Investigation of the effect of ergonomic flooring on the distribution of foot pressure in long standing

Introduction: Many occupations require prolonged standing during exercise, which is one of the most important causes of musculoskeletal disorders, causing pain and discomfort in the back, lower limbs, and especially the soles of the feet, resulting in improper distribution of pressure in the soles of the feet. Epidemiological studies also show a strong association between prolonged standing and pressure on the lower back and lower limbs. One of the ergonomic solutions to reduce the problems caused by long-standing activities is to correct the surface under the fee. Therefore, this study investigates the effect of ergonomic flooring and conventional flooring on the distribution of foot pressure in healthy individuals; based on that, the effect of using ergonomic flooring in comparison with conventional flooring, more appropriate distribution, and reduction of pressure in the sole can be determined. Materials and Methods: This descriptive-analytical study was performed on 16 students with a mean age of 27.87±7.31 and a body mass index of 24.15±4.31. According to previous comparative studies and data analysis obtained from pilot samples, by considering the 95% confidence interval, the samples were determined by the convenience sampling method. Each participant was measured at eight anatomical points for one hour at two different surfaces of ergonomic and ordinary floor. Foot pressure distribution using a pedar-x device while the volunteers were barefoot. Data were analyzed by paired t-test and Wilcoxon using SPSS software. Results: This study showed that the ergonomic flooring significantly reduced the mean pressure on the plantar pressure (p≤0.001). Also, there is a significant difference in the mean pressure of left and right legs in different anatomical points when using ordinary surfaces and flooring (p≤0.001). Conclusion: There is a difference between the distribution of plantar pressure in ergonomic flooring and conventional flooring. Ergonomic flooring has better distribution than the ground and reduces the pressure on the sole during static activities.

The Effect of CO2 Laser Irradiation Combined with TiF4 and NaF Varnishes on Enamel Hardness: An In Vitro Study

PURPOSE

To assess the effects of experimental titanium tetrafluoride (TiF4) varnish and commercial sodium fluoride (NaF) varnish with CO2 laser on enamel hardness.

MATERIALS AND METHODS

Ninety human enamel samples were randomly assigned to one of the following groups: 1. control (no treatment) (CO); 2. NaF varnish (2.26%) (NF); 3. TiF4 varnish (2.45%) (TF); 4. CO2 laser (La); 5. NaF varnish (2.26%) with CO2 laser (NFL); 6. TiF4 varnish (2.45%) with CO2 laser (TFL). Enamel surface changes were determined by Vickers microhardness (VH) test with a load of 1000 g and a dwell time of 12 s. Each sample was indented three times. Data were analysed using one-way ANOVA and Tukey's test.

RESULTS

The mean surface microhardness was 245.5 VH in the CO group, 280.3 VH in group NF, 338.7 VH group TF, 277.0 VH in group La, 345.3 VH in group NFL, and 368.0 VH in group TFL. Statistical analysis showed that groups TF, NFL, and TFL had statistically significantly higher surface hardness than the control group (p < 0.05).

CONCLUSION

The microhardness of enamel treated with TiF4 varnish with or without laser irradiation was statistically significantly greater than that of the control group. Thus, using TiF4 to increase enamel surface microhardness can be recommended.

Outsourcing in Shiraz University of Medical Sciences; a before and after study

Background

Outsourcing is a kind of participation between public and private sector. This should be monitored and supervised to enhance the quality of outsourced services and to prevent new problems in this area. Shiraz University of Medical Sciences (SUMS) hospitals increasingly use outsourcing in recent years.

Objectives

The present research aimed at comparing outsourced departments of SUMS from economic view, accessibility of services, and service quality during the years 2010–2012.

Methods

A before and after descriptive and analytical design was applied in outsourced departments of SUMS in 2014. First, 17 indicators were extracted by Delphi technique. Then, all outsourced units were assessed using economic, access to services, and quality indicators during 2010 to 2012.

Results

After outsourcing, in all pharmacies and dentistry units, except one, loss decreased and benefit increased from public sector viewpoint. The number of personnel for one pharmacy and two laboratories was decreased, while it remained unchanged for dentistry units. The total number of clients was increased for all pharmacies and laboratories and decreased for one dentistry unit. Patient satisfaction for pharmacies, laboratories, and dentistry units was 73.4%, 80.3%, and 78.5%, respectively. Also, employer’s satisfaction from contraction was 60%, 68%, and 93.3% for pharmacies, laboratories, and dentistry units, respectively.

Conclusion

Outsourcing as an effective strategy resulted in increase in the personnel, client, and stakeholder satisfaction. Also, it increased benefit and decreased cost for public sector. It is recommended that rules for the implementation of this strategy and monitoring the private sector should be defined.

Patient Involvement in Care and Breast Cancer Patients’ Quality of Life- a Structural Equation Modeling (SEM) Approach

In cancer patients, improving the quality of life is a basic goal of treatment, with the patient – physician relationship as a major factor. Therefore the aim of this structural equation modeling study was to analyze the influence of patient involvement in care on quality of life in 411 breast cancer patients undergoing outpatient chemotherapy and radiotherapy. Two questionnaires were used: 1-patient-physician questionnaire, 2-EORTC QLQC-30 (to measure QOL). The structural equation model exhibited an excellent data fit (Chi-Square= 31.04 / RMSEA= 0.042), T-values for all paths with the exception of that between patient satisfaction and emotional- cognitive function, were significant. According to the findings, various aspects of the physician-patient relationship are significantly and positively associated with quality of life and increasing patient involvement in care by increasing trust and satisfaction, was associated with marked improvement. The findings of this study emphasized the importance of an effective relationship between doctor and patient as a contributing factor for improving the quality of life. Therefore it is suggested that policymakers and decision-makers active in strategic planning for the health system and physicians responsible for treatment pay more attention to developing and improving relationships with patients as an approach to improving patient outcomes, particularly with reference to quality of life.

Microleakage of an Enhanced Resin-Modified Glass Ionomer Restorative Material in Primary Molars

OBJECTIVES

Resin composites, glass ionomers (GIs), or a combination of these materials have gradually replaced silver amalgam in pediatric dentistry. The purpose of this study was to compare the microleakage of Class II (box only) cavity restorations with ACTIVA Bioactive Restorative Glass, resin-modified GI (RMGI), and composite in primary molars.

MATERIALS AND METHODS

A total of 65 primary molars with at least one intact proximal surface were selected in this in-vitro study. After debridement of each tooth, Class II (box only) cavities were prepared. Based on the type of the restorative material and the application of etching and bonding adhesives, the samples were categorized into five groups: (1) composite; (2) RMGI (Fuji II LC)+conditioner; (3) RMGI (Fuji II LC); (4) enhanced RMGI (ACTIVA Bioactive Restorative Glass)+etching/bonding; and (5) ACTIVA Bioactive Restorative Glass. The restored teeth were thermocycled for 2000 cycles. After embedding in an acrylic resin, the degree of dye penetration at axial and gingival walls was assessed using a stereomicroscope. The data were statistically analyzed by analysis of variance (ANOVA) and Tukey's test.

RESULTS

Resin-based composite (RBC) Z250 showed the least microleakage, while RMGI showed maximum microleakage at axial walls. The mean degree of microleakage at gingival margins was the lowest in RBC Z250 and ACTIVA+etching/bonding groups and the highest in RMGI+conditioner and RMGI groups.

CONCLUSIONS

The microleakage of ACTIVA Bioactive Restorative material in the absence or presence of etching and bonding could be comparable to the microleakage of composites.

General self-efficacy and diabetes management self-efficacy of diabetic patients referred to diabetes clinic of Aq Qala, North of Iran

BACKGROUND

Self-efficacy is one of the factors involved in successful self-care of diabetic patients. The aim of this study was to evaluate general self-efficacy and diabetes management self-efficacy and to determine their association with glycemic control in diabetic individuals, referred to the diabetes clinic of Aq Qala city, North of Iran.

METHODS

In this cross-sectional study, 251 type 2 diabetes mellitus patients were enrolled using census method. Data collection tools consisted of Sherer General Self-Efficacy Scale (SGSES) and Diabetes Management Self-Efficacy Scale (DMSES) with minor demographic adjustments and hemoglobin A₁C test. Data were analyzed using descriptive statistics and analytical techniques include independent t-test, Spearman correlation coefficient and linear regression were applied for further data analysis.

RESULTS

The mean and standard deviation age of subjects was 56.17 ± 10.45 years. The mean level of HbA₁C of studied subject was 8.35 ± 2.02%. There was a negative correlation between age and general self-efficacy and diabetes self-efficacy while, there was a positive correlation between general self-efficacy and diabetes self-efficacy (P < 0.001). Results of the regression analysis showed that duration of the disease was the only variable which had a significant effect on the level of hemoglobin A1C (P < 0.001), so that for each year of having the disease, the level of hemoglobin A₁C increased by 0.084% (CI 95% = 0.048-0.121).

CONCLUSIONS

General self-efficacy and diabetes self-efficacy does not affect glycemic control in diabetic individuals. The duration of the disease is the only affecting variable on glycemic control by its worsening in diabetic individuals. Interventions are recommended to help glycemic control in individuals who are having this disease for longer periods. Moreover, further studies on the affecting factors on poor glycemic control of diabetic patients as well as the role of time variable, are recommended.

The molecular and morphological variations of Culex pipiens complex (Diptera: Culicidae) in Iran

BACKGROUND & OBJECTIVES

Taxonomic status of Culex pipiens is well-known as many years with such a wide variety of morphological and biological characteristics. These changes have been the subject of extensive investigation by many researchers. There are a little information about the morphology and molecular data of Cx. pipiens complex in Iran. The taxonomic status of the complex is very important because of medical and veterinary importance and wide distribution in the country.

METHODS

This study was carried out in 11 areas in Iran using dipping technique from April 2009 to October 2010. Molecular study was carried out using primers F1457 as forward and B1256 as reverse, which amplified Ace.2 gene and performed PCR-RFLP using ScaI restriction enzyme.

RESULTS

Culex quinquefasciatus found in south to central areas of Iran and reported as sympatric with Cx. pipiens in the central regions. Culex pipiens distributed in many areas of the country. Sequencing alignment of Ace.2 gene of Cx. quinquefasciatus and Cx. pipiens showed 6.5% variation in 46bp, especially in intron locus of gene. Culex pipiens complex from Iran are located in two separate clades with sister branches using phylogenetic sequencing tree.

INTERPRETATION & CONCLUSION

The male genitalia found as the most reliable diagnostic characters for identification of Cx. pipiens complex in Iran that confirmed by amplify the Ace.2 gene in the samples but we recommended the use of sequencing PCR products of microsatellite loci and COI gene in future study.

The Morphological Variations of Culex pipiens Larvae (Diptera: Culicidae) in Yazd Province, Central Iran

BACKGROUND

Culex pipiens complex shows variations in morphological and biological characters including different biological forms and has medical and veterinary importance. Because of having morphological variations, sometimes it is not easy to separate this species from Cx. quinquefasciatus and Cx. torrentium. The aim of this study was to identify the Culex pipiens complex species in order to use in control programs in the future.

METHODS

This study was carried out in two randomly selected rural villages in Yazd County, eastern Iran using dipping technique from April to October 2009. The data were analyzed using SPSS software version 16.

RESULTS

Average of siphon index in fourth-instrar larvae was 3.86±0.03, the minimum and maximum were calculated 2.43 and 5.14, respectively. Siphon/Saddle index was measured as average, minimum and maximum 3.2±0.2, 2.78, and 4.42 respectively. In our study, only 4 specimens had single seta 1 on segments III and VI (2.5%) and the remaining beard double seta (97.5%). The maximum 3-6 branches seta 1a-S and 1b-S (95%) were observed on siphon.

CONCLUSION

More populations of Culex pipiens from different areas of Iran need to be studied to gain complete information about the taxonomy and ecology of the species in the country.