​Journal of Education and Health Promotion
Year:2022 | Volume:11 | Issue:5|Papers Count:65

BACKGROUND: “, Three‑, way summaries”,(TWS) are a teaching–, learning tool in which students respond to a question or topic inquiry by three different summaries (10–, 15 words, 30–, 50 words, and 75–, 100 words). The aim of this study was to introduce TWS, to establish its impact on learning retention, and to identify students’,perception for TWS. MATERIALS AND METHODS: It was an educational interventional study. It was carried out in two randomly allocated groups, Group A having TWS as intervention and Group B without TWS, followed by crossover of the groups. Participants were assessed using two multiple choice question (MCQ) tests, ten marks each (one immediately and second after 1 week) during both phases. Students’,perception regarding TWS was assessed by questionnaire using Likert scale. Statistical analysis was done by two‑, tailed independent t‑, test. RESULTS: Both groups’,performance deteriorate after 1 week, but it was affected more in Group B without TWS (4. 85 ±,1. 89–, 4. 70 ±,2. 05, P = 0. 05) as compared to Group A with TWS (5. 30 ±,1. 81–, 4. 63 ±,1. 90, P = 0. 69). While in second phase, performance of the Group B with TWS improved more significantly (5. 92 ±,2. 24–, 6. 83 ±,2. 21, P = 0. 04) in comparison with Group A without TWS (4. 96 ±,1. 89–, 5. 66 ±,2. 35, P = 0. 09). Most of the students liked TWS as an educational tool using Likert scale (72%–, 86% agreeing and strongly agreeing). CONCLUSIONS: TWS is highly acceptable teaching–, learning tool which improves learning retention.

BACKGROUND: Educators and health assistants can act as key players in controlling the pandemic. In general, they are respected by the community, especially in rural areas, and can help guide and raise the population’, s awareness of preventive measures. The objective of this paper is to evaluate the results in knowledge progress of an e‑, learning course offered to educators and health assistants by a public university and to analyze the profile and satisfaction of the participants. MATERIALS AND METHODS: A single group pre‑,and post‑, test design based on a questionnaire, interventional, study was conducted in the period from April 20th to June 20th. All participants of the course answered sociodemographic and satisfaction questionnaire and a pre‑,and post‑, test. Data were descriptively arranged and regarding the distribution and comparison of means and frequency, paired t‑, test for group comparisons. P < 0. 05 was statistically significant. Data were collected from the Moodle®,teaching platform, without identifying the participants. RESULTS: A total of 674 participants were enrolled in the five groups, and 583 concluded the course (86. 5%). The reasons for those who did not access the entire course (n = 47) were: Lack of time, difficulty in accessing the internet, and lack of experience with distance learning courses. On the evaluation of the course platform, from the tutors in general and the degree of satisfaction in several questions, participants marked maximum grades. The comparison between pre‑,and post‑, proficiency scores showed increased proficiency of the enrolled groups (P < 0. 0001). CONCLUSIONS: The course contributed to the training of health assistants and educators, preparing them to act in a participatory way in the prevention and control of the pandemic. The course was well evaluated and there was a progression of knowledge by the participants.

BACKGROUND: Recordings of live streaming e‑, lessons of pathology at medical school of National and Kapodistrian University of Athens, Greece are uploaded to the e‑, class portfolio of each student enrolled in the course. We measured the number of views each video received and noticed that this number exceeded the number of enrolled students. Our main aim was to investigate the correlation between the upload of an educational video and the views it got so as to determine when the proper time is for professors to e‑, share or upload an educational video for the students. MATERIALS AND METHODS: We measured the number of views of the recorded e‑, lessons when all videos were uploaded, with a frequency of 15 days. We used analysis of variances statistical analysis to find the significance of the amount of time each video had been uploaded on the virtual platform of the course. We also applied t‑, tests to assess the significance of alteration of the number of views related to the amount of time until the examinations. RESULTS: Time was a statistically significant factor in the impact of an educational video. The two‑, factor analysis without interaction measured P ≃,0. 001, proving the strong correlation between time and the increase of views. As the examination date was approaching, there was a statistically significant increase in the number of views of the videotaped e‑, lessons. Almost 50% of the views of each of the videos took place in the two‑, week examination period of the course. CONCLUSIONS: The educational videos that contained the core learning concepts of the pathology course should be uploaded first. The complex learning points of the pathology course must be available at the beginning of the semester. Additionally, recordings of videos covering the complex learning points of the course should be uploaded as an additional tool of asynchronous e‑, learning for the students who choose to watch their former e‑, lessons to prepare for the examinations.

BACKGROUND: The unexpected increase in COVID‑, 19‑, related waste and its inappropriate disposal had blown up the threat of retransmission of this infection and adversely impacted the environment. The aim of this study was to evaluate the existing knowledge about the handling of biomedical waste (BMW) in the COVID‑, 19 Hospital setting among health‑, care workers (HCWs). MATERIALS AND METHODS: It was a prospective cross‑, sectional study done for 3 months, i. e., October 2020–, December 2020 among nursing professionals across all seniority posted in COVID hospital. A pretested questionnaire comprised 20 questions was used as a study tool. RESULTS: The response rate of our study was 94%. The mean age of respondents was 33. 97 years, and the mean length of service was 8. 32 years. The study revealed that the respondents had a mean knowledge score of 12. 21 (Median 12, standard deviation 2. 129 and 95% confidence interval of 11. 92–, 12. 51). CONCLUSIONS: There is consensus among the researchers/scholars that COVID‑, BMW hazards are much more significant than regular BMW. Therefore, its awareness among the HCWs can be a panacea for safer handling of BMW generated in COVID Hospital.

Coronavirus disease 2019 (COVID‑, 19) has caused different kinds of psychological consequences. Identifying and providing psychological plans and protocols can be effective in promoting patients’,mental health. The study was conducted to investigate the effect of psychological interventions in response to stress, anxiety, and depression in COVID‑, 19 patients. The present study was performed based on a systematic review. The studies were done by using different combinations of keywords in databases such as Science Direct, ProQuest, PubMed, and Google scholar search engines and in Persian databases such as Magiran, SID, Iranmedex from July 25 to September 7, 2020. Out of 4533 articles that were found after extensive search, 9 articles were evaluated and qualitatively analyzed for data extraction with the 2010 consort checklist. The final articles were from different countries of China, the USA, France, Italy, and Iran and were about COVID‑, 19 patients and their health‑, care providers. Interventions ranged from relaxation, music therapy to mental health and extensive psychological skills including adaptation methods, mindfulness and self‑, care, and crisis management. Anxiety was the highest and then stress and depression were the next indicators. The results showed a positive effect of these interventions on stress, anxiety, depression, and even the quality of life, sleep and family and child function. The number of studies in this field is increasing. We see a variety of psychological and educational interventions every day. It is hoped that by designing standard protocols for psychological intervention, effective steps can be taken to improve the mental health of patients and health‑, care providers.

BACKGROUND: Social distancing policy during the COVID‑, 19 pandemic may affect physical activity levels. This study aimed to compare physical activity levels before and during the pandemic and to explore physical activity correlates among Indonesian young adults. MATERIALS AND METHODS: This longitudinal study was conducted before the pandemic (n = 141) in September 2019 and was followed by an online follow‑, up survey during the pandemic (79% response rate) in September 2020. Physical activity was measured using the global physical activity questionnaire and was classified into “, sufficient”,and “, insufficient. ”,The potential correlates of physical activity were constructs from social‑, cognitive theory and health belief model. Those were measured using a validated questionnaire in the follow‑, up survey. Physical activity levels before and during pandemics were compared using the Wilcoxon signed‑, rank test. Simple logistic regressions were used to assess the relationships between each potential correlate and physical activity status during the pandemic. RESULTS: Physical activity levels decreased significantly during the pandemic, mostly in the work‑, related domain. Participants with favorable physical activity‑, related constructs were more likely to be physically active. The odds ratio ranged from 3. 41 (95% confidence interval [CI] = 1. 15–, 10. 11) in participants with higher self‑, efficacy to 4. 50 (95% CI = 1. 44–, 14. 06) in those with higher outcome expectations of physical activity. CONCLUSION: A significant decline in physical activity during the COVID‑, 19 pandemic among Indonesian young adults was confirmed. The application of behavioral change theories for explaining physical activity status during the pandemic in this population is also supported. It is recommended to incorporate these constructs to develop physical activity interventions in this target population.

BACKGROUND: The loss of a pregnancy can result in grief, guilt, self‑, doubt, anxiety, and post‑, traumatic stress disorder (PTSD). Considering the side effects mentioned for mental health and the fact that the symptoms will linger if left untreated and even adversely affect the subsequent pregnancies. The current study was designed to assess the impact of individual counseling on stress, anxiety, and depression in mothers with pregnancy loss. MATERIALS AND METHODS: The study commenced 100 women who experienced pregnancy loss (in Urmia/2018-2019),they were enrolled using convenience sampling and block randomization. The intervention group received four individual counseling sessions (weekly sessions with a duration of 1 h) based on Warden’, s principles. The control group received routine care. The Depression Anxiety Stress Scale (DASS‑, 42) was filled out at baseline, the pre‑,and post‑, intervention. Analyses were performed using the Chi‑, square, paired, or individual t‑, tests, when necessary. P value < 0. 05 was considered significant. RESULTS: There were no significant differences regarding socio‑, demographic characteristics and clinical features between groups at baseline. Intra‑, group analysis showed that all outcome measures in the intervention group were significantly improved. According to inter‑, groups analysis, a significant association was found between pre‑, test and post‑, test in the intervention group (P < 0. 05). CONCLUSION: Results of this study can clarify the psychological effects of pregnancy loss in these mothers and help the officials and responsible parties to plan the treatment and rehabilitation of these women and include them in the healthcare system.

BACKGROUND: Taking exercise in health sector is one of the important steps to implement the disaster risk management programs, especially preparedness phase. The present study aimed to identify indexes and factors affecting successful evaluation of disasters preparedness exercises in hot wash stage. MATERIALS AND METHODS: This study was a qualitative content analysis. Data were collected by purposeful sampling through in‑, depth and semi‑, structured individual interviews with 25 health professionals in the field of disasters. The data were analyzed using directed content analysis method by which the initial codes were extracted after transcribing the recorded interviews and immersing them in the data analysis. The initial codes were reviewed, classified, and subdivided into several stages to determine the main classes. RESULTS: The data analysis resulted in the production of 24 initial codes, 5 subcategories, 2 main categories of “, evaluation and exercise debriefing”,and “, modification of programs and promotion of exercise operational functions”,under the original theme of “, exercise immediate feedback. ”,CONCLUSION: This study can be considered a suitable standard guide for health care organizations to evaluate successfully disasters exercises in hot wash stage, maintain and promote their preparedness, and properly respond to disasters.

BACKGROUND: Online learning environments are becoming more frequent in teaching and learning than ever before. Asynchronous learning provides “, high degree of interactivity”,between participants and helps them to reflect upon their ideas/thoughts, before sharing them with others leading to more insightful responses and in‑, depth learning. Moderating an online discussion is an art and challenging task, which needs meticulous planning and effective execution approaches. One of the major challenges in online discussion is to ensure active participation and interest among participants, and therefore, it reiterates the need for inclusion of interactive strategies to enable it meaningful and effective. The present article is to share our experiences in moderating session on “, Dramatics in Medical Education”,(DIME) as a part of ML web discussion of Foundation for Advancement in International Medical Education and Research (FAIMER) at one of the regional FAIMER institutes in India. MATERIALS AND METHODS: Thirty‑, two FAIMER fellows participated in online discussion on DIME, supplemented with various engagement triggers including, sharing of real‑, life situation case scenarios, motivational quotes, competitions and rewards, script writing, script editing exercises by using Forum Theatre method, discussion on uploaded academic videos on “, YouTube, ”,use of mnemonics, etc. RESULTS: Online discussion yielded improved knowledge and positive attitudes of participants toward DIME. Task‑, based exercises within authentic or realistic situations, teamwork, and interactions facilitated active learning of participants. CONCLUSIONS: Appropriate planning, well coordination, and interactive strategies can foster learning and reflective abilities as well as develop favorable perceptions of learners toward virtual mode of teaching‑, learning.

INTRODUCTION: Educators, academicians, and teachers are responsible for the development of the nation’, s human capital. Teacher coping methods are becoming more widely recognized as a key factor in determining teacher effectiveness. The aim of this study was to identify the various coping strategies adopted by high school teachers in Southern India. MATERIALS AND METHODS: A cross‑, sectional study was conducted in government, aided, and unaided schools of Udupi, a coastal district in Southern India. A self‑, administered questionnaire was used to collect the data from 460 high school teachers chosen based on convenience sampling. The coping strategies were identified using a modified version of Brief COPE(Coping Orientation to Problems Experienced) Inventory (Carver, 1997). Data were entered using SPSS version 15 and descriptive statistics was performed. RESULTS: The study found that teachers had moderate level of coping skills in all domains. The most popular coping techniques used by secondary school teachers were positive reframing, active coping, and planning,nevertheless, substance use was recognized as the least popular coping strategy. CONCLUSION: Positive reframing, active coping, and preparation were the most commonly used coping strategies by the teachers in the survey. Teachers are a vital resource who have received less attention than they deserve for their psychological well‑, being. A customized intervention program based on their perceived needs could be a good place to start.

BACKGROUND: Health‑, care workers have to use the N95 mask as a part of the protection kit during the COVID‑, 19 pandemic. The adverse effects of such practice are not fully elucidated. The study aims to evaluate negative impacts of N95 face masks on health‑, care personnel at COVID‑, 19 care units. MATERIALS AND METHODS: One hundred and twenty‑, two health‑, care workers (aged 20–, 58 years) from various health‑, care settings in Sulaimani, Iraq, from January to August 2020, were enrolled in this prospective, cross‑, sectional study. The physiological variables (blood pressure, heart rate, and oxygen saturation) were recorded before putting on the N95 mask and postremoval of the mask. The incidence of adverse effects such as headache, difficulty breathing, redness, irritation, and dizziness were also reported as a number and percent at the end of the work shift. RESULTS: There was a statistically significant difference in the physiological parameters after removal of the mask compared with baseline. Only diastolic pressure was significantly lower in those working >6 h when compared to those working 1–, 6 h. The changes in physiological markers were poorly and nonsignificantly associated with the duration of wearing the mask. Moreover, 67. 2%–, 70. 5% of the participants complain of headaches and breathing difficulties, while 45. 9%–, 51. 6% reported signs of itching, redness, and irritation. However, health‑, care workers who put on the face mask >6 h showed signs of headache, breathing difficulties, and itching at the exposed areas higher than those working for 1–, 6 h. CONCLUSION: N95 mask negatively impacts the physiological variables of health‑, care providers. The adverse effects may lead to excessive exhaustion after long shifts in the intensive care unit during treatment of COVID‑, 19 patients.

Pandemic 2019 is observed in all sectors of the world which had caused a huge disruption in the education system in India as well as worldwide adding challenges to student’, s life. We aimed to provide an outline on E‑, Learning and the difficulties experienced by students of various colleges in the southern parts of India and to conduct knowledge, attitude and practices (KAP) analysis based on student’, s perception regarding E‑, learning by collecting an online survey, 346 valid questionnaires were retrieved. In order to evaluate the association between the variables of KAP, structural equation modeling was used for data analysis. The influencing factors of KAP were observed to know the effect of the pandemic on E‑, learning from the model. The result finding moderately fit the collected data and reveals a good fit of the model in the means of satisfying the threshold values.

BACKGROUND: Unsafe medication administration and medication errors pose a threat to medication safety. Safe medication is one of the most important nursing practices that plays an important role in preventing medication errors. The aim of this study was to assess the medication administration of nurses in cardiac wards and its relationship with some demographic characteristics. MATERIALS AND METHODS: The present study was conducted as an observational study in 2021 with the 60 nurses who working in the medical cardiac wards of one selected hospital affiliated with the Isfahan University of Medical Sciences. Data were collected using three‑, part tools (demographic information, medication checklist (55 items), and documentation checklist (8 items). The checklist was completed by the observer after observing the nurses’,medication administration. Data analysis was conducted using descriptive and inferential statistics in the SPSS software (version 16, SPSS Inc., Chicago, IL, USA). A P < 0. 05 was considered statistically significant. RESULTS: The mean total score of the principles of injection and oral medication administration were 82. 53 ±,10. 75 and 75. 76 ±,9. 62, respectively. The mean score of the principles of injection and oral medication administration in the morning shift was significantly higher than the evening and night shifts (P < 0. 001). The relationship between the mean score of the principles of injection medication (r = 0. 234, P = 0. 067), oral medication (r = 0. 222, P = 0. 083), and the nurses’,work experience no significant. The rate of adherence to the principles of medication administration in the premedication administration stage was higher than during and after drug administration. CONCLUSION: Although the mean score of medication administration of nurses in the medical cardiac wards was at the desired level, it is necessary to monitor and plan by nursing managers to improve medication administration. Reducing the number of night shifts, adhering to accreditation programs in the hospital, continuous monitoring of nurses in terms of compliance with the principles of medication are among the proposed solutions to improve the safe medication in nurses.

BACKGROUND: Cancer is one of the leading causes of death globally. A considerable number of different cancer types may be preventable, using primary intervention techniques, such as health education, cancer awareness, behaviors and lifestyle modifications. The present study conducted a comparative assessment of cancer awareness among undergraduate students of the United States and India. MATERIALS AND METHODS: Students from an Institution in India (KC) (55 females, 33 males), and an Institution in the United States of America (SHU) (226 female, 58 male) during 2019–, 2020 participated in this study. Participants (n = 372) across all majors and all years (first through fourth year) completed an online questionnaire and answered the questions on their demographic characteristics (e. g., gender, age, and location), academic status (e. g., year of study, major), multiple‑, choice questions about cancer knowledge, and opinion questions (e. g., “, where would you find info, ”,“, should therapies be free”, ). Student responses were collected using Qualtrics Survey Software. Excel was used to analyze responses. We conducted statistical Χ, 2 tests for independence to determine whether there is a statistically significant difference between the expected frequencies and the observed frequencies in one or more categories of a contingency table, with a significance of ɑ,= 0. 01. While small sizes due to the small institutions and the response pool, we note that we achieved the necessary “, n”,for all tests reported. RESULTS: Our research shows a few important statistically significant differences, including knowledge of cancer and breast lumps is dependent on location, ranking of global cancer deaths is dependent on location, and that cancer knowledge is dependent on the information source. All for Χ, 2 tests with P < 0. 001. CONCLUSIONS: Further encouragement of education for young people in various aspects of cancer and cancer prevention, as well as information facility and sources of reliable data, could be helpful for improving the overall health and primary prevention. A thorough assessment is needed to understand the responsible factors for the observed cancer knowledge variations among students of two different places.

BACKGROUND: Coronavirus disease‑, 2019 (COVID‑, 19) pandemic can aggravate the health problems in slum areas. The present study intends to examine the challenges of health protection of slum’, s residences during the COVID‑, 19 pandemic with the Social Determinants of Health perspective, in Kerman city in Iran. MATERIALS AND METHODS: The present study was a qualitative content analysis. Data were collected by purposeful sampling in‑, depth and semi‑, structured interviews with 16 people. The interviews were conducted (from October to December 2020) with the local representatives of the slum’, s residents, health‑, care workers, managers of facilitation offices, and welfare social service centers that are located in slum areas (Interview’, s guide is attached). The textual material from the interviews was entered into the MAXQDA software and directed content analysis was used to analyze the data. RESULTS: Data analysis led to the identification of 4 categories (Sociocultural, Situational, Economical, and Physical environment) and 12 subcategories: Sociocultural: lack of awareness, begging culture, low trust in disease control programs, low bottom‑, up planning, and increasing violence,Situational: decreasing donors’,activities and canceling important meetings,Economical: unemployment, decreasing in income, and increasing limitations of many institutions in providing resources,and Physical environment: inadequate space and inappropriate conditions in some houses and alleys for people protection against Corona viruses. CONCLUSIONS: Slum residents have faced many challenges during the COVID‑, 19 pandemic. These challenges can affect the health of slum and other urban dwellers. Multidisciplinary thinking and actions are needed. Increase awareness and engagement slum residents in control disease programs should be considered.

BACKGROUND: Performing appropriate and regular screening can effectively reduce cervical cancer and mortality rate, however, the available evidence suggests that women’, s participation in cervical cancer screening remains low in middle‑,and low‑, income countries, and that it is necessary to identify appropriate intervention methods to change behavior. The present study was designed to determine the effect of decision‑, aid‑, based counseling on cervical cancer screening behavior among women. MATERIALS AND METHODS: This trial study was conducted on 154 women with no history of Pap smear during the past 3 years and refers to Tabriz health care centers. The participants were assigned to the intervention (decision aid based counseling) and control (routine health education) groups through randomized block design with block sizes of 4 and 6 and a 1: 1 allocation ratio. The data were collected using the sociodemographic and fertility characteristics, stages of change checklist, and shared decision‑, making (SDM) and decisional conflict (DC) questionnaire before and 6 months after the intervention by interview and then, analyzed by SPSS24 software. The independent t‑, test, ANCOVA tests were used. RESULTS: A significant difference was observed between the two groups in terms of changing the stages of cervical cancer screening behavior 6 months after the intervention. As after the intervention, the frequency of individuals entered the preparation or action stage was more than the control group (P = 0. 001). The mean score of SDM in the intervention group was significantly higher than the control group after intervention ([45. 49 ±,1. 18] vs. [27. 56 ±,1. 18] [Mean Difference (MD): 17. 92,95% confidence interval [CI]: 14. 59–, 21. 25,P < 0. 001]). The mean score of DC in the intervention group was significantly lower than the control group after intervention ([29. 16 ±,1. 09] vs. [34. 14 ±,1. 09] [MD: −, 4. 97,95% CI: 1. 09–, 8. 04,P < 0. 002]). CONCLUSIONS: This study revealed that evidence‑, based information communicated between clients and clinicians has very important role in clients’,health‑, related behavior. It is recommended, health care providers apply decision‑, aid‑, based counseling for promoting the cervical cancer screening behavior among women.

BACKGROUND: Over the past few years, a rapidly growing number of science and technology parks (STPs) in health sector have emerged across the world. There has been little discussion in the literature to show how STPs could make an attractive environment to absorb and retain potential firms. This is even more challenging for specialized STPs in health sector. The aim of this study is to identify the attractive factors for firms in a STP in health sector. MATERIALS AND METHODS: A scoping review method was undertaken to review the literature on seven databases (ScienceDirect, Scopus, ProQuest, Google Scholar, EconPapers, PubMed, and ISI Web of Science) for peer‑, reviewed articles published until 2019. The search results were screened against the inclusion of criteria to ensure they met the objectives. The eligible papers were then assessed on the basis of the full text, and finally the results were extracted. RESULTS: The attractive factors for firms and talents in multidimensional STPs and those in health sector are extracted and summarized. The attractive factors of multidimensional STPs, which includes health sector firms, and those specialized in health sector are summarized in three main categories,factors created by government and universities, and factors related to STP policies and those expected by the firms. CONCLUSION: To make STPs attractive for firms in health sector, there is a list of factors that are required to be done not only by STP itself, but also by the national and local government and industries. It is important to consider the factors that are expected by the firms to be implemented. The results of this study suggest that making STPs attractive for health sector firms needs close collaboration between government, universities, related industries, and STPs all together.

BACKGROUND: Intellectual property rights (IPRs) are increasingly becoming significant for sustainable growth of today’, s knowledge‑, based society. An inappropriate knowledge regarding IPR can fail to reserve rights for one’, s intellectual creation. Hence this study was planned with an aim to assess knowledge, awareness, and practices regarding intellectual property rights in India amongst the health-care professionals in Belagavi city. MATERIALS AND METHODS: A descriptive cross‑, sectional study was conducted among the postgraduate students and faculty of six health‑, care professional institutions in Belagavi, Karnataka. A total of 724 responses were recorded using convenient sampling. Data was collected using self‑, administered validated questionnaire which included demographic details and total 20 questions pertaining to knowledge, awareness, and practices regarding IPR. Two‑, point Likert scale was used. Descriptive statistics, Mann–, Whitney U‑, test, and Chi‑, square test were applied. RESULTS: A total of 724 responses were recorded, 411 from postgraduate students and 313 from faculty of 6 health‑, care professional institutions. It was observed that 24. 3% and 39. 3% of postgraduate students and faculty participants, respectively, had maximum knowledge while 35. 5% of faculty and 27. 5% of postgraduate students had maximum awareness regarding IPR in India. Only 17. 6% and 10. 2% of faculty and postgraduate students had previously attended workshops on IPR. CONCLUSION: The present study identified that both faculty and postgraduate students of health‑, care profession have less knowledge and awareness regarding IPR. However, both knowledge and awareness regarding IPR were better among faculty when compared to postgraduate students. Thus, the academic community requires a higher level of sensitization and exposure to IPR in India.

BACKGROUND: Investigating the status of intergenerational relationships of elderly parents with their adult childen is very important in examining issues related to the status of the elderly such as well being and quality of life and other aspects of elderly life. Giveeen the significance of the topic, the current study aimed to examine the psychometric properties of the Persian version of “, Intergenerational Relationship Quality Scale for Aging Parents and Their Children”,(IRQS‑, AP). MATERIALS AND METHODS: A total of 463 community‑, dwelling elders (aged 60 years or older) in Tehran participated in this study through multistage cluster sampling method. To investigate reliability, the construct and convergent validity of the IRQS‑, AP, confirmatory factor analysis (CFA), and interclass correlation coefficient were done. RESULTS: The content validity index was 0. 84 for the entire tool. In the CFA, we found the instrument had a four-factor structure and adequate internal consistency. The scale had a significant and positive correlation with the two measures of loneliness and depression. Furthermore, Cronbach’, s alpha was estimated at 0. 77, and the high value of the interclass correlation was 0. 82. CONCLUSION: The IRQS‑, AP is a valid and reliable scale that can be used to examine the status of intergenerational relationship quality in Iranian elder population.

BACKGROUND: In the past, textbook or printed material was the only source of information for medical students or post-graduate students. After the introduction of internet, knowledge can be accessed easily which is updated with various aids such as animation, videos which improve the learning efficiency. This study was conducted to compare the learning efficiency between textbookbased seminar to that of internet-based seminar in postgraduate students of the department of dermatology. MATERIALS AND METHODS: It was a non-randamized controlled study. The postgraduate students in the department of dermatology, Jawaharlal Nehru Medical college, DMIMS(DU), Sawangi (Meghe), Wardha, Maharashtra, India were divided into two equal groups by simple randomization method by flipping the coin. Totally 20 seminar topics were divided into two groups (A and B) consisting of 10 seminars in each group. Postgraduate students assigned in group A were asked to prepare seminar solely from textbooks while in group B, students were asked to prepare seminar by referring internet. Feedback form which consists of 7 points, i. e. appearance, completeness of preparation, clarity of presentation, appropriate use of audio visual aids, understanding of subject, ability to answer questions, and overall performance were filled up from faculties and postgraduate students after completion of each seminar. Pretest and post-test were filled up from postgraduate students before and after each seminar respectively. Learning gain was calculated by comparing the scores of pretest and posttest. Paired t-test was used to compare results in the group and unpaired t-test was used to compare results between the two groups. RESULTS: Faculties’,feedback on overall performance was higher (4. 59 ±,0. 15) in web-based seminars as compared to in textbook-based seminars (3. 85 ±,0. 1) with significant P = 0. 008. Furthermore, postgraduate students’,feedback showed statistical significant value of 0. 02 in webbased seminars (4. 65 ±,0. 06) compared to textbook-based seminars (3. 2 ±,0. 06). Learning gain was significantly higher in web-based seminar compared to textbook-based seminar with P = 0. 02. CONCLUSION: It can be concluded that web-based learning can improve the learning efficiency in postgraduate medical students.

BACKGROUND: Sleep quality is an important factor in adolescents’,health,physical as well as psychological. The aim of this study was to determine sleep quality and daytime sleepiness and their effect on the quality of school life (QSL) and achievement. MATERIALS AND METHODS: This cross‑, sectional study was conducted in high schools. The data collection was done on a random sample of 500 students from 15 to 19 years. The questionnaires included the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality and the Epworth Sleepiness Scale to measure daytime sleepiness as well as QSL. Data were analyzed by SPSS 25. Linear and logistic regressions were used to obtain adjusted and unadjusted odds ratios as well as predictors. RESULTS: The mean PSQI score was 6. 2 ±,2. 4. It was realized that 377 participants (75. 4%) were poor sleepers,6. 2% had excessive daytime sleepiness. There was a significant association between age and quality of sleep (P < 0. 04). No association between gender and quality of sleep or between the quality of sleep and school achievement was found. Linear regression exhibited a significant relationship between the quality of sleep and daytime sleepiness (β,= 0. 218,t = 4. 982, P = 0. 000). There was a significant, inverse correlation between sleepiness and the total score of QSL (P = 0. 000). Stepwise linear regression analysis exhibited that daytime sleepiness (P = 0. 002) and school achievement (P = 0. 001) were predictors of QSL. CONCLUSION: According to the study results, sleepiness affects school performance and QSL, and on the other hand, daytime sleepiness is under the effect of sleep quality.

BACKGROUND: Conducting online classes and assessment during the COVID‑, 19 pandemic is not without challenges. The world of medical education is adapting online training and assessment because of COVID‑, 19 pandemic restrictions. The present study was conducted to assess the students’,perception regarding the process, difficulties encountered and perceived effectiveness of online assessment. MATERIALS AND METHODS: Online viva‑, voce (theory and visual based) was conducted in a government medical college in Karwar, Karnataka, India using videoconferencing application (Google Meet) to 149 second MBBS students as a formative assessment in 2020 over 3 months. Ten students per day joined Google Meet, 10 questions were asked to each student and assessed using a tutor marking system (on‑, spot). A feedback questionnaire (Google Form) was administered to students who attended online Viva‑, Voce. Data was analysed using descriptive and inferential statistics (Student’, s t‑, test). RESULTS: Out of 149 students, 132 participated and responded to a feedback questionnaire. Majority of the participants (91%) agreed that questions covered all topics kept for viva, 82% of them felt it would be helpful for performance in final examinations. Thirty percent of students faced network issues at their places, 45% felt nervous while facing viva in the presence of other students and 35% of participants preferred online methods over traditional viva voce. Online viva voce can be transparent (90%) and less biased (88%) if done in structured format. CONCLUSION: Online viva‑, voce may become relevant and effective in medical education assessment with transparent marking system for students’,performance.

BACKGROUND: Today, considering the importance of bioterrorism, it may be time to assess the risk of bioterrorism as an important priority. Nurses, as the broadest group of therapy group, are very influential in this regard. General aim: To determine the impact of bioterrorism education through two methods of lectures and booklets on the knowledge and attitude of nursing staff. Practical Aim: Minimizing the damage caused by bioterrorism attacks by empowering nursing staff. MATERIALS AND METHODS: This two-group semiexperimental intervention study was performed as a before and after education intervention with the participation of 80 nursing staff of Shams Al-Shomus Nezaja Hospital affiliated to Health Administration of Islamic Republic of Iran Army Ground Forces. The study population included all hospital nursing staff in 2021. The inclusion criteria included having a willingness and informed consent to participate in the study and exclusion criteria included unwillingness to continue cooperation and failure to complete more than 10% of the questionnaire by the subject. This study was performed on 77 nurses in 2021. The nurses were divided into two groups: lecture and booklet. First, the pretest was completed by the nurses. After the educational intervention, both groups completed the posttest. Both groups then completed the questionnaire again after about 2 weeks. First, all the data were measured for normal distribution by the Kolmogorov–, Smirnoff test. Statistical description was expressed for the variables with normal distribution as the ratio of geometric mean ±,standard error and for abnormal variables as mean ±,standard error. To compare the means of the studied quantitative variables, t-test and Wilcoxon matched-paired statistical tests were used. The significance level was considered <0. 05. SPSS. 16 and Graph Pad Prism 8. 0. 1 softwares were used to analyze the statistical data. RESULTS: Using both methods is effective in improving the level of knowledge and betterment attitude, but according to the paired t-test in comparison of the two groups, at intervals immediately after training and 2 weeks after training, a significant increase in the average knowledge score of the lecture group Statistically shows (P < 0. 001). However, the analysis of attitude scores was performed between the two groups of lectures and booklets, which did not show statistically significant changes between them. CONCLUSIONS: One of the most important issues in the performance of medical staff in bioterrorism attacks is useful, effective, correct, and sufficient training. According to the results of the present study, bioterrorism training leads to increasing the level of knowledge and betterment the attitude of nurses in the field of bioterrorism. Therefore, the inclusion of training courses in medical centers, especially military medical centers, is necessary and sensitive

BACKGROUND: Contribution to antibiotic resistance can happen at two interfaces –,doctor prescribing antibiotics inadvertently or patient’, s usage of antibiotics inadvertently. This study was conducted among diabetic inpatients in a rural tertiary health center in Kolar, South India, to assess the various practices related to antibiotic use and to explore the possible reasons for these practices with regard to antibiotic use. MATERIALS AND METHODS: An exploratory sequential mixed‑, methods study was conducted with an initial cross‑, sectional quantitative study followed by qualitative in‑, depth interviews during August–, September 2019. A pretested semi‑, structured questionnaire was used to capture the sociodemographic, disease‑, , and treatment‑, related characteristics and practices related to antibiotic use. An open‑, ended interview guide was used to conduct in‑, depth interviews. The practices to antibiotic use were reported using frequency (percentage). Manual descriptive content analyses were done by two investigators separately to identify codes under the broad topic “, reasons for adopted practices with regard to antibiotic use. ”,RESULTS: Of the 152 diabetic inpatients interviewed, 20 (13. 2%) felt that antibiotics are safe drugs and can be used commonly. Among these inpatients, seven (4. 6%) knew that antibiotics can kill bacteria and four (2. 6%) perceived ‘, antibiotic resistance’,as a big problem in India. The practice of checking the expiry date before using antibiotics was seen in 21 (13. 8%) and 44 (29%) of them finished the full course of antibiotics. A total of six codes were identified under the broad theme of “, reasons for adopted practices with regard to antibiotic use”,among diabetic inpatients. CONCLUSIONS: Less than one‑, third of them completed the antibiotic course given by the doctor, and almost everyone was ready for over‑, the‑, counter purchase of antibiotics offered by the pharmacist. The reasons for such practices were mostly attributed to the “, partial drug purchases”,and “, incomplete advice by the doctor. ”,There is an urgent need to plan and deliver an interventional package to enhance the knowledge and inculcate good antibiotic usage practices among these high‑, risk populations.

BACKGROUND: Road traffic accidents (RTAs) are an emerging public health issue of global concern causing 1. 35 million deaths per year. They are the leading cause of death among 5–, 29 years who contribute to the future and current productive population of the country. The outcome of mortality and permanent disability are public health concerns. We determined the factors associated with RTAs among medical undergraduates and assessed their knowledge of road traffic rules. MATERIALS AND METHODS: This study had 500 medical undergraduates from a tertiary hospital located in Chengalpattu district, Tamil Nadu. Data were collected using questions from “, Road safety question bank”,issued by Ministry of Road Transport and Highways, Government of India, sent as Google forms to students. Descriptive statistics were used and multivariate analysis was performed to identify risk factors associated with RTAs. RESULTS: The mean age of the students was 21. 4 (standard deviation = 1. 7) years. About 30. 4% of students suffered from RTAs in the past 2 years. Practice of drunken driving and mobile phone usage showed significant association with RTA occurrence (P < 0. 001). Multiple logistic regression revealed that students crossing speed limits and jumping signals had 3. 19 and 2. 04 times more risk of sustaining RTAs. Seventy‑, five percent of students had good knowledge on road traffic rules. CONCLUSION: Nearly half the subjects have suffered RTA in the past 2 years. Students who over speed, jumped signals and used mobile phones while driving sustained more RTAs. Overall, road traffic rules knowledge was satisfactory. Students need education on risky driving behaviors and aftermath of crashes.

BACKGROUND: Basic infection control measures are required in India’, s health‑, care setting in Neonatal Intensive Care Units (NICUs) to lower the prevalence of hospital‑, associated infections. The aim of the present study was to assess practices followed by nurses of NICUs for nosocomial infection prevention. MATERIALS AND METHODS: From January to February 2020, a descriptive cross‑, sectional study was conducted. Participants in the study were chosen by total enumeration sampling technique, i. e., 60 nurses were included in this study who working in tertiary care institutions, India. The study respondents’,knowledge and practice for nosocomial infection control strategies were assessed by using a 30‑, item and 27‑, item questionnaires, respectively. SPSS (version 23. 0) was used to analyze the data collected. RESULTS: Results showed that all nurses (100%) were females, belongs to the age group of 26–, 35 years (82%), hold professional qualifications (34%) in GNM as well as post basic BSc nursing, married (72%), had 1–, 5 years of professional experience (66%), and working in the NICUs for 1–, 3 years (74%). Most of nurses (55%) had never attended any session on nosocomial infection prevention. Nurses of NICUs (70%) had just a moderate degree of understanding on nosocomial infection prevention. Nurses’,practice showed good practise (60%) for nosocomial infection prevention in NICUs. CONCLUSIONS: The necessity to adopt health‑, care policy about nosocomial infections and execution of regular training program to upgrade and refresh nurses’,knowledge and practices regarding for nosocomial infection control measures is indicated to fill gap among knowledge and practices concerning nosocomial infection control and prevention.

INTRODUCTION: Targeting the huge burden of adolescent anemia, the Weekly Iron and Folic acid Supplementation (WIFS) was launched by the Government of India. Few studies have been done to assess the effective functioning of the program since its inception. The present study was done to assess the knowledge WIFS among adolescents of Madhya Pradesh and the associated factors. MATERIALS AND METHODS: A cross‑, sectional study was done in a total of six districts (3 districts where the national adolescent program was implemented and 3 districts where it was not) of Madhya Pradesh. Multistage stratified random sampling technique was used for the enrollment of 3213 adolescent boys and girls, and a prestructured and validated tool was used to collect paperless data. Ethical approval and consent from the participants were obtained. Statistical analysis was performed using SPSS v21. RESULTS: It was observed that the knowledge of WIFS was more among adolescent girls (29. 3%) as compared to adolescent boys (14. 1%). More of the adolescent girls received Iron and folic acid tablets as compared to adolescent boys (60. 8% girls vs. 24. 1% boys). Mostly, the adolescents got Iron tablets from school followed by Anganwadi and PHC/CHC. Girls, rural location, literacy, below poverty line status, knowledge of anemia, adolescents who got iron and albendazole tablets, and adequate consumption of iron tablets (>4) were associated with higher knowledge of WIFS. CONCLUSION: The knowledge of WIFS was found to be less in adolescent boys. There is a hint of the fact that effective execution of the program among its beneficiaries leads to an automatic increased knowledge of the program, at least among the beneficiaries. Thus, an indirect but significant indirect finding is that the nationwide WIFS program needs to be put to greater focus among the adolescent boys, apart from its major focus on the female gender among most age groups.

BACKGROUND: The severe acute respiratory syndrome coronavirus (SARS‑, CoV‑, 2) has become a public health concern worldwide. It is important for pregnant women to know about the mode of transmission, symptoms, and preventive measures against COVID‑, 19. The aim of this study was to evaluate the awareness and outlook of pregnant women and practical measures taken by them against COVID‑, 19. MATERIALS AND METHODS: This cross‑, sectional questionnaire‑, based study was conducted for 1 month (June 10, 2020–,July 10, 2020) in the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India. A prevalidated questionnaire was given to 109 pregnant women to assess the knowledge, attitude, and practice acquired against COVID‑, 19 infection. The Chi‑, square test or Fischer’, s exact test was used to compare categorical data. RESULTS: Among 109 participants, 103 (94. 5%) had good knowledge, 4 (3. 7%) had average knowledge and 2 (1. 8%) had poor knowledge about COVID‑, 19. Majority of them had a positive attitude for the protective measures taken for the prevention of disease. CONCLUSIONS: Since there is no valid treatment for COVID‑, 19, prevention is the only key to curve this infection. In the present study, 94. 5% pregnant women had overall good knowledge score about the mode of transmission, symptoms, and preventive measures against COVID‑, 19.

BACKGROUND: In a world where education directly influences the quality of life of an individual, educational handicaps are a grave issue that plagues the lives of those affected. The current study aims to find out whether there is a difference in the cognitive style and working memory capacity among adolescents with specific learning disability (SLD) in comparison to their age‑, matched equivalent group without SLD. The study also targets to find out if there exists any relationship between cognitive style and working memory. MATERIALS AND METHODS: A total of sixty participants were selected (thirty adolescents with learning disability and thirty age‑, matched adolescents without learning disability) from Bangalore district of Karnataka and Thrissur district of Kerala using purposive sampling method. The tools used were the Indian adaptation of Embedded Figures Test by Nigam (1997) and the Wechsler Intelligence Scale for Children‑, Fourth Edition by Wechsler (2003). RESULTS: The results showed that there exists a significant difference in cognitive style dimensions of field dependence and independence between adolescents with learning disability (M = 11. 6, standard deviation [SD] = 6. 52) and adolescents without learning disability (M = 25. 2, SD = 7. 33) as well as in the working memory capacity between adolescents with learning disability (M = 66. 7, SD = 19. 26) and adolescents without learning disability (M = 102, SD = 14. 93) groups under study (p < 0. 01). The results also indicate that there exists no significant relationship between cognitive style and working memory. CONCLUSION: Adolescents with SLD was found to be field dependent and has low working memory capacity than adolescents without learning disability. The results reflect the need for developing cognitive interventions to enhance working memory capacity and cognitive style for helping adolescents with learning disability in all areas of their functioning, such that the society benefits as a whole.

BACKGROUND: Women undergoing breast cancer treatment, especially those of reproductive age, experience sexual health challenges. The aim of this study is to design an interventional program for promoting the sexual health of women undergoing breast cancer treatment. MATERIALS AND METHODS: This is a mixed qualitative‑, quantitative exploratory study consisting of four phases. In the first phase, the needs and strategies for promoting sexual health of Iranian women with breast cancer in Isfahan city will be identified through a qualitative study. The patients will be selected using purposive sampling method and the data will be collected through semi‑, structured interviews. In the second phase of the study, the relevant literature will be reviewed. In the third phase, the initial version of the program will be designed based on the results of qualitative study and review of literature, the appropriate strategies are prioritized by the members of the panel of experts, and then, the final interventional program is prepared. In the fourth phase, the designed interventional program will be conducted as a quasi‑, experimental study in two groups of intervention and control and the effectiveness of the program on sexual quality of life, sexual satisfaction, and sexual function of women undergoing breast cancer treatment will be evaluated. The type of the intervention will be selected based on the results of the previous phases and the opinion of the expert panel. CONCLUSIONS: The results of this study are expected to contribute to the design of an interventional program based on the needs of women undergoing breast cancer treatment and promote health and meet the sexual health needs of breast cancer patients.

Sir, COVID‑, 19 pandemic has disrupted the world entirely. Many countries are facing multiple waves of the pandemic within a short period. As we face these waves, we start learning more about disease epidemiology, prevention, and management....

BACKGROUND: Our study aimed to compare pectoral nerve (PEC) block with local anesthetic (LA) infiltration for providing analgesia in superficial breast surgeries. MATERIALS AND METHODS: This prospective comparative randomized study included seventy American Society of Anesthesiologists I and II female patients undergoing excision of fibroadenoma. In Group 1, the LA mixture was infiltrated in the desired planes. In Group 2, PEC I and PEC II blocks were performed under ultrasound guidance. Patients were observed at regular time intervals for pain scores, time to first analgesic request, and the number of patients requiring rescue analgesia with the cumulative analgesic requirement, hemodynamic changes, and any adverse events. RESULTS: The patients were comparable in demographic profile, duration of anesthesia, and hemodynamic parameters. NRS scores at all times after extubation were significantly lower in Group 2 as compared to Group 1 (P < 0. 0001). All patients in Group 1 required additional analgesia, while only two in Group 2 received rescue analgesia (P < 0. 0001). The time to first analgesic request was significantly longer in Group 1 as compared to group 2 (9. 5 + 0. 70 h vs. 1. 35 + 0. 83 h) (P < 0. 0001). The cumulative requirement of tramadol in Group 1 (96. 88 ±,16. 45 mg) was significantly higher than in Group 2 (6. 47 ±,26. 38 mg) (P < 0. 0001). No adverse event was reported in either group. CONCLUSION: PEC block is a useful method for achieving effective and long‑, lasting analgesia. It is an efficient and safe alternative to LA infiltration in patients undergoing fibroadenoma excision.

BACKGROUND AND AIM: Bipolar disorder (BD) is one of the most challenging psychiatric disorders in the management area that can lead to functional, occupational, and cognitive disorders. Without proper care, this complication can lead to profound psychological challenges and even death. The aim of this study is to design a minimum data set (MDS) for BD. MATERIALS AND METHODS: This descriptive cross‑, sectional study was conducted in two steps. In the first step, a survey was conducted in PubMed, Web of Science, and SCOPUS databases to identify the demographic, managerial, and clinical data elements. Then, the required data elements were extracted from the studies by the data extraction form and used in a questionnaire. In the second step, to confirm the data element set, the designed questionnaire was distributed and collected among 20 psychiatrists and subspecialists during a two‑, stage Delphi technique. Descriptive statistics (frequency and mean) were conducted to analyze the data. RESULTS: Totally, 112 managerial and clinical data elements in 14 categories were extracted from the studies. Based on the experts’,opinion and their consensus, 88 necessary data elements were considered to bipolar MDS. “, Medication nonadherence, ”,“, history of suicide, ”,and “, substance abuse and addiction”,were the most important data elements. CONCLUSION: In this study, an MDS was designed for BD. Providing this MDS, in addition to improving the clinical processes, it is possible to help electronic system designers and health data managers to know what information should be included in the health systems or any kind of self‑, care or self‑, management software to meet the information needs of these patients.

BACKGROUND: Disaster can pose significant challenges to the health infrastructure in the community. Hospitals are the central unit for providing health services in the disaster response plan. With regard to the vital role of military hospitals in health response to disaster, this study was carried out with the aim of investigating the disaster risk management (DRM) challenges in military hospitals in Iran. MATERIALS AND METHODS: The current study was qualitative research performed in 2020 in military hospitals in Iran. Participants consisted of 12 managers and staff of the military hospitals in Tehran and professionals in health in emergencies and disasters who were included in the study by the purposive sampling technique. Semistructured individual interviews based on the interview guide were exploited for the data collection, and a content analysis method was used to analyze them. RESULTS: DRM challenges in military hospitals were explained in the form of six categories: “, management and leadership, planning, prevention and mitigation, preparedness, response, and recovery”,and 22 subcategories. CONCLUSION: Managers’,awareness of DRM challenges in hospitals, particularly military hospitals, and the design and implementation of solutions can lead to the promotion of hospital DRM and hospital preparedness to deal with disasters.

BACKGROUND: In recent years, among managers and designers of health‑, care spaces, there has been a growing tendency to move toward hospital design by combining patient perceptions and expectations of the physical environment of the care area. The main idea of this study was to present a conceptual model of hospital architecture in our country with a patient‑, centered approach based on some factors that were affecting the sense of place. This model determined the architectural features of treatment spaces from a patient’, s lived experience that could have a positive mental effect on patients as well. The main question of the research was how to adapt the objective perception to the patient’, s mental perception to create a sense of place in the hospital space? MATERIALS AND METHODS: This research was qualitative with a phenomenological approach, conducted between July and December 2020. Purposeful sampling consisted of 23 patients, 13 males in the male surgery unit and 10 females in the gynecology unit, who were interviewed in‑, depth. They were hospitalized for at least 3 days in two hospitals (Dr. Pirooz in Lahijan and Ghaem in Rasht). The data were analyzed by the Colaizzi method. RESULTS: The results consisted of 530 primary codes, 57 subthemes, and 7 main themes. The main themes were hospital location, access to hospital, hospital identity, hospital dependency, hospital attachment, human interactions in the hospital, and hospital evaluation. CONCLUSION: The hospital form guided the patient, and the hospital function directed and obviated the patient’, s needs. The healing environment and human interactions with it caused the patient to be satisfied with the hospital environment.

BACKGROUND: Some pharmaceutical company sales representatives are using bribes to encourage increasing medication prescriptions. In 2012, GlaxoSmithKline paid $3 billion on a felony charge related to bribing doctors to prescribe the company’, s medications. Using Hunt and Vitell’, s general theory of marketing ethics, the purpose of this qualitative multiple case study was to explore strategies some sales managers in the pharmaceutical industry used to improve marketing training to reduce unethical sales representative behavior. MATERIALS AND METHODS: Data were collected from company reports and documents provided by sales managers and semistructured interviews with five sales managers of different pharmaceutical companies in the northeast region of the United States. Data were analyzed using thematic analysis and Yin’, s 5‑, step process of compiling, disassembling, reassembling, interpreting, and concluding thematic data analysis. RESULTS: Three themes emerged from data analysis: developing ethical standards, developing organizational policy, and implementing training and development programs. A key recommendation is that pharmaceutical sales managers identify ethical standards to inculcate in their business practices to achieve ethical marketing training that can result in sales representatives’,ethical behavior. The implications for positive social change include the potential for sales managers to develop strategies to reduce unethical behavior in the pharmaceutical industry. CONCLUSION: Reducing unethical behavior may lead to more trust between patients and physicians, improving patient satisfaction and promoting prosperity for the community through enhancing the quality of health care.

The use of complementary and alternative medicine (CAM) is common in infertile women in different countries. The purpose of the current study was to review the infertile women’, s needs in relation to CAM use. This narrative review was conducted through searching English databases including Scopus, PubMed, Embase, Web of Science, Cochrane library as well as Persian databases consisted of SID, and Magiran. The used keywords included “, CAM/therapy, needs, and Infertility. ”,All studies published in English peer‑, reviewed journals from conception to October 2020, which examined the infertile women’, s needs in the field of CAM use were included in the review. In the process of data extraction, two researchers screened the title, abstract, and full text of the articles. Out of the 2166 articles reviewed, 29 articles including six qualitative and mixed methods studies, four review, and 19 quantitative studies met the inclusion criteria. The results showed that infertile women have different needs in six domains consisted of educational and informational needs, the need for psychological counseling, supportive needs, the need for CAM use counseling, the need to treatment consistent with women’, s culture and demands, and the need to the integration of CAM with conventional medicine. Awareness of infertile women’, s needs toward CAM use can help health policymakers and planners in designing and implementing counseling services in accordance with the demands and culture of infertile couples. It also helps to develop a coherent program to integrate the use of CAM in the classical infertility treatment.

BACKGROUND: Delay in the diagnosis and management of obstetric complications lead to raised mortality rate. This can be curtailed by appropriate implementation of the educational intervention among the health‑, care providers. Hence, this review aimed to identify the literature evidence of the efficacy of various educational interventions training in the management of obstetric complications. MATERIALS AND METHODS: We searched PUBMED, Web of Science, SCOPUS, Google Scholar, Cochrane, and maternity care databases with studies published from 2011 to 2021 for identifying studies related to this educational intervention review using MeSH terms and free terms. The search process was also done on the websites of the World Health Organization and the reproductive health library in the English language. From the 1823 abstracts reviewed, 16 studies were included (15 quasi‑, experimental, 01 randomized clinical trial, and 01 exploratory research design). We identified studies that included skill assessment of nurses, midwives, auxilliary nurse‑, midwives (ANMs), medical students, interns, and doctors after implementing various educational interventions. RESULTS: According to the findings of this literature, achieving enhanced nursing management of obstetric complications has been developed. Especially, it suggests through better nursing training and education and also by providing sufficient resources, time, and coordination with obstetric specialists, nurses and midwives will be able to implement their care roles, which include proper diagnosis, appropriate intervention, advanced care, client education, and psychological support. The efficacy of each educational intervention varies and depends on the participants’,understanding, interest, and the advancement of the teaching‑, learning method used. CONCLUSION: This systematic review reveals abroad and logical move towards the evaluation of various educational interventions in the field of obstetric complications. Among all the educational interventions implemented, mobile application, and simulation‑, based training play a major role in improving the knowledge and skills of health‑, care providers in the management of obstetric complications.

BACKGROUND: The trainee teacher seems to be more and more faced with frustration and stress during the training phase, caused by accumulation of requirements and duties, making them susceptible to the risk of burnout. The purpose of this work is to study the academic burnout of trainee teachers at the Rabat‑, Sale‑, Kenitra region’, s Regional Center for Education and Training Professions during the COVID‑, 19 pandemic. MATERIALS AND METHODS: Seven hundred thirty‑, nine trainee teachers responded to a self‑, questionnaire comprising the Maslach Burnout Inventory–, Student Survey scale in its French validated version, as well as stress factors during the academic year 2020–, 2021. Both inferential and descriptive methods of data analysis were used to represent the effect of sociodemographic variables on burnout levels during the COVID‑, 19 pandemic. RESULTS: In agreement with the literature, most of trainee teachers show moderate and high levels of academic exhaustion,the main stressors presented are financial instability and training overload, and the level of study influences the scale of burnout among trainee teachers. CONCLUSION: The result of this study can serve as a predictor of academic burnout among Moroccan trainee teachers.

BACKGROUND: The exponential increase of cases and the emergence of the new COVID‑, 19 variants continue to be a challenge. It remains crucial to assess whether or not minimum health standards against COVID‑, 19 are consistently followed. This study determined the higher education students’,practice of protective measures against COVID‑, 19 of more than a year into the pandemic. MATERIALS AND METHODS: A questionnaire web survey, cross‑, sectional study was conducted among higher education students (n = 2309) of a public university in the Philippines. Data were analyzed using the SPSS software. RESULTS: Results indicated that students generally had a high practice of COVID‑, 19 preventive measures. However, only 45. 9% always practice physical distancing measures, and only 35. 9% always seek information related to COVID‑, 19 after more than a year into the pandemic. Female, married, graduate level, with a monthly family income of PHP 10, 000 and above, and personal knowledge of someone who tested for COVID‑, 19 had a significantly higher practice of COVID‑, 19 protective measures. Older age, higher general self‑, reported health status, and higher intention to comply with recommended protective health behaviors were significantly correlated with higher practice of preventive measures against COVID‑, 19. CONCLUSION: After more than a year of being into the pandemic, students still practice preventive health behaviors, however, this is not done consistently. As the pandemic is still not over in the country and many parts of the world, continuous monitoring and a reminder to practice minimum protective health protocols are needed to mitigate and prevent the spread of COVID‑, 19.

BACKGROUND: Male reproductive health is a necessary pillar of childbearing. If a reproductive health assessment is conducted in the preconception period, the chance of a healthy pregnancy can increase. This qualitative study aimed to explore men’, s reproductive health needs before conception in Iran. MATERIALS AND METHODS: This research was a qualitative study conducted in Bushehr city, Iran to explore men’, s reproductive health needs from April 2021 to November 2021. 30 semistructured interviews were conducted with married men, women, healthcare providers, and specialists individually in the health centers. The sampling method used in this study was purpose‑, based with maximum variety. All interviews were digitally recorded and transcribed verbatim in Persian and analyzed using directional content analysis. MAXQDA software version 12 was used to facilitate data analysis. RESULTS: From the data analysis, 2 themes, 15 categories, and 38 subcategories emerged. The themes included evaluation and health promotion recommendations. It consisted of 10 categories: reproductive life plan evaluation, medical history evaluation, family and genetic history evaluation, social history evaluation, sexual health evaluation, medication evaluation, laboratory evaluation, physical examination, lifestyle evaluation, and mental health evaluation. Health promotion recommendations included five categories: nutritional recommendations, stress management, avoiding harmful behaviors, protective measures against harmful exposure, and need for education. CONCLUSIONS: Our results showed that men need a comprehensive evaluation of reproductive health and recommendations to improve their health in the preconception period. Our study findings can inform healthcare providers to increase men’, s participation in reproductive health.

BACKGROUND: Living with children with autism spectrum disorder (ASD) can affect different aspects of parents’,physical and mental health and quality of life. This study aimed to identify parents’,perceptions of their quality of life and factors influencing such perceptions and investigate how they cope with difficulties in their daily lives. MATERIALS AND METHODS: This study was conducted using a qualitative research design to gain insight into how children with ASD may influence their parents’,quality of life. A total of 31 parents and school counselors were selected by the snowball sampling method in autism schools in Tehran in the academic year 2018–, 2019. Semi‑, structured interviews were used to collect the data. Each interview was held based on a preprepared guideline by the researchers. In‑, depth questions were also asked as needed. Finally, the data were analyzed using the content analysis approach. RESULTS: The participants reported a variety of difficulties and crises to cope with in their daily lives. The factors reported to decrease the quality of life were categorized into six main themes and 20 subthemes. The main themes included “, family interactions, ”,“, parenting, ”,“, daily living, ”,“, health, ”,“, financial issues, ”,and “, community‑, related. ”,CONCLUSIONS: Due to the diversity and multilevel factors affecting the quality of life of parents having children with ASD, it is essential to adopt a comprehensive approach with the participation of all stakeholders in the development, design, and implementation of future interventions.

BACKGROUND: COVID‑, 19 initiated in December 2019 in Wuhan, China, and over a period of time, the infection outspread across the world in a rapid pace. To protect the people and to further limit the spread of infection, lockdown was declared in most parts of the world including India. As all people were forced to stay indoors during this pandemic, internet was the only source of entertainment whose overuse has side effects on anxiety and sleep quality. This study is aimed to know the impact of Internet addiction during COVID‑, 19 on anxiety and sleep quality among college students of Bhubaneswar city. MATERIALS AND METHODS: This was a web‑, based cross‑, sectional, questionnaire study. It administered 475 students from six colleges. The students were assessed by a proforma containing demographic details, patterns of internet use, Youngs Internet Addiction Test, Generalised Anxiety disorder score, and the Pittsburgh Sleep Quality Index. Statistical analysis was done using SPSS version 21. 0 using Chi‑, square test and Wilcoxon signed‑, rank test. RESULTS: The mean age of the study group was 18. 81 ±,1. 189. Out of 475 students, 60. 6% were female and 39. 4% were male. 23. 6% and 13. 4% of recruited students had severe internet addiction and anxiety disorder, respectively. The mean global PSQI score in the study was 6. 356 ±,1. 88. About 84. 6% of the students had poor global sleep quality score. All components of sleep quality were significantly associated (P = 0. 000) with different degrees of internet addiction except sleep duration (P = 0. 589) and efficiency (P = 0. 767). CONCLUSION: Females were highly addicted than males. The study findings specified that students’,excessive internet usage leads to anxiety, and affects mental health. Monitoring and controlling students’,internet addiction through informative sessions on how to use the Internet adequately is useful.

The present study aims to systematically review the women’, s knowledge, attitude, and practice (KAP) of breast cancer (BC) screening methods to get enough information for policymakers to orient the screening strategies. All English KAP studies on BC screening methods in five databases up to January 2021 were included. The quality of the final articles was assessed using the STROBE checklist. The qualitative synthesis was performed. Out of 5574 retrieved articles, 28 were included. About 64% of the articles were of high quality. Overall, there were poor knowledge, negative attitude, and low practice between women. The educational programs and cultural plans can encourage regular screening. Women’, s excessive optimism to their BC risk should be eliminated by focusing on the risk of the disease, more.

BACKGROUND: Few women in history were respected by society because of their contributions to the field of science, arts, politics, and so on, but in general, women are deprived of their rights and being refrained from decision‑, making in major areas of individual and family life. This research tried to investigate the degree of empowerment and quality of life (QOL) of the women to find out the relationship between empowerment and QOL of women. MATERIALS AND METHODS: An exploratory survey was carried out among 210 purposively selected married women aged between 20 and 49 years in a selected municipality area of West Bengal. Data were obtained by one‑, to‑, one interviews using Women Empowerment Interview Schedule and WHOQOL Scale BREF. RESULTS: The mean total QOL score of the women was found as 98. 59 ±,13. 61. The transformed scores in the physical, psychological, social relation, and environmental domains were 74. 92 ±,14. 97, 66. 58 ±,15. 78, 81. 00 ±,18. 07, and 65. 28 ±,17. 99, respectively. The degree of empowerment was calculated as 64. 71 ±,6. 79. Among the women, 5% had poor, 62% had medium, and 33% had a high degree of empowerment. A weak positive correlation (r = 0. 325, P = 0. 001) was found between QOL and empowerment. Significant associations were established between empowerment and education (Fisher’, s exact = 13. 975 [0. 007]) and education gap with husband (Fisher’, s Exact = 8. 68, P 0. 069). Multiple regression analysis between empowerment dimensions and QOL shows that personal or family dimensions, including health, are a significant predictor for the QOL (P < 0. 01). CONCLUSION: Most of the women had medium degree of empowerment. Increased degree of empowerment improves their QOL of women. Women should be aware of their rights that can enhance the empowerment in different dimensions of life.

BACKGROUND: Assessment of the patient safety competency is necessary for the growth of nursing and safe care profession as well as evaluation of the nurses’,educational needs. The present study was conducted to determine psychometric properties of the Persian version of the patient safety competency self‑, evaluation (PSCSE) tool in Iranian psychiatric wards. MATERIALS AND METHODS: All nurses (n = 209) working in two psychiatric hospitals of Kerman, Iran, were included in the present cross‑, sectional study using census method. This tool contains 41 items: six items are related to knowledge, 14 items deal with attitude, and 21 items are about skill dimension. Psychometric properties of the questionnaire including its content and face validity were also examined. The factor structure of the questionnaire was evaluated using exploratory factor analysis. The internal consistency and reliability were assessed by test–, retest method with an interval of 14 days. Cronbach’, s alpha and corrected item‑, total correlation were used to measure reliability. RESULTS: The content validity index was 0. 65 and the content validity ratio was 0. 89. Item 14 was removed from the skill domain because it was not related to the psychiatric ward. According to the results of factor analysis, there was a significant relationship between the questions and the relevant factors. The correlation coefficient for test–, retest with 14 days interval was intraclass correlation coefficient = 0. 92 for the whole instrument and 0. 89, 0. 89, and 0. 92 for the domains of knowledge, attitude, and skill, respectively. The internal consistency coefficient (Cronbach’, s alpha) of the whole tool was 0. 95 and 0. 95, 0. 79, and 0. 95 for the domains of knowledge, attitude, and skill, respectively. Finally, PSCSE Questionnaire was obtained with 40 items in dimensions of knowledge (6 items), attitude (14 items), and skills (20 items). CONCLUSION: Persian version of the nurses’,competency tool in ensuring patient safety in psychiatric wards has acceptable psychometric characteristics.

BACKGROUND: Despite the great comparative advantage of Iran in terms of infrastructure, technology, and human resources as well as the significance of medical tourism in the tourist industry, in practice, the quality of human resources has received less attention. Consequently, this study was conducted to design a model of competency‑, based training for Iranian medical tourism. MATERIALS AND METHODS: This study was an exploratory mix, and the Delphi method and semi‑, structured interviews were used for the qualitative part of this study. In the second part, the analytical method was utilized for the quantitative part of this study. RESULTS: The results indicated the main components of medical tourism to be public interactions and private interactions and seven subcomponents. Medical Tourism’, s Competency includes three main components and seven subcomponents. CONCLUSION: Although some training separated and scattered is present in Iran’, s medical tourism. However, Iran requires a comprehensive training model of which its design was explained in this paper.

In COVID pandemic, attending the continuing medical education, workshops, and conferences with physical attendance is not possible. We designed, developed, and hosted the first of its kind academic virtual/online conference at par with an in‑, person academic conference to disseminate the expertise of the renowned subject experts along with researchers to present their research work due to the ongoing pandemic. We, in this article, had summarized the most critical steps in order to make the process easier for first‑, timers while providing our more comprehensive walkthroughs on each step. We choose a live session of the speakers on the Zoom meeting mode to retain the atmosphere of a live conference. WhatsApp, Google (Google Meet and E‑, mail), and Kahoot were other platforms to communicate with speakers, researchers, and participants to seamlessly participate. A number of advantages in terms of protection for delegates/speakers and their families came from the Virtual Conference on Nutrition and Health, restricting the spread of COVID‑, 19, low budget for organizers, economically much cheaper alternatives both for speakers and participants, dissemination of knowledge, time productive, and meeting research paper presentation eligibility for a professional course. When one is new to technology, try adding an innovative aspect as a starting point to future virtual and in‑, person events, and seeing how it works is imperative. Ensuring Internet bandwidth, updated hardware, or webcam and/or microphone functionality at the participant end is critical.

BACKGROUND: Although basic life support (BLS) has been taught in school by a variety of professionals, it is still unclear that, whether the instructor’, s previous cardiopulmonary resuscitation (CPR) experience is an important factor. This study aimed to compare the effect of BLS training, based on trainer experience in actual situations, on knowledge and skills of secondary high school students. MATERIALS AND METHODS: In this randomized controlled trial, 150 high school students were selected based on the inclusion criteria and then assigned into two groups, (76 in Group A), and (74 in Group B) randomly. Both groups were trained according to adult BLS: 2020 American Heart Association guidelines on mannequins in three 60 min in‑, person training sessions. The knowledge and skill scores were measured for both groups before, immediately, and 1 month after intervention by a questionnaire. Data were analyzed by the SPSS software version 22, using Chi‑, square, Mann–, Whitney U, repeated‑, measure ANOVA tests, and statistically modeling at a significance level of 0. 05. RESULTS: There were no significant differences between groups regarding demographic characteristics. The knowledge and skill scores in both groups increased significantly compared to baseline immediately and 1 month after the intervention (P = 0. 001). However, there was no significant difference in knowledge scores between groups (P = 0. 076(. However, at the immediacy and 1 month after the intervention, the skill score in “, Group A”,was significantly higher than the “, Group B”,(P = 0. 001). CONCLUSIONS: The trainer’, s experience of CPR in the actual setting in the transfer of BLS knowledge is not important, but it improved Student’, s BSL skill acquisition score.

BACKGROUND: Change is a multidimensional and pervasive issue in the modern world, and organizations are constantly changing in social, cultural, political, economic, and technological fields. Change leadership is a model that employs a combination of leadership styles to keep the employees and the organization prepared for learning and continuous growth. This study aims to identify the dimensions and components of change leadership in medical sciences education to move toward third‑, generation universities through a qualitative approach. MATERIALS AND METHODS: The present study was an applied explorative qualitative study. Participants included the experts in the field of management and key informants in the field of change leadership and third‑, generation universities who were selected through purposive sampling. The research tool was semi‑, structured interviews aimed at the identification of dimensions and components of the change leadership. Interview‑, guided questions were about change leadership to move toward the third‑, generation universities followed by probing questions. Colaizzi content analysis technique was used to analyze the data. RESULTS: Data from interview transcript analysis resulted in the identification of 335 initial codes, 13 subcategories, and 3 categories or dimensions. The main categories included “, change leadership roles and specifications, ”,“, providing a context and preparing for change, ”,and “, change leadership process and path. ”,Each of the main dimensions included several components. CONCLUSION: The importance of leadership in the process of change is since change entails the establishment and institutionalization of new systems and structures which is impossible without an effective leadership style. Leaders have high expectations of their followers and inspire them to strive toward organizational goals and facilitate the realization of the shared vision through encouraging them. As a leadership paradigm for organization performance improvement capable of encouraging employees and building an organizational culture in which ethical procedures are considered behavioral norms, change leadership seeks to predict the environment changes so that it can move in accordance with them.

BACKGROUND: The main manifestations of coronavirus disease‑, 2019 (COVID‑, 19) are similar to the many other respiratory diseases. In addition, the existence of numerous uncertainties in the prognosis of this condition has multiplied the need to establish a valid and accurate prediction model. This study aimed to develop a diagnostic model based on logistic regression to enhance the diagnostic accuracy of COVID‑, 19. MATERIALS AND METHODS: A standardized diagnostic model was developed on data of 400 patients who were referred to Ayatollah Talleghani Hospital, Abadan, Iran, for the COVID‑, 19 diagnosis. We used the Chi‑, square correlation coefficient for feature selection, and logistic regression in SPSS V25 software to model the relationship between each of the clinical features. Potentially diagnostic determinants extracted from the patient’, s history, physical examination, and laboratory and imaging testing were entered in a logistic regression analysis. The discriminative ability of the model was expressed as sensitivity, specificity, accuracy, and area under the curve, respectively. RESULTS: After determining the correlation of each diagnostic regressor with COVID‑, 19 using the Chi‑, square method, the 15 important regressors were obtained at the level of P < 0. 05. The experimental results demonstrated that the binary logistic regression model yielded specificity, sensitivity, and accuracy of 97. 3%, 98. 8%, and 98. 2%, respectively. CONCLUSION: The destructive effects of the COVID‑, 19 outbreak and the shortage of healthcare resources in fighting against this pandemic require increasing attention to using the Clinical Decision Support Systems equipped with supervised learning classification algorithms such as logistic regression.

BACKGROUND: Satisfaction of patients is among the top priorities of health‑, care providers. Meeting with families is essential for patients who are admitted to various wards, although it has been restricted for many reasons such as its impact on physiologic indicators. This present research study aimed to exploring the influence of scheduled meetings on physiological indicators of hospitalized patients satisfaction facing acute myocardial infarction in the intensive care unit. MATERIALS AND METHODS: This study was a nonrandomized clinical trial with a control group conducted in the cardiac care unit ward of Hamadan’, s Ekbatan Hospital. Sixty patients with acute myocardial infarction were chosen through convenient sampling and assigned to intervention (planned meeting) and control (routine meeting) groups in a nonrandomized manner. Data were collected by a researcher‑, made questionnaire of patient satisfaction and the observatory checklist of physiologic indicators and then analyzed in IBM SPSS Statistics v23. RESULTS: The total mean score of satisfaction did not significantly differ between the two groups (P = 0. 921). The satisfaction of patients for “, the conduct of visitors”,was significantly higher in the intervention group (P = 0. 005). During the study, no meaningful difference was found between the two groups for physiologic indicators (P > 0. 05), while these indicators, except for blood O2 saturation, were meaningfully increased in the control group during routine meetings (P < 0. 05). CONCLUSION: Planned meetings did not promote total satisfaction of patients with meetings, but improved some aspects of satisfaction, such as the conduct of visitors. The planned meeting is recommended as an alternative for a routine meeting, as it did not affect the physiologic indicators of patients in the intervention group.

BACKGROUND: Applying new methods of clinical education seems to provide nursing students with educational opportunities. The present study aimed to compare the effectiveness of training through demonstration, video display, and virtual social space on the learning of clinical skills among nursing students. MATERIALS AND METHODS: In this semi‑, experimental research with posttest that was performed in 2019, thirty nursing students of the seventh semester were randomly assigned to three groups of demonstration, video display, and the social virtual space education with ten people in each group. The research was conducted in the hemodialysis ward of university hospitals. Each group was trained and evaluated during 10 days with 5‑, h sessions continuously. Participants’,skills were evaluated using eight self‑, made, valid and reliable checklists, and the three groups were compared. For data analysis such as the means and standard deviations and inferential statistics, Mann–, Whitney test, Kruskal–, Wallis likelihood‑, ratio, and Chi‑, squared test in SPSS version 16 were used. RESULTS: The results indicated that practical skill levels in the group of virtual social network were significantly higher than the two groups of video display (P = 0. 045) and demonstration (P = 0. 03). In addition, the group of virtual space had significantly higher scores than those of the other two groups only in two skills of “, prime”,and “, disconnecting the patients from the machine”,(P < 0. 05). CONCLUSION: Proper use of networks and social virtual space for clinical training, along with conventional methods of learning, provides good learning opportunities and is affordable in terms of time, cost, and process.

BACKGROUND: Empathy is regarded as a fundamental personal attribute for in-training and inpractice doctors. Several factors may play a significant role to facilitate or prevent the ability of doctors’,empathy toward their patients. The objective of the present study is to investigate the relationship of empathy with personality traits (extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience) among undergraduate medical students. MATERIALS AND METHODS: This study was based on a correlational, cross-sectional design and was conducted from January 2020 to April 2020. The sample consisted of 301 undergraduate medical students studying in different medical colleges situated in Riyadh, Saudi Arabia. Personal information form, the big-five personality inventory, and the interpersonal reactivity index scales were administered. Obtained data were analyzed by applying several methods such as mean, standard deviation, Mann–, Whitney U test, Pearson’, s correlation coefficient, and multivariable linear regression. RESULTS: Regression analysis revealed that personality dimensions accounted for 10–, 19% of the variance in scores of empathy sub-dimensions of perspective-taking, empathetic concern, fantasy, and personal distress. Agreeableness was found to be associated with empathetic concern and perspective-taking. Openness to experience was found to be significantly related to perspective-taking and fantasy, whereas extraversion was negatively associated with perspectivetaking. Neuroticism had an association with personal distress, empathetic concern, and fantasy. Additionally, no gender difference was observed and students with people-oriented specialty preferences showed significantly higher scores on empathy sub-domains than technology-oriented students. CONCLUSION: This study confirmed that personality dimensions play a notable role to predict empathetic behaviors among Saudi undergraduate medical students. This study would help to design individualized strategies by incorporating personality dimensions in the training program to enhance empathetic behavior among medical students.

BACKGROUND: Early childhood caries is like an epidemic, especially in the developing world, hence exploring its appropriate factors in causing the disease the need of the hour. Hence, the aim of the present study was to evaluate social and behavioral determinants of early childhood caries within the region of Ambala, Haryana. MATERIALS AND METHODS: The present survey elaborated oral examination among 398 study participants within the age group of 4–, 5 years. Carious tooth was recorded using Gruebbel’, s deft DEFT index using clean mouth mirror and probe. A questionnaire comprising 21 questions in English as well as Hindi was prepared. There was an interviewer who took the interview of parents or caregivers. The questionnaire consisted of questions which were aimed at gaining information regarding infants feeding practice, social factors, and dental health behavior. The results of the study were tabulated, and inferential statistics were applied using ANOVA test along with regression (multiple logistic) procedure. RESULTS: The occurrence of caries was affected by the behavioral factors such as breastfeeding habits, bottle feeding habits, age of beginning of solid foods in children. There was no influence of age of beginning of taking fluid from cup. Besides social factors like annual family income, education of mothers, age of mother at the time of birth of children, age of children, order of children in the family had a significant effect over the occurrence and severity and extent of caries. Factors such as gender of children and profession of mother did not have had a significant role in early childhood caries. Dental health habits such as tooth brushing frequency, brushing under supervision, frequency of toothbrushing, quantity of toothpaste used had a significant effect over the frequency, and acerbity of caries in early infanthood. CONCLUSION: It can be concluded from this study that there is a significant correlation between several social and behavioral determinants and early childhood caries.

BACKGROUND: Professional identity includes the values and beliefs of a nurse that guide her thinking, action, and interaction with patients. The stressful conditions of the COVID‑, 19 pandemic may have affected nursing students’,resilience and attitudes toward their profession. Therefore, the aim of this study was to investigate the professional identity and resilience in nursing students during the COVID‑, 19 pandemic. MATERIALS AND METHODS: This cross‑, sectional descriptive study was performed in November and December 2020 with the participation of all nursing students of Babol University of Medical Sciences who spent at least one semester of internship in a hospital during the COVID‑, 19 pandemic. Data were collected using demographic questionnaire, Connor‑, Davidson resilience scale, and nursing students’,professional identity scale. Data analysis was performed using independent t‑, test, ANOVA, and correlation tests at a significance level of 0. 05. RESULTS: Nursing students in the 3rd, 5th, and 7th semesters have spent a minimum of 13 and a maximum of 151 days of internship during the pandemic period. The mean score of professional identity of nursing students was 61. 86 ±,9. 34 and their mean resilience score was 32. 08 ±,13. 54. The resilience score of 92% of students was below 50. Professional identity was significantly stronger, and resilience was considerably higher in students who were satisfied with their profession and lived with their families (P < 0. 05). In other words, students with higher professional identity scores had higher resilience (r = 0. 39, P = 0. 000). CONCLUSION: Despite a good professional identity score, the resilience of nursing students during the COVID‑, 19 pandemic is low. Therefore, professors and the clinical education system should provide more support for students in such stressful times as the COVID‑, 19 pandemic period.

BACKGROUND: Metamotivation is a process that students use to monitor their motivational states to reach their academic goals. To date, few studies have addressed the ways that medical students manage their motivational states. This study aim to identify the motivational strategies of medical students as they use the metamotivational process to monitor and control their motivational states. MATERIALS AND METHODS: This qualitative study uses directed content analysis of the narrative responses of 18 medical students to draft an in‑, depth and semistructured interview protocol which were conducted through WhatsApp due to social distance restrictions of COVID‑, 19. Data were collected, encoded, and analyzed using deductive content analysis approach descripted by Elo and Kyngä, s. RESULTS: Seven main themes were extracted as the motivational strategies of medical students including “, regulation of value, ”,“, regulation of situational interest, ”,“, self‑, consequating, ”,“, environmental structuring, ”,“, efficacy management, ”,“, regulation of relatedness, ”,and “, regulation of situational awareness. ”,In this study by identifying new strategies, we provide a broader framework of metamotivational strategies in the field of the progression of learners in medical education. CONCLUSION: Medical students use a variety of strategies to regulate their academic motivation. To sustain and improve the motivation of medical students, identifying and strengthening metamotivational strategies is the first step.

BACKGROUND AND AIM: Given the growing trend of aging and the limited resources of the health system, the lack of long‑, term prior government planning, and reduced growth of the productive force of society, identifying strategies for planning and action to deal with future aging is very important. In this regard, the study was conducted to identify strategies for dealing with the aging population from the perspective of health system experts. METHODS: The qualitative content analysis study was performed on 29 Iranian male and female experts in the aging and health scope from Isfahan, Tehran, Tabriz, and Babol who purposefully participated in the semi‑, structured interview. Data were classified by qualitative content analysis. RESULTS: Two concepts emerged according to the participated experts’,opinions, regarding the strategies of the Iranian health system in dealing with future aging: “, executive policy”,strategies, including “, design, planning and implementation, ”,“, evaluation and standardization, ”,“, strengthening demand‑, driven”,and “, modeling national and international experiences, ”,“, preventive policies”,strategy, which includes “, Focus on prevention, ”,“, Focus on values and competencies, ”,“, Educational empowerment, ”,“, Knowledge‑, based empowerment, ”,“, Empowerment of age‑, related groups, ”,“, Economic empowerment, ”,and “, Social support. ”,CONCLUSION: The diversity and breadth of the mentioned strategies indicate the necessity of comprehensive readiness and adaptation of health services to the elderly conditions and characteristics. Purposeful planning and timely implementation of programs and policies to better address the health system with future aging will be possible by using practical strategies.

BACKGROUND: Students’,perception of their academic environment has a substantial influence on their actions, academic accomplishments, satisfaction, goal attainment, and behavior. The study was carried out to evaluate the perception of academic environment in physiotherapy students, and to identify the specific domains which could act as predictors of academic performance. MATERIALS AND METHODS: This descriptive, cross-sectional research was conducted over 12 months using total population sampling. Three hundred and forty‑, three (139 postgraduate and 204 final year) final year and postgraduate physiotherapy students from five colleges of Mumbai and Navi Mumbai, who conformed to the inclusion benchmarks, participated in the study. Perception of educational environment was evaluated using Dundee Ready Education Environment Measure (DREEM). Academic performance was evaluated using the percentage obtained in the last university examination. Data were entered in MS Excel (©, Microsoft, USA) and converted to Stata Version 15. 1©,StataCorp, College Station, for further analysis. The mean values and standard deviations for perception of educational environment were calculated and linear regression models were used to conduct multivariate analysis for each item in the questionnaire. RESULTS: The mean total DREEM score of physiotherapy students was 129. 97 ±,22. 72. Students whose Students’,Academic Self‑, perception scores were in the “, Feeling more on the positive side”,category showed a 4. 17 point increase in percentage scores as compared with those who reported feeling like a total failure/had many negative aspects to their academic self‑, perception (95% confidence interval [CI]: 2. 46, 5. 89,P < 0. 001). Students whose Students’,Perception of Learning (SPoL) scores were in the “, Teaching highly thought of”,category showed a 2. 75 point increase in percentage scores as compared with those who viewed teaching poorly/negatively (95% CI: 0. 44, 5. 06,P = 0. 02). CONCLUSION: Physiotherapy students had a “, more positive than negative”,view of the academic environment,however, a few “, problematic areas”,need to be remediated. Efforts to improve students’,academic self‑, perception may improve their academic performance since this was the strongest predictor of their academic performance, followed by total DREEM scores and SPoL.

BACKGROUND: In terms of public health, vaccination is considered as the most effective approach against the infectious diseases. Accepting and receiving the first vaccine produced as an innovation may not be easy. Therefore, the present study was conducted to investigate the predictors of intention to receive COVID‑, 19 vaccine by Iranians aged 18–, 70 years based on the health belief model in 2021. MATERIALS AND METHODS: This descriptive study was performed on 2365 people aged 18–, 70‑, year old in Iran by random cluster sampling. Receipt of data was done electronically questionnaire through the Porcelain system. Data were analyzed using SPSS software version 20 using Chi‑, square, one‑, way analysis of variance, independent t‑, test, and multiple regression analysis at a significance level of 0. 05. RESULTS: The mean score of receiving the Iranian corona vaccine was 3. 06 ±,1. 30 out of 5 points. About 16. 7% reported that they will definitely choose the Iranian vaccine. The highest correlation was between the intention to receive the vaccine with self‑, efficacy (r = 0. 239, P < 0. 001) and barriers to receiving the vaccine (r = −, 0. 237, P < 0. 001). Self‑, efficacy (β,= 0. 114, P < 0. 001), perceived barriers (β,= −, 0. 126, P < 0. 001), and benefits of vaccine (β,= 0. 061, P = 0. 022) were most important predictors the intention to receive the vaccine. CONCLUSION: Approximately 38% reported that they would definitely and probably not choose the Iranian corona vaccine. Therefore, it is suggested that more information should be provided about the features and benefits of domestically produced vaccines compared to foreign products.

While battling the life‑, threatening complications of COVID‑, 19, its effect on the menstrual cycle and infertility has been somewhat ignored. This brief review aims on highlighting the importance of menstrual abnormalities being experienced during the post‑, COVID period and to make the clinicians aware about what to expect in regard of menstrual abnormalities by learning from various studies that have been conducted worldwide. This review article was written with systematic literature review with the help of data search machine such as PubMed, Scopus, Web of Sciences, and Google Scholar. A search strategy leads to the extraction of 160 related articles that after the removal of inappropriate and duplicate articles, 33 articles were selected for the review. To find other potentially relevant articles, the references of the extracted articles were thoroughly examined. The search was carried out using keywords including “, COVID‑, 19, ”,“, Menstrual abnormalities, ”,and “, Infertility. ”,Using OR and AND, the keywords mentioned above were combined and then utilized in the search box of the databases. Articles published from January 2020 to September 2021 were included in this study. It includes worldwide data ranging from studies done in China, India, Ireland, Turkey, Jordan, and Germany. During the post‑, COVID period, there is a significant alteration in the sex hormones of females infected by COVID‑, 19 which may manifest as menstrual cycle abnormalities such as decreased cycle length or prolonged menstrual cycle bleeding. It may also manifest as infertility due to ovarian failure due to suppression of ovarian function COVID‑, 19 a novel coronavirus which is presently a pandemic has affected the world in manner reminding the world of 1918 Spanish flu. However, while battling the deadly pandemic, the clinicians should also be aware of the repercussions of the effect this infection has on multiple organs such as ovarian suppression leading to infertility, oligomenorrhea, or menorrhagia.

BACKGROUND: In India, competency‑, based medical education (CBME) is gaining foothold to transform the medical student into a doctor fulfilling community and societal needs. With that end in view the teaching faculty are getting sensitized and trained by the National Faculty Development Program (FDP). We aimed to assess the awareness about FDP among teaching faculty in medical colleges and study the attitude and perceived barriers to implementation of CBME. METHODOLOGY: A cross‑, sectional, electronically distributed, questionnaire‑, based study was conducted among medical faculty in India. The questionnaire identified participants’,awareness, attitude, and perceived barriers to CBME. Descriptive analysis was employed for continuous variables and internal comparison employing Chi‑, square test with α,<0. 05 for statistical significance. RESULTS: Among 251 participants 90. 2% faculties from private institutes had undergone FDP as against 71% from Government sector (P = 0. 008). We observed that 92. 4% were aware, 80. 2% had undergone Curriculum Implementation Support Program and 95. 2% did agree that CBME will improve the medical education system. Major challenges perceived were high student to faculty ratio (67. 7%), ill developed infrastructure (41. 4%) and difficulties in assessment (41. 1%). The popular solutions suggested were to increase faculty strength (73. 7%), improve infrastructure (69. 3%), extra remuneration (35. 9%) and increase administrative support (30. 7%). There was significant difference of opinions between teaching faculty of government and private sector (P = 0. 017). CONCLUSION: Most of the medical faculty are aware of the need and have acquired a positive attitude towards enforcement of CBME. However, significant barriers do exist in the form of manpower and resources which need to be addressed.

BACKGROUND: To ascertain the effectiveness of a collaborative model between the Department of Community Medicine and state health department to improve MCH outcomes among the urban poor in Chandigarh. MATERIALS AND METHODS: A quasi‑, experimental study was conducted from 2011–, 12 to 2015–, 16 in the intervention and control areas. A collaboration was established between the state health department and the Department of Community Medicine of an autonomous institute. The intervention and control areas were mainly inhabited by the poor migrant population. Critical elements of an efficient collaboration such as the early engagement of partners, clearly stated purpose with common goals, effective communication, and no financial conflict were implemented in the intervention area. MCH program’, s implementation was strengthened through supportive supervision, enhanced community engagement, male partner involvement, tracking of high‑, risk pregnant women, and identification of problem families. Trend analysis of MCH indicators was done. The difference‑, in‑, difference (DID) analysis was done to measure the net effect of the intervention. RESULTS: All the MCH indicators improved significantly in the intervention area compared to the control area (P < 0. 05). DID analysis depicted a net increase in the early registration of pregnancies by 18%, tetanus toxoid immunization by 9. 2%, and fully immunized children by 8. 6%. There was also an improvement in the maternal mortality ratio by 121. 1 points, infant mortality rate by 2. 2 points, and neonatal mortality rate by 2. 6 points in the intervention area. CONCLUSION: An innovative, collaborative model between the state health department and the Department of Community Medicine effectively improved the MCH outcomes in Chandigarh.

BACKGROUND: Hospital Statistics and Information System is one of the most important health information systems in Iran used in all hospitals in this country. Usability problems can reduce the speed and precision of users when interacting with this system. This study aimed to identify the usability problems of a national health system called “, AVAB”, . MATERIALS AND METHODS: This descriptive cross‑, sectional study was conducted in 2020, and three experts evaluated the usability of this system independently by the heuristic evaluation method. Nielsen’, s usability principles were used to identify usability problems and to classify their severity. RESULTS: A total of 86 unique problems were identified. The highest number of problems were related to the two principles of “, help and documentation”,and “, match between system and the real world”,with 23 and 11 usability problems, respectively. The lowest number of problems were related to the two principles of “, visibility of system status”,and “, help users recognize, diagnose, and recover from errors, ”,each with three problems. 58. 1% of the identified problems were in the group of major and catastrophic problems. CONCLUSIONS: With the help of heuristic evaluation method, a significant number of usability problems of Hospital Statistics and Information System were identified. Most of the identified problems were major and catastrophic, and it is necessary to solve these problems by the designers and developers of this system.

BACKGROUND: The Health System Reform Plan, especially in medical education, has undoubtedly caused changes in the university. The continuation of this project requires recognizing the challenges confronted by those in charge of its implementation. This study aimed to explore the challenges of the implementers of the Transformation and Innovation Plan in Medical Education in the universities of Macroregion 5. MATERIALS AND METHODS: The qualitative research was conducted using the content analysis method. Semi‑, structured interviews with health and medical education managers were used to collect information. Participants were 11 educational leaders of universities who were selected by purposeful sampling. Data collection continued until data saturation was reached. Data analysis was performed continuously and simultaneously with data collection. The Graneheim and Lundman methods were used to analyze the data. RESULTS: From 11 interviews, one theme, five categories, and 12 subclasses were obtained. Five categories include lack of proper groundwork, weak leadership, structural problems, inability to fund, and inadequate monitoring. CONCLUSION: Innovation and transformation in medical education are one of the critical missions and admirable actions of the Ministry of Health in the field of education, but a review of this plan can, in addition to identifying shortcomings and problems, pave the way for success, and progress in future programs.