A Report on Results of a Qualitative Study on the Factors affecting the Implementation of Clinical Back Pain Guide

Introduction: Today, the use of clinical guidelines is increasing. Unfortunately, their use in therapeutic clinics is facing barriers.   The purpose of this study is to investigate the barriers to the use of clinical guidelines to try to resolve them. Methods and Materials: Qualitative study method was used to study the barriers of using clinical guidelines. 15 physiotherapists from the private and public centers of Tehran participated in the study. In one interview, all of their comments were recorded in relation to the clinical management of back pain. Results: After interviewing each other, their views were summarized and eventually classified into five groups. Conclusions: Despite the positive attitude of interviewed people towards using clinical guidelines, the results showed that there are significant barriers in this regard. Some of the most important barriers are: Content validity of the guide , Individual attitudes , Authorities influencing the implementation process , Financial factors and Publishing and implementation strategyKeyword : Low Back Pain Guideline, Guideline Implementation, Impliments Barrier

Analyzing Cytotoxic and Apoptogenic Properties of Scutellaria litwinowii Root Extract on Cancer Cell Lines

The Scutellaria species (Lamiaceae) is used as a source of flavonoids to treat a variety of diseases in traditional medicine. In spite of many reports about the cytotoxic and antitumor effects of some species of this genus, anticancer researches on one of the Iranian species S. litwinowii have not yet been conducted. The cytotoxic properties of total methanol extract of S. litwinowii and its fractions were investigated on different cancer cell lines including AGS, HeLa, MCF-7, PC12 and NIH 3T3. Meanwhile, the role of apoptosis in this toxicity was explored. The cells were cultured in DMEM medium and incubated with different concentrations of herb plant extracts. Cell viability was quantitated by MTT assay. Apoptotic cells were determined using propidium iodide staining of DNA fragmentation by flow cytometry (sub-G1 peak). Scutellaria litwinowii inhibited the growth of malignant cells in a dose-dependent manner. Among solvent fractions of S. litwinowii, the methylene chloride fraction was found to be more toxic compared to other fractions. The IC50 values of this fraction against AGS, HeLa, MCF-7 and PC12 cell lines after 24 h were determined, 121.2 ± 3.1, 40.9 ± 2.5, 115.9 ± 3.5 and 64.5 ± 3.4 μg/ml, respectively. Scutellaria litwinowii induced a sub-G1 peak in the flow cytometry histogram of treated cells compared to control cells indicating that apoptotic cell death is involved in S. litwinowii toxicity. Scutellaria litwinowii exerts cytotoxic and proapototic effects in a variety of malignant cell lines and could be considered as a potential chemotherapeutic agent in cancer treatment

Low back pain:Moving toward mechanism-based management

Low back pain is a complex, multifactorial, and heterogeneous condition, but this does not make it an exception in medicine. Management of low back pain based on a mechanistic approach and developing more effective multidisciplinary treatment is possible and would finally implement the biopsychosocial model of care

The Comparative study of the effect of ethical valuation different criteria on economic policy making and its implications for Islamic economics

Although economists typically try to make their theories free from ethical evaluations, their theories are value laden. In this paper, we examine the impact of ethical schools on economic policies. The findings of the paper show that consequential, deontological, virtue-based and rights-based ethics have a particular impact on economic policy making. These approaches, while affecting the definition of the goals of economic policies, provide the basis for establishing the principles that define the framework of economic policies for achieving those goals. The result of this trend is that neoclassical utilitarian economists, with an emphasis on the role of complete competition market for achieving welfare, propose price policies to compensate market failure. The policy orientation in the capability-based approach of Sen and rights-based Contractarianism of Rawls, through the creation of changes in the structure of the market and the introduction of new institutions, is respectively, human development and the provision of basic goods to the poorest of the community. The feminist virtue-based economists also propose the promotion of the role of women's caring activities in their policy orientations

Electrochemical exfoliated graphene oxide nanosheets modified graphite electrode for clozapine sensing

Graphene oxide nanosheets (GONs) are ideally suited for implementation in electrochemical applications due to their large electrical conductivity, large surface area and low production costs. In this research, electrochemical exfoliated graphene oxide-modified graphite electrode was developed for voltammetric determination of clozapine (CLZ). The dependence of oxidation peak current on the pH of the solution, scan rate and concentration of analyte were studied to optimize the experimental conditions for electrochemical determination of CLZ. The experimental results suggested that the modified electrode promoted electron transfer reaction for the oxidation of CLZ. The modified electrode exhibited high effective surface area, more reactive sites and excellent electrocatalytic activity toward the oxidation of CLZ. In the concentration range of 0.75–100 µM of CLZ in citrate buffer solution (CBS, pH 6), the anodic peak currents, measured via differential pulse voltammetry (DPV), presented good linear relationship with limit of detection (LOD) of 2.15 nM and good sensitivity of 0.0477 µA µM−1. The proposed method was successfully applied to quantify the amount of CLZ in the blood serum and plasma of schizophrenia patient

Additively manufactured porous scaffolds by design for treatment of bone defects

There has been increasing attention to produce porous scaffolds that mimic human bone properties for enhancement of tissue ingrowth, regeneration, and integration. Additive manufacturing (AM) technologies, i.e., three dimensional (3D) printing, have played a substantial role in engineering porous scaffolds for clinical applications owing to their high level of design and fabrication flexibility. To this end, this review article attempts to provide a detailed overview on the main design considerations of porous scaffolds such as permeability, adhesion, vascularisation, and interfacial features and their interplay to affect bone regeneration and osseointegration. Physiology of bone regeneration was initially explained that was followed by analysing the impacts of porosity, pore size, permeability and surface chemistry of porous scaffolds on bone regeneration in defects. Importantly, major 3D printing methods employed for fabrication of porous bone substitutes were also discussed. Advancements of MA technologies have allowed for the production of bone scaffolds with complex geometries in polymers, composites and metals with well-tailored architectural, mechanical, and mass transport features. In this way, a particular attention was devoted to reviewing 3D printed scaffolds with triply periodic minimal surface (TPMS) geometries that mimic the hierarchical structure of human bones. In overall, this review enlighten a design pathway to produce patient-specific 3D-printed bone substitutions with high regeneration and osseointegration capacity for repairing large bone defects

The Effectiveness of CBTAC Protocol on Burdens of Alzheimer’s Disease on Caregivers and their Sense of Coherence

Background: Alzheimer's disease is predicted to increase dramatically in the near future. Alzheimer caregiving brings about serious problems for caregivers. Considering corrosive consequences of Alzheimer’s disease on Alzheimer caregivers, finding an effective intervention is necessary. Thus, the present research was conducted by the aim of investigating the effectiveness of CBTAC protocol on burdens of Alzheimer’s disease on caregivers and their sense of coherence.Methods: This study was a quasi-experimental research with pretest-posttest control group design. The target population included all mild Alzheimer’s disease patients and their caregivers referred to neurology ward of the hospitals in Rasht during summer 2018. According to the medical records and results of screening, 40 mild Alzheimer’s disease patients and their caregivers were recruited by convenience sampling method. After sampling, research participants were randomly assigned into two experimental (n= 20) and wait list control (n= 20) groups. The Impact of Alzheimer’s Disease on Caregiver Questionnaire and Sense of Coherence Scale were used to measure burdens of Alzheimer’s disease on caregivers and caregivers’ sense of coherence. The CBTAC provided for the experimental group participants in 25 sessions of 90-minutes. In the end, the data analyze have done by multivariate analysis of covariance (MANCOVA) and using SPSS24 software.Results: The findings indicated that the CBTAC had significant effect on burdens and sense of coherence of Alzheimer caregivers in experimental group (p <0.01). In other words, the CBTAC decrease burdens and increase sense of coherence of Alzheimer caregivers significantly (p <0.01).Conclusion: Based on research results, the CBTAC is an effective intervention in decreasing caregiving burden and increasing sense of coherence of Alzheimer caregivers. Therefore, the CBTAC is a multicomponent intervention that can be used to improve competency and mental health of Alzheimer’s caregivers