Background: Infectious diseases are common problems in mass gatherings, especially when there is a lack of health system preparedness. Since Iran is one of the most important countries on the walking path of Arbaeen and has a vital role in providing health services to pilgrims, the experiences of health challenges by participants is of key importance. The aim of this study is to explore stakeholders’ experiences on the health system's preparedness and challenges, and to provide suggestions for preventing infectious diseases during the Arbaeen mass gathering. Methods: A qualitative research method was used with a conventional content analysis approach. The number of participants was 17, including 13 executive managers and 4 health policymakers who entered the study among participants. Semi-structured interviews were used to generate the data. Interviews were analyzed by means of content analysis after face-to-face interviews. Results: Data analysis resulted in the extraction of four main themes and 11 sub-themes. Health infrastructure defects in Iraq has three sub-themes (health abandonment in Iraq, the weaknesses in health culture and problems related to the health system); poor control of the causative factors of infectious diseases has three sub-themes (the underlying factors of the prevalence of contagious diseases, health system response to communicable diseases and ignoring the risks of the Arbaeen ceremony); the low perception of risk in pilgrims has three sub-themes (lack of awareness in pilgrims, fatalism in pilgrims and unhygienic belief in pilgrims); and the ineffectiveness of health education has two sub-themes (training shortage in the targeted group and educational content problems) that shows participant’s experiences of the health system's challenges for coping with infectious diseases during the Arbaeen ceremony. Conclusion: Pilgrim-based training, planning and controlling other challenges may change these threats to opportunities and improve the health of participants of the mass gathering of Arbaeen in the region.

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Objective: Providing effective and correct care to patients requires clinical competence. One of the important components in clinical competence is spiritual intelligence the purpose of the study was to consider the correlation between clinical competence and spiritual intelligence in students who are children of victims of war of Hamadan University of Medical Sciences in 2019. Method: The cross-sectional study was carried out on 145 Martyrs' and War Veterans' Students of medical, nursing, midwifery, and paramedical schools. Sampling was done through census of students of operating room, anesthesia, medicine, nursing, midwifery, laboratory science, and radiology. The data collection tools were Kazdin et al’s (1986) Spiritual Intelligence questionnaire and Liu et al’s (2009) Clinical Competency Assessment questionnaire. Data were analyzed by SPSS 23 software. Results: The results of data analysis showed a direct, positive, and significant linear relationship between spiritual intelligence and clinical competence of all students (P < 0.05). According to the students' self-report, the highest mean score of clinical competency of the students was related to medical students with a mean score of 37 and the lowest to the laboratory students with a mean score of 30 (P =0.012). In addition, the results showed that the highest mean score of spiritual intelligence belonged to nursing students with a score of 48 (good spiritual intelligence) and the lowest to radiology students with a score of 39 (moderate spiritual intelligence) (P =0.019). Conclusion: We found that there is a direct and positive correlation between spiritual intelligence and clinical competence, so it seems that promoting spiritual intelligence may be associated with an increase in clinical competence.

<b><i>Introduction:</i></b> Pruritus is one of the most common problems in a uremic syndrome that reduces the quality of life due to the constant unpleasant feeling. The purpose of this study was to investigate the effect of ostrich oil massage on the severity of pruritus and quality of life in hemodialysis patients. <b><i>Methods:</i></b> In this study, 68 hemodialysis patients with pruritus were selected based on the available sampling method. The intervention group used 1 mL ostrich oil on the pruritus area for 10 min each night for 1 month. The control group received a placebo massage. Pruritus severity questionnaire-based itch severity scale and quality of life questionnaire were completed, respectively, at the end of each week and at the end of the period. Statistical analysis was done using SPSS software version 23 and applying on independent <i>t</i> test, paired <i>t</i> test, and analysis of covariance. <b><i>Results:</i></b> During the first and second weeks after the treatment, there was no statistical difference between the mean scores of pruritus severity in both groups (<i>p</i> &#x3e; 0.05); however, in the third and fourth weeks after the treatment, the mean severity level of pruritus in the ostrich oil group was lower than in the placebo group, and these differences were statistically significant between the two groups (<i>p</i> &#x3c; 0.05). There was no significant difference in quality of life between two groups of ostrich and placebo. <b><i>Conclusion:</i></b> The use of ostrich oil was effective in reducing pruritus in hemodialysis patients. This method can be proposed as a complementary method for relieving pruritus in hemodialysis patients.