OCD and healthy controls, but positive links in OCDs’ brain networks have more tendency to make hub. Moreover, lower number of unbalanced triads and higher number of strongly balanced triad reduced the balance-energy in OCDs’ brain networks that conceptually has less requirement to change. We hope these findings could shed a light on better understanding of brain functional network in OCD.

Background Child laborers are often defined as work that deprives children of their childhood, their potential and their dignity, and that is harmful to physical and mental development. Child laborers are one of the most vulnerable groups in domestic violence. Domestic violence severely affects the physical and mental health, and consequently affects substance dependence and resilience to suicide of these children. Accordingly, it is essential to examine domestic violence, substance dependence, and suicidal ideation in working children. Objectives the present study aimed to investigate the relationship between exposure to domestic violence and substance dependence and suicide resilience on the other among child laborers in Iran. Methods This study employed cross-sectional research. 600 child laborers were selected via convenience and snow ball sampling from one rehabilitation and welfare center and three charity organization societies in the west of Iran, from January to August 2022. They completed questionnaires. Data were analyzed by SPSS software version 22 and with using descriptive statistics (frequency, percentage, mean and standard deviation) and ANOVA, independent t-test and the multiple linear regression model with a backward strategy. Results Findings showed that exposure to domestic violence has a strong and direct correlation with substance dependence (r = 0.94, p < 0.001) and strong and indirect correlation with suicide resilience (r =- 0.91, p < 0.001). Also substance dependence has a strong and direct correlation with suicide resilience (r = -0.87, p < 0.001) in child laborers. Variables of substance dependence, suicide resilience, gender, guardian’s disease status, living status and age can predict 76.51% of the variance in domestic violence in these children. Conclusion Child laborers experience a lot of domestic violence, which severely affects their suicide resilience and substance dependence in them. Therefore, there is an urgent need for systematic support programs with content (teaching self-care behaviors, stress management, avoiding tense and violent environments) in order to support of these children and reduce domestic violence against them and subsequently reduce substance improve abuse resilience to suicide in these children.

Background and Aim: The coronavirus pandemic has had a negative impact on the health and well-being of communities and individuals around the world. One of the concerns about the COVID-19 epidemic is the impact of social isolation due to social distancing on the mental health of older adults. This study aimed to investigate the relationship between mental health and loneliness among seniors during the COVID-19 pandemic. Materials and Methods: In this cross-sectional study, 211 retirees of Kermanshah University of Medical Sciences were selected by available sampling method in 2021. Data were collected through the Demographic, Mental Health Questionnaire (GHQ-28) and the Adult Social and Emotional Feeling Questionnaire (SELSA-S). Data were analyzed using paired t-test, one-way analysis of variance, covariance, and chi-squared tests. The significance level was considered 0.05. Results: The mean age of participants was 71.26 years and the results showed a significant relationship between feeling lonely and mental health (r = 0.535, p = 0.001). There were statistically significant relationships between mental health and social functioning (r = −0.204, p ≥ 0.001) and depression (r = 0.501, p = 0.001) and also between mental health and three subscales of loneliness: romantic loneliness (r = 0.001, p = 0.001), social loneliness (r = 0.493, p = 0.001), and family loneliness (r = 0.289, p = 0.001). Conclusion: Feeling lonely during the coronavirus disease pandemic has a negative effect on the mental health of older adults; therefore, it is necessary for mental health professionals to improve the mental health of the elderly with proper planning and interventions.

BACKGROUND: Appropriate self-management (SM) is crucial in controlling epilepsy and improving self-efficacy, medication adherence and avoidance of seizure triggers in patients with epilepsy (PWE. The aim of this study was to evaluate SM and its predictors among adult PWE in Iran. METHODS: This cross-sectional study was conducted in 2021. The participants were 335 adult PWEs that were selected from healthcare settings in Hamadan, Iran. Epilepsy Self-Management Scale (ESMS) was used to measure patients' self-management behaviors. Data were analyzed using the independent samples t-test, Pearson’s and Spearman’s correlation analyses and multiple linear regression analysis. RESULTS: The mean score of SM was 114.37±11, indicating moderate level of SM, and the mean scores of SM in the medication management, seizure management, and safety management subscales were significantly more than the mean scores of the other subscales (P < 0.05). Age, place of residence, marital status, seizure type, seizure frequency, and epilepsy duration significantly predicted 53% of the variance of SM (adjusted R square = 0.532). CONCLUSION: PWEs have moderate SM and need SM-related education, particularly about lifestyle management and information management. Predictors of SM should be considered to boost SM practice.