طاهره صادقی

With advancements in treatment and an increase in the prevalence of diseases, the number of patients requiring mechanical ventilation in intensive care units (ICUs) continues to rise each year. The ABCDE bundle is a multi-component, evidence-based approach designed to improve patient outcomes in the ICU. This study aimed to determine the effect of the ABCDE bundle on the risk of pressure ulcers, deep vein thrombosis and delirium in patients undergoing mechanical ventilation.

Methods & Materials: 

This randomized, single-blind clinical trial was conducted between September 2021 and January 2022. The sample included 100 patients undergoing mechanical ventilation in the ICU department of Imam Reza Hospital in Mashhad, who were randomly assigned to either the intervention or control group using block randomization. The intervention group received the ABCDE bundle over a period of 7 days. The control group received routine care. The criteria for assessing complications included the risk of pressure ulcers and deep vein thrombosis (DVT), evaluated at the end of the intervention and on days 0, 1, 3, 5, and 7. The study utilized several assessment tools: the COMHON Index for pressure ulcers, the Wells Deep Vein Thrombosis Scale, and the Delirium Evaluation Tool in the Intensive Care Unit (CAM-ICU). Data analysis was performed using SPSS software version 20, employing chi-square, Mann-Whitney, and independent t-tests.

A decrease in the average pressure ulcer risk score was observed in the intervention group on day seven (P<0.05). In this group, the incidence of delirium fell decreased from 64.4% to 13.3% (P<0.05), indicating a statistically significant reduction. Additionally, the risk score for deep vein thrombosis in the control group significantly increased on day seven compared to the intervention group (P<0.05).

The use of the ABCDE bundle significantly reduces the risk of pressure ulcers, deep vein thrombosis, and delirium in patients undergoing mechanical ventilation and represents an effective strategy that can be implemented by nurses and other trained healthcare professionals.

Gonadotropins are the main drugs for ovarian stimulation in assisted reproductive cycles. There are many different types of urine, purified or recombinant gonadotropins. This study was performed aimed to compare the clinical outcomes of two types of recombinant Cinal F gonadotropin Iranian company and Gonal F of foreign company.                                

This retrospective study was conducted in 2015-2019 on 521 infertile women (263 Cinal F and 258 Gonal F) who were referred to Milad Center affiliated to Mashhad University of Medical Sciences and were candidate for IVF. Clinical Outcomes including number of follicles, number of obtained oocytes, number of metaphase1 and 2 oocytes, number of high-quality embryos, rate of ovarian hyperstimulation syndrome, and positive pregnancy test were compared in Cinal F and Gonal F groups. Data were analyzed by SPSS statistical software (version 23) and Independent t-test and chi-square test. P<0.05 was considered statistically significant.

The incidence of ovarian hyperstimulation syndrome and positive pregnancy test was not significantly different in the two groups (P> 0.05). In the Gonal F group, the percentage of good embryo quality was better than Cinal F group (p = 0.017). The number of total follicles and oocytes, metaphase 1 and 2 oocytes and the number of necrotic and low-quality oocytes, and the number of embryos and frozen embryos were not significantly different (P> 0.05).

In this study, there was no evidence in favor of the difference between cinal and foreign drug in the success rate of assisted reproductive cycles. Regarding to the scarcity and high cost of Gonal F, Cinal can be used with confidence in the IVF cycle.

Sexual satisfaction is a key factor in quality of life that depends on several factors including healthy, pleasant and painless sexual relations. Treatment of sexual dysfunction should be given special attention due to the impact on the relationship between couples and family stability. This study was performed with aim to determine the effect of inhalation of Elaeagnus angustifolia flower essence on dyspareunia and sexual satisfaction of women at reproductive age.

This three-group randomized clinical trial study was performed on 99 women referring to health centers in Mashhad in 2019-2020. The study's units were assigned into three groups. The first group used the essence for 4 weeks, 3 times a day for 20 minutes each time and the second group once only 20 minutes before intercourse as inhalation and the third group did not receive any intervention. The Sexual Function Index (FSFI) was completed before the intervention and at the end of the 4th week after the intervention in all three groups. Data were analyzed by SPSS software (version 21) and one-way analysis of variance, Chi-square and Kruskal-Wallis tests. P<0.05 was considered statistically significant.

The mean score of sexual pain after the intervention in the first intervention group was 4.3±0.8, in the second intervention group was 4.7±0.7 and in the control group was 4.0±0.8. Based on the results of the intra-group test, the intervention was significantly increased only in the second intervention group (p<0.05). The mean score of sexual satisfaction after the intervention in the first intervention group was 4.2±0.7, in the second intervention group was 4.7±0.9 and in the control group was 3.8±0.5. Based on the results of intra-group test, the intervention was significantly increased only in the second intervention group (p<0.001).

Inhalation of Elaeagnus angustifolia essence 20 minutes before intercourse can effectively increase sexual satisfaction by reducing pain and discomfort during sexual intercourse. Therefore, it can be used as an affordable herbal supplement with minimal side effects.

Intravenous (IV) catheterization is one of the common painful procedures in children. This study aimed to investigate the effect of cold and warm vibration on pain caused by IV catheterization in 3- to 6-year-old children using a buzzy device.

A randomized clinical trial was carried out in 108 children in Mashhad Akbar Pediatric Hospital selected via random blocking. They were divided into three groups to receive warm vibration, cold vibration, or vibration only (control group). In this study, a musical vibrating device in a form of bee with either a warm or cold pack was attached for 5 min at approximately 5-10 cm above the intravenous continuous infusion (IVCI) site. In last minute, vibration was applied, then, IV catheterization was done. The Wong-Baker FACES Pain Rating Scale (WBS) was used to rate pain severity. Data were analyzed in SPSS V19 at a significance level of 95%.

Before the intervention, there were no significant differences in mean pain score between the three groups (P>0.05). Pain score was significantly different during the procedure (P<0.05). Significant difference was seen in pain score between the two intervention groups (P<0.05). The pain score was found to be significantly different between the intervention group that received cold vibration and the control group (P<0.05), but, the score was not significantly different between the group with warm vibration and the control group (P>0.05).

Both cold and warm vibrations could reduce the pain caused by injection, but cold vibration showed greater effect on reducing pain. Therefore, cold or warm vibrating devices are suggested in management of aggressive painful procedures in children.

VAP prevention is a top priority in the intensive care units. The study was conducted to compare the effect of using normal saline and distilled water for tracheal suctioning on the incidence of ventilator-associated pneumonia and hemodynamic indexes in ventilator-dependent patients.

The present study is a randomized clinical trial that was conducted from 2017 to 2018 on 60 ventilator-dependent patients in the ICUs of Jafar Sadeg Hospital affiliated to Alborz University of Medical Sciences. Patients were allocated to the two intervention and control groups by block random allocation method. The hemodynamic parameters of patients (respiratory rate, heart rate, blood pressure, and SPO2) were recorded in a form 5 minutes before and after the suctioning in each Shift. Finally, the incidence of VAP and changes in hemodynamic indexes in the two groups were compared.

The two groups did not differ from each other significantly (P = 0.79) in terms of tracheal culture and incidence of VAP. The results showed that intra-group hemodynamic indexes (heart rate, blood pressure, respiratory rate and SPO2) did not differ significantly before and after the suctioning in normal saline and distilled water groups. The inter-group test showed that, the two groups only had a significant difference in the level of arterial oxygen saturation after the intervention (p = 0.006).

As the level of SPO2 was higher in the normal saline group, it is better to use normal saline as a diluent for pulmonary secretions before tracheal suctioning.

The first point in any educational program is determining the educational needs. Appropriate information, knowledge and training will help couples base their marital life on the right foundation. The present study examined premarital educational needs of couples referring to Taybad health center.

The present study was a descriptive-analytical study that was performed cross-sectionally on 382 couples (191 men and 191 women). The marriage volunteers who referred to Taybad health center was performed from September to December 2019.Two questionnaires of demographic information and educational needs were used for data collection. The educational needs questionnaires included 46 questions in seven domains. Questionnaires were delivered to the couples and collected after completion. Data were entered in SPSS version 21, then, descriptive statistical indices, Pearson correlation test, Independent t, Mann Whitney U, Chi-square, and Kruskal-Wallis Data were analyzed.  

The mean age of female and male participants was 19.22 ± 4.54 and 24.38 ± 4.30 respectively. There was a significant difference in educational needs according to age, place of residence, level of education and job (p <0.05). The first three priorities of educational needs were relationship with spouse and family (with an average of 49.53 points), fertility (with an average of 33.76 points) and sexual relations (with an average of 20.16).

The need for education in all areas was above average. Couples have a tendency for more education in the field of relationship with spouse and family.

In language teaching, vocabulary and its development play an important role in learning. One way to increase vocabulary is to build words in the same family. Persian words appear in a new structure due to the combination with "vands". Sometimes these words create new words, and sometimes only the semantic scope increases and decreases, without a new word being introduced. Words are very diverse and have different meanings. One of the dominant semantic relationships between words is the "family relationship". Grammar books pay less attention to which categories of words can form words in a family. Some have mistakenly introduced all words as family members, which of course is not the case. To get to this point, a general understanding of Wends must be provided. This is important because some words are "descriptive" and do not create new words, but only prepare the word to take on a new role in the sentence. These words can in no way form a family of words. Others, known as derivative verbs, fall into the category of homogenous verbs. Due to the importance of this issue in language teaching, in this article, by examining the structure of words, the types of homonymous verbs and their semantic application are expressed.

The use of narcotics during pregnancy is accompanied by injuries such as preterm delivery, low birth weight and severe complications such as birth defects, which can lead to increased stress, decreased self-regulation and hospitalization in infants with the escalation of stress caused by the environment in these infants, there is a need for an evolutionary care approach. Swaddlers and nests are effective interventions for these babies. The purpose of this study was to compare the effect of nesting and swaddling on the self-regulation behavior of the newborn with the addicted mother.

This cross-overal clinical trial was performed on 30 infants who were admitted to neonatal intensive care unit of Mashhad and had addicted mother with gestational age of 32 to 38 weeks. The sampling method was simple random sampling. The infants were divided into two groups of swaddling in the first three days (group A) and nesting in the first three days (group B), and the second three days in the opposite group, respectively. The duration of the intervention was six days. The demographic information questionnaire and the checklist form of observing the infant's behaviors were used for assessing stress and the Finnegan scale was used to assess the degree of neonatal abstinence syndrome. Data was analyzed using SPSS software.

Based on the results of independent t-test, the percentage of self-regulation behaviors was not significant in the first three days of the swaddle and the first three days of the nest group (P = 0.066).

The results showed that the effect of nesting and swaddling on the self-regulating behaviors of the newborn with the addicted mother was not significantly different. Therefore, these two methods do not differ significantly. According to the conditions of the newborn, the part and the mother's desire can be selected from one of them.

“Ulul al-bāb" is a special expression in the epistemic and moral system of the Holy Qur'an which describes outstanding servants and believers. The commentators in the explanation and exemplification of this term have different opinions, including the owners of reason, the owners of the full rationale and the owners of healthy intellect. However, by reflecting on the verses that highlight the attributes of "Ulul al-bāb ", we find that the commentators' views are not complete. According to the findings of the research and also according to the verses context, “Ulul al-bāb " is one who understands and receives the noble divine teachings at its highest level after divine prophets and saints, apart from any impurity and temptation. In addition to recognize the right and false, they choose the best way in the direction of divine obedience, while at the same time they are rational and praisers people and they are gifted by wisdom. Therefore, interpreting Ulul al-bāb to the wise men means to ignore all aspects of their personality; while Qur’an mentioned remarkable features for Ulul al-bāb, according to which such individuals have a full intellect in both theoretical approaches and scientific attitudes and have reached the peak of the maturity of the practical intellect in the course of action.

Telenursing and Multimedia are the educational methods for mothers and it seeks to involve them into the process of caring the premature newborns. Being succeeded in breastfeeding represents the mother's ability to breastfeed the baby. This study aimed to investigate the effect of post-discharge education through Telenursing and Multimedia methods on the success in breastfeeding the newborns aged 35-37 weeks.

A six -month clinical trial was conducted on mothers and newborns in the rage of 35-37 weeks who were fed with breast milk and admitted to the Neonatal and obstetric intensive care unit of Emam Reza Hospital, Ghaem and Um-ol-Benin Hospital of Mashhad. The samples were randomly divided into two intervention groups (each group included 30 newborns). The effect of Telenursing and Multimedia methods on the success of lactation was compared in both groups. The data were analyzed using IBFAT and BEET tools, SPSS 19 and descriptive and inferential statistics (Chi-square and independent t-test)

The results suggested a significant difference between the means of breast feeding in both educational groups (p <0.05). There was no significant difference in terms of sucking in both educational groups (P>0.05). Breastfeeding status was significantly different (P<0.05). There was no significant difference between the means of weight before and after intervention (P >0.05). But telenursing and multimedia methods differed significantly before and after the intervention (P<0.05)

The findings represented that both educational methods had similar effects on the behavior of mother and baby in breastfeeding (based on BEET TOOL), effective nutrition of infant, frequency and the period of breastfeeding.

Premature rupture of membrane (PROM) is a common complication in midwifery and a serious consequence during pregnancy. This event can cause 18-20% prenatal mortality and 21.4% prenatal morbidity. Therefore, it is essential to use methods that can predict PROM. Regarding this, the purpose of the present study was to investigate the relationship between striae gravidarum and PROM among the primigravid women.
This predictive correlational study was conducted on 600 primigravidwomen with the gestational age of 35-37 weeks in Bojnourd, Iran. The study population was selected through convenience sampling technique. The participants were monitored and followed up until delivery, and thereafter divided into two groups of with PROM and without PROM. The data were collected using physical examination, interview, telephone follow ups, and patients’ medical records. In addition, the severity of striae gravidarum was determined by the Atwal scale. Data analysis was performed in SPSS (version 17) using descriptive statistics, Kolmogorov-Smirnov, Man-Whitney U test, Chi-square test, and logistic regression. P-value less than 0.05 was considered statistically significant.
According to the results, 445 (74.2%) participants had striae gravidarum, and PROM occurred in 22.3% of the cases (n=134). The results of the logistic regression test showed that the females with severe striae gravidarum were 2.617 times more prone to the incidence of PROM, compared to those without striae gravidarum (P=0.010).
According to the findings, the severity of striae gravidarum can be used as an indicator to predict the incidence of PROM. In order to prevent from such an event, the midwives and gynecologists can provide the mothers having severe striae gravidarum with proper recommendations in this regard.

The incidence of vaginal candidiasis and the number of treatment resistant cases are high; moreover, chemical medications are associated with serious adverse effects. Therefore, the use of herbal medicines is taken into consideration because they do not affect the normal vaginal flora and have low side effects. In vitro studies confirmed the favorable antifungal effects of coconut oil on various species of Candida, especially on the resistant species such as Candida glabrata and Candida tropicalis. This study was conducted to compare the effect of vaginally administered coconut oil and clotrimazole on Candida species.
This triple-blind clinical trial was conducted on 71 patients, who were assigned into two groups of coconut oil (35 individuals) and clotrimazole (36 individuals) in Mashhad, Iran, 2017. Data were collected using demographic data form and observation record sheets. The patients received the medicines by applicator for a week. Thereafter, physical examination and re-cultivation were carried out; and the success in the treatment included a negative culture and symptom relief. Data analysis was performed using independent samples t-test, Fisher’s exact and Chi-squared tests with the help of SPSS software, version 19. P-value less than 0.05 was considered statistically significant.
In this study, there was no significant difference between the groups in terms of the frequency of Candida albicans, glabrata, and tropicalis at the pre- and post-intervention phases (P=0.98, P=0.34, P=0.73, respectively). Regarding the success in the treatment, no significant difference was observed between the effects of vaginally administered coconut oil and clotrimazole on various species of Candida (P>0.05).
Considering the beneficial effects of vaginally administered coconut oil on candidiasis, it is recommended to use it to treat this disorder.

Neonatal jaundice is one of the most common problems in neonatal period. Considering that the most effective and most commonly used neonatal jaundice treatment is phototherapy, the use of complementary therapies such as massage and herbal medicines is common in our society to reduce jaundice. Therefore, the present study was conducted to compare the effect of cotoneaster manna drop (bilineaster) and massage on bilirubin in neonates under phototherapy.
This clinical trial was conducted on 68 neonates admitted to the pediatric ward of Vali-Asr Hospital in Birjand in 2015. The neonates were randomly divided into three groups. The control group (n=21) received the routine care. The massage group (n=23) received massage by field technique, three times a day for 15 minutes in addition to phototherapy. The cotoneaster manna drop (bilineaster) group (n=24) received three oral drops of bilineaster for every eight kilograms of body weight in addition to phototherapy. Then, the rate of reduction in neonatal bilirubin was compared in the three groups (IRCT: 2016101830370N1).
FINDINGS: The mean reduction rate of bilirubin per hour in the first 24 hours was 0.27±0.19 in the control group, 0.23±0.17 in the massage group and 0.25±0.18 in the bilineaster drop group. In addition, the mean reduction rate in the second 24 hours was 0.4±0.26 in the control group, 0.22±0.18 in the massage group and 0.26±0.22 in the bilineaster drop group. In the third 24 hours, the mean reduction rate was 0.19±0.17 in the control group, 0.9±0.13 in the massage group and 0.7±0.1 in the bilineaster drop group, which had no significant difference (p>0.05).
The results of this study showed that field massage and administration of cotoneaster manna drop (bilineaster) during neonates’ hospitalization had no effect on the reduction of bilirubin in neonates under phototherapy and these interventions cannot be effective

The application of information technology for the delivery of library services through websites has removed many temporal and spatial limitations. This study aimed to identify the available services and resources on the websites of central libraries at universities of medical sciences in Iran.
The population of this descriptive study comprised 36 central-library websites of medical universities in Iran. A researcher-made checklist was used to collect data, which were then analyzed through descriptive statistics using SPSS 18.
According to the findings, “electronic mail”, “access to services via mobile” and “how-to-use-a-library instructions” were mentioned as modern technologies in 83.3%, 2.8% and 77.8% of websites, respectively. However, nothing was found on “e-learning copyright”. Concerning librarianship and library publications, 69.4% of websites included “new library sources and references”.
Considering the daily development of information technology, it is essential to regularly revise library websites and employ new technologies to enhance them.

The challenges that patients face after intestinal ostomy surgery can lead to impaired adjustment and self-efficacy. There is evidence suggesting these variables have reciprocal effects on each other. Therefore¡ the present study aimed to determine the correlation between adjustment and self-efficacy in patients with intestinal ostomy.
Methods & Materials: This descriptive correlational study was conducted on 76 patients with intestinal ostomy hospitalized in hospitals affiliated to Mashhad University of Medical Sciences using convenience sampling method in 2015. Research instruments were comprised of the demographic and disease information questionnaire¡ the Stoma Self-efficacy Scale¡ and the Ostomy Adjustment Inventory. The SPSS software v.19 using descriptive and inferential statistics was used to analyze the data.
The results of Pearson correlation test showed a significant and positive linear correlation between the mean score of self-efficacy and the dimensions of adjustment: acceptance (P The results revealed that the dimensions of social engagement and acceptance of ostomy were the most important factors in relation to self-efficacy. Therefore¡ in order to care for patients with intestinal ostomy especially in the early months after surgery¡ it was recommended to help patients adjust themselves to the physical appearance of ostomy and maintain their social engagement¡ by designing and implementing appropriate educational and supportive interventions.

The Neuropsychological performance in patients with anxiety disorders has received much less attention. The present study set out to compare one of the executive performances that means shifting function in two groups of social anxious and normal. Also, The aim of the present study was to investigate performance in this function both of processing efficacy and performance effectiveness.
In this causal-comparative study, recruited 24 patients with social anxiety disorder and 24 non patients in multi-stage cluster sampling method and were implemented tests of Connor Social Anxiety Scale, Self-reported mental effort scale, and Wisconsin Card Sorting Test, The results were analyzed with SPSS software and MANOVA test.
The results showed significant differences between the two groups in both components of performance in the shifting function namely processing efficacy (P The group of social anxious in compare with normal group showed deficient in the shifting function of working memory. The deficiency observed were related to cognitive models of anxiety disorders specially Attentional Control Theory.

the prevalence of unhealthy weight control behaviors in adolescents is increasing and unhealthy weight control behaviors can have serious physical and mental consequences in adolescents. The aim of this study was to determine the effect of education based on Health Belief Model on the prevention of unhealthy weight control behaviors in female adolescents aged 13-15 year.
This was a quasi-experimental study conducted on 160 girls in high schools of Karaj city. Sampling was performed in two stages: in the first stage, schools were randomly selected and assigned to two groups. In the second phase, samples, based on the entry criteria, were selected by convenience sampling. Data for pre-test were collected using a questionnaire in both groups. The experimental group received the educational intervention in the form of presentations in four sessions, conducted along with questions and answers. Eight weeks after the educational intervention, post-test was given to both groups and data were analyzed before and after the training using SPSS software and Fisher's exact test, chi-squared and independent and dependent t-tests.
In comparison of the mean score of Health Belief Model parts (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, guide to action, and preventive behaviors) between the intervention and control groups, there was a significant difference between before and after the intervention (P The results of this study showed that educational interventions based on Health Belief Model can be effective in preventing unhealthy weight control in adolescents. On this basis, it is suggested to run trainings in order for the prevention of unhealthy weight control behaviors based on Health Belief Model for young people and in schools.

The present research is a descriptive and cross sectional with the aim of analyzing the factors affect the employment matching the field of study for nursing graduates studying in Qazvin medical science university in 2013. Data were collected on 406 students of B.S. who were graduated from the School of Nursing and Midwifery during 2007-2011. The information was gathered through a questionnaire that its validity and reliability were confirmed and it was done by telephone call with recording conversations, visiting and e-mail. Data were described as the frequency of distribution, number and percent. The results showed that, the most of graduates worked as a nurse and lake of employment is related to personal reasons. The work load and low income were the main of these reasons. Thus, according to the importance of this job for the society, focusing on increasing the income and creating facilitation regarding the situation and difficulties can provide a situation that every nursing graduate start to work as a nurse.

Learning Strategies includes overt and covert behaviors, which are associated with success in learning. On the other hand, training students who are able to live in environments with diverse values, rapid technological changes, and developments in the socio-cultural complex is one of the unique challenges to a university administrator. Therefore, this study was performed to investigate the association of personal characteristics and educational experiences of the students of Zanjan University of Medical Sciences with their academic achievements.
This descriptive correlational study was conducted on the students of Zanjan University of Medical Sciences during 2014-2015 academic year. Students were selected through random stratified sampling based on gender and discipline (N=352). The research tool was the college students’ experiences questionnaire (CSEQ). Data was analyzed using descriptive statistics and multiple regression.
All three dimensions of college students’ experiences, including perceptions of quality of environment, quality of effort, and social integration are significant anticipators of their academic achievements respectively and predict 0.415 of achievements variances.
Taking into account the personal characteristics and educational experiences of college students for their academic achievements in medical universities is essential. In spite of the impact of academic environments ranging from individuals and facilities for college students, improving these factors contribute to better communication between students and faculty members and.

The Information and Communication Technology entered to libraries in the 1960s. The type of technologies that used in the libraries are "NFC"and "RFID". The aim of study is determine the technical capability of the NFC and RFID technologies in improving services of academic libraries and compare these based on Beredy pattern.

The research has been done with comparative-descriptive approach and by Beredy pattern.
Findings: The main findings of research includes the similarities and differences of "NFC" and "RFID" according to Beredy Comparative Pattern and basis on criteria that includes application, components of Library system, components of hardware, software, firmware, standard situation, frequency range, operating frequency, distance of Reading, speed, communication mode, mode of operation, environment of performance, and security that is presented in the form of table.
Originality: This research leads to better understanding and implementing the "NFC" in academic libraries of Iran, in the near future.

In the process of continuing education, nurses are one of the most important audience in hospitals need the development of teaching and learning methods to enhance their performance. This research is based on the need for proper training of intensive care units (ICU) nurses for arterial blood gas interpretation skills in the care of critical patients and has been done the effect of formative assessment with appropriate feedback for development of this skill.
This is a Quasi Experimental study that 90 nurses working in Critical Care setting of three Hospital were participate in this study. The samples were selected based on available sampling method and inclusion criteria. Arterial blood gas interpretation skills of nurses were measured before and after the educational intervention. Results were compared using descriptive and inferential statistical methods with SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc.
The primary mean score were 13.86 ± 3.7 for oral written group, 12.93 ± 2.27 for written group and 12.43 ± 2.51 for control group. Also there were no significant difference between three groups before intervention (P = 0.157). The mean score after intervention were 20.33 ± 1.58 for oral-written group, 18.40 ± 1.84 for written group and 15.96 ± 1.56 for control group. The mean scores between groups have a significant differences after intervention (p This study showed that using formative assessment and provide proper feedback is effective on learning and using formative assessment with written and oral feedback improve arterial blood gas interpretation skills. So it is recommended that formative assessment with written and oral feedback be used in educational programs.

Always in second language education principles and rules BhKargyry or lack of adherence to it can be seen that the success or failure of people. ZmantBkhsh a key issue that could be discussed and individual learning support and support in this regard, taking into account the "intuitive principle" is. The purpose of the visual, physical and visual display according to different MvqytHay BhKar MyYnd in the process of education. What people make it through the eyes MyBynnd, communicating with it easier and faster it is digested. In terms of language education into account as well if the teacher informative, attempt ZbanMvzan of his sense of opportunity that most brands, Mvz·hHay can run more smoothly transferred to them and sustains it stabilize. Is an intuitive principle applied in four phases. That first teacher through the "motion" for ZbanMvz to dramatize things objectively, at a later stage ZbanMvz can communicate with its content, communication that leads to "brace" He and finally Mvz·hHa in his mind "embodies" the. After visualization Mvz·hHa in mind, he "discovered the meaning of" lies in Mvz·hHa MyPrdazd. In this paper the "intuitive principle" in second language education with regard to cases been investigated.

Considering the elements of knowledge management (availability, creation, and transfer of knowledge) is very important in digital libraries websites and makes the performance better. So this paper aim to identify the knowledge management criteria in Iranian selected digital library's websites and study of observance scale
The research method was descriptive survey and from applied research type. Data collecting has been based on check list according with K-ACT model (Knowledge- Access Creation Transfer). The population of this study was 7 digital library websites, including Noor, Payame noor, Islamic Parliament, Tebyan, DID, National Digital Library of Iran and Astan Quds Razavi that were selected based on accessibility.
This research findings showed that use of knowledge management criteria in the selected digital libraries websites is moderate and the access to website criteria is highest and lowest is online participation criteria. Tebyan DL earned first rank among seven libraries with 56 percent compliance with the standards of knowledge management in the digital library's web sites.
Study of knowledge management criteria in the selected digital library websites has shown that these criteria has not been favorably applied that it stems from criteria incompatible with the principles, rules and standards. Due to these problems, designers of digital libraries can be effective in promoting these websites and enhance the quality of digital library services with aware of users’ needs and attention to use of these criteria.