Journal of Education and Health Promotion
Volume:11 Issue: 1, Jan 2021

The aim of the present study was to show the effect of public health educational campaign regarding antibiotic use and microbial resistance on knowledge, attitude, and practice of people in Isfahan.

This quasi‑experimental study was conducted in October 2019 on the public population in Isfahan (a city in the center of Iran). Simple random sampling was done in ten urban areas.). A total of 708 people participated in the study. For assessing the knowledge, attitude, and practice a related researchers‑made questionnaire was used in the present study. Finally, data were entered into SPSS (20) and analytical statistics including paired t‑test were used. The statistical significance level was considered <0.05.

The majority of participants in this study were female 434 (61.9%) and the rest of them were male. The mean ± standard deviation of age was 31.68 (11.11), range of 11–67. More than 50 present of participants had a Bachelor’s degree (37.7%) and diploma (27.7%). Most individuals were self‑employed 277 (43.1%). About the type of marriage, 54.89% were single and others were married. Results showed that the mean of knowledge and attitude was increased after the intervention (P < 0.05).

Increase knowledge between people, adherence to treatment and minimizes healthcare costs, however, “antibiotics are misused so often because of the belief that these are benign drugs. In the absence of urgent corrective and protective actions, the world is heading towards a postantibiotic era, in which many common infections will no longer have a cure and once again, kill unabated

According to the World Health Organization, estimates about 1,800,000 people lived with disability in Tehran. Against there is little evidence of physical access to rehabilitation facilities in Tehran. This study is aimed to assess the physical access to physical rehabilitation facilities in Tehran and compare it with the country.

This is a cross‑sectional study conducted since January to April 2017. We used a master facilities list of rehabilitation facility that developed in Iran to collect the information. The samples of this study included all existing physical rehabilitation centers in Tehran province. Data analysis was done using the SPSSr version 21.0 (SPSS Inc., Chicago, IL).

The results showed that rehabilitation facilities existed at different levels, including inpatient (10.51), outpatient (224.28), community based (36.72), and long‑term care (4.96)/1,000,000 populations. Rehabilitation services are provided by rehabilitation professional including: Physical medicine and rehabilitation specialists (8.7), physiotherapists (132.89), occupational therapists (57.4), speech therapists (42.11), and audiologists (48.84) (in 1,000,000 populations).

Tehran needs to increase the physical access to rehabilitation facilities and compared with country was disproportionate physical access to facilities in most cases. It is necessary to establish an interdisciplinary referral system between different rehabilitation providers.

Emergency department (ED) overcrowding is one of the leading problems of health‑care organizations, discerned by ED medical staff, but it has never been measured objectively.

A 2 months prospective cross‑sectional study was conducted to compare ED overcrowding measurement tools with the perceptions of ED emergency physician and ED assistant nursing superintendent (EDEP/EDANS).

The results have shown that perceptions of ED overcrowding as noted by EDEP and EDANS, taken on a Likert scale, were 83.34% and 86.67%, respectively. Kappa values show a significant agreement between EDEP and EDANS subjective perceptions with objective values of the National Emergency Department Overcrowding Study (NEDOCS), Real‑time Emergency Analysis of Demand Indicators (READI), and Emergency Department Work Index (EDWIN) scales. Furthermore, all three scales have statistically significant correlation; NEDOCS and READI had highest level of correlation coefficient (r = 0.662, P < 0.01) whereas READI and EDWIN shows least correlation coefficient value (r = 0.155, P < 0.01).

Therefore, these scales may serve to quantify the subjective impressions of ED overcrowding. Evidence is clear of overcrowding harms, measures are needed to provide urgent medical care and future work up is need of the hour to systematically evaluate interventions and guide evidence‑based policies.

Clinical rounds provide opportunities for medical students to acquire essential skills to practice medicine in the real world. Although this kind of training is one of the most important components of medical education, it is replete with barriers in its effective implementation. This study aimed to investigate medical students’ experiences concerning the barriers and strategies of clinical rounds in Kerman University of Medical Sciences (KMU).

This qualitative research was conducted on 12 medical students in KMU in 2017. Purposive sampling was used and participants in three grades (stagers, interns, and residents) were selected, and individual semi‑structured interviews were conducted until data saturation. The average of the interview time differed among the three batches (stagers, 51 min; interns, 38 min; and residents, 31 min). Content analysis using deductive approach was used for data analysis. MAXQDA version 10 was used for data analysis.

Data analysis yielded the identification of six themes related to the system of clinical education, fields of clinical education, clinical environment, educational program, medical teachers, and medical students concerning the barriers and five themes related to the strategies for clinical rounds.

Findings revealed a deeper understanding of medical students’ experiences. Our investigation identified multiple challenges embedded in our context and strategies to overcome them. As teaching in clinical rounds is invaluable, there is a need to take into account the identified challenges and overcome them. Thus, more effective rounds with higher efficacy toward students’ professional development can be implemented.

This study aimed to identify models for the participation of the city council and municipality with the health system in selected countries.

This is a descriptive comparative study conducted in 2020 qualitatively. The countries studied were examined in terms of the following characteristics: type of political structure, type of health system, level of cooperation between local government and health system, municipal financing, type of financial participation of local government and health system, method or institution for participation Created, level of participation, local government influence on health system decisions, advantages and disadvantages of a partnership between local government and health system. Data were collected through valid databases (PubMed, Scopus, Embase, and Google Search engine) and website of the World Health Organization, local government, and the Ministry of Health of countries concerned and analyzed in a framework of analysis.

Countries were divided into two groups in terms of a partnership between the health system and local governments, which had a distinct partnership between the health system and local government and without their participation. Factors that contribute to the creating and strengthening of partnerships include beliefs of health authorities and local government, the need for participation, transparency in participatory programs, designing a specific mechanism for participation, local authority, and financing joint participation plans.

In countries with planned participation, citizens have better access to services. Citizens’ participation, as well as the private sector, is greater in health issues. In these countries, participation in health financing by the private sector and other related agencies has increased. Planning and service delivery increases according to neighborhood needs. The variety of services provided and the use of new methods of service are more, and in these countries, the focus of the Ministry of Health on the preparation of strategies and monitoring the quality of services is increasing.

Medical Council of India has suggested competency‑based curriculum for undergraduate students to make it learner centric. One‑month “Foundation course” was introduced at the beginning of the course to promote better adaptation to the new curriculum. A cross‑sectional study was conducted to analyze the feedback from students who attended the foundation course.

All first‑year Bachelor of Medicine and Bachelor of Surgery students who underwent 1‑month foundation course were included in the study. The course was conducted in six modules. All the sessions were handled by efficient resource people and conducted in an interactive manner. A form in which response against each topic/talk was graded as average, good, or excellent was used to obtain the feedback. Data were analyzed using Statistical Package for Social Sciences 16 software. Responses among various modules were subjected to Chi‑square two‑sided test with Yates’s correction.

A total of 98 students (32 males and 66 females) attended the foundation course of 21 days. Among the modules conducted, basic skill training module was scored excellent (67%) remarks, followed by sports and extracurricular activities (64.6%) (P = 0.8806). Among the skill training module, both basic life support training and first aid on medicine/pediatrics achieved 92% excellent score. One of the orientation module sessions, research methodology, scored least. The descending order of excellent remarks was skill module > sports and extracurricular activities > field visit to the community and primary health center > orientation modules > enhancement of language.

Attention should be given to include more topics concerned to the modules of skill training and extracurricular activities in upcoming years. Foundation courses can increase the confidence and better adaptability of the students toward a new environment.

Health promotion is one of the most important aspects in pregnancy, and health‑promoting behaviors are one of the major determinants of health under the influence of various factors. This study aimed to determine the association between social support and psychological factors with health‑promoting behaviors in pregnant women.

This cross‑sectional was performed on 375 pregnant women when they had 24–28 weeks in Ilam, October 2018 to May 2019. Two‑stage cluster sampling was performed after checking the inclusion criteria. Data collection tools consisted of four questionnaires that were completed in self‑report form. The collected data were analyzed by the descriptive and inferential tests with the SPSS software version 19.

The mean score of health‑promoting behaviors was 139.87 (21.26) and self‑healing and physical activity had the highest and the lowest mean 27.67 (4.84) and 16.29 (4.84), respectively. Linear regression analysis showed a significant difference between different level of stress, anxiety, depression, and social support with health‑promoting behaviors (P < 0.001). The results showed that one‑point increase in the score of stress, anxiety, and depression led to the 2.2%, 6.1%, and 24.1% reduction of health‑promoting behaviors, respectively, and one‑point score increase in social support resulted in 40% increase in health‑promoting behaviors (P < 0.001).

A negative association was found between psychological factors and a positive relationship with health‑promoting behaviors. Although perceived moderate health promotion behaviors and perceived social support were moderate, they did not have a good status in terms of psychological factors. Given awareness of the issues under study in each region is essential and planning to improve stress, anxiety, and depression, as well as promoting and correcting inappropriate behaviors through planned interventions are required.

Inappropriate and irrational use of numerous advanced diagnostic imaging technologies has recently been highlighted in many countries and has gathered the attention of policymakers. This matter has not only increased health costs in countries but also resulted in adverse health results. Various factors are involved in the inappropriate or unnecessary use of advanced medical imaging techniques including patient‑related, physician‑related, technological, and ultimately radiologist‑related factors. This calls for the provision of new guidelines by policymakers to encourage all service providers to make appropriate use of such techniques. One of the main approaches in this regard is the application of clinical guidelines and decision support systems. The present study was a systematized review that conducted in January 2019, and the articles related to palliative care requirements on databases of Web of Science, PubMed, Scopus, ScienceDirect, Ovid, ProQuest, Wiley, and Google Scholar from January 1, 2009, to January 20, 2019, were searched. Strategy for searching and selecting the articles was Preferred Reporting Items for Systematic Reviews and Meta‑Analyses Guidelines. Overview of the studies shows that various reasons for the overuse of diagnostic imaging technologies and effects of applying clinical guidelines on reducing diagnostic costs of treatment are investigated in this article with respect to various aspects and viewpoints. Clinical guidelines can be significantly effective in evaluating suitability and quality of referrals for diagnostic imaging, if only adapted properly.

“Stress” acts as both etiological link and also as an outcome in the case of diabetes mellitus. There is a paucity of literature regarding stress levels and also factors associated with it among diabetic patients in India.

To assess the perceived stress levels and their associated factors among diabetic inpatients in a rural tertiary health care center, South India.

A facility‑based cross‑sectional analytical study was conducted among inpatient diabetics seeking care at a rural tertiary care center in Kolar district of Karnataka. A pre‑tested semi‑structured questionnaire was used to capture the sociodemographic, disease‑related, treatment‑related and behavior‑related characteristics of the inpatients. The outcome of “perceived stress” was captured using a standard questionnaire of Cohen Perceived Stress Scale–10. Poisson regression was used for multivariable analysis, and the association was expressed as prevalence ratio with 95% confidence intervals (CI).

Out of the 247 study participants analysed, “perceived stress” was seen among 97 (39.3%) of the participants (95% CI: 33.3%–45.5%). Multivariable analysis showed that factors like younger age, lesser duration of diabetes, presence of any comorbidity, being underweight, having conflicts at work place/home in the last 1 month, and not having enough money for treatment had shown higher levels of “perceived stress.”

About two out of five inpatient diabetics seeking care from rural tertiary health centres had shown to have “perceived stress.” There is a need for the inclusion of stress management techniques in the diabetes education program at all levels of health‑care systems.

 Clinical supervision is a mechanism that allows medical trainees to learn their profession through the practice of clinical activities alongside more experienced physicians who ensure safe and timely care delivery. Therefore, recognizing of medical students experiences as people who will provide health services to people in future can be an important source for gathering information and planning to improve the quality of clinical education. The aim of this study was to explain the experiences of medical students from clinical educational supervision.

This study was a qualitative content analysis conducted on 15 interns of the surgery and internal departments of medical and educational centers in Islamic Azad University Najafabad Branchin Isfahan, Iran to discover. The sampling method was purposive, and data were collected through semi‑structured interviews in 2019. Data analysis was performed using a qualitative content analysis method with a conventional inductive approach.

Five main categories and ninesubcategories were developed. The main categories include fundamental role, relaxed alertness, shadow education, toxic education, and abandoned educational.

The educational clinical supervisory has an efficient performance in clinical teaching which needs to be more assessed and improved.

Childbearing is an important event in a couple’s life. The parents might have children with disability that affected on their well‑being after the children’s birth. Well‑being considered as an important aspect of a couple’s quality of life which may alter the future of their fertility. The present study was conducted to the association of psychological well‑being and fertility intention in parents with educable intellectually disabled children.

The study was a cross‑sectional descriptive research conducted on parents of children with intellectual disability (n = 386). Parents were selected randomly of schools of exceptional education and welfare. The data were collected using Ryff’s scale of psychological well‑being, demographic information, and fertility intention questionnaire. Data were analyzed using descriptive and analytical tests including independent t‑test, Chi‑square test, Mann–Whitney U‑test, and Logistic regression.

The majority of parents (83.9%) reported the negative infertility intention. Despite the mean score of well‑being in parents without fertility intention (75.71 ± 11.67) was lower than parents with fertility intention (76.90 ± 11.27), the difference was not statistically significant (P > 0.05). The logistic regression analysis indicated that the parents’ age and number of children with intellectual disability were predictors of fertility intention (P < 0.05), and their increase decreased the fertility intention.

It seems that the lack of difference in psychological well‑being scores between the two groups of parents might be due to the equal severity of disability in children. The results also indicated parents’ age and the number of children correlated with fertility intention. The findings can be used to advance counseling programs in the field of healthy reproduction for this group of parents.

Foot problems are most common among patients with diabetes, and they are an important cause of morbidity in patients with diabetes mellitus (DM). They can be prevented by following a simple foot care practice. The study objective was to stratify the level of risk for diabetic foot ulcer (DFU) among patients with diabetes by screening.

A descriptive cross‑sectional study design was adopted in this study. The sample size was 196, and a standardized INLOW’S 60‑s diabetic foot screening tool was used to assess the risk of diabetic foot. Data collection was done by face‑to‑face interview, and diabetic foot risk (DFR) was assessed by direct observation, inspection, and palpation methods.

Among the 196 patients, majority required yearly foot screen in both feet. The mean and standard deviation of the level of DFR in the left foot (LF) and right foot (RF) was 4.31 ± 2.267 and 4.51 ± 2.391, respectively. There was a statistically significant association between the practice of treatment and level of foot screening recommendation in the LF with Chi‑square value of χ2 = 8.20 (df = 2) and RF with Chi‑square value of χ2 = 7.95 (df = 2) at P < 0.05 level.

Health‑care providers should be made aware of the regular practice of screening the foot of diabetic patients along with health education awareness programs. It may be helpful to identify the foot ulcer risk at an early stage. It will prevent further complications of DFU and recurrence of ulcer and will reduce the economic burden to patients and their family members and the health‑care system.

Making decision for separation from the spouse is one of the crises which are followed by unpleasant feelings such as self‑criticism in the people. The purpose of the present study was to investigate the effectiveness of compassion‑focused therapy (CFT) on self‑criticism of the women applying for divorce.

The research design was quasi‑experimental with pretest, posttest, and control group type. The population included all the women applying for divorce who referred to an intervention‑in‑crisis center under the supervision of the organization of well‑being in the city of Tehran in 2019. It had the convenient sampling method where the subjects were accommodated into two groups of fifteen women both in the experimental and control groups. The present study had the convenient nonrandom sampling method and the statistical population included 30 women from whom 15 women were accommodated into experimental group and so were 15 in the control group. Sampling method was in available, nonrandom type wherein 15 women were accommodated in the experimental group and so were 15 women in the control group. The experimental group participated in eight 90‑min sessions of CFT and the control group did not receive any intervention. Before and after practical experimental administration, both the groups were assessed through self‑criticism questionnaire by Smart et al. (2016). The statistical method used in the data analysis was ANCOVA.

The results showed that at the error level of 0.5, after controlling the effect of pretest scores as a covariance factor, the mean of the experimental group was significantly lower than the mean of the control group, which shows that CFT approach has been effective in reducing self‑criticism.

As a result, CFT approach can help the people who face the crisis of making decision for divorce and self‑criticism to be able to confront this issue effectively and achieve mental health.

Volunteers are valuable human resources for service‑providing organizations. Health system requires their participation and cooperation in all sectors to achieve more success. The present study was conducted to recognize factors influencing the use of volunteer clinical forces (VCFs) in Tehran hospitals from 2018 to 2020.

This is a qualitative study, based on grounded theory approach, and was done through semi‑structured interviews. The studied population included the experts, managers of hospitals, and high‑ranking managers in the Ministry of Health, Iranian Red Crescent Organization, and health nongovernmental organizations (NGOs). Nineteen persons were selected by purposeful sampling method and interviewed. The achieved data were analyzed by content analysis method.

The results showed that using VCFs in Tehran’s hospitals was affected by eight following factors: organizational, legal, policy‑making, economic, social, security, personal, and cultural dimensions. These findings illustrated the necessity of making changes in the structures, the rules, and the culture of health system to fit the bases with new approaches.

VCFs amplify the quality and structure of service providing for patients in hospitals. The focus of policymakers and high‑ranking managers in health system is on accelerating their use permanently and legally. Developing health‑centered NGOs facilitates the access to VCF, lessens nonclinical loads of hospitals, and improves the organization of human forces. The experiences and knowledge of VCFs cause to develop hospitals’ resilience, develop social participation, and improve social capitals in medical field

Evidence‑based practice (EBP) is the integration of clinical expertise, patient values, and best research evidence into the decision‑making process for patient care. Identification of barriers that refutes the use of EBP in day‑to‑day practice will go a long way in designing programs for inculcating EBP among physiotherapy students. Therefore, the aim of this study was to identify perceived barriers to EBP among physiotherapy students.

A convenience sample of 429 participants were recruited from physiotherapy colleges affiliated to a State Health Science University as per the inclusion criteria. Participants were asked to fill the self‑reported questionnaire that was developed by researchers based on possible items from previously developed surveys. Data collected were tabulated and analyzed by descriptive statistics. Response frequencies for the survey questions were determined and displayed in graphical formats.

The study comprised of 182 final year students, 112 interns, and 135 postgraduate students having a mean age of 21.29 (0.85), 22.30 (0.77), and 24.34 (1.45) years, respectively. Majority of participants reported insufficient time, poor understanding of statistical analysis, lack of research skills, lack of formal training, lack of access to paid article, poor ability to critically appraise articles, and inadequate infrastructure facilities as barriers towards practicing EBP.

Physiotherapy students perceived various organizational, training‑related, and personal barriers toward the use of EBP. Effective education could prove to be the most powerful tool to overcome these barriers toward the use of EBP.

A key step for improving the effectiveness of diabetes self‑management education (DSME) is to identify its restrictors.

The aim of this study was to explore the restrictors of the effectiveness of DSME.

This descriptive qualitative study was conducted in March 2016–2017. Participants were 16 DSME providers (viz., physicians, nurses, nutritionists, and psychologists) and nine DSME receivers (viz., patients and their family members) – 25 in total. Semi‑structured interviews were held for data collection. Interviews were transcribed word by word and analyzed through conventional content analysis approach proposed by Graneheim and Lundman.

The restrictors of the effectiveness of DSME were categorized into three main categories and 11 subcategories, namely patients’ limited welcoming of DSME classes (allocating limited time for participation in DSME classes, inadequate knowledge about diabetes mellitus [DM] importance, inappropriate educational environment, and financial problems), unfavorable adherence to treatments: serious challenge (inattention to educations, poor motivation for adherence to medical recommendations, and inattention to the psychological aspects of DM), and the difficulty of adult education (the difficulty of changing health‑related attitudes and behaviors, mere information delivery during education, adults’ physical and perceptual limitations, and diabetes educators’ limited competence in adult education).

The findings of the present study provide an in‑depth understanding about the restrictors of the effectiveness of DSME. DM management authorities and policymakers can use these findings to develop strategies for improving the effectiveness of DSME

Cardiovascular diseases are among progressive diseases that begin in childhood and are manifested mainly in adulthood. This study was assessed the validity and reliability testing of the Persian version of the Perceived Health Competence Scale (PHCS) among patients with cardiovascular diseases referred to Shahid Rajaie Heart center in Tehran, Iran.

In this cross‑sectional study, a convenience sample of 700 patients with cardiovascular diseases referring to Shahid Rajaie Heart center in Tehran were recruited (response rate = 100%; n = 700). Content validity was established using translation and back‑translation procedure and getting views of the expert panel. The content validity of the questionnaire was measured using content validity ratio (CVR) and content validity index (CVI). Reliability was ascertained using Cronbach’s alpha. The stability was confirmed using intra‑class correlation coefficients.

In this study, CVI = 0.81 and CVR = 0.72 were calculated. Scale reliability was sufficient (α = 0.78; range = 0.73–0.77). Furthermore, reliability based on the stability of the whole scale was 0.75.

The PHCS‑Persian confirmed as a valid and reliable instrument to measure perceived health competence. The PHCS‑Persian scale could be a useful, comprehensive, and culturally sensitive scale for assessing perceived health competence.

The aim of this interventional study was to introduce classroom quality circles (QCs) among first‑year MBBS students, to assess the effectiveness of QCs on learning experience of the students, and to evaluate the students’ satisfaction level during the process of learning.

A problem pool was created through a questionnaire. The study was carried out in the department of biochemistry, for a period of 6 months. Student’s quality circle (SQC) group of five students was created. Then, feedbacks were collected from students by SQC after every class/topic delivered, and fortnightly meeting was held between the SQC group and faculty members of the department, and issues were brought to focus depending on these feedbacks collected by them. Possible initiatives and improvements were done on teaching–learning strategies depending on the outcome of these discussions.

The effectiveness of SQC group was assessed by a pre‑post questionnaire (Questionnaire‑3) feedback from the students and scoring was done based on 5‑point Likert scale. There was a statistically significant difference (P = 0.009) between the mean of pre‑post questionnaire. To analyze the students’ satisfaction level, a set of questionnaires were given to them and scoring was done. Thirty‑four students agreed, 11 students were neutral, and 6 students were disagreed, that introduction of SQC was effective in solving their problems related to teaching and learning of biochemistry.

SQC creates an environment of student centric, fairness, student empowerment, improving solving skills. Implementation of student‑generated feedback through introduction of SQC has improved the quality of the course as well as its delivery. It complements and supplements in achieving students intended learning outcome and hence may contribute to overall learning quality in the long run.

Behavioral and emotional problems are the most common form of child psychiatric pathology. Parenting styles are one of the factors affecting the formation of children’s personality and the use of inefficient styles can lead to several negative consequences such as behavioral problems. The aim of the present article is to describe a variety of parenting styles and their relationship with children behavioral problems. The present study reviews a variety of parenting styles including Kazdin’s Parent Management Education Model, Barclay’s Parent Training Program, Adler and Dreikurs Approach, and Positive Parenting Program. Finally, based on reality theory, parenting is neglected to be one of those styles. Therefore, it is imperative to do a research based on reality theory with existential psychotherapy and with the view that everyone chooses to behave, external pressure is always an imposition, the children learn from their mistakes, and everyone is responsible for his own happiness.

This study aimed to examine the effect of educational intervention using the health belief model on knowledge, attitude, and function of women about Pap test at health centers.

This randomized controlled clinical trial was conducted on 120 women who were allocated into two groups (intervention = 60 and control = 60). The sampling method was a multistage cluster. The training was provided in two sessions for 90 min. Data gathering tool was a 4‑part researcher‑made questionnaire including demographic characteristics, knowledge, health belief model structures, and function. Women were evaluated and completed the questionnaire in two stages (before and 2 months after training). Data were analyzed by Kolmogorov–Smirnov, Wilcoxon, linear regression, Mann–Whitney U‑test, Fisher, Chi‑square, and marginal homogeneity tests.

At baseline, there was no significant difference between the groups regarding the mean of knowledge and the structures of health belief model scores. The average scores of participants in terms of health belief model structures were increased significantly after the training sessions. Furthermore, the comparison of the performance of Pap smear before training showed that in the intervention group (23.3%) and in the control group (31.7%), there was no significant difference in terms of the history of performing the Pap smear test (P = 0.414). However, a significant difference (P = 0.001) was observed after training in the intervention group (31.7%) and in the control group (3.3%).

Educational intervention using the health belief model is effective in increasing knowledge, attitude, and function of women in terms of providing useful and required education.

The study aims to record the perceptions of medical faculties regarding the effectiveness of theory‑based examination to assess the newly introduced competencies of attitude ethics and communication (AETCOM) in the competency‑based medical curriculum for Indian medical graduates.

This is an analytical cross‑sectional study performed on the month of February 2020 where a prevalidated questionnaire consisting of components of AETCOM was e‑mailed to the teaching faculties of IQ City Medical College via Google Forms. Consenting faculties responded. Their results were analyzed by inbuilt Google statistics and were cross‑verified with SPSS 20.0.

Sixty percent faculties strongly agree regarding the beneficial role of mandatory inclusion of AETCOM competencies in competency‑based medical education. About 61.66% of faculties strongly agree that both formative assessment and summative assessment of AETCOM are essential. Although 48.33% of faculties believed that theoretical questions can be used to assess AETCOM, 51.66% of faculties do not agree that theory examination serves as an effective tool to assess AETCOM. They believe that AETCOM cannot be written on paper and attitude can change in reality when facing a real‑world clinical scenario in contrast to what is written in answer script during creative writing.

Assessment of AETCOM is essential and it should be preferably done via a practical approach in a real‑world simulated scenario and not by written theoretical examination.

Education is one of the most important approaches to preventing infectious diseases at the time of the pandemic. The purpose of the study was to develop an intervention‑training program using an intervention mapping approach (IMA) to prevent COVID‑19 infection in adults at the time of the pandemic by health workers.

The present study was a study protocol where IMA was used as a planning framework for developing an intervention‑training program to prevent COVID‑19 infection in adults at the time of the pandemic by health workers in Ardabil city. Six intervention mapping (IM) steps have been described in this protocol. As the first step, needs assessment was performed by reviewing the studies, qualitative evaluation, and interviews. In the second step, the matrix of change objectives was designed from the intersection of performance goals and determinants. Later on, after designing the program and planning the program implementation, the program evaluation plan was developed.

IMA guided us in designing and implementing a control‑oriented training program with the participation of the participants along with the definition of outcomes, performance goals and determinants, theoretical methods and practical applications, intervention program, implementation, and step by step assessment.

IM is a control‑oriented, systematic, participation‑based approach to design and implement targeted and on‑going health promotion programs based on the needs of the target group at the time of the pandemic by health workers.

Road traffic continues to be a major developmental issue and a public health concern. Road accidents in India kill almost 1.5 lakh people annually, and India accounts for almost 11% of the accident‑related deaths in the world. Prevention of road traffic accidents is very crucial by creating awareness and taking proper measures toward road safety.

The aims of this study were to assess the knowledge about road safety regulations and to assess the attitude and practices regarding road safety regulations. SETTINGS AND DESIGN: This cross‑sectional study was conducted in a pharmacy college.

Study participants were all 4 academic years’ pharmacy students who know driving two‑ or four‑wheeler motor vehicle. Data were collected from a sample of 132 by predesigned pretested semi‑structured questionnaire. STATISTICAL ANALYSIS USED: Data were presented in proportions with confidence interval using SPSS ver. 22.

81.1% of the participants knew the minimum age to obtain driving license. Only 16% follow the road signs strictly and 76% wear helmet for long‑distance ride. Poor attitude was observed for wearing helmet for short‑distance ride, pillion rider wearing helmet, and drink and drive.

Majority of the participants were aware of road safety regulations. In spite of having positive attitude toward road safety measures by participants, they could not translate attitude into practice.

During the immediate post delivery period, women are particularly susceptible to distension of the bladder. Complementary and alternative medicine is becoming an established intervention modality within the contemporary health care system. However, very little is known about the impact of foot reflexology on the urinary system. The aim of this study was to evaluate the effect of the most popular type of complementary therapy (the foot reflexology) on first voiding time following elective cesarean section without urinary catheter.

This experimental study was performed on 61 pregnant women in Pastor Hospital, Mashhad, Iran, who met the inclusion criteria. Accordingly, participants were randomly allotted to either treatment or control groups. The intervention group received a single 20‑min foot reflexology session at 2–3 h after the surgery. The time taken for first void was recorded by research assistant that blinded to the allocation of groups. The findings were recorded and analyzed with the SPSS software by using of Chi‑square, independent t‑test, Mann–Whitney, and Fisher exact methods P < 0.05 was considered as statistically significant.

Using General Linear Model (GLM) for controlling of confounding variables, the results of t‑test showed significant differences between two groups in terms of first voiding time (P = 0.001) following surgery.

It seems that the use of foot reflexology as a nursing care plan to prevent urinary retention after cesarean section without urinary catheter does shorten first voiding time and increase maternal satisfaction.

Health‑care workers in community service professions are the formerly candidate for occupation burnout. This study aimed to investigate the relationship between empowerment and job burnout among auxiliary health workers (behvarzan) at Fasa University of Medical Sciences.

In this descriptive‑analytical study, 120 auxiliary health workers were enrolled using the census. Spritzer’s psychological empowerment and Maslach burnout inventory questionnaires were used to collect the data. Then, they were analyzed through the SPSS software, using descriptive analytical tests.

The findings of this study revealed that the auxiliary health workers’ empowerment was in the range of 22–75 with a mean ± standard deviation [SD] of 48.5 ± 9.71, which is in a fairly high level considering the highest score (75) in this scale. Moreover, with respect to burnout (mean ± SD of 58.03 ± 18.64), 36 participants (30%) had low level of burnout, 69 subjects (57.5%) were at the intermediate level, and 15 (12.5%) suffered high levels of job burnout. According to the results of this study, there were a high correlation and negative relationship (r = 0.406, P > 0.001) between psychological empowerment and job burnout among the auxiliary health workers. On the other hand, all empowerment components (competence, autonomy or independence, effectiveness, and trust) had a reverse and significant association with burnout.

Based on the results of this study, the auxiliary health workers (behvarzan) were in a good range of empowerment; also, the dimensions of empowerment were correlated with job burnout in Fasa university‑affiliated hospitals’ health workers. On the other hand, demographic features had no association with these two factors. It is suggested that health authorities should take measures to empower the workers and identify and remove the effects of the various dimensions of job burnout among the health workers in these hospitals.

Many countries are implementing measures for social distancing to contain the spread of the coronavirus disease 2019 (COVID‑19) pandemic. The Indian government also issued an order for complete lockdown of the country, with all the nonessential services, including most of the services for nonemergency health issues, being temporarily suspended.

This study aimed to understand the effect of pandemic lockdown on medical advice‑seeking behavior and the medication practices of the non‑COVID Indian patients confined to homes, who would have normally visited the outpatient departments (OPDs) for medical advice.

It was a questionnaire‑based, cross‑sectional study conducted online during the lockdown period. The questions dealt with medical advice‑related practices, self‑medication, the sources of medical advice, and the need to visit emergency department. Evaluation of data was done as for descriptive studies.

A total of 106 people (34%) out of the 312 participants had either old or new health problems. Ninety‑six of such people (90.5%) tried to manage their sufferings by either continuing the drugs prescribed earlier or by making phone calls to doctors along with taking the help of home remedies, if needed. Ten (9.5%) of the symptomatic participants did not consult any doctor waiting for natural course of relief. None of the participants practiced self‑medication of modern medicine therapy. Only one participant (of the total 312) took hydroxychloroquine as self‑medication for assumed prophylactic therapy against the COVID‑19 infection.

Most of the people with medical conditions, confined at home due to national lockdown, are coping with their problems without any irrational self‑medication with modern medicines or any misuse of prophylactic therapy against the COVID infection. This seemingly positive trend may also have been due to the strict enforcement of the lockdown rules by the law enforcement agencies.

Cardiopulmonary resuscitation (CPR) is regarded as the most important skill of the medical staff who is required to be aware of the latest changes to the CPR guidelines so that they can take the most effective actions in the critical conditions of CPR. Therefore, the present study aimed to determine the levels of CPR literacy among the personnel of universities of medical sciences based in Kermanshah and Khuzestan provinces based on the latest 2015 CPR guidelines in 2019.

In this descriptive, analytical, cross‑sectional study, 525 subjects were selected as the sample population using the two‑stage cluster sampling. For data collection, a researcher‑made questionnaire was used, whose content validity and reliability were confirmed (r = 0.71). The study screened the data received and analyzed valid data set through the ttest and Spearman’s correlation coefficient by incorporating SPSS Statistics software version 23.0. In addition, P < 0.05 was considered statistically significant.

The 2015 CPR literacy levels of the samples were as follows: excellent (85 subjects or 16.2%), good (404 subjects or 77%), and average (36 subjects or 6.9%). The results of Pearson’s correlation coefficient revealed a weak and inverse relationship between the levels of CPR literacy and the age of samples (r = −0.092) and work experience (−0.029), which were statistically significant. In addition, the results of Mann–Whitney U‑test demonstrated that the level of CPR literacy among the personnel of Ahwaz University of Medical Sciences exceeded that among the personnel of Kermanshah University of Medical Sciences (P < 0.001).

It is suggested that in retraining the nursing and paramedical personnel, CPR be carried out with more emphasis on the changes introduced in this guideline compared to that in 2010, including esophageal tracheal airway, reasons for the cessation of CPR, intraosseous infusion, and induced hypothermia.

Commitment to implementing cardiac rehabilitation (CR) plays an important role in managing the problems caused by heart diseases. Commitment to the treatment plan implementation is accompanied by numerous positive consequences. This study was carried out to explain the consequences of commitment to CR.

Data were collected through semi‑structured individual interviews with 26 participants (13 CR specialists and 13 patients), using purposeful sampling. Interview questions focused on the factors influencing the formation of commitment to the CR and its consequences. Conventional content analysis with Graneheim and Lundman’s approach was used to analyze the data. To obtain data trustworthiness, Lincoln and Guba’s criteria were used.

The findings were classified in three categories: purposeful of a purposeful behavior structure (sense of controlling and managing the condition, sense of responsibility, sense of security), formation of active performance structure (interaction between the patient‑family‑treatment team, stabilization of behavior and prevention of intermittent behavior, no cessation of the treatment plan and adherence to it, directing behaviors and adaptation to conditions) and achieving dynamic and effective care (active follow‑up of the treatment plan, sense of satisfaction, reduced readmission, reduced costs, improved quality of life, reduced anxiety and concerns about treatment failure, increased self‑care ability).

The results show that the patient’s commitment to CR is accompanied by optimal consequences. The results of this study can help design the training plan for the CR staff and develop the clinical practice guidelines to provide educational‑care approaches to patients to reinforce their commitment.

In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) became evident in Wuhan, China, and then spread rapidly worldwide. Numerous drugs and vaccines are under clinical trial pipeline for investigation against coronavirus disease 2019 (COVID‑19) infection. The aim of this systematic review was to discuss about investigational new as well as repurposed drugs currently under trial for COVID‑19 infection. An exhaustive search was carried out for this review article including scientific databases of PubMed, Embase, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Web of Science, ScienceDirect, ProQuest, Google Scholar, and Scopus search engines using keywords of “Coronavirus,” “COVID‑19,” “MERS‑CoV,” “MERS,” “SARS‑CoV‑2,” and “SARS‑CoV‑1” and “Solidarity trial” and their Persian‑equivalent keywords from inception until May 2020. After screening the 296 articles searched from different databases (PubMed = 97 and other search engines = 199), 52 articles were included in the final systematic review. It was found that the World Health Organization introduced a Solidarity international clinical trial to discover an effectual treatment of COVID‑19. Based on established in vitro and in vivo activity against different strains of coronaviruses, four repurposed drugs – remdesivir, lopinavir/ ritonavir combination, lopinavir/ritonavir with beta‑1a, chloroquine, and hydroxychloroquine – were considered for clinical trial against COVID‑19. A number of other drugs and vaccines are under clinical trial pipeline for investigation against COVID‑19 infection. Despite multitude of treatment options available, treatment of choice is still not well established. Moreover, optimum supportive care and monitoring of seriously ill patients is the need of the hour.

Identifying the learners’ problems is important. Besides, many factors are associated with academic failure, among which time management and stress are more important than any others based on evidence. By using a systematic review and meta‑analysis, this study aims to synthesize the findings of studies about the correlation of time management and stress with academic failure to suggest a more in‑depth insight into the effect of these two factors on academic failure. Four databases were searched from the inception of January 2018. Publication bias was evaluated visually using funnel plots and sized up by Egger’s test. Ninety‑four articles were found to be qualified for inclusion after full‑text review and additional manual reference made. Of these, 8 were studies of educational interventions that were reviewed in this paper. Regarding the relation of stress and academic performance, the Funnel plot (results not shown) and Egger’s test showed no publication bias in the studies (P = 0.719). Based on this result, the estimated pooled correlation (reverted by hyperbolic tangent transformation) between stress and academic performance was found to be −0.32 (95% confidence interval: −0.38–−0.25). In conclusion, the review recognized a series of potentially mutable medium‑to‑large correlates of academic achievement, time management, and stress. It would be essential to have experimental data on how easily such self‑regulatory capacities can be altered, and these interventions could help students enhance their potential, providing empirical tests for offered process models of academic achievement.

Today, the quality of health services is considered to be providing “error‑free” services, at the right time, by the right person and with the least resources. In recent years, education through evidence‑based care has been emphasized by health system policymakers as a way to improve care standards. Therefore, the purpose of this study is to teach clinical error management to midwifery students in Shahid Sadoughi University of Medical Sciences in Yazd.

The present study was performed using consensus‑based methods based on Delphi technique to identify the most common errors and the best educational solution for its management with the participation of 21 midwives by purposive sampling method in Shahid Sadoughi University of Medical Sciences in Yazd in 2018. The rate of agreement was 75% or more. Descriptive statistical methods and SPSS‑18 software were used for analysis.

The most important errors mentioned were as follows: In the field of hospital care, it was the scope of care during labor and in clinical care, it was the scope of prenatal care. The most important error reduction strategies that were considered in the clinical guide in general were emphasizing the following: active supervision of instructors during the provision of students’ clinical services, paying attention to the evaluation of service provision with the least incidence of errors in end‑of‑course evaluation, make changes in clinical teaching methods, attention to the use of active teaching methods and the use of educational software. The cases were considered separately in each of the mentioned errors. DISCUSSION AND

Incidence of errors in pregnancy and childbirth as the most errors of midwifery students in the field of hospital and clinical care was agreed on. Therefore, considering this issue and the importance of preventing errors to provide quality services to mothers and infants, it seems that it is time to make changes in clinical education in this field by emphasizing the use of active educational methods.

The study aimed to design, implement, and evaluate the process of advisor and teaching assistant (TA) to increase the quality of cascade training in principal educational groups, presenting the obstacles and problems of this educational intervention and introducing them to educational planners.

This applied developmental research was conducted in Isfahan University of Medical Sciences in 2017–2018 in principal educational groups (internal medicine, surgery, pediatrics, gynecology, and cardiology). For this purpose, a working party called TAs was composed of managers, faculty members, and active and interested assistants, including 24 people. The action plan, bylaws, job description, and logbooks were completed by the method of the focus group. Getting the report, monitoring the activity, exchanging the ideas, and drawing up the various plans were continuously done through bi‑monthly in‑person meetings, and the virtual group was organized for monitoring, starting a training logbook, and doing semi‑organized interviews to evaluate.

In a total of 1131 h, various educational activities were conducted such as cooperating with the advisor, teaching some part of a class, holding a workshop, contributing to question design, preparing the educational resources, and organizing an educational round.

Improving the knowledge, attitude, and practice of assistants in cascade training, regulating their activities, learning the teaching skills, and exercising them with the teacher were some of the most significant opportunities of this study.

Concept maps hold great potential for the students as it helps in the formulation of new concepts as well to evaluate the learning ability of the students. However, the use of concept maps as a teaching tool in medical students in India has not been explored, to the best of our knowledge. This study was conducted to assess the use of concept maps in improving learning among medical students.

This study was conducted among III MBBS students belonging to two batches. This study was carried out in two stages. In first stage, pretest was taken to test the knowledge of students. Later, introductory class was taken on tuberculosis and concept map was used to explain the given concept and later posttest was taken. In second stage, feedback was taken from the students regarding the concept map. Pre‑ and post‑test results were compared using Wilcoxon test.

Significant difference between pretest (4 ± 1.593) and posttest (10 ± 0.762) score was seen (P < 0.0001). More than 50% of students scored full marks in posttest, whereas no one got full marks in the pretest. Positive response (82.09%) was received from the students when feedback was taken regarding the use of concept map.

Concept maps are found to be an effective teaching and learning tool for medical students. They can be used to enhance meaningful learning in students and can be practiced more in the students for better understandings of the concepts.

Diabetes is one of the most common metabolic disorders in the world and because of high prevalence and incidence rate, it is a serious challenge posed to the health system in Iran. Despite extensive knowledge of the desirable care for these patients, evidence suggests that the quality of care provided to these patients is not desirable.

The aim is to develop a training program to enhance the preparation of health professionals for evidence utilization in providing comprehensive health cares to patients with diabetes.

This is an exploratory mixed‑method study using consecutive qualitative–quantitative methods that will be conducted in three phases using the approach proposed by Werner and DeSimone to design the program. In the first phase, a qualitative study will be conducted for context assessment and identification of the requirements to enhance evidence utilization taking into account the overall knowledge translation process using semi‑structured interviews with policymakers and health professionals. In the second phase, a training program will be designed based on the data extracted from the first phase, experts’ opinions, and review of the literature. In the third phase, the training program will be implemented, and its effectiveness on the readiness of multidisciplinary health professionals for evidence utilization will be evaluated.

The results of this study will provide a better understanding of how to identify and incorporate contextual factors and the real needs of health‑care professionals and develop a program tailored to improving their readiness to use evidence. It can subsequently lead to providing quality care to patients with diabetes

Critical nutrition literacy (CNL) plays an important role in how college students make everyday decisions about nutrition choices. Increasing CNL is an aim of many introductory nutrition courses, but there are limited instruments measuring this construct. This study aimed to assess the changeability of CNL and the relationship between CNL and markers of diet quality in young adults. DESIGN: This was a two‑phase research project consisting of a nonexperimental, pre–post study and a cross‑sectional assessment from 2018 to 2019. Participants were U.S. college students, 18‑24 years old, recruited from introductory‑level courses from three participating universities, located in Rhode Island, West Virginia, and New Jersey.

Interventions consisted of (1) a 4‑credit, 13‑week nutrition course and (2) a cross‑sectional, online behavior, environment, and perception survey. CNL was measured using the Revised CNL Tool (CNLT‑R) instrument across both phases. Measures for phases include: (1) the changeability of CNL and (2) the relationship between CNL and markers of diet quality. ANALYSIS: Paired t‑tests and multivariate analysis of variance were utilized through SPSS version 25.0.

CNL score significantly increased from baseline to postintervention from 3.38 ± 0.48 to 3.61 ± 0.55 (P = 0.014). There was an overall significant effect of CNL on markers of diet quality, such as cups of fruits and vegetables (F/V) and teaspoons of added sugar (F [2,1321] = 3.12, P < 0.05; Wilks’ Λ = 0.99).

This research found that an introduction to nutrition course was associated with an increase in CNL and that CNL is related to diet quality. The instrument could be used by nutrition educators as an outcome assessment. Future research should investigate other components of the CNL construct as well as predictive validity.

Ergonomics of schools and school furniture is one of the main issues in students’ education. The proportion of school furniture to the anthropometric dimensions of students is one of the main ergonomic challenges in schools that affect students’ health. This systematic review study aimed to examine the match between anthropometric measures and school furniture dimensions among Iranian students. A systematic review was carried out using databases to Google Scholar, SID, IRANDOC, PubMed, MEDLINE, and ScienceDirect and specific keywords to find papers published before March 2020. The references of seminal studies were also used to extend the search scope. Totally, 11 studies entered the review. The results showed that there was no proportion between classroom furniture and students in schools under study. This lack of proportion was evident at different grades in both boys’ and girls’ schools. The results showed a lack of proportion between classroom furniture and Iranian students. There is a need to design and procure furniture based on the anthropometric dimensions of the society that will help to health promotion of students. An updated national anthropometric databank of Iranian students can be a step to solve the problem.

Oral health practitioners are at the frontline of infection, particularly with respiratory viruses such as the novel coronavirus. Knowledge, awareness, and attitude of these workers are considered important in preventing and controlling the outbreak. This study aims to review the literature to provide a better understanding of the status of dentists and other oral health practitioners’ knowledge, attitude, and awareness about COVID‑19.

A systematic review was conducted through Web of Science, PubMed, Scopus, and ProQuest up to May 6, 2020. All the knowledge, attitude, and practice studies on oral health workers about respiratory contagious outbreak the same as severe acute respiratory syndrome, Middle East respiratory syndrome, and COVID‑19 were included in the meta‑analysis.

A total of eleven studies were included in the meta‑analysis. 85.5% of the dentists and oral health practitioners had a high level of awareness about virus transmission modes (95% confidence interval [CI]: 78.6%–92.4%; P < 0.001). 80.7% of the oral health practitioners gave right answers to the questions related to virus transmission modes (95% CI: 69.9%–91.4%; P < 0.001), and 79.9% of the dentists had a positive attitude about virus transmission modes (95% CI: 66.4%–93.4%; P < 0.001).

This meta‑analysis shows that the level of dentists and oral health practitioners’ knowledge, awareness, and attitude was relatively high about the respiratory contagious diseases as well as COVID‑19. The present results can shed further light for policymakers to support the best evidence medical education for all health‑care workers the same as oral health practitioners. Preventing the dissemination of misinformation along with preparing comprehensive guidelines can be considered by the oral health policymakers, particularly in the more infected regions.

 Hospital‑acquired infections (HAIs) are a global problem. One of the common causes of HAI is through the health‑care workers, mainly because of failure to comply with the recommended infection control guidelines.

The aim of our study was to educate and train the nurses regarding infection control practices and assess the impact of training and assess whether this training actually made any change in the incidence of catheter‑associated urinary tract infection (CAUTI) and intravenous (IV) line‑related infections.

Baseline knowledge, attitude, and practices study of willingly participating 105 nurses regarding infection control was done. The incidence of CAUTI and IV line‑related infection was calculated in the areas of their postings. They were trained via an educational module regarding infection control practices. We again assessed the incidence of CAUTI and IV line‑related infections in the same areas 2 months after training. Data analysis was done using SPSS version 20.0. Student’s t‑test was used to analyze the difference in the prevalence of CAUTI and IV line‑associated HAIs pre intervention and post intervention.

There was reduction in the incidence of IV line‑related infection, though it was not significant (P 0.15) and no change in the incidence of CAUTI after intervention.

Single educational module though improved nurses’ knowledge and attitude regarding infection control but failed to result in significant improvement in practices and incidence of HAIs.

We know that risk communication is equally important as risk identification, which is usually not communicated properly to the patients and resulting in poor outcomes, especially in hypertensive patients.

Our study objective was to evolve and test a colour coded client segmentation based public health approach to educate the community to deal with problem of hypertension.

This cross‑sectional pilot study was done in March 2020 among purposively approached in a primary health centre to 100 people aged above 18 years, among them 41 gave written consent for the study and their demographic information was noted. They were given colour coded cards as per the current blood pressure level and previous history of hypertension. On each colour coded card, specific advice was written for that category. For all the participants, blood pressure and treatment seeking behaviour was noted. For hypertensive patients, adherence to medication and non‑pharmacological measures was noted.

Mean age of the participants was 46.5 ± 13.06 years. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the participants were 135 ± 16.85 mm Hg and 86 ± 11.42 mm Hg, respectively. Among the participants, 10 (24.39%) had a known history of hypertension. Among them, as per the blood pressure levels measured on the day of the study 50% (5) had their blood pressure levels under control. Interestingly 16 (39%) participants were found hypertensive incidentally.

It is evident from the studies that colour coded approach is used in multiple ways, in multiple settings, for multiple diseases. To our knowledge, little focus has been given for hypertensive disorders in the community level. We merely bother about making their risk profiling, even in the digital age. Sometimes physicians in emergency become puzzled whenever patients collapsed in front of them and we missed the “Golden Hour” for the treatment by searching patients’ medical details. CONCLUSION AND RECOMMENDATIONS: The above problem can be solved by risk profiling of chronic patients by colour coded OPD/Health cards.