[Effectiveness of solution- focused brief therapy [SFBT] on couple burnout and divorce tendency in married women]

Introduction: Couple burnout is one of the problems that is a main reason for emotional divorce because of its adverse and destructive effects on marital system and creating psycho-emotional distance in a couple, and this problem, if untreated, will prepare the grounds for formal divorce. The solution-focused brief therapy is a postmodern approach in couple therapy and family therapy which focuses on finding solutions by the client in cooperation with the therapist. In this study we investigated the effectiveness of solution-focused brief therapy in couple burnout and divorce tendency among married women

Methods: This research is a quasi-experimental study and pretest-posttest with control group design is used. The population consists of all married women with marital conflicts and problems who have visited Golha House of health, located in the 6[th] district of Tehran city in the second half of 2013. In this study, the sampling method was available sampling. Thus, 30 women who were qualified to participate in meetings and had earned the highest scores in the survey questionnaire were selected, and they were placed in experimental and control groups through random assignment [each n=15]. The data gathering tools in this study were pains couple burnout measure [CBM] and the Divorce Tendency Scale of Roswelt, Jonson and, Moro [DTS] 1986, which were completed by the subjects in the pretest. The intervention group was exposed to solution-focused brief therapy for seven two-hour sessions in groups, in a step-by-step manner with the sequence of one session per week. But no intervention was performed in the control group. The data were analyzed by using descriptive statistics methods and through multivariate analysis of covariance [MANCOVA] in software SPSS20

Results: The results of multivariate analysis of covariance showed a significant reduction in couple burnout and divorce tendency [P= 0.000] of married women after performing solution-focused brief therapy. The mean and standard devietion of couple burnout and divorce tendency of interference group in pretest respectively was 113/6 +/- 20/04 and 126/53 +/- 31/12 and in post test stage was 94/6 +/- 21/69 and 102/26 +/- 22/15. In control group also mean and standard devietion of couple burnout and divorce tendency before interference respectively was108/53 +/- 16/68 and 106/46 +/- 27/21 and after interference was 106/93 +/- 28/16

Conclusion: According to the findings of this research, it can be concluded that solution-focused brief therapy has been able to be effective in reducing couple burnout and divorce tendency among married women. Counselors and family therapists can use this short-term, efficient and effective therapy approach to solve marital conflicts and help people to improve their marital relationships

[Exploring the role of job plateau in the human resources burnout in career development path case study: Welfare Organization of East Azarbaijan]

Introduction: in recent years, one of the concepts that has attracted industrial and organizational psychologists' attention is employees' exhaustion called burnout having a direct relationship with inefficiency of human capital

Methods: this is an applied descriptive survery. The study population was 230 employees of East Azerbaijan province welfare. The data were collected by a researcher- made questionnaire based on the theory of Bardvik and the burnout theory of Maslach. For assessing the validity [Symbolic or formal] and thee reliability SPSS was used which showed 0/760 and 0/880, respectively. The data were analyzed by descriptive and inferential statistics

Result: all variables in the research hypotheses, other than those of the first and second hypotheses, appeared to have a significant correlation, with a correlation coefficient of 0.056 which is less than less than 0.05. According to the statistics tables and linear regression analysis, it could be concluded that per unit change in the independent variable is explained by a change in the dependent variable

Conclusion: the results indicate that, career plateau and its dimensions, except for the lack of learning, are effective on staff burnout in Welfare Organization of East Azerbaijan province

[ effect of hope therapy on quality of life in multiple sclerosis patients]

Introduction: Multiple sclerosis is one of the most common chronic diseases of central nervous system that can change people's life especially in youth. It causes serious loss of quality of life and gradually increases people's inability. One of the successful measures of therapeutic interventions in chronic patients is quality of life. Therefore, the present study was an attempt to investigate the effect of hope therapy on quality of life in multiple sclerosis patients

Methods: In this study, one of the quasi- experimental designs called unequal control design was used. Sampling of this study was objective, voluntary and available. 24 subjects on voluntary basis in control and experimental groups were counted. Questionnaire of quality of life was used to collect data. After administering pre-test, experimental group participated in 8 sessions of 90 minutes of hope-therapy but control group received no interventions during the experiment. Both groups were finally post-tested. Data were analyzed with SPSS software and ANOVA test

Results: The results showed that after therapeutic sessions, quality of life in experimental group in comparison to control group found a significant difference, while, gender effect wasn't significant. The interactive effect of gender and intervention wasn't also significant. It means that behavioral change of subjects participating in post-test on quality of life in both groups didn't depend on their gender

Conclusion: Hope-therapy improved quality of life in multiple Sclerosis patients. Therefore, using therapeutic approach in multiple sclerosis patients and other patients with chronic diseases is recommended

[Affecting factors the choice of delivery and attitude of pregnant women admitted to the civil hospitals, the Social Security Organization in 2013]

Background: Cesarean delivery is usually limited to cases where it is not possible through normal path, or is associated with serious risks for the fetus and mother, therefore it is expected, Caesarean section should be used in limited and specific cases and the rate of it does not exceed certain limits. Unfortunately, nowadays reported cesarean section rate is more than acceptable in the country. Lack of awareness of the complications of cesarean and negative attitude toward normal vaginal delivery was of the causes of the increased tendency of pregnant women to have cesarean. The aim of this study was to investigate the factors affecting on selection of the methods of delivery and attitude of pregnant women admitted to the civil hospitals Social Security Organization in 2013.

Materials and Methods: This research was descriptive–analytical and cross–sectional. In this study of 2521 pregnant women in 67 civil hospitals Social Security Organization across the country had referred in the summer of 2013, using simple random sampling were examined. For data collection, a questionnaire including demographic characteristics, the questions about reasons for selection of cesarean, and attitude measurement toward vaginal delivery and cesareanwas prepared by voting of midwives and obstetricians and then, after final approval by test-ratest method, completed through interviews withpergenant mothers. For the data analysis were used of SPSS 22 software and chi-square and T-tests.

Results: The mean age mothers were 27.64 +/- 0.21 and also 57% of them had a higher education diploma. The cesarean rate was 50.7% in women in the study. 57% of women tend to be more moderate cesarean [p<0.001]. Their main reasons for choosing cesarean were analgesia operating procedures, the lack of harm to the fetus, preventing tearing and deformed genitalia, do not require frequent examinations and suggestion of doctor or midwife. Significant statistically association was between current birth mothers with maternal age, spouse's age, age at marriage, level of Education, job, income, previous delivery, parity, stillbirth, infertility and miscarriage and a family history of cesarean section [p<0.001]. There was significant relationship between level of knowledge and attitude toward cesarean delivery [p<0.001]. But there was no found significant association between the attitude of the normal vaginal delivery with mother's level of knowledge [p=0.31].

Conclusion: According to the survey results and the relationship between attitudes to caesarean and selection, it is essential to deal with the excessive increase in cesarean and achieve an acceptable limit this type of delivery [cesarean section], Necessary actions should be performed to raise the awareness of women about the benefits of normal vaginal delivery and disadvantages of cesarean section.

Determining dimensions of Iranians' individual social health: a qualitative approach

Social health is important to be assessed as a dimension of health. The aim of study was to determine domains and sub-domains of individual social health of Iranians. This study was carried out with a qualitative approach, using thematic content analysis. Twenty five experts participated in interviews, using individual semi-structured interviews between November 2010 and June 2011. This data supported with strong search. Two main areas extracted from these interviews including social support and social function. The social support domain contained seventeen sub-areas, including social support at the time of disease; disability; daily life issues, etc. And the social function as second domain contained twelve sub-areas, including: financial aids to others; emotionally aids to others; participating in social groups, etc. We developed a conceptual framework for social health in the individual level in Iranian population. It makes preparations for providing a valid and reliable measurement scale for social health in next studies and evidence-based policy-making

Caring curriculum: a new paradigm in nursing education

Recently, the current behavioral approach in nursing education has been critiqued by many nurse authors and leaders. One of the important reasons for this critique is that while caring is the core and the nature of nursing, teaching caring in nursing education has been overlooked. This article aims to propose an approach to integrating caring in nursing education curriculum through a comprehensive review of the related literature and exploration of the historical background of nursing education. A comprehensive review of literature was performed in databases of IranMedex, Irandoc, PubMed, ScienceDirect, ERIC, ProQuest and Ovid by keywords of clinical scholar model, critical- explanatory model and ethical care in education during 1950- 2011. The review indicated that the traditional and behavioral nature of nursing education has not been able to create caring behaviors in nursing students. The curriculum proposed by nursing scholars incorporates ethics of care in nursing education and changes the relationship between student and teacher while it improves innovation and caring elements. It also teaches students to see from others' perspective as a requirement for nurse-client relationship. Caring curriculum by challenging the behavioral approach to nursing education emphasizes on caring concept and its integration into nursing education, nursing service and nursing administration

[Effect of therapeutic play on postoperative pain of hospitalized school age children in pediatric surgical ward]

A majority of children experience moderate to severe postoperative pain. To ensure adequate pain relief in pediatric patients, non pharmacological techniques are needed for use in conjunction with pain medication. The aim of this study was to determine the effect of therapeutic play on postoperative pain of hospitalized school age children in surgical ward of Sheikh's Pediatric Hospital affiliated to Mashhad Medical University in 2009-2010. In this randomized clinical trial, 40 hospitalized children in surgical ward between the age of 8 and 12 years old were selected and randomly assigned to the experimental group who participated in a session of therapeutic play that lasted between 30 and 45 minutes whereas those in the control group received routine care. Data collection tools included demographic questionnaire and Objective Numeric Pain Scales. The intensity of pain was assessed before [Phase1], immediately after [Phase2], and 15 minutes after [Phase3] intervention or routine care. The validity of 'Objective Pain Scales' and 'Numeric Pain Scales' were determined by concurrent validity [0/89] and between 'Objective Pain Scales' and 'Face pain Scale' [0/95]. Reliability of 'Objective Pain Scales' was measured by inter -rater reliability [0/95]. Data were analyzed by SPSS v16. The results showed that children in the experimental group reported having significantly less pain [p. The finding of this study have shown the positive effect of therapeutic play on postoperative pain of hospitalized school age children

Interleukin-12 and tumor necrosis factor-BETA gene polymorphisms as genetic susceptibility factors for brucellosis in iranian patients

Some reports suggest that the cytokine gene polymorphisms can contribute to the resistance or susceptibility to brucellosis. The aim of this study was to find out any probable association of genetic polymorphisms of Interleukin-12 [+1188 A/C] and TNF-beta [+252 A/G] with susceptibility to the disease. One hundred and ninety-six patients with brucellosis and 81 healthy farmers [controls] who owned infected animals and consumed their contaminated dairy products were included in this study. IL-12 [+1188 A/C] and TNF-beta [+252 A/G] genotyping were carried out for all of the subjects. The results showed that the frequencies of IL-12 AA genotype and A allele were higher in controls than in patients while TNF-beta AA genotype and A allele were significantly higher in patients compared to the controls. These findings suggest that the inheritance of the above-mentioned genotypes and alleles can be considered as genetic factors conferring resistance or susceptibility to brucellosis

[Opposite clear corneal incisions versus on-axis incision during phacoemulsification to correct pre-existing astigmatism]

To compare the efficacy of adding an opposite clear corneal incision [OCCI] on the steep axis during phacoemulsification in reducing the pre-existing corneal astigmatism. This randomized clinical trial was performed on 120 eyes with corneal astigmatism of >1D undergoing phacoemulsification. Incisions were made based on the type of astigmatism as follows: superior or superior+OCCI in the with-the-rule and temporal or temporal+OCCI in the against-the-rule astigmatism. Patients were followed with refraction, keratometry and topography. Statistical analyses were done using one and two ways ANOVA and Tukey-a test. Mean corneal astigmatism was 1.82 +/- 0.86 D in the superior+OCCI group and 1.74 +/- 0.86 D in the temporal+OCCI group preoperatively which respectively decreased to 1.31 +/- 0.59 [P= 0.013] and 1.19 +/- 0.64 [P= 0.009] postoperatively. No significant changes occurred in the amount of astigmatism in none of the two single incision groups. Paired OCCI on steep axis is a useful technique to correct mild to moderate pre-existing astigmatism with no need to extra skill or instrumentation

[ effect of cardiopulmonary resuscitation workshop on nurses' sustained learning]

The effect of the presence of trained personnel in the team on the outcome of resuscitation has been proved in previous studies. An informative need assessment, in the environment of present study, reveals the role of the nurses' knowledge in Cardiopulmonary Resuscitation [CPR]. Therefore, this study was designed to determine the effect of education through workshop on nurses' sustained learning regarding resuscitation. An interventional study, using pre-test and post-test was carried out. The data gathering tool was a questionnaire consisted of two parts including individual characteristics and 21 multiple choice questions about necessary actions in cardiopulmonary resuscitation. This questionnaire was answered by the participants before, immediately after, and 6 months after the workshop. The results were analyzed using Repeated Measure ANOVA by SPSS software. The highest score, the lowest score and the mean score in pre-test were 17, 6 and 10.12, respectively. These scores for the post-test were 21, 13 and 17.96, respectively. For the test held after 6 month, the highest score was 17, the lowest was 10 and the mean score was 15.02. Comparing the means of these tests showed a significant difference between the pre-test, post-test, and the test after 6 months. Although CPR workshops met the needs felt by nurses to some extent, the repetition of these workshops in regular bases [six months at maximum], seems to be necessary

Rat liver perfusion and hepatocytes isolation

Perfused rat liver and isolated hepatocytes are useful to study specific metabolism of this organ. Traditionally, mechanical, chemical and enzymatic methods have been used to isolate hepatocytes, and it appears that a mixed method is the preferred choice. The rat liver perfused in situe in three subsequent steps, 10 minutes with Krebs-Ringer solution containing ethylene diamine tetra-acetic acid [EDTA, 2mM] without calcium and magnesium, and 1 minute with the same solution, however, without EDTA in open non-recirculatory pathway. This followed by 10 minutes with Krebs-Ringer solution, containing collagenase [200 IU/mL] in closed recirculatory system. The hepatocytes were isolated, collected and incubated [6-8 X 10[6] cells/mL] for 3-hours in Krebs-Ringer solution, under the atmosphere of O[2]:CO[2] [95:5]. The cell viability was assessed with tripan blue exclusion and lactate dehydrogenase [LDH] leakage. Assay of LDH activity, the marker of cytosolic enzyme, show that more than 92% and 88% of the enzyme had been retained in the cells, with less than 8% and 12% leakage from the damaged cells in the beginning and end of incubation, respectively. Microscopic evaluation showed that the majority of the cells had intact plasma membrane without vacuoles. When the cells were stained with dye, less than 5% of vital dye included these cells. The results showed that perfusion of the rat liver with the solution containing calcium chealator and collagenase can yield about 10 mL of hepatocytes with a viability of more than 90%

Evaluation of rK39 strip test for the diagnosis of visceral leishmaniasis in infants

This study estimated the sensitivity and specificity of the rK39 strip test compared with the immunofluorescent antibody test and microscopy of bone marrow aspirate smears [the gold standard] in 47 children with suspected visceral leishmaniasis. A control group of children with other diagnoses [tuberculosis, toxoplasmosis, systemic lupus erythematosus, malaria or cutaneous leishmaniasis] were also tested to check false positive results. The sensitivity and specificity of the strip test were 82.4% and 100% and that of immunofluorescent antibody were 100% and 92.7%. The rK39 strip test is reliable where there is no access to laboratory facilities

[Frequency of some of the factors affecting adults cardio -pulmonary resuscitation outcome in Emam Khomeini hospital]

Despite 40 years of cardiopulmonary resuscitation [CPR] therapies, overall survival rates after cardiac arrest remain poor. On the average, 10-15% of patients who undergo cardiopulmonary resuscitation following a cardiopulmonary arrest in hospitals, are discharged but this rate is different in different countries. Information on who is likely to benefit from cardiopulmonary resuscitation is essential for decision making regarding resuscitation efforts. The purpose of present study was to determine the outcome of cardiopulmonary resuscitation [CPR] for in-hospital cardiac arrests and to identify risk factors associated with survival to the time of hospital discharge.A 1-year descriptive study in Emam Khomeini Medical Center that is a 1000-bed tertiary, academic and regional referral center was preformed. The samples were adult inpatients [mean age 58.12 +/- 19.16 years], excluding those who had cardiac arrest in the operating room. Eighty seven patients analyzed. A check list was used to assess the performance and quality of CPR team and a questionnaire was used for assessment of knowledge in personnel. Among eighty-seven resuscitated patients, sixteen [18.4%] survived after resuscitation but all of them died after 3-100 hours. Twenty seven [31.4%] patients arrested in the intensive care unit, 14 [15.1%] on the ward and 46 [53.5%] in the emergency room. There was no significant difference in survival based on location of arrest. Factors associated with poor outcome were age, interval between collapse and start of CPR, systolic pressure, arterial pH, K, initial rhythm, time of arrest, and duration of CPR. The skill of resuscitation team was associated with survival.Based on these data, survival till hospital discharge rate after cardiac arrest remains low. It is necessary to improve the skills and update the knowledge of resuscitation team. Hospital managers and nursing associations should consider CPR training and continuing education for all nurses and residents. They should also establish a special CPR Team in Hospitals

[An evaluation of the side effects of anti Tuberculosis drugs in patients with Tuberculosis and factors affecting them in Imam Khomeini hospital]

During the course of treatment with anti - tuberculosis drugs in patients with pulmonary and extra pulmonary tuberculosis, unusual reactions such as hepatitis, rash, fever, flu like syndrome, neuropathy, . . . due to three potentially hepatotoxic drugs, Isoniazid, Rifampicin, and Pyrazinamide occur. Hepatotoxic reactions are vital because fulminant hepatic failure is devasting and may be fatal without liver transplantation. To determine the frequency and predisposing factors of drug reactions in patients managed with anti- tuberculosis drugs, we arranged retrospective case control study in Imam Khomeini Hospital.120 patients with hepatitis and other adverse reactions after receiving ant tuberculosis drugs in case groups and 240 patients without any drug reaction after receiving anti tuberculosis drugs in control group were evaluated. Most common adverse events were hepatitis 35.8%, abnormal liver enzyme without overt hepatitis 18.3%, skin rash 11.6% nausea and vomiting 8.3%, arthralgia 5.8%, flu like syndrome 5%. Old age more than 65 years [P=0.047], chronic liver disease [P= 0.008], renal failure [P=0.009], severe tuberculosis [P=0.001] and HIVIAIDS [P<0.039] were predisposing factors for adverse reaction in our patients. In conclusion, close monitoring for symptoms or signs of hepatitis among patients receiving anti-tuberculosis drugs especially old patients, who have chronic liver or kidney failure, patients with HIVI AIDS and patients with severe tuberculosis must be considered

[Infectious diseases and traveling]

As international travels have become increasingly common for both business and tourism, physicians are confronted with innumerable travelers suffering from unknown syndromes and infectious diseases, thus it is necessary for physicians to maintain familiarity with current guidelines and recommendations about travel medicine and prevention of related infectious diseases. Fever, travelers' diarrhea, skin eruptions, respiratory and CNS involvement are diseases seen among travelers on return which make them visit the physicians. Consultation and a checkup prior to traveling with the aim of immunization, recommendations about traveler's diarrhea, malaria and diseases transmitted by blood or sexual contacts are steps that could be taken by the physicians before travel. Knowledge about the epidemiology and etiology of traveler's diseases, destination and immunization status of travelers can prevent complications, morbidity and mortality attributed to infectious diseases in travelers

Prevalence of measles antibody in children of different ages in Shiraz, Islamic Republic of Iran

An outbreak of measles due to secondary vaccine failure prompted this investigation into the prevalence of measles antibody in children. We studied 608 children in 7 different age groups: 6, 9, 14 and 18 months and 6, 10 and 15 years. Children in the 2 youngest groups received no vaccination; the rest were vaccinated at 9 months and 15 months. The 15-year-old age group received an additional vaccination. Transplacental measles antibody [Ab] decreased from 10.0% at 6 months to 0% at 9 months. Measles Ab was positive in 52.9% [14 months], 89.4% [18 months], 60.8% 96 years], 45.0% [10 years] and 96.8% [15 years].To increase Ab levels, a booster vaccination is recommended, administered either with the second DPT booster or at pre-high school age

Prevalence of antibody to Brucella species in butchers, slaughterers and others

Brucellosis is being reported with increasing frequency in the Islamic Republic of Iran. Serum antibodies in high-risk and general populations help to define cut-off levels and can be used as a simple and rapid diagnostic tests in infected areas. We performed the rose Bengal test [RBT], serum agglutination test [SAT] and 2-mercaptoethanol [2ME] titre determination on 415 healthy individuals including butchers, slaughterers and others. Positive results were found by RBT, SAT titre [1:80] and 2ME titre >/= 1:20 in slaughterers [10%, 20% and 6% respectively], butchers [6%, 4% and 1% respectively] and the general population [1%, 2% and < 1% respectively]. A single SAT titre >/= 1:80 in the presence of 2ME titre >/= 1:20 can be diagnostic in this region

Diurnal variations in hepatic and plasma lipids and in the activities of hepatic phosphatidate phosphohydrolase and heart lipoprotein lipase

Diurnal variations of liver and plasma lipids and of the activities of liver phosphatidate phosphohydrolase and heart lipoprotein lipase were determined in male rats kept for 15 days with alternating 12 h periods of darkness and light. Plasma triacylglycerol concentration increased during the dark period reaching a peak at 07:00 h. Hepatic phosphatidate phosphohydrolase activity was also elevated at the early part of the dark with a peak at 23:00 h. The circadian rhythms of hepatic triacylglycerol and phospholipids were less pronounced. Heart lipoprotein lipase activity was maximum at 15:00 h and its nadir point was at 07:00 h. The data were used to calculate definite circadian rhythm for VLDL-triacylglycerol secretion rate which coincided with those of liver phosphatidate phosphohydrolase and plasma triacylglycerol. It is concluded that the change in hepatic phosphatidate phosphohydrolase activity could be responsible for the diurnal variations of VLDL-triacylglycerol secretion rate and that both lipoprotein lipase activity and VLDL secretion rate are the major causes of plasma triacylglycerol diurnal variations