Effect of foot reflexology on anxiety and agitation in patients under mechanical ventilation after open heart surgery: A randomized clinical trial study

زمینه و هدف: رویکردهای غیر دارویی از جمله ماساژ بازتابی پا به علت کاهش عوارض و هزینه ها در کانون توجه محققین در جامعه بیماران مختلف قرار گرفته است. این مطالعه با هدف بررسی تأثیر ماساژ بازتابی پا بر اضطراب و بیقراری بیماران تحت تهویه مکانیکی پس از جراحی قلب باز انجام شد. روش بررسی: این مطالعه کارآزمایی بالینی کنترل شده، سه گروهی و دو سو کور با طراحی اندازه گیری مکرر در دو بیمارستان وابسته به دانشگاه علوم پزشکی بقیه الله (عج) تهران، از بهمن1392 تا اردیبهشت 1393 انجام شد. 96 بیمار کاندید جراحی قلب باز به روش نمونه گیری در دسترس انتخاب و به صورت تخصیص تصادفی در سه گروه آزمون (ماساژ بازتابی پا 34 نفر)، درمان نما (تماس سطحی پاشنه پا 30 نفر) و کنترل (مراقبت های معمول 32 نفر) قرار گرفتند. در گروه آزمون، ماساژ بازتابی پا به مدت20 دقیقه بر روی نقاط بازتاب قلب و ریه، انجام شد. میزان اضطراب و بیقراری بر اساس مقیاس سنجش اضطراب (FAS) و مقیاس سنجش بیقراری ریچموند (RSAS) در 6 مرحله زمانی ثبت شد. یافته ها: داده های آماری 92 بیمار (31 نفر گروه آزمون، 30 نفر گروه درمان نما و 31 نفر گروه کنترل) جمع آوری گردید. در مقایسه روند تغییرات سطح اضطراب و بیقراری، آزمون درون گروهی فریدمن نشان داد، بین میانگین سطح اضطراب و بیقراری در گروه ها در مراحل زمانی مختلف تفاوت معنی دار آماری وجود دارد. همچنین آزمون کروسکال والیس نشان داد میزان اضطراب و بیقراری بین سه گروه در مراحل مختلف زمانی تفاوت معنی دار آماری با یکدیگر ندارند. نتیجه گیری: ماساژ بازتابی پا در نقاط بازتابی مربوط به قلب و ریه تغییر معنی داری در کاهش اضطراب و بیقراری بیماران پس از جراحی ایجاد نکرد

A Qualitative Inquiry into the Illocutionary Speech Acts Performed by Iranian EFL Learners in Facebook

The purpose of this qualitative study was to investigate speech acts performed by Iranian EFL learners on the social network of Facebook in their interaction with their teacher and with their peers in response to divergent and evaluative questions. A page was constructed for the students in order to provide the opportunity for their answering divergent and evaluative questions posed by the researchers. A total of 240 comments including 1680 speech acts were collected from five EFL students during an academic semester. Content analysis of the collected data revealed that participants primarily used expressive speech acts in response to divergent questions and directive speech acts in response to evaluative questions. The results also revealed differences in using emoticons regarding the difference in power relations between the teacher and students. Further findings and implications are discussed in the paper

Implementation of self-management support in cancer care and normalization into routine practice: a systematic scoping literature review protocol.

BACKGROUND: Cancer survivors face a myriad of biopsychosocial consequences due to cancer and treatment that may be potentially mitigated through enabling their self-management skills and behaviors for managing illness. Unfortunately, the cancer system lags in its systematic provision of self-management support (SMS) in routine care, and it is unclear what implementation approaches or strategies work to embed SMS in the cancer context to inform health policy and administrator decision-making. METHODS/DESIGN: A comprehensive scoping review study of the literature will be conducted based on methods and steps identified by Arksey and O'Malley and experts in the field. Electronic searches will be conducted in multiple databases including CINAHL, CENTRAL, EMBASE, PsycINFO, MEDLINE, AMED, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE) (up to Issue 2, 2015), ISI Proceedings (Web of Science), PsychAbstracts, and Sociological Abstracts from January 1997 to November 5, 2018. Following the PRISMA-Extension for Scoping Reviews (PRISMA-ScR), two authors will independently screen all titles/abstracts to determine eligibility, data will be abstracted by one author and checked by a second author, and findings will be narratively summarized based on constructs of implementation in the Normalization Process Theory. DISCUSSION: This will be the first scoping review study to synthesize knowledge of implementation of SMS in the cancer care context and the implementation approaches and strategies on embedding in care. This information will be critical to inform health policy and knowledge end users about the necessary changes in care to embed SMS in practices and to stimulate future research

Treatment of Levodopa-induced dyskinesia with Vitamin D: A Randomized, double-blind, placebo-controlled trial

Dyskinesia refers to any involuntary movement, such as chorea, dystonia, ballism that affect any part of the body. Levodopa-induced dyskinesia is a neurological disorder that afflicts many patients with Parkinson disease usually 5 years after the onset of levodopa therapy and can cause severe disability. The pathophysiology of this dyskinesia is complex and not fully understood. However, the association between vitamin D and Parkinson disease is interesting. The present study was conducted to evaluate the effect of vitamin D on levodopa induced dyskinesia in patients with Parkinson’s disease .In this Double blind clinical trial, 120 patients with PD divided into two groups randomly, vitamin D and placebo group. A dose of 1000 IU/d was selected, Demographic information is registered. In the first visit, three variables have been measured which were the duration, severity of dyskinesia and unified Parkinson’s disease rating scale (UPDRS). These variables were measured again after 3 months and the data was analyzed using SPSS 22. There are no differences between two groups after 3 months. This study revealed, vitamin D has no effects on improvement of levodopa induced dyskinesia

A novel homozygous variation in the PANK2 gene in two Persian siblings with atypical pantothenate kinase associated neurodegeneration

Pantothenate Kinase-associated Neurodegeneration (PKAN) is an autosomal recessive disorder that is caused by variation in pantothenate kinase-2 gene (PANK2) gene on chromosome 20. The common presentation of this disease includes progressive dystonia, Parkinsonism, retinopathy, cognitive impairment, and spasticity. The typical magnetic resonance imaging finding is eye of the tiger sign in globus pallidus and not pathogenic and not found in all patients. In the present study, we describe two siblings who have a novel variation of the PANK2 gene. These patients with the same genotype, have different ages at the onset of disease and also the various severity of the disease. The description of these cases helps to understand this disease, its symptoms, pathogenesis, and its treatment

Symptomatic Unilateral Subdural Effusion as the First Presentation of Suprasellar Arachnoid Cyst

Background and Importance: Arachnoid cysts are benign nontumoral lesions that are usually found incidentally in brain imaging. Suprasellar Arachnoid Cysts (SSACs) are rare. They can cause hydrocephalus and increased intracranial pressure, lower cranial nerve impairment and endocrine disorder. Sometimes arachnoid cysts become complicated by subdural hematoma/hygroma.  Case Presentation: We describe a patient with a suprasellar arachnoid cyst that was complicated with symptomatic subdural effusion and increased intracranial pressure after minor trauma. Conclusion: Although these cysts are rarely complicated with subdural hematoma/hygroma, and intracystic hemorrhage, the probability of subsequent subdural hygroma and increased intracranial pressure should not be underestimated

Correlation of nanostructural parameters and macromechanical behaviour of hyperbranched-modified polypropylene using time-resolved small-angle X-ray scattering measurements

Polypropylene (PP) is modified utilizing a poly(ester amide)-based hyperbranched polymer (PS). A maleic-modified PP is used to enhance the compatibility. Usual tensile experiments are carried out. The nanocrystalline structure is studied using small-angle X-ray scattering (SAXS) while a uniaxial mechanical load is simultaneously applied. SAXS patterns are analysed using procedures written in PV-WAVE. The chord distribution function (CDF) is calculated and nanostructural parameters such as long period (lp) and nanodeformation (ϵNano) are extracted. The correlations between macromechanical parameters and nanostructures are studied. Mechanical results show that PS has a plasticizing effect. Reactively blended samples demonstrate enhanced mechanical properties. SAXS patterns reveal a well-known structure of PP as a peculiar architecture of the nanostructure. Crystalline branching occurs in a geometry that is known as a mother–daughter crystal lamellar structure, also called a crosshatching structure. It is concluded that adding PS distorts the stacking of crystalline domains. The structural information from SAXS patterns in reciprocal space is visualized in real space in the calculated CDFs. The CDFs indicate that in simple blends, lp of the crystalline stacks increases compared to blank PP. Nevertheless, reactively blended samples show an increase of lp compared to blank PP; however, they possess smaller lp compared to simple blends

Nevasic audio program for the prevention of chemotherapy induced nausea and vomiting: A feasibility study using a randomized controlled trial design.

PURPOSE: Pharmacological therapy is only partially effective in preventing or treating chemotherapy induced nausea and vomiting (CINV). Therefore, exploring the complementary role of non-pharmacological approaches used in addition to pharmacological agents is important. Nevasic uses specially constructed audio signals hypothesized to generate an antiemetic reaction. The aim of this study was to examine the feasibility of conducting a randomized controlled trial (RCT) to evaluate the effectiveness of Nevasic to control CINV. METHODS: A mixed methods design incorporating an RCT and focus group interviews. For the RCT, female breast cancer patients were randomized to receive either Nevasic plus usual care, music plus usual care, or usual care only. Data were analysed using descriptive statistics and linear mixed-effects models. Five focus group interviews were conducted to obtain participants' views regarding the acceptability of the interventions in the trial. RESULTS: 99 participants were recruited to the RCT and 15 participated in focus group interviews. Recruitment targets were achieved. Issues of Nevasic acceptability were highlighted as weaknesses of the program. This study did not detect any evidence for the effectiveness of Nevasic; however, the results showed statistically significant less use of anti-emetics (p = 0.003) and borderline non-significant improvement in quality of life (p = 0.06). CONCLUSIONS: Conducting a non-pharmacological intervention using such an audio program is feasible, although difficulties and limitations exist with its use. Further studies are required to investigate the effectiveness of Nevasic from perspectives such as anti-emetic use, as well as its overall effect on the levels of nausea and vomiting.This work was supported in part by funding from the Cancer Experiences Collaborative (CECo), a Research Collaborative funded by the National Cancer Research Institute in the UK; and Mashhad University of Medical Sciences in Iran. We are grateful to DAVAL Ltd, UK for providing us with Nevasic CDs and CD players free of charge for the purposes of this study