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Migraine has close associations with depression and anxiety. Catastrophizing, an alarmist reaction to pain, has been proposed as one of the mediators in the relationship between headache and emotional distress. However, much experimental evidence is needed to make such a view more validated. The aims of this study are to examine the effects of mood induction on the pain responses and to investigate the role of pain catastrophizing in the relationship between pain and mood amongst a sample of patients with migraine. For this purpose, 60 patients with migraine were recruited from a headache clinic in Tehran-Iran and were randomly assigned into one of three groups: negative mood induced group, positive mood induced group and control group. The following instruments and measures were used in this study: mood induction by presenting different types of films (positive, negative), a computerized cognitive task to elicit pain, Beck Depression Inventory and Pain Catastrophizing Scale. The results showed that while the induction of depressed mood increased the pain intensity, the induction of positive mood reduced it significantly ( p < 0.05). Further analyses revealed that catastrophizing is as a confounding factor in the relationship between pain and mood. Once catastrophizing scores were entered into the analyses as a covariate, the significant effect of mood on the pain intensity reduced. In conclusion, both mood and catastrophizing are important factors in understanding the migraine pain. Clinical implications of these findings are discussed in the paper. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message Pain-related catastrophizing and mood induction are important factors in understanding pain intensity amongst patients with migraine pain., Catastrophizing as a confounding factor in the relationship between pain and mood may partially mediate the relationship between mood and pain., Therapeutic interventions should focus on the reduction of depression and catastrophizing. [ABSTRACT FROM AUTHOR]

Objectives: The effects of different physiotherapy protocols on patients suffering from grade‐I spondylolisthesis have been thus far examined in a limited number of clinical trials. Therefore, the main purpose of this study was to compare the effects of lumbar segmental stabilization and general exercises on clinical and radiologic criteria in grade‐I spondylolisthesis patients. Methods: This study was a double‐blind randomized controlled trial (RCT) with a test–retest design and parallel groups. A total of 26 patients with grade‐I spondylolisthesis were thus randomly assigned to experimental group (13 patients, lumbar segmental stabilization exercises) and control group (13 patients, general exercises). Subsequently, pain, functional disability, kinesiophobia, translational motion, angular motion and slip percentage of the vertebra were investigated. Results: Of the 120 people recruited in this study, only 26 patients were eligible. According to pre/post‐intervention comparison, a statistically significant decrease was observed in the experimental group in terms of pain (p = 0.000), functional disability (p = 0.004), kinesiophobia (p = 0.002), translational motion (p = 0.043) and angular motion (p = 0.011), but not for slip percentage (p = 0.122). Considering the control group, a statistically significant decline was reported for pain (p = 0.043) and functional disability (p = 0.002). However, no significant differences were found for other variables in the control group. With regard to inter‐group comparison, there was no statistically significant difference between the two groups regarding the given variables except for kinesiophobia (p = 0.040). Conclusion: Both lumbar segmental stabilization and general exercises led to reduction in pain and functional disability of patients with grade‐I spondylolisthesis. Therefore, lumbar segmental stabilization exercises seemed to be better than general ones with reference to improving kinesiophobia and intervertebral movements. [ABSTRACT FROM AUTHOR]

ABSTRACT Benign prostatic hyperplasia ( BPH) is a common problem of the elderly population. This study was conducted to investigate the effect of Urtica dioica on the clinical symptoms of BPH. This double-blind clinical trial included 248 patients with symptomatic BPH in Shohada Ashayer Hospital of Khorramabad. The patients were randomly divided into four groups of treatment with U. dioica 3 g, U. dioica 5 g, U. dioica 7 g and treatment with prazosin 1 mg alone as the control group. The clinical symptoms, patients' quality of life and level of serum prostate-specific antigen ( PSA) were measured before and 2 months after the intervention. The results of the study showed significant differences between the four groups after the intervention for the scores of clinical symptoms and patients' quality of life, while no significant differences were found for serum PSA levels. Sheffe post hoc comparisons showed significant improvements in the scores of the patients' clinical symptom in the U. dioica 5 g/d and U. dioica 7 g/d groups. The results of the study showed that simultaneous consumption of higher doses of U. dioica, up to 7 g/d, plus prazosin, compared with the consumption of prazosin alone, resulted in significant improvements in the clinical symptoms of BPH. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to investigate the effectiveness of an orientated tour in reduction of children's anxiety before elective surgeries. Anxiety is a common emotional reaction following surgical experience among children that can result in increasing postoperative pain, increasing analgesic use. Methods: The study was a blinded clinical trial; 70 children were randomized into two groups (intervention and control). All children received standard preoperative care, while those in the intervention group also received an orientated tour with their mother of the operation room the night before the surgery was carried out. The children's anxiety was assessed by the 'Child Drawing: Hospital' instrument and vital signs measured before and after intervention in both groups. Data were analyzed with SPSS ver. 11.5 software. Results: Anxiety decreased in the intervention group following implementation of the orientated tour ( P = 0.024). Following the orientated tour in the intervention group, respiration rate ( P < 0.000) and blood pressure ( P < 0.001 systolic and diastolic) were significantly reduced, while heart rate and body temperature were not significantly different to pre-intervention. Comparison changes of vital signs following the orientated tour between the two groups was not significant. Conclusion: Implementation of an orientated tour of the preoperative room can decrease anxiety levels in children before elective surgeries, but it has no clinical effect on vital signs. [ABSTRACT FROM AUTHOR]

Rational and objectives To assess the effects of a tailored and activating educational intervention, based on a three-stage modified Prochaska model of readiness-to-change, on the performance of general physicians in primary care (GPs) regarding management of depressive disorders. Methods Parallel group, randomized control trial. Primary hypothesis was that performance would improve by 20 percentage units in the intervention arm. The setting was primary care in southern Tehran. The participants were 192 GPs stratified on stage of readiness-to-change, sex, age and work experience. The intervention was a 2-day interactive workshop for a small group of GPs' at a higher stage of readiness-to-change ('intention') and a 2-day interactive large group meeting for those with lower propensity to change ('attitude') at the pre-assessment. GPs in the control arm participated in a standard educational programme on the same topic. The main outcome measures were validated tools to assess GPs' performance by unannounced standardized patients, regarding diagnosis and treatment of depressive disorders. The assessments were made 2 months before and 2 months after the intervention. Results GPs in the intervention arm significantly improved their overall mean scores for performance regarding both diagnosis, with an intervention effect of 14 percentage units ( P = 0.007), and treatment and referral, with an intervention effect of 20 percentage units ( P < 0.0001). The largest improvement after the intervention appeared in the small group: 30 percentage units for diagnosis ( P = 0.027) and 29 percentage units for treatment and referral ( P < 0.0001). Conclusions Activating learning methods, tailored according to the participants' readiness to change, improved clinical performance of GPs in continuing medical education and can be recommended for continuing professional development. [ABSTRACT FROM AUTHOR]