احمد علیپور

In this survey, the intervention of cognitive behavioral stress management (CBSM) on psychological and immune indices and pain in patients with Rheumatoid Arthritis is studied.  <span class="s26"><span class="bumpedFont15">Method <span class="s17"><span class="bumpedFont15">: Statistical population of the study consisted of patients who referred to the rheumatology clinics in the northern parts of Tehran.  44 participants aged 25–60 using purposive sampling in accordance with inclusion and exclusion criteria selected and in two groups of 22 individuals were examined. Psychological, immune and pain evaluation tests of depression, anxiety and stress scale, blood sample, and McGill pain inventory were conducted in two stages of pretest and posttest using multiple covariance analysis.  <span class="s26"><span class="bumpedFont15">Results <span class="s17"><span class="bumpedFont15">: The results showed a significant effect of the stress management intervention on depression  <span class="s4"><span class="bumpedFont20">(F <span class="s13"><span class="bumpedFont20">1 <span class="s13"><span class="bumpedFont20">,37 <span class="s4"><span class="bumpedFont20">= <span class="s4"><span class="bumpedFont20">4/318, P= 0/046, η <span class="s5"><span class="bumpedFont20">2  <span class="s4"><span class="bumpedFont20">=0/104) <span class="s17"><span class="bumpedFont15"> among patients with RA. The use of this intervention was effective in reducing the immune parameter (CRP)  <span class="s4"><span class="bumpedFont20">(F <span class="s13"><span class="bumpedFont20">1 <span class="s13"><span class="bumpedFont20">,38 <span class="s4"><span class="bumpedFont20">= 17/593, P= 0/001, η <span class="s5"><span class="bumpedFont20">2  <span class="s4"><span class="bumpedFont20">=0/316) <span class="s17"><span class="bumpedFont15"> and their pain  <span class="s4"><span class="bumpedFont20">(F <span class="s13"><span class="bumpedFont20">1,39 <span class="s4"><span class="bumpedFont20">= 4/885, P= 0/033, η <span class="s5"><span class="bumpedFont20">2  <span class="s4"><span class="bumpedFont20">=0/111) <span class="s17"><span class="bumpedFont15">.  <span class="s26"><span class="bumpedFont15">Conclusion <span class="s17"><span class="bumpedFont15">: According to the results, employing this method for RA patients is very helpful and it can be suggested for improving their psychological and physical conditions.

The studies since the second half of the 20th century have revealed the effect of stress on the heart and vessels with mediating neurological indicators and techniques of dysfunctional coping techniques. They also have shown that stress management and the improvement of coping techniques improve the indicators. The present study examined the appraisal of the effect of coping-therapy on cortisol, Interleukin 6 (IL-6) and Interleukin 1β (IL-1β) in comparison with the control group. The study was a quasi-experimental research with pre-test and post-test design conducted on 44 patients (randomly assigned into two experimental and control groups) suffering from coronary heart disease who were hospitalized in Shahid Rajaei Heart Hospital in Tehran in 2011. The experimental group was treated with coping-therapy, and the immunological indicators of both groups were measured using ELISA at the beginning, the fourth, the eighth, (immediately after the end of treatment), the tenth, and the fourteenth weeks. The collected data were analyzed using repeated measures ANOVA by SPSS version 17. The gender and education of the sample was controlled statistically. The results revealed that coping-therapy could significantly decrease cortisol, IL-6, IL-1β from the eighth to the end of the fourteenth week (follow-up). Considering the cognitive limitations of the present study, one can conclude that coping-therapy may decrease the negative effects of stress on immunological indicators through improving dysfunctional techniques to effective ones, and in this way, reveal the positive effects on health.

Textbooks are the most important forms of media in open and distance universities. As a result, they should have features that enable the distance learners to attain in-depth learning without the presence of an instructor. This study aims to design a comprehensive model for open and distance university textbooks through analyzing the textbook concept using the hybrid model. In the initial stage, a review of literature up to 2011 was done (119 cases) using several databases.  Then, a field study was carried out by assessing 2 textbooks from open universities of England. Finally, data collected from the two previous stages were analyzed and evaluated, using Strauss and Corbin's method, and a proper model was proposed for open and distance university textbooks.