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Objectives Herbal medicines, as a treatment method, have received a great deal of attention. The effects of two herbal medicines namely Zingiber officinale and Echinacea on alleviation of clinical symptoms and hospitalization rate of suspected COVID-19 outpatients were examined. Methods A clinical trial with 100 suspected COVID-19 outpatients as participants was conducted. The participants were allocated randomly to two groups of 50 members. The intervention group received concurrent Zingiber officinale (Tablet Vomigone 500 mg II tds) and Echinacea (Tablet Rucoldup I tds) for seven days in addition to the standard treatment. The control group only received the standard treatment (Hydroxychloroquine). After seven days, alleviation of clinical symptoms and hospitalization rate were examined. In addition, 14 days after treatment, the hospitalization was assessed again by telephone follow up. Results The two groups were identical in terms of basic characteristics. Improvement level as to coughing, dyspnea, and muscle pain was higher in the intervention group (p value <0.05). There was no significant difference between the two groups in terms of the other symptoms. In addition, the hospitalization rate in the intervention and control groups were 2 and 6% respectively, which are not significantly different (p value >0.05). Conclusions Taking into account the efficiency and trivial side-effects of Zingiber officinale and Echinacea, using them for alleviation and control of the clinical symptoms in COVID-19 outpatients is recommended.

The present study was carried out to explore Iranian nurses' use of placebos in clinical practice and their knowledge and attitude towards its use. A cross-sectional, descriptive study was conducted using self-report questionnaires. All nurses working in a university hospital in Arak (n=342) were invited to participate in the study. Among 295 respondents, 221 (75%) reported that they had used at least one placebo within the past year and 179 (81%) told patients they were receiving actual medication. The most common reason and symptom for placebo use were after unjustified demand for medication and pain, respectively. Only 60 (20.33%) of the nurses believed that placebos should never be used. Results showed that most nurses in our study had used placebos and probably will continue to use them. Placebo use is viewed as ethically permissible among nurses. Some patients benefit from the placebos, but their use raises ethical questions. The role of placebo treatment, its mechanisms, and its ethics issues should be taught to nurses.

Background: The Brief COPE is widely validated and popularly used in assessing coping strategies in major life stressors on various populations. This study carried out to determine the validity and reliability of the Persian version of the Brief COPE among wives of patients under hemodialysis. Methods: The Brief COPE was translated into Persian language according to the standard method and the psychometric properties of the instrument were assessed among 212 wives of patients under hemodialysis in Tehran, Iran, in 2016. Content validity was established, by 15 expert opinions. Face validity was determined by respondents and expert opinion. Construct validity was analyzed through confirmatory factor analysis. The Cronbach's alpha coefficient and intraclass correlation coefficient were used to determine the internal consistency and test-retest reliability, respectively. Results: All 28 Items of Brief COPE scale had content validity index greater than 0.7, suggesting a good validity value of the items in terms of relevancy (range 0.8 - 0.94). The wording of some items was modified to make them more readily understood by the participants, although the core meaning of each item was kept intact and to observe Iranian cultural adaptation; two items were adjusted. Result of confirmatory factor support 14 factor structure of the scale has good fit. Cronbach's alpha coefficient was acceptable for the total scale (α= 0.77) and for subscales (range 0.7 - 0.91). The intraclass correlation coefficient was acceptable for scale (r=0.76, P value= 0.001). Conclusion: The Persian translation of the Brief COPE is a valid and reliable instrument to determine coping strategies in women living with the husband on hemodialysis.

BACKGROUND AND AIM: There is a growing interest in learning styles of undergraduate health-care professional students; however, the evidences about learning styles over time during undergraduate programs are rare. In this study, the learning styles of undergraduate health-care professional students from the beginning to the completion of the program were examined to determine changes in learning style over time. METHODOLOGY: This is a longitudinal descriptive study from 2015 to 2018. A total of 101 health-care professional students were selected by census method. Learning styles were evaluated using the Perceptual Learning-Style Preference Questionnaire three times in the study at the beginning (T1), the middle (T2), and the end of the educational course (T3). The data were analyzed using repeated measures ANOVA. RESULTS: In T1, auditory (mean = 13.99) and visual (mean = 13.54) styles were preferred as major learning styles, whereas at T2, visual style (mean = 13.6) was the only preferred major learning style. At T3, the major learning styles were kinesthetic (mean = 14.32), tactile (mean = 13.98), and visual (mean = 13.58). There were statistically significant differences in auditory, kinesthetic, tactile and group scale scores between the three time points ( P < 0.05). Group learning style was in the negative type at all three time points. CONCLUSIONS: Learning styles can change depending on the context, environment, teaching method, and the subject of learning material and are probably a flexible changing feature rather than a fixed inherent feature a student possesses.

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Background & Aim: The caregivers of hemodialysis patients experience a heavy caregiving burden. More caregiving pressure and burden have been reported of the women than men insofar as they are encountered with more physical and psychological problems. This paper explores the challenges faced by women living with husband on hemodialysis. Methods & Materials: The study followed a conventional content analysis method. The participants were selected through a purposive sampling method in hospitals of Shahid Beheshti University of Medical Sciences, Tehran, Iran, in 2017-2018. The first author performed semi-structured, individualized interviews with 14 participants. Results: By analyzing the data, the main category "Immersing in problems" was extracted with two following categories: 1- Inadequate support network (subcategories: inadequate informational support, inadequate instrumental support, inadequate emotional support) and 2- Difficult coexistence with problems (subcategories: role overload, worry and anxiety, fear and hope for the future, suffering of frequent dialyses). Conclusion: The findings of the study showed that women living with the husband on hemodialysis have been encountered with challenges and numerous stressing factors in the course of caregiving. Given the challenges experienced by participants, telenursing, and community health nurses can play an essential role in eliminating the many problems of hemodialysis patients and their caregivers.

The role of mobile devices in learning processes is growing rapidly and it is imperative to assess the effect of this technology. This paper explores the experience of healthcare professional students with regard to the educational impacts of mobile learning. We conducted a qualitative study using a conventional qualitative content analysis based on Graneheim and Lundman (2004) method to collect and analyze the experiences of 23 healthcare professional students. Two themes, each with subthemes, emerged from the findings: (1) perceived benefit in learning process, and (2) reflective self-assessment. The results revealed that mobile learning has a positive impact on both the process and the outcome of learning in healthcare professional students. Therefore, creating a supportive condition to promote mobile learning is recommended.