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  Background and Objective: Coma due to brain injury is an important complication resulting in unconsciousness and reducing the capacity of responding to the environment. This study aimed at examining the effect of organized voice auditory stimulation, which was performed by a nurse, on the length of coma in the patients suffering from head injury.

  Material and Methods: This clinical-trial study was applied on 40 patients in the critical care unit of Panje Azar Hospital. The patients were randomly recruited to one of the two groups (each group 20 patients). The intervention group was stimulated by the voice of a male nurse. Hearing stimulation was conducted in the morning and night shift about 15 minutes each time for 10 days. The patient consciousness was measured by GCS scale and analyzed by ANOVA and t-test (P<0.05), using SPSS Soft ware.

  Results: ­ The average age of intervention and control group was 28.20 ± 11.49 and 27.8 ± 13.22, respectively. Before stimulation in the first day, there is no significant difference between the GCS of intervention group (5.95 ±0.68) and that of control (5.95 ± 0.64). The results indicate that the intervention group has become consciousness from the 5th day (GCS of 8.25 ± 1.19) and control group (GCS of 7.80 ± 1.96) from the 10th day.

  Conclusion: The study show that the auditory stimulation in the intervention group compared to control group gives rise to the improvement of ­the level of consciousness in comatose patients .

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Background and objective: Coronary Bypass Graft Surgery (CBG) is one of the therapeutic approaches having the leading effects on the function of the patients. Because of paramount importance of self-efficacy and self-esteem, we aimed to evaluate the effectiveness of family-centered empowerment on the self- efficacy and self-esteem of the patients undergoing coronary bypass surgery.
 Material and Methods: This case control clinical trial was conducted on 102 patients with elective heart surgery and 102 of their active family members in 2011.‌ The patients were selected via convenience sampling and randomly assign ed to experimental and control group. After measuring the self-efficacy and self-esteem, family-centered empowerment care, including individual training, group discussion, film and active participation,‌ was performed in experimental and just routine care in control group. Using PASW statistics-18, we analyzed the data.
Results: The results showed that the two groups were the same considering population variables and the mean scores of self-efficacy and self-esteem. The level of self-efficacy and self-esteem in case group were significantly higher than those of controls (P<0.000). After intervention, the mean score of self-efficacy and self-esteem were increased (P<0.0000).
Conclusion:‌In regard with the results,‌ family-centered ‌empowerment care ‌in patients undergoing CBG is practically feasible , and it can be helpful in improving self-efficacy and self- esteem.

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Background and Objective: Learning and academic achievement are the most important subjects in educational psychology influenced by some individual and situational factors. Because of lack of studied research, there is not accurate statistic about nursing students’ motivation and its relation with academic achievement. Thus, we aimed to determine the relationship between nursing students’ motivation and academic achievement in Guilan University of medical sciences. 

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Background: Since health-promoting lifestyle is an important determinant of health status, this study aimed to compare the health-promoting lifestyle in medical and non-medical students of Guilan, Iran.
Methods: This is a cross-sectional study with a descriptive-analytical approach that was performed on 1319 students of medical sciences and non-medical sciences in Guilan, 2014. The data collection tool was 52-item HPLP Π in six dimensions (health responsibility, physical activity, nutritional habits, stress management, spiritual growth, and interpersonal relationships). Data was analyzed using one-way ANOVA, T-test, and Kruskal–Wallis test.
Results: The mean health-promoting lifestyle among students of Guilan University and Guilan University of Medical Sciences was (129.5± 7.17) and (128.1± 19), respectively. There was a significant difference between the two studied population in terms of health responsibility (p= 0.0001). Students of medical sciences had 3.2 times more favorable health promoting lifestyle (OR = 3.123, 95% CI = 1.57-6.3), married students 6.1 times (OR= 1.55, 95% CI = 1.05-2.32), students with mothers with under diploma degree 2.6 times (OR= 2.6 95% CI = 1.49-4.62), students with fathers with diploma 1.7 times (OR = 1.7, 95% CI = 1.2-2.56), and physical education and sports science students 5.8 times (OR = 8.5, 95% CI = 3.42- 20.95) had a more optimal health promoting lifestyle.
Conclusion: In the present study, students' health-promoting lifestyles are in an unfavorable condition. Since the students in the future will be responsible for managing different sectors of the country and will play a role in changing the other health-promoting behavior of other strata of the society, it is important to consider their health-promoting lifestyles by providing facilities and eliminating the shortcomings.
Keywords: lifestyle, health-promoting, students

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Background and objectives: Lower levels of health literacy have been associated with adverse health outcomes, especially for elderly.
Methods: This cross-sectional study was conducted on 290 retired elder from the Retirement Centers in Rasht city by Convenient sampling during the year 2017. Data collection tools included, Test of Functional Health Literacy in Adults(TOFHLA) and general health standard questionnaire (GHQ-28). The data were analyzed using descriptive and inferential statistics in SPSS.
Results: More than half of the participants (54.8%) had adequate health literacy. The highest mean of the health literacy was in the domain of reading comprehension (36.30±7.90) and then in the domain of numeracy (36.11±11.60). There was a significant relationship between the level of health literacy and the level of education, the level of education of the spouse and the history of cancer(P<0.05), the mean of the general health of the subjects was 20.67±8.27. by adjusting the effects of demographic variables, there was a significant relationship between the health literacy and the general health (P=0.04), such that by improving each level in the health literacy status, the chance of a favorable general health status, increases by 1.4 times (Odds Ratio=1.4).The findings, show a 0.95 confidence interval for variables related to general health.
Conclusion: This study approved that the level of education was the most important determinant of health literacy and general health, identifying elderly with poor health literacy and providing them with appropriate education can play a major role in promoting community health.

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Background: Infants are regarded as the most vulnerable group with special needs in natural disasters. Since midwives are responsible for providing reproductive health services for infants in natural disasters, this study was performed to assess their professional competencies. Methods: This cross-sectional study was conducted in Tehran, Iran. A total of 361 midwives were selected by cluster sampling method. After giving them informed consents, they participated in the study and completed the researcher-made questionnaire on providing health services for infants in natural disasters. Their professional competence was investigated through self-assessment in terms of their perceived importance, knowledge, and skill. Midwives inclusion criteria were as follows: having a degree in midwifery, having at least 6 months of experience in one of the public hospitals in the city, and a desire to participate in the study. Those who did not complete about 15% of the questionnaire items were decided to be excluded from the study.The Questionnaire included 10 items about infant care designed based on literature review of the resources and associated with the goals of MISP (Minimum package of the reproductive health services in natural disasters). To evaluate the instruments` validity, the questionnaire was given to 15 faculty members of the Nursing and Midwifery School of Tehran University of Medical Sciences. Five midwives were members of Tehran Red Crescent. After receiving comments from midwives and faculty members, the questionnaire items were reviewed. For analyzing the questionnaire reliability, the Cronbach coefficient α was calculated with 0.8. The data were analyzed by using SPSS, version 17. The analyses included descriptive and analytical statistics such as ANOVA, t-test at a significance level P<0.05. Results: Mean (SD) total score of professional competency of midwives in providing services for infants in natural disasters was 91.95(20.2) obtained from 3 subcategories: perceived importance, 39.83(9.55); knowledge, 22.5(5.06); and skill 30.16(6.86). There were significant relationships between the scores of professional competency of midwives with age (P=0.053), degree of education (P=0.028), workplace (P=0.053), and experience in natural disaster (P=0.047). About 49.86% of midwives demonstrated middle level of professional competency. The lowest knowledge and skill score were reported in managing common neonatal problems e.g. asphyxia, sepsis, physical trauma, which require referral and stability. Conclusions: The average scores of professional competencies of midwives to deliver Reproductive health service to infants in natural disasters show the necessity of related and integrated education. It is recommended that by holding emergency maneuvers and natural disaster simulations, midwives be educated with regard to natural disasters in order to know how to respond in these challenging situations.