Background One of the most important indicators of the effectiveness of teaching can be the academic achievement of learners, which can be influenced by different factors such as learning methods and individual motivations. The purpose of this study was to determine the ability of predicting academic achievement based on learning motivation strategies and outcome expectations based on a theoretical model. Methods This descriptive-analytic study was conducted with the participation of 380 male and female students of nine faculties of medical sciences of Shahid Beheshti University of Tehran. Multi-stage sampling along with the questionnaire of motivational strategies for learning and student outcome expectation scale were used for data collection. The college grade point average (CGPA) of students’ past grades was considered as the academic performance variable. Data analysis was performed using Structural Equation Modeling (SEM) in AMOS software. Results The mean score of the structure of learning strategies, motivational strategies, outcome expectations, and students’ GPA did not show significant statistical differences in terms of gender, marital status, residence location, field of study, and educational level. There was a direct and significant relationship between the motivational strategies’ structures ( R = 0.193, p < 0.001) as well as learning strategies ( R = 0.243, p < 0.001) and the CGPA, while there was no relationship between outcome expectations and CGPA. Path analysis revealed that self-regulating learning strategies and motivational strategies can predict the academic achievement of these students. Conclusions Considering the importance of active and independent learning among medical students, it is necessary for lecturers to use interactive and student-oriented patterns of teaching. Also, students should become familiar with self-regulating learning skills to better understand the information they receive. Electronic supplementary material The online version of this article (10.1186/s12909-019-1527-9) contains supplementary material, which is available to authorized users.

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1 ، * ‫عامری‬ ‫فرزانه‬ 2 ، ‫حقانی‬ ‫حمید‬ 3 ‫قبادی‬ ‫علی‬ ، 4 ‫چکیده‬ ‫هدف‬ ‫و‬ ‫زمینه‬ ‫ت‬ ‫تعیین‬ ‫هدف‬ ‫با‬ ‫مطالعه‬ ‫این‬ ‫سوختگی،‬ ‫به‬ ‫مبتال‬ ‫بیماران‬ ‫در‬ ‫درد‬ ‫مدیریت‬ ‫اهمیت‬ ‫به‬ ‫توجه‬ ‫با‬ : ‫أ‬ ‫ثیر‬ ‫ت‬ ‫معطر‬ ‫روغن‬ ‫با‬ ‫ماساژی‬ ‫درمانی‬ ‫رایحه‬ ‫رکیبی‬ ‫زمینه‬ ‫درد‬ ‫شدت‬ ‫بر‬ ‫بابونه‬ ‫و‬ ‫اسطوخودوس‬ ‫شد.‬ ‫انجام‬ ‫سوختگی‬ ‫به‬ ‫مبتال‬ ‫بیماران‬ ‫ای‬ ‫بررسی‬ ‫روش‬ ‫تجربی،‬ ‫نیمه‬ ‫مطالعه‬ ‫یک‬ ‫در‬ : ‫دیماه‬ ‫زمانی‬ ‫بازه‬ ‫در‬ 1396 ‫اردیبهشت‬ ‫تا‬ 1397 ، 105 ‫بیمار‬ ‫مرکز‬ ‫در‬ ‫بستری‬ ‫سوختگی،‬ ‫به‬ ‫مبتال‬ ‫درمانی‬ ‫آموزشی‬ 3 . ‫استادیار‬ ، ‫ب‬ ‫دانشکده‬ ‫زیستی،‬ ‫آمار‬ ‫گروه‬ ‫ایران‬ ‫تهران،‬ ‫ایران،‬ ‫پزشکی‬ ‫علوم‬ ‫دانشگاه‬ ‫هداشت،‬ . 4 . ‫استاد‬ ‫ی‬ ‫ار‬ ، ‫آموزش‬ ‫گروه‬ ‫ی‬ ‫سنت‬ ‫طب‬ ‫ی‬ ، ‫پزشک‬ ‫علوم‬ ‫دانشگاه‬ ‫بهداشت،‬ ‫دانشکده‬ ‫ی‬ ‫ا‬ ‫ی‬ ‫ران،‬ ‫ا‬ ‫تهران،‬ ‫ی‬ ‫ران‬ . AbstractBackground & Aims: Given the importance of pain management in burn patients, the present study aimed to assess the effect of aromatherapy massage with aromatic oils of lavender and chamomile on the intensity of the background pain in burn patients. Materials & Methods:This quasi-experimental study was conducted on 105 patients with burn injuries admitted to Shaheed Motahari Hospital in Tehran, Iran during January-May 2018. The patients were selected via convenience sampling and allocated to three groups of control, placebo massage, and combined aromatic oil massage by drawing lots and blocks of four with cards. The interventions were performed 20 minutes before bedtime in three sessions for one week. The control group only received routine care. Data were collected using the visual analogue scale (VAS). Data analysis was performed in SPSS version 20 using descriptive statistics (frequency, frequency percentage, mean, and standard deviation), and inferential statistics (Chi-square, Fisher's exact test, analysis of variance, and paired t-test) were applied to determine the significance. Results: Before the interventions, the three groups had no significant difference in terms of the pain score (P=0.746), while after the intervention, the results indicated a significant difference between the three groups in terms of the pain score, (P<0.001), so that the mean pain intensity was lower in the combination oil massage group compared to the other groups, as well as the placebo group compared to the control group. Conclusion: Considering that aromatherapy massage could effectively improve the background pain in burn patients as a non-pharmacological, simple method, it is recommended that nurses and burn injuries medical teams apply this technique in the routine care program of these patients.

The current study was conducted to assess the effects of simultaneous usage with vitamin D3 and chromium picolinate (CrPic) supplementations on homeostasis model assessment of insulin resistance (HOMA-IR), fasting blood glucose (FBS), hemoglobin A1c (HbA1c), tumor necrosis factor-α (TNF-α), and lipid profile in type 2 diabetes mellitus (T2DM). Ninety-two patients with T2DM were randomly allocated to the following 4 groups for 4 months: (I) placebo of vitamin D3 (n = 23); (II) vitamin D3 supplement at a dose of 50 000 IU/week (n = 23); (III) CrPic supplement at a dose of 500 μg/day (n = 23); and (IV) both vitamin D3 at a dose of 50 000 IU/week and CrPic at a dose of 500 μg/day (n = 23). HOMA-IR levels increased significantly in groups I and II after the intervention. However, this increase in group I was significantly higher than that in group II after the treatment. HOMA-IR levels were controlled in groups III and IV during the intervention. TNF-α decreased significantly in groups II, III, and IV after the intervention. FBS, HbA1c, and lipid profile did not change significantly in total groups after the intervention. It seems that chromium and vitamin D3 co-supplementation are probably effective in controlling HOMA-IR by decreasing TNF-α in T2DM. Novelty Chromium alone and/or in simultaneous pretreatment with vitamin D3 is more effective than vitamin D3 in controlling HOMA-IR in T2DM. Chromium and vitamin D3 alone and/or in simultaneous pretreatment decrease TNF-α in T2DM.

Purpose In some countries, telephone-based support is one of the key services used for supporting patients with cancer. However, there is a lack of research on the efficacy of this method in Iran. This study aimed to evaluate the effects of telenursing on supportive care needs (SCNs) of patients with cancer undergoing chemotherapy. Methods This randomized controlled trial was conducted on 60 patients with cancer undergoing chemotherapy who were randomly assigned and allocated to two groups, an intervention group and a control group. Patients' SCNs were assessed in the baseline, and 1 and 2 months after commencement of the intervention using the SCNs Survey-Short Form 34. The data were analyzed through descriptive statistics, t-test, and repeated measure test, by SPSS version 16. Results There were no significant statistical differences in the mean score of dimensions and total SCNs between the two groups in baseline (p˃0.05). However, the results showed that the mean score of dimensions and total SCNs in the intervention group were significantly less than the control group, after the intervention (p˂0.05). Conclusions Telephone-based support is an effective method to address and reduce SCNs of patients with cancer undergoing chemotherapy through increasing access to support for this population especially who may be in rural and remote settings. During the COVID_19 pandemic and given the vulnerability of patients with cancer, telephone support can be used to avoid unnecessary visits to hospitals and reduced the risk of transmitting the virus to the patients. Trial registration number IRCT20170404033216N1 Keywords Cancer. Supportive care needs. Tele-nursing. Quality of life * Nazi Nejat

COVID‐19 significantly affects patients' mental health, triggering a wide range of psychological disorders, including anxiety. The aim of this study was to investigate the effect of mandala colouring on the anxiety of hospitalized COVID‐19 patients. In this randomized controlled clinical trial, 70 hospitalized patients with COVID‐19 were randomly divided between the intervention and control groups. Standard care was provided for both groups. The intervention group spent 30 min/day for six consecutive days performing mandala colouring. Patient anxiety was measured prior and subsequent to the intervention in both groups using the Spielberger State‐Trait Anxiety Inventory. Data were analysed using SPSS software version 25. The mean anxiety score was not significantly different between the two groups before the intervention (P = 0.08). Subsequent to the intervention, the mean anxiety score in the intervention and control groups was 44.05 ± 4.67 and 67.85 ± 6.25, respectively, indicating a statistically significant (P = 0.0001) decrease in the anxiety measured among the intervention group as compared with that of the control group. The results of this study show that 30 min of mandala colouring daily is an effective strategy for reducing anxiety in hospitalized COVID‐19 patients. Mandala colouring can complement routine treatment and provides a non‐pharmaceutical option for decreasing patient anxiety.

Patients with type 2 diabetes mellitus (T2DM) have been known to be suffering from coenzyme Q10 (CoQ10) deficiency which results in some complications in them. The purpose of this clinical trial study was to evaluate the effects of CoQ10 supplementation on serum values of adiponectin (A), leptin (L), 8-isoprostane, malondialdehyde (MDA), the A/L ratio in women with T2DM. Sixty-eight women with T2DM were enrolled in the current study and were randomly divided into drug (n = 34) and placebo (n = 34) groups who were consuming 100 mg CoQ10 and 100 mg cellulose acetate per day for 12 weeks, respectively. Measurements were performed at the beginning and after the intervention. Serum values of adiponectin (p = .001) and the A/L ratio (p = .001) were increased while values of leptin (p = .041), MDA (p = .023), 8-isoprostane (p = .004) were decreased significantly in drug group after intervention. This study had shown that CoQ10 supplementation in women with T2DM was effective in elevation of adiponectin and the A/L ratio and reduction of leptin, MDA and 8-isoprostane which could result in improving insulin resistance and modulating oxidative stress situation.

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