Background. Self-directed learning plays an important role in nursing education and is associated with academic achievement, communication self-efficacy, assertiveness, responsibility, and students’ clinical competencies. This study was conducted to analyze the existing research on the level of self-directed learning in nursing students. Methods. In this systematic review and meta-analysis, all studies that had examined the level of self-directed learning in nursing students until March 2, 2020, were searched in Science Direct, Ovid, Scopus, PubMed, ProQuest, Web of Science, and Google Scholar databases. In the meta-analysis section, I2 index and the random effects model were used. Comprehensive Meta-Analysis software (version 2) was used for data analysis. Results. The mean score of self-directed learning in 12 articles with 3830 samples was 156.73 ± 1.47 out of 200 (95% CI: 153.3–160.1). These scores were 153.50 ± 2.71 (95% CI: 148.18–158.82) and 154.67 ± 1.32 (95% CI: 157.50–159.32) in the male and female students, respectively. There was a significant relationship between self-directed learning and sample size, year of study, and semester ( p < 0.05 ). Conclusion. The mean self-directed learning in nursing students was at a moderate level, which does not seem to be sufficient. Given the positive role of self-directed learning in nursing education, it is essential that nursing professors teach self-directed learning skills to students via training courses.

Background Nursing education programs are designed to decrease the gap between theory and practice. It is believed that internship programs can decrease this gap. An internship program has newly been implemented in Kermanshah Nursing School. However, the efficiency of this program has not been assessed. Therefore, the aim of the present study was to explore the challenges related to the internship education of nursing students. Methods The study was conducted as qualitative research. The participants were eight nursing students who had at least one semester of experience in internship. They were selected through purposive sampling. Data gathering was done through semi-structured interviews, which were recorded and analyzed through a three-stage content analysis approach. For data management, MAXQDA-10 was used. Results Out of the eight participants, three were male, and all were in the final year of their education. In total, 423 primary codes emerged after analyses, which were placed in seven categories, including: education before internship, lack of support, planning difficulties, interaction with staff, invisible evaluation, welfare defects, and professional identity. Conclusion The study revealed the challenges of the internship program for nursing students in Iran. Some of the problems were related to educational background, others were associated with the shortcomings of the cultural aspects of the context. Therefore, it is recommended to optimize the clinical training of nursing students in the internship program by addressing these challenges.

Introduction Non - traumatic headaches are one of the most common causes of referral to hospital emergency. This study aimed to compare the efficacy of intranasal ketamine and intravenous ketorolac on acute non-traumatic headaches. Methods This randomized and double-blind clinical trial was conducted in 2019. One hundred and forty samples were randomly divided into intranasal ketamine (A) and intravenous ketorolac (B). Group (A) received ketamine intranasal (0.75 mg/kg, max 75 mg), and group B received intravenous ketorolac (30 mg). Headache severity was measured on arrival, 30, 60, and 120 min after intervention with Visual Analogue Scale (VAS). The side effects were recorded an hour after the intervention. Result The mean difference of pain intensity 30, 60, and 120 min after the intervention between the two groups was statistically significant (p < 0.001). In the first 30 min, significant changes were observed in the VAS levels of the two groups. These changes were significantly greater in the intranasal ketamine group (p < 0.001). Side effects such as fatigue, dizziness, general discomfort, nausea, increased heart rate, and hypertension were significantly higher in the ketamine group (p < 0.05). Conclusion Intranasal ketamine and intravenous ketorolac both effectively reduced headaches. However, more analgesic effects of intranasal ketamine in a short time can be considered as a selective approach to reducing headaches. Trial registration IRCT20180108038276N3, Registered 29 September 2019. Ethics committee reference number IR.KUMS.REC.1398.068.

Background. Since nurses are considered a role model in society, they should have sufficient knowledge, attitude, and practice in the field of oral hygiene. This study was aimed to assess the nurses’ knowledge, practice, and attitude towards toothbrush maintenance and use. Methods. In this cross-sectional study, 325 nurses working in hospitals affiliated to Kermanshah University of Medical Sciences were randomly recruited. Data collection tools included a demographic information form and a researcher-made questionnaire on knowledge, attitude, and practice regarding toothbrush maintenance and use. Data were analyzed by SPSS software using descriptive and inferential statistics (Mann–Whitney U and Kruskal–Wallis H). Results. The mean scores of nurses’ knowledge, attitude, and practice were 59.2 ± 16.4, 64.2 ± 20.6, and 51.4 ± 17.0 out of 100, respectively. There was no statistically significant relation between nurses’ knowledge, attitude, and practice and their gender, age, level of education, and work experience. Conclusions. Nurses had moderate knowledge, attitude, and practice regarding toothbrush maintenance and use, which is not very desirable given their role model. Therefore, training courses are recommended to be held to increase the nurses’ knowledge, attitude, and practice regarding toothbrush maintenance and use.

Objective: Cigarette smoking is an important and preventable risk factor, especially for adolescents and high school students. This issue has become one of the challenges for health system. Thus, the present study aimed to investigate the prevalence of smoking among Iranian high school students. Method: This systematic review and meta-analysis study was done by searching PubMed, Scopus, Web Science (WOS), Science Direct, SID, and Google Scholar using the following keywords: “student” and “smoking” from 2000 to March 2018. After initial and critical appraisal, data were entered into a checklist and analyzed by a comprehensive meta-analysis software. Results: The prevalence of smoking was 7.9% by combining the results of 49 articles. Males and females had 10.6% and 4.5% smoking prevalence, respectively. The overall prevalence of smoking was higher in northern areas in Iran (22.4%). Males in the northern (22.4%) and females in western regions (5.3%) were more smokers. There was a significant relationship between the prevalence of smoking with the year of publication, sample size, and age (P < 0.001). Conclusion: In this study, Students' tendency to smoke was different in various regions of Iran, and had a high rate (7.9%). This figure indicates the necessity for planning some coherent educational programs for the public.