The Effectiveness of a supportive educative program on mothers’ knowledge and behavior about breast feeding in health care centers of Shahrekord city 2012

Background and aims: Breast feeding because of many advantages is preferred on any replacement feeding for all infants. One of the major causes of discontinuation of breast feeding is insufficient knowledge of mothers from the benefits of it. So, the aim of this study was the effect of a supportive educative program on mothers' knowledge and performance that referred to health care centers of Shahrekord city. Methods: In this quasi-experimental study, carried out in 2012, 168 mothers (each group, 84 persons) were divided randomly into two groups: experimental and control. The program performed in nine sessions of 2 hours. Data collection tool was questionnaire. Questionnaires were completed by both groups; the training received after re-training questionnaire was completed by two groups. The data were analyzed by software SPSS. Results: The demographic characteristics of 2 groups were not significant different. Average scores of breastfeeding information before launching the application in the experimental group was 78.59±18.49 and in the control group 75.93±18.62 and after the program in the experimental group was 89.90±13.85 and in the control group 77.24±15.45. The average of performance scores before the program in the experimental group was 45.41±24.62, and in the control group 50.62±25.33 and after the run the program in the experimental group 76.45±21.08 and in the control group 51.04±24.80 respectively. There was no significant difference between mean knowledge and performance scores of experimental and control groups before the intervention (P=0.35), but after the intervention, difference was significant (P<0.001). Conclusion: The results showed the effectiveness of this supportive educative program on increasing mothers' knowledge and performance about breast-feeding. Regarding the cheap, simple and appropriate ability to run of the program recommended that the program performed by health workers for breastfeeding mothers even be extended to other women of reproductive age

The effect of Cornus mas in preventing recurrent urinary tract infections in women: A randomized controlled trial

Background and aims: Urinary tract infections (UTIs) are one of the most common and the second leading infections, after respiratory tract infections, in women. Currently, various chemical drugs are used to prevent the UTIs. Chemical drugs may cause antibiotic resistance and cause resistant strains likely grow in the long-term treatment with antibiotics. The aim of this study was to investigate the effect of Cornus mas in preventing recurrent UTIs in women aged 15-45 years referring to Ayatollah Kashani Hospital Clinic in Shahrekord. Methods: This experimental study (Parallel Design and Triple-blind) was conducted on 42 women aged 15-45 years referring to Ayatollah Kashani Hospital Clinic of Shahrekord and diagnosed with chronic cystitis. The exclusion criteria were neurogenic bladder, genitourinary system anatomical abnormalities (hydronephrosis, ureterocele stone, etc), and bacterial resistance. The women were randomly assigned to 2 groups. At baseline, the women were examined for any functional and anatomical disorders and if it was necessary, they underwent ultrasound. After the current UTIs were treated and the women clinically recovered, one group was administered with Cornus mas tablet 500 mg and another group administered with placebo for 6 months. All the women were followed up for 6 months. Every 2 months, the patients were clinically examined and their urine cultures were investigated for the clinical signs of cystitis. As the symptoms of the UTIs occur, the patients were recommended to refer for repeated urine culture. All patients (42 women) completed the study. Results: In our study, no significant difference was observed between the groups in terms of recurrent UTI recurrence, although there were differences (P>0.005). Positive urine culture in Cornus mas group was 19 and in placebo was 33.4. In terms of dysuria in 6 months and the second time, there was a significant difference between placebo and Cornus mas (P=0.004) Dysuria in Cornus mas group was 14.2 and in placebo was 56.2. Conclusion: Cornus mas can decrease dysuria and frequent urination in patients with recurrent UTIs, so it can be used in the treatment of these patients

Caregiver burden among Iranian heart failure family caregivers: A descriptive, exploratory, qualitative study

Background: Living with patients of chronic diseases such as heart failure (HF) is a diffi cult situation for the caregivers. This study explored the Iranian family caregivers’ burden of caregiving for patients with HF. Materials and Methods: Eighteen family caregivers of the HF patients from two governmental medical training centers in Isfahan, Iran were recruited using purposive sampling. Data were collected through face-to-face semi-structured interviews. Each interview was transcribed verbatim and was thematically analyzed concurrently. Results: Four major themes emerged from the analysis of the transcripts: Lack of care-related knowledge, physical exhaustion, psychosocial exhaustion, and lack of support. Family caregivers believed that they have little knowledge about the patients’ disease, drugs, and how to perform caregiving roles. They experienced negative physical and psychosocial consequences of full-time and highly extended caregiving roles, such as musculoskeletal disorder, fatigue, and sleep disturbance, and a high level of anxiety, stress, and social isolation. Caregivers believed that they receive little familial and organizational support on the emotional and fi nancial dimensions of caregiving. Conclusions: The fi ndings of this study can be used by healthcare providers, especially nurses, to provide more effective social, informational, and professional support for family caregivers

The effectiveness of a supportive educative group intervention on family caregiver burden of patients with heart failure.

BACKGROUND Living with heart failure patients is a complex situation for family caregivers. Few studies have been conducted to examine the effects of interventional programs to ease this condition. The purpose of this study was to determine the effectiveness of a supportive educative group intervention in reducing family caregivers' burden of caregiving. MATERIALS AND METHODS This randomized clinical trail was conducted at a selective teaching hospital in Isfahan, Iran in 2012. The intervention consisted of four weekly multimedia training sessions of 2 h that included education and family support for 50 family caregivers. Caregiver burden was measured using the Zarit Burden Interview (ZBI). Paired t-test, Student's t-tests, and repeated measures analysis of variance (ANOVA) were used to test for significant differences of the mean scores of burden between the intervention and control groups over a 3-month period. RESULTS The intervention was successful in reducing caregiver burden over time both at the end of the intervention period (P = 0.000) and 3 months after the intervention (P = 0.000). CONCLUSIONS Nurses and other healthcare providers can use the findings of this study in order to implement effective programs to reduce family caregivers' challenges and to provide them more support

Religious attitudes and spiritual health among elderly inpatient adults in Shahrekord hospitals

Background and Objectives: Human is a multidimensional creature and spiritual domain is the central dimension which has an undeniable effect on gaining health. The most important part of nursing care with family based approach is to help people in achieving optimal level of health. On the other hand, religious attitudes and spiritual health is an important domain of life in ageing period. Therefore, this study was conducted to assess the religious attitudes and spiritual health among elderly inpatients in Shahrekord hospitals. Methods: This descriptive correlational study was conducted in 1392 in Shahrekord hospitals. A total of 308 geriatric patients who were admitted to a surgical ward, were recruited through random sampling. Two sets of questionnaires regarding religious and spiritual health were used as the instruments. After collecting the data, descriptive (frequency, mean, variance, standard deviation) and analytical (independent t test, Pearson correlation) statistics were used by SPSS statistical software. Results: The results showed that 68.8% of patients possessed large religious attitude with an average of 140.68 ±30.14. Spiritual health in 51.3 percent of samples was described to be low while the obtained average score was 86.18 ± 16.61. However, Pearson test showed that there is a positive significant correlation between religious attitudes and spiritual health (r =0.83, P =0.05). Conclusions: The present study revealed that there is a significant relationship between religious attitudes and spiritual health and people with high religious attitudes have high spiritual health

Cancer risk among patients with multiple sclerosis: A cohort study in Isfahan, Iran

Background: Multiple sclerosis (MS), a central nervous system (CNS) autoimmune disorder, affects 2.3 million people around the world. Cancer kills around 7.5 million people annually. Both diseases have similar risks and intertwining molecular causes. Most studies focusing on MS and cancer have found an insignificant difference or reduction in the amount of cancer found in the MS community. Methods: We performed a cohort study using data from Isfahan Multiple Sclerosis Society (IMSS) and Isfahan cancer society and followed-up for 8 years on average (2006-2014). All of the 1718 MS patients were diagnosed according to McDonald's criteria, then standardized incidence ratio and the numbers of expected cancer case were calculated. Results: While patients had an insignificant change in cancer prevalence, men had fewer cancer cases and women showed an increased prevalence of cancer. Certain types of cancer proved statistically significant. Breast cancer, nervous system cancers, and lymphoma were elevated in the cohort. Conclusion: Our results support the hypothesis that MS significantly affects certain cancers in a protective or associative manner. All cancer rates, except breast cancer, cancers located in the nervous system, and lymphomas were reduced in cohort, suggesting that unregulated immune function may provide protective effects to MS patients against cancer

Family Caregivers' Experiences of Caring for Patients With Heart Failure: A Descriptive, Exploratory Qualitative Study

Background: Living with heart failure is a complex situation for family caregivers. Many studies addressing the challenges faced by heart failure family caregivers have already been conducted in Western societal settings. Sociocultural factors and perspectives influence the family caring experience and roles. The ethnic/culturally based differences in family caring behavior make this a subject worth further exploration and clarification. Purpose: This study explores the experiences of family caregivers in Iran of caring for patients with heart failure. Methods: A descriptive, exploratory, and qualitative approach was applied to gain authentic insight into the experiences of participants. Purposive sampling was used to recruit 21 family caregivers from three educational hospitals in Isfahan, Iran. Data were collected using semistructured interviews and field notes. Interviews and field notes were transcribed verbatim and concurrently analyzed. Results: Three major themes emerged from the analysis of the transcripts: caregiver uncertainty, lack of familial and organizational support, and Allah-centered caring. Participants believed that they did not have the basic knowledge related to their disease and drugs. In addition, they received little guidance from the healthcare team. Lack of support and insurance as well as financial issues were major problems faced by the caregivers. They accepted the providence of Allah and noted that Allah always helps them accomplish their caregiving responsibilities. Conclusions/Implications for Practice: The care performed by the caregivers of patients with heart failure exceeds their individual capabilities. Nurses, other healthcare providers, and health policy makers may use the findings of this study to develop more effective programs to address these challenges and to provide more effective support. Sociocultural factors and perspectives were the primary factors affecting the caregiving experiences of participants in this study. Improved understanding of these factors and perspectives will help healthcare providers develop and implement suitable intervention programs for caregivers. Healthcare professionals should develop context-based intervention programs to promote caregiver capabilities and encourage caregivers to participate to facilitate the caregiving roles of caregivers

Association of TIM-1 5383-5397ins/del and TIM-3-1541C > T polymorphisms with multiple sclerosis in Isfahan population

Multiple sclerosis (MS) is an organ-specific autoimmune disease in central nervous system, affecting about 2.5 million people around the world. Probable involvement of two newly identified immunoregulator molecules, TIM-1 and TIM-3, has been reported in autoimmune diseases. In this study, for the first time, the association of TIM-1 5383-5397ins/del and TIM-3 -1541C>T polymorphisms with MS in an Iranian population was considered. The results of our study showed that there is no significant association between TIM-1 5383-5397ins/del and MS (P = 0.38); however, the frequency of CT genotype of TIM-3 -1541C>T in patient group was significantly higher than the control group, and there was a significant association between CT genotype and MS (P = 0.009, OR = 4.08)

Endothelial function, inflammation, thrombosis and basal ganglia perivascular spaces in patients with stroke

Background and Objective: Recent studies suggest perivascular spaces are a marker of small vessel disease, blood–brain barrier permeability, and inflammation, but little is known about their risk factors and associations with peripheral blood markers. Materials and Methods: In prospectively recruited patients with recent minor ischemic stroke, we investigated the influence of age, sex, hypertension, diabetes, and smoking on the severity of perivascular spaces in the basal ganglia seen on T2- weighted magnetic resonance imaging. We assessed plasma markers of endothelial function (von Willebrand factor, intracellular adhesion molecule-1), inflammation (interleukin-6, tumor necrosis factor-alpha, C-reactive protein), and thrombosis (fi- brinogen, prothrombin fragments 1 + 2, thrombin–antithrombin complex, tissue plasminogen activator, D-dimer). We used a validated semi-automated method to measure basal ganglia perivascular spaces count and volume. We tested uniand multivariable associations between blood markers and basal ganglia perivascular spaces count and volume. Findings: In 100 patients (median age: 67 years, range: 37-92), on adjusted analysis, basal ganglia perivascular spaces count was associated with age (r = .117, P = .003) and hypertension (r = 2.225, P = .013). On multivariable linear regression, adjusted for age, sex, hypertension, smoking and diabetes, reduced von Willebrand factor was associated with increased basal ganglia perivascular spaces count (r = −.025, P = .032). Conclusion: The association of increased basal ganglia perivascular spaces count with reduced von Willebrand factor is novel. As von Willebrand factor may promote cerebral endothelial integrity, insufficient von Willebrand factor is consistent with dysfunctional cerebral endothelium and increased basal ganglia perivascular spaces in cerebral small vessel disease. Quantitative perivascular spaces measurement may increase sensitivity to detect cerebral endothelial dysfunction