Aims: The aim of this study was to evaluate the effects of an aquatic training course on the kinematic walking patterns of elderly women. Materials and Methods: Thirty elderly women aged 60–70, who had entry criteria for research, voluntarily entered the study process, of which nine women refused to continue cooperation. Participants were randomly assigned into control (n = 10, 63.2 ± 3.1) and experimental groups (n = 10, average age 64.4 ± 3.3). The exercise program consisted of an 8 week of aquatic protocol, three sessions a week, and each session was performed for 60 min. The h/p/cosmos gait analyzer was used to evaluate the kinematic patterns of walking on the treadmill with the force plate, and the velocity variables (km/h), cadency (steps/min), step length (Cm), and step time (s) were measured in two stages of pretest and posttest. Results: The results suggested that aquatic training had a significant effect on the kinematic patterns of walking (walking speed, cadency, and length of step) in elderly women (P ≤ 0.05). Conclusion: Since walking patterns and walking quality have a significant effect on maintaining balance and functional independence in the elderly populations, any intervention that improves these patterns will have a significant effect on the balance of elderly people. Therefore, water resistance exercises can improve the walking patterns in elderly women.

Introduction: Integration in the health system can improve the coordination and continuity of care for the patient. Clinical integration can facilitate the continuous, comprehensive, and coordinated provision of services at the individual level. This study was conducted to determine the effect of clinical variables on the integration of Iran's health system in 2017–2018. Methodology: This is an applied research which has been used in different stages of review, comparative, and quantitative methods in terms of necessity. In the first stage, various patterns of the theory and practice of integration of the health system were studied through library studies. Then, the common and noncommon dimensions of these patterns were set in a comparative table. After determining the variables of various patterns of integration, a questionnaire was developed, and its validity and reliability were confirmed. At the field stage, a survey of 506 experts and management experts of hospitals, data were collected, and exploratory and confirmatory factor analysis was performed. Results: Based on the results of the exploratory factor analysis in the clinical field, “the development of multifaceted care plans and team meetings” with the highest score of 0.649 was the most important. Regarding the standard coefficients of correlation analysis, the effect of the clinical factor on integration was 0.91. Furthermore, “case management,” “providing continuous care,” and “using protocols and clinical guidelines” with 0.79 factor load are the most important factors in the clinical integration of the health system. Conclusion: The health system can increase the quality of care through the development of multifaceted care plans and multiple team meetings, the development of coordination and continuity of care, focusing on the needs of patients, and step up the development of integration in the health system.

Background and Purpose: Excessive use of communication technologies such as mobile phones can lead to addiction; in this research, the prevalence of mental disorders among nursing staff dealt with the situation has been examined. Materials and Methods: This descriptive study has been implemented on 222 nurses Shahid Beheshti Hospital of Kashan in 2016. Data of mobile-phone addiction were assessed using a Persian questionnaire with standard reliability validity. The questionnaire included demographic information, including age, sex, marital status, education, and information about the possibilities of mobile features. The data analyzed by software SPSS and descriptive and analytical statistical methods were used. Results: Totally, 32 cases (14.4%) had scores higher than the overall mean score of the questionnaire, in addition to there was a significant difference regarding the sex, time, stress, difficulty in concentrating, error in clinical practice, and the mean score of mobile addiction (P = 0.001, <0.001, 0.003, >0.001, and 0.027). In addition, there was a significant relationship between the accident, job performance, speed, accuracy, and overall mean addiction to mobile-phone addiction. Conclusion: This study revealed that lots of people suffer from addiction to mobile phones, their work indexes are affected in some cases.

Background: There is mounting evidence that moderate- to high-intensity exercise training has a key role in skeletal muscle adaption. Low-intensity exercise with Blood flow restriction (BFR) associated with unique effect on muscle hypertrophy. Aims: The aim of this study was to investigate the effect of acute interval walking with BFR on phosphorylation of 4EBP1, P38, ERK, and myostatin (MSTN) of skeletal muscle in inactive men. Materials and Methods: Five healthy inactive men were participated in the study. Training protocol includes five intervals 2-min walking with BFR at 50%–60% maximum heart rate and 1 min at rest. All samples were collected immediately before exercise and 3 h after BFR training. Phosphorylation of 4EBP1, P38, and ERK skeletal muscle was evaluated by Western blotting and MSTN by Elayza test. Dependent t-test was used to analyze the data after subtracting the posttest score from the pretest. Results: However, there was a significant difference between the pre- and post-test for 4EBP1 (P = 0.001), ERK (P = 0.049), and MSTN (P = 0.0009). There was no significant difference between the pre- and post-test of P38 (P = 0/452) (P ≥ 0.05). Conclusion: As a result, acute interval walking with BFR activates mammalian target of rapamycin and mitogen-activated protein kinase pathways signaling in inactive men.

Aims: Heart transplantation is a valuable technique but the side effects of this surgery should be considered. The purpose of this study was to investigate the effect of rehabilitation training in patients who candidate for heart transplantation. Materials and Methods: This study was done by semi-experimental clinical trial method. Participants were selected from people who refer to the clinic (2010–2018). The information of the patients who candidate for heart transplantation (4 women, 14 men) were obtained (age: 60 ± 13, body mass index: 26.7 ± 3.7). Hemodynamic parameters were measured before and after the treatments. Training setting was at least 3 months and based on the exercise test of patients. Pharmacological and nutritional control and lifestyle education were also carried out. Results: The hemodynamic parameters were improved significantly (P ≤ 0.05). In some cases improvement in Pro Brain natriuretic peptide and homocysteine were observed. Conclusion: Along with other surgical techniques, it was possible to change the lifestyle as much as possible and encourage patients to noninvasive treatment. Patients should follow strict discipline, nutritional and drug policies. Patients should continue this lifestyle and positive thinking regularly. Probably the most important reason for patients undergoing heart transplant is sarcomeropathy. For this reason, regular exercise with effects on genetic signaling pathways can improve this condition if diagnosed early. Despite all the medical controls, it is likely that the most important point that improves patient's reliance is the patient's trust in the treatment method and the existence of a human relationship between the patients and the physician.

Aims: The aim of the present study was to investigate the effectiveness of acceptance and commitment therapy (ACT) on intolerance of uncertainty (IU), experiential avoidance (EA), and symptoms of generalized anxiety disorder (GAD) in individuals with type II diabetes. Materials and Methods: This study was quasi-experimental study with pretest/posttest design. In this study, 24 individuals with type II diabetes were selected by convenience sampling method and then randomly designed into two experimental and control groups. The experimental group participated in eight sessions of ACT, while the control group was not in any treatment. The participants completed GAD 7-item scale, Penn State Worry Questionnaire, IU scale, and Acceptance and Action Questionnaire-II. Data were analyzed by multivariate analysis of covariance. The significance level was 0.05. Results: The findings showed that ACT decreased the IU, EA, and symptoms of GAD in an individual with type II diabetes (P < 0.05). Conclusions: The results showed that ACT might be an efficient way to decrease the IU, EA, and symptoms of GAD in an individual with type II diabetes. Furthermore, therapists can use this therapeutic approach for decreasing IU, EA, and symptoms of GAD in the individual with type II diabetes.

Aims: The lack of adjustment of couples is not only devastating families but also ruin family relationships in second marriage. The aim of the study was to explain the couples' adjustment model based on the components of the schematic modes and coping styles among blended and normal families. Materials and Methods: The research method was descriptive from type of correlation. The statistical population consisted of normal and blended families of Mazandaran. Samples were selected through stratified random sampling (313 normal and 250 blended). To gather the data, the Spaniel Marital Adjustment Scale (1976), schematic questionnaire (1999), and the Ultra Extreme Compensation Questionnaire (1994) were used. To analyze the data, path analysis was used. Results: The findings showed that in both families, childhood and dysfunctional modes predict couple adjustment in a negative way (P < 0.05), and dysfunctional parenting mode has negative significant effect on couples adjustment in normal and not significant in blended families. The healthy adult mode has positive significant effect in normal and nonsignificant effect on the blended couples. Conclusions: Based on the findings, especially in the blended families that is the weakness of healthy adult modes and the emotional changes of couples in the components of the schematic modes suggest a decline in the compatibility of the spouses.

Aims: Staphylococcus epidermidis is an important bacterium, also one of the 40 species related to the Staphylococcus family. It can be found in the human normal body flora, commonly on the skin, and less commonly on mucosal flora. Instrument and Methods: In the cross-sectional study, we were isolated samples according to the laboratories standards, and S. epidermidis identification were collected for 1 year, 90 S. epidermidis from urinary tract infections of children were selected from educational hospitals in Isfahan, (Iran). In this way, we use the Kirby–Bauer method. S. epidermidis isolates were collected for determined biofilm producing method, with culturing in (Congo red agar) medium and microplate titration. Results: The results reveal that 45 methicillin resistance S. epidermidis isolates produce biofilm in different levels. The high resistance was for methicillin (50%), erythromycin (43.5%), ciprofloxacin (50.2%), and penicillin (46.9%). The lowest resistance was for linezolid (4%) and nitrofurantoin (5%). Conclusions: The results of our study show the high prevalence of antibiotic-resistant and biofilm producing of S. epidermidis strains, especially, in methicillin resistance S. epidermidis strains in the Isfahan hospitals, which could be a reservoir for antibiotic resistance genes.

Background: The comorbidity profile among chronic kidney disease (CKD) patients can influence and predispose them to increase mortality and health-care costs. In addition, there could also be a prolongation in the length of hospital stay and recurrent frequency of hospitalization. Aim: This study was predominantly designed to highlight and create awareness concerning the burden of comorbidity profile among CKD patients in renal practice. Materials and Methods: This was a descriptive prospective study of 18-month duration that was carried out to review the medical case records of consented adult CKD patients attending a Nigerian Tertiary Kidney Care Hospital from January 2015 to June 2016. Results: This study involved 123 consented adult CKD patients comprising 82 (66.67%) males and 41 (33.33%) females, with a mean age of 53.81 ± 16.03 years. A majority of the respondents 45 (36.59%) were having 2 comorbidities with hypertension in 103 (83.70%), diabetes mellitus in 39 (31.70%), obesity in 24 (19.51%), heart failure in 11 (8.90%), obstructive uropathy in 8 (6.50%), human immunodeficiency virus infection in 7 (5.70%), peptic ulcer disease/gastroesophageal reflux disease in 7 (5.70%), gastroenteritis/gastrointestinal tract sepsis in 6 (4.9%), stroke in 5 (4.10%), adult polycystic kidney disease in 5 (4.10%), and hepatitis B virus infection in 5 (4.10%), being the most frequent. Eighty-six (69.9%) patients were in CKD Stage 5, 15 (12.2%) were in CKD Stage 4, 19 (15.5%) were in CKD Stage 3, 2 (1.6%) in CKD Stage 2, and the remaining one (0.8%) in CKD Stage 1. Regarding the form of nephrological interventions offered, majority of the respondents 66 (53.66%) were on maintenance dialysis, followed by 53 (43.09%) on conservative care, while 4 (3.25%) were on renal graft transplant. Conclusion: The prevalence rates for comorbidities such as hypertension, diabetes mellitus, and obesity were significantly high among these CKD patients; this agreed with the previous studies conducted in other regions of the world. In this study, the comorbidity profile among CKD patients may significantly increase the risk of mortality, recurrent frequency of hospitalization, length of hospital admission, and health-care costs.

Aims: Bullying is an ever-increasing phenomenon in schools and it has far-reaching consequences on children and adolescents, for which necessary measures must be taken to prevent and reduce it. This study was aimed to investigate the effectiveness of mindfulness-based cognitive therapy for child (MBCT-C) on bullying behavior among children. Materials and Methods: the population of this study consisted of Grade 3 through 5 students in Kashan town in 2017–2018 school years. The sample consisted of 20 students who had been selected by inclusion and exclusion criteria. The conventional sampling method was used. A quasi-experimental design was used in this study. Participants completed the Illinois Bullying Scale before and after the intervention of experimental and control groups. Data were analyzed using analysis of covariance. Results: The findings showed that MBCT-C had a significant effect on bullying behavior reduction and the effect size in this intervention was 0.89. Furthermore, results from individual mean scores in bullying scale questions indicated that in pretest both experimental and control groups, “excluding others from in a group of friends” was the most frequent behavior and mindfulness training had effectively the highest effect on decreasing this character. Conclusion: It suggests that intervention concerning diminishing bullying behaviors may start with mindfulness training.