زهرا ترابی

Strengthening and improving neuromuscular control in various ways, including technique modification, in order to prevent sports injuries, as a principle, is always of interest to researchers and athletes. Landing technique after jumping during sports such as volleyball is known as one of the most important non-contact mechanisms of knee joint ligament injury. The purpose of this study was to investigate the effect of dynamic neuromuscular stability (DNS) exercises on knee functional tests in female athletes.

30 female volleyball players (age 22.06±3.39 years, height 1.67±0.04 m, weight 63.70±8.86 kg and body mass index 22.81±3.38 kg/m2) with at least three years of experience in volleyball training, they participated in this research and were randomly divided into two control groups (15 people) and an experimental group (15 people). Tuck Jump and Landing Error Scoring System (LESS) tests were recorded as subjects' performance scores. The kinematic variables of the subjects' lower limbs were measured by two cameras from the sagittal and frontal views during the Tuck Jump and LESS tests, before and after DNS exercises. The functional error of the subjects was recorded using the Kinovea software and recorded in the special table for scoring the tests. The subjects of the experimental group participated in the program of DNS exercises for 6 weeks and 3 sessions per week (each session lasting about 50 minutes). In order to analyze the data, independent and dependent parametric t-tests were used for data with normal distribution, and Mann Whitney U and Wilcoxon non-parametric tests were used for data with non-normal distribution in SPSS version 23 software.

The findings of the current research showed that DNS exercises was led to a significant decrease in the average Tuck Jump errors from 10.66 in the pre-test to 7.80 in the post-test (p=0.001), the score of the LESS from 8.13 in the pre-test to 4.53 in the post-test (p=-0.001) and the ligament dominance score decreased from 1.40 in the pre-test to 0.8 in the post-test (p=0.003) in the experimental group.

According to the results of the present study, it seems that performing DNS exercises in female volleyball players reduces the risk of injury and improves Motor-performance and is probably effective in the rehabilitation of athletes. Therefore, the use of DNS exercises in sports with frequent jumps and landings such as volleyball is recommended to prevent ACL injury.

Considering the lack of theoretical studies in the field of tourism marketing professional competence, the present study has discussed a future-oriented reflection on tourism marketing professional competence with a view to sustainable development.

Design/methodology/approach: 

The required data were collected from two parts of the research literature to identify the indicators of professional qualification (marketing) of tourism, as well as the opinions of nine senior managers of government organizations and reputable tourism companies to identify the local structure of the indicators. In order to identify the indicators, the inductive content analysis tool was used, and to present the native model, the theme analysis tool was used in the Max QDA software.

The findings of the study showed that the professional competence of tourism industry activists can be evaluated based on 88 skills, knowledge, personality, attitudinal, motivational, and general indicators. Moreover, the results showed that the country's tourism marketing professional qualification system included six dimensions of skills, knowledge and information, behavioral indicators, general competencies, management capabilities, and auxiliary enhancing factors.

The tourism industry and tourism marketing will not be able to influence the behavior and decisions of customers without the presence of people who can show behavioral flexibility and have a high level of self-confidence and creativity. In addition, the ability of leadership refers to the existence of charismatic abilities in a person, and the existence of such abilities and characteristics means the ability to deeply influence others.

Originality/value:

The issue of professional competence in the tourism industry is considered extremely vital. Despite this importance, the studies show that there is not much theoretical attention to the issue of tourism marketing professional competence and the effective indicators of measuring such competence in the country, and the present study seeks to solve this gap among domestic studies.

Today, high-quality and competent human resources are one of the key assets in every system and industry. On the one hand, having such a capital can generate sustainable competitive advantages, and on the other hand, it is one of the most important factors for obtaining operational efficiency. Health tourism and related marketing activities are among the fields that are highly dependent on quality human resources. Also, due to the interaction and interaction of this industry with all segments of society and international health tourists, the competences of health tourism marketing activists is one of the most key issues in the mentioned industry. Despite this importance, studies show that there is not much theoretical attention to the issue of professional competence in health tourism marketing and the effective indicators of measuring such competence in the country that the present study aims to solve this research gap among domestic studies. The development of Iran's health tourism industry is not possible only by recognizing and relying on strengths and potentials; the weaknesses and challenges of this nascent industry in our country are issues that should not be ignored. Knowledge and awareness of issues and problems of health tourism helps managers, planners and policy makers in the field of tourism and health to use a systematic perspective and all-round efforts to improve and develop the state of health tourism in Iran. Due to the lack of theoretical studies in the field of what is the professional qualification of health tourism marketing, despite the efforts in the field of health tourism, we have not yet achieved a worthy position in this industry. Therefore, in this research, the design of the professional competency model for health tourism marketing has been investigated in the post-Corona period.

The current research is a mixed research because it uses qualitative and quantitative methods in order to collect and analyze data. To identify the components, qualitative approach and systematic review tools, inductive content analysis and Delphi were used, and in order to investigate the relationships between different components and its final verification, quantitative approach and structural equation modeling method were used. The statistical community for collecting qualitative research data consists of university professors, senior managers in the field of health, and deputies of the General Directorate of Cultural Heritage, Tourism and Handicrafts of Yazd Province and senior managers of reputable tourism companies that used the snowball sampling method. 9 managers, assistants and supervisors were interviewed along with managers of tourism companies and academic experts. In the quantitative phase, the field method and standard questionnaire were used. Finally, 13 components were identified and the main research model was structured using MAXQDA software.

Therefore, the components resulting from the analyzes carried out in two different parts, i.e. the analysis of tourism marketing literature and the analysis of interviews conducted with experts and the combination of the obtained results, include the following 13 components, which are: General professional performance, analytical skills, specific professional skills, general professional skills, job information and awareness, job commitment, professional attitude, desire for career development, inherent individual characteristics, increasing factors of competence, basic job assignment knowledge, Bright personality and psychological abilities. Among them, psychological abilities and increasing competence factors were identified as the main and most effective dimensions in the path of better development of health tourism marketing during social distancing and after and the element of general professional performance is the least important among the investigated dimensions.

The unprecedented growth of the tourism industry in the past few years and the competition at the global level have faced the health tourism marketing discussion with new challenges, which has made researchers look for more effective marketing strategies. Therefore, the need for a systematic and targeted planning for marketing in Iran is increasing day by day. Therefore, one of the factors that can develop and improve the tourism industry in this area is the use of effective professional qualification tools and parameters. Based on this, there is a need for a model under the title of health tourism marketing professional qualifications that will be a guide for people and managers to create promote or develop qualifications that optimize health tourism skills. Based on this, the tourism industry and health tourism marketing are practically without people who are psychologically capable of showing behavioral flexibility and have a high level of interest in health tourism, curiosity, creativity, physical and mental health, and self-confidence, it will not be able to influence the behavior and decisions of customers. In addition, the ability of leadership in this industry strongly refers to the existence of charismatic performance in the individual, and the existence of such capabilities and characteristics means the ability to deeply influence others. As a result, with the disappearance of the existing weaknesses in Iran's health tourism value chain, each of the patients will confidently return to our country to receive more services. Customer satisfaction is what makes the reputation of the quality of Iran's medical and beauty services spread to health tourists across the borders.

Type 2 diabetes is the most common type of diabetes in the world. Health education can prevent complications or disease progression in patients by changing their behavior. Therefore, this study was conducted to investigate the effect of applying the health belief model on the change of nutritional behavior in women with type 2 diabetes in Shahrekord.

This study is a quasi-experimental study with control group. The target group is patients referring to health centers in Shahrekord. The instrument of study is a 3-part questionnaire including demographic information, model constructs Health Belief and self-assessment checklist of nutritional behaviors. The intervention was conducted in 40-minute six sessions. Data were analyzed by SPSS software and statistical tests before, immediately and three months after the intervention.

The difference between the mean scores of nutritional behaviors and structures of the health belief model, which included: awareness, perceived sensitivity, perceived benefits, perceived barriers before, after and 3 months after the intervention was significant (P <0.05). Among the constructs of the health belief model, the perceived intensity construct was not significant despite the increasing trend (P <0.05).

The findings of this study indicate that education based on the Health Belief Model will improve the nutritional behaviors of female patients with type 2 diabetes and help planners and policymakers to take fundamental steps to change the behavior of this group of patients.

Musculoskeletal disorders is very common in drivers of public vehicles. Therefore, the purpose of this study was to measure the correlation between muscle fatigue assessment (MFA) and Cornell musculoskeletal discomfort questionnaire (CMDQ) in taxi drivers in Shahroud in 2017. This descriptive study was performed on 140 taxi drivers in Shahroud in 2017. Data were collected using demographic questionnaire, CMDQ and MFA chart. Statistical analysis was performed by descriptive statistics (frequency, percentage, mean) and inferential statistics (Eta coefficient). The MFA results showed that 82% of lumbar muscle fatigue level was very high. The CMDQ results also showed that most musculoskeletal disorders was in the lower back and the least musculoskeletal disorders was in the forearm. Correlation between MFA and CMDQ showed that the highest correlation was in the back region with Eta=0.574 and the lowest correlation was in the neck region with Eta=0.294. The high correlation between MFA and CMDQ showed that MFA can be used instead of CMDQ. CMDQ is a self-report method and there is the possibility of non-cooperation or false report..

Epidemics of diarrhea caused by contaminated food and water occur frequently worldwide, especially in developing countries. The aim of this study was to identify the factors contributing to the development and spread of diarrhea epidemics caused by Shigella flexneri in Isfahan in the spring of 2015.

Following the first reports and activation of the surveillance system, a matched case-control study was conducted in 360 cases with diarrhea and 360 controls. Data were gathered using a questionnaire, and conditional logistic regression was used to provide adjusted odds ratios and 95% confidence intervals.

Consumption of contaminated fresh vegetable (OR=4.50, 95% CI=2.88-7.01) was the source of the epidemic. Contact with similar patients (OR=7.19, 95% CI=4.26-12.12), presence of similar patients in the family (OR=33.2, 95% CI=13.64-80.82), food consumption on special events (party, wedding ceremony, funeral, etc.) (OR=1.67, 95% CI=1.06-2.62), being a government employee (OR=3.08, 95% CI=1.64-5.78) and being illiterate (OR=2.91, 95% CI=1.10-7.67) were the risk factors of the spread of the epidemic.

In this study, consumption of fresh vegetable contaminated with Shigella flexneri was the source of the infection. According to the Epidemic Management Team, contamination occurred due to non-standard wastewater irrigation of agricultural lands. Therefore, it is important to consider the standards of agricultural production and compilation of a comprehensive program to improve the status of the wastewater purification system in the environmental sciences by the relevant organizations to prevent diarrhea epidemics

Job burnout is one of the most important factors affecting intent to leave among nurses and quality of care. The purpose of this study was to investigate the effect of demographic and organizational variables and also job stress on burnout among nurses.
This cross sectional study was done among 170 randomly selected nurses of a hospital in Shahroud. Data were collected using organizational demographic questionnaires, Nursing Stress Scale (NSS) and Maslach Burnout Inventory (MBI) questionnaire. The data analysis was performed by Pearson correlation and multiple logistic regression at 0.05 significant level using SPSS version 24.
Among the dimensions of occupational stress, conflict with peers and lack of support had the highest (11.79±4.45) and the lowest (3.77±1.64) average respectively. The highest average of burnout was belonged to emotional exhaustion (19.29±9.65). Emotional exhaustion had a significant correlation with lack of support (OR=1.91, CI=1.14-3.18), inadequate preparation (OR=2.01, CI=1.13-3.57) and conflict with physicians (OR=1.64, CI=1.45-1.92). In addition, the depersonalization was positively correlated with death and dying, lack of support and personal accomplishment had a negative and positive association with inadequate preparation and clinical experience.
The results of this study showed that improving some aspects of occupational stress, such as conflict with physicians, inadequate preparation, lack of support, death and dying, as well as improvement of shiftwork schedule might reduce perceived burnout.
exhaustion had a significant correlation with lack of support (OR=1.91, CI=1.14-3.18), inadequate preparation (OR=2.01, CI=1.13-3.57) and conflict with physicians (OR=1.64, CI=1.45-1.92). In addition, the depersonalization had positively correlated with death and dying, lack of support and personal accomplishment had a negative and positive relation with inadequate preparation and clinical experience.
The results of this study showed that improving some aspects of occupational stress, such as conflict with physicians, inadequate preparation, lack of support, death and dying, as well as improvement of shiftwork schedule might reduce perceived burnout.

Reading is a kind of mental-lingual process based on the visual information, reader's awareness, as well as phonological and semantic rules. This skill is the most fundamental learning tool for students, since reading, and comprehension are the basic requirements to acquire any written information. The lack of success in acquiring reading skills in early school years can genuinely prevent students from achievement in most other educational subjects. Research shows that most children with reading complications suffer from problems in motor coordination and auditory processing. Based on the above, the present study aims to answer the following question: is sound therapy with Forbrain able to help students with reading difficulties improve their reading performance and auditory discrimination? This study was a quasi-experimental design with pretest-posttest with the control group. The sample group consisted of 20 students who were studying in elementary school (second and third grade). They were selected by available sampling method from the stated sample and assigned randomly to two experimental and control groups. In this Study Data collected by Reading - Dyslexia Test (Karami nori & Moradi 2008) and Wepman auditory discrimination test (WADT 1987). The criteria for entry into the study included: Not having dyslexia according to DSM-5, The lowest scores in the Reading & dyslexia test, not taking the drug (Ritalin), being In the age range of 7 to 9 years, and having a normal IQ in the Wechsler Intelligence Test. Exit criteria include: having other intermittent disorders such as ADHD, having unprofitable families (such as divorce, parenthood addiction, etc.), having Physical sensory problems. After pre-test the experimental group for 20 sessions trained by integrated cerebellar training method (1hour), and auditory correction method (30 minute with Forbrain headset), while the control group received no intervention. Then, the subjects of the two groups tested by post-test. Data were analysed by SPSS22 in p=0.05. As pretest scores were considered as a covariant variable, to determine its impact on the posttest, analysis of covariance used. To this end, the assumptions of variance homogeneity and the normal distribution of scores- as main covariance assumptions- were investigated. The results of the Levene test approved the homogeneity of the data (Auditory Discrimination: F=29.65, P<0.11; Reading Skills: F=1.66, P<0.33). The data analysis based on the Kolmogorov–Smirnov test shows the normal distribution of data in both groups. Since the prerequisites for covariance observed, the data were analysed using Analyze of Covariance (ANCOVA).  The results of ANCOVA shows significant differences in mean of reading skills (p= 0.02), and auditory discrimination (p=0.00) in the experimental group decreased significantly. This difference also was significant for all subscales of reading skills (Chain words, Understanding words, Rhyme test, The concept of text, Read the words) except Reading non-words, Naming picture and Deleting sounds (p=0.44, 0.32, 0.06). According to the previous study, the results obtained in this study show that the integrating of cerebellar training method with vibration have a significant effect on reading skills and auditory discrimination students with reading difficulties. Because of the effectivity of the present intervention in the treatment of auditory discrimination, the same method can be employed to treat or prevent other learning disorders. Although this intervention is not a perfect treatment for all types of learning disorders, it is a major component since hearing plays a prominent role in the learning process without its training and adjustment learning will be hard.

Given the important effects of loneliness on health and it has not been studied precisely in our country among the spouses of personnel deployed to long-term missions, therefore, the current study was done to investigate loneliness and related factors among spouses of naval personnel.
In this cross-sectional study with simple random sampling, 120 spouses of personnel deployed to long-term naval missions were selected in one of the regions of the navy in 2015. They were assessed using the short form of the Social-Emotional Loneliness Scale (SELSA-S). Data were analyzed by SPSS software.
The mean and standard deviation of romantic loneliness, family loneliness, social loneliness, and general loneliness were 12.8±7.6, 7.8±4.5, 12.5±4.9, and 32.9±9.8, respectively. Also, it was found significant differences in loneliness scores (general, social, or family) among different age groups, number of children, and work experience of spouse (p The highest value in loneliness is related to romantic loneliness score. Younger women with fewer children are at risk of more loneliness in its all aspects.

Sudden and unexpected environmental crises can cause severe psychological symptoms that known as Post-Traumatic Stress Disorder (PTSD). The purpose of this study is investigating the effectiveness of Cognitive Emotion Regulation on Anxiety Sensitivity in patients PTSD.
Research Methodologies were single subject multiple baselines method, Anxiety Sensitivity Inventory (ASI) and Impact of Event Scale-(IES-R) edition. Statistical society was three military patients with PTSD disorder selected through convenience sampling method. Eight treatment sessions and one follow-up period was administered for each subject. In addition, percent recovery equation & diagnostic remission were used to evaluate the recovery rate.
The results shown cognitive emotion regulation procedures had a clinically significant decreasing on anxiety sensitivity of patients.
Anxiety sensitivity is one of the first vulnerability factors associated with inevitably turmoil. Instructions of cognitive emotion regulation procedures have been able to treat the symptoms by decreasing on anxiety sensitivity in patients.

There is little information about the association between metabolic syndrome and colorectal cancer risk. Therefore، this study was aimed to investigate a comparison between colorectal lesions in patients with and without metabolic syndrome. This study descriptive- analytic study was performed among 114 patients in 50 years and higher referred to clinic of Isfahan Shariati hospital. After their experiments were taken، patients divided in two groups with or without metabolic syndrome، and for both groups، colonoscopy was done. According to the existence or lack of polyp and then due to andenoma polyp with advanced pathology، andenoma polyp without advanced pathology، patients divided and compared in two groups. Of 119 cases studied from these persons، 45. 6% was suffering from metabolic syndrome، which 42. 2% of these patients was observed andenoma، and 63. 6% andenoma polyps with advanced pathology. Only، 12. 9% of patients without metabolic syndrome were observed andenoma polyps، which 25% of these numbers was advanced pathology polyps. The prevalence of andenoma in males (%41. 5) was more than females (%17. 5) (p<0. 05). According to the findings of this research، it may be persons who have metabolic syndrome and they have more preparation to detect neoplastic lesions. So، colonoscopy in lower age in this group with risk factor is offered in order to screening and prevention from malignant colorectal lesions.

Supplementations of chromium (Cr) have been shown to exert beneficial effects for the management of type-2 diabetes, as reflected by a decline in insulin response. Prevalence of chromium deficiency in patients with prediabetes is not well understood; the aim of this study was to evaluated the amount of this prevalence.

In this cross-sectional descriptive study, were recruited 132 patients with prediabetes. Participants were randomly selected from those referred to the Shariati hospital, Isfahan, Iran. Fasting venous blood samples were collected from participants to measure the levels of chromium, insulin, fasting blood sugar and 2-hour post load plasma glucose. Body mass index was calculated. Determination of Cr was carried out by atomic absorption spectrometry.

Of 132 patients, 24 were excluded due to failure to complete the test. Among remained patients, 34 (31.5%) had chromium deficiency, and 74 (68.5%) had normal serum levels of chromium. A significant inverse relationship was found between chromium levels and age in normal group.

Levels of chromium deficiency is relatively common in patients with prediabetes and it is necessary to eliminate chromium deficiency in screening patients for diabetes.

Peliosis hepatis is a rare liver disease characterized by blood-filled cavities scattered irregularly throughout the liver. Risk factors for peliosis include chronic illness such as AIDS، tuberculosis، cancer also use of some drugs such as anabolic steroids and azathioprine. The aim of the present study was to evaluate the curative properties of crocus sativus petals on induced peliosis hepatis in rats. Thirty two male Wistar rats (weight: 180-220 g) were randomly divided into four equal groups: group 1 (healthy group) received only IP normal saline، group2 received IP 80mg/kg. bw gentamicin، group3 IP 80mg/kg. bw gentamicin+ 40mg/kg crocus sativus petal extract، and group 4 was given IP 80mg/kg. bw gentamicin+ 40mg/kg crocus sativus petal extract. At the end of the experiment، the rats were anesthetized and their blood samples were collected through cardiac puncture for AST and ALT measurement. Then، the livers of the subjects were excised and fixed in formalin. It was found that AST significantly increased in gentamicin group (P<0. 05) compared to the healthy group and groups treated by means of crocus sativus petal extract. Moreover، there was no significant differences between the groups administered the extract and those given gentamicin. Histologically،heterogeneous multiple blood-filled cavities were observed in gentamicin group (2) and the treatment groups (3 and 4). The results of the present study show that doses of hydroalcoholic extract of crocus sativus do not effect on peliosis hepatic and telangiectasis due to gentamicin sulfate in rats

Acute coronary syndrome is a collection of symptoms that could be different in female and male due to their differences in the physical or psychological and cultural differences subjects. This study was aimed to compare the clinical symptoms of chest pain and acute coronary syndrome in women and men hospitalized in the intensive coronary care units. In this cross sectional study the pain characteristics and clinical symptoms of acute coronary syndrome of admitted patients to the coronary intensive care units were compared. We helped as the questionnaire and McGill Pain Scale as studied research instrument. Data was analyzed by SPSS software with Chi-square test, t test and calculation the odds ratios and confidence intervals. The pain by women has more chance to occur in the other places other than chest. Being a woman enhances the chance of experiencing the heart palpitations, anorexia, nausea, indigestion, shortness of breath and sweating would whereas men were more likely to feel vomiting. Bloating, hiccup, fainting, dizziness and anxiety were similar in both sexes. Women have showed the different symptoms than men, so more attention to women’s health is important dealing with these symptoms.

The aim of the present research was to study the relationship among attachment and identity styles with general health and academic achievement of female pre-university school students in Qazvin city. Study sample consisted of 324 pre-university school students. They were selected by means of the multi-stage cluster sampling method. Attachment styles, identity styles and general health of the subjects were measured using the Cloinz and Rid's Adult Attachment Scale, Berzonsky Identity Styles, and Goldberg General Health Questionnaire, respectively. Results of the study indicated that: identity styles and learning styles were significantly correlated to each other and also were significantly correlated with general health of the subjects. Identity styles and academic achievement were significantly correlated. The correlations among attachment styles and academic achievement were not significant.