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Purpose: This study was conducted to evaluate a smartphone-based online electronic logbook used to assess the clinical skills of nurse anesthesia students in Iran. Methods: This randomized controlled study was conducted after tool development at Ahvaz Jundishapur University of Medical Sciences in Ahvaz, Iran from January 2022 to December 2022. The online electronic logbook involved in this study was an Android-compatible application used to evaluate the clinical skills of nurse anesthesia students. In the implementation phase, the online electronic logbook was piloted for 3 months in anesthesia training in comparison with a paper logbook. For this purpose, 49 second- and third-year anesthesia nursing students selected using the census method were assigned to intervention (online electronic logbook) and control (paper logbook) groups. The online electronic logbook and paper logbook were compared in terms of student satisfaction and learning outcomes. Results: A total of 39 students participated in the study. The mean satisfaction score of the intervention group was significantly higher than that of the control group (P=0.027). The mean score of learning outcomes was also significantly higher for the intervention than the control group (P=0.028). Conclusion: Smartphone technology can provide a platform for improving the evaluation of the clinical skills of nursing anesthesia students, leading to increased satisfaction and improved learning outcomes. [ABSTRACT FROM AUTHOR]

Aim: The study aimed at evaluating the effect of posture correction and stretching movements on lordosis and lumbar pain in pregnant women. Background: An increased lumbar lordosis during pregnancy is considered one of the most common causes of lumbar pain. Methods: This quasi‐experimental study was performed on 66 pregnant women referred to health centers in Tabriz, Iran, from November 2020 to June 2021. The participants were randomly assigned to the intervention and control groups. The intervention group received training of posture correction movements and stretching exercises during pregnancy from 16 to 18 to 35–37 weeks of pregnancy in six sessions for 45–60 min. The data were collected using a flexible ruler and a visual analog scale. Independent t‐tests, repeated measures ANOVA, and ANCOVA tests were used. Results: The mean (standard deviation: SD) of lumbar lordosis increased from 45.12 (2.07) to 54.97 (2.20) in the intervention group at 35–37 weeks and changed from 44.28 (2.03) to 55.54 (3.39) in the control group at 35–37 weeks (adjusted mean difference: −1.24, 95% confidence interval: −2.48 to −0.005, P = 0.04). The mean (SD) of lumbar pain at 28–30 weeks was 2.80 (1.72) in the intervention group and 3.74 (2.23) in the control group (P = 0.09). However, the mean (SD) of lumbar pain at 35–37 weeks in the intervention group 4.38 (2.45) was significantly lower than that in the control group 5.83 (2.96) (P = 0.04). Conclusion: This study provides evidence for the potential health benefits of training posture correction and stretching movements on controlling lumbar lordosis and reducing lumbar pain during pregnancy. Summary statement: What is already known about this topic? One of the most common causes of low back pain refers to the enhancement of lumbar lordosis.The standard corrective movements and stretching exercises approved during pregnancy increase muscular strength and reduce the severity of lordosis if they are done regularly. What this paper adds? This is the first study that investigates the impact of a childbirth preparation program including posture correction and stretching movements on lordosis and lumbar pain in pregnant women.The findings indicate that the posture correction movements and stretching exercises delivered in childbirth preparation classes are effective in controlling the enhancement of lumbar lordosis during pregnancy and reducing lumbar pain. The implications of this paper: Training of posture correction and stretching movements during pregnancy is recommended for all pregnant women with no contraindication to exercise during pregnancy and even for women with a history of caesarean section who may decline to participate in the preparation classes for physiological birth.Evidence‐based posture correction/exercise guidelines during pregnancy should be developed and embedded in prenatal care. [ABSTRACT FROM AUTHOR]

Objectives: Nausea is one of the most important symptoms of patients undergoing chemotherapy. This study aims to determine the effects of aromatherapy with sour lemon on nausea in patients undergoing chemotherapy. Methods: A total of 50 patients undergoing chemotherapy were randomly assigned to experimental and placebo (control) groups. The two groups completed the visual analogue scale for nausea before and the first to the fourth week after starting the intervention. The intervention was performed during chemotherapy. Using a dropper, a paper towel was saturated with 3 drops of sour lemon essential oil; however, for the control group, 3 mL of water as a placebo was spread on a paper towel. The intervention in the experimental and control groups was performed once a week for 4 weeks during weekly chemotherapy sessions. Results: At the beginning of the study, no significant difference was observed between the mean score of nausea in the two groups (P>0.05). The first to the fourth week after starting the intervention, significant differences were observed between the mean score of nausea in the two groups (P<0.05). The results of the repeated measures analysis of variance indicated that the mean score of nausea changed over time in the experimental group, indicating a gradual decrease in the mean score of nausea (P<0.05). Discussion: Our findings indicated that aromatherapy with sour lemon can be effective in reducing nausea in patients undergoing chemotherapy. [ABSTRACT FROM AUTHOR]

Background & Objective: As bleeding is a serious complication during and after hysterectomy, this paper aims to compare the short-term outcomes of ChitoHem and Surgicel use in posterior bladder bleeding during hysterectomy. Materials & Methods: In the present clinical trial, 46 patients who were candidates for abdominal hysterectomy in Hajar Hospital in Shahrekord, were randomly divided into two groups. In group A, superficial cauter and Surgicel were used and in group B, superficial cauter and ChitoHem were used to control bleeding. Hematocrit and hemoglobin levels were determined before, and six and 12 hours after surgery. Drain discharge volume, time to stop bleeding and bleeding volume were also determined. The pain was determined by the VAS scale at the time of recovery, 48 hours postoperatively, and one and three months postoperatively. Data were analyzed by SPSS statistical software. Results: Based on repeated-measures test, the mean of hemoglobin in the studied times showed a significant difference, so that in six and 12 hours after surgery they were significantly less than the ones before surgery, but their mean was not significantly different between the two groups. The mean pain score one month after surgery in group B was significantly lower than group A (P <0.001). The mean volume of drainage and clotting time in group B were significantly lower than group A (P <0.01). The mean volume of intraoperative bleeding, the frequency of vaginal bleeding and cuff-related complications were not significantly different in the two groups. Conclusion: The results of the present study show that ChitoHem is probably effective in reducing bleeding during hysterectomy surgery. [ABSTRACT FROM AUTHOR]

Background: Sexual desires and sexual activities are one of the natural needs of every human being, which if not used in the right direction, may become problematic and lead to various sexual disorders, including hypersexuality. The aim of this research was to compare the dialectic behavior therapy and aripiprazole drug on impulsive behavior in hypersexual patients. Methods: The paper is an experimental study based on control and treatment groups with pre-test and post-test and follow up. 54 male and female patients with hypersexuality having at least diploma, from four hospitals and psychiatric centers of Isfahan, were selected and assigned randomly in two groups of treatment (18 patients in every group) and one group of control (18 patients). Pre-test stage was done for three groups by Barratt Impulsiveness Scale Version 11 (BIS- 11). The first treatment group underwent DBT intervention for 8 sessions of 2 hours (once a week) and the second experimental group was prescribed aripiprazole for two months. Afterwards, the post-test and follow up was done for all three groups. Results: A significant difference was observed regarding the variable of impulsive behavior and all its components between the experimental and control groups (P<0.05). And the drug Aripiprazole had an effect on the motor impulsivity component of impulsive behavior and improved it (P = 0.01). Also, there is a difference between the effects of DBT and aripiprazole, with the greater effect of DBT, in the variables of impulsive behavior (P = 0.01). Conclusion: Based on the results, it can be said that the intervention of DBT and aripiprazole drug can have an effect on impulsive behavior of patients and DBT can be used as an complementary treatment. [ABSTRACT FROM AUTHOR]

Background: Low back pain (LBP) is a multifactorial disorder associated with a high range of physical and psychological burden on the society. Patient-led goal-setting approach has shown potential effects for improving chronic LBP. However, there are few studies investigating its benefits when combined with a supplementary intervention. This paper, therefore, presents a protocol for a randomized control trial (RCT) to study the effect of a patient-led goal-setting approach combined with pain neuroscience education (PNE) or manual therapy (MT) among patients with chronic LBP. Methods: A total of 105 patients suffering from chronic LBP will be recruited via flyers displayed in hospitals and universities, and those meeting the study's criteria will randomly be allocated into a patient-led goal-setting approach with the PNE group, and/or with the MT program group, and/or a control group. The primary outcomes will be the pain intensity and disability. Secondary outcomes include quality of life, depression, anxiety and stress, fear avoidance beliefs, kinesophobia, pain self-efficacy, catastrophic pain, neurophysiology of pain, and central sensitivity. All the outcomes will be recorded at 2 months after receiving the treatment as post-test sessions and after 4 and 12 months as follow-up sessions. The Ethics Committee in Research at Sport Sciences Research Institute of Iran approved the protocol of this trial (IR.SSRC.REC.1400.084). Written, informed consent to participate will be obtained from all participants. All methods will be conducted in accordance with the ethical standards of the Declaration of Helsinki and in accordance with relevant guidelines and regulations. We will disseminate the findings through peer-reviewed publications and conference presentations and send them to the participants. Discussion: This trial will demonstrate which supplementary intervention can better improve the impact of a patient-led goal-setting approach to treat LBP. If successful, the results will potentially have implications for athletic trainers, physiotherapists, and health care practitioners. Trial registration: IRCT Iranian Registry of Clinical Trials IRCT20210927052616N1. Registered on November 03, 2021. [ABSTRACT FROM AUTHOR]

Purpose: High levels of depression and anxiety in the family caregivers of a patient with cancer affect their quality of life. The purpose of this study was to investigate the effects of a mindful self-compassion (MSC) training program on self-compassion in the family caregivers of patients with cancer. Design/methodology/approach: In 2020, this quasi-experimental study used convenience sampling to select 92 family caregivers of patients with cancer presenting to the oncology ward of Seyed-Al-Shohada Hospital, Isfahan, Iran. The subjects randomly assigned to two groups participated in an online MSC program for 1.5 months. All the participants completed a self-compassion scale (Neff) before, immediately after and one month after the intervention. The data were analyzed using the Mann–Whitney U test, the Chi-squared test, the LSD test, the t-test and repeated measures ANOVA. Findings: The total mean score of self-compassion, respectively, obtained as 64.64 ± 8.23 and 64.44 ± 4.94 in the experimental and control groups before the intervention significantly increased to 81.15 ± 7.94 and 64.06 ± 5.22 immediately after and 78.94 ± 8.22 and 64.22 ± 4.85 one month after the intervention (P < 0.001). Practical implications: Given the potential for negative psychological impacts for patients, caregivers and clinicians in cancer care, the online MSC program can be recommended to support and reduce psychological distress in them. Originality/value: This paper examined the effect of the online MSC program on self-compassion in the family caregivers of patients with cancer and can contribute to our understanding of the value of integrating mental health of caregivers and care of patients with cancer. [ABSTRACT FROM AUTHOR]

Objective: Evaluate methodological quality of type 2 diabetes RCTs conducted in Iran and cited in clinical practice guidelines and systematic reviews and meta-analyses. Methods: We conducted a descriptive methodological quality review, analyzing 286 Randomized Controlled Trials (RCTs) on diabetes mellitus published in Iran from July 2004 to 2021. We searched six databases systematically and evaluated eligible articles using the CONSORT 2010 checklist for abstracts. Two investigators assessed the data using a 17-item checklist derived from CONSORT. Additionally, we examined the citations of each RCT in 260 clinical practice guidelines, with a specific focus on the adequate reporting of outcomes. Results: Out of 6667 articles, 286 analyzed. Poor reporting and failure to meet criteria observed. Only 3.8% cited in guidelines. Reporting rates: primary outcomes (41.9%), randomization (61.8%), trial recruitment (12.6%), blinding (50.8%). 27.9% cited in systematic reviews, 50.34% in systematic reviews and meta-analyses, 26.57% in meta-analyses. 67.8% of papers cited in systematic reviews. Adherence highest for participants, objective, randomization, intervention, outcome; lowest for recruitment, trial design, funding source, harms, and reporting primary outcomes. Conclusions: Poor methodological reporting and adherence to CONSORT checklist in evaluated RCTs, especially in methodological sections. Improvements needed for reliable and applicable results in guidelines, reviews, and meta-analyses. Inadequate outcome reporting challenges researchers, clinicians, and policymakers, impacting evidence-based decision-making. Urgent improvements in RCT registration necessary. [ABSTRACT FROM AUTHOR]

Background: Although conventional writing procedures are still the dominant instructional procedures in English as a foreign language (EFL) contexts, instructors are still struggling with time limitations to improve EFL students writing skills properly. Additionally, EFL students are not engaged in the writing process since they lack the required information about the writing tasks. Objectives: The present study, therefore, applied a sequential explanatory mixed‐methods approach to explore the impact of a flipped writing classroom on EFL students' writing skills (i.e. writing content, writing organization, and language use) and writing motivation on the one hand and possibly recommend a better instructional procedure for students' writing skills and writing motivation in EFL context on the other hand. Methods: To this aim, two intact classes were selected as the participants of the study. The two classes were randomly assigned to a flipped classroom with 27 EFL students and a non‐flipped classroom with 24 EFL students. The non‐flipped classroom was instructed through conventional writing instruction over 16 sessions whereas the flipped classroom was taught with the same content in a flipped writing mode in 10 sessions. Two timed writing tasks, a writing motivation scale, and an individual semi‐structured interview were used to gather the required data. Results and Conclusions: The findings indicated that the flipped writing classroom outperformed the non‐flipped writing classroom in improving the EFL students' writing performance, writing organization, language use, and writing motivation; however, no significant differences were found between the two groups' writing content. Moreover, the data analysis from the individual semi‐structured interview indicated that the flipped students had positive attitudes and perceptions towards the flipped writing classroom which further supported the quantitative findings. Implications: Practical implications for collaborative writing instruction using video clips and other electronic materials are suggested. Lay Description: What is already known about this topic: In a flipped classroom model, English language students can view video clips prior to class time in order to use the class time for doing academic exercises and projects in a collaborative manner.As in student‐centred learning environments, a flipped classroom engages English language students in more active learning processes, encourages them to enquire about the video lectures, and tests and evaluates their skills in applying knowledge.Individual differences, such as motivational variables and affective factors disjointedly or conjointly affect writing processes, especially in English language contexts. What this paper adds: Flipping an English language collaborative writing course improves English language students' writing performance, writing organization, language use, and writing motivation.Flipped classroom is more effective than non‐flipped classroom in improving English language students' writing performance, writing organisation, language use, and writing motivation.Flipped English language students hold positive attitudes and perceptions towards flipped collaborative writing classroom. Pedagogical implications: English language instructors are recommended to design a flipped classroom to provide English language students with video clips before class time, so students can have more collaborative and evaluative writing activities during the class time.English language students can have and receive more peer/instructor writing mediations on the writing tasks and make better use of class time (based on the video clips) and develop their writing performance accordingly.By designing a flipped classroom, English language students can enhance their writing motivation, and also, they properly cover the required materials in a shorter time. [ABSTRACT FROM AUTHOR]

Aim; One of the cancer treatments is chemotherapy; Anxiety is one of the important; symptoms of patients undergoing chemotherapy. Considering the effect of lemon aromatherapy on improving anxiety in patients without cancer, maybe it can also improve the anxiety of patients with cancer This study aimed to determine the possible effect of lemon scent on the nausea and vomiting of patients undergoing chemotherapy. Instruments & Methods This is a one-sided blind clinical trial study, which was carried out on 50 patients undergoing chemotherapy at Shahid Beheshti Hospital in Kashan, Iran in --2021-2022. Patients were randomly divided into two test and control groups. During chemotherapy, three drops of lemon essential oil were used and in the control group, 3cc of water were poured on a paper napkin. The subjects were then asked to breathe normally. This method was used once a week for 4 weeks during chemotherapy. Data were analyzed using SPSS 16 software. Findings The mean age of intervention and control groups were 52.20t9.63 and 51.48 ± 12.29 years, respectively (p=0.81) The mean duration of the disease of intervention and control groups were 40.04±27.53 and 35.32±19.57 months, respectively (p=0.48). No significant differences were seen between two groups in the demographic characteristics; sex, marital status, education level, underlying disease, and cancer type. The ANOVA test with repeated measures showed no significant decrease in overt and covert anxiety of patients over time (p>0.05). Conclusion Aromatherapy with lemon essence has no effect on the overt and covert anxiety of the cancer patients undergoing chemotherapy. [ABSTRACT FROM AUTHOR]

Background: The transition from teacher‐centred towards student‐centred approaches in English language teaching, accompanied by developments in educational technology, has attracted researchers' attention to reverse teaching or flipped class. The related literature asserts that this mode of instruction might influence instructors' and students' participation in the class. Objectives: To shed more light on the role of flipped class in affecting language learning strategies and skills, this study applied a sequential explanatory mixed‐methods approach to explore the impact of flipped class on English as a foreign language (EFL) learners' writing metacognitive strategies and writing skills. Methods: Forty‐six intermediate EFL learners with an age range of 21–27, studying at a private language institute, were randomly divided into two groups of 23 learners. The two groups were randomly assigned to a flipped class, which received writing metacognitive strategies and writing skills through video clips before the class time, and a non‐flipped class, which received writing metacognitive strategies and writing skills in a conventional way during the class time. Results and Conclusions: The results revealed that both flipped and non‐flipped classes improved the EFL learners' writing metacognitive strategies, writing performance, writing content, and writing organisation. Furthermore, one‐way ANCOVA analyses indicated that the flipped class outperformed the non‐flipped class in writing metacognitive strategies, writing performance, writing content, and writing organisation. Thematic analyses, which were used to help analyse individual semi‐structured interviews, uncovered a number of categories and themes, signifying the flipped learners' positive perceptions towards the flipped class, such as enhancing motivation, self‐confidence, and writing collaboration. Implications: Pedagogical implications were discussed for flipping writing metacognitive strategies and writing skills. Lay Description: What is already known about this topic?: Metacognitive strategies, including planning, monitoring, and evaluation strategies, help English language learners become more successful writers.Writing skills, including writing content, writing organisation, and language use, help learners deal with collaborative writing activities effectively.Flipped class has been shown to be an effective mode of instruction to improve English language learners' language learning strategies and skills. What this paper adds?: Flipped class improves English language learners' writing metacognitive strategies, writing performance, writing content, and writing organisation.Flipped class is more effective than non‐flipped class in improving English language learners' writing metacognitive strategies and writing skills.English language learners' motivation, self‐confidence, and writing collaboration are increased as a result of the flipped writing course. Pedagogical implications: Writing metacognitive strategies and writing skills need to be flipped in English language contexts in order to free up time for more effective in‐class collaborative writing activities. [ABSTRACT FROM AUTHOR]

In-person, individual counseling using the PLISSIT model is a well-known approach to help people with sexual problems. Evidence suggests that Grouped Sexuality Education (GSE) can be as effective as in-person sexuality education. The efficacy of PLISSIT versus GSE has not previously been evaluated in women with Breast Cancer (BC). In this paper, we report on the effect of PLISSIT versus GSE on self-reported sexual behaviors experienced by women after a BC diagnosis (n = 75). The women were randomly allocated into three groups, with 25 women in each arm. Data analysis of the intention-to-treat population (n = 65) revealed efficacy of both GSE and PLISSIT in improving sexual behaviors (p < 0.0001) with a positive change in sexual capacity, motivation and performance after 6- and 12-weeks post-intervention follow ups. We found the GSE model showed a greater efficacy than the PLISSIT model. Due to the substantial needs faced by women with cancer and the cost associated with implementing the PLISST model, GSE seems to be more effective. We recommend GSE for Iranian communities where management of sexual problems is at an early stage and where the sexuality of women with cancer is routinely overlooked. [ABSTRACT FROM AUTHOR]

Background and Aim: The aim of this study was to evaluate and compare the effect of curcumin and ibuprofen on pain control, in terms of pain intensity and duration of analgesia after extraction of the third molar of the mandible in the maxillofacial surgery department of the University School of Dentistry Islamic Azad Medical Sciences in the academic year 1400-1399. Material and Methods: The study was performed as a double-blind randomized clinical trial on 48 patients who were candidates for mandibular third molar surgery. they should also write their pain intensity one hour after taking the second dose of the drug after seeing the first symptoms of pain based on the VAS scale and the duration of their analgesia from the time of taking the drug (which was one hour before surgery for all patients) to the first signs of pain appeared on a piece of paper. Data analysis was performed using Two sample T test power analysis of PASS software version 22. Results: The results of our study showed that the duration of analgesia after Curcumin use is shorter compared to Ibuprofen (P<0.001). This difference was also statistically significant. Also, after taking the second dose of the drug, patients treated with ibuprofen reported less pain intensity, although this difference was not statistically significant (P=0.39) Conclusion: Ibuprofen compared to Curcumin further reduces patients' pain and also has a longer duration of pain for patients after extraction of the third molar of the mandible. [ABSTRACT FROM AUTHOR]

Purpose: The family of leukemia patients, due to their caring role, often feels psychological distress. A practical need-based program carefully considers the set of requirements of nursing service recipients. This paper illustrates the efficacy of a designed family-need-based program on relieving stress, anxiety, and depression of family caregivers of leukemia patients. Methods: In this controlled trial, sixty-four family caregivers of leukemia patients referring to a medical center in Iran were recruited by convenience sampling and randomly divided into study and control groups. The study group attended a designed need-based program. The control group did not receive the intervention. Stress, anxiety, and depression of both groups were simultaneously measured and compared in three time-points using the scale of stress, anxiety, and depression (DASS-42). Data were analyzed using descriptive and inferential statistics. Results: Before the program, the average scores of stress, anxiety, and depression were 31.16 ± 4.14, 21.37 ± 6.31, and 27.56 ± 4.24 for the study group and 31.09 ± 4.48, 20.34 ± 6.56, and 28.78 ± 4.72 for the control group. After the program, the average scores of stress, anxiety, and depression were 10.56 ± 3.37, 6.75 ± 2.99, and 7.37 ± 2.76 for the study group and 34.87 ± 2.51, 23.65 ± 4.96, and 32.56 ± 3.49 for the control group, respectively. Results of the independent t test indicated no considerable difference before the program (P > 0.05) and a significant difference after the program (P < 0.001) between the two groups. Conclusion: This family-need-based program can decrease the level of stress, anxiety, and depression of the family caregivers of leukemia patients and may potentially alleviate the psychological distress of family caregivers over their caring role. [ABSTRACT FROM AUTHOR]

Background and Aim Fibromyalgia syndrome is a chronic disease that causes widespread musculoskeletal pain. It primarily affects women and negatively impacts many aspects of a person’s psychological and social life. This study aimed to compare the effectiveness of cognitive therapy based on mindfulness and compassion therapy on automatic negative thoughts, psychological symptoms, pain intensity, and quality of life in patients with fibromyalgia syndrome. Methods & Materials This research is a quasi-experimental study with a pre-test-post-test design with two experimental and one control group. The statistical study population consisted of all individuals with fibromyalgia syndrome referred to Mehregan Pain Clinic in Mirdamad (District 3), Seyed Khandan Clinic (District 4), and Taleghani Hospital Pain Clinic (District 1) in Tehran City, Iran. Of them, 30 patients were randomly selected and divided into three groups of experimental 1, experimental 2, and control; each group will include 10 people. The instruments used in this study included the World Health Organization quality of life questionnaire (WHOQOL BREF), pain intensity questionnaire (PIS), psychological symptoms questionnaire (Anxiety, Stress and Depression [DASS]), and automatic negative thoughts (QNS). Ethical Considerations This study was approved by the Research Ethics Committee of Arak Branch, Islamic Azad University (Code: IR.IAU.ARAK.REC.1400.005). Results The analysis of covariance showed the effectiveness of both cognitive therapies based on mindfulness and compassion therapy on four variables of pain intensity, psychological symptoms, automatic negative thoughts, and quality of life (P<0.05). Comparing the two intervention methods showed that both therapies had almost the same effect on pain intensity, psychological symptoms, and automatic negative thoughts (P<0.05) but the effectiveness of mindfulness intervention on the quality of life was significantly higher than compassion intervention (P<0.05). Conclusion The results indicate that cognitive therapy based on mindfulness and compassion therapy are suitable for people with fibromyalgia under appropriate treatment. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Healing of the inferior alveolar nerve injury during dental procedures is one of the biggest concerns of dentists. There are still debates on different treatment modalities. Purpose: This study aimed to compare the effect of 940nm and 810nm diode lasers on the repair of the inferior alveolar sensory nerve. Materials and Method: In this single-blinded randomized clinical trial, 39 patients with inferior alveolar nerve injury were divided into three groups: 1. 810nm laser irradiated, 2. 940nm laser irradiated, and 3. No laser irradiation (control group). All patients were treated in 12 sessions (3 days per week) and evaluated using a complete clinical neurosensory test (CNT), including brushstroke, 2-point discrimination, pinprick nociception, and thermal discrimination before and after treatment. Results: The mean dysesthesia of the patient treated with 810nm diode laser was significantly lower than the control group in all sessions (the 1st (p= 0.003), 3rd (p=0.008), 7th (p= 0.006), and 12th sessions (p= 0.005)). The 810nm laser resulted in more satisfaction in patients than the control group in almost all sessions (1st (p< 0.001), 7th (p= 0.028), and 12th (p= 0.006)). More patient satisfaction was seen in the 1st and 3rd sessions in the 810nm laser than in the 980nm laser (p< 0.001 and p= 0.003, respectively). Conclusion: 810nm diode laser can be better than 940nm in repairing inferior alveolar sensory nerve damage. [ABSTRACT FROM AUTHOR]

Background: The status of effective therapeutic interventions has been highlighted by rising concerns about adolescent addiction to information and communication technologies (ICT), especially Instagram. Accordingly, the present study was conducted to investigate the effectiveness of the individual psychotherapy program for ICT addiction, focusing on reducing the severity of Instagram addiction... [ABSTRACT FROM AUTHOR]

Introduction: Knee osteoarthritis (KOA) is one of the most common and prevalent debilitating chronic diseases across the world with various adverse effects such as pain and movement limitations which impact the health status and quality of life of the patients in the long run. Objectives: This study aimed to investigate the effects of self-care education on pain, quality of life, and consequences of disease in patients with KOA in Southern Iran. Methods: This is a randomized controlled clinical trial using a pretest–posttest design. Eighty patients with KOA were enrolled in this study and randomly allocated to a control and an intervention group. The data collection instruments included VAS: Visual Analog Scale, the SF-36 quality of life scale, and the Knee Injury and Osteoarthritis Outcome Score. The collected data were analyzed through SPSS v. 22, using descriptive tests, paired t -tests, independent t -tests, Chi-square, and ANOVA. A P level of <.05 was considered as the significant level. Results: Before the self-care educational intervention, no statistically significant difference was found between the control and intervention groups in pain intensity, quality of life, and consequences of osteoarthritis. After the self-care educational intervention, the findings revealed a significant difference between the intervention group's mean ± standard deviation for pain intensity (41.25 ± 21.74), quality of life (49.87 ± 14.74), and consequences of KOA (39.06 ± 12.15), respectively (P <.05). However, in the control group, there was no significant difference. Conclusion: Based on the results of this study, the positive effect of self-care education on patients with osteoarthritis was shown as to their pain intensity, quality of their lives, and reduction of the disease consequences. Thus, healthcare managers are recommended to apply this type of intervention for patients with osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: Intravenous lidocaine has shown promise as an effective analgesic in various clinical settings, but its utility for pain management in emergency departments, especially for bone fractures, remains relatively understudied. Objective: This study compared intravenous lidocaine to pethidine for femoral bone fracture pain management. Methods: This double-blind, randomized, controlled clinical trial was conducted in the emergency department of AJA University of Medical Sciences affiliated hospitals. Patients aged 18–70 years-old with femoral bone fracture and experiencing severe pain, defined as a numerical rating scale (NRS) of pain ≥ 7, were included in the study. One group received intravenous pethidine (25 mg), while the other group received intravenous lidocaine (3 mg/kg, not exceeding 200 mg), infused with 250 ml saline over 20 min. Pain levels were evaluated before treatment administration (0 min) and at 10, 20, 30, 40, 50, and 60 min after treatment administration using the NRS. Results: Seventy-two patients were enrolled in the study. Demographic characteristics and pain scores were similar between the two groups. The mean pain scores upon arrival for the lidocaine and pethidine groups were 8.50 ± 1 and 8.0 ± 1, respectively; after one hour, they were 4.0 ± 1 and 4.0 ± 1, respectively. While there was a statistically significant reduction in pain in both groups after one hour, there were no clinically or statistically significant differences between the two groups (p = 0.262). Pethidine had a higher incidence of adverse events, though not statistically significant. Additionally, females required more rescue analgesics. Conclusion: The administration of intravenous lidocaine is beneficial for managing pain in femoral bone fractures, suggesting that lidocaine could be a potent alternative to opioids. Trial Registration: IRCT20231213060355N1 (https://irct.behdasht.gov.ir/trial/74624) (30/12/2023). [ABSTRACT FROM AUTHOR]

Objective Postoperative rehabilitation protocols, such as immobilization and non-weight-bearing periods during the acute phase after anterior cruciate ligament (ACL) surgery vary depending on the surgeon or the institution and lack clear standardization. Weight bearing (WB) after ACL reconstruction (ACLR) is critical. This study compares the results of WB immediately after surgery and partial WB with a brace after ACLR. Materials & Methods In this randomized clinical trial, the block random sampling method was used to select 84 patients who were divided into two groups. Group 1 was allowed to have full WB after surgery and Group 2 was asked to use braces after surgery, and they were divided into partial WB for one month and then full WB. Meanwhile, demographic information was recorded. The Lachman test, anterior knee pain, and kneeling pain before and one month after the surgery were also recorded. Knee function was evaluated using the international knee documentation committee, knee injury and osteoarthritis out-come score, and Lysholm scales before surgery and 1, 3, and 6 months after surgery. The data were analyzed using the SPSS software, version 20, and the Fisher exact test, the chi-square test, the Friedman test, and repeated measures analysis of variance. Results Most of the patients were men under 30 years of age. There was no statistically significant difference in the demographic information of the patients in the two groups. Kneeling pain, anterior knee pain, and the Lachman test did not differ between the two groups one month after the surgery. There was no difference between the two groups in the scores using the international knee documentation committee, knee injury and osteoarthritis outcome score, and Lysholm score in the 6-month follow-up. All the examined indicators in each group improved over time. Conclusion WB immediately after surgery compared to partial WB at 1, 3, and 6 months after ACLR do not differ; therefore, patients can bear full weight if they tolerate it. [ABSTRACT FROM AUTHOR]

Objective Autism is one of the most common neurodevelopmental disorders. It causes problems in social cognition, communication, and understanding of self and others’ feelings, and has a negative effect on the quality of a person’s life. The present study determines the effectiveness of the Cogniplus cognitive training program on the social cognition (theory of mind (ToM) of children with autism spectrum disorder (ASD). Materials & Methods In a semi-experimental study with a pre-test, post-test design, and a control group with a two-month follow-up, 65 children (44 male and 21 female) from 6 to 11 years old with ASD were selected based on the convenience sampling method from individuals referred to one of autism rehabilitation centers in Shahr-e-Ray City, Iran. They were assessed by the autism spectrum screening questionnaire (ASSQ). Overall, 50 children (33 male and 17 female) with a score of 19 and above on the autism spectrum screening questionnaire were diagnosed with high-functioning autism. They entered into the study according to the inclusion criteria as follows: having speech ability, the absence of motor or intellectual disability, and visual and hearing impairments. Meanwhile, they were matched based on their age. They were randomly and equally assigned to two experimental and control groups. The parents completed the ToM test. The experimental group participated individually in 20 sessions (twice a week, 30 min per session), in the Cogniplus cognitive training program, but the control group only received mainstream services (occupational therapy, speech therapy, art therapy, and music therapy). The parents completed the ToM test in the last session and two months follow-up. The data were analyzed by the correlation analysis, analysis of regression, and generalized estimating equations in the SPSS software, version 27. Results The results of generalized estimating equations analysis showed that the Cogniplus cognitive training program improved social cognition (total, first level, and second level of ToM). Meanwhile, the β coefficient showed that 2.9, 3.08, and 0.96 of the variations, respectively, in the ToM levels as the first, the second, and the total, in children with ASD who received Cogniplus cognitive training program. Also, the variations lasted after a two-month follow-up. Conclusion Considering the positive effect of the Cogniplus cognitive training program on social cognition, the use of the Cogniplus cognitive training program can solve the need for therapists who have new cognitive insight into training. Also, the implementation of such programs can help to improve the social cognition of children with autism disorder with high functioning in real-life situations. [ABSTRACT FROM AUTHOR]

Purpose: The rapid and limitless outbreak of the coronavirus in 2019 caused athletes to quarantine in their homes, resulting in stress and anxiety and the experience of negative symptoms, such as sleep disorder. The present study aims to investigate the effect of 8 weeks of yoga exercise on athletes' anxiety and... [ABSTRACT FROM AUTHOR]

Purpose: The current study aims to investigate the effect of a comprehensive warm-up program on functional movement (FM) patterns and landing errors of young male wrestlers. Methods: For this purpose, 50 wrestlers from Karaj City, Iran were selected as available to participate in the research and then randomly divided into two... [ABSTRACT FROM AUTHOR]

Background: At present, combined provision of direct composite restorations and dental bleaching has become increasingly popular to meet the esthetic demands of patients. This study aimed to assess the effect of internal bleaching on microtensile bond strength of composite to freshly veneered enamel. Methods: In this in vitro experimental study, 50 sound extracted human premolars were randomly divided into five groups (n=10). All teeth received composite veneers. Two groups underwent no further intervention and were subjected to measurement of microtensile bond strength of composite to enamel 24 hr and one week after the veneering. The remaining three groups underwent internal bleaching. Group 3 underwent bleaching one month after the veneering, and microtensile bond strength was measured after 24 hr. In groups 4 and 5, bleaching was performed immediately after the veneering. Microtensile bond strength was measured after 24 hr in group 4 and after one month in group 5. Data were analyzed using one-way ANOVA. Results: All the groups were not significantly different regarding the mean bond strength (p=0.110), but they were significantly different in terms of the mode of failure (p=0.01) such that the mode of failure was mainly adhesive in the three bleached groups. Conclusion: Internal bleaching after composite veneering has no significant effect on microtensile bond strength of composite to the enamel. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to evaluate the effect of the planned pre-electroconvulsive therapy (ECT) family teaching on depression, anxiety and stress of caregivers of patients with mental disorders receiving ECT. Design/methodology/approach: In this quasi-experimental study, 130 participants were randomized allocated into intervention or control groups. The planned family teaching program consisted of four 90 min sessions held during four weeks. Assessments occurred at pre-intervention (one week before the first session), and post-intervention (one months after the four session). Data were collected using demographic questionnaire and Depression, Anxiety and Stress Scale (DASS-21). Mean comparisons were performed using Student's t-test while effect sizes were estimated by Cohen's d coefficient. The significance level was considered less than 0.05. Findings: The mean scores of the depression, anxiety and stress levels in the intervention group were significantly reduced compared to the control group (p=0.001). Originality/value: The family pre-ECT teaching intervention and counseling decreased the depression, anxiety and stress level of family caregivers of patients with mental disorders receiving ECT and the maintenance of other favorable conditions at baseline. These results suggest that even a short-term educational intervention for family members of patients received ECT can improve emotional outcomes of treatment in the family. [ABSTRACT FROM AUTHOR]

The effect of the implementation of student response systems (SRSs) in teaching on the critical thinking (CT) of young students was investigated. The study benefited from a quasi‐experimental design and a pretest/posttest set‐up. Subjects consisted of 156 K‐8 students in Tehran during 2016–2017, selected through a multistage cluster sampling, and randomly assigned to either the experimental group (EG) or the control group (CG). The regular curriculum of the students contained a weekly session of a course titled "Thinking and Lifestyle." Ten sessions of the course were conducted using SRS (aka clickers) for EG, whereas CG kept receiving the same content in the conventional form. The teaching period was followed by the posttest. ANCOVA showed that, in contrast with CG, EG scored significantly higher on CT test after the intervention. The effect was shown to be only significant for the students at the lower side of the performance spectrum. Thus, in this inaugural study of clickers in schools in Iran, it was empirically demonstrated that clickers, as a relatively new piece of technology, can be successfully utilized during early adolescence in the pedagogical strategies in general and for the improvement of CT of students in particular. Lay Description: What is already known about this topic: For improvement in the critical thinking of learners as an essential objective of education, different approaches have been previously taken.The performance of student response systems at the K–12 level has not been studied as extensively as the collegiate level.What this paper adds: Success of clickers at the core of a question‐driven instructional set‐up for teaching critical thinking to K–8 students is empirically demonstrated.The reported results further enrich the body of literature on the pedagogy of critical thinking and the use of clicker technology for learners in their early teen years.Implications for practice and/or policy: The findings of this work encourage both practitioners and policy makers to take further steps towards more extensive incorporation of student response systems in the instructional strategies/designs for teaching of complex skills and tasks to adolescent learners. [ABSTRACT FROM AUTHOR]

Introduction: In recent decades, E-learning has gained widespread recognition globally as a vital application of information and communication technology. Objectives: The present study investigated the effectiveness of non-attendance triage training based on the ESI-IV system on the knowledge and ability of pre-hospital emergency staff. Patients and Methods: This study was a semi-experimental interventional study, and the study population consisted of the pre-hospital emergency staff of Ahvaz university of medical sciences academic hospitals in 2021. The study tool was a questionnaire on the awareness and performance of the triage system of hospital emergency (ESI). Initially, both questionnaires were completed, and submitted the triage training file to the intervention group. Two weeks after the first phase—completion of the questionnaire for the first time— and the study of the file by the subjects, the questionnaire was completed again by the intervention group, and the data of both groups were compared. Results: According to the results, the mean of awareness and decision-making in the control group before and after the intervention was (11.8, 10.85, and 13.82) and (7.51, 7.36, and 8.86) respectively. The results indicate that non-attendance triage training based on the ESI-IV system was effective in the knowledge and ability of the pre-hospital emergency personnel had a positive and significant impact, and remains at a good level. Conclusion: The present results of the research indicate that the use of non-attendance training as an effective method can improve interns’ knowledge and ability. [ABSTRACT FROM AUTHOR]

Objectives: Ventilator-associated pneumonia (VAP) increases the length of hospitalization and mortality rate. This study aimed to determine the effect of propolis mouthwash on the incidence of VAP in intensive care unit (ICU) patients. Materials and methods: Triple-blind, comparative randomized, controlled clinical trial was conducted over one year, with 110 ICU patients at Imam-Hossein and Bahar hospitals (Shahroud) and Kowsar Hospital (Semnan) in Iran. The intervention group used 15 cc of 0.06% propolis mouthwash solution twice daily at 8 AM and 4 PM for seven days. The control group used 15 cc of 0.2% chlorhexidine mouthwash at the same times and duration. Data were collected using a demographic questionnaire, APACHE II, Beck Oral Assessment Scale, and Modified Clinical Pulmonary Infection Score (MCPIS). Results: There was no significant difference in demographic information, disease severity, and oral health between the two groups before and after intervention (P > 0.05). The incidence of VAP in the intervention group compared to the control group was 10.9% vs. 30.9% on the third day (P = 0.0166, 95% CI: 0.53–0.83 and RR = 0.35), 23.6% vs. 43.6% on the fifth day (P = 0.0325 and 95% CI: 0.31–0.95 and RR = 0.54), and 25.5% vs. 47.3% on the seventh day (P = 0.0224, 95% CI: 0.32–0.92, and RR = 0.54). The Mann–Whitney indicated the incidence of VAP was significantly lower in the intervention group on the third, fifth, and seventh days. Conclusion: Propolis mouthwash can be considered as an alternative to chlorhexidine mouthwash for ICU patients. Clinical relevance: Propolis mouthwash serves as a simple, economical intervention to potentially reduce incidence of VAP. Trial registration: (IRCT20110427006318N12, date 02.04.2019). [ABSTRACT FROM AUTHOR]

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Background: It is difficult to obtain healthy oocytes in poor ovarian responders with conventional treatment methods. Thus, the need to investigate new methods is essential. This study aims to investigate ovulation induction outcomes in patients with decreased ovarian reserve (DOR) in two groups treated with double stimulation (DuoStim) during the follicular and luteal phases in comparison with the antagonist cycle. Materials and Methods: This was a randomised clinical trial that enrolled the patients with reduced ovarian reserve. The patients referred for in vitro fertilization (IVF) at Molud Infertility Clinic, Ali Ebn Abitalib (AS) Hospital, Zahedan, Iran from 2020 to 2021. Participants were randomly divided into two groups, those who underwent treatment with DuoStim during the follicular and luteal phase (case group) and those who received the conventional antagonist cycle (control group). Results: The mean number of metaphase II (MII) eggs was 7.7 ± 3.1 in the case group and 6.1 ± 3.9 in the control group (P=0.063). The mean total number of retrieved eggs in the case group was 9.2 ± 3.7 and in the control group, it was 6.9 ± 4.4 (P=0.023). The mean number of embryos obtained in the case group was 6.5 ± 3.9; in the control group, it was 4.7 ± 2.8 (P=0.016). Conclusion: The DuoStim method can effectively play a role in increasing the total number of retrieved eggs and embryos (registration number: IRCT20120817010617N8). [ABSTRACT FROM AUTHOR]

Aim: Our objective was to assess the efficacy and safety of adding alpha-pinene (a herbal terpenoid) to quadruple therapy compared to a placebo in improving symptoms and Helicobacter pylori (H. pylori) eradication rates in Functional dyspepsia (FD) patients. Background: FD is a prevalent upper gastrointestinal condition, and no definitive pharmacological treatment is available for its management. Methods: We conducted a randomized, double-blinded, placebo-controlled trial on FD patients diagnosed with H. pylori infection. We collected baseline demographic data and assessed FD symptoms in the participants. Patients were randomly allocated to receive either standard quadruple therapy with α-pinene capsules (0.25 mg/day) or quadruple therapy with a placebo for two weeks. We employed a validated questionnaire, the Short Form Leeds Dyspepsia Questionnaire (SF-LDQ), to evaluate FD symptoms. The eradication rate of H. pylori was compared between the two groups one month after completing the treatment regimens. Any reported adverse drug reactions (ADRs) were documented throughout the trial. Results: Over four months, a total of 66 patients completed the trial. Notably, there were no significant differences in baseline SFLDQ scores between the two groups (p=0.83); however, a significant divergence emerged at the trial's conclusion (p=0.03). The H. pylori eradication rates did not show notable differences between the two treatment arms (p=0.43). Importantly, there were no dropouts from the trial due to ADRs. Among reported ADRs, participants experienced abdominal pain, headache, diarrhea, and a metallic taste, with no significant variance in incidence rates observed between the two groups (p=0.62). Conclusion: These findings suggest that α-pinene could be an effective and safe agent for reducing FD symptoms. [ABSTRACT FROM AUTHOR]

Introduction: Polycystic ovary syndrome causes a decrease in sexual function and health-promoting behaviors. The present study compared the effectiveness of emotionally focused therapy and cognitive-behavioral therapy on sexual function and health-promoting behaviors in women with polycystic ovary syndrome. Method: This semi-experimental study was carried out on women with polycystic ovary syndrome referred to the infertility clinic of Afzalipur Hospital in Kerman, in 2022. For this purpose, 45 patients were selected using convenience sampling and were then randomly placed into two experimental groups and one control group (15 people in each group). The experimental groups were subjected to the interventions of emotionally focused therapy and cognitive-behavioral therapy. The questionnaires on sexual function and promoting lifestyle were used. Data were analyzed using SPSS21 software and variance analysis. Results: Findings revealed that the cognitive-behavioral therapy of emotionally focused therapy had significant effects on sexual function and health-promoting behaviors (P<0.05). The comparison of two therapies revealed that the effectiveness of cognitive-behavioral therapy on sexual function and health promoting behaviors is more than emotionally focused therapy. Moreover, there was no statistically significant difference between post-test and follow-up scores (P>0.05), which shows the lasting effect of the interventions on sexual function and health promoting behaviors in mothers with polycystic ovary syndrome. Conclusion: According to the results, the use of cognitive-behavioral therapy can be more effective on sexual function and health-promoting behaviors in women with polycystic ovary syndrome. [ABSTRACT FROM AUTHOR]

Purpose Insufficient physical activity leads to an increase in chronic diseases. Skills-based health education methods are supposed to be more successful than traditional methods to promote healthy behaviors. Skills-based health education is an approach to create healthy lifestyles and skills using participatory methods. The purpose of this paper is to examine the effects of skill-based education method on physical activities of female adolescents.Design/methodology/approach This was an experimental study on 80 female public high school students aged 12-14 years old in Tehran. The participants were randomly divided into two groups: experimental group of 40 girls who were educated using “Skills-based education method,” and control group of 40 girls who were educated by lecture as a routine educational method for health promotion. Data were collected using a valid and reliable questionnaire to assess physical activity-related knowledge, attitudes and behavior. Data were gathered three times; before, immediately after (Phase 1) and two months after educational intervention (Phase 2). Data analysis was performed using SPSS 20.Findings Intra-group comparison demonstrated that both educational methods can increase knowledge, attitude and behavior of the students after intervention comparing to before intervention (RMANOVA; p<0.05). However, the comparison between groups demonstrated a significant higher increase of knowledge (t-test; p<0.01 and p<0.0; phase 1 and 2, respectively), and behavior (t-test; p<0.01 and p=0.002; phase 1 and 2, respectively) but not attitude (p=0.083 and p=0.125, phase 1 and 2, respectively) among the students participated in the experimental “skilled based health education” group rather than the control “lecture” group.Originality/value Skill-based health education comparing to routine lecture-based education creates deep and long lasting knowledge and behavior and is highly recommended for promoting physical activity and other health-related knowledge and among adolescents. [ABSTRACT FROM AUTHOR]

INTRODUCTION Cesarean section (C-section) is one of the most prevalent surgeries among women. The preoperative stages in the surgery day and lack of control over being in an unfamiliar situation and feeling danger cause anxiety, and consequently, instability in patients. This study aimed to determine the effect of familiarization with preoperative nursing care on anxiety and vital signs of patients in cesarean section. METHODS This randomized controlled trial study was performed on 80 pregnant candidates for C-section in Hamadan Fatemieh Hospital, Iran, in 2020. Patients were randomly divided into control (n=40) and intervention (n=40) groups. The control group just received the routine intervention of the hospital, but the intervention group, in addition, received the two familiarizing sessions with preoperative nursing care. Data were collected via vital signs sheet and Spielberger situational anxiety questionnaire and were analyzed using SPSS16 software at a significance level of p=0.05. RESULTS Before the intervention, there was no significant difference between the mean anxiety scores of the control and intervention groups, and the two groups were homogeneous (p=0.396). However, after the intervention, the mean anxiety of the intervention group decreased significantly (p=0.001) and increased in the control group (p=0.600); and the mean post-test of the two groups showed a significant difference (p=0.001). After the intervention, the mean heart rate, respiration rate, systolic and diastolic blood pressure in the intervention group decreased significantly (p<0.05). However, there was no significant difference in heart rate and systolic blood pressure of the control group (p>0.05). CONCLUSIONS Based on the results of this study we conclude that familiarity with preoperative care reduces the level of anxiety and stabilized the level of vital signs parameters. [ABSTRACT FROM AUTHOR]

The elderly is passing from a stage to another new stage of life, with cognitive changes and a reduction in the physiological functions of this age. With increasing age, spiritual needs and attitudes increase. So, this study was conducted aimed to investigate the effect of group spiritual therapy on the cognitive state of the elderly. This experimental study was conducted in two experimental and control groups on 50 elderly people in Golestan Province in 2012, by simple random sampling. Data collection tool was Mini-Mental State Examination. In the experimental group, eight group therapy sessions were performed for 45–60 min a week twice. The data were analyzed by software SPSS-16 using descriptive statistics (mean score and SD) and inferential statistics (paired t test, independent t test and covariance test). Independent t test before the intervention in both groups showed no significant difference (P = 0.52). But this test showed a significant difference after the intervention (P < 0.01). Also, ANCOVA test showed a significant difference in both groups (η = 0.26) (P < 0/01). Regarding the effect of group spiritual therapy on the cognitive state of the elderly, it can be used as a complementary, low cost and effective method for improving the cognitive state of the elderly. For this reason, it is recommended because spiritual therapy creates the concept and meaning of life and increases the life expectancy and quality of life in the elderly. [ABSTRACT FROM AUTHOR]

Introduction: Teaching inhaler techniques to nursing students is crucial. Objective: This study aimed to investigate the effect of simulation-based education on patient training correct inhaler technique in nursing students. Methods: This is a single-blind, randomized controlled trial in which nursing students are randomly allocated into two groups of control (n = 41) and intervention (n = 40). The students' mean score of correct inhaler technique was measured before and one week after intervention, using checklists of inhaler techniques. Results: The mean score of control group was significantly lower than the intervention group (p <.001). The results also revealed that there was no significant difference in students' level of confidence regarding the ability to educate patients on inhaler techniques before the intervention, while all students were shown to have higher levels of confidence in this term after the intervention. Conclusions: Simulation is an effective way to train nursing students in the correct inhaler techniques. [ABSTRACT FROM AUTHOR]

Background: The use of contraceptive methods is influenced by their effectiveness, availability, and minimal side effects. OCPs are one of the most effective and widely used methods of pregnancy prevention worldwide. This method not only prevents pregnancy but also helps prevent and treat other diseases. One of the main reasons for discontinuing this method is the emotional disturbances associated with its use. Lavender is an evergreen, fragrant plant that has gained significant attention for its anti-anxiety effects. This study was conducted to investigate the effect of lavender essential oil capsules on mood disorders during the use of COCs. Methods: This triple-blinded clinical trial was conducted on 60 married women (aged 15–49 years old) who were consumers of COCs, referring to 26 health centers in Tabriz, Iran. The participants were randomly assigned to either the intervention (consuming one gelatin capsule containing 80 mg LEO daily) or control (consuming one placebo capsule daily) group. The intervention continued for 56 days. Scores for positive and negative were determined using the Positive and Negative Affect Schedule (PANAS) questionnaire; and for stress, depression, and anxiety were measured using the DASS-21 questionnaire on day's 28th and 56th post-intervention. Data analysis was conducted using the t-test and ANOVA with repeated measures, and a p-value of < 0.05 was considered significant for all analyses. Results: A statistically significant difference was observed in mood disorders, stress, and depression between women receiving LEO or placebo. The consumption of LEO increased the positive mood on day 28 [MD (95% CI): 4.5 (2.1 to 7.0), p = 0.001] and day 56 [5.9 (3.4 to 8.3), p < 0.001] while decreased the negative mood on day 28 [MD (95% CI): -3.5 (-5.3 to -1.3), p < 0.001] and day 56 [-4.3 (-6.3 to -2.2), p < 0.001], stress on day 28 [MD (95% CI): -4.9 (-7.1 to -2.8), p = 0.001] and day 56 [-5.3 (-7.6 to -3.1), p < 0. 001], and depression on day 28 [MD (95% CI): -3.0 (-4.9 to 1.1), p = 0.003] and day 56 [-3.1 (-5.0 to 1.2), p = 0.002]. There was no statistically significant difference between the two groups in terms of anxiety. Conclusions: The consumption of LEO with COCs improved mood disorders and reduced stress and depression. The use of hormonal contraceptives and mood changes should be considered by providers. Therefore, regarding the possibility of mood changes, it is expected that appropriate counseling and education will be provided to women who consume COC., providing appropriate solutions, including the simultaneous use of LEO. [ABSTRACT FROM AUTHOR]

Background and objective: Oropharyngeal interventions are an accepted method to improve the nutritional performance of premature infants. Considering the countless benefits of breast milk and the few studies on the use of breast milk as an oral-pharyngeal intervention, this study was conducted with the aim of determining the effect of oral-pharyngeal administration of breast milk on nutritional outcomes in premature infants. Materials and methods: In this clinical trial, 80 premature infants hospitalized in the neonatal intensive care unit of Amir al-Mu'minin Hospital in Semnan (a city in Iran) were randomly assigned to intervention (n = 40) and control groups (n = 40). Infants in the intervention group were given breast milk, and infants in the control group were given sterile water as a placebo. The data collection tool included demographic and clinical questions checklist, including sex, gestational age, weight, milk administration time, lavage and its amount, vomiting, abdominal distension, and so on. Data analysis was performed using SPSS23. Results: The mean volume of total milk received by infants (p = 0.047) and the mean volume of milk received by mouth (p < 0.000) at the time of discharge were higher in the intervention group. Moreover, the time to start enteral nutrition in the intervention group was lower than in the control group (P = 0.012). Administering mother's milk through the oropharyngeal method led to a reduction in infants' length of stay in the hospital (P = 0.022). Conclusion: Based on the results of the present study, the oropharyngeal administration of breast milk in the first days after the birth of premature infants admitted to the hospital improves the outcomes related to their nutritional status. Therefore, it is suggested that this convenient, safe, and feasible method be used in hospitalized premature infants as soon as possible so that premature infants can benefit from the important advantages of breast milk. [ABSTRACT FROM AUTHOR]

Introduction: Autism is considered a neurodevelopmental disorder. Children with autism are known to have qualitative defects in communication and social interactions, as well as repetitive and limited behaviors. In addition, these children have deficits in joint attention. The present study aimed to determine the effectiveness of the joint attention training program on the neuropsychological abilities and mental flexibility of children with high-functioning autism aged 3 to 7 in Abadan City, Iran. Material & Methods: A semi-experimental design with pretest-posttest and a control group was conducted in 2021 for 30 children with high-functioning autism disorder in Fereshtagan and Noandish centers in Abadan, Iran. The sampling was performed in an accessible way and via the randomized balanced blocks method in the experimental and control groups. Moreover, the assignment and joint attention training program was implemented in the intervention group. The data were collected using the Autism Spectrum Screening Questionnaire (ASSQ, Ehlers and Gillberg, 1993), Continuous Performance Task (CPT, Connors, 2004), and Wisconsin Card Sorting Test (WCST, Grant and Berg, 1948). The obtained data were analyzed through the multivariate covariance test and at a significance level of 0.05 using the SPSS software. Results: In the intervention group, the mean (standard deviation) of neuropsychological abilities decreased from 7.82 (0.93) in the pre-test to 6.26 (0.84) in the post-test (P<0.001). In the intervention group, the mean (standard deviation) of cognitive flexibility decreased from 7.00 (1.00) in the pre-test to 6.22 (0.70) in the post-test (P<0.001). Discussion & Conclusion: Considering the effectiveness of the joint attention training program in improving neuropsychological abilities and mental flexibility, the implementation of this program is recommended for preschool counselors and psychologists to improve the conditions of children, especially those with high-functioning autism. [ABSTRACT FROM AUTHOR]

Objective: Consequences of imprisonment include negative psychological effects, social stigma, and challenges for reintegrating into society. In this regard, this study aimed to investigate the effectiveness of Rational Emotive Behavior Therapy (REBT) on self-control and impulsivity among male prisoners. Method: A randomized controlled clinical trial (RCT) utilizing a design the included pretest, post-test, and follow-up assessment as well as a waiting-list control group was conducted. A total of 30 male prisoners were selected using convenience sampling and randomly assigned to experimental and waiting list control groups (the intervention group (n = 15) and the control group (n = 15)). The participants in the experimental group underwent the 12-session REBT intervention over a period of six weeks. (For six weeks). All participants responded to the Self- Control Scale (SCS) and Dysfunctional Impulsivity Questionnaire (DFIQ) as dependent variables at three time points (pretest, post-test, and one-month follow-up). A repeated measures analysis of variance was used to analyze the data. Results: The results revealed that after the implementation of the REBT intervention, the mean scores of self-control increased (P < 0.05), while the mean scores of impulsivity diminished significantly (P < 0.05). Furthermore, these changes remained relatively stable during the follow-up period (P < 0.05). Conclusion: Based on the findings of this study, it can be inferred that REBT intervention plays a significant role in diminishing self-control deficits and mitigating impulsivity among incarcerated individuals. These results present promising implications for the utilization of REBT in lowering recidivism rates. [ABSTRACT FROM AUTHOR]

Background: Despite the widespread use of extracorporeal shock wave lithotripsy (ESWL) as a treatment for kidney stones, it is essential to apply methods to control pain and improve patient comfort during this procedure. Therefore, this study aimed to investigate the effect of acupressure at the Qiu point on pain intensity and physiological indices in patients undergoing ESWL. Methods: This randomized, sham-controlled clinical trial was conducted at the Shahid Beheshti Educational-medical Center in Hamadan City (western Iran) from May to August 2023. Seventy-four eligible patients were split into intervention (n = 37) and sham (n = 37) groups. Ten minutes before lithotripsy, the intervention group received acupressure at the Qiu point, while the sham group received touch at a neutral point. The primary outcomes were pain intensity measured by the Visual Analog Scale (VAS) and physiological indices such as blood pressure and heart rate at baseline, 1, 10, 20, 30, 40, and 50 min after the intervention. The secondary outcomes included lithotripsy success and satisfaction with acupressure application. Results: The analysis of 70 patients showed no significant differences in the demographic and clinical information of the patients across the two groups before the study (P > 0.05). Generalized estimating equations revealed that the interaction effects of time and group in pain and heart rate were significant at 30 and 40 min (P < 0.05). The results of this analysis for systolic blood pressure revealed a significant interaction at 30 min (P = 0.035). However, no significant interaction effects were found for diastolic blood pressure changes (P > 0.05). Conclusions: Acupressure at the Qiu point positively impacts pain in patients undergoing ESWL treatment and increases their satisfaction. However, these results for physiological indices require further studies. Thus, acupressure can be considered a simple, easy, and effective option for pain management in patients during this procedure. Trial registration: [https://en.irct.ir/trial/69117], identifier [IRCT20190524043687N4]. [ABSTRACT FROM AUTHOR]

Background: While palliative care for patients with heart failure has gained global attention, in Iran most palliative care interventions have focused only on cancer patients. The purpose of this study is to determine the feasibility and acceptability of a telehealth palliative care intervention to improve the quality of life in patients with heart failure in Iran. Methods: This single-site, pilot randomized controlled trial of a telehealth palliative care intervention versus usual care was conducted on patients with New York Heart Association class II/III heart failure recruited from a heart failure clinic in Iran. Under the supervision of a nurse interventionist, intervention participants received 6 weekly educational webinars and concurrent WhatsApp® group activities, with 6 weeks of follow-up. Feasibility was assessed by measuring recruitment, attrition, and questionnaire completion rates; acceptability was assessed via telephone interviews asking about satisfaction and attitudes. Secondary outcomes measured at baseline and 6 weeks included quality of life (PKCCQ and FACIT-Pal-14), anxiety and depression (HADS), and emergency department visits. Results: We recruited and randomized 50 patients (mean age 47.5 years, 60% men). Among those approached for consent, 66% of patients agreed to participate and total study attrition was 10%. Also 68% of patients successfully completed at least 4 out of the 6 webinar sessions. Acceptability: 78% of patient participants expressed willingness to participate in the present study again or recommend other patients to participate. There was a trend towards improvement in anxiety and depression scores in the intervention group though the study was not powered to detect a statistical difference. Conclusion: This nurse-led, early telehealth-palliative care intervention demonstrated evidence of feasibility, acceptability, and potential improvement on quality of life in patients with heart failure in Iran. Trial registration: The study was registered at the Iranian Registry of Clinical Trials (IRCT) at 14 November, 2021, and can be found on the Iranian Registry of Clinical Trials Platform. IRCT registration number: IRCT20100725004443N29. [ABSTRACT FROM AUTHOR]

Introduction: Mothers are more responsible for raising their children, and they are usually the main caregivers of disabled children. The present study aimed to determine the effectiveness of behavioral activation therapy on social avoidance in mothers of children with cerebral palsy. Material & Methods: This study with a quasi-experimental research design had a pretest, post-test, and a control group. The research sample consisted of 40 mothers referred to Occupational Therapy Centers in Ilam, Iran, in 2021. Then, they were randomly assigned into an experimental group (n=20) and a control group (n=20). The experimental group received behavioral activation group therapy based on the protocol provided by Kanter, Bush, and Rush during eight 90-minute sessions in one group session per week[S1]. Information was collected using a social phobia questionnaire (SPI) by Connor et al. (2000) in two stages of pre- and post-interventions. Covariance analysis and SPSS software (version 27) were used for data analysis. Results:Based on the obtained results, at the end of the treatment, the social avoidance scores of the intervention group were significantly reduced compared to the control group (P<0.05). Discussion & Conclusion: The study showed that behavioral activation therapy has a favorable effect on reducing the severity of symptoms of social avoidance disorder in mothers of children with cerebral palsy. Therefore, this treatment is suggested as a complementary treatment along with drug treatments to improve psychological symptoms in these people. [ABSTRACT FROM AUTHOR]

Background. Post-dural puncture headache (PDPH) as an annoying complication after spinal anaesthesia and is of great importance in patients undergoing caesarean section. Objectives. This study aimed to evaluate the effect of nasal oxytocin on the incidence and severity of PDPH after caesarean section. Material and methods. This double-blinded randomised clinical trial was carried out on 170 patients undergoing elective caesarean section in Kamali Hospital, Karaj, Iran, from May 2021 to September 2021. Participants were randomly assigned to receive three puffs of intranasal oxytocin (30 IU) (intervention group) or intranasal normal saline (0.3 ml of 0.09% saline solution) (control group) as a placebo right after delivery. The occurrence of PDPH was the primary outcome, and participants were also asked about the use of analgesics and associated symptoms. Results. The results showed that the rate of PDPH was not significantly different between the two groups at 12 (p = 0.108) and 72 (p = 0.245) hours after surgery, but it significantly reduced the incidence of PDPH at 24 (p = 0.022) and 48 hours (p = 0.042). Oxytocin did not reduce the analgesic requirement compared to the control group (p > 0.05). Oxytocin did not significantly mitigate PDPH associated symptoms, including tinnitus, vertigo, nausea and double vision (p > 0.05). Conclusions. Administration of intranasal oxytocin in combination with routine analgesic for post-dural puncture headache after caesarean section is beneficial and reduces the incidence of headache after 24 and 48 hours of surgery. Use of nasal oxytocin has no effect on the need for sedation and reduction of associated symptoms (dizziness, diplopia, nausea, tinnitus). [ABSTRACT FROM AUTHOR]

Background & Objective: Studies have shown contradictory results regarding the use of pregabalin and melatonin as analgesic agents. Because the analgesic effects of these drugs as preemptive have not been compared in abdominal hysterectomy, one of the most common surgical procedures in women with moderate to severe pain, under general anesthesia. The aim of this study was to compare the pretreatment effects of melatonin and pregabalin on postoperative pain intensity in total abdominal hysterectomy (TAH). Materials & Methods: Ninety Patients were randomly divided into three groups (N=30): the first group received oral melatonin (6 mg), the second group received pregabalin (50 mg), and the third one who took no drug. Serum melatonin and betaendorphin levels were measured before and after the surgery. Pain intensity was assessed by the Numerical Rating Scale at 1,6,12, and 24 hours after the surgeries. Results: At 12 hrs after the surgery, mean pain intensity in the melatonin group was significantly lower than the pregabalin group, and in the pregabalin group was significantly lower than the third group (P<0.05). At 24 hrs after the TAH, the mean pain intensity in the melatonin group was significantly lower than the third group (P<0.05). Conclusion: injection preventive melatonin is more effective than pregabalin to reduce pain throughout the first 24 hrs after the TAH. [ABSTRACT FROM AUTHOR]

Background The human immunodeficiency virus (HIV) infection is important because it can cause stigma and psychological, family, and social problems in affected people. Objective This study aims to investigate the effect of schema therapy on adaptive and maladaptive strategies of cognitive-emotion regulation in people with HIV. Methods This is an interventional study with a pretest-posttest design. Thirty people with HIV were selected by a convenience sampling method and randomly divided into two groups of intervention and control. Garnefski et al.’s cognitive-emotion regulation questionnaire - short form (CERQ-SF) was used to collect data. The intervention group received 10 two-hour sessions of group treatment based on Young’s schema therapy model. The data analysis was performed in SPSS software, version 26 using descriptive statistics (frequency, percentage, mean, standard deviation) and analysis of covariance (ANCOVA). The significance level was set at 0.05. Results The results ANCOVA showed that group schema therapy affected the use of adaptive strategies (acceptance, positive refocusing, refocusing on planning, positive reappraisal, and putting into perspective) and maladaptive strategies (self-blame and catastrophizing), (P<0.001). However, it had no significant effect on other-blame (P=0.033) and rumination (P=0.102). Conclusion Schema therapy can increase the use of adaptive strategies and reduce the use of maladaptive strategies (self-blame and catastrophizing) of cognitive-emotion regulation in people with HIV. [ABSTRACT FROM AUTHOR]

Purpose: Pronation in the foot is a normal rolling movement occurring at the subtalar joint during running. The human foot, as the primary interface with our environment, presents morphological and postural changes following prolonged running. This study aims to identify running mechanics while training on the sand in runners with pronated feet. Methods: Thirty runners with pronated feet were in the control group, and 30 runners with pronated feet were in the experimental group. An experimental group conducted an 8-week corrective exercise program, while a control group did not exercise. A force plate was included to collect ground reaction forces in the walkway. An analysis of variance (ANOVA) with repeated measures test was conducted to identify the presence of an interaction between the within-and between-subject factors on the dependent variables. The significance level was set at P<0.05. Results: The experimental group displayed lower first peak vertical ground reaction force (P=0.026), peak mediolateral ground reaction force (P=0.000), anterior-posterior impulse (P=0.032), loading rate (P=0.004) and a larger last peak vertical ground reaction force (P=0.000) during training on the sand. Irrespective of the group under consideration, a lower first peak mediolateral ground reaction force (P=0.000), peak positive free moment amplitude (P=0.001), and a larger last peak mediolateral ground reaction force (P=0.003) observed in the post-test compared to the pre-test. Conclusion: We suggest that training on sand may be a suitable intervention to change running mechanics in male runners with pronated feet. [ABSTRACT FROM AUTHOR]

Background: Patients with Acute Coronary Syndrome (ACS) experience high levels of anxiety that may cause instability of hemodynamic indices, increased risk of ischemia, myocardial infarction and poor quality of life. Aromatherapy can affect patients' anxiety levels and improve hemodynamic indices. This study aimed to evaluate the efficacy of aromatherapy on anxiety and hemodynamic indices in ACS patients. Methods: This study was a double-blind, randomized clinical trial conducted on 154 ACS patients. The participants were classified into two equal groups of intervention and placebo through the block randomization method. The data collection tools consisted of demographic information, a shortened 6-item version of the Spielberger questionnaire and a form of hemodynamic indices. For two consecutive nights, the intervention group inhaled 7 drops of the chamomile essential oil (%10) and the placebo group inhaled 7 drops of the sesame oil poured on a sterile cotton ball. The hemodynamic indices were collected half an hour before, one and four hours after the intervention until the next morning. The Spielberger questionnaire was completed once before the intervention and once after the end of the intervention, by the researcher through an interview. The number of heart rate (HR) was counted for a full minute. Also, the blood pressure (BP) of all the samples was measured by the researcher. Data analysis was done using Chi-square, paired t-test, and analysis of variance (ANOVA) in SPSS22. Results: The mean and standard deviation of the age of patients were 58/2 ± 11.6 and 59.7% of them were female. The results of ANOVA showed a significantly lower anxiety score as well as systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR in the intervention group compared to those of the placebo group (P < 0.001). The decrease in anxiety score after the intervention, in the intervention and placebo groups was (5.2 ± 1.9) and (1 ± 1. 18) respectively. In the intervention group, the SBP and DBP after the intervention, was significant (P < 0.05). Also, the HR was significant (P < 0.001) after the intervention. Conclusions: Aromatherapy could reduce anxiety and improve hemodynamic indices in ACS patients. Trial registration: IRCT20080825001083N11. [ABSTRACT FROM AUTHOR]

Background: Although acupressure is proposed to boost sleep quality and alleviate anxiety in various disorders, no trials have yet documented these consequences in burn victims. Considering the high importance of managing sleep quality and anxiety among burn patients utilizing adjunctive non-pharmacological measures, this study sought to investigate the impacts of acupressure on sleep quality and anxiety among a population of Iranian patients with burn injuries. Methods: This trial was performed on 72 patients with second- or third-degree burns, who were divided into two equal arms to receive routine care plus 10-minute acupressure on either real acupoints (i.e., Yintang and Shen men) or sham points for three consecutive nights. Sleep quality and anxiety were investigated at baseline (T1) and on the fourth day (T2) by using St. Mary's Hospital Sleep Questionnaire (SMHSQ) and Spielberger's State-Trait Anxiety Inventory for State Anxiety (STAI-S), respectively. Results: The mean scores of SMHSQ and STAI-S were significantly lower in the real acupressure arm at T2 (P < 0.001 in two cases), implying better sleep quality improvement and higher anxiety alleviation. Also, the reduction in mean changes of SMHSQ and STAI-S scores from T1 to T2 was significantly more in the real acupressure arm (P < 0.001 in two cases). Conclusion: Acupressure, as a low-cost complementary method, could be potentially helpful in enhancing sleep quality and decreasing the anxiety of burn patients. Additional long-term trials are required to identify the sustainability of the findings. Trial Registration No: IRCT20130424013110N13 (Registration date: 19/03/2021, https://www.irct.ir/trial/55076). [ABSTRACT FROM AUTHOR]

Objective: Patients with leukemia suffer from significant psychological, spiritual, and social symptoms. Therefore, the current research aimed to study the impact of spiritual end-of-life support on the quality of life for leukemia patients. Method: To this end, the present quasi-experimental research with a pre-test and post-test design was performed. The sample included 60 cancer patients randomly assigned to intervention and control groups through the method of permutation block. The experimental group received spiritual support intervention for eight sessions of 60 minutes, while the control group received no intervention. Patients filled out the questionnaire of World Health Organization Quality of Life. The World Health Organization conducts a three-phase assessment to measure the quality of life. These phases include a pre-test, which is conducted before any intervention takes place. Then comes the post-test, which occurs after the intervention. Finally, there is a follow-up assessment conducted two months after the post-test. The obtained results were analyzed by repeated-measures analysis and independent samples t-test using SPSS software. Results: The findings from the repeated measures analysis revealed that there was a statistically significant interaction between time and group (P = 0.01). In other words, being compared to the control group, the spiritual support significantly increased the life quality of the patients in the experimental group. The experimental group witnessed a sustained enhancement in the quality of life for a period of two months following the intervention (follow-up, P = 0.01). Conclusion: Ultimately, the provision of spiritual support has the potential to enhance the overall well-being of individuals approaching the end of their lives, offering solace and aiding them in comprehending the true essence and purpose of their existence. [ABSTRACT FROM AUTHOR]