Middle East Journal of Rehabilitation and Health Studies
Year:2021 | Volume:8 | Issue:2|Papers Count:12

Background: Recently, the healthcare systems have turned towards cost-effective services such as primary healthcare (PHC) due to the increasing costs of health services. Objectives: This study aimed to develop a departmental accreditation model for primary healthcare in Iran. Methods: Initially, primary standards were obtained by making use of available scientific documents in service delivery units in the realm of primary healthcare in Iran as well as by obtaining feedback from their specialists. Then, all primary standards were entered into Delphi questionnaire and evaluated on a 9 point Likert scale by 15-20 experts based on two criteria of significance and feasibility. Finally, the final standards were specified based on the qualitative points obtained from the experts. Data were analyzed using SPSS version 18. Results: The final model obtained had 231 standards and 3065 measures in the twelve defined units. The total mean score was 8. 38 and7. 65 for thesumof modelmeasures in two criteria of significanceandfeasibility, respectively. The twelve standard domains were developed for accreditation of service provider units, including specialized realms of communicable diseases, non-communicable diseases, population and family health, mental-social health and addition, teenage, youth, and school health, disaster management, environmental health, occupational health, oral health, healthy nutrition, health education, and promotion, as well as medication and laboratory. Conclusions: Given that the developed model encompasses all PHC domains, its implementing will result in continuous enhancement in the quality and safety of PHC in Iran.

Background: Regular exercise can alleviate oxidative stress. There are no studies examining changes in this variable as a result of an intense acute taekwondo (TKD) exercise. Objectives: We aimed to investigate the effect of one bout of intense TKD exercise on superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT), total antioxidant capacity (TAC), and malondialdehyde (MDA) in adolescent female taekwondokas. Methods: Ten adolescent female taekwondokas (age: 13. 71 2. 05 years; bodymassindex: 19. 75 2. 83kg/m2) voluntarily participated in the present study. They performed one bout of intense TKD protocol. Blood samples were obtained before and immediately after exercise. Then, SOD, GPx, CAT, TAC, and MDA were measured using the spectrophotometric method. Plasma volume was corrected using the Dill and Costill equation. Data were analyzed using a paired-sample t test. The significance level was set at P < 0. 05. Results: The results revealed that CAT activity (P = 0. 043) and serum TAC level (P = 0. 039) significantly increased after TKD exercise. However, no significant change was found in SOD (P = 0. 414), GPx activity (P = 0. 196), and MDA levels (P = 0. 377) immediately after exercise. Conclusions: Collectively, lipid peroxidation did not occur after one bout of intense TKD exercise in adolescent girls, which may be due to increased TAC levels and the activity of the CAT enzyme.

The search for disease-related targets and studying drug-protein and protein-protein interactions are central issues that would accelerate the clinical approval of a drug. Also, by developing an accurate method in this regard, time and resource consumption will significantly decrease. The low efficiency of some drugs in humans is a grave issue leading to a low rate of FDA approval after spending billions of dollars and decades of research. Several strategies and methods have been expanded to fill this gap, such as drug affinity responsive target stability (DARTS), stability of proteins from rates of oxidation (SPROX), cellular thermal shift assay (CETSA), and finally, thermal proteome profiling (TPP). The TPP is based on the combination of CETSA and quantitative mass spectrometry. Amongrecently introduced proteomics technologies, TPP demonstrates the ability to offer detailed proteomic profiles for the large-scale analysis of protein-ligand interactions, including endogenous ligands and proteins like cofactors and metabolites. TPP facilitates the identification of the markers governing drug efficacy and toxicity and provides an unbiased measure for estimating the rate of drug-target engagement. At a glance at TPP steps, after protein extraction, the molecule is exposed to different temperatures and drug concentrations. After discarding solubilized and stabilized proteins, the protein’ s identity is investigated by mass spectrometry analysis. As a result of the protein’ s structural stabilization after binding to its substrate, TTP helps to accurately identify target proteins with high throughput. In this study, we aimed to introduce the basics of this method and review most recent studies on this technique.

Personality disorders (PDs) are one of the most common psychiatric problems worldwide (1). In addition to morbidity and mortality, these disorders can lead to numerous high-risk behaviors such as risky driving, alcohol abuse, substance addiction, delinquency, violence, suicide, and homicide (2). Although the epidemiological data are necessary to provide comprehensive treatment systems and health policies in this area, in Iran, as a multi-ethnic and multi-cultural country, a few epidemiological studies are available for PDs. . . .

Background: The Persian language assessment, remediation, and screening procedure (P-LARSP) is the first formal approach to the analysis of language samples. Objectives: The present study aimed to investigate the unanalyzable utterances and mean length of utterances (MLUs: morpheme/ analyzable text units) based on the first two sections of the P-LARSP. Methods: Experienced speech and language pathologists (SLPs) collected and analyzed the 10-minute language samples from 96 typical children aged 18-60 months within the context of free play. The unanalyzable units included unintelligible utterances, symbolic noise, deviant, incomplete, ambiguous, and stereotyped units, repetition, and structurally abnormal text units. Results: No significant differences were observed between the age groups in terms of the total number of the text units (P > 0. 05) and unanalyzable text units (P = 0. 08). Analyzable text units (P = 0. 008) and MLUs (P = 0. 004) were significant across the age groups. In addition, each category of the unanalyzable text units had a specific pattern, and the percentage of the incomplete utterances increased significantly from 18 to 60 months of age (P = 0. 002). Conclusions: By applying the first two sections of the P-LARSP, we could sieve the analyzable from the unanalyzable text units and demonstrate the increasing trend of MLUs across the age groups. Increased incomplete utterances with age should be considered by SLPs during intervention and evaluation.

Background: Dysphagia is commonly seen in patients with severe dementia and increases the risk of mortality. The nature of the swallowing disorders caused by cognitive difficulties differs from post-stroke dysphagia. The relationship between dysphagia and cognitive function is vital for determining the best diagnostic and treatment plan for dementia-associated dysphagia. Objectives: In the current research, we suggest a model to identify the role of cognitive function in the occurrence of dysphagia in dementia patients. Methods: Ninety patients with dementia will be recruited in this experimental research. Dysphagia is screened and confirmed using the albertinen dementia dysphagia screening (ADDS) and the video fluoroscopic swallowing exam (VFSE). Also, cognitive function will be assessed by the mini-mental status examination (MMSE). The information related to dysphagic and non-dysphagic patients will be entered into structural equation models. Finally, the direct and indirect (i. e., via cognition) relationships between brain lesions and dysphagia will be evaluated. Results: The present study will provide evidence regarding the role of cognitive function in dysphagia occurrence in individuals with dementia in a structural equation model. Also, differences in performance (presence or absence of movement disorders) will be assessed in different types of dementia using another model. Conclusions: Moreover, the relative sensitivity of various cognitive domains to dysphagia will be determined in a separate model.

Background: Despite participation is an important outcome of person’ s rehabilitation process. there is no reliable and valid instrument for evaluation of participation in Persian-speaking spinal cord injuries (SCI). While SCI has serious damages on person’ s social participation, assessment of participation demands culturally adapted and valid instruments. Objectives: This study took place to obtain a valid, reliable instrument for evaluation of Rehabilitation-Participation (P-USER-P) in an Iranian SCI. Methods: This study was methodological research, participating in 200 individuals. Analysis of face and content validity, discriminant validity, internal consistency, and reliability conducted after receiving permission and verification of the backwardstranslation from the main developer. Results: During the cultural adaptation process, several modifications proposed by experts’ panel were made to ensure adaptation of items’ descriptions with Iranian culture. The Cronbach’ s and ICC coefficients of the frequency, restriction and satisfaction subscales were 0. 61, 0. 71, 0. 69, and 0. 75, 0. 84, 0. 84, respectively. The instrument also showed good reliability and discriminant validity characteristics. Conclusions: P-USER-P is a valid and reliable instrument for measuring objective and subjective participation in SCI patients. It is also adapted with Iranian culture which qualifies its utility in the rehabilitation process of Persian-speaking SCI patients.

Autism spectrum disorder is one of the most common developmental disorders, which depends on a variety of factors, including specific characteristics defined by social interactions, restricted interest, repetitive behaviors (1), stereotypes, and perceptual and expressive language. . . .

Objectives: This study was done to investigate the influences of cryotherapy on the joint position sense (JPS) and extensor muscles torque of the knee. Methods: Forty healthy volunteers (20 men, 20 women; age range, 21 – 30 y) participated. Two cooling pads were applied to the knee and anterior thigh for 15 minutes at 4° C. The accuracy of the knee JPS was evaluated before and after cooling in two angles, including 45° and 60° flexion. Extensor muscles torque of the knee was obtained in two velocities of 30° /s and 120° /s. Results: The effect of time and the interaction between the group and time were not significant for both active and passive repositioning error tests of the knee joint angles (P  0. 05). The knee extensor’ s muscle torque increased significantly during both velocities of 30° /s and 120° /s, immediately and 30 minutes after the cryotherapy in the experimental group (P 0. 01). Cooling for 15 minutes made a higher knee extensor muscle torque and did not change the JPS. Conclusions: These findings should be considered for therapeutic programs that involve exercise immediately after a period of cryotherapy.

Background: Some variables, such as age, gender, regional and dialectical differences influence speech tempo. Men and younger individuals speak faster than women and the elderly. Therefore, these variations should be considered when assessing speaking rate. Objectives: Since different accents influence speaking rates and there is no previous study investigated speech tempo with respect to regional and accent differences in Iran, and given that the elderly are more prone to problems influencing speaking rate, the present study was done to compare speech tempo and speaking rate in two different accents, namely Tehrani and Semnani, and to investigate some related factors. Methods: This cross-sectional study was performed on 200 elderly women selected via convenience sampling method. Speech tempo, speaking rate, verbal fluency, and cognition scores were compared using an independent-samples t-test. Pearson’ s correlation coefficient test was used to assess correlations between speaking rate and level of education, Montreal cognitive assessment (MoCA), and verbal fluency scores. Results: No significant difference was found in speech tempo between the studied accents (P = 0. 13). Speaking rate was significantly slower in the Tehrani accent than the Semnani one (P = 0. 04). The Tehrani elderly obtained significantly less scores in verbal fluency and MoCA ((P  0. 001) and (P = 0. 04), respectively. In both groups, speaking rate had a significant correlation with verbal fluency and MoCA scores but not with level of education. Conclusions: Although, our results showed no difference in speech tempo between the studied accents, the Tehrani elderly unexpectedly spoke more slowly meaning that they paused more while speaking. There was a relationship between faster speaking, better verbal fluency, and cognitive performance.

Background: Cognitive-attentional syndrome (CAS) is one of the primary constructs of depression, the treatment of which is highly challenging because of its high prevalence and the emergence of symptoms such as feelings of sadness, emptiness, and hopelessness. Objectives: The present study aimed to investigate the effectiveness of behavioral activation (BA) and acceptance and commitment therapy (ACT) in CAS in patients with depression. Methods: This quasi-experimental research utilized a pretest, posttest, and two-month follow-up design with a control group. The study population comprised 260 patients with a diagnosis of depression who referred to the psychological centers of Ahvaz in 2019. The sample consisted of 45 patients with depression selected by convenience sampling. We randomly divided the participants into two experimental groups (BA and ACT) and a control group (n = 15 per group). The research instrument included the cognitiveattentional syndrome (CAS-1) questionnaire. Data were analyzed using SPSS version 24. 0 with descriptive and inferential statistics, such as mean, standard deviation, and multivariate analysis of covariance (MANCOVA). Results: In terms of CAS and its components, there was a significant difference between the experimental and control groups in the posttest and follow-up phases (P = 0. 0001). Besides, ACT and BA significantly reduced CAS and its components in the posttest phase (P = 0. 0001). However, the effectiveness of BA in decreasing CAS and its components remained during the follow-up phase. Furthermore, the results showed that ACT was more effective in reducing attention to threat and metacognitive beliefs during the posttest phase. Conclusions: According to research findings, both BA and ACT are efficient therapies in reducing CAS in patients with depression. Thus, both approaches can be used to strengthen treatment interventions to reduce CAS in patients with depression.

Background: The first andmost basic area of occupational performance is the activities of daily living. These activities of life highly depend on the contextual and ecological (environmental) factors. Cultural values, parental expectations, social routines, and physical environment influence acquisition time of a child’ s daily activities. At present, there is no comprehensive and adapted-culturally tool to evaluate the daily life activities of Iranian children aged 3-6 years. Objectives: This study aimed to investigate the factor structure, construct validity, and reliability of the Activities of Daily Living in Iranian Children (ADLIC) scale. Methods: The participants were 470 Iranian parents of children among the ages from 3 to 6. Exploratory factor analysis, internal consistency, and test-retest reliability were conducted for data analysis. Convergent validity was measured by correlation to the Pediatric Evaluation of Disability Inventory (PEDI). Results: The results indicated that ADLIC has excellent reliability due to internal consistency (Cronbach’ s alpha 0. 96). Furthermore, the temporal stability of ADLIC was supported using the Intra-class correlations coefficient, which ranged between 0. 95 and 0. 98. Convergent validity between the ADLICandtwo subscales of PEDI, including self-care (0. 88)and mobility (0. 80), was good. The ADLIC scale showed a clear factor structure with five main components and ten factors based on the findings. Conclusions: ADLIC has excellent psychometric properties, including internal consistency and temporal stability, and can be used as a reliable and valid measure to assess the daily living activities of children aged 3-6 years.