زهرا پارسایی مهر

 The mental health of soldiers is a vital issue that has posed many challenges today. The aim of this study was to review the mental health of Iranian soldiers and its influencing factors.

 In this systematic review study, papers published over a period of 15 years between the years 2004-2019 were reviewed. Electronic search in Persian and English with the keywords; soldierschr('39') health, military mental health, soldierschr('39') mental disorders, army,‌ armed forces and soldiers in Scopus, Pubmed, Google Scholar, SID, iranMagiran, Medlib and Iranmedex was done. In the initial search; 615 papers related to soldiers’ mental health were obtained. In the screening stage, 286 papers were retrieved and according to the exclusion and inclusion criteria, 18 papers were selected.

 According to the studies, it can be said that the mental health status of Iranian soldiers is dependent on two general categories of external (family environment, economic, cultural and psychological factors) and internal factors (existing facilities, commanderschr('39') approach, type of duty). And the manner of training). The results of this study showed that some Iranian soldiers suffer from mental disorders such as depression, anxiety, sleep disorders, drug addiction, personality problems including paranoid, mania, schizophrenia, hysteria and narcissism. Numerous factors including individual, family, social, economic, cultural, managerial and organizational factors affect their mental health status.

 The increase in mental disorders among young people, especially soldiers, makes it necessary to provide effective strategies to improve their mental health. In this regard, assessing the personality traits of soldiers upon entering military bases and holding confrontation workshops can prevent possible damage as much as possible.

Transient loss of consciousness (TLOC) is one of the common causes for referral to hospital. Syncope and seizure can cause TLOC. Syncope and seizures can be the consequences of each other's. Their common features often lead to misdiagnosis. 

The purpose of this study was to present a patient (male, over 80 years), who received antiepileptic treatment for 6 years for seizure-related transient loss of consciousness.

Due to repeated episodes of suspected syncope, insertion of a dual-chamber PPM was done. After three years of follow-up, he did not report the occurence of the TLOC.

The frequency of the TLOC and its complications emphasize the importance of proper assessments, diagnosis, and treatment. A comprehensive history taking, exact examination, and para-clinical assessments can be very helpful for diagnosis. An incorrect diagnosis can cause economic, psychological, and social problems.

Compliance with standard precautions is the basic scale for control of hospital infections. Nurses play a major role in this compliance. Therefore, this study aimed to evaluate the level of compliance with standard precautions by ICU nurses in hospitals of Sabzevar, Iran. This descriptive study was conducted on ICUs of hospitals of Sabzevar in 2012. Research population included 50 male and female nurses selected via census sampling. Data were collected using demographic characteristics questionnaire and an eight-section checklist of performance. In addition, data analysis was performed in SPSS version 11. In this study, the participants obtained the following scores in compliance with standard precautions of: washing hands (2.68±1.23 from the total of 0-12), method of washing hands with water and soap (3.50±1.56 from the total of 0-4), washing with alcohol (2.80±1.12 from the total of 0-3), wound dressing (7.00±2.78 from the total of 0-10), drug injection (7.58±2.95 from the total of 0-14), oral and tracheal suction procedures (5.82±2.15 from a total of 0-12), use of mask (3.90±1.86 from a total of 0-6) and hospital gown (2.10±1.14 from a total of 0-5). The nurses had a poor performance regarding washing hands, whereas they had a moderate performance in terms of drug injection, suction procedures, use of mask and hospital gown. Nonetheless, they had good performance regarding washing hands with water and soap and alcohol and wound dressing. Considering the results of the study, it is recommended that regular courses of infection control education be held and equipment (sink, hand wash detergents, and napkins) be provided for handwashing with sustainable monitoring

Human Trafficking has weakened health, safety and security all nations that are affected and causes many people with physical and psychological problems. The nurses are first line the recognition, leadership and management of victims. Therefore, this review study aimed to investigate the role and function of nurses in dealing with victims of human trafficking. In this review article, published 17 articles were reviewed between years (2000-2018). Electronic search in two languages: Persian and English with keywords (human trafficking, human trafficking nursing, human health trafficking, Health provider role in human trafficking, nursing care and human trafficking, healthcare and human trafficking) were conducted on internal databases (SID, Magira, Iranmedex) and abroad (pubmed, proquest, Google Scholar, Scopus). In the face of victims of human trafficking, the medical staff is involved in three broad areas of support, identification and treatment and demonstrates its effective functioning. In addition to identifying the victims, they should be able to ask for proper and correct questions and to provide care and examination of any immediate need, including the treatment of physical lesions, sexually transmitted infections, pregnancy diagnosis, and suicidal thoughts. Solving this challenge requires an interdisciplinary team work (health system, judicial system, executive system, and legislatures). Its application in preventive services, identification, support and treatment of victims, which has a positive impact on the health of the community. It is suggested that the tripartite forces of the country look at this issue and work together to solve the problems of this phenomenon.

Strategies such as expansion of roles, development of associations, documentation, determining proper measurement tools, specific and accurate definitions, interprofessional team formation, having the support of administrators, expansion of nursing services in the community, and interprofessional educations can play an effective and important role in the professional autonomy of nurses. According to Papathanassoglou et al., one of the important strategies of developing professional autonomy is expansion of the professional roles of nurses (1). In order to achieve positive professional identity and development of autonomy, nurses need to improve their public image and gain a stronger position in healthcare organizations, which can be obtained through increasing their presence in scientific and professional assemblies and specialized nursing organizations. In general, specialized nursing organizations must use strategies and establish rules to strengthen their professional identity and achieve autonomy in nurses.
Nursing standards act as a measure taken to form the professional and legal basis for nursing and obtain safe performance (2). The existence of standards makes nurses accountable and responsible for their actions and provides the necessary knowledge, attitude, skills, and judgment for clinical decision-makings. Nursing profession rules must be accurately employed by management groups as a factor for professional autonomy along with official relations. Having a determined function area by individuals and maintaining professional autonomy could be achieved by observing the professional regulations and establishing a job description. In this respect, one of the effective strategies is the use of hospital information system and quality of data report documentation, which can play an important role in achieving professional development. While the nursing process is carried out by nurses, it is necessary to improve the documentation system to further enhance the accreditation of interventions and increase its quality to achieve high-quality interprofessional communications.
According to Toulabi et al., nursing documentation system could be improved by providing a prepared nursing report form, placing the network on a portable electronic device or above the patients’ bedside, and having access to remote health, which consequently contribute to effective implementation of data recording system. Improvement of capabilities of the nursing electronic documentation system and interprofessional relations will lead to the provision of accurate and scientific care. In addition, enhancement of nursing documentation system leads to the recognition of duties and responsibilities by nurses and determining of the position of the field for other healthcare groups (3). Moreover, nursing information documentation systems increase the improvement of care and functional areas of nurses in fields of management and education, thereby improving the decision-making of nurses and their role as a member of the interprofessional team.
One of the important challenges in the field of professional autonomy is the vague definition and the use of inappropriate means for measurement. The existence of tools plays an important role in assessing and determining the strengths and weaknesses of roles and responsibilities of nurses. According to Skar, the lack of a clear definition of autonomy has led to multiple interpretations and the creation of a one-dimensional view on independent performance of nurses. Therefore, a definite definition of autonomy and a certain theory are required in the field of nursing (4).
Another important issue to be considered in this area is teamwork, which is a necessity of cooperation of nurses with other team members. According to Sollami et al., effective teamwork increases the quality of care and motivation and decreases work conflicts. One of the important influences of teamwork is increasing professional autonomy, which itself leads to improved skills, competency, responding ability, trust, respect, and decision-making ability in nurses (5). Independent decision-making requires the approval and support of managers since it improves the self-confidence, efficiency and progress of work, motivation and safety. Studies in this field have suggested that managers in clinical systems can help the autonomy of nurses by making proper decisions. According to Sarkoohijabalbarezi et al., inefficient management structures are the most important deficiencies in achieving progress in the nursing profession, creating negative attitudes (e.g., frustration and dissatisfaction) in nurses toward their profession and, thereby, causing the intention to leave the profession (6).
The support of managers and the approach used by these individuals to resolve conflicts among their staff can be effective in promoting relationships between members of a healthcare team. In fact, managers can contribute to the improvement of the interprofessional communications between employees with the appropriate support of the personnel. The development of nursing services at the community level is a great opportunity for nurses in the field of employment and presenting nursing society's capabilities in promoting community health and providing qualitative and suitable services to the public. In addition, expanding the primary services with the management of nurses in the community determines how a university nurse can provide people with low and affordable services. In this regard, Gagne and Choi have marked that service provision systems at the community level can play a significantly important role in the decision-making and planning, prevention, care, and referral to the physician in the healthcare team with the leadership of the nurses. Furthermore, promoting primary care by nurses will create an opportunity for introducing the nursing community to the people.
Management and planning of these services by nurses at an extensive level in the community increase the professional autonomy of these individuals (7). Freedom of action and authority in managing the conditions of community members and providing and improving care can be effective in the autonomy of nurses. On the other hand, while nurses can provide people with the most complex issues and problems and most critical services at home, cultural problems in society and obstacles to these activities must be resolved.
Finally, it seems that special attention must be paid to interprofessional education in order to achieve professional autonomy. In this respect, the priorities of nursing education must focus on creating educational programs that increase the strength of individuals. Therefore, it seems crucial to correct the curriculum of students to better recognize and respect themselves and develop their independent behaviors, and use educational strategies and proper interactive styles for empowering students and acquiring professional autonomy.

Aim. The aim of this study was to assess the causes of dysfunctional ventilatory weaning response after cardiac surgery
Background. One of the most important complications after cardiac surgery is the prolonged mechanical ventilation, because it is associated with the increase in mortality (30-40%). Extubation of endotracheal tube within the 6 hours post operation is considered as a gold standard improving heart function, increasing patients’ comfort, decreasing respiratory complication, and decreasing cost and hospitalization. The prolonged mechanical ventilation and dysfunctional ventilatory weaning response (DVWR) are the risk factors for cardiac surgery and controlling and preventing them is necessary.
Method. This was a descriptive cross-sectional study in which 80 patients admitted to Cardiac Surgery Department of Imam Reza Hospital in Mashhad were selected within a 4 months period by convenience sampling method. Patients with mechanical ventilation over 6 hours were recruited. Data were analyzed in SPSS software.
Findings. DVWR was significantly associated with smoking (p=0.03), and delayed recovery from anesthesia was the most common reason associating with DVWR (55.3%).
Conclusion. By controlling factors of the DVWR, we can reduce the duration of mechanical ventilation.

Kidney transplant surgery may impact various aspects of the life and results in individual and psychological problems. Receiving a kidney from a cadaver donor is associated with beliefs related to death of donor and with recipient’s survival. The aim of this study was to compare the rate of depression in patients receiving kidney from living donors with cadaveric donor kidney transplant، patients that were referred to nephrology clinics in hospitals of Mashhad University of Medical Sciences in 2010.

A descriptive – comparative design was used. The sample of the study consisted of 60 patients receiving kidney from living donors and 60 cadaveric kidney transplantation attended to nephrology clinics in hospitals of Mashhad University of Medical Sciences. Data were collected by a demographic questionnaire and Beck depression Inventory. The reliability of this test was evaluated with test-retest and Pearson correlation test was 0. 95. Data were analyzed with SPSS software (version 13).

Depression scores in living kidney transplantation group were 11. 6±5. 7، and in the cadaveric group was 16. 4±9. 4. Independent t-test showed a significant difference between two groups scores of depression (P<0. 005).

The results showed a higher depression scores in kidney transplantation from cadaveric donors. Therefore it is recommended that efforts to detect and treat depression be included in the care of transplant patients before and after the surgery.