The effect of changing position and early ambulation after cardiac catheterization on patients' outcomes: A single-blind randomized controlled trial

Background: Cardiac catheterization is the gold standard diagnostic test for coronary heart diseases. In order to minimize the post-procedure complications, patients are restricted to prolonged bed rest that is always accompanied by fatigue and discomfort. Objective: The aim of this study was to assess the effect of changing position and early ambulation on the level of comfort, satisfaction, and fatigue and on the amount of bleeding and hematoma after cardiac catheterization. Participants: A sample of 70 patients, who had undergone a non-emergency 6-French cardiac catheterization via the femoral artery from September to November, 2006. Methods: In a single-blind randomized controlled trial, each patient was randomly assigned to either the control or experimental group. The patients' position in the experimental group was intermittently changed during the first 6 h after catheterization. Seven hours after the procedure, they were allowed to be ambulated and to undertake their self care activities. A pillow was placed under the patients' bodies. Patients in the control group were managed as routine; they were restricted to a 10-24 h bed rest bed rest in supine position with the affected leg straight and immobilized and a sand bag on the puncture site for at least 8 h. The levels of comfort, satisfaction and fatigue, and the amount of bleeding and hematoma were measured at regular intervals after the procedure. Results: The patients in the experimental group had significantly higher comfort and satisfaction and lower fatigue levels than the control group at 3, 6, 8 h and the next morning after catheterization (P 0.05). Conclusion: The results of this study showed that the levels of comfort, satisfaction and fatigue after catheterization are related to the duration of bed rest and patients' position in bed. Changing patients' position accompanied by early ambulation after cardiac catheterization are associated with increasing comfort and satisfaction levels and decreasing the level of fatigue without increasing the amount of bleeding and hematoma. © 2009 Elsevier Ltd. All rights reserved

Identifying the Dimensions & Evaluation of Path Model in Physical Education Course in Primary School

Physical education and sports are the integral part of education in adolescence and is a useful tool that provides opportunities for real life experiences. The purpose of this study was to assess the extent of explaining and modeling method is studying physical education in primary schools that was performed by the descriptive survey method. The population sample consisted of 100 elementary school physical education teachers in   IslamShahr on 1391-1392. Research tool was researcher made questionnaire with 30 closed questions. Cronbach's alpha reliability test (Course offered in the game, 0/865, to evaluate 0/912, to compete0.61, class management 60/0 and teaching methods 0/891) was used, Which has been named and classified according to the exploratory analysis. The result showed that there is a meaningful correlation between teaching physical science factors in terms of game, teaching methods evaluation and competitions. In teaching physical science teaching by using game, teaching and completion were factors that teachers pay more attention to them, but the teacher’s class management methods has meaningful relation to students’ completion. So we can suggest our managing suggestion in this regards

Domestic violence and suicide attempt among married women: A case‐control study

The aim of this study was to investigate the impact of domestic violence‐related factors on suicide attempt in married women. Suicide is a global public health concern that poses significant burden on individuals, families and communities. There is limited research on factors predicting suicide attempt in women. A retrospective case‐control design was adopted. Using a convenience sampling method, 610 participants, admitted to a teaching referral hospital in Northwest of XXX, were recruited to the study and assigned to case or control groups based on whether or not they had attempted suicide. The participants in two groups were matched in the terms of important demographic characteristics. Domestic violence‐related factors were considered as independent variables and suicide attempt as dependent variable. Descriptive statistics, simple and multivariate logistic regression analysis were used to analyze the data. Odd ratios (OR) of domestic violence related factors were compared between the groups. We used STROBE checklist as an EQUATOR in this study. The mean age of participants in the case and control groups was 28.4 years and 29.45 years, respectively. The infidelity was the strongest predictor of suicide attempt in women (OR 44.57, 95%CI 6.08‐326. 63, p<0.001), followed by being threatened to physical assault by husband (OR 37.01, 95%CI 11.54‐118.67, p<0.001), jealousy of husband (OR 23.46, 95%CI 11.63‐47.30, p<0.001), and previous attempts to divorce (OR 16.55, 95%CI 5.91‐46.31, p<0.001). Suicide attempt was significantly lower in women who reported a sense of peace in life or lived with their mother or father‐in‐law (p<0.001). To reduce the risk of suicide in women, violence against women should be condemned and appropriate prevention measures be taken by health professionals. Recognizing risk, assessment and referral of victims of domestic violence should be an integral part of health care systems.N/

Psychometric properties of the 12-item WHODAS applied through phone survey: an experience in PERSIAN Traffic Cohort

Background Due to limited capability to function in post-injury daily life injury, survivors need to be reliably assessed without need to commute more than necessary. The key action is to determine the level of functioning difficulties. Having the opportunity of conducting a national post-crash traffic safety and health cohort study, we aimed to translate into Persian and assess the psychometric properties of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) through phone surveys six month post injury. Methods First, having World Health Organization permission, we tested the translation validity by forward translation, expert panel evaluation, back-translation, pre-testing and cognitive interviewing, and finalizing the Persian WHODAS. Then, through a psychometric study within a national cohort platform, the validity, reliability and applicability of the 12-item WHODAS was assessed through phone surveys. We included data of 255 road traffic injury patients enrolled from the cohort at six-month follow-up. The psychometric assessment (internal consistency reliability and stability reliability) was conducted on test-retest data of 50 patients with an average 7-day time span. An exploratory factor analysis tested the construct validity using extraction method of principal component factor and oblique rotation on data from 255 patients. Regarding the multiple criteria including an eigenvalue > 0.9, Cattell's scree test, cumulative variance, and the theoretical basis, the minimum number of factors were retained. Data were analyzed using STATA statistical software package. Results The respondents were mostly male (81%), employed (71%), educated (87%), and with a mean age of 37.7(14.9). The Persian version had high internal consistency reliability (Cronbach's alpha = 0.93) and excellent stability reliability (ICC = 0.97, 95% CI: 0.92-0.98). An exploratory factor analysis retained four factors defining 86% of all the variance. Factors of Self-care, Mobility, and Cognition were completely retained. Conclusions The brief Pesrian WHODAS 2.0 was highly reliable and valid to be applied through phone interviews post injury

Impact of rural Family Physician programme on maternal and child health indicators in Iran: an interrupted time series analysis.

OBJECTIVES: The establishment of the Family Physician (FP) programme in the rural areas of Iran in 2005 has made health services accessible and affordable. This paper aims to assess the overall trends of maternal and child health (MCH) indicators in a 20-year period and possible effects of the FP programme (intervention) on these indicators in Iran. DESIGN AND SETTING: An interrupted time series analysis was conducted on 20 annual MCH-related data points from 1994 to 2013. The intervention time was at the 12th data point in 2005. OUTCOMES: MCH indicators were grouped into three categories: structure (mother's age, education, occupation and gravidity), process (number of antenatal care visits (ACVs), laboratory tests, ultrasounds and natural vaginal deliveries (NVDs)) and outcomes (maternal mortality ratio (MMR), neonatal mortality rate (NMR), birth weight (BW), history of abortion and/or stillbirth, and haemoglobin level (Hb)). RESULTS: The adjusted slope of the ACV trend decreased sharply after the intervention (b=-0.36, p<0.01), whereas it increased for the frequency of ultrasounds (b=0.2, p<0.01) and did not change for number of laboratory tests (b=-0.09, p=0.95). The intensification of the descending slope observed for NVD (b=-1.91, p=0.03) disappeared after the adjustment for structural confounders (b=1.33, p=0.26). There was no significant slope change for MMR (b=1.12, p=0.28) and NMR (b=0.67, p=0.07) after the intervention. The slope for the history of abortion trend was constant before and after the intervention, but it considerably intensified for the history of stillbirths after the intervention (b=1.72, p<0.01). The decreasing trend of BW turned into a constant mode after the intervention (b=33.2, p<0.01), but no change was observed for Hb (b=-0.02, p=0.78). CONCLUSION: Although the FP programme had a positive effect on the process and proximal outcome indicators (BW), no dramatic effect on mortality outcome indicators was distinguished. It shows that there should be determinants or mediators of mortality outcomes in this setting, other than accessibility and affordability of MCH services.Esmaeil Khedmati Morasae is part-funded by the National Institute for Health Research Collaboration for Leadership in AppliedHealth Research and Care, North West Coast (NIHR CLAHRC NWC)

Validity and reliability of the Iranian preterm birth experiences and satisfaction scale: A methodological and cross-sectional study

Background: Women's experience and satisfaction with childbirth care are increasingly being addressed by health care providers, managers, and policymakers. Due to need for a validated special scale for assessing satisfaction of women with preterm birth, we aimed to translate and adapt the first specific tool, Preterm Birth Experiences and Satisfaction Scale (P-BESS), into Persian language and evaluate its psychometric properties. Methods: A methodological and cross-sectional study was conducted in two tertiary levels of maternal hospitals in Tabriz. The Iranian version of the scale was developed from the original English version using forward-backward translation. After confirmation of its face and content validity, the scale was completed by 201 women who had given birth prematurely. Results: Exploratory factor analysis revealed three factors (staff professionalism and empathy, confidence in Staff, information and explanations) with eigenvalues greater than 1, explaining a total variance of 55.4%. Confirmatory factory analysis showed that the 17-item, three factor model fitted the data well: the root mean square error of approximation 0.060. There were moderate correlations between the total and sub-scales of Iranian P-BESS and overall satisfaction (r = 0.45 to 0.66), as well as need for improvement (r = -0.46 to -0.61), which confirm convergent validity. Internal consistency and test-retest reliability of the scale and its sub-scales were satisfactory (α = 0.852 to 0.922, intraclass correlation coefficient; 0.83 to 0.92). Conclusion: The Iranian version of P-BESS is a valid and reliable scale which can be used by policy makers, managers, health care providers and researchers

Effects of Royal Jelly and Tocotrienol Rich Fraction in obesity treatment of calorie-restricted obese rats: A focus on white fat browning properties and thermogenic capacity

Background: Obesity has reached an alarming rate worldwide. Promoting thermogenesis via increasing the function of brown adipose tissue (BAT) or white adipose tissue (WAT) browning has been proposed as a new protective approach against obesity. The goal of this study was to evaluate the effects of Royal Jelly (RJ) and tocotrienol rich fraction (TRF) on BAT activation and WAT browning during calorie restriction diet (CRD) in obesity model. Methods: In this experimental study, 50 obese Wistar rats were randomly divided into 5 groups and then received one of the following treatments for a period of 8-week: High-fat diet (HFD), CRD, RJ + CRD, TRF + CRD, and RJ + TRF + CRD. Effects of RJ and TRF, individually and in combination on body weight and the expression of key thermoregulatory genes in WAT and BAT were examined by quantitative real-time (qRT-PCR). Also, morphological alterations were assessed by hematoxylin and eosin staining. Results: RJ (- 67.21 g ±4.84 g) and RJ + TRF (- 73.29 g ±4.51 g) significantly reduced weight gain relative to the CRD group (- 40.70 g ±6.50 g, P < 0.001). In comparison with the CRD group, RJ and RJ + TRF remarkably enhanced the uncoupling protein1 (UCP1) expression in WAT (5.81, 4.72 fold, P < 0.001) and BAT (4.99, 4.75 fold, P < 0.001). The expression of PR domain containing 16(PRDM 16), cAMP response element-binding protein1 (CREB1), P38 mitogen-activated protein kinases (P38MAPK), and Bone morphogenetic protein8B (BMP8B) have significantly increased following RJ and RJ + TRF treatments (P < 0.001). However, the expression levels of CCAAT/enhancer-binding protein beta (CEBPβ) and Bone morphogenetic protein7 (BMP7) did not remarkably change. Multilocular beige cells in WAT and compacted dense adipocytes were also observed in BAT of RJ and RJ + TRF received groups. TRF showed no substantial effects on the expression of the mentioned thermoregulatory genes and brown fat-like phenotype. Conclusion: Our results suggest that, Royal Jelly promotes thermogenesis and browning of WAT, contributing to an increase in energy expenditure. Thus, Royal Jelly may give rise to a novel dietary choice to attenuate obesity. © 2020 The Author(s)