Journal of Education and Health Promotion
Volume:9 Issue: 10, Oct 2019

The investment decision can be affected by changing levels of uncertainty and risk. The main objective of this research was to identify, characterize, and quantify the parameters which are essential in evaluation hospital construction projects and provide useful modeling techniques to give the best investment decisions for investors in Iran’s health‑care projects investment.

The methodology of this study was employing discounted cash flow (DCF) and real option valuation to investigate the feasibility investment in the public hospital construction project. The Islamshahr, Mashhad, and Fardis hospitals were included in the analysis. Economic indices of DCF methods were internal rate of return (IRR) and net present value.

The economic evaluation of the Black–Scholes model was almost as same as the binomial tree model, but there was a significant difference between the real options model and traditional methods. According to the traditional methods, the profitability with IRR for Islamshahr, Mashhad, and Fardis hospital projects was 35%, 43%, and 26%, respectively. Black–Scholes model showed profitability only for Islamshahr and Mashhad hospitals, and there was no adequate profitability for investors of Fardis Hospital project during the study.

The methods derived from the real options valuation could provide a more flexible and reliable indices for investors in dynamic and high revolution economic conditions. On the other hand, dynamic economic evaluation models can be applied to correctly evaluate the projects because of Iran’s health revolution and its health plans.

Providing the high‑quality services in hospitals depends on to minimize conflict between all members within a health team. This study aimed to identify the causes of conflicts experienced by clinical and administrative staff in hospitals.

A cross‑sectional study was carried out in 2018. The sample included 320 clinical and administrative staff from six hospitals affiliated to Ardabil University of Medical Sciences that were selected using two‑step clustering sampling method. Data collection was accomplished by self‑administered questionnaires. Descriptive statistics, t‑test, and ANOVA were used for data analysis.

Total conflict score revealed that clinical staff had higher levels of perceived conflict than administrative staff. In terms of organizational position, the study results showed a significant difference in the reported conflict between nurse groups and other groups (physicians and paramedical, administrative, financial, and logistic staff). The most important causes of conflict in the viewpoint of clinical staff were organizational and job characteristics (3.54 ± 1.28), poor management (3.51 ± 1.12), and inefficient communication system (3.42 ± 1.33). For administrative staff, on the other hand, poor management (3.18 ± 1.33), inefficient communication system (3.17 ± 1.36), and attitudes and perceptions (3.06 ± 1.41) were shown to be paramount factors.

Clinical and administrative staff of hospitals are like parts of a train track. The irrational relationship between them will result in distortion and lower quality of services. Therefore, effective strategies to decrease staffs’ experience of conflict need to be developed. This might create a healthier and more productive work environment which positively affects the care quality

HIV‑infected patients with poor antiretroviral therapy (ART) adherence are prone to depression, and depression can exacerbate the disease condition. This study was conducted to determine ART Adherence based on Information, Motivation, and Behavioral Skills (IMB) Model and its association with depression among HIV‑positive patients.

This descriptive–correlational study was carried out on people over the age of 18 years with HIV/AIDS, who referred to the Behavioral Diseases Counseling Center in Kerman City, Iran, in 2017. In this regard, 119 patients were selected using the table of random numbers. To collect the data, we used the Beck’s depressioninventory‑II and the IMB researcher made questionnaire to evaluate the ART adherence.

The results of the study reveal that a significant association was observed between the total adherence and all constructs of the IMB model (P < 0.001). Risk perception and self‑efficacy had the highest mean scores regarding the ART adherence. The prevalence of depression was 71.5% among patients. Information, personal motivation, and total adherence had a significant association with depression.

IMB model was an appropriate and practical strategy with regard to the ART adherence among people living with HIV who are prone to depression and drug consumption is crucial for them to achieve the 90‑90‑90 target. This article created a questionnaire to assist policy‑makers and health professionals designing interventions to improve adherence and health outcomes of ART.

Despite all efforts that have been made to promote professional behavior among medical trainees, unfortunately, reports from medical schools around the world confirm the prevalence of nonprofessional behaviors by medical students. Experts in the field of medical ethics and medical education in different countries have suggested several reasons for failing to minimize unprofessional performance among medical students.

This qualitative study aimed to promote our understanding from the challenges faced by Iranian medical students in providing professional behavior. The study was first conducted in the form of a semi‑structured face‑to‑face interview with medical students and then completed with a focus group discussion (FGD) session. Forty‑nine medical students participated in the interviews and 11 students participated in the FGD session. Qualitative conventional content analysis was used for examining the data.

The participants classified the obstacles of professional behavior into the following three main categories: problems related to educational system, problems related to the society, and problems related to students themselves.

Regarding the impact of various personal, social, and educational factors on the creation and expansion of unprofessional behaviors among medical students, it is essential to have a comprehensive approach for solving the problem.

Poisoning is an important global health problem that leads to increase in mortality and morbidity. Worldwide, a million people die each year because of poisoning. The incidence of poisoning is also highest in India, with an estimated death of 50,000 people every year. There is a paucity of literature on various factors associated with poisoning which hinders effective poisoning prevention.

The present study aimed to study the pattern of poisoning among patients in a tertiary care center and to assess the factors associated with poisoning.

The prospective study was conducted at the intensive care unit of a tertiary care hospital from May 2018 to September 2018. All the patients who had exposure to poisoning were included in the study. A pretested questionnaire was administered, and information regarding sociodemographic factors, type, mode, and outcome of poisoning were obtained. Statistical analysis was done through SPSS version 21.

Of 106 poisoning patients admitted, 55.7% were female and majority were from rural area (52.8%). The major type of poisoning was suicidal (86.8%). Among suicidal, tablet poisoning was predominant (35.8%), followed by corrosive poisoning (17.9%) and Organophosphorus poisoning (13.2%). The major reason for suicidal poisoning was family problems (63.4%), and the association was statistically significant (P < 0.001). Suicidal poisoning was more among the age group of 21–30 years and middle socioeconomic status, which was statistically significant (P < 0.001). The prevalence of poisoning was 20.8% and 19.8% among homemakers and college students, respectively, which was statistically significant.

Young adults, especially homemakers and college students, are more affected from poisoning in the current study. The involvement of family, educational institutes, and community is very important in identifying the risk factors and timely counseling. Emphasis should be made on legislative measures to combat socioeconomic problems.

Insufficient physical activity is a global health‑care problem and is considered an independent risk factor for chronic diseases. The present research aimed to explore the effect of an educational intervention based on the theory of planned behavior (TPB) and stages of change on promoting women’s physical activity.

This quasi‑experimental research was conducted on 68 women who voluntarily visited the health‑care centers of Mashhad. They were selected by randomized multistratified sampling method and were divided into two groups of intervention (n = 34) and control (n = 34). The data collection tools included a demographic information questionnaire, a questionnaire based on the TPB and stages of change, and the International Physical Activity Questionnaire. The data were statistically analyzed by SPSS software version 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (paired t‑test, correlation coefficient, and covariance). The significance level of P < 0.05 was considered in this study.

No statistically significant difference was found between the intervention and control groups before the intervention in terms of the scores of the TPB constructs and physical activity (P > 0.05). However, after the educational intervention, a significant difference was observed in the mean scores of TPB constructs and physical activity (P < 0.05). In addition, no statistically significant difference was found in the stages of change between the two groups after the intervention.

The results of this study pointed to the effectiveness of educational intervention and the necessity to use educational interventions to help adopt preventive behaviors. Therefore, the use of well‑established educational models rather than conventional methods is recommended.

The safety of hospitalized patients in the intensive care units (ICUs) is threatened due to incidents and adverse events, including medication errors. Medication error refers to any preventable event at different stage of medication process, such as prescription, transcription, distributing medication, and administration, which can lead to incorrect use of medicines or damage to the patient. This study aimed at investigating the effect of the interprofessional education of medication safety program on medication errors of physicians and nurses in the ICUs.

The study was conducted using a quasi‑experimental method (single group, before and after) in 2017. The setting of the study included one ICU of selected teaching hospital affiliated to Isfahan University of Medical Sciences located in the Central Iran with a total of 23 beds. Participants included 50 members of the health‑care team (physician, nurse, and clinical pharmacist) with at least 1 year of work experience in the ICUs. Participants were selected using censuses sampling method. Data were collected using a two‑section self‑made questionnaire. Data were analyzed through descriptive, analytical statistics, and version 16 of the SPSS software (P < 0.05).

According to reporting of physicians, nurses, and clinical pharmacist, the medication error 1 month after implementation, the interprofessional education of medication safety program was significantly lower than before the implementation of it (P < 0.001).

Interprofessional education helps to improve interprofessional collaboration and patient care through the promotion of various professions of health to increase interprofessional collaboration compared to single profession education, which individuals learn in isolation and merely in their profession. Therefore, interprofessional education of medication safety program can reduce medication error and promote patient safety in the ICUs.

Evaluation of educational courses is important for estimating the achievement of learning goals and identifying the best way to learn. The present study is an attempt to assess the effectiveness of education through role‑playing on the learning outcomes in nursing students based on the Kirkpatrick’s evaluation model.

A quasi‑experimental study was conducted with participation of 74 nursing students at Iran University of Medical Sciences in 2016–17. The participants were selected through census and were randomly allocated to control (n = 35) and experimental (n = 39) groups. The common method of education was implemented for the control group, and the experimental group experienced role‑playing educational method. In the next semester, each student was assigned to educate two patients at the hospital. The knowledge level of the participants at the end of the semester and patients’ satisfaction with the educations by students in the next semester were measured as the outcomes of learning. Kirkpatrick’s model was used to assess the learning outcomes.

The mean score of students, at the second level of Kirkpatrick’s model, in the experimental group (63.85 ± 13.88) was significantly higher than that of the control group (46.41 ± 16.22, P < 0.001). The mean score of patients’ satisfaction with patient educational performance, at the fourth level of the model, in the experimental group (73.26 ± 3.47) was significantly higher than that of the control group (47.32 ± 6.83, P < 0.001).

The evaluation by the Kirkpatrick’s model showed that use of role‑playing method improved learning outcome of nursing students.

Special learning outcomes are considered for medical and health sciences education which can be acquired by some interactive learning systems in the human brain. Given the importance of this issue, based on literature, we attempted at mentioning certain practical points for medical and health sciences educators to employ in preclinical and clinical teaching.

We searched databases of PubMed, Proquest, Scopus, ERIC, and ISI Web of Science for relevant literature from January 2010 to January 2019.

From a total of 1029 records, 30 articles along with 35 papers from snowballing and hand searching were included in this study. The following 12 main items were encompassed: teaching students the basic neuroscience of learning and set individual learning goals, “just right challenge” heeding the balance between supervision and autonomy, brain‑friendly coaching, repetition with spaced learning, visualization as a powerful learning tool, multimodal teaching, cognitive learning and mental model, cognitive‑emotional learning, active and social learning, creativity and art, sleep, medical faculty’s participation regarding the courses of “neuro‑education studies,” and “neuro‑myths” were suggested for brain‑friendly medical and health sciences teaching.

We considered 12 practical points for brain‑aware medical and health sciences teaching according to the recent literature on the basis of the association between education, cognitive science, neuroscience, and psychology. Interdisciplinary research and practice regarding this issue can improve teaching–learning quality, students’ well‑being, and ultimately patient outcomes.

Eighty percent of women during their reproductive age experience some symptoms attributed to premenstrual phase of the menstrual cycle. Premenstrual syndrome (PMS) is characterized by emotional, behavioral, and physical symptoms that occur during late luteal phase of menstrual cycle and are relieved after the onset of menstruation. Aerobic exercise and yoga are one of the ways to reduce these symptoms. The aim of this study was to compare the effects of aerobic exercise and yoga on PMS.

A total of 72 participants of PMS, referred for physiotherapy treatment (mean age 28 years), were enrolled and allocated into two groups (Group A and B) by simple computerized randomization. Patients in Group A received aerobic exercise and in Group B received yoga movements for 40 min, 3 times a week for 1 month. The pain intensity (Visual Analog Scale) and PMS Scale were measured before, at the end of 15 days, and 1 month of treatment program.

Data were analyzed by paired t‑test, unpaired t‑test, and one‑way ANOVA; and the results showed that both aerobic exercise and yoga movements significantly reduced pain intensity and PMS symptoms. Significant reduction in PMS symptoms was found in patients treated with yoga compared to aerobic exercise; however, no significant difference was found in pain intensity between these two groups (P > 0.05).

It is concluded that both aerobic exercise and yoga movements are effective in treating PMS; however, yoga is more effective in relieving the symptoms of PMS than aerobic exercise.

It is essential to provide key information and support to every woman regarding pregnancy and childbirth to enable all women to make a fully informed decision regarding their choice of reproduction. The study aimed to find the impact of an educational program based on the Theory of Planned Behavior (TPB) on health promotion and childbearing of minor thalassemia couples. SUBJECTS AND

This study was quasi‑experimental. A total of 70 women with minor thalassemia held in Minudasht health center were classified into two groups: study and control. The study group received the educational program based on TPB, and the control group only received the routine program. The data were collected using the TPB‑based questionnaire at baseline and 3 months after the intervention. They were analyzed by Chi‑square, Student’s t‑test, Wilcoxon test, and regression analysis through SPSS version 16.

The mean (standard deviation) ages of the participants in the control and study group were 30.69 (6.20) and 31.08 (6.66), respectively. There were significant differences between the two groups (study vs. control) in terms of perceived behavioral control, intention, attitude, or childbearing behavior (P < 0.001). The change in fertility behaviors had a significant increase in the study group (62.8%) compared to the control group (2.9%) (P < 0.001).

Based on the results, the TPB is an effective model to explain fertility intentions and behaviors in Iranian women with minor thalassemia; however, further researches are needed to generalize our findings to other people including healthy women.

Academic burnout is a worldwide problem that troubles students at all academic levels. Despite the significant effects of this problem on students’ mental health and academic achievements, yet, it has not been adequately studied in Iranian system of academic education. Therefore, we aimed to explore the incidence of academic burnout status and its associated factors among the students at Guilan University of Medical Sciences. SUBJECTS AND

This cross‑sectional study was conducted over a number of 303 students at Guilan University of Medical Sciences during 2016. Study samples were selected through the stratified random sampling method, and a set of data including sociodemographic information, educational status, study habits, and burnout inventory status was collected for each sample. Items of burnout inventory status were based on the Maslach Burnout Inventory. Data were analyzed using descriptive and inferential statistics including t‑test and linear regression.

The students in our study reported a mean of 2.53 ± 0.7 for academic burnout score. Along with related factors of academic burnout, marital status (P = 0.029), grade point average (P = 0.002), being interested in field of study (P = 0.000), and study time (P = 0.000) were significantly associated with academic burnout of students. Furthermore, the incidence of academic burnout did not differ between male and female students.

Regarding the considerable prevalence of academic burnout among students of medical sciences, it is needed that policymakers implement more effective educational programs considering the associated factors of academic burnout.

Due to the importance of correct interpretation of electrocardiogram (ECG) in the quality of healthcare delivery, new educational methods are increasingly being implemented and evaluated. In this regard, the purpose of this study was to compare the traditional and virtual teaching methods on the interpretation of cardiac dysrhythmia in nursing students.

The present study is a quasi‑experimental research with pretest and posttest design. Sixty nursing students in the seventh semester from schools of nursing in Urmia and Khoy cities were randomly assigned to two virtual and traditional education groups. Students’ knowledge was measured by a researcher‑made 30‑item test.

The mean and standard deviation of the students’ scores in the traditional education group was 11.20 ± 4.41 and 14.40 ± 4.62 and in the virtual group was 11.30 ± 2.74 and 18.43 ± 4.68, pre‑ and post‑training, respectively. Paired t‑test showed a significant difference between the mean score of pretest and posttest in both types of training (P < 0.001). According to the results of independent sample t‑test, there were no significant differences between the two groups before the training (P > 0.05). However, in the posttraining period, there were significant differences between traditional and virtual education groups (P < 0.001).

Considering the results of this study, which shows the positive effects of virtual education method on nursing students’ knowledge about cardiac dysrhythmia, this method can be used as an alternative or complementary method to the traditional education.

Unnecessary and excessive activation of alarms (“false alarm”) in neonatal intensive care unit (NICU) often results in alarm fatigue among health‑care professionals, which can potentially result in deleterious effects in sick neonates. AIMS AND

The aim of this study is to reduce the frequency of false alarms from multiparameter monitors (MPM) by 50% from the existing baseline level over a period of 12 weeks.

In this quality improvement (QI) project conducted over 1 year (November 2016–October 2017) at All India Institute of Medical Sciences, New Delhi, we collected data on activation of false alarms from MPM (outcome measure) over a period of 2 months in 134 randomly selected observations of 1‑h duration (baseline phase [10 days, 20 observations] and developing and testing the changes in five Plan‑Do‑study‑Act (PDSA) cycles over the next 50 days, 114 observations. We also measured the pre‑ and postassessment of knowledge level in use of MPM among health‑care professionals using checklist (process measure). Following that, we continued data collection for next 10 months to check sustenance of the project.

Baseline characteristics including gestation, birth weight, and sickness level did not vary during the study period. The median (range) number of activation of false alarms/hour/MPM was 23 (18–35) in the baseline phase. This reduced to 22 (17–30), 19 (15–30), 16 (14–30), 14 (8–17), and 9 (6–12) at the end of 1st, 2nd, 3rd, 4th, and 5th PDSA cycles, respectively. In sustenance phase, it could be maintained in target range from January 2017 to October 2017.

Small sustained changes can contribute a lot in continuous QI in decreasing false alarms and subsequent improvement of neurodevelopmental outcomes discharged neonates.

Spiritual intelligence is better defined as a capacity to discover and develop true meaning, deep purpose, and vision in life. The purpose of the present study was to determine the predictive role of demographic variables affecting the overall spiritual intelligence in diabetic adolescents.

In 2016, a cross‑sectional study was conducted involving 200 adolescents with type 1 diabetes referring to the Iranian Diabetes Association consenting to participate. The inclusion criteria were: age ranging from 15 to 21 years, more than a year since last diagnosed with diabetes, patients’ full awareness of their disease, not having other physical‑psychological illnesses, and not taking any psychiatric or narcotic drugs. Spiritual intelligence was measured using the Spiritual Intelligence Self Report Inventory questionnaire consisting of 24‑questions. The alpha Cronbach’s method was applied to validate the questionnaire in terms of content, form, and data with the reliability calculated as 0.903. Demographic data were analyzed using SPSS software version 18.

On total, 56% of the participants were female, 17.10 ± 1.85, and the mean duration of diabetes was 5.98% ± 3.79%, 62.5% reported diabetes history among immediate relatives. Forty‑two percent of the participants were the oldest child in the family first children of the family and 29.5% were studying at the university. The mean score of spiritual intelligence was 60.42 60.42 ing from 15 to 21 years regression test using the enter method (ANOVA: 0.703, F: 0.739) showed that none of the demographic components explored did not significantly alter the scores that assessed spiritual intelligence.

The outcome of the current study portrayed that demographic features do not necessarily alter the overall spiritual intelligence scores, thereby not necessarily affecting an individual’s overall spirituality

Medical career exploration is a continuous process that one should invest on throughout their academic life. However, lack of resources and time are the main barriers in establishing suitable intervention. Therefore, the needs for flexible intervention are crucial, as it can improve medical career choices. This study aimed to improve career self‑efficacy and to open the insight of medical students in choosing a variety of medical careers.

This study was conducted using quasi‑experimental study design with nonequivalent control groups design (pretest‑posttest) using a modified model from a preexisting medical career intervention (MedJob™) labeled as MiniMedJob™. A total of 122 1st‑year medical students from Sriwijaya University, Indonesia, were voluntarily joining the study. The effectiveness of MiniMedJob™ in increasing students’ self‑efficacy was evaluated using Wilcoxon and Mann– Whitney statistical tests using IBM SPSS Statistics for Windows, Version 24.0, Armonk, New York.

MiniMedJob™ was proven effective to improve medical students’ career self‑efficacy (P = 0,000). The mean of the pretest and posttest for the intervention group was 77.79 ± 10.12 and 87 ± 8.36, respectively. While for the control group, the mean of pretest was 87.00 ± 8.36 and for the posttest group was 83.55 ± 7.96. Despite the higher score of the intervention group compared to control group, statistically, it was insignificantly different (P = 0,084).

MiniMedJob™ is proven effective in improving medical students career self‑efficacy despite their shorter period and fewer activities compared to preexisting intervention model.

Hospitals are the main axis of health‑care reforms or national health plans; therefore, accurate recognition of hospital costs based on operational indexes to these plans is necessary. The impact of implementing national health plans on the performance of health systems is ambiguous and misleading; therefore, the aim of this study was to assess the impact of Healthcare Reform Plan (HRP) on the micro level (e.g., educational or university hospitals).

This study was a descriptive retrospective study that research variables are checked in 1 year before and mean of 3 years after implementation of HRP by self‑administrated checklist in selected public‑educational hospitals covered by the medical universities in Tehran. The final analysis of the data was performed using cost–performance ratio and independent t‑test for comparing the variables’ changes before and after HRP.

Unlike adjusted hospitalization costs, most operational indexes were not significant. The per capita cost adjusted of hospitalization in first and mean of 3 years after HRP increased 49.49% and 16.31%, respectively (P < 0.001), the adjusted cost per day was increased by 24.48% and 21.46% (P < 0.001), and adjusted cost per bed was increased 47.06% and 20.07% compared to before HRP (P < 0.001).

Given the lack of alignment in adjusted cost changes in exchange for functional indicators, certainly, it cannot be argued that HRP had a favorable or undesirable effect on the hospitals.

In the development perspective of each country, it is important to pay attention to the health sector and improve health indicators; therefore, planning in training and distribution of human resources in the health sector is an important factor to achieve the health system goals. The aim of this study was to investigate the effect of changes in health sector human resources on infant mortality rate (IMR), maternal mortality rate (MMR), and under‑five mortality rate (U5MR) in Iran.

This was an econometric study (data panel) that conducted retrospectively and used data from the period 2006 to 2017 among Iranian provinces. Three regression models were used to determine the effect of health sector human resources (physicians, nurses, and paramedical staff) on the IMR, MMR, and U5MR. The random‑effects model was selected over the fixed‑effects model to assess the effect of health sector human resources on health outcomes.

Results showed that the number of physicians in different models has a stronger impact on these mortality rates than those of nurses and paramedics, so that a 1% increase in the number of physicians leads to 2.1%, 3.8%, and 2.2% decrease in IMR, MMR, and U5MR, respectively. Furthermore, per capita income has a bigger impact on these mortality rates than human health resources.

Increasing the number of human resources in the health sector, especially the number of physicians, by investing in these resources by providing educational facilities, plays an important role in improving the mothers’ and infants’ health indicators.

Although rabies is highly fatal, with timely and correct postexposure prophylaxis (PEP) of animal bite victims, it could be prevented. Medical school students should be trained about the appropriate rabies management during their formative years so that they put the right practice later on. The study was conducted to assess the knowledge about rabies epidemiology and prophylaxis among medical students and to find the effect of an educational intervention.

This was a quasi‑experimental study conducted with 156 third academic year medical school students at a tertiary care teaching hospital. The study participants were given health education intervention. A study tool assessed the knowledge of study participants on domains such as epidemiology of rabies, pre-exposure prophylaxis (PrEP) and PEP, and national program guidelines of rabies prevention. The study tool was administered before and after the intervention. The impact of educational intervention was measured with scores. Wilcoxon signed‑rank test was applied to test the difference.

The overall total mean pretest total score was 14.9 (±3.7) and posttest score was 22.7 (±3.23) for a maximum score of 29. The mean pretest scores for epidemiology, PrEP and PEP and national program components were 6.09, 7.95, and 0.85 respectively. Likewise, the mean posttest scores were 8.09, 13.26, and 1.35 respectively. There were a statistically significant improvement in the scores after health education intervention.

After educational intervention, there were statistically significant improvement in the scores of all the three domains. PrEP and PEP and national program domain of rabies need to be emphasized during formative years.

Mass gatherings (MGs) are established for different religious, social, political, cultural, and sport motivations. Many risks threaten the participants` health in MGs for different reasons. One duty of health‑care system is to identify the risks and manage them to reduce the participants` injuries in MGs. This study aimed to identify and classify the risks threatening the health of participants in MGs and review related articles systematically. SUBJECTS AND

In this study, we investigated electronic databases including Science Direct, PubMed, Ovid, ProQuest, Web of Science, Scopus, and Google Scholar. This systematic review investigated those health articles which studied MGs published after 2000. Keywords that were searched included (Mass gathering OR Crowd) AND (Assessment OR Evaluation) AND (Disaster OR Emergencies) AND (Injuries OR Stamped). The final full text articles were assessed qualitatively by STROBE article assessment checklist, and then the data extracted from the results of the articles were analyzed and reported.

Initially, a total of 1874 articles were found, qualitative exclusion and inclusion criteria were applied, and finally 29 full‑text articles were selected for the analysis. More than forty health‑related risks were recognized. In order to better understand the risks and use of the results more efficiently, the risks were classified and reported into the following five domains: environmental risks, individual risks, psychological risks, public health risks, and management risks.

Many risks threaten the health of participants in MGs. Recognizing and managing the risks are considered the primary and basic essentials of health sector for the better management of MGs.

Health services utilization is a complex behavioral phenomenon affected by multiple factors including availability, distance, cost and quality of health services as well as personal attitudes, cultural beliefs, and socioeconomic characteristics. This study aimed to assess the status of health‑care utilization among dwellers of slums in one of the Iran’s big cities.

This was a cross‑sectional study in which 559 slums people were selected using a random clustered sampling method. Data on health services utilization were collected using health equity assessment and response tool questionnaire. Data analysis was performed using descriptive statistics and logistic regression analysis through SPSS ver. 22.

In this study, 42.5% (238) people who required outpatient services. 21% (118) of them were able to use them. Furthermore, among the families, who needed outpatient services during the past month, 15% (38) were able to use the services for at least once. Regarding inpatient services, 62% (349) of people needed hospitalization, of which 31% (175) were able to be hospitalized. Age (P = 0.2), gender (P = 0 <001), marital status (P = 0 <001), income status (P = 0.1), and education (P = 0.21) determined utilization of outpatient services; however, inpatient services utilization was affected by age (P = 0.03), gender (P = 0.02), marital status (P = 0 <001), and income status (P = 0.32). The final model of multiple regression showed that, there was a relationship between age (odds ratio [OR] =1.7, confidence interval [CI] 95% = 0.47–0.88), marital status (OR = 2.78, CI 95% = 0.64–1.2), and the use of inpatient services.

The utilization of health services in slum areas is not desirable. As it was showed that the utilization of health services in slums people is a multifactorial event; thus, proper planning and policy for this increasingly demand are essential.

Attempts to put the available teaching–learning time to better use and address the needs of students by increasing active involvement led to the evolution of the flipped classroom (FC). It involves providing study resources for students to use outside the class so that class time is freed up for instructional activities. This study was done to assess the effectiveness of flipped classroom activity as a teaching–learning method.

In this interventional study, 98 students were divided into two batches of flipped class and conventional small group teaching (SGT). An online Google group was created for the batch of FC. Brief introduction and prerecorded videos related to the assigned topic were posted in the Google group. Discussion was carried out in the form of solving cases and problem‑solving exercises. Pretest and posttest were conducted at each session, and an end of module test was conducted for both the groups.

There was a significant difference between the pre‑ and posttest scores and also the mean scores of summative test between two groups (P < 0.001). The perception of the students regarding FC was also evaluated. Eighty‑two percent strongly agreed that FC was more engaging and interesting in comparison to traditional class. Seventy‑six percent strongly agreed that more such classes should be conducted in the future.

Flipped classroom improved the student performance and learning experience effectively as compared to conventional SGT, and students’ response was also largely positive.