Health-related quality of life and medication adherence in elderly patients with epilepsy

© 2019 Polish Neurological Society. Objective. Considering the high prevalence of epilepsy in the elderly and the importance of maximising their quality of life (QoL), this study aimed to investigate the relationship between medication adherence and QoL, and the mediating effects of medication adherence on the association between serum antiepileptic drug (AED) level and seizure severity with QoL in elderly epileptics. Methods. In a longitudinal study, 766 elderly patients with epilepsy who were prescribed a minimum of one antiepileptic drug were selected by convenience sampling method. A Medication Adherence Report Scale (MARS-5) questionnaire was completed at the baseline. Seizure severity and QoL were assessed after six months using the Liverpool Seizure Severity Scale (LSSS) and the QoL in Epilepsy (QOLIE-31) questionnaires respectively. Serum level of AED was also measured at six-month follow-up. Results. Medication adherence was significantly correlated with both seizure severity (β = -0.33, p < 0.0001) and serum AED level (β = 0.29, p < 0.0001) after adjusting for demographic and clinical characteristics. Neither QoL nor its sub-classes were correlated with seizure severity. In addition, a significant correlation was not observed between serum AED level and QoL. However, medication adherence was significantly correlated with QoL (β = 0.30, p < 0.0001). The mediating effects of medication adherence on the association between serum AED level (Z = 3.39, p < 0.001) and seizure severity (Z = -3.47, p < 0.001) with QoL were supported by the Sobel test. Conclusion. This study demonstrates that medication adherence has a beneficial impact on QoL in elderly epileptics. Therefore, adherence to treatment should be monitored to improve their QoL

The Effect of Aromatherapy with Peppermint Essential Oil on Nausea and Vomiting in the Acute Phase of Chemotherapy in Patients with Breast Cancer

BACKGROUND AND OBJECTIVE: Chemotherapy is one of the main treatment options for cancer patients. Nausea and vomiting are also the most common side effects of chemotherapy drugs. The aim of this study was to determine the effect of aromatherapy with peppermint essential oil on nausea and vomiting in the acute phase of chemotherapy (the first 24 hours) in patients with breast cancer. METHODS: This randomized clinical trial was conducted on 100 women with breast cancer who were referred to the chemotherapy centers of Imam Khomeini Hospital on an outpatient basis for the first course. Patients were randomly divided into intervention and control groups. Peppermint essential oil was used in the intervention group, while normal saline was used in the control group. Frequency and severity of acute nausea and vomiting in the first night after chemotherapy were recorded and compared using Rhodes standard questionnaire with a mean score of 0 – 32. FINDINGS: The two groups were not statistically different in terms of age, duration of cancer, history of alcohol abuse and history of nausea and vomiting. The mean score of nausea in the aromatherapy group was 1.1±1.02 and in the in the control group was 1.82±1.39 (p<0.014). The mean score of vomiting in the intervention group was 0.34±0.66 and in the control group was 0.66±0.97 (p<0.032). CONCLUSION: The results of this study showed that the use of aromatherapy with peppermint essential oil, along with the use of routine anti-nausea / vomiting drugs, can reduce nausea and vomiting in the acute phase of chemotherap

The Effects of Two Planning Interventions on the Oral Health Behavior of Iranian Adolescents: A Cluster Randomized Controlled Trial.

PURPOSE: The aim of this study was to investigate the effectiveness of a planning intervention (specifying when, where, and how to act) and an implementation intention intervention (specifying the same in the format of an if-then plan) in increasing self-reported brushing in adolescents. METHODS: The study adopted a cluster randomized controlled trial design, and 1158 students in 48 schools were randomized to planning, implementation intention, or active control conditions. After baseline assessment, all participants received a leaflet containing information and recommendations on oral health and instructions on correct brushing behavior. After reading the leaflets, they were provided with a toothbrush and toothpaste plus a calendar in which to record their brushing. Participants in the planning condition and in the implementation intention condition also received instructions to form specific plans regarding brushing behavior. Self-reported brushing, perceived behavioral control, self-monitoring, intention, frequency of planning, oral health-related quality of life, and dental plaque and periodontal status were measured 1 and 6 months later. RESULTS: Both intervention conditions showed a significant improvement in the frequency of self-reported brushing, self-monitoring, frequency of planning, intention, perceived behavioral control, plaque index, periodontal health, and oral health-related quality of life compared to the control condition at both follow-ups. Comparing the two intervention conditions revealed that adolescents who received the implementation intention intervention had significantly greater improvement in the frequency of self-reported brushing, intention, frequency of planning, and periodontal health than those in planning condition. CONCLUSIONS: Taken together, the findings suggest that forming implementation intentions as well as planning has the potential to increase dental self-reported brushing rates in adolescents, but that forming implementation intentions has the strongest impact on dental hygiene behavior and is, therefore, recommended. TRIAL REGISTRATION NUMBER: The trial was registered with the ClinicalTrials.gov database (NCT02066987) https://www.clinicaltrials.gov/ct2/show/NCT02066987

A comparison between two methods of measuring total fat in the Iranian soldiers

Background: Constant checkup and control of body fat mass is an important parameter for the health and efficiency of individuals in any society. This parameter is especially crucial in army soldiers since physical fitness is a key role in reaching high physical performance, health, and survival in war. Objective: This study was designed to compare two methods of measuring fat, the method of circumference-based military equations (CBEs) to estimate body fat mass compared to the method of skinfold thickness-based equation (SBE) in Iranian soldiers. Methods: This cross-sectional study was conducted on 246 Iranian soldiers were recruited in Tehran (2016). Height, waist, and neck circumference were measured and the total body fat mass was calculated using CBEs. Then, the results of using Pierson’s correlation and Bland-Altman methods were compared with Jackson and Pollock’s skinfold thickness measurement. Findings: The total body fat mass of the soldiers using CBEs was 18.94±6.30% and using Jakson and Pollock’s skinfold thickness formula was 17.43±4.45%. The correlation between the two methods was r=0.984 and SEE was 1.1% (P<0.001). Conclusion: The more body fat makes the error waist circumference greater. The error is so much that don’t use this method to measure fat

Mothers' perception of obesity in schoolchildren: A survey and the impact of an educational intervention

Objectives: To investigate mothers' awareness of their children's weight problem, and to evaluate the impact of an educational intervention on improving mothers' recognition of obesity in their children. Methods: Twelve primary schools from Tehran, Iran, were randomly chosen. Obese children were selected, and 300 mothers participated in the study. A questionnaire was completed by the mothers, who were then randomly divided into two groups. One group received education on obesity, whereas the other group did not receive any intervention. After 2 months, the same questionnaire was completed by both groups. A multiple logistic regression was performed. Results: Mother's pre-existing knowledge on obesity, their education and occupation, as well as family income, had significant effects on mothers' accuracy in identifying obesity in their children. The educational intervention significantly improved mothers' ability to identify obesity in their children compared with those without any intervention (OR = 15.23; 95%CI 5.95-38.96). Conclusions: In Iran, a large proportion of mothers do not have general knowledge on healthy body weight for children, thus failing to recognize that their children are obese. Educational interventions could reduce the rate of such mistake and subsequently alter parental care. Copyright © 2011 by Sociedade Brasileira de Pediatria