1 Shahid Sadoughi University of Medical Sciences 278 Education & Health The Importance of Training Health Workers in Preventing the Spread of Dengue Fever Karimiankakolaki Zohreh b b Department of Health, ShK.C., Islamic Azad University, Shahrekord, Iran 1 5 2025 9 1 1477 1479 25 12 2024 25 03 2025 In a report by  World Health Organization on dengue fever, approximately 390 million infections with the virus are reported annually. Almost 40% of the world's population is in areas at risk of this infection.(Bhatt et al., 2013, WHO, 2024). Dengue fever increased significantly from 2008 to 2015, spreading with widespread travel to various continents, including the Americas, Asia, and parts of the Pacific (WHO, 2024). Dengue fever closely resembles the flu in terms of symptoms and is associated with risks such as severe bleeding and respiratory distress. (WHO, 2009). Symptoms of the disease range from asymptomatic to symptomatic, afebrile to hemorrhagic, and usually begin 5-7 days after the mosquito bite (Sampat, 2021). Clinical features of the disease include fever with rash, severe headache, pain behind the eyes, muscle and joint pain (Halstead, 2007). In the Eastern Mediterranean region, the World Health Organization has reported multiple outbreaks of dengue in recent years, particularly in Pakistan, Saudi Arabia, and Yemen. Recently, evidence of the disease has been seen in Iran, in which some patients had traveled to endemic areas, including Malaysia, India, and Thailand, and some had no travel history and were from Sistan and Baluchestan province in southeastern Iran, neighboring Pakistan, and Kurdistan province in western Iran (Ghasemzadeh et al., 2016, Heydari et al., 2018). Iran has a hot and dry climate at which many dengue transmitter mosquitoes can live, for example, stagnant and dirty water in car wheels and flowerpots, etc. Therefore, dengue can be considered as a treat in Iran (Ebrahimi et al., 2016). Dengue fever has heavy economic costs, and controlling it requires improving preventive strategies (Al-Zurfi et al., 2015). It is also necessary to examine the behavior of infected patients in seeking health services (Elsinga et al., 2015). Public education and mass campaigns help control the disease, and the World Health Organization emphasizes encouraging people to cooperate to solve this problem. (Dickinson et al., 2012, WHO, 2015). Mosquito-related education programs can help with population-based management (Stefopoulou et al., 2018). Knowledge, attitude, and performance of health workers are considered important factors that influence the incidence and transmission of dengue disease (Handel et al., 2016). Despite efforts to develop an effective vaccine for all four serotypes of the virus, the only practical solution to prevent and control the disease is health education and reducing the population of carriers. Since health workers interact directly with patients and are known as the front line of diagnosis, information and treatment of the disease, their education can play an important role in preventing, treating and controlling the spread of the disease and promoting community health (Ho et al., 2013). Therefore, educational interventions regarding dengue fever should emphasize increasing the knowledge and attitudes of health workers to lead to appropriate performance and behavior for adequate disease management. Training health workers in the identification, assessment, selection, and implementation of disease prevention and management protocols is essential.(Nikookar et al., 2023, Zida-Compaore et al., 2022). The first line of treatment and prevention of dengue fever in Iran are health workers, which shows the importance of their role. In recent years, educational interventions in the form of continuing medical education for health workers have been held in priority areas regarding dengue fever. (Nikookar et al., 2023). These educational interventions aim to help change the performance of health workers to provide appropriate services. (Guad et al., 2021, Nikookar et al., 2023). Considering the above, • Health system workers are the first line of contact with patients and also provide education on preventive behaviors regarding this disease. • Knowledge, attitude, and performance of health workers are important factors that affect the incidence and transmission of dengue. • Education of health workers regarding this disease can play an important role in preventing, treating, and controlling the spread of the disease and promoting community health.  
285 Social Health The Relationship between Economic Inequality and Social Health: Solutions to Reduce the Gap Marzban Ameneh c c Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. 1 5 2025 9 1 1480 1482 20 01 2025 10 05 2025 Economic inequality is one of the most significant social and health challenges faced by communities around the world. Its direct and indirect impact on social health is a subject that has garnered considerable attention (1). With the widening economic gap between individuals and social groups, access to healthcare and social welfare services for low-income populations has become significantly restricted, leading to negative effects on quality of life and social cohesion (2). This letter explores the connection between economic inequality and social health and proposes solutions to bridge this gap.   287 Psychology The Effect of Transcranial Direct Current Stimulation on Self-Esteem and Weight: A Pilot Study on Overweight Individuals Soleymani Mazar Amirreza d Gharayagh Zandi Hassan e Ghayour Najafabadi Mahboubeh f Sorbi Mohammad Hossein g Yari Geshnigani Hossein h d Department of Sport Psychology, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran e Department of Sport Psychology, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran f Department of Motor Behavior, Faculty of Sport Sciences and Health, University of Tehran, Tehran, Iran g Department of Psychology, Faculty of Educational Sciences and Psychology, University of Birjand, Birjand, Iran h Department of Psychology, Faculty of Psychology and Educational Sciences, Islamic Azad University Marvdasht Branch, Shiraz, Iran 1 5 2025 9 1 1483 1492 05 11 2024 15 04 2025 Background: Low self-esteem and overweight are significant factors that can affect mental health and quality of life. Transcranial direct current stimulation (tDCS), as a non-pharmacological method, has the potential to affect physical and psychological health. The present study aimed to investigate the effect of tDCS on self-esteem and weight reduction in overweight individuals.  Methods: This quasi-experimental study was conducted using a pretest-posttest design with a control group. A total of 24 men aged 20 to 40 years from gyms in Mashhad were selected through purposive sampling in 2024 and randomly assigned to experimental and control groups. The study utilized the following tools for data collection: demographic form, Eysenck Self-Esteem Questionnaire, and body mass index (BMI) measurement. Both groups participated in standard physical fitness training; however, the experimental group additionally received anodal tDCS (2 mA, 20 minutes per session, for 10 consecutive sessions). The control group received a sham stimulation protocol. Data were analyzed using one-way ANCOVA in SPSS-21.  Results: The findings indicated a significant difference in self-esteem between the two groups after controlling for the pretest effect (P = 0.004, F = 10.39). The effect size of tDCS on self-esteem was 33%, suggesting a moderate impact. However, the effect of tDCS on BMI was minimal and did not lead to significant weight reduction.  Conclusion: The results suggest that tDCS, in combination with physical exercise, can have a positive impact on self-esteem in overweight individuals, but does not significantly contribute to weight loss. Further research is recommended to explore long-term effects of this intervention.    271 Psychology Investigating the Relationship between Personality Factors and Suicide Risk Tabatabai Tooba i Rashidpour Parvaneh j Ghasemirad Hamidreza k Nadi Mohammad l Giahi Yazdi Mehrnoush m Owliaey Hamid n Bidaki Reza o Taheri Amirhossein p i Department of Medical Science, Yazd Branch, Azad University, Yazd, Iran j Department of Psychiatry, Medical School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran k Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran l Department of Psychiatry, Medical School, Shahid Sadoughi University of Medical Sciences, Yazd, Iran m General Practitioner, Social Security Organization of Yazd, Iran n Department Of Forensic Medicine & Clinical Toxicology, Yazd Branch, Islamic Azad University, Yazd, Iran o Department of Psychiatry, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran p Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 1 5 2025 9 1 1493 1502 25 11 2024 23 02 2025 Background: The present study aimed to investigate personality traits of patients who commit suicide by drug intoxication. Methods: This cross-sectional study evaluated 180 patients who attempted suicide by drug intoxication at Shahid Beheshti Hospital, Yazd, Iran in 2022. Due to the census design, all patients who met the study criteria were enrolled. The risk of committing suicide was divided into low, low-to-moderate, and moderate-to-high risk categories using the Paterson criteria. Personality characteristics of the participants were compared using the temperament and character inventory (TCI) in different groups of suicide-attempting risk. Data were evaluated using SPSS version 23. Kruskal-Wallis test and Chi-Square test were used for analysis. Results: The frequency of patients with low, low-to-moderate, and moderate-to-high risk of committing suicide accounted for 45.6%, 46.2%, and 7.2%, respectively. Reward dependence (RD) (P-value = 0.011) and cooperation (P-value = 0.003) represented significant decreases with increasing suicide risk using Kruskal-Wallis test. Other factors of the TCI, including novelty seeking (NS) (P-value = 0.880), harm avoidance (HA) (P-value = 0.660), persistence (P) (P-value = 0.361), self-directedness (SD) (P-value = 0.138), and self-transcendence (ST) (P-value = 0.623), were not associated with the risk of suicide attempt. There was a significant difference in the frequency of factors associated with the risk of suicide, including marital status, depression, and alcohol addiction in terms of age, and sex using Chi Square test (P<0.05).. Conclusion: These results highlight the potential importance of reward dependence and cooperation in understanding suicide risk. In this regard, lower reward dependence and reduced cooperation are associated with higher suicide risk, while other psychological traits assessed by the TCI may not be as relevant.     270 Social Behavior The Prevalence of Child Abuse among Primary School Students Gharishvandi Laleh Lotfizadeh Masoud Jafari Mahnaz Fatahian Fatemeh Davoodi Zahra Karimi Zahra Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran. Department of Public Health, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran Department of Public Health, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran School of Public Health, Iran University of Medical Sciences, Tehran, Iran 1 5 2025 9 1 1503 1511 17 11 2024 18 03 2025 Background: Child abuse is a major psychological and social problem in all countries and is affected by a set of cultural, social, and family factors as well as some characteristics of children. This study was conducted to determine the prevalence of child abuse among primary school students in Shahrekord. Methods: This cross-sectional study was conducted in 2024 on 245 students from fourth to sixth grades in public schools of Shahrekord selected through cluster sampling. Four clusters were randomly selected from all primary schools in this area, 4 clusters were randomly selected and then the final sample (126 females) was randomly selected from the above sections. Hosseinkhani researcher-made Child Abuse Questionnaire was used in this study. Chi-square, t-test, analysis of variance, and correlation coefficient were used to analyze the data. Results: The results of the study showed that 30.6% of children experienced physical abuse, 56.4% of them had experienced emotional abuse, and 99.6% experienced negligence as a type of abuse. The data showed only a significant relationship between negligence and fathers' education (p=0.032), so increasing fathers' education level led to more negligence. There was a significant relationship between having an experience of emotional-psychological abuse and having an experience of physical abuse (P <0.001), i.e, students who had higher score in emotional-psychological dimension reported more child abuse in physical dimension. Conclusion: Considering the high prevalence of child abuse among students, it is necessary to take steps to reduce child abuse by educating parents on correct pedagogical methods.   273 Health Attitudes of Healthcare Team towards Interprofessional Collaboration Botshekanan Roya Tahmasbi Simin Department of Health Services Management, ShK.C., Islamic Azad University, Shahrekord, Iran Department of Nursing, ShK.C. , Islamic Azad University, Shahrekord, Iran 1 5 2025 9 1 1512 1524 28 11 2024 08 01 2025 Background: Inter-professional collaboration (IPC) is vital in enhancing the quality of healthcare. Hence, this study aims to evaluate the attitudes of healthcare staff towards interprofessional cooperation. Methods: The study utilized a descriptive-analytical method. The medical teams from two hospitals of Shahrekord University, constituted the study population. Using stratified sampling, 325 individuals were selected.on 2020  Data were gathered by Jefferson Interprofessional Attitude Questionnaire, consisting of demographic information and IPC questions (20 items.. SPSS (20) was used for data analysis, and variables were assessed by descriptive tests, one-sample t-tests, t-student tests, Levene tests, and ANOVA. Results: The mean scores for attitudes towards IPC were as follows: general practitioners (4.54 ± 0.31), specialists (4.94±0.37), nurses (4.84±0.40), midwives (4.86±0.36), radiologists (4.86±0.43), nutritionists (4.69±0.46), laboratory staff (4.97±0.38), pharmacists (4.99±0.49), operating room anesthesiologists (5.09 ±0.38), environmental and occupational health experts (5.07±0.35), and psychologists (5.19±0.34). There was a significant difference (p < 0.05) between general practitioners and anesthesia and operating room experts. The relationship between demographic data with mean score of IPC was not significant, but it was significant forjob experience of 15-20 years (sig = 0.001 and F = 8.81). Conclusion: Managers should promote a positive attitude towards IPC within the healthcare team. By implementing an educational strategy, cooperation and performance among healthcare staff can be enhanced.   269 Family & Health Application of the Betty Neuman Systems Model in Nursing Care of a Breast Cancer Patient: A Case Study Falakdami Atefeh Rafiei Hossein Razaghpoor Ali Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Guilan, Iran Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran Non-Communicable Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran 1 5 2025 9 1 1525 1538 12 11 2024 10 01 2025 Background: Nursing theories provide structured frameworks that guide practice and enhance care quality. The Betty Neuman Systems Model, widely utilized in the care of patients with chronic diseases, adopts a holistic approach by addressing various dimensions of a patient's health. Therefore, this study aims to apply the model in the nursing care of a patient with breast cancer. Methods: This case study, conducted in Iran in 2021, involved a 47-year-old breast cancer patient selected through purposive sampling. Data were collected via interviews, medical records, and physical examinations. Using the Betty Neuman Systems Model, the interactions among five key variables—physiological, psychological sociocultural, developmental, and spiritual—were assessed, and intra-, inter-, and extra-personal stressors, along with the patient's reactions, were identified. This, in turn, informed the formulation of nursing diagnoses and the development of a comprehensive care plan, which included goals, targeted interventions across three levels of prevention, and outcomes. Results: Analysis of the five variables and stressors resulted in 13 nursing diagnoses, including 8 actual and 5 risk diagnoses. The model's evaluation of the nursing care plan indicated positive outcomes for the patient. Conclusion: This study demonstrated the practical application of the Betty Neuman Systems Model in developing a personalized nursing care plan for a breast cancer patient. The findings highlight the model utility in addressing patients' holistic needs and provide practical insights for oncology nursing practice.   268 Education & Health Students' Perceptions of the Positive Aspects of Electronic Teaching on Face-to-Face Learning in Post-COVID-19 Pandemic: A Phenomenological Study Kargar Shouroki Mohammad Khalil Shakeri Mohsen Barzegar bafrooei Kazem Hassani Hossain Department of Psychology and Educational Sciences, Yazd University, Yazd, Iran Department of Psychology and Educational Sciences, Yazd University, Yazd, Iran Department of Psychology and Educational Sciences, Yazd University, Yazd, Iran Department of Psychology and Educational Sciences, Yazd University, Yazd, Iran 1 5 2025 9 1 1539 1550 05 11 2024 19 02 2025 Background: The purpose of the present study was to investigate the perceptions of Yazd University of Medical Sciences students about the positive aspects of electronic teaching on face-to-face teaching in the post-COVID-19 pandemic. Methods: This was a qualitative research with a phenomenological approach. Participants in the research included 10 students of Shahid Sadoughi University of Medical Sciences, Yazd,  in the academic year 2022-2023 who were selected through purposive sampling. The research data collection tool included a semi-structured interview. Method of data analysis adapted from Smith  was used, and the criteria of rigor and trustworthiness were considered. Results: Eexperienced perceptions of medical students regarding the positive effects of electronic teaching were investigated and four main themes, including improving the hardware and software of virtual education, understanding the value of medical staff and health laws, increasing knowledge sharing and the role of virtual education, facilitating access to national and international education, and 12 sub-themes were achieved. Conclusion: Based on the results of the current research, the positive experiences gained from e-learning during the COVID-19 pandemic can be used when distance learning is necessary, such as air pollution or unexpected events. Therefore, policy makers and planners of medical education can improve the quality of education by taking advantage of these experiences.   265 Education & Health The Effectiveness of Group Reality Therapy on the Psychological Well-being of students fazlalipour masoud khalediyan mohamad salehi mehdi Department of Statistics, Payame Noor University, Tehran, Iran Department of Psychology, Payam Noor University,Tehran, Iran Department of Education, University of Kurdistan, Sanandaj, Iran 1 5 2025 9 1 1551 1558 08 10 2024 24 02 2025 Background: Reality therapy aims to foster responsibility-taking and help individuals establish a successful identity. This study investigates the effectiveness of group reality therapy on students' psychological well-being.  Methods: The study population comprised all Payame Noor University students enrolled at Ghorveh branch during 2022. The research employed an experimental design with both experimental and control groups. A random sample of 30 students was selected, with 15 participants assigned to the experimental group, which received nine 90-minute sessions of group reality therapy. The remaining 15 students formed the control group. Data were collected using Carol Ryff's Psychological Well-Being Scale. Results: The findings showed descriptive information regarding psychological well-being in pretest and posttest for both control and experimental groups. Psychological well-being mean value of students in experimental group in pretest was 308.01 ± 9.38, while posttest mean value for the same group was 317.73 ± 8.99. In contrast, psychological well-being mean value of students in control group in pretest was 309.93 ± 8.84, with posttest mean value for this group being 310.46 ± 8.96. The findings revealed that group reality therapy significantly improved the students' psychological well-being (p < 0.05). Conclusion: Group reality therapy is an effective intervention for enhancing students' psychological well-being, Therefore, this method can be used to improve the psychological well-being of students.   280 High Risk Bbehavior Study of Knowledge, Attitude and Practice of Dentists and Dental Assistants about HIV Infection and Dentists’ Knowledge of Oral Manifestations of HIV Dehghanian Maryam Tahmasbi Simin Department of Health Services Management, Sh.K.C, Islamic Azad University, Shahrekord, Iran. Department of Nursing, Sh.K.C, Islamic Azad University, Shahrekord, Iran 1 5 2025 9 1 1559 1569 19 01 2025 26 04 2025 Background: HIV/AIDS can be transmitted in healthcare settings including dentistry. Therefore, specific strategies are necessary to prevent its spread. This study aims to examine the for Knowledge Attitude and Practice of dentists and dental assistants regarding HIV infection and their knowledge of the oral manifestations of AIDS in public and private dental centers in Shahrekord. Methods: A cross-sectional survey was conducted in 2021 in Shahrekord, Iran, involving 108 dentists and 104 dental assistants through a census sampling method. Data were collected using validated questionnaires assessing knowledge, attitude, and performance regarding HIV/AIDS, as well as awareness of oral manifestations. Data analysis was performed using SPSS software, version 20 Results: According to the results, the mean scores for Knowledge Attitude and Practice of dentists were 16.18 ± 2.06, 53.73 ± 7.19, 70.04 ± 5.13, respectively. The average knowledge, attitude, and practice scores for dental assistants were 14.77 ± 2.1, 50.2±6.10, and 62.96 ± 5.11. There was no significant relationship between the knowledge and practice of dentists and dental assistants regarding HIV infection.) P > 0.05(. However, there was a significant relationship between dentists' knowledge of HIV infection and their knowledge of oral AIDS manifestations (p < 0.001). Conversely, no significant relationship was found between dentists' attitudes and practice and knowledge of oral AIDS manifestations (p < 0.05). Among the demographic data, only the age and work experience of dentists with knowledge of AIDS were significant (p < 0.05).                              Conclusion: The knowledge of dentists and dental assistants regarding AIDS is moderate, emphasizing the need for continuous training. Dentists scored higher in knowledge, attitude, and practice compared to dental assistants. However, the lack of a significant relationship between knowledge and practice suggests that theoretical education alone is insufficient, highlighting the importance of practical training.   272 Psychology Assessment and Comparison of Distress and Suicidal Behavior in Medical and Paramedical Students Safa Mitra Mirenayat Maryam Sadat Abedi Mohsen Fakharian Atefeh Ansari Negin Norouz Afjeh Mahsan Haji Zadeh Farzaneh Ghassem Boroujerdi Fatemeh Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Pulmonary Rehabilitation Research Center (PRRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Pulmonary Rehabilitation Research Center (PRRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Pulmonary Rehabilitation Research Center (PRRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Faculty of literature and humanities, Lorestan University, Khoram Abad, Iran Pulmonary Rehabilitation Research Center (PRRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 1 5 2025 9 1 1570 1579 25 11 2024 04 02 2025 Background: The sudden outbreak of coronavirus disease in 2019 resulted in major changes in  mental health of healthcare workers as the front line of fighting against thedisease. Medical students who were from the main members of healthcare workers suffered double pressure. The goal of current study was evaluation of suicidal behavior and psychological distress in medical and paramedical students to determine the mental health status of these students by identifying the mentioned factors. Methods: This is an applied, comparative and cross-sectional study. The sample members (302 participants) were selected by accessible method from medical students in Masih Daneshvari Hospital in 2023-2024. The Kessler Psychological Distress Scale (K6) and Suicide Behaviors Questionnaire-Revised (SBQ-R) were completed by all the participants. Data were analyzed by T, Chi square, Pearson and ANOVA tests by SPSS-22. Results: The highest and lowest risk of suicide was between interns (M=7.37) and fellowships (M=3.71), respectively. The highest and the lowest score of psychological distress was between interns (M=10.82)  and paramedical PhD students (M=6.9), respectively. Men had suicidal thought or attempt more than twice as likely as women (7.69% vs. 2.35%). The probability of suicide in future was more in men than women (1.53% vs. 0). There was a strong and significant (P ≤0.00) correlation between questions of suicidal behavior questionnaire and psychological distress. Conclusion: The higher scores of suicide and psychological distress of medical students in primary educational years, can reflect the high pressure volume, which they gain more compatibility, skill and ability for coping with the problems over time. By achieving the results of the current study, researchers would pay attention to psychological issues in healthcare workers, probable problems would be solved, and eventually, treatment of patients would done by more confidence 286 Social Behavior Investigating the Relationship between Critical Thinking and Self-efficacy of Healthcare Managers of Ahvaz University of Medical Sciences Peivand ahmad alavi azam TorabiPour Amin Department of Health Services Management, Shk.c., Islamic Azad University, Shahrekord, Iran. Department of Nursing and Midwifery, Shk.c., Islamic Azad University, Shahrekord, Iran Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 1 5 2025 9 1 1580 1587 20 01 2025 10 05 2025 Background: Critical thinking and self-efficacy play an important role in achieving the workplace. This study aimed to determine the relationship between critical thinking and self-efficacy in healthcare managers of Ahvaz University of Medical Sciences. Methods: This descriptive correlational study was conducted on 115 healthcare managers affiliated to Ahvaz University of Medical Sciences using census sampling method in 2019. Data were collected using standard Ricketts' Critical Thinking Questionnaire and Sherer General Self-Efficacy Scale and were analyzed by descriptive and analytical statistics (Spearman correlation coefficient) using SPSS 24 software. Results: There was a significant relationship between mean scores of critical thinking and self-efficacy of health managers (P <0.001) and self-efficacy with the beta coefficient of 0.436 could significantly predict critical thinking. The mean critical thinking score of healthcare managers was 125.96±10.62, and the mean self-efficacy score of healthcare managers was 34.67±6. 87. Conclusion: According to the research findings, critical thinking has a direct and positive relationship with managers' self-efficacy. To apply these findings, it is recommended that authorities take necessary measures to strengthen and develop critical thinking among healthcare managers to establish a stronger foundation for enhancing their self-efficacy.   282 Life Style Investigation of Health Promotion Behaviors among the Elderly Gerayllo Sakineh Badeleh Shamushaki Mohammad taghi Ghorbani Somayeh Arab Alireza Department of Public Health, Student Research Committee, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran Golestan Research Center of Psychiatric, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran. General Physician, Golestan University of Medical Sciences, Gorgan, Iran 1 5 2025 9 1 1588 1599 13 02 2025 02 05 2025 Background: Performing health-promoting behaviors is the most important and effective factor in maintaining the health of the elderly. Therefore, this study investigated health promotion behaviors and their related factors among the elderly population in Gorgan city. Methods: This cross-sectional descriptive-analytical study was conducted in 2023. Using a multistage sampling method, four comprehensive health centers in Gorgan city, Iran, were randomly selected, and a total of 170 elderly individuals aged over 60 years were conveniently recruited into the study. Data were collected using the standardized Health-Promoting Lifestyle Profile II (HPLP–II) questionnaire. After data collection, the data were analyzed and reported using SPSS version 26 software and parametric statistical tests, including t-test, ANOVA, and Pearson correlation coefficient, at a significance level of less than 0.05. Results: In this study, 44.1% of the elderly were male and 55.9% were female. The mean age of the participants was reported as 66.70 ± 7.23 years. A statistically significant difference was observed between the mean score of health promotion behaviors and demographic variables, including education level, economic status, and presence of underlying diseases (p < 0.05). Pearson correlation results indicated a positive correlation between health promotion behaviors and their subdomains (p < 0.05). The highest mean score was related to the interpersonal relations domain (32.28), while the lowest score belonged to the physical activity domain (13.52). Conclusion: Considering the results and the importance of health-promoting behaviors, particularly the low average scores in physical activity and stress management, it is necessary to emphasize these areas. Implementing continuous education programs based on elderly surveys, alongside strategic planning to encourage their active participation in health-related matters, can enhance health promotion among the elderly population.   274 Education & Health Violin Plots: An Enhanced Tool for Data Visualization in Health Studies Shishebor Zohreh Sajjdnia Zahra Sharafi Maryam Department of Statistics, College of Science, Shiraz University, Shiraz, Iran Department of Statistics, College of Science, Shiraz University, Shiraz, Iran Department of Statistics, College of Science, Shiraz University, Shiraz, Iran 1 5 2025 9 1 1600 1606 11 12 2024 23 03 2025 Statistical knowledge enables us to utilize appropriate methods for data collection, conduct accurate analyses, and effectively communicate results. Statistics plays a pivotal role in scientific discoveries, data-driven decision-making, and predictive modeling. Statistical plots serve as powerful tools for enhancing data visualization and facilitating data communication. By examining a statistical graph, underlying patterns and relationships within the data become more discernible. Visualizations are a far more effective way of communicating statistical findings to a non-technical audience. Charts and graphs make complex data relationships much easier to understand than tables of numbers or statistical reports. Even for technical audiences, a well-designed statistical graphics can quickly convey the key insights. When we are dealing with a new dataset and do not have a specific hypothesis to test, visual analysis excels at revealing patterns, outliers, and potential relationships that might not be apparent from numerical summaries alone. Statistical tests assume a certain structure in the data; visual inspection helps determine if that assumption is justified. Statistical graphs like box plots, scatter plots, and histograms can readily highlight outliers that might be missed by statistical tests focused on central tendencies. These outliers might be errors or genuinely interesting data points requiring further investigation. It is crucial to remember that ocular and statistical analysis are complementary, not competing, approaches, so both should be used. Visualizations guide the choice and interpretation of statistical tests, while statistical tests provide a more rigorous quantification of observed patterns in the data.  Using both methods together leads to more robust and reliable conclusions (Hullman et al., 2015; Tan & Shi, 2019; Wainer & Thissen, 1981).