محمدحسن رخشانی

AIDS is a public health problem for which screening tests are recommended for prevention. This study aimed to determine the impact of an educational intervention based on the precaution adoption process model on HIV screening. 

A semi-experimental study was conducted on 120 third and fourth-year nursing students in Sabzevar city in 2019 using random sampling. Data collection tools, researcher-made questioner with appropriate validity and reliability, included demographic information, awareness, and constructs of the precaution adoption process model. Data was collected before, two weeks, and two months after the intervention in intervention and control groups. Data was analyzed using SPSS19 software and tests including Chi-square, independent t-test, GEE, and multiple linear regression.

In the present study, 21.7%, 35%, 28.3%, and 15% of students were in stages 2, 3, 4, and 5, respectively. After the intervention, 55% of individuals in the intervention group progressed to stage 6 (action). The educational intervention increased awareness by 4%, sensitivity by 6%, perceived benefits by 16%, and self-efficacy. Additionally, the behavior of the intervention group improved more than three times compared to the control group (P=0.028).

The study results indicated that the educational intervention to students, despite being implemented at various stages of the model, increased the likelihood of them moving closer to the stage of performing the behavior. Therefore, designing educational interventions to promote the target group from stages of non-engagement or decision-making to HIV testing is recommended.

One of the methods of preparing the cervix for induction of labor is use of drugs. Use of prostaglandins and estradiol is one of these methods. The aim of this study was to compare the effects of estradiol and misoprostol on cervical preparation.

This study included 100 pregnant women with Bishop score of less than four who had referred for normal delivery. The participants assigned to groups of misoprostol suppository and estradiol cream by random method. The women were examined every two hours and cervical Bishop score and labor progress were assessed. If uterine contractions were not suitable after 6 hours, induction with oxytocin was performed by the conventional method. Finally, two groups were compared in relation to Bishop score, onset of uterine contractions, lengths of labor stages, rate of cesarean section, and maternal and fetal complications by use of  SPSS22 software. p<0.05 was considered significant.

After two and four hours, Bishop scores were higher in the estradiol group than those in the misoprostol group (P<0.05). Need for oxytocin in the first and second stages of labor was more in the misoprostol group than in the estradiol group (P=0.001). The duration of the first stage in the misoprostol group was higher compared to that in the estradiol group (P=0.004) and there was no statistically significant difference between the lengths of the second and third stages and the type of delivery. (P > 0.05)

Estradiol cream can be used to prepare the cervix for childbirth. Use of this method, can reduce the duration of the first stage of labor without any complications for mothers and babies. This method can reduce the rate of cesarean section and result in better health of the mothers and babies.

Diabetes is associated with an increased risk of cancer. Because of the metastatic nature of cancer, the survival of women with breast cancer is decreasing despite receiving various treatments such as chemotherapy, radiotherapy, etc. The aim of this study was to investigate the relationship between diabetes and the risk factors related to the survival of breast cancer patients.

This was a descriptive-analytical study. Patients were selected via systematic random sampling and then divided into diabetic and nondiabetic groups. Then the 5-year survival rate of patients was were compared.

The mean and median for survival were 9.95 and 13.00 years. The risk of death in breast cancer patients positive for estrogen receptor was significantly reduced compared with patients negative for estrogen receptor (HR, 0.314; 95% CI, 0.109–0.907; P = 0.03).

The results of the study indicate that the survival of breast cancer patients in diabetics is not significantly different from non-diabeticsUse of metformin and estrogen receptor positivity is associated with higher 5-year survival rates in women with breast cancer. Therefore, cancer screening programs in high-risk groups, especially in diabetic patients, and hyperglycemic control may affect survival time.

Preventive measures such as training and preventive people skills are for personal protection in endemic areas that the aim of this study was to determine the predictors of preventive behaviors of cutaneous leishmaniasis in students based on Health Belief Model and BASNEF model.

In this descriptive-analytical study, 379 students of Neyshabur city were selected and studied by multistage cluster sampling. A questionnaire was designed to collect data and was completed based on the study patterns.

Significant correlation (P <.01) was found between all constructs of the models except perceived sensitivity and awareness with behavioral intention. Comparing the two models studied, the BASNEF model constructs predicted 32% of the total and the Behavioral belief model constructs 24% of the variance in intention to prevent leishmaniasis behaviors.

The prevalence of Leishmaniasis prevention behaviors in the studied community was moderate, which should be improved through educational interventions given that the disease is endemic in Neyshabur. Training programs aimed at enhancing attitudes, abstract norms, self-efficacy and perceived benefits as well as reducing perceived barriers can be effective in promoting leishmaniasis prevention behaviors.

Brucellosis is one of the most important public health problems in developing countries, especially in rural areas closely related to animals. This study determines the effectiveness of an educational intervention based on Protection Motivation Theory on promoting preventive behaviors from brucellosis between the farmerchr('39')s ranchers in the comprehensive rural health center.

In this quasi-experimental study, 110 ranchers of the farmer (in two groups of intervention and control) were selected by two-stage cluster sampling. The data collection instrument was a researcher-made questionnaire consisting of two parts; the first part included demographic questions, and the second part related to knowledge of the disease and the Protection Motivation Theory questions. The data were analyzed by SPSS 16 using Mann Whitney, Shapiro-Wilk, Kruskal-Wallis, Regression, Fisherchr('39')s Exact Test, and Chi-Square.

After the educational intervention, awareness and all protection motivation theory structures in the intervention group compared to the control group have increased significantly (p<0.05). Also, the structures of protection motivation theory predicted 0.66% of the variance of preventive behaviors, and among them, self-efficacy and motivation related to behavior were the strongest predictors.

This study confirms the effectiveness of an educational intervention based on the Protection Motivation Theory on adopting brucellosischr('39')s preventive behaviors.

Fear of childbirth increases obstetrical interventions, and causes complications for mother and fetus and is one of the important factors affecting the increased rate of cesarean. This study was performed with aim to investigate the effects of childbirth preparation classes program on fear of normal vaginal delivery measured with Wijma Delivery-Expectancy questionnaire.

This randomized clinical trial study was performed on 132 nulliparous women in Sabzevar Health Centers during 2017-2018. The subjects were randomly divided into two groups of intervention and control. The intervention group participated in childbirth preparation classes and the control group received only the routine prenatal care. Wijma Delivery Expectancy Questionnaire (W-DEQ) Version A&B was completed before and after the intervention and 14 days after delivery by the mothers. Data were analyzed by SPSS software (version 22) and t-test and Repeated Measurement Variance Analysis.  P<0.05 was considered statistically significant.

The mean total score of questionnaire and all the factors except the fear of fetal injury were significantly higher in the intervention group than the control group (p <0.05). Also, the scores of all factors except fear of fetal injury increased in the intervention group from pre-test to post-test and follow-up (P <0.05). The scores of fear of fetal injury in the intervention group decreased in post-test while in the control group decreased after childbirth; comparison of means showed difference between two groups (p=0.01).

Childbirth preparation classes held in Sabzevar increased the fear of childbirth. Therefore, the content of this training course must be assessed.

Work alienation is related with negative consequences on the employees and the organization’s efficiency. Considering the role of nurses in the healthcare system main purpose of this study was to study the relationship between perceptions of job characteristics and organizational support with job alienation among nurses Working in hospitals affiliated with the Sabzevar University of Medical Sciences.

this study was Analytical descriptive (Cross – sectional) in 2018. The population were 181 Nurses in hospitals in Sabzevar who were selected by cluster sampling. We used three instruments in this study, Job Characteristics (Hackman & Oldham),Organizational support (Eisenberger et al) and Jab Alienation (Boeree). Information analyzed by Descriptive and inferential statistics includes linear regression and variance analysis by SPSS 21.

mean and standard deviations scores Job Characteristics were 60/73 ± 1/61, Motivational Potential Score 9/2 ± 4/25,Organizational support 61 ± 8/52, Job alienation 96/88 ± 1/73. Also based on the results of regression analysis, there is a relationship between perception of Job characteristics and organizational support with Job alienation (p < 0.05).

The results showed that there is a meaningful and reverse relationship between Job Characteristics and Organizational support with Jab Alienation, The variables of job characteristics show a greater variation of the job alienation. Therefore, it is suggested a qualitative study to explain the various characteristics of the nursing profession in order to provide ways to enrich the components of the job characteristics.

 Preoperative anxiety is associated with adverse effects such as fatigue, nausea, vomiting, agitation, increased demand for analgesics, and prolonged postoperative hospitalization. This study aimed to investigate the impact of mental imagery on anxiety in patients undergoing hernia repair surgery.

 In this randomized clinical study, after obtaining informed written consent, 56 patients for hernia surgery were randomized into two experimental and control groups. In the experimental group, guided imagery was applied. Data was collected using the State-Trait Anxiety Inventory (STAI). The collected data was analyzed using SPSS V. 20.

 The average age of participants was 30.8±11.22 years, and 73% of them were male. The average of STAI level in guided imagery group before intervention were 41.42±6.75 and 32.22±9.87, respectively, which decreased to 33.07±4.31 and 28.14±7/86 after intervention. On the other side, the average of STAI level in the control group were 39.71±4.58 and 29.68±8.49, respectively, which increased to 44.60±6.44 and 38.42±7.21 at the end of the study. Statistically, the paired t-test showed a significant difference between the levels of anxiety before and after study in two groups (P<0.001). 

 This study cleared that performing preoperative mental imagery can reduce the STAI level in patients before surgery.

Neuropathic pain is one of the common, important, and irritating complications in diabetes.  Despite the importance of this pain, there is still no effective treatment for that. The aim of this study was to determine the effect of evening primrose oil and gabapentin on neuropathic pain in patients with type 2 diabetes. This triple-blind clinical trial was performed on 70 patients with diabetic neuropathy who obtained score 2 from the Michigan Questionnaire and referred to the Department of Endocrinology at Khayyam clinic affiliated to Hakim Hospital in  Neyshabour from December 2017 to May 2018. The participants were divided into two groups of 35 people. The intervention group was treated with a capsule of evening primrose oil orally  (1000 mg) twice daily for three months and gabapentin (300 mg) daily. On the other hand, the control group was treated with gabapentin (300 mg) and placebo. The neuropathy pain severity was measured before and after the end of three-month intervention using Michigan and McGill Pain Questionnaires. Data analysis was performed in SPSS software (version 21) through Fisher's exact test, ANCOVA, multilevel logistic regression, Mann Whitney U test, Kolmogorov-Smirnov test, and the Chi-square tests. P-value less than 0.05 was considered statistically significant. According to the results obtained from the McGill questionnaire, the mean scores of neuropathy before the intervention were obtained at 10.12±0.57 and 9.85±0.65 in the intervention and control groups, respectively. However,  the mean scores of neuropathy after the intervention were estimated at 6.18±0.48 and 8.31±0.60 in the intervention and control groups, respectively, which was statistically significant (P<0.02). Evening primrose oil is effective in reducing neuropathic pain in type 2 diabetic patients. Therefore, this can be a supplementary treatment for reducing pain associated with diabetic neuropathy.

It is important to maintain proper endotracheal tube cuff pressure during hospitalization in intensive care units (ICUs). Among variables affecting endotracheal tube cuff pressure (p. cuff) in patients is various nursing practices. So, this study assessed the effect of body position changes on p. cuff in patients hospitalized at the ICU.

In this clinical trial, mechanically ventilated patients with oral endotracheal tube hospitalized at the ICU were enrolled. The patients were selected using the purposive sampling method. A demographic data checklist and Richmond Agitation Sedation Scale were used to collect the data. p. cuff changes, after changing body position to the left and right at bed angles of 30° and 45°, were immediately measured and recorded. The data were analyzed using the SAS and SPSS 19 software packages along with descriptive statistical tests, chi-square test, independent t-test and ANOVA at the significance level of 0. 05.

The results of this study showed no significant relationship between demographic variables and endotracheal tube cuff pressure changes. The results indicated a significant relationship between endotracheal tube cuff pressure at 30-degree bed angle and cuff pressure in the body position changes to the left (p = 0. 004) and right (p = 0. 00), as well as between 45‎° head of bed and cuff pressure in the body position changes to right (p = 0. 012).

The endotracheal tube cuff pressure was observed to change by changing the patient's position, change. Therefore, it is recommended to measure p. cuff and regulate it within the therapeutic range.

Administration of medications is an important part of treatment and care provided by nurses. Medication errors in nursing profession is one of the most common health care mistakes.One of the factors in the incidence of medication errors, job stress, so stress management and efficient use of preventive methods necessary to appear. The aim of this study is to determine the effect of a Stress Inoculation training on the medication error of nurses.
The present research is, a field trial controlled study.The population included 100 nurses in medical, surgical and pediatric hospitals constitute Sabzevar University of Medical Sciences. Nurses are selected using quota sampling permutation blocks were divided into two groups.The intervention group, stress inoculation training (workshop 2 days 8 hours a week) was conducted.The data collecting by a researcher-made forms of occupational demographic information and registration forms medication errors,during the two stage, one months before and one and a half months after the intervention was completed by both groups. Data were analyzed by means of SPSS-11/5 and SAS 9.1 statistical software using descriptive statistics, Mann-Whitney, Chi-square, Fisher, T test and generalized estimation equations.
The mean and standard deviation of medication errors in the intervention group before stress inoculation training 5/65 ± 2/30 and a half months was 2/68 ± 1/57. Analysis of data between the mean medication errors samples before and after the intervention groups showed significant differences (PStress inoculation training can reduce the incidence of medication errors.

Introduction and Aims: One of the important strategies to control cutaneous leishmaniasis is preventive behaviors and evaluation of preventive behaviors from leishmaniasis and detecting factors associated with the disorder is the first step in planning for training intervention. Since there is no standard questionnaire in this regard, this study aimed to design and psychometric native tools to evaluate the preventive behaviors of cutaneous leishmaniasis based on BASNEF Model in students of Neyshabur.
In this sectional study, we designed a primary tool after investigated the scientific sources and Needs assessment beliefs Based on BASNEF Model on 25 people from the study population. For psychometric tools, we used artificial validity with the participation of 20 students and content validity (By measuring the ratio of the content validity and content validity index) through an expert panel with the participation of 10 health education experts and tool designed experts. Construct validity (using confirmatory factor analysis) was performed in LISREL software by selecting 226 high school students by using a multistage random sampling method. To determine the reliability of the tool, we used internal consistency and test-retest method.
The basic questionnaire version was designed with 46 items then some items were modified by artificial and content validity.in artificial validity, 2 items were excluded because of having an impact score less than 1.5 and content validity by taking a cut-off point./79 to measure content validity index and cut-off point./62 for the credit test, the number of 8 items to be removed and items Number declined to 36 in artificial and content validity rate. In constructing validity, AGFI = 0.90, RMSEA = 0.040 were obtained by Confirmatory Factor Analysis, Respectively. The reliability of the tool was approved through internal consistency (0/864 = α) and retest test (0/993 =ICC)
The results showed that prevention behavior questionnaire of skin, cutaneous Based on BASNEF Model is valid and reliable with 36 items, and because of the strength of suitable factor structure and psychometric properties, researchers can use it in the related studies.

Constipation is the predominant gastrointestinal complication experienced after a stroke and can result in increased intracranial pressure. The main treatment for constipation is symptomatic treatment including taking laxatives and increasing dietary fiber; this treatment is associated with complications and limitations. Due to the positive effects of probiotics in the treatment of digestive problems, this study aimed to investigate the effect of synbiotic supplements on the constipation of stroke patients admitted to the ICU.
In this randomized clinical trial, subjects were randomly divided into two groups; intervention (n = 33) and control (n = 32). Defecation frequency was measured before initiating the study. Patients in the intervention group, in addition to routine treatment, received synbiotic supplements, every 12 hours for a week while the control group received only conventional treatment. During the one-week study, the frequency of defecation was measured and recorded.
In the experimental group; the average number of defecations was more than once a day; (1.22); while in the control group this value in one day and two days equaled 0.62 and 1.24 respectively (P This study showed that synbiotic supplementation in stroke patients increased the frequency of defecation. Therefore probiotics can be used as a non-drug therapy in the treatment of constipation in these patients.

High-Sensitivity C-reactive protein (hs-CRP) is the most reliable means of diagnosing and controlling hidden inflammation and infection in the body. poor nutritional status in older adults with increased serum levels of CRP, followed by systemic inflammation is linked. It appears that diet has an significant effect on chronic inflammation affecting the progression of the disease. This study aimed to examine the association between macronutrients intake with serum High sensitivity C-reactive protein in elderly located in nursing homes in Sabzevar.
This cross-sectional analytical study included 105 nursing home residents from Sabzevar city, stratified sampling method was performed. Anthropometric indexes, BMI and WHR were measuremed according standard methods. Nutrientional intake per person was collected and determined by using the N4 software. Blood samples were collected for measurement of serum hs-CRP. Data were analyzed by using SPSS software descriptive statistics and regression.
In the present study, a significant positive correlation between total fat and cholesterol intake and a significant inverse correlation between fiber intake and serum high sensitivity C- reactive protein was observed. Among Anthropometric indexes, hs-CRP has a statistically significant relationship with BMI.
According to results of this study, diets high in fiber, low in fat, low cholesterol should be the first level of prevention in this age group and it can reduce inflammation remarkably.

Bloating, is a common complication in patients with stroke; that increased intracranial pressure due to cerebral hypoxia in these patients. Most drugs have adverse effects to relieve flatulence.So this study aimed to investigate the effect of synbiotic supplement on stroke patients; was performed.
The study, on 65 stroke patients; was done. They were randomly divided into two groups: control (n = 32) and intervention (n = 33) and the size of their abdominal circumference were measured before the study. The intervention group, in addition to routine treatment, for a week, every 12 hours, recived fermented prbiotic supplement Zhari Takhmir and the control group was given only a laxative( MOM = 15cc) prescribed by a doctor. In the end, abdominal circumference in all patients were evaluated again. Data using analysis of covariance model, were analyzed .
After a week, abdominal circumference measurements in two groups showed that; in the intervention group on average waist size of 6.1 inches had reduced compared to baseline( p=0.028). But the changes were not significant in the control group.
The study showed that a probiotic supplementation reduces abdominal circumference and distention in patients with stroke; Therefore, probiotics can be used as a non-drug therapy in the treatment of these patients.

Spiritual health is a component of human health. Despite of its importance in recent years the concept of spirituality and spiritual care in nursing as a nurses duties, there are few studies in this field especially in our country Iran. Aim: This study was aimed to investigate nurses and nursing students’ viewpoints about spirituality and spiritual care of patients.
This cross-sectional study conducted in hospitals affiliated with the Sabzevar University of Medical Sciences. Sampling performed for students by census and for nurses by two-stage sampling. Study instrument was Spirituality and Spiritual Care Rating Scale- SSCRS. Data was analyzed by SPSS software ver.16.
The mean total score of attitude towards spirituality and spiritual care in nursing students participating in the study was 54.57±1.74 and 52.44±0.88 in nurses. The mean score differences in nurses and students were not statistically significant and by demographic characteristics.
Participant's attitude toward spirituality and spiritual care was desirable and this could be considered as an asset for health managers. Further studies about factors affected their attitude were offered.

Objectives Constipation is a predominant gastrointestinal problem after the onset of stroke, which may increase intracranial pressure. Treatment of constipation includes using laxatives and fibers, which is associated with complications and limitations. Regarding the effect of probiotics to treat digestive problems, the current study aimed at investigating the effect of probiotics on constipation in the patients with stroke admitted to Intensive Care Unit (ICU).
Methods The current randomized clinical trial was conducted on 65 patients with stroke. Patients with nasal-gastric tube and absence of rejection in 3 consecutive days were enrolled to the study. They were randomly divided into 2 groups of intervention (n=33) and control (n=32); the frequency of their bowel movements were measured before the study. Subjects in the intervention group received a probiotic supplement every 12 hours; however, the ones in the control group received the only routine conventional treatment for a week. After a week, all subjects were assessed for the improvement of constipation. Data were analyzed by SAS software version 9.1 using Poisson regression model.
Results In the intervention group, the mean number of bowel movements was more than once a day, 1.22, and in the control group it was 0.62 (PConclusion The current study showed that probiotic supplement consumption increased the frequency of constipation in patients with stroke. Therefore, probiotics can be used to treat constipation in such patients.

Objectives Quality of work life has important role in job satisfaction and quality of services. Personality compatibility with profession is one of the issues that affect job satisfaction. This study was conducted for the purpose of evaluation of nurses’ quality of work life in Sabzevar University of Medical Sciences, and comparing it with their demographic data and its correlation with personality-profession compatibility.
Materials & Methods This cross-sectional study was conducted among nurses in Sabzevar University of Medical Sciences by two-stage sampling (quota - random) method. Holland personality-profession compatibility questionnaire and quality of life questionnaire were used for this study, after confirming their reliability and validity by coefficient and expert agreement. The obtained data were entered into SPSS and were analyzed with statistical analysis.
Results The average quality of work life in the studied nurses was 20.51 and standard deviation was 4.16. About 39.5% of nurses were dissatisfied with the quality of their work life, 4.8% satisfied, and 1.6% was very satisfied. Personality of the 20.6% of participants was quite compatible, 33.4% was relatively compatible, and 46% was incompatible with nursing profession. Average quality of work life in terms of personality compatibility differences was not statistically significant.
Conclusion In this study, the quality of work life has been reported poor, and most nurses showed inappropriate personality for this profession. According to the main results, attention of managers to these two important issues in this group, as the largest health care provider group, was suggested.

By knowing of minimal knowledge in the diabetics and by attending to the high prevalent of effects and low quality level of life in the diabetic patient, discovering an appropriate educational method is important. The purpose of this study is comparative assessment of effect of education in the OREM`s self-care model way with current method on the quality of life in diabetic type 2 patients. This study was done on the base of randomized clinical trial method on diabetic type 2 referrals to diabetic clinics of Sabzevar city at the year of 1392. Control group were under the current education of diabet center and the case group was trained by lectures, question and response, group discussion, films and educational notes. One month after ending education, all of research units were assessed using special measure of quality of life in diabetics (ADD QOL 19). Data were analyzed by SPSS software and kai - square, mann-whitney, co-variances and logistics regression exams. In this study 50.7% (38 person) were women and 49.3 (37 person) were men. After the educational implementation, mean and SD score of QOL in the control and case groups respectively were -1.48 ± 0.719 and 1.815 ± 0.931 in the physical dimension; -1.9 ± 0.643 and 2.22 ± 0.778 in the psycho spiritual dimension; 1.48± 0.719 and 1.85 ±0/931 in social dimension. After the educational implementation, in the co-variances exam meaningful differences were seen between mean scores of QOL of two groups. Unlike the current method, education plan of OREM`s model extolled the QOL of diabetics. Therefore, this method is recommended for use.

Background and cardiac catheterization is one of the most common diagnostic and therapeutic methods of heart disease, Teaching methods such as group training creates the feeling of comfort and make the patients more relax, as well as it changes their psychological and physiological responses. The present study was conducted to determine the effect of group emotional expressions, on stress level of patients awaiting for cardiac catheterization. This interventional study (randomized trial) was carried out on 80 patients undergoing coronary angiography for the first time, in Vasee Hospital of Sabzevar in 2014. The samples were selected according to patients available on random days. In the intervention group, emotional expression method was performed. Data were collected via State Trait Anxiety Inventory (STAI), and standard anxiety questionnaire. Data were analyzed by SPSS software using Chi-square, Fisher exact and analysis of covariance. (Significant level=0.05) The average age of participants in this study was about 54.11±10.67 years. Among all patients, 39 participants (48.8%) were male and 41 participants (51.2%) were females. In the intervention group, mean score of STAI decreased significantly in comparision to the control group (p‹0.010). Group expression of emotions affect patient’s anxiety undergoing first time coronary angiography. Therefor it's recommended to use this method befor cardiac catheterization performance.

Depression is the most common mental disorder in patients undergoing hemodialysis. This disorder has adverse effects on the course of disease and treatment process and is recognized as an independent risk factor for death in hemodialysis patients. The purpose of this study was to determine the relaxing effects of Benson relaxation technique on depression in patients undergoing hemodialysis. This clinical trial was performed on 65 hemodialysis patients. Subjects were randomly divided into two groups: control group (n=32) and intervention group using Benson relaxation technique (n=33). The intervention group performed Benson relaxation exercises twice a day for 20 minutes over one month. Beck Depression Inventory was completed one month before and one month after the intervention. The control group received usual treatments (IRCT: 2014011115393N2( Overall, 51 patients were male in the present study. The mean age of participants was 48.57±9.18 years in the intervention group and 49.93±8.17 years in the control group. Before the intervention, there was no significant difference between the groups in terms of the studied variables. The mean score of depression in the intervention group decreased from 32.46±9.86 before the intervention to 23.30±9.23 after the intervention; the difference was statistically significant (p<0.001). Also, the mean score of depression in the control group changed from 30.58±9.24 before the intervention to 30.83±9.63 after the intervention. The results of this study showed that Benson relaxation technique is effective in reducing depression in hemodialysis patients. Therefore, by applying this technique, we can take a major step towards improving and preventing patients’ psychological problems.

Background & Poor sleep quality is common among hemodialysis patients. On the other hand, hemodialysis patients are encountered with carnitine deficiency. L-carnitine is a dietary supplement that has various metabolic functions and decreases the complications during dialysis. The purpose of this study was to determine the effect of oral L-carnitine supplementation on sleep quality in hemodialysis patients. In this double blind randomized clinical trial, 59 qualified hemodialysis patients were gone under investigation in Imam Khomeini Hospital in Shirvan during 2013. Patients were divided into intervention and control groups by permutation blocking method. Patients in the intervention group received 500 mg of L-carnitine supplement twice a day, and the placebo group was similarly taking placebo for 12 weeks. Tools for data collection consist of demographic form and Pittsburgh Sleep Quality Index which were completed before and after the intervention. Data were analyzed with SPSS statistical software version 11.5 and using independent t-test, Mann-Whitney test, chi-square, Fisher, Wilcoxon tests, Analysis of Covariance and significance level of P0.05. Before intervention, the mean PSQI scores were 9.6±4.2 and 10.1±4.13, respectively in the drug group and the placebo group and, after the intervention, the scores were, respectively, 6.4±2/8 and 9/7±3/48 that showed significant differences in both groups, compared to baseline(P0.05). Also, The PSQI score decreased by 33% in the intervention group and by 3/9% in the control group. Based on the Pittsburgh Sleep Quality Index, the lower score demonstrates a better condition of sleep qualiy. This study showed that oral L-carnitine supplementation can improve sleep quality in hemodialysis patients.

although, Self-esteem can improve mental health, studies indicated that nursing students‎'Self-esteem level, especially‎ in female is not desirable. Exercise may be influenced on enhancing self-esteem. The aim of the present study was to investigate the effects of Pilates exercises on self-esteem of female nursing students. This randomized control trial(single blinded) study was performed on 62 female nursing students at medical sciences university of sabzevar 2014. After selecting participants via convenience method, they were divided randomly into an experimental (n= 32) and a control(n = 30) group. The experimental group did the Pilates exercise twice a week for 2 months while, the control group continued their daily activities. Then, self-esteem level assessed and abtained data was analyzed by means of SPSS software (version 18) using descriptive statistics, paired t-test and covariance test. before intervention, the average score of self-esteem in experimental‎ group was 90/09‏±‏‎ (‏‏8/20) and in control‎ group ‎was 92/80‏±‏‎‎‏)‏9/22),whereas at the end of intervention these scores for experimental and control groups was observed as observed as 100/34± (‏‏7/72) and ‎94/10‏±‏‎‎‏)‏9/22), respectively which this difference was significant statistically (p=0/002). in the present study, performance of pilates exercise was effective to improve female nursing student's self-esteem, therefore, there is suggested to use this as an attractive and harmless method for enhancing the students’ self-esteem level.

To determine the effective teaching factors managers، colleagues، teachers’ self-assessment and students'' opinions can be used. The purpose of this study was to compare and prioritizing the effective teaching indicators from teachers and students’ view point. Instrument & In this cross-sectional study، 60 faculty members and 385 students from Nursing، Midwifery، Health and Paramedical، and Medical Sciences Schools of Sabzevar University of Medical Sciences were entered in the study using simple random sampling in 2012-13. Data gathered by bipartite questionnaire containing demographic and prioritizing the most important indicators of effective teaching in four areas of scholarship، teaching methods، the power of communication and personality. Data were collected by SPSS 15 software using descriptive and inferential statistics (Chi-square test). From teachers and students’ view point scholarship in the area of science and technology features، clear transmission of the content in teaching method، justice in evaluating in the area of relationship power and clear and simple expression in the area of personality traits had the highest priority. In the characteristics of knowledge (p=0. 0004)، teaching design (p=0. 0001)، easy access to the teacher (p=0. 003)، generating motivation (p=0. 0001) and re-explanation of the content (p=0. 003) there was no significant difference between teachers and students. From the viewpoint of teachers and students، knowledge characteristics، clear transferring of the contents، justice in evaluating، clear and simple explanation have the highest priority to the of effective teaching aspects. Comparing the priorities in each areas، there are some differences among students and teachers’ view point.