Intensive care units (ICU) still face a high risk of primary and nosocomial infection. Pathogens in ICU are generally becoming more resistant to antimicrobial drugs, but there are differences between countries, possibly moving to different antibiotic usage patterns. It seems necessary to have adequate knowledge about local microbes and their sensitivity patterns in order to prepare an effective experimental treatment protocol in the ICU. In this study, the bacteriological profile and antibiogram of cultures performed in the ICU are investigated.

The cross-sectional study examined all culture samples obtained from patients in four intensive care units at Imam Reza Hospital, Mashhad, Iran, during 2016 to 2019. Culture and antibiogram information was extracted from the HIS system and compared with patient files whenever necessary. In order to analyze the data, SPSS software was used along with the Chi Square test.

In total, 1569 samples were examined, and 674 (42.95%) were positive for microbial culture. As the most commonly isolated bacteria, Acinetobacter accounted for 32.9% of the cases in 222 cases. Candida accounted for 85 cases (12.6%), Staphylococcus aureus 81 cases (12%), and Klebsiella 59 cases (7.8%). Colistin, the most effective antibiotic against Acinetobacter, showed a resistance rate of 0.9%, whereas carbapenems were not effective against over 95% of these bacteria.

Acinetobacter was the most common Gram-negative bacillus in intensive care units, accounting for more than half of infections. In addition, most of the tested antibiotics, except colistin, were resistant to these strains. Since these microorganisms are multidrug resistant, it is crucial that infection control processes in intensive care units are reviewed and standard antibiotics are prescribed.

The aim of the present study was to investigated the comparison effects of eight weeks of continuous and high intensity interval swimming on irisin tissue levels and insulin sensitivity in male rats with metabolic syndrome.

48 male Wistar rats with six weeks of age and a weight range of 150-180 gr were randomly divided into four groups of eight including: standard control, metabolic syndrome control, moderate continuous swimming+metabolic syndrome (CT+MetS) and high-intensity interval swimming+metabolic syndrome (HIIT+MetS). The training was carriedout for eight weeks and five days a week, equivalent to 65 and almost 100 percent of the maximum oxygen consumption, respectively, for the program of CT and HIIT swimming. Measurement of blood and tissue variables (visceral fat and liver) was done by ELISA method and statistical analysis was done using one-way analysis of variance and at a significance level of p<0.05.

The results showed that CT and HIIT swimming after induction of metabolic syndrome increased level of irisin in the liver tissue and visceral fat of rats (p=0.002 and p=0.0001, respectively); so the changes were higher after HIIT. The glucose levels in the CT and HIIT swimming group were significantly lower than the standard and the metabolic syndrome control (p=0.0001) groups. No significant difference was observed in the insulin sensitivity (p=0.67) between the training groups and the metabolic syndrome control group.

It is possible that moderate and high intensity intermittent swimming induce protective effects on metabolic syndrome by increasing irisin and reducing blood glucose.

Amygdalin is a cyanogenic compound naturally present in apricot, peach, bitter almond, plum and apple seeds. The aim of this study was to evaluate the effect of amygdalin on cell survival and Malondialdehyde (MDA) level in the SK-BR-3 breast cancer cell line and to compare these effects on the healthy MRC-5 cell line.

Breast cancer cell line SK-BR-3 and healthy cell line MRC-5 were used in this study. To study the effect of amygdalin on the survival of these two cell lines and on the surface of MDA, concentrations of 2.5, 5, 10, 20, 40 and 80 mg/ml of amygdalin were used. Cell survival was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and MDA level was assessed by thiobarbituric acid and spectrophotometric method. Statistical comparison of the mean between the groups was performed using a one-way analysis of variance (ANOVA) followed by a post hoc Tukey's test.

Based on the results of the present study, amygdalin in a dose-dependent manner significantly reduced SK-BR-3 tumor cell survival and also significantly increased MDA levels in this cell line (P <0.05), but it there were no statistically significant effect on the normal survival of MRC-5 cells and MDA levels (P >0.05).

Amygdalin kills SK-BR-3 breast cancer cells by increasing the level of MDA in these cells.

The aim of this study was to determine the effectiveness of cognitive behavioral  therapy on emotional processes in students with social anxiety disorder.

The present study was a quasi-experimental study with a pretest-posttest design and follow-up with a control group. The statistical population of the present study included all 26 to 18 year old female undergraduate students of Guilan University (11271 people) in the academic year 1397-98. At this stage, the Social Panic Questionnaire (SPIN) of Connor et al. (2000) was administered to all undergraduate female students of Guilan University who were selected using random sampling method. Cognitive behavioral  therapy sessions for social anxiety disorder (Hayes, 2004) were conducted in 10 2-hour group sessions, but the control group remained on the waiting list. Analysis of variance with repeated measures and SPSS software were used to analyze the data.

The results showed that cognitive behavioral  therapy on the improvement of repression (F=10.80, P=0.003), unpleasant emotional experience (F=12.86, P<0.001), emotional symptoms Processing (F=16.95, P<0.001), avoidance (F=19.65, P<0.001) and emotional control (F= 21.23, P<0.001) of the experimental group subjects It was effective.

It can be concluded that cognitive behavioral  therapy was effective on emotional processes in girls with social anxiety disorder.

Purpose of this study was to investigate of prevalence, phylogenetic groups and antibiotic resistance pattern EAEC isolated from diarrheic children in Mashhad city.

This cross-sectional study conducted for one year. In total, 450 diarrhea samples of children under 10 years of age were collected from children's specialized hospital in Mashhad. After isolation of Escherichia coli, EAEC isolates were identified by PCR molcular method. Phylogenetic groups of EAEC isolates were determined using the original and updated 2019 method. Antimicrobial susceptibility test was performed using disc diffusion methods(Kirby-Bauer method) against 12 antibiotics.

44(9.8%) EAEC isolates were identified from 422(93.8%) Escherichia coli isolates by PCR. Seven phylogroups including D(40.9%), unknown(27.3%), G(11.4%), B1(9.1%), F(4.5%), B2(4.5%) and A(2.3%) were detected among EAEC isolates.The highest diversity of antibiotic resistance patterns was related to Phylogroup D. EAEC isolates showed the highest resistance to amoxicillin and erythromycin 100%. Overall, 97.7% of EAEC isolates were with multiple drug resistance(MDR).

The present study showed a significant presence of EAEC strains. Considering the role of EAEC in chronic diarrhea and growth retardation syndrome in children, it is suggested that the identification of EAEC strains to be considered in diagnostic laboratories in cases of children’s diarrhea. on the other hand, due to the high prevalence of multiple resistances, antibiogram test is required to treat diarrhea in children.

Sexual addiction is a psychiatric disorder with unpleasant personal, interpersonal, legal, social, and physical outcomes. Sexual addiction is mainly rooted in unpleasant experiences within family and during childhood. The purpose of this study was to investigate comparison of self-concept and childhood traumas of people with sexual addiction disorder with healthy people.

This study was a causal-comparative investigation and using purposive sampling method, was carried out on 50 people with sexual addiction disorder and 50 healthy people in the control group matching with age and academic. The study made use of the sexual addiction screening test-revised (SAST-R) of Carnes and et al, self-concept questionnaire (SCQ) of Rogers and short form of the childhood trauma questionnaire (CTQ-SF) of Bernstein and et al. In this study, Multivariate analysis of variance (MANOVA) was used for data analysis.

The results of multivariate analysis of variance showed that there is a difference between self-concept and childhood traumas of people with sexual addiction disorder with healthy people; in this way, the people with sexual addiction disorder have lower scores in negative self-concept and childhood traumas than the healthy people.

These results have important implications of the role of unpleasant experiences in the family on the sexual behaviors of people in the later years of life. So that those who have negative self-concept and more childhood trauma are more to sexual addiction disorder.

Various studies have demonstrated that different rest Intervals has a significant effect on hormonal, metabolic and cardiovascular responses. This factors can lead to different muscle damage responses.

20 untrained subjects (25.4 ± 0.068 years, height 1.74 ± 0.97 cm and weight 30.8 ± 8.48 kg) in three sessions of eccentric resistance exercise with 24 hours rest between each session Participated in this study. Subjects were divided into 2 groups of 10 subjects who performed 50 eccentric contractions with number of 5 sets, 10 repetitions, and the interset rest interval 1 and 3 minutes with 85% of one repetition maximum (1RM). Alpha necrosis tumor factor, were measured immediately before , immediately after each session and 24 hours after the last training session. Variance analysis with repeated measurment and Bonferroni post- hoc test were used to statistical analysis of data.

Alpha necrosis tumor factor in the immediately after each training session and 24 hours after the last training session in 2 groups significantly increased (P <0.05), but no significant difference in All dependent variable was found in 2 groups at different time points.

The repetition of eccentric exercise for three consecutive days causes muscle damage that can be a factor influencing the immune system and causing inflammatory responses in untrained individuals independent of manipulating the interset rest intervals.

A positive attitude towards drugs is an important factor in drug-seeking behavior, the occurrence of dependence and the continuation of drug abuse. The aim of this study was to determine the mediating role of ego capacity in the relationship between attachment styles and attitude towards addiction of clients who are quitting.

The method of this present study was descriptive-correlational. The statistical population of this research included all addicts who referred to addiction treatment centers in one district of Tehran for addiction treatment from July to October 2019. 214 samples were selected using random cluster sampling method. The data collection tools were Hazan and Shaver's Adult Attachment Questionnaire (1987), Markström et al.'s (1997) Psycho-Social Ego Strength Inventory, and Theoretical Addiction Attitude Questionnaire (1379).

Data analysis using structural equation modeling showed that secure attachment style had a negative effect on positive attitude towards addiction (β = -0.317; p < 0.01) and anxious insecure attachment style (p < 0.01) β; p<0.01) and insecure avoidant (β=0.375; p<0.01) have a positive effect on positive attitude towards addiction. Also, secure attachment style has a positive effect on negative attitude towards addiction (β=0.364; p<0.01) and anxious insecure attachment styles (β=0.315; p<0.01) and insecure avoidant (341) β = -0.01; p < 0.01) have a negative effect on the negative attitude towards addiction. Ego capacity has a positive effect on the negative attitude towards addiction (β=0.512; p<0.01) and has a negative effect on the positive attitude towards addiction (β=0.744; p<0.01). Secure attachment style has a positive effect on ego capacity (β=0.743; p<0.01) and anxious insecure attachment styles (β=0.732; p<0.01) and insecure avoidant attachment styles (β=0.01; p<0.01) β; p<0.01) have a negative effect on ego capacity.

According to the findings of this study, it seems that supportive treatments can be appropriate in managing and reducing the intensity of consumption and modifying the attitude towards addiction, and in general, treating addiction and preventing relapse, and it is one of the costs imposed on families, society and the system. Reduce healthcare.

Diabetes is one of the most common metabolic diseases that has macrovascular and microvascular complications including nephropathy, retinopathy and neuropathy. Electrolyte and vitamin D disorders have also been seen in diabetic patients. The aim of this study was to investigate the relationship between serum levels of vitamin D, sodium and potassium with nephropathy in patients with type 2 diabetes.

This case-control study was performed on 83 patients with type 2 diabetes referred to Shahrivar Hospital in Mashhad in 2019 who were divided into two groups with nephropathy and no nephropathy. Fat, creatinine, FBS, HbA1c, GFR profiles were evaluated along with other demographic information. Serum level of vitamin D was measured by ELISA method and serum level of sodium and potassium was measured by atomic absorption spectrophotometry in all patients. IBM-SPSS v.20 software was used to analyze the findings and the significance level of the tests was less than 0.05.

The mean age was 59.27±10.62 years which included 45 men and 38 women. Body mass index (P-value=0.009), Smoking (P-value=0.005), Duration of Diabetes, Systolic and Diastolic Blood Pressure, Potassium, FBS, HbA1c, Creatinine, GFR were significantly different between the two groups. (P-value=0.0001 for each). Also, there was a significant relationship between serum vitamin D level (P-value=0.004) with the incidence and serum potassium level with the severity of nephropathy (P-value=0.001).

Control of serum levels of vitamin D and potassium can affect the incidence and severity of diabetic nephropathy, so control of these variables is recommended in these patients.

Obsessive-compulsive disorder is one of the most frequent mental disorders. On the one hand, various theoretical models emphasize different structures; on the other hand, OCD psychotherapies result in inadequate therapeutic outputs. Therefore, it is essential to look into this subject. This study extracted OCD diagnostic components based on lived experiences.

This study is qualitative and phenomenological. The information was gathered through the use of semi-structured interviews and criterion-based sampling. Accordingly, six participants with OCD were interviewed. The themes were extracted through performing interviews and obtaining lived experiences.                                                     

In this research, four organizing themes were extracted. The organizing themes include Cognition (catastrophizing, should, excessive responsibility, and labeling), emotions (anger, fear, and sense of guilt), behavior (inspection, excessive washing, and avoidance), and lifestyle (interactions, excretion, work/education, and leisure activities). These organizing themes were the main components that can facilitate diagnosing and understanding OCD.  

OCD is related to two major cognitive perceptions: 1. Excessive damage (risk) phobia, 2. Taking on excessive responsibility for damages (risks).

Breast milk is the main food of infants, but shortening the duration of breastfeeding is a serious problem, especially in developing countries. Reducing the amount and duration of exclusive breastfeeding can lead to an increase of two to three Equal in the rate of malnutrition, infection and infant mortality.The aim of this study was to evaluate the effectiveness of educational interventions in increasing the continuity of exclusive breastfeeding.

Literature search was performed using four databases of Scientific Jihad Scientific Information Center (SID), Iran Scientific Information and Documentation Research Institute (Irandoc), Database of Iranian Publications (Magiran) and Google Scholar. The present study includes studies from 5/24/2010 to 7/12/2020.

A total of 11 studies, including data from 1275 participants, met the inclusion criteria. Eleven studies measured the amount of exclusive breastfeeding before and after the intervention, and 4 articles used the model and theories of health education for the intervention. The planned behavior pattern has been used in 3 studies and the health belief model once to improve breastfeeding.

Designing and implementing an educational intervention to continue breastfeeding significantly improves the awareness of the need for breastfeeding and leads to continued breastfeeding behavior in mothers. Education can be effective in improving performance, awareness and attitudes among parents about how to breastfeed the baby.

Dimensional stability of removable dentures in various disinfecting agents is considered an important and necessary property. The purpose of this study is to evaluate the dimensional stability of two types of heat-cured acrylic after immersion in distilled water, ozonated water and sodium hypochlorite solution.

In this in-vitro study, 60 disk-shaped samples were made, including 30 samples of Acropars heat cure acrylic resin and 30 samples of Pro Base heat cure acrylic resin. 30 samples of each acrylic were divided into three subgroups (n=10): 1) Immersion for 8 hours in distilled water (control group). 2) immersion for 8 hours in 1% sodium hypochlorite and 3) immersion for 8 hours in ozonized water. After every 8 hours, the solutions were changed and all samples were placed in disinfectant solutions for 16 weeks. Before and after immersion in each of the environments, the diameter of the samples was measured with an accurate micrometer with an accuracy of 1 micron. Finally, the obtained data were analyzed through appropriate statistical tests.

Results showed that the dimensional changes of Pro Base heat cure acrylic resin by immersion in any of the 1% sodium hypochlorite solutions, ozonated water and, distilled water are not significant, and the dimensional changes of Acropars (Iranian) acrylic resin are not also significant in each of these solutions. Therefore, both disinfectant solutions are suitable for disinfection of dentures.

After 16 weeks of immersion, the change in dimensions of heat cure acrylic resins in ozonated water is clinically acceptable, and according to the confirmation of the appropriate disinfection property of ozonated water in previous research and further studies, it can be suggested to the patients as a suitable disinfectant for disinfection of dentures.

the age when menarche start as a reproductive trait has undergone a significant decline over the twentieth century which is widely attributed to the environmental factors. The current study aims to investigate the environmental factors impacting on menarche in the girl’s school in Kermanshah, Iran.

in this case-control study, 400 participants of age 12 and over were recruited based on a cluster sampling strategy from three neighborhoods in Kermanshah, Iran. The questionnaires were measured based on demography, physical and socio-economical statues items. Logistic regression, Independent sample T test, Mann-Whitney and chi-square were used for statistical calculations.

It was observed that the girls with early menarche were significantly taller and heavier than non-menarcheal. The obese and overweight girls had respectively 3.36 and 2.55 higher chance to early age at menarche in comparison with normal BMI ones. The mean birth weight of early menarche girls was 0.18 kg lower than the healthy girls. However, there were no significant difference in the age of complementary feeding and the breast-feeding period among the two groups. The girls who had low physical activity(OR=0/56, 95% CI 0/32-0/98), medium , and high, had respectively 44%,48% and 59% lower risk of early menarche compared to inactive students. The statistical findings approved a correlation between the family income and premature menarche, whereas there was no correlation between parental education, occupational status and early menarche. Finally, girls whose mothers had also early menarche tended to have the same experience compared to control group.

Candida albicans is a yeast-like part of the normal flora of the mucosal surfaces of the oral cavity, digestive tract, and vagina. This study aimed to determine the prevalence of candidiasis and its relation with predisposing factors such as age, sex, smoking and disease type (gastrointestinal problems, diabetes, and Alzheimer's disease).

In this cross-sectional study, lesions of 183 patients suspected of candidiasis(vaginal discharge, anal swab and oral)were sampled in2018.Candida species were identified using morphological, biochemical tests and culture on the CHROMagar Candida medium and the PCR-RFLP method was used for definitive identification of the candida species. Sampling was done with the consent of the subjects and the required data were recorded in the relevant questionnaire. The necessary data were recorded in the relevant data sheets and analyzed by Fisher and Chi-square test(P.value=0.05).

Of the 183 samples studied, Candida albicans with 98 cases(53.55%)had the highest contribution. Results showed that 78.12% of people with gastrointestinal candidiasis aged 55 to 80 years were suffering from Alzheimer's disease(P.value<0.05). Also among the 56 diabetic patients, 36 (64.28%) had oral candidiasis, most of which were in the age group of 18-30 years(P.value<0.05). The distribution of vaginal candidiasis was significantly associated with gastrointestinal infections and age. There was no significant relationship between the distribution of candidiasis and smoking and sex(P.value>0.05).

This study showed that candidiasis is highly prevalent in people with predisposing conditions, especially diabetes, Alzheimer's and people with digestive problems. Candida albicans and Candida tropicalis are the major contributing factors.

Chronic kidney failure is one of the diseases that affect the quality of life of people today. Peritoneal dialysis is one of the treatments for chronic kidney failure. Education is an important part of the care program that helps the patient to play an important role in the treatment process. The aim of this study was to evaluate the needs of patients undergoing peritoneal dialysis, which is based on nursing diagnoses, nursing interventions and the results obtained during the nursing process. Then, according to the needs of patients, a self-care educational program was developed.

The present study is a descriptive study that was performed on 74 patients referred to peritoneal dialysis wards of 5 medical centers. Demographic-clinical information was collected through patients' medical records and educational needs through face-to-face and telephone interviews with patients undergoing peritoneal dialysis. The training needs were determined based on the nursing diagnoses of the International Association of North America, and finally the self-care program was developed through nursing interventions related to common diagnoses and their expected outcomes. Data were analyzed by SPSS software version 26.

Among the 20 nursing diagnoses presented in NANDA in patients undergoing peritoneal dialysis, 5 diagnoses including: water and electrolyte disorders, infection, constipation, sleep disorders, and skin integrity disorders are the most common. Self-care was developed to meet these needs.

milk, which has antibacterial, antiviral, antifungal and antiparasitic activity. Antimicrobial peptides have been receiving a lot of attention in recent decades due to having suitable properties such as fast killing, wide spectrum of activity and also their effectiveness in relation to drug resistance.

The purpose of this study is to investigate the antibacterial effect of silver lactoferrin nanocomplex on Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter baumannii and Streptococcus pyogenes.
For this purpose, silver nanoparticles were first loaded on lactoferrin. Then, to confirm the loading of silver nanoparticles on lactoferrin, the zeta potential was measured by the zeta potential determination device. Also, with the help of Raman spectroscopy, FTIR and scanning electron microscope, the properties of this nanocomplex were investigated. Then the effect of lactoferrin + silver nanocomplex on cells was investigated to determine the toxicity of this compound on cells. The antibacterial properties of lactoferrin + silver nanocomplex on Pseudomonas aeruginosa bacteria, Staphylococcus aureus bacteria, Streptococcus pyogenes bacteria and Acinetobacter baumannii bacteria were investigated by MTT test, MIC, MBC tests and diffusion in agar hole.

The results show that lactoferrin + silver nanocomplex had the most lethal effect on Streptococcus pyogenes bacteria and the least effect on Acintobacter baumannii bacteria

Synthesis of silver-lactoferrin nanoparticle complex can be used as an innovative, economic antimicrobial agent in the field of medicine and food industry.

Research has shown that positivist psychotherapy leads to marital adjustment in couples. On the other hand, acceptance and commitment therapy has been effective in reducing issues such as conflict and conflict, adaptation and commitment meaning a rich and meaningful life, but there is a research gap in comparing the two approaches. The purpose of this study is to compare the effectiveness of couples. Positive therapy and therapy was based on acceptance and commitment to increase marital adjustment in couples.

The method of the present study was quasi-experimental with a pretest-posttest design with a control group. The statistical population included all couples seeking divorce who had referred to family counseling centers in Iranshahr in 1399 for couple therapy. 45 couples were selected by convenience sampling method and then randomly divided into two groups of 30 experimental and one group of 30 controls. Participants responded to the Lock and Wallace Marital Adjustment Questionnaire (1995). Couples therapy, positive therapy Seligman and Sequent Mihali (2000) and therapy based on acceptance and commitment Hayes, Strosahel and Wilson (2012) performed in 8 sessions of 90 minutes on the experimental groups and after the post-test sessions. Done. Finally, after the post-test, the results were analyzed by analysis of covariance.

The results showed that couples therapy, positive therapy and acceptance and commitment based therapy were effective in increasing marital adjustment in couples (P <0.01). Also, positive couple therapy training had a more significant effect than acceptance and commitment therapy (P <0.01).

Considering that both interventions had a strong effect on increasing marital adjustment, but positive couple therapy was more effective in increasing marital adjustment and negligence, so the combination of these two methods in couples therapy interventions will probably lead to more effective results.

Cancer chemotherapy is a big challenge due to the adverse effects of anticancer drugs. Therefore, the effort is to use natural products with therapeutic and safe potential to treat all kinds of diseases. This research aims to discover the anticancer potential of the prebiotic Bovicin HC5. The survival rate of Huh-7 human hepatocellular carcinoma cells after treatment with different concentrations of Bovicin HC5 was investigated by MTT assay. Assays of caspase 3, 8, and 9 activities in Huh-7 cancer cells treated with the Bovicin HC5 IC50 concentration were conducted to determine the degree of cell apoptosis. Boyden Chambers were used to assessing Huh-7 cancer cells' invasion ability after being treated with sublethal doses of Bovicin HC5. Using specific primers and the Real-Time PCR method, proapoptotic bax and antiapoptotic bcl-2 expression levels in Huh-7 cells treated with the Bovicin HC5 IC50 concentration were quantified. ANOVA statistical test was used to analyze the data (p<0.05). The results of the MTT test showed that the viability of Huh-7 cells treated with different concentrations of Bovicin HC5 decreased significantly depending on the concentration and treatment time (p<0.001). As a result, a 400 µM concentration and 72-hour duration resulted in the greatest effects. The IC50 concentration of Bovicin HC5 was determined to be 300 µM. The activity of caspases 3, 8, and 9 in treated Huh-7 cells increased significantly after 72 hours in a time-dependent manner and compared to the control by about 1.9 times (p<0.01), and 2.36 times (p<0.01) and 2.62 times (p<0.001).

 The birth of a child with a disability causes mothers to face various psychological, emotional and social injuries. according to this the present study was conducted to investigate the effectiveness of self-compassion training on hoping for constructive relationships of mothers with exceptional children.

 The present study was quasi-experimental with pretest, posttest, control group design. The statistical population of the research included mothers with exceptional children whose children were studying in one of the exceptional schools of Rafsanjan city in the academic year of 2019-2019, and their number was 320 in total. 37 mothers with exceptional children were selected through voluntary sampling method and were randomly accommodated into experimental and control groups. The experimental group received self-compassion training during twelve sessions. The applied questionnaires included Hope Questionnaire (Snyder et al, 1991). The data from the study were analyzed through Covariance using SPSS statistical software version 23.

 The results showed that self-compassion training has significant effect on the hoping for constructive relationships (F=47.57; Eta=0.58; P<0001) in mothers with exceptional children.

 According to the findings of the present study, self-compassion training can be used as an efficient method to improve hoping for constructive relationships of mothers with exceptional children through focusing on the method of Visualizing compassion for self and others, using creative helplessness, articulating worthwhile goals, fostering compassionate behaviors, and developing intelligent behaviors.