MEDICAL JOURNAL OF MASHHAD UNIVERSITY OF MEDICAL SCIENCES
Year:2020 | Volume:62 | Issue:6|Papers Count:24

Introduction: The purpose of this study was to investigate the effectiveness of stress management and anger management on quality of life, pain relief and pain intensity in patients with migraine. Materials and Methods: The method of this research was applied to the target and based on the nature and method of the pre-test and post-test semi experimental design with control group. The statistical population of this study was female migraine sufferers in Hashtgerd city in year 96. The sample consisted of 30 female migraine patients who were purposefully selected based on inclusion criteria and were randomly assigned to two groups of 15 subjects. In this study, the group received stress management training and anger management training package, and the control group did not receive any training. Data were collected by questionnaire of quality of life (SF-36), Researcher's Scale of Canner and Davidson (2003) and Pain Inventory (BPI). Results: The results of this study showed that Stress and Anger management training improves the quality of life and resilience, as well as decreases pain intensity in women with migraine.  Conclusion: According to the findings of this study, it is recommended to include stress management and anger instruction training packages in migraine patients' programs.

Introduction: Children become irritable, restless, and excited in response to excruciating pain. Most children anticipate the pain caused by the injection and are prevented from doing so by non-adaptive anxious behaviors prior to the injection, so the aim of this study was to investigate the effect of different methods of thinking on the pain caused by venous thrombosis. In children 6-3 years old. Materials and Methods: This quasi-experimental study was performed on 110 children admitted to the pediatric ward of Peymaniyeh Hospital in Jahrom city by available and random sampling method. The data collection tools in this study included three demographic information questionnaires, children's behavioral pain scale and numerical pain measurement scale. Data analysis was performed using SPSS software version 21 and descriptive and inferential statistical tests.  Results: Comparison of research groups in terms of scale of behavioral pain analysis using test Mann Whitney showed that there was a significant difference between all groups of musical balls, inflating balloons, in the mother's arms, the musical ball + the mother's arms, and controlling (p-value <0. 05). The "control" group had the highest and the "musical ball + mother embrace" group had the lowest average pain behavior and pain measurement.  Conclusion: Implementing a mindfulness program has reduced the pain caused by sprains in children. Therefore, it is possible to reduce the effects of destructive and stressful procedures in children who experience a lot of pain during painful procedures when diagnosing, treating and controlling their disease with various deviant methods.

Introduction: Cancers are one of the leading causes of death in the world after cardiovascular disease. The epidemiology of cancer in each region depends on race, age, sex, cultural, social, nutritional, and lifestyle habits. This study aims to determine the standardized incidence of common cancers in Torbat-e-Jam. Materials and Methods: The present study was performed cross-sectionally on all diagnosed cases of cancer in Torbat Jam city in 2014. In this study, after eliminating non-native and recurrent cases, 206 patients were evaluated and the standardized age of various cancers was calculated. Results: In this study, out of 206 cancer patients, 52. 9% were men and 47. 1% were women. The standardized incidence of cancer in men and women was 167. 3 and 137. 6 percent, respectively. The most common cancers in men are gastric cancer with 24 cases (22%), esophagus with 20 cases (18. 3%), skin with 10 cases (9. 2%) and esophageal cancer in women with 22 cases (22. 7%), and breast cancer with 22 cases (22. 7%). And stomach with 9 cases (9. 3%). Conclusion: According to the results of the present study, the most common cancers in Torbat Jam in 1393 are cancers of the gastrointestinal tract and breast, respectively, so conduct research with advanced methods, proper implementation of screening programs and early diagnosis and training of all community groups on risk factors and Signs and symptoms of cancer are essential.

Introduction: Diabetes is the cause of more than 1. 3 million deaths worldwide. Exercise programs reduce glycosylated hemoglobin levels by about 0. 6 percent from 8 weeks to one year. Keeping HbA1C below 7% not only prevents the onset of diabetes complications in the springs, kidneys and nerves, but also prevents them from progressing and prevents them from progressing. Exercise in type 2 diabetic patients should be taken to improve patient well-being. Materials and Methods: 75 diabetic women were selected and randomly assigned to intervention and control groups. The physical activity test was performed with the HbA1C test and then the prepared training program was performed on the intervention groups. The HbA1C and posttest tests were repeated in the intervention and control group. The data collection method includes a demographic profile questionnaire of the studied individuals and a short version of the International Physical Activity Questionnaire. Appropriate tests were used to investigate the relationship between each factor. Results: The HbA1C level in the control group before and after the mean intervention was 3. 8 59 1. 59 and 8. 8 33 1. 33, respectively. And in the study of the statistical relationship between HbA1C level after intervention in the control and control group, there was a statistically significant relationship with independent t-test (P = 0. 005). After the intervention, all patients were able to perform soft movements and cooling movements. Conclusion: The program of promoting physical activity based on the exercise protocol in type 2 diabetic patients has been effective in improving the health index of patients.

Introduction: Different approaches have searched various causes for mental harm, one of which is the cause of genetic damage in mental health. On the other hand, it is one of the hereditary characteristics of blood groups in humans. Therefore, in this research, the status of psychological injuries has been investigated in a variety of blood types. Materials and Methods: This study was a causal-comparative study. The research population consisted of 175 non-participants in Isfahan labs in 1397 that were selected as available. The data collection tool was Minnesota Multidisciplinary MMPI-2 Personality Inventory He, McCain Leigh (1984) analyzed the data collected after encoding using SPSS-23 statistical software. Results: The results of the research indicated that there was a significant difference between the mental harm with different types of blood groups, that is, there was a significant difference between the subjects with different blood groups at least in terms of one of the variables (P (0. 05) Conclusion: According to the results, there is a significant relationship between depression in the blood group A and O, and there is a significant relationship between B-type B and social introversion compared to other blood groups.

Introduction: The aim of this study was to compare the efficacy of supportive-expressive and cognitive-behavioral psychotherapy on depression and adherence to hemodialysis patients. Materials and Methods: The study had a quasi-experimental design with pretest and post-test. A total of 45 patients undergoing hemodialysis were selected through purposive sampling and randomly allocated to the three study groups. 15 patients were treated by supportive – expressive psychotherapy, 15 patients by cognitive-behavioral psychotherapy and 15 patients were in the control group. The measurement tool was Beck Depression Inventory II and End stage renal disease adherence questionnaire (ESRD-AQ). The data were analyzed through spss-23. Results: Results in the study of multivariate indicators and significance level of 0. 001 in the group of supportive-expressive psychotherapy showed the size of short-term (pre-test-post-test) effect was 0. 90 and long-term (pretest-follow-up for 4 months) was 0. 80 and in cognitive-behavioral therapy With the same significance level, the short-term effect was 0. 61 and the long-term effect was 0. 39, and finally, with the Benfroni test and using the average comparison profile, the short-term and long-term effect in supportive-expressive psychotherapy was higher than cognitive-behavioral therapy. Conclusion: Supportive-expressive psychotherapy is more effective in improving the depressive symptoms of these patients than cognitive-behavioral psychotherapy, but no significant difference was found between these two types of psychotherapy for adherence.

Introduction: Rapid Sequence Induction and Intubation (RSII) is used when the patient is at high risk of pulmonary aspiration of gastric contents. Various side effects of succinylcholine such as sore throat, fasciculation, and myalgia led us to search for a solution to mitigate succinylcholine’ s complications. The goal of this study was, therefore, to determine if the Intravenous (IV) administration of lidocaine can affect the incidence of succinylcholine-based sore throat, myalgia, and fasciculation following an appendectomy. Materials and Methods: A clinical trial was performed in 2016 on 90 patients (aged 15-70) who were referred to Shahid Mohammadi Hospital (Bandar Abbas, Iran) for an appendectomy. Patients were randomly divided into two groups. Patients’ demographic information (e. g. age, weight, and gender) were recorded. Participants in the first and second groups received lidocaine and normal saline (NSS), respectively, immediately following RSII and shortly before succinylcholine administration. Patients were asked to survey them in terms of any sore throat, myalgia, and fasciculation symptoms. Data were analyzed using IBM SPSS Statistics 23. 0, and descriptive and inferential statistics. Results: Fifty-five percent of the participants were male and forty-five percent were female. The mean age at the group receiving normal saline was three years more than that of the group receiving lidocaine. The incidence of sore throat was considerably lower in patients receiving lidocaine. The incidence of myalgia was nearly equal in both groups. And the rate of mild fasciculation incidence was higher in the group receiving lidocaine, while patients receiving normal saline experienced a higher rate of severe fasciculation incidence. Conclusion: The use of lidocaine has no significant effect on the incidence of succinylcholine side effects such as the intensity of sore throat, myalgia, and fasciculation.

Introduction: Musculoskeletal disorders are one of the most important and most common occupational injuries that lead to disability and absence from work. Given the increasing prevalence of musculoskeletal disorders, this study aimed to investigate the prevalence of disorders in gynecologists in 2017. Materials and Methods: In this cross-sectional study, all experts participating in the 14th International Congress of Gynecologists and Obstetrics of Iran were selected based on a census method. Finally, 50 subjects participated in the study. Nordic questionnaire including demographic information and general and specific occupational questions were used for data collection. Data were analyzed using two-sample t-test, chi-square test. Results: The highest and lowest level of pain perception among specialists after the onset of work was on average in the neck area (81%) and elbow (15%). The frequency of pain and discomfort experienced by musculoskeletal disorders during the last year was Neck (73%), Lower Back (63%), Shoulders (41%), Upper Back (36%), Knees (34%), Wrists (24%), Arms (16%) and elbows (7%) reported. Also, there was a statistically significant relationship between age, work experience, hours of activity per week with pain in different areas of the body (P-value <0. 05). Conclusion: The prevalence of skeletal disorders in gynecologists is high because the main tasks of this occupation are to bend for examination. Ergonomic assessment with more accurate methods as well as ergonomic interventions in the workplace of gynecologists with lower job satisfaction is needed.

Introduction: Today, the Internet is an integral part of students' daily lives. Alongside the many benefits that are available on the Internet, its harmful effects are particularly debated in the health field. Minor psychological disorders such as depression, anxiety, and stress can affect people's daily functioning of life. The purpose of this study was to investigate the relationship between internet addiction and anxiety, stress, and depression in Mashhad medical students. Materials and Methods: A descriptive-analytical study was conducted on 329 medical science students of Mashhad University of Medical Sciences in the second semester of the academic year 2018-2019. The students were selected using stratified random sampling method. Data were collected using two questionnaires of Young Internet Addiction Assessment Questionnaire (IAT) and Depression, Anxiety and Stress Questionnaire (DASS-21(. Results: The mean age of students was 22. 72± 4. 01 years. The mean duration of Internet use was 4. 18± 2. 51 hours / day and the mean score of Depression was 5. 72± 4. 87 and Anxiety was 4. 65± 4. 06 and Stress was 8± 4. 70 (from 21 score). The results of logistic regression showed that there is a significant relationship between internet addiction and minor psychological disorders. Conclusion: Due to the high prevalence of Internet use among students and its association with minor psychological disorders, it seems essential that relevant authorities, by cultivating, informing, and planning to leisure optimization, resolve the problem of addiction Internet and thus reduce the severity of mild mental disorders.

Introduction: Despite advances in medical and surgical therapies, ostomy surgery is still one of the main treatment procedures for many colorectal cancer patients. This study aims to design and fabricate a new colostomy bag that reduces the complications of this procedure and improves the quality of life for these patients, and at the same time maintains a lowprofile. Materials and Methods: The current study is an experimental interventional study on an animal model. The designed system consists of two tubes that can move inside each other, which are placed inside the intestine. The system measures the amount of waste material by measuring the pressure applied to the cap of the tubes. The device was tested on five Dutch rabbits to assess its efficiency. After insertion of the tube in the animals, pressure measurement and timely creation of acoustic alarms by the device were evaluated as the criteria for this assessment. Results: Pressure evaluation shows that after a pressure increase of more than 10 mmHg, the sound system of the device is switched on and the colon is ready for discharge. The discharge was done between 0-2 times per day within three days. On the first day, there was some difficulty in drainage and in some cases drainage was not done via the tube. The average discharge pressure values measured within three consecutive days for animals are 11. 07 + 0. 17 mmHg, 11. 11 + 0. 33 mmHg, and 12. 042 + 0. 25 mmHg for the first, second, and third day, respectively. Conclusion: The results of the animal model in the study indicate that designing this device can provide proper drainage and, therefore, by developing this study we can provide a solution to create a suitable ostomy bag that can solve many of the problems associated with the current tube designs and provide comfort to the patients.

Introduction: Many studies have shown that the organization of mental health services in schools is a fundamental strategy for improving the health of students and ultimately the whole community. So, the purpose of this study was to investigate the effectiveness of mental self-care Training on mental health and social adjustment of students. Methods: This was a quasi-experimental study with pre-test and post-test design with experimental and control groups. The statistical population consisted of 40 students of Arak school counseling who were selected based on inclusion and exclusion criteria and were randomly divided into two groups. Data were collected using the Levibond and Levibond (1995) Depression, Anxiety and Stress Scale, and the Sinha & Singh (1993) social adjustment scale. The self-care training course was 10 sessions 2-hour. Data were analyzed using multivariate analysis of covariance test. Results: The results of analysis of covariance between two groups on adjusted scores of social adjustment variable showed that 42% of social adjustment changes, 39% of depression changes, 26% of anxiety changes and 43% of stress changes by independent variable (self-care training). Explained. That is, mental self-care training was effective on depression, anxiety, stress and social adjustment in students (P <0. 05). Conclusion: According to the results of the present study, it can be said that self-care education provided to students will reduce depression, anxiety and stress and increase social adjustment. Therefore, educational administrators, and all centers dealing with students, are recommended to use mental selfcare education to enhance mental health and improve students' social adjustment.

Introduction: Cancer patients, in addition to physical problems, are also involved in psychological issues. One of the harms that this disease can cause is a decrease in mental well-being. The aim of this study was to determine and compare the effectiveness of group counseling with Gestalt method and positive psychology on the mental well-being of women with lung cancer. Materials and Methods: The research method was semi-experimental with pre-test-post-test design with control group. From the community of patients in the cancer ward of Valiasr Hospital in Qom, 30 people were selected and randomly assigned to three groups. The research questionnaire was the mental well-being of Keyes and Magyarmo (2003). The results were analyzed using binary covariance and Ben Ferroni tracking test. Results: The results showed a significant level of Wilkes Lange index at 0/01 level (Wilks Lambda = 0. 486, P=0. 001, Wilks Lambda =0. 264, µ 2=6/9). This result shows that by controlling the effect of pre-test, the mean of the group's variables in the "mental well-being" variable is significantly different. In fact, with the control of the effect of pre-test and the inclusion of alpha-rate Bonferroni (0/016), the observed difference is significant only in the two components of "psychological well-being" and "social wellbeing", and in the "emotional well-being" component, there is a significant difference between the groups there was not. Conclusion: Both Gestalt and Positive Psychology methods affect the mental well-being of women with cancer, but the effect of Positive Psychology is greater.

Introduction: The purpose of this study was to compare the effectiveness of Cognitive-Behavioral Play Therapy and FRIENDS program training on behavioral disorders in children with separation anxiety disorder. Materials and Methods: The present study was a quasi-experimental and pretest-posttest design with two experimental and one control group. The statistical population of this study consisted of all children referred to Behavioral Disorders Clinics in west of Tehran who were selected by convenience sampling method. The first and second experimental groups received 10 sessions of 30 to 45 minutes of cognitive-behavioral game therapy and the FRIENDS program. The research tools were Achenbach's Child Behavior Checklist. Results: The results of the covariance analysis showed that the cognitive behavioral game therapy and the education program of FRIENDS was effective on behavioral disorders of children with separation anxiety disorder (P≤ 0. 001). The results of comparing the effectiveness of the two approaches showed that play therapy had more effect on the improvement of behavioral disorders than the FRIENDS program (P≤ 0. 001). Conclusion: Both Cognitive-Behavioral Play Therapy and FRIENDS Training can be used to improve behavioral disorders in children with separation anxiety disorder, but play therapy is more effective.

Introduction: The aim of this study was to investigate the Effect of 12 weeks Resistance training on heart’ s functional and structural characteristics in elderly women. Methods: The research method was quasi-experimental and the research design was pre-test, post-test, follow up with experimental and control groups. The statistical population of the study consisted of elderly in Kermanshah Welfare Center. The sampling method was purposive and based on inclusion and exclusion criteria among 60-65 years old women. 27 persons were randomly divided into experimental and control groups. Echocardiography was used to measure heart structure. Repeated measurement test was used to determine the effectiveness of exercise and Bonferroni test was used at the P≤ 0. 05 level. All calculations were performed using SPSS 24 software. Results: The results showed that in all structural variables, the difference between pre-test and post-test was significant in the experimental group (p <0. 001). Due to the difference in the means, scores from pre-test to post-test increased. There was also a significant difference between the mean posttest and follow-up of the experimental group (p <0. 001). Also in all structural variables, the difference between pre-test and post-test in control group was not significant (p = 1. 000). Due to the difference in the means, pre-test to post-test scores did not change significantly. (05 /0≤ p). Conclusion: According to the findings of this study, it can be concluded that 12 weeks of resistance training had a significant effect on the structural parameters of the heart of elderly women.

Introduction: Examination of referrals to child clinics shows that many children have problems with social competence and anxiety; The purpose of this study was to determine the effectiveness of play therapy Based on cognitive-behavioral approach On the social competence and anxiety of children. Methods: A quasi-experimental design with pre-test and post-test with control group was used. Of all the children referred to clinics in district 6 of Tehran city in 1397, 30 were selected and randomly assigned to two experimental and control groups. Research tools were social competence and children's anxiety. The method of the study was that after the pre-test, the cognitive-behavioral game therapy was administered to the experimental group. Finally, both groups received post-test. Results: The analysis of covariance showed that after eliminating the pretest effect, the mean of post-test scores in social competence and children's anxiety were statistically significant (p <0. 001). Conclusion: This study showed that cognitive-behavioral play therapy is effective on increasing social functioning and decreasing anxiety in children.

Introduction: The purpose of this study was to investigate the effectiveness of Play Therapy Based on Sensory Diet in Sensory Adjustment Vestibular Sense / Balance in autistic Children in Tehran City in 1397. Methods: The method of this study was quasi-experimental with pretestposttest design with control group. The statistical population of the study included all children with autism in Tehran Autism Society. The statistical sample of this study consisted of 20 individuals who were selected by convenience sampling and were randomly assigned to experimental (n = 10) and control (n = 10) groups. The experimental group received 25 minutes of 45-minute sessions of sensory-based game therapy and the control group remained on the waiting list. Data collection was done according to Wini Don (1997) standard sense test and then analyzed by repeated measures ANOVA. Results: The results showed that Play Therapy Based on Sensory Diet in Sensory training significantly (P <0. 05) improved the vestibular / balance sensitivity of autistic children. Conclusion: Therefore, it can be concluded that sensory regimen-based play therapy as an effective method can improve the sense of balance in children with autism disorder.

Introduction: In recent decades, researchers have become increasingly interested in examining cognitive factors in obsessive-compulsive patients; schema therapy is one of the most effective therapeutic approaches in various domains. The purpose of this study was to determine the effectiveness of schema therapy on the rumination and anxiety of obsessive-compulsive patients. Materials and Methods: The present study was a quasi-experimental study with pretest-posttest design with control group. The statistical population of this study consisted of all individuals with OCD 1 in Tehran. Through recall and referral to psychology clinics in district 1 of Tehran, 30 patients with obsessive-compulsive disorder were selected and randomly assigned into two groups of experimental and control. Then the experimental group underwent 10 sessions of Schema Therapy and at the end of both groups the post-test was performed. Results: The results of covariance showed that schema therapy had a positive and significant effect on reducing rumination and anxiety in obsessive-compulsive patients (p≤ 0. 001). Conclusion: Schema therapy can reduce the rumination and anxiety of patients with obsessive-compulsive disorder.

Introduction: Nowadays, due to changing urban life style and its complications, especially stressful urban living conditions, the conditions for various diseases, including headache, have been provided. Although headache has a wide variety of forms, but its two main types are migraine headaches and tension headaches that have been studied in this study. Materials and Methods: This study was a correlational study. The population was studied by stress disorder patients in Mashhad in 1997. Neurology clinics as well as neurosurgery offices, as well as zoologists and clinical psychologists, among whom 300 were randomly selected and accessed and exclusion criteria were considered. Results: The results showed that behavioral activation system had a direct effect on resiliency. Behavioral inhibition as the second subsystem of brainbehavioral systems has a negative effect on resiliency and the War and Escape system as a third subsystem has a positive effect on resilience. Conclusion: According to the results of this study, there is a positive and significant relationship between behavioral inhibition system and emotional exhaustion and headache. Also, emotional exhaustion is associated with impaired emotional regulation.

Introduction: Patients with chronic pain, in addition to physical problems, also have problems in psychological areas, especially quality of life and happiness. The aim of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) on quality of life and happiness of patients with chronic pain. Methods: In the present study, according to the type of data collection, semi-experimental designs were used. The design of this research was pretest-post-test designs with a control group. From the statistical population of patients with chronic pain in region 2 of Tehran, 28 people were selected by available methods, who were randomly divided into two groups of 14 as the experimental group and the control group. The research questionnaires were the Oxford Quality of Life Questionnaire of the World Health Organization and the Kabat Zayn (2003) mindfulness training package was used. Data were analyzed by covariance test. Results: The results of covariance showed that mindfulness has a positive and significant effect on increasing the quality of life and happiness of patients with chronic pain (p 00 0. 001). Conclusion: mindfulness-based cognitive therapy (MBCT) is effective on quality of life and happiness of patients with chronic pain; Therefore, it is suggested to use mindfulness techniques on patients with chronic pain.

Introduction: Autism, as a developmental disorder, always causes problems for children in their lives and continuously leads them to isolation and away from society and finding a reliable instrument for this disorder is a need. The aim of this study was to test the reliability of the Movement Assessment Battery for Children-Second Edition (MABC-2) in children with autism spectrum disorder aged 3-16 years in Tehran. Materials and Methods: In the current study, 100 children with autism disorder aged 3 to 16 years were selected. The instrument used in this study was the Movement Assessment Battery for Children-Second Edition (MABC-2). The data was collected by two testers who were familiar with the test, and according to the manual of the test. The reliability between testers, test-retest reliability with a two-week interval and internal consistency reliability were calculated. All tests were two-tailed, and p<0. 01 was considered significant. Data analysis was performed using SPSS software (version 23, SPSS) Results: Reliability between testers was calculated by calculating intraclass correlation coefficient for manual dexterity skill 0. 973, aim and cache skill 0. 948, balance Skill 0. 967 and total score 0. 970. In the internal reliability of the test, correlation coefficient was obtained for the skill of the manual dexterity 0. 950, aim and cache skill 0. 902, balance skill 0. 942 and total score 0. 948. To verify the internal consistency of the test, Cronbach's alpha coefficient was obtained in manual dexterity Skill 0. 856, aim and cache skill 0. 836, balance skill 0. 924 and total score 0. 917. Conclusion: According to the results, the MABC-2 Test is a reliable measure to assess motor development in autistic children and adolescents in Tehran.

Introduction: Research has shown that green empowerment of employees affects many managerial and psychological components of employees. Accordingly, the present study was conducted with the aim of the role of green empowerment of employees on some managerial and psychological components of green in sports organizations. Methods: The present study was a descriptive correlational study. The statistical population consisted of all employees of the Ministry of Sports and Youth (890 people). The statistical sample was selected based on Cochran's formula of 268 people using a simple random sampling method. The green human resource empowerment questionnaire of Degalvar et al. (2013), the role of human resource business partner Connor et al. (1996), and the green human resource management of Jabour (2011) were used. Structural equations with partial least squares approach were used using SPS software and SmartPLS version 3. Results: The results showed that green empowerment of employees has a significant relationship with green analysis and job description, green performance evaluation, green employment, green rewards and green training in sports organizations. Conclusion: Based on the research findings, it is suggested to the managers of sports organizations to use the managerial and psychological components considered in this research in order to empower employees.

Introduction: Without an effective management system, the education system will not be able to achieve its goals. Lean management is one of the most effective and innovative approaches today in many manufacturing, service, commercial and even administrative organizations and companies. The purpose of this study was to identify the dimensions and components of lean management in first grade high schools. Materials and Methods: The research method was mixed (quantitative and qualitative). In the qualitative part, semi-structured interviews were conducted with 15 management experts at two levels of faculty members of universities and school principals who were selected by purposeful method and using the results of coding method in three stages of open coding, the central and selective analyzes of the interviews were conducted and a fivepoint Likert scale questionnaire was developed. The reliability of the questionnaire was estimated as 0. 98 by Cronbach's alpha. In the quantitative part of the statistical population, 1059 high school principals in Tehran were selected by cluster sampling and 283 individuals were selected by using Cochran formula to answer the questionnaire and as the sample size. Results: After data coding and factor analysis, 7 key components of management and leadership, structure, human resources, communication, technology, organizational culture and process and 60 sub-components were identified. Conclusion: Lean management has certain components that can be used to achieve school goals more effectively as a new approach.

Introduction: Modeling Structural Relations of Health Promoting Lifestyle Based on Sense of Coherence, Psychological Flexibility and Impulsivity with the Mediating Role of Body Dissatisfaction in Cardiovascular Disease patients with Obesity Methods: The research method is correlation using structural equation modeling. The statistical population of this study consisted of all cardiovascular patients with obesity in Tehran in 2018, out of whom, 220 were selected through stratified cluster sampling and available as the sample. Research tools were: Health Promoting Lifestyle Walker et al. (1987), Sense of Coherence Kimiai et al. (2013), Psychological Flexibility Bund et al. (2011), Impulsiveness Bart (1995), and Body Dissatisfaction Littleton (2005) all of them had acceptable validity and reliability. The evaluation of the proposed model was analyzed using the path analysis method. findings: The results showed that Sense of Coherence, psychological flexibility and impulsivity influence health promoting lifestyle by mediating body dissatisfaction in cardiovascular patients with obesity (P <0. 05). In the structural model section, the results showed that the effect of psychological flexibility on health promoting lifestyle with mediator role of body dissatisfaction in cardiovascular patients with obesity is 1. 14. Impact of impulsivity on health-promoting lifestyle with mediating role of body dissatisfaction in cardiovascular patients with obesity is-1. 07. The effect of sense of cohesion on health promoting lifestyle with mediator role of body dissatisfaction in cardiovascular patients with obesity is 0. 91. Conclusion: Therefore, it is possible to increase the Sense of Coherence and psychological flexibility through the establishment of workshops and changes in the health-promoting lifestyle of people at risk for obesity-related cardiovascular disease. Therefore, considering these variables helps prevent researchers and therapists designing more appropriate treatments.

Introduction: Depression affects individuals' psychological and emotional processes. according to this The present study was conducted to determine the effectiveness of cognitive and behavioral hypnotherapy on the selfesteem and emotion-seeking of the women with depression who refer to consultation centers. Materials and Methods: The statistical population of the present study was all women suffering from depression who referred to consultation centers in zone 1 in the city of Tehran from March to May 2019. The research method was quasi-experimental with pretest, posttest and control group design. The samples in the present study included 30 women with depression disorder who were selected through convenient sampling method and randomly replaced into experimental and control groups. The experimental group received eight ninety-minute sessions of therapeutic interventions related to cognitive and behavioral hypnotherapy during two months once a week. The applied instruments included depression questionnaire (Beck et. al, 1996), emotion-seeking questionnaire (Zuckerman, Eysenck & Eysenck, 1978) and self-esteem questionnaire (Coopersmith, 1967). After collecting questionnaires and extracting raw data, the data analysis was conducted via SPSS23 through descriptive statistics and ANCOVA methods. Results: The results showed that cognitive and behavioral therapy significantly affects self-esteem and emotion-seeking of the women suffering from depression who referred to consultation centers (p<0. 001) in a way that this therapy was able to lead to the improvement of self-esteem and decrease of emotion-seeking in the women suffering from depression. Conclusion: the findings of the present study showed that the cognitive and behavioral hypnotherapy through employing techniques such as Induction of relaxation techniques, presentation of positive thoughts, spread of awareness and positive therapeutic beliefs can be used as an efficient treatment to improvement of self-esteem and decrease of emotion-seeking in the women suffering from depression.