A. Abyad, MD, MPH, MBA, AGSF, AFCHSE (Editor) A. Abyad, MD, MPH, MBA, AGSF, AFCHSE (Editor) Abyad Medical Center & Middle East Longevity Institute Azmi Street, Abdo Center, 2nd Floor PO BOX 618, Tripoli LEBANON Tel & Fax: 961 6 443684/5/6 Email: aabyad@cyberia.net.lb Web: www.amc-lb.com

This issue is rich with a number of research and review papers in addition to a review by the publisher on Zika Virus.

A paper from Saudi Arabia attempt to explore current birthing services in KSA from care consumers' perspectives by reporting women's birthing experiences and voices. The author stressed that reporting the voices of women giving birth in KSA in order to inform policy developments within the Saudi maternity healthcare system is important to understand what the women want from the service and how to improve it. Within the first 24 hours after giving birth in one of the three selected public hospitals, 169 women shared their birth experience through their responses to an open-ended question on a questionnaire or by contributing in one-to one conversation with the researcher. Thematically analysing 169 written responses and notes for conversation have produced two main categories which include themes and number of sub-themes. The first and major category is "The relationship between women and care providers during birth" which considered by most women the leading cause for better and satisfied birth experience if this relationship characterised by support, respect, trust, and empowerment. The second category is "Hospital rules and policies and childbirth experience" especially if these policies restrict women choices and brought into action without full explanation to women about why these policies are active. The author concluded that Maternity care policy makers in Saudi Arabia have to consider women voices in building and reviewing maternity policies and focus on empowering childbearing women and ensuring safe motherhood.

A on a cross -sectional study from Iran with the main aim is to determine the Knowledge, attitude, performance towards crack abuse side effects according the students gender and pertinent faculty The present descriptive and analytical research Knowledge, attitude, performance towards crack abuse side effects according the students gender and the research population (n = 906) consisted of all the students from different faculties of Islamic Azad University, Islamshahr Branch and were selected using the stratified sampling method and were allocated to respective groups according to gender. The data collection tool was a questionnaire. The research data were analyzed using the t-test, and also Chi-square and ANOVA tests and the Pierson correlation coefficient. Data related to the measurement of the students 'knowledge , attitude, and performance regarding the short-term and long-term crack abuse side effects are shown in tables 1, 2, 3, and 4. The results obtained revealed that students' needs assessment towards crack abuse side effects at three levels, namely their knowledge , attitude, and performance were lower than 50%; such that 58.2% had a low-level knowledge , 55.5% had a negative attitude, and 49% of them had an unfavorable performance level. The author concluded that the findings related to the comparison of the mean male and female students' knowledge , attitude, and performance regarding crack abuse side effects revealed a statistically significant correlation at the areas of attitude and performance; also a statistically significant correlation was observed between gender and attitude (mean attitude among females and males was 71.10 and 68.97, respectively) and between gender and performance (mean performance among females and males was 78.5 and 73.9, respectively), i.e. attitude and performance was higher among females. (P ? 0.000 in all cases).

A thesis from Saudi Arabia described ICU nurses' experiences of end of life care. Critically ill patients and death are common in the intensive care unit. Evidence indicates problems that affect the quality of end of life care. Non-beneficial or palliative care is not explicitly supported by critical care policy. Many patients do not feel comfortable in the ICU. This situation can distress ICU nurses when providing end of life care. A literature review was used and 16 recent scientific articles were included in this study. Findings were organized in Word files and data analysis was inspired by qualitative content analysis. The result emerged many of ICU nurses challenges that may affect the quality of end of life care. This included incompatible ICU environment, different behaviors and cultures, feeling of unnecessary care and lack of the following; emotional support, involvement, procedures, standards and knowledge. On the other hand, it found that an effective teamwork might improve nurses' feelings in providing end of life care. Further, ICU nurses have significant roles in supporting dying patients and their families to be at peace, comfort and meet their needs. Yet, modify dying patient's environment and allow family presence in the ICU are important, as well as, single rooms are considered as an ideal place for dying patients and their families. The author concluded that many challenges of providing end of life care were presented. These challenges may affect the quality of end of life care, frustrate ICU nurses and may struggle nursing care and the personality of nurses. On the other hand, ICU singles rooms were recommended in end of life care and there are some significant roles may support dying patients and their families.