BackgroundThe objective of this randomized, double-blind, placebo-controlled study was to evaluate the efficacy of sustained-release methylphenidate (MPH-SR) in treatment of methamphetamine dependence.MethodsFifty-six individuals who met DSM-IV-TR criteria for methamphetamine dependence participated in this 10-week trial. The participants were randomly allocated into two groups and received 18 to 54 mg/day sustained-released methylphenidate or placebo for 10 weeks. Craving was evaluated by a visual analogue craving scale every week. Urinary screening test for methamphetamine was carried out each week. The Beck Depression Inventory-II (BDI-II) was used to monitor participant depressive symptoms at baseline and bi-weekly during the treatment period.ResultsAt the end of the trial, the MPH-SR group was less methamphetamine positive compared to the placebo group and the difference was significant (p = 0.03). By the end of the study, MPH-SR group showed significantly less craving scores compared to the placebo group [MD (95% CI) = -10.28(0.88-19.18), t(54) = 2.19, p = 0.03]. There was greater improvement in the depressive symptoms scores in the intervention group compared to the placebo group [MD (95% CI) =2.03(0.31-3.75), t (54) =2.37, p = 0.02].ConclusionSustained-released methylphenidate was safe and well tolerated among active methamphetamine users and significantly reduced methamphetamine use, craving and depressive symptoms.Trial registrationIRCT201202281556N38

BackgroundThe burden of caring for People with Dementia (PWD) is heavy; identifying incentives that motivate them in providing care is essential in facilitating and optimizing care. This study aims to explore and describe these motivating factors.MethodsWe conducted this qualitative study between January 2016 and January 2017 in Isfahan, Iran. Data were extracted through in-depth, semi-structured interviews with 19 caregivers of PWD. These data were then examined through thematic content analysis.ResultsWe identified four categories of psychological motives based on the caregivers’ feedback and experience. These include 1) Moral-based motives, 2) Religious, and spiritual motives; 3) Financial motives, and 4) Wicked motives.ConclusionsOur results revealed several aspects of caregivers’ motives. They include moral, religious, and spiritual aspects; sharing housing accommodations, and the likelihood of inheriting a portion of the patient’s assets based on unspoken rules and informal arrangements in the family, and wicked and immoral aspects. These findings can inform future efforts in enhancing the experiences of caregivers of PWD, and subsequently, the quality of care these patients receive. It further suggests that family members, members of a religious and spiritual organization, as well as social media, could play important roles in setting the stage.

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BackgroundDiabetes is one of the most common metabolic disorders which are rapidly increasing. Distance training is a cost-effective, easy and accessible way in which time and place dimensions of communication are removed.ObjectiveTo determine the effects of mobile text messages on raising knowledge of men with type 2 diabetes.MethodsThis educational experiment recruited 76 people selected by convenient sampling from a population of male patients with type 2 diabetes presenting to Sedigheh Tahereh Research Center in Isfahan, Iran, in 2015. They were randomly assigned into intervention and control groups. Data were collected with a questionnaire of demographic characteristics and questions pertaining to the variable of knowledge, through interview. The intervention group received training and follow-up through cell phones and text messages for 12 weeks. Data were analyzed in IBM-SPSS version 20 using Mann-Whitney test, Chi-square, Independent-samples t-test and paired-samples t-test.ResultsFindings suggested that patients’ knowledge in both groups significantly increased after the training (p<0.001). However, this rise in the intervention group was significantly higher than that of the control group (p<0.001).ConclusionThe results indicated that designing and implementing educational programs based on text messages and cell phones can improve knowledge in diabetics.

BackgroundPsychological events in people with dementia (PWD) lead to behavioral disorders that require targeted planning for caregivers on how to adapt to these behaviors. A progressively lowered stress threshold (PLST) model provides effective interventions for caregivers to adapt to the behaviors of people with dementia (PWD). Therefore, this study aims to determine the impacts of educational intervention based on the progressively lowered stress threshold extended (PLSTE) model on the caregiving of people with dementia (PWD) in Isfahan, Iran.MethodsThis exploratory mixed methods study was initially conducted with a qualitative approach to content analysis type from May 2016 to June 2018. Data were collected in a qualitative stage through in-depth nonstructured interviews with 29 People with Dementia (PWD)'s caregivers using the "new comment" command and then analyzed. The researcher designed a multisectional questionnaire, including demographic characteristics, knowledge measurement, and monitoring the practice of caregivers. The validity of the questionnaire was verified by a panel of experts, and its reliability was confirmed using the Cronbach alpha coefficient (knowledge section 0.838 and practice section 0.802). To adjust the intervention program, the educational content based on the PLSTE model was used for 38 caregivers available at two elderly nursing centers in Isfahan. This educational intervention was designed and managed for the first time in our community. None of the caregivers agreed to refuse to receive the educational content, So the evaluation of the program lacks a randomized controlled group. The data were collected immediately and one month after the educational intervention using a questionnaire.ResultsAccording to the results of the qualitative section of this study, the researcher was able to add a cultural and belief class and then the related intervention method to the PLST model. In the quantitative part, paired t-test indicated that the mean scores of knowledge, caregiving practice, and exposure to Challenging Behaviors (CB) in all dimensions of practice immediately and one a month after intervention were significantly higher than the mean scores before intervention (P < 0.05).ConclusionConsidering the impacts of this intervention, educating caregivers with PLST extended the care model is recommended, with a specific focus on cultural and traditional issues of society, to improve the knowledge and practice of caregivers in caregiving skills and appropriate exposure to challenging behaviors people with dementia (CBPWD).Trial registration No. IRCT20180421039370N1 -2019-01-11-http://www.irct.ir