فهرست مطالب

Rehabilitation Journal - Volume:13 Issue: 25, Sep 2015

Iranian Rehabilitation Journal
Volume:13 Issue: 25, Sep 2015

  • تاریخ انتشار: 1394/08/30
  • تعداد عناوین: 21
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  • Asghar Dadkhah* Pages 5-7
    The Iranian Rehabilitation Journal has published many articles related to different dimensions of treatment and psycho-education. As a reference we will review some articles which already published in this Journal. Dadkhah and his colleagues evaluated an individually family-based Dohsa exercise programme of balance in the aged people and its effect on self confidence for performing common daily tasks with less falling could be influenced by training (1). Sajedi, et al (2) stated that in addition to conventional methods, complementary medicine like homeopathy has been used in treatment of neuro developmental disorders. They tried to determine the effect of adding homeopathic treatment to rehabilitation on abnormal reflexes of children with spastic cerebral palsy. Regarding children rehabilitation, we understand that children have different needs than adults, and all of the professionals should be fully licensed and specially trained in pediatrics. The facilities for babies, children and their families should be designed with kid friendly waiting rooms and size-appropriate equipment with the most advanced technology and the providers should work to help children gain new skills and abilities that they arent able to learn on their own and help children to return to their previous functional status.
    Keywords: Dimensions of Rehabilitation, Treatment, Education
  • Maryam Sheydaei, Narges Adibsereshki *, Guita Movallali Pages 8-13
    Objectives
    Emotional intelligence skills begin at home, and with positive interactions with parents and other children. Parents can help children recognize their emotions, name them, and learn how to respect their feelings and adapt to social situations. The aim of the present study was to investigate the effectiveness of emotional intelligence training on the communication skills of students with intellectual disabilities.
    Methods
    This study was quasi-experimental, with a pre-test, post-test design and a control group. The sample consisted of 32 educable students with intellectual disabilities (14-18 years old).
    Results
    The results showed that the intervention program had created a significant difference between the scores of the experimental and control groups (P<0.05), and that the scores for communication skills were increased, both post-test and also in the experimental group follow-up (P<0.05).
    Discussion
    Emotional intelligence training enhanced the communication skills of students with intellectual disabilities. Teachers, professionals, and clinicians could use these training in their practices.
    Keywords: emotional intelligence, communication skills, intellectual disability
  • Ali Kashi, Mahmoud Sheikh, Asghar Dadkhah *, Rasool Hemayattalab, Elaheh Arabameri Pages 14-22
    Objectives
    The aim of this study was to evaluate the effect of “Kashi practices” on the improvement of psycho-motor skills in people with Down syndrome.
    Methods
    In this research, 28 men with Down syndrome between 21 and 43 years of age (mean age 25.917 ± 3.889) were randomly assigned to either a control (n=14) or an experimental group (n=14). All persons in the experimental group followed 12 weeks of selected exercise training (Kashi practices) three times a week. Prior to the start of the study, and after the three-month training period, each member in both groups was assessed according to the Bruininks Oseretsky Test of Motor Proficiency (BOTMP).
    Results
    The results indicated that Kashi practices could cause a significant improvement in psycho-motor skills in several variables such as strength, endurance, power, agility, reaction time, balance and running speed in the experimental group (P<0.05). These changes were not significant in control group (P>0.05) in any compression.
    Discussion
    These results showed that Kashi practices could cause a significant improvement in psycho-motor skills and can be an important step to improve physical fitness, physical activity and quality of life in people with Down syndrome.
    Keywords: Kashi practices, Psycho, motor skill, Down syndrome
  • Afsun Nodehi Moghadam *, Sirvan Ghorbanipour, Poorya Yaghmaei, Fatemeh Khassaf Pages 23-27
    Objectives
    It is important to recognize any risk factors for the development of injuries in the athletic population. The aim of this study was to investigate the association between joint hyper mobility and low back pain in Iranian hyper mobile and non-hyper mobile athletes.
    Methods
    50 athletic patients with low back pain (age=23.20±12.79 years) and 51 healthy athletes (age=24.28± 13.70) from Iranian athletic teams were screened for hyper mobility using the Beighton score (0-9, with higher scores indicating increasing hyper mobility). The athletes’ profiles, medical histories and chosen sport were collected by means of a questionnaire.
    Results
    The mean (SD) Beighton score in females with low back pain and healthy subjects were 5.07±2.30 and 4.93±1.79 respectively. However, no significant difference was found between the two groups (p=0.54). The mean (SD) Beighton score in males with low back pain was also higher (5.11±1.72) than in healthy subjects (4.36±1.82). However, the result of an independent t test showed no significant difference between the two groups (p=0.07).
    Discussion
    Further studies are needed to determine the effects of hyper mobility on low back kinematics and injuries in different sport types.
    Keywords: athletic injury, hyper mobility, low back pain, benign joint hyper mobility syndrome
  • Masoud Yavari, Ramin Farzam *, Azade Riyahi Pages 28-31
    Objectives
    The objective was to determine the results of early active controlled motion in the patients rehabilitated by our new protocol.
    Methods
    91 fingers in 64 patients with flexor tendon repair in all zones were enrolled in a single group (quasi-experimental) clinical trial. 58 fingers in 43 patients were assessed at least three months postoperatively. Outcomes were defined using the ‘White’ criteria for thumbs and the ‘Strickland’ criteria for other fingers.
    Results
    The results for range of motion of fingers were Excellent in 70.7%, good in 13.8%, fair in 6.9% and poor in 8.6%. There were 3 (5.17%) postoperative tendon ruptures.
    Discussion
    Early active controlled motion with our rehabilitation protocol shows acceptable postoperative results. This rehabilitation protocol is more effective if carried out from the 1st to 4th weeks after surgery, under the supervision of a surgeon or hand therapist. Then, from the 4th to 6th weeks, it should be performed at a hand therapy clinic and from the 6th to 12th weeks at home, supervised by a hand therapist.
    Keywords: flexor tendon, early active controlled motion, rehabilitation protocol
  • Marzieh Heidari, Seyed Massood Nabavi, Malahat Akbarfahimi *, Masoud Salehi, Mohammad Torabi, Nami Pages 32-38
    Objectives
    This study was designed to evaluate the psychometric features of the Persian version of the Fatigue Impact Scale (FIS-P) tool when used in Iranian MS patients.
    Methods
    140 MS patients and the equivalent number of healthy controls completed the following assessments: FIS-P, Fatigue Severity Scale (FSS), SF-36 questionnaire and the Mini Mental State Examination (MMSE).
    Results
    A significant inverse correlation between FIS and the quality of life (SF 36 assessment tool), as well as a positive and significant correlation with the FSS were noted. The Intraclass Correlation Coefficient (ICC) values for the inter-rater reliability for the physical, cognitive, and social sections and the whole questionnaire were 0.89, 0.86, 0.95 and 0.98, respectively. The FIS Persian version was shown to possess a high reliability (with a Cronbach’s alpha of 0.953). Likewise, the ICC values for the test-retest reliability were 0.86, 0.87, 0.92 and 0.93 for the physical, cognitive, social subscales and the whole questionnaire, respectively. This suggested a high reliability for the FIS-P.
    Discussion
    With a proper validity and reliability, the Persian-version of FIS retains the capability for being used in the assessment of fatigue and evaluation of the treatment and rehabilitation effects on fatigue-related symptoms among Persian-speaking patients with MS.
    Keywords: Multiple Sclerosis, Fatigue, Fatigue Impact Scale, Psychometric, Persian
  • Hamed Salmanzadeh *, Mohammad Rasouli Pages 39-48
    Objectives
    Nowadays, Snap-fits are used in the automotive industry as a proper alternative for mechanical joints, cabling joints, and car interior lining joints. Due to the special form of these joints, which are assembled manually, the contact area between Snap-fits and the worker’s fingertips can be too small. This can cause skin pain on the worker’s fingertips. Therefore, an ergonomic study of these assembly operations can be useful for the automotive industries. This study was thus undertaken to investigate the severity of mechanical stress on fingertips.
    Methods
    In the first stage, the FEM-Method is used to analyse the influence of some effective factors including gender, age, the thickness of the epidermis of a skilled worker, wearing gloves, amount of force, force angle, and snap-fit material parameters during snap-fit assembly. For this purpose, four thumb models, 50% male and 50% female from 20-29 and from 50-59 years old, are used.
    Results
    The mechanical stress is directly associated with gender, age, thickness of epidermis, and the amount of force, and inversely associated with wearing gloves, and force angle.
    Discussion
    The maximum compressive stress and the greater deformation of skin in the male group as compared to the female group is due to the smaller size of women’s thumbs and a less thick outer layer of women’s skin. Moreover, for old people, a higher elastic modulus leads to a greater stiffness of their skin. Finally, the young people’s modulus does not have a significant effect on the maximum compressive stress and total deformation of the skin.
    Keywords: Assembly, Thumb, Snap, fit, mechanical stress, FEM
  • Shafigh Mehraban, Bahman Bahmani *, Mojtaba Azimian, Poorya Rezasoltani Pages 49-53
    Objectives
    This present study aims to examine the effectiveness of cognitive behavioral-based stress management training on anxiety in female MS patients.
    Methods
    This study employed a semi-experimental research method with pre test post-test, control group and random assignment. The statistical population fully consisted of female MS patients referred to the Iran MS association in 2014, from which 24 individuals were selected by accessible sampling, who were randomly divided into intervention and control groups. For measuring the independent variable, Beck’s Anxiety inventories were used.
    Results
    The results of ANCOVA showed that cognitive-behavioral-based stress management training was effective in reducing the anxiety of female MS patients (p≤ 0.05).
    Discussion
    According to the results obtained, we believe that the cognitive behavioral-based stress management training program has been effective on anxiety reduction in female MS patients. Thus, this training method can be used for target groups and the general population as an interventional program.
    Keywords: Stress management, cognitive, behavioral method, multiple sclerosis
  • Faezeh Asadollahpour *, Kowsar Baghban, Parisa Mirbalouchzehi Pages 54-58
    Objectives
    The purpose of this research was to explore the possible differences in the working memory of monolingual (Persian) and bilingual (Persian-Baluchi) children. We wanted to examine if there is a statistically significant relationship between working memory and bilingualism.
    Methods
    Four working memory (WM) tests, assessing three WM components, were administered to 140 second grade school students, of whom 70 were monolinguals (35 girls and 35 boys) and 70 were bilinguals (35 girls and 35 boys). The tests used are the following: Forward Digit Span Test, Backward Digit Span Test, Non Word Repetition Test, Maze Memory Test. The results of the two groups were analyzed with multi-group confirmatory factor analysis, aiming to find out any differences in the working memory function of bilingual and monolingual children, and to determine which group has an advantage.
    Results
    The multi-group confirmatory factor analysis was used to measure various WM factors across the two language groups. The findings showed that there were significant language effects on Forward and Backward Digit Span and Non Word Repetition Task (p‹0.001), and no significant language effects on Maze Memory (p›0.001).
    Discussion
    This study revealed that bilingual children had a better WM, which holds processes and updates information over short periods of time, than monolingual children.
    Keywords: Working memory, bilingual, monolingual
  • Sahar Nurani Gharaborghe, Mohsen Sarhady, Seyed Mohammad Sadegh Hosseini *, Saideh Sadat Mortazavi Pages 59-63
    Objectives
    Most definitions equate Quality of Life with motor function. Theaim of this study is to examine the association between gross motor function and Quality of Life for children with cerebral palsy.
    Methods
    In this analytical cross–sectional study, 60 children with cerebral palsy aged 4-12 were selected through convenience sampling based on inclusion criteria from occupational therapy clinics in Hamadan. Cerebral Palsy- Quality of Life questionnaires were completed by the parents of the participants, and the gross motor function of all children was evaluated by the Gross Motor Function Measure. All data was analyzed by SPSS 16.
    Results
    The analysis of the data showed statistical significance between gross motor function and Quality of Life domains such as (social well-being and acceptance (p=0.017), feeling about functioning (p=0.003), participation and physical health (p=0.003), pain and feelings about disability (p=0.018), access to services (p=0.009)), while there wasn’t any relationship seen between them in emotional well-being (p=0.54) and family health (p=0.796).
    Discussion
    Based on the findings of this research, there isn’t any relationship between gross motor function and the psychosocial domains of Quality of Life. It means that children with cerebral palsy have the potential to have a high psychosocial Quality of Life score even if they have poor motor function.
    Keywords: Cerebral Palsy, Movement, Quality of Life, Child
  • Reihaneh Alikhani, Fatemeh Ostaresh, Mojgan Babanejad, Nilofar Bazazzadegan, Hossein Najmabadi *, Kimia Kahrizi Pages 64-68
    Objectives
    Hearing loss (HL) is the most common sensory disorder, and affects 1 in 1000 newborns. About 50% of HL is due to genetics and 70% of them are non-syndromic with a recessive pattern of inheritance. Up to now, more than 50 genes have been detected which are responsible for autosomal recessive non-syndromic hearing loss, (ARNSHL). In Iran, HL is one of the most common disabilities due to consanguineous marriages. The aim was to investigate the prevalence of three new ARHL genes (GJB4, GJC3, and SLITRK6) reported in neighboring countries among Iranian families with ARNSHL.
    Methods
    One hundred unrelated families with at least two affected siblings in consanguineous marriage, who were negative for GJB2 gene mutations, were selected. By using three STR markers for each gene, homozygosity mapping was performed.
    Results
    Two families showed linkage to GJB4, six families were linked to GJC3 and only one family linked to SLITRK6. The samples of these families who showed linkage were sent for Sanger sequencing to detect the causative mutations. However, after analyzing the sequencing results, no mutation could be detected in either of the families. Molecular analysis for these nine families is underway in order to determine the pathogenic mutations using whole exome sequencing.
    Discussion
    These data demonstrate a very low prevalence of mutation in these three genes (GJB4, GJC3, and SLITRK6) in the Iranian population, since no mutation was detected in our study group of 100 families.
    Keywords: Autosomal recessive non, syndromic hearing loss, homozygosity mapping, linkage analysis, Iran
  • Manijeh Soleimanifar, Zahra Mosallanezhad, Morteza Asgari, Marzieh Shirazikhah, Reza Fadayevatan, Mahyar Salavati *, Mohammad Parnianpour Pages 69-76
    Objectives
    To evaluate the reliability of head and trunk acceleration measured by MTx sensors during walking on Level and Irregular surfaces and to compare the differences between healthy young and old adults.
    Methods
    Participants were 20 young female university students and 20 non faller elderly women in Iran, 2013. Two MTX sensors were used to measure head and trunk accelerations in the vertical (VT), anterior-posterior (AP), and medial-lateral (ML) directions while participants walked on a 7-meter walkway.
    Results
    ICC values in young group were higher as compared to non- faller elderly group; ICC was greater than 0.7 for 89.47% (34/38) of variables in young group and for 60.52% 23/38) in non- faller. Intersession reliability for upper trunk coordination indices in regular surface and in young group showed highest values as compared with other conditions in both groups, whereas the lowest intersession reliability was found in irregular floor surface indices in non-faller elderly group.
    Discussion
    The calculated ICC, SEM, CV%, MDC values suggest that the MTX sensors provide precise recordings and detect small changes in upper trunk accelerometric parameters. ICC values were influenced by the age and the floor condition. In healthy young, all ICC values in regular surface were higher than 0.7. Floor condition effect was noticeable in elderly especially in ML direction. During walking on irregular surface, ML acceleration, velocity and harmonic ratio in elderly showed lower repeatability.
    Keywords: Reliability, Upper Trunk Coordination, Walking, MTx Sensor, elderl
  • Nasrollah Vaisi *, Mohammad Rostami, Zohreh Zangooei, Mohammad, Ali Khaksar, Beldachi Pages 77-83
    Objectives
    This study intended to examine the effectiveness of mindfulness based cognitive therapy on moderating maladaptive schemas and affective control in students suffering from learning disabilities.
    Methods
    This experimental research was conducted using pretest-posttest and a control group. The population included all the female students who were studying in the Koohdasht's middle schools (academic year: 2012-2013). The sample included 40 female students suffering from learning disabilities who had been randomly selected out of Koohdasht's middle school students after identification and a structured clinical interview and they were put into experimental and control groups 20 students each group). For data collection, Affective Control Scale and Young Schema Questionnaire were used.
    Results
    The results of multivariate covariance analysis showed that mindfulness based cognitive therapy has significantly decreased maladaptive schemas, depression, anxiety, and anger in subjects (p<0.001).
    Discussion
    This finding represents important implications regarding education and mental health improvement in exceptional students. Therefore, it is recommended to use this therapeutic package in schools and clinics as a supplement to other therapies in order to decrease negative emotions and to prevent formation of maladaptive schemas in these students.
    Keywords: mindfulness, based cognitive therapy, maladaptive schemas, affective control, learning disability
  • Ashraf Karbalaee, Nouri, Ali Hosseini *, Ahmad Hajebi, Hasan Rafii, Abbas Motevalian Pages 84-88
    Objectives
    Schizophrenia is responsible for a significant proportion of burden of mental diseases in Iran. Lack of a follow-up system has resulted in the repeated hospitalizations. In this study it is hypothesized that standardized living skills training delivered to participants with schizophrenia in outpatient and inpatient centers can be effective compared to a control group (with occupational therapy) in reducing psychopathology severity and increasing quality of life.
    Methods
    This is a multi-centered parallel group randomized controlled trial in Iran and it is single-blinded. Eligible participants are randomly allocated into two groups in a 1:1 ratio. Participants are assigned by stratified balanced block randomization method. The trial is conducted in the cities of Tehran and Mashhad. Its aim is to recruit 160 clients with schizophrenia. The intervention for the experimental group is social living skills training. The intervention for the control group is occupational therapy. The intervention for both groups is conducted in 90 to 120-minute group sessions. The primary outcome of the study would be a decrease in psychopathology severity, an improvement in participant's quality of life, and reduction in family burden will be followed for 6 months.
    Discussion
    This paper presents a protocol for a randomized controlled trial of independent and social living skills training intervention delivered to participants with schizophrenia. If this intervention is effective, it could be scaled up to be developing for policymaking and improving outcomes for schizophrenic participants and their families in Iran.
    Keywords: social living skill training, schizophrenia, inpatients, outpatients, occupational therapy
  • Malek Amini, Aryan Shamili, Marzieh Pashmdarfard* Pages 89-93
    Objectives
    This study was designed to determine the effects of Volar-Dorsal Wrist/Hand Immobilization Splint on upper extremity motor components and function of stroke patients.
    Methods
    fourteen patients were participated in this study. The patients were selected based on the inclusion and exclusion criteria, and were given the splint after a primary evaluation. They were re-evaluated after one, two and three months. In order to assess spasticity, the range of motion, and upper extremity function, the Modified Ashworth Scale (MAS), the goniometry, and fugl-meyer assessment were used respectively. The splints were used 2 hours during the day and the whole night in three months.
    Results
    The amount of the upper extremity function changes (P (v) =0.07) was not significant: and the amount of the ranges of the motion changes (P (v) =0.02) were statistically significant. The changes in range of motion of other joints and spasticity were not significant (P (v)>.05).
    Discussion
    The results of the present study indicated that, volar-dorsal wrist/hand immobilization splints can improve the AROM of metha-carpophalengeal joints. Although spasticity, the range of motion of other joints, and the upper extremity function went through some changes due to splinting (3month),these changes were not significant, which requires further research.
    Keywords: Stroke, Splint, Spasticity, Range of motion, Function
  • Navid Mirzakhani *, Negar Miri, Lavasani, Atieh Javantash, Rama Yasaei, Zahra Pashazadeh Pages 94-102
    Objectives
    The purpose of this study was to develop an Iranian Hand writing Speed Test (I-CHST) for testing of Iranian students aged 8-12. To date, no norms of handwriting speed have been published for hand-writing speed of the Iranian students.
    Methods
    A sample of 400 typically developing Iranian students across four age cohorts was recruited. Among those 400 students 50% were girls and 50% were boys. 73% were studding at government schools and 27% were from the private schools. 79% were right handed and 11% were left handed. The results showed that the handwriting speed assessment test has excellent inter-rater reliability (r=1, p=0.000) and construct validity (r=0.798, p=0.000).
    Results
    The findings showed that handwriting speed increases with age and the rate of increase was found to be greatest among Iranian children aged 8-12. It is also found that the girls aged 11-12 wrote faster than boys of the same age.
    Discussion
    Based on this research, I-CHST was a valid and reliable test for testing the hand writing speed in Iranian children and it could be used for testing or intervention purposes by the therapists at clinics.
    Keywords: Handwriting speed, Typically Developing Children, Occupational Therapy, Test Development
  • Talieh Zarifian *, Shima Matloubi, Tahereh Sima Shirazi, Enayatollah Bakhshi Pages 103-108
    Objectives
    Word definitional skills (WDSs) were classified according to the quality of both semantic content and syntactic form. The aim of the present study was to investigate the syntactic development in WDSs in typically developing school- age children.
    Methods
    In this cross-sectional and descriptive- analytical study, 150 of typically developing school- age children participated by the multistage sampling method in the second to sixth grade from primary schools in 1, 7 and 17 municipal districts of Tehran. The definition skill was assessed with word definition task. The reliability was assessed by two independent values and the validity was determined by the content. The results were analyzed by the SPSS (22th version) statistical software and with the method of independent- samples T test, univariate analysis of variance and Tukey test.
    Results
    The form analysis revealed that all children use phrase/clause or simple sentence, transitional form and Aristotelian form frequently, but by increasing the age, definitions were developed from simple syntactic structure into Aristotelian form, in fact mean score of the form in word definition was significantly increased by age (p< 0.001).
    Discussion
    Owing to the findings of this study, the development of word definitional skills in terms of form was developed from phrase/clause or simple sentence and transitional form responses into Aristotelian form. Also WDSs are closely related to academic success and the development of literacy.
    Keywords: definition, development, student, syntax, form
  • Farzad Farmani, Mohammad Ali Mohseni Bandpei *, Mahmood Bahramizadeh, Gholam Reza Aminian, Mohammad Reza Nikoo, Mohammad Sadeghi, Goghari Pages 109-112
    Objectives
    Ankle Foot Orthoses (AFOs) are widely utilized to improve walking ability in hemiplegic patients. The present study aimed to evaluate the effect of Rocker bar Ankle Foot Orthosis (RAFO) on functional mobility in post-stroke hemiplegic patients.
    Methods
    Fifteen hemiplegic patients (men and women) who were at least 6 months post-stroke and able to walk without assistive device for at least 10 meters voluntarily participated in this study. The patients were examined with and without RAFO. Their functional mobility was evaluated through 10-meter walk test and Timed Up and Go (TUG) test. Also, paired t-test was used to analyze obtained data.
    Results
    When patients used RAFO, their gait speed significantly increased (p 0.05). Also, the time of performing TUG test experienced a significant decrease using RAFO compared with utilizing shoe only (p<0.05).
    Discussion
    RAFO led to a significant improvement in functional mobility in hemiplegic patient’s secondary to stroke. It seems that, it has been due to the positive effect of rocker modification on improving push off and transferring weight during stance phase of gait.
    Keywords: Rocker bar, Ankle Foot Orthosis, functional mobility, hemiplegic patients
  • Zahra Nikmanesh *, Leila Parandeh, Syed Hamid Reza Abtahi, Mahsa Sepehrnejad, Mohammad Hossein Nilforoush Pages 113-118
    Objectives
    The present study aimed to investigate the relationship between religious coping and quality of life of mothers of children with hearing deficiency.
    Methods
    In this study, 55 mothers of children with hearing deficiency referred to Isfahan Cochlear Implant Center, from June to August 2012, were selected through applying census method. The participants answered the questionnaires of Religious Coping and Quality of Life (FS36).
    Results
    Results of correlation analysis indicated that there was a significant negative relationship between negative emotions toward God and the mental dimension of quality of life. Moreover, there was a significant positive relationship between benevolent appraisal and the physical dimension of quality of life. Regression analysis showed that negative emotions could explain 7.2% of variations in the mental dimension of respondents’ quality of life.
    Discussion
    The increase in negative religious coping behaviors (e.g. negative emotions toward God) was associated with reduction of quality of life of mothers of children with hearing deficiency.
    Keywords: Religious Coping, Quality of Life, Mothers of Children with Hearing Deficiency
  • Firoozeh Sajedi, Mahbobeh Ahmadi *, Roshanak Vameghi, Alireza Akbarzadeh, Mohammad Ali Mazaheri Pages 119-125
    Development is a dynamic and continuous phenomenon that is under the influence of various factors forming a complicated multidimensional system together. Any impairment in these factors can lead to impaired development in children, which is one of the most common problems in children. Therefore, this study provides a brief overview of these factors and the way they affect early childhood development. A brief review was performed in databases including Google scholar, PUBMED, Proquest, SID, Magiran, Iranmedex, Irandoc with following keywords: child development, income, occupation, education, employment, boy, girl, gender, sex, social class, Race and Ethnicity. All of article was reviewed then categorized based on WHO model. Among the papers reviewed, most of the studies were about employment, education, and income and most of them investigated these risk factors in terms of socioeconomic status. Structural factors of social determinants of health had a close relationship with each other, and they had affected development through each other. Given that, only few studies on structural factors, except for socioeconomic factors, have been conducted and little attention has been paid to the way these factors affect child development, further studies in this area are required to propose a model in order to better understand the interaction between these factors.
    Keywords: child development, income, occupation, education, employment, boy, girl, gender, sex, social class, Race, Ethnicity
  • Mohammad Ali Mardani, Gholamreza Aminian, Mokhtar Arazpour *, Stephen William Hutchins, Amir Fayaz, Masoud Eglali, Farhad Tabatabaian, Fatemeh Zarezadeh, Modtafa Mardani Pages 126-130
    Objectives
    Microtia is the most commonly seen congenital ear defect, and involves an auricular deformity either unilaterally or bilaterally. The aim of this study was to fabricate silicone prostheses for a child with bilateral microtia using an innovative technique.
    Methods
    This method involved the construction of bilateral ear prostheses using clips, which were located within the layers of the silicone superstructure.
    Results
    Surgical reconstruction was not indicated due to the patient’s age; so prosthetic reconstruction was advised in this case.
    Discussion
    Two prosthetic ears were manufactured, with one being attached using an adhesive method and the other by a self suspension method. The child and his parents were very satisfiedby the cosmetic and aesthetic appearance of the prostheses fitted. This technique has been proven to be suitable for pediatric patients with microtia
    Keywords: Microtia, prosthetic reconstruction, ear prosthesis