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Background: Child abuse has different meanings in different societies however, there is no uniform definition for child abuse. The present study was conducted to survey the relationship between family, emotional, and social factors and child abuse in girl primary schools in Tehran.

 Materials and methods: It was a case-control study. Initial data were obtained using child abuse, family, emotional and social questionnaires. Totally, 1300 primary girl students were randomly selected through districts 2,3,4,7 and 16. Then, 60 students scored higher the cut point were selected as the abused children (the case group) and 60 matched students scored below the cut point were served as the control group.

Results: Totally, 78.3% of abused children's fathers and 83.3% of their mothers were alive. These figures were 91.7% and 95% for non-abused children, respectively. Of abused children, 30% were abused with their mothers however, 33.3% of non-abused children were abused with their classmates. Meanwhile, 75% of abused children experienced severe physical violence. There was a significant association between child abuse and the following factors: age, occupation, level of education, economic status, number of children, divorce, drug addiction, social isolation and lack of access to social support.

 Conclusion: Results have revealed that there was a significant association between child abuse and age, occupation, level of education, economic status, number of children, divorce, drug addiction, social isolation and lack of access to social support.

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Background: Neuroblastoma is the most common tumor in infancy and wilms’ tumor is the most common malignant tumor of kidney in childhood. Both the tumors are usually within the differential diagnosis of each other. This study compares the clinical manifestations, sex and age distribution of childhood wilms’ tumor and neuroblastoma at one of Tehran children hospitals.
Materials and Methods: The study is an analytic cross-sectional one performed randomly on 50 wilms’ tumor and 50 neuroblastoma patients at children medical center during years 1372 till 1382. Objective variables were obtained by reviewing patient’s medical records and by using a kind of check list. The data were analysed by SPSS software and using Chi-square test.
Results : In both groups, the most common age group for the patients’ initial presentation was 2-5 years old and the average age of presentation was 3.5 years old. Neuroblastoma was more common in boys but wilms’ tumor in girls. The first and the most common clinical manifestation was an abdominal mass. Hematuria and hypertension were more common in wilms tumor and fever, hepatomegaly and metastasis were so in neuroblastoma.
Conclusion: Wilms’ tumor and neuroblastoma must be considered in any child presenting with abdominal mass. The possibility of neuroblastoma is more likely in ill patients, with systemic signs and metastasis.

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Background: In order to achieve the objectives of MDGs especially reduction of child mortality, the effectiveness of services must be increased. The main objective of the present study is surveying the effectiveness of child health services in Iran Health System.
Materials and methods: This cross sectional study was performed based on existing data. We compared data of 1500 children with their sibling.
 Results: The weight and height of second children were increased as compared to first children. Performance of health care personnel was also improved in growth chart drawing, promoting breast feeding, and on time complementary feeding.
Conclusion: Health network performance showed promotion, however, monitoring and assessing guidelines must be changed.

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Background: Children's physical growth is of utmost importance and their height and weight measurements are the most valuable factors in order to study and evaluate the quantity and quality of their growth. In Iran, like many other countries, NCHS standard charts are used, however, due to ethnic and geographical variations local charts should be prepared in order to compare children’s status of health and growth. Materials and method: During the present cross sectional study, some primary schools were selected randomly and the height and weight of all 7-11 years old students (2224 students) were measured. Those with known disease affecting growth were excluded.
Results: Our results indicated that the mean of height and weight of 7 years old girls had been 120.04cm and 21.23kg, respectively, however, these figures increased to 140.49cm and 31.88kg by the age of 11 years. These figures were 119.32cm and 21.5kg and 139.36cm and 31.98kg for 7 and 11 years old boys, respectively.
 Conclusion:Results revealed that the mean height and weight of children in Shahrood is lower than the international standards. This suggests that nursing education should be improved to provide a higher level of health services. Also parents, teachers and school health care providers need some further training regarding children nourishment, health, vaccination and disorders and disease prevention, as these factors have critical roles in children's physical growth.

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Background: Hyper IgE syndrome is a rare primary immune deficiency disorder characterized by pulmonary and cutaneous infection, eczema, and elevated serum IgE levels. In this article, 4 patients with hyper IgE syndrome and recurrent pulmonary infection were reported.
Case Report: Four girls with history of recurrent pulmonary infections were worked up and hyper IgE syndrome was diagnosed for them. All patients had recurrent pulmonary infections including pneumonia, bronchiectasis, pulmonary abscess, hydropneumothorax. Serum IgE levels were greater than 2000 Iu/ml in all cases. Microbial cultures showed staphylococcus aureas and pseudomans aeroginosa in two cases. All patients respond well to the wide spectrum intravenous antibiotics. Extra-pulmonary manifestations including purulent lymphadenitis, and skin and brain abcesses were observed. Conclusion: Hyper IgE syndrome causes recurrent pulmonary and extra-pulmonary infections which response fairly well to wide spectrum antibiotic therapy.

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Background: MAZDAK project that is child friendly environment program with community-based approach in terms of all-round development of children in Iran is running as a pilot in the neighborhood of Eivanak in the West of Tehran. Materials and methods: This study was a community-based participatory research (CBPR) of the health system research (HSR). All of the households in Eivanak neighborhood area of Tehran were considered in the study. Results: MAZDAK was designed to monitor child development, care and safety by organizing local community and participating parents. For facilitating the parent’s participation, some group of local women were organized, named REZAKAR, to connect parents. Now, 300 people of local family are under the study and monitoring the child development (by ASQ) and home safety evaluation (by checklist) and related interventions has been implemented in partnership with parents and the volunteers. Conclusion: Important requirements, such as inter-sectoral collaboration and cooperation of parents, should be considered for the early childhood development projects to make the better process. Although it has a lot of efficacy, but it has several challenges at different stages of participation and community mobilization and sustainability of the local organizing face. Evidence from a variety of initiatives during the implementation of such projects is the collective wisdom to deal with this challenge is to be able to guide similar efforts. Keywords: Comprehensive childhood development (ECD), Community-based participatory research (CBPR), MAZDAK, Volunteers, Children, Health.

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Background: the most common painful and frequent invasive interventions in children’s hospital is venipuncture. The purpose of this study was to compare the two techniques of auditory distraction (Hear music) and mentally (bubble maker) in venipuncture induced pain in hospitalized children.
Materials and methods: This clinical trial was done on all ill children hospitalized in 5 sections of 12 wards in children’s subspecialty hospital in Qom. The subjects were selected through gradual random sampling method and were randomly placed in two experimental groups and a control group (32 in bubble maker, 32 in hear music and 32 in control group). A bubble maker toy and cheerful chidish music was used to create distraction. The Oucher pain tool was used to evaluate severity of pain. Data was analyzed by SPSS software ver.22.
Results: one –way ANOVA results showed a significant difference of pain intensity between the bobble maker group and the control group and also the music group with the control group (p˂0.001). The pain intensity in the bobble group was the least and in the control group was the highest and there was a significant difference between the two groups of music and bubble maker (p= 0.009).
Conclusion: the results of the children’s distraction in three groups of bubble, music and control showed that there is a significant decrease in mean score of pain intensity in bubble group. So, active distraction (bubble maker) may effectively reduce the pain intensity in 6-12 years old children.

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Background: Childhood obesity is associated with an increase in childhood morbidity, so that outpatient visits, hospitalization repetitions and the need for treatment in obese children are higher than non-obese children. The purpose of this study was to examine the relationship between parents' lifestyle and childhood obesity and its comparison in single and multi-child families.
Materials and methods: This study was a descriptive-correlation on 400 primary school students in Mashhad City in a multi-stage cluster sampling method based on the purpose. A questionnaire consisting of three sections of demographic, researcher-made LSQ lifestyle, and a Dianna bavmerind parenting method was used.
Results: There was a significant relationship between dimensions of lifestyle of families and obesity of children in some dimensions, so that significant negative correlation was found between physical health, sleep and rest, exercise and health, weight and nutrition control, disease prevention and environmental health, and BMI of children (p=0.001). In terms of psychological, mental, social health, drug avoidance, and prevention of events, no significant relationship was seen regarding the BMI of children. There was a significant difference between lifestyle dimensions in single child families and multiple children ones (p=0.001). There was no correlation between different styles of parenting and BMI in obese children (P>0.05).
Conclusion: Training parents about the causes of obesity in children and also monitoring children in their family, school, and environment can be effective in improving their lifestyle.

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Background: Children on dialysis need long-term care. The child's illness and the conditions associated with his/her treatment and care expose the mother to various psychological stresses. Resilience maintains good decision-making power and performance in stressful situations. The aim of this study was to investigate of resilience status among mothers of children on dialysis.
Materials and methods: This descriptive cross-sectional study was performed on all mothers of children undergoing dialysis in Children's Medical Center, Mofid Hospital, Ali Asghar Hospital and Bahrami Hospital. A total of 166 eligible mothers were selected by census and completed a two-part questionnaire including demographic information and Connor-Davidson Resilience Scale. Data analysis was performed using SPSS software version 22 at a significance level of 0.05.
Results: The mean of resilience was 3.35 out of 4 points and was at strong level. Also, the mean of dimensions of personal competence/strength, trust in personal instincts, tolerance of negative emotions, control and spirituality in individuals were 3.37, 3.17, 3.43, 3.45 and 3.33, respectively. The resilience of mothers of children undergoing hemodialysis was significantly higher than children under peritoneal dialysis (p=0.047). There was no significant association between maternal age, maternal education, maternal status of morbidity, child age, child gender, number of children in the family and duration of dialysis and mean maternal resilience.
Conclusion: The resilience situation was at a good level. Due to the importance of resilience, it is recommended to provide educational and empowerment interventions for parents of children with chronic diseases.
 

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Background: Childhood poisoning is a global problem and one of the causes of child mortality. Among the causes of poisoning in children and adults in Iran, opioids are one of the most important factors and among them, methadone is the most common. The aim of this study was to compare the education of prevention of children's poisoning with methadone using two methods of lectures and group discussion on the awareness of mothers treated with methadone who referred to addiction treatment centers in Birjand City in 2020.
Materials and methods: The present study was an interventional study with and before and after design performed on 90 mothers treated with methadone. Sampling was done by cluster random sampling in three groups of lecture, group discussion and control. Data were collected using demographic questionnaire and mothers' knowledge questionnaire and analyzed by SPSS software version 21.
Results: In the lecture group education, the mean knowledge of mothers before education was 5.97 and after education was 10.57. Also, the mean knowledge of mothers in group discussion before and after education was 6.30 and 13.47, respectively.
Conclusion: Group discussion training improved the awareness of methadone-treated mothers more than lecturing.
 

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Background: Fatigue and anxiety have a bad effect on the physical and mental health of mothers and challenge the quality of child care and living conditions. This study was conducted aimed to investigate the effect of laughter therapy on the fatigue and anxiety of mothers of children admitted to the psychiatric department of Tehran Hospitals.
Materials and methods: An experimental study with pre-test and post-test design was performed on 70 (Two groups of 35 participants) mothers of children admitted to Ali Asgar and Razi hospitals. The intervention group participated in 8 laughter therapy group sessions with an average duration of 60 minutes. Demographic information questionnaires, Fatigue Assessment Scale (FAS) and State-Trait Anxiety Inventory (STAI) were used to collect data. Data analysis were done using SPSS software version 16.
Results: In the pre-test stage, there was no significant difference in the mean of fatigue and anxiety between the two groups (p>0.05). The comparison of fatigue and anxiety of the intervention group showed that a significant differences were observed in the mean of this variables and its dimensions after the intervention (p<0.05), while there was no such significant changes in the control group regarding fatigue and anxiety and their dimensions (p<0.05). By 0.741 and 0.735 changes of fatigue and anxiety variance are explained by the independent variable, respectively.
Conclusion: Laughter therapy is an effective intervention to reduce fatigue and anxiety in mothers of children hospitalized in psychiatric wards. Due to the low cost, lack of complications and the possibility of implementation; it is recommended to implement this intervention in similar conditions and other vulnerable people.