@article{ author = {Zadeh-Hendijani, Bahman and HoseinpourDelavar, Sedigheh and karimi, mohammad and ghahramani, mehr}, title = {The effect of circadian rhythm on response of neuropeptide Y and leptin to eight weeks of aerobic training in non-athlete obese young men}, abstract ={Background & Aims: In recent years, the issue of weight regulation, energy balance and energy homeostasis, appetite and food intake has always been a major topic of discussion among exercise physiology researchers. On the other hand, due to the close relationship between obesity and various factors related to the regulation of appetite and role of some peptides, many researchers interested to find better understanding on this field. Energy balance regulation is a complex issue and several mechanisms are involved in weight regulation; including genetic, physiological and behavioral factors. The hypothalamus is an important part of the brain that plays an important role in energy balance by secreting neuropeptides and various chemical transmitters. The hypothalamus exerts this regulatory action through two sets of signals. The activity of a group of signals reduces body fat, including serotonin and leptin, while another group of signals increase body fat and this action is done through an appetizing neuropeptide such as neuropeptide Y. Leptin is a peptide  hormone that is mainly synthesized and released by subcutaneous fat cells in a fixed, pulsating manner with a peak secretion at midnight .Leptin levels are highly correlated with circadian rhythms and sleep status. Leptin levels increase during the biological night and peak during the biological morning. In conclusion, it seems that the issue of regulating energy balance and eating behavior or appetite, affected by various neuro-hormonal factors. Exercise intervention is also considered as one of the effective factors in creating a negative energy balance and starting the process of reducing excess body fat. Numerous studies have been performed on the effect of aerobic exercise on weight loss and improvement of some neuro-hormonal factors affecting the regulation of energy balance, but in many of these studies there are conflicting results. One of the less discussed topics is the circadian rhythm and changes in some neuro-hormonal factors at different times of day. The aim of this research was to study effect of circadian rhythm on response of neuropeptide Y and leptin to eight weeks of aerobic training with moderate intensity in non-athlete obese young men. Methods: In a quasi-experimental study with pretest-posttest design, 36 non-athlete obese young men with means of age 25.4±3.3 years, weight 98.3±7.7 kg and body mass index 31.8±1.1 kg/m2 were selected purposely and available. Prior to participation, all subjects read and signed informed, voluntary consent forms. The subjects divided randomly into three equal groups (n=12) of control, morning training and evening training. Training intervention was performed during eight weeks, three sessions and with an intensity of 60-75 percent of maximum heart rate. The aerobic training program started in the first week with an intensity of 60% of the maximum heart rate and then every two weeks the aerobic training was increased by 5%. Each session consisted of 10 minutes warming-up, 40 minutes interval aerobic training and 10 minutes cooling-down. During exercise, the heart rates of subjects were monitored using a Polar heart rate monitor. The morning training and evening training groups, performed aerobic training program at 10 am and 5 pm respectively. During the exercise intervention, the subjects used a similar diet and were prohibited from taking any medications or supplements. Before and after training intervention, blood sampling was performed at 10 hours fasting state. Plasma levels of neuropeptide Y and leptin were analyzed using validated ELISA kits. Data were analyzed by using one-way analysis of variance and at significant level at p<0.05. Results: The finding of this study indicated that eight weeks of aerobic training intervention in morning and evening caused to significant decrease in plasma levels of leptin (p=0.03) and significant increase in plasma levels of neuropeptide Y (p=0.0001).In comparison between morning and evening training, the changes of Leptin levels (p=0.02) and neuropeptide Y levels (p=0.0001) was more in evening training. Conclusion: Circadian rhythms are a set of endogenous autonomous oscillators that act to coordinate the body's internal clock in a 24-h day/night cycles and allow different organisms to have adaptation to fluctuating environment. The circadian rhythms are stimulated by the daily changes of light and are followed by hormonal fluctuations; especially the hormones involved in the discussion of appetite. According to the results of this study, eight weeks of aerobic training with moderate intensity causes to changes in plasma levels of neuropeptide Y and leptin hormones, so that these changes in evening training were more than morning training. The lowest concentration of leptin is at noon and the highest is at midnight. This is due to the effects of insulin on leptin and increased glomerular filtration in the morning. It is not yet clear how these circadian rhythm changes affect the role of leptin in weight control. A further decrease in leptin levels in the evening training group is probably related to lower baseline leptin levels at that time. Several mechanisms increase neuropeptide Y. Neuropeptide Y is sensitive to blood glucose and is activated by decreases in blood glucose levels. Aerobic exercise reduces muscle glycogen stores and increases glucose uptake by active muscles. lowering blood glucose levels is significantly associated with increased appetite. Decreases in blood glucose stimulates the secretion of neuropeptide Y. Another mechanism of increase in neuropeptide Y levels is its negative association with leptin levels. As some studies have shown, under positive energy balance conditions, high leptin levels are associated with suppression of neuropeptide Y expression. The results of the present study showed that a decrease in plasma levels of leptin was associated with an increase in plasma levels of neuropeptide Y. In addition, previous investigations have shown that Cortisol and growth hormone are among the most important hormones affecting the increase of leptin levels that are affected by the circadian rhythm. This is probably an explanation for the significant increase in neuropeptide Y levels in the evening training group. One of the limitations of the present study was the lack of evaluation of hormones such as cortisol, insulin and growth hormone, which fluctuate under the influence of circadian rhythms. In conclusion it seems that eight weeks of aerobic training with moderate intensity may have positive effects on changes in neuropeptide Y and leptin hormones involved in the discussion of appetite. These changes seem to be more in the evening training.}, Keywords = {Appetite, Obesity, Circadian Rhythm, Aerobic Exercise}, volume = {28}, Number = {8}, pages = {1-10}, publisher = {Iran University of Medical Sciences}, title_fa = {تأثیر ریتم شبانه روزی بر پاسخ نوروپپتیدY و لپتین به هشت هفته تمرین هوازی در مردان جوان چاق غیرورزشکار}, abstract_fa ={زمینه و هدف: ریتم شبانه‌روزی با تغییرات روزانه در میزان نور تحریک می‌شود و نوسانات هورمونی به‌ویژه هورمون‌های درگیر در بحث اشتها را به دنبال دارند. هدف تحقیق حاضر، مطالعه اثر ریتم شبانه‌روزی بر پاسخ نوروپپتید Y و لپتین به هشت هفته تمرین هوازی در مردان جوان چاق غیرورزشکار بود. روش کار: در یک مطالعه نیمه تجربی، 36 مرد جوان چاق غیرورزشکار با میانگین سن 3/3±4/25 سال، وزن 7/7±3/98 کیلوگرم و شاخص توده بدن 1/1±8/31 کیلوگرم بر مترمربع، به صورت هدفمند و در دسترس به عنوان آزمودنی انتخاب شدند. آزمودنی‌ها به‌طور تصادفی به سه گروه مساوی شامل؛ کنترل، تمرین صبح و تمرین عصر تقسیم شدند. مداخله تمرین هوازی طی هشت هفته، سه جلسه در هفته و با شدت 60 تا 75 درصد ضربان قلب بیشینه اعمال گردید. قبل و پس از مداخله تمرین، خون‌گیری در شرایط 10ساعت ناشتایی انجام شد. داده‌ها با استفاده از آزمون تحلیل واریانس یک‌راهه و در سطح معناداری 05/0>p تجزیه و تحلیل گردید. یافته‌ها: مداخله تمرین هوازی در صبح و عصر باعث کاهش معنادار در مقادیر لپتین (03/0=p) و افزایش معنادار در نوروپپتید Y (0001/0=p) گردید. در مقایسه بین تمرین صبح و عصر، تغییرات لپتین (02/0=p) و نوروپپتید Y (0001/0=p) در تمرین عصر بیشتر بود. نتیجه‌گیری: براساس یافته‌ها، تمرینات هوازی با شدت متوسط می‌تواند اثرات مثبتی بر تغییرات هورمون‌های نوروپپتید Y و لپتین در بحث اشتها داشته باشد. به نظر می‌رسد این تغییرات در تمرینات عصر بیشتر باشد.  }, keywords_fa = {اشتها, چاقی, ریتم شبانه روزی, فعالیت ورزشی هوازی}, url = {http://rjms.iums.ac.ir/article-1-6471-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6471-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Nematalahi, Mahsa and Farzanehhesari, Amin and Farzanegi, Parvi}, title = {TGF-β1 response to eight weeks combined training with different orders in slow and fast twitch muscles in Wistar rats}, abstract ={Background & Aims: Skeletal muscle is a highly malleable tissue capable of significant metabolic and morphological adaptations in response to disruptions in cellular homeostasis induced by exercise. Resistance and endurance training represent divergent exercise modes, with each inducing distinct responses within the muscle milieu that act to minimize cellular stress. The well-known adaptive features of chronic muscle contraction include muscle hypertrophy and increased strength. These features are induced by high-intensity muscle contraction, such as that involved in resistance exercises. Other typical adaptations are increases in oxidative capacity and glucose uptake, which are induced by low-intensity, high volume muscle contraction, such as that observed during EE. combined training, a combination of endurance exercises (EE) and resistance exercise (RE) in succession, is used widely in exercise prescription to simultaneously improve muscular strength and cardiovascular function. Interestingly, accumulating evidence indicates that this combination of the two exercise modes may hamper strength and muscle hypertrophic adaptations to RE. However, studies on the effects of physiological adaptations of EE on RE-induced muscle hypertrophy have shown mixed results. Intriguingly, a recent study in humans reported that EE performed prior to RE increased muscle mass to a greater extent than long-term RE alone, suggesting that EE may not always attenuate RE-induced muscle hypertrophy. Transforming growth factor beta 1 (TGF-β1) is a polypeptide member of the transforming growth factor beta superfamily of cytokines. TGF-β1 plays essential roles in various biological processes, including cell growth, differentiation, apoptosis, tissue development, and inflammation. While transient TGF-β expression may contribute to muscle regeneration after injury, the chronic elevated expression of TGF-β in skeletal muscle may be detrimental. Although the role of TGF-β in muscle mass regulation and skeletal muscle fibrosis has been studied extensively, the effects on hypertrophy signaling pathways muscle cells and underlying mechanisms are not well understood. Furthermore, taking into account the functional and mechanistic similarities between TGF-β and myostatin, as well as the fact that both ligands have been implied as possible therapeutic targets for muscle wasting disorders, the purpose of the present study was to determine the effect of eight weeks of combined training with different order on TGF-β1 in fast and slow twitch muscles in male wistar rats. Methods: In this study, 40 adult male Wistar rats (age: 10 weeks, weight: 180-200 gr) were maintained on a 12:12-h dark-light cycle in a temperature-controlled environment (22 oC) with free access to standard laboratory chow and tap water. Before the allocation to their respective groups, all animals underwent three familiarization sessions, separated by 48-h intervals, to get acquainted with the exercise protocols (i.e., endurance and strength exercises). Rats were randomly allocated into resistance training (n=8), endurance training (n=8), resistance- endurance training (n=8), endurance- resistance training (n=8) and control (n=8) groups in equal laboratorial condition. Resistance training was conducted for 8 weeks (5 sessions/week) on a special 1-meter high ladder (divided by 26 stairs) with the loading of percent of overloading test (%75 of weight body) in the first week and increased to 30gr per week. Training included 10 sets of with 2 min rest between sets. Endurance training consisted of treadmills run, that speed and duration of running gradually increased during training period, from 9 m/min and 10 minutes in the first week to 30 m/min and 60 minutes in the last week. Animals in the endurance- resistance group performed the EE protocol first. 5 min after the completion of the EE bout, they were placed in the strength-training apparatus to perform the RE protocol. In the resistance- endurance group performed RE 5 minutes before EE. Animals were killed by decapitation 24 h after the exercise protocols and the flexor hallucis longus (FHL) and soleus muscles were removed from both legs, weighed on an analytical balance, frozen in liquid nitrogen, and stored at -80oC for further analysis. The proteins levels of TGF-β1 were measured by ELISA method. After normality (Shapiro Wilk test) and variance assurance (Levene test), the groups were compared by one-way analysis of variance and the Tukey post hoc test was applied for multiple comparison purposes. The level of significance was set at P ≤ 0.05. Results: The results showed that weight of FHL and soleus muscles significantly increased in all experimental groups compared to control group. The TGF-β1 in fast twitch muscle decreased significantly in strength group (p=0.008). Although both resistance- endurance training and endurance- resistance training resulted in no significantly decrease in TGF-β1 for FHL and soleus, but there were no significant differences between combined training with differing order (P≥0.05). Conclusion: It seems that exercise order in combined training result in no different effect on TGF-β1 in fast and slow twitch muscles in wistar rats. The majority of current molecular data suggests that endurance exercise does not compromise early anabolic responses to resistance exercise. Thus, sports scientists but mostly the coaches should be very careful about the training strategies which they are willing to follow, when a combination of endurance and resistance training is needed, by taking into consideration how different training modalities interact between them. In an effort to maximize the training adaptations from a combined and thus limit the effects, sports scientists and coaches should consider the level of fatigue from both modules and the need of inter-session time intervals to minimize the training induced overall fatigue. However, further elucidation of the molecular factors mediating the specificity of training adaptation in human skeletal muscle is warranted, which in turn may provide additional mechanistic insight into the combined interference phenomenon. Ultimately, improved understanding of the roles of individual combined training variables, including within-session exercise order in modulating the interference effect is required to guide exercise prescription for simultaneously maximizing divergent training adaptations. Future work should aim to further clarify the roles of these training variables in acute and particularly chronic interference in trained individuals to inform practical recommendations for minimizing interference between combined resistance and endurance exercise.  }, Keywords = {Combined training, TGF-β, Slow twitch muscle, Fast twitch muscle}, volume = {28}, Number = {8}, pages = {11-20}, publisher = {Iran University of Medical Sciences}, title_fa = {پاسخ فاکتور رشد تغییر شکل دهنده بتا به هشت هفته تمرین ترکیبی با ترتیب متفاوت در عضلات تند وکند تنش موش}, abstract_fa ={زمینه و هدف: مطالعات زیادی نقش سایتوکاین TGF-β1 در تنظیم رشد و ماتریکس خارج سلولی و تمایز سلولی را نشان داده­اند. هدف از مطالعه حاضر، مقایسه اثر 8 هفته تمرین ترکیبی با دو ترتیب مختلف بر میزان TGF-β1 عضله اسکلتی تند و کند تنش موش‌های نر ویستار می­باشد. روش کار: برای انجام این مطالعه، 40 سر موش نر ویستار  به روش تصادفی به 5 گروه: تمرینی مقاومتی، استقامتی، مقاومتی-استقامتی، استقامتی- مقاومتی و کنترل تقسیم شدند. ﮔﺮوه ﺗﻤﺮﻳﻦ مقاومتی به مدت 8 هفته (5 جلسه در هفته) که شامل بالا رفتن از نردبان مخصوص به ارتفاع 1 متر و متشکل از 26 پله بود که بر اساس درصدی از آزمون اضافه بار (75 درصد وزن) در هفته اول شروع و هر هفته 30 گرم با آن اضافه شد. تمرین استقامتی بر روی تردمیل و با شدت 12 متر در دقیقه و زمان 15 دقیقه در هفته اول شروع و با افزایش سرعت و زمان دویدن به 30 متر در دقیقه و زمان 60 دقیقه در هفته هشتم رسید. از روش آماری تحیلیل واریانس یکطرفه و سطح معناداری 05/0 ≥α استفاده شد. یافته ­ها: نتایج نشان داد که تمرین مقاومتی منجر به کاهش معنیدار میزان TGF-β1 عضله تند انقباض نسبت به گروه کنترل شد (008/0P=). اگرچه هر دو تمرین ترکیبی منجر به کاهش غیرمعنیدار TGF-β1 شدند ولی تفاوت معنی­داری بین گروه­های تمرین ترکیبی با ترتیب متفاوت مشاهده نشد (05/0P≥). نتیجه ­گیری: به نظر می­رسد که ترتیب اجرای تمرین ترکیبی منجر به پاسخ متفاوتی در بیان TGF-β1 عضلات تند و کند انقباض موش‌های ویستار نمی­شود.  }, keywords_fa = {تمرین ترکیبی, فاکتور رشد تغییر شکل دهنده, عضله تند تنش, عضله کند تنش}, url = {http://rjms.iums.ac.ir/article-1-6335-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6335-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Fasihi, Ahmad and Siyahkohiyan, Marefat and Jafarnezhadgero, Amirali and Fasihi, Leila and Sheikhalizade, Hame}, title = {The effect of exhaustive fatigue protocol on knee muscle co-contraction in healthy and pronated foot individuals during walking}, abstract ={Background & Aims: Fatigue can change the biomechanical parameters of movement by Inability to produce enough force to perform a certain motor task (1). Abnormalities in the lower extremities (such as the pronated foot) can adversely affect the biomechanics of human movements (such as walking) and cause unstable symptoms in the joints and lack of co-contraction in the lower extremities (2). In a dynamic position such as walking, from a biomechanical point of view, the simultaneous function of the agonist and antagonist muscles around the joint as well as the loads on the joint are important to maintain the position and stability of the joint (13). Due to structural changes such as increased internal rotation of the tibia and abduction of the anterior leg at the pronated foot and thus reduced impact absorption when running, fatigue may cause more pressure to be applied to the active muscles and structures involved in walking during the stance phase (10). Considering the role of co-contraction of the muscles around the knee in the control and stability of the knee joint during walking, and also due to the lack of sufficient studies on co-contraction while walking, Therefore, a more detailed study of this issue is necessary after fatigue (16). Also, recognizing the effect of fatigue on muscle co-contraction of the muscles around the knee during walking can provide a new perspective for biomechanics and other rehabilitation specialists to better implement the rehabilitation program (15). Therefore, The main purpose of this study was the effect of exhaustive fatigue protocol on knee muscle co-contraction in healthy and pronated foot individuals during walking. Methods: Fourteen young men with pronated feet With average (age 24.66±3.29 years and height 170.52±11.66 cm and weight 66.56±15.42 kg) and 14 healthy feet With mean (age 25.27±3.14 years and height 173.7±6.2 cm and weight 72.3±4.7 kg), participated in the study. The fatigue protocol of this study was to run at the heart rate deflection point (HRDP) level until fatigue. HRDP is defined as the point of deviation of the heart rate from a straight line in examining the relationship between workload and heart rate, which is used as a criterion for planning the intensity of aerobic exercise (20). Two foot switches were used to record the time characteristics of the stance stage, ie contact of the heel with the ground and separation of the toes from the ground, one of them was installed in the outer part of the posterior part of the heel and the other was installed on the first sole-toe joint. In the classification of different stages of walking from the moment of heel contact with the ground to the moment of toe contact with the ground as the heel contact stage, the time interval between toe contact with the ground to the heel separation as the middle stage of establishment and the time interval between heel separation from the ground and toe separation (23). Electromyography activities of the Rectus femoris (RF), Vastus medialis or VM, Vastus lateralis (VL), Semitendinosus (ST), Biceps femoris (BF), Gastrocnemius medialis (GM), and Tibialis anterior (TA) muscles in two stages before and after fatigue protocol (pre-test and post-test) using (Biometrics Ltd, UK) 8-channel wireless and bipolar surface electrodes Model of surface electrode pairs Bipolar Ag / AgCl (25 mm center-to-center distance, 100 MPa input impedance, Common-mode rejection ratio (CMRR) less than 110 dB at 50 to 60 Hz) were recorded (25).To evaluate the normality of the data, Shapirovilk test was used. To compare the data between the pre-test and post-test stages of the two groups analysis of variance with repeated measures(ANOVA) and Bonferroni post hoc test were used. The statistical analysis was performed using the SPSS software version 25, the significance level was considered(p≤0.05). Results: The results showed that after fatigue in both pronated and healthy foot groups, during the pre-test and post-test stages of walking, general knee joint co-contraction in the mid-stance phase (p=0.014) and the swing phase (p=0.032) Significantly decreased. and the Flexor/extensor directed co-contraction of the knee joint during the heel contact phase phase in the pronated foot compared to the healthy foot group, during the pre-test and post-test stages, was significantly reduced (p=0.031). and the the internal/external directed co-contraction of the knee joint during the mid-stance phase phase in the pronated foot compared to the healthy foot group, during the pre-test and post-test stages, was significantly reduced (p=0.048).Another part of the results of the present study showed that after fatigue in both pronated and healthy foot groups, during the pre-test and post-test stages of walking, the Vastus medialis / Vastus lateralis directed co-contraction of the knee joint during the push off phase, Significantly increased (p=0.012). The other components did not show any significant differences. Conclusion: The general knee co-contraction of both pronated and healthy foot groups Significantly decreased. it seems that fatigue that occurs as a result of changes in muscle function, by changing the locomotor system can change the mechanics of movement and joints while running. Therefore, perhaps this difference in muscle activity observed after fatigue is one of the mechanisms for changes in joint mechanics and reduction of general contraction.An increase in directional co-contraction in people with pronated feet indicates an increase in pressure on the internal structures of the ankle. Long-term running may expose the internal structures of the foot to the risk of overload and injury. In general, one of the factors in the change in the degree of stability and loads of the joint can be the contraction of the muscles around the joints (22). This means that if there is a decrease in joint stability, the contraction of the muscles around the joint will change to stabilize the joint. In other words, the change in contraction is a sign of instability in the joint. Therefore, it is suggested that in investigating the effects of fatigue on walking mechanics and the incidence of walking injuries in people with pronated foot, muscle co-contraction in the joints should be considered to determine whether these changes to compensate for traumatic mechanical changes after fatigue created or related to muscle adaptation to long-term activity.  }, Keywords = {Pronated foot, Co-contraction, Walking, Exhaustive Fatigue Protocol}, volume = {28}, Number = {8}, pages = {21-32}, publisher = {Iran University of Medical Sciences}, title_fa = {تاثیر پروتکل خستگی درمانده ساز بر هم‌ انقباضی عضلات اطراف زانو در افراد سالم و با پای پرونیت طی راه رفتن}, abstract_fa ={زمینه و هدف: خستگی به وسیله ناتوانی در تولید نیروی حرکتی، می‌تواند پارامترهای بیومکانیکی حرکت را تغییر دهد. هدف این مطالعه تاثیر پروتکل خستگی بر هم‌ انقباضی عضلات اطراف زانو در افراد سالم و با پای پرونیت طی راه رفتن بود. روش کار: در این مطالعه تعداد 28 آزمودنی به صورت تصادفی به 14پای پرونیت و 14 نفر پای سالم تقسیم شدند. فعالیت الکترومایوگرافی عضلات منتخب قبل و بعد از اجرای پروتکل ثبت گردید. پروتکل خستگی، دویدن در سطح نقطه شکست ضربان قلب تا رسیدن به درماندگی بود. داده‌ها با استفاده از نرم‌افزار SPSS و آزمون تحلیل واریانس با اندازه گیری‌‌های مکرر مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: هم ‌انقباضی عمو‌می‌مفصل زانو، پس از خستگی در هر دو گروه پای پرونیت و سالم، در فاز میانه ‌استقرار (014/0=p) و نوسان (032/0=p). به طور معنی‌داری کاهش یافت. و هم ‌انقباضی جهت‌دار، فلکسوری/ اکستنسوری، در گروه پای پرونیت در مقایسه با پای سالم در فاز تماس پاشنه (031/0=p) و داخلی/ خارجی در فاز میانه استقرار (048/0=p) به طور معنی‌داری کاهش یافت. نتیجه‌گیری: هم ‌انقباضی عمو‌می‌در هر دو گروه کاهش یافت. ضعف عضلات اطراف مفصل به دلیل خستگی می‌تواند یکی از دلایل آن باشد. هم ‌انقباضی جهت دار، فلکسوری/ اکستنسوری و داخلی/ خارجی زانو پس از خستگی در گروه پای پرونیت در مقایسه با پای سالم کاهش یافت. خستگی احتمالا ساختارهای داخلی پای پرونیت را بیشتر در معرض خطر آسیب قرار می‌دهد. بنابراین، پیشنهاد می‌شود که در بررسی اثرات خستگی بر مکانیک راه رفتن به هم ‌انقباضی عضلات در مفاصل توجه شود}, keywords_fa = {پای پرونیت, هم ‌انقباضی, راه رفتن, پروتکل خستگی درمانده ساز}, url = {http://rjms.iums.ac.ir/article-1-6585-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6585-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Ahmadi, Mohsen and Kazemzadeh, Yaser and Mirzayan, Sanaz and Shahedi, Valioah and Eizadi, Mojtab}, title = {Improvement of glucose levels and insulin resistance in the absence of change in adiponectin expression in subcutaneous adipose tissue in response to intence interval training in obese diabetic rats}, abstract ={Background & Aims: Type 2 diabetes is the most common endocrine disorder of the consequences of obesity. Adiponectin, due to its anti-diabetic properties and anti-atherogenic effect, plays an important role in the treatment goals of type 2 diabetic patients and metabolic syndrome. Adiponectin, also called Acrp30, AdipoQ, GBP-28 and APM1, is a 244 amino acid protein that is mainly secreted by adipose tissue. This anti-inflammatory cytokine was simultaneously detected by 4 different groups in different ways. Decreased plasma or serum levels due to some genetic or environmental factors play a significant role in the prevalence of diabetes or insulin resistance syndrome. Unlike other adipokines, such as TNF-α and resistin, which cause insulin resistance in obese or type 2 diabetics, adiponectin expression is reduced in obese and insulin-resistant animal models. A decrease in plasma adiponectin pushes the onset of diabetes in these animal models along with a decrease in insulin sensitivity. Moderate to severe exercise improves serum adiponectin concentrations. After 8 weeks of swimming training by diabetic rats, a significant increase in serum adiponectin levels and its mRNA expression in visceral adipose tissue was observed. Insulin resistance improves adiponectin-independent exercise through exercise. 8 weeks of aerobic training led to increased expression of adiponectin gene and protein in visceral adipose tissue, decreased insulin resistance and blood glucose in obese rats. In another study, 12 weeks of aerobic training increased the expression of adiponectin type 1 and 2 receptors (AdipoR1, AdipoR 2) in blood mononuclear cells along with increased insulin sensitivity and decreased abdominal circumference in young men. This anti-inflammatory cytokine is highly expressed in subcutaneous adipose tissue and affects insulin signaling pathways. Therefore, the present study aimed to determine the effect of 8 weeks of intermittent exercise on adiponectin expression in subcutaneous adipose tissue, insulin resistance, and blood glucose and serum insulin levels. Methods: The statistical population of the present experimental study consists of all male Wistar rats of Pasteur Institute of Iran, among which 16 10-week-old male rats weighing 210 to 250 g were purchased. The induction of type 2 diabetes was followed by 8 weeks of high-fat diet and intraperitoneal injection of STZ. The rats were divided into interval and control groups. The rats of this group participate in training program from the twentieth week. The control group did not participate in the training program during this period. 48 hours after the last training session, all rats in the periodic and control groups are described after a 10-hour night fast (fasting). 48 hours after the last training session (10 to 12 hours fasting), rats in both groups by intraperitoneal injection of a mixture of ketamine 10% at a dose of 50 mg / kg and xylosine 2% at a dose of 10 mg / kg were anesthetized. The animal's chest was then dissected and a blood sample was taken directly from the animal's heart to ensure minimal animal harm. Subcutaneous adipose tissue was sampled and after washing in physiological serum, it was immersed in 1.8 microtubes containing RNAlaterTM fluid with a ratio of 20% for molecular experiments. Comparison of variables between the two groups was performed using independent t-test. All statistical analyzes were performed using SPSS / Win software version 22. Results: Results from independent t-test also indicate a significant difference between each of the variables of fasting glucose, serum insulin and insulin resistance between the two groups. In other words, intermittent exercise led to a significant decrease in fasting glucose (P <0.001) and insulin resistance (P = 0.002) and also a significant increase in serum insulin (P <0.001) compared to the control group. However, no significant difference was observed in the expression of adiponectin in subcutaneous adipose tissue. In other words, 8 weeks of intermittent exercise did not affect adiponectin expression in subcutaneous adipose tissue in obese type 2 diabetic rats (P = 0.949). Conclusion: In the present study, despite no change in adiponectin expression in response to intermittent exercise, glucose levels and insulin resistance decreased significantly. In other words, 8 weeks of intermittent exercise resulted in a significant reduction in glucose and insulin resistance in obese type 2 diabetic rats compared to the control group who did not participate in the exercise program. However, adiponectin expression in subcutaneous adipose tissue was not affected by intermittent exercise. Other studies have attributed lower blood glucose directly to increased insulin function or improved insulin resistance in response to exercise in diabetic rats. Despite the evidence for the effectiveness of exercise on insulin function and glycemic profile in diabetic rats, improvement in insulin resistance was observed in the study of improved insulin function in the absence of adiponectin expression change in subcutaneous adipose tissue. Previous studies, however, have strongly emphasized the potential effect of adiponectin on protein levels or gene expression on insulin signaling pathways in adipose and muscle tissue. In the present study, although the lack of significant change in adiponectin expression in subcutaneous adipose tissue may be attributed to the small number of samples studied or the length of the training period, it is also possible that the effect of periodic exercise on serum adiponectin levels in rats Studies have shown that adiponectin expression in adipose tissue and failure to measure serum adiponectin levels is one of the limitations of the present study. This is because the effects of exercise may affect protein levels or the expression of adiponectin in other tissues of the body, such as muscle or liver tissue. Also, the improvement in insulin resistance in response to intermittent exercise may be attributed to a decrease in inflammatory cytokines. Because increased expression or levels of these proteins in target tissues such as adipose tissue leads to increased insulin resistance. Decreased blood glucose levels may also be rooted in increased serum insulin in response to intermittent exercise. Because independent of changes in insulin at target tissue levels such as adipose and muscle tissue, increasing serum insulin levels in response to exercise leads to lower blood glucose and improved glycemic profile. Since in the present study, the induction of type 2 diabetes in obese rats was due to partial destruction of the pancreas by intraperitoneal injection of low-dose STZ, insulin synthesis and release from pancreatic beta cells was certainly reduced. Therefore, research studies have revealed that continuous exercise through both hyperplasia and hypertrophy of beta cells leads to the repair of these cells, which results in increased synthesis and secretion of insulin from the pancreas and ultimately improve glucose membrane transfer in the target tissue. In this regard, Eizadi et al. (2017) attributed the decrease in blood glucose in response to long-term intermittent exercise in type 2 diabetic rats to increased serum beta and insulin function. It should be noted that in the present study, intermittent exercise was associated with an increase in serum insulin compared to the control group. Interval training is associated with improved fasting glucose in type 2 obese diabetic rats. Despite no change in adiponectin expression in subcutaneous adipose tissue, this improvement may be attributed to increased insulin function or decreased insulin resistance in response to the exercise process. No change in adiponectin expression is reported while dependence of insulin signaling pathways in adipose tissue has been reported in laboratory studies. The lack of significant change in adiponectin expression may be attributed to the small number of samples studied, but further studies in this area are suggested.  }, Keywords = {Interval training, Adiponectin expression, Insulin Resistance, Type 2 diabetes}, volume = {28}, Number = {8}, pages = {33-43}, publisher = {Iran University of Medical Sciences}, title_fa = {بهبود سطوح گلوکز و مقاومت انسولین در غیاب تغییر بیان آدیپونکتین در بافت چربی زیر پوستی در پاسخ به تمرینات تناوبی شدید در رت های چاق دیابتی}, abstract_fa ={  زمینه و هدف: شواهد ژنتیکی از نقش مؤثر عوامل رونویسی در مسیرهای سیگنالینگ انسولین در بافت هدف حکایت دارند. مطالعه حاضر با هدف تعیین اثر تمرینات تناوبی شدید بر بیان آدیپونکتین در بافت چربی زیرپوستی همچنین گلوکز، انسولین و مقاومت انسولین در رت‌های چاق دیابتی نوع 2 انجام شد. روش کار: برای این منظور 16 سر رت نر ویستار 10 هفته‌ای توسط 8 هفته رژیم غذایی پرچرب چاق شده سپس به‌واسطه تزریق درون صفاقی استرپتوزوتوسین (STZ) دیابتی نوع 2 شدند. پس از القای دیابت، رت‌ها به دو گروه های تمرین تناوبی (8 = n) و کنترل (8 = n) تقسیم شدند. گروه تناوبی در یک دوره تمرینات تناوبی 8 هفته‌ای به تعداد 5 جلسه در هفته در قالب تکرارهای دویدن روی تریدمیل با استراحت فعال بین تکرارها شرکت نمودند و گروه کنترل در برنامه تمرینی شرکت نداشتند. 48 ساعت پس از آخرین جلسه تمرینی رت‌های هر دو گروه در شرایط ناشتا قربانی شدند و سطوح گلوکز، انسولین و مقاومت انسولین همچنین بیان آدیپونکتین در بافت چربی زیرپوستی اندازه‌گیری شده و توسط ازمون تی مستقل بین دو گروه مقایسه شدند. یافته‌ها: تمرینات تناوبی به کاهش معنی‌دار گلوکز ناشتا (001/0 > P) و مقاومت انسولین (002/0 = P) همچنین افزایش معنی‌دار انسولین سرم (001/0 > P) نسبت به گروه کنترل منجر شد. تفاوت معنی‌داری در بیان آدیپونکتین در بافت چربی زیرپوستی بین دو گروه مشاهده نشد (949/0 = P). نتیجه‌گیری: علیرغم عدم‌تغییر بیان آدیپونکتین در بافت چربی زیرپوستی، تمرینات تناوبی به‌واسطه بهبود عملکرد انسولین و افزایش انسولین سرم  به کاهش گلوکز خون در رت‌های دیابتی نوع 2 منجر می‌شود. شناخت مکانیسم‌های عهده‌دار پاسخ آدیپونکتین به تمرینات تناوبی نیاز به مطالعات بیشتر دارد.  }, keywords_fa = {تمرین تناوبی, بیان آدیپونکتین, مقاومت انسولین, دیابت نوع 2}, url = {http://rjms.iums.ac.ir/article-1-6626-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6626-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Geramfard, Nahid and Naghibi, Saeed and ShariatzadehJoneydi, Mohammad and Barzegari, Ali and Saadatmand, Minoo}, title = {Changes in PKa gene expression following three models of continuous training with moderate, high intensity and high intermittent intensity training in liver tissue of male Wistar rats}, abstract ={Background & Aims: The liver is a metabolic organ responsible for the detoxification of various substances. Harmful metabolic products formed in other organs can be indirectly affected. The liver contains proteins and enzymes with large antioxidant capacity. Many biochemical markers are involved in regulating liver behavior; obviously, evaluating the behavior of these markers is effective in identifying mechanisms affecting liver function. Protein kinase-A (PKa) is a hepatic protein marker whose activity is dependent on cellular levels of cyclic adenosine monophosphate (cAMP) and is dependent on the protein kinase AMP Is also famous. PKa So far, several links have been observed between PKa gene expression and cardiovascular disease, hypertension, type 2 diabetes, cancer, and osteoarthritis, which lead to the importance of this protein as one of the influential factors in the level of general health. Thus, tracking PKa signaling can identify pathways and health-related changes. Aerobic exercise has beneficial effects on liver function and improves its metabolism and antioxidant capacity. Following aerobic exercise, hepatic enzyme markers have been shown to significantly decrease and improve liver function in patients. Periodic exercises are an effective approach to improving the capacity of aerobic and anaerobic systems. These exercises have been shown to increase oxidative and glycolytic enzymes. Few studies have compared the different intensities of exercise on cell signaling pathways in liver tissue. On the other hand, studies that have examined PKa have yielded conflicting results. Although in several studies this increase in PKa levels following physical activity has not been observed, aerobic exercise with different intensities seems to have a direct effect on liver factors, but given that the effects of different types Aerobic training with different intensities has been performed on Pka liver markers; Therefore, in this study, following the answer to the question whether there is a significant difference between the three training methods of HIIT, HIT and MIT on the expression of Pka gene in liver tissue? Methods: In the present study, 32 8-week-old male Wistar rats with an average weight of 237 ±33 g were purchased from the Pasteur Institute. After being transferred to the animal laboratory environment, these animals are housed in transparent polycarbonate cages in an environment with a temperature of 22 ± 1.4 °C, the humidity of 45 to 55%, four heads in each cage with free access to water and closed. Foods were maintained according to a 12-hour sleep-wake cycle. Animals were randomly divided into 5 groups: control group (Co) (8 heads), moderate intensity training (MIT) (8 heads), high-intensity training (HIT) (8 heads), and high-intensity interval training (HIIT) (8 heads) were divided. The MIT protocol was performed in such a way that in the first week, 5 minutes of warm-up, 5 minutes of cooling, and 20 minutes of the main body of the exercise, including running at 65% VO2max at a speed of 20 m/min, was added to the training time every week. In the sixth week, the training time reached 37 minutes and remained constant until the end of the eighth. Also, the training speed was unchanged from the first week to the eighth week and was equal to 20 meters per minute. The HIT protocol in the first week included: 5 minutes of warm-up, 5 minutes of cooling, and 20 minutes of running training with 65% VO2max at a speed of 20 m/min and an increasing slope of the treadmill. The training time was increased every week, so that in the sixth week the training time reached 30 minutes and remained constant until the end of the eighth. On the other hand, the slope of the strip was 2% in the first and second weeks and 2% was added to the slope every 2 weeks to reach 8% in the seventh and eighth weeks. Also, the training speed from the first week to the eighth week was 20 meters per minute and was kept constant. The HIIT protocol also included 10 minutes of warm-up before the workout, in the first to fourth weeks including 3 intense intermittent runs with an intensity of 90 to 100% VO2max and a speed of 30 meters per minute in 4 minutes and 3 low-intensity intermittent runs. With 50 to 60% VO2max and at a speed of 20 meters per minute in 3 minutes. From the fifth to the eighth week, it also includes 4 intense intermittent runs with an intensity of 90 to 100% VO2max at a speed of 30 meters per minute in 4 minutes and 3 low-intensity intermittent runs with 50 to 60% VO2max at a speed of 20 meters per minute. It took 3 minutes. The main body time of the exercise was 28 minutes per repetition. Mice in the control group did not participate in any exercise program but were placed on a stationary treadmill for 10 to 15 minutes per session to adapt to the environment to create the same conditions. After in vitro analysis of the samples, descriptive statistics including standard mean and standard deviation and inferential statistics were used to quantitatively describe the data. First, the Shapirovilk test was used to determine the normality of data distribution, and the Leven test was used to determine the homogeneity of variance. Due to the normal distribution of data, parametric tests including one-way analysis of variance and Tukey's post hoc test were used at a significance level of p≥0.05. Results: The results of one-way analysis of variance showed that there was a statistically significant difference in the expression of Pka gene in the liver tissue of rats in the study groups (p<0.001). Findings of the Tukey post hoc test also showed that there was no significant difference in pka gene expression between MIT and HIT groups compared to the HIIT group (p= 0.746, p= 0.565, respectively). While there is a significant difference between HIIT and control groups (P = 0.001), so that in the HIIT group it has increased by 0.004 units compared to the control group. Also, a post hoc test in training groups showed that there was no significant difference in pka gene expression between HIT and MIT groups (p= 0.364). However, there was a significant difference in PKa gene expression between MIT and HIT groups compared to the control group (p= 0.001), so that in MIT group 0.005 units and HIT group 0.003 units Increased to the control group. Conclusion: The results of the present study showed that three different training methods (MIT, HIT and HIIT) increased the level of PKa in rat liver tissue and the difference between the effect of the present training protocols and the path of their possible signaling mechanisms is not clear. More research is needed in this area.    }, Keywords = {Moderate Intensity Continuous Training, High Intensity Continuous Training, High Intermittent Intensity Training, PKa, Liver}, volume = {28}, Number = {8}, pages = {44-53}, publisher = {Iran University of Medical Sciences}, title_fa = {تغییرات بیان ژن PKa متعاقب سه مدل تمرین تداومی با شدت متوسط، شدید و تناوبی شدید در بافت کبد رت‌های نر نژاد ویستار}, abstract_fa ={زمینه و هدف: تمرینات هوازی اثرات مفیدی بر عملکرد و آنزیم­های کبد دارد و باعث بهبود متابولیسم و ظرفیت آنتی‌اکسیدانی آن می‌شود. به همین علت هدف از پژوهش حاضر بررسی تأثیر سه روش تمرینی تمرینات اینتروال با شدت بالا، تمرینات پر شدت و تمرینات با شدت متوسط بر بیان ژن PKa در بافت کبد رت­های نرجوان نژاد ویستار بود. روش­ کار: در این مطالعه تجربی، 32 سر موش صحرایی نر نژاد ویستار 8 هفته­ای با میانگین وزنی­33±237 گرم به‌طور تصادفی به 4 گروه کنترل، تمرین هوازی با شدت متوسط (MIT)، تمرین هوازی شدید (HIT)، تمرین هوازی تناوبی شدید (HIIT) تقسیم شدند. برنامه­های تمرینی در گروه­های تجربی به مدت 8 هفته و 5 روز در هفته انجام شد. 48 ساعت پس از آخرین جلسه تمرینی، نمونه­برداری از بافت کبد انجام گرفت. بیان ژن­ PKa در بافت کبد با روش PCr تعیین شد. یافته‌ها: بیان PKa در هر یک از گروه­های ورزشی مورد مطالعه در مقایسه با گروه کنترل، به‌طور معنی­داری افزایش یافت (001/0p=). در مقایسه سه مدل تمرین مشخص گردید که بیان PKa در گروه MIT نسبت به سایر گروه­های تمرینی افزایش معنی‌داری داشته است (001/0p=). نتیجه ­گیری: هر سه شیوه تمرینی توانست با بهبود بیان ژن­های مورد مطالعه، تغییرات مطلوبی در کاهش پیامدهای ناشی از آسیب بافت کبد ایجاد نماید. با این حال به نظر می‌رسد که تمرینات MIT تأثیرات مطلوب­تری داشته است، هرچند در این زمینه به تحقیقات بیشتری نیاز است.}, keywords_fa = {تمرین تدوامی با شدت متوسط, تمرین تداومی با شدت شدید, تمرین تناوبی شدید,PKa , کبد}, url = {http://rjms.iums.ac.ir/article-1-6678-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6678-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Langarizadeh, Mostafa and Khalili, Minoo and Bayazian, Gholamrez}, title = {Development of a mobile application for self-care of patients with cleft lip and palate}, abstract ={Background & Aims: Cleft lip and palate is a common birth defect that is caused by abnormal facial growth in early embryonic stage. The disease complex causes are associated with various environmental and genetic factors (1, 2). The prevalence of cleft lip with or without cleft palate is one in 700 live births, annually (5). In Iran the prevalence of orofacial clefts is 1.4 per 1000 live births (6). Children with cleft lip and palate may have a variety of impairments including dental problems, persistent otitis media, nutritional problems, and learning, speech, and language disorders (9, 10). Due to the complex nature of facial clefts and the numerous medical problems that patients are involved with, treatment management is required with a team consisting of several specialties (11, 12). This multidisciplinary team usually includes: speech therapists and audiologists, clinical nurse specialists, orthodontists, ENT specialists, clinical, genetic and psychological counsellors. Initial treatment starts prenatally or shortly after birth and may continue into early adulthood (12, 13). Helping parents of newborns with cleft lip and palate in terms of feeding methods plays a significant role in proper weight gain. (3) In addition, in the age of preschool, improving oral health behavior can lead to plaque control in children with cleft lip and palate (15). Information which people obtain through information technologies affects their health-related behaviors and decisions in 33 to 48% of cases (18). Health information technology may provide unique opportunity to improve self-care behaviors, so patients can easily exchange information with healthcare providers and access their necessary information in a timely manner (20). Çınar et al reported that parents of children with cleft lip and palate tended to seek information about cleft lip and/or palate disease on virtual networks such as Facebook (21). Hemati et al showed that happiness-training program had a positive effect on improving mothers' performance in caring of their children with cleft lip and palate (30).  The main purpose of this study was to develop a mobile application for self-care of patients with cleft lip and palate in order to increase the awareness of parents and patients and reduce their unnecessary visits to medical centers. Methods: This research was a developmental-applied study, consisted of two stages: the first was to determine educational content requirement, and second a mobile based self-care application was developed and evaluated. The sample in first stage comprised 20 specialists in Otorhinolaryngology, maxillofacial and Plastic surgery, and Speech therapy who were employed in the hospitals of Hazrat Rasool, Ali Asghar, and Imam Khomeini. Data collection has been done using a questionnaire developed to determine the educational content. Two answers were considered for each question: necessary and unnecessary to identify the necessity of software options from specialists’ point of view. Each option that received positive feedback more than 60 percent was included in the application. At the second stage, based on the results obtained from first stage, an application was designed using Kotlin programming language in Android environment. The prototype was then sent to 30 patients with cleft lip and palate or their parents to use it for at least one week. Finally, the standard Questionnaire for User Interface Satisfaction (QUIS) version 5.5 was used to evaluate user satisfaction and application usability. This 10-choice Likert scale questionnaire with a score of zero to nine consists of six sections including: user's personal information, overall reaction to the software, screen, terminology and system information, learning, and system capabilities. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) software. The scores of each part of the questionnaire were classified into three levels as "not good" (0-3), " medium" (3.1-6) and "good" (6.1-9). Results: Based on results (descriptive statistics) of the first stage of this study, physicians considered all items as necessary with the average score more than 60 percent. These items have three main topics including: different types of cleft lip and palate, disease management at different ages, and parent guide. Each of which includes sub-categories that are all listed in the software. After developing of application, we sent to 30 parents of children with cleft lip and palate who had smartphone through WhatsApp. User must register and enter his/her personal and clinical data first. After one week, an electronic questionnaire link has been sent for users that patients or their parents could fill and submit their comments. The results of usability evaluation questionnaire showed that users evaluated the software at "good" level. Conclusion: One of the best tools to raise awareness and improve people's self-care skills are mobile-based applications. Studies showed that mobile health could be an effective way to facilitate disease management, treatment follow up, access to information anywhere and anytime, and lower excess health care costs (20). Nabovati et al. reported that using mobile based applications had a positive effect on the health outcomes of patients with asthma. They concluded that all applications included in their study, recorded user data and half of them were educational with reminder (28). In our study, according to participants’ answer, we found out that this self-care application has a positive effect on patients with cleft lip and palate. So, such application could be a practical and satisfying option in order to improve the knowledge level of parents having children with cleft lip and palate, in terms of caring of their children and reduce their anxiety.}, Keywords = {Cleft lip and palate, Smart phone, Mobile application, Education, Self-care}, volume = {28}, Number = {8}, pages = {54-63}, publisher = {Iran University of Medical Sciences}, title_fa = {ارائه برنامه کاربردی خود مراقبتی مبتنی بر تلفن همراه برای بیماران مبتلا به شکاف کام و لب}, abstract_fa ={زمینه و هدف: بیماری شکاف کام و لب یکی از نقایص شایع مادرزادی است که ناشی از اختلال در فرایند رشد صورت در ابتدای دوران جنینی می­باشد. به دلیل طبیعت پیچیده این بیماری هدف اصلی این پژوهش ارائه برنامه کاربردی خود مراقبتی مبتنی بر تلفن همراه برای بیماران مبتلا به شکاف کام و لب بود تا گامی در جهت افزایش آگاهی والدین بیماران و کاهش مراجعات غیرضروری آنها به مراکز درمانی برداشته شود. روش کار: پژوهش حاضر از نوع توسعه­ای-کاربردی بود. ابتدا جهت تعیین محتوای آموزشی، پرسشنامه­ای تهیه شد و به 20 نفر از پزشکان متخصص گوش و حلق و بینی، جراحی فک و صورت، جراحی پلاستیک، و متخصصین گفتار درمانی شاغل در بیمارستان­های حضرت رسول (ص)، حضرت علی اصغر (ع)، و امام خمینی (ره) ارائه گردید. بر اساس نتایج، نمونه اولیه برنامه کاربردی با زبان برنامه نویسی کاتلین در محیط اندروید استودیو طراحی شد. سپس نمونه اولیه برای والدین 30  نفر از بیماران مبتلا به شکاف کام و لب مراجعه کننده به بیمارستان حضرت علی اصغر (ع) ارسال شد و به مدت یک هفته مورد استفاده قرار گرفت. در نهایت جهت ارزیابی قابلیت استفاده و میزان رضایت کاربران پرسشنامه کوییز در اختیار آنها قرار گرفت. یافته ­ها: بر اساس نتایج آماری حاصل از پرسشنامه، پزشکان تمام اقلام اطلاعاتی را ضروری دانستند. این اقلام شامل سه عنوان اصلی انواع شکاف های دهانی، مدیریت بیماری در مراحل مختلف سنی و راهنمای والدین بود. نتایج حاصل از تحلیل آماری پرسشنامه ارزیابی قابلیت استفاده نشان داد که کاربران نرم­افزار را درسطح خوب ارزیابی کردند. نتیجه­ گیری: یکی از بهترین ابزارهای ارتقا سطح آگاهی و بهبود خود مراقبتی افراد، نرم­افزارهای مبتنی بر تلفن همراه است. همچنین برای ارتقاء سطح دانش والدین کودکان مبتلا به شکاف کام و لب در زمینه مراقبت از فرزند خود و کاهش اضطراب آنها، استفاده از نرم افزار خودمراقبتی مبتنی بر گوشی­های هوشمند می­تواند گزینه مناسبی باشد.}, keywords_fa = {شکاف کام و لب, گوشی های هوشمند, برنامه کاربردی, آموزش, خودمراقبتی}, url = {http://rjms.iums.ac.ir/article-1-6736-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6736-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Shamsabadi, Reza and ZoljalaliMoghaddam, Seyed Hamid and Baghani, Hamid Reza and Mahdavi, Seyed Rabi}, title = {A review of 3D printing technology and its applications in surgery}, abstract ={Background & Aims: The considerable growth of 3D printing technology in recent years has led to the application of this emerging technology in many medical fields, in which recently performed studies have shown the special importance of this technology which can enhance the results of the treatment method. Since, surgery is one of the main modalities to treat patients, the advent of 3D printing technology in surgery and the creation of different patient organs with 3D printers, improve the surgeon's performance. Hence, the accuracy and quality of the surgery can be enhanced. The aim of this study was to review the current statues and the applications of the 3D printing technology in surgery. Methods: By searching the indexed articles in Persian and Latin databases, Scopus, PubMed, Science direct, Scholar, 34 studies were reviewed. Results: 3D printing applications in surgery: Generally, the ability to generate a physical object with complex structures from a digital model has been introduced as the 3D printing technology which offers many advantages over the traditional manufacturing. The most important advantage of 3D printing technology is the ability to produce objects based on individual needs in which can reduce the costs of their production. Furthermore, complex preoperative procedures can be practiced. In other words, 3D printed models allow physicians to become familiar with medical procedures which possible problems created during the operation, can be identified before the operation. This modern technology generally includes three main steps to generate 3D objects from imaging data. The first step is the acquisition of image data. Then, the interest region is extracted which is termed as the segmentation. Finally, the digital data is transferred to the 3D printers to produce the 3D object.  For 3D model production, printer selection highly depends on speed, accuracy, cost, and availability of the printing materials. Recent advances in 3D printing technology have made it possible to use various biocompatible materials such as titanium and degradable polyesters to produce 3D models. Complex surgeries require more precise visual understanding before the surgery to ensure about the success of the treatment. In this regard, 3D printing technology can be a promising way to produce faster and cheaper models. In addition, this modern technology enables producers to produce highly specialized products for a wide range of patient organs. Applying a physical model results in better performance and greater visual perception about the desired treatment area, which can significantly reduce the side effects during surgery. Since a large contribution of the surgical process can be performed outside the operating room hence, 3D printed models can reduce the operation time. In fact, before the operation, surgeons will have enough time to make decisions, evaluate solutions and focus on other key elements during the operation. So, based on the basic role of 3D printing technology in surgery, the purpose of the present review is to investigate the current state of 3D printing technology and its clinical application in surgery for the construction of various 3D organs via medical imaging data. In this paper, some applications such as maxillofacial, spinal, liver, etc., are briefly discussed. Maxilla-facial and cranial facial reconstruction are the complex procedure which have been one of the first and most proven applications of 3D printing in the field of surgery to correct the facial deformities after the tumor resection. In this method with the application of 3D printers, at first, a 3D model of the desired anatomy is prepared to reduce a significant amount of time for linking the titanium plates to transplant adjacent bones (while the patient is anesthetized). Also, the production of titanium implants using the 3D printers will result in a very precise fit with the target tissue, the risks of maxillofacial surgery can be reduced. The use of 3D printing applications before or during complex surgeries like congenital heart defects has been reported in several studies. Since, acquiring to the real anatomical structures in patients with complex congenital defects, are sometimes unpredictable, treatment planning and surgical decision-making require a thorough understanding of three-dimensional anatomy. Therefore, the 3D printing technique, as a widely used method in all medical fields can overcome the defects of common preoperative imaging, especially in cardiovascular surgery. The other application of 3D printing technology includes spinal surgery in which due to the complex anatomy of the spine and the delicate nature of the surrounding structures, 3D printers will improve preoperative planning and increase the accuracy during the surgery. Liver surgery can be another suitable candidate for performing 3D printing technology to create 3D printing models. The two main applications of 3D printing technology in this field include training or necessary planning for surgery and liver functional cell printing through bio-printing technology that can be used in the study of liver disease and pharmaceutical research. Renal tumor resection is the other example of 3D printing applications in which 3D models have an exclusive role to enhance the accuracy of renal surgery. The 3D printed models can accurately display three-dimensional spatial relationships between different anatomical and pathological structures. Three-dimensional printed kidney models may also facilitate interdisciplinary communication and decision-making about the management of patients undergoing renal surgery.  In the field of renal surgeries, employing of 3D printed models plays a specific performance to train young surgeons which consequently increases the practical skills of surgeons which can accurately visualize the anatomical and morphological relationship compared to volumetric imaging. The obtained results of performed studies in the field of 3D printing show the potential significance of this technology in surgery which can lead to improvement of therapeutic outcomes. Since the printed models by 3D printing technology have an appropriate fit to the anatomy, the use of these models can reduce the associated errors during surgery. It is worth noting that despite the valuable advantages of this technology, some disadvantages such as limited printing size and costly printing process can be discussed which many studies try to address the deficiency of 3D printing technology in clinical applications. The cost of 3D printed models varies according to the type of performed printing method and applicable software which requires specialized users. The main mentioned costs for 3D model creation include hardware, software, and printed materials. In the future, the production costs of 3D models would be likely reduced in which the use of 3D models would become more traditional in common clinical operation. The 3D printed physical models are based on medical imaging which are prone to errors during the imaging procedures. Hence, increasing the accuracy of creating printed models requires improving the clinical imaging methods. Generally, with the advances in this modern technology, faster, cheaper, and more accurate models can be produced.}, Keywords = {3D printing technology, Surgery, Rapid prototyping, Surgical training, Treatment planning}, volume = {28}, Number = {8}, pages = {64-75}, publisher = {Iran University of Medical Sciences}, title_fa = {مروری برتکنولوژی چاپ سه بعدی و کابربردهای آن در جراحی}, abstract_fa ={زمینه و هدف: رشد چشم­گیر تکنولوژی چاپ سه­بعدی در سال­های اخیر موجب کاربرد این فناوری نوین در بسیاری از زمینه­های پزشکی شده است به­طوریکه مطالعات انجام شده در دهه­های اخیر نشان­دهنده اهمیت ویژه این تکنولوژی در بهبود عملکرد بسیاری از روش­های درمانی می­باشد. از آنجا که جراحی یکی از اصلی­ترین روش­های درمان در حوزه پزشکی محسوب می­شود، ظهور تکنولوژی چاپ­سه بعدی در زمینه جراحی و ایجاد قسمت­های مختلف بدن بیمار، موجب بهبود عملکرد جراح و افزایش سطح دقت و کیفیت جراحی خواهد شد. در واقع از آنجا که جراحی­های پیچیده جهت اطمینان از موفقیت­آمیز بودن روش درمانی به کاررفته نیازمند درک بصری دقیق­تر قبل از عمل بوده، تکنولوژی چاپ سه­بعدی می­تواند به­عنوان یک روش نوید بخش برای تولید مدل­های دقیق­تر، سریع­تر و ارزان­تر در نظر گرفته شود. علاوه براین، امکان تولید محصولات بسیار تخصصی برای طیف گسترده­ای از بیماران توسط فرآیند چاپ سه­بعدی، به عنوان انقلابی در علم و هم­چنین صنعت شناخته شود. بنابراین با توجه به اهمیت بیش از پیش فرآیند چاپ سه­بعدی در جراحی­های پزشکی، هدف از انجام مطالعه مروری حاضر، بررسی وضعیت فعلی فناوری چاپ سه­بعدی و کاربردهای بالینی آن در ایجاد قسمت­های سه­بعدی مختلف بدن بیماران با استفاده از داده­های تصویربرداری پزشکی جهت به­کارگیری در فرآیند­های جراحی می­باشد. روش کار: برای بررسی کاربردهای تکنولوژی چاپ سه­بعدی در جراحی، با جستجو در مقالات نمایه شده در پایگاه­های داده فارسی و لاتین Scopus ،PubMed ،Science direct ،Scholar ، در نهایت تعداد 34 مطالعه مرور گردیدند. یافته­ ها: نتایج مطالعات انجام شده نشان­دهنده اهمیت بالقوه تکنولوژی چاپ سه­بعدی در جراحی می­باشد به­­طوریکه می‌تواند منجر به بهبود نتایج درمانی به­دست آمده شود. هم­چنین از آنجا که وسایل تولید­شده توسط فن‌آوری چاپ سه‌بعدی، متناسب با آناتومی هر بیمار می‌باشد، بکارگیری این وسایل می‌تواند خطاهای مرتبط به­وجود آمده در حین عمل را کاهش دهد. در این مقاله سعی شده است تا کاربردهایی هم­چون جراحی فک و صورت، ستون فقرات، کبد و ... به طور خلاصه مورد بحث قرار گیرد. شایان ذکر است علاوه بر مزایای بسیار با ارزش این تکنولوژی، می­توان به معایبی هم­چون محدودیت در اندازه چاپ و هزینه­بر بودن فرآیند چاپ اشاره کرد که مطالعات بسیاری سعی در رفع کاستی­های موجود تکنولوژی چاپ سه­بعدی در کاربردهای بالینی دارند.  }, keywords_fa = {تکنولوژی چاپ سه‌بعدی, جراحی, نمونه‌سازی سریع, آموزش جراحی, طراحی درمان}, url = {http://rjms.iums.ac.ir/article-1-6433-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6433-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Kazemi, Nasibe and Shadmehri, Saeedeh}, title = {The effects of exercise on changes of adipokines secreted by adipose tissue in women with breast cancer}, abstract ={Background & Aims: Breast cancer is the most common tumor in women and is the second leading cause of death from cancer after lung cancer. This type of cancer accounts for 25% of all cancers and 12% of cancer-related deaths and is associated with invasion, metastasis and high recurrence rates, especially metastatic capacity of the brain and lungs (1). Over the past 3 decades, patient survival has increased due to advances in treatment and diagnosis. However, patients' quality of life is still negatively affected by the side effects of chemotherapy. Targeted and hormonal therapies do not have long-term effects in most cases, and some patients resist treatment with a significant reduction in therapeutic effect. Epidemiological and etiological evidence show that aberrant fat is a significant factor and a negative prognostic factor for breast cancer (2). Adipose tissue plays an essential role as an energy storage medium and can act as endocrine cells to produce various active substances (3). In addition, studies have confirmed that adipocytes adjacent to invasive cancer cells, referred to as cancer-related fat cells, are involved in the development of breast cancer (4). Breast tissue is composed of 90% adipose tissue with permanent interactions between epithelial cells and fat cells (5). Adipocytes and their precursor mesenchymal stem cells (MSCs) may maintain tumor phenotypes by acting as energy reservoirs for neighboring cancer cells or by secreting signaling molecules and vesicles containing proteins, lipids, and nucleic acids (6). For a long time, adipose tissue was considered an energy source. Today, it is well established that adipose tissue plays a major role in metabolism as a member of the endocrine glands responsible for secreting biologically active molecules called adipokines. Adipokines have hormonal function and as growth factors that modulate insulin resistance, regulate fat and glucose metabolism, and participate in pro-inflammatory and anti-inflammatory responses (7). Adipokines are classified as hormones, growth factors, angiogenic factors, and cytokines. Among them, leptin, adiponectin, resistin and chemerin have the most studies (10). Exercise has many benefits for healthy and unhealthy populations. Repetition of exercise not only directly plays an important role in the prevention of breast cancer (incidence rate), controlling the progression of breast cancer and improving the patient's physical abilities and balance, but also indirectly reduces fatigue and nausea and increases Self-esteem and quality of life in patients with breast cancer (11). Epidemiological studies have shown that exercise can regulate factors that increase the risk of breast cancer, thus reducing the incidence and mortality of breast cancer (12,13). Breast cancer is still a major medical, social and economic problem due to its increasing prevalence and adverse treatment outcomes. Numerous scientific reports show the benefits of physical activity on various pathophysiological aspects of breast cancer. Changes in adipokines secreted by adipose tissue in response to exercise can increase insights into proposing an appropriate exercise strategy to improve the function of hormone secreted by adipose tissue in breast cancer. In this review, we will discuss the importance of breast adipose tissue and then discuss the different roles of breast adipose tissue in the development and progression of breast cancer. Then we deal with adipokines secreted from adipose tissue and the response of these adipokines to sports activities. According to the above, the present study intends to investigate the effects of exercise on changes of adipokines secreted by adipose tissue in women with breast cancer. Methods: Search for studies on the changes of adipokines in response to exercise in breast cancer in articles published in the reputable databases Springer, Hindawi, PubMed, Google Scholar, Scopus, SID and ISC using the keyword Exercise Training, adipokines (Leptin, adiponectin, resistin and chemerin) were performed. 16 studies of adipokines responses to exercise in women with breast cancer were reviewed. Results: In many studies, the regulation of adipokines secreted by adipose tissue, including increase in adiponectin and decrease in leptin and resistin levels, was observed in women with breast cancer. Also, Exercise interventions that reduce fat mass modulate the concentration of adipokines. Conclusion: Most research on the relationship between fat and adipokines has been on the progression of breast cancer (68-70). Also, Positive correlations have been reported for waist-hip ratio, waist circumference, or other indicators of obesity and breast cancer risk in women (71). Exercise is a safe and effective adjunctive treatment for breast cancer. Exercise can affect body fat and composition if energy intake equals or exceeds energy absorption. Because adipokines are secreted from adipose tissue, any exercise intervention that reduces fat may be desirable (56). However, it is important to note that energy expenditure during exercise, independent of fat reduction, can also improve the regulation of adipokines, and this strategy can ultimately improve the prognosis of breast cancer (13). Considering the levels of adipokines studied, it was found that the changes in all these biomarkers are, at least indirectly, related to body size. Therefore, the effect of exercise can be entirely or partially dependent on weight loss (50). One of the chronic adaptations resulting from exercise is the regulation of the production and secretion of adipokines, which leads to beneficial molecular adaptation in adipose tissue and immune cells. Therefore, exercise is responsible for changes in adipose tissue function that are able to reverse the metabolic disorder observed in the breast cancer population. Studies have shown that the greatest effect on adipokines is achieved with long-term exercise, 12 weeks or more (45-50, 54, 56). Regardless of the greater understanding of the mechanisms by which exercise beneficially modulates adipokine concentrations in breast cancer, physicians should continue to support exercise as an adjunct to breast cancer because exercise alters the net balance of most obesity-related hormones Therefore, beneficial modification of the tumor microenvironment ultimately improves the quality of life and clinical outcomes of patients. As mentioned, after reviewing research on exercise and its effects on adipokines in breast cancer, it was found that increased energy intake, regardless of fat reduction, may play an important role in improving hormonal factors in the tumor microenvironment. Otherwise increases breast tumorigenesis. Therefore, future research should focus on determining the role of energy consumption and its potential mechanisms in reducing adipokine concentrations in obese breast cancer populations. Interactions between biomarkers should also be considered in future etiological studies, while exercise interventions should examine the effects of exercise independently of weight loss, various exercise prescriptions, and effects on central obesity. In general, based on the limited evidence to date, more research is needed to elucidate the response of adipokines to exercise interventions and their possible role in breast cancer. In summary, most studies have reported the regulation of adipokines secreted by adipose tissue, including an increase in adiponectin and a decrease in leptin and resistin levels in women with breast cancer. Also, the reduction of fat mass due to exercise interventions was associated with modulating the concentration of adipokines. Therefore, it is suggested to emphasize the need for exercise in breast cancer.  }, Keywords = {Breast cancer, Exercise, Adipose tissue, Adipokines}, volume = {28}, Number = {8}, pages = {76-89}, publisher = {Iran University of Medical Sciences}, title_fa = {مروری بر اثر فعالیت های ورزشی بر تغییرات آدیپوکاین های مترشحه از بافت چربی در زنان مبتلا به سرطان سینه}, abstract_fa ={زمینه و هدف: بافت چربی یک اندام غدد درون‌ریز پیچیده است و در سرطان پستان نقش دارد. پاسخ آدیپوکاین‌های ترشح شده از بافت چربی به ورزش در سرطان پستان از اهمیت بالایی برخوردار است. هدف از پژوهش حاضر، مروری بر روی مطالعات انجام شده جهت بررسی اثرات فعالیت‌های ورزشی بر تغییرات آدیپوکاین‌های مترشحه از بافت چربی در زنان مبتلا به سرطان سینه می­باشد. روش کار: مطالعات مربوط به تغییرات آدیپوکاین‌ها در پاسخ به فعالیت‌های ورزشی در سرطان سینه در مقالات منتشر شده در Springer, Hindawi، PubMed، Google Scholar، Scopus، SID وISC  با استفاده از کلیدواژه­های ورزش، سرطان سینه و آدیپوکاین‌ها (لپتین، آدیپونکتین، رزیستین و کمرین) جستجو شد. 16 مطالعه پاسخ آدیپوکاین‌ها به ورزش در زنان مبتلا به سرطان سینه مورد بررسی قرار گرفت. یافته‌­ها: در بسیاری از مطالعات، تنظیم آدیپوکاین‌های ترشح شده از بافت چربی شامل افزایش آدیپونکتین و کاهش سطوح لپتین و رزیستین در زنان مبتلا به سرطان پستان مشاهده شد. همچنین مداخلات ورزشی که منجر به کاهش توده چربی می‌شود منجر به تعدیل غلظت آدیپوکاین‌ها می‌شود. نتیجه‌گیری: یکی از سازگاری‌های مزمن ناشی از ورزش در زنان مبتلا به سرطان سینه، تنظیم تولید و ترشح آدیپوکاین‌ها است که با سازگاری مولکولی مفید در بافت چربی مرتبط است. اگرچه مطالعات بیشتری با بررسی اثر فعالیت‌های ورزشی بر تغییرات آدیپوکاین‌ها در زنان مبتلا به سرطان سینه مورد نیاز است.}, keywords_fa = {سرطان سینه, فعالیت ورزشی, بافت چربی, آدیپوکاین ها}, url = {http://rjms.iums.ac.ir/article-1-7007-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-7007-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Ehsani, Abolfazl and SohrabiEsmrood, Faramarz and GhorbanJahromi, Rez}, title = {The effect of mindfulness-based stress management intervention on students\' self-efficacy and optimism}, abstract ={Background & Aims: The aim of this study was to determine the effectiveness of mindfulness-based stress management training on academic burnout, self-efficacy and students' optimism. The family is the cornerstone of human societies and plays a significant role in the strength of social relations and the growth of each individual in society. In this regard, efforts to strengthen the family and stabilize relationships within the family, firstly, the health and individual well-being of family members and secondly, improve the level of social health. The family institution as an institution that has long been considered by researchers in socializing and transferring basic life skills can have various functions, one of which is to raise healthy and efficient children. This function will be achieved if we have the necessary knowledge in the field of recognizing relationships and the impact of parental behavior on children's behavior and make appropriate decisions at the right time. It is important to have the right mindset. Mindfulness is a concept that in recent years, under the influence of Buddhist thought, has attracted the attention of psychologists, psychotherapists and researchers. Mindfulness is defined as the state of arousal and awareness of what is happening in the present moment. Mindfulness helps us to understand that negative emotions may occur, but they are not a permanent part of the personality. It also allows the individual to respond thoughtfully rather than respond to events involuntarily. Duarte and Pinto-Gouveia (1) in a study examined the effect of mindfulness on adaptive behaviors and concluded that mindfulness has a significant effect on improving adaptive behaviors in personal and professional life. Carrots, Steinboon, Speaker, Rah and Van Schick (2016) have also reported similar results and have concluded that mindfulness has an effect on improving adaptive behaviors and reduces psychological problems. In this regard, psychologists have been using mindfulness for some time to reduce stress levels and stress management. Mindfulness-based stress management training teaches people to observe thoughts, feelings, and situations without judgment and not to act impulsively. Mindfulness-based stress management seeks to reduce stress and increase the level of psychological well-being of individuals. Therefore, mindfulness-based stress management training for parents can change the behavior of parents, which can affect the interaction of parents with students, as well as their behavior. So far, no coherent and significant studies have been conducted in this field that the researcher in this study seeks to investigate the effectiveness of stress management training based on mindfulness on academic burnout, self-efficacy and optimism of students. Self-efficacy, hope and optimism are three concepts that are closely related. All three of these structures are related to the expectations of achieving positive results in the future, and of course there are differences. Regarding hope and self-efficacy, Snyder (2) stated that self-efficacy mainly refers to the expectation or expectation of a person who thinks he can do a certain activity, while hope is related to the expectations that a person has. He thinks he will achieve his goals. In line with this claim, Bandura (3) compared self-efficacy with expectations of goal outcomes. In this regard, output and performance expectations are different, because people can believe that a particular action will produce certain results, but if they have serious doubts about whether they can take the necessary action. Such information does not affect their behavior. On the other hand, optimism is a kind of hope for the result. According to Snyder (2), as opposed to hope and optimism, optimism is primarily expected to have positive results regardless of one's actions, while hope is explicitly about the expectations that are met. Positive results will occur through planning (directions) and motivation (authority) of the person. Shereer, Carver, and Bridge (4) define optimism as "hopes that are generalized - hopes that are more or less relevant to one's entire living space." Methods: This research is applied in terms of purpose and quasi-experimental in terms of method. The statistical population of the study included first year high school students in Tehran in the first semester of the 2018-2019 academic year and their parents, of which 30 students (15 as an experimental group and 15 as a control group) Together with their parents, they were selected as a study sample by multistage cluster random sampling. Among the experimental group, mindfulness-based stress management training based on Kabat-Zinn (5) training package was performed in 8 two-hour sessions and during this period, the control group did not receive any training. Data collection tools required for the study included Berso burnout questionnaire, Scheier et al.'s (6) self-efficacy beliefs questionnaire, and a revised version of the life orientation test. Finally, after ensuring the normal distribution of research variables, the data obtained from the research questionnaires were analyzed using analysis of covariance. Results: The results showed that mindfulness-based stress management training has a significant effect on reducing the level of academic burnout and improving students' self-efficacy and optimism. Conclusion: From the findings of the present study, it can be concluded that reducing the level of academic burnout and improving self-efficacy and optimism of students need to learn stress management skills based on mindfulness among parents. Mindfulness-based stress management seeks to reduce stress and increase the level of psychological well-being of individuals. Therefore, mindfulness-based stress management training for parents can change the behavior of parents, which can affect the interaction of parents with students, as well as their behavior. So far, no coherent and significant studies have been conducted in this field that the researcher in this study seeks to investigate the effectiveness of stress management training based on mindfulness on academic burnout, self-efficacy and optimism of students. Self-efficacy, hope and optimism are three concepts that are closely related. All three of these structures are related to the expectations of achieving positive results in the future, and of course there are differences. In general, it can be concluded that improving students' self-efficacy and optimism requires learning mindfulness-based stress management skills among parents. Therefore, it is appropriate for schools to improve the psychological factors in students by providing suitable conditions for the development of stress control based on mindfulness, planning and management at work.}, Keywords = {Stress Management, Self-Efficacy, Optimism}, volume = {28}, Number = {8}, pages = {90-98}, publisher = {Iran University of Medical Sciences}, title_fa = {تأثیر مداخله کنترل استرس مبتنی بر ذهن‌ آگاهی بر خودکارآمدی و خوش ‌بینی دانش‌‌آموزان}, abstract_fa ={زمینه و هدف: کنترل استرس مبتنی بر ذهن‏آگاهی، فرایند ایجاد حالت‏های شناختی، ذهنی و عاطفی انعطاف‏پذیری است که می‏تواند در بهبود عوامل روانشناسی مؤثر باشد، بنابراین هدف از تحقیق حاضر تعیین اثربخشی آموزش کنترل استرس مبتنی بر ذهن‏آگاهی بر خودکارآمدی و خوش‏بینی دانش‏آموزان بود. روش کار: در این مطالعه شبه آزمایشی، جامعه آماری شامل دانش‏آموزان دوره اول متوسطه شهر تهران در نیمسال اول سال ‏تحصیلی 98-1397 و والدین آنها بود که از این بین با توجه به نیمه آزمایشی بودن مطالعه تعداد 30 دانش‏آموز  به همراه والدینشان به روش نمونه‏گیری تصادفی به عنوان نمونه در نظر گرفته شد که به دو گروه آزامایشی (تعداد= 15 نفر) و گروه کنترل (تعداد= 15 نفر) تقسیم شدند. آموزش کنترل استرس مبتنی بر ذهن‏آگاهی بر اساس بسته آموزشی کابات‏زین (1970) در 8 جلسه دو ساعته اجرا شد. ابزارهای گردآوری داده‏ها شامل پرسشنامه باورهای خودکارآمدی شرر و همکاران (1982) و نسخه تجدیدنظرشده آزمون جهت‏گیری زندگی اسچیر و همکاران (1994) بود. داده‏های به دست آمده به کمک آزمون t مستقل و t وابسته مورد تحلیل قرار گرفتند. یافته‌ها: یافته‏ها نشان داد که آموزش مدیریت استرس مبتنی بر ذهن‏آگاهی در بهبود خودکارآمدی و خوش‏بینی دانش‏آموزان تأثیر معناداری دارد به طوری که سطح خودکارآمدی و خوش‏بینی افزایش معناداری داشتند (05/0>p). نتیجه‌گیری: به طور کلی می‏توان این‏گونه نتیجه‏گیری نمود که بهبود خودکارآمدی و خوش‏بینی دانش‏آموزان نیاز به یادگیری مهارت‏های کنترل استرس مبتنی بر ذهن‏آگاهی در بین والدین دارد.}, keywords_fa = {کنترل استرس, خودکارآمدی, خوش‌بینی}, url = {http://rjms.iums.ac.ir/article-1-7169-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-7169-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} }