COVID-19 is a serious threat to public health, worldwide. This new viral disease is the third coronavirus epidemic in the 21st century, following Severe Acute Respiratory Syndrome (SARS) and Middle-East Respiratory Syndrome (MERS). The major transmission method is through respiration; however, it is unclear why the virus is so easily transmitted among individuals. Symptoms of this virus include fever, coughs and respiratory distress. In this letter, we describe the actions taken by the nursing system of the hospitals in the cities in Iran in response to the COVID-19 epidemic. Human resources management, Personnel training and Facilities, and resources management was the main category implementation at the hospital-level for confronting COVID-19. In epidemics, health personnel, especially nurses, are at the forefront of the fight against the disease. Nurses should take care of people who are experiencing severe forms of the disease and should do so for long hours using protective equipment. Therefore, in addition to providing adequate protective equipment, they may need implementation of public health measures in a way to help reduce the number of new infected cases and reduce the burden placed on the health care team. Hence, public education and compliance with health guidelines by the people should be highlighted so that nurses can provide better care to those in need.

Traumatic brain injury, known as a silent epidemic, is considered as one of the leading causes of injury and disability and is a major health-related concern worldwide. Based on the level of consciousness, TBI is usually divided into three types of mild, moderate, and severe. Moderate to severe brain injury, as compared to mild brain injury, often results in long-term disorders that require more rehabilitation interventions. People with brain injury suddenly develop physical, cognitive, behavioral, and emotional disorders that can lead to severe disabilities, especially regarding their work, productivity, and social and family responsibilities. Therefore, it is essential to provide support for recovery and regaining independence through rehabilitation interventions. Early rehabilitation is one of the most important phases of rehabilitation which is crucial to maintain and improve brain function, improve quality of life, and prepare the patient to return to their daily activities of and community participation. According to studies and guidelines, early rehabilitation care can be categorized into three classes of early specialized thorough care, purposeful and patient-centered care, and teamwork care. Accurate recognition of the components of early rehabilitation and its implementation can lead to reduced hospital stay, reduced medical costs, improved neurological function, improved quality of life, and thus the patients’ successful return to work and community.

Background & Aim: Cardiopulmonary arrest as a life-threatening condition needs urgent interventions to protect individuals’ life and prevent irreversible damages to vital organs. This study aimed to investigate the effect of simulation-based education on the knowledge and performance of nursing students of adult basic life support cardiopulmonary resuscitation (BLS-CPR).
Methods & Materials: This study used a pretest-posttest study with a control group. It was conducted at Iran University of medical sciences, Tehran, Iran, in 2017. In this study, 49 nursing students at the sixth education semester were assigned using the simple random allocation into two groups of intervention (n=28) and control (n=21). Initially, the conventional BLS education was provided to the two groups of intervention and control using the conventional method. Next, the intervention group received simulation-based education. The knowledge and performance of the students before, immediately after, and three months after the intervention were assessed using a modified knowledge assessment questionnaire and a modified performance evaluation checklist about BLS in adults.
Results: The students’ knowledge in the intervention group immediately after (p<0.001) and three months after the intervention (p<0.05) were significantly higher than the control group. The mean scores of performance immediately after (p<0.001) and three months after the intervention (p<0.001) were significantly higher than the control group.
Conclusion: Simulation-based education increased the knowledge and performance of nursing students in the field of BLS-CPR. According to the results, integrating conventional training with simulation-based education can be effective in learning BLS among nursing students. 

Background & Aim: Non-invasive ventilation is a procedure that reduces respiratory stress and improves gas exchange, using a patient-ventilator interface; however, it presents consequences such as the development of facial pressure ulcers. We aim to identify the factors associated with facial pressure ulcers in Intermediate Care Facilities patients submitted to non-invasive ventilation.
Materials & Methods: A cross-sectional descriptive and analytic study was performed in an intermediate care facilities, of a Portuguese hospital, from August to October of 2018, the study population consisted of patients hospitalized in this unit, who underwent to non-invasive ventilation. Data were collected through an observational form developed to obtain the information of the entire period of hospitalization of the patient. The software used to analyze the data was IBM SPSS Statistics for Windows, Version 23.0. For the descriptive analysis, absolute and relative frequencies also means and standard deviations were computed. Also, to describe the association between the variables, The point biserial correlation coefficient (rpb) were calculated. For data analysis, a significance level of .05 (α) was used.
Results: 14.6% of the individuals developed PU, all in the nasal pyramid. NIV was used for 6.07±3.91 days, and PU developed between the 3^rd and the 20^th day. It was observed that the presence of PU had a significant positive correlation with the GCS score (rpb=0.390, p=0.012) and a significant negative correlation with the duration of NIV (rpb=-0.438, p=0.004). Dependency level, PU risk, and nutritional risk did not correlate with the development of PU.
Conclusion: The pressure ulcers associated with non-invasive ventilation appear to be more frequently developed on the nasal pyramid and between the 3^rd and the 20^th day. Moreover, the level of consciousness and the time of administration of non-invasive ventilation are associated with the development of pressure ulcers.

Background & Aim: The birth of an abnormal infant and his admission to the intensive care unit creates various mental health effects on their mothers and increases their anxiety. The goal of this study was to determine the effect of supportive programs on the anxiety of mothers of infants with gastrointestinal anomalies.
Methods & Materials: This randomized controlled clinical trial was conducted in the Neonatal Intensive Care Unit in Tabriz, Iran. In this study, 50 mothers who had infants with gastrointestinal anomalies were assigned randomly to control and intervention groups. The control group received routine care, and the intervention group received special supportive care: emotional, informational, self-esteem, and caring support during four sessions for a 45-minute duration. Maternal anxiety was measured using the State-Trait Anxiety Inventory. Data were analyzed by using SPSS/19 and paired-sample and independent t-test.
Results: The results showed that both groups of mothers had high-level anxiety in the pre-test. In the post-test, the mothers' anxiety level in the intervention group was significantly lower than the control group. ANCOVA test to compare the mean difference of state and trait anxiety in both groups showed that these changes were statistically significant (P<0.001).
Conclusion:  This study tried to introduce a protocol to protect mothers of gastrointestinal anomalies, which could be used in the Neonatal Intensive Care Unit. The findings of this study also highlighted the importance of supporting one of the fundamental principles of family-centered care. Based on the outcomes of this research, emotional, informational, self-esteem, and caring support could reduce the mother’s anxiety.

Background & Aim: In many countries, human milk banks (HMBs) are included in children's health policies and regulations and are supported as an extension of national breastfeeding policies. Currently, there are no active HMBs in Turkey. This study aimed to evaluate the attitude, knowledge, and views of mothers about breast milk donation and HMBs.
Methods & Materials: This descriptive study was conducted in a university hospital postnatal clinic in Eskişehir between January and April 2019. The study population comprised of 250 multipara mothers. Data were collected with the help of a questionnaire comprising three sections.
Results: Only 28.4% of mothers knew about HMBs. A total of 40.8% of mothers indicated that they were against the establishment of HMBs in Turkey. However, only 61 mothers (24.4%) approved of obtaining milk from HMBs. Mothers who did not agree to the establishment of HMBs (77.5%) stated that babies who are fed with breast milk from the same mother would be milk siblings, and it would be an ethical problem if they got married to each other.
Conclusion: Most mothers are hesitant to donate their milk to HMBs, mostly due to religious concerns. Even in a group of Turkish Muslim populations whose sociocultural level can be considered high, resistance against HMBs is thoughtful. It is essential to organize public campaigns, especially through social media, to raise awareness of HMBs. When the results of the study were taken into account, it is believed that an HMB model where the donors and recipients meet each other is necessary.

Background & Aim: Academic incivility has a common problem in academic settings including nursing schools. The aim of the present study was to explore nursing students’ experiences of faculty incivility.
Methods & Materials: This was a conventional qualitative content analysis approach. Fourteen bachelor’s nursing students were purposefully recruited from two faculty of nursing in, Karaj, Iran. Data were gathered through semi-structured interviews and analyzed via the conventional content analysis. .
Results: We derived two main categories from students’ experiences; “hidden faculty incivility” and “obvious faculty incivility”. Hidden incivility contained four subcategories, includes lack of mastery over the subject matter, inattentiveness to the learning climate of the class, inability to manage the class, and unfair evaluation. Obvious incivility also included the three subcategories of speech-behavior contradiction, authoritative behavior, and unconventional behavior.
Conclusion: This study suggests that faculty incivility can have various aspects and beyond obvious offensive behaviors which mainly pertains to faculty interaction and teaching skills. Nursing faculties and nursing education authorities need to acquire adequate knowledge about the different aspects of faculty incivility and employ strategies for its prevention and alleviation.

Background & Aim: This trial aimed to compare the pain relief and side effects of Oral Acetaminophen (OA) and Intravenous Acetaminophen (IVA) after CABG surgery.
Methods & Materials: This parallel-group, triple-blinded, randomized trial was conducted on 113 CABG patients from September 2017 through February 2018.  The samples were selected through blocked randomization and allocated into two groups using computer-generated. The participants administered 1gr oral (OA group, n=57) or intravenous Acetaminophen (IVA group, n=56) every 6h for the first 24h following surgery; also, pain controlled in both group with Morphine multimodal analgesia strategy. Pain intensity measurement by VAS was followed after extubating the endotracheal tube at the 0, 1, 6, 12, 18 and 24 hours during the rest and deep breathing. The Morphine consumption and the incidence of nausea and vomiting in the first 24h were assessed. Data were analyzed using SPSS software and Chi-square, t-test, mixed ANOVA and ANCOVA test.
Results: The pain score in the IVA group was found to be statistically significantly lower than the OA group at rest (P<0.001) and during deep breathing (P<0.001) in the first 24h. There was no statistically significant difference between groups regarding the cumulative Morphine consumption (P=0.056). The use of IVA was associated with a reduction in frequencies of nausea and vomiting incidents (P=0.029).
Conclusion: Administration of IVA for the management of postoperative pain in CABG patients significantly reduced pain score and incidence of nausea and vomiting compared to OA. Any reduction in cumulative Morphine consumption did not accompany the lower pain.

Background & Aim: Mothers with children with cerebral palsy experience various problems during the care process, especially after surgery. Since these problems of parents directly affect the care provided to the child, it is essential to evaluate the problems that families experience in this process. This study aims to explore the experiences of mothers of children with cerebral palsy and to find out how these mothers care for their children that underwent single-event multilevel orthopedic surgery due to cerebral palsy.
Methods & Materials: A descriptive phenomenological study was used to explore the life experiences of 24 participants who had children with CP. This study was performed in the Department of Orthopedics at a Training and Research Hospital in Turkey, between March and July 2015. The study was completed with the participation of 24 mothers who had children with cerebral palsy. A qualitative, face-to-face and in-depth interview technique were used for data collection. Colaizzi’s method and Professional Software for Qualitative and Mixed Methods Research 11 software were used for analysis.
Results: The mean age was 37.29±6.86. Based on the mothers’ care experiences data, three main themes were identified, namely “Be concern about the process,” “Facing the Difficulties and Coping,” “Adaptations the changing family lifestyle.”
Conclusion: The findings demonstrated that CP affects intra-family relations and functions, and contributes to various physical and mental health problems, and financial statement. We believe that the findings may help healthcare professionals to provide and plan education in the field of healthcare services in a way that helps families cope with the process successfully.

Background & Aim: Anemia is one of the most common complications of chronic renal failure, which is associated with increased fatigue, dyspnea, depression, malaise, prolonged hospitalization and mortality. Some patients are resistant to erythropoietin therapy. Therefore, the purpose of this study was to determine the effect of thyme honey on anemia in hemodialysis patients.
Methods & Materials: The present clinical trial was conducted in 2018 at Kowsar Hospital of Semnan on hemodialysis patients randomly selected with convenience sampling method within two groups of case (n=28) and control (n=27). The case group received thyme honey (33 g) daily for one month. The control group did not consume thyme honey. Blood samples were taken from the patients before and after the intervention with 10-hour fasting and then blood parameters were assessed.
Results: The mean ±SD reduction rate in hemoglobin level was 0.46±0.96 in the case group and 0.23±3.15 g/dl in the control group, but no significant difference using independent t-test (P=0.758). The mean±SD reduction rate in hematocrit percentages was 1.20±2.78 in the case group and 0.11±8.53 in the control group, but there is no significant difference between the two groups using independent t-test (P=0.590).
Conclusion: Results showed that daily administration of 33 grams of thyme honey had no effect on anemia in hemodialysis patients. Further studies are recommended with modification of the methodology regarding the type, dose, duration and instructions of honey consumption for better results.