Journal of Education and Health Promotion
Volume:11 Issue: 4, May 2021

The current corona virus disease 2019 (COVID‑19) pandemic has led to the disruption of academic activities including medical education which has made online learning only available options for continuing education worldwide. Online learning has its own limitations, which are further amplified if not implemented properly. Hence, there is a need to assess various barriers faced in the implementation of effective online learning.

The objective of the study was to identify the barriers and motivators in online learning among medical undergraduates. SUBJECTS AND

This internet‑based cross‑sectional study was conducted among medical undergraduates of Punjab. The data collection tool was a semi‑structured self‑made questionnaire prepared using “Google Forms,” which was then circulated in the WhatsApp groups of the students. Received responses were imported to the Microsoft Excel sheet and statistical analysis was done.

Out of the 592 participants, 533 (90%) faced some kind of problem in online learning. Major among them were lack of personal interaction with teachers (52%), distractions at home (43.6%), technology failure (43.2%), limited access to the Internet (39.2%), visual fatigue (38.5%), and increased workload (25%). Benefits perceived were the comfortable environment of home (41%), easy accessibility of recorded lectures (36.8%), and the opportunity to keep in touch with studies (35%).

The online learning process is not a replacement for routine classroom teaching and clinical postings in medical education. However, it can supplement routine teaching, especially during current COVID‑19 pandemic‑like situations. Most of the students (90%) were facing some kind of difficulty in the online learning process due to unplanned and sudden shifts. Therefore, it is necessary to identify and eliminate the various barriers to make online learning effective.

Preterm birth (PTB) is one of the most important factors that increase the risk of chronic diseases and postpartum death in infants. The aim of this study was to determine the maternal factors that affect the birth of preterm infants in the city of Bandar Abbas.

This is a case–control study that was performed on 400 preterm infants. Sampling was done by a simple method, and information was gathered by interviewing the mothers and their medical records. Data were collected by SPSS software version 16. To compare risk factors in the two groups, conditional logistic regression was used, and P < 0.05 was considered statistically significant.

Results showed that factors such as type of delivery (odds ratio [OR] = 3.584, 95% confidence interval [CI]: 1.981–6.485), preeclampsia (OR = 2.688, 95% CI: 1.164–6.207), history of PTB (OR = 4.171, 95% CI: 1.483–11.728), premature rupture of membranes (OR = 3.273, 95% CI: 1.745–6.137), care during prenatal (OR = 0.334, 95% CI: 0.159–0.701), placental abruption (OR = 3.209, 95% CI: 1.209–8.519), placenta previa (OR = 9.333, 95% CI: 2.086–41.770), and cervical insufficiency (OR = 11, 95% CI: 1.381–87.641) were independent risk factors of preterm infant birth.

The PTB risk is higher for women with cervical insufficiency, history of placenta previa, and history of preterm. Early recognition and management of these high‑risk conditions among pregnant women may lead to a reduction in PTB rates.

COVID‑19 is a serious and costly problem for communities. Observing health issues and performing preventive behaviors is influenced by their knowledge and skills of people toward COVID‑19. Hence, this study investigated the knowledge, skill, and practice of the public of Shahrekord toward COVID‑19.

The present study was performed as a cross sectional. Data were collected using an online questionnaire from 540 Shahrekord residents who were selected via convenience sampling in 2020. Knowledge, skill, and practice toward COVID‑19 were assessed using a prevalidated questionnaire. Collected data were analyzed by SPSS‑21 software (one‑way analysis of variance, Pearson test, and regression test).

In this study, 39.1% were male, and 60.9% were female and 46.3% were 20–25 years. The mean score of knowledge, skill, and preventive behaviors was 75.69 ± 17.85, 53.87 ± 27.40, and 59.97 ± 23.79, respectively. There was a significant direct relationship between knowledge and skill (P = 0.05 and r = 081) so that public with more knowledge had a better skill as well. There was a significant association between age (P = 0.036), education level (P = 0.019) , and job (P = 0.014) with knowledge. In addition, a significant association between job (P = 0.027) and marital status (P = 0.014) with skill was observed. Knowledge, skill, and demographic variables predict 37.6% preventive behavior.

The majority of the participants had good knowledge, moderate skill, and relatively enough practice. Government and policymakers must consider these knowledge levels, skill, and practices to implement productive interventions for preventing the COVID‑19.

Responsibility of individuals in adapting to life events depends on the intertwined cooperation of intellectual and emotional capacities, and a person’s success in life depends on his emotional responses. Given that health‑care providers are at the forefront of providing health services, they need to improve their job performance with better control of their emotions and better social relationships. The aim of this study was to determine the relationship between emotional intelligence, social responsibility, and job performance in health‑care providers and caregivers.

A cross‑sectional correlational study was performed on 270 health workers working in the western cities of Isfahan province in the first quarter of 1998 by random classification sampling method. To collect information, two questionnaires of Bradbury emotional intelligence, responsibility, social responsibility, whose validity and reliability had been proven in previous studies, and job performance scores of the samples were used. The collected data were analyzed using descriptive tests and Pearson correlation.

The participants were 270 health workers and caregivers with a mean age of 34.54 ± 7.26. 87.5% of the samples were female and 21.5% were male. The mean score of social responsibility was 124.95 ± 10.41, the mean score of emotional intelligence was 125.58 ± 15.86, and the mean score of job performance was 86.91 ± 9.0.18. The results of Pearson correlation showed that all four components of social responsibility and total emotional intelligence have a significant correlation at the level of 0.01. Total emotional intelligence and each of its components did not show a significant correlation with job performance. Between social responsibility and job performance of health workers, only the moral component significantly predicts job performance (r = 0.133 and P = 0.026).

Although the results of the study showed that the job performance, social responsibility, and emotional intelligence of the study group were desirable, the score of some components of social responsibility and emotional intelligence is lower than their maximum score. In addition, according to the results of the study that showed the relationship between emotional intelligence and social responsibility and some of their components with job performance, improving the knowledge and skills of health‑care providers and caregivers in the field of social responsibility and emotional intelligence and their components seems necessary.

The biotechnology revolution and the emergence of new ways to change the genetic material of an organism have led to an increased risk of biological wars. Coping strategies against these threats is very important to improve the health of people. Therefore, due to the importance of this issue, this study is aimed to review the scope of using biotechnology and genetic engineering in wars and coping strategies in all over the world. In this review study, database includes of PubMed, Web of Science, Google Scholar, Scopus, and Science Direct were searched. The search was limited to reviewed articles in English published between 1990 and 2020. The primary search results generated 148 relevant references. After eliminating the duplicates and articles which were not related to the review of the abstract, 11 references were identified for inclusion in this review. Based on the results of these studies, the advances in genetic engineering can lead to the development of new weapons for other types of conflict and war scenarios, secret operations, and sabotage activities. Rapid developments in biotechnology and genetics have created environmental, ethical, political, and social challenges for many communities. Increasing awareness and sensitivity, monitoring, and building capacity for effective coping are essential. Biotechnology areas that will probably significantly contribute to countering biological weapons include recognizing the human genome, strengthening the immune system, identifying bacteria and viruses’ genome, equipment for biological identification, new vaccines, new antibiotics, and anti‑viral drugs must be monitored.

With the emerging knowledge and understanding of novel coronavirus infection, dentists must be capable of resuming their practice with necessary precautions in near future; hence, the aim of the present study was to evaluate the knowledge, attitude, and practices along with felt challenges by the dentists concerning practicing dentistry during pandemic in India.

An online cross‑sectional questionnaire study was conducted on the dental practitioners of Uttarakhand, India. The dentists were approached by obtaining their E‑mail address from the heads of dental institutions or dental association branches in the state. The knowledge, attitude, and practices along with apparent challenges of practicing during pandemic were assessed using closed‑ended questionnaire. The relationship between the mean scores and demographic variables was determined using Student’s unpaired t‑test by keeping the significance level below 0.05.

Out of 759 respondents, a total of 458 respondents were male (60%), whereas 301 (40%) were female. The mean knowledge scores were higher in females (11.06 ± 2.12) compared to males (9.72 ± 4.53), which was statistically significant (P < 0.05). The mean practice score was lower in males (17.49 ± 6.47) compared to females (19.26 ± 6.69) and likewise lower scores were seen in graduates compared to specialists and these differences were again statistically significant (P < 0.05). Majority of the study participants felt that following various safety guidelines were not feasible (96.97%) and too expensive (96.44%) and considered them as a challenge.

It is imperative that dentists should be fully prepared before resuming their services and reach the right kind of awareness to limit the spread of the disease.

Substance use relapse after treatment is one of the most important aspects of addiction. The present study aimed to investigate the factors affecting the substance use relapse among Iranian addicts.

This cross‑sectional study was conducted in 2019 on 396 addicts referring to the addiction treatment centers in Hamadan, who were selected using a cluster random sampling method. The data were collected by a two‑section questionnaire (demographic variables and risk factors for substance abuse recurrence). The collected data were analyzed using descriptive statistics and logistic regression analysis.

The participants’ mean (standard deviation) age was 36.56 (8.8) years, and 84.6% of the participants had a history of relapse. The logistic regression analysis revealed that marital status (odds ratio [OR] = 2.594; 95% confidence interval [CI]: 1.472–4.570), personal willingness (OR = 8.186; 95% CI: 1.875–35.738), pleasure (OR = 2.738; 95% CI: 1.122–6.679), drug availability (OR = 3.392; 95% CI: 1.023–11.247), family disputes (OR = 4.583; 95% CI: 1.345–15.609), an addicted friend (OR = 2.693; 95% CI: 1.014–7.157), and close addicted relatives (OR = 3.513;95% CI: 1.193–10.348) were the main predictors of addiction relapse (P < 0.05).

The present study confirmed the effect of several factors (namely demographic, individual, interpersonal, environmental, and behavioral) on the substance use relapse. Accordingly, designing and implementing some interventions based on the findings of the present study may contribute to preventing substance use relapse.

Support services are a very important element for all educational institutions. The aims of this study were to explore the components of the student support system in blended learning for universities of medical sciences in Iran.

The present study was performed qualitative with exploratory approach. The tool used to collect data was a semi‑structured interview, after conducting interviews with 17 e‑learning experts and specialists of universities of medical sciences, we reached information saturation. The study was conducted at Aja University of Medical Sciences in Tehran in 2020. Data analysis was performed as Thematic Content Analysis by Attride‑Stirling method.

From the content analysis of the interviews, 6 main themes and 19 sub‑themes were obtained. Main themes included “Scientific- cognitive Support”, “Systematic Support”, “Human Resource Support”, “Emotional Support”, “Technical Support” and “Financial- economic Support”.

Based on the results of this study, 6 basic components and its subcomponents of the student support system were obtained. It is suggested that the educational officials of medical universities with blended learning use the results of this study in setting up their student support system for academic success in e‑learning and medical students.

Pregnant women are classified as one of the vulnerable groups. Physiological and psychological changes during pregnancy predispose them to serious psychiatric disorders; if not identified and treated in time, it can have a negative and long‑term impact on mental health. The aim of this study was to determine the effect of cognitive–behavioral counseling of pregnant women with the presence of a spouse on the level of stress, anxiety, and postpartum depression.

The present study is a clinical trial that was performed on 40 pregnant women with a gestational age of 32–28 weeks (20 in the intervention group, 20 in the control group) who were randomly assigned to the intervention group and the control group according to the inclusion criteria. Cognitive–behavioral group counseling in the presence of spouses was performed by the midwife and under the supervision of a psychologist, in eight sessions, each session lasting 90 min, once a week for the intervention group. The control group received routine care and a counseling session. Data collection tools were demographic information questionnaire and Depression–Anxiety– Stress Scale 21, which were completed before the intervention, immediately after the intervention, and on the 14th day after delivery in both groups. Data analysis was performed using statistical tests, independent t‑test, repeated measures test, Bonferroni post hoc test, and Kolmogorov–Smirnov test.

The results of this study showed that the mean scores of stress, anxiety, and depression in the two groups in the preintervention stage were not significantly different (P < 0.05), but in the postintervention stage and follow‑up, the mean scores of stress (P < 0.001), depression (P = 0.010), and anxiety (P = 0.029) in the intervention group were significantly reduced compared to the control group.

According to the research findings, cognitive–behavioral group counseling can be effective as an approach in improving the symptoms of stress, anxiety, and depression in pregnant women. Therefore, it is necessary to plan properly to use this counseling approach to manage stress, anxiety, and depression in women during pregnancy.

Short‑term academic procrastination may be accompanied by negative outcomes such as anxiety, stress, and depression. The current study aims to evaluate the two parameters of procrastination and test anxiety in physiotherapy students and explore whether a relationship exists between them.

A descriptive, cross‑sectional survey with a prospective study design was carried out over a period of 6 months. The study used a two‑staged cluster sampling

220 undergraduate and postgraduate physiotherapy students from colleges in Mumbai and Navi Mumbai participated in the study, ensuring participation of students from each year of the course. The Westside Test Anxiety Scale was administered to evaluate test anxiety, and the Academic Procrastination Scale was used to evaluate procrastination. To illustrate the basic demographics of the participants, descriptive statistics were used. A correlation matrix was used to analyze the correlation between the two parameters.

The mean procrastination score of the physiotherapy students was 74.1. Amongst undergraduates, the highest procrastination was seen in the 3rd Bachelor of Physiotherapy students (mean = 76.7), whereas among postgraduates, the highest procrastination was seen in Master of Physiotherapy 1 students (mean = 75.7). The mean test anxiety score was 3, indicating moderately high test anxiety among students. There was a statistically significant, positive correlation between test anxiety score and procrastination score (P value = 0.000, Pearson’s correlation co‑efficient = 0.383).

Both test anxiety and the tendency to procrastinate were present among undergraduate and postgraduate physiotherapy students, in varying degrees. There was a positive correlation between the two factors.

There is abundant documentation in literature that presence of maternal periodontal infections has been attributed to serious health problem to the mother and the child. Regular evaluation of any illness burden is required for planning preventive and treatment strategies and fills the existing health gap. There is a lack of literature about the predictors and prevalence of periodontal diseases in expectant women in the slum areas of Patna.

It was a cross‑sectional study conducted on pregnant women of slum areas of Patna, Bihar, by convenience sampling method. Using a questionnaire, data collection was carried for demographic and oral hygiene habits information. Periodontal examination was done using modified community periodontal index criteria (WHO, 2013) by recording bleeding on probing (BoP), periodontal pockets (PD) and loss of attachment (LoA). The prevalence of potential predictors was estimated and bivariate analysis was performed with BoP, PD, and LoA and then to explore the prevalence of odds ratio (ORs) multivariate logistic regression framework was employed. The level of significance was kept at P < 0.05.

A higher level of BoP and PD was observed among women who had the habit of cleaning their teeth once daily a day than those who cleaned their teeth with brush twice a day. Oral cleanliness (hygiene) frequency established the maximum OR of 2.77 (2.07–3.71) for BoP. Gingival bleeding robustly was related with PD. Among all multivariate framework of predictors of LoA, BoP, and PD came as the firmest predictors.

Teaching correctly how to maintain oral hygiene and periodic periodontal check‑up can improvise the general well‑being and adverse pregnancy outcomes can be lessened.

Population aging has increased the need for long‑term care of older persons who suffer from multi‑morbidity and chronic conditions. Today, the majority of older people are living alone in their home in which they try to cope with highly risky conditions such as sensory impairment, diminished mobility, and medication management. Recent developments in information technologies could improve the access to care for older people as well as reducing the need for full‑time caregivers both in homes and institutions such as nursery homes and hospitals. This study aimed to review the economic evaluation of such technological advancements in the care of older people. Through a systematic approach, electronic databases were searched and of 2732 records retrieved, three papers were included in the final review. Three different models of economic evaluation including cost analysis, cost–benefit analysis and cost‑effectiveness analysis were applied in these studies in the context of telemedicine and older persons’ care. Since the methodological approaches were quite different and the outcomes reported were not consistent between studies, no meta‑analysis was applicable and we qualitatively reviewed the papers. All studies have reported cost savings associated with the use of telemedicine technologies such as video visits and smart homes in the care of older persons.

Reproductive motivation is a complex issue that has cultural, behavioral, and ideological roots and changes in the context of population transfer and economic and social development. Reproductive motivations include positive and negative motivations that can be influenced by education. Training can be done in different ways. It seems that face‑to‑face training increases learning. On the other hand, face‑to‑face training increases participants’ cooperation and desire for educational topics. Therefore, the aim of this study was to compare and determine the effect of two counseling methods on the fertility motivation of infertile couples.

This intervention study was performed on 68 men and women with infertility referring to Milad Infertility Center in Mashhad in 2016–2017. Subjects were randomly assigned to two methods of counseling. Participants completed written consent to participate in the study. Infertile couples were included in the study if they met the inclusion criteria. The fertility motivation questionnaire was completed by the participants at the beginning of the study before the consultation and 2 weeks after the consultation. The collected data were analyzed by SPSS Software Version 16.

According to the independent t‑test, there was no statistically significant difference between the mean scores of positive fertility motivation in the two groups of face‑to‑face and telephone counseling before the intervention. Independent t‑test showed that 2 weeks after the intervention, there was no significant difference between the two groups in terms of this variable (P = 0.283). There was no statistically significant difference between the mean scores of positive fertility motivation in the face‑to‑face counseling group before and after the intervention. Further, in the telephone counseling group, there was no significant difference between the mean scores of positive fertility motivation in the two stages before and after the intervention. According to the independent t‑test, there was a statistically significant difference between the mean scores of negative fertility motivation in the two groups of face‑to‑face and telephone counseling before the intervention (P = 0.025). However, this test showed that there was no significant difference between the two groups in terms of this variable 2 weeks after the intervention.

The results of this study showed that face‑to‑face and telephone counseling did not have a significant effect on fertility motivations of infertile couples. In other words, the mean scores of positive and negative fertility motivations before and after counseling remained unchanged in both groups and the two groups did not differ in this regard. In other words, the issue of fertility motivation in infertile women can be affected by different characteristics such as social, family, cultural, and economic conditions of individuals. If infertile people do not make having a child a necessity in their lives and cope with it more easily, no counseling can change their motivation. On the other hand, if infertile women consider having a child as an essential part of their married life and the health of their married life, counseling can have the greatest effect on them.

COVID‑19 has a great impact on medical sciences education. Some researches have been conducted on the effects of the COVID‑19 pandemic on medical sciences education in the world. The aim of this study was to identify the effects of this disease on medical sciences education in Iran.

This futures study research was carried out using the future wheel method in Iran’s University of Medical Sciences in the spring of 2020. A semi‑structured interview was also conducted on the vice chancellors of medical sciences universities, faculty presidents, faculty vice chancellors, faculty members, medical education specialists, and university students, who were purposefully identified. The interview continued until achieving data saturation. Analysis of the interviews was performed by MAXQDA version 10 software.

The effects were presented at three levels including primary effects, secondary effects, and third effects. In addition, 16 primary effects, 51 secondary effects, and 24 tertiary effects were recognized. One primary effect of the coronavirus (COVID‑19) pandemic on medical sciences education in Iran was fear, stress, and anxiety among students and faculty members as well as staffs to get the disease. In addition, rumor was circulated concerning the infection of some people, thus, there was a need for holding courses regarding stress management and rumor management. One secondary effect of the coronavirus (COVID‑19) pandemic on medical sciences education in Iran was allocation of a number of educational hospitals to the referral hospitals of COVID‑19. One tertiary effect of the coronavirus (COVID‑19) pandemic on medical sciences education in Iran was increasing the number of virtual courses.

The most important effect of this disease on medical sciences education is the postponement of practical and apprenticeship classes, and consequently the increased length of the academic term that leads to delay in the students’ graduation, which can reduce the workforce. On the one hand, this disease causes death of a number of students, educational and medical staffs, and faculty members, as well as reduces the workforce. Also, lengthening the recruitment of faculty members will add to this challenge. In this regard, there is a need to plan to compensate for the shortage of required human resources.

Online self‑assessment tools have become an important asset among current teaching, learning, and assessment methods, especially among medical students. Developments in information technology and recent changes in methods of undergraduate learning, especially with the current COVID‑19 pandemic situation, will provide an impetus among students to uptake this assessment tool. The study is aimed at bringing out the perception of medical students in using an online self‑assessment tool in Biochemistry on the topics “Liver Function Tests” and “Renal Function Tests.”

This study was an observational study conducted among 150 1st ‑ year medical students employing an online self‑assessment tool in Biochemistry, and the perception response toward the questionnaire was graded.

The participation was 100%, with the perception questionnaire having a good internal validity (α = 0.847). The students’ response was maximum for questions 9 and 10, which favored for provision of instantaneous feedback and application of the same tool for other topics. A positive correlation was observed between questionnaires for perceived learning and perceived engagement using the online self‑assessment tool (r ± 0.554, P = 0.001).

Self‑assessment tools have an impact on the learning of students only when provided in a suitable environment such as immediate feedback and nonranking mechanisms.

Online learning (OLL) methodology has been incorporated in higher education extensively on the mount over the last few decades and with the onset of COVID‑19 situation, the virtual method in academia became essential. After observing worldly destructions and death due to coronavirus, the WHO declared a high alert emergency, and since Pakistan started to follow lockdown since March 2020 to prevent high penetration and consequently, the online teaching method was adapted to keep the learning atmosphere alive. The study is aimed to identify the influencing factors and compliance for the implementation of the OLL system in COVID‑19 and, in the future, nonpandemic state as well.

The present study is designed to observe the adaptability and hurdles among pharmacy students, and for the purpose of the study, a questionnaire on the Likert scale was developed and asked to respond from pharmacy undergraduate and postgraduate students after taking consensus, which further analyzed through IBM SPSS Statistics Version 26.

The outcomes of the study were analyzed with a high level of conformity; however, the gender‑based reservations were observed, and moreover, merits of OLL were observed with high jeopardy.

The adaptation of OLL, though proved as the only troubleshooter in an uncontrollable situation and enabled universities, professors, and students for patience, resilience, and hopefully, will serve as swift safeguard for future challenges of epidemic and pandemic disasters. According to the evolution theory, brain adaptability and plasticity of human organisms grow the capacity to adjust itself with an advanced characteristic.

Employees spend most of their time at work, and hence, it is important to pay attention to health‑promoting behaviors. The purpose of the present study was to investigate the status of health‑promoting behaviors of employees in the Medical University of Ilam‑Iran.

This cross‑sectional, descriptive study has been conducted by the participation of 208 employees, whom selected through the simple random sampling method. In the present study, participants completed Walker’s Health Promoting Life Style Profile II in the self‑report form. The gathered data were analyzed using software at the significant level of 0.05. Data were analyzed by the independent samples t‑test, one‑way analysis of variance, and Pearson correlation coefficients.

The highest correlation of health‑promoting behaviors was related to spiritual growth (r = 0.785), stress management (r = 0.777), interpersonal relationships (r = 0.767), health responsibility (r = 0.730), nutrition behaviors (r = 0.641), and physical activity (r = 0.611) were in the next places (P < 0.001), respectively. Among sub‑scales, the highest correlation was observed between spiritual growth and stress management (r = 0.676, P < 0.001) and the lowest correlation between physical activity and interpersonal relationships (r = 0.253, P < 0.001).

The score of physical activity was lower compared to other dimensions of health promoting behaviors. Therefore, it is necessary to make more effective interventional measures for improving physical activity status.

Female sexual dysfunction is a common and often distressing public health problem. This study aimed to determine the effect of the sexual health program on female sexual function and attitude in reproductive age in the west of Iran.

This was a field trial study. A total of 103 women attending health centers were assigned into two groups; an experiment and a control group. Data collection tool involved sociodemographic characteristics questionnaire, sexual female attitude questionnaire, and the Female Sexual Function Index (FSFI), which was completed by participants before and after the implementation of a sexual health education program. Data were analyzed using SPSS software version 22.

The results revealed that after the intervention, female sexual function in the experiment group based on the FSFI tool was significantly improved (P < 0.01) in the domains of desire, arousal, orgasm, satisfaction, pain, and the total score compared with the control group. Besides, there was no significant difference between posttest mean score of sexual attitude in the experiment group and control group (P > 0.05). However, a significant difference was found in the mean score of sexual attitudes in the experimental group before and after the intervention (P = 0.004).

The findings showed that sexual health program was effective in improving women’s sexual function and attitude in the experiment group. It is recommended that the effect of other training methods remain to be addressed on women’s sexual function and attitude.

Chronic liver disease is associated with decreased quality of life. The quality of life of children with chronic liver disease is related to their quality of life. Malnutrition is associated with death from cirrhosis, development of complications, and health‑related quality of life in people with liver disease. Therefore, this study was conducted to determine the effect of nutritional adjustment program on quality of life in children with chronic liver disease.

This clinical trial study was performed on children with chronic liver disease referred to the nutrition clinic of Ghaem Educational‑Research Center in Mashhad in 2015. In this study, 77 children with chronic liver disease were randomly divided into two groups. Before and after the intervention, patients’ quality of life was assessed with the PedsQL™ 4.0 generic core scale questionnaire. Data analysis was performed using SPSS16 software.

In the postintervention stage, the mean total score of quality of life in the experimental group was 1965.0 ± 270.9 and in the control group was 1522.5 ± 321.3 (P < 0.001). The difference in quality of life score of physical, social, and school performance in the two groups was significant.

According to the results of this study, it seems that interventions that can improve the quality of life of children with chronic liver disease can be an important step in advancing these people toward a healthy and quality life. As a result, it is possible to take steps to improve the quality of life of patients by encouraging children with liver disease and providing information about diet.

Length of stay (LOS) and patients’ outcome are two important indicators in intensive care units (ICUs). The severity of illness influences these variables and could have a predictive value in clinical settings. The impact of severity of illness on the LOS and outcomes in patients admitted to ICUs was investigated in a selected hospital in Iran in 2019.

This research was a descriptive longitudinal study. Data were prospectively collected on 150 patients. The sequential organ failure assessment (SOFA) score, LOS, and demographic variables of the patients were recorded. Abbreviated mental test and Barthel index measuring activities of daily living questionnaires were completed at the time of the discharge from ICU and 1 month later to show the patient outcomes. Data analysis was performed using Chi‑square test, t‑test, analysis of variance, Pearson’s correlation, and linear and ordinal logistic regression with SPSS software version 16.

The mean of LOS was 11.21 ± 10.54 days. 24.7% of the patients were discharged from ICUs with optimal recovery, 49.3% with poor recovery, and 26% died in ICUs. One month after discharge, 67.6% of patients had optimal recovery, 24.3% had poor recovery, and 8.1% died. The SOFA score had a significant relation with LOS and patient outcomes in discharge and 1 month later. All the patients with SOFA score <5 survived, and all the patients with SOFA score more than 12 died.

The severity of illness had a significant relation with LOS and patient outcomes in the time of the discharge from ICU and 1 month later. It seems that the initial SOFA score of 12 and higher can be suggested as a cutoff point for poor prognosis in ICU patients.

To extend our knowledge of social barriers in relation to mental health, the present study was conducted to investigate the impact of social barriers on mental health help‑seeking among Saudi Arabians aged 18 years and above.

This cross‑sectional study was carried out on 1632 participants in 2018 during the months of October and November. The participants completed self‑administered online surveys about the demographic characteristics, social barriers, and knowledge and attitudes about mental health.

The majority of the participants agreed that social barriers could prevent them from seeking mental health help. Stigma was chosen as the most common social barrier among the participants (76.3%), followed by culture (61.5%) and negative perceptions (56.2%).

Social barriers are a challenge in seeking mental health. Increasing public awareness of available services and resources as well as developing programs to fight stigmatization should be initiated to create more positive attitudes toward people with mental illness and promote holistic well‑being.

In the recent years, the accreditation of educational institutions and hospitals has attracted a lot of attention in different countries to ensure the quality of medical education. In this regard, examining the experiences of different countries will help to improve the world and local standards. This study was an attempt to explore the lived experiences of senior managers about the educational accreditation challenges and appropriate strategies to overcome these challenges.

The authors used a phenomenological approach to explore the lived experiences of the senior managers about educational accreditation of teaching hospitals affiliated to Iran University of Medical Sciences. Semi‑structured interviews were conducted to reach data saturation. For this purpose, three semi‑structured face‑to‑face interviews and six electronic interviews were conducted. Data were analyzed using the Colaizzi method.

Data analysis showed that the most important challenges of educational accreditation of teaching hospitals were related to standards and criteria, executive policies of accreditation, and educational, attitudinal, and financial infrastructures. The strategies expressed by the participants were categorized into four themes including reviewing and revising standards and criteria, planning for education, providing human and financial resources, and modifying the executive structure of accreditation.

In order to improve the quality of educational accreditation programs, it is necessary to identify and find a solution for the existing challenges by experiential support of the senior managers of teaching hospitals and the other stakeholders (e.g., faculty members and students). It also provides an opportunity for educational policy‑makers to improve the hospital’s educational accreditation program.

Most patients with myocardial infarction (MI) suffer from one or more risk factors such as obesity and overweight, unhealthy diet, lack of physical activity (PA), and high blood pressure. Individual control of these risk factors by lifestyle modification raises the probability of survival in these patients; hence, we used a self‑management intervention to assess its effect on the lifestyle of post‑MI patients.

This quasi‑experimental study was conducted on 92 hospitalized MI patients in Hamadan province in 2016. Convenience sampling method was used for selecting the participants. The patients were selected and assigned to experimental and control groups. The main parameters (diet, blood pressure, waist circumference, and body mass index [BMI]) were measured at the baseline and 8 weeks after discharge. Domestic PA was the only parameter measured 8 weeks after their discharge. A self‑management intervention was adopted for the experimental group. The data were analyzed using paired and independent‑sample t‑tests with SPSS software version 16.

The comparison of the scores obtained for diet, blood pressure, waist circumference, and BMI in post‑MI patients revealed no statistically significant difference between the two groups at the beginning of the study (P > 0.05). Following the intervention, the experimental group had a significantly higher mean score for diet and domestic PA (walking program from 1st week to 8 weeks), compared to the control group (P < 0.001); however, the intervention had no significant effect on BMI, waist circumference, and systolic and diastolic pressure (P > 0.05).

The findings indicated that the program had an impact on some risk factors. Therefore, it is recommended to use self‑management support in MI patients during the discharge process to improve their lifestyle.

Education is considered as one of the most important well‑known roles of nurses, which is based on the patients’ needs and awareness level. Thus, training the skill to nursing students is highly prioritized. The present study aimed to compare traditional and role‑play training methods on nursing students’ performance and satisfaction in the principles of patient education course.

The present quasi‑empirical study was conducted in 2019 among 36 fourth‑semester nursing students at the School of Nursing in Borujen branch. In this regard, the students were randomly divided into experimental (n = 18) and control (n = 18) groups and trained through role‑play and traditional methods, respectively. The data were collected using demographic questionnaire, training method satisfaction form, and student performance evaluation checklist (30 items), among which the two last ones were researcher made. Then, data were analyzed by SPSS software version 19 and using descriptive and analytical statistical tests such as Chi‑square and Mann–Whitney.

The results demonstrated a statistically significant difference (P < 0.05) between the mean score of students’ satisfaction with teaching method in the control (17.15 ± 0.89) and experimental groups (19.03 ± 1.49), as well as between that of their performance in the control and experimental groups (115.31 ± 2.07 and 118.28 ± 3.59, respectively).

Based on the results, role‑play training method affected nursing students’ performance in the principles of patient education course higher. Thus, using the method in training students and in‑service training for nursing personnel is recommended to education planners and nursing education authorities for improving the skill.

Employing appropriate and deserving staff is goal of human resource management (HRM). A group of staff at medical science universities are clinical teachers. Considering the position and importance of these peoples, this study addresses the challenges of recruiting clinical teachers.

This is a qualitative study of the conventional content analysis done in Isfahan medical university in 2018. The participants were selected through intensity sampling of purposive sampling method, and data were obtained through semi‑structured interviews conducted to survey 23 experts and clinical faculty members concerning the challenges involved in employing clinical teachers. Data were analyzed using conventional content analysis method and OneNote 2013.

Two main categories and ten subcategories were classified as follows: HRM inadequacy in educational departments with six subscales such as indefiniteness of the workforce status for HR managers, reluctance of educational departments to increase human resources, nonproportionality of the teacher–student ratio, recruitment of faculty based on the needs in the treatment sector, weakness of the infrastructure to use nonfaculty teachers, and reduced public interest in employment as a faculty and weakness of the selection process with four subscales based on data analysis such as undesirable manner of selection, recruitment based on the score given by the national board of medical examiners, purpose‑based calls to recruit predefined individuals, and personal and emotional issues, rather than managerial standards, governing cooperation with teachers.

Recruitment process is part of HRM tasks. Employment system in a medical sciences university must be considered to improve the clinical faculty recruitment. HRM inadequacy in educational departments and weakness of the selection process are challenges that affect the employment system. According to these findings, it is necessary to review the regulations and tasks of HRM in medical sciences universities.

The practice of yoga is proven to have physical, cognitive and emotional benefits for school children. Despite this many schools do not include yoga in their daily schedule. The reasons cited are lack of time and resources. To overcome these problems the present study aimed to develop and validate a short duration Integrated classroom yoga module. The design guidelines were that it should be possible to practice in the classroom environment and that it could be led by the class teacher. In this way the module would overcome the problem of both time and resource.

The study had two main phases. In the first phase, selected ICYM practices based on the literature review were validated by 21 subject matter experts using Lawhse’s content validity ratio (CVR) formula. In the second phase, a pilot study using a paired sample prepost measurement design was carried out on 49 high school children. The study was conducted in June 2019. The intervention period was 1 month, and the test variables were physical fitness, cognitive performance, self‑esteem, emotional well‑being, and personality characteristic. Paired sample t‑test was the analysis tool and the software used was the Statistical Package for the Social Science version 26.

In the Lawshe’s CVR analysis, 17 out of the 24 practices tested were rated by experts as essential as was the overall module (CVR score ≥0.429). In the pilot study, there were significant differences in the postmean scores compared to premean scores, for all the 4 EUROFIT physical fitness testing battery tests (P < 0.02), all the three scores of the Stroop color‑word naming task (P < 0.001) and the Rosenberg self‑esteem scale (P < 0.008).

ICYM was validated and found feasible by the present study. It was found to have a statistically significant impact on physical fitness, cognitive performance, and self‑esteem variables. However, a randomized control trial with a longer intervention period is needed to strengthen the present study.

Little is known about the inference that physical activity (PA) may have on academic performance and learning styles of Latin American dental students.

In this cross‑sectional study, an administrative dataset and a voluntary university characterization provided information about PA and academic performance. Moreover, 218 dental students of the University of Antioquia in Colombia completed a structured questionnaire to identify their learning styles. To analyze the information obtained a Pearson correlation, and logistic and linear regression models were implemented.

A total of 131 (60%) students informed being physically active (PA group), and 87 (40%) did not report PA (non‑PA group). The results showed a high‑grade point average (GPA) in the PA group (P = 0.01). The PA group showed a preference for the theorist and pragmatist learning styles with statistically significant differences between the groups (P = 0.004 and P < 0.0001, respectively). It was also observed a statistically significant Pearson positive correlation between the theorist style and higher GPA (r = 0.15; P = 0.04). The multivariate regression model showed that PA protects against lower means of GPA (odds ratio = 0.3; 95% confidence interval [CI]: 0.09–0.7, P = 0.01). Furthermore, the adjusted linear regression models also showed that PA protects against lower means of the theorist (β= −0.15; 95% CI: −0.02 to − 0.002, P = 0.002) and pragmatist styles (β= −0.18; 95% CI: −0.03 to − 0.006, P = 0.0006). Interestingly, men were statistically significant in all multivariable models.

This study suggests that PA is associated with higher academic performance and the theorist and pragmatist styles. Male students were also more physically active; therefore, it is relevant to establish strategies to stimulate physical activities in dental students, especially in women, including extracurricular activities.

The demands and learning challenges in medical schools are not efficiently overcome by all learners. Despite the gravity of the problem, there is a dearth of studies to identify, define, and address the needs of learners. Thus, the present study was designed to do a situational analysis to identify and define the problems of learners and to develop a model for student support system in our institution.

A phenomenological type of qualitative research was undertaken. One‑to‑one in‑depth interviews (IDIs) were conducted, 10 each among undergraduate medical students, faculties and parents (n = 30) to understand the problems of students and their suggested solutions from each one’s perspective. The interviews were audio‑recorded, transcribed verbatim, and manual thematic analyses were performed.

Manual thematic analysis of the transcripts yielded 16 subcategories and 7 categories. The various categories that emerged are (1) curriculum related; (2) interpersonal adjustment problems; (3) personal issues and family problems; (4) cognitive learning disabilities; (5) poor organizational skills; (6) students’ lack of motivation; and (7) miscellaneous. Based on the problems and their suggested solutions, a model for the essential components of a student support system for our college was developed. It outlines the principal roles of four key stakeholders, namely students, faculties, parents, and college administration.

It has been found that students face various academic problems, personal, interpersonal and family level issues. We developed the support system model suitable for our context. In future, it may be implemented and evaluated to check if it achieves the desired purpose.

Self-care for diabetes is very important in preventing complications of diabetes and also improving quality of life. This study aims to find the various self‑care practices of type 2 diabetes patients who are being treated at a rural health center of a medical college and the factors influencing self‑care.

This is a hospital‑based cross‑sectional study. Type 2 diabetes patients registered and receiving treatment from the noncommunicable disease clinic of a rural health center were administered a pretested questionnaire, developed based on different diabetes self-care questionnaires making changes as appropriate and including most aspects of self-care practices. The proportion of compliant was then cross-tabulated with background characteristics and their glycated hemoglobin (HbA1c) levels. SPSS version 16.0 was used for the analysis.

Among 390 patients with a mean age 56 years, 25.5% adhered to at least four dietary modifications, 46% were physically active, and 57% had good compliance to drugs; hypoglycemia prevention practices ranged from 21% to 51%. Except for avoiding barefoot walking (90%), other foot‑care practices were followed by only a quarter of them. Among ever users, 69.2%, 64.3%, and 29.4% have quit smoking, alcohol, and tobacco use, respectively. Adherence to dietary modifications and drug compliance were associated with a lower HbA1c level of ≤7 g% (P < 0.05).

In this study, the compliance to physical activity or medications is much better than dietary changes and foot-care practices. Focused education programs and monitoring during follow-up visits will improve self-care in the less adhered to aspects. Those who are adherent to dietary modifications and drugs have better glycemic control.

With recent changes in the curriculum of bachelor of medicine and bachelor of surgery (MBBS) course to meet the global trends and to fulfill the standards expected from an Indian medical graduate, introduction of newer teaching methodologies becomes mandatory. The usage of flipped classroom (FCR) in medical education has always been rewarding. This study was to evaluate the effectiveness of FCR as a teaching method in comparison with traditional lectures in histology sessions in Sri Ramaswamy Memorial (SRM) Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India.

This interventional study was conducted among the 1st year MBBS students in SRM Medical College Hospital and Research Centre for a period of 1 year (2018–2019 academic year). The histology sessions were taught using both traditional lectures and FCR methodology. Pre‑ and posttests were conducted for each traditional and FCR session with ten multiple‑choice questions pertaining to that topic. Students’ performance was assessed by paired t‑test (for pre‑ and posttest comparisons) and independent t‑test (for traditional and FCR posttest mark comparison) using SPSS software version 26. A feedback survey based on Likert scale was also conducted on the students and was analyzed. P < 0.05 was considered statistically significant.

Posttest marks had statistically significantly improved when compared to pretest marks (P < 0.0001) in both traditional and FCR teaching methods. Comparison of posttest marks showed statistically significantly higher marks in FCR when compared to traditional teaching (P < 0.0001). Similarly, students’ feedback survey showed that FCR benefitted the students in achieving the competency required.

FCR methodology of teaching histology had a very impressive outcome and the students’ perception was very positive.

The National Examination of Knowledge in Medicine establishes the knowledge profile (PdC) a physician must possess to practice public medicine in Chile. However, no study has evaluated the perception of dermatology training regarding the acquisition of the minimum competencies required. This study described and compared the impressions of the dermatology training received by the University of Chile (UCh) graduates with graduates from other national and international faculties of medicine.

This was a cross‑sectional study, based on a single survey model, applied via E‑mail to registered physicians in an online database, with emphasis on UCh medicine graduates, from the generations 2012 to 2016. The data were collected anonymously, tabulated, and analyzed in MINITAB.

From 908 UCh graduates, 141 surveys were answered (15.5%). Nine of 10 physicians considered “important” to obtain knowledge in dermatology. About 68.8% found the information they received was adequate. When comparing UCh graduates with other Chilean universities, UCh graduates had a slightly better impression of their training. When comparing Chilean versus foreign graduates, the latter presented a better perception of their preparation in cutaneous pathology.

UCh graduates were satisfied with their dermatological training at the undergraduate level and felt better prepared than colleagues from other Chilean universities when facing cutaneous pathologies.

Fire is one of the most important threatening factors for hospitals and needs special attention. The present study was conducted to explain the factors affecting hospital emergency evacuation following fire based on hospital administrators’ experiences.

This was a qualitative study conducted employing the content analysis approach. Participants included 22 hospital administrators in Tehran, Lorestan, Kurdistan, and Ilam provinces. The participants were purposefully selected and included until reaching principle of data saturation. Data were collected through in‑depth semi‑structured interviews from November 2019 to August 2020 and analyzed by the content analysis method.

Factors affecting hospital emergency evacuation during fire were categorized into five main categories and 17 subcategories including response to incident (five subcategories of fire nature, emergency evacuation, service provision, coordination and communication; and collaboration and companionship), human factors (two subcategories of individual characteristics and competencies), hospital preparedness (three subcategories of planning, safety and security; and information management system), environmental factors (two subcategories of hospital design and infrastructure; and weather condition), and finally ethical values (five subcategories of human dignity, trust, altruism, responsibility and accountability; and empathy).

The results of this study indicated that during fire in Iranian hospitals, several factors in addition to available standard guidelines affect the emergency evacuation process that need to be considered. Hospital emergency evacuation during fire is a complex process and necessitates a full and high‑level hospital preparedness, so using the results of this study can be used to develop and practice evacuation plans and improve the hospital preparedness.

Coronavirus disease 2019 (COVID‑19) is an infectious disease caused by a newly discovered coronavirus and the WHO declared it a pandemic, and due to the high risk, the most government throughout the world have temporarily closed schools, colleges, and universities. The impact of this COVID‑19 has been hit the education system worldwide, and according to the UNESCO, as of March 23, 2020, around some 1.3 billion learners worldwide were not able to attend educational institutions so to continue the education, most of the universities are providing teaching through online mode, but there are challenges of technological issue, time management, and adaptability.

COVID‑19 virus has resulted in significant psychological distress for many individuals, particularly, those in underserved communities. Social media have the potential to be one of the most effective tools for mental health campaigns, reaching wide audiences in the shortest amount of time. In this paper, the potential of harnessing social media platforms to address mental health needs in underserved populations is presented. In addition, description of the preliminary implementation of a social media mental health campaign, the 5 × 5 campaign, is described as an example of the feasibility and benefits of such efforts. Key implications gleaned from the implementation process are also presented.

Utilizing a participatory approach, the 5 × 5 campaign aimed to improve recognition of mental health symptoms, promote help seeking, and provide immediate strategies for self‑care for individuals experiencing psychological distress related to the COVID‑19 pandemic in low‑income, high‑risk communities in and around Guatemala City. Campaign content was promoted on Facebook, Instagram, and WhatsApp from April 2020 to June 2020.

Preliminary analysis of the 5 × 5 campaign demonstrated feasibility and substantial impact with over 84,000 individuals reached by the campaigns through initial messaging and shares.

The 5 × 5 highlights the feasibility of using social media campaigns for mental health promotion and key factors that should be incorporated in the planning of social media mental health campaigns aimed at promoting awareness, engaging underserved communities, and encouraging help seeking.

Drug abuse is one of the most important threats to human beings today, leading to disability and even early death. In the past, opium had only therapeutic uses, but now, drug addiction is one of the major public health problems in Iran. Opium and its derivatives are the most commonly used illicit drugs in this country. Therefore, this study was conducted to evaluate the treatment strategies of opium addiction from the perspective of Persian medicine. In this narrative review, the search was conducted using appropriate keywords in the authoritative books of Persian medicine documentations of databases of PubMed, Google Scholar, PsycINFO, American Academy of Medical Sciences, United Nations Office on Drugs and Crimes with keywords of opioid and opium since 2000 AD. In Persian medicine books, “Afioon” means poppy plant (Papaver somniferum), which is called opium in English and “Theriac” in Persian. To quit, they should be gradually reduced and replaced with appropriate spices such as henbane (Hyoscyamus niger) seeds or mandrake (Mandragora officinarum) fruit or root or poppy (P. somniferum) seeds or poppy shell or Lettuce (Lactuca sativa) seeds, or castor testis or nutmeg (Myristans fragrans) fruit or ajwain (Trachyspermum copticum) seeds or baked bread. Opioid quit should be gradual and delayed in time of consumption and gradual reduction of opium levels, and bodies that have become lean for a long time will gradually recover with adequate nutrition over time.

The Swiss cheese model of accident causation is a model used in risk analysis and risk management, including aviation safety, engineering, healthcare, and emergency service organizations, and as the principle behind layered security, as used in computer security and defense in‑depth. This study aimed to develop and weight the occupational health leading indicators using the Swiss cheese model.

The present study was a descriptive, cross‑sectional study; occupational health performance assessment indicators were classified into five main groups of chemical, physical, ergonomic, psychosocial, and biological harmful agents. In addition, potential hazards and their prevention methods were identified using the Swiss cheese model. The leading performance measurement indicators (n = 64) were developed based on preventive methods and were weighted and rated by fuzzy analytic hierarchy process.

Thirty‑six out of 64 indicators were related to the management measures, 25 indicators were related to exposure to harmful occupational agents, and the remaining indicators were occupational‑related illnesses and diseases rate. Considering the importance and frequency of indicators, psychological agents were the most important indicators (40%) and physical agents had the greatest frequency (59%).

Process of indicators’ development has demonstrated that the major occupational health prevention measures in the oil and gas industry are concentrated on physical, psychological, and chemical agents, respectively. Thus, to provide protection for employees against occupational diseases and improve health performance indicators, paying special attention to mentioned agents is essential in the oil and gas industry.

Knowledge of a disease can influence paramedic’s attitudes and practices, and incorrect attitudes and practices directly increase the risk of infection. Understanding paramedic’s knowledge, attitudes, and practices (KAPs) and possible risk factors helps to predict the outcomes of planned behavior. To assess KAP regarding COVID‑19 through Google form among paramedical staff at tertiary care teaching institutes of central India.

A cross‑sectional, multicentric, questionnaire‑based study was conducted from May 2020 to August 2020 among 230 paramedical staff from two tertiary care teaching institutes through Google form. Data were analyzed by Chi‑square test and parametric test using GraphPad prism software version 5.0.

All participants had knowledge about symptomatology of COVID‑19. However, significantly more participants in nursing cadre know about definition of close contact. The mean knowledge score was 4.84 ± 0.6. The mean score for attitude was 4.48 ± 0.83. Overall, 54.78% of paramedical staff follow correct prevention strategies. Of them, significantly more nursing staff correctly practice infection control measures upon arrival of COVID‑19 patients (P = 0.033). There was a significant difference among both groups regarding wearing of appropriate personal protective equipment while transporting/accompanying patients who are confirmed with COVID 19 (P = 0.009). The overall score for practice is 3.97 ± 1.03. The practice score was significantly better in nursing cadre as compared to nonnursing cadre (P = 0.038).

Majority of the participants had good knowledge and positive attitude. Nursing cadre follows better preventive practices as compared to nonnursing cadre while performing COVID‑related duties. Considering these facts, dodges responsible for poor practices should be identified and resolved so that India will be able to conquest the battle against the disease.

Patient satisfaction is a comprehensive measurement of patients’ happiness with the level of health care delivered to them both inside and outside the physician’s office. It is commonly used as an indicator to assess the health‑care quality and affects a wide range of components related to the provision of health services such as ease of access, medical malpractice, and clinical outcomes. The study aimed to analyze patients’ satisfaction with the quality of health care they received at the outpatient department of Klinik Kesihatan Maharani Muar Healthcare Facility (KMMHF), Johor.

This cross‑sectional study was conducted between August and December 2019 period. Demographic information and information on patients’ feelings about their physicians, treatment, and health facilities provided were collected from 407 consented patients in a simple random sampling survey using a researcher‑made, an adapted Medical Interview Satisfaction, questionnaire which was pilot tested before administration to the patients. Data were analyzed with SPSS version 23. Descriptive statistics and correlational and group comparison analyses were utilized.

Of the 407 patients studied for physician–patient satisfaction, the overall mean of all the respondents responding was 4.089 ± 0.5, which was ranked the highest among the three objectives. The effectiveness of treatment came as the second highest with the overall mean of 4.088 ± 0.5. Finally, the overall health‑care facilities had the lowest overall mean of 4.077 ± 0.5 among the three.

Most patients who visited KMMHF were mostly satisfied with the outcomes of physician–patient interaction in the clinic.

Prenatal education provides opportunities for health promotion of healthy behaviors and risk reduction. Quality and coherence with prenatal health promotion best practices depend on an individual class instructor. The objective of our study was to document the experiences, practices, and perceptions of our diverse Ottawa, Canada community of prenatal educators.

In this quantitative, mixed methods e‑survey conducted in Ottawa, Canada, prenatal educators were asked to describe their prenatal class settings, delivery formats, content, perceptions of pregnant women, and recommendations. Data were analyzed by descriptive statistics and thematic content analysis.

Respondents included public health nurses and a diverse group of “allied childbirth educators” (ACE). Topics related to pregnancy, labor, and postpartum issues were well addressed; however, established and emerging risks to pregnancy were omitted. Nurses were more likely to discuss lifestyle risks to pregnancy and general prenatal health promotion, whereas ACE respondents emphasized informed consent and individualized counseling. Women marginalized by social exclusion including Indigenous women, immigrants, and women with disabilities were perceived as missing from prenatal educational settings.

Heterogeneity of prenatal education provides opportunities for collaboration; however, established and emerging risk factors to pregnancy are neglected topics. Addressing the needs of diverse communities of pregnant women requires timely, evidence‑based, inclusive, and culturally safe delivery of prenatal health promotion.

Blended learning (BL), the integration of online with face to face teaching, is established as a teaching method in higher education. Understanding the learner’s readiness toward online component of BL is important in designing and delivering BL. Nursing students require proficiency in interpersonal relationship and social interaction apart from knowledge and skills. BL may provide an opportunity to acquire the professional skills better than the traditional face to face sessions. The objectives of this study were to identify the nursing student’s readiness toward BL and perceptions about the online learning component of BL.

First‑ and second‑year entry level graduate nursing students of Sri Ramachandra Institute of Higher Education, Chennai, India, were the participants of the study. This study used a mixed method approach. An online questionnaire, developed based on the literature and expert consensus, was used in the first phase. A focus group discussion (FGD) with ten random participants of the survey was conducted to understand the perceptions and readiness to adopt the online component of BL. The present study was conducted from December 2019 to January 2020. Survey results were analyzed through descriptively. Content analysis was carried to summarize FGD results.

A total 158 students of entry level nursing graduate programme participated in the survey. 53.8% of felt BL will have positive effect on their learning and 70% of the respondents were ready to adopt BL. The FGD identified two themes: (I) Readiness to adopt online learning as a component of BL and (II) perceived barriers and challenges in adopting online contents.

Entry level nursing graduate students had a positive perception about the online components. Majority of them are confident in accessing the online contents. Willingness to learn through online, previous experience with online learning, and perceived advantages of online component might influence the learner’s readiness. Availability of internet and absence of teachers were perceived as the barriers to online learning by the participants.

Fertility is always one of the most important functions of the family. Having a child equals growing up and entering the adult world. Adoption is one of the methods that can be considered to treat infertility. One of the duties of health professionals, especially midwives, is to advise and educate infertile people, which helps them in a way beyond medical treatment. Therefore, this study was conducted to determine the effect of face‑to‑face and telephone counseling on the desire for adoption in infertile couples.

The present study was a two‑group counseling intervention study that was performed on 34 infertile couples referred to Mashhad Infertility Center. Infertile couples were randomly assigned to face‑to‑face and telephone counseling groups. All participants completed the Adoption Adoption Questionnaire at the beginning and end of the study. Data were analyzed by spss16 software.

The mean score of propensity to adopt in the face‑to‑face counseling group 2 weeks after the intervention was significantly higher than before the intervention. Furthermore, the mean score of desire for adoption in the telephone counseling group increased significantly 2 weeks after the intervention compared to before (P < 0.001). Adoption scores varied in the face‑to‑face counseling group at 3.15 and in the telephone counseling group at 3.23. There was no statistically significant difference between the two groups (P < 0.885). The most common reason for not wanting to adopt was hope for self‑treatment and having children (70.6% women and 67.6% men). The most common reason for accepting an adopted child was the strong need to have a child (23.5% in women and 23.5% in men).

According to the results of this study, counseling can increase people’s awareness of the conditions of adoption and thus increase the desire of people to accept the adopted child. For this reason, considering adoption counseling sessions for infertile couples who have been receiving infertility treatment for a long time but have not become pregnant can help the couple decide.

Studies have shown that quality of life in women with unintended pregnancy is significantly less than the ones with wanted gestation. Therefore, this study was aimed to determine the effect of intervention based on the positive psychology interventions on women’s QoL with unintended pregnancies in Kermanshah, Iran.

In this randomized clinical trial, 40 women with unintended pregnancy met the eligibility criteria and were randomized into experimental (n = 20) or control (n = 20) groups. The Short‑form 36‑item Questionnaire (SF‑36) was administered at pretest, post‑test, and six weeks after the intervention. Positive psychology interventions were performed in each session once a week for 10 weeks, with a duration of 90 minutes. The Friedman test and Mann–Whitney U‑test were used to analyze QoL and all eight domains for within‑group and between‑group comparisons, respectively. The level of confidence was set at 0.05 significant.

Distribution of matched variables was not significantly different between the two trial groups. Over the intervention period, the mean of total scores of QoL and seven dimensions showed significant improvement among the experimental group, whereas in the control group, it decreased significantly (P < 0.05). In addition, in the posttest and follow‑up stages, the mean score of six dimensions of QoL was higher than the control group (P < 0.05).

According to the results of the present study, unintended pregnancy has side effects on QoL in women. Positive counseling interventions can improve the quality of life in women with unintended pregnancy.

Benefactors of nongovernmental organizations (NGOs) are the hidden public health promotion systems. These benefactors are the symbol and intermediary of people participation, which is one of the main arms of health promotion and reduction of poverty and injustice in the societies. The present study is aimed to identify the benefactors’ experiences in NGOs in terms of providing and promoting health‑oriented services.

This study was conducted with a qualitative approach. The total number of participants was 32, which consisted of 25 chief executive officers from active and inactive organizations. Active organizations refer to organizations that submitted their 6‑month report at the time of the investigation and whose operating license was renewed and in operation and seven officials of the social deputy of governmental organizations related to NGOs. Data collection was performed by using semi‑structured interviews and with purposive sampling and then continued until data saturation. Furthermore, the content analysis method was used for data analysis. MAXQDA software version 2007 was used to manage quality data.

During the data analysis, the following four subcategories were obtained: “high effort in empathy with fellow human beings,” “role of merit in the success of donors,” “creating a platform for social attention for the client’s spontaneity,” and “respect of the client,” which were the results of experience and dimensions. The performance of non‑governmental organizations is in line with the confrontation and responsibility of non‑governmental organizations with a focus on health‑oriented services.

Having benevolent motives, benefactors attempt to provide conditions, in which help seekers have more chance for living through establishing new, sustainable, and future‑reassuring conditions.

With the increase in the elderly population in the world and the consequent increase in diseases and their physical and mental problems, improving self‑care behaviors by increasing self‑efficacy in the elderly plays an important role in promoting their health and can increase their life satisfaction. This study aimed to investigate the effect of self‑care self‑efficacy program on life satisfaction of the elderly referred to selected health centers in Isfahan, Iran, in 2014.

This study was a quasi‑experimental study with two experimental and control groups and was performed on 64 elderly people referred to selected health centers in Isfahan. The samples were randomly divided into experimental and control groups, and a self‑care self‑efficacy program was performed on the experimental group. Data collection tools included demographic information questionnaire and life satisfaction indexes A questionnaire. Data were analyzed using the statistical tests such as Chi‑square, independent t‑test, Mann–Whitney, repeated measures analysis of variance, and Least Significant Difference (LSD) post hoc test.

There was no significant difference between the two groups in terms of demographic characteristics. Before the intervention, the mean score of life satisfaction was not statistically significantly different between the two groups (P = 0.88). However, immediately and 1 month after the intervention, the mean score of life satisfaction in the experimental group increased, and this score was significantly different between the two groups (P < 0.001).

The results of this study showed that the self‑care self‑efficacy program has been effective in increasing the life satisfaction of the elderly. Therefore, using this self‑care self‑efficacy program is recommended to promote life satisfaction in the elderly

Following the COVID‑19 pandemic, the Government of India announced lockdown from March 25, 2020, which included measures such as social distancing, canceling mass gatherings, and closure of schools and colleges. Since the present generation of students spends a lot of time on social media, especially WhatsApp, the utility of the same to discuss the various public health domains of COVID‑19 through multiple‑choice questions (MCQs) was explored.

This longitudinal study was conducted among 154 participants (undergraduates, interns, postgraduates, and teaching faculty) for 3 months. MCQs on COVID‑19 were disseminated through WhatsApp status of the investigator, and feedback regarding the same was taken at the end of 3 months. The activity log was maintained, and the information was downloaded as a comma‑separated value (CSV) file and exported to MS Excel. Descriptive statistics were applied. The location of the participants was entered into the Microsoft Excel sheet and converted into CSV file. The Geographical data were analyzed in the Quantum Geographical information System (QGIS).

Among the 154 study participants, 48% were undergraduates, 10.4% were interns, 30.6% were postgraduates, and 11% were teaching faculty. Eighty‑nine percent of the participants felt that WhatsApp can be used as a platform for discussing MCQs. 89%, 93%, and 89.6% of the participants felt that the exercise improved their analytical skills, helped in self‑directed learning, and improved collaborative learning, respectively.

Majority of the participants responded that WhatsApp can be used as a platform to discuss MCQs and that the exercise helped in collaborative and self‑directed learning.

To have a thorough understanding of epidemic surveillance, it is essential to broaden our knowledge of death tolls worldwide. This study aimed to determine the age‑standardized mortality rate (ASMR) and predictors of mortality among coronavirus disease 2019 (COVID‑19) patients.

In this cross‑sectional design, all COVID‑19 patients with a positive polymerase chain reaction test in the population covered by Arak University of Medical Sciences (AUMS) were entered to the study. Data collection was conducted by phone interview. The study variables comprised age, sex, coronary heart diseases, diabetes, and some symptoms at admission. The adjusted odds ratio (OR) and 95% confidence intervals (CIs) were obtained by logistic regression. The direct method was applied to calculate ASMR (per 100,000) of COVID‑19. The analysis was applied by STATA software 12.0.

A total of 208 cases of COVID‑19 (out of 3050 total infected cases) were dead and 2500 cases were recovered. The mean age of dead patients was 70 years. The COVID‑19 fatality rate in the population equaled 6.8%; in those patients who were 70 years old or more, however, the case fatality rate was 16.4%. The ASMR of COVID‑19 was 12.9 (CI 95%: 11.2, 14.8). The odds of COVID‑19‑related death in the age over 60 were 10.87 (CI 95%: 6.30, 18.75) times than lower 45 years old. Moreover, it was observed that COVID‑19 significantly increased the odds of COVID‑19‑related death in diabetes patients (OR = 1.45, CI 95%: 1.02, 2.06, P = 0.036).

The ASMR of COVID‑19 was relatively higher in males than females. In general, the COVID‑19 fatality rate was relatively high. We found that older age and diabetes can have impact on the death of COVID‑19, but the headache was found to have a negative association with the COVID‑19‑related death.

Diabetes mellitus (DM) is one of the main public health troubles diabetic foot ulcer (DFU) is one of the most important and relatively common causes of hospitalization. This study investigates the prevalence of peripheral artery disease (PAD) in Imam Reza Hospital of Kermanshah during 2017–2018.

This study is descriptive‑analytical. The study population was 196 cases with infectious DFUs admitted to Imam Reza Hospital of Kermanshah during 2019–2020. The presence or absence of PAD was assessed in these cases. The collected data were analyzed by SPSS software (version 18.0).

Among 196 patients studied, 120 (61.22%) patients had PAD. The prevalence of PAD was higher in men than in women and it was more common in Type 2 DM patients than in Type 1 DM patients. The majority of ulcers were located on the nonplantar surface of the foot. Moreover, the prevalence of PAD had a significant relationship by increasing the duration of diabetes (P = 0.041), history of amputation (P = 0.002), history of diabetic foot (P = 0.006), and peripheral neuropathy (P = 0.005).

A considerable number of diabetic patients with DFU had PAD. This necessitates more intense interventions to manage PAD as a strong risk factor for DFU in diabetics. Neurovascular assessment of diabetic patients and early diagnosis of PAD may be appropriate interventions to prevent development of DFUs. We recommend trial studies to find out the best methods to address early detection of PAD in diabetics.

Infertility is one of the main concerns in women’s lives that may lead to psychological imbalance and disrupt their sexual relationship. The study was conducted with the aim of evaluating role of mental health in prediction of sexual function in infertile women.

This analytic‑descriptive study was conducted in 2015–2016 in 424 infertile women referring to Fatemeh Zahraa Infertility and Reproductive Health Center, Babol, Iran. The participants filled out the Female Sexual Function Index (α = 0.72–0.90), General Health Questionnaire (GHQ‑28, α = 0.86), and demographics questionnaires. Linear regression used to analyze the data.

The mean of total GHQ was 23.57 ± 12.06. The highest mean of GHQ subscales was social dysfunction (8.68 ± 3.69). There was a negative association between GHQ with the overall sexual function of infertile women (r = −0.397, P < 0.0001). The higher mental health disorder was associated with lower sexual function. Furthermore, there was an inverse significant association between all the subscales of mental health and sexual function. Based on the multiple linear regression analysis, the variables of anxiety and sleep disorder (β = −0.143, P < 0.035), social dysfunction (β= −0.139, P < 0.003), depression symptoms (β = −0.121, P < 0.046), sexual intercourse frequency (β = 0.272, P < 0.0001), and educational level (β = −0.110, P < 0.016) were the significant predictors of perceived sexual dysfunction after adjusting for other variables. The strongest predictor of the GHQ subscale was anxiety and sleep disorder.

Undesirable conditions of mental health and its adverse effects on sexual function and also other predictors emphasize the need to develop more effective screening and supportive strategies with the help of the psychologists.

Physical activity and nutrition interventions are the most important ways to prevent gestational diabetes. The purpose of the study was to determine the effect of healthy lifestyle intervention to promote preventive behaviors of gestational diabetes in the rural woman of Shoush city.

In an experimental study, 60 pregnant women were selected using simple random sampling and allocate into intervention group (n = 30) and nutrition program. The study was conducted from September to June 2018. The data were collected in baseline and 1 month and 3 months of follow‑up phase and were analyzed using Chi‑square test, repeated‑measure test, and generalized linear model (GLM). The α = 0.05 was considered as significance.

The mean age in the intervention and control group was 25.9 ± 5.6 and 27.2 ± 5.9, respectively. The GLM test showed a significant increase in the physical activity level and the mean of nutrition behaviors within the intervention group over time (P = 0.013). Further, based on the results of repeated‑measure test, the mean of weekly MET‑minute was increased in the intervention group in comparison to the control group at 1 month and 3 months of follow‑up (P < 0.001). DISCUSSION AND

The lifestyle interventions are appropriate programs to the reduction of the risk of development of gestational diabetes in pregnant women.

The coronavirus, which is caused by acute respiratory syndrome, appeared in Wuhan, China, in December 2019 and gradually spread around the world until almost all countries became infected with the coronavirus. In Iran, the outbreak of coronavirus began on February 21, 2020, with the report of infection of two people in the city of Qom. The aim of this study is to evaluate the clinical findings of neonates born to pregnant women with corona disease.

During this case study (February 21 to November 30, 2020), out of 88 pregnant mothers who referred to the hospitals of Shahid Beheshti University of Medical Sciences, 44 live neonates were born from 42 pregnant women with COVID‑19, who were evaluated for clinical signs by studying their files and reported as a case series, due to limited samples, No statistical analysis of the study was performed.

In studies of clinical records of hospitalized mothers and infants, among the polymerase chain reactions (PCRs) provided for all infants, one PCR was reported positive 2 days after birth, whereas this infant 10 min after birth, immediately after routine procedures, due to positive mother’s PCR was isolated from the operating room. However, all of the infant’s clinical symptoms were normal during the 3‑day hospital stay for routine postpartum care. Twenty‑eight days after birth, the baby was reevaluated for clinical, laboratory, and chest X‑ray symptoms, all of which were normal. The PCR of other neonates was negative, and five intubated neonates, two twin, and two single died, and the other neonates were discharged. In evaluating the clinical records of mothers of these infants, the mean age is 30 years, and the average gestational age is 35 weeks, 32 cases of caesarean section, and 10 cases of normal delivery.

We describe epidemiological data, demographics, signs and symptoms on admission, laboratory results, comorbidities, infection COVID‑19 in the mothers and neonates, chest radiography and computed tomography findings, treatment received for COVID‑19, and clinical maternal, fetal, and neonatal outcomes. Due to the fact that the study population is small consist of 42 mothers with COVID‑19 infection, among all PCR samples from infants born to COVID‑19 positive mothers, the PCR result of one case was positive, and the rest of was negative. Therefore, vertical transmission of COVID‑19 through the placenta to the fetus cannot be confirmed or denied, nor can the COVID‑19 confirmed or denied the baby’s postnatal complication during pregnancy.

Emotional intelligence and interpersonal sensitivity are known as important nursing skills. They have significant role in the promotion of nurses working life and the health care which they provide. The goal of this study was the determination of the relationship between emotional intelligence and interpersonal sensitivity with quality of work life in nurses working in governmental hospitals of Tehran city in 2019.

This investigation was a descriptive‑analytical and correlation study which was conducted among 256 nurses working in five governmental hospitals in Tehran. The studied nurses were selected through in access sampling method. The instruments of research included demographic, emotional intelligence, interpersonal sensitivity, and work life quality questionnaires. The analysis of data was done by descriptive and deductive statistics (t‑test and Pearson correlation coefficient) and also SPSS.

The conditions of emotional intelligence, interpersonal sensitivity, and work life quality of nurses were, in turn, in average, severe, and weak levels. The correlation between emotional intelligence and work life quality of nurses was significant (P ≤ 0.05) and they were positively correlated with each other (r = 0.311). The relationship between interpersonal sensitivity and work life quality of nurses was significant (P ≤ 0.05) and they were negatively correlated with each other (r = −0.43).

The development of emotional intelligence and sensitivity in reciprocally interpersonal relations of nurses lead to fundamental changes in nurses’ attitude toward themselves, their colleagues, patients and their profession and can promote their work life quality. Therefore, these two skills are necessary for nurses and they should be taken into consideration by nursing schools, faculty members, instructors, and nursing managers.

Social media addiction (SMA) led to the formation of health‑threatening behaviors that can have a negative impact on the quality of life and well‑being. Many factors can develop an exaggerated tendency to use social media (SM), which can be prevented in most cases. This study aimed to explore the reasons for SMA.

This qualitative study was conducted using content analysis. A total of 18 SM addicted subjects were included through purposive sampling. Data were collected through semi‑structured interviews and analyzed using the Lundman and Graneheim qualitative content analysis method.

The main category of “weakness in acquiring life skills” was extracted with three themes: “problems in socializing” (including communicating and escaping loneliness), “problems in resiliency” (including devastation in harsh conditions and inability to recover oneself and “lack of problem‑solving skills”(including weaknesses in analysis and decision making and disorganization in planning).

Weakness in life skills plays an important role in individuals’ addiction to SM and formation of the health‑threatening behaviors. Since SMA can affect behavioral health, policymakers must adopt educational and preventive programs to increase the knowledge and skills of individuals in different societies in the modern world.

Despite the development of valuable teaching methods and assessment tools in the field of surgery education, yet unpreparedness for independence practice by surgical residents remains a problem in most of the countries.

This study aims to explain the surgical residents’ experience of the teaching and learning process in the operating rooms in Iran.

This study is a qualitative research that was done from May 2019 to June 2020 in Tehran and eight other cities in Iran. The selected methodology was constructivist grounded theory. The study setting was 11 teaching hospitals. Data were collected through 36 in‑depth interviews and 132 h of observation. Participants were selected initially by purposive sampling and then by theoretical sampling for covering gaps and completing categories.

Findings showed that the confused educational system was the main concern of the residents’ experience of the teaching and learning process in the operating room. This concern is investigated by dividing into four subcategories: Education in the shadow of treatment, inefficient education, patient safety versus trusting residents for independent practice, and unstructured assessment.

Based on residents’ experience about challenges such as inefficient education, the influence of patient safety versus trusting residents for independent practice, and unstructured assessment, the surgical residents’ education in the operating rooms needs to revise.

Mindfulness as an intervention approach in mental health has been increasingly used to promote health in young people. The aim of this study was to investigate the effectiveness of mindfulness training on coping with stress, test anxiety, and happiness to promote health in female high school students.

The design of this study was quasi‑experimental with control group, with pretest and posttest. The statistical population of the study included all the female students studying in the secondary high school in the city of Sanandaj in Iran with 2890 students, 40 of whom were selected by simple random sampling method and were randomly assigned to the experimental (20 individuals) and control groups (20 individuals). Participants completed the Oxford Happiness (0.79), Sarason Exam Anxiety (0.87), and Andler and Parker Stress Management (0.81) Questionnaires. The method of intervention was training based on mindfulness. Data were analyzed using covariance analysis.

The results showed that in the posttest, a significant difference was seen between the mean scores of the participants of the experimental and control groups in the variables of problem‑oriented, emotion‑oriented, and avoidant coping variables (P < 0.05). In addition, the results showed that in the posttest, there was a significant difference between the mean scores of test anxiety; happiness; and happiness components including life satisfaction, self‑esteem, active well‑being, satisfaction, and positive mood (P < 0.05).

Based on the results of the present study, it can be said that mindfulness training is an effective intervention to improve coping styles, test anxiety, and happiness in students.

Developed countries have strong health and demographic surveillance system (HDSS), whereas there is a dearth of such system in developing countries like India. India depends on national surveys and individual studies for public health information. At present All India Institute of Medical Sciences – New Delhi HDSS and Vadu HDSS are well established HDSS in India.

We developed a HDSS in a remote rural area of South India and named as Community Health Information Management System (CHIMS) This covered 20 villages around Rural Health Training Centre – Chunampet. We collected the family and demographic information from March 2018 to October 2018. Pregnancy, birth, under‑five and mortality data were collected once in every 3 months with the help of interns, Medical Social Workers. Data collection done using CHIMS Guide and entered in EpiData software. EpiAnalysis, Quantum Geographic Information System, Dropbox were the other freely available software used in this program.

CHIMS HDSS covered 14924 individuals belonging to 4486 households in the surrounding twenty villages. Population density was 213/km2 . CHIMS consumed very limited resources in terms of workforce, materials, and transport. CHIMS database was used as a baseline database for many other studies. This CHIMS HDSS helped in many publications, postgraduate thesis dissertations and mainly attracted many extramural research funds from leading government Research Institutes from India.

CHIMS proved to be a robust surveillance system in providing vital public health information about the community and attracted more extramural funds to the institute.

Direct transmission of notifiable disease information in a real‑time and reliable way to public health decision‑makers is imperative for early identification of epidemiological trends as well as proper response to potential pandemic like ongoing coronavirus disease 2019 crisis. Thus, this research aimed to develop of semantic‑sharing and collaborative‑modeling to meet the information exchange requirements of Iran’s notifiable diseases surveillance system.

First, the Iran’s Notifiable diseases Minimum Data Set (INMDS) was determined according to a literature review coupled with agreements of experts. Then the INMDS was mapped to international terminologies and classification systems, and the Health Level seven‑Clinical Document Architecture (HL7‑CDA) standard was leveraged to define the exchangeable and machine‑readable data formats.

A core dataset consisting of 15 classes and 96 data fields was defined. Data elements and response values were mapped to Systematized Nomenclature of Medicine‑Clinical Terms (SNOMED‑CT) reference terminology. Then HL7‑CDA standard for interoperable data exchange were defined.

The notifiable disease surveillance requires an integrative participation of multidisciplinary team. In this field, data interoperability is more essential due to the heterogeneous nature of health information systems. Developing of INMDS based on HL7‑CDA along with SNOMED‑CT codes offers an inclusive and interoperable dataset that can help make notifiable diseases data more comparable and reportable across studies and organizations. The proposed data model will be further modifications in the future according probable changes in Iran’s notifiable diseases list.

Nowadays, one of the most important challenges of the universities and higher education centers is academic dishonesty among students. Academic dishonesty is done through cheating, deception, and plagiarism, which creates serious educational, studious, and social problems for the students and society. The purpose of this study was to compare the effect of virtual and workshop training on the knowledge and attitude of M. S. students in terms of plagiarism.

This research was an applied interventional study of quasi‑experimental type having pretest and posttest and the participants of this study included 90 M. S. nursing students of Medical Science University of Shiraz in the southwestern part of Iran.

The comparison of the three groups indicated that virtual and workshop training, both, developed the knowledge and attitude of students regarding plagiarism; however, the comparison between two methods did not indicate a statistically significant difference.

Both virtual and workshop training methods had an effect on increasing students’ knowledge and attitude. Regarding the positive effect of training academic dishonesty using two workshop and virtual training methods, both can be used as efficient and effective methods in training dimensions depending on the condition and facilities to prevent and reduce plagiarism in students.

Academic procrastination is a complex phenomenon and a common behavior among nursing students. Due to procrastinating behaviors, students cannot show their real performances in learning processes. In order to stop this behavior, it is crucial to know the most common causes of procrastination in the first place. The aim of this study was to identify a variety of different possible factors influencing academic procrastination among nursing students.

A qualitative study method with the content analysis approach was conducted from October 2019 to March 2020. Participants were 67 nursing students and 8 nursing educators from 3 nursing schools in Iran. Face‑to‑face semi‑structured interviews and focus group discussions were used for data gathering. An inductive approach to content analysis was used for data analysis.

Five categories and 24 subcategories emerged from the data analysis: “student‑related factors,” “educator‑related factor,” “assignment characteristic‑related factors,” “institution‑related factors,” and “nursing work‑related factors.”

The present study showed that nursing students’ academic procrastination can have a wide range of causes and a comprehensive effort is needed to address the problems. The result of our study will be useful to nursing students, educators, and nursing administrators in relation to what constitutes nursing students’ academic procrastination, as well as how nursing education can play an effective role in decreasing tendency to procrastination.

Social health is considered as an important part of good health both individually and socially. The purpose of this study was to examine the content of the official medical sciences curriculum in undergraduate degrees from a social health perspective.

This qualitative content analysis study was conducted in 2019 at the Isfahan University of Medical Sciences using a deductive approach based on Hsieh and Shannon's directed content analysis. For this purpose, official curricula in the fields of Public Health, Occupational Health, Environmental Health, Nursing, Midwifery, Nutrition Sciences, and Health Services Management were analyzed using MAXQDA 12.

The results showed that a total of 136 codes related to the components of social health were identified in the topics of undergraduate medical sciences majors. Most to least relevant topics belonged to the fields of Public Health (61 codes), Midwifery (22 codes), Nursing (16 codes), Occupational Health (12 codes), Environmental Health and Nutrition Sciences (each 10 codes), and Health Services Management (5 codes), respectively. Among the components of social health, only the component related to access to insurance and health services was mentioned in all seven disciplines. However, the components of poverty and inequality were only included in three disciplines (Public Health, Nursing, Midwifery).

Regarding insufficient focus on social health in curricula, revision of educational curricula is suggested from the perspective of social health, particularly in areas such as poverty and inequality, unemployment, population, violence, and gender discrimination.

Continuous pertinent trainings for infection prevention and control (IPC) measures are essential to ensure quality health‑care services along with the safety of the health personnel. Amid the COVID‑19 pandemic, the current study focusses on the utilization of explicated video modules training of all health‑care personnel of the institute and assessment of the effectiveness of video training for IPC practices during COVID‑19 pandemic.

A quasi‑experimental study, one group pre‑ and posttest design, using Google Questionnaire forms was conducted at a tertiary care center. The training was assisted by trained tutors, and three in‑house videos were demonstrated to the participants regarding specific IPC measures; “Do’s and Don’ts;” “Hand hygiene and personal protective equipment’s (PPE)” and “Environmental cleaning and disinfection.” SPSS software version 23 (IBM Corp., N. Y., USA) was used for the analysis using the descriptive statistics, Chi‑square test, Fisher’s t‑test, ANOVA, and post hoc Tukey’s test.

The level of knowledge increased significantly by 16% in the posttest. Statistically significant association between the levels of knowledge in pretest as well as posttest scores and age (P < 0.001), designation (P < 0.001), and years of experience (P < 0.001) was identified. The participants were satisfied with the video‑assisted trainings and willing to use videos for revision.

Video‑assisted training modules similar to this study may be utilized to enhance the knowledge of various cadres of health‑care staff regarding IPC practices.

Existential anxiety (EA) revolves around the question of ultimate concern related to life and death. It gets more prominent when there is an exposure to stressful experiences where the stress is profound and resources seem insufficient. The objective was to measure the prevalence and magnitude of EA in the study population from the Kashmir valley during the COVID‑19 pandemic.

In this cross‑sectional study, data were collected through social media. All the participants belonging to the Kashmir valley were included. EA questionnaire developed by Weems et al. was used.

A total of 132 subjects were included. The prevalence of EA concerns was death 55%, fate 62%, emptiness 73%, meaninglessness 32%, guilt 55%, and condemnation 64%. The mean EA score was 5.0. EA was higher in those who had been diagnosed with mental illness ever in their life by a psychiatrist than those who had no such history. EA score was much higher in those who had ever felt a need to visit a psychiatrist than those who had not. There was no statistically significant difference in the mean scores of EA for those who never felt this need and those who felt this need since the start of the COVID‑19 pandemic.

There was a high prevalence of EA in the study population from the Kashmir valley. Relative concerns were more prevalent than absolute concerns. EA score was higher among those who had mental health issues compared to others.

Polycystic ovary syndrome (PCOS) has a profound effect on patients’ quality of lives; and it is important to identify the affecting factors. The aim of this study was to assess the status of and relationship between coping strategies and quality of life in women with PCOS.

In this cross‑sectional study, we recruited 200 married women (20– 50 years old) with PCOS from Arash and Bu Ali hospitals in Tehran in 2019–2020. Data were collected using the two following questionnaires: Coping strategies and quality of life. Data were analyzed using the regression analysis test in the SPSS‑21.

The results showed that 119 (59.5%) participants were identified with increased hirsutism, 166 (83%) women were obese, 140 (70%) had irregular menstruation and 136 participants (68%) had painful menstruation as the side effects of PCOS. Sixty nine (34.5%) individuals reported unknown side effects. There was a relationship between emotional coping strategy and problem solving coping strategy with quality of life (beta = 0.270 and 0.219, respectively).

Patients with PCOS were more likely to use emotional coping strategies. Low quality of life exacerbated symptoms of the disease.

Health care‑associated infections (HAIs) are associated with high morbidity, mortality, and costs in the health‑care sector. Large proportions of HAIs are preventable by following infection prevention activities such as hand hygiene (HH) and biomedical waste management (BMWM).

The aim was to evaluate the effectiveness of a structured teaching session on the cognitive and psychomotor domains of BMWM and HH practices in a tertiary health‑care institute.

Every participant was evaluated for pretest knowledge assessment using a prestructured format along with skill demonstration. The training included interactive sessions, open discussion, and demonstration of various skills with the active participation of various participants by trained faculty and infection control nursing officers. On completion, every participant underwent posttest evaluation.

During 11‑month study period, 450 health‑care professionals (HCPs) participated in the training program. Cognitive domain score increased from 16.3 ± 2.4 to 21.3 ± 2.0 from pre‑ to post‑test, respectively. In psychomotor domain, pre‑ and post‑test scores for HH were 8.3 ± 3.5 and 14.3 ± 1.4, for BMWM, the corresponding values were 8.6 ± 2.1 and 9.8 ± 0.7, respectively. Overall change in the mean (± standard deviation) score between pre‑ and post‑test for various domains of assessment was 5.0 (±2.7), 6.0 (±3.5), 1.1 (±1.8), and 12.2 (±5.3) for knowledge, HH skill demonstration, BMW segregation skill, and cumulative assessment, respectively.

The initiation of a structured training program can result in a significant increase in participants’ cognitive and psychomotor domains of learning, which may have an indirect impact on the prevention of HAIs.

The flipped classroom pedagogy allows students to introduce a topic and gather their own meanings outside of the classroom, then explore the topic and create their meanings or exclude their misconceptions during class. Our aim was to enhance the ability of self‑directed learning (SDL) among medical undergraduates. Pedagogical benefits of the model are highlighted along with potential challenges to its use.

Kemp’s Instructional model was used to design flipped classroom. Need analysis was done to assess the perceptions of the students on the current teaching practices and their expectations for adoption of innovative methods. Validation of content was done by Delphi method by subject experts across the institutions. Content included objectives; case scenarios and extended multiple choice questions. Students were divided into two groups. Group A and Group B, 50 in each. A topic was given 1 week prior and both groups were subjected to a pretest to identify their self‑study performance. Group A was exposed to 4 sessions of flipped classroom. They were provided with PowerPoint slides with voice recordings. In the classroom, first 30 min was meant for quiz and next 30 min was meant to clarify the doubts. Group B were exposed to the 4 regular lecture sessions. Both the groups were subjected to the posttest and test after 4 weeks. Later with another topic, flipped classroom was conducted for all the 100 students and the feedback was taken from all the students and faculty using a validated questionnaire.

Posttest scores of students who were flipped were statistically significant (p < 0.001). Most (98%) students opined that these interactive sessions evoked interest in the topic. Flipped classroom sessions were found to be effective in improving students’ learning behavior toward SDL, collaborative learning skills and critically analyzing the basic concepts.

By following a systematic process (Kemp’s instructional Model, it is possible to design need‑based flipped classroom sessions. They are found to be effective in improving students’ learning behavior toward deep learning, self‑efficacy, SDL, collaborative learning skills, critically analyzing the basic concepts. In a flipped classroom, “the learning environment transforms into a dynamic and more social space where students can participate in critiques or work through problems in teams.

Nurses have a challenging job and encounter more stressful situations. In response to these situations, they demonstrate adaptive or maladaptive cognitive emotion regulation strategies (CERS). As there is a lack of literature regarding the factors predicting the selection of CERS , the present study aimed to investigate the role of age, sex, marital status, working experience, type of ward, and education level in predicting these strategies in Iranian nurses.

A descriptive correlational study was conducted to examine predictive factors’ emotion regulation strategies used by 193 nurses who worked at six hospitals under the supervision of Qazvin University of Medical Sciences in 2018. The study population were selected by stratified random sampling method. Data were collected by two questionnaires, one demographic questionnaire and the other was Cognitive Emotion Regulation Questionnaire conducted by Garnefski (α = 0.8). Data analysis was performed using correlation and multiple linear regression.

The results showed that there is a significant relationship between the “type of ward” and “age” with adaptive and maladaptive strategies. In the multiple linear regression model, two variables of age (P = 0.03) and type of ward (P = 0.04) were able to predict 23% of variance CERS.

Based on the results of this study, health‑care providers and hospital managers should pay attention to factors related to adaptive and maladaptive CERS.

The rate of reporting medication errors is lower than the actual rate. The role of education, encouragement, and promotion of reporting culture can contribute to the increase of errors reporting. This study was to investigate the effect of motivational program on reporting of medication errors in the pediatric units.

A quasi‑experimental study with pre‑ and post‑test design was done through 60 nurses working in the pediatric wards of the selected hospital in Isfahan, Iran in 2018–2019. Nurses participated in the study through the census sampling method. Data were collected using a questionnaire based on eight medication principles completed by the nurses before and after the intervention. The intervention was conducted through a motivational program in two parts of training and positive reinforcement. Data were analyzed through the descriptive statistics (frequency, mean, and standard deviation [SD]) as well as inferential statistics (Wilcoxon test and paired t‑test).

After the intervention, the most medication error reports (60%) were in the principle of right medication (similar name). Furthermore, the total score (SD) of medication error reporting was significantly increased from 7.35 (2.43) before the intervention to 17.04 (5.59) after the intervention (t = 8.03, P < 0.001).

Motivational program increased medication error reports. Therefore, the managers can improve medication care and the safety of children through continuous education and encouragement in the hospitals.

Sex ratio is an important social indicator measuring the status and equality of female in society. The falling sex ratio of our country is a demographic disaster that is waiting to happen and is a matter of grave concern. Perception of gender by mothers or families has long‑term implications on how children are nurtured during their lives. This study was done to understand mother’s preference for the gender of the child and their concerns about the same.

An observational cross‑sectional study was carried out using a semi‑structured questionnaire. Two hundred and thirty‑four mothers were interviewed. Frequencies and percentages were calculated. Pearson’s Chi‑square test was used to check the significance of the association.

Study results depict that 26.47% of the mothers who were already having a male child still preferred son. Preference for son was 24.52% and 48.61% among earning mothers and nonearning mothers, respectively. Out of 206 mothers said that they would prefer male child. Reasons cited were as follows: sons carry family name forward (30.6%), having daughters leads to increased expenditure (20.9%), daughters are subjected to different problem in their lifetime mainly violence (11.7%), and sons supported their parents in old age (10.7%).

Preference for male child was found to be equally prevalent in both urban and rural areas. Mothers should be educated about the effect of declining sex ratio along with financial capacity building of women and providing social security to senior citizens which was the main reason for son preference .The impact of gender imbalance on individuals, families, and on society has to be emphasized at every possible point of contact with health‑care delivery system.

New epidemiological studies acknowledge the detrimental effects of dust storms on health. The aim of this study was to systematically review the effects of dust storms on the morbidity and mortality rates of cardiovascular and respiratory diseases. The results of this study were obtained based on articles published in English-language journals. For the purpose of this study, all articles published until the end of 2020 based on the search in the “Scopus,” “Web of Science,” and “PubMed” databases were selected. Articles were searched independently by two trained researchers. Dust storms are the cause of many diseases and health-related complications, of which cardiovascular and respiratory diseases are common. It is necessary to recognize and investigate the harmful effects of dust storms to prevent serious harms to human societies. In the reviewed articles, the impact of dust storms on several diseases, including cardiovascular and respiratory diseases,has been analyzed. Most of these articles acknowledge the effect of dust storms on increasing the incidence and mortality rate of these diseases, although in some articles this effect is not statistically significant. Many studies conducted around the world confirm the harmful effects of dust storms on cardiovascular and respiratory diseases, including increase in the number and duration of hospitalizations, as well as increase in mortality and exacerbation of these diseases. However, some studies do not consider the harmful effects of dust storms on the above diseases to be statistically significant.

Some nursing schools in Iran with the aim of training qualified nurses have set up master’s degrees in emergency nursing. In any case, there are challenges in the implementation of this discipline in academic nursing centers which prevent the fulfillment of goals and missions in the curriculum.

In this qualitative study, four graduates of the master of emergency nursing and 13 undergraduate students were purposively recruited from the Nursing and Midwifery Faculty in Qom, Iran. Data were collected through semi‑structured interviews and analyzed through conventional content analysis.

Emergency nursing master’s program challenges consist of two categories: nonproductive course design and unresolved infrastructure. The extracted subcategories were unfit curriculum, inappropriate content, nonspecialized program, unclear roles, improper course planning, unskilled human resources, and poor educational facilities.

Based on the experiences of nursing graduates, the curriculum of master of emergency nursing in Iran needs to be substantially revised in terms of content and structure

The ethical guidelines and ethical atmosphere of the hospital affect the quality of nursing care. Improving the health of patients in most cases depends on the observance of ethical points and ethical behaviors by nurses. The aim of this study was to determine the effect of hospital ethics and ethical training guidelines on improving the quality of nursing care and nurses’ professional ethics.

This is a descriptive‑analytical study. This study was performed by multi‑stage relative cluster sampling on 260 qualified nurses in 2014. Data were collected using the Hospital Ethical Climate Questionnaire and the Judgments about Nursing Decisions Questionnaire and analyzed using SPSS software version 19.

The results showed that nurses’ perceptions of the ethical climate of hospitals were relatively positive. The ethical behavior of nurses was moderate and good. Nurses’ perception of the ethical climate scores was not related to the ideal ethical behavior of nurses (r = 0.11, P = 0.86).The ethical climate perceptions of nurses were related to real workplace ethical behavior score (r = 0.188, P = 0.002). The results also showed that ethical guidelines can improve the quality of nursing care.

Considering the results of this study, it seems that holding nursing ethics training programs can be a big step toward promoting the professional behavior of nurses and the observance of professional ethics by nurses.

Since the advent of coronavirus disease 2019 (COVID‑19) infection, there is debate whether pregnancy outcome in COVID‑19 is more severe as compared to general population. Pregnant population is particularly susceptible to viral infections due to altered immune response. H1N1 infection and Zika virus infection led to unfavorable maternal and fetal outcomes.SARS during pregnancy has been linked previously with high risk of spontaneous abortions, preterm births and intrauterine growth restriction. The effects of this novel virus need to be studied.

This is a single‑center descriptive prospective observational study of 65 pregnant women with reverse transcriptase–polymerase chain reaction confirmed COVID‑19 infection, regardless of gestational age at diagnosis, admitted from April 15 to June 30, 2020, at the COVID hospital in SN Medical college a tertiary center of Agra in North India. Maternal and perinatal outcomes were studied. Data were analyzed using the SPSS software for windows. Continuous variables were expressed as mean ± standard deviation. Categorical variables were expressed as numbers and percentages.

Majority 88.4% of the women were asymptomatic. Rest had mild illness only. Majority 94.23% were third‑trimester pregnancies; preterm birth was not reported in any singleton pregnancy. Majority 85% were delivered by cesarean section done for obstetric indications.Maternal outcome of all patients was favourable, and only two women who had moderate pneumonia recovered. Maternal mortality was reported in only 1 case. All neonates were negative for COVID‑19. Neonatal outcome was favorable.

COVID‑19 in pregnancy led to mild symptoms only.Infection in the third trimester did not led to adverse obstetric outcome including preterm labor and premature membrane rupture. SARSCoV2 infection in pregnancy did not increase the risk of maternal mortality. Vertical transmission of COVID‑19 was not found in neonates .The maternal, neonatal, and perinatal outcomes of COVID‑19 patients infected in late pregnancy were favorable.

Critically ill patients on mechanical‑ventilation are always at a higher risk of acquiring ventilator‑associated respiratory infections. The current study was intended to determine the antibiotic‑resistance pattern of bacteria recovered from the endotracheal (ET) specimens of ventilated patients.

This was a single‑centered, retrospective study carried out in a 400‑bed tertiary care hospital in Oman. The data of profile and antibiotic resistance pattern of bacterial isolates recovered from ET aspirates of ventilated patients during the period from January 2017 to August 2019 were retrieved from hospital database. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) software version 22 (IBM, Armonk, New York, USA). Descriptive statistics were applied to find the frequencies and percentages. Charts and tables were constructed.

In total, 201 bacterial isolates recovered from ET secretions of 154 ventilated patients were studied. The rate of isolation was predominant among males (65.6%) and in elderly people (50%). Gram‑negative bacilli (GNB) were predominantly (88.6%) isolated. Acinetobacter baumannii (31.3%) was the most common isolate and 86% of them were multidrug‑resistant strains. Klebsiella pneumoniae (23.9%) and Pseudomonas aeruginosa (22.9%) were the other common GNB, whereas Staphylococcus aureus was the most frequently isolated Gram‑positive bacteria. Gentamicin showed good in vitro activity against S. aureus and all the GNB except A. baumannii reflecting good choice for empirical therapy.

Gram‑negative bacteria were the predominant isolates in ET secretions of ventilated patients. There was an alarmingly high rate of antimicrobial resistance among GNB. A rational use of antibiotics, regular monitoring of antibiotic resistance and use of right combination of drugs, in addition to refining of existing infection control practices are critical to control the emergence of drug‑resistant strains.

Breast cancer is the most common type of cancer among women and it is the second leading cause of mortality among cancers in women and a major health issue in developed countries. Although there are simple and effective screening methods, just minority of women use them. Given the high prevalence of breast cancer in Isfahan women and the low prevalence of screening behavior, the present study aimed to determine the impact of theory‑based educational intervention on breast self‑examination (BSE) behavior and mammography.

The present experimental study was conducted on 93 women referred to comprehensive health centers in Isfahan through convenience sampling, and by this way 46 women were included in the control group and 47 in the intervention group. Data collection was done by a valid and reliable questionnaire. Furthermore, educational interventions were performed for the intervention group in three sessions. Furthermore, the data were completed in the intervention group before, immediately after, and 3 months after intervention and before and 3 months after intervention in the control group. The data were analyzed by SPSS (16); and paired t‑test and repeated measure test were used for analysis in the intervention group and also independent t‑test and paired t‑test were employed to analyze data of the control group.

The results showed significant changes in perceived benefit constructs (P = 0.023), knowledge (P < 0.001), self‑efficacy (P < 0.001), and behavioral intention regarding BSE (P = 0.035) in the intervention group over time, but changes were not significant in both perceived susceptibility and severity in the intervention group. As far as mammography behavior is concerned, only the perceived benefit construct in the intervention group had significant changes. In terms of the screening behavior, only BSE behavior significantly changed before and after intervention.

The study showed that theory‑based education by applying of constructs such as perceived benefits and self‑efficacy and intention for BSE model could promote breast cancer screening behavior such as BSE. Therefore, it is suggested that health educators utilize educational texts based on these constructs to increase their influence on individuals via screening behavior for breast cancer.

Diabetes is one of the most expensive and chronic diseases of elderly age. Knowledge and self‑care behaviors play an important role in treating diabetes and preventing its side effects. This study aimed to investigate the effect of peer group on self‑care behaviors and glycemic index in the elderly with type II diabetes mellitus in Fasa city, Fars province.

This quasi‑experimental study was conducted on 100 elderly patients with type II diabetes (50 patients in the intervention group and 50 in control group) referred to the diabetes center. Among the elderly, the intervention group was selected as a trainer based on the checklist of the peer group and was trained by the researcher. In addition to the usual care of the diabetes clinic, the patients in the intervention group received training from their peers for 8 weeks during 8–45 min of training sessions. Data were collected using a valid self‑reported questionnaire including demographic variables, awareness, and diabetes self‑care behaviors (Summary of Diabetes Self‑care Activities), as well as free practice (fasting blood sugar [FBS] and hemoglobin A1c [HbA1c]), which was completed by both groups before and 2 months after the intervention. Then, the data were entered into the SPSS statistical software, version 22 and were analyzed using Chi‑square test, independent t‑test, and descriptive statistical methods. P < 0.05 was considered statistically significant.

The results showed that the two groups of intervention and test were identical in terms of demographic information. In the intervention group, before and after 2 months of educational intervention, there was a significant difference in increasing awareness and self‑care behavior in diet, physical activity, blood sugar testing, foot care, and medication (P < 0.001). However, this difference was not significant in the control group (P < 0.05). In the intervention group, the mean FBS and quarterly (HbA1c) index decreased significantly (P < 0.05).

This study showed that teaching self‑care program, in the same way, has been effective in improving self‑care behavior and blood sugar index in the elderly with diabetes and suggested that this educational method be used in other chronic diseases.

Traditional methods are not able to differentiate which feature customers regard as attractive, mandatory, performance, and which feature customers are indifferent about. These categories can only be differentiated based on a specific technique called Kano survey. Specific aim of this study was to categorize the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction survey questions into Kano categories.

Design of the study was survey research. It was conducted from 6/2019 to 8/2019 at OSF Saint Francis Medical Centre in Peoria, Illinois, USA. A 34 question Kano survey (17 positive and 17 negative questions) based on HCAHPS patient questionnaire was designed. Surveys were analyzed using Kano analysis template. Comparative analysis of Kano categories based on demographics was also performed.

39 current patients and 25 caregivers completed the survey. All of the 17 HCAHPS questions except “noise level at night” were classified as mandatory requirement with highest number for information on “indications of medicines.” There was a minimum variability in the satisfaction coefficients but large variation in the dissatisfaction coefficients. More patients above 50 years consider “help going to bathroom” as mandatory (70.2% vs. 40.7%, P = 0.01). Sixty‑four percent of caregivers considered “explain things (nurse)” as mandatory as opposed to 51.2% of patients (P = 0.03).

Current U. S healthcare consumers have high expectations from healthcare delivery and consider most HCAHPS questions as mandatory requirements. Kano analysis needs to be done on a larger, more diverse hospital setting and potentially the HCAHPS survey needs to be modified to reflect prevailing healthcare customer requirements.

Evaluation is one of the most important tools for determining the quality of any educational program, which can lead to reformation, revision, or termination of programs. Quality in higher education requires assessment and judgment of goals and strategies, executive policies, operational processes, products, and outcomes. The Context, Input, Process, and Product (CIPP) model is a comprehensive perspective that attempts to provide information in order to make the best decisions related to CIPP. Due to the importance of this topic, the present study examined the application of the CIPP model in the evaluation of medical education programs through a systematic review.

In this systematic review, Persian databases including ISC, SID, Mag Iran, CivilicaL, and Noormags and English databases including PubMed, Web of Science, Scopus, ProQuest Dissertations, Embase, CINAHL, ERIC, and Google Scholar were searched using relevant keywords, such as evaluation, program evaluations, outcome and process assessment, educational assessment, and educational measurements. The search was done with no time limits and 41 papers were obtained until May 22, 2020. This systematic review was performed by following the data extraction steps and assessing the quality of the studies and findings. Critical Appraisal Skills Programs and Mixed‑Methods Appraisal Tool checklists were used to check the quality of the papers.

This systematic review was conducted on 41 studies, 40 of which were research papers and one was a review paper. From the perspective of the CIPP model of evaluation, most papers showed quite a good level of evaluation of educational programs although some studies reported poor levels of evaluation. Moreover, factors such as modern teaching methods, faculty members, financial credits, educational content, facilities and equipment, managerial and supervisory process, graduates’ skills, produced knowledge, and teaching and learning activities were reported as the factors that could influence the evaluation of educational programs.

Due to the important role of evaluation in improvement of the quality of educational programs, policymakers in education should pay special attention to the evaluation of educational programs and removal of their barriers and problems. To promote the quality of educational programs, policymakers and officials are recommended to make use of the CIPP model of evaluation as a systemic approach that can be used to evaluate all stages of an educational program from development to implementation.

Several preventive measures were used by governments around the world to suppress the transmission of SARS‑CoV‑2, including quarantine. During quarantine more people are at risk of developing mental health problems as social media exposure was increasing.

The objective is to investigate the impact of social media exposure during coronavirus disease 2019 (COVID‑19) pandemic on depression, anxiety, and stress.

A cross‑sectional study was conducted between April and May 2020 during the large scale social restriction in Indonesia using online questionnaire Indonesian citizens over 18 years of age were invited to take part by answering online questionnaire through Google forms (http://bit.ly/duniamayaCOVID). Data gathered were demographic data, depression, anxiety, and stress that were assessed using Depression Anxiety Stress Scale‑21, duration of social media usage, and social media platforms used during COVID‑19 pandemic. Data was analysed using Pearson Chi‑square and ANOVA. Statistically significant variables and additional risk factors was analyzed using multinomial logistic regression.

The median age was 24 years (range 17–56 years), 121 (55,0%) samples were female. The three most frequent social media platforms used by participants were Instagram, WhatsApp, and YouTube. Female were more likely to suffer from mild‑moderate depression compared to male (odds ratio [OR]: 2.344; 95% confidence interval [CI]: 1.105–4.972; P = 0.026) and more likely to suffer from severe‑extremely severe anxiety (OR: 2.066; 95% CI: 1.019–4.187; P = 0.044). Social media exposure was associated with less likelihood to suffer from severe‑extremely severe depression, mild‑moderate, and severe‑extremely severe anxiety, mild‑moderate stress.

Social media exposure was associated with less depression, anxiety, and stress in the COVID‑19 pandemic era. Medical professionals and government officials could use social media to disseminate knowledge about COIVD‑19 to bring positive psychological effect.

Physical education is undergoing a major transformation period that leads that school discipline to influence the lifestyles of young people to help them adopt behaviors conducive to their well health and well‑being. Health education (HE) integrates with various intervention strategies in the field of health such as disease prevention and health promotion. In schools, the HE comes in many forms and in relation to several disciplines. Our study focuses on the current situation of HE in physical and sports education (PSE) in middle school. Specifically, the research question we developed is: “What is the contribution of the PSE to the HE of middle school students?”

This qualitative research was carried in Marrakech. Semi‑structured interviews were conducted with ten PSE teachers after receiving their informed consent. Deductive content analysis was used in this study.

Among the main results, there is a certain diversity of teachers’ representations on HE and PSE. These teachers say mobilize PSE to contribute to the HE of students. However, it was noted that their teaching practices are at odds with the perspective of the inclusion of HE in the field of PSE.

In the absence of a clear vision concerning physical activity and sport in relation to “healthy” and “active” schools, it seems very unlikely to influence the thoughts and practices of HE teachers; strongly attached, as they often are, to their representations of their discipline.

The outbreak of new pathogens or the resurgence of pathogens that have already spread is a serious challenge to public health. Coronavirus is a pathogen that seems to invade the human respiratory system in the first place. Coronaviruses form a large family and are so called because of the presence of crown like cristae on their surface.

This is a cross‑sectional, descriptive study conducted to assess the status of patients with COVID‑19 who were hospitalized in an educational hospital. For this purpose, 142 patients hospitalized in this hospital were followed up 2 weeks after discharge and were inquired about the symptoms they had upon admission to the hospital, the number of hospitalization days, the history of underlying disease, and so on. Descriptive data analysis was done with the SPSS software version 22.

The findings of this research showed that overweight or obese people (about 66%) is more likely to contract the disease. It also seems that older people (37.3% older than 60 years old) and those with a history of diseases (69.6%) such as diabetes, high blood pressure, or heart disease are more prone to COVID‑19. The most common symptoms of COVID‑19 patients included fever (64.5%), shortness of breath (67.4%), and dry cough (50.4%).

it seems that high risk group (obese people, old people, and people with a history of disease) is more likely to be infect with coronavirus so they should more careful than others. Another important issue is that policy‑makers must play an active role in public awareness of dangers of COVID‑19 and ways to prevent it.