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SummaryBackground: Hospital stays for patients with pressure ulcers (PU) increased nearly 80% from 1992 to 2006. Most PU's developed during an admission, often despite preventive efforts from clinical staff. Data from Electronic medical records (EMR's) were used to prepare daily patient risk factor and PU information for nurses to help prevent PU development and exacerbations. Objectives: The objectives of this study were to determine whether: 1) dissemination of an automated daily report with patient risk and current status of pressure ulcers ("PU Daily") helps prevent the development of pressure ulcers, and 2) using the PU Daily information impacts the severity of pressure ulcers that develop in an acute care setting. Methods: A pre-post study with four control units was designed to determine the impact of the PU Daily in intensive care units (ICU) in a large medical center. The control units included ICU's using the same EMR and similar complexity of cases with a high risk of developing a PU. The pre-post study took place over a six month period (March -August 2009). Results: A total of 6,735 cases were included in the study. The intervention unit showed a significant decrease (p = 0.004) in PU's at post-evaluation; none of the four comparison units showed a decrease at the p<0.05 level. The intervention led to a significant reduction in the total number of PU's documented (p <0.000) and the number of Stage II PU's (p = 0.046). Conclusion:The intervention with the PU Daily showed a significant decrease in the total PU's and severity of PU's and allowed for implementation of interventions that help prevent the development of PU's. As EMR's become more widely available, this intervention showed a reduction in PU's. Future studies should further develop this intervention and include multiple institutions and patient populations.

Background: Patients with spinal cord injuries suffer from some psychological problems, such as inadequate emotional regulation and flexibility for adapting to the post-injury condition. In this regard, acceptance and commitment therapy (ACT) can improve psychological flexibility and emotional regulation. Objectives: The main goal of this study was to analyze the effectiveness of ACT in improving psychological flexibility and emotional regulation in patients with spinal cord injuries. Methods: This quasi-experimental design study was based on a pretest-posttest method with a control group. The study population consisted of all patients with spinal cord injury referred to Jalaeipour Rehabilitation Center in Tehran. The study sample included 30 patients with spinal cord injury selected by the purposive sampling method. The inclusion criteria were patients aged 20 to 55 years, residing in Tehran, and with at least a high school diploma. The injury duration varied between one and five years, and the injuries were thoracic and lumbar injuries and an intermediate score of psychological flexibility and emotion regulation. The exclusion criteria were patients with cervical spinal cord injuries, as well as patients who were simultaneously receiving another psychological treatment together with the subjects who suffered from brain damage. Patients were randomly assigned to the experimental and control groups based on random numbers. There were 15 patients in each group. The intervention group received ACT during eight sessions (1.5-hour group therapy) held once a week at Jalaeipour Rehabilitation Center in Tehran (2018), while the control group received routine care. Dennis and Vander Wal’s cognitive flexibility inventory (CFI) and Gross and John’s emotion regulation questionnaire (ERQ) were completed before and one week after the intervention. The data were analyzed using multivariate analysis of covariance (MANCOVA). Results: There was a significant difference in demographic indicators between the two groups. Based on MANCOVA with the baseline score, the mean scores of psychological flexibility and emotion regulation had a significant difference regarding the results of ACT between the experimental and control groups (P < 0.05). Conclusions: According to the findings, ACT can improve psychological flexibility and emotional regulation in patients with spinal cord injuries.

Objectives: This study aimed to determine the effects of Acceptance and Commitment Therapy (ACT) on the Sense of Coherence (SOC), Locus of Control (LoC), and Posttraumatic Growth (PTG) in patients with Multiple Sclerosis (MS). These factors were explored according to the prevalence of psychological problems in these patients. Methods: This was a quasi-experimental study with a pre-test, post-test and a control group design. The study population included all patients with MS from Iran’s MS Association in Tehran City, Iran. The study sample included 30 patients (n=15/group) who were selected by purposive sampling technique and according to the study inclusion and exclusion criteria. The study participants were randomly assigned to the experimental and control groups. After obtaining necessary permissions and informed consent, a pre-test was initially performed. The instruments used in this study were ‎the 29-item Antonovsky’s Sense of Coherence Scale; the 29-item Julian Rotter’s Locus of Control Scale, and the 21-item Tedeschi and Calhoun’s Posttraumatic Growth scale. Several studies supported the reliability and validity of these scales. The experimental group received 8 sessions (once a week, each session: 1.5 h) of group Acceptance and Commitment Therapy (ACT). However, the control group received no intervention. After the intervention, according to the instructions, the post-test was performed. Data analysis was conducted using SPSS V. 21. Multivariate Analysis of Covariance (MANCOVA) was performed to examine between-group differences data. Results: The study findings indicated that ACT was effective on the SoC; however, it had no significant effect on the LoC and PTG (P=0.05). Discussion: Participation in ACT sessions could enhance the SoC of patients with MS. Accordingly, it can be improved by accepting and enhancing these patients’ commitment to change through psychotherapy approach and increasing their SoC.

In this paper we generalize the ideas of de Broglie and Bohm to the relativistic case which is based on the relativistic Schrodinger equation. With this approach, the relativistic forms of the guidance equation and quantum potential are derived. In our formulation of the Relativistic Bohmian Mechanics, the quantum equilibrium hypothesis (ρ = |ψ| 2 ) and the probabilistic interpretation of the wave function are not an intrinsic feature of the theory as expected from the theoretical structure of Bohmian mechanics, however we can still extract the statistical predictions of the considering theory. By assuming the quantum equilibrium hypothesis in the non-relativistic case and acceleration of particles by an external field, we go to the relativistic regime. In this case the quantum equilibrium would not be established and the theory will have testable predictions that can be compared to the results of relativistic quantum mechanics. Here we present the calculations for some simple examples.