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Background: With the outbreak of the Coronavirus, many restrictions are imposed on the processes of a funeral procession, funeral ablution, burial, mass mourning, and the memorial gathering of the family, relatives, friends, and neighbors. Objectives: Given the lack of research on the mourning experiences of families of the dead infected with coronavirus, the present study was to fill this gap in the literature. Methods: In this qualitative study, some semi-structured individual interviews were carried out in the Bu Ali Sina Medical Educational Center, Sari, Iran, with 16 individuals of the families of the dead with coronavirus, who were selected using the purposive sampling method. The interviews were recorded, transcribed, encoded, and categorized, and the data analysis was performed using Graneheim and Lundman’s qualitative approach. Guba and Lincoln’s criteria were also adopted to ensure the data reliability and validity. Results: Four main themes (namely psychological, behavioral, and physical reactions, virtual mourning, regretful mourning, and feelings of rejection and fear) and twelve subthemes were extracted from the collected data. Conclusions: According to the research results, COVID-19 changed the personal and social lives of the families with dead infected with Coronavirus from different perspectives. In this regard, providing support to families during the mourning period would help them better adjust with such changes causing the loss of a family member.

Introduction: Objective Structured Clinical Examination (OSCE) is a valuable method in clinical evaluation of nursing students. The OSCE was first held in Nasibeh School of Nursing and Midwifery. The successful outcome of this exam encouraged other Nursing school to use the OSCE in evaluating the nursing studentschr('39') clinical competency before their completion of undergraduate course. The aim of this study was to investigate the feedback of fourth year nursing studentschr('39') feedback about OSCE as an assessment tool for their clinical competence and skills. Material and Methods: This study has a cross sectional descriptive design. All of the 36 undergraduate nursing students in the eighth semester who attended the OSCE Exam at the Nasibeh School of Nursing and Midwifery affiliated to Mazandaran University of Medical Sciences participated in this study. The questionnaire was designed and developed by the researchers. The questionnaire assesses nursing studentschr('39') viewpoints of the OSCE characteristics. Results: The results of this study show that OSCE has been accepted by the most of the undergraduate nursing students as an evaluation method for their clinical competency. For most students OSCE was reliable, covered a wide range of discipline and fair aspects. Having the OSCE was a positive practical experience for most students. However, several students felt that OSCE was not hold properly. Conclusion: The feedback received regarding this evaluation method provides evidence that OSCE is a valuable method for evaluating undergraduate nursing studentschr('39') competency. Such feedback is considered helpful for further development of OSCE.

BACKGROUND: Coronavirus (COVID-19) is an infectious respiratory disease. Quarantine is often accompanied by unpleasant experiences for those who go through it. The aim of this study was to determine the mental health status of people during quarantine in northern Iran. MATERIALS AND METHODS: This cross-sectional study was conducted during the quarantine period of coronavirus. Conventional sampling was done from March 6 to April 6. Six hundred and forty-two individuals were included. Inclusion criteria were living in Sari and being home quarantined during the corona outbreak. Exclusion criteria included hospitalization history due to corona and unwillingness to participate in the study. In this study, the General Health Questionnaire-28 was used online to collect the required data. To analyze the data, descriptive and inferential statistics (t-test, analysis of variance, and correlation coefficient) were used. RESULTS: In this study, individuals were included in the investigation with a mean age of 38.74 ± 11.89 (ranged from 15 to 73). Most of the participants were female (72.85%) and married (71.34%). According to the results, 21.5% of the participants had poor mental health. Mean mental health scores have a statistically significant relationship with gender, marital status, education, occupation, quarantine period, patients with corona, and exposure to a patient with corona (P ≤ 0.05). Furthermore, a negative correlation coefficient was observed between age and mental health score (correlation coefficient = −0.31, significance >0.001). CONCLUSION: The average score of mental health has a significant relationship with gender, marital status, education, occupation, quarantine period, corona, and exposure to a patient with corona. Given the high prevalence of mental disorders in people during the COVID-19 epidemic, educating people and planning to reduce the psychological effects of the epidemic can be helpful.

Context: Pressure ulcers are among the main postoperative complications which isassociated with an increased length of hospitalization. Determining risk factors of postsurgical pressureulcers is crucial for developing prevention and treatment strategies. Aims: This study aimed to investigate the incidence rate of pressure ulcer and related risk factors after general surgery. Settings and Design: This descriptive cross-sectional study was carried out in three hospitals in Mazandaran province in 2016. Materials and Methods: The sample size was 191 surgical patients undergoing general surgery by using census method. Data were collected in pre-, intra-, and post-operative period using demographic and clinical questionnaires and also, through the Braden Scale for Predicting Pressure Ulcer Risk. Statistical Analysis Used: Descriptive statistics, t-test, Chi-square, and univariateand multivariate logistic regression were used to analyze the data. Results: The incidence rate of postoperative pressure ulcers in patients was 17.8% (34 out of 191 patients). Based on the multivariate logistic regression model, significant correlations existed between the incidence of pressure ulcers and the following variables: age over 70 years old (P = 0.003), history of hypertension (P = 0.035), history of heart diseases (P = 0.029), Braden score

BACKGROUND: In recent decades, managing health-service systems has faced multiple challenges. Identifying and resolving these challenges promote the efficiency and effectiveness of hospital activities. AIM: The present study aimed to explore the human factors affecting health service managers.MATERIAL AND METHODS: In this qualitative study, in-depth unstructured interviews were conducted with 29 employees who were in close contact with the health service managers. All the interviews were transcribed verbatim. Data were collected using purposeful sampling and were analysed using conventional content analysis via MAXQDA software.RESULTS: A group of 29 participants were interviewed (male 65.5%, female 34.4%). "Managing managers" has been identified as the primary theme with four supporting secondary themes including the inappropriate appointment of managers, the impact of human and social needs of managers, influential employees, and disrupting organisational communications. These are the challenges faced by managers in managing human resources in health-service organisations.CONCLUSION: Results showed that employees manage their managers within the organisation so that they can prevent managers from concentrating on their management affairs and tasks resulting in the distortion of management practices. The results of this study can help the key policy makers and planners in health-service organisations to guide the organisation to pursue its goals through appointing appropriate managers and identifying influential employees.

Background: Open heart surgery patients experience too much mental pressure, so this study has been made to investigate the relation between the anxiety and hope to life in open heart surgery patients. Methods: This study is a cross sectional study. Eighty patients, who have been the candidates for open-heart surgery in Fatemeh Zahra hospital in Sari-Iran, were selected through convenience sampling method. The data collection instruments included standard questionnaires to measure life hope, anxiety and life expectancy. The data were analyzed MANCOVA and Pierson. Results: Theresults showed that there was no significant statistical difference between anxiety scores and hope to life before open-heart surgery and a month after that (P>0.005). In addition, the correlation intensity between anxiety and hope to life was reversed, defective and significant (P=0.000 and r=-0.930). Conclusion: The finding of present study indicated that open-heart surgery patients have tolerated and experienced too much anxiety and also have low hope to life, therefore, they need more training and social and family support. Key words: Anxiety, Hope, Open heart surgery, Life expectancy, Stress.

Background and Aim: The psychological changes and physiological limitations during multiple sclerosis (MS) disease diminish the social relations. Consequently, losing social supports leads to more physical and psychological complications such as fatigue syndromes. Therefore, this study aimed to investigate the relationship of social support and fatigue syndromes in MS patients. Methods: This study was a descriptive-analytic which randomly selected 46 patients with MS. The patients evaluated through demographic information, standard modified social support scale, fatigue severity scale, modified fatigue impact scale, and fatigue descriptive scale. Gathered data analyzed using descriptive and inferential statistical Pearson's correlation coefficient. Results: Mean score for variables were as following: Fatigue severity 4/3 ± 1/6, perceived fatigue 34/6 ± 19/5, quality of fatigue 62 ± 3/9, and social support 65/6 ± 23/1, respectively. According to the Pearson statistical test, there was signification association between social support with fatigue severity (P = 0.002 and r = −0.474), fatigue perception (P = 0.001 and = −0.478), and fatigue perception sub-scales, i.e. physical (P = 0.005, r = −0.432), cognitive (P = 0.003, r = −0.0457), and psychosocial (P = 0.009, r = −0.341), respectively. However, there was not significant relationship between social support and fatigue quality (P = 0.59). Conclusion: According to the results of current study, all aspects of social support can impact fatigue symptoms in MS patients. Therefore, it is suggested to develop educational programs for caregivers of patients to improve the mental and physical quality of life of patients.

Gynaecological disorders, such as cervical, ovarian, and endometrial cancers are the second most prevalent cancer types in women worldwide. Therapeutic approaches for gynaecological cancers involve chemotherapy, radiation, and surgery. However, lifespan is not improved, and novel medications are required. Among various phytochemicals, berberine, a well-known natural product, has been shown to be a promising cancer chemopreventive agent. Pharmacokinetics, safety, and efficacy of berberine have been investigated in the several experiments against numerous diseases. Here, we aimed to provide a literature review from available published investigations showing the anticancer effects of berberine and its various synthetic analogues against gynaecological disorders, including cervical, ovarian, and endometrial cancers. In conclusion, berberine has been found to efficiently inhibit viability, proliferation, and migration of cancer cells, mainly, via induction of apoptosis by both mitochondrial dependent and -independent pathways. Additionally, structural modification of berberine showed that berberine analogues can improve its antitumor effects against gynaecological cancers.

Background and Aim : This study aimed to determine whether the Full Outline of Unresponsiveness (FOUR) score is an accurate predictorof discharge outcome in traumatic brain injury (TBI) patients and to compare its performanceto Glasgow coma scale (GCS). Materials and Methods: Thisis diagnostic study conducted prospectively on 53 TBI patients admitted to ICU of education hospitals of Medical Science University of Mazandaran during February 2013 to June 2013. Data collection was done with a checklist including biographic, clinical information and outcome. The FOUR score and GCS were determined by the researcher in the first 24 hours. Outcomes considered as in-hospital mortality and poor neurologic outcome (Glasgow Outcome Scale (GOS) 1-3) in discharge time from the hospital. Results: In terms of predictive power for in-hospital mortality, the area under the receiver operating characteristic (ROC) curve was 0/92 (95% CI. 0/81-0/97) for FOUR score and 0/96 (95% CI. 0/87-0/99) for GCS. In terms of predictive power of poor neurologic outcome, the area under the ROC curve was 0/95 (95% CI. 0/86-0/99) for FOUR score and 0/90 (95% CI.0/79-0/96) for GCS as evidenced by GOS 1-3. The cut-off of 6 showed sensitivity and specificity of total four score predicting poor outcome at 0/86 and 0/87 while the cut-off of 4 showed the value of in hospital mortality at 0/90 and 0/90. The total GCS score showed sensitivity and specificity 0/100 and 0/61 at cut-off 7 in predicting poor outcome while in predicting mortality at cut-off of 4 this range was 0/100 and 0/92. Conclusion: The FOUR score is an accurate predictor of discharge outcome in TBI patients. Thus, researchers recommend for therapeutic Schematizationto use in neurosurgical patients at admission day.

Background: Hemodialysis patients usually experience high levels of psychological stress, anxiety, and depression. Reducing these matters in patients provides more psychological resources to cope with their physical situation. Aim: The present study aimed to explore the efficacy of Benson's relaxation technique for stress, anxiety, and depression of patients with hemodialysis. Materials and Methods: Eighty hemodialysis patients were selected from two hospitals as an intervention and control groups. Then Benson relaxation training was implemented in the intervention group for 15 min twice a day during 4 weeks. The patients were assessed by depression, anxiety, and stress scale; which was completed before and after the intervention. Results: There were significant differences between stress and anxiety levels in case group before and after intervention (P < 0.001) and there is no meaningful difference between the mean of depression value in case group before and after intervention (P < 0.22). Conclusion: Instructing Benson's relaxation technique is accompanied by reducing stress and anxiety level of hemodialysis patients. Reducing stress and anxiety levels can provide more calmness for the patients so that pursuing medical therapy would be accompanied with more tranquility. Authors have suggested to improve and prevent the patients' psychological problems as well as other chronic disorders by applying this practice.

Aim Working as a nurse, by its nature, causes a high degree of stress. Nurses are exposed to the higher levels of occupational, physical, and mental stresses in critical care units than the nurses in other units of a hospital. The aim of this study was to determine the effect of training for resilience on the intensive care unit nurses' occupational stress and resilience level. Methods This study is a quasi-experimental intervention study that was done by recruiting 30 nurses who were selected from critical care units of an educational hospital in Sari City, Iran, through convenience sampling between April 2015 and February 2016. The resilience training was provided in 5 sessions of 90 to 120 minutes. The pretest-posttest approach was used in this study, and the nurses completed the Connor-Davidson Resilience Scale, and Expanded Nursing Stress Scale, before and 2 weeks after the training program. Results The mean score of the occupational stress of the participants decreased significantly after the intervention (P = .001), and the mean score of resilience increased significantly after the intervention (P = .001). Conclusion The results confirm the effectiveness of resilience training on occupational stress and resilience level of nurses working in the intensive care units.

Background: Traumatic brain injury (TBI) is a common cause of mortality and disability worldwide. Choosing an appropriate diagnostic tool is critical in early stage for appropriate decision about primary diagnosis, medical care and prognosis. Objectives: This study aimed to compare the Glasgow coma scale (GCS), full outline of unresponsiveness (FOUR) and acute physiology and chronic health evaluation (APACHE II) with respect to prediction of the mortality rate of patients with TBI admitted to intensive care unit. Patients and Methods: This diagnostic study was conducted on 80 patients with TBI in educational hospitals. The scores of APACHE II, GCS and FOUR were recorded during the first 24 hours of admission of patients. In this study, early mortality means the patient death before 14 days and delayed mortality means the patient death 15 days after admitting to hospital. The collected data were analyzed using descriptive and inductive statistics. Results: The results showed that the mean age of the patients was 33.80 ± 12.60. From a total of 80 patients with TBI, 16 (20%) were females and 64 (80%) males. The mortality rate was 15 (18.7%). The results showed no significant difference among three tools. In prediction of early mortality, the areas under the curve (AUCs) were 0.92 (CI = 0.95. 0.81 - 0.97), 0.90 (CI = 0.95. 0.74 - 0.94), and 0.96 (CI = 0.95. 0.87 - 0.9) for FOUR, APACHE II and GCS, respectively. In delayed mortality, the AUCs were 0.89 (CI = 0.95. 0.81-0.94), 0.94 (CI = 0.95. 0.74 - 0.97) and 0.90 (CI = 0.95. 0.87 - 0.95) for FOUR, APACHE II and GCS, respectively. Conclusions: Considering that GCS is easy to use and the FOUR can diagnose a locking syndrome along same values of subscales. These two subscales are superior to APACHI II in prediction of early mortality. Conversation APACHE II is more punctual in the prediction of delayed mortality.

Aim: We aimed to determine the epidemiology and symptoms of red eyes in patients from Northern Iran. Materials and Methods: A descriptive study was planned involving 840 patients referred to the eye clinic of Bu-Ali Sina hospital in Sari, Iran, with the chief complaint of eye redness. Results: Of 840 patients, 525 were men (62.5%) and 315 were women (37.5%). Most of the patients were over 39 years of age. 55.7 percentage of them lived in cities and 44% were from villages. The most common eye symptoms with eye redness were: Eye abrasion (57%), tears in eyes (49%) and swollen eye lid (30%). Red eyes without any symptoms in eyes were diagnosed as runny nose (4.2%) and headaches (3.4%). 11.9% and 19.6% of the patients had a previous history of red eye and had visited doctors for red eyes respectively. Conclusions: Red eyes are more common in men than women. Introducing dangerous causes of red eyes in the future can help to health care professional to on time diagnosis of red eyes related problems.

Background: Occlusion of central venous catheters is one of the limiting factors in using them. Heparinized saline solution is the standard solution used for keeping the catheters open. Objectives: This study aimed to determine the effect of heparin saline solution and normal saline in maintenance of patency of central venous catheters. Patients and Methods: This double-blind study was performed on 84 patients of intensive care unit who had central venous catheters. The patients were randomly divided into two groups of heparin saline receivers and normal saline receivers. In the heparin group after each drug injection into the lumen, 3 mL of heparin saline solution was injected in the catheter as well. The other group only received 10 mL of normal saline instead. The catheters were examined for blood return and flushing every eight hours for 21 days. Data was analyzed using SPSS software version 20 and descriptive and analytic statistics were studied. Results: There was no significant difference in the rate of flushing (P = 0.872) and possibility of taking blood samples from catheters (P = 0.745) in the two groups of heparin and normal saline receivers. Furthermore, using heparin had no effect on prolonging the survival of catheters. Conclusions: Considering possible side effects of heparin and the increase in treatment charges and the fact that using heparin did not have a significant effect on patency and survival of catheters in the studied patients, it is recommended to use normal saline solution to maintain the patency of central venous catheters.

Background: Considering the significant role of nurses in health care and the importance of commitment in public health, the aim of this study was to examine the association between work-related stress, and job satisfaction and commitment among nurses. Methods: This cross-sectional study has been performed among 100 nurses working in a teaching hospital affiliated to Mazandaran University of Medical Sciences, northern Iran, in 2015. The participants were assessed by standard questionnaires on work-related stress, and job satisfaction and commitment. Descriptive indexes were analysed via regression and correlation. Results: The participants were aged between 25 and 45 years. In total, 85% of nurses held a bachelor degree and the rest were postgraduates. Most of the nurses (77%) had experience in their job for more than 10 years. Total score of mean job commitment showed a high score among nurses (102.9±8.9); job satisfaction also showed a mean of (261.6±27.44). Total score of work-related stress was (112.0±11.99). The results indicated that job satisfaction and work-related stress explained 54% of variance in job commitment. The overall job satisfaction (Beta = 0.471, p Conclusion: The results of the present study showed that work stress and job satisfaction affects job commitment among nurses. Therefore, it is advisable to pay more attention to job satisfaction and stress in these sensitive occupations, to promote commitment and job efficacy.

Background: Today, substance dependence and illegal trading of narcotics is considered as a global issue. Since mental disorder has been reported in about 90% of the substance dependents, this study aimed at determining the rate of mental health in the substance dependents in Sari Township in 2011. Materials and Methods: In this study, 500 substance-dependent patients were selected using convenience sampling method. To collect data, SCL-90-R was used for the evaluation of their mental health and a demographic questionnaire was employed for identifying their personal information. The obtained data were analyzed by descriptive and inferential statistics using the SPSS software. Results: It was found that 90.4% of the participants were susceptible to mental disorder. Most of them suffered from depression, psychoticism, interpersonal sensitivity, anxiety, and paranoia. Also, there was significant relationship between the mental health of single, divorced and married addicts (P Conclusion: Due to the presence of mental disorder in the substance-dependent patients, it is recommended to help treat them by providing them with education, psychotherapy, and psychiatric medication.

Executing a strategy is a complicate process that seeks to reach the best results for guarantee some achievements. To explore barriers related to executing diseases prevention and control, is crucial to resolve weakness and improve administration of therapeutic procedure. This study aims to explore obstacles of implementing acquired immune deficiency syndrome (AIDS) prevention and control strategies in Mazandaran province of Iran.This cross sectional study was conducted during 2012. The samples included 130 managers, experts and employees of Mazandaran University of Medical science of Iran and the other organization and agencies participating in an AIDS national program. The data were analysed by the chi-square method through SPSS software.The results showed that among eight factors of obstacles of implementing strategy including educational, technological, cultural, communication, legal, political, organizational and economic factors, technology and political issues are recognized as obstacles.Technology as an inter-organizational factor and political factors as out-organizational factors, could affect the successful executing of AIDS control and prevention strategies, therefore the health care providers should pay more attention on these matters.

Background: We investigated the contributing causes and factors leading to eye enucleation procedure among the patients referred to the ophthalmology clinic of the Center Eye Hospital in Tehran, Iran. Patients and Methods: We retrospectively analyzed the clinical records of patients referred to the ophthalmology clinic of the Center Eye Hospital in Tehran, Iran, in the past 3 years. The data retrieved were analyzed. Results: A total of 313 patients underwent eye enucleation during the past 3 years. The average age of the patients was 36.7 years (range: 20–44 years). Two hundred and eight patients (66.5%) were males and 105 (33.5%) were females. One hundred and sixty-nine patients had the right eye enucleation while 144 patients had the left eye enucleation. The various procedures included enucleation (83%), evisceration (13.4%), and exantration (3.6%). The factors leading to these procedures included trauma (33.2%), phthisis bulbi (20.7%), tumors (15.7%), and infections (10.5%). Conclusion: In our study population, trauma was the main factor leading to eye enucleation. Hence, measures to increase social awareness and knowledge to reduce trauma cases are necessary as a preventive approach to reduce eye enucleation procedures. Concurrently, ophthalmologists should also pay more attention in early diagnoses and screening of eye health, especially detecting tumor cases such as retinoblastoma and postsurgical care to reduce secondary infections will be effective actions to reduce the overall rate of enucleation.

To investigate the prevalence rate of hepatitis B (HVB) and hepatitis C (HCV) co-infection in HIV positives in Mazandaran province.This descriptive cross-sectional study lasted from 2008 to 2010. The population of this study included 188 HIV positive persons confirmed to be infected by tests of ELISA I, II and western blood (WB) in the hospitals of Mazandaran University of Medical Sciences and Health Services. After getting permission, 5 cc venous blood samples were taken and drawn into a lab tube without citrate.Among the total of 188 HIV positive patients in Mazandaran province, only 80 patients were available, 62 had moved to other provinces, and 46 had died. Of the samples, 66 (82.5%) were males and 14 (17.5%) were females with the mean age of 37. Among the patients, nine (11.3%) were co-infected with HIV/ HBV, 27(33.8%) with HIV/HCV, while 20 (25%) were co-infected with HIV/HBV/ HCV. Only one patient had travelled abroad and eight of them stated that they had used shared syringes.The differences in the rate of HBV and HCV co-infection can be due to the epidemiologic conditions of viruses with different factors including different risk factors causing infection with these factors such as the rate of virus penetrating the body, the manner of penetration, patients' health condition, patients' culture, and their socio-economic condition, etc.

Background and Aim: One of the goals of health care team is to improve the quality of life of patients during and after hospitalization period. Therefore, this study aimed to examine the effect of performing discharge planning on ischemic heart disease patient's physical quality of life. Methods: This quasi-experimental study was performed on 74 ischemic heart disease patients which randomly allocated to discharge-planning group (n = 37) and usual care group (n = 37). The discharge-planning included the patients’ educational needs, self-care instructions for patients, and caregivers. This program was performed through supporting patients during hospitalization and after discharge. The physical aspect of quality of life was assessed by standard questionnaire Short Form 36 and the data were analyzed through Mann–Whitney, independent t-test, variance analysis, Friedman and Wilcoxon. Results: There was no significant difference between intervention and control groups in physical aspects of the quality of life before intervention (P = 0.423) while two groups were significantly different after intervention (P = 0.000) and quality of life of patients in the case group improved significantly. Conclusion: Applying the discharge-planning program as an effective, efficient, cost-effective, and noninvasive intervention on physical aspects of the quality of ischemic heart disease patients’ lives is useful and helpful. Hence, it is recommended to use this program to promote and improve the quality of ischemic heart disease patients’ lives.

Background and Aim: Less information is available about the role of job burnout and life satisfaction relationship among nurses and especially midwives in Iran. Therefore, we set out to analyze the relationship between life satisfaction and occupational burnout among Iranian nurses and midwives of medical institutions. Materials and Methods: A cross-sectional survey was conducted in 2013 on 260 subjects in Mazandaran, northern Iran. The questionnaires assessed the socio-demographic characteristics, life satisfaction, and job burnout. Data analyzed by SPSS software through statistical methods such as description and Pearson correlation. Results: The respondents had medium scores in job burnout and in life satisfaction. Subscales of job burnout was significantly and negatively related to life satisfaction scale. Conclusion: Our study reveals that all dimensions of both life satisfaction and burnout syndrome are relevant factors affecting nurses and midwives. We hope that these findings will offer some suggestions for health sector managers to keep their nurses and midwives motivated and stable.

Background: People spend a considerable part of their childhood time in the schools, a phase that coincides with their physical and mental growth. A healthy educational environment is vital to student's health and wellbeing. Materials and Methods: This study is a descriptive study conducted in 100 primary schools (both state and nonprofit schools) from Sari's Districts 1 and 2 in Iran. Sampling was performed by census and data were collected using the standard questionnaire by direct interview. Data were analyzed by Excel and SPSS software (Version 20.0. IBM Corp, Armonk), NY: IBM Corp using independent numerical T2 testing. Results: Significant relationship was observed between the kind of schools ( P = 0.045) and their locations ( P = 0.024), however the health, safety and environment (HSE) ratings among boys only versus girls only schools were similar ( P = 0.159). Interestingly private and nongovernment schools and primary schools from Sari's districts one had consistently higher HSE ratings. Conclusion: The differential and higher HSE ratings in primary schools run by Private organizations and primary schools from Sari's districts one could be due to manager's awareness and implementation of recommended HSE standards, schools neglecting and overlooking these standards had lower HSE ratings. It is necessary that schools with lower HSE ratings are made aware of the guidelines and necessary infrastructures allocated to improve their HSE ratings.

Staff burnout is increasingly noticed as a research issue in the mental-health field. Regarding the importance and key role of nurses and technicians in health care services, this study aimed to evaluate job burnout in relation to education, age and occupation. This study was a correlational and descriptive cross-sectional study that selected all nurses and technicians working on Mazandaran University of Medical Science. The job burnout of participants measured through Maslach occupational burnout inventory. The gathered from participants data analysed by correlation and T-test method through SPSS software. The finding showed the nurses had high level of job burnout. Job experiences and age were in relation to job burnout. There was no relationship between marital status and job burnout. The personnel with higher education presented higher level of job burnout than staff that holds the lower degree of education. Job's burnout was related to factors such as age, job experiences and education level. Considering importance and sensitivity of health care professional's job some suggestions explained in this research.

Background and Aims: Today Glasgow coma scale (GCS) is the most well-known and common score for evaluation of the level of consciousness and outcome predict after traumatic brain injuries in the world. Regarding to some advantages of the full outline of unresponsiveness (FOUR) score over GCS in intubated patients, we're going to compare the precision of these two scores in predicting the outcome predict in intubated patients. Methods: This research was a diagnostic-based study, which was conducted prospectively on 80 patients with Traumatic brain injury who were intubated and admitted to Intensive Care Unit (ICU) of Educational Hospitals of Mazandaran University of Medical Science during February 2013 to August 2013.The scores of FOUR and GCS were measured by the researcher in the first 24 h of admission in ICU. The information's recorded in the check list including the mortality rate of early and late inside of the hospital interred to excel. The findings were analyzed using SPSS software, through descriptive statistics and regression logistic. Results: The results showed of 80 patients 21 patients (20%) were female and 59 patients (80%) were male. The age average of the samples was 33.80 ΁ 12.60 ranging from 16 to 60 years old. 21 patients (26.2%) died during treatment. Of 21 patients, 15 patients died during first 14 days (18.7%) and 6 patients died after 14 years (7.5%). The area under curve (AUC) of FOUR score in early mortality was 0.90 (C 1 = 0.95, 0.88-0.90). The amount AUC for GCS was 0.80 (C 1 = 0.95, 0.78-0.84), which in delayed mortality it was ordered as 0.86 (C 1 = 0.95, 0.84-0.90) and 0.89 (C 1 = 0.95, 0.78-0.88). Conclusion: The research results indicated that FOUR score is more exact and more practical in intubated patients regarding lack of verbal response factor in early mortality prediction in GCS. Hence, it is recommended for health professionals to use the FOUR score to predict the early outcome of intubated patients with traumatic brain injuries.

Background and Purpose: Violence is defined as unnecessary hostile behavior in clinical environments, which may lead to psychological abuse by colleagues. This systematic review aimed to evaluate violence and its associated factors among nurses. Methods: In this study, we searched for articles and patented documentations published until December 2014 via databases such as PubMed, Medline, Scopus, Google Scholar, Iranian Journal Database (Magiran), Scientific Information Database (SID), IranMedex and Iranian Biomedical Journal. Using keywords such as violence, horizontal violence, lateral violence, prevalence, predisposing factors and bullying, we found 84 articles out of 19,000 search results. Results: Violence has a variable definition in different cultures. Violent behavior in clinical environments is influenced by factors such as age, gender, work experience, work shifts, working hours and employment status of medical staff. In nurses, violence could lead to adverse outcomes, such as physical and psychological damages. Conclusion: According to the results of this study, male and younger nurses are more frequently exposed to violent behavior compared to female and elder nurses. Therefore, nurses should be informed on the adverse effects of violent behavior. In this regard, authorities and management of medical centers should show zero tolerance for violent behaviors on behalf of nursing staff.

Background: Sensory deprivation is one of the common complications of coma patients in the intensive care unit (ICU). The purpose of this study was to investigate the impact of a familiar voice to consciousness level in coma patients. Methods: A total of 13 patients with traumatic coma (8 ≥ Glasgow′s coma scale [GCS]) admitted in ICU ward were randomly assigned to control and experimental groups. The experimental group was treated twice a daily each time 15 min with a familiar recorded MP3 sound for 2 weeks. The control group received only natural voices of environment. GCS applied to evaluate patients′ level of consciousness. Finding: Findings showed that duration to reach GCS = 15 was significantly shorter in the experimental group (χ 2 = 12/96, P < 0/001). Conclusion: These findings imply that providing familiar auditory stimulation programs for coma patients in the ICU could be effective.

Background and Aims: The hemodialysis (HD) patients are experiencing high biopsychosocial stress on all levels. Therefore, this study was designed to survey on physiologic and psychosocial stressors among HD patients in two educational hospitals of Northern Iran. Materials and Methods: This cross-sectional study included 80 HD patients who were referred to Khomeini and Fatemeh Zahra hospitals in Mazandaran (Northern Iran) during the year 2011. Data were collected using a demographic information record sheet and Baldree Hemodialysis Stress Scale. Finding: The following physiologic stressors were noted: Fatigue (51.25%), limited time and places for enjoyment (46.25%), and physical activation limitation (32.5%). Similarly the following psychosocial stressors were observed: Fistula (58.75%), limitation of drinking water (47.5%), low quality of life (47.5%), travelling difficulties to the dialysis center (45%), treatment cost (41.5%), and low life expectancy. The stress level was high in women who were married, younger, less dialysis vintage, and belonged to a low education level. Conclusion: This study reports that HD patients have with significant physical and psychosocial problems and they need education, family, and social supports.

Background Caregivers have a considerable role in caring and recovery of cancer patients. They may experience psychological problems such as depression, anxiety and decreases in quality of life (QOL). Present study aimed to explore depression and quality of life and their relationship among care givers of patients with breast cancer . Methods In this cross sectional study, enrolled 63 care givers of women with breast cancer attending IMKH hospital in Iran as outpatients during 2009–2010. In order to assess the QOL and depression, we used Caregiver QOL Index-Cancer (CQOL-C) and Beck Depression Inventory respectively. Results We found depression has strong negative correlation with QOL and participants with depression were more likely to have a poorer overall QOL. Conclusions Depression has some effects on QOL of breast cancer patients’ care givers. Assistance and giving information through education and intervention from healthcare professionals is the key of improve the ability of caregivers to enhance their QOL.

In this paper, inspired by the ultraviolet deformation of the Friedmann-Lema\^{\i}tre-Robertson-Walker geometry in loop quantum cosmology, we formulate an infrared-modified cosmological model. We obtain the associated deformed Friedmann and Raychaudhuri equations and we show that the late time cosmic acceleration can be addressed by the infrared corrections. As a particular example, we applied the setup to the case of matter dominated universe. This model has the same number of parameters as $\Lambda$CDM, but a dynamical dark energy generates in the matter dominated era at the late time. According to our model, as the universe expands, the energy density of the cold dark matter dilutes and when the Hubble parameter approaches to its minimum, the infrared effects dominate such that the effective equation of state parameter smoothly changes from $w_{_{\rm eff}}=0$ to $w_{_{\rm eff}}=-2$. Interestingly and nontrivially, the unstable de Sitter phase with $w_{_{\rm eff}}=-1$ is corresponding to $\Omega_m=\Omega_d =0.5$ and the universe crosses the phantom divide from the quintessence phase with $w_{_{\rm eff}}>-1$ and $\Omega_m> \Omega_d$ to the phantom phase with $w_{_{\rm eff}}, Comment: 11 pages, 2 figures, accepted for publication in PLB