maryam ghorbanzadeh

Heart failure (HF), a worldwide epidemic with significant morbidity and mortality risks, is frequently secondary to cardiovascular disorders and probably is the common final way to survive patients. Almost 25% of hospitalized patients with acute HF are expected to be readmitted within 30 days post-discharge, and the rates of rehospitalization increase to almost one-third at 60 days and 60 percent within one year of discharge. Although care planning for patients with heart failure is complex, multidisciplinary, and resource-dependent, optimal self-care management along with appropriate educational intervention and follow-up strategy could be able to reduce readmissions, decline the duration of hospitalization, increase life expectancy, decrease the rates of mortality, and reduce costs of healthcare services for patients with HF. However, there are contradictions in previous reports about the efficacy of self-care, mainly due to patients’ non-adherence to self-care behaviors. Therefore, the current study aimed to review the investigations on the effectiveness of self-care of HF patients in reducing hospital readmissions and increasing quality of life, and discuss novel approaches for predischarge educational interventions and postdischarge follow-up strategies.

In order to integrate and coordinate structure and architecture in the creation of structural architecture, the basic question is whether it is possible to identify the influencing factors in this architecture and the position of each of these factors? For this purpose, in this article, the "Theory of structural architecture" is explored using the Grounded Theory research method, in order to clarify the causal conditions, intervening conditions, context conditions, strategy and consequences of structural architecture. The result extracted from this article shows that for the design of structural architecture, achieving causal conditions with features such as scientism and critical wisdom is a basic approach. Also, the intervening conditions in this architecture include the tectonical context; Executive capacity, economic issues, land and neighborhoods, building use, environment and vernacular identity and climate, culture and harmony with the time and scale of the building are those that have an intervention effect on the context conditions or Tectonical Features in three functional, formal and semantic domains. These features are divided into 18 attributes (such as: intelligence, safety, flexibility, strength and balance, optimality, attention to details, definition of space, inspiration from nature, attention to post-occupancy needs, unity, composition with context, force cutting and optimal form, geometry, proportions to scale, messaging, beauty, compatibility and sustainability). Strategy of structural architecture resulting from the article is categorized into two parts: review and action. In tectonical review and categories of analysis and decision, the designer is required to pay attention to vernacular architecture and eco-tech architecture, and in tectonic action, it is necessary to use constructivist pedagogy in teaching structural architecture with multiple components such as exploratory model and critical and creative thinking. The consequence of benefiting from structural architecture is in many components such as promoting peace and comfort in the living environment.

Children with cleft lip and palate have a wide range of emotional and social problems and low self-esteem from birth these problems affect the childchr('39')s mental function.

The aim of this study was to assessment the psychological and social status of children with cleft lip and palate referred to orthodontic research center in Shiraz.

This descriptive-analytical study was performed on 60 children with cleft lip and palate referred to Shiraz Orthodontic Research Center in 2018. Samples were selected easily and non-randomly from those referred to the Orthodontic Research Center. Strengths and Difficulties Questionnaire Which evaluates childrenchr('39')s problems and abilities; Completed by parents. Finally, data analysis was performed with SPSS software version 21. Descriptive indices (central and dispersion) and one-way analysis of variance were used to analyze the data.

The mean total score of problems (Hyperactivity and behavioral problems, emotional symptoms, altruistic behavior) of children with cleft lip and palate was 7.61± 1.50; Which was average in mental health. All indicators of ability and problems are significant difference between the groups of cleft palate, cleft lip and cleft palate (P<0.001).

Early evaluations and timely intervention in cleft lip and palate children increase families awareness of the rehabilitation process.

Premature infants undergo a lot of stressors during treatment procedures in the neonatal intensive care units which causes significant physiological changes in these neonates. Multi-sensory stimulation is a broad category of interventions designed to improve the evolutionary and physiological outcomes of premature infants hospitalized in the neonatal intensive care unit to minimize stress in this environment. So, the study aimed to evaluate the effect of multi-sensory stimulation on physiological parameters in preterm infants.

This double-blind clinical trial conducted in the neonatal intensive care unit of Shahid Motahari Hospital in Jahrom from April to December 2016. In this study, 80 preterm infants with a gestational age of 34 to 36 weeks were selected by non-probability sampling method and were randomly divided into two groups of multi-sensory stimulation and control. Neonates in the intervention group received a multi-sensory stimulation program for 60 minute. The multi-sensory stimulation program was included a combination of auditory, tactile, motor and visual stimulation. The preterm infants in the control group received only usual care. The data collecting tool was a questionnaire and checklist for physiological parameters of preterm infants.

The results showed that the two groups were homogeneous in terms of fetal age, birth weight, the height of birth, first and fifth minute Apgar score of birth. The results showed that there was no significant difference between the mean of physiological indexes in the two groups before the intervention. Statistical tests showed that there was a decreasing trend in the average of all physiological indices during the intervention (first and second half during the intervention) (P<0.001), However, these changes were not significant in the control group (P<0.05). Also, analysis of variance (ANOVA) with repeated measures showed that there was a significant difference between changes in physiological variables between the two groups at different stages of evaluation (P<0.001).

Multi-sensory stimulation leads to a decrease in heart rate and respiratory rate and the stability of blood pressure in preterm infants.

Delivery is a stressful event and maternity blues after delivery is most common postpartum mood disorder that happiness is one of the most important factor in coping with stress and depression. So, this study was performed with the aim to determine relationship between happiness and perceived stress during labor and maternity blues.

This descriptive correlational study was done in 2017 on 80 pregnant women referring to Taamin Ejtemaei hospital of Zahedan. At the time of referral, was completed Oxford happiness questionnaire and Cohen perceived stress questionnaire during labor and was completed Back depression questionnaire on the third and tenth days after delivery. Data was analyzed by Spss software (version 16) and Spearman/Pearson correlation coefficients and regression.

The result of Pearson correlation coefficients showed a significant reverse correlation between happiness and perceived stress (P < 0.0001, r = - 0.88) and a significant reverse correlation between happiness and maternity blues of the third day (P < 0.0001, r = -0.92) and tenth day (P < 0.0001, r= - 0.90)

There is a relationship between happiness with perceived stress during labor and maternity blues after delivery. With higher levels of the happiness of pregnant women, the less stress will be felt during labor and they will be less affected by mood disorders and postpartum depression. Therefore, the provision of happiness for women can improve their mental health at the time of delivery and afterwards.

Sexual instinct is one of the basic needs of man and the concept of marital satisfaction is also the most important factor for the stability of marital relationship. The trend of changes in sexual activity during pregnancy can affect sexual function and sexual satisfaction of pregnant women; therefore, providing appropriate strategies can increase marital satisfaction. This study was performed with the aim to determine the effect of the educational program of sexual health with pelvic floor muscle exercises on sexual satisfaction and performance of pregnant women.

This clinical trial study was conducted on 60 eligible pregnant women referred to two health centers in Zahedan in 2018. Subjects were randomly divided into two groups of 30 intervention and control groups. Group training for sexual health was done for two weeks and exercise for 6 weeks in the intervention group. In both groups, pretest and posttest were taken. Data were analyzed by descriptive and inferential tests of Chi-square, t-test, and independent t-test in SPSS 16 software.

There was no significant difference between two groups in terms of individual variables such as mother's age, education, employment status, gestational age, number of pregnancies. Findings showed that there was a significant difference between the mean of satisfaction score and sexual function at the post-intervention stage between the two groups (P < 0.001). This difference was not significant between the two groups before the intervention.

Regarding the effect of sexual training and kegel exercise on sexual satisfaction and sexual function during pregnancy, it is recommended that these simple educational interventions should be considered in order to improve the psychological and sexual status of pregnant women.

 There is a relationship between diseases and the quality of life. Epilepsy is a disease that is unpredictable and uncontrollable and its actions are limited to scattered and brief education. Therefore, this study aimed to investigate the effect of family-centered empowerment program on the quality of life of mothers with epileptic children.

This clinical trial was undertaken on 60 mothers with epileptic children. Thirty mothers with epileptic children participated in family-centered empowerment sessions and 30 mothers with epileptic children served as the control group. Personal information form and quality of life questionnaire were administered at baseline and 75 days after intervention. In order to analyze data, chi-square test, independent t-test, paired t-test, and covariance were used accordingly.

The quality of life between the two groups was not significantly different at the beginning of the study, but it was significantly different 75 days after the onset of the empowerment program. In other words, the family-centered empowerment program had a significantly positive impact on the quality of life of mothers with epileptic children (P = 0.03).

According to the results of this study, the family-centered empowerment program can be considered as a potent alternative in health care system to enhance the quality of life of families with epileptic children.

Preventive measures for psychiatric preparation are one of the nursing practices and are part of their duties before painful procedures. The aim of this study was to investigate the problems of nurses in the use of child and maternal psychological preparation before painful procedures for the child. This is a descriptive study that was conducted randomly in hospitals of Mashhad in 2017 in a random sample of 81 nurses working in pediatric wards who had a history of at least 3 months working. The data collection tool was a researcher-made questionnaire containing questions about demographic characteristics and the most important barriers and problems of nurses regarding the use of child and maternal psychological. Data were analyzed by SPSS 11.5 using descriptive statistics. Most of samples are women (96.7%) and the level of education were bachelors (90.7%). Nurses reported their problems from the most disturbing as:large amount of work in the section comparing to the number of nurses (93%), management not supporting nurses (86.75%),lack of sufficient toys and entertainment tools (73.3%), improper arrangement of working shifts (70%). Nurses in pediatric wards, can play a significant role in the psychological preparation of the child and the mother before the painful procedure by using the findings of this research, which itself improves the quality of the procedure.

There are extremely stressful stimuli in the NICU environment. Although attempts have already saved neonates in this unit, this can disturb the adaptability of the infants with environmental stimuli. In this study, 120 preterm infants were randomly divided into experimental and control groups. The quiet time protocol was implemented at 16:00 - 18:00 while the control group received a routine program at 11:00 - 13:00. SpO2 and respiratory rate were measured in 15-min intervals and one hour before and after both times. The sound level and light intensity were also measured. Data analysis was done by independent t-test, Mann Whitney, and ANOVA using SPSS version 11.5. Of all infants, 40% were girls and 60% were boys. Regarding intra-group comparison, the Friedman’s nonparametric test showed that the percentage of oxygen saturation in the quiet-time group was not significantly different at the first, second, and third hours during the intervention (P = 0.32); in the control group, it was not also significant. The respiratory rate at the second hour of the intervention was lower in the quiet time group than in the control group (P < 0.07). The implementation of the quiet time protocol can decrease heart rate and respiratory rate through a decrease in environmental stimuli (noise, light, and infant handling), and thus, is recommended for reducing stress in preterm infants.

Assessing the evolutionary process of children is a reliable means of checking their health status. Because early diagnosis of developmental disorders and timely treatment of it can prevent irreversible neurological complications and disorders. This study is a descriptive cross-sectional study. The research community of children aged 4 to 24 months is covered by health centers in Jahrom. Sampling was done as a simple sampling. The instrument used in this study was an Age and Stages Questionnaires (ASQ), which was completed to study growth and development by Parents. Each questionnaire has 30 questions and evaluates individual-social domains, delicate movements, large movements, communication, and problem solving. Of the 155 children ,102 cases were female (58%) and 53 cases boys (30%). The mean age of the children was 5 ± 10 months.Most children in the age range of 12 months (36 %) . The lowest score was related to communicating (52.4 ± 7.50) and the highest score was for problem solving (56.7 ± 5.01). According to the results of this study, evolutionary delay was observed in children. It is recommended that they be identified as soon as possible so that they are treated before entering school and prevent future educational, social and occupational problems.

preterm birth is considered as a risk factor for developmental disabilities, which can lead to long-term effects on the nervous system of children.
The aim of this study was to determine the effect of multi-sensory stimulation on neurodevelopment of premature infants.
In this two-group double-blind clinical trial conducted from June to August 2016 in Iran, 80 preterm infants were randomly divided into two groups. The Intervention group received multisensory stimulation for 12 min per session, 5 sessions per wk along with routine NICU care the control group received ward's routine care. Neuromuscular Maturity each infant was assessed by New Ballard Score.
The intervention group showed higher Neuromuscular Maturity compared to the control group. The Posture, Arm Recoil, Popliteal angle and Heel to ear were statistically significant between the groups.
The results shows that Multi-sensory stimulation can have beneficial effects on the development of neuromuscular in premature infants.

Premature infants experience physical problems, psychological and evolutionary natural compared to other neonates, In most cases, hospitalization is inevitable in the neonatal intensive care unit. That is, the mothers suffer a lot of stress and tension. This study was conducted to determine the coping strategies Baastrs mothers with premature infants admitted to the Neonatal Intensive Care Unit
In this cross-sectional, 70 mothers with premature infants admitted to the neonatal intensive care unit of Bentohoda Hospital, Mashhad were participated. The data collection instrument was a demographic and Brife Cope
The highest Average scores in areas related to the problem focused coping strategies were means of support and active coping, for the emotion-focused coping were religious strategy, the use of psychological support and acceptance and for dysfunctional coping strategy were unthinkable temporary problem , self-blame and denial. None of the demographic characteristics were not significantly associated with maternal coping styles.
Most styles of coping in mothers of preterm infants has been positive. instrumental support and religion As important strategies for in coping with stress induced premature birth. Thus providing social and psychological strategies for emotional support mothers of premature infants hospitalized in the intensive care unit infants seem necessary.

Aims and Post operative nausea and vomiting is one of the most common complications after surgery. The newest drug for induction and maintenance of anesthesia is propofol. Its consumption due to the rapid onset, short duration of action, Anti-nausea and vomiting property and comfortable feeling after surgery is on the rise.
In this clinical trial, 90 patients undergoing general surgery were randomly divided into three groups. In the first group induction-dose was 1/5mg/kg propofol, in the second group, induction-dose was 2 mg/kg propofol and in the third group, 2/5mg/kg propofol was used. Based on self-reporting scale and frequency of vomiting, the evaluation condidering the severity and incidence of nausea and vomiting was done in three stages: Exactly after the surgery, and 2 and 6 hours afterwards. Data was analyzed by Spss software.
Findings: The results showed that considering age, gender, duration of NPO time, and operation time, no significant difference was found among the three groups. Based on one-way analysis of variance there was no significant difference between groups in severity and incidence of nausea and vomiting.
Propofol has positive effect incontrolling nausea and vomiting after surgery in different doses. Therefore, administration of Propofol (with divided doses and without the need for pumps) is simple and cheap.

Despite the importance of local educational standards for the correct implementation and evaluation of higher education programs, studies show such standards do not exist for the master’s degree in neonatal intensive care nursing. Therefore, the purpose of the present study was to develop basic educational standards for program evaluation and accreditation of the master of sciences course in neonatal intensive care nursing.
This study was a descriptive survey conducted using the Delphi survey method in 2014. A total of 20 experts, including infants and medical education specialists, administrators of the department of education, faculty members of the department of pediatrics, nursing administrators of neonatal intensive care units, and students and graduates of the neonatal intensive care nursing course were selected through purposive sampling. First, items related to basic educational standards were extracted through an extensive review of databases. Subsequently, 3 sessions in 2 rounds were held with the experts and basic educational standards for the evaluation of the master of sciences course in neonatal intensive care nursing were developed on the basis of consensus.
This study led to the proposal of 20 items as basic educational standards for the evaluation of the master of sciences course in neonatal intensive care nursing. In the first round, 25 items, of the total 41 items, were agreed upon by experts. Statistical results showed the content validity index in clear expression, importance, and availability in the second round was 0.94, 0.92, 0.87, respectively.
Considering that the checklist of basic educational standards was developed by experts, it is hoped it will gain high acceptability and be an efficient model for the evaluation of the master’s program in neonatal intensive care nursing.