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                  <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
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              <elementText elementTextId="10131">
                <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
Comparing Quality of Life Before and After Surgery in&#13;
Patients With Cushing Disease: A Before-After Study</text>
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                <text>Quality of life (QoL), Cushing, Disease</text>
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                <text>Introduction: Cushing disease is a rare problem that usually has an important effect on the&#13;
quality of life (QoL).&#13;
Objective: This survey aimed to evaluate patients’ QoL and determine predictors of improving&#13;
QoL scores in patients.&#13;
Materials and Methods: In this before-after study, basic characteristics were collected&#13;
from 56 patients with Cushing disease who underwent endoscopic transsphenoidal&#13;
surgery, and their QoL score during one year was assessed. Finally, predictor factors of&#13;
QoL score improvement were identified. To compare the QoL scores before, 6 months,&#13;
and 12 months after surgery, repeated measures ANOVA and for determining predictors&#13;
of QoL score improvement, multivariable logistic regression analysis was used. P&lt;0.05 was&#13;
considered significant in all tests.&#13;
Results: The Mean±SD age of the samples was 33.92±12.82 years, and 43 (76.8%) were&#13;
female. In all 56 patients who underwent endoscopic transsphenoidal surgery, the QoL score&#13;
significantly improved. In multivariable logistic regression analysis, weight loss (OR= 1.2, 95%&#13;
CI; 1.01-6.5, P=0.01), no fatigue (OR= 2.1, 95%CI; 1.6-8.3, P=0.009), no decreased libido (OR=&#13;
1.5, 95% CI; 1.2-10.62, P=0.01), no gonadal axis disorder (OR=2.2, 95% CI; 1.07-4.06, P=0.01)&#13;
and post-operation no thyroid axis disorder (OR=2.5, 95% CI; 1.8-5.7, P=0.01) were predictors&#13;
for more QoL score improvement.&#13;
Conclusion: According to the results of this study, many factors can affect the quality of life in&#13;
patients with Cushing disease. Therefore, support groups should include the cooperation of&#13;
physicians and psychologists, provision of health services, and social support to improve the&#13;
QoL of patients.</text>
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            <description>An entity primarily responsible for making the resource</description>
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              <elementText elementTextId="10134">
                <text>Arezoo Chouhdari , Omidvar Rezaei , Mohammad Samadian , Guive Sharifi , Kaveh Ebrahimzadeh , Zahra Davoudi</text>
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              <elementText elementTextId="10135">
                <text>April 2023, Volume 33, Number 2</text>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10136">
                <text>peri irawan</text>
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                <text>english</text>
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        <name>Cushing, Disease</name>
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        <name>Jurnal Internasional</name>
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        <name>Quality of Life (QoL)</name>
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                  <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
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            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10152">
                <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
Atypical Symptoms of Acute Coronary Syndrome and&#13;
Their Predictors</text>
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          <element elementId="49">
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            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10153">
                <text>Acute coronary syndrome, Signs and symptoms, Clinical presentation</text>
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          <element elementId="41">
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                <text>Introduction: The most important diagnostic indicator of Acute Coronary Syndrome (ACS)&#13;
is typical clinical symptoms, like chest pain, but many patients may experience nonspecific&#13;
(atypical) symptoms. Understanding these symptoms and their associated factors results in&#13;
early diagnosis and more appropriate treatments.&#13;
Objective: We aimed to determine atypical clinical symptoms and their predictors in patients&#13;
with Acute Coronary Syndrome.&#13;
Materials and Methods: This cross-sectional study was conducted on 1167 patients with&#13;
ACS hospitalized at a specialized hospital in Rasht City, Iran, between December 2019 and&#13;
October 2020. The research samples were selected by a consecutive sampling method.&#13;
Data were collected through a researcher-made questionnaire by interview, in which&#13;
sociodemographic characteristics, risk factors, disease-related factors, and symptoms of&#13;
patients with ACS were collected. Data analysis was done by descriptive statistics and&#13;
multiple logistic regression by the backward LR (likelihood ratio) method. The significance&#13;
level was set as P&lt;0.05.&#13;
Results: In this study, 56.3% of the patients were male. The Mean±SD age of the patients was&#13;
60.9±11.1 years. About 28.1% of the patients experienced atypical clinical symptoms. The&#13;
most common atypical symptoms were shortness of breath (29.4%), back pain (18.3%), and&#13;
left shoulder pain (12.7%). The predictors of atypical symptoms were age (OR=0.98, 95% CI;&#13;
0.975 - 0.999, P=0.047), alcohol use (OR=1.86, 95% CI; 1.047 - 3.303, P=0.034), brain diseases&#13;
(OR=2.36, 95% CI; 1.463 - 3.811, P=0.001), blood diseases (OR=1.45, 95% CI; 1.059 - 2.002,&#13;
P=0.021), and gastroesophageal reflux (OR=1.31, 95% CI; 1.006 - 1.719, P=0.045)&#13;
Conclusion: Since more than a quarter of ACS patients have unusual symptoms, detecting&#13;
these symptoms and related factors can help in early diagnosis and conduct more appropriate&#13;
medical treatment.</text>
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          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10155">
                <text>Masoumeh Rezvani , Mohammad-Taghi Moghadamnia , Ehsan Kazemnejad Leili , Majid Pourshaikhian , Hojjat Houshyari Khah</text>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10156">
                <text>April 2023, Volume 33, Number 2</text>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10157">
                <text>peri irawan</text>
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            <description>The file format, physical medium, or dimensions of the resource</description>
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              <elementText elementTextId="10158">
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          <element elementId="44">
            <name>Language</name>
            <description>A language of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10159">
                <text>english</text>
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        <name>Acute coronary syndrome</name>
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        <name>Clinical presentation</name>
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              <description>A name given to the resource</description>
              <elementTextContainer>
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                  <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10161">
                <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
Social Competence and Its Related Factors in High School&#13;
Students: A Cross-sectional Study</text>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10162">
                <text>Social competence, Students, Adolescent, Social skills</text>
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          <element elementId="41">
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            <description>An account of the resource</description>
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                <text>Introduction: Social competence can help adolescents achieve effective social interactions&#13;
and establish and maintain successful relationships with peers and society.&#13;
Objective: The purpose of this study was to determine the status of social competence and&#13;
its related factors in high school students in Rasht City, Iran.&#13;
Materials and Methods: In the cross-sectional analytical study, 491 high school students in&#13;
&#13;
Rasht were selected by multi-stage random cluster sampling. The study tool was a two-&#13;
part questionnaire: the demographic characteristics of the participants and the social&#13;
&#13;
competence questionnaire. Descriptive statistics, 1-way analysis of variance (ANOVA), the&#13;
Pearson correlation coefficient, independent t test, and multiple linear regression were&#13;
used for statistical analysis.&#13;
Results: Of 491 students, 65.4% were female, 63.1% were the first child of the family, and&#13;
94.3% had normal sleep amount. Also, 94.1% of students lived with their parents. Their mean&#13;
social competence was at the desired level (261.7±8.31, total score: 47-329). There was a&#13;
significant relationship between school grade point average (r=0.271, P=0.001), duration of&#13;
Internet use (r=-0.103, P=0.022), and students’ sleep amount with social competence based&#13;
on 1-way ANOVA test (P=0.005). Based on multiple linear regression analysis, a high-grade&#13;
point average was associated with increased social competence (B=7.54, 95% CI; 5.43 to 9.78,&#13;
P=0.001) and female gender (B=-6.71, 95% CI; -13.15 to -0.26, P=0.04), being the second child&#13;
compared to the first (B=-8.19, 95% CI; -14.48 to -1.90, P=0.011), insomnia (B=-19.07, 95% CI;&#13;
-36.14 to -2.01, P=0.029) and parental divorce and living with father (B=-46.47, 95% CI; -81.95&#13;
to -10.99, P=0.01) were associated with low social competence (R2&#13;
=0.16).&#13;
&#13;
Conclusion: These results can help managers plan educational and training organizations and&#13;
promote parents’ awareness to eliminate everyday barriers and develop social competence&#13;
in adolescents.</text>
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          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
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              <elementText elementTextId="10164">
                <text>Fatemeh Hosseinzadeh Siboni , Abdolhosein Emami Sigaroudi , Moluk Pouralizadeh , Saman Maroufizadeh</text>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10165">
                <text>April 2023, Volume 33, Number 2</text>
              </elementText>
            </elementTextContainer>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10166">
                <text>peri irawan</text>
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          <element elementId="44">
            <name>Language</name>
            <description>A language of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10168">
                <text>english</text>
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        <name>Adolescent</name>
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      <tag tagId="25">
        <name>Jurnal Internasional</name>
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      <tag tagId="1080">
        <name>Social competence</name>
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      <tag tagId="1081">
        <name>Social skills</name>
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      <tag tagId="431">
        <name>Students</name>
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              <description>A name given to the resource</description>
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                <elementText elementTextId="10106">
                  <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10170">
                <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
Counseling Therapy With Hatha Yoga on Adherence Level, Nutritional Status, and Quality of Life Among HIV-Infected Adolescents </text>
              </elementText>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10171">
                <text>Counseling therapy, Yoga, Adherence level, Nutritional status, Quality of life, HIV, Adolescents</text>
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            <name>Description</name>
            <description>An account of the resource</description>
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                <text>Introduction: HIV infection and AIDS are associated with numerous challenges, and infected&#13;
people experience extreme despair, fear, anxiety, and depression. However, counseling&#13;
therapy and yoga techniques may help ease stress-related illness, produce internal strength&#13;
through relaxation, and enhance immunity.&#13;
Objective: This study aimed to evaluate the effectiveness of counseling therapy and Hatha&#13;
yoga on the adherence level, nutritional status, and quality of life (QOL) of HIV-infected&#13;
adolescents.&#13;
Materials and Methods: A randomized controlled trial study was conducted. Through the&#13;
&#13;
simple random method, 388 (195 in the experimental and 193 in the control group) HIV-&#13;
infected adolescents were selected. The data of HIV-infected adolescents and caregivers&#13;
&#13;
were collected from four main Antiretroviral Therapy clinics in Chennai, India, through&#13;
Standardized Antiretroviral Therapy adherence, QOL, and a structured nutritional&#13;
assessment questionnaire. Motivational counseling was given to the experimental&#13;
group, and the researcher demonstrated selected asanas. The data were collected from&#13;
both groups at 0, 3, and 6 months intervals. The descriptive statistics of mean, standard&#13;
deviation, and inferential statistics of the student independent t test and Chi-square test&#13;
were used to determine the effectiveness of interventional variables in both groups.&#13;
Results: The Mean±SD age of the experimental group of adolescents was 13.6±2.2 years,&#13;
and that of the control group was 13.8±2.4 years. There is an improvement range in the&#13;
experimental vs the control group for the components of adherence level (13.4% vs 4.9%)&#13;
and QOL (15.1% vs 0.9%) at a significance of P=0.001 with a 95% confidence interval. Also,&#13;
the nutritional gain score was significantly increased to 9.3% vs 1.5% (P=0.05). Regarding CD4&#13;
(cluster of differentiation 4) count, the baseline mean score was 664.86 vs 669.72, whereas,&#13;
in the sixth month, it significantly increased to 840.35 vs 703.35 (P=0.001).&#13;
Conclusion: Motivational counseling and behavior modification of yoga efficiently improved&#13;
health status and well-being among HIV-infected adolescents in the experimental group&#13;
compared to the control group.</text>
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                <text>Rajathi Sakthivel</text>
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                <text>peri irawan</text>
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        <name>Nutritional status, Quality of life, HIV, Adolescents</name>
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                  <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
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                <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
Explaining the Childbirth Experience With the Support&#13;
of a Doula in an Iranian Setting: A Qualitative Study</text>
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                <text>Introduction: An expectant mother’s experience of normal vaginal delivery significantly&#13;
impacts her health. One of the determinants of a positive experience is to enjoy constant&#13;
support during labor.&#13;
Objective: This study was conducted to understand the mother’s childbirth experience with&#13;
the support of a doula during labor and delivery.&#13;
Materials and Methods: This research was a qualitative study with a content analysis&#13;
approach. A total of 16 pregnant women that gave birth with the assistance of doulas in a&#13;
hospital in Zanjan City, Iran, were included in this qualitative study with a content analysis&#13;
approach. Purposive sampling was used to select the participants in 2019. The study&#13;
data were collected through in-depth, semi-structured interviews with mothers, then&#13;
transcribed and coded. All interviews were conducted in one session, so 16 interviews&#13;
were obtained. Data analysis was done using the method proposed by Graneheim and&#13;
Lundman.&#13;
Results: The participants were 18-35 years old (27.5±6.7 years). Three women had a primary&#13;
school education, 7 had a high school diploma, and 6 had a university education. Four women&#13;
were employed, and the rest were homemakers. After data analysis, 4 main categories and&#13;
8 subcategories were extracted. Main categories and subcategories include comprehensive&#13;
support (physical support, mental support), assisting in materializing the motherhood dream&#13;
(inducing calm in the mother, being released from pain and suffering), internal reinforcement&#13;
(self-esteem, pain acceptance), and mother-centered care (doula as a different supportive,&#13;
bidirectional relationship).&#13;
Conclusion: Pregnant mothers’ satisfaction with delivery is affected by their experience.&#13;
According to the results, all mothers were satisfied with doula support during delivery. The&#13;
doula’s presence made childbirth a positive and satisfactory experience. The doula guided&#13;
mothers from fear, pain, and ignorance to happiness and satisfaction. It is necessary to&#13;
familiarize expectant mothers with the doula and the services they provide and facilitate their&#13;
presence in labor and delivery rooms.</text>
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                <text>Solmaz Heydari Fard , Zahra Behboodi Moghadam , Mahsa Khoshnam Rad</text>
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                <text>April 2023, Volume 33, Number 2</text>
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                <text>peri irawan</text>
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                  <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
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                <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
Effect of Acupressure on Anxiety, Stress, and Depression Among the Primary Family Caregivers of the Patients with Stroke</text>
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                <text>Introduction: Psychological distress is prevalent among the primary family caregivers of&#13;
patients with stroke.&#13;
Objective: This study evaluated the effects of acupressure on anxiety, stress, and depression&#13;
among the primary family caregivers of Patient With Stroke.&#13;
Materials and Methods: In this sham-controlled randomized clinical trial, 96 family&#13;
caregivers of Patient with Stroke were selected and allocated to the acupressure (n=40)&#13;
and sham (n=42) groups. The study data were collected using demographic questionnaires&#13;
for the patients and caregivers, the Barthel index (for assessing independence in daily&#13;
living activities,) and the Persian version of the Depression Anxiety Stress Scale (DASS).&#13;
Participants in the acupressure group received training about acupressure on the Yin Tang&#13;
and HT7 points, while participants in the sham group received training about acupressure&#13;
on the CV24 and TB5 sham points. The acupressure intervention lasted for 30 consecutive&#13;
days. Statistical tests, including the Kolmogorov-Smirnov test, the independent t test,&#13;
the Chi-square test, the Fisher exact test, the Wilcoxon, Mann-Whitney U test, and the&#13;
analysis of covariance (ANCOVA) were applied to analyze the data.&#13;
Results: The mean ages of the participants were 46.1±12.1 years in the acupressure group&#13;
and 42.7±11.8 years in the sham group. The mean ages of the patients in these groups&#13;
were 75.1±8.1 and 76.8±9.7 years; respectively. Regarding the demographic characteristics,&#13;
no significant differences were observed between the acupressure and the sham groups.&#13;
Regarding the pre-test mean scores of anxieties, stress, and depression, there were no&#13;
significant differences between the acupressure and the sham groups. Anxiety and stress&#13;
significantly reduced after the intervention only in the acupressure group (P&lt;0.05). However,&#13;
depression did not change substantially during the study. The ANCOVA indicated significant</text>
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                <text>Najmeh Javan Sangani , Hossein Rahimi , Seyed Mohammad Mousavi Mirzaei , Hamidreza BahramiTaghanaki , Seyyed Abolfazl Vagharseyyedin</text>
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                  <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
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                <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
Effect of Auditory Stimulation With Occupational Noise on the Consciousness Level in Comatose Traumatic Brain Injury Patients: A Clinical Trial Study </text>
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                <text>Introduction: Auditory stimulation is a treatment method for sensory deprivation of comatose&#13;
patients, which helps wake up the patient by activating the choroid plexuses in the brain.&#13;
Objective: This study aims to determine the effect of auditory stimulation with occupational&#13;
noise on the consciousness level of comatose patients with traumatic brain injury (TBI).&#13;
Materials and Methods: This clinical trial was conducted on 50 comatose patients with TBI&#13;
hospitalized in intensive care units of one of the hospitals in Qom City, Iran. They were&#13;
randomly assigned to two groups of control (n=25) and intervention (n=25) using the&#13;
block randomization method. The intervention group received auditory stimulation with&#13;
occupational voice for 10 days in the morning and evening shifts, each for 15-20 minutes.&#13;
The consciousness level of patients was evaluated before and after stimulation using the&#13;
Glasgow Coma Scale (GCS). The obtained data were analyzed using descriptive statistics,&#13;
the Chi-square test, the independent t test, and the generalized estimating equations&#13;
model.&#13;
Results: The Mean±SD ages of the patients were 35.92±14.68 years in the intervention group&#13;
and 33.32±13.74 years in the control group. No significant difference was observed between&#13;
the two groups regarding demographic or disease-related variables. The Mean±SD scores&#13;
of GCS before the stimulation were 5.28±1.81 in the control group and 5.12±1.90 in the&#13;
intervention group. This difference was not statistically significant. The Mean±SD scores of GCS&#13;
after the stimulation were 6.60±3.25 in the control group and 8.80±4.05 in the intervention&#13;
group. This difference was statistically significant (P=0.038). The level of consciousness in the&#13;
intervention group increased more than in the control group in the 10th day of study.&#13;
Conclusion: Auditory stimulation with occupational noise can increase the consciousness&#13;
level of comatose patients with TBI. Auditory stimulation can raise the consciousness level of&#13;
these patients hospitalized in intensive care units.</text>
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                <text>Mohammad Goudarzi Rad , Maryam Esmaeili , Mahsa Haji Mohammad Hoseini , Amir Hamta , Masoumeh Zakerimoghadam</text>
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JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
The Association Between Pre-pregnancy Body Mass Index and Gestational Weight Gain on Pregnancy Outcomes: A Retrospective Cohort Study </text>
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          <element elementId="49">
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            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10219">
                <text>Body mass index, Pregnancy outcomes, Pregnancy weight gain</text>
              </elementText>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10220">
                <text>Introduction: Elevated pre-gestational body mass index (obese/overweight) and improper&#13;
gestational weight gain are important risk factors for predicting adverse pregnancy outcomes.&#13;
Objective: We aimed to identify the association between pre-pregnancy body mass index&#13;
(BMI) and gestational weight gain on birth outcomes.&#13;
Materials and Methods: Data from this retrospective cohort study were extracted from&#13;
1457 (out of 1800) pair health records belonging to the pregnant mother and infants at&#13;
Ahvaz Iran health care centers from 2010 to 2018. Ten public health care centers were&#13;
randomly selected from the headquarters west and east of Ahvaz City. The samples were&#13;
selected based on the inclusion criteria. They divided into different groups based on&#13;
BMI (underweight, normal, overweight, and obese) and gestational weight gain (GWG)&#13;
groups (inadequate and excessive versus adequate). Pregnancy outcome was analyzed&#13;
according to the GWG during pregnancy for each BMI group through multivariable&#13;
multinomial logistic regression. Relationships between maternal BMI, GWG, and offspring&#13;
weight were examined. The analysis of covariance (ANCOVA) was used with adjusting&#13;
the baseline values. The risks for adverse birth weight outcomes in women with different&#13;
pre-pregnancy BMIs and GWGs were tested using the multivariable multinomial logistic&#13;
regression analysis.</text>
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          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10221">
                <text>Kambiz Ahmadi Angali , Maryam Azhdari , Maria Cheraghi , Parvin Shahri , Shokrollah Salmanzadeh , Fatemeh Borazjani</text>
              </elementText>
            </elementTextContainer>
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          <element elementId="40">
            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10222">
                <text>April 2023, Volume 33, Number 2</text>
              </elementText>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10223">
                <text>peri irawan</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="42">
            <name>Format</name>
            <description>The file format, physical medium, or dimensions of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10224">
                <text>pdf</text>
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          <element elementId="44">
            <name>Language</name>
            <description>A language of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10225">
                <text>english</text>
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      <tag tagId="97">
        <name>body mass index</name>
      </tag>
      <tag tagId="25">
        <name>Jurnal Internasional</name>
      </tag>
      <tag tagId="1030">
        <name>Pregnancy outcomes</name>
      </tag>
      <tag tagId="1031">
        <name>Pregnancy weight gain</name>
      </tag>
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        <src>https://repository.horizon.ac.id/files/original/499ad0c789025304d9f626d4a57a1e79.pdf</src>
        <authentication>24823fdcdb88d55d0c33bd962afe95b7</authentication>
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          <description>The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.</description>
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            <element elementId="50">
              <name>Title</name>
              <description>A name given to the resource</description>
              <elementTextContainer>
                <elementText elementTextId="10106">
                  <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
</text>
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    <elementSetContainer>
      <elementSet elementSetId="1">
        <name>Dublin Core</name>
        <description>The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.</description>
        <elementContainer>
          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10239">
                <text>JURNAL INTERNASIONAL KEBIDANAN 2020-2023 UNIVERSITAS KEDOKTERAN GUILAN VOLUME 33 ISSUE 2.&#13;
JOURNAL OF HOLISTIC NURSING OF MIDWIFERY.&#13;
Violence Against Pre-Hospital Emergency Medical Service Personnel in Guilan Province, Iran: A Cross-Sectional Study </text>
              </elementText>
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          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10240">
                <text>Violence, Emergency medical service, Prehospital emergency care</text>
              </elementText>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10241">
                <text>Introduction: The first contact between emergency patients and medical services is carried out by&#13;
emergency medical services (EMS). EMS personnel must deliver high-quality and high-speed services.&#13;
This condition might cause high levels of stress and violence in the patients and their companions.&#13;
Objective: In this research, we aimed to study the violent acts against pre-hospital EMS personnel&#13;
in Guilan Province, Iran.&#13;
Materials and Methods: This research was a cross-sectional study. A total of 110 EMS personnel&#13;
working in Guilan Province in the north of Iran were selected using a random selection method&#13;
between March and June 2020. A researcher-made questionnaire was used to collect the study&#13;
data from the EMS personnel. The results were analyzed by the Poisson regression.&#13;
Results: A total of 144 questionnaires were sent to the personnel, of these 110 were completed.&#13;
The mean age of the participants was 34.89±3.65 years and all of them were male. About 61.8%&#13;
of the samples experienced some kind of physical or verbal violence in the past 3 months. All&#13;
cases of physical violence were perpetrated by men and half of them were done by close relatives&#13;
of the patients. A significant relationship was found between the marital status of the EMS&#13;
personnel and the number of physical violence they experienced (β=2.246, 95% CI; 0.058 to 4.446,&#13;
P=0.032). In addition, the number of experienced physical violence was higher in those staff who&#13;
worked at road EMS services compare to city or town EMS services (β=1.519,95% CI; 0.092 to&#13;
2.934, P=0.001). According to the EMS personnel, most of the attacks were answered calmly. The&#13;
personnel revealed that the most important reason for not reporting physical violence was the&#13;
futility of reports and the lack of guidelines for reporting violence.&#13;
Conclusion: The findings of this study confirm that pre-hospital EMS are at high risk of workplace&#13;
violence in Guilan Province which highly affects their health and well-being. Training EMS personnel&#13;
and strengthening their communication skills are important factors in reducing violence against&#13;
emergency services technicians.</text>
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          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10242">
                <text>Payman Asadi , Mohsen Esmaeili , Nazanin Noori Roodsari , Elham Gheysvandi , Enayatollah Homaie Rad</text>
              </elementText>
            </elementTextContainer>
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          <element elementId="40">
            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10243">
                <text>April 2023, Volume 33, Number 2</text>
              </elementText>
            </elementTextContainer>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10244">
                <text>peri irawan</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="42">
            <name>Format</name>
            <description>The file format, physical medium, or dimensions of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10245">
                <text>pdf</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="44">
            <name>Language</name>
            <description>A language of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="10246">
                <text>english</text>
              </elementText>
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            <elementTextContainer>
              <elementText elementTextId="10247">
                <text>text</text>
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        <name>Emergency medical service,</name>
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      <tag tagId="25">
        <name>Jurnal Internasional</name>
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      <tag tagId="1029">
        <name>Prehospital emergency care</name>
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      <tag tagId="1027">
        <name>Violence</name>
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