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Background: Malnutrition, loss of body weight, muscle and fat mass wasting are common in patients with Parkinson's disease, and are associated with disability, longer length of hospital stay, impaired immune system and increased risk of mortality. The aim of this study was to assess the nutritional status in patients with Parkinson's disease and its relation to the severity of the disease. Methods: This cross- sectional study was conducted on 130 patients with Parkinson's disease, with a mean (SD) age of 59.1 (12.9) years in disease stages of 1 to 4. In this study, the Mini Nutritional Assessment (MNA) questionnaire was used along with anthropometric measurements (Body Mass Index (BMI), Mid-arm circumference (MAC), Calf Circumference (CC)) to evaluate the nutritional status, and they were applied by a trained nutritionist. Hoehn and Yahr Scale were used to determine the severity of the disease. One-way ANOVA test was used to assess the relationship between anthropometric indices, nutritional status and severity of disease. Assessment of the relationship between age, duration of disease and nutritional status was categorized according to MNA score, and was performed, using one-way ANOVA. Chi - Square test was utilized to assess the relationship between education level and nutritional status. SPSS Version 18 was used for data analysis. Results: In this study, 30% (n=39) of the participants were diagnosed with normal nutritional status, 58.5% (n=76) were at risk of malnutrition and 11.5% (n=15) were malnourished according to MNA. Reduction of weight, and muscle mass wasting was observed in different disease stages. Muscle mass wasting and worsening nutritional status, based on MNA score, showed a significant increase as the disease progressed, MAC (p=0.009), MNA score (p<0.001). After assessing the relationship between education level, age, duration of disease with nutritional status, the results revealed a significant relationship between age (p=0.008), education level (p<0.001) with nutritional status according to MNA score. Conclusion: Reduction of BMI, depletion of muscle mass, and worsening of nutritional status according to MNA, was observed in many patients along with an increase in the severity of the disease. Assessing nutritional status in those with Parkinson's disease to provide information to identify necessary nutritional intervention is highly recommended.

Premenstrual syndrome (PMS) is a common disorder. Due to the knowledge lack of the precise etiology of this syndrome, different treatment methods are recommended, one of them is the use of medicinal herbs. This study aimed to investigate the effect of Valerian ( xié cǎo) root extract on the intensity of PMS symptoms. In this double-blind clinical trial, 100 female students of Islamic Azad University, Tonekabon Branch, Mazandaran Province, Iran, with PMS were randomly divided into groups receiving Valerian (scientific name: Valeriana officinalis) and placebo in 2013. The participants received 2 pills daily in the last seven days of their menstrual cycle for 3 cycles and recorded their symptoms. The data collection tools included demographic information questionnaire, daily symptom severity questionnaire, and a provisional diagnosis of premenstrual syndrome questionnaire. Data were compared previous, one, two, and three cycles after student's intervention using and analyzed by independent t-test, paired t-test, chi-squared test, and repeated measures ANOVA in SPSS 16. A significant difference was seen in mean emotional, behavioral and physical premenstrual symptom severity in the intervention group before and after the intervention (P < 0.001). However, this difference was not statistically significant in the control group. The results of this study showed that Valerian root extract may reduce emotional, physical, and behavioral symptoms of premenstrual syndrome.

Objective: To evaluate the effects of henna on the results of pulse oximetry in healthy women., Methods: 100 young women (20-60 years of age) were recruited. The Iranian original red henna was used to colour the index finger of THE non-dominant hand; the middle finger of the same hand was the control. Blood oxygen saturation was simultaneously measured by two calibrated pulse oximeters., Result: Henna did not affect pulse oximetry measurement of oxygen saturation. There was no statistically significant difference between the control and the henna dyed fingers., Conclusions: Henna is not likely to change the accuracy of oxygen saturation measured by pulse oximeter., Clinical Trial Registration: 20120906159N20., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Background: Burn patients experience high levels of predictable anxiety during dressing changes while anti-anxiety drugs cannot control these anxieties. The nurses can limit the side effects of medications by undertaking complementary therapies. Hand pressure massage was introduced as a technique that can reduce these anxieties. This study aimed to investigate the effect of hand pressure massage using Shiatsu method on underlying anxiety in burn patients., Methods: In an available randomized study, 60 burn patients with underlying pain were enrolled. They were randomly allocated in two groups of hand massage and the control. The anxiety of underlying burn pain before and after the massage was evaluated using Burn Specific Pain Anxiety Scale (BSPAS)., Results: The difference for anxiety scores in the hand Shiatsu massage group before and after massage were statistically significant, but in the control group was not significant., Conclusion: Based on our findings, 20 minutes of hand Shiatsu massage in conjunction with analgesic medications can be beneficial to control the anxiety of burn patients.

Background: Spiritual care should be considered an important part of holistic and multidisciplinary care and it has not been given much importance so far. We should begin with student nurses, who will soon be clinicians, to find out about potentiality of the nursing profession to put spiritual care into practice. Little has been known about spiritual well-being, spirituality, and spiritual care perspectives among nursing students. In this study, a comparison has been made in spiritual well-being, spirituality, and spiritual care perspectives between the first and fourth year baccalaureate nursing students., Materials and Methods: This is a descriptive-comparative study that was carried out among 283 nursing students. All the students were Iranians studying in the universities of Iran, Tehran, and Shahid Beheshti medical sciences. They volunteered to participate in the study. There were 105 first year students and 178 fourth year students. The questionnaires used were on Spiritual Well-being (SWB) Scale, Spiritual Perspective Scale (SPS), and Nursing Spiritual Care Perspective Scale (NSCPS). The statistical analysis was performed using the SPSS software, version 10. The data were analyzed using descriptive statistics (distribution frequency, mean, and standard deviation). Mann-Whitney test was to compare each item and independent t-test to compare the mean values of two groups., Results: Regarding spiritual well-being, there were no significant differences between the two groups. 98.8% of the first year students and 100% of the fourth year students were in the category of moderate spiritual well-being. Neither were there any significant differences between the two groups in spiritual perspective and spiritual care perspectives., Conclusions: The scores of fourth year nursing students were similar to those of first year students in spiritual well-being, spirituality, and spiritual care perspectives, though the fourth year students had already undergone 4-year nursing course. Including spiritual care in the curriculum of nursing students' courses will add to their understanding and provision of spiritual care. This will fill the present gap evident in the system in Iran. At present, the educational system here does not make use of spiritual care as part of its comprehensive curriculum.

Background: Patients who have shoulder pain usually have compensatory or contributory deviation of shoulder motion during arm elevation. In the traditional scapulohumeral rhythm, the share of the acromioclavicular (AC) and the sternoclavicular (SC) joint movements and also the role of AC internal rotation angle are unknown., Objectives: The main purpose of this study was to measure and compare the segmentary scapulohumeral rhythm (SSHR) during scapular arm elevation at a steady rotational speed in athletes with and without impingement syndrome., Patients and Methods: Using a speedometer, the maximum speed of arm elevation was measured in 21 men in each of the involved and uninvolved groups. Using fluoroscopy on the dominant side, SSHR during scapular arm elevation at a rotational speed equal to 1/30 of maximum speed was compared between the two groups. The ratio of glenohumeral (GH) elevation angle to AC rotation angle in the scapular plane was considered as SSHR., Results: The maximum speed of arm elevation between the two groups was significantly different (P < 0.001). The rhythm of the involved group significantly exceeded the rhythm of the uninvolved group in a part of the first quarter range of the arm elevation. SSHR during arm elevation in the uninvolved group did not change significantly (P = 0.845); however, it decreased significantly in the involved group (P = 0.024)., Conclusions: Speed differences between the two groups were probably due to the pain in some ranges of arm elevation. SSHR in the involved group probably changed in order to compensate downward rotation of the scapula in the resting position. Study of the AC upward rotation range can be misleading; therefore, the study of scapulohumeral rhythm is recommended.

Background: During the menopausal period, sexual desire may decrease. Therefore, restoring the sexual desire may help to improve sexual functioning in this group of women. The aim of this study was to examine the effect of Ginkgo biloba extract (GBE) on sexual desire in postmenopausal women., Materials and Methods: In this triple-blind, randomized, placebo-controlled trial, 80 healthy female volunteers attending three healthcare centers of Tehran University of Medical Sciences (TUMS) were enrolled. The instrument of this study had two main parts. The first part covered the personal characteristics of the volunteers and the second part used the Sabbatsberg Sexual Rating Scale (SSRS) to subjectively evaluate sexual desire before and after intervention. The participants received GBE at a dose of 120-240 mg (n = 40) or received placebo (n = 40) daily for 30 days. The results were analyzed using Mann-Whitney test. All analyses were performed using SPSS software., Results: The sexual desire was significantly improved in the GBE group compared to the placebo group (P = 0.02)., Conclusions: In this study, we found that GBE had a positive effect on sexual desire of menopausal women; thus, these findings support the positive effect of GBE on the sexual function of menopausal women.

Objective: To compare the clinical efficacy of olive oil and the Saj(®) cream on the occurrence and severity of striae gravidarum., Design: Parallel randomized controlled clinical trial., Setting: West Health Centre, Lolagar and Akbarabadi Hospitals, Tehran, Iran., Interventions: 360 Nulliparous women at their second trimester of pregnancy randomly (simple randomization) allocated into three groups of olive oil, the Saj(®) cream, and control that finally 150 of them (50 subjects in each group) completed the study. Control group did not receive any medication/intervention. At gestational age of 38-40 weeks the participants were evaluated regarding the occurrence of striae on abdominal skin and its severity that were primary outcome of the study., Results: In the olive oil group, striae occurred in 72% of the participants, which were mild, moderate, and severe in 32%, 26%, and 6% of the cases, respectively. In those who received Saj(®) cream, striae occurred in 64% of the cases, which were mild, moderate and severe in 16%, 34%, and 14% of the cases, respectively. With regard to the control group, striae occurred in 60% of the participants, among which striae were mild, moderate, and severe in 22%, 24%, and 14% of the cases, respectively. There were no statistically significant differences among the three studied groups regarding the incidence or severity of striae., Conclusion: Neither olive oil nor the Saj(®) cream were effective in preventing the occurrence of striae gravidarum or affecting its severity. Further studies to examine the effect of other herbal/chemical preparations on occurrence of striae gravidarum are recommended., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The study aimed to explore associations between sexual function, demographic variables, health and menopausal status among middle-aged Iranian women. Participants were 200 Iranian middle-aged women (40-65 years). All women completed the Female Sexual Function Index and the Brief Profile of Female Sexual Function. Data were analyzed using a Pearson correlation statistical test, a one-way analysis of variance, an independent t test, and a linear regression analysis. Advanced age, lower education, and socioeconomic status were significantly correlated with the lower scores on the Female Sexual Function Index. Lower scores on the Female Sexual Function Index were associated with being retired; having a hysterectomy or oophorectomy; and presence of hot flashes, vaginal dryness, health problems, prescription drug use, and cold sweats. There were no significant associations between middle-aged women's sexual function and ethnicity, body mass index, alcohol consumption, severity of hot flashes, and hot flash frequency. Sexual desire was decreased or absent in 94.5% of the postmenopausal respondents. Our findings appear that sexual function is associated with sociodemographic characteristics of Iranian middle-aged women. Gender-sensitive counseling and medical services for aging Iranian women can improve the quality of women's sexual lives.

Background: This study aimed to provide an understanding of the relationship between the ethical climate at the workplace and job satisfaction among nurses., Methods: 210 nurses working in selected wards in the Tehran University of Medical Sciences were asked to fill out questionnaires on their work environment and level of job satisfaction. The data collection tools included a questionnaire to obtain demographic data, the Olson moral climate questionnaire and Minnesota job satisfaction questionnaire. The data were analysed using SPSS software version 14., Results: We found a significant positive relationship between the ethical climate and the level of job satisfaction among the nurses. Among the demographic variables, the working shift, income level and type of duties allocated had a significant relationship with job satisfaction., Conclusion: Hospital managements should pay attention to the factors influencing job motivation among nurses, including the ethical climate of the work environment.

Aim: Reduction of labor pain is one of the most important aspects of obstetric care. Heat therapy, typically applied to the woman's back, lower abdomen, groin, and/or perineum during last stage of labor, is an easy pain relief method that does not require highly skilled care. The effectiveness of heat therapy applied to the perineum during the first stage of labor has not been evaluated. This study aimed to evaluate the effectiveness of heat therapy for pain and woman's satisfaction during physiological labor., Subjects and Methods: Sixty primiparous women aged 18-35 years old were randomly assigned to heat therapy and control groups. Pain and satisfaction scores were measured by visual analog scale. The measurements of satisfaction were accomplished after birth. Data were analyzed by using the t-test and chi-square, Results: Mean pain scores in the heat therapy group were significantly lower than the control group (P < 0.05). The mean satisfaction score in the heat therapy group was significantly higher than in the control group (P < 0.05)., Conclusion: Heat therapy, an inexpensive complementary treatment with low risk, can reduce the intensity of pain and increase mothers' satisfaction with care during the active phase of labor., (Wiley Periodicals, Inc.)

Objective: In recent years, humman papilomaviruses (HPV) infection is the most common type of sexual trasmitted diseases (STD) in majority of countries. It's a significant source of morbidity and mortality worldwide. In this study, we aimed to compare the history of reproductive disease between two groups of Iranian women with and without HPV infection through colposcopy precedure., Materials and Methods: This case -control study included 210 women reffered to a training gynecology hospital of Tehran University of Medical Science in Tehran. Case group was composed of 70 women with diagnosis of HPV infection, while control group was composed of 140 women with no sign of mentioned-infectious diseases of the control group. Reproductive history was prepared using the standard questionnaire, and obtianed data were analized by SPSS 20., Results: OUR FINDINGS SHOWED THAT THE RISK FACTORS FOR HPV INFECTION WERE AS FOLLOWS: low parity (p = 0.000), reduction of number of weekly sexual intercourse (p = 0.000), no consumption of oral contraceptive pill (OCP) (p = 0.006), and history of withdrawal contraceptive method (p = 0.001)., Conclusion: Improvement of our knowledge about reproductive factors associated with HPV may help us to identify women at risk and to develope different methods of preventive interventions.

Aim: Assessment of activities of daily living (ADL) can be helpful for designing individualized rehabilitation programs for disabled individuals. Measuring and comparing the basic ADL (BADL) and instrumental ADL (IADL) independence between middle aged and senior Iranian blind war survivors (IBWS) was the aim of this study., Methods: This cross-sectional study assessed BADL and IADL of 312 blind war survivors, using the Barthel Index and the Lawton-Bordy scale. Data collection was carried out in a recreational event for the blind war survivors in Mashhad, Iran, 2008., Results: The majority of the participants were male (99%), and more than 80% had multiple injuries. None of them were independent in all BADL and IADL. Older groups were more dependent in IADL such as telephone use, drug management, financial management, and BADL such as walking on uneven surfaces, bed/chair transfer and using stairs. The functional status and activities' level differences between those aged younger than 50 years and those aged older than 50 years were significant (P<0.05)., Discussion: In the present study, all the IBWS were dependent in at least one ADL. Multiple physical injuries could be one of the main reasons for the dependency in this group. IBWS aged older than 50 years were considerably more dependent in their BADL and IADL than the younger group. It appears that starting the fifth decade of age in IBWS might cause some considerable decrease in their function. Training and individualized rehabilitation programs are warranted., (© 2012 Japan Geriatrics Society.)

Background: The aim was to compare outcome measures of refractive error by the Plusoptix S08 photorefractor with measures obtained by retinoscopy and cycloretinoscopy in children., Method: The refractive error of the right eye of 144 non-strabismic children, aged 2.5 to 5.5 years, was determined by Plusoptix S08 photorefraction, retinoscopy and cycloretinoscopy. Agreement between outcome measures of refractive error (spherical error, cylindrical error and spherical equivalent) by the three techniques were tested by Bland-Altman limits of agreement., Results: The mean difference for spherical equivalent results of photorefraction (P(se)) minus those of retinoscopy (R(se)) and photorefraction minus those of cycloretinoscopy (CR(se)) were +0.53 ± 0.62 D and -0.22 ± 0.75 D, respectively. The 95 per cent limits of agreement for spherical photorefraction with retinoscopy and cycloretinoscopy were ±1.22 D (range -0.69 to +1.75) and ±1.47 D (range -1.69 to +1.25), respectively. The mean difference for cylindrical results of photorefraction (P(c)) minus those of retinoscopy (R(c)) and Pc minus those of cycloretinoscopy (CR(c)) were +0.11 ± 0.39 D and +0.13 ± 0.44 D, respectively. The 95 per cent limits of agreement for P(c) with R(c) and CR(c) were ±0.76 D (range -0.65 to +0.87) and ±0.86 D (range -0.73 to +0.99), respectively. The mean and standard deviation of weighted axes difference, comparing Plusoptix S08 and retinoscopy was 0.25 ± 0.36 and comparing Plusoptix S08 and cycloretinoscopy was 0.29 ± 0.51. Eighty-two per cent of the spherical equivalent findings in photorefraction and cycloretinoscopy show a difference of within 1.00 D. Regarding cylindrical power, this percentage is 96.6 per cent., Conclusion: As the findings demonstrate a fairly good consistency between the results of the Plusoptix S08 Photorefractor without using cycloplegic agents and those of cycloretinoscopy, the Plusoptix S08 is a fairly accurate tool to estimate refractive errors of children in the limited working range of the instrument., (© 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.)

Background: This study aimed to determine the impact of an empowerment program on maternal stress., Materials and Methods: During May 2009-May 2010, this quasi-experimental study was performed in the neonatal intensive care unit (NICU) of Shahid Akbarabadi, Rasoul-e-Akram, and Aliasghar Hospitals affiliated to Tehran University of Medical Sciences (Iran). The program consists of an educational CD along with written information and reinforcing activities for parents in the intervention group, and routine education was performed in the control group. We evaluated 140 mothers who were aged 18-37 years, had a gestational age of 28-37 weeks with singleton pregrancy, and with the birth weight of the newborn being less than 2500 g. The participants did not have chronic mental or physical illnesses. They were randomly assigned to two groups of intervention and control., Results: A statistically significant difference was observed between mean (SD) stress scores of mothers before and after the intervention in the intervention group [123.00 (97.24) vs. 75.00 (7.16); P < 0.01)]., Conclusion: This study showed the importance of training mothers in reducing their stress and enabling them to appropriately communicate with and care for their premature newborn.

Purpose: Self-management majorly determines the health status of patients with epilepsy because the most important strategies for controlling seizures include receiving and adhering to prescribed therapies, and making appropriate lifestyle adjustments. Patients with epilepsy have various educational needs and must adopt many self-management behaviors to control their condition. This study was a clinical trial that evaluated the effects of an educational program on self-management in patients with epilepsy., Methods: Participants (n=60) were recruited from the Neurology Clinic in Zanjan, Iran. Patients were randomly assigned to the intervention and control groups (n=30 in each). The intervention group received four educational sessions on epilepsy, including a self-management plan. All participants completed the Epilepsy Self-Management Scale before the intervention and 1 month post-intervention. The chi-square test, Fisher's exact test, independent t-test, and paired samples t-test were used to compare the groups., Results: At baseline, demographic characteristics and self-management scores did not differ significantly. One month after the intervention, self-management scores differed significantly (p<0.001) between the two groups., Conclusion: The educational program had beneficial effects on self-management behaviors in patients with epilepsy., (Copyright © 2012 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)

Objective: Menopause is a significant event in most women's lives because it marks the end of a woman's natural reproductive life. The purpose of this study was to determine the effect of aromatherapy massage on menopausal symptoms., Methods: A randomized placebo-controlled clinical trial was conducted at a menopausal clinic at a gynecology hospital in Tehran. The study population comprised 90 women who were assigned to an aromatherapy massage group, a placebo massage group, or a control group. Each participant in the aromatherapy massage group received 30-minute aromatherapy treatment sessions twice a week for 4 weeks with aroma oil, whereas participants in the placebo massage group received the same treatment with plain oil. No treatment was provided to participants in the control group. The outcome measures in this study were menopausal symptoms, as obtained through the Menopause Rating Scale., Results: The mean baseline level of the menopausal score did not differ among all groups. However, after eight sessions of intervention, the Menopause Rating Scale score differed significantly among the three groups (P < 0.001). Post hoc analysis revealed that women in both the aromatherapy massage group and the placebo massage group had a lower menopausal score than the control group (P < 0.001). When the aromatherapy massage and the placebo massage groups were compared, the menopausal score for the aromatherapy massage group was found to be significantly lower (P < 0.001) than for the placebo group., Conclusions: The results of the study demonstrate that both massage and aromatherapy massage were effective in reducing menopausal symptoms. However, aromatherapy massage was more effective than only massage.

Background: To investigate and to compare the effectiveness of a nurse short message service (SMS) by cellular phone and telephone follow-up by nurse on Glycosylated hemoglobin (HbA1c) levels in people with type 2 diabetes., Methods: Semi experimental study consisted of 77 patients with type 2 diabetes that randomly assigned to two groups: telephone follow-up (n = 39) and short message service (n = 38). Telephone interventions were applied by researcher for 3 months. SMS group that received message daily for 12 weeks. Data gathering instrument include data sheet to record HbA1c and questionnaire that consisted of demographic characteristics. Data gathering was performed at two points: initial the study and after 12 weeks. Data analyzed using descriptive and inferential statistics methods with SPSS version 11.5., Results: Demographic variables were compared and all of them were homogenous. Results of this study showed that both interventions had significant mean changes in HbA1c; for the telephone group (p = 0.001), with a mean change of -0.93% and for the SMS group (p = 0.001), with a mean change of -1.01%., Conclusion: Finding of this research showed that intervention using SMS via cellular phone and nurse-led-telephone follow up improved HbA1c for three months in type 2 diabetic patients and it can consider as alternative methods for diabetes control.

Aim: To compare the effectiveness of two methods of follow-up: short message service and telephone follow-up on type 2 diabetes adherence for three months., Background: Using telemedicine approaches may preserve appropriate blood glucose levels and may improve adherence to diabetes control recommendations in diabetic patients., Design: A quasi-experimental, two-group, pretest and post-test design was used in this study to evaluate the effectiveness of nurse's follow-up via cellular phones and telephones., Methods: The sample consisted of 77 patients with type 2 diabetes that randomly were assigned to two groups: telephone follow-up (n = 39) and short message service (n = 38). Telephone interventions were applied by a researcher for three months; twice a week for the first month and every week for the second and third month. For three successive months, the short message service group that received messages about adherence to therapeutic regimen was examined. The data gathering instrument included data sheets - to record glycosylated haemoglobin - and the questionnaire related to adherence therapeutic regimen. Data gathering was carried out at the beginning of the study and after three and six months. The data were analysed using descriptive and inferential statistic methods with SPSS version 11.5., Results: Results showed that both interventions had significant mean changes in glycosylated haemoglobin. For the telephone group (p < 0.001), a mean change of -0.93 and for the short message service group (p < 0.001), a mean change of -1.01. There was no significant difference in diet adherence (p = 0.000), physical exercise (p = 0.000) and medication taking (p = 0.000) adherence in either groups., Conclusion: Intervention using short message services of cellular phones and nurse-led-telephone follow-up improved HbA1c levels and adherence to diabetes therapeutic regimen for three months in type 2 diabetic patients., Relevance to Clinical Practice: Both of follow-up intervention uses in this study can decrease HbA1c levels and escalate adherence to diabetes control recommendations in people with type 2 diabetes for three months., (© 2012 Blackwell Publishing Ltd.)

Introduction: Post-episiotomy discomfort and its consequences can affect maternal quality of life and mental health as well as the mother and baby relationship. Complementary medicine is increasingly used and Lavender oil is frequently prescribed due to its antiseptic and healing properties., Method: This clinical trial involved 60 qualified primiparous women admitted for labor in Kamali Hospital in Karaj, Iran. They were randomly categorized into two groups: case (using Lavender oil) and control (usual hospital protocol). Participants pain and discomfort were recorded using a Visual Analogue Scale (VAS) and a Redness, Edema, Ecchymosis, Discharge Scale (REEDA). Pain was evaluated at 4 h, 12 h and 5 days following episiotomy. Collected data was analyzed in SPSS 14 using an independent t-test and chi-square., Results: There was a statistical difference in pain intensity scores between the 2 groups after 4 h (p = 0.002, and 5 days (p = 0.000) after episiotomy. However, differences in pain intensity between the two groups, at 12 h post-surgery, were not significant (p = 0.066). The REEDA score was significantly lower in the experimental group (Lavender oil group) 5 days after episiotomy (p = 0.000)., Conclusion: According to these findings, use of Lavender oil essence can be effective in reducing perineal discomfort following episiotomy. It is suggested that Lavender oil essence may be preferably to the use of Betadine for episiotomy wound care., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Objective: Sleep disturbances reduce the quality of life. About 50% of postmenopausal women experience sleep disturbances such as insomnia. Complementary and alternative medical therapies may be useful for the management of sleep disturbances among postmenopausal women. The aim of the present study was to evaluate the effects of valerian extract taken nightly on the improvement of sleep quality in postmenopausal women experiencing insomnia., Methods: A randomized, triple-blind, controlled trial design was used for this study. Participants consisted of 100 postmenopausal women aged 50 to 60 years who were experiencing insomnia. A demographic data form and the Pittsburgh Sleep Quality Index were used to collect data. The women were randomly divided into two groups. Each group received either 530 mg of concentrated valerian extract or a placebo twice a day for 4 weeks. Descriptive and inferential statistics were used to analyze the data., Results: A statistically significant change was reported in the quality of sleep of the intervention group in comparison with the placebo group (P < 0.001). Also, 30% of the participants in the intervention group and 4% in the placebo group showed an improvement in the quality of sleep (P < 0.001)., Conclusions: Valerian improves the quality of sleep in women with menopause who are experiencing insomnia. Findings from this study add support to the reported effectiveness of valerian in the clinical management of insomnia.

This study was performed in order to determine the effects of olive oil on striae gravidarum (SG) occurring within the second trimester of pregnancy. The intervention group, applied olive oil on their abdominal skin area twice a day until the end of the study term. The control group did not use any oil. Striae occurred in 40% of women using olive oil whilst striae were noted to occur in 50% of the control group. There was no significant difference between the intervention and control groups. This study notes that the use of olive oil to the end of the second trimester in pregnancy was not effective in reducing the occurrence of striae gravidarum., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Introduction: Anxiety can be a contributor to labor pain, which is known to be multifactorial. Because there is little information available on the efficacy of birth ball use for labor pain management, this study aimed to evaluate the effectiveness of use of a birth ball on labor pain, contractions, and duration of the active phase of labor., Methods: In this randomized controlled trial, 60 primiparous women aged 18 to 35 years were divided into birth ball and control groups. Pain scores were measured by a visual analogue scale., Results: Mean pain scores in the birth ball group were significantly lower than the mean pain scores in the control group (P < .05). There were no significant differences between duration of the active phase of labor or the interval between uterine contractions in the 2 groups (P > .05)., Discussion: Although the use of a birth ball had no effect on the duration of the active phase of labor, the duration of uterine contractions, or the interval between contractions, this complementary treatment could reduce the intensity of pain during the active phase of labor., (© 2011 by the American College of Nurse-Midwives.)

Background: Health-related quality of life measurements are necessary tools for current situation assessment of all populations. They are absolutely beneficial for evaluation of rehabilitation services which are known as major clinical sources for improving quality of life in physically impaired patients.The design and implementation of this study involved determination of the relationship between war-related physical impairments and quality of life in blind war survivors., Methods: This was a cross-sectional study of a representative population of war victims blind in both eyes who attended a day conference. SF 36 was used for quality of life assessment and demographic data was gathered by a validated questionnaire. An expert internist visited and evaluated subjects' physical health., Results: Participants had a mean age of 43.20±8.34 years. There were 96.5% males and 3.5% females with a mean SF-36 score of 59.20±22.80. The most prevalent physical injury was shrapnel hit in the face (43.6%) and the mean time since onset of injury was 21.84±4.23 years. Quality of life had a significant relation to physical impairments (P=0.006) and the number of injuries had a significant effect on quality of life (P=0.003, f=3.788)., Conclusion: Physical impairments related to war injuries significantly influenced quality of life in the study group. Participants with more impairments reported lower quality of life. Considering the physical problems that accumulate with increasing age, therefore the process of ageing would cause enhanced burden to the future of blind war survivors even though, according to the physical component scale, they have a better quality of life than lower limb amputee war survivors. Assistive devices with proper instruction on their use can help this population improve their abilities and improve their quality of life.

Chronic Obstructive Pulmonary Disease (COPD) is a public health problem worldwide. Increased energy and protein needs, decreased energy and protein intake are common in COPD patients. Adequate intake is essential to improve pulmonary function and immune system, prevention of weight loss and maintaining muscle mass and strength. Assessment of energy and protein intake and its relationship with pulmonary function in COPD patients was performed in this study. The study group included 63 COPD patients. For all subjects, evaluation of energy and protein intake by Food Frequency Questionnaire (FFQ) and 24-hour recall, spirometry for measuring pulmonary function and determining disease severity were performed. The subjects were divided into three groups based on disease severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages. Relationship between energy and protein intake with pulmonary function was assessed. Energy and protein intake were lower than the calculated energy and protein demand for all groups. Significant relationship was found between the amount of protein intake extrapolated from food frequency questionnaire with Forced Vital Capacity (FVC) (r=0.2, P=0.02) and Vital Capacity (VC) (r=0.3, P=0.008). The results of the study suggest that accurate evaluation of protein and energy intake and requirements should be included in the goals of medical treatment of COPD patients.

Background: Quality of Life measurements are necessary tools for effectively evaluating health services. In the population of patients afflicted with war-related blindness in Iran, such measurements have yet to be documented and utilized. "The design and implementation of this study involved the determination of a baseline score for QOL in a population of Iranian blinded in the Iraq-Iran war in order to facilitate the design of interventions intended to improve the population's QOL.", Methods: This was a cross-sectional study of a representative population of 250 war victims blind in both eyes at a 14-day recreational conference., Results: Participants had a mean age of 43.20(SD8.34) and their composition was 96.5% male and 3.5% female with a mean SF-36 QOL score of 59.20(SD22.80). An increasing level of education among the participants correlated with a higher QOL score (p = 0.006). The QOL also has a significant correlation to number of injuries (p < 0.0001). High systolic and diastolic blood pressure, hearing loss, and tinnitus had negative individual correlations to QOL (p = 0.016, 0.016, 0.005, p < 0.0001). The male sexual disorders of erectile dysfunction and premature ejaculation both had significant correlations to QOL (p = 0.026, p < 0.0001). Hypercholesterolemia showed significant correlation to QOL (p = 0.021)., Conclusions: As blind war survivors' age, they will present with a greater set of burdens despite their relatively better QOL in the physical component scale when compared with lower limb amputees. Risk factors of cardiovascular attack such as high blood pressure and hypercholesterolemia were present and need future interventions., Keywords: Quality of life, blindness, SF36, health.

Background: Obesity and diabetes are the most important problems of public health. Evidence from molecular animal research and epidemiologic investigations indicate that calcium intake may have an influence on body composition, weight and insulin resistance. The objective of this study was to determine the effects of calcium supplementation on body composition, weight, insulin resistance and blood pressure in the face of calorie restriction in obese adults., Methods: A double blind randomized placebo-controlled trial on 40 adults with Body Mass Index > 25kg/m(2) was conducted. Subjects were maintained for 24 weeks on a balanced deficit diet (-500 kcal/d deficit) and randomly assigned into two groups with 1000 mg ca/d as calcium carbonate or placebo., Results: There were no significant differences in variables at the 12th and 24th week between the two groups. The lean mass showed no significant increase in the calcium group at the 12th week compared to baseline and in placebo group at the 24th week compared to the 12th week. The insulin concentration showed a significant decrease in the calcium group at the 12th week compared to the baseline (p < 0.05). The diastolic blood pressure had a significant decrease at the 24th week compared to the 12th week in both groups (p = 0.013-0.009)., Conclusions: Results from this study suggest that 24 weeks of supplementation with 1000 mg ca/d did not have any effect on weight, body composition, insulin resistance and blood pressure beyond what can be achieved in an energy restricted diet in obese adults.

Background: War is a known cause of tremendous physical injuries to different body organs, and eyes are not exceptions. War-related no visual acuity (NVA) affects both the victim and the family. Activity of daily living (ADL) can display personal life independency and is considered as a morbidity index. This study was designed to investigate the ADL profile of war survivors with NVA., Methods: This cross-sectional study was conducted in 2007 in Iran. In this study, 500 Iranian people with war related NVA were invited to take part in a camp in Mashhad city. ADL was evaluated using Barthel Index and demographic data were collected using a data sheet. Stepwise linear regression was used to determine the associates of ADL., Results: The overall response rate to the invitation was 50%. From the total 250 participants 96.5% were male with a mean age of 43 ± 8 years. Only 8.3% had no dependency in ADL and other 91.7% had some ranges of dependency in at least one of the daily living activities. ADL score was higher in highly educated participants, those younger than 50 years old, those with less co-morbid physical problems (hearing loss) and those with regular physical exercises. According to regression analysis, age and duration of war related NVA were significant predictors of ADL., Conclusions: According to the results, both age and the time passed from war related NVA increase the dependency of people with war related NVA.

Aim: This paper is a report of a study examining the effects of a supportive counselling programme on the academic performance of Iranian nursing students experiencing academic failure., Background: In order to using limited educational resources effectively, nursing students experiencing academic failure should be immediately identified in order that appropriate intervention can take place., Method: Data were collected over a 12-month period in 2006-2007, with 42 Bachelor of Science nursing students who displayed poor academic performance. They were randomly allocated to receive either supportive or ordinary counselling. The mean grades in basic theoretical courses, special courses, and also the combination of both basic and special courses was compared between the two groups., Findings: Over the study period, there were improvements in the mean grades of special courses and also in both basic and special courses of male students in the experimental group, compared with those of male students in the control group (0.27 against -1.43, P = 0.014; and 1.87 against -0.40, P = 0.009; respectively)., Conclusion: A supportive counselling programme can improve the academic performance of male nursing students. Replication of the current study with larger samples and longer duration is recommended.

Background: Information about web-based education outcomes in comparison with a face-to-face format can help researchers and tutors prepare and deliver future web-based or face-to-face courses more efficiently. The aim of this study was to compare the effectiveness of web-based and face-to-face continuing education methods in improving nurses' knowledge about AIDS., Methods: A quasi-experimental method was used with a pre-test and post-test design. In this study 140 nurses with BSc degrees were chosen through a random sampling method and divided into a web-based and a face-to-face group by random allocation. For the former group the intervention consisted of a web-based course on AIDS; the latter received a 3-hour lecture course on the same subject. At the beginning and end of the course in both groups, the nurses' knowledge was measured by a questionnaire. Pre- and post-test scores were compared within and between the groups., Results: The results show that there was no significant difference between the groups in either the pre-test (t(138) = -1.7, p = 0.096) nor the post-test (t(138) = -1.4, p = 0.163) scores in the knowledge test. However, there was a significant difference in the pre-test and post-test scores within each group (web-based, t(69) = 26, p < .001; face-to-face, t(69) = 24.3, p < .001)., Conclusion: The web-based method seems to be as effective as the face-to-face method in the continuing education of nurses. Therefore, the web-based method is recommended, as complementary to the face-to-face method, for designing and delivering some topics of continuing education programs for nurses.

Accurate evaluation of healthcare information systems (HCIS) relies upon the choice of appropriate indicators. Iranian healthcare and health industry professionals were surveyed, by means of a descriptive cross sectional study, in order to identify the indicators they considered most relevant to the evaluation of healthcare information systems currently in use in Iran. It was concluded that effective evaluation of HCIS should encompass a variety of perspectives and methodologies (including qualitative methodologies), focus upon technical, economic and organisational concerns, and involve diversely constituted research teams.