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Links between violence, aggression, and mental illness are well documented. Despite this association, our current understanding of the factors for and optimal treatment of aggression remains limited. This lack of knowledge is alarming because nurses, particularly pediatric nurses who treat aggressive children, are frequent targets of patient aggression. Consequently, the aim of this article is to provide information regarding the concept of aggression in child patients, assessment of violent behavior, implementation of interventional treatment and a review of medical, psychological and social strategies which assist in the understanding of aggression and its clinical intervention. However, the etiology of aggression for the most part still remains a mystery.

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Children are the biggest national investment that a society can make. With increased child population so too have their problems increased, amongst which are the increased incidence of street children, which as a result has endangered their health. This research is a descriptive and cross sectional study towards determining the effective factors on the self-concept of street children aged 6-12 years who were referred to the Khajouye Kermani culture house of Tehran in 1380. In this regard, 140 street children between the ages of 6-12 were chosen. The method was a 4-part questionnaire which included personal, family and societal information and questions related to the self- concept of the children. The data was collected by interviews with the children. In accordance with the average and the deviation criteria achieved, the level of self-concept was divided into four groups, extremely negative, negative, positive and extremely positive. The results showed that half of the subjects (50%) had very negative concepts of themselves and only 2.2% of them had a very positive self- concept levels. Therefore the street children had a very low self- concept level. Also as concerns the factors affecting self- concept was also a meaningful relationship between self- concept and some factors such as gender, education, level of income, duration of work, level of happiness within the family, counseling, reaction to the child's mistakes, having necessities for the home, adequate nutrition and clothing, having street friends before work (P<0.05). Therefore street children are at risk as regards their mental and physical development because they suffer from low self- concept levels and require special attention. Because of the vast responsibilities nurses can play an important role to improve of the health of these children.

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Nowadays violence can be widely observed in many societies and one of these cases is domestic violence, the effect of which can be seen both on individuals and the society as a whole. If domestic violence persists it can result in divorce and in the long run may even result in murder, the effect of which both on the individual and the society is obvious. Disorder, homelessness and orphaned children are the disgraceful results of violence. This Research is a descriptive study on physical and Psychic complications of wife abuse on women who were referred to the Tehran legal medical authorities. The methods for gathering data were a questionnaire of personal information of both husband and wife, check list form consisting of 12 physical injuries and a standard test B K to measure the level of depression and self-esteem. The result of this research shows that the most prevalent physical and Psychic problem existent among women suffering from physical abuse from their husbands were as follows: physical injury and extreme fatigue (99%) severe depression (43%) and low self-esteem (65%).

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Introduction: Pain caused by some therapeutic and nursing procedures has been a major concern of health care providers. Injection pain is a common complaint of patients. Materials and

Methods: This quasi-experimental investigation was conducted to compare the pain intensity caused by standard, and Z-Track method for intramascullar (I.M) injection. The samples were 100 female nursing student volunteers that were selected by convenience sampling. Each sample was injected two times blindly: first by standard and then by Z-Track method, with 24 hours interval. None of them knew the method of injection for each time. The injection solution was 1 ml sodium chloride. Pain intensity was measured by a numerical pain assessment scale and pain experienced by every body was compared with herself.

Results: The results showed that the pain associated with IM injection was significantly decreased when Z-Track method was used.

Conclusion: The researcher can join to other authors stating that Z-Track can be the technique of choice for all I.M injections.

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Introduction: In hypertensive patients M position (sitting, right arm at the level of heart and both plantar surface of foots on the floor) is the standard position for measurment of blood pressure since it reveals the “true” pressure. Materials and

Methods: It is a quaziexperimental study that compares effect of different positions of limbs on blood pressure of hypertensive patients. The sample size was consisted of 100 hypertensive patients. A questionnaire and a check list for systolic and diastolic blood pressure of the patients in different positions were used. One researcher collected all of the data. At first demographic data, weight and hight were recorded. After 5 minutes in sitting position in 3 different comparing positions, M (sitting, right arm at the level of heart and both plantar surface of foots on the floor), A (sitting, right arm hanging beside the body and both plantar surface of foots on the floor) and B (sitting, right arm hanging beside the body and right foot on the left knee), blood pressure was measured and recorded. The study methods included interview and physiologic measurement. The paired t-test for related measure was applied in order to analyse the data.

Results: The results showed that the difference of mean systolic and diastolic blood pressure in “A & M”, “B & M” and “B & A” positions was significant (paired t test, p<0.0001) and the mean of systolic and diastolic blood pressure in “A” position was more than “M” position, “B” position was more than “M” position and “B” position was more than “A” position.

Conclusion: According to the findings of this study, “B” position has the greatest effect and “M” position has the lowest effect on increasing the systolic and diastolic blood pressure. This research indicated that attention to the limbs position during the measurement of blood pressure is very important.

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Introduction: Hepatitis is a serious danger to heath of delivery room s personnels since direct exposure to the blood occurs in 25 percents of viginal labours.

Materials and Methods:This descriptive study carried out in order to evaluate knowledge about hepatitis B among midwives and midwifery’s students in delivery rooms in hospitals related to Medical Sciences universities in Tehran. The study group consisted of 120 persons (60 midwives and 60 midwifery’s students) and hospitals were selected through cluster sampling and samples selected randomly. Data collected by a questionnaire from June to September 2002. Data were analyzed with descriptive statistics and chi-square test.

Results: Results showed that knowledge were moderate in majority of midwives and midwifery s students. There was no significant difference between knowledge about hepatitis B in three universities.

Conclusion: This research showed that knowledge of midwives and midwifery s students about hepatitis B wasn t adequate hence training courses is recommended in order to increase knowledge of midwives and more attention must be paid to education of midwifery’s students about blood born diseases, especially hepatitis B.

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Introduction: To reduce the morbidity and mortality of cardiovascular diseases, patients are emphasized on following the exact prescription order of their antihypertensive and other cardio vascular medications.

Materials and Methods: The purpose of this study was to identify factors related to medication compliance in patients with coronary heart disease. A descriptive analytical study was designed and a total of 150 patients with coronary heart disease were chosen with convenience sampling among patients in one of the cardiovascular clinics affiliated to Tehran University of Medical Sciences. The instrument included a questionnaire for the demographic data, side effects of the drugs, physical condition, level of cognition and self-reporting of the patients about medication non-compliance A questionnaire which was about attitude evaluation A data evaluation form to calculate the rate of medication compliance Biophysiologic measurments and finally, available documents. The data were collected in two consecutive steps: at the first appointment, the questionnaires were filled. At the second appointment (1 month later) medication compliance rates which was based on counting of pills, were calculated.

Results: The data were analyzed with descriptive statistics, chi-square test, Fisher’ exact test and Tchoprof coefficient. Only 28% of the patients had met the drug regimens appropriately but 56% of them had a poor record. There was a meaningful relationship between the self – reporting of the patients and counting of the pills (p value<0.005). In addition, some factors such as age, education, occupation, teaching and its sources, duration of acquiring the cardiac disease, number of hospitalization and level of cognition of patients under investigation were assessed as effective elements to use the pills properly.

Conclusion: No meaningful relationship was found between sex, marital status, parenthood status, living arrangement, health insurance situation, health personnel availability, positive family history of cardiac disease, co-existence of another disease, difficulty in providing of the drugs, side effects of the drugs, physical condition and attitude and medication compliance. In conclusion, by providing some educational programs about drug regimens, based on the level of cognition, experiences, capabilities, and also the living style of the patients, medication compliance can be improved.

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Introduction: Satisfaction from marital relation is a fundamental factor in stability and maintenance of marital bond. Sexual satisfaction is one of the effective factors in spouse relation satisfaction.

Materials and Methods: This research is a correlation study. A sample of 400 women referring to health care centers in Arak city was selected randomly in 2003. The information collecting tools were questionnaires. To analyze the data, the descriptive statistical, frequency distribution charts, the mean and central tendency as well as inferential statistics (2 test and Kruskal Wallis) have been applied.

Results: According to the results, there was a meaningful relationship between having orgasm and sexual relation satisfaction, nonsexual relation satisfaction with spouse and marital relation satisfaction. Also, there was a meaningful statistical relationship between orgasm experience and variables of age, spouse s age, education, spouse s education, duration of marriage, number of children, and family s income.

Conclusion: There is a relationship between women s orgasm experience and the amount of satisfaction from marital relation. Hence, it was suggested that the health planners and the officials in charge pay more attention to women s sexual problems and a sexual counseling clinic be established in health care centers.

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Introduction: Low back pain is a very common complaint in communities as about 80% of people experience it throughout their life. Low back pain has negative effects on different aspects of the patients lives. One of the palliative treatments of low back pain is accupressure.

Materials and Methods: A single blind clinical trial study was conducted to evaluate the effects of accupressure on low back pain in Khorram Abad city Tamin Ejtemaei hospital in 2002. Ninety patients were selected by convenience sampling and then they randomly divided into three groups: Experimental (accupressure was applied in real points), plasebo (sham accupressure was applied in four shampoints) and control (without any intervention). The subjects were 36 males and 54 females, ranging in age from 20-50 years. All three groups used Acetaminophen tablet (325 mg) for pain relief. Data were collected by an structured questionnaire, pain assessment numerical scale and three self reported scale.

Results: The results of study indicated that accupressure and sham accupressure could alleviate low back pain severity, but reduction of pain was statistically significant only in experimental group (p<0.0001). Decline in the amount of medication usage in experimental group was statistically significant (p<0.0001).

Conclusion: In conclusion, the study showed use of accupressure was effective on pain relief and it can be used as a safe treatment.

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Introduction: Anually, 585000 women die from complications of pregnancy and childbirth in the world. Using postpartum contraceptive methods helps to prevent repeated pregnancies.

Materials and Methods: This research is a descriptive and analytic cross-sectional study that has been performed among women who refered to health centers of Kermanshah city in 2002 to evaluate contraceptive use during two years postpartum and attitude toward it. In this study, some of health centers of Kermanshah city had been selected with cluster sampling and then 260 married women in fertility ages attending these health centers who had delivered during previous two years were selected, using stratified random sampling. Data collecting was performed by interview using a questionnaire that was consisted of 5 parts the data were analyzed using 2 and Fisher exact test, student T-test, Pearson and Logistic regression. Standard deviation (Sd) was reported for mean values.

Results: The findings of this research indicated that 50.4% of women had a positive attitude toward using contraceptive methods during two years postpartum and 79.2% were using some contraceptive method. Husband education (p=0.036), having sexual activity (p=0.001), the time that has been elapsed from the last delivery (p=0.001), number of pregnancies (p=0.013), tendency to have more children (p=0.037), attitude toward contraceptive use (p=0.001), the type of breast feeding (exclusive or partial) (p=0.001), and quality of menstural cycles (p=0.001) were in relation to use of contraceptive methods during two years postpartum.

Conclusion: According to these findings, attitudes and believes, breast feeding status and quality of menstural cycles play an essential role in postpartum contraception. Therefore, key steps to better family planning services at this time include effective counseling and starting training programs.

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Pregnant women can be infected with TORCH (toxoplasmosis, other virus, rubella, cytomegalovirus and herpes) which have been linked to fetal or neonatal malformations. Toxoplasmosis is the most common of these infections. Toxoplasma is an intracellular parasite that is found in animals, including sheep and mice. It is transmitted in the feces of cats who have consumed infected mice and in meat from infected animals. The disease in humans may have no symptoms or may cause lymphadenopathy, fatigue, fever, sore throat, eye pain, and rash. It may be mistaken for influenza or mononucleosis. At least half of all pregnant women in the united states have antibodies to toxoplasma. The rate of infection in pregnancy is 1-5 in 1000 birth. When infection does occur, spontaneous abortion, chorioretinitis, anemia, liver damage, CNS abnormalities and prenatal death may result. Pregnant women should be treated for acute toxoplasmosis to prevent fetal malformations. Neonates must also be treated, even if asymptomatic. Midwives and nurses play an important role in home assessment and prenatal teaching to prevent this infection. This preventive advice has significantly reduced the incidence of toxoplasmosis in areas where it has used systematically.

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Introduction: There are different methods of teacher evaluation .The aim of this study was to investigate process of teacher evaluation in selected Iranian Medical of Sciences Universities.
Materials and Methods: In this descriptive-analytic study, we investigate the existing documents and performed serial semi-structured interviews with evaluation staff in the universities. The implementation of the whole process of staff evaluation at universities were also observed. The data were analyzed considering both qualitative and quantitative approaches. The descriptive analytic method as well as content analysis was applied for data analysis.
Results: Review of the teachers by students was the dominant method for teacher evaluation in the selected universities. This method have some important advantages and disadvantages which are discussed in this article according to the findings.
Conclusion: According to the results of this study, it is highly recommended to use a combination of different methods for evaluation of the university teachers as well as decision making purposes.

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Introduction: Obesity is a problem to individual’s health and determintion of its causative factors is essential for prevention of obesity and maintenance of health.
Materials and Methods: This research is a case-control analytic study (prospective) which has been conducted in kindergartens and pre-elementary schools affiliated to health organization in Qazvin city. After a preliminary study on twenty 5-6 year-old children, 35 obese (case) and 70 normal (control) children were chosen. The kindergartens and pre-elementary schools were selected based on random cluster case-picking method. The tools were a questionnaire, tape meter and spring scale. The obesity was defined as a weight/ height ratio more that two standard deviation above average for sex. The statistical tests were 2, t test and Mann-Whitney test.
Results: The findings showed that the individual characteristics of the child, except weight birth and playing hours, were congruous in case and control groups. Also there was no significant difference between milk-feeding patterns in case and control groups, 77.1% and 85.7% dominant feeding on mother's milk, 20% and 8.6% feeding on formula and 2.9% and 5.7% feeding jointly on mothers milk and formula, respectively. In case of length of each feeding pattern group, no meaningful difference in two groups was found. Therefore all the survey hypotheses were rejected.
Conclusion: According to the research findings, no meaningful relationship between feeding patterns in infancy and obesity in 5-6 year-old children was found and hence probably other factors are playing a role in predisposing to obesity. It is recommended that more extensive researches being carried out in this field.

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Introduction: Menopause, the permanent cessation of menstruation, is an important event in the long process of climactrium, signaling a change from the years of fertility to infertility. Postmenopausal women have many physical and mental problems.

Materials and Methods: The objective of this study was to determine the mental problems of menopausal women referred to the health care centers of Ilam University of Medical Sciences in 2003. The research tools in this analytical-descriptive study were a questionnaire, record sheet and standard tests composed of Beck and Cattle scales. The data were collected by interview. The samples consisted of 150 menopausal women who had been selected by random sampling method. The data analysis was done by SPSS software.

Results: The results showed that short-term memory disorder (39.3%), mild depression (32%) and mild anxiety (27.7%) were the most common mental problems. There was a significant relationship between depression and marital status (p=0.029) and having knowledge about menopause (p = 0.04). Anxiety had no relationship with any variables (p>0.05) but there was an association between depression and anxiety (p = 0.002).

Conclusion: The findings show that the menopausal women suffer from mental problems, which influence their quality of life and community health. Thus, planning educational and health care programs to help them overcome these obstacles is essential.

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Introduction: It is necessary to give the essential educations to the patients and their families during hospitalization and after discharge. We conducted this study with objective of determining educational needs of patients undergoing CABG and their families at discharge and one month later.   

Materials and Methods: This research is a survey study. 60 patients and 60 members of their family who were selected by simple randomization. Data were collected by questionnaire. The questionnaire was prepared in two parts questions about disease and demographic characteristics and specific educational needs about wound care, activity and rest, drugs, nutrition and other needs of patients and their family. The data were collected in two stages: at discharge and one month later and analyzed with SPSS software. Descriptive and inferential statistical methods (t test,  test and variance analysis) were used to analyze the data. Results: At discharge, most of the patients and their families had respectively moderate and high levels of educational needs. Both groups had moderate educational needs about rest and activity, drugs use (general educational needs), nutrition and other needs. Patients have low but their families have high educational needs about drugs use (special educational needs). At one month after discharge, most of the patients and their families had moderate educational needs in all of the mentioned categories. The t statistical test didn’t show significant correlation between educational needs at discharge and one month later in patients and families. The  test showed significant differences between educational needs of the patients and their families (p=0.036) at discharge but didn’t show such a difference one month after discharge (p= 0.558).

Results: showed a significant relationship between educational needs and level of education.

Conclusion: Since most educational needs of the patients and their families concern the uses of drugs and wound care, and also most patients were unable to count their pulse, we suggest nurses pay more attention to these problems and give the essential training to the patients and their families.

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Introduction: Nowadays continuing education is considered an essential part of nursing education. This study was planned to evaluate the effect of continuing education of neonatal intensive care nursing on knowledge and the practice of nurses who were working in the children’s hospitals.

Materials and Methods: A semi-experimental study was carried out including 42 nurses of the children’s hospitals affiliated to Tehran University of Medical Sciences during 18 months in 1999- 2000. The data were collected by a questionnaire and a checklist. The questionnaire included demographic information and 60 multichoices questions based on the knowledge of the neonatal intensive care nursing. The observation checklist contained 5 parts, how to establish: resuscitation operation, endotracheal suction, management of the patient under mechanical ventilation, nasogastric tube insertion and feeding by gavage. At the end of the training courses the questionnaire and the checklist were completed again individually. The result of the pre and post tests and checklist were compared in the areas of knowledge and practice. The data was analyzed by 2 and paired t Student test.

Results: Statistical analysis showed a meaningful difference in the knowledge and practice after the continuing nursing education (p<00001).               

Conclusion: This research revealed the positive effect of the continuing nursing education on the knowledge and the practice of the nurses who were working in the pediatric wards. It is important to consider the continuing nursing education program to promote the health care system.

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Introduction: A balanced and proper diet is an essential factor in maintaining individual’s health. The improvement of feeding in different age groups, especially children, is considered a significant step in primary health care.

Materials and Methods: This research is a descriptive and analytic study. A sample of 225 mothers whose babies were between 0-24 months and who were referred to selected centers were chosen, using random sampling. The tool was a questionnaire. To analyze the data, the descriptive statistical, frequency distribution charts, the mean and central tendency as well as inferential statistics (2 test and Pearson correlation) were applied.   

Results: The findings of the research showed that there is a meaningful relation between variables of age, occupation, the method of the last delivery, inclination of mother to the breast feeding, age of fetus at the time of birth, hospitalization of the neonate, the time of first breast feeding after the childbirth, the quality of baby’s nutrition while he is hospitalized, the quality of the baby’s first nutrition, the time of starting aid-feeding, using the aid-milk and using the pacifier by the baby with the duration of breast feeding. Such a relationship was also found between husband’s idea about the breast feeding, examination of the breast during the pregnancy, teaching the advantages of the breast feeding and its correct method during the pregnancy, the place of the last childbirth, teaching the importance and the correct method of breast feeding after the childbirth, an encouraging and supporting husband concerning breast feeding, presence of the mother and the baby in a same-room after the childbirth, manner of arranging the intervals and times of the breast feeding, breast feeding during the night, renewed pregnancy and the duration of breast feeding in each session with the duration of breast feeding.

Conclusion: According to the findings of the research, different factors affect duration of the breast feeding. Necessity of the midwife’s attempt to instruct mothers during pregnancy and after childbirth was affirmed. The necessity of instruction of the medical groups about breast feeding is also made clear more than before.

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Introduction: Immunization is the most effective means of improving health. In the absence of a proper and regular immunization program, people and especially children will be left at high risk of many infectious diseases. This study was designed to assess Expanded Program on Immunization (EPI) for mothers and children under 2 years old in Shahriar, South west of Tehran.

Materials and Methods: This research was a cross-sectional study. standard cluster sampling was applied to select 210 children in the age group 18-24 months old and 240 women with a child less than 1 year of age who were resident in Shahriar city. Standard formats were used for collection of the data. Descriptive and analytic tests (chi squares, Fisher exact-test, t test, ANOVA, bivariate and logistic regression module) were applied to analyze the data.

Results: The results showed that vaccination coverage in children was over 90 percent. 17.6 percent of the children were partially vaccinated and 41.4 percent were vaccinated completely but with more than one-month delay. The important character which was strongly associated with more than one month delay in immunization was center of childhood immunization. Although 83.8% of women with a child under 1 year age had received twice tetanus immunizations, only 13.3% of women had obtained the complete series of five immunization. The character which was associated significantly with dT immunization status was the length of time that mother had been living in Shahriar.

Conclusion: There are some barriers in vaccination delivery, including unefficient recall and follow up systems and scattered records of dT vaccination. These factors were statistically associated with immunization status and therefore some proper solutions against these barriers should be introduced. It is now time for a boost to be given to both quality and sustainability of appropriate immunization programs.

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Introduction: Massage of the limbs is a safe procedure that could have therapeutic effects and cause physical and psychological relaxation of patients in intensive care unit (ICU).

Materials and Methods: This survey is a quaziexperimental study that assessas immediate effects of foot massage on patient’s vital signs in a general ICU. After a pilot study, a sample size of 50 patients was chosen. A questionnaire about demographic data and a 3-table checklist for recording vital signs (heart rate, peripheral O2 saturation and mean arterial pressure) was used. The data gathered by interview and physiologic measurement. For every patient, vital signs were recorded every 1 minute interval for 5 minutes (after completing the demographic data). Then foot massage was applied for five minutes and during the massage patients’ vital signs recorded every minute. Immediately the patients’ vital sings were recorded every minute for five minutes. The mean of each parameter was calculated and compared the values at baseline, during massage, and after massage.

Results: The findings showed that there was a significant difference between mean heart rate, mean arterial pressure and mean spO2 before and during foot massage (p<0.0001). Difference between mean heart rate, mean spO2 and mean arterial pressure during and after foot massage was not significant but, deference of mean heart rate and mean arterial pressure before and after massage was significant (p< 0.0001). Difference of mean spO2 before and after massage was also significant (p<0.003).

Conclusion: According to the findings of this study, foot massage has a potential beneficial effect on patients vital signs and last at least for 5 minutes. This effect could be due to increasing relaxation which moderates the changes of vital signs, caused by stress.

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Introduction: Death of a patient is an unavoidable stage of nursing and in many cases nurse is the only person who takes care of the patient at the time of death. An experienced and committed nurse obliges her/himself to care for the patient before and after death in the best way possible.           

Materials and Methods: This research is a descriptive study that carried out in order to determine knowledge and attitude of the nurses about pre and post-death cares. The samples were 227 nurses of Imam Khomeini Complex Hospital. The number of subjects chosen from each hospital was proportional to the number of nurses of that hospital. The samples were selected randomly. Data were collected by a questionnaire, validity of which was confirmed by content validity and reliability of it was confirmed by test-retest method. Data were analyzed with descriptive statistics.

Results: Results showed that in majority of the nurses level of knowledge about pre-death cares was moderate and was poor about post-death cares. The majority of the nurses had a positive attitude about pre-death cares and a relatively positive attitude about post-death cares. There was not any sample with negative attitude about pre or post-death cares.

Conclusion: Regarding the undesirable level of knowledge and positive attitude of the nurses under study concerning pre and post-death cares and considering that the necessity for improving the knowledge is training and education, the results of this research can help authorities to provide training and educational programs for enhancing nurses’ knowledge regarding pre- and post-death cares.