Search

Background Health promotion of children and adolescents through participation in purposeful and meaningful activities is one of the focuses of occupational therapy. In this study, in line with the Iranian culture, a tool for assessment of Iranian adolescents’ participation in daily occupations/activities was developed and validated. Method An exploratory sequential mixed method was used to develop and validate the tool. Content and structural validity and reliability of the initial version were estimated. Results During the validation process, the items were reduced to 54. Data were collected from 481 adolescents to investigate factor analysis. According to principal component analysis, the Kaiser–Meyer–Olkin index was 0.88, and the analysis yielded seven factors explaining 47.2% of the total variance. The tool showed excellent internal consistency and test–retest reliability. Conclusion This newly developed Participation Assessment Tool for Iranian adolescents is a valid and reliable measure for assessing the participation of this group in daily activities.

Aim Considering the wide impact of endometriosis on various aspects of health, this study aimed to explore the impact of endometriosis on Iranian women's lives. Design The present study used a qualitative approach and conventional content analysis. Methods Twenty patients suffering from endometriosis referring to Imam Khomeini Hospital in Tehran took part in this study. The sampling was done purposefully until data saturation. After deep semi-structured interviews, the content analysis of the interviews was done according to the steps proposed by Zhang and Wildemuth. Results The mean age of the participants was 34.53 (SD: 5.81) years (range: 23-43) with duration of illness of 6.30 ± 5.86 years. Their educational level varied from high school to university, and most of them were employed. Analysis of the data from participants' experiences led to the formation of 5 categories under the titles "Physical suffering, instability of marital life, mental disorder, disruption in social life and self-care" and 11 subcategories. Conclusion The findings of the present study showed that endometriosis can adversely affect women's lives including physical, sexual, psychological and social problems. Although in some cases patients adopt different strategies for self-care, the need for more support is felt.

Endometriosis is a debilitating chronic disease that affects 10% of the general female population, with a frequency of 38% in infertile women. This review aims to provide an overview of the impact of endometriosis on different aspects of reproductive health. A literature search was performed in four international databases, including PubMed, Science Direct, Scopus, and Google scholar, from January 1995 to December 2019 to identify the potentially relevant articles. We included all relevant articles published in English and identified 46 studies on health issues in women with endometriosis. The research suggests that women with endometriosis are at risk for physical, psychosocial, social, and sexual disturbances and obstetrical complications. More research is needed to clarify better understanding of endometriosis complications specifically obstetrical consequences.

Background Health-promoting lifestyle (HPL) is any measure taken to maintain a person’s health. The most important and influential factor in maintaining and enhancing health are health-promoting behaviors (HPB). This study aimed to determine HPB and their predictors among Iranian men. Methods In this cross-sectional study, 783 Iranian men, living in Tehran, were selected, using multistage cluster sampling. The employed questionnaires, namely the sociodemographic questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), and the second part of the Personal Resource Questionnaire (PRQ 85-Part 2), were completed through interviews. The relationship between the dependent variables (HPLP-II and its subdomains) and independent variables (sociodemographic characteristics and social support) was investigated using the adjusted General Linear Model (GLM). Results The mean ± standard deviation of the total HPLP-II score was 2.72 ± 0.44 in the range of 1–4. Among the six dimensions of the HPB, the participants achieved the highest score (3.00 ± 0.52) and lowest score (1.96 ± 0.56) in spiritual growth and physical activity, respectively. The Pearson test showed that the perceived social support was significantly correlated with HPLP-II (r = 0.23; p r = 0.09–0.24; p Conclusions The research findings confirmed the importance of social support and modifying variables (social and personal) in the incidence of HPB in men.

Introduction The Upper Limb Functional Index (ULFI) is a patient-reported outcome measure (PROM) designed to evaluate both the functional status and the level of participation in patients with upper limb musculoskeletal disorders (ULMSDs). The purpose of this study was translation, cross-cultural adaptation, and psychometric evaluation of the original ULFI into Persian (ULFI-Pr). Methods The original ULFI was translated into Persian through double forward and backward translations. Consecutive symptomatic upper limb patients (n = 180, male = 60%, age = 38.21 ± 7.13) were recruited and completed the ULFI-Pr and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires. Internal consistency and test-retest reliability were determined using Cronbach’s Alpha and the Intra-class Correlation Coefficient (ICC2.1). Criterion validity was analyzed by evaluating the Pearson’s r correlation coefficient between the ULFI-Pr and DASH questionnaires. Construct validity was examined through exploratory factor analysis (EFA) using Maximum Likelihood Extraction with Promax rotation. Results The original ULFI was translated and cross-culturally adapted into Persian with only minor wording changes. The ULFI-Pr demonstrated high levels of internal consistency (α = 0.91) and test-retest reliability (ICC2.1=0.92). The correlation between the ULFI and DASH was high (r = 0.71). The EFA demonstrated a one-factor structure that explained 38.2% of total variance. No floor or ceiling effects were observed. Conclusion The ULFI-Pr can be considered as a region-specific, single-factor structure PROM for evaluation of patients with upper limb disorders for clinical and research purposes in Persian language populations.

Background Obstetric triage is a new idea, so the design and implementation of it requires identification of its concept and structure. The aim of this qualitative study was to explore the concept and structure of the obstetric triage in Iran. Methods The purposive sampling was done and it continued until reaching the theoretical saturation. Thirty-seven semi-structured interviews were conducted individually and face-to-face. Interviews were audio recorded, transcribed, and analyzed using conventional content analysis. Results Two themes, 8 main categories, and 16 subcategories emerged from the content analysis of the interviews and observations. The themes were the concept and structure of obstetric triage. The concept of obstetric triage consisted of three categories of nature, process, and philosophy of obstetric triage. The structure of obstetric triage included five categories of assessment criteria, emergency grading, determining the appropriate location for patient guidance, initiation of diagnostic and therapeutic measures, and timeframe for initial assessment and reassessment. Conclusion Findings highlighted that obstetric triage is a process with a dual and dynamic nature. This process involves clinical decision making to prioritize the pregnant mother and her fetus based on the severity and acuity of the disease in order to allocate medical resources and care for providing appropriate treatment at the right time and place to the right patient. The results of this study could be used for the design and implementation of the obstetric triage system.

Background: The stomach plays a vital role in the human body. Its clinical problems are very prevalent. : Nowadays, new branches of science have emerged because of human individual differences. Many medical schools such as Iranian Traditional Medicine (ITM) established the basis for the prevention, diagnosis, and treatment based on individual differences. Objective: The purpose of this study is to summarize identification indices of Gastric Dystemperament to help in better diagnosis. Methods: This was a qualitative review study. Definitions and symptoms of Stomach Dystemperament were derived from reliable sources of ITM from 900 AD to 1900 AD (Kamil-al-sinaa al Tibbiya, Teb-e-Akbari, Exir Azam, Al-Qanun fi al tibb, Mansouri Fi-al-teb, Al-Havi, Zakhire Kharazmshahi, Hidayat al-Muta’allemin fi al-tibb, Ferdos al-Hekmat fi al-tib, Sharh Al Qurashi al-Qanun, Sharh-e asbab al-Alamat) and English and Persian indices. Results: The most important factors and symptoms to be considered as gastric dystemperament include digestion, thirst, appetite, belching, bloating, gastric emptying time, burning stomach, reflux, gastric pain, the effect of food quality (coldness, heat, wet, dryness), mouth moisture and taste, tongue and mouth status, quality of body waste material (urine, stool), and palpation of the stomach area. Conclusion: Iranian Traditional Medicine sources have mentioned the indicators of gastric dystemperament, which can be used for more effective diagnosis and treatment and even prevention of gastric diseases.

Introduction Enhancing participation is the focus of occupational therapy. Comprehensive and accurate assessment ensures that clinicians can tailor an intervention to the client’s needs. This systematic review was completed to identify Persian adolescents’ participation measures and critically appraise them. It would be helpful in the selection of the most appropriate instrument to use in adolescent-related research and clinical practice. Method Ten bibliographic databases, four Iranian and six international, without year limits were searched up to June 2019. A systematic search was directed according to COSMIN guidelines for systematic reviews of patient-reported outcome measures and PRISMA guidelines (Systematic review registration: CRD42017073581). Results Seven measures were extracted from the articles. Reviewing the content and psychometric properties of the measures as well as the methodological quality of the studies indicated that the Modified Activity Questionnaire is the only measure with consistent and moderately reliable results. It measures adolescent participation in leisure activities but not all domains of participation. Conclusion There may be a growing need for adapting existing Persian measures or developing new ones based on specific age features related to puberty-stage alongside cultural, social and academic demands, which have a significant effect on adolescents’ participation in meaningful occupations. High methodological quality in designing such studies also has great importance.

β-thalassaemia major (BTM) has a high prevalence worldwide and is associated with considerable morbidity and mortality. The aim of this review is to provide an illustrative overview of the reproductive health and pregnancy related issues in females with β-thalassaemia. A literature search was performed in four international databases (1980-2018) to identify the potentially relevant articles. Common reproductive health disorders are hypo-gonadotrophic hypogonadism, infertility, delayed or absent sexual development, diabetes, hypothyroidism, hypoparathyroidism, osteopenia, preeclampsia, gestational hypertension, polyhydramnios, oligohydramnios, thrombosis, renal failure, peripheral vascular resistance, placenta previa, pleural effusion and pulmonary hypertension. Many of those aspects are related to iron overload and to ineffective erythropoiesis. Foetal complications include neural tube defects, abnormalities in different organs, spontaneous abortion, foetal loss, preterm birth, foetal growth restriction and low birth weight. Antenatal screening and accurate genetic prenatal examinations are effective measures to early diagnosis of thalassaemia and a detailed plan for management of pregnancies in BTM is important for favourable maternal and foetal outcome.

The prevalence of renal stones in industrialized countries is about 10 to 12%, and its incidence has increased in recent years. Renal stone is strongly dependent on dietary habits, so dietary changes are the most promising intervention to reduce renal stone production. Nutrition from the perspective of traditional Persian medicine is one of the important pillars of prevention and treatment of diseases such as renal stones. In this article, we intend to outline the nutritional managements indicated in Avicenna’s book of canon of medicine on renal stones. According to Avicenna, renal stone producing foods are concentrated and viscous foods, including some dairy products, meats, cereals, fruits, pastries, breads and some foods. Many such foods discriminated by Avicenna to be viscous and thus stone forming are also shown by modern science to increase the risk of renal stone production although based on diverse mechanisms. This issue may be an example that traditional medicine may suggest experienced-founded phenotype-based shortcuts for better research hypothesis designs.

BackgroundDisasters may result in mass casualties and an imbalance between health care demands and supplies. This imbalance necessitates the prioritization of the victims based on the severity of their condition. Contributing factors and their effect on decision-making is a challenging issue in disaster triage. The present study seeks to address criteria for ethical decision-making in the prioritization of patients in disaster triage.MethodsThis conventional content analysis study was conducted in 2017. Subjects were selected from among Iranian experts using purposeful and snowball sampling methods. Data were collected using semi-structured interviews and were analyzed by the content analysis.ResultsEfficient and effective triage and priority-oriented triage were the main categories. These categories summarized a number of medical and nonmedical factors that should be considered in the prioritization of the victims in disaster triage.ConclusionA combination of measures should be considered to maximize the benefits of the prioritization of causalities in disasters. None of these measures alone would suffice to explain all aspects of ethical decision-making in disaster triage. Further investigations are needed to elaborate on these criteria in decision-making.

To study the effect of four interventions on lower back pain (LBP) alongside time and to identify whether changes in nutrition and doing traditional Persian remedies (massage and rubbing white Lily oil) could relieve the LBP using a short-time treatment. The population of this study consisted of 89 subjects with chronic LBP collected in traditional Persian medicine clinics. The outcomes were two indices for LBP, Oswestry disability index (ODI), and numerical rating scale (NRS), measured three times with an interval of four weeks. Age was not an effective variable in both LBP indices. Effective interventions for both indices are almost the same. For ODI, sex (= male), nutrition, massage, using White Lily oil, and time had decreasing effects on ODI, but interactions of sex with nutrition and massage had increasing effects on ODI. For NRS, sex (= female), using White Lily oil, time, and interactions of sex with massage and nutrition had decreasing effects, but nutrition, massage, and interactions of sex with White Lily oil had increasing effects on NRS.

Background We aimed to report, for the first time, the results of the Iranian National Population-based Cancer Registry (INPCR) for the year 2014. Methods Total population of Iran in 2014 was 76,639,000. The INPCR covered 30 out of 31 provinces (98% of total population). It registered only cases diagnosed with malignant new primary tumors. The main sources for data collection included pathology center, hospitals as well as death registries. Quality assessment and analysis of data were performed by CanReg-5 software. Age standardized incidence rates (ASR) (per 100,000) were reported at national and subnational levels. Results Overall, 112,131 new cancer cases were registered in INPCR in 2014, of which 60,469 (53.9%) were male. The diagnosis of cancer was made by microscopic confirmation in 76,568 cases (68.28%). The ASRs of all cancers were 177.44 and 141.18 in male and female, respectively. Cancers of the stomach (ASR = 21.24), prostate (18.41) and colorectum (16.57) were the most common cancers in men and the top three cancers in women were malignancies of breast (34.53), colorectum (11.86) and stomach (9.44). The ASR of cervix uteri cancer in women was 1.78. Our findings suggested high incidence of cancers of the esophagus, stomach and lung in North/ North West of Iran. Conclusion Our results showed that Iran is a medium-risk area for incidence of cancers. We found differences in the most common cancers in Iran comparing to those reported for the World. Our results also suggested geographical diversities in incidence rates of cancers in different subdivisions of Iran.

Background: Disasters are medically defined as events in which the demands for patients’ care far exceed the available resources. In such situations, triage and rationing of limited resources are inevitable. A decision regarding triage needs not only scientific guidelines but also an ethical framework and supporting policies. This study aims to provide a comprehensive review of the criteria for ethical decision-making in disasters triage. Materials and Methods: Medline (Via pubMed.com), Scopus, Web of Science, and ProQuest databases will be searched from 1990 to July 2017 using a defined search strategy. Other search resources include Google Scholar, World Health Library, Global Ethics Library, Gray Literature Report website, and World Health Organization (WHO), which will be searched using a modified search strategy. The manual search will be conducted in two journals with the highest number of retrieved titles in the Scopus search and the reference list of selected articles. Study selection, quality assessment, and data extraction will be done by the first author, and the second reviewer will check the results, and probable disagreements will be resolved through discussion and review by a third reviewer. Results: This systematic review will identify all factors a triage officer should be considered when he or she would like to make an ethical decision. Conclusion: Transparency and consistency are two main procedural ethical values of disaster triage. The result of this review could be used to make a consistent decision in disaster triage.

Policymakers require estimates of the future number of cancer patients in order to allocate finite resources to cancer prevention, treatment and palliative care. We examine recent cancer incidence trends in Iran and present predicted incidence rates and new cases for the entire country for the year 2025. We developed a method for approximating population-based incidence from the pathology-based data series available nationally for the years 2008 to 2013, and augmented this with data from the Iranian National Population-based Cancer Registry (INPCR) for the years 2014 to 2016. We fitted time-linear age-period models to the recent incidence trends to quantify the future cancer incidence burden to the year 2025, delineating the contribution of changes due to risk and those due to demographic change. The number of new cancer cases is predicted to increase in Iran from 112 000 recorded cases in 2016 to an estimated 160 000 in 2025, a 42.6 increase, of which 13.9 and 28.7 were attributed to changes in risk and population structure, respectively. In terms of specific cancers, the greatest increases in cases are predicted for thyroid (113.8), prostate (66.7), female breast (63.0) and colorectal cancer (54.1). Breast, colorectal and stomach cancers were the most common cancers in Iran in 2016 and are predicted to remain the leading cancers nationally in 2025. The increasing trends in incidence of most common cancers in Iran reinforce the need for the tailored design and implementation of effective national cancer control programs across the country. © 2021 Union for International Cancer Control.

INTRODUCTION Sex addiction is a major psychiatric disorder in which a person is compelled to participate in sexual activities despite negative consequences. This study was conducted to localize a brief sex addiction screening instrument (PATHOS) for use in the Iranian population and to determine variables predictive of sex addiction in the general Iranian population. METHODS In this study, we evaluated the psychometric properties of PATHOS in a sample of 443 Iranians in 2018. Data were analyzed using exploratory factor analysis (Factor 10.8.04 software). Simple and multiple linear regression analyses were used to investigate construct validity and variables predictive of addiction. RESULTS Exploratory factor analysis identified two factors in this dichotomous questionnaire and reported the questionnaire's test-retest reliability in the target population. Prognostic variables for sexual addiction in the Iranian population were determined to be female gender, higher education, viewing pornographic videos, having multiple sex partners, having difficulty interacting in sex, and history of masturbation. CONCLUSION The Persian version of the brief sex addiction screening instrument (PATHOS) has sufficient reliability and validity in the Iranian population. The predictive variables of sex addiction are indicative of the presence of risk of this disorder in Iranian samples and more studies are needed in order to enable prevention and treatment.

Background Male reproductive health is a relatively new concept, and most men are neglected in reproductive health discussions. Therefore, it appears that there is insufficient information about the male reproductive health. This study aims to design a psychometric instrument for assessing the male reproductive health-related behavior. Methods/design This is a sequential exploratory mixed-method study with a classical instrument development design. It will be conducted in two qualitative and quantitative phases on the studied units including the men living in Tehran. In the first phase, a qualitative study of a contractual content analysis approach will be conducted in order to perceive the concept of male reproductive health-related behavior, determine the dimensions of the questionnaire, and explore the items. In the second phase, a quantitative study will be carried out to evaluate the psychometric properties as well as (form, content, and construct) validity and reliability of the instrument designed in the first phase. Finally, the instrument will be scored and interpreted. Discussion Discovering men’s perception of concept of reproductive health-related behavior can help design a valid and reliable questionnaire which can be used in studies evaluating the male reproductive health-related behavior. Ethical code IR.TUMS.FNM.REC.1397.157.

There is uncertainty about the applicability of developed country triage scales in the developing population.To develop and validate an obstetric triage scale in Iran.This exploratory sequential mixed-method study was conducted on experienced gynecologists, emergency medicine, midwives, and nurses as evaluators, and pregnant or parturient women as sample. Development of obstetric triage acuity index was done using qualitative study and literature review. Thirty-two evaluators in two rounds evaluated the clinical impact score, content validity ratio, and content validity index. The tool performance was compared with a standard reference in 415 women. The association of urgency levels with hospitalization, resource utilization, and emergency department length of stay were assessed in 599 women. Five midwives independently double-triaged 234 convenience women to estimate inter-rater reliability.Out of 191 items in the initial draft, 9 (4.7%) items in the face validity, 33 (18.1%) in the first, and 5 (3.2%) in the second content validity round were removed because not meeting the expected thresholds. Nine items added based on evaluators' suggestions. Finally, total items had a kappa above 0.74, and S-CVI/Ave, S-CVI/UA were 0.99 and 0.86, respectively. There was a significant correlation between the two tools (The designed OB triage scale showed good validity and reliability in the tertiary teaching hospital. Studying this tool at lower levels, non-educational, and public hospitals are recommended for external validity testing.

Background Since labor and delivery units often serve as emergency units for pregnant women, the use of obstetric triage systems with poor or inadequate quality can lead to unintended consequences such as over and under-triage and so a waste of humans and financial resources. Therefore, this systematic review was conducted to evaluate the measurement properties of obstetric triage tools. Methods PubMed, EMBASE, and Medline were searched to identify studies in October 2018 and were updated in May 2019. The risk of bias COSMIN checklist was used to evaluate the quality of the studies. The quality of every measurement property was appraised by the update criteria of COSMIN. Evidence quality was judged using the modified GRADE approach. Results A total of 444 studies were retrieved in initial search. Six studies evaluating 4 tools were included in this study. All the included studies reported only content validity and reliability. The quality of evidence varied from very low to moderate. The quality of content validity and reliability of the included tools was sufficient except for the reliability of the maternal-fetal triage index. The obstetric triage acuity scale (OTAS) was found to have higher reliability than other tools. Conclusions Due to insufficient evidence, the conclusions about the quality of measurement properties of each obstetric triage tool may be uncertain. This review emphasizes the necessity for further studies with robust methodological quality on the measurement properties of obstetric triage tools.

Introduction Endometriosis is a disabling disease impacting on different aspects of reproductive health. The present study aims to develop and evaluate the psychometric properties of a questionnaire to measure the reproductive health in women with endometriosis. Material and methods This study used an exploratory mixed-methods design and included three phases. In the first phase, a sample of 20 women with endometriosis participated in semi-structured interviews. In the second phase, item pools were generated. In the third phase, face validity, content validity, and construct validity were assessed. To estimate the reliability of the tool internal consistency and test-retest methods were used. Results sixty items were included in the psychometric evaluation stage of the scale. After the assessment of the content validity ratio (CVR), content validity index (CVI), and exploratory factor analysis, 15 items were omitted, leaving 35 items in the final scale. The exploratory factor analysis revealed four factors: physical problems, psychological problems, counteracting strategies, and instability of marital life. The reliability, according to Cronbach’s alpha was 0.809, and the external reliability, as evaluated by the test-retest method and the intraclass correlation, was 0.825. Conclusion ERHQ is a new, valid, and reliable patient-generated instrument to measure the reproductive health in women with endometriosis. It can be used by researchers and health providers to provide a better understanding of the impact of endometriosis on different aspects of reproductive health over time and to meet the needs of patients living with this condition.

Background. Communication, behavioural disturbances and low motivation influence the functional potential and the effectiveness of interventions in adolescents with cerebral palsy (CP). While the model of human occupation (MOHO) is a conceptual model in occupational therapy, no research on the volition of adolescents with CP in daily activities has been undertaken. Aim. To explore the elements contributing to the volition of adolescents with CP based on their own experience Methods. A qualitative approach using directed content analysis with volition of MOHO as a framework was applied. Semi-structured in-depth interviews were carried out with five adolescents with CP and five parents of the same adolescents. Results. In this study primary codes were categorized into eight categories: family and community-related values, individual values, individual perceptions of ability level, sense of control over conditions, enjoying performing activities, enjoying interpersonal relationships, physical context features and social context features. Conclusions. Personal causation in interaction with environmental features is strongly influenced by adolescents’ motivation. Significance. Occupational therapists could improve the motivation of adolescents with CP in interaction with the individual’s volition with focussing on self-efficacy for promoting personal causation. Adapting to the physical environment and changing the attitudes of others to these adolescents is necessary.

Background: Self-determination skills enable to support an individual’s needs and make decisions to function independently. Improvement of self-determination skills has had a positive result for adolescents at risk of Emotional and Behavioral Disorders (EBD). The aim of this study was to investigate the effect of occupational therapy interventions on the self-determination skills of adolescent girls at risk of emotional-behavioral disorders. Methods: In this single-blind control trial study, 14-16-years-old girl students (n=54) at risk of EBD were recruited by cluster sampling from secondary high schools of Tehran, Iran. Youth self-report Questionnaire (YSR) was used to include adolescents at risk of EBD in the study and were randomized into the intervention (n=27) and control group (n=27) by block randomization. The Student Self-Determination Scale (SDSS) and the Self-determination Parent Perception Scale (SDPPS) were used to collect data. Students in the intervention group participated in 8 – once a week- sessions of occupational therapy and the control group received no training. Data were analyzed by repeated-measures analysis of variance (RMANOVA), Bonferroni test and SPSS 16.0 version. The significance level was set at 0.05. Results: The score of self-determinations (SDSS) increased significantly in the intervention group after the intervention (p0.05); also, the score of parents' perception of student self-determination (SDPPS) increased but there were not significantly different (p=0.064). Conclusion: The findings indicated self-determination skills could be taught to adolescents at risk of EBD in OT sessions. Since self-determination has been identified as the necessary skills for adolescents at-risk to transition into adulthood, occupational therapists have an important role in promoting self-determination skills in adolescents at risk of EBD.

In a pot experiment, essential oil composition, extract polyphenolic content and antioxidant activity of Pimpinella anisum L. seeds (aniseed) treated with 5-aminolevulinic acid (5-ALA) (0.1 and 0.2% w/v) were investigated. In all living organisms, the compound 5-ALA is natural and has various effects on plants physiology. 5-ALA has attracted increasing attention as a plant growth regulator (PGR) owing to its nontoxicity to humans, crops and animals. The essential oil constituents in the aniseed are significantly changed by 5-ALA foliar application. Sesquiterpenes, particularly β-bisabolene, (447.51 and 424.39 g kg−1) were nominated as the predominant fundamental class of essential oil components under 5-ALA treatments. Also, after foliar application of 5-ALA at the level of 0.2% w/v, polyphenolic contents as well as the antioxidant activity of aniseeds extract increased. The highest level of chlorogenic acid (0.47 mg g−1) as the main phenolic compound was obtained from the 5-ALA (0.2%) treated aniseeds. In conclusion, the results demonstrated the potential and positive efficacies of 5-ALA to improve the pharmaceutical properties and oil composition of aniseeds.

Introduction: Identifying what adolescents perceive as their lifestyle and exploring the factors persuading their decisions to engage in or avoid healthy or unhealthy lifestyle behaviors could improve the ability of healthcare professionals to develop innovative preventive strategies and modify negative health behaviors in adolescents. Hence, the literature on adolescent health-related issues reported by adults showed a rarity of information from adolescents themselves. Materials and Methods: A qualitative study using the thematic analysis approach was conducted. Data were collected by semi-structured, digitally recorded interviews from 32 male adolescents. Interviews were transcribed verbatim, and after collecting the data, the thematic analysis process was started and conducted in six phases. Results: After data collection, the interview texts were transcribed, and approximately 800 initial codes were extracted. The initial codes were reevaluated to yield 48 main themes. Hence, the final thematic map was created as having 5 overarching themes and 12 subthemes, showing that interviewees emphasized unhealthy lifestyle. Conclusions: The components of unhealthy lifestyle seem important to them because they consider that they could lead a healthy lifestyle through elimination of negative behaviors.

Garlic (Allium sativum, Liliaceae) is used widely as a spice and medicinal herb not only in its native region (Central Asia and northeastern Iran) but also all around the world. Garlic has abundance chemical compounds such as allicin, alliin, S-allyl cysteines, thiacremonone, diallyl-disulfide, diallylsulfide, and others. This medicinal plant and its constituents offer a lot of benefits including free-radical scavenging, anti-inflammatory, anticholesterolemic, anti-gastric ulcer, antimicrobial, anticancer, and antioxidant properties. Garlic also modulates the activity of several metabolizing enzymes. This review summarizes various in vitro and animal studies on the protective effects of garlic against natural and chemical toxicities. It has been shown that garlic and its major components can ameliorate the toxicity of different agents in brain, kidney, blood, liver, embryo, spleen, pancreas, heart, reproductive system in part through radical scavenging, antioxidant effect, reducing lipid peroxidation, anti-inflammatory, chelating agent, cytoprotective activities, increase protein synthesis in damaged tissues, suppressing apoptosis, modulation of p53, phosphoinositide 3-kinase, Akt, nuclear factor (erythroid-derived 2)-like 2, antioxidant responsive element, p38 MAPK, inducible nitric oxide synthase, cyclooxygenase-2, cytosolic phospholipases A2, cleaved-caspase-9, cleaved-caspase-3 Bcl-2, Bcl-2-associated X, peroxisome proliferator-activated receptor gamma, NF-jB, nuclear factor-kappaB signaling pathways and cytochrome P450 enzymes. With controlled clinical trials, garlic may be introduced as a universal antidote or protective plant against many toxic agents.

Background: Advances in surgical and medical management have significantly reduced the length of time that patients with spinal cord injury have to stay in hospital; however, less attention has been paid to their psychological issues. Objectives: This study aimed to determine the effect of self-care program training on self-efficacy in veteran with spinal cord injury. Methods: This study is a randomized control trial study that in that pre-test/post-test plan with the control group was used. All of the veterans with paraplegia spinal cord injury, who referred to a private hospital in 2017 - 2018, were our statistical study population. Sixty veterans were selected based on the inclusion criteria and purposive sampling method and randomly divided into two groups of experimental and control by using a table of random numbers. For the intervention group, six sessions of a 60 - 45-minute self-care education were performed. Patients filled Moorong self-efficacy scale before, one week and one month after the intervention. SPSS statistical software version 19 was used to analyze the data using chi-square, Fisher’s exact test, independent t-test, and repeated measures. Results: The results showed that no significant difference was between the two groups of the intervention and control in terms of demographic characteristics. The mean self-efficacy score was 39.26 ± 4.03 in the intervention group, and 38.56 ± 3.99 in the control group before the intervention, which reached to 43.86 ± 5.15 and 38.36 ± 3.89 one week and 51.16 ± 5.36 and 39.26 ± 4.16 one month after the implementation of the intervention, respectively and this difference was significant in the intervention group (P ≤ 0.001). Conclusions: According to the results, self-care program training is effective in self-efficacy of veterans with spinal cord injury. Therefore, this method is simple, non-invasive, low-cost, and effective in increasing self-efficacy and the treatment of these veterans, which may be applied to nurses.

BACKGROUND: Over 70% of patients hospitalised in an intensive care unit (ICU) often experience moderate to severe pain due to pre-existing diseases, trauma, surgery, aggressive procedures, and routine ICU care. Many patients hospitalised in ICU are not able to speak and express their pain due to various causes, including mechanical ventilation, reduced consciousness, and administration of sedative drugs. Therefore, the use of observational and behavioural pain tools is recommended in this group of patients given their inability to express pain. AIM: To examine the existing observational and behavioural tools for assessment of in Nonverbal Intubated Critically Adult Patients after Open-Heart Surgery. METHODS: A systematic review of available observational and behavioural tools for assessment of pain was undertaken using the COSMIN checklist. A literature search was conducted using the following databases: Ovid, Science Direct, Scopus, PubMed, and CINHAL databases, Google Scholar search engine as well as Persian resources Sid, Magiran, Iran doc, and IranMedex up to the end of 2017 were reviewed. RESULTS: A total of 47 studies that had examined five tools used in intensive care units after cardiac surgery in patients under mechanical ventilation were reviewed. Each of the five tools included behavioural and observational items, and only one tool had physiological items. All the tools had been evaluated regarding validity and reliability. In the three tools, sensitivity, specificity, responsiveness, and satisfaction were considered. CONCLUSION: Based on available evidence and investigations, CPOT and BPS tools have good validity and reliability to be used in pain assessment in Nonverbal Intubated Critically Adult Patients after Open-Heart Surgery. The NVPS tool requires more studies to be further confirmed before the assessment of pain in this group of patients.

Background: Mineral trioxide aggregate (MTA) is known as a common biomaterial for pulpotomy of primary molars, with limitation including high cost, difficult handling, and long setting time. This study was conducted to compare the clinical and radiographic success rate of Allium sativum oil and MTA in pulpotomy of primary molar teeth. Materials and Methods: This randomized, controlled, clinical trial was performed on a group of children with at least two symptom-free primary molars requiring pulpotomy. A total of 90 teeth were randomly assigned into two groups: After pulp amputation and hemostasis, Group I received MTA as medication in the pulp chamber and Group II received Allium sativum oil over the pulp stumps. Pulp chamber was then filled with reinforced ZOE paste (zinc oxide eugenol) and teeth were restored using stainless steel crowns. The follow-up scheme of 6, 12, and 18 months was set, and teeth evaluation was conducted by a calibrated pediatric dentist based on the modified criteria proposed by Zurn and Seale. The results were analyzed using the generalized estimating equation analysis with the P = 0.05 as the level of significance. Results: The clinical success rate was 100% in both groups after all follow-ups. The radiographic success rate was, however, 91.1% after 6.75. 6% after 12 and 18 months in Group II while it was 95.6% after 6, 91.1% after 12 and 18 months in Group I in those follow-up points. The difference between the two groups was not statistically significant. Conclusion: According to the results, Allium sativum oil has a high clinical and radiographic success rate comparable to those of MTA.

Introduction: Anxiety and stress are common problems before coronary artery bypass graft surgery has a destructive effect on the patient's condition. One of the medications therapies that are effective in reducing anxiety level is Aromatherapy. The aim of this study is to assess the effect of inhalation aromatherapy on physiological and psychological parameters of patients who are candidate for coronary artery bypass graft. Method: In this pilot study, 30 patients candidate of coronary artery bypass graft were selected by convenient sampling method. For intervention on the morning of the surgery, patients inhaled Lavender essential oil from a distance of 5 cm of the nose, for 20 minutes. Physiological and psychological parameters of patients the day before surgery and then 5 and 30 minutes after intervention was estimated by Form vital signs and DASS questionnaire. Data were analyzed in three phases using Descriptive Statistics and repeated measures ANOVA by SPSS.17. Results: 20% of patients were female, 80% male with an average age of 65/36±8/05. The results show a significant difference between the three time phases in variable of the pulse (P = 0/041), respiration (P = 0/040) and stress (P=0.046). Discussion: Aromatherapy can be an effective way to reduce stress levels and pulse in patients candidate for coronary artery bypass graft. Since this results study obtained from a pilot study, to Generalize the results, clinical trials with larger sample size is recommended.

Background Delay in stomach discharge is a challenge for patients who are tube fed and may result in serious side effects such as pneumonia and malnutrition. Purpose This study was designed to determine the respective effects of the semirecumbent (SR) supine and right lateral (RL) with a flatbed positions on the gastric residual volume (GRV) of mechanically ventilated, critically ill adult patients. Methods A randomized, crossover clinical trial design was used to investigate GRV in 36 critically ill, ventilated adult patients who were hospitalized in the intensive care unit. GRV was measured at 3 hours after three consecutive feedings. GRV was first measured in all of the participants in the supine position; after which, participants were randomly assigned into one of two therapeutic positioning groups (Group A: assessment in the SR position and then the RL position; Group B: assessment in the RL position and then the SR position). Results GRV was significantly lower in both the SR and RL positions than in the supine position. GRV in the SR and RL positions did not vary significantly. The in-group measurements for GRV did not significantly differ for any of the three positions. In Group A, GRV was significantly lower at each subsequent measurement point. Conclusion/implications for practice Positioning patients in the RL and SR positions rather than in the supine position is an effective strategy to reduce GRV. Furthermore, placing patients in either the RL or SR position is an effective intervention to promote faster digestion and feedings.

Background: Patients with heart valve disease need to receive long-term care from their family members after surgical valve replacement. Thus, family caregivers should have adequate self-efficacy for patient care. Objectives: This study examined the effects of the family-centered empowerment model (FCEM) on self-efficacy and self-esteem among the family caregivers of patients with prosthetic heart valve. Methods: In this quasi-experimental study, forty patients together with one of their family caregivers were consecutively recruited and allocated to an intervention or a control group. The FCEM was used in three to five sessions for patients in the intervention group. Besides, we sent their family caregivers educational cards containing the same educations provided to their patients. Finally, an educational session was held for family caregivers in which their questions were answered and each of them was provided with an educational booklet containing the same materials as the educational cards. Patients and their family members in the control group received routine care. Self-efficacy and self-esteem of family caregivers were assessed before, 1 week, and 1.5 months after the intervention. Data analysis was performed through the independent-samples t- test and the repeated measures analysis of variance. Results: Before the intervention, the mean scores of self-efficacy in the control and the intervention groups were 26.68 ± 4.79 and 26.79 ± 5.49, whereas the mean scores of self-esteem in these groups were 33.74 ± 4.55 and 33.84 ± 4.72, respectively. None of the between-group differences were significant. After the intervention, the mean scores of self-efficacy and self-esteem in the intervention group were significantly greater than the control group (37.32 ± 2.68 versus. 29.89 ± 2.20 and 36.26 ± 3.66 versus. 29.26 ± 5.84; P < 0.05). Conclusion: The use of the FCEM promotes self-efficacy and self-esteem among the family caregivers of patients with prosthetic heart valve.

Owing to the effect of acute and chronic hypohydration on health and the lethal effects of hyperhydration, an appropriate amount of water intake is important for each individual. Traditional Iranian medicine (TIM) is a holistic system one of whose important parts deals with lifestyles and how to maintain health, including the amount of water intake for every person and the appropriate principles of drinking water. In this study, Avicenna's Canon of Medicine, Rhazes' Benefits of Food and Its Harmfulness, and conventional medical articles were reviewed to evaluate the amount of water intake for each person and the principles of drinking water. TIM has expressed an individualized difference in the amount of water intake in the form of temperament and the relationship between the appropriate time of drinking water with other daily activities. In this view, drinking water at the inappropriate time causes liver and gastrointestinal diseases; it can create the foundation for conducting new studies in the field of appropriate water intake and lifestyle changes to reduce malnutrition complications.Die Aufnahme einer adäquaten Menge an Wasser ist wichtig, da sich ein akuter oder chronischer Flüssigkeitsmangel auf die Gesundheit auswirkt und eine Hyperhydratation zum Tod führen kann. Die traditionelle iranische Medizin (TIM) ist ein ganzheitliches System, das in einem seiner zentralen Bestandteile auf den Lebensstil sowie auf die Erhaltung der Gesundheit abzielt, darunter auch die Wassermenge, die jeder Mensch aufnehmen sollte und die richtigen Prinzipien des Wassertrinkens. In der vorliegenden Studie wurden der Kanon der Medizin von Avicenna, die Vorteile von Lebensmitteln und ihre Schädlichkeit von Rhazes und konventionelle medizinische Artikel überprüft, um die von jedem Menschen aufzunehmende Wassermenge und die Prinzipien des Wassertrinkens zu bewerten. Gemäß TIM bestehen individuelle Unterschiede hinsichtlich der Wasseraufnahme je nach Temperament und sie betont den Zusammenhang zwischen dem richtigen Zeitpunkt des Wassertrinkens und anderen Alltagsaktivitäten. Danach führt das Trinken von Wasser zum falschen Zeitpunkt zu Leberkrankheiten und gastrointestinalen Erkrankungen. Dies könnte die Grundlage für neue Studien darstellen, in denen die adäquate Wasseraufnahme und Lebensstiländerungen untersucht werden, um malnutritionsbedingte Komplikationen zu verringern.