1 The Mediating Role of Maternal Stress and Family Quality of Life in the Association Between Parenting Styles and Behavioral Challenges in Students with Intellectual Disabilities https://brieflands.com/journals/semj/articles/162274 10.5812/semj-162274 1 Background :Behavioral challenges in students with intellectual disabilities (IDs) are influenced by parenting practices. Maternal stress and family quality of life may modulate these associations. Objectives :To examine how parenting styles relate to behavioral problems in students with IDs and to test whether maternal stress and family quality of life mediate these associations. Methods :In a cross-sectional correlational study with a descriptive-analytical approach, 100 students aged 10 to 14 with mild IDs were recruited from exceptional schools and rehabilitation centers in South Tehran during the 2022 - 2023 academic year. IQ was assessed with the Raven Intelligence Matrices, with scores ≥ 70 classifying mild ID. Mothers completed validated questionnaires on Parenting Styles, Parental Stress, Quality of Life, and the Rutter Behavioral Problems Scale. Data were analyzed using Spearman correlation coefficients and path analysis with SPSS version 27. Results :The study examined the impact of parenting styles (authoritarian, authoritative, and permissive) on behavioral problems among 100 students with IDs (82 with mild ID and 18 with moderate ID; mean age 11.22 ± 1.29 years) and their mothers (mean age 45.21 ± 6.39 years), focusing on the mediating roles of maternal stress and family quality of life. Across the mediation model, parenting styles were differentially linked to behavioral problems. Authoritative parenting was associated with higher maternal stress (median = 97.0, IQR = 14.3) but better quality of life, particularly in social relations (64.0, 35.9) and general health (81.4, 21.5). Authoritarian parenting correlated positively with behavioral problems (R = 0.571, P = 0.025), increasing mild and moderate issues (β = 0.22, P < 0.001), mediated strongly by maternal stress (indirect effect β = 0.43, P < 0.001). Conversely, authoritative parenting showed a protective effect, reducing behavioral problems (β = -0.23, P < 0.001), with quality of life domains like mental health (β = -0.42, P < 0.001) and general health (β = -0.39, P < 0.001) as significant mediators. Permissive parenting had a weaker, mixed impact (β = 0.09–0.19, P < 0.001), with maternal stress exacerbating outcomes (indirect effect β = -0.37, P < 0.001). Conclusions :This study underscores the substantial influence of parenting styles on behavioral challenges in students with IDs. In this sample, authoritarian and permissive styles tended to be linked with higher behavioral problems, while authoritative parenting was associated with fewer problems, suggesting a protective pattern. These associations are partly explained by maternal stress and elements of family quality of life. However, the study's demographic limitation in Tehran constrains the generalizability of its findings. Future research should include more diverse groups and explore other factors. Additionally, enhancing parental awareness and offering targeted workshops will empower families to better support their students’ behavioral needs. 1 14 Negar Anaraki-Kordi Department of Psychology and Education of Exceptional Children, Faculty of Behavioral Sciences and Mental Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran negaranaraki6622@gmail.com Masoume Pourmohamadreza-Tajrishi Department of Psychology and Education of Exceptional Children, Faculty of Behavioral Sciences and Mental Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran mpmrtajrishi@gmail.com Neda Ali Beigi Department of Psychiatry, Psychosis Research Center, Faculty of Behavioral Sciences and Mental Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran nedapsych@gmail.com Razieh Bidhendi-Yarandi Department of Biostatistics and Epidemiology, Faculty of Social Welfare, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Iran razi_bidhendi@gmail.com No Keyword 1.pdf [0]Association AP.Diagnostic and statistical manual of mental disorders: DSM-5-TR. 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1 The Correlations Between Academic Procrastination and Academic Burnout with Symptoms of Adult Attention Deficit Hyperactivity Disorder (ADHD) in Clinical Medical Students in Northern Iran https://brieflands.com/journals/semj/articles/159756 10.5812/semj-159756 1 Background :Given the high prevalence of attention deficit hyperactivity disorder (ADHD), particularly among students, and its potential impact on academic burnout and procrastination, this study aimed to examine the correlation between ADHD, academic burnout, and procrastination. Methods :This cross-sectional study was conducted in 2023 at Babol University of Medical Sciences in Northern Iran. Clinical medical students were enrolled based on specific inclusion and exclusion criteria. Participants completed three validated scales: The Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS v1.1), the Procrastination Assessment Scale for Students (PASS), and the Maslach Burnout Inventory-General Survey for Students. Demographic and questionnaire data were analyzed using appropriate statistical methods. Results :The study of 256 clinical medicine students found that 54.7% were female, with 78.9% admitted on their first attempt. The average scores for ADHD (ASRS), procrastination, and burnout were 48.76 ± 8.58, 85.15 ± 13.84, and 43.57 ± 14.86, respectively. Higher ASRS scores were significantly linked to increased procrastination (P < 0.001) and burnout (P = 0.030). Younger students showed higher burnout (P = 0.033), and those from families with four children had more procrastination (P = 0.045). Other demographic factors were not significant. Conclusions :This study establishes a distinct connection between ADHD and increased levels of academic burnout and procrastination among clinical medicine students. Students with higher ADHD scores are the most likely to continue to experience greater burnout and procrastination. This points to a necessity for effective and timely interventions and measures with respect to ADHD in the vulnerable population to reduce their risk of burnout and procrastination. 1 8 Armon Massoodi Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Iran armonmassodi2@gmail.com Farzan Kheirkhah Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Iran drfarzankh@yahoo.com Baharak Moeini Student Research Committee, Babol University of Medical Sciences, Babol, Iran Iran baharak.moeini71@gmail.com Hemmat Gholinia Ahangar Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran Iran h_gholinia@yahoo.com No Keyword 2.pdf [0]Moffitt TE, Houts R, Asherson P, Belsky DW, Corcoran DL, Hammerle M, et al.Is Adult ADHD a Childhood-Onset Neurodevelopmental Disorder? Evidence From a Four-Decade Longitudinal Cohort Study. Am J Psychiatry. 2015;172(10):967-77. [PubMed ID: 25998281]. [PubMed Central ID: PMC4591104]. doi: 10.1176/appi.ajp.2015.14101266.##[1]Evans SW, White L.Book Review: Attention deficit hyperactivity disorder: State of the science/best practices. J Attention Disord. 2005;9(1):369-70. doi: 10.1177/1087054705279567.##[2]Willcutt EG.The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics. 2012;9(3):490-9. [PubMed ID: 22976615]. [PubMed Central ID: PMC3441936]. doi: 10.1007/s13311-012-0135-8.##[3]Berger I.Diagnosis of attention deficit hyperactivity disorder: much ado about something. Isr Med Assoc J. 2011;13(9):571-4. [PubMed ID: 21991721].##[4]Connor DF, Doerfler LA.ADHD with comorbid oppositional defiant disorder or conduct disorder: discrete or nondistinct disruptive behavior disorders? J Atten Disord. 2008;12(2):126-34. 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J Psychopathol Behav Assessment. 2022;45(1):48-57. doi: 10.1007/s10862-022-09996-2.##[9]Michielsen M, Comijs HC, Aartsen MJ, Semeijn EJ, Beekman AT, Deeg DJ, et al.The relationships between ADHD and social functioning and participation in older adults in a population-based study. J Atten Disord. 2015;19(5):368-79. [PubMed ID: 24378286]. doi: 10.1177/1087054713515748.##[10]Ercan ES, Unsel-Bolat G, Tufan AE, Karakoc Demirkaya S, Bilac O, Celik G, et al.Effect of Impairment on the Prevalence and Comorbidities of Attention Deficit Hyperactivity Disorder in a National Survey: Nation-Wide Prevalence and Comorbidities of ADHD. J Atten Disord. 2022;26(5):674-84. [PubMed ID: 34032170]. doi: 10.1177/10870547211017985.##[11]Miller CW.Procrastination and Attention Deficit Hyperactivity Disorder in the College Setting: The Relationship Between Procrastination and Anxiety. Minneapolis, Minnesota: Capella University; 2007.##[12]Bolden J, Fillauer JP."Tomorrow is the busiest day of the week": Executive functions mediate the relation between procrastination and attention problems. J Am Coll Health. 2020;68(8):854-63. [PubMed ID: 31241415]. doi: 10.1080/07448481.2019.1626399.##[13]Wachholtz A, Rogoff M.The relationship between spirituality and burnout among medical students. J Contemp Med Educ. 2013;1(2):83-91. [PubMed ID: 25485165]. [PubMed Central ID: PMC4255468]. doi: 10.5455/jcme.20130104060612.##[14]El-Masry R, Ghreiz S, Helal R, Audeh A, Shams T.Perceived stress and burnout among medical students during the clinical period of their education. Ibnosina J Med Biomed Sci. 2022;5(4):179-88. doi: 10.4103/1947-489x.210543.##[15]Kafry D, Pines A.The Experience of Tedium in Life and Work. 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1 Death Related to Aluminum Phosphide Poisoning from 2013 to 2018 in Alborz-Iran and Preventive Measures https://brieflands.com/journals/semj/articles/149091 10.5812/semj-149091 1 Background :Aluminum phosphide (ALP) is a highly toxic pesticide used to protect rice from pests in Iran, and it is inexpensive and available for use as a means of suicide. Objectives :This study aims to show the trend of deaths due to ALP poisoning in Alborz province from 2013 to 2018 and to investigate their sociodemographic, toxicological, and forensic characteristics. Methods :In this cross-sectional study, all cases of fatal poisoning due to ALP were included. All demographic and poison lab information was extracted from forensic records. We used SPSS 22 software to calculate the incidence of death and chi-square and t-tests for data analysis. Results :A study of 140 cases due to ALP poisoning over six years showed that the mean incidence rate of death referred to the legal medicine organization was 8.3 cases per million of the population of Alborz province. The highest and lowest mortality rates were 12.53 per million in 2014 and 5.42 per million in 2015, respectively. The mean age of the deceased was 32.1 years, the male/female ratio was 1.5, 53.6% had undergraduate education, and 56.5% were employed. Additionally, 99.2% of deaths were due to suicide. Conclusions :The findings showed that many deaths caused by ALP were intentional and suicidal. Strict implementation of the law banning the sale of ALP tablets to the public, educating and warning about the risks of ALP, and strengthening social support, especially in high-risk groups, can reduce the incidence of deaths from ALP poisoning. 1 9 Fariba Zamankhani Non-communicable Disease Department, Alborz University of Medical Sciences, Karaj, Iran Iran fb.zamankhani@yahoo.com Aliyehsadat Mousavifar Statistics Department, Alborz University of Medical Sciences, Karaj, Iran Iran aliyehmousavifar@yahoo.com No Keyword 3.pdf [0]Mehrpour O, Jafarzadeh M, Abdollahi M.A systematic review of aluminium phosphide poisoning. Arh Hig Rada Toksikol. 2012;63(1):61-73. [PubMed ID: 22450207]. doi: 10.2478/10004-1254-63-2012-2182.##[1]Sinha N.Aluminium phosphide poisoning. Indian Journal of Medical Specialities. 2018;9(3):167-70. doi: 10.1016/j.injms.2018.06.006.##[2]Dorooshi G, Mirzae M, Fard NT, Zoofaghari S, Mood NE.Investigating the Outcomes of Aluminum Phosphide Poisoning in Khorshid Referral Hospital, Isfahan, Iran: A Retrospective Study. J Res Pharm Pract. 2021;10(4):166-73. [PubMed ID: 35769843]. [PubMed Central ID: PMC9235370]. doi: 10.4103/jrpp.jrpp_88_21.##[3]Shokrzadeh M, Zarei H, Jalilian J, Badeli A, Ebrahimi Falahtalab F, Shayeste Y.A comparison of mortality rate caused by aluminum phosphide with other poisonings in Golestan Province, Iran, 2010-2016. Medical Journal of Mashhad university of Medical Sciences. 2017;60(5):689-90.##[4]Alinejad S, Zamani N, Abdollahi M, Mehrpour O.A Narrative Review of Acute Adult Poisoning in Iran. Iran J Med Sci. 2017;42(4):327-46. [PubMed ID: 28761199]. [PubMed Central ID: PMC5523040].##[5]Navabi SM, Navabi J, Aghaei A, Shaahmadi Z, Heydari R.Mortality from aluminum phosphide poisoning in Kermanshah Province, Iran: characteristics and predictive factors. Epidemiol Health. 2018;40. e2018022. [PubMed ID: 29807406]. [PubMed Central ID: PMC6060335]. doi: 10.4178/epih.e2018022.##[6]Etemadi-Aleagha A, Akhgari M, Iravani FS.Aluminum Phosphide Poisoning-Related Deaths in Tehran, Iran, 2006 to 2013. Medicine (Baltimore). 2015;94(38). e1637. [PubMed ID: 26402837]. [PubMed Central ID: PMC4635777]. doi: 10.1097/MD.0000000000001637.##[7]Tavakoli-Far B, Mahdi Navesi B, Salehi T, Hosseini A, Rahimzadeh M, Dehghan-Tarzjani MH, et al.To Investigate the Abundance of Aluminum Phosphide Poisoning in Karaj-Iran from 2006 to 2011. Alborz University Medical Journal. 2018;7(3):207-12. doi: 10.29252/aums.7.3.207.##[8]Center IS.[Iran-statistical-yearbook]. Tehran: IRAN: Statistical Center; 2020.FA.##[9]Kordrostami R, Akhgari M, Ameri M, Ghadipasha M, Aghakhani K.Forensic toxicology analysis of self-poisoning suicidal deaths in Tehran, Iran; trends between 2011-2015. Daru. 2017;25(1):15. [PubMed ID: 28610598]. [PubMed Central ID: PMC5470324]. doi: 10.1186/s40199-017-0181-1.##[10]Karunarathne A, Bhalla A, Sethi A, Perera U, Eddleston M.Importance of pesticides for lethal poisoning in India during 1999 to 2018: a systematic review. BMC Public Health. 2021;21(1):1441. [PubMed ID: 34294076]. [PubMed Central ID: PMC8296580]. doi: 10.1186/s12889-021-11156-2.##[11]Morovatdar N, Moradi-Lakeh M, Malakouti SK, Nojomi M.Most common methods of suicide in Eastern Mediterranean Region of WHO: a systematic review and meta-analysis. Arch Suicide Res. 2013;17(4):335-44. [PubMed ID: 24224668]. doi: 10.1080/13811118.2013.801811.##[12]Khosravi A, Rabbani B, Tabrizi GS.[Report of Mortality rates by universities/faculties of medical sciences 2017-2019]. Tehran, Iran: Ministry of health; 2021.FA.##[13]Chaudhary DS.An Epidemiological Study of Fatal Aluminium Phosphide Poisoning At Rajkot. IOSR Journal of Pharmacy (IOSRPHR). 2013;3(1):17-23. doi: 10.9790/3013-31101723.##[14]Bagherian F, Kalani N, Rahmanian F, Abiri S, Hatami N, Foroughian M, et al.Aluminum phosphide poisoning mortality rate in Iran; a systematic review and meta-analysis. Arch Acad Emerg Med. 2021;9(1). e66.##[15]Soltaninejad K, Nelson LS, Bahreini SA, Shadnia S.Fatal aluminum phosphide poisoning in Tehran-Iran from 2007 to 2010. Indian J Med Sci. 2012;66(3-4):66-70. [PubMed ID: 23603623].##[16]Glonti K, Gordeev VS, Goryakin Y, Reeves A, Stuckler D, McKee M, et al.A systematic review on health resilience to economic crises. PLoS One. 2015;10(4). [PubMed ID: 25905629]. [PubMed Central ID: PMC4408106]. doi: 10.1371/journal.pone.0123117.##[17]Avcin BA, Kucina AU, Sarotar BN, Radovanovic M, Plesnicar BK.The present global financial and economic crisis poses an additional risk factor for mental health problems on the employees. Psychiatr Danub. 2011;23 Suppl 1:S142-8. [PubMed ID: 21894123].##[18]Chang SS, Stuckler D, Yip P, Gunnell D.Impact of 2008 global economic crisis on suicide: time trend study in 54 countries. BMJ. 2013;347:f5239. [PubMed ID: 24046155]. [PubMed Central ID: PMC3776046]. doi: 10.1136/bmj.f5239.##[19]Hajizadeh AA, Jafari J, Khodamoradi H.[Investigating the impact of economy on suicide rate in Iran]. Police Cultural Studies. 2021;8(2 (29)):1-14.FA.##[20]Choy B, Arunachalam K, S G, Taylor M, Lee A.Systematic review: Acculturation strategies and their impact on the mental health of migrant populations. Public Health Pract (Oxf). 2021;2:100069. [PubMed ID: 36101596]. 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1 The Impact of the COVID-19 Pandemic on Breast Cancer Screening and Treatment in Shiraz: A Cross-sectional Study in Southern Iran https://brieflands.com/journals/semj/articles/163358 10.5812/semj-163358 1 Background :Timely breast cancer diagnosis and treatment are crucial for patient survival. The COVID-19 pandemic disrupted healthcare access, worsening outcomes in diseases like cancer. Objectives :This study compared breast cancer screening and treatment before and after the pandemic in Shiraz, Iran. Methods :This cross-sectional study used breast cancer screening (mammography) data from 2019 to 2022, collected from health insurance and Social Security records in Fars province. Data from breast cancer surgeries at one referral hospital in Fars province were also included. The study compared pre- (2019) and post-COVID-19 (2020 - 2022) periods. A checklist was developed to collect demographic and clinical data. In total, 2,460 patient records were analyzed. Statistical analysis, which included a one-sample t-test and chi-square test, was performed using SPSS software version 22 with a significance level of 0.05. Results :Between 2019 and 2022, the total number of mammography procedures significantly declined during the COVID-19 pandemic, dropping from 31,965 in 2019 to 17,819 in 2020 and further to 10,217 in 2021, before partially recovering to 30,988 in 2022 (P = 0.001). This downward trend was observed in both bilateral and unilateral mammography. Concurrently, patient outcomes were adversely affected, with mortality rates increasing from 2.4% in 2019 to 4.7% in 2020, peaking at 6% in 2021, and then decreasing to 4.1% in 2022, a statistically significant change (P = 0.004). Additionally, the mean age of deceased patients was significantly higher than that of discharged patients across both periods (P < 0.001). There were no significant differences in gender distribution (P = 0.650) or marital status (P = 0.330) between deceased and discharged groups. However, disease stage distribution differed significantly (P = 0.002), with early-stage breast cancer (stages I and II) being more common among deceased patients, particularly during the pandemic. Conclusions :This study shows that COVID-19 significantly affected patient diagnosis and outcomes. Reduced diagnostic mammograms likely led to delayed diagnoses and higher mortality. Older age and widowhood were linked to worse outcomes, highlighting the need for targeted healthcare planning. 1 9 Hafez Shojaadini Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran Iran Iran hafezshojaadini@gmail.com Sulmaz Ghahramani Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran Iran suli.ghahraman@gmail.com Yasamin Khosravaninezhad Department of Emergency Medicine, School of Paramedics, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran Iran yasamin.nezhad97@gmail.com Zahra Maleki Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran Iran maleki5146@gmail.com Ashkan Akbarzadeh Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran Iran Iran ashkanakbarzadeh98@gmail.com Fatemeh Javanmardi Department of Microbiology, Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Iran javanmardi_sahar@yahoo.com Fatemeh Shaygani Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran Iran Iran sadaf.shaygani46@gmail.com Kamran Bagheri Lankarani Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran Iran kblankarani@gmail.com No Keyword 4.pdf [0]World Health Organization.Breast cancer. Geneva, Switzerland: World Health Organization; 2025. Available from: https://www.who.int/news-room/fact-sheets/detail/breast-cancer.##[1]Seyedkanani E, Hosseinzadeh M, Mirghafourvand M, Sheikhnezhad L.Breast cancer screening patterns and associated factors in Iranian women over 40 years. Sci Rep. 2024;14(1):15274. [PubMed ID: 38961238]. [PubMed Central ID: PMC11222508]. doi: 10.1038/s41598-024-66342-0.##[2]Ministry of Health.[Ministry of Health]. 2025. FA. Available from: https://behdasht.gov.ir/.##[3]Filip R, Gheorghita Puscaselu R, Anchidin-Norocel L, Dimian M, Savage WK.Global Challenges to Public Health Care Systems during the COVID-19 Pandemic: A Review of Pandemic Measures and Problems. J Pers Med. 2022;12(8). [PubMed ID: 36013244]. [PubMed Central ID: PMC9409667]. doi: 10.3390/jpm12081295.##[4]Richards M, Anderson M, Carter P, Ebert BL, Mossialos E.The impact of the COVID-19 pandemic on cancer care. Nat Cancer. 2020;1(6):565-7. [PubMed ID: 35121972]. [PubMed Central ID: PMC7238956]. doi: 10.1038/s43018-020-0074-y.##[5]Jazieh AR, Akbulut H, Curigliano G, Rogado A, Alsharm AA, Razis ED, et al.Impact of the COVID-19 Pandemic on Cancer Care: A Global Collaborative Study. JCO Glob Oncol. 2020;6:1428-38. [PubMed ID: 32986516]. [PubMed Central ID: PMC7529504]. doi: 10.1200/GO.20.00351.##[6]Shah R, Hanna NM, Loo CE, David M, Mafra A, Fink H, et al.The global impact of the COVID-19 pandemic on delays and disruptions in cancer care services: a systematic review and meta-analysis. Nat Cancer. 2025;6(1):194-204. [PubMed ID: 39747650]. doi: 10.1038/s43018-024-00880-4.##[7]Richman I, Tessier-Sherman B, Galusha D, Oladele CR, Wang K.Breast cancer screening during the COVID-19 pandemic: moving from disparities to health equity. J Natl Cancer Inst. 2023;115(2):139-45. [PubMed ID: 36069622]. [PubMed Central ID: PMC9494402]. doi: 10.1093/jnci/djac172.##[8]Hosseini Z, Raisi L, Maghari AH, Karimollahi M.Missed nursing care in the COVID-19 pandemic in Iran. Int J Nurs Knowl. 2023;34(3):179-84. [PubMed ID: 36029159]. [PubMed Central ID: PMC9538638]. doi: 10.1111/2047-3095.12390.##[9]Talei A, Tahmasebi S, Akrami M, Zangouri V, Rezaianzadeh A, Arasteh P, et al.The Shiraz Breast Cancer Registry (SBCR): study design and primary reports. Per Med. 2018;15(6):471-9. [PubMed ID: 30375263]. doi: 10.2217/pme-2018-0047.##[10]Pruss M, Neubacher M, Dietzel F, Krawczyk N, Cieslik JP, Mohrmann S, et al.Retrospective Impact of COVID-19 Pandemic on Primary Breast Cancer Care. Breast Care (Basel). 2024;19(5):270-81. [PubMed ID: 39439862]. [PubMed Central ID: PMC11493392]. doi: 10.1159/000541015.##[11]Ng JS, Hamilton DG.Assessing the impact of the COVID-19 pandemic on breast cancer screening and diagnosis rates: A rapid review and meta-analysis. J Med Screen. 2022;29(4):209-18. [PubMed ID: 35593115]. [PubMed Central ID: PMC9127453]. doi: 10.1177/09691413221101807.##[12]Dennis LK, Hsu CH, Arrington AK.Reduction in Standard Cancer Screening in 2020 throughout the U.S. Cancers (Basel). 2021;13(23). [PubMed ID: 34885028]. [PubMed Central ID: PMC8656505]. doi: 10.3390/cancers13235918.##[13]Girardi F, Marini S, Porra F, Carpentieri S, Marchet A, Saibene T, et al.The Impact of COVID-19 on Treatment Practices for Patients With Early Breast Cancer: A Cross-Sectional Study From a Large Cancer Center in Italy. Oncologist. 2023;28(12):e1179-84. [PubMed ID: 37699107]. [PubMed Central ID: PMC10712907]. doi: 10.1093/oncolo/oyad255.##[14]Cairns A, Inman I, Perko A, Martin T, Chiba A, Howard-McNatt M.Are Breast Cancer Patients Presenting With Higher Stage Since the COVID-19 Pandemic? Am Surg. 2023;89(9):3784-7. [PubMed ID: 37260157]. [PubMed Central ID: PMC10240290]. doi: 10.1177/00031348231173985.##[15]Kang YJ, Baek JM, Kim YS, Jeon YW, Yoo TK, Rhu J, et al.Impact of the COVID-19 Pandemic on the Diagnosis and Surgery of Breast Cancer: A Multi-Institutional Study. J Breast Cancer. 2021;24(6):491-503. [PubMed ID: 34979596]. [PubMed Central ID: PMC8724378]. doi: 10.4048/jbc.2021.24.e55.##[16]Ramirez-Soto MC, Salazar-Pena M, Vargas-Herrera J.Estimating Excess Mortality Due to Prostate, Breast, and Uterus Cancer during the COVID-19 Pandemic in Peru: A Time Series Analysis. Int J Environ Res Public Health. 2023;20(6). [PubMed ID: 36982065]. [PubMed Central ID: PMC10049374]. doi: 10.3390/ijerph20065156.##[17]Alagoz O, Lowry KP, Kurian AW, Mandelblatt JS, Ergun MA, Huang H, et al.Impact of the COVID-19 Pandemic on Breast Cancer Mortality in the US: Estimates From Collaborative Simulation Modeling. J Natl Cancer Inst. 2021;113(11):1484-94. [PubMed ID: 34258611]. [PubMed Central ID: PMC8344930]. doi: 10.1093/jnci/djab097.##[18]Concepcion J, Yeager M, Alfaro S, Newsome K, Ibrahim J, Bilski T, et al.Trends of Cancer Screenings, Diagnoses, and Mortalities During the COVID-19 Pandemic: Implications and Future Recommendations. Am Surg. 2023;89(6):2276-83. [PubMed ID: 35420510]. [PubMed Central ID: PMC9014329]. doi: 10.1177/00031348221091948.##[19]Cairns A, Jones VM, Cronin K, Yocobozzi M, Howard C, Lesko N, et al.Impact of the COVID-19 Pandemic on Breast Cancer Screening and Operative Treatment. Am Surg. 2022;88(6):1051-3. [PubMed ID: 35417262]. [PubMed Central ID: PMC9014363]. doi: 10.1177/00031348221087920.##[20]Vanni G, Pellicciaro M, Materazzo M, Pedini D, Portarena I, Buonomo C, et al.Advanced Stages and Increased Need for Adjuvant Treatments in Breast Cancer Patients: The Effect of the One-year COVID-19 Pandemic. Anticancer Res. 2021;41(5):2689-96. [PubMed ID: 33952500]. doi: 10.21873/anticanres.15050.##[21]Mayo M, Potugari B, Bzeih R, Scheidel C, Carrera C, Shellenberger RA.Cancer Screening During the COVID-19 Pandemic: A Systematic Review and Meta-analysis. Mayo Clin Proc Innov Qual Outcomes. 2021;5(6):1109-17. [PubMed ID: 34693211]. [PubMed Central ID: PMC8520861]. doi: 10.1016/j.mayocpiqo.2021.10.003.##[22]Gaughan AA, MacEwan SR, Rush LJ, Gatti-Mays ME, Pariser AC, McAlearney AS.Perspectives of patients undergoing neoadjuvant chemotherapy for breast cancer during the COVID-19 pandemic. Cancer Rep (Hoboken). 2023;6(10). e1882. [PubMed ID: 37584345]. [PubMed Central ID: PMC10598258]. doi: 10.1002/cnr2.1882.##[23]Zhao F, Henderson TO, Cipriano TM, Copley BL, Liu M, Burra R, et al.The impact of coronavirus disease 2019 on the quality of life and treatment disruption of patients with breast cancer in a multiethnic cohort. Cancer. 2021;127(21):4072-80. [PubMed ID: 34292583]. 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1 Effect of Serum Ferritin Level on the Response to Standard Chemotherapy in Acute Myeloid Leukemia Patients https://brieflands.com/journals/semj/articles/161086 10.5812/semj-161086 1 Background :A high ferritin level in acute myeloid leukemia (AML) patients acts as a growth factor for leukemic cells, and its antioxidant effect may reduce the effectiveness of cytotoxic chemotherapy drugs, including anthracyclines.Methods :All adult patients with AML from 2013 to 2023, who had received 7+3 chemotherapy protocol at Namazi and Amir hospitals in Shiraz provided that Ferritin and C-reactive protein (CRP) level were checked before chemotherapy were included. We evaluated complete remission rate, overall survival (OS) and event-free survival (EFS) in 67 new cases. Results :The EFS was significantly longer in patients with serum ferritin levels below 1000 ng/mL compared to those with serum ferritin levels of 1000 ng/mL or higher [estimated mean and 95% CI: 25.65 (19.29 - 32) vs 11.6 (8.19 - 15.13) months, P = 0.018]. Conclusions :Ferritin levels at diagnosis are indicative of patient survival. The AML patients with serum ferritin levels greater than 1000 experienced shorter EFS compared to those with ferritin levels below 1000. 1 6 Nasrin Namdari Department of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran Iran sonanamdari@yahoo.com Ali Ghane-Shahmirzadi Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran Iran alighanei98@gmail.com Sezaneh Haghpanah Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Iran sezanehhaghpanah@gmail.com Maral Mokhtari Pathology Department, Shiraz University of Medical Sciences, Shiraz, Iran Iran maral_mokhtari@yahoo.com No Keyword 5.pdf [0]Döhner H, Weisdorf DJ, Bloomfield CD.Acute Myeloid Leukemia. N Engl J Med. 2015;373(12):1136-52. [PubMed ID: 26376137]. doi: 10.1056/NEJMra1406184.##[1]Ferrara F, Schiffer CA.Acute myeloid leukaemia in adults. Lancet. 2013;381(9865):484-95. [PubMed ID: 23399072]. doi: 10.1016/s0140-6736(12)61727-9.##[2]Short NJ, Rytting ME, Cortes JE.Acute myeloid leukaemia. Lancet. 2018;392(10147):593-606. [PubMed ID: 30078459]. [PubMed Central ID: PMC10230947]. doi: 10.1016/s0140-6736(18)31041-9.##[3]Paul S, Kantarjian H, Jabbour EJ.Adult Acute Lymphoblastic Leukemia. Mayo Clin Proc. 2016;91(11):1645-66. [PubMed ID: 27814839]. doi: 10.1016/j.mayocp.2016.09.010.##[4]Wang F, Lv H, Zhao B, Zhou L, Wang S, Luo J, et al.Iron and leukemia: new insights for future treatments. J Exp Clin Cancer Res. 2019;38(1):406. [PubMed ID: 31519186]. [PubMed Central ID: PMC6743129]. doi: 10.1186/s13046-019-1397-3.##[5]Bertoli S, Paubelle E, Bérard E, Saland E, Thomas X, Tavitian S, et al.Ferritin heavy/light chain (FTH1/FTL) expression, serum ferritin levels, and their functional as well as prognostic roles in acute myeloid leukemia. Eur J Haematol. 2019;102(2):131-42. [PubMed ID: 30325535]. doi: 10.1111/ejh.13183.##[6]Buranrat B, Connor JR.Cytoprotective effects of ferritin on doxorubicin-induced breast cancer cell death. Oncol Rep. 2015;34(5):2790-6. [PubMed ID: 26352101]. [PubMed Central ID: PMC4583531]. doi: 10.3892/or.2015.4250.##[7]Cermak J, Balla J, Jacob HS, Balla G, Enright H, Nath K, et al.Tumor cell heme uptake induces ferritin synthesis resulting in altered oxidant sensitivity: possible role in chemotherapy efficacy. Cancer Res. 1993;53(21):5308-13. [PubMed ID: 8221666].##[8]Hasegawa S, Morokoshi Y, Kanda H, Tsukamoto S, Zheng J, Tsuji AB, et al.H-ferritin overexpression promotes radiation-induced leukemia/lymphoma in mice. Carcinogenesis. 2012;33(11):2269-75. [PubMed ID: 22843505]. doi: 10.1093/carcin/bgs251.##[9]Lebon D, Vergez F, Bertoli S, Harrivel V, De Botton S, Micol JB, et al.Hyperferritinemia at diagnosis predicts relapse and overall survival in younger AML patients with intermediate-risk cytogenetics. Leuk Res. 2015;39(8):818-21. [PubMed ID: 26002512]. doi: 10.1016/j.leukres.2015.05.001.##[10]Tachibana T, Andou T, Tanaka M, Ito S, Miyazaki T, Ishii Y, et al.Clinical Significance of Serum Ferritin at Diagnosis in Patients With Acute Myeloid Leukemia: A YACHT Multicenter Retrospective Study. Clin Lymphoma Myeloma Leuk. 2018;18(6):415-21. [PubMed ID: 29673622]. doi: 10.1016/j.clml.2018.03.009.##[11]Ihlow J, Gross S, Sick A, Schneider T, Flörcken A, Burmeister T, et al.AML: high serum ferritin at initial diagnosis has a negative impact on long-term survival. Leuk Lymphoma. 2019;60(1):69-77. [PubMed ID: 29846127]. doi: 10.1080/10428194.2018.1461860.##[12]Thurnham DI, McCabe LD, Haldar S, Wieringa FT, Northrop-Clewes CA, McCabe GP.Adjusting plasma ferritin concentrations to remove the effects of subclinical inflammation in the assessment of iron deficiency: a meta-analysis. Am J Clin Nutr. 2010;92(3):546-55. [PubMed ID: 20610634]. doi: 10.3945/ajcn.2010.29284.##[13]Armand P, Kim HT, Virtanen JM, Parkkola RK, Itälä-Remes MA, Majhail NS, et al.Iron overload in allogeneic hematopoietic cell transplantation outcome: a meta-analysis. Biol Blood Marrow Transplant. 2014;20(8):1248-51. [PubMed ID: 24769316]. [PubMed Central ID: PMC4099413]. doi: 10.1016/j.bbmt.2014.04.024.##[14]Armand P, Kim HT, Cutler CS, Ho VT, Koreth J, Alyea EP, et al.Prognostic impact of elevated pretransplantation serum ferritin in patients undergoing myeloablative stem cell transplantation. Blood. 2007;109(10):4586-8. [PubMed ID: 17234738]. [PubMed Central ID: PMC1885508]. doi: 10.1182/blood-2006-10-054924.##[15]Bazuaye GN, Buser A, Gerull S, Tichelli A, Stern M.Prognostic impact of iron parameters in patients undergoing allo-SCT. Bone Marrow Transplant. 2012;47(1):60-4. 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1 Medical Students’ Empathy Towards the Patient; Does Their Perceived Social Support Play a Role? A Cross-sectional Study https://brieflands.com/journals/semj/articles/158227 10.5812/semj-158227 1 Background :The correlation between doctors and patients is greatly influenced by empathy. Understanding the patient’s emotions can aid physicians in responding appropriately. Objectives :The present study aimed to determine the correlation between empathy with the patient and the perceived social support of medical students. Methods :This analytical cross-sectional study was conducted in 2023, involving 260 medical students at Alborz University of Medical Sciences. The study utilized the Multidimensional Scale of Perceived Social Support (MSPSS), Jefferson Scale of Empathy-Health Professions Student (JSE-HPS), and a socio-demographic information checklist. Statistical analyses were performed using chi-square, Fisher’s exact test, t-test, Mann-Whitney, analysis of variance (ANOVA), Kruskal-Wallis test, Spearman’s rank correlation coefficient, and multiple linear regression, all conducted using SPSS v23 software at a significance level of less than 0.05. Results :The students’ overall empathy score was 108.53 (16.43). Severe perceived social support resulted in a higher empathy score than moderate and mild perceived social support (P = 0.001). According to the linear regression test, medical students’ empathy was significantly determined by their level of social support (β = 0.161, P = 0.01) and gender (β = 0.146, P = 0.02). Conclusions :Considering the significant correlation between empathy with patients and perceived social support among medical students, implementing interventions to enhance social support among them, especially among boys, seems necessary. 1 9 Malihe Farid Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran Iran malihefarid@yahoo.com Sahar Ghaderi Medicine Faculty, Alborz University of Medical Sciences, Karaj, Iran Iran saharakghaderi0076@gmail.com No Keyword 6.pdf [0]Hojat M.Definitions and Conceptualization. Empathy in Patient Care. New York, NY: Springer; 2007. p. 3-15. doi: 10.1007/0-387-33608-7_1.##[1]Hojat M.Patient Outcomes. Empathy in Patient Care. New York, NY: Springer; 2007. p. 163-72. doi: 10.1007/0-387-33608-7_10.##[2]Derksen F, Bensing J, Lagro-Janssen A.Effectiveness of empathy in general practice: a systematic review. Br J Gen Pract. 2013;63(606):e76-84. [PubMed ID: 23336477]. 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1 Review of the 'Women’s Diseases and Infertility' Course in the Midwifery Bachelor’s Curriculum Based on the Kern Curriculum Revision Model https://brieflands.com/journals/semj/articles/160587 10.5812/semj-160587 1 This article has no abstract regards to the type of article 1 3 Kowsar Qaderi Kermanshah University of Medical Sciences, Kermanshah, Iran Iran kowsar.qaderi@gmail.com Ghobad Ramezani Education Development Center, Kermanshah University of Medical Sciences, Kermanshah, Iran Iran ramazanighobad@gmail.com No Keyword 7.pdf [0]Rasouli D, Norouzi A, Ramezani G, Hashemi A, Neisani Samani L.The Trends of Attitude Change and Interprofessional Collaboration Competencies among Medical and Nursing Students of Iran University of Medical Sciences. Med J Islam Repub Iran. 2023;37:124. [PubMed ID: 38318413]. [PubMed Central ID: PMC10843343]. doi: 10.47176/mjiri.37.124.##[1]Ho KHM, Cheng HY, McKenna L, Cheung DSK.Nursing and midwifery in a changing world: Addressing planetary health and digital literacy through a global curriculum. Nurs Open. 2024;11(1). e2075. [PubMed ID: 38268246]. [PubMed Central ID: PMC10748439]. doi: 10.1002/nop2.2075.##[2]Achampong EK.Assessing the Current Curriculum of the Nursing and Midwifery Informatics Course at All Nursing and Midwifery Institutions in Ghana. J Med Educ Curric Dev. 2017;4:2382120517706890. [PubMed ID: 29349334]. [PubMed Central ID: PMC5736297]. doi: 10.1177/2382120517706890.##[3]Abdolalipour S, Mohammad-Alizadeh-Charandabi S, Babaey F, Allahqoli L, Ghaffari R, Mirghafourvand M.Mapping of Iranian midwifery curriculum according to the International Confederation of midwives competencies. BMC Med Educ. 2023;23(1):791. [PubMed ID: 37875917]. [PubMed Central ID: PMC10599037]. doi: 10.1186/s12909-023-04755-7.##[4]Rosser BRS, Mkoka DA, Rohloff CT, Mgopa LR, Ross MW, Lukumay GG, et al.Tailoring a sexual health curriculum to the sexual health challenges seen by midwifery, nursing and medical providers and students in Tanzania. Afr J Prim Health Care Fam Med. 2022;14(1):e1-9. [PubMed ID: 35695444]. [PubMed Central ID: PMC9210149]. doi: 10.4102/phcfm.v14i1.3434.##[5]Shaban I, Leap N.A review of midwifery education curriculum documents in Jordan. Women Birth. 2012;25(4):e47-55. [PubMed ID: 21955442]. doi: 10.1016/j.wombi.2011.09.001.##[6]Aalaa M, Sanjari M, Amini MR, Ramezani G, Mehrdad N, Tehrani MRM, et al.Diabetic foot care course: a quasi-experimental study on E-learning versus interactive workshop. J Diabetes Metab Disord. 2021;20(1):15-20. [PubMed ID: 34178821]. [PubMed Central ID: PMC8212321]. doi: 10.1007/s40200-020-00630-0.##