مجله سلامت جامعه
سال پانزدهم شماره 1 (بهار 1400)

Aging is associated with some gradual physiological changes in body systems, including a decrease in muscle strength and range of motion, an increase in reaction time, as well as alterations in balance and sensory systems. Physical activity can be used to prevent, delay, or treat age-related problems. The study aims at specifying the effects of vestibular exercises on the balance performance of inactive elderly.

This study was a quasi-experiment conducted in Karaj in 2019, with pre-test, post-test, and control groups in which 40 inactive male volunteers older than 60 years were randomly assigned into an experimental group (20) and a control group (20). The experimental group participated in vestibular exercises for twelve sessions (three 45-minute sessions per week). The dynamic balance test was used to measure equilibrium performance. The one-way ANCOVA (analysis of covariance) was used to analyze the data.

The results of covariance analysis indicated a significant difference in the mean of balance performance between experimental group and control group after the intervention (p<0.05). The score of balance performance in the experimental and control groups was 19.45±0.23 and 20.55±0.15, respectively, indicating enhanced balance performance in the experimental group.

Considering the effects of vestibular exercises on the enhancement of balance performance of the elderly, it is suggested that planning these exercises be mandatory for the elderly community. Poor balance and fall risk in the elderly can be prevented through appropriate vestibular exercises.

The identification of risk factors for breast cancer has an important role in examining the status of cancer care system. Therefore, the present study was conducted to determine the relationship between reproductive factors and breast cancer in women aged 35 to 70 years based on the data from the first phase of Shahedyeh Cohort Study (SCS) in Yazd province.

This descriptive, cross-sectional study was conducted using the data from the first phase of SCS in Yazd province in 2015-2017. In this study, 4820 women aged 35 to 70 years were investigated, including 25 (0.6%) with a history of breast cancer and 4795 (99.4%) without any history of breast cancer. The data used in this study included demographic and reproductive histories of the women. The data were analyzed using Chi-square, t-test, and logistic regression.

The results showed that breastfeeding for less than 11 months increases the chance of breast cancer by 2.78 times, hormone therapy after menopause by 2.07 times, the onset age of menopause ≥46 by 1.71 times, having a history of abortion by 1.63 times, taking contraceptive pills by 1.59 times, age at menarche ≤13 by 1.49 times, and being overweight and obesity by 1.45 times.

According to the results, breastfeeding for less than 11 months, hormone therapy after menopause, the onset age of menopause after 46 years, and taking contraceptive pills were the most important risk factors for breast cancer.

The decline of communication between couples and the occurrence of burnout can bring about potentially harmful and dangerous effects and consequences for couples and children. Both couple therapy based on acceptance and commitment and cognitive-behavioral couple therapy are valuable and evidence-based approaches that a great deal of research has supported. . Therefore, this study was conducted to compare the effectiveness of cognitive-behavioral couple therapy and acceptance and commitment couple therapy in reducing marital burnout in couples.

This study was a quasi-experimental study with pretest, posttest and control group with 2-month follow-up. The statistical population included all couples who visited Mehrsai Counseling and Psychotherapy Center in Ashkhaneh in 2019, among whom, 60 people were selected by  convenience sampling technique and assigned to three equal groups. Therapeutic interventions were applied for each of the two couple therapy approaches in 12 sessions, 1 session per week and 90 minutes per session. But the control group did not receive any medical intervention. The Pines couple burnout measurement was used to collect data. Data were analyzed by descriptive statistics and repeated measures analysis of variance/ repeated measures ANOVA.

According to the results of this study, the two approaches to couple therapy made significant changes in reducing marital burnout and its dimensions in the post-test and 2-month follow-up stages(p<0.05), and there was no significant difference between the effectiveness of these two treatments(p>0.05).

Overall, the findings of the present study provide empirical support for both therapeutic approaches to reduce marital burnout in couples, and the knowledge of family and marital therapists about these therapies can be helpful.

Menopausal vasomotor symptoms are one of the major issues reducing women's quality of life. Thus, this study aims to determine the effectiveness of gratitude meditation on perceived stress caused by vasomotor symptoms in postmenopausal women.

The present study was quasi-experimental, and its design was pretest-posttest with follow-up (one month later). The statistical population was women aged 55-45 in Tonekabon with normal menopause and vasomotor symptoms (hot flashes and night sweats) and records in health centers in 2019. Participants were selected by eligible methods after obtaining informed consent; then, they were randomly divided into two groups of 15 experimental and control. The experimental group was trained in the 8-week gratitude meditation program based on the "Greenberg" Meditation Instruction (2010) and the Islamic Gratitude Meditation program of "Esfahanians" et al. (2016), while the control group did not receive any intervention. The instrument used was Cohen Perceived Stress Questionnaire (1983). Data were entered into Spss16 software and analyzed by repeated-measures analysis of variance.

There was a significant difference between the experimental and control groups in terms of mean perceived stress, which was stable until the follow-up stage.

Gratitude meditation is a method appropriate to Iranian women and can be used to reduce their perceived stress during menopause.

According to the World Health Organization, heart disease is the leading cause of death, and lifestyle changes can reduce the incidence of heart disease. Therefore, this study aims to determine the effect of cognitive-behavioral stress management training on anxiety, depression, and resilience of coronary heart disease patients.

This study was an educational trial with pre-test, post-test, and control group design. The statistical population of the study consisted of all men with coronary heart disease referred to the heart clinic of Tohid Hospital in Sanandaj. By purposive sampling method, 30 people were selected and divided into experimental (n=15) and control (n=15) groups, which completed the Resilience Scale and the Depression-Anxiety-Stress Scale. In the experimental group, cognitive-behavioral stress management training was conducted in 10 sessions, a 1-hour session per week; however, the control group did not receive the training program. After training, the groups were retested. Data were analyzed using independent and paired t-tests and multivariate analysis of covariance.

The results showed that the educational intervention of stress management by cognitive-behavioral method had a significant positive effect on reducing depression and anxiety (p < 0.05) in the experimental group in the post-test stage. The difference between the mean resilience scores of the subjects in the two groups in the post-test stage was statistically significant (p < 0.05).

The findings suggest that the cognitive-behavioral stress management intervention can be effective as a selective psychotherapy method and also a supplement in the medical treatments of cardiovascular patients. Therefore, it benefits to consider this kind of option as a part of the treatment plan for patients with cardiovascular diseases.

Falls have dangerous consequences, high prevalence, long-term effects, and significant costs among the elderly. The present study aimed at determining the effect of resistance and hydrotherapic exercises and on the balance and reaction time in the elderly with mild cognitive impairment.

The present study was a quasi-experimental pretest-posttest one with a control group. From among women with mild cognitive impairment referring to medical centers in Kermanshah in the spring of 2019, as many as 30 people were selected by using random convenience sampling. They were then randomly assigned into two groups i.e. experimental and a control (10 samples in each group). The experimental groups practiced for 8 weeks (3 sessions a week, each session lasting 40 minutes). Static balance was measured by using with both open and closed eyes and applying the Sharpened Romberg Test (SRT) and dynamic balance was measured by the Timed Up and Go Test(TUG) before and after the training period. Simple and selective reaction times were measured as well. The data were analyzed by analysis of covariance and paired t-test.

The difference between pre-test and post-test scores was not significant for the variables of static balance with open eyes, dynamic balance and simple reaction time. The difference between these scores was significant for Sharpened Romberg Test with closed eye; static balance and evaluation of selective reaction time was significant (p < 0.05). There was a significant difference between post-test and pre-test scores (except for dynamic balance) in the intervention groups (p < 0.05). There was no significant difference in the effectiveness of treatment methods.

Given the effectiveness of resistance exercises and hydrotherapy, these methods can be used as effective therapies by physiotherapists to improve the balance and selective reaction time among the elderly suffering from mild cognitive impairment.

 The aim of this study was to compare the effectiveness of positive thinking skills training and acceptance / commitment therapy on self- disability of shy girl students.

 The statistical population of this quasi-experimental research included all the female high school students in Tabriz in the academic year 2020-2021; as many as 45 shy students were randomly selected by using a multistage cluster purposive sampling technique, and the samples were then randomly assigned into two groups i.e. experimental and control (15 people in each group). Groups completed the Jones & Rudwalt (1982) Self-Disability Questionnaire as the pre-test and post-test. Positive Thinking and acceptance / commitment therapy skills training (eight sessions, two sessions per week for 4 weeks) was conducted in the experimental groups. The results were analyzed using multivariate and univariate analysis of covariance.

 Both positive thinking skills training and acceptance and commitment therapy had significant effects on the self- disability (p < 0.001); in comparison to to positive thinking skills, acceptance / commitment therapy had a greater effect on reducing self- disability (p < 0.001).

  Given the superiority of the effectiveness of acceptance / commitment therapy to reducing self- disability of shy female students, it is recommended the use this  technique.

 Biological changes caused by aging can affect the functioning of the human locomotor system. The purpose of this study was to compare the effect of exergaming vs. fall-proof exercises on ankle joint proprioception and fear of fall among the elderly.

Forty-five elderly men, aged 60-74 years voluntarily participated in this semi-experimental study that includes a control group. Participants were randomly assigned into three groups including exergaming (n=15), fall-proof prevention exercises (n=15) and control (n=15). Participants in the training groups exercised for 6 weeks, three 70-minute sessions per week. Participants in the control group did continue their regular daily lifestyle. Ankle joint proprioception was recorded at 10 degrees of Dorsiflexion and 20 degrees of Plantar-flexion by Electro goniometer. The Self-Efficacy Questionnaire was applied for recording fear of fall among the elderly. Data were analyzed using paired t-test and two-way covariance ANOVA and using SPSS software version 24.

 The results of two-way covariance analysis showed a significant improvement in ankle joint proprioception at both 10° dorsiflexion and 20° plantarflexion angles in both groups (fall-proof, exergaming). Fear of fall was also improved similarly in both training groups (p < 0.05). The outcome measures were not significantly changed in the control group.

 Six weeks of both exergaming and fall-proof training can improve the ankle joint proprioception and the fear of fall in elderly men. Both the exergaming and fall-proof training are recommended for elderly men.