مجله تحقیقات نظام سلامت
سال پانزدهم شماره 4 (زمستان 1398)

Osteoarthritis is the most common arthritis that can lead to chronic pain and severe disability in patients. Researchers are looking for new treatments that are effective with fewer side effects. Curcumin is a beneficial ingredient in turmeric with anti-inflammatory properties and plays an important role in the protection of the joints against destructive factors. Gingerol and piperine are the effective ingredients of ginger and black pepper, respectively, that may lead to the reinforcement and continuation of the effect of curcumin. The aim of the present study was to determine the efficacy of turmeric, ginger, and black pepper extracts in pain and functional improvement of patients with chronic knee osteoarthritis in comparison to that reported for naproxen.

A total of 60 patients with knee osteoarthritis grades 2 and 3 were enrolled in this study. The subjects were randomly divided into two groups to receive naproxen capsule or extracts of turmeric, ginger, and black pepper (mixodin capsule) every day for 4 weeks. The pain and performance scores of the subjects were evaluated at the initiation and end of the study. Moreover, the pain levels were measured using the visual analog scale. The performance changes were also assessed by the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire. Food intake (24hour dietary recall) was recorded at the initiation, during, and at the end of the study.

Out of 60 volunteer patients, 30 subjects in the mixodin group and 30 cases in the naproxen group completed the study. According to the obtained results, the pain score and performance of the patients decreased significantly (P=0.001). However, there was no difference in the level of pain reduction between the groups.

The results of this study revealed that the administration of mixodin twice a day for 4 weeks similar to naproxen can improve the pain score and performance of patients with chronic knee osteoarthritis.

In recent years, Acceptance and Commitment Therapy (ACT) has been widely used, with an emphasis on accepting problems as an integral part of human life and increasing psychological flexibility. In this regard, the current study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) on the body image of women with breast cancer after mastectomy surgery.

This study was a quasi-experimental study with pre-test and posttest design with the experimental and control groups. The study population consisted of 26 patients who were selected by purposeful sampling from "Alla Charity Center" in Isfahan in 2015 and were randomly assigned to two groups of 13 cases. The experimental group received ACT in 8 one-hour weekly sessions. The Multidimensional Personality Attitude Questionnaire (1990) was completed by both experimental and control groups in the pretest and post-test stages. The obtained results were analyzed in SPSS software.

The results of covariance analysis revealed that there was a significant difference between the mean scores of body image and its dimensions in the experimental and control groups. Moreover, it was found that ACT was effective in the improvement of body image in patients of the experimental group (P<0.05).

As evidenced by the obtained results, the ACT can be of great help in the alleviation of psychological problems in women with breast cancer.

Health literacy (HL) is the capacity to obtain, process, and understand basic health information and the required services to make proper health decisions, which empowers the individuals to perform self-care behaviors. This study aimed to determine the relationship between health literacy and self-care in patients with type 2 diabetes.

This cross-sectional study was conducted on 390 patients who referred to rural health centers with type 2 diabetes in Babol, Iran, during 2017. The data were collected using Health Literacy for Iranian Adults and the Summary of Diabetes Self-Care Activities. Furthermore, the data were analyzed in SPSS software (version 20) through one-way ANOVA, t-test, and Pearson correlation coefficient.

According to the results, the mean±SD HL of the patients was 48.56±16.31. Moreover, the results revealed that 55.9% of the patients had an inadequate level of HL. Moreover, the mean±SD of self-care score was obtained at 50.77±15.18 in one week. The results also revealed no significant relationship between HL and self-care behavior (P=0.064). However, HL was significantly correlated with gender, age, marital status, educational level, occupational status, socioeconomic status, and disease duration (P<0.05). Furthermore, self-care behavior was significantly correlated with the number of family members, educational level, and disease duration (P<0.05).

Given that over 50% of the patients have an inadequate level of HL, and considering that demographic characteristics play an important role in HL and performing self-care behavior, it is suggested that health care providers include these issues while developing healthcare programs.

Dyslexia is one of the important factors affecting the lack of educational progress in elementary school students. Therefore, the purpose of this study was to evaluate the impact of perceptual-motor training on the reading performance of students with dyslexia in the girl students of the third grade of elementary school in Isfahan, Iran.

This pretest-posttest study was carried out on 30 subjects selected through the convenience sampling method from the students with dyslexia who referred to the learning disorder center of Isfahan. The subjects were randomly assigned into the two groups of intervention and control with 15 participants in each group. The students of the experiment group received ten two-hour sessions of individual perceptual-motor training, while the subjects in the control group did not receive any intervention. The research instruments used for this study included reading screening test, and Wechsler Intelligence Scale for Children. The reading screening test was completed both pretest and posttest.

Findings of the statistical analysis demonstrated that the total score of reading progress had a significant difference between the students of control and test groups. Moreover, it was revealed that perceptual-motor training could significantly affect diverse abilities, such as word separating, gap filling, text reading, and letter pronunciation (P<0.05). However, no significant difference was observed between the two groups of intervention and control in terms of word segmentation and spelling.

According to the results of this study, perceptual-motor training can be applied as a technique for improving the reading performance of students with dyslexia.

Prevalence of migraine is reported at 14.7% and 14% around the world and Iran, respectively. Zinc deficiency is recognized as one of the nutritional problems worldwide. People with migraines have lower levels of zinc, as compared to healthy individuals. The present study aimed to determine the effect of zinc supplementation on symptoms and C-Reactive Protein as a sensitive marker of inflammation among patients with migraine.

This double-blinded randomized clinical study was conducted on 80 patients with migraine in Isfahan, Iran, in 2016. Participants were randomly assigned to the intervention and control groups. The patients in the intervention and control groups received one daily dose of 220 mg zinc sulfate (50 mg zinc) and a placebo (starch) for 8 weeks. The symptoms of migraine attacks, including the severity of headache, frequency and duration of headache, headache diary result (HDR), and C-Reactive Protein (CRP) levels were measured for each patient at baseline and at the end of the trial.

At the commencement of the study, there was no significant difference between the two groups regarding migraine symptoms. In addition, the intervention decreased the severity (P=0.048), frequency (P = 0.026), and headache diary result (HDR) (P=0.02), as compared to the placebo. Nonetheless, the two groups were significantly different regarding the mean duration of headache attacks (P=0.092).

As evidenced by the obtained results, zinc supplementation for 8 weeks may be an effective treatment for migraine symptoms.

In recent decades, job strategies are moving toward generating motivation and satisfaction in employees. Most of the organizations are trying to apply these strategies to improve their efficiency and optimize their resources. Motivated employees are of remarkable importance for the success of an organization. With this background in mind, the present study aimed to investigate the intrinsic and extrinsic factors of job motivation among the employees of the health care network of Kuhdasht, Iran.

This descriptive-analytical study was performed through a crosssectional design. A total of 309 employees were selected through the random systematic sampling method from the statistical population consisting of the health care network staff. The data collection tool was the Herzberg questionnaire encompassing the intrinsic and extrinsic factors of job motivation. Data were analyzed by the Pearson and Spearman correlation tests, in addition to the independent t-test and one-way analysis of variance using the SPSS software version 20.

Our findings demonstrated that the mean score of the extrinsic factors of job motivation (80.4±9.02) was higher than the mean score of the intrinsic factors (56.02±9.4). The mean score of work nature among the intrinsic factors and the mean scores of income and job security among the extrinsic factors were found to be higher than the other variables. The experience of the staff and level of education were reported to have inverse relationships with the intrinsic and extrinsic factors, respectively. Moreover, the mean score of intrinsic factors and the total score of job motivation were significantly higher in female employees than their male counterparts. The mean score of intrinsic factors was significantly different between the employees of different occupational categories. The latter score was significantly higher among the staff of the health care and health services, compared to the administrative, financial, and service staff. Furthermore, the score of intrinsic factors and total score of job motivation had a statistically significant relationship with the type of recruitment. These scores were significantly lower in the staff of contractual employment, in comparison with other employees.

Although taking into consideration the intrinsic and extrinsic factors is important in job motivation, the nature of work, salary, income, and job security are of considerable value in terms of creating job motivation.

Multiple Sclerosis (MS) is a chronic progressive disease coinciding with the ages of social activities. Therefore, this disease is associated with significant effects on the quality of life and psychological status of these patients. It is well-accepted that the psychological status of patients is an effective factor in the process of treatment and living in chronic conditions. With this background in mind, the present study was conducted to identify the psychological status of these patients from their own perspective and specialists' viewpoints.

The current qualitative study was conducted with a thematic analysis approach. The participants of the current study included 24 MS patients with maximum diversity in gender, age, illness duration and severity, and 8 experts in neurology, psychiatry, clinical psychology, and nursing from Guilan province. Participants were selected by a purposive sampling method and the data were gathered through unstructured interviews which continued up to data saturation. Data analysis was performed using a thematic analysis approach by the Attride-Stirling method.

From the total information, three global themes, including individual problems, interactive problems, and disease-related problems were identified. Individual problems included: personality disorders, depression, sleep, cognitive, anxiety, physical, self-regulation, selfdestructive behaviors, psychosis, as well as substance and alcohol abuse. Interactive problems incorporated: interpersonal sensitivity, aggression, sexual, social, and dependence. In addition, disease-related problems involved reaction to disease.

As evidenced by the obtained results, patients with MS are involved in several psychological problems in individual, interactive and disease-related domains. Accordingly, it is necessary to develop and present psychological programs and interventions based on these problems in order to improve their mental status, quality of life, and adaptability.

Oral administration of astaxanthin may improve the symptoms of depression and cognitive function through its beneficial effects on inflammation and oxidative stress. This study was conducted to determine the effects of astaxanthin on depressive symptoms and cognitive performance in patients with type II diabetes mellitus.

This double-blind randomized placebo-controlled clinical study was performed on 44 patients with type II diabetes mellitus aged 30-60 years. The patients were randomized into two groups to receive 8 mg astaxanthin (n=22) or placebo (n=22) daily for 8 weeks. Changes in depression and cognitive performance were assessed by Beck Depression InventoryII (BDI-II) and Cognitive Functioning Questionnaire, respectively.

After 8 weeks of intervention, the baseline cognitive function score was significantly improved only in the astaxanthin group during the study (P<0.01). However, there was no significant decrease in the BDI-II score in any of the research groups.

As the findings indicated, astaxanthin supplementation in diabetic patients had positive effects on cognitive function over 8 weeks.

Anthracene is an organic compound and environmentally resistant pollutant that causes severe damage to human health due to toxic and carcinogenic properties. The present study aimed to investigate the efficiency of magnetic dendrimer nano-adsorbent for the removal of anthracene from aqueous solutions.

In this study, the synthesized iron oxide nanoparticles were modified by dendrimer polymer chains and 4-aminophenol ligand. The Fourier-transform infrared spectroscopy, X-ray diffraction, and scanning electron microscopy were conducted to examine the nano-absorbent properties. Different operational parameters in the adsorption process in batch and laboratory conditions were also studied, and the adsorbent reusability was correspondingly examined in this study. The residual concentration of anthracene in aqueous solution was determined and reported by a spectrophotometer.

Optimization results showed that the maximum adsorbent capacity under optimum conditions (pH=7, 20 mg/L anthracene concentration, 0.5 g/L adsorbent dosage, and 30 min contact time) was equal to 83 mg/g. The experimental data fitted with different isotherm models showed that the equilibrium data were well described by the Langmuir model. In this study, the adsorption process overlapped more with the pseudo-second-order kinetics model.

The obtained results indicated that the synthesized nanostructured adsorbent has a high adsorption capacity with high recovery and is efficient enough to remove anthracene from aqueous solutions.

Training has an important role in decreasing accidents and increasing safety level in workplaces. The aim of this study was to compare the effect of in-person training with that of virtual training on using personal protective equipment among the workers of an open stone quarry.

This study was conducted on 75 workers of an open stone quarry in 2018. The study population was divided into three groups of control, inperson training, and virtual training. The educational content was compiled by the researchers and then confirmed by a group of experts. Data regarding the use of personal protective equipment at workplace were collected by means of a questionnaire both before and after training. Data analysis was performed using the Chi-square test, paired sample t-test, and ANOVA.

The results revealed no significant difference among the research groups before training in terms of using personal protective equipment (P>0.05). However, after training, there was a significant difference among the groups in this regard (P<0.003). Accordingly, the rate of using safety helmet and mask increased in both virtual training (P=0.005 and P=0.0001, respectively) and in-person training (P=0.043 and P=0.0001, respectively) groups as compared to that in the control group (P˂0.05).

The findings of this study showed that in-person and virtual training methods were effective in increasing the adoption of personal protective equipment and safety behaviors. It seems that the use of virtual training as an alternative or complementary method for traditional methods can be an appropriate approach for retraining and improving self-care and safety behavior among the workers of the quarries.