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Background & Aims: Premenstrual syndrome (PMS) is considered to be a common abnormality in the women of the reproductive age, which reduces efficiency in various professional groups. The present study aimed to determine the prevalence of PMS and its influential factors in the operating room technologists. Materials & Methods: This cross-sectional study was conducted on 112 operating room technologists in the teaching hospitals affiliated to Iran University of Medical Sciences during 2016-2017. The participants were selected via census sampling. Data were collected using three questionnaires of demographic characteristics, PMS symptom screening, and occupational stress. Data analysis was performed in SPSS version 23 using descriptive and inferential statistics (Fisher's exact test and Chi-Square). Results: Approximately 57.1% of the operating room technologists had moderate-to-severe PMS. No significant correlations were observed between age, body mass index, education level, physical exercise, and regular exercise with PMS. However, there were significant correlations between PMS, type of physical exercise (P=0.027), and occupational stress (P=0.005). Conclusion: According to the results, PMS had a lower prevalence in the technologists with less occupational stress and those with physical exercise (especially endurance training) comparatively. Therefore, it is recommended that training interventions be implemented in order to reduce occupational stress and encourage physical exercise in these healthcare professionals.

Abstract Background & Aims: Sexual abuse is the most damaging type of abuse which has been increased significantly in recent decades so prevention of sexual abuse is crucial. This study aimed to determine the knowledge, attitude and practices of parents regarding child sexual abuse prevention program in elementary school and preschool children. Material & Methods: In this descriptive study, 536 parents of elementary and preschool children in schools of Arak, were enrolled by cluster random sampling. Data was collected by child sexual abuse (CSA) questionnaire and analyzed descriptive statistics using SPSPC (v. 16). Results: The results showed that of all parents, 343 (66%) had good knowledge and 177 (34%) had poor knowledge about the prevention of sexual abuse of children. Of all parents, 383 (80.63%) had good attitude and 92 (19.37%) had poor attitude toward prevention education of sexual abuse. Also 456 parents (85.71%) had good performance and 76 parents (14.29%) had poor performance regarding prevention of sexual abuse. Conclusion: Considering the poor knowledge a one third of the parents regarding the prevention of sexual abuse, providing strategies to increase their knowledge seem necessary.

Abstract Background & Aims: To increase the adolescents’ health, parents are required to share the needed information about reproductive health with them and answer their questions in a timely manner. Ignoring this need due to different reasons leads to getting information from unhealthy sources. This study was performed in the city of Tehran to determine parents' views about teaching contraceptive methods for their female students. Material & Methods: It was a descriptive, cross-sectional study. The research population consisted of all Iranian parents of 10-19 years old high school girls living in Tehran in 2013. Cluster sampling was used to select a sample size of 400. Data was gathered using a questionnaire containing three parts of demographic characteristics, parents' views about teaching contraceptive methods and appropriate time, method and sources for teaching contraceptive methods and was analyzed by descriptive statistics and Chi- square test using SPSS-PC (v. 18). Results: According to the findings, 66.7% of parents believed that talking with their daughters has a positive effect on her heath. Chi- square test showed that there is a significant relationship between mothers’ positive perspective about talking with their daughters and mothers’ job (p

Abstract Background & Aim: Adolescents experience a kind of entrapment with anxiety during maturity period and disregard to the problems associated with adolescence would have negative effects on their health, orientation and self-esteem. Girls have more problems than boys in health aspects, and psychological and social domain due to physiological differences, social roles, and traditions governing the community. This study was performed to determine the relationship between anxiety and self-concept among female adolescents. Material & Methods: It was a correlational, cross -sectional study that was conducted during 2011-2012 in Tehran. Through cluster sampling, 159 female high schools students were recruited from the 4th educational district . Data was gathered by demographic sheet, Coppersmith’s Self Esteem scale and Spielbergerr Scale and analyzed by descriptive statistics, Spearman correlation coefficient and regression analysis using SPSS-PC (v.16). Results: The findings showed that %53.5 of the students had moderate anxiety and %63/5 of them had moderate self-concept. In the mean while, %18.3 of the students had severe anxiety or low self-concept. Spearman correlation test determined a negative significant association between the students’ anxiety and their self-concept (p

Background: Quality of life in post-menopausal women and menopausal symptoms are closely related concepts. Influence health education policy in order to promote health and adopt a menopause lifestyle requires alternative strategies, including health training programs with community – based interventions. The current study aims to survey the effects of support groups on quality of life of post-menopausal women.Methods: A blind field trial (2010) was conducted at Saadatmandii Clinical Center (Robat Karim, Iran). 110 women were selected randomly divided into test and control groups (consisting of 55 ones). Menopause specific quality of life questionnaire (MENQOL) was used for evaluation of life quality before and three months after intervention; there was no intervention in the control group. Data were analyzed by using SPSS/16. Qualitative variables were analyzed using chi-square tests and quantitative variables were analyzed using Mann-Whitney and Wilcoxon test, paired T-test and independent t-test.Results: There was significant difference between vasomotor, psychosocial, physical, sexual aspects and life quality of this group pf women (P

Background: Quality of life in post-menopausal women and menopausal symptoms are closely related concepts. Influence health education policy in order to promote health and adopt a menopause lifestyle requires alternative strategies, including health training programs with community - based interventions. The current study aims to survey the effects of support groups on quality of life of post-menopausal women. Methods: A blind field trial (2010) was conducted at Saadatmandii Clinical Center (Robat Karim, Iran). 110 women were selected randomly divided into test and control groups (consisting of 55 ones). Menopause specific quality of life questionnaire (MENQOL) was used for evaluation of life quality before and three months after intervention; there was no intervention in the control group. Data were analyzed by using SPSS/16. Qualitative variables were analyzed using chi-square tests and quantitative variables were analyzed using Mann-Whitney and Wilcoxon test, paired T-test and independent t-test. Results: There was significant difference between vasomotor, psychosocial, physical, sexual aspects and life quality of this group pf women (P

Background: Given the limited research conducted on the role of a human co-driver in mitigating occupational health and safety risks, this study aims to investigate the impact of a co-driver on health and safety conditions in the truck transportation process., Methods: The truck transportation process was divided into three main stages: truck loading, driving, and unloading. Using the job safety analysis (JSA) method, an analysis of the tasks within each stage was conducted, allowing for the identification of essential and safe tasks and conditions. A questionnaire, based on this information, was developed, validated, and used in this study., Results: The findings of this study demonstrate that a human co-driver positively impacted the drowsiness and alertness levels of truck drivers. Furthermore, improvements were observed in driving and parking performance, alongside a reduction in strenuous tasks and subsequent fatigue. The results conclusively indicate that the presence of a human co-driver significantly enhances health and safety conditions, particularly during the driving stage in comparison to the other stages of the truck transportation process., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Depression is more common in diabetic patients, with a 1.5-fold increased risk of death.Melissa officinalis (M. officinalis) have anti-diabetic and anti-depression activities. The study aimed to determine the efficacy of M. officinalis extract on depression, anxiety, and sleep quality in patients with type 2 diabetes with depressive symptoms., Methods: In this double-blind clinical trial, 60 volunteer patients (age range 20-65 years) with type 2 diabetes mellitus with symptoms of depression were randomized into the intervention (received 700 mg/day hydroalcoholic extract; n = 30) or control group (received 700 mg/day toasted flour; n = 30). Dietary intake, physical activity, anthropometric indices, FBS (Fasting blood sugar), hs-CRP(High-sensitivity C-reactiveprotein), depression, anxiety, and sleep quality were determined at the beginning and end of the study. Depression and anxiety were assessed by Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI), respectively; sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI)., Results: Sixty participants received M. officinalis extract or placebo, of which 44 patients completed the 12-week double-blind clinical trial. After 12-week the mean change of depression and anxiety scores were statistically significant between the two groups (p < 0.001 and p = 0.04, respectively), but no significant differences were observed in FBS, hs-CRP, anthropometric indices, sleep quality, and blood pressure.In the intervention group, there was a significant decrease in depression and anxiety severity(p < 0.001 and p = 0.01, respectively) at the end of the study compared to the baseline., Trial Registration: All protocols in this study were followed in accordance with the Helsinki Declaration (1989 revision). Ethical approval for this study was obtained from the Iran University of Medical Sciences Ethics committee (IR.IUMS.FMD.REC 1396.9413468004; research.iums.ac.ir). The study was registered at the Iranian Registry of Clinical Trials (IRCT201709239472N16); Registration date: 09/10/2017., (© 2023. The Author(s).)

Background and Aim: Previous studies have shown that Rheum ribes (R. ribes) could be effective in controlling the blood glucose levels. This study was conducted to determine the effects of R. ribes supplementation on glycemic indices and apolipoproteins in patients with type 2 diabetes mellitus (T2DM)., Methods: In the present randomized double-blind controlled trial, 60 type 2 diabetic patients aged 30-60 years with a body mass index (BMI) of 20-30 kg/m 2 and hemoglobin A1c (HbA1c) of 6-8% were enrolled. Patients were randomly assigned to receive 450 mg of aqueous R. ribes extract (AG), 450 mg of ethanolic R. ribes extract (EG), or placebo (PG) three times daily for 6 weeks. At the baseline and at the end of the study, blood glucose levels, homeostatic model assessment of insulin resistance (HOMA-IR) and the homeostatic model assessment of β-cell dysfunction (HOMA-B), as well as apolipoprotein A-I (ApoA1) and apolipoprotein B (ApoB) were measured., Results: There was a significant decrease in the serum levels of insulin in AG and EG groups (P = 0.003 and P = 0.001, respectively), HOMA-IR (P = 0.01 and P = 0.001, respectively), HOMA-B (P = 0.002 and P = 0.001, respectively), ApoB (P = 0.006 and P = 0.03, respectively), ApoB/ApoA1 ratio (P = 0.016 and P = 0.04, respectively). However, a significant increase in ApoA1 (P = 0.08 and P = 0.05, respectively) with no significant changes in blood glucose, at the end of study compared to beginning values, were observed. None of the variables showed a significant change in PG. At the end of the study; while there were significant differences in insulin (P = 0.04), HOMA-IR (P = 0.03), HOMA-B (P = 0.01), ApoB (P = 0.02), and ApoB/ApoA1 ratio (P = 0.03) among the groups but ApoA1 had no significant change., Conclusion: Consumption of R. ribes intake could have beneficial effects on insulin resistance and apolipoproteins in type 2 diabetic patients. (Registered at en.irct.ir, identification number: IRCT201410142709N31)., (© 2023. The Author(s).)

Experimental and some clinical studies have shown beneficial effects of rosemary leaf on liver function and biochemical parameters. The present study aimed to examine the impact of rosemary leaf powder with a weight loss diet in patients with nonalcoholic fatty liver disease. In a randomized double-blinded clinical trial, 110 patients were randomly assigned to receive either 4 g rosemary leaf or placebo (starch) powders for 8 weeks. In addition, all participants in the study were given weight loss diet and physical activity recommendations. Compared with baseline, alanine aminotransferase (p < .001), aspartate aminotransferase (p < .001), alkaline phosphatase (p < .001), gamma glutamyltransferase (p < .001), fasting blood glucose (p < .001), fasting insulin (p < .001), insulin resistance (p < .001), total cholesterol (p = .003), triglyceride (p < .001), low-density lipoprotein cholesterol (p < .001), and anthropometric indices (weight, body mass index, and waist circumferences) decreased significantly in the rosemary and placebo group with weight loss. However, after 8 weeks, no significant difference between the rosemary and placebo groups was detected in the variables as mentioned above except homeostasis model assessment of β-cell dysfunction (p = .014). The findings of the current clinical trial study revealed that rosemary group did produce changes, but they were not statistically different from those produced by the diet/activity intervention alone., (© 2022 John Wiley & Sons Ltd.)

The way workers perceive noise exposure can play an important role in the adoption of safety behaviors. Therefore, the determination of the relationship among risk awareness, behavior, and exposure can be an extremely important issue in controlling noise exposure. The aim of this study was to investigate the association between risk perception and practice of workers. Workers from 16 printing houses in Tehran province participated in present study. A questionnaire was used for determining the level of risk perception and practice about hearing conservation. The results revealed a significant relationship between risk perception and safety behavior adoption (P < 0.001). A positive and significant correlation was found between these two variables (P < 0.001; r s = 0.912). Also, the results showed that workers with hearing impairment had a better practice. In addition, attention should be paid to preventive principles and encouragement of hearing protection devices usage among employees.

Background: Calorie restriction (CR) is known as a nutritional gold standard for life extension and different studies have shown that insulin-like growth factor (IGF1) reduction through CR may be involved in CR's anti-aging effects. Besides, time-restricted-feeding (TRF) is also highlighted due to more feasibility and positive health effects. We designed this study to compare the effects of CR and TRF on IGF1 and other metabolic parameters., Methods: Fifty-two male Wistar rats (3 weeks old) were subjected to either a control (CON, n = 11) diet or high-fat diet (HFD, n = 42) for 17 weeks. In the second phase of the study, the HFD group were divided into four groups ( n = 9) 1) 30% CR, 2) Night Intermittent Fasting (NIF, active phase), 3) day intermittent fasting (DIF, rest phase), and 4) Ad-Libitum (AL) with a standard diet for 10 weeks. Blood samples were collected at the end of both phases., Results: HFD increased IGF1 and deteriorated lipid profiles, except for triglycerides ( P : 0.018, 0.008.0.012, 0.032) but CR in these obese subjects could not lower the IGF1 level. HDL significantly decreased in DIF compared to CON and CR ( P ; 0.001). Meanwhile, HOMA-IR increased in DIF and was significant compared to CR ( P : 0.002). Serum glucose levels decreased in CR compared to all groups except for CON ( P : 0.001)., Conclusion: Data indicates the role of previous obesity on the effect of CR on the IGF1 level and highlights the effect of inappropriate time of food intake on HDL and APOA1., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 International Journal of Preventive Medicine.)

This study aimed to investigate the effects of vitamin D and magnesium co-supplementation on muscle strength and function, body composition, and inflammation in vitamin D-deficient middle-aged women. In this study, 83 healthy middle-aged women (40-55 years) with vitamin D deficiency were randomly assigned into two groups: (1) intervention: receiving a 50,000-IU vitamin D soft gel (weekly) plus a 250-mg magnesium tablet (daily); (2) control: receiving a vitamin D placebo (weekly) plus a magnesium placebo (daily), for 8 weeks. Before and after the intervention, anthropometric indices, muscle strength, muscle function, and some inflammatory markers were measured. After 8 weeks of supplementation, significant difference was observed in handgrip strength and time for Time Get Up and Go (TGUG) test between the intervention and placebo groups (P < 0.05). Regarding percentage of fat mass (FM%) and fat free mass (FFM%), and knee extension strength, there was no significant difference between the two groups at the end of intervention (P > .05). Serum 25(OH)-D levels increased significantly (P < 0.001) and its change was significantly different between the two groups, at the end of the intervention (P < 0.001). Serum level of hs-CRP decreased significantly in the intervention group compared to baseline (P < 0.001), and the change in hs-CRP was significant between the two groups at the end of the intervention (P < 0.01). Furthermore, serum level of TNF-α declined significantly in the intervention group compared to baseline (P < 0.001) but, no significant differences were seen between the two groups in regard of serum levels of TNF-α and IL-6 after the intervention (P > 0.05). Our findings show that vitamin D and magnesium co-supplementation, for 8 weeks, in healthy middle-aged women with vitamin D deficiency have beneficial impacts on muscle strength, muscle function, and probably inflammation.

Objectives: This study aimed to investigate the effects of raw red beetroot consumption on metabolic markers and cognitive function in type 2 diabetes patients., Methods: In a quasi-experimental study, 44 type 2 diabetes patients (57 ± 4.5 years) consumed raw red beetroot (100 g, daily), for 8 weeks. Metabolic markers including body weight, glucose and lipid profile parameters, inflammatory and oxidative stress markers, paraoxonase-1 activity, hepatic enzymes, blood pressure and cognitive function were measured at the beginning and end of 8 weeks., Results: Raw red beetroot consumption resulted in a significant decrease in fasting blood sugar (FBS) levels (-13.53 mg/dL), glycosylated hemoglobin (HbA1c)(-0.34%), apolipoproteinB100 (ApoB100) (-8.25 mg/dl), aspartate aminotransferase (AST) (-1.75 U/L), alanine aminotransferase (ALT) (-3.7 U/L), homocysteine (-7.88 μmol/l), systolic (-0.73 mmHg) and diastolic blood pressure (-0.34 mmHg), anda significant increase in total antioxidant capacity (TAC) (105 μmol/L) and cognitive function tests (all P values <0.05). Other variables did not change significantly after the intervention., Conclusions: Raw red beetroot consumption for 8 weeks in T2DM patients has beneficial impacts on cognitive function, glucose metabolism and other metabolic markers., Competing Interests: Conflict of interestNone., (© Springer Nature Switzerland AG 2021.)

ABSTRACT Objectives: Studies have shown that probiotics may decrease anxiety symptoms, but to our knowledge so far no trial has investigated the effects of probiotics in generalized anxiety disorder (GAD). The aim of the present study was to determine the effects of probiotics as adjunctive therapy on anxiety severity and quality of life (QOL) in patients with GAD. Methods: Forty-eight drug-free patients with a diagnosis of GAD based on DSM-V criteria were randomly assigned to two groups to receive daily either one capsule of probiotics or placebo in addition to 25 mg sertraline for 8 weeks. Probiotic capsules contained 18*10 9 CFU Bifidobacterium longom, Bifidobacterium bifidum, Bifidobacterium lactis and Lactobacillus acidophilus bacteria. Results: Intention to treat analysis was performed in 39 Patients who completed at least 4 weeks of the intervention. After 8 weeks, the score of Hamilton Rating Scale for anxiety (HAM-A) decreased more in the probiotics + sertraline (PS) group ( p  = 0.003). Although the reduction of Beck Anxiety Inventory (BAI) was also more in the PS group, it was not significantly different from that of the sertraline alone(S) group. Moreover, despite the greater reduction of State-Anxiety Inventory score in the PS group, the score of Trait-Anxiety Inventory was not statistically different between the two groups at week 8. With regard to QOL, there was no significant difference between the two groups in the change of the score of QOL domains. Conclusions: Probiotics + sertraline combination was superior to sertraline alone in decreasing anxiety symptoms after 8 weeks in patients with GAD, although it did not affect QOL.

This study was aimed at evaluating the suitability of sesame paste as an ingredient in white compound chocolate using response surface methodology. A D-optimal combined mixture-process design with three mixture components, sesame paste (15%-30% w/w), soy flour (0%-15% w/w), and milk powder (0%-15% w/w) under variable amount of emulsifier was used to optimize textural (hardness, cohesiveness, and adhesive force) and thermal ( T onset and T m ) properties of white compound chocolate containing sesame paste. The results showed that the linear effect of all the mixture components was significant ( p  < .05) on the responses. Applying a desirability function method, the optimum proportion of mixture components, and emulsifier level were as follows: sesame paste 15.5% w/w, milk powder 7.5% w/w, soy four 7% w/w, and emulsifier 0% w/w, respectively. At optimum point, hardness, cohesiveness, adhesive force, T onset , and T m were 367.07 (N), 0.63, 8.46 (N), 28.1 (°C), and 33.7 (°C), respectively. The predicted values were confirmed through validation experiment., Competing Interests: The authors declare that they do not have any conflict of interest., (© 2021 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Background and Aims: Improved vitamin D levels can have a favorable effect on some metabolic variables. The objective of the current study was to determine the effects of vitamin D supplementation during a weight-loss intervention on the levels of omentin-1, spexin, lipid profiles, and inflammatory factors in obese and overweight participants., Methods and Materials: In this double-blind placebo-controlled randomized clinical trial, 70 overweight and obese participants with vitamin D deficiency (25(OH)D ≤ 20 nmol/L) were assigned into the intervention (a daily dose of 2,000 IU vitamin D + low-calorie diet) and placebo (placebo + low-calorie diet) groups for 8 weeks. Anthropometric parameters, serum levels of 25-hydroxy vitamin D (25(OH)D), lipid profiles, omentin-1 and spexin levels, high-sensitivity C-reactive protein (hs-CRP), and soluble intercellular adhesion molecule-1 (sICAM-1) concentrations were assessed before and after the intervention., Results: Vitamin D supplementation after the intervention led to a significant decrease in triglycerides (TG) ( P = 0.02), very-low-density lipoprotein-cholesterol (VLDL-C) ( P = 0.02), and hs-CRP ( P = 0.03) concentrations and a significant increase in the serum vitamin D level ( P < 0.001). Furthermore, after adjusting for baseline values, age, and baseline BMI, the levels of serum high-density lipoprotein-cholesterol (HDL-C) ( P = 0.01) increased significantly, and a significant reduction was observed in the concentration of sICAM-1 ( P = 0.01) in the intervention group. However, we did not find any significant difference in serum omentin-1 and spexin concentrations between the groups after intervention., Conclusions: Vitamin D supplementation along with a low-calorie diet (LCD) program for 8 weeks significantly decreased the inflammatory markers in obese individuals, while it did not alter serum omentin-1 and spexin concentrations., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Elhameh Cheshmazar et al.)

Background: Children with mental retardation have various clinical problems. They mostly have motor delay and sensory deficit. Neurorehabilitation focuses on restoring remaining abilities. Thus, the present study was designed to study the effects of simultaneous use of sensory-motor therapy on manual skills of children with mental retardation. Methods: In this study, 120 educable boys and girls with mental retardation (9-12 years) were selected from 2 preprimary and primary exceptional centers in Tehran using stratified sampling method considering the geographical dispersion. The participants were divided into 2 equal trial and control groups using simple random sampling. Lincoln-Oseretsky Motor Development Scale, Purdue Pegboard test, and Handwriting Legibility Checklist of Persian Language were used. Simultaneous sensory stimulations and motor exercises were used for 3 one-hour weekly sessions for 12 consecutive weeks. Pre and posttests were done for evaluation. Using parametric paired and independent samples t tests, the findings were analyzed in SPSS 23. Results: The manual skills significantly improved following therapeutic use of simultaneous sensory stimulation and motor exercise (p=0.001). In the control group, the pre and post evaluation difference was not significant (p=0.813) Conclusion: Based on the findings of this study, simultaneous use of sensory-motor techniques can have better clinical results in the trial group compared to the control group. Thus, these types of techniques should be used more in clinics. However, further studies are needed for more comparison between separate applications of these techniques., (© 2019 Iran University of Medical Sciences.)

Background: Type 2 diabetes (T2D) is accompanied by elevated inflammation, oxidative stress, hyperlipidemia and hyperglycemia which all contribute to cardiovascular disease pathogenesis. Saffron as a complementary medicine and source of antioxidants could play a role in alleviating diabetes and its complications. The aim of this study was to determine the effects of saffron supplementation as an adjunct therapy in T2D., Patients and Methods: This randomized controlled trial included 80 T2D patients with a mean age of 54.1 years. Participants were randomly assigned into two groups to take either saffron tablets (100 mg/day; n=40) or placebo (n=40) for 12 weeks. Fasting blood samples were obtained at the beginning and after the intervention period to quantify glycemic factors, lipid profile, and biomarkers of inflammation and oxidative stress. Anthropometric indices and dietary intakes were also measured at baseline and at study end., Results: Compared with placebo, saffron supplementation resulted in significant decreases in waist circumference ( p <0.001) and malondialdehyde (MDA) ( p =0.001). There was no statistically significant difference in other indices, including anthropometric parameters, serum insulin, fasting blood glucose, HbA1c, insulin sensitivity indices, lipid profile, high-sensitivity C-reactive protein, total antioxidant capacity, and tumor necrosis factor-α between the study groups ( p >0.05)., Conclusion: Overall, 12 weeks of saffron supplementation in diabetic patients had beneficial effects on waist circumference and serum MDA levels. However, saffron did not influence other evaluated cardio metabolic risk markers in diabetic patients., Competing Interests: The authors report no conflicts of interest in this work., (© 2019 Ebrahimi et al.)

Objective: Microalbuminuria and hypertension are the risk factors for diabetic nephropathy, and increased levels of liver enzymes are prevalent among diabetic patients. The aim of this research was to examine the effects of Crocus sativus supplementation on nephropathy indices, liver enzymes, and blood pressure in patients with type 2 diabetes (T2D)., Materials and Methods: This placebo-controlled, randomized clinical trial was performed among 80 T2D patients. Subjects were randomly assigned to either Crocus sativus (n = 40) or placebo (n = 40) groups and treated with C. sativus and or placebo for 12 weeks, respectively. Alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), serum urea, creatinine, 24-hr urine albumin, systolic blood pressure (SBP), diastolic blood pressure (DBP), physical activity, and dietary intakes were measured and blood samples were taken at baseline and after the 12‑week intervention to assess the differences between the two groups., Results: C. sativus supplementation compared with the placebo resulted in a significant reduction of SBP (P<0.005). However, changes in other indices including liver enzymes, serum creatinine, serum urea, and 24-hr urine albumin, and DBP were not significantly different between the two groups (p>0.05). Also, no significant changes in dietary intakes and physical activity were seen between the two groups., Conclusion: This report shows that daily supplementation with 100 mg C. sativus powder improved SBP. However, it did not considerably improve DBP, nephropathy indices and liver functions in T2D patients after 12 weeks of administration., Competing Interests: The authors declare no conflict of interests.

Objective: Diet plays a critical role in the management of non-alcoholic fatty liver disease (NAFLD). Studies on the NAFLD's experimental models have reported that soy had positive effects on the improvement of metabolic parameters. However, there is a lack of clinical trials regarding the efficacy of whole soy foods. Therefore, this study was conducted to determine the effect of soy milk on some of the metabolic characteristics in patients with NAFLD., Methods: Sixty-sex patients diagnosed with NAFLD were included in this randomized, parallel, controlled trial and were randomly assigned to either the soy milk or control group. Both groups received a 500-deficit calorie diet plan. Also, patients in the soy milk group consumed 240 ml/day soy milk for 8 weeks. Fasting blood sugar (FBS), serum insulin, HOMA-IR, HOMA-β%, and QUICKI as well as serum malondialdehyde (MDA), plasma fibrinogen, and blood pressure (BP) were measured at the beginning and end of the study., Results: After 8-weeks of intervention, soy milk group had a greater significant reduction in serum insulin(-3.44 ± 5.02 vs. -1.09 ± 3.77 μIU/ml, P = 0.04), HOMA-IR (-0.45±0.64 vs -0.14 ± 0.47, P = 0.03), systolic (-3.81±4.15 vs -1.48±2.93 mmHg, P = 0.01) and diastolic (-2.39±2.80 vs. -0.94±2.76 mmHg, P = 0.04) BP, and also, a significant increase in QUICKI (0.02± 0.032 vs. 0.008±0.018, P = 0.04) compared to the control group. While, changes in the FBS, HOMA-β%, fibrinogen, and MDA were not significantly different between the study groups., Conclusion: A low-calorie diet containing soy milk had beneficial effects on serum insulin, HOMA-IR, QUICKI, and BP in patients with NAFLD., (Copyright © 2019. Published by Elsevier Ltd.)

Background: Since the presence of a co-driver can be considered as a companion, partner, or friend for a driver through eliminating driver's loneliness, it plays a significant role in health and safety of drivers. The objective of this study was to investigate the effect of co-drivers on depression and occupational stress on male truck drivers., Methods: This study was an interventional case-control study. Seventy truck drivers were selected and divided into two groups: case (33 truck drivers with co-drivers) and control (37 truck drivers without co-drivers). Two Goldberg depression inventories (for evaluating driver's depression) and the Karasek job content questionnaire (for evaluating driver's job stress) were used to collect data which were completed by interview., Results: The results showed that job content values for the case group were higher in all dimensions except job nature. The comparison of the percentages showed significant difference between two groups. Depression rate in drivers with co-driver is truly less than depression rate in drivers without co-driver. There was significant positive relationship between dimensions of job content and depression rate., Conclusion: According to the results of this study, it can be claimed that a co-driver decreases stress and loneliness of drivers, as well as increases work performance and job satisfaction, and, in turn, leads to a decrease in job-related depression.

Melissa officinalis is a plenteous source of antioxidant flavonols and flavonoids that contain health-promoting and antidiabetic properties, so this study was undertaken to provide the first assessment of the antidiabetic properties of hydroalcoholic extract of M. officinalis in type 2 diabetic patients. We did a randomized, placebo-controlled trial which included 62 patients, receiving either M. officinalis capsules (700 mg/d; n = 31) or the placebo (n = 31) twice daily for 12 weeks. There were significant differences in serum FBS (P = 0.007), HbA 1c (P = 0.002), β-cell activity (P = 0.05), TG (P = 0.04), HDL-c (P = 0.05), hs-CRP (P = 0.001), and systolic blood pressure (P = 0.04) between the two groups at the end of the study; but total cholesterol, LDL-c, insulin, and HOMA-IR showed no significant changes between the groups. In M. officinalis group, there was a significant change in HDL-c (P = 0.009) and QUICKI (P = 0.005) compared with baseline values. No adverse effects were observed. It seems that M. officinalis is safe and effective in improvement of lipid profile, glycemic control, and reduction of inflammation., (© 2018 John Wiley & Sons, Ltd.)

Objective: Studies in experimental models of nonalcoholic fatty liver disease (NAFLD) have reported positive effects of soy components in improving metabolic parameters. Whether such effects could be achieved through consumption of whole soy foods in patients with NAFLD is still unclear. Therefore, this trial was conducted to assess the effects of soy milk on metabolic parameters of patients with NAFLD., Methods: This parallel randomized clinical trial was conducted on 70 patients with NAFLD. Patients in the soy milk group consumed 240 ml of soy milk daily as a part of low-calorie diet (i.e., 500-deficit calorie diet) for 8 weeks. Patients in the control group just followed the low-calorie diet. Grade of fatty liver, liver enzymes, lipid profile, serum high-sensitivity C-reactive protein (hs-CRP), and anthropometric indices were measured at baseline and the end of the trial., Results: At the end of the trial, the soy milk group had significantly higher reduction in serum alanine aminotransferase (ALT) (-12.06 ± 17.61 IU/L in the soy milk group versus -5 ± 8.58 IU/L in the control group, p = 0.04) and hs-CRP (-1.32 ± 1.60 mg/L in the soy milk group versus -0.36 ± 1.54 mg/L in the control group, p = 0.01) compared to the control group. However, changes in fatty liver grade and other liver enzymes, including aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase, as well as lipid profile and anthropometric indices were not significantly different between the treatment groups., Conclusion: Consumption of soy milk in the context of a restricted-calorie diet for 8 weeks had favorable effects on serum ALT and hs-CRP in patients with NAFLD.

Diet plays a measurable role in breast cancer (BC) prevention. The aims of this study were to assess nutrition-related BC prevention Knowledge, attitudes and practice (KAP) of female university students and to examine the relationship between demographic characteristics of students and their KAP. We conducted a cross-sectional study among 500 female students from Iran University of Medical Science (IUMS). A pretested self-administered questionnaires were used to assess the participants' nutrition-related BC prevention KAP. A total of 500 students completed the survey. Students' knowledge with the mean score of 16.97, significantly varied by age (P= 0.03), the field of study (P= 0.001) and family history of BC (P= 0.01). The mean score of attitudes and practice toward nutrition-related BC prevention factors were 24.86 and 39.39, respectively. A significant relationship was observed between nutrition knowledge and attitude (r = 0.27, P < 0.001). Also, Nutrition-related attitudes were positively correlated with the BC prevention dietary practices (r = 0.23, P < 0.001). Nutrition KAP about BC prevention factors was found to be influenced by individual factors such as age, field of study, familial history of BC, job and residency status. Together, our findings confirm that increasing nutrition knowledge is not sufficient for dietary behavior change, but is necessary.

Background: The purpose of this study was to investigate the safety and effects of Melissa officinalis, a good source of bioactive components, on apolipoprotein (Apo)B, Apo A-I, and their ratio, lipids ratios and intercellular adhesion molecule-1(ICAM-1) in patients with type 2 diabetes., Methods: For the present randomized, double-blinded, placebo-controlled clinical trial, 70 type 2 diabetic patients aged 20-65 years old were randomly assigned to receive hydroalcoholic extract of M. officinalis (HEMO) (700 mg/d) or placebo twice-daily for 12 weeks., Results: There were significant differences in serum Apo A-I, TC/ HDL-c and LDL-c/ HDL-c between the two groups at the end of the study (p < 0.05), but we did not show significant differences in the values for Apo B, Apo B/Apo A-I, TG/HDL-c, ICAM-1 and liver enzymes include AST, ALT, and ALP between the study groups. Although both groups showed a significant reduction in ICAM-1, AST and, ALP (p < 0.05), no significant differences in ICAM-1, AST and, ALP were observed. At end, in M. officinalis group, there was a significant increase in Apo A-I (p = 0.003) and significant reduction in TG/HDL-c (p = 0.05) compared with initial values, as well as in placebo group, there was a significant rising in Apo B/Apo A-I (p = 0.02) and significant reduction in Apo A-I (p = 0.001) compared with baseline values., Conclusions: M. officinalis is safe and effective in improvement of Apo A-I, Apo B/Apo A-I, and lipids ratios as key factors promoting cardiovascular disease (CVD) in type II diabetic patients., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Burn is the worst tragedy among modern societies that individuals may experience. One of the most important problems of burns is pain; particularly at the time of treatment including burn dressings, debridement, surgical incisions and physiotherapy. The aim of this study was to determine the effect of rhythmic breathing on pain of dressing change in patients with burns., Methods: This semi-experimental clinical trial study with a control group was conducted on 60 eligible burn patients who were selected using convenient sampling method and allocated randomly in two groups of test and control (each n=30). Data collection tools included demographic data and pain observation questionnaires. The rhythmic breathing was individually and orally trained to the patients of test group in a room separated by dividers for a 20-minute session. The pain intensity in test and control groups before and after dressing was investigated for three consecutive days., Results: Friedman test results showed that pain intensity in both control and test groups had statistically significant differences. The pain intensity after rhythmic breathing reduced more in the test group, and this reduction was more significant during 3 days., Conclusion: Rhythmic breathing is an effective method on pain reduction of dressing change in patients with burn injuries., Competing Interests: The authors declare no conflict of interest.

Non-alcoholic fatty liver disease (NAFLD) has been suggested to be well correlated with altered blood pressure. This study was conducted to determine the effects of symbiotic and vitamin E supplementation on blood pressure and inflammatory indices of patients with NAFLD. This randomized, double-blind, placebo-controlled trial was performed among 60 NAFLD patients aged 25 to 64 years old. Participants were randomly divided into four groups to receive a 400 IU alpha-tocopherol and 2 × 10 8 CFU/g symbiotic supplement for 8 weeks. The anthropometric parameters, systolic blood pressure (SBP) and diastolic blood pressure (DBP), serum malondialdehyde (MDA), nitric oxide (NO) and tumor necrosis factor α (TNFα) were assessed at baseline and after 8 weeks of intervention. After 8 weeks of intervention, combined symbiotic and alpha-tocopherol, symbiotic and alpha-tocopherol alone administration, compared with the placebo, resulted in significant decreases in SBP (-17.07±2.1, -16.07±3.56, -1.73±2.25 and -1.55±3.01 mmHg, P=0.01), serum MDA (-1.19±0.5, -0.12±0.65, 0.14 ± 0.64 and 0.16±0.34 nmol/mL, P<0.001), serum TNFα (-15.62±13.93, -9.24±7.12, -11.44 ± 15.47 and 3.01±1.71 pg/ml, P<0.001) concentrations. A significant decrease in serum AST (-11.36±4.52, -7.43±8.58, -5.93±6.61 and 2.5±5.75 μmol/L, P <0.001), ALT (-12.79±3.65, -3.66±6.81, -6.54±7.66 and 4.16±3.43 μmol/L, P <0.001) and ALP (-26.8±11.1, -4.56±9.22, -14.48±12.22 and 5.19±2.64 μmol/L, P <0.001) was seen. Variations in DBP and serum NO concentration were not significant. Alpha-tocopherol and symbiotic supplementation among patients with NAFLD resulted in decreased SBP, serum MDA, TNFα levels and enzymes liver; however, they did not affect DBP and serum NO concentration.

Background: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world. Oral administration of symbiotic and Vitamin E has been proposed as an effective treatment in NAFLD patients. This study was carried out to assess the effects of symbiotic and/or Vitamin E supplementation on liver enzymes, leptin, lipid profile, and some parameters of insulin resistance (IR) in NAFLD patients., Materials and Methods: We randomly assigned sixty NAFLD adult patients to receive (1) symbiotic twice daily + Vitamin E-like placebo capsule; (2) 400 IU/d Vitamin E + symbiotic-like placebo; (3) symbiotic twice daily + 400 IU/d Vitamin E; and (4) symbiotic-like placebo + Vitamin E-like placebo for 8 weeks., Results: Symbiotic plus Vitamin E supplementation led to a significant decrease in concentrations of liver transaminase ( P ≤ 0.05). Mean difference of apolipoprotein A-1 was more significant in symbiotic group compared to control. However, mean difference of apolipoprotein B100/A-1 was only significant in symbiotic group compared to control. At the end of the study, significant differences in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were seen between the symbiotic plus Vitamin E and control groups ( P < 0.001). Furthermore, intake of symbiotic plus Vitamin E supplements led to a significant decrease in concentrations of triglycerides (TG) after the intervention. Significant differences in leptin, fasting blood sugar (FBS), and insulin levels were seen between the symbiotic plus Vitamin E and control groups at the end of the study ( P < 0.001). In contrast, symbiotic and/or Vitamin E supplementation did not affect high-density lipoprotein cholesterol and homeostasis model assessment for IR levels., Conclusion: In our study, symbiotic plus Vitamin E supplementation was the most effective treatment in lowering liver enzymes, leptin, FBS, insulin, TG, TC, and LDL-C among NAFLD patients., Competing Interests: There are no conflicts of interest.

Objective: Evidence indicates that NAFLD patients are vitamin D deficient. Vitamin D has new roles in lipid and glucose metabolism. The aim of this study was to examine the effects of calcitriol supplementation on the NAFLD progression based on liver lipid accumulation, serum lipid profile and insulin resistance., Methods: We randomly assigned 73 patients with NAFLD-confirmed by ultra-sonography to 12 weeks of treatment with hypocaloric diet (reduction of 500 kcal per day) plus 25 µg of calcitriol supplement or a hypocaloric diet plus placebo. Before and after treatment, we assessed anthropometric parameters, grade of fatty liver, serum lipoproteins, liver enzymes and insulin level., Result: Baseline variables were not significantly different between groups. A statistically significant reduction in anthropometric measures was observed over the 12 weeks in both groups. However, no significant differences were seen between groups after intervention. Compared with the placebo, reductions in triglyceride and an increase in HDL cholesterol were seen over the 12 weeks of intervention in the calcitriol group (P = 0.002 and P = 0.004). AST level was decreased in the calcitriol group (-4.2 ± 4.3 µmol/L, P < 0.001), but increased in the placebo group (12.6 ± 6.1 µmol/L, P = 0.02) after 12 weeks. Reductions in mean difference of ALT, insulin and HOMA were significantly higher in the calcitriol than placebo group (P = 0.01, P = 0.007 and 0.01)., Conclusions: Calcitriol supplementation combined with weight loss diet showed no significant effects on anthropometric measures in NAFLD patients. However, it may have positive effects on lipid profile, liver enzyme tests and insulin sensitivity during a weight-loss program.

Objectives: Type 2 diabetes is the most common metabolic disorder worldwide. Evidence supports a role for royal jelly (RJ) in reduction of serum glucose and lipids in animals and healthy subjects. The purpose of this study was to determine the effect of RJ intake on serum glucose, apolipoprotein A-I (ApoA-I), apolipoprotein B (ApoB) and ApoB/ApoA-I ratios in patients with type 2 diabetes., Methods: Fifty patients with type 2 diabetes participated in a double-blind, placebo-controlled study. The participants were randomly divided into RJ and placebo groups and were given doses of 1000 mg royal jelly or placebo 3 times a day for 8 weeks, respectively. Weight, height, fasting blood glucose, ApoA-I and ApoB were measured at baseline and endpoint., Results: There were no significant differences in baseline characteristics and dietary intakes between groups. The mean difference in glucose concentrations decreased in the RJ group (-9.4 mg/dL vs. 4 mg/dL; p=0.011). The mean difference in ApoA-I concentrations increased in the RJ group (34.4 mg/dL vs. -1.08 mg/dL; p=0.013). There was a significant decrease in mean difference of ApoB/ApoA-I in the RJ group compared with the placebo group (0.008 vs. 0.13; p<0.044), respectively., Conclusions: These data suggest that RJ intake may have desirable effects on serum glucose, Apo-A-I concentrations and ApoB/ApoA-I ratios in people with type 2 diabetes., (Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)

Background: Post-term pregnancy is an important factor in perinatal mortality and morbidity. Generally, to reduce perinatal mortality in pregnancy, the delivery is done before adverse perinatal morbidity occurs. To prevent prolonged pregnancy, labor is induced with chemical drugs and complementary therapies. Due to the side effects and contraindications of chemical medicine, the use of herbs has been investigated in the induction of labor in post-term pregnancy., Objectives: This study was done to identify the effect of chamomile on inducing labor in women with post-term pregnancy of Shahid Akbarabadi hospital in Tehran in 2013., Patients and Methods: This double-blind clinical trial study was performed in Iran on 80 post-term pregnant women with a gestational age of 40 weeks or more, a single pregnancy, 18 - 35 years old, cephalic presentation, an estimated fetal weight of 2500 - 4000 grams, an absence of uterine contraction, a cervical Bishop score of less than 4, the safety of the membrane, and low-risk pregnancy; they were randomly assigned to one of two groups of 40 women. Each of the participants was given a bottle containing 42 capsules (500 mg each) and took 2 capsules every 8 hours. The data were collected through the questionnaire of demographic observational, and examinal characteristics. Descriptive statistics, independent samples t-test, and Fisher's exact test using SPSS (16/win) were used to determine and compare the effects of drugs on inducing labor in the groups., Results: After a week of using the first dose, the results showed that in 92.5% of the chamomile group and 62.5% in the placebo group, delivery symptoms started after taking the oral capsules, and there were significant statistical differences between the two groups for the onset of labor (P = 0.003) There was a noticeable statistical difference between the two groups regarding the mean interval time to the onset of labor pain after taking the capsules (P = 0.000)., Conclusions: In this study¸ chamomile stimulated labor in post-term pregnancy. With further studies, chamomile, which has no chemical side effects, can be suggested for stimulating labor in post-term pregnancy.

Helicobacter pylori infection, the most common chronic bacterial infection in the world, and an important cause of gastrointestinal disorders, may be involved in the pathogenesis of some extra-gastrointestinal disturbances, as well as an increase in blood levels of certain inflammatory markers. Anti-bacterial activity against Helicobacter pylori and anti-inflammatory properties of omega-3 fatty acids have been studied in several research studies. The purpose of the present study was the comparison of the effects of Eicosapentaenoic Acid and Docosahexaenoic Acid supplementation on Helicobacter pylori eradication, serum levels of some inflammatory markers and total antioxidant capacity. In a randomized, double-blind, placebo-controlled clinical trial, 97 Helicobacter pylori positive patients (64 patients in the two intervention groups and 33 in the control group), received 2 grams daily of Eicosapentaenoic Acid, Docosahexaenoic Acid or Medium Chain Triglyceride oil as placebo, along with conventional tetra-drug Helicobacter pylori eradication regimen, for 12 weeks. Helicobacter pylori eradication test and measurement of concentration of interleukine-6, interleukine-8, high-sensitivity C-reactive protein and total antioxidant capacity were performed after the intervention. There was no significant difference in eradication rate of the infection, levels of interleukine-6 and total antioxidant capacity among the three groups, while the levels of interleukine-8 and high-sensitivity C-reactive protein were statistically different. Eicosapentaenoic Acid or Docosahexaenoic Acid supplementation had no significant differential impact on the eradication of Helicobacter pylori infection, and serum levels of interleukine-6 and total antioxidant capacity. However, it had a desirable effect on the levels of interleukine-8 and high-sensitivity C-reactive protein in Helicobacter pylori positive patients.

Aim: The fruit of the pomegranate (Punica granatum) has a high content of polyphenols and is renowned for its antioxidant capabilities. In particular, it is recognized as reducing oxidative stress and, therefore, playing a productive role in obstructing the pathogenesis of fatty liver disease. The aim of the present study was to evaluate the effects of consumingpomegranate juice (high in antioxidant content) and orange juice (low in antioxidant content) when combined with a hypocaloric diet on liver enzymes and the antioxidant status of patients., Methods: In a randomized clinical trial, 65 patients who exhibited non-alcoholic fatty liver disease (NAFLD) at a mean age of 39+/-8 years received 250 mL pomegranate juice or orange juice per day as a substitute for two servings of fruit in a hypocaloric diet over a period of 12 weeks. The subjects' levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total antioxidant capacity (TAC), malondialdehyde (MDA) and tumor necrosis factor-α (TNF-α) were measured at the beginning and end of the study., Results: At the end of the study, the levels of liver enzymes and body mass index (BMI) had significantly decreased in both groups. A significant increase in TAC was also observed in the subjects in the pomegranate group (p <0.01)., Conclusion: Consumption of fruits that are high in antioxidants could represent a useful means to improve the antioxidant status of NAFLD patients who follow a hypocaloric diet.

Background: Animal studies have shown antioxidant effects of Royal Jelly (RJ) and its effect on insulin resistance as the most common complication of Type 2 diabetes. This study was conducted to determine the effect of RJ intake on serum total antioxidant capacity, Malondialdehyde and insulin resistance in T2DM., Methods: In this randomized controlled trial, forty-six type 2 diabetic patients, aged 25-65 years, with BMI of 20-30 kg/m(2), and HbA1c of 6-8% were included. The patients were randomly assigned to receive 1000 mg of RJ supplement or placebo, 3 times daily for 8 weeks. HOMA-IR, anthropometric measurements, fasting blood glucose, serum insulin, total antioxidant capacity and malondialdehyde level were measured., Results: In comparison with placebo, HOMA-IR decreased (P=0.015) while serum total antioxidant capacity increased significantly in RJ group (P=0.016). No significant difference was detected for serum insulin and MDA in two groups., Conclusions: RJ intake may have favorable effects on serum TAC and HOMA-IR in diabetic patients.

Background: Work-related accidents result in human suffering and economic losses and are considered as a major health problem worldwide, especially in the economically developing world., Objectives: To introduce seasonal autoregressive moving average (ARIMA) models for time series analysis of work-related accident data for workers insured by the Iranian Social Security Organization (ISSO) between 2000 and 2011., Methods: In this retrospective study, all insured people experiencing at least one work-related accident during a 10-year period were included in the analyses. We used Box-Jenkins modeling to develop a time series model of the total number of accidents., Results: There was an average of 1476 accidents per month (1476·05±458·77, mean±SD). The final ARIMA (p,d,q) (P,D,Q)s model for fitting to data was: ARIMA(1,1,1)×(0,1,1)12 consisting of the first ordering of the autoregressive, moving average and seasonal moving average parameters with 20·942 mean absolute percentage error (MAPE)., Conclusions: The final model showed that time series analysis of ARIMA models was useful for forecasting the number of work-related accidents in Iran. In addition, the forecasted number of work-related accidents for 2011 explained the stability of occurrence of these accidents in recent years, indicating a need for preventive occupational health and safety policies such as safety inspection.

Background: One of the main criteria to verify the effectiveness of a health training program is to measure quality of life in menopausal women., Objectives: Hence the aim of this review was to evaluate the effects of self-directed learning (SDL) on MENQOl., Patients and Methods: The present single blind field study was conducted in Saadatmandi Health Center of Robat Karim (Iran, Southwest of Tehran Province) from August to December 2010. One handred and ten menopausal women were selected using convenience sampling method and then divided into two experimental (Self-directed Learning) and control groups of 55 each. Four manuals were developed to guide the women in the experimental group containing practical ways to treat menopausal symptoms. They were distributed among the participants for four weeks on a specific day. Menopausal Specific Quality of Life Questionnaire (MENQOL) was used to determine and compare quality of life scores of these women (before and three months after intervention sessions). The control group did not receive any intervention. Statistical analysis was performed by SPSS/16 software using Kolmogorov-Sminov, ANOVA, independent paired t test and Chi-square test., Results: There were significant statistical differences between two groups regarding the age of subjects; age of menopause; economic, educational and employment status; number of dead and living children; BMI and vasomotor, physical, sexual and psycho-social postmenopausal symptoms. The implementation of Self-directed Learning (SDL) model leads to a significant statistical difference in scores of vasomotor symptoms (16.32 ± 5.92 to 13.26 ± 5.31), psychosocial symptoms (34.8 ± 11 to 27.18 ± 10.83), physical symptoms (75.02 ± 18.07 to 61.42 ± 15.49), sexual symptoms (15.36 ± 6.10 to 12.00 ± 4.97) and the overall score for quality of life (141.5 ± 41.09 to 113.86 ± 36.6) (P < 0.001). No significant changes were found in the QOL scores of the control group., Conclusions: Implementation of self-directed learning provides a useful strategy that should be included in health intervention and national surveillance programs in order to improve health and therapeutic compliance in postmenopausal women.

Assessing learners' needs is an integral part of any curriculum and course design , namely English for specific purposes (ESP), syllabus design, materials development, teaching methods and testing issues. Critical approach to needs analysis, which is a relatively recent approach, acknowledges the rights of different stakeholders including teachers, students and administrators in the process of needs analysis. However, there has been no formal need analysis for syllabus design at postgraduate level in Medical Universities affiliated to the Ministry of Health in Iran. This study, conducted in 2011, was an attempt to assess the reading and writing needs of postgraduate students in ESP courses on the basis of critical approach to needs analysis. The study population consisted of 67 people: 56 postgraduate students, 5 heads of departments, 5 ESP instructors and 1 executive manager at the Ministry of Health in Iran. Ethical and demographic forms, needs analysis questionnaires, and a form of semi-structured interview were the instruments of the study. According to the findings, there was a discrepancy between students' and instructors' perception of learners' needs and the assumed needs appearing in the syllabi prescribed by the Ministry of Health in Iran. This study showed that a call for critical needs analysis in which the rights of different stakeholders are acknowledged is necessary for meeting the requirements of any ESP classes especially at postgraduate level where the instructors and learners are fully aware of learners' needs.

Objective: User acceptance of information technology has been a significant area of research for more than two decades in the field of information technology. This study assessed the acceptance of information technology in the context of Health Information Management (HIM) by utilizing Technology Acceptance Model (TAM) which was modified and applied to assess user acceptance of health information technology as well as viability of TAM as a research construct in the context of HIM., Methods: This was a descriptive- analytical study in which a sample of 187 personnel from a population of 363 personnel, working in medical records departments of hospitals affiliated to Tehran University of Medical Sciences, was selected. Users' perception of applying information technology was studied by a researcher-developed questionnaire. Collected data were analyzed by SPSS software (version16) using descriptive statistics and regression analysis., Results: The results suggest that TAM is a useful construct to assess user acceptance of information technology in the context of HIM. The findings also evidenced the perceived ease of use (PEOU) and perceived usefulness (PE) were positively associated with favorable users' attitudes towards HIM. PU was relatively more associated (r= 0.22, p = 0.05) than PEOU (r = 0.014, p = 0.05) with favorable user attitudes towards HIM., Conclusions: Users' perception of usefulness and ease of use are important determinants providing the incentive for users to accept information technologies when the application of a successful HIM system is attempted. The findings of the present study suggest that user acceptance is a key element and should subsequently be the major concern of health organizations and health policy makers.

E-learning as an educational approach has been adopted by diverse educational and academic centers worldwide as it facilitates learning in facing the challenges of the new era in education. Considering the significance of virtual education and its growing practice, it is of vital importance to examine its components for promoting and maintaining success. This analytical cross-sectional study was an attempt to determine the relationship between four factors of content, educator, learner and system, and effective e-learning in terms of demographic variables, including age, gender, educational background, and marital status of postgraduate master's students (MSc) studying at virtual faculty of Tehran University of Medical Sciences. The sample was selected by census (n=60); a demographic data gathering tool and a researcher-made questionnaire were used to collect data. The face and content validity of both tools were confirmed and the results were analyzed by descriptive statistics (frequency, percentile, standard deviation and mean) and inferential statistics (independent t-test, Scheffe's test, one-way ANOVA and Pearson correlation test) by using SPSS (V.16). The present study revealed that There was no statistically significant relationship between age and marital status and effective e-learning (P>0.05); whereas, there was a statistically significant difference between gender and educational background with effective e-learning (P<0.05). Knowing the extent to which these factors can influence effective e-learning can help managers and designers to make the right decisions about educational components of e-learning, i.e. content, educator, system and learner and improve them to create a more productive learning environment for learners.

We conducted a text message-based intervention for weight management over three months by two months intervention and one month wash-out period. In a quasi-experimental study with control (n = 40) and experimental group (n = 40), 80 overweight and obese employed women were entered. Participants were recruited via announcement. All subjects attended a face-to-face information session and received a booklet that contained food calorie chart and strategies and recommendations for weight management. The experimental group received text messages (SMS) about weight management twice a day for two months, in addition to the information and the booklet which they had received in the information session. Also, the experimental group was instructed to weekly self-weight and to send the data to the principle researcher. All subjects were measured for baseline and secondary weight in a standardized manner by a nurse, and the data were compared between the two groups. Experimental group lost more weight than the control group (1.5 kg difference, P = 0.018). Text messaging seems to be an effective channel of communication for weight management in Iranian overweight and obese women. The clinical trial registration number is IRCT201204029360N1.