Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 12 3 2017 06 28 147 153 EN Shahram Hajirezaei Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran. Abolfazl Mohammadi Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Soleimani Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Rahiminezhad Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Mohammadi Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran AND Psychiatric and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. C. Robert Cloninger Center for Psychobiology of Personality, Sansone Center for Well-Being, Washington University St. Louis, St. Louis, MO, USA. 2016 12 14 Objective: This study was conducted to compare the profile of Temperament and Character dimensions in patients with major depressive disorder and bipolar mood disorder and control group. Methods: In this causal-comparative study the population consisted of two clinical groups (major depressive disorder and bipolar mood disorder) and a non-clinical group. The sample was 193 subjects (77 patients with major depressive disorder, 86 patients with bipolar mood disorder, and 30 normal people) with an age range of 18-65 years and the mean age of 40.1. They were selected from Roozbeh psychiatric hospital using available sampling method. Tools used in this research included Temperament and Character Inventory-140 and General Health Questionnaire-28. Collected data were analyzed by statistical methods of independent t-test and one-way analysis of variance using Statistical Package for the Social Sciences-22 software. Result: The results of comparing the groups showed that there was a significant difference among groups in dimensions of Novelty Seeking, Harm Avoidance, Persistence, Self-Directedness and Cooperativeness (P <0.05). The results showed that only in the Novelty Seeking dimension, the mean was different in males and females (P <0.05). Conclusion: In general, our results showed that patients with major depressive disorder and bipolar mood disorder have different personality profile in some dimensions of Temperament and Character compared with control group. https://ijps.tums.ac.ir/index.php/ijps/article/view/901 https://ijps.tums.ac.ir/index.php/ijps/article/download/901/637

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 12 3 2017 06 28 154 162 EN Sophia Esalatmanesh Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran Mojtaba Biuseh Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Ali Noorbala Psychosomatic Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran. Seyed-Ali Mostafavi Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran Farzin Rezaei Qods Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran. Bita Mesgarpour National Institute for Medical Research Development (NIMAD), Tehran, Iran. Payam Mohammadinejad Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. Shahin Akhondzadeh Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2017 06 28 Objective: There are different pathophysiological mechanisms for obsessive- compulsive disorder (OCD) as suggested by the serotonergic, dopaminergic, and glutamatergic hypotheses. The present study aimed at comparing the efficacy and safety of saffron (stigma of Crocus sativus) and fluvoxamine in the treatment of mild to moderate obsessive- compulsive disorder. Method: In this study, 50 males and females, aged 18 to 60 years, with mild to moderate OCD, participated. The patients were randomly assigned to receive either saffron (30 mg/day, 15 mg twice a day) or fluvoxamine (100 mg/day) for 10 weeks. Using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Adverse Event Checklist, we assessed the patients at baseline, and at the second, fourth, sixth, eighth, and tenth week. Finally, the data were analyzed using general linear repeated measures. Results: In this study, 46 patients completed the trial. General linear repeated measures demonstrated no significant effect for time-treatment interaction on the Y-BOCS total scores [F (2.42, 106.87) = 0.70, P = 0.52], obsession Y-BOCS subscale scores [F (2.47, 108.87) = 0.77, p = 0.49], and compulsion Y-BOCS subscale scores [F (2.18, 96.06) = 0.25, P = 0.79]. Frequency of adverse events was not significantly different between the 2 groups. Conclusion: Our findings suggest that saffron is as effective as fluvoxamine in the treatment of patients with mild to moderate OCD. https://ijps.tums.ac.ir/index.php/ijps/article/view/1115 https://ijps.tums.ac.ir/index.php/ijps/article/download/1115/647

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 12 3 2017 06 28 163 171 EN Arsia Taghva AJA University of Medical Sciences, Tehran, Iran. Zahra Farsi Community Health Department, Faculty of Nursing, AJA University of Medical Sciences, Tehran, Iran. Yavar Javanmard AJA University of Medical Sciences, Tehran, Iran. Afsaneh Atashi Faculty of Psychology, Bangalore University, Bangalore, India. Ahmad Hajebi Addiction and High Risk Behavior, Tehran Institute of Psychiatry, Faculty of Behavioral Sciences and Mental Health, Iran University of Medical Sciences (IUMS), Tehran, Iran. Mojgan Khademi Department of Child Psychiatry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2016 09 30 Background: Many people who accesses mental health services usually do not seek treatment to avoid the consequences of stigma and label of mental illness. Determining each of these aspects related to stigma reduction barriers seems necessarily. Objective: A qualitative study was undertaken to investigate stigma reduction barriers toward mental disorders in Iran. Methodology: The present study used content analysis and was carried out from 2013 to 2015. All stakeholders have been chosen by purposive sampling technique. All data obtained through 16 individual interviews, 2 focus groups and 6 written narratives. The data were collected, coded and analyzed accordingly.  Results: The major themes were: The universality of stigma, Beliefs, Attitudes and lack of awareness, Mental health providers and other specialists, Cultural barriers, Structures and policy makers, Insufficient financial resources. Conclusion: It is necessarily to identify the barriers of stigma reduction programs in Iran to increase the quality of life of mental patients. In the present study due to the presence of mental health stakeholders the main barriers have been obtained.  https://ijps.tums.ac.ir/index.php/ijps/article/view/823 https://ijps.tums.ac.ir/index.php/ijps/article/download/823/638

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 12 3 2017 06 28 172 181 EN Hamid Sharif Nia School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran. Saeed Pahlevan Sharif School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran. Rebecca H Lehto Associate Professor Michigan State University College of Nursing, Michigan, USA Kelly A Allen Honorary Fellow. The Melbourne Graduate School of Education, The University of Melbourne. Melbourne, Australia Amir Hossein Goudarzian Nursing, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran. Ameneh Yaghoobzadeh Master in Geriatric Nursing, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Ali Soleimani Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. 2016 09 27 Objective: The psychometric properties of a scale should be re-assessed routinely with different samples to ensure its generalizability. The present study aimed to determine the reliability and validity of the Persian Version of Death Depression Scale (DDS) in Iranian patients with Acute Myocardial Infarction (AMI). Methods: The face validity, content validity and construct validity (i.e. factorial, convergent, and discriminant validity) of the DDS were assessed using a sample of 407 AMI patients. Confirmatory factor analysis was conducted using the ratio chi-square by degrees of freedom (χ2/df), the Goodness-of-fit index (GFI), Comparative Fit Index (CFI), Incremental Fit Index (IFI), Normed Fit Index (NFI), and Root Mean Square Error of Approximation (RMSEA). Convergent and discriminant validity were assessed using average variance extracted (AVE), maximum shared squared variance (MSV), and average shared square variance (ASV). Internal consistency, test–retest, and construct reliability (CR) were used to assess reliability of the Persian Version of DDS. Results: Based on principle component analysis and consideration of conceptual meaning, a four-factor solution was selected, explaining 75.89% of the total variance. Goodness-of-fit indices (c2(98) = 583.646, p < .05, c2/df= 5.956, GFI = .856, CFI = .902, NFI = .885, IFI = .902, RMSEA (90% C.I.) = .110 (.102 - .119) in the final DDS structure demonstrated the adequacy of the four-domain structure of the DDS. Convergent and discriminant validity was used to assess the construct validity of the DDS. The reliability was greater than .70. Conclusion: The DDS was found to be a valid and reliable assessment tool for death depression in Iranian patients with AMI. https://ijps.tums.ac.ir/index.php/ijps/article/view/822 https://ijps.tums.ac.ir/index.php/ijps/article/download/822/639

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 12 3 2017 06 28 182 187 EN Payam Amini Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. Roya Najafi-Vosough Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran. Ali Ghaleiha Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran Hossein Mahjub Research Center for Health Sciences and Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran 2016 08 10 Objective: Bipolar disorder is characterized by periods of manic, depression, or mixed episodes. The purpose of this study was to assess the development of bipolar disorder episode over the time as well as determining the risk factors affecting bipolar disorder. Methods: This retrospective cohort study was conducted in Hamadan Province, the west of Iran, from April 2008 to September 2014 including 124 patients with bipolar disorder. All patients had experienced four recurrences. Generalized Estimating Equation (GEE) as a longitudinal modeling approach was used due to longitudinally recording of bipolar disorders. A significant level of 0.05 was considered for the tests. Results: The mean (SD) age of the 124 patients was 33.2 (11.55). GEE showed that the odds of manic males than depressed or mixed (as well as manic or depressed than mixed female patients according to proportionality of odds) is 1.99 times than those of females. The odds ratio of mania than depression or mixed (as well as mania or depression than mixed) is 0.441 for patients who used both drugs and psychotherapy comparing to only drugs. As well, the odds ratios comparing spring to winter and autumn are 2.01 and 1.82, respectively Conclusion: The results from this study using GEE method showed that in an Iranian bipolar disorder patients, mania is much more prevalent than depression or mixed as well as mania and depression than mixed. Sex, treatments and the seasons of recurrence can determine the episode of bipolar disorder. https://ijps.tums.ac.ir/index.php/ijps/article/view/766 https://ijps.tums.ac.ir/index.php/ijps/article/download/766/640

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 12 3 2017 06 28 188 193 EN Malihe Sohrabivafa Department of Health and Community Medicine, Faculty of Medicine, Dezful University of Medical Sciences, Dezful, Iran. Mohammad Ali Tosang Department of Health and Community Medicine, Faculty of Medicine, Dezful University of Medical Sciences, Dezful, Iran. Seyedeh Zeynab Molaei Zadeh Department of Health and Community Medicine, Faculty of Medicine, Dezful University of Medical Sciences, Dezful, Iran. Elham Goodarzi Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran. Zahra Sadat Asadi Health Education & Promotion, Department of Community Medicine, School of Medicine, AJA University of Medical Sciences, Tehran, Iran. Alireza Alikhani Deputy of Medical Education Development Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Salman Khazaei Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran. Seyedeh Leila Dehghani Department of Public Health, Behbahan Faculty of Medical Sciences, Behbahan, Iran. Reza Beiranvand Instructor of Epidemiology, Department of Epidemiology, Faculty of Medical Sciences, Shushtar, Iran. Zaher Khazaei Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran. 2016 10 22 Introduction: Adolescence is a period of evolution that there is the incidence probability of risky behaviors such as drug abuse, risky sexual behavior and compatibility problems. The goal of this study was to investigate the prevalence rate of risky behaviors among students of Dezful University of Medical Sciences in 2014. Method: This is a descriptive-analytical cross-sectional study, which cluster random sampling were used to selecting subjects. Young's Risk Behaviors Scale (YRBS) was used to evaluate risky behaviors and factors affecting it. The mean, standard deviation, Chi-square tests, t-tests and ANOVA were used to analysis of data. Results: The study was included 150 (50%) female and 150 (50%) male. The most frequency was the age group of 20-24 years old. There was a statistically significant difference between average scores of risky behaviors among female and male students (p˂0.05). The results of study showed that the prevalence of risky behaviors, high speed in driving and drug consumption is different in various fields of study (p˂0.05). Conclusion: The prevalence of risky behaviors among students of Dezful University is relatively low, and the prevalence of these behaviors in girls was far less than male students. Risky behaviors were associated with background variables exception of mother's job.   https://ijps.tums.ac.ir/index.php/ijps/article/view/838 https://ijps.tums.ac.ir/index.php/ijps/article/download/838/641

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 12 3 2017 06 28 194 200 EN hayder Al-kuraishy Department of Pharmacology, Toxicology and Medicine, College of Medicine, Almustansiriya University, P.O. Box 14132, Baghdad, Iraq. Ai Al-Gareeb Department of Pharmacology, Toxicology and Medicine, College of Medicine, Almustansiriya University, P.O. Box 14132, Baghdad, Iraq. 2016 09 17 Objective: The aim of present study was evaluation the effect of Panax Ginseng on malondialdehyde (MDA) serum levels during eustress on normal healthy volunteers. Method: 65 healthy volunteers were recruited from medical students at college of medicine with age range (22.61±3.63) years, the volunteers were divided into two groups, Group A: 35 subjects treated by Panax Ginseng 500mg/day regarded as treated group. Group B: 30 subjects treated by placebo 500mg/day regarded as control group. Baseline data was obtained and then after one month of study for following induction of psychological stress through daily psychomotor performance task and visual working memory accuracy testing while; stress-induced oxidative stress was assessed by malondialdehyde (MDA) serum levels. Results: placebo showed significant increases in MDA serum levels p=0.0004 which related with significant increases in perceived stress scale from p<0.0001, while; Panax Ginseng led to significant reduction in MDA serum levels from p<0.01 that related with significant increment in perceived stress scale p=0.02. Conclusion: An MDA serum level is positively correlated with eustress and this association is modulated by   Panax Ginseng therapy that produced significant reduction in MDA and rising of eustress level. https://ijps.tums.ac.ir/index.php/ijps/article/view/803 https://ijps.tums.ac.ir/index.php/ijps/article/download/803/642

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 12 3 2017 06 28 201 205 EN Atieh Dolatian Department of Cellular-Molecular Nutrition, School of Nutrition Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Seyed Masoud Arzaghi Elderly Health Research Center, Endocrinology and Metabolism population sciences Institute, Tehran university of Medical sciences, Tehran, Iran Mostafa Qorbani School of Medicine, Community Medicine Department, Alborz University of Medical Sciences, Karaj, Iran Hamideh Pishva Department of Cellular-Molecular Nutrition, School of Nutrition Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran 2016 04 10 Objective: obesity and depression are likely to interact mutually which makes it unclear if obesity causes depression or it leads to obesity; and how the genotypes have a role in obesity and depression. Methods and Materials: This cross sectional study was conducted on a sample of 400 individuals from the participants in the third phase of the comprehensive Iranian Multicenter Osteoporosis Study (IMOS). Anthropometric measurements and depression were assessed. To investigate the NPY polymorphism, PCR-RFLP was used. Binary logistic regression model was employed to determine depression as the dependent factor and gene polymorphism Results: the frequency of NPY rs16139 was 6%. No significant association could be found between NPY genotypes and depression (p >0.05). Furthermore, the results suggest that those with central obesity seem an increased chance of developing depression (P=0.02). Conclusion: There is a significant relationship between obesity and depression and obesity is a possible cause of depression. Waist circumference and abdominal obesity as components of metabolic syndrome have the most important effects on depression. https://ijps.tums.ac.ir/index.php/ijps/article/view/656 https://ijps.tums.ac.ir/index.php/ijps/article/download/656/644

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 12 3 2017 06 28 206 213 EN Seyed Hamzeh Hosseini Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran.Department of Psychosomatic, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran. Alireza Rafiei Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Ali Gaemian Department of Cardiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. Abdolhakim Tirgari Department of Psychiatry, Member of Psychiatry and Behavioral Sciences Research Center, Sari, Iran. Aliasghar Zakavi Department of Islamic Thought, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. jamshid Yazdani Department of Biostatistics, Health Sciences Research Center, Faculty of Health Sciences, Mazandaran University of Medical Sciences, Sari, Iran. Jafar Bolhari Mental Health Research Center (MHRC), Tehran Psychiatric Institute, Iran University of Medical Sciences (IUMS), Tehran, Iran. Mahmood Golzari Faculty of Psychology and Educational Sciences, Allame Tabatabai University, Tehran, Iran. Zahra Esmaeili Douki Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran. Nazanin Vaezzadeh Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran. 2016 04 24 Objectives: Our objective is to compare the effects of RCBT, CBT, and sertraline on depression, anxiety, biomarker levels, and the quality of life in patients after coronary artery bypass graft (CABG) surgery. Method/Design: This is a randomized controlled trial with parallel groups. A total of 160 patients after CABG surgery will be screened for anxiety and depression according to clinical interviews based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and Hospital  Anxiety Depression Scale (HADS) scores (≥ 8). To assess religious attitude, Golriz and Baraheni’s religious attitude questionnaire will be used. Participants will be randomly allocated to four groups of 40 including three intervention groups (RCBT, CBT, and sertraline) and one control group (usual care). RCBT and CBT programs will consist of 12 one-hour weekly sessions. The participants in the pharmacological intervention group will receive 25-200 mg/d of sertraline for three months. The (SF-36) will be administered to assess the patients’ quality of life. Blood samples will be taken and biomarker levels will be determined using the enzyme-linked immunosorbent assay (ELISA). The primary outcome will be the reduction in anxiety and depression scores after the interventions. The secondary outcomes will be increases in quality of life scores and normalized biomarker levels after the interventions. Discussion: If RCBT is found to be more effective than the other methods, it can be used to improve patients’ health status after CABG surgery. Irct ID: IRCT201404122898N5 https://ijps.tums.ac.ir/index.php/ijps/article/view/672 https://ijps.tums.ac.ir/index.php/ijps/article/download/672/645

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 12 3 2017 06 28 214 218 EN Atefe Kamaloo Department of psychiatry Tehran University of Medical Sciences, Roozbeh Hospital, Tehran, Iran. Ahmad Ahmadipour Department of psychiatry Tehran University of Medical Sciences, Roozbeh Hospital, Tehran, Iran. Ali labbaf Department of Emergency Medicine, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran. Elham Hesari Department of Emergency Medicine, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran Somaye Valadkhani Department of Emergency Medicine, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran Jeyran Zebardast Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran. Mohammad Arbabi Department of psychiatry,psychosomatic ward,Imam Khomeini hospital, Tehran University of Medical Sciences, Tehran, Iran. 2017 06 28 Objective: Emergency medicine residents are a high–risk group for burnout syndrome. This was a qualitative study with content analysis on emergency medical residents with 2 aims: evaluating the incidence of occupational burnout syndrome and identifying the points of view and attitudes of emergency medical residents about factors related to occupational burnout syndrome. Method: For this study, 2 sessions of focus group discussions were set up at Imam Khomeini hospital affiliated to Tehran University of Medical Sciences. Each session took 90 minutes, and 20 emergency medicine residents in their first or second year of emergency medicine residency participated in the sessions. Data were coded   by MAXQDA10 software. Results: Data were categorized in 4 themes as follow: (1) the characteristics of emergency medicine; (2) ambiguity in residents’ duties; (3) educational planning; and (4) careers. Data on the proposed solutions by residents were analyzed and coded in 3 groups including (1) changes in personal life; (2) arrangement in shifts; and  (3) educational issues. Conclusion: According to findings of this qualitative study, most of emergency medicine residents have experienced exhaustion sometime during the course of their residency. Psychological supports may help the residents to cope with their career difficulties and probable burn out. https://ijps.tums.ac.ir/index.php/ijps/article/view/1116 https://ijps.tums.ac.ir/index.php/ijps/article/download/1116/648

Tehran University of Medical Sciences Iranian Journal of Psychiatry 1735-4587 12 3 2017 06 28 219 222 EN Majid Kheirollahi Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Reza Pourreza Isfahan University of Medical Sciences, Isfahan, Iran Fariborz Khorvash Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Kazemi Isfahan University of Medical Sciences, Isfahan, Iran Gilda Amini Isfahan University of Medical Sciences, Isfahan, Iran 2016 10 27 Objective: The human prostacyclin receptor gene (PTGIR) encodes the human prostacyclin (PGI2) receptor. PTGIR is a part of vasodilator system during the migraine attacks and probably has an important role in the mechanism of this disease. Materials and Methods: We used direct PCR and sequencing to determine the any variants in PTGIR gene. A blood sample was collected from the patients and genomic DNA was extracted. Polymerase chain reaction was carried out on extracted DNA. The PCR products were then sequenced using a cycle sequencing kit, on an automated DNA sequencing machine. Results: In reviewing of familial and clinopathological of these two patients, both patients have migraines with visual aura and their mothers also are suffering from migraines. Their parents had been married strangers. Direct sequencing analysis of exon 2 of the PTGIR gene showing the presence of two mutations in two patients. These mutations were heterozygote that made the following changes; g.1626T>A, c.754T>A, cDNA.867T>A, and p.S252T for the first mutation and c.753C>T, cDNA866C>T, g.1625C>T, p.C251C for the second mutation. The first mutation alters the amino acid and is a novel mutation. The second change is a conservative mutation that have already been reported. Conclusion: The prediction results predicted the variant would negatively affect the protein’s function and seems to be disease causing. Although functional analysis is required to confirm the association between the variant and the disease. https://ijps.tums.ac.ir/index.php/ijps/article/view/843 https://ijps.tums.ac.ir/index.php/ijps/article/download/843/646