Journal of Education and Health Promotion
Volume:10 Issue: 2, Feb 2020

In the dedicated intensive care settings, health‑care providers need to have higher temporal cognition and sympathovagal balance to optimally deliver critical care interventions.

The objective of the study was to estimate the parameters of the temporal cognition and autonomic function of paramedical staffs in acute health‑care settings.

In this study on 81 healthy adult paramedical personnel, temporal cognition was assessed using auditory reaction time (ART), visual reaction time (VRT), critical flicker fusion frequency (CFFF), Stroop test (ST), and digits forward test (DFT); Autonomic functions were assessed by heart rate (HR) and blood pressure (BP) variability, and all these outcomes were analyzed with their academic performance.

Out of 81 healthy adult nonteaching technical personnel, majority was female; the mean age was 25.10 ± 3.93 years. Age and gender were not significantly related with screen times in terms of smartphone use, playing video games, or regularly using computer; academic performances were also not significantly related with screen times in terms of smartphone use, playing video games, or regularly using computer. In the conventional domains, during analysis of physiological and psychological variables under study, there was no significant relation with screen times when compared with HR, systolic BP, diastolic BP, mean arterial pressure, body mass index, ART, VRT, CFFF, ST, and DFT. Playing video games and regular computer use were significantly correlated with age, gender, AP, CFFF, ST, and DFT.

This study on paramedical personnel showed a positive relation of temporal cognition and sympathovagal autonomic balance with performing a task or function.

Assessment interprofessional collaboration (IPC), in community health‑care setting usually has been neglected due to the lack of standard tools and assessors. In the present study, the IPC checklist extracted from CANMEDS collaborator toolkit for teaching and assessing the collaborator role is contextualized in Iranian community healthcare.

According to CANMEDS Toolkit, an instrument extracted for IPC assessment. Using Chavez’ toolkit, face and content validity were studied through two rounds of Delphi by 12 experts of TUMS. Qualitative content validity including content validity index (CVI), and content validity ratio (CVR) were assessed following watching a standard video about IPC by them. Construct validity was studied by confirmatory factor analysis through LISREL software. To check reliability, Cronbach’s alpha was calculated, and the other 12 experts completed checklists in test–retest process with a 2‑week interval.

Face and qualitative content validity were confirmed using the Delphi method. CVI and CVR were calculated as 0.61 and 0.86. In factor analysis, x2/df and RMSEA were calculated as 1.363 and 0.036; CFI, IFI, GFI, and AGFI were >0.7, and hence, the construct validity was confirmed. Cronbach’s alpha was 0.953 for internal consistency. Test–retest was also calculated as 0.918 indicated to confirm reliability.

CANMEDS framework as an assessment tool for evaluating IPC in community health setting is not only valid and reliable in the Iranian context but also it is easy to use for respondents resulted from the rational number of items in community.

Due to time constraints and a significant increase in medical information, one of the ways to keep physicians and medical teams up to date is to use evidence‑based medicine. The current research focused on the effects of the educational role of clinical informationist (CI) on improving clinical education among medical students based on the Kirkpatrick (KP) model.

The method was semiexperimental research in two group designed with pretest and posttest. The research population included thirty medical students for each group that was selected by the convenience time‑based sequential sampling method. The study data were collected using a researcher‑made two questionnaires and a checklist. Data were analyzed by the descriptive statistics and inferential statistics using SPSS version 20 software.

Based on the first level of the KP model, the total mean of medical students’ satisfaction in the experimental group was 4.06 from 5. Based on the second, third, and fourth levels of the model, the independent t‑test showed that before the intervention, the mean scores of attitude, knowledge, information‑seeking skills and behaviors, and also clinical skills were not significantly different in both the intervention and control groups (P > 0.05). After the intervention, the results of covariance test showed that attitude, knowledge, information‑seeking skills and behaviors, and also clinical skills of the intervention group are significantly better than that of the control group (P < 0.001).

Training and the presence of the CIs in the clinical round had resulted in the improved satisfaction, attitude, knowledge, and information‑seeking skills while also improving information‑seeking behaviors and clinical skills of medical students.

Knowledge management enhances efficiency, empowers employees, and enhances organizational health. Social capital provides a good basis for more productive human resources, and training hospitals also play a key role in the health‑care system. The purpose of this study was to determine the relationship between knowledge management and social capital with organizational health in selected educational hospitals of Tehran in 2018.

This analytical cross‑sectional study was performed on 310 medical staff of hospitals using proportional sampling method. The data gathering tools consisted of three standard questionnaires of knowledge management, social capital, and organizational health. Data were analyzed using descriptive and inferential statistics using SPSS version 22 software.

Most participants in this study were male (8/66%) and in the age group 31–36 years. The mean of knowledge management and organizational health were 3.43 and 3.49, respectively. There is a significant direct relationship between knowledge management components and organizational health. Moreover, there is a significant but weak direct relationship between knowledge management and social capital with organizational health dimensions (P ≤ 0.05).

Considering the relationship between knowledge management and social capital with organizational health, enhancing the level of organizational health can help to improve the dimensions of knowledge management and social capital. It is suggested that hospital managers, using knowledge management and social capital components, enhance organizational health so that the hospital is more prepared to adapt to the complexities and changes in the market providing services.

Occupational stress is known as harmful physical and emotional responses that occur when the requirements of the job do not match the resources, needs, or capabilities of an employee, leading to poor mental and physical health.

The objective of the present study was to assess the effect of 1‑week residential yoga training program on occupational stress and its subscales among principals.

Thirty‑three principals with ages 40–59 years completed the assessment. They received yoga training at Kaivalyadham Yoga Institute. All the participants were recruited by Kendriya Vidyalaya Sangathan as part of their on‑duty yoga training. At the baseline and after 1 week of yoga training participants were assessed for occupational stress. The yoga intervention was given in the morning and evening for 105 min. Apart from yoga training, all the participants were engaged in lectures based on stress management, yoga for total health, meditation, yoga in school education, and scientific basis of yoga, daily for 3 h.

The principals showed a significant decrease in role overload (P < 0.001), role ambiguity (P < 0.01), role conflict (P < 0.05), under participation (P < 0.001), powerlessness (P < 0.001), intrinsic impoverishment (P < 0.01), law status (P < 0.001), and overall occupational stress (P < 0.001) after 7 days of yoga training intervention. However, there was no significant change in unreasonable group and political pressure (P > 0.05), responsibility for persons (P > 0.05), poor peer relations (P > 0.05), strenuous working conditions (P > 0.05), and unprofitability (P > 0.05) after yoga training intervention.

The present study suggests that 1 week of residential yoga training program can improve occupational stress in principals.

Effective communication is one of the most important factors in advancing the goals of library services and the identifying factors affecting it and having a single model for such factors are of utmost importance. The aim of this study was to develop a structural model of self‑compassion measured based on spiritual intelligence (SQ) as factors affecting communication in medical library and information science students.

This was a correlational study done by structural equation modeling method. A total of 290 undergraduate and graduate students of Medical Library and Information Sciences of Iran’s Universities of Medical Sciences were selected by simple random sampling. In this study, the data were collected by the Neff’s Self‑Compassion Scale and the King’s Spiritual Intelligence Self‑report Inventory. Self‑compassion measured based on SQ was tested by goodness‑of‑fit indices. Statistical analysis was performed using SmartPLS software.

The results showed that there was a significant relationship between SQ and self‑compassion. Furthermore, the positive values of predictive indices could confirm the self‑compassion measured based on SQ. Composite reliability indicated the high reliability of SQ and self‑compassion.

According to the fitting indices of the model, it can be concluded that the self‑compassion model has an acceptable fit on the basis of SQ.

Spiritual healing is a complementary and alternative treatment with different meanings in different cultures and religions. However, the concept has not been defined from the cancer patients’ points of view. The present study was done with the aim of concept analyses of spiritual healing from Iranian cancer patients’ viewpoints.

The study was done using a hybrid method at three phases including of theoretical study, field study, and final analysis. In the theoretical study phase and using the keyword “spiritual healing,” pertinent articles were searched in main databases. In the field study phase, ten cancer patients were interviewed, and in the final phase, the two other phases were analyzed. After determining features, antecedents, and consequences, a conclusive definition of spiritual healing from Iranian cancer patients’ viewpoints was proposed.

Spiritual healing from Iranian cancer patients’ viewpoints was featured with four themes, including connection with paranormal forces; effective, noninvasive, inexpensive, and efficient therapeutic method; a way to achieve piece, adaptation, and health and influenced by cultural and religious beliefs. Spiritual healing is a complementary and alternative treatment that helps careseekers to achieve health through paranormal forces and energies. As the findings showed and according to the participants’ viewpoints, the source of such forces and energies was divine force and the healers were mediums to transfer the energy.

The findings supported that religion and faith were the key elements of spiritual healing in the Iranian Islamic context.

Sexual health education, especially in adolescents, faces excess challenges in many cultures. Iranian adolescents, especially boys, have many educational needs in the field of sexual health that have not been met due to various obstacles. The main purpose of this qualitative study was to explore the challenges of sexual health education for Iranian adolescent boys.

This qualitative content analysis study was conducted through individual semi‑structured in‑depth interviews from 45 participants (20 adolescents and 25 key adults). Data were analyzed using inductive conventional content analysis based on the Graneheim and Lundman’s approach via MAXQDA software (version 2010) by VERBI GmbH Company, Berlin, Germany.

In total, 2 categories and 11 subcategories emerged; including, “extrapersonal barriers to sexual health education for adolescent boys” containing seven subcategories of lack of clear policies, family inadequacy, social barriers, cultural heterogeneity, school inadequacy, cyber threats, and educational process inadequacy concerning adolescent sexual health education as well as “intrapersonal barriers to sexual health education for adolescent boys” comprised four subcategories of uncontrolled emotions of adolescence, adolescent rebellion, information and communication weaknesses, and adolescents’ concerns about being judged by others.

The findings clarify some barriers to sexual health education for adolescent boys. Therefore, it was recommended to develop community‑based educational programs to change attitudes of families and society toward addressing the challenges of providing sexual health education to adolescent boys. Moreover, it was suggested to utilize an educational program specific to adolescent boys, tailored to the Iranian culture, using the potential of religion.

The principal objective of clinical guidelines is to improve the quality of medical care. However, standardized evaluation of the adoption into daily practice is missing. The aim of our study was to investigate the implementation of guideline recommendations on the management of arterial hypertension (AH) in German general practitioner’s (GPs) offices.

A questionnaire focusing on the implementation of the German guidelines for the management of AH was developed and prospectively rolled out in 3.200 GPs and field‑based specialists in internal medicine in Germany. Data were interpreted in an explorative way.

Data from 689 German physicians that participated in the survey were analyzed. Effectiveness of lifestyle changes in the management of AH was rated as very high or high in 36.6%. When lifestyle changes only will not normalize blood pressure (BP), medical treatment will be initiated after 2–6 months by majority of physicians. Decision for mono‑ or combination therapy was driven by BP and patient’s risk profile. Choice for a specific antihypertensive substance was based on the recommendations of scientific guidelines in the majority of GPs.

Medication treatment algorithms recommended in 2015 by German guidelines are well accepted by GPs. Lifestyle changes are voted by only slightly more than one‑third as a reasonable tool for the management of AH in the setting of the medical office. This might reflect a lack of certified medical education regarding this topic. Our study was not designed to register the time from publication of guidelines to practical implementation.

The most important reasons for choosing cesarean include negative attitude of pregnant women toward natural childbirth, and it is not easy for many women to make a decision about the choice of delivery, Midwives as responsible individuals, play an important role in providing maternal counseling and care during pregnancy and childbirth and the postpartum period. This study was carried out to determine the effect of individual counseling on attitudes and decisional conflict in the choice of delivery among nulliparous women.

This clinical trial was performed on 90 nulliparous women with 28–30 weeks of gestational age, who were referred to health‑care centers in Mashhad. They were divided randomly into intervention and control groups. The intervention group received the counseling program individually during three sessions, while the control group received routine care, childbirth attitudes, and decisional conflict on choice of delivery were compared on women of 34–36 weeks of pregnancy. Data collection tools included demographic details form, Childbirth Attitudes Scale and Decisional Conflict Scale; data were analyzed using Chi‑square tests, Fisher’s exact test, Mann–Whitney test, t‑test, parried t‑test, and ANCOVA in SPSS v. 16, and P < 0.05 was considered statistically significant.

After consultation, there was a significant difference in attitude score between the intervention group (86.577 ± 13.531) and the control group (69.955 ± 19.858) (P < 0.001), And there was a significant difference in decisional conflict score between the intervention group (0.614 ± 0.626) and the control group (1.216 ± 0.949) (P < 0.001), and there were significant differences between the two groups in terms of preferred delivery (P < 0.001).

According to the results of this randomized control trial, individual counseling in nulliparous women during pregnancy leads to a positive attitude toward natural childbirth, informed decision‑making, and increase in the selection of natural childbirth.

The attitude of nurses with regard to patients’ rights bears greater influence on its practice in the health‑care settings. As health‑care organizations grow toward standardization, positive changes in the attitude of health‑care professionals are demanding.

The objectives of this study were to assess the attitude of nurses with regard to patient rights in two teaching hospitals, to devise a training program on patient rights for nurses, and to compare the impact of training with regard to patient rights on the attitude of nurses in two teaching hospitals.

This quasi–experimental study with one‑group pre‑ and post‑test research design for a sample of 200 nurses was carried out during the year 2017 at two multispecialty hospitals in India. The sample size was selected based on convenience sampling method. For the pretest, attitude was measured on a 5‑point Likert scale through a questionnaire containing 27 items. Small‑group teaching method was used to train nurses in groups of 8–10. Posttest was done through the same attitude questionnaire 1 week after the training program.

In both the hospitals, the nurses had a favorable attitude toward patient rights before the training program; after training, majority of the nurses had the most favorable attitude toward patient rights. A statistically significant difference was observed in the attitude of nurses with regard to patient rights within the hospitals, before and after training nurses on patient rights (P < 0.001).

Health‑care organizations require developing planned teaching programs for nursing care professionals in order to influence their knowledge and attitude on patient rights. Their positive attitude toward patient rights leads to improved outcomes and effective nursing care practices.

Negative attitudes toward vaginal delivery are an important reason for pregnant women to undergo a cesarean section. Therefore, this study was performed to evaluate the effect of motivational interviewing on attitude and choice of primigravida women on type of delivery in requesting elective cesarean section.

In this single‑blind clinical trial, 120 primigravida women in 28–31 weeks of gestation with normal pregnancy determined by a multistage sampling were randomly chosen from ten health centers of Zahedan city in 2019 and were divided into two groups. Motivational interviewing was performed in four sessions within 90 min in the experimental group, and the control group received routine care service. Attitude (before and 1 month after the intervention) and performance (after delivery) were evaluated using a valid and reliable researcher‑made questionnaire. The collected data were analyzed using different proportions, paired t‑test, independent t‑test, covariance analysis, and Shapiro–Wilk and the Chi‑square methods.

There was a significant difference in the attitude of participants between the two groups after the intervention (P = 0.001). The mean difference of pre‑ and posttest was significant in relation to attitude scores in the two groups (P = 0.001), and the difference between the two groups was also statistically significant between the two groups in terms of delivery type (P = 0.03).

We conclude that motivational interviewing can be a useful tool to change the attitude and decrease the rate of unnecessary cesarean among pregnant women. It is recommended to examine the impact of this method on women from different societies who have various educational backgrounds and cultures.

Iran’s health system has always faced many challenges in the field of disaster risk management. The establishment of early warning systems in countries has been identified as an important component of preparedness and risk reduction.

This study aims to extract the experiences of those involved in the field of risk management in relation to the challenges and problems of early warning system establishment in the Iran’s health system. SUBJECTS AND

This was a qualitative study, which has been conducted using a content analysis method. Data were collected through semi‑structured interviews with 16 individuals who had at least one disaster management experience at the emergency operation centers. Sampling was done purposefully. The data were then analyzed using the Grenheim method.

Nine subcategories of data were analyzed that included legal vacancies, challenges related to protocols and guidelines, weaknesses in the prediction infrastructure, weaknesses in the communication infrastructure, poor coordination, scarcity of resources, inadequate education, information management challenge, and evaluation challenge, and three main categories were extracted that included policy challenges, infrastructure challenges, and management challenges that represented the issues experienced in establishing an early warning system in the Iranian health system.

Policy‑makers and managers of health system need to pay special attention to improve the legal framework and standard protocol, strengthening infrastructures, increasing management performance in the field of coordination, education, allocation of resources, flow of information, and evaluation system.

This study discussed about challenges and opportunities of institutional accreditation in Iranian medical universities. The lesson learned of the first round of the accreditation would direct initiatives and solutions for future accreditation.

This research is a qualitative content analysis research that studied the experience of the survey visit teams. Semistructured interviews with a purposive sampling approach were done to reach data saturation. Constant comparative method was used to analyze the data.

The emergent themes were incompatible scheduling with accreditation workload, accreditation sustainability, the weakness of the survey instrument, advantage of the survey instrument, the quality of evaluators’ survey, the opportunity of progress for universities, accreditation perspective, defendable cost opportunity, perceived injustice, and the leading strategies. In this study, the relationship between categories and themes was shown with a systematic approach.

In medical education systems, it is necessary to continue the research and development studies using the findings in each accreditation period to achieve the prospect of international accreditation.

Stroke causes physiologic functional changes such as vascular resistance and arterial remodeling. This study aimed to explore the effects of 3‑month regular home‑based exercise rehabilitation on brachial flow‑mediated dilation (FMD), daily physical activity, and upper and lower extremity sensorimotor of the acute ischemic stroke patients.

This randomized control trial was done from August 2017 to September 2018. Patients with unilateral ischemic stroke were recruited from inpatient wards at an educational hospital. Patients were randomly assigned to the home‑based rehabilitation program (intervention group) or usual care (control group). Fugl‑Meyer upper and lower extremity sensorimotor score and Barthel score were evaluated in both the groups before and 3 months after baseline assessment. Furthermore, brachial artery vasomotor reactivity (FMD) hemiparetic arm assessed vascular health. The intervention group received home‑based rehabilitation exercise program for 3 months. The control group did not receive home‑based rehabilitation program and incentive telephone call. All data were collected and analyzed by SPSS software (version 20) and appropriate statistical tests.

Forty ischemic stroke patients (twenty in the intervention group and twenty in the control group) were examined. Results showed that Barthel score and Fugl‑Meyer upper and lower extremity score and FMD in the intervention group were significantly higher than the control group after 3‑month home‑based exercise rehabilitation (P < 0/001).

Twelve‑week regular home‑based exercise training was well tolerated by the intervention group. After this period, improvements were reported in brachial FMD as well as daily physical activity and upper and lower extremity functional capacity.

Due to the increasing prevalence of diabetes in the world, the assessment of the patient needs is essential. Understanding the needs of patients will play a very important role in providing an effective training program for patients. This study aimed to explain the health‑care needs of patients with diabetes in Iran’s health‑care system.

The present study was conducted using a modified Delphi technique in three rounds in 2017–2018. In the first round, patients’ needs were extracted based on qualitative interviews and a review of the literature. Then, the second and third rounds were determined through surveys, achieving maximum consensus and grading the importance of the patients’ basic needs. Participants selected using purposeful sampling and included 58 diabetes patients, family, and providers of the health system who were referred to urban health centers, rural, and one of the clinics of Darreh Shahr, Ilam Province. For data analysis, qualitative content analysis was used in the first Delphi round and descriptive statistics were used in the second and third rounds.

Regarding health‑care needs of patients with diabetes, four main themes included: information and knowledge needs, need for reinforcement/reform of religious‑cultural beliefs, need for health self‑management, and ultimately supportive needs have emerged.

According to the results, before designing and developing effective educational programs, the need assessment to improve knowledge, correcting unrealistic attitudes and beliefs, as well as modifying their self‑care behaviors and performance in preventing diabetes is recommended.

In this era of globalization, urbanization, and rapidly expanding unhygienic food corners across the globe, the incidence of food poisoning is very common nowadays.

The aim of our study was to investigate the perceptions and readiness of schoolteachers to accept notifications on food poisoning as a part of education to the students.

A descriptive cross‑sectional study was carried out with the help of a validated questionnaire for data collection. Our research involved schoolteachers from both primary and secondary schools in Muar. The questionnaire was pretested among the eligible trainee teachers and yielded an internal consistency reliability coefficient (c = Cronbach’s alpha) of 0.082. This study was conducted from October 29, 2017, to December 14, 2018, in Muar. Our sample size was 259. Ethical consent was obtained from the Institution Ethical Committee.

A total of 259 schoolteachers from both primary and secondary schools in Muar were included in this study. In our study, 81.1% of the teachers responded that they can easily educate their students about food poisoning. Most of them (93.1%) were ready to receive notifications on food poisoning in any mode, and about 72% of the teachers preferred WhatsApp as their mode of receiving notification. The least (1.2%) preferred mode of notification was LINE (a social app). Teachers’ willingness to disseminate the information regarding food poisoning was also higher (98.5%).

We concluded that majority of the schoolteachers had a good perception and were ready to receive the notifications on food poisoning through WhatsApp as a part of education to the students.

Due to increasing number of the world population, elderly individual’s quality of life (QOL) is a matter of concern and marital status as one of the objective measures of QOL is of paramount importance. This study was done to compare the QOL between single and remarried elderly.

This case–control study was conducted on 200 elderly people in Qaen (Southern Khorasan province), Iran. The research sample consisted of two groups of single and remarried elderly, 100 in each group. A demographic and LEIPAD (an acronym deriving from the name of Leiden and Padua universities) QOL questionnaires were completed by the participants via interview.

There was a significant difference between single and remarried elderly groups in the QOL (P < 0.001). Linear regression showed that marital status (P < 0.000), economic situation (P < 001), primary education (P < 0.0002), and diploma (P < 0.030) opposed to the illiterate were significantly related to the QOL. In other words, being married and higher economic situation and education increase the QOL. There was a significant negative correlation between the age (P < 0.000) and QOL. The strongest factor was age.

Marital status, income, and education play an important role in all aspects of QOL in older adults. Thus, being married can be a protective factor against physical, psychological, and social problems in old age. Realizing this issue in consultation process of elderly peoples is recommended.

Data on the factors affecting long‑term mortality following a stroke in Iran are scarce. The current research aimed at investigating the extent of 2‑year mortality following a stroke and the factors affecting it in the northwest of Iran.

This prospective cohort study was conducted in Tabriz, Northwest of Iran. Patients with computed tomography/magnetic resonance imaging confirmed the first‑ever stroke were included in this study and followed up to 2 years. Clinical examinations, including the severity of the stroke using the modified National Institutes of Health Stroke Scale (mNIHSS), were conducted by a neurologist. The general characteristics, lifestyle factors, and laboratory tests were also completed. To estimate the survival, Kaplan–Meier analysis was used; and for group comparison, the log‑rank method was applied. To identify the factors predicting 2‑year mortality, semiparametric Cox regression analysis was used.

A total of 1036 first‑ever stroke patients were included in the present study. The mortality rates of stroke in 6‑month, 1‑year, and 2‑years follow‑up periods were 31.6%, 34.5%, and 38%, respectively. The two‑year mortality rate was 33.6% in ischemic and 58.7% in hemorrhagic stroke (P < 0.001). In the multivariate Cox model, variables age, type of stroke, diabetes, and severity of the stroke, according to the mNIHSS index, were identified as factors predicting 2‑year mortality following the stroke.

The 2‑year mortality following acute stroke was relatively high compared to that of in developed countries. Implementation of secondary prevention is recommended to better management of modifiable predictors of mortality.

Blended learning (BL) refers to a systematic teaching method, which combines the aspects of face‑to‑face and online interactions using appropriate Information and Communication Technologies. This mixed‑method systematic review (SR) protocol is developed with the objective to determine the effectiveness and appropriateness of BL in the health‑care professional education. Mixed‑method SR protocol: For the purpose of this SR, PICO is defined as P‑entry level graduate students of health sciences program; I‑BL; C‑traditional face‑to‑face training; and O‑achievement of learning outcomes, learner’s and teacher’s perception (primary). The search will be done through possible database using predetermined search strategy. Eligible studies will be appraised independently by authors. Joanna Briggs Institute’s mixed‑method protocol will be used to assess and synthesis the data. This protocol is registered with the International Register of Systematic Reviews (PROSPERO) with the registration number CRD42018082699.

Medical education is facing a challenge in meeting society’s demands about their health improvement. Due to this, it seems necessary to educate creative and thoughtful staff for health‑care system. By this introduction, this study aimed to compare the effect of “learning based on classic education” and “learning based on participatory education” on nursing students critical thinking.

Thirty‑eight nursing students participated in this study. Students were chosen by census method and were divided into two groups randomly. The California critical thinking questionnaire was used for data collection. Data were analyzed using SPSS v. 19 by descriptive statistics and t‑test.

The results showed a significant difference between the mean score of critical thinking before and after conducting the “learning based on participatory education” method. Difference between mean score was significant between the two groups. This mean score was more increased in group which “learning based on participatory education” method was conducted.

The increased score of critical thinking among students with “learning based on participatory education” method showed the welcome of students toward new and dynamic methods of teaching the critical thinking and proved this that critical thinking can be useful in nursing education.

Hemophagocytic lymphohistiocytosis (HLH) is caused by overactivation of immune system. Gene mutations, infections, malignant, and autoimmune trigger the development of the disease.

Clinical data and peripheral blood samples of 21 patients suspected of HLH were collected in Shiraz Medical Centers 2017–2018. Peripheral blood samples were analyzed for soluble interleukin‑2 receptor alpha (sIL2Rα) marker (sCD25), and the results were compared with 36 normal controls as well as comparison with clinical findings and other laboratory parameters.

Twenty‑one patients (11 males and 10 females) with an average age of 5.2 were investigated. In this study, peripheral blood samples were taken from 16 newly diagnosed patients before treatment, and five were posttreatment blood samples. The mean sIL2Rα level before treatment in 16 patients was 9023 pg/ml. The mean peripheral blood sample of the 36 controls was 3025 pg/ml. The mean of the five posttreatment samples was 4198 pg/ml. Significant difference between pretreatment and the control group was observed. However, no significant difference was detected between after treatment samples and the control group. By comparing the sIL2Rα levels between patients with increased aspartate aminotransaminase (AST) and patients with normal AST level, there was a significant difference in the amount of IL2Rα level.

This study highlights the importance of IL2Rα marker in the diagnosis and follow‑up, during treatment and suppression. Furthermore, a significant difference with respect to AST level requires further investigation.

Eaching methods are the stimulation, guidance, direction, and encouragement for learning and also the means to achieve the desired educational objectives.

This study aimed to assess peer learning (PL) versus conventional teaching (CT) regarding antenatal assessment in terms of knowledge, skills, and satisfaction among nursing students.

This was a quasi‑experimental study conducted on 51 B.Sc.Nursing 3rd‑year students who were selected by convenient sampling and randomly assigned to PL (n = 21) and CT (n = 30) group. Sample characteristics pro forma, structured knowledge questionnaire, observational checklist, and satisfaction rating scale wereused to collect data from nursing students through self‑report and observational technique.

The study results revealed that the mean posttest knowledge score (19.1 ± 0.75) in PL group was higher than that in CT group (17.0 ± 0.741) and the mean rank skill score of PL group (44.90) was higher than that in the CT group (20.30). There was no significant difference (t = 1.08, P > 0.05) in mean posttest knowledge score, whereas the significant difference was found in posttest skill score (Z = 5.00, P ≤ 0.01) among nursing students. Most of the nursing students were satisfied with the CT method. There was a mild positive correlation (r = 0.25) between knowledge and skills regarding antenatal assessment among nursing students.

Based on the findings of the study, it can be concluded that both PL and CT groups were found to be equally effective in improving knowledge and skills of nursing students regarding antenatal assessment.

Suicide ideation is one of the common mental health problems among university students. This study aimed to explain suicide ideation susceptibility by examining the relationships between psychological factors.

The population of the study included all female undergraduate students at the University of Isfahan in autumn 2018. A sample of 180 individuals were selected through multistage sampling from different faculties and majors. The scales used in this study included adults attachments inventory, Coping Inventory for Stressful Situation, Dysfunctional Attitudes Scale, and Suicide Ideation Scale. The statistical analyses included t‑test, Pearson correlation, and path analysis.

Suicide ideation was reported in 25% of the participants. The t‑test analysis indicated that the mean scores for dysfunctional attitudes (P < 0.01) and problem‑focused coping (P < 0.01) were significantly different in with and without suicide ideation groups. Suicide ideation significantly correlated with problem‑focused coping (r = −0.42, P < 0.01), emotion‑focused coping (r = 0.25, P < 0.05), and dysfunctional attitudes (r = 0.23, P < 0.05). Path analysis showed that dysfunctional attitudes and emotion‑focused coping significantly influenced suicide ideation. Moreover, the indirect effect of insecure (ambivalent and avoidant) attachment styles by mediating role of dysfunctional attitudes and emotion‑focused coping was statistically significant (P < 0.01) and the indirect effect of dysfunctional attitudes by mediating role of emotion‑focused coping as well (P < 0.05).

Insecure attachment styles and dysfunctional attitudes work as stress–diathesis model in predicting suicide ideation and increase suicide ideation susceptibility by affecting emotion‑focused coping strategy. The hypothesized model in this study can help formulate, evaluate, and prevent suicide risk.