Shiraz Emedical Journal
Volume:19 Issue: 5, May 2018

Relapse following abstinence from substance use is common. In this study, we evaluated the effectiveness of training, based on a cognitive-behavioral relapse prevention model in individuals with opiate dependence.
A total of 50 substance abusers were selected via simple random sampling among the clients of Aftab Center, Tehran, Iran for substance dependence treatment. The subjects were randomly divided into 2 groups: routine addiction treatment program and the developed intervention, plus the routine addiction treatment program. All the subjects completed the questionnaire on demographic variables and addiction history, Inventory of drug-taking situations, and drug avoidance self-efficacy scale at baseline and after the intervention. The patients were followed-up for 3 and 6 months after the intervention. ANOVA, Chi square test, and ANCOVA test were performed for data analysis, using SPSS version 19.
In this study, the mean age of the subjects was 38  11.26 years. Based on the results, social pressure was the most frequent high-risk situation, followed by negative emotional and physical states. In the 3-month follow-up, 8% and 24% of the subjects from the intervention and control groups dropped out, respectively. Nevertheless, no significant differencewas found between the groups in terms of the dropout rate. At the end of 6 months, 84% and 48% of the subjects from the intervention and control groups showed abstinence from drug use, respectively. The findings indicated a significant difference regarding self-efficacy between the groups (P Design of interventions based on cognitive-behavioral models, which can improve self-efficacy, may be effective in relapse prevention.

Increasing evidence leaves no doubt that significant disparity in health arises from uneven distribution of wealth across populations. Diverse patterns in pervasiveness of social factors eventually become manifest in heterogeneous face of disease prevalence, morbidity, and mortality rate within and between communities and remarkably affect expectancy of human life. Here, we presented the formulation and implementation of executive actions as well as a monitoring system for social determinants of health (SDH) initiated by the Ministry of Health and Medical Education (MOHME) since 2006.
This was a descriptive review of various actions performed by MOHME on social elements to reduce health disparities.
Nomination of national think tank committee and sensitizing and mobilizing sectors other than health in all policies resulted in approval of 52 health indicators at the government level. Emphasis was placed on the collaborative efforts particularly on developing a monitoring system which could show the distance between achievements and goals and assure the effectiveness of implemented actions on reducing health inequities.
We pictured the road which was paved by MOHME on social determinants of health (SDH) to facilitate the evaluation and formulation of the future actions to reduce health disparities in a more effective manner.

Family plays a crucial role in improvement and treatment continuation of individuals under methadone treatment. Understanding, supporting, and accepting the patient by the family and friends are factors influencing the treatment and rehabilitation process.
Theaimof this study was to determine the effect of family counselingonacceptance and support rates of patients under MMT.
In this quasi-experimental study, 50 patients (25 in the intervention group and 25 in the control group) under methadone treatment, in addiction treatment centers, in Kermanshah were selected through cluster sampling and randomly divided into 2 intervention and control groups. Data collection from the patients in both groups was conducted before and 4 weeks after last session intervention using family support and acceptance questionnaires. Intervention for patients’ family members (2 primary members for each patient) was held as a group-counseling meeting using Michael Free’s methodology. Patients in the intervention and control group received only the usual care of the center. Data were entered into SPSS software (version 18) and analyzed using appropriate statistical tests.
The family social support rate for the patients before and 4 weeks after counseling in the control group changed from 165.1423.91 to 152.3617.66, indicating no significant difference. Additionally, this rate increased in the intervention group from 156.16  22.88 to 167.6  20.41, showing a significant difference. The rate of family acceptance of patients before and 4 weeks after counseling in the control group changed from 26.86  4.94 to 26.30  4.48, showing no significant difference. Furthermore, this rate in the intervention group increased from 26.936.38 to 31.763.72, indicating a significant difference.
The results of the study showed that family counseling could increase the support rate for drug addicts and their acceptance by the family.

The aim of this study was to investigate the immediate effects of the protocol of phonation into tube on DSI as an objective multi-parametric approach for measuring voice quality and perceptual self evaluation in senior students participating in clinical training to become speech language pathologists (SLPs).
Eleven future SLPs (7 females and 4 males) with an average age of 22.51 performed the protocol of phonation into tube. The immediate effects of phonation into tube exercise program were evaluated by dysphonia severity index (DSI) and self-evaluation of perceived phonatory comfort.
After phonation in the tube exercise program, DSI and all its parameters significantly improved. Results of the paired t-test showed that MPT (P = 0.02), F-high (P = 0.001), i-low (P The results of this study suggest that phonation in tube exerciseprogrammaylead toanimprovementof vocal quality and voice fatigue in future SLPs.

The first year of clinical work is one of the most important steps in the career life of nurses. Although some studies have been done regarding NGNs, a few studies have been conducted about coping strategies of newly graduated nurses in the first year of clinical work. The aim of this study was to explore and describe the coping strategies of NGNs in the first year of clinical work in Tehran, the capital of Iran.
This study was conducted using the grounded theory methodology. In this study, 20 participants were selected using a purposive and theoretical sampling method. The data were collected by semi-structured in-depth interviews. For data analysis, the constant comparison method based on Strauss - Corbin approach was used.
Data analysis revealed that two strategies were used by NGNs, which included “positioning” at the beginning of work and then later, stabilizing the obtained “position (place)”. The core category of this study was “struggles to settle in the workplace.”
This study showed that NGNs tried to create a perfect position in the ward and then consolidate the created position. The results of this study can serve as a good guide to develop training and supporting programs for NGNs and be used in helping them adapt better to the new position. However, it is recommended to do further studies in this regard.

One of the most important factors determining the health of individuals is their health promoting behaviors. This study was conducted to investigate the status of health promoting behaviors of students at Shiraz University of Medical Sciences.
This cross-sectional descriptive-analytical study was conducted on 370 students of Shiraz University of Medical Sciences, during year 2017. Data were collected through a standard health-promoting lifestyle questionnaire that was designed with 10 dimensions (physical health, exercise and wellbeing, weight and nutrition control, disease prevention, psychological health, spiritual health, social health, refrain from drug, accident prevention and environmental health with a total of 70 questions). Data were analyzed using descriptive statistics, T-test, analysis of variance (ANOVA), and Pearson’s correlation coefficient by the SPSS software, version 23, at a significance level of  = 0.05.
The mean score of total health promoting behaviors was evaluated as 4.70  1.2 , which was in a good range. Avoiding medicines and drugs (5.141.08) had the highest and exercise and health (4.071.50) had the lowest mean score. There was a positive and significant correlation between all components of health promoting behaviors (P The status of health promoting behaviors was estimated to be desirable. Also, holding health education programs focusing on exercise and health in academic settings is recommended.