Background: Depression, anxiety, and stress are the most prevalent psychological disorders among patients with chronic renal failure. These disorders increase mortality rate, impair immune function, reduce treatment adherence and quality of life, and heighten the risks of malnutrition, infection, and cardiovascular diseases. One potentially effective strategy for the management of psychological disorders is peer education; however, its effects on patients receiving hemodialysis are still unknown. Objectives: This study was conducted to investigate the effects of peer education on depression, anxiety, and stress among hemodialysis patients. Methods: This was a quasi-experimental study. Patients were randomly recruited and allocated in intervention and control groups. In the intervention group, patients were provided with two 120-minute peer education sessions per week for eight successive weekssixteen sessions in total. Patients in the control group solely received routine care services, which included no education by peers. Data were collected before and immediately after the intervention via the 42-item Depression Anxiety Stress Scale. Results: Before the intervention, the groups did not significantly differ from each other, respecting the mean scores of depression, anxiety, and stress (P > 0.05). After the intervention, significant decreases in the mean scores of depression, anxiety, and stress were observed in the intervention group (P < 0.05), while none of the mean scores significantly changed in the control group (P > 0.05). Consequently, posttest mean scores in the intervention group were significantly lower than the control group (P < 0.05). Conclusions: Peer education is effective in significantly alleviating hemodialysis patients' depression, anxiety, and stress. Therefore, peer education is recommended for alleviating psychological problems among patients receiving hemodialysis.

Abstract-Cloud computing has become a universal trend now. So, for users, the reliability is an effective factor to use this technology. In addition, users prefer to implement and get their work done quickly. This paper takes into account these two parameters for resource allocation due to their importance In this method, the Imperialist Competitive algorithm with the addition of a cross layer of cloud architecture to reliability evaluation is used. In this cross layer, initial reliability is considered for all the resources and the implementation of their tasks and due to the success or failure of implementation, reliability of resources is increased or reduced. Reliability and makespan are used as a cost function in ICA for resource allocation. Results show that the proposed method can search the problem space in a better manner and give a better performance when compared to other methods.

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