Recognition of the factors affecting the medical students' academic success is one of the most important challenges and concerns in medical schools. Hence, this study aimed to investigate the mediating effects of metacognitive learning strategies and learning-related emotions in the relationship between academic self-efficacy with academic performance in medical students. Methods: The present study was carried out on 279 students of medicine studying at Shiraz University of Medical Sciences. The students filled out three questionnaires: academic emotions (AEQ), metacognitive learning strategies, and academic self-efficacy questionnaires. The data were analyzed using SPSS and Smart PLS3. Results: The results of structural equation modeling revealed that the students' self-efficacy has an impact on their learning-related emotions and metacognitive learning strategies, and these, in turn, affect the students' academic performance. Moreover, learning-related emotions influence the metacognitive learning strategies, which in turn mediate the effect of emotions on academic performance. Discussion: The results of this study revealed that metacognitive strategies and learning-related emotions could play a mediating role in the relationship between students' self-efficacy and academic performance.

Today, postgraduate students experience a variety of stresses and anxiety in different situations of academic cycle. Stress and anxiety have been defined as a syndrome shown by emotional exhaustion and reduced personal goal achievement. This article addresses the causes and different strategies of coping with this phenomena by PhD students at Iranian Universities of Medical Sciences. The study was conducted by a qualitative method using conventional content analysis approach. Through purposive sampling, 16 postgraduate medical sciences PhD students were selected on the basis of theoretical sampling. Data were gathered through semistructured interviews and field observations. Six hundred fifty-four initial codes were summarized and classified into 4 main categories and 11 subcategories on the thematic coding stage dependent on conceptual similarities and differences. The obtained codes were categorized under 4 themes including "thesis as a major source of stress," "supervisor relationship," "socioeconomic problem," and "coping with stress and anxiety." It was concluded that PhD students experience stress and anxiety from a variety of sources and apply different methods of coping in effective and ineffective ways. Purposeful supervision and guidance can reduce the cause of stress and anxiety; in addition, coping strategy must be in a thoughtful approach, as recommended in this study.

Adherence to fluid restrictions and dietary and medication guidelines is important for adequate management of hemodialysis (HD) patients. This study aimed at assessing the factors suggestive of adherence in uremic patients on HD. Two hundred HD patients were recruited by census method. Data on blood urea nitrogen (BUN), serum potassium and phosphate levels, and interdialytic weight gain (IWG) were collected from medical records and analyzed. Most of the patients (56%) did not adhere to fluid restrictions. Nonadherence to phosphate, potassium, and BUN levels was 25.5%, 5.5%, and 4.5%, respectively. In addition, there was a relationship between BUN, serum potassium and phosphate levels, and IWG with educational status (p ≤ .05). However, there was no correlation between BUN, serum potassium and phosphate levels, and IWG with sex, age, financial status, marital status, and duration of dialysis (p > .05). Based on the results, most of the patients adhered to dietary and medication regimens. Educational level of the patients was associated with adherence to fluid restriction. It was concluded that dietary compliance may be improved by using dietary counseling techniques and that education motivates patients to change and comply with dietary recommendations.