Self-Management Exercises Intervention on Text Neck Syndrome Among University Students Using Smartphones.

BACKGROUND: The prevalence of neck pain due to the overuse of mobile phones has been reported among university students. AIM: This study aims to investigate the impact of self-management corrective exercises on text neck syndrome among university students using smartphones. METHODS: This experimental study was conducted on 60 students in the two experimental and control groups. Demographic information and the Neck Disability Index (NDI) questionnaires were used for data collection. The Severity of Neck Pain (SNP) was determined using the visual analog scale. The head and neck tilt angles, the gaze angle, and the amount of change in the forward head posture were determined using photogrammetry and Kinovea software. The experimental group performed corrective exercises 5 days a week for 8 weeks. The desired variables were re-determined in both groups after the intervention. RESULTS: The SNP and NDI in the experimental group after the intervention decreased by 0.61-1.45, and 1.20-5.14, respectively. Significant differences between the measured variables before and after the intervention in the experimental group showed that the head tilt angle (7.17-22.30 degrees), gaze angle (3.21-23.5 degrees), and forward head posture (3.26-5.42 cm) were reduced, and the neck tilt angle (2.00-17.24 degrees) increased and improved after the intervention in various measurement positions. CONCLUSIONS: After performing the corrective exercises, 36.6% of the SNP and 13.3% of the NDI were reduced in the experimental group. Head and neck angles during using smartphones in a sitting position on a chair without a backrest were the most awkward posture compared with other postures.

Could melatonin prevent Vancomycin-induced nephrotoxicity in critically ill patients? A randomized, double-blinded controlled trial.

Background: Previous research showed some clinical benefits regarding the nephroprotective effect of melatonin. So, this study aimed to evaluate the beneficial effect of oral melatonin on preventing acute kidney injury (AKI) in patients who received vancomycin therapy in the intensive care unit (ICU). Methods: We performed a randomized, double-blinded, placebo-controlled pilot study in an academic hospital. Adult patients admitted to the ICU who received vancomycin with normal gastrointestinal and kidney function were randomized into treatment or placebo groups. After that, enrolled patients received a tablet of melatonin (3 mg) or placebo twice daily for seven consecutive days. The occurrence of AKI was assessed by RIFLE criteria (by measurement of serum creatinine (SCr)) and plasma neutrophil gelatinase-associated lipocalin (NGAL) concentration. Moreover, other data related to renal functions and SOFA were also compared between groups. Results: A total of 90 patients were included in the study, while 21patients in the placebo group and 20 in the intervention group completed the study. There were no significant differences between groups regarding baseline SCr, BUN, urine output, NGAL, SOFA, and glomerular filtration rate (GFR). Our results showed that these differences remained insignificant after a 7-day follow-up between groups. However, the incidence of AKI was significantly lower in the melatonin group based on the NGAL cutoff (> 150 ng/mL). Conclusion: We detected a significant decrease in vancomycin-induced nephrotoxicity incidence in patients receiving melatonin compared to placebo. However, more clinical trials in a larger population were required to confirm this result.

The Effect of Incorporating Silica Stone Waste on the Mechanical Properties of Sustainable Concretes.

Incorporating various industrial waste materials into concrete has recently gained attention for sustainable construction. This paper, for the first time, studies the effects of silica stone waste (SSW) powder on concrete. The cement of concrete was replaced with 5, 10, 15, and 20% of the SSW powder. The mechanical properties of concrete, such as compressive and tensile strength, were studied. Furthermore, the microstructure of concrete was studied by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy analysis (EDX), Fourier transformed infrared spectroscopy (FTIR), and X-Ray diffraction (XRD) tests. Compressive and tensile strength of samples with 5% SSW powder was improved up to 18.8% and 10.46%, respectively. As can be observed in the SEM images, a reduced number of pores and higher density in the matrix can explain the better compressive strength of samples with 5% SSW powder.

Comparison of Energy and Nutrient Contents of Commercial and Noncommercial Enteral Nutrition Solutions.

BACKGROUND: Nutritional support plays a major role in the management of critically ill patients. This study aimed to compare the nutritional quality of enteral nutrition solutions (noncommercial vs. commercial) and the amount of energy and nutrients delivered and required in patients receiving these solutions. MATERIALS AND METHODS: This cross-sectional study was conducted among 270 enterally fed patients. Demographic and clinical data in addition to values of nutritional needs and intakes were collected. Moreover, enteral nutrition solutions were analyzed in a food laboratory. RESULTS: There were 150 patients who fed noncommercial enteral nutrition solutions (NCENS) and 120 patients who fed commercial enteral nutrition solutions (CENSs). Although energy and nutrients contents in CENSs were more than in NCENSs, these differences regarding energy, protein, carbohydrates, phosphorus, and calcium were not statistically significant. The values of energy and macronutrients delivered in patients who fed CENSs were higher (P < 0.001). Energy, carbohydrate, and fat required in patients receiving CENSs were provided, but protein intake was less than the required amount. In patients who fed NCENSs, only the values of fat requirement and intake were not significantly different, but other nutrition delivered was less than required amounts (P < 0.001). CENSs provided the nutritional needs of higher numbers of patients (P < 0.001). In patients receiving CENSs, nutrient adequacy ratio and also mean adequacy ratio were significantly higher than the other group (P < 0.001). CONCLUSION: CENSs contain more energy and nutrients compared with NCENSs. They are more effective to meet the nutritional requirements of entirely fed patients.

Efficacy of Attribution Retraining on Mental Health of Epileptic Children.

BACKGROUND: Epilepsy affects children's quality of life and leads to social and mental problems. Promoting the mental health of children, especially epileptic ones, and preventing problems affecting them constitute major concerns for every country. Mental health promotion requires intervention programs. OBJECTIVES: We sought to assess the efficacy of attribution retraining on the mental health of epileptic children. PATIENTS AND METHODS: The present study is a semi-experimental investigation with a pretest and posttest design and includes a control group. Thirty children, comprising 17 boys and 13 girls, were selected randomly from the Iranian epilepsy association in Tehran and assigned to experimental and control groups. They answered to the general health questionnaire (Goldberg and Hiller, 1979). The experimental group participated in 11 training sessions (twice a week; 45 minutes for each session) and received attribution retraining. The data were analyzed using the multiple analysis of covariance. RESULTS: The findings showed that the experimental group, in comparison with the control group, experienced a reduction in physical symptoms, anxiety and insomnia, social dysfunction, and depression and an increase in mental health significantly (P < 0.01) after the training sessions. There were no significant differences, however, between the two groups at 6 weeks' follow-up. CONCLUSIONS: Attribution retraining improved mental health in the epileptic children in our study. It, therefore, seems to be an appropriate intervention for promoting the mental health of children.

Effects of pain management program on the length of stay of patients with decreased level of consciousness: A clinical trial.

BACKGROUND: Critical care patients are at higher risk for untreated pain. Pain has persistent and untreated effects on most of the body systems and results in development of complications, chronic pain, and increased length of stay. The aim of this study was to determine the effects of the implementation of a pain management program on the length of stay in patients with decreased level of consciousness, admitted in Al-Zahra hospital intensive care units (ICUs) in 2013. MATERIALS AND METHODS: In this clinical trial, 50 subjects with decreased level of consciousness were selected by convenient sampling from the ICU wards of Al-Zahra hospital, Isfahan, Iran and were randomly assigned to two groups of study and control. Pain management program was applied on the study group and routine care was implemented in the control group. Data including demographic data and length of stay of patients in the ICUs were collected and analyzed using descriptive statistics and Chi-square test, independent t-test, and paired t-test. RESULTS: Results showed that out of 50 subjects attending the study, there were 40% female and 60% male subjects in study, and 52% female and 48% male subjects in control group. (P = 0.395). Overall mean length of stay of the patients in the ICUs was significantly lower in the case group [3.2 (1.4)] days compared to the control group [7.4 (4.8) days] (P < 0.001). CONCLUSIONS: This study showed that overall mean length of stay of patients in the ICUs was significantly lower in the study group compared to the control group. It is suggested to use this program for patients in ICUs with decreased level of consciousness after a general surgery.

The effect of an upper respiratory care program on incidence of ventilator-associated pneumonia in mechanically ventilated patients hospitalized in intensive care units.

BACKGROUND: Ventilator-associated pneumonia (VAP) is a common side effect in patients with an endotracheal tube. This study aimed to evaluate the effect of an upper respiratory care program on the incidence of VAP in mechanically ventilated patients. MATERIALS AND METHODS: In this clinical trial, 62 patients with endotracheal tube were selected and randomly allocated to intervention or control group. In the intervention group, an upper respiratory care program was performed and in the control group, routine care was done. Modified Clinical Pulmonary Infection Questionnaire was completed before, and on the third, fourth, and fifth day after intervention. Data were analyzed by repeated measure analysis of variance (ANOVA), chi-square, and independent t-test through SPSS 13. RESULTS: The results of this study showed that until the fourth day, the incidence of VAP was similar in both intervention and control groups (P > 0.05), but on the fifth day, the incidence of VAP in the intervention group was significantly lower than in the control group (P < 0.05). CONCLUSIONS: The results of this study showed that in patients with an endotracheal tube, an upper respiratory care program may reduce the incidence of VAP. Therefore, in order to prevent VAP, nurses are recommended to perform this upper respiratory care program.

Comparing the APACHE II score and IBM-10 score for predicting mortality in patients with ventilator-associated pneumonia.

BACKGROUND: VAP is defined as pneumonia in patients who use ventilators. The acute physiology and chronic health evaluation (APACHE II) scoring system was originally developed for predicting mortality in patients who were admitted to the intensive care unit. Due to the complexity, a simpler score called IBMP-10 was developed. We designed the study to confirm and further investigate these two methods. MATERIALS AND METHODS: This cross-sectional and analysis-descriptive study was done at the moment of VAP diagnosis on 60 patients in intensive care units. APACHE II and the IBMP-10 scores were calculated. ROC curves were generated to compare the new prediction rule with the APACHE II score. Results were reported as adjusted odds ratios with 95% confidence intervals (CIs). Analyses were performed using SPSS, version 20 and P values of 0.05 were considered to be statistically significant. RESULTS: APACHE II Score means (P < 0.001) and IBMP-10 score (P < 0.001) means had significant increase in Non-survivor patient than in patients who survived. APACHE II can be used as a good prediction measure for mortality rate. In IBMP-10 method, specificity and PPV were greater than APACHE II, but in mc-nemar test, there was no significant difference between the two methods (P = 0.55). Both prediction rules had high NPV. In our study, survivors' prediction value in APACHE II was 46.7%, and in IBMP-10, it was 46.7%. CONCLUSION: IBMP-10, compared to APACHE II, has greater sensitivity, specificity, and AUC to predict mortality. So the consequence of the use of IBMP-10 was better than APACHE II.

Comparison of the effects of enteral feeding through the bolus and continuous methods on blood sugar and prealbumin levels in ICU inpatients.

BACKGROUND: Appropriate nutritional support is effective on achievement of expected outcomes in intensive care unit (ICU) patients. Although several studies have suggested different conclusions about the effectiveness of tube feeding methods, there is no specific program of nutritional support for patients who have been hospitalized. There is a possibility for complications due to an inadequate nutrition. The aim of our study is to compare the effects of enteral feeding through the bolus and continuous methods on blood sugar and prealbumin level among the ICU inpatients. MATERIALS AND METHODS: Fifty subjects were selected by convenient sampling from April to Aug 2013 in the ICU wards of Alzahra Hospital, Isfahan, Iran, and randomly assigned to study and control groups in this clinical trial. The subjects in the study group received infusion pump feeding while the control group received bolus feeding for 72 h. Blood sugar was checked for every 4 h for 72 h and the prealbumin level was assessed on the first and the fourth day in two groups. RESULTS: In the study group, the mean blood sugar significantly decreased on the fourth day, compared with the first (P = 0.03, F = 3.85) and third (P = 0.01, F = 3.15) day. In the control group, the mean blood sugar increased from the first day. It was significantly higher in the control group on the second day (P = 0.02, F = 3.55), compared with the study group. In the study group, there was a significant difference in the mean prealbumin before and after intervention (P = 0.048, t = 1.97), but no significant difference was observed in the control group. There was a significant difference between two groups after intervention (P = 0.04, t = 2.05). CONCLUSION: The obtained results showed that supportive nutrition through a continuous method had an effect on critical patients' blood sugar control and made a better nutritional status for these patients through an increase of prealbumin level. Positive effects of this feeding method can result in appropriate outcomes for patients' recovery and reduce the complications.

Effect of temperature and button mushroom varieties on life history of Lycoriella auripila (Diptera: Sciaridae).

Temperature-dependent development and population growth parameters of the fungus gnat, Lycoriella auripila (Winnertz), on button (737 and A15) mushroom were evaluated at nine constant temperatures, ranging from 8, 10, 12.5, 15, 20, 22.5, 25, 27, and 30 degrees C and developmental rates were modeled as a function of temperature. At 25 and 27 degrees C, an average of 20.89 and 22.43 d was needed for L. auripila to complete its development from oviposition to adult eclosion on 737 and A15, respectively. The population failed to survive at 8 and 30 degrees C. The developmental times of males or females on each variety at various constant temperatures differed significantly. The regression and Ikemoto and Takai linear models, in the absence of 10, 12.5, and 27 degrees C, described the relationship of developmental rate to temperature for male and female of L. auripila very well. Data were fitted to various nonlinear temperature-dependent models. The Logan 6 and Briere 1 nonlinear models provided the best estimation for Topt and Tmax and are highly recommended for the description of temperature-dependent development of L. auripila on 737 and A15, respectively. On 737 variety, significant differences were observed among all growth parameters at various temperatures. The intrinsic rate of natural increase (r(m)) for L. auripila was 0.134 on 737 variety at 25 degrees C, which was significantly >0.052 on A15 variety at the same temperature. No other data are available in using linear and nonlinear models to describe the relationship between temperature and L. auripila development. Understanding the influence of temperature on development of L. auripila is discussed with respect to pest management in mushroom production.

Application of Burn's wean assessment program on the duration of mechanical ventilation among patients in intensive care units: A clinical trial.

BACKGROUND: Weaning decision for the patients on a mechanical ventilation (MV) device is often made based on personal judgments and experiences, which results in longer MV length of stay and higher costs. Therefore, the present study aimed to the effect of application of Burn's wean assessment program on MV length of stay among the patients hospitalized in intensive care units (ICUs). MATERIALS AND METHODS: This is a clinical trial in which 50 patients connected to mechanical ventilators for more than 48 h were selected through convenient sampling and were randomly divided into two groups of 25 subjects. Burn's wean assessment program was employed in study group, while weaning was assessed by a physician in control group. The findings were analyzed by descriptive (frequency distribution, mean and SD) and inferential (independent t-test, Chi-square, Fisher's exact test, and Mann Whitney) statistical tests. RESULTS: The findings showed that length of MV was 134.2 (20.5) h which was significantly less than the control (P = 0.03). CONCLUSION: The results showed that application of Burn's wean assessment by the nurses to assess patients' readiness for weaning from the ventilator is a safe method in day time and shortens the length of MV in ICUs compared to the routine methods.