مجله دانشگاه علوم پزشکی رفسنجان
سال چهاردهم شماره 1 (پیاپی 72، فروردین 1394)

Exercise-based interventions have been used as an effective non-pharmacological alternative for both prevention and treatment of poor sleep in clinical and healthy people. The purpose of this study was to evaluate the efficacy of aerobic exercises on sleep quality of chronic psychiatric patients admitted in rehabilitation centres. This study was a clinical trial. The samples were 22 chronic psychiatric male patients of rehabilitation centres in Ardabil that selected by simple random sampling and randomly assigned in experimental and control groups. The experimental group has received 10 sessions (each session lasted 45 minutes) aerobic exercise and the control group received no intervention. Data were gathered with Pittsburgh Sleep Quality Index (PSQI) and analyzed using chi-square test and analysis of covariance (ANCOVA). The results showed that the post-test scores mean of experimental group were lower than control group in components of subjective sleep quality (0. 36)، delay in sleeping (0. 73)، sleep duration (0. 09)، use of soporific medications (0. 89)، daily dysfunction (0. 09) and total score of sleep quality (2. 27) (p<0. 05) and 19%-75% of these scores variances explained with reception and no reception of intervention. Planning of aerobic exercises in daily routine of psychiatric patients admitted to rehabilitation centres can prevent secondary and related problems induced from sleep disorders by improving of patient''s sleep quality.

Infertility is a stressful experience for women which require high levels of emotional adjustment. The aim of this study was to investigate the relationship between attachment styles and ego-strength with adjustment to infertility in women. The design of the present study was descriptive. A total number of 346 women referring to infertility clinic of Valie-asr Reproductive Health Research Centre (Tehran Imam Khomeini Hospital) participated in the study. Data was collected via demographic information questionnaire، Adult Attachment Inventory (AAI)، Ego-Strength Scale (ESS) and Adjustment to Illness Scale (AIS). There were significant positive correlation between secure attachment style and adjustment to infertility (r=0. 12، p<0/05) and significant negative correlation between adjustment to infertility and avoidant attachment style (r=-0. 21، p<0/01) and ambivalent attachment style (r=-0. 37، p<0. 01). There were also significant positive correlation between ego-strength and adjustment to infertility (r=0. 41، p<0. 01). Many of the treatments also had significant negative correlation with adjustment to infertility (r= -0. 35، p<0. 01). In regression analysis، ego-strength، ambivalent attachment style and number of the treatments predicted 35 percent of the variance of adjustment to infertility. These results can be helpful in identifying the high risk patients and planning psychological interventions.

Nurses are people who do important works in hospitals. Studies have shown that the strain level among nurses has inverse relation to the quality of care provided by them. One of the factors that can affect the nurse''s behavior and performance in the workplace is mental workload. The aim of this study was to assess the mental workload and its affected factors among the nursing staff. This descriptive study was conducted among the nursing staff of Kashan educating hospitals during 2014. Sampling was performed by census among 480 nurses at six Treatment center. Demographic information and mental workload data were gathered by using demographic information questionnaire and NASA task load index، respectively. The data were analyzed by using t-test، one way ANOVA and Pierson correlation confession analytical tests. Effort score (78. 61±18. 15) and frustration score (47. 82±30. 91) obtained the highest and lowest rates. Total mental workload was estimated 69. 54±15. 71. There was significant relationship between mental workload factors and age، shift working and type of contract. But، there was no significant relationship between mental workload and work experience work duration and working unit. The mental workload among the nursing staff is high. According to the relationship between mental workload aspects، performing the corrective actions in order to reduce each aspects can affect on mental workload perfectly.

Infant mortality rate (IMR) is one of the most important sensitive indicators of the socio economic and health status of a community. The aim of this study is to investigate the infant mortality rate (IMR) during 2001-2011 in Fars province and study socio economic factors that influence IMR. This is a quantitative study. Data was gathered from death registration of Ministry of Health (2001-2011)، National Organization for Civil Registration and DHS (2000). In model development، logistic regression was utilized to determine the significance of socioeconomic indicators on IMR. According to death registration data،total IMR has been declining from 15. 9 per 1000 live birth in 2001 to 13. 7 in 1000 live birth in 2011. The result of logistic regression analysis showed that a positive significant relation (p ≤ 0. 05) exists between IMR and predictive variables such as mother''s age at birth، experience of still-birth، experience of abortion، number of children and a negative significant relation (p ≤ 0. 05) exists between IMR and variables including parental education، mother''s age at marriage، health index، settlement، and economic index. As study indicated، 13. 8 % decline was registered for the decade (2001-2011). The next improvements are mall due to stochastic levels of infant mortality. However efforts to promote maternal and child care along with more training and counseling could be effective in more declines in IMR.

Continuity of breast-feeding up to 6 months may be associated with some challenges for some mothers. Probably، the maternal personal characteristics such as their emotions can change the breast-feeding patterns. The aim of this study was to determine maternal affectivity and the pattern of breast-feeding. In this cross-sectional study، affectivity and beast-feeding patterns of 412 mothers was surveyed by Watson''s PANAS-X and researcher made questionnaires and through face to face interviews. Systematic random sampling was done by using health care centers list in last 6 months. Data was analyzed using chi-square test، t-test، Fisher''s exact and one way ANOVA test. Overall 69. 5% mothers had exclusive breast-feeding for 6 months. Mothers who had preterm infants had higher mean score of negative affectivity (p=0. 042) and those who had exclusively breast-feeding had lower mean score of negative affectivity (p=0. 005). The mean scores of positive affectivity in mothers who had been started the first breast-feeding during the first hour after birth، were higher (p= 0. 040). Mothers with negative affectivity might be considered as a predictive factor for her breast-feeding performance.

The most important goal of clinical researches is publishing the results in order to improve human health. If the results will be accepted by the scientific community، researcher aim would be achieved at improving public health. A published article does not guarantee the acceptance of its findings by the scientific community، hence، research should be done by considering a scientific plan. Due to the increasing amount of research studies، experts attempted to provide guidelines for standardization of a piece of scientific medical research. Researches related to the diagnostic tests، are important studies in medical sciences، it is because of their critical role in detection of many diseases by using laboratory processes such as microbiology، immunology، pathology، etc. Early diagnosis of diseases results in developing the treatment process and therefore controlling and inhibiting the spread of pathogens from patients to others. With regard to the fact that Iran placed among the 30 countries leading in publication of scientific journals related to diagnostic tests and according to important role of standardization of research design and final report of diagnostic tests، the present study was performed to introduce the STandards for the Reporting of Diagnostic accuracy studies (STARD).

Although intracranial pressure (ICP) monitoring is considered as the standard care for traumatic brain injuries، it is not routinely used in Iran. Hence، the purpose of this study is to reveal the primary results of the applying ICP monitoring in patients with traumatic head injuries in Bahonar Hospital in Kerman. The present study is a cross-sectional one in which all the patients with traumatic brain injuries referred to this given center and received the ICP monitoring were evaluated. We examined the clinical and imaging findings at admission as well as mortality and the complications related to the ICP catheter. The outcome was assessed according to the Glascow Outcome Scale (GOS) at six months after occuring trauma. The data were analyzed using t-test for quantitative variables and Chi-square test for categorical ones. Eighteen patients with traumatic brain injury were undergone ICP monitoring during this time. Eight operations were performed on 6 patients based on their ICP. All the three patients with refractory high ICP died during hospital admission. Higher primary GCS and reactive pupil، were related to the better GOS scores six months after trauma. It seems that ICP monitoring is a safe and effective treatment modality in patients with traumatic brain injury. However، it is necessary to conduct more studies with a large sample size and control group.

The D-test is performed by placing clindamycin and erythromycin impregnated disks at a standard distance on the agar plate then looking for the flattening of inhibition zone around the clindamycin disk. A positive D-test indicates clindamycin inducible resistance and also predicts treatment failure possibility of this antibiotic in clinic. Prevalence of staphylococcal inducible resistance to clindamycin through the D-test was the aim of this study. In this descriptive-cross-sectional study، inducible resistance to clindamycin was examined on the 150 isolated Staphylococcus aureus (n=103) and coagulase-negative staphylococci (n=47) collected from nasal employees and clinical samples by using D-test. The statistical analysis was performed using chi-square test. Out of 103 isolated S. aureus، 22 (21. 4%) were methicillin-resistant (MRSA). Among the tested samples، 3 (2%)، 1 (0. 6%) and 2 (1. 3%) had D، D+ and HD phenotypes، respectively. Fifty-four (36%) of isolations exhibited resistance to both clindamycin and erythromycin. Prevalence of resistance to clindamycin and erythromycin between isolated MRSA and methicillin-susceptible S. aureus (MSSA) was statistically significant (p<0. 05). Phenotypical resistance to erythromycin is not always attributable to clindamycin resistance. Therefore، staphylococcus strains resistant to erythromycin and susceptible to clindamycin should be subjected to D-test assay.