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This study aimed to explore the strengths and weaknesses of e-learning during the COVID-19 pandemic from the perspective of its primary stakeholders, namely professors and students, and to provide practical solutions. Design is a qualitative study. We enrolled 22 faculty members and 58 students purposively. Research data were collected through a data collection checklist and via email and continued until the data were saturated. The qualitative content analyses were the basis of analysis in this study. Strengths were presented in 6 themes and 26 subthemes, weaknesses in 5 themes and 23 subthemes, and solutions were presented in 5 themes and 20 subthemes. Save money, time and energy; use modern software and educational technologies; and the ability to individualize education were among the strengths of e-learning. The most important weaknesses related to e-learning include infrastructure difficulties, problems related to the ability of professors and students to use educational systems. The most beneficial solutions offered included improving and upgrading the e-learning infrastructure, empowering professors and students to use educational systems. We concluded that using online teaching has many strengths as well as some weaknesses. Identifying these strengths and weaknesses can help policymakers plan better.

Over the past 2 decades, cancer has been the leading cause of death worldwide. Accordingly, cancer patients are the largest group of patients admitted to a hospice, accounting for 40% of overall hospice admissions every year. Therefore, the purpose of this systematic review is to investigate the outcomes of caring for cancer patients at hospices.PubMed, Scopus, and Web of Science databases were searched for English language articles published during the period from January 2008 to January 2022. The keywords used to search in this systematic review were included hospice, cancer, and neoplasm (for PubMed search only), which were searched in the titles and abstracts of the articles.Out of 803 articles found in the initial search, 38 were selected based on inclusion criteria. The studies indicated that hospice care resulted in outcomes such as reduced referral and admission to the emergency department (only one study reporting opposite results), reduced length and number of hospital admissions, reduced use of chemotherapy and radiotherapy, increased pain reports, improved pain management, enhanced end-of-life quality, significantly reduced cost of treatment, reduced number of invasive interventions, death at home, increased survival and satisfaction of patients, and poor nutritional support.Given the numerous and significant benefits of care in a hospice for cancer patients, health managers are recommended to consider developing hospices and introducing patients to these centers. Besides, they need to compensate for some shortcomings by, for example, providing better nutritional support and developing a care plan based on the type of cancers that the patients are suffering in hospices so that more specialized services can be delivered.

Background: Looking after patients undergoing hemodialysis is very critical, because of the disease's complications. In the context of hemodialysis, the essential duty of nurses is reducing the inflammation resulting from the vascular access. Methods: This clinical trial was conducted during one month on 101 hemodialysis patients in Montaserie and Imam Reza hospitals, Mashhad, Iran. Sampling was accomplished using Non-probability Convenience method. Using random allocation, the patients were categorized into three groups including those who received a combination of alcohol and Betadine to disinfect the area (n = 37; henceforth, group (1), those who underwent a concurrent application of alcohol after Betadine (n = 33; henceforth, group (2), and the control group (n = 31)). In group 1, the vascular access site was disinfected with Betadine solution, and alcohol was mixed with a ratio of 2:1 before the dialysis initiated. In group 2, alcohol and Betadine were separately used for disinfection. In the control group, the routine method of disinfection was performed using Betadine, while antiseptic precautions were taken into account. During 12 sessions (4 weeks), the vascular access site of patients was evaluated,in terms of the inflammation criteria postulated by the Iranian Nurses Association. Data were analyzed using SPSS16 software (Sig P < 0.05) Results: Mean inflammation severity was lower in group 1 in comparison with group 2 (P = 0.039). No significant difference was observed between group 2 and the control group (P = 0.079). Conclusions: This combination can be used, if the study is going to be repeated in other hospitals, due to the fact that the combination of alcohol and Betadine is a simple, inexpensive, and most importantly is an effective way for reducing the inflammation of the vascular access site in hemodialysis patients.

Background: The diagnostic and therapeutic uses of lead aVR in coronary artery disease, especially LAD stenosis, are very important in evidence-based nursing. Objectives: The aim of this study was to evaluate the knowledge and performance of nurses in applying lead aVR. Methods: In this descriptive cross-sectional study, 88 nurses working in critical care units were enrolled. The data collection tool was a researcher-made questionnaire, which assessed the knowledge and performance of nurses. The data were analyzed in SPSS software (version 16) using t-test, Kruskal-Wallis test, Mann-Whitney test, and correlation coefficient test. Results: The mean score of nurses’ knowledge was 19.6 ± 5.1 (out of 60) and the majority (53.4%) had an undesirable knowledge level. The mean score of nurses’ performance was 17.3 ± 1.1 (out of 60) and the majority (67%) had an undesirable performance. Moreover, the performance score raised as work experience increased (P = 0.01; r = 0.6). Conclusions: Given the inappropriate knowledge and performance levels of nurses concerning lead aVR application, it is recommended to modify the educational content and implement new educational methods in order to increase the knowledge and performance of nurses in this regard.

Background: Using thinking-based scientific methods such as paper-based and electronic nursing processes in nursing education can lead to education of skilled and efficient experts that can affect students’ satisfaction in addition to their quality of care. The present study aimed to compare the effects of recording and implementing the nursing process based on two methods (paper-based and electronic) on the quality of patient care and nursing students’ satisfaction. Methods: This randomized-field trial was conducted in 2014 on 64 nursing students that were randomly assigned into two groups of paper-based and electronic nursing process. The intervention included a one-day training on the nursing process and then its implementation on patients using the two mentioned methods during two weeks of internship. Quality of care was measured through a researcher-designed care quality questionnaire before and after the intervention. Students’ satisfaction with the implementation of the nursing process was measured through a researcher-designed students’ satisfaction questionnaire after the intervention. Results: The mean (±standard deviation) score of students’ satisfaction in the paper-based nursing process and the electronic process was 37.3±4.7 and 68.9±14.2, respectively. There was a statistically significant difference between the two groups (P=0.015). After the intervention, the mean score of care quality in the electronic group was 46.9±5.6 and the mean score of the paper-based group was 39.9±9.2. This difference was also statistically significant (P

Summary Role modeling is a powerful form of learning and an integral part of medical education. Although role modeling has a longstanding history, it has not received enough attention in medical education. The aim of this study was to present a comprehensive review of the literature to describe dimensions of role modeling in medical education. Review of the literature was undertaken using the international databases with the following search terms or their combinations: “role modeling”, “observational learning” and “medical education” up to September 2014. Relevant articles were retrieved. A total of 39 articles were included in this review. The results showed that clinical excellence, humanistic personality and excellence in teaching composed three essential elements of role modeling. Basic outcomes of role modeling in medical education are humanism and professionalism. In conclusion, role modeling as an outstanding educational approach has been recommended for enhancing humanism and professionalism in medical education.

Relationship was introduced as an essential element of care since the beginning of theorizing in nursing. However therapeutic relationship has been conceptualized by different theorists, an integrated approach is not provided. This study aimed to perform a systematic review to explain the therapeutic relationship in the contemporary nursing practice. Electronic databases were searched from conception to October 2015 using keywords including therapeutic, relationship, communication, nurse, and patient. We used PRISMA guideline to report data. Original studies relevant to the therapeutic relationship were included. Exclusion criteria include abstracts that were irrelevant to the concept of study, grey literature and review and commentary articles. Disagreements between researchers were solved by consensus. Twenty studies were finally included into the review process. Data were organized into three categories including composition of therapeutic relationship, context of therapeutic relationship and confirmation of therapeutic relationship. The therapeutic relationship is composed of significant knowing and meaningful connecting with patients. Few studies confirmed applicability of therapeutic relationship in nursing practice. Therapeutic relationship ensures humanity to be preserved during nursing care and patients’ hospital stay; it faces with strong barriers such as nursing shortage. The nursing shortage seriously threatens the heart of nursing. Therapeutic relationship needs to be investigated further in order to be supported by evidence-based nursing in order to confirm the applicability of relationshipbased caring theories.

Objective This study was designed to determine the effect of clofibrate on neonatal uncomplicated jaundice treated with home phototherapy. Methods This clinical trial study was performed on 60 newborns with jaundice that received home phototherapy. Inclusion criteria were body weight between 2500 to 4000 gr, breastfed, total serum bilirubin (TSB) between 14 to 20 mg/dl, aged over 72 hours. The neonates were randomly divided into two groups. All received home phototherapy. Group I received a single dose of 50 mg/kg clofibrate and the other group served as control group. Total serum bilirubin level was measured every 24 hours. Findings Two groups were matched regarding weight, sex, age and first TSB. At 24 and 48 hours of treatment, the mean values of TSB in the clofibrate group were 13.72 (1.56), 9.5 (0.56) and in the control group 15.30 (1.44), 12.6 (1.44). The results show that TSB was significantly decreased after 24 and 48 hours in clofibrate group (P