Journal of Education and Health Promotion
Volume:12 Issue: 7, Aug 2022

Mother–child attachment is formed from early stages of pregnancy and peaks in the second trimester and continues until after childbirth. The fetal or neonatal death as a tragic event could lead to the grief experience among parents, especially mothers. The present study aimed to determine the effect of a coping program on mothers’ grief following perinatal deaths.

This trial study was performed on 56 women with the experience of perinatal death during the last 1–3 months with a score of Perinatal Grief Scale (PGS) ≥91, who were referred to the health centers of Tabriz, Iran, from September 2020 to June 2021. Participants were randomly assigned into the intervention and control groups through stratified blocking on the basis of the stillbirth and neonatal death using Random Allocation Software with a block size of 4 and 6 with a ratio of 1:1. The intervention group received a coping program individually during three sessions, once a week for 45–60 min. Data collection tools included the demographic and obstetric characteristic questionnaire and PGS. The data were analyzed using SPSS24. The groups were compared through t‑test, and ANCOVA after adjusting the effect of baseline score.

Prior to coping program, the mean standard deviation of the grief total score was 108.32 (14.31) in the intervention group and 107.92 (6.65) in the control group (P = 0.89). After coping program, the mean of the grief total score was 82.28 (16.72) in the intervention group and 101.05 (12.78) in the control group. After adjusting the effect of baseline score and stratified factors, the mean of the grief total score in the intervention group was significantly lower than that in the control group [Adjusted mean difference (AMD): −18.77, 95% confidence interval: −26.79 to − 10.75, P ≤ 0.001].

Conducting a coping program during 1–3 months after experiencing perinatal deaths is effective in reducing the mothers’ grief reactions. It is recommended to evaluate the effectiveness of the same intervention after perinatal deaths for both parents with a longer follow‑up period in further studies.

Asymptomatic bacteriuria (ASB) is commonly seen during pregnancy due to the various morphological, hormonal, and physiological changes the body undergoes. If left undiagnosed, it can lead to conditions such as pyelonephritis and preterm delivery which could culminate in causing maternal and fetal morbidity and mortality. Therefore, this study aims to determine the prevalence, risk factors, microbial profile, and antibiotic susceptibility patterns associated with ASB in a tertiary healthcare center.

A cross‑sectional study was carried out where 150 urine samples were obtained from pregnant women within the gestational age of 13–36 weeks. Randomized stratified sampling was the method of sampling used. A questionnaire was also administered to them to determine potential risk factors. The samples were cultured and identified using biochemical tests. Antibiotic susceptibility tests were carried out by Kirby–Bauer disc diffusion method. Statistical analysis was carried out using Chi‑square test. The graphs and tables were generated using Microsoft Excel and Word.

Out of the 150 samples that were obtained, 8 samples had significant bacteriuria which is a prevalence of 5.33%. Escherichia coli was the most frequently isolated organism accounting to 45% of the isolates. The other organisms that were isolated were Enterococcus, Klebsiella pneumoniae, Coagulase negative staphylococcus (CONS), Candida albicans, and Group B Streptococcus which measured to 11% of the total distribution each. In the antibiotic sensitivity tests, among the gram‑negative isolates, marked resistance to Ampicillin and Amoxycillin along with sensitivity to Cotrimoxazole and Nitrofurantoin. Of the gram‑positive isolates, there was sensitivity to Ampicillin and Nitrofurantoin. A positive correlation was seen between the age groups of 23–27 and the prevalence of ASB.

The prevalence of ASB in this study shows that ASB is not uncommon in the population. Despite the World Health Organization (WHO) guidelines and National Health Mission recommendations to make urine check‑ups a routine, it not carried out, possibly due to cost implications. However, it poses a risk for severe maternal and fetal outcomes and hence, should be screened for on a regular basis. Thus, this study emphasizes the importance of screening pregnant women for ASB for promoting better maternal and fetal health.

Surrogacy has become an alternative family formation option for women who are unable to carry a pregnancy. There is no comprehensive care program despite the different nature of this pregnancy. The present study aimed to develop a reproductive health‑care program for surrogate mothers within the cultural and social context of Iran.

In the present sequential exploratory mixed methods study, first through a qualitative approach surrogate mothers, care providers, and policy makers of reproductive health services were selected purposefully. Data were collected by using the in‑depth semi‑structured interviews and analyzed. A care program draft was designed by integrating results of the qualitative study and reviewing the literature and guidelines, then appropriateness of each proposed care was assessed by a two‑Rounds Delphi technique (RAM), and the final reproductive health‑care program for surrogate mothers was developed.

The surrogate mothers’ reproductive health needs were summarized in four main categories: surrogate mothers’ extra care, educational training, psychological support, and protecting against surrogacy`s social and familial consequences. The reproductive health‑care program for surrogate mothers were developed in four sections: prepregnancy health screenings and legal counseling; special care during embryo transfer until pregnancy confirmation; psychological support and prenatal care of surrogacy until delivery and follow‑up postpartum care.

Women face many challenges in surrogacy and need special care such as legal counseling, reproductive health care, and psychological support. Implementation of this care program seems to help improve the reproductive health of these mothers

People living with noncommunicable diseases (PLWNCDs) are often disproportionately affected due to adverse interaction with socioecological and biological factors. Hence, it is imperative to learn from their lived experience to gain a greater understanding of interactions as well as explore their priorities and needs in accessing care and identify areas of priority action through multistakeholder engagement.

The qualitative study with grounded theory approach was conducted between October and December 2020. An online key‑informant interview with the health policymaker, virtual group discussion with eight PLWNCDs, and in‑depth telephonic interviews with five PLWNCDs were conducted, after obtaining informed consent using interview guide, developed, and validated by the experts. Data collection continued till data saturation was achieved. Transcripts generated from the interview recordings were coded using hand‑code technique and analyzed thematically.

Challenges faced by PLWNCDs in accessing care were lack of empathy and support from health‑care professionals, stigma, financial hardship, and hospital overcrowding. Caregivers emphasized on the felt need to involve civil society organizations (CSOs) in raising awareness toward noncommunicable diseases (NCDs) at family, community, and policymaking levels. The need for home‑based NCD care and rehabilitation centers was voiced by the PLWNCDs. Impediments toward effective implementation of NCD policies were adoption of a “top‑down” approach, poor awareness about government health insurance schemes, skewed distribution of empanelled hospitals in and around cities, nonavailability of qualified health‑care professionals in underserved areas, aggravated allocation‑utilization disparity during COVID‑19 pandemic, and lack of robust information technology infrastructure to support access to telemedicine services.

The collective role of governments, CSOs, and health‑care providers, along with meaningful involvement of PLWNCDs, would help to create an enabling environment for overcoming the challenges of access to care and thus achieve universal health coverage

Learners have various processing and understanding of the environment and issues and choose different strategies for problem‑solving considering learning and studying approaches. The purpose of this study was to examine medical students’ learning approaches and their association with academic performance and problem‑solving styles.

This study was conducted using the descriptive‑correlational method. The statistical population comprised medical students of Iran University of Medical Sciences during the academic year of 2019–2020. Of them, 168 subjects were chosen based on simple random sampling and Morgan Table. Study tools include the Standard Approaches and Study Skills Inventory for Students (ASSIST) Questionnaire, which includes 18 items and a Likert five‑choice spectrum, and includes a deep, superficial, and strategic approach. Its reliability was determined by Cronbach’s alpha of 0.81. Problem‑Solving Style Questionnaire developed by Cassidy and Long was used. This instrument included 24 items and 6 components, and its reliability equaled 0.83, which was their grade point average. Data were analyzed using normality tests, paired t‑test, Pearson correlation coefficient, and regression through SPSS 16 software.

Results implied the positive and significant relationship between deep‑strategic approaches, problem‑solving styles, and academic performance of medical students (P < 0.001); furthermore, there was no significant difference between learning approaches based on gender (P > 0.001), while there was a significant difference between two groups in terms of problem‑solving styles (P < 0.001).

Because deep and strategic approaches predict academic performance and problem‑solving styles, the diagnostic assessment must be done at the beginning of the educational process to determine the type of learners’ approaches. Such an evaluation can be used to implement instructional strategies and educational designs to improve the academic performance of students

The mini‑clinical evaluation exercise (mini‑CEX) is a formative assessment tool designed to provide feedback on skills essential to good medical care by observing an actual clinical encounter. However, the bigger advantage of mini‑CEX is the structured feedback that it provides to the students as well as the faculty, thus helping them to make better decisions.

This study was a cross‑sectional observational study. Sixteen surgery residents volunteered for participation and five professors conducted sessions; hence, 80 mini‑CEX encounters. Seven core clinical skill assessments were done, and the performance was rated on a 9‑point scale (grouped into unsatisfactory, satisfactory, and superior). Immediate feedback to the residents was given by the faculty. Delayed feedback from faculty and residents regarding the perception of mini‑CEX was taken. Statistical analysis was done using SPSS version 20 and analysis of variance (ANOVA) for inferential statistics.

As planned, 80 (100%) mini‑CEX encounters were conducted. Surgery residents showed improvement that was statistically significant in the competencies of medical interviewing skills, physical examination skills, humanistic qualities/professionalism, and counseling skills. Most of the faculty (80%) were able to identify the gaps in the knowledge of students and areas of improvement for their teaching. However, 60% of the faculty felt that it required more effort than traditional methods. The mean time taken by the assessor for observation and feedback to residents was 12.51 min and 5.68 min, respectively. The mean scores of evaluator satisfaction and resident satisfaction with mini‑CEX sessions were 6.04 and 7.49, respectively.

Mini‑CEX improves the learning environment in residency and also leads to improvement in medical interviewing skills, physical examination skills, humanistic qualities/ professionalism, and counseling skills. It is done in the actual patient encounter and hence prepares the resident better for dealing with patients in the future.

The main purpose of this study was to evaluate the use of Telegram as an Instant messaging application in clinical teaching of medical students, especially clinical ward rounds.

In this quasi‑experimental study, Telegram as an Instant messaging application was employed. To do this, a Telegram group entitled as “Lavender” was created and then selected patients were divided between students and externs daily. After that, students and externs were asked to take medical histories, perform complete physical examinations, and then share their data in the Lavender group. Ultimately, to evaluate the effects of this intervention, two quantitative and qualitative approaches were used.

From the students’ point of view the highest average was associated with “Readiness for teaching round” (3.71 ± 1.34) and the lowest average was related to “Time‑saving for studying about illnesses” (2.08 ± 1.44). In addition, medical trainees mentioned that reporting patients’ daily medical histories and progress notes could create a reflective process. The suggestion made by many medical trainees was to select and discuss simpler cases who have more teaching points for them, while other trainees recommended focusing on common illnesses in the Lavender group.

The use of messaging software applications such as Telegram in medical education has created a new paradigm, which could facilitate interpersonal interactions among trainees.

Lifestyle and nutritional transitions in the society driven by globalization have led to the rising burden of cholelithiasis. The present study was done to assess the impact of lifestyle, stress, menstrual pattern, and cardiometabolic risk factors on young females with cholelithiasis.

A hospital‑based case–control study was conducted on young females of 18–45 years. Cases and age‑matched controls were compared on their lifestyle parameters like demography, marital status, occupation, educational status, family income, stress along with menstrual pattern, cardiometabolic parameters like anthropometric measures, blood pressure (BP), fasting blood sugar (FBS), and lipid profile. Chi‑square test and unpaired t‑test were used for the analysis of data using SPSS software, and P < 0.05 was considered statistically significant.

The majority of the cases were from rural areas, married, homemakers leading a comparatively sedentary lifestyle consuming more red meat, less literate, and belonged to a lower economic group with significantly more stress compared to controls. The age of menarche, neither the regularity nor irregularity of the menstrual cycle (regular cycle 21–35 days), showed any difference, but cases had significantly more pregnancies and usage of oral contraceptives compared to controls. Waist–height ratio, systolic BP, FBS, triglyceride, low‑density lipoprotein (LDL), and very low-density lipoprotein (VLDL) were significantly higher in cases. Cases had a 14.4 times more risk of developing metabolic syndrome when compared with controls.

Married, rural, less literate Indian women leading a sedentary lifestyle, consuming more of red meat, and soft drinks with increased psychosomatic stress are more prone to develop cholelithiasis. Women who use hormonal contraceptives have increased occurrence of cholelithiasis and they were more prone to develop metabolic syndrome. The need for the hour is health education, to implement simple lifestyle changes, thereby decreasing the incidence of cholelithiasis in young females.

A new domain of “personal and professional development” was introduced as a core competency of health‑care providers. This study aimed to explore the experiences of learners and faculty members about what competencies or skills were essential for the professional development and success of health‑care providers.

This is a qualitative study using an inductive content analysis approach in 2019–2020. In the present study, 58 academic faculty members participated by purposeful sampling including ten associate professors (17.24%) and 24 assistance professors (41.37%), in addition to 23‑year medical residents (20.65%) and 4th‑year nursing students (20.65%). Individual and group interviews were conducted. Data were analyzed by the inductive content analysis approach introduced by Graneheim and Lundman.

The qualitative data were classified in 953 open codes and eight categories, which were further divided into four main categories: “socio‑emotional skills,” “life‑long learning skills,” “coping skills,” and “well‑being strategies.”

The present results showed socioemotional and coping skills affect interpersonal and professional interactions that contributed to their improved health‑care providers’ capabilities. Participants also considered lifelong learning as influential in developing professional capabilities and keeping their knowledge and skills up‑to‑date for accountability to duties. Moreover, using well‑being strategies protects the mental and physical health of health‑care providers. These skills are synergistic, and their combination can have a significant role in improving the personal and professional capabilities.

The Covid‑19 outbreak has led to an unprecedented burden on the healthcare infrastructure. High morbidity and mortality rates have resulted in a state of stress and distress among the general population which has also impacted health professionals.

This study was conducted to identify mental health disturbances among health professionals during the Covid‑19 pandemic.

It was a cross‑sectional study, conducted in a Medical College in Himachal Pradesh, India. A self‑administered anonymized questionnaire was administered to the healthcare workers. Mental health status was assessed using Patient Health Questionnaire Anxiety‑Depression Scale (PHQ‑ADS). In addition, a 15‑item questionnaire was prepared to identify the probable causes of stress in HCWs during the Covid‑19 Pandemic. A statistical analysis used t‑test was used to find the significance of the correlation between the PHQ‑ADS score and the agreement score of different factors.

The response rate for the questionnaire was 27%. Anxiety and depression were seen in 29% of participants, ranging from mild (18.3%), moderate (4.7%), and severe (5.9%). Among females 43.7% of the participants and among males, 13.1% had anxiety and depression. High PHQ‑ADS scores were seen in nursing staff (70%) and postgraduate students (30%), who were in the third decade of life. Most (81.7%) of the HCWs were concerned about transmitting the disease to their near ones. Fear of coming to the hospital and dealing with patients.

Even sub‑threshold syndromes among HCWs need to be identified before they evolve into overt diseases. The psychological needs of healthcare workers should be prioritized as they are key players in the fight against Covid‑19.

Teaching anatomy in a clinical context can aid students in appreciating how the subject will apply to their future career as nurses as well as in other administrative roles. Anatomy is voluminous, making it difficult to retain the factual information in the long run; therefore, this study primarily focuses on whether case‑based learning (CBL) with integrated anatomy learning can help in retention of the information over short as well as long spans of time. It also focuses on how profitable would the students be with this different style of learning, and whether it can facilitate in better understanding of the basic and clinical concepts.

The current study was conducted in the Nursing College of All India Institute of Medical Sciences, Bhopal, India to integrate CBL and evaluate its effect compared to the highly compartmentalized, didactic lectures among the nursing students. The extent of knowledge retention was analyzed by conducting a series of tests before as well as after CBL intervention. Feedback and suggestions were obtained from the students by using the 5‑point Likert scale method.

The post‑test scores of the students improved by 21% after the CBL. More than 85% of the students opined that CBL improves critical thinking, team work, self‑directed learning, and communication skills.

CBL promotes effective short‑term retention and facilitates comprehension of key concepts. CBL also plays an important role in improving the professional skills of the students, which otherwise is not taught, and equips them for their future careers.

Hospital‑onset coronavirus disease‑2019 (COVID‑19) infection has been reported and is probably linked to ineffective implementation of infection prevention and control measures. Contaminated surfaces and air are considered a key part of the transmission dynamics of severe acute respiratory syndrome, Middle East respiratory syndrome, influenza, and other organisms in hospitals. This study aimed to assess the extent and persistence of surface contamination with COVID‑19.

It was a hospital‑based cross‑sectional study conducted for a period for 2 weeks from December 03, 2020, to December 16, 2020, in Kathua district of J and K, India. The environmental samples were taken from the patient care area that included COVID isolation ward and intensive care unit (ICU) as per the guidelines of WHO Protocol “Surface sampling of COVID‑19: A practical “how to” protocol for health care and public health professionals after seeking copyright permission from the WHO. Universal standard precautions were strictly followed. Descriptive analysis was done using the MS‑Excel and expressed in numbers and percentages.

A total of 140 surface samples were taken, 70 each from the COVID ICU and isolation ward. The results of ten samples from the ICU turned out to be positive and 20 samples were positive from the isolation ward. Eleven (78.6%) out of the 14 samples taken from the corners of the ICU and isolation ward were found to be positive.

Our study revealed surface contamination in the hospital setting both in COVID ICU and isolation ward particularly from the corners of the COVID ICU and isolation ward followed by the samples taken from the linen. Strict adherence to COVID appropriate behavior, increased frequency of disinfection in high‑risk areas, and sensitization of the staff are mandatory to minimize the infection risk.

One of the crises facing human beings is coronavirus disease. This disease was identified in December 2019 in Wuhan, China. With the death of two patients with respiratory complications in Qom Hospital on February 20, 1998, and the confirmation of their positive test, the arrival of COVID‑19 disease in Iran was officially confirmed and Khorshid Medical Center as the main reception the Medical Center for patients with COVID‑19 from August 3, 2010. The purpose of this study is to document the experiences of Khorshid Training Center in coronavirus crisis management to improve crisis management knowledge.

This research was conducted qualitatively with grounded theory method in the period from March 1998 to the end of May 1999. The study population was Khorshid Educational and Medical Center. Sampling was done purposefully among medical staff, support, and hospital officials. The number of samples with the mentioned conditions reached 44 people. Data were collected using a semi‑structured questionnaire and analyzed in the style of grounded theory in the style of Strauss and Corbin.

Data collected after sorting, analysis, conceptual analysis; they were coded and categorized into four groups of challenges, weaknesses, strengths, and actions based on the specific objectives of the research in 5 natures, reorganization, accident control system, medical equipment and supplies, human resources, and clinical approaches.

According to the points classified in the challenges and weaknesses, it was found that the hospital has faced several problems in corona crisis management. The management team, taking advantage of strengths in various areas, has taken effective measures to improve corona crisis management. It has led to the provision of appropriate services to the patients of the Medical Center.

Healthy children are the foundation for a healthy and developing nation. Perceived behavioral control (PBC), comprising control belief and perceived power, is a person’s perception of the ease or difficulty of performing the behavior of interest. For facilitating regular physical activity and regular healthy dietary practices among the adolescents, PBC is an important construct to develop and implement appropriate interventions. The aim is to assess PBC to perform regular physical activity and regular healthy dietary practices and measure their statistical relationship among the school‑going adolescents in an urban area in West Bengal.

A school‑based cross‑sectional study was conducted among 251 adolescents aged 12–16 years after taking consent and assent for participation in the study. Data were collected with self‑administered questionnaire on sociodemographic variables and the two domains of PBC, i.e., control beliefs and perceived power, related to regular physical activity and regular healthy dietary practices. Each PBC total score was calculated by multiplying control belief score and perceived power score for each respondent. Partial correlation coefficient was calculated between regular healthy dietary practices and regular physical activity.

Among the total 251 responses analyzed, 34.7% and 27.5% students belonged to age group 14 and 15, respectively. It was observed that the mean (± standard deviation) score of PBC regarding regular healthy dietary practices was 100.7 (±27.7) and for regular physical activity was 106.0 (±21.4). The correlation between PBC of regular healthy dietary practices and regular physical activity was 0.421 and was statistically significant.

In case PBC score over any behavior is higher, behavioral intention and ultimately chances of performing that particular behavior increases. Designing appropriate school‑based health promotion strategies can lead to healthier children fostering regular healthy dietary practices and regular physical activity in their homes and communities.

Health education is a crucial consideration in the healthcare system and has the potential to improve global health. Recently, researchers have expressed interest in streamlining health education, utilizing digital tools and flexible curriculums to make it more accessible, and expanding beyond disease and substance abuse prevention. They have also expressed interest in promoting global health through health and safety promotion programs. Amidst the COVID‑19 pandemic, climate change, the refugee crisis, and overpopulation, healthcare crises are erupting all over the world. A lack of health education has and will continue to have a profound impact on community healthcare indicators, particularly in low‑income nations. Current priorities within the health education sector include digitization, equity, and infectious disease prevention. Studies and data from university journals and other academic databases were analyzed in a literature review. Health education programs have a significant positive impact on attitudes and behaviors regarding global health. Improving upon these programs by digitizing them and expanding upon the scope of health education will help ensure that such interventions and programs make a significant difference.

Researchers have examined the association between self‑esteem and obesity in past studies. However, most studies have focused on pediatric or adolescent populations. In this pilot study, we aim to explore the association of self‑esteem with weight status in young adults, a group of individuals in a significant and pivotal period of their lives whose needs and challenges have received little attention in previous studies.

Exactly 127 college juniors and seniors in the Midwest participated in late 2017. For our survey, we collected the following information: body weight, height, self‑esteem score from the state self‑esteem scale, grade point average, risk of eating disorders, sleep quality, nutritional behavior, lifestyle (smoking, frequency of exercise, alcohol drinking, average daily time watching television, playing video games, and social media use), and demographic and socioeconomic background. We used logistic regression for our analysis.

The logistic regression indicates that a one‑point increase in the self‑esteem score was negatively associated with a young adult’s odds of having an unhealthy weight (being overweight or obese) by approximately 3%. Furthermore, soda drinking is a statistically significant factor associated with weight status.

This finding suggests self‑esteem is positively associated with a healthy weight in young adults. A larger‑scale study should be conducted in the future to validate this relationship and better understand young adults’ needs.

In the COVID‑19 outbreak, women with a history of miscarriage need more mental health. Anxiety and meta‑worry as consequences of miscarriage, besides concerns due to pregnancy during coronavirus, show the necessity of appropriate online and face‑to‑face educational counseling. This study aimed to evaluate the effectiveness of online metacognitive educational counseling versus face‑to‑face method on anxiety and meta‑worry in these women.

In this randomized clinical trial, 80 women with a history of miscarriage, anxiety, and meta‑worry referred to Imam Jafar Sadegh hospital (labor, women ward and women clinic), Meybod, Iran, were selected conveniently and randomly assigned into two groups (n = 20/each). The participants received 8‑session metacognitive educational counseling package online or face‑to‑face. Data were collected by Beck Anxiety Inventory, Wellz meta‑worry questionnaire at baseline, week eight, and follow up as primary outcomes and analyzed via SPSS software (Anova and Repeated measure statistic tests).

Anxiety in the 12th week (online group 13.75 ± 3.59 vs. face to face 18.25 ± 5.91, P = 0.04) was statistical significantly less than baseline (respectively 22.15 ± 5.67 vs. 22.35 ± 4.93, P = 0.56); with fewer anxiety scores in the online group. Meta‑worry in the 12th week (online group 11.90 ± 2.59 vs. face to face 15.70 ± 4.06, P = 0.03) was statistically significant compared to baseline (respectively 17.15 ± 2.70 vs. 18.50 ± 3.47, P = 0.36); with fewer meta‑worry scores in the online group. Belief about worry in 12th week (online group 66.50 ± 14.60 vs. face to face 78.45 ± 9.27, P = 0.01) was statistical significantly less than baseline (respectively 85.50 ± 8.87 vs. 86.05 ± 8.85, P = 0.96); with less score of belief about worry in the online group.

Online and face‑to‑face metacognitive educational counseling methods decreased anxiety, meta‑worry, and belief about worry in women with miscarriage. But online educational counseling was more effective. Distance online counseling in COVID‑19 can help the mental health of women with miscarriage.

Job satisfaction has been described to be an important for individuals as well as for the society in general. However, several factors were introduced to be crucial for job satisfaction; one of the more influenced factors in satisfaction experiences is individual personality. The present study aim is to identify the relationship between the five major traits of personality and job satisfaction with virtual education among teachers of students with learning difficulties.

The research is a descriptive quantitative design. The research population consists of 94 male and female teachers who are involved in primary and intermediate public schools in Saudi Arabia. Data were then exposed to the analysis, namely, descriptive statistics, Pearson correlation, and Mann–Whitney U test to obtain the answers to the research questions at the level of <0.05.

Based on the results, the most common personality trait among the study sample is conscientiousness, while neuroticism was the least common among the five traits. It was also found that there are differences between males and females in all dimensions of job satisfaction with virtual education (satisfaction with the nature of work – the relationship with colleagues and bosses – the relationship with parents) and the overall score in favor of females, except for the dimension of the relationship with colleagues and superiors, where males and females are equal.

The average score of the personality types and job satisfaction is moderate. Job satisfaction has a significant relationship with personality types. In addition, partial significant differences were found among the study variables. Given the importance of identifying teachers’ personality in the workplace, reducing psychological and work factors effects in the educational environment among teachers can be helpful to enhance their job satisfaction. The study therefor, enumerated implications and recommendations based on the findings.

Infection with COVID‑19 has resulted in considerable mortality all around the world. This study aimed to investigate the effect of convalescent plasma on the treatment of hospitalized patients with COVID‑19 in Imam Khomeini Hospital at Ardabil, Iran.

In this quasi‑experimental clinical trial, patients over 18 years of age with polymerase chain reaction‑positive COVID‑19 were admitted based on the clinical criteria of respiratory distress with hypoxia (O2 saturation <90) and tachypnea (R Relative Risk (RR) >24) with moderate‑to‑severe lung involvement and in the 1st week of respiratory disease who were not intubated were nonrandomly assigned to two groups: convalescent plasma therapy (CPT) group (197 cases) and control group (200 cases). We used the Chi‑square, t‑test, Fisher’s exact test, and Pearson’s correlation coefficient for statistical analysis.

Analyses revealed that length of stay in hospital was significantly lower in the CPT group as compared to the control group (P = 0.001). Twenty‑four cases (22.0%) in the CPT group and 85 cases (78.0%) in the control group needed intubation. Furthermore, mortality was 17 cases (18.3%) in the CPT group and 76 cases (81.7%) in the control group, the difference of which was also found to be statistically significant (P < 0.05).

It seems that CPT can be used as an alternative treatment at the early stages of COVID‑19 to prevent the progress of the disease, reduce the need for intubation and consequently the length of stay in hospital, and finally, decrease mortality

Patients diagnosed with cancer and who undergo cancer treatment are at potential risk of bone marrow suppression leading to prolonged hospitalization, delay in treatment, and chemotherapy dose reductions, which ultimately results in significant morbidity and mortality. This sequential exploratory study using a mixed‑method approach was aimed to develop and validate a neutropenic nursing care (NNC) bundle for neutropenic patients admitted in a tertiary care hospital, Uttarakhand.

This sequential exploratory study design with an instrument developmental model was used to develop the NNC bundle. It consisted of two phases: Qualitative phase and quantitative phase. In the qualitative phase, focused group discussion with eight oncology nurses was performed to derive themes related to neutropenic nursing care using conventional content analysis. An extensive literature review was also performed on these themes to explore the current pieces of evidence for item pool generation. In the quantitative phase, a preliminary draft bundle was developed, and two Delphi rounds (I and II) were carried out among the five experts for the content validation of the NNC bundle and a final bundle was developed.

Major domains identified for the bundle were hand hygiene, care of central and peripheral lines, routine oral care, antiseptic bath, peri‑anal care, diet, and environmental hygiene. The content validity index (CVI) of the bundle was found to be >80% for all the items with I‑CVI >0.8 and S‑CVI = 0.99 after conducting two rounds of Delphi.

The present study has provided a set of valid written neutropenic nursing interventions to prevent complications in neutropenic patients. The NNC bundle should be subjected to other levels of evaluation that measure the bundle’s practicability and suitability for the intended field.

Due to the severity of the earthquake, it may need immediate treatment and transfer of the injured people to advanced medical centers, as well as dispatch of the expert team and specialized health equipment to the accident‑affected area. Aerial emergency is an important responsibility of the health care system in this situation. The study aimed to extract the prehospital emergency challenges of Iran aerial operations emergency in response to the earthquake.

The study was qualitative content analysis with conventional approach. Sampling was done in a purposive method and data were collected through semi‑structured interview. The panel involved consists of 26 health professionals in medical emergencies. Recorded interviews were transcribed into written and then conventional content analysis was used to derive coding categories directly from the text data.

Content analysis is provided 97 initial codes, 20 subcategories and 4 main categories including challenges of “response assessment,” “support,” ”pre‑hospital staff‑management,” and “response operation,” respectively.

The results showed that the necessity to assess the affected area, staffing, and management actions, including integrated operations command and the development of a dedicated response plan, as well as the use of strategies inter‑organizational coordination in the response phase to earthquake. This study also emphasized that providing standard equipment, support actions, and strengthening communication infrastructure, and updating the aerial emergency system should be considered as one of the priorities of the emergency organization of Iran to provide a desired response to the earthquake.

Modern research today proves an increase in the incidence of ischemic stroke. Risk factors for vascular disease have become more common among young people. Clinical studies have shown that hypertension, dyslipidemia, and diabetes are traditional risk factors among the elderly. The aim of the study was to improve diagnostic approaches to cerebrovascular disorders in patients with hypertensive encephalopathy (НE) by clarifying the development of pathogenesis mechanisms, based on a comprehensive clinical study.

This qualitative study was carried by clinical and neurological examination; neuropsychological examination (Mini‑Mental State Examination, abbreviated multifactorial personality questionnaire, Beck depression scale, Spielberger scale).

The study was examined 351 patients (150 men, 201 women) with НE in hypertension of 2 degrees. The clinical examination was performed according to a two‑stage method, which involves the establishment or exclusion of symptomatic hypertension. The study did not include patients with secondary hypertension, diabetes mellitus, cardiac arrhythmias, and conduction disorders, heart failure who suffered from acute cerebrovascular accident and myocardial infarction.

The necessity of obligatory examination by a neurologist of patients with arterial hypertension for detection of manifestations of НE with the use of modern research methods, which allows to prevent damage to target organs, and first of all – brain damage, has been proved.

Despite new anticoagulants’ developments, warfarin is still one of the most commonly used medicines, particularly in the cardiovascular system. One of the significant challenges with warfarin is the prevalence of dangerous side effects such as bleeding and drug and food interactions, which can negatively affect patients if not adequately controlled. As health‑care team members, nurses have a crucial role in prescribing this medicine and educating patients. In this regard, this study was conducted to determine the knowledge and practice of nurses working in the cardiovascular wards regarding warfarin.

In this cross‑sectional, descriptive study, knowledge and practice of 239 nurses working in the cardiovascular wards of teaching hospitals affiliated to Iran University of Medical Sciences have been investigated using European Cardiovascular Nurses Knowledge questionnaire on anticoagulants and the checklist for high‑risk drugs safety instructions. The sampling was performed through the stratified sampling method with proportional allocation. Data were analyzed using the SPSS software version 16 through descriptive and inferential statistics (independent t‑test, one‑way analysis of variance, and Pearson correlation coefficient) (Inc., Chicago, IL, USA).

The mean scores of knowledge (18.51 ± 3.87) and practice (10.53 ± 2.12) were slightly higher than the median, and the lowest mean score was related to knowledge on drug interactions (7.62). The practice had a statistically significant relationship with knowledge (P ˂ 0.001). Regarding demographic variables, there was a statistically significant relationship between nurses’ knowledge and the education level (P = 0.009) and nurses’ practice and age (P = 0.022), work experience (P = 0.032), and work experience in cardiovascular wards (P = 0.036).

Based on the findings of this study, the knowledge of nurses working in the cardiovascular wards about warfarin was not sufficient, and their practice was of poor quality. Nurses’ lack of knowledge and improper practice can jeopardize drug safety in patients and cause serious side effects such as bleeding. Proper training of nursing students and nurses about warfarin as a high‑risk drug, its side effects, and drug‑food interactions, and the emphasis on patient education in patients receiving this medicine can effectively reduce the incidence of side effects.

Osteoporosis is a specific condition which is characterized by low bone mineral density (BMD) and deterioration of bone structure resulting in an increased susceptibility to fractures. It contributes to a great deal of morbidity and mortality, and is a large burden to the healthcare system, especially in the case of the elderly population. In the last four decades, a plethora of studies have reported characteristic oral radiographic findings in the early stages of osteoporosis, suggesting the possible use of oral radiographic signs for the early detection of the condition. Digital orthopantomographs (OPGs) are usually taken for the screening of dental patients during routine dental evaluations. These radiographs and the characteristic changes seen on them may have a significant role in the screening for initial osteoporotic changes. A number of precise radiomorphometric indices of the mandible have also been developed to allow quantification of the mandibular bone mass for identification of the initial signs of osteoporosis. The present review focuses on the possible role of panoramic radiographs in the initial screening for osteoporosis in dental clinics in high‑risk groups.

Breast cancer (BC) is the most common cause of cancer‑related deaths in women globally. Currently, many machine learning (ML)‑based predictive models have been established to assist clinicians in decision making for the prediction of BC. However, preventing risk factor formation even with having healthy lifestyle behaviors or preventing disease at early stages can significantly lead to optimal population‑wide BC health. Thus, we aimed to develop a prediction model by using a genetic algorithm (GA) incorporating several ML algorithms for the prediction and early warning of BC.

The data of 3168 healthy individuals and 1742 patient case records in the BC Registry Database in Ayatollah Taleghani hospital, Abadan, Iran were analyzed. First, a modified hybrid GA was used to perform feature selection and optimization of selected features. Then, with the use of selected features, several ML algorithms were trained to predict BC. Afterward, the performance of each model was measured in terms of accuracy, precision, sensitivity, specificity, and receiver operating characteristic (ROC) curve metrics. Finally, a clinical decision support system based on the best model was developed.

After performing feature selection, age, consumption of dairy products, BC family history, breast biopsy, chest X‑ray, hormone therapy, alcohol consumption, being overweight, having children, and education statuses were selected as the most important features for prediction of BC. The experimental results showed that the decision tree yielded a superior performance than other ML models, with values of 99.3%, 99.5%, 98.26% for accuracy, specificity, and sensitivity, respectively.

The developed predictive system can accurately identify persons who are at elevated risk for BC and can be used as an essential clinical screening tool for the early prevention of BC and serve as an important tool for developing preventive health strategies.

Nursing is one of the most stressful occupations. Educational intervention regarding stress management can play an important role in reducing occupational stress among nurses The present study aimed to determine the effectiveness of educational intervention on reducing oxidative stress caused by occupational stress in nurses: A health promotion approach in a hospital in western Iran.

The present interventional study was performed in 2019 among 92 nurses working at the Kosar Hospital located in the city of Sanandaj in the country of Iran. Occupational stress was evaluated using the Osipow Occupational Stress Questionnaire. Oxidative stress was measured by taking blood samples and measuring the enzymatic activity of superoxide dismutase (SOD), malondialdehyde, and catalase (CAT) using SOD, malondialdehyde (MDA), and CAT kits. Educational intervention was carried out in the second stage. Three months after the intervention, data were taken again.

The results of the present study indicated that there was a significant difference in occupational stress between before and after the educational intervention (P < 0.05). A significant reduction in MDA (P = 0.038) and SOD (P = 0.048) was observed after educational intervention, but this was not the case for CAT (P = 0.592). There was no significant correlation between occupational stress with oxidative stress parameters before and after the educational intervention (P < 0.05). No significant difference in occupational stress was observed between men and women. Among the oxidative stress parameters under evaluation, MDA was higher among men compared to women and this was statistically significant.

Educational intervention regarding occupational stress is effective in reducing oxidative stress among nurses. The group meetings teach stress management to the participants and enable them to better manage their stress by utilizing their own capabilities. Thus, attention to this issue is vital in maintaining the mental and physical health of nurses and, in turn, improves the quality of care rendered.

COVID‑19 pandemic lockdown has brought all sectors to be dwindled with no exception of the academic system. Even professional courses like medical and allied health academic courses were also not spared. The academic requirements were not met as required to do so. Webinar has become a good source of virtual platform acting as a bridge for attaining the gaps in accomplishing the curriculum to the students during these curfew times. Our study aimed to know the value of webinars on teaching–learning processes among the medical and allied health science students in India.

The study design is a cross‑sectional study with 2084 students who attended at least one webinar. An online survey questionnaire was sent, and the data were collected on participant’s perspective on the effectiveness of webinar, post webinar assessment by their satisfactory level of gain of information through webinars and their plan to apply in future.

Participant’s perspective on effectiveness of webinar showed 66.7% of agreement with the webinar use. In post webinar assessment, the use of webinar was in agreement with 69.9% of the participants. Furthermore, we observed a significant association with the gain of information in post webinar assessment (P < 0.05) and a significant association with their plan to apply in future (P < 0.05).

Our results showed that the students were satisfied with the webinar teaching and acknowledged it to be an effective tool in the teaching–learning process to gain new knowledge and wish to attend webinars in future as a part of their curriculum. Thus, webinars have a constructive effect in the teaching and learning process in professional courses during pandemic lockdown.

Infertility is one of the most important challenges in the modern life that can damage the sexual satisfaction and marital intimacy of couples. The present study was aimed to investigate the effectiveness of reality therapy on sexual satisfaction and marital intimacy of infertile women.

This quasi‑experimental study was conducted with a pretest‑posttest design and follow‑up. The statistical population was infertile women who were referred to Imam Sajjad Shahriyar Hospital in 2019–2020. 15 infertile women selected by purposive sampling and underwent reality therapy (8 sessions of 90 min). Data were collected using index sexual satisfaction (ISS) and marital intimacy questionnaire. Data analysis was performed using SPSS‑24 software, analysis of variance with repeated measures and post hoc Bonferroni test.

The results of analysis of variance showed that there was a significant difference between the scores of sexual satisfaction and marital intimacy in posttest and follow‑up stages compared to pretest (P < 0.05).

Based on the results, reality therapy can be used as an effective intervention to improvement sexual satisfaction and marital intimacy of infertile women.

Intentional self‑harm (ISH) is one of the most important entities of consultation‑liaison psychiatry. This study aimed to assess the clinical profile of individuals with intentional self‑harm referred to consultation‑liaison (CL) psychiatric services in a tertiary care hospital.

The present study was a cross‑sectional hospital‑based study, in which purposive sampling was done for sample selection. A total of 60 subjects of ISH referred for evaluation in a tertiary care psychiatry hospital on specified days were recruited to the study after obtaining informed consent. Demographic and clinical details such as the nature of the self‑harm attempt, method of attempt, number of attempts, the reason for the attempt, and regret/remorse about the attempt were documented using the semi‑structured proforma.

A total of 60 subjects were included in the study. About 80% of them were below the age of 30 years. The majority (80%) were females, 65% were from a rural background, 56.7% were married. The most common method of ISH was self‑poisoning. Interpersonal conflicts with family members (50%), followed by interpersonal conflicts with the spouse/partner (21.7%) were the commonest reason/precipitating factors that lead to intentional self‑harm. Also, 45% of our study population did not have any diagnosable psychiatric illness at the time of assessment, and the most common psychiatric diagnosis was personality disorders (20%).

Intentional self‑harm is common in young married females from rural backgrounds. Self‑poisoning is the most common method of deliberate self‑harm. More than half of the individuals were diagnosed with the psychiatric illness at presentation.

Schools are ideal setting for children’s oral health‑promoting programs. It is an integrated model for oral health‑promoting schools (OHPS) with the capacities of dental school’s curriculum and dental students as workforces. In this protocol, the principle of planning and implementation of the oral health program is described.

Based on the PRECEDE‑Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (PROCEED) planning model, a framework for determining the potential predisposing, reinforcing, and enabling factors that could be intervening was diagnosed. To adapt the phases of the planning model for integration of the “OHPS” principles and the dental students’ curriculum, the following steps are supposed to be considered: Phases 1–5 which are to assess the baseline data will include the assessment of children oral health status and parents and teachers’ knowledge, attitude, and performance. Phase 6 or implementation phase will be allocated to oral health education interventions for students, parents, and teachers, professional screening, prevention, and referral. Phase 7 or the process assessment phase will be to record the number of screened students, the amount of fissure sealant and fluoride provision, and percentage of trained parents and teachers. Phase 8 or the impact assessment phase will assess the students’ improvement in knowledge and practice, decayed, missing, and filled teeth scores, teachers and mothers’ oral health attitudes and behaviors, and brushing and flossing behaviors. At the last, cost analysis of the program and long‑term monitoring of the interventions is suggested.

In case that the effectiveness of this model is proven, it can be implemented by other dental schools for the primary schools in their regions. Considering the number and distribution of dental schools in the country, this model is executable as targeted population oral health promotion approach in 6–12‑year‑old schoolchildren.

Clinical decision‑making is not only stressful to physicians, but also to patients and even their companions. Thus, managing uncertainty in clinical decision‑making is essential which requires knowing its origins. Therefore, this study aimed to understand determinants of uncertainty in clinical decision‑making from the perspective of clinical physicians.

This is a qualitative study which is done during October to November 2020. An in‑depth interview is performed with 24 specialists of clinical groups including obstetrics, surgery, internal medicine, and pediatrics, working in teaching hospitals affiliated to Iran University of Medical Sciences. All the interviews were recorded, transcribed and analyzed according to the steps suggested by Graneheim and Lundman. The interviews were analyzed through comparative method. Then, the interviewer created initial codes, categories, and key concepts and sent them to fourteen physicians for member check.

According to the participants’ view, determinants of uncertainty in clinical decision‑making consisted of three themes: individual determinants, dynamics of medical sciences, and diagnostic and instrumental constraint. Individual determinants can be related to the physician or patient. The dynamics of medical sciences could be explained in two categories: variation of medical science and complexity. Diagnostic and instrumental constraint category could be also explained in subcategories such as lack of efficient diagnostic tests and unknown etiology.

To curb uncertainty, the more accessible way is considering interventional programs with a focus on individual determinants related to physicians, such as strengthening doctor–patient relationships, and considering related mandatory retraining courses to reduce insufficient knowledge of physicians.

One of the important causes of anxiety in COVID‑19 disease is the inability to regulate emotion and lack of self‑control during threatening conditions. The psychotherapy technique has been effective in reducing these symptoms. Therefore, this study attempted to evaluate the effectiveness of compassion‑based therapy on emotion regulation and self‑control in patients with COVID‑19 after discharge.

It was a quasi‑experimental pretest‑posttest study with a control group. The statistical population consisted of 30 men (15 in each group) who were in the quarantine period of COVID‑19 disease. Available sampling was used and the participants were randomly assigned to experimental and control groups. In the experimental group, compassion‑based treatment was performed in 10 sessions of 90 min. Tanji’s self‑control questionnaire and Garnofsky’s Emotion Regulation questionnaires were used. Data analysis were performed using SPSS 21 software and multivariate analysis of covariance.

There was a significant difference between the mean scores of emotion regulation and self‑control variables in the experimental and control groups (P < 0.001). The effect of this treatment on increasing the emotion regulation score was 49% and on increasing the self‑control score was 37%.

Compassion‑based therapy can increase cognitive regulation and improve self‑control in patients with COVID‑19 disease. It is suggested that this intervention can be used in psychological treatment programs.

The ancient Indian science of Yoga makes use of voluntary regulation of breathing to make respiration rhythmic and calm the mind. This practice is called pranayama. Nadisuddhi pranayama means “purification of subtle energy paths,” inhalation and exhalation are through alternative nostrils for successive respiratory cycles. Surya Anuloma‑Viloma pranayama means “heat generating breathing particle” when the respiratory cycle of inhalation and exhalation is completed through the right nostril exclusively. When completed through the left nostril alone, the practice is called “Chandra Anuloma‑Viloma pranayama,” which means a heat‑dissipating or cooling liberating practice. We compared the effect of right nostril breathing (RNA) and left nostril breathing (LNB) pranayama on heart rate variability.

The study was conducted at the Department of Physiology at an institute of national importance, after obtaining necessary ethical approvals from the Institutional Ethics Committee. Twenty healthy kriya yogi volunteers (mean age: 44 years), who are regular practitioners for the last 10–20 years, were inducted into the study. RNB pranayama starts with closing the right nostril with the thumb of the left hand followed by exhalation through the right nostril and inhaling slowly through the same nostril. This forms one round of RNB pranayama. In contrast, inhalation through the left nostril and exhalation through the right nostril exclusively is called chandrabhedana pranayama (chandrabhedana means moon‑piercing breath in Sanskrit) with a similar variation called Chandra Anuloma‑Viloma pranayama in which inhalation, as well as exhalation, is performed through the left nostril exclusively. The recording of electrocardiogram (ECG) for heart rate variability (HRV) analysis was taken by heart rate variability (Dinamika HRV‑Advanced Heart Rate Variability Test System, Moscow, Russia). The resting and during readings of heart rate variability parameters were compared and post hoc analysis was done using Bonferroni and Holm multiple comparisons for repeated measures.

Time domain parameters: Standard deviation of normal to normal RR intervals (SDNN) and root mean square of successive NN interval differences (RMSSD) were increased at a high level of statistical significance during both pranayama maneuvres. Frequency domain parameters: LF, LF/ HF ratio increased significantly. Parasympathetic activity is represented by LF when the respiration rate is lower than 7 breaths per min or during taking a deep breath. Thus, when the subject is in a state of relaxation with slow and even breathing in both RNB—right nostril and Chandra—LNB, the LF values can be very high, indicating an increase in parasympathetic activity rather than an increase in sympathetic regulation.

Our study is an acute study, where changes in HRV were seen after 5 min of RNB and LNB. However, statistically, there is not much difference in the immediate effects of the two pranayamas on heart rate variability in regular yoga practitioners.

Nursing students have a role in the awareness of risk factors in the development of healthy lifestyle behaviors. Nursing students’ awareness of disease risk factors plays a role in developing healthy lifestyle behaviors. Therefore, it was aimed to determine the relationship between the effect of nursing students’ healthy lifestyle behaviors and cardiovascular disease risk factors’ knowledge levels and obsessive–compulsive symptoms.

This was a descriptive cross‑sectional study. Two hundred and twenty‑four students studying in the nursing departments of two foundation universities participated in the study between April and October 2020. Sociodemographic information form, Health Promoting Lifestyle Profile II (HPLP‑II), Cardiovascular Disease Risk Factors Knowledge Level (CARRF‑KL), and Maudsley Obsessive–Compulsive Inventory (MOCI) were applied to the students.

It was found that the nursing students’ healthy lifestyle behaviors (123.53 ± 25.78) and cardiovascular risk factors’ knowledge level (21.08 ±± 2.70) were high. Obsessive–compulsive symptoms (16.12 ± 6.22) were moderate. In the correlation of sociodemographic characteristics, it was found that age correlated with the nutrition subdimension of CARRF‑KL and HPLP‑II, income level correlated with HPLP‑II, place of residence correlated with HPLP‑II, CARRF‑KL, and MOCI, and having a health problem correlated with health responsibility. Income status, place of residence, and presence of health problems were found to be correlated with HPLP‑II in all subdimensions in the regression analysis. In the regression analysis of HPLP‑II with CARRF‑KL and MOCI scales, it was found that it was significantly related to interpersonal relations, spiritual growth, stress management, and total score dimensions.

Healthy lifestyle behaviors of nursing students are related to cardiovascular risk factors’ knowledge level and obsession symptoms. In addition, some demographic characteristics affect healthy lifestyle behaviors.