Journal of Education and Health Promotion
Volume:12 Issue: 10, Nov 2022

The aim of this study was to identify the parents’ experience of moral education to their children in secondary school and with a phenomenological method.

Participants include parents of students who received a high score after taking Dr. Lotfabadi’s moral development test and extracting the results. The students’ parents consciously and satisfactorily participated in the semi‑structured interviews prepared for this purpose, and the interviews continued until the saturation stage, so the final sample size was 22 participants. The data obtained from the interview were then analyzed using the Van Menen method to discover the meaning of the students “parents” experiences of moral education.

Findings were revealed in 5 main themes of social ethics, family ethics, individual ethics, self‑care ethics, and environmental ethics and 15 sub‑themes.

According to the findings of this study, it seems that parents to pay more attention to the components of social ethics, family ethics, individual‑human ethics, self‑care ethics, environmental ethics to succeed in raising children with desirable moral development pay special attention to these components to raise worthy children with desirable moral development.

Social networks are integrated in our lives and, amongst other functions, they are a means of dissemination. There are numerous social network accounts dedicated to health that could be used as an educational resource. The aim of this study was to evaluate the quality of accounts dedicated to health in different social networks, assessing their content and didactic and technological effectiveness and accessibility.

Observational cross‑sectional descriptive study in which an analysis of social networks related to health was carried out from April to June 2021 in Spain. Twenty‑eight accounts were analysed using a mixed qualitative‑quantitative methodology. Content analysis of the speeches disseminated through the selected accounts was performed. In addition, the quality of the accounts was assessed with the Instrumento de Evaluación de Recursos Educativos Digitales (#IE_RED) (Digital Educational Resources Evaluation Instrument [#IE_RED]).

Four categories were identified according to the content: student‑focused profiles, specific professionals’ profiles, current health issues and profiles promoting a healthy lifestyle. In addition, the quality of the accounts obtained a score that indicates they meet the requirements to be validated as a good educational digital resource but could be improved. Instagram social network accounts and those managed by nurses scored significantly higher.

The analysed accounts were revealed as a quality tool for health dissemination, with varied content and applicable to teaching. Their use could be applied both to the training of health professionals and to the promotion of the population’s health.

There is not much information about high‑risk behaviors in young groups, especially students. This study was conducted to estimate the prevalence of high‑risk behaviors in students of universities of medical sciences in West Azerbaijan Province, Iran, by network scale‑up (NSU) method.

This cross‑sectional study was performed on 450 students from the universities of medical sciences. A researcher‑developed checklist was used to collect the data. We considered number 16 for the social network size of students according to a previous study. Based on the response of individuals to each of the high‑risk behaviors (including cigarette smoking, hookah use, opium consumption, alcohol drinking, tramadol/ecstasy taking, and extramarital sex) in their social network, the prevalence of these behaviors was estimated. The required calculations were performed using the NSU method. Furthermore, 95% uncertainty interval (UI) was calculated using the bootstrap method.

Totally, 196 (44%) participants were male. The mean age (standard deviation) of the participants was 22 ± 2 years. Results showed that hookah use (20% 95% UI [18.9–21.1]) and opium consumption (0.4% 95% UI [0.24–0.6]) had the highest and lowest frequencies, respectively. Cigarette smoking (17% 95% UI [15.8–18]), alcohol use (8.3% 95% UI [7.5–9.1]), extramarital sex (8.2% 95% UI [7.4–9]), and tramadol/ecstasy taking (4% 95% UI [6.4–4.6]) were the next most common high‑risk behaviors, respectively.

Given that hookah use and cigarette smoking are the most common high‑risk behaviors in students, especially males, appropriate cultural activities and educational programs should be employed by relevant authorities to reduce these behaviors.

Childbirth is regarded as an important life event for women, and growing numbers of them are making the choice to give birth by cesarean delivery. Increasing rate of births by cesarean section is an issue of concern in many countries. In order to reduce the rates of unnecessary cesarean sections, it is essential to acquire information of the reasons that motivate physicians to carry out cesarean sections rather than vaginal deliveries. The objective of present study is to evaluate whether the education process for undergraduate medical students affects their decision‑making.

The present study was cross‑sectional and questionnaire based. A total of 292 students participated in the study. Out of which, 150 were first‑year students and 142 were doing internship in Maharashtra Institute of Medical Education and Research (MIMER), Talegaon Dabhade, Maharashtra, India. The study was conducted in the months of June and July 2019. Data was collected with the help of person to person interview of all the participants who satisfied the inclusion criteria after obtaining their informed consent. The data was entered by using Microsoft Excel 2007 and was analyzed using Epi Info version 3.3.2. The data was tabulated and analyzed according to responses which were given by the respondents.

A total of 292 students answered the questionnaire. Age of participants varied between 19 and 23 years. 130 males and 162 females were the subjects, out of which 40 students declared fear of labor. Most of the students preferred vaginal delivery over cesarean sections in all the four scenarios. The difference of opinion was significant in case of an uneventful pregnancy and normal pregnancy under their care. For general population as healthcare manager this difference of opinion was not significant. In case of one’s own or partner’s delivery, internship students preferred cesarean section but this difference was statistically non‑significant.

Most of the students would recommend vaginal delivery because this form of delivery has fewer risks as compared to cesarean section. Majority of students chose vaginal delivery for the birth of their own child; however, a higher number of interns as compared to first year students preferred cesarean section. Pain associated with vaginal delivery was the most common reason given for choosing cesarean section. The student’s preference for childbirth changed in due course of graduation toward cesarean section. This indicates a probable effect of medical education on permissive culture of cesarean section as a mode of delivery.

One of the most important sensory disorders that usually occur after viral infections, especially human coronaviruses and rhinoviruses, is anosmia or loss of olfactory sense. The aim of the present study was to investigate olfactory disorders in children with COVID‑19 disease admitted to Hazrat Masoumeh Hospital in Qom.

This descriptive‑analytical study was conducted on 85 children admitted to Hazrat Masoumeh Hospital in Qom by using a convenience random sampling method. Data were collected using a checklist containing demographic data. The collected data were entered SPSS 18 software and were analyzed using descriptive and analytical statistics.

In the present study, the results showed that the mean age of participants was 6.59 ± 3.27 years and more patients were Iranian (n = 69, 87.3%), had a history of underlying disease (n = 51, 64.6%), had a history of vaccination (n = 78, 98.7%), and did not have contact with a suspected patient (n = 43, 54.4%). Among the signs and symptoms of the disease, only the symptoms of fever (n = 71, 89.9%), weakness and lethargy (n = 44, 55.7%), and anorexia (n = 44, 55.7%) were observed in most patients. Moreover, 87.3% (n = 69) of the patients did not have olfactory. Furthermore, no association was found between age (P = 0.803), length of hospital stay (P = 0.397), white blood cell (P = 0.624), lymph (P = 0.638), Polymorphonuclear (PMN) (P = 0.493), erythrocyte sedimentation rate (P = 0.507), C‑reactive protein (P = 0.085), and O2sat (P = 0.205) and olfactory disorders, but a significant relationship was found between patient weight (P = 0.002) and olfactory disorders.

According to the results of the study, it can be said that in order to increase the strength of the immune system of children, especially overweight children, appropriate and planned action should be taken to prevent problems in these children.

Short peripheral catheterization is the common procedure performed in every hospital with patients’ admittance. It becomes challenging when it comes to children and requires more knowledge and skills. The aim of the current study was to assess the effectiveness of the reinforcement program on adherence to short peripheral catheter (SPC) care guidelines among registered nurses.

A quasi‑experimental study was conducted among 44 registered nurses by observing 96 SPC care events before and after the reinforcement program in pediatric wards of a tertiary care hospital in Eastern India. The study was conducted in a tertiary care public hospital in Eastern India in 2019, and the data collection tool included children’s and nurses’ socio‑demographic data and an observation checklist on intravenous catheterization care. Descriptive statistics were used to explain the participant characteristics, and McNemar’s test was used to identify the adherence to SPC care guidelines.

There was a statistically significant improvement in most steps, such as hand washing, gloving, tray preparation, documentation initiation, maintenance, and removal (P = 0.001). A statistically significant reduction in the early stage of phlebitis was found from 66.7% in pre‑intervention to 37.5% in post‑intervention (P = 0.027).

The majority of nurses adhered to SPC care guidelines after the reinforcement program. From the study findings, it is recommended that regular reinforcement related to peripheral catheter care acts as a stimulant to adhere to SPC care guidelines. The nursing administration should take initiative by conducting in‑service training for the nurses, which motivates them toward practicing quality nursing care.

Infertility is a crisis in the life of couples that could affect their relationships. The present study was conducted to evaluate the relation between infertility factors and the quality of marital relationship in infertile couples who were referred to the Fertility and Infertility Center of Isfahan.

The present study was conducted cross‑sectional on 131 infertile couples who were referred to the Fertility and Infertility Center of Isfahan and had the inclusion criteria and were selected using convenient sampling method. Data gathering tool for the present study was Perceived Relationship Quality Components (PRQC). All the data were analyzed using SPSS software version 21. Analysis was conducted using descriptive and inferential statistics (independent t‑test and one‑way analysis of variance). The level of significance was set at 0.05 for all the statistical tests.

The mean score of PRQC for women and men was 84.05 and 88.46, respectively, and their difference was statistically significant. There was a significant relation between the score of PRQC in women (P = 0.028) and men (P = 0.030) with the infertility factor. Results showed that the mean score of perceived quality of different aspects of the marital relationship was significantly lower when the infertility factor was female (P < 0.05). In women aspects of “satisfaction” (P = 0.024) and “commitment” (P = 0.011) and in men aspect of “love” (P = 0.004) from the perceived aspects of relationship had a significant relation with the infertility factor.

Perceived quality of different aspects of marital relationship had a significant relation with infertility factor in infertile couples. Results of the present study showed that when infertility had female causes, the quality of relationship was more affected. Therefore, in infertility counseling, simultaneous counseling for both spouses with emphasis on women, along with treatments, should be considered.

Professional identity formation (PIF) refers to the possession and exhibition of the conduct of a medical professional. It’s an external representation of a medical personnel’s feelings, beliefs, experiences, and values that influence the provision of holistic patient care. Apart from training medical students to be competent and skilled physicians, one of the goals of today’s medical education must be to encourage them to achieve professional identity formation. Many medical schools across the globe have made this explicit during the clinical years of study, but we believe that professional identity formation starts as early as day one of medical school. So, for educators, apart from delivering basic science subject content during early years of study, the creation of learning opportunities and pedagogic space in the curriculum to enhance competencies of PIF becomes mandatory. This competency‑based educational approach will help medical students transform and reconsider their own values and beliefs by relating to the behaviors that are expected by the profession, colleagues, and patients when they graduate as medical doctors. In this paper, we discuss how a competency‑based curriculum should provide opportunities for students to interact and communicate effectively with patients and colleagues, to self‑reflect on their own personal identity before creating a professional identity that is unique to the profession, to make the right judgment and confidently practice medicine in a business‑based healthcare system.

Earthquake is a natural disaster severely affecting the societies’ health, hygiene, and welfare as such the most effective method to respond to its damages is to develop a readiness plan. This study aimed to discover thematic patterns and co‑author relationships extracted from relevant publications to plan an earthquake response.

This descriptive–analytical study adopted the scientometric approach and used word co‑occurrence and social network analysis. The published articles indexed in PubMed were retrieved from 1970 to 2021 using a combination of keywords “earthquake and response.” The data were analyzed in VOSviewer, UCINET, and NetDraw software.

The following six thematic clusters with a social map were extracted: Initial response of the healthcare system, response to probabilistic risks after the hazard, response to mental health and community resilience, response to public health, response to post‑traumatic stress disorders, and staff’s response to the needs assessment and continuity of diagnostic treatment services. Moreover, social network analysis revealed the great impact of Japanese and Chinese authors and institutes.

The present study detected many gaps in the literature on earthquake response, which can contribute to developing a general framework to prepare integrated healthcare earthquake response plans to promote the performance of this system.

The cancer is uncontrolled growth and spread of cells that affect almost all parts of the body. One of the most prevalent cancers in the female genital system is cervical cancer. The aim of present study was to determine the effect of educational intervention using the Precaution Adoption Process Model (PAPM) on cervical cancer screening behavior (Pap smear test) among women.

In this interventional study that was done in Karaj health centers (2016), women (aged 15‑49 years) were in the third stage of behavior change process based on PAPM randomly assigned to experimental and control groups. The data collection tool was a PAPM‑based questionnaire whose validity and reliability were confirmed. Gathered data were analyzed using statistical software SPSS 16 and statistical tests (t‑test, repeated measures analysis of variance, and Wilcoxon, Chi‑squared, Fisher’s exact, and Mann‑Whitney tests).

The result showed that the stages of the decision‑making process between the two groups were significantly different at the time immediately and 2 months after the intervention (P > 0.001). Also the results of the intervention based on the health belief model health belief model (HBM) components, regarding variables of knowledge, perceived susceptibility, perceived benefits, perceived barriers, and subjective norms, the mean scores in the experimental group were significantly different between the three sections before, immediately, and 2 months after the intervention (P > 0.001).

This study provides hints how persons could be influenced to move from the “Deciding about action” positions into to the stages of decided to act, adoption, and maintenance for promoting cervical cancer screening behavior.

The COVID‑19 pandemic has led to numerous psychological consequences and a drastic increase in the workload of nurses. The present study aimed to investigate the correlation of the job turnover intention of Iranian nurses with job satisfaction and burnout in the COVID‑19 pandemic.

This cross‑sectional descriptive study was conducted on 300 nurses working in the hospitals in Sabzevar, Iran from October 2020 to January 2021. Data were collected using the questionnaires of turnover intention, Spector job satisfaction, and Maslach burnout in a self‑report manner. Correlation analysis was used. Then, for assessing a predictive model used a simple linear regression and multiple linear regression analyses. Data analysis was performed using SPSS version 24.

The results showed that the variables of burnout and job satisfaction are effective on nurses’ willingness to job turnover. Furthermore, among the background variable, the findings showed that the economic status of nurses and the male gender of patients under their care can be effective on nurses “job turnover intention and can be used as predictor variables of nurses” job turnover intention.

According to the results, special attention must be paid to the job satisfaction, burnout, and the economic situation (as a mediator variable) of nurses to prevent their job turnover in the COVID‑19 pandemic. Therefore, it is recommended that health managers prevent the job turnover intention of nurses in the COVID‑19 pandemic by taking psycho‑socio‑economic support measures.

In the last 20 years, the public health community has expressed concerns over the unprecedented increase of cesarean section (CS) delivery. Rising global concerns over this escalation that has gone out of control should not be overseen. The purpose of this study is to develop an application‑based education model and prenatal yoga to reduce the occurrence of cesarean section (CS) delivery.

This studywasan exploratory mixed methodsresearchthat consisted of twostages: stage 1, which wasa qualitative study on model formulation through in‑depth interviews and forum group discussions (FGDs); and stage 2, which aimed to test whether the formulated model was effective in reducing the occurrence of cesarean section delivery.

The result of this study wasused todevelop an application‑based education model, which wascombined with prenatal yoga, to reduce the occurrence of cesarean section delivery

One of the main tasks of educational institutions, in addition to developing students’ professional competencies, is to develop decision‑making and problem‑solving skills, which are themselves influenced by critical thinking that should be developed by instructors at the university. The aim of this study was to compare the level of critical thinking skills in students and faculties of Ahwaz Jundishapur University of Medical Sciences.

In this cross‑sectional descriptive study, the sample consisted of 81 medical students and 52 faculty members of the medical school who were teaching and studying in 2021. The research method was descriptiveanalytical and the data collection tool was the California Critical Thinking Questionnaire Form B. SPSS‑18 software and t‑test were used to analyze the data.

The mean score of students’ critical thinking skills was 12.49 ± 4.43 and that of faculties was 12.44 ± 3.76 and no significant difference was observed between the scores of the two groups (P = 0.94).

The findings of the study show that the level of critical thinking skills in both faculties and students is below the standard and poor. The results of the study indicate the weakness of critical thinking in students and faculties in all dimensions, which indicates the need to teach critical thinking skills at the university level. Therefore, educational planners and faculty officials should pay more attention to developing critical thinking skills in their educational programs.

Physical therapists provide important services for improving health and function for the general population; however, physical therapy (PT) is infrequently accessed by persons with a primary diagnosis of severe mental illness (SMI). This study examined the attitudes of PT students before and during their participation in a service‑learning (SL) program for people with SMI.

A cross‑sectional institutional review board approved qualitative study collected 1‑h semi‑structured qualitative interviews from seven graduates of a doctor of PT program. Participants were from a New Jersey University program in the USA who participated in an SMI SL experience. Participants were asked about participant attitudes toward people with SMI and their observations during a SL experience using an interview guide. All interviews were digitally recorded, transcribed, and coded using interpretive phenomenological analysis by a team of researchers. This type of qualitative analysis aims to explore participants understanding of their experience without pre‑conceived theoretical direction. Recordings, transcripts, and field notes were reviewed for recurring ideas that were summarized into codes. Through independent coding, reflexivity memos, and consensus meetings, data were further analyzed to identify themes. Investigator triangulation addressed differences and aided consensus development.

Before the SL experience, the students reported negative perceptions about people with SMI and feelings of uncertainty and unpreparedness to work with this population. According to student reports, SL supported their personal and professional development and allowed them to see that PT services are beneficial for people with SMI.

The results of this study indicate that PT students have negative attitudes of people with SMI and feel unprepared to work with this population. The results also support SL as an effective strategy for helping students in their preparation for working with people with SMI.

Iron deficiency anemia (IDA) is one of the most common anemias, especially in children 4–23 months. Therefore, prophylaxis is necessary to improve iron status as well as reduce IDA in Toddlers. The aim of this study was to compare the efficacy of daily supplementation with ferrous gluconate (FG) and ferrous sulfate (FS) on iron status in toddlers.

A total of 120 healthy toddlers were divided randomly into 2 groups at the Amir‑Kabir Hospital, Arak, Iran and received FS and FG from March 2020 to December 2020. Iron status was evaluated at baseline and after 6 months of supplementation. The statistical significance of the differences in iron status between FS and FG groups was calculated using Student’s t‑test and the Pearson’ s Chi‑square test for qualitative variables. SPSS software (version 16, Chicago, IL, USA) was used for statistical analysis.

Comparison of iron status of FS and FG groups toddlers at baseline and after 6 months of supplementation showed that there was a significant difference in hemoglobin (Hb) (10.46 vs. 12.45, P = 0.001) and ferritin level (28.08 vs. 59.63, P = 0.001).

Although prophylaxis with FG led to a higher Hb and ferritin levels, our study recommended that both FG and FS supplements were effective for prophylactic use in the prevention of IDA. However, FG was more effective than FS because FG group that received FG supplementation indicated a higher Hb and ferritin levels in comparison to the FS group that received FS supplementation.

Life skills are crucial for young adults to lead a successful, satisfying, and productive life. There is enough evidence suggesting a positive relationship between life skills and academic performance. Substance abuse among adolescents is a common problem that often leads to academic disorientation and delinquent behavior. This study aimed to determine whether life skills and attitudes toward alcohol abuse predicted school students’ academic achievement.

The participants (N = 726) enrolled in senior secondary schools of Sikkim, a north‑eastern state of India, constituted the population of the present study. Data were collected using the “Life Skills Assessment Scale” developed by Subashree and Nair (2014), and the “Attitude towards Alcohol Abuse Scale” developed by the investigators.

Life skills and attitude toward alcohol abuse significantly predict students’ academic achievement. 15.3% variance in academic achievements of the students was explained by life skills and attitude toward alcohol abuse. Further, the t‑test result reflects that both the variables had significant predictive power to predict students’ academic achievement.

The finding shows that there was a significant relationship between academic achievement and life skills and attitude toward alcohol abuse of school students. Life skills and attitude toward alcohol abuse predicted 15.3% of the variance in academic achievement.

Parents play a key role in the care, monitoring, management of symptoms experienced in children with cancer, the support, and follow‑up of treatment. However, there is a paucity of research as how to improve the health literacy of parents with cancer. The aim of this study was to identify the best and most important strategies to promote health literacy in parents of children with cancer.

A two‑step modified Delphi method was used to establish consensus in Iran in 2021. Fourteen experts representing oncology, clinical nursing, and faculty members of nursing were selected by purposive sampling. In round one, 90 strategies to promote health literacy obtained in the qualitative study were distributed to the experts, which were scored from 1 to 5. In order to discuss statements without consensus in the first round, round two was held in a face‑to‑face meeting. Descriptive statistics such as mean, standard deviation, and percentage of response frequency were used to calculate agreement levels between experts.

In round one, 57 statements reached a consensus. In round two, 21 statements reached a consensus. Finally, 78 statements reached consensus representing four domains including functional health literacy, interactive health literacy, critical health literacy, and care health literacy.

Delphi method helps to identify the best and most important strategies to use in health literacy promotion programs for parents of children with cancer. Identifying these strategies will help health officials, planners, and policymakers.

The behavioral aspects of human beings influence the incidences of cancer cases directly and indirectly. The factors like positive thinking and motivation were found to change the behavior toward knowledge and awareness of cancer. The main objective of the study is to assess the knowledge and awareness of select Indians about reproductive cancer.

The online survey method assessed various components of knowledge and awareness about reproductive cancer. A Google Form has been distributed through social media platforms such as e‑mail, Instagram, Facebook, and WhatsApp. The coded data has been computed in SPSS (version 25) by IBM (USA) for the analysis. Univariate and bivariate data analysis has been drawn to justify the objective.

Nearly 68 percent of the respondents were aware of reproductive cancer. Among them, 17 percent know about cervical cancer, and 12.5 percent have awareness about breast cancer. Electronic and print media (41.2 percent) were major sources of information about reproductive cancer. Nearly 48 percent of respondents reported that multiple sexual partners and poor sexual hygiene were risk factors for reproductive cancer. Around 57 percent of respondents reported reproductive cancer is preventable, 59 percent knew about cancer screening, and 63.5 percent knew the treatment process. The gender of the respondents was associated (p‑value = 0.002) with awareness of reproductive cancer. It has been found that there is a significant association between knowledge of screening tests and the treatment process of reproductive cancer. The marital status of respondents is strongly associated (p‑value = 0.000) with the awareness of reproductive cancer.

The factors like knowledge of reproductive cancer and awareness proceed as an important role in cancer prevention. A gender‑neutral cancer awareness program is needed to increase cancer awareness irrespective of marital status.

Complications of chronic liver disease (CLD) in children play an important role in mortality and disability. This disease is one of the health problems of the country and due to its chronic and irreversible disease, it needs care and treatment education programs. Therefore, this study was performed to determine the effect of nutrition adjustment training program on anthropometric indices in children with CLD.

This clinical trial study was performed on 75 children (45 in the intervention group and 30 in the control group) with CLD in the nutrition clinic of Ghaem Educational‑Research Center in Mashhad. Children and caregivers with inclusion criteria entered the study after completing written consent. Anthropometric indices (abdominal circumference, body water level, body fat, height, weight, body mass index, arm circumference) were measured and recorded in children at the beginning of the study. Children and their caregivers were randomly divided into control and intervention groups. The intervention group underwent nutritional adjustment (calculation of energy and carbohydrates, lipids and proteins, vitamins and minerals, calculation and selection of diet) training (face to face) for 6 sessions (each session 90–120 min, three times a week for 2 weeks). Twelve weeks after the start of the study, children in both intervention and control groups were evaluated for anthropometric indices. The collected data were analyzed by SPSS software version 16 and descriptive and analytical statistical tests (Mann–Whitney and Wilcoxon).

The results of Wilcoxon statistical test showed that children in the intervention group at the end of the study compared to the beginning of the study had significant changes in scores around the abdomen (P = 0.001), total body water (P = 0.009), total fat (0.001 > P), height (P = 0.001), weight (P < 0.001), body mass index (P < 0.001), arm circumference (P < 0.001). The mean scores at the end of the study increased compared to the beginning of the study, but the mean scores of the studied indices in the control group did not change significantly.

The results of this study showed that diet adjustment training program can be effective on anthropometric indices of children with CLD. For this purpose, the use of this educational method is recommended to improve the anthropometric indices of these children.

Medical education is competitive across the globe. The long duration of the medical and paramedical courses and exposure to clinical settings potentially causes mental health issues. The aim of this study was to estimate the prevalence of depression, anxiety and stress among undergraduate students in a private medical college in South India.

This cross‑sectional study was conducted among paramedical and medical students at a private medical college hospital and research center in South India in the year 2021. The required sample size was calculated as 783 with an expected prevalence of 53%, 95% confidence interval (CI), design effect 2.0, and non‑response of 10%. The study participants were selected based on simple random sampling. After obtaining informed consent, the data was collected using an email questionnaire. Standard data collection tools such as the Perceived Stress Scale (PSS); and the Depression, Anxiety and Stress Scale ‑ 21 (DASS‑21) questionnaire were used. The investigator computed the odds ratio (OR) and adjusted odds ratio (aOR) with a 95% CI.

Out of 1200 students, 1015 (85%) responded to the email questionnaire. Among them, 639 were females (63%), and 925 were paramedics (91%). Prevalence of depression, anxiety and stress were 59%, 43% and 11%, respectively. Almost 95% of students experienced moderate‑to‑severe stress in the last one month. Prevalence was higher among females and students of medical courses. Students of final year of college (aOR = 2.0; 95% CI = 1.2–3.5) and students of medical course (aOR = 1.5; 95% CI = 1.1–2.4) were independently associated with stress among the study participants.

There is high prevalence of depression, anxiety and stress among medical college students in south India. The final year of study and medical course were independently associated with higher stress than others. We recommend periodic assessment of mental health status and additional mental health care for final year students and medical students.

Anxiety is the most common health problem and the second leading cause of disability worldwide. Patients undergoing surgery often experience anxiety. It is necessary to use appropriate interventions to achieve the best results. The aim of this study is to develop, implement, and evaluate of anxiety management program for gynecological surgery patients under spinal anesthesia.

This participatory action research will be conducted through four phases; problem identification, planning, action, and evaluation phases in the Gonbad‑e‑Kavous Shahada, hospital in northeastern of Iran. These phases will be guided based on the Promoting Action on Research Implementation in Health Services framework. Participants will be included using purposive sampling method. We will use both of qualitative (semi‑structured interview, observation) and quantitative (questionnaire) approaches for data collection through the study.

For anxiety management of patients, context‑based interventions should be performed. Combination of multidimension approach based on health‑care providers, patients, and environment will have an effect to solve the problem in the clinical setting.

The COVID‑19 pandemic has disordered the lives of millions in an unprecedented way. A state of mental health crisis has emerged across the globe. The lifestyle and well‑being of the individual and social integrity have been adversely affected. One‑third of US citizens and one in five Indian citizens suffer from depression due to this pandemic. This scoping review aimed to estimate the mental health challenges and their possible solutions in the recent two years (2020–2021). Our search strategy used search engines such as Medline, Google Scholar and PubMed. The search strategy used the MeSH keywords “Mental Health AND Covid‑19”. The findings emerged in the following key points: anxiety and depression, social isolation and quarantine, and vulnerable or high‑risk groups. Out of 216 articles screened, 20 were found eligible to meet the inclusion criteria. Most of the studies focused on psychological anxiety, stress and mental disorder during the pandemic. Psychosocial assessment and monitoring in the context of COVID‑19 should include inquiries about stressors related to COVID‑19, like exposure to infected sources, infected family members, loss of loved ones, physical distance; secondary adverse events like economic loss, psychosocial effects like depression, anxiety, psychosomatic preoccupations, insomnia, increased substance use, domestic violence; and indicators of vulnerability like pre‑existing physical or psychological conditions.

Improving the quality of clinical education requires continuous review of the current situation, identifying strengths, and correcting weaknesses. This study aimed to investigate the association between academic motivation with quality of clinical education, academic achievement, and burnout.

This cross‑sectional study was done in 2020 on all of the 140 internship students of Shahrekord University of Medical Sciences, using the consensus method. The data collection tools included standard questionnaires such as Herman’s Academic Motivation, Clinical Education Quality, Maslach Modified Academic Burnout, Pham and Taylor Academic Achievement, Satisfaction of Educational Welfare Facilities. Data were analyzed using SPSS (ver. 22) software and descriptive statistics (mean, standard deviation, frequency and percentage of frequency), Spearman rank, correlation coefficient and Mann–Whitney and Kruskal–Wallis statistical tests. P < 0.05 is considered statistically significant.

The mean ± SD of age was 25.68±2.03. 86 (61.4%) of the internship were female and 87 (62.1%) were single. Mean± SD of academic motivation and quality of clinical education were 81.51± 8.73 and 28/99± 11/52 respectively. Also, the Mean± SD of academic achievement and academic burnouts were 147/61± 14/94 and 42/37± 10/42 respectively.

Academic motivation had a meaningful and positive relationship with academic achievement and satisfaction of welfare facilities but a negative correlation with academic burnout. Also, academic achievement and academic burnout had a negative correlation but a positive correlation was seen between the quality of clinical education and satisfaction of welfare facilities.

Considered the results, recommended improving welfare education facilities by using up‑to‑date training aids, upgrading educational infrastructure, and employ young staff in the education office. For improving the quality of clinical education, appropriate educational methods, conducting developmental assessments continuously, using simulated environments, and improving students’ motivation.

Obstructive sleep apnea (OSA) is a sleep disorder characterized by intermittent complete and partial airway collapse, resulting in frequent episodes of apnea and hypopnea. The Berlin questionnaire (BQ) is a simple, inexpensive instrument used to screen for OSA, which is about risk factors for sleep apnea, namely, snoring behavior, daytime sleepiness or fatigue, and the presence of obesity or hypertension. This 10‑question test has since then become well known for its accuracy in predicting the presence of sleep apnea in patients. Cephalometry is a relatively inexpensive method and it permits a good assessment of the soft tissue elements that define the soft palate and its surrounding structures. Therefore, the present study aims to study the morphology of the soft palate using lateral cephalometry and classify it into various types. And to identify the individuals with OSA syndrome through a particular type of soft palate and correlate it with the BQ.

This prospective study was conducted in the Department of Oral Medicine and Radiology of D.Y.Patil Dental College, Pune. About 150 subjects for the study were selected by random sampling from the outpatient department of Oral Medicine and Radiology and the patients were referred from the orthodontics department. Lateral cephalograms were assessed for soft palate morphology types, and all participants filled the BQ. A Chi‑square test was applied. The level of significance was set at P < 0.05.

Among six types of the soft palate, the maximum number of participants had type 2 (rat‑tail type) of the soft palate (26.0%). A highly significant association was found between the BQ (positive and negative response) and soft palate morphology types (i.e., P < 0.01). A maximum number of participants who responded to the BQ had type 5 (S type) of the soft palate (76.47%).

The type 2 (rat‑tail) soft palate was the most frequent type, while the type 4 (straight‑line) shape was the least common among all the six types. The persons with type 5 (S‑shape) soft palate responded more positively to the BQ as compared to other types of soft palate. This shows that a particular type of soft palate could be responsible for causing OSA syndrome. CLINICAL SIGNIFICANCE: Lateral cephalogram and BQ, which are relatively inexpensive and widely available, can be used in resource‑limited and thickly populated countries like India to correctly identify patients with OSA syndrome.

Social skills are necessary for teenagers to have good interactions, accept roles, and adapt to conditions in the community. The present study investigated the effect of cognitive‑behavioral educational intervention on students’ social skills.

This experimental study was completed on 102 female students in Khomeini Shahr, Isfahan. Fifty‑seven students participated in the online cognitive‑behavioral educational program of social skills for five sessions, and 57 students were assigned to the control group. The data from the Matson Evaluation of Social Skills with Youngsters (for subjects aged 4–18 years old) were collected before and 1 month after the interventional program. The data were analyzed using SPSS 25, independent t‑test, Mann–Whitney test, and Chi‑squared test.

The independent t‑test showed that before the intervention, the total mean score of social skills and its variables were not significantly different between the intervention and control groups (P > 0.05). However, after the intervention, the total mean score of social skills and the variables of appropriate communication skills, relationship with peers, and impulsive behaviors in the intervention group was significantly more than the control group, but the mean scores of antisocial and arrogant behaviors (haughtiness) were not significantly different between the two times in the intervention and control groups.

The results show that participation in educational intervention significantly increased student’s social skills development; it is suggested to incorporate cognitive‑behavioral intervention in educational programs for adolescents.

Coronavirus disease 2019 (Covid‑19) pandemic has increased virtual education use. This study aimed to determine the attitude of nursing students of Ahvaz Jundishapur University of Medical Sciences towards virtual education and its relationship with their satisfaction during the Covid‑19 pandemic.

This descriptive‑analytical study was conducted during 2020–2021 with the participation of 229 nursing students (undergraduate, graduate, and doctoral) who had spent at least one semester virtually at Ahvaz Jundishapur University of Medical Sciences. The sampling method was convenience. The data collection tool was a questionnaire consisting of three parts. The first part included students’ demographic information and the second and third parts included the standard questionnaire of individual development and educational assessment to determine students’ attitudes toward virtual education and their satisfaction with this type of education. IBM SPSS statistics 22 software and descriptive and analytical statistical tests were used for data analysis.

According to the study results, the mean score of students’ attitudes toward virtual education was 35.1 ± 11.3 and the mean score of students’ satisfaction with this educational method was 88.3 ± 30.6, both of which are at the desired level. Also, a direct relationship was found between students’ attitudes and satisfaction scores (P < 0.001).

In this study, the attitude of nursing students to virtual education and their satisfaction with this educational method had been at the desired level. Therefore, the relevant authorities should also consider the necessary planning in the field of using this educational method and improving students’ attitudes towards it under normal conditions.

A growing body of literature now identifies higher levels of anxiety, depression, and stress among medical students as a distinct mental health domain. The competency‑based medical education (CBME) curriculum was introduced to revamp the existing curriculum with an aim to garner constructive impact on the mental health of undergraduate medical students. As such, we sought to draw comparisons between the mental health of medical students, studying the old (2018 batch) and the new (2019 batch) medical education systems in India.

We designed a survey that contained structured questions pertained to anxiety (HAM‑A, GAD‑7), depression (HAM‑D, BDI), and stress (PSS) amongst medical undergraduate students of 2018 and 2019 batches at the Government Doon Medical College (GDMC), Dehradun, India.

Contrasting the 2018 and 2019 batches, the introduction of CBME resulted in a significant two‑fold decrease in moderate anxiety, as exhibited by both HAM‑A (6.0 vs 3.0, P = 0.016) and GAD‑7 (3.5 vs 1.0, P = 0.037) scales, although no significant change in mild and severe anxiety, and overall depression (BDI: P = 0.05, HAM‑D: P = 0.05) or stress (PSS: P = 0.86) was found.

The CBME system has made a significant impact on the mental health of undergraduate medical students for anxiety, albeit its effect on depression and stress remains equivocal. Future studies are warranted to compare the effect of CBME in other undergraduate and postgraduate courses across the country to help predict the psychological impact of the newfangled CBME education system.

The high prevalence of coronavirus disease‑2019 (COVID‑19) has a lot of stress on medical students. This study was conducted to investigating the adaptation strategy with COVID‑19 health anxiety in nursing students

This study was designed as a cross‑sectional study. Participants of the study were 431 students of the Nursing and Midwifery Faculty of Shahid Beheshti University of Medical Sciences. Inclusion criteria were studying at the time of the outbreak of COVID‑19 and willingness to participate in the study. Data collection tools included participated in the study. Data collection tools included a demographic questionnaire, Health Anxiety and Coping Inventory for Stressful Situations (Short Form). Reliability of tools was assessed and confirmed with Cronbach’s alpha coefficient. Cronbach’s alpha coefficient of health anxiety was 0.76 and Cronbach’s alpha coefficient of Coping Inventory for Stressful Situations was 0.79. Data were collected between July 2020 and September 2020. Pearson’s correlation coefficient was used to examine the relationship between the data. Data were analyzed with SPSS 26.

Findings indicated that most of the participants were female, single, 22–28 years old, and undergraduate students. The mean of COVID‑19 health anxiety was 5.59 ± 17.04. Results showed that 19.58 ± 5.05 of the participants used avoidance‑focused adaptation strategies, 25.12 ± 3.88 problem‑focused adaptation strategies, and 19.32 ± 5.13 emotion‑focused adaptation strategies.

The COVID‑19 health anxiety was higher in female, young, and married students. The problem‑focused adaptation strategy should be further taught so that students can better coping with COVID‑19 health anxiety.

Tobacco is one of the biggest threats to the public health. Tobacco harms not only human health but also the environment. The Cigarette and Other Tobacco Products Act (COTPA) was implemented in India in 2003. Compliance of these laws in public places is mandatory. This study presents an innovative model to make hospitals tobacco‑free. The aim is to assess the effectiveness of implementation of tobacco‑free hospitals among security guards, tobacco users, and key observers visiting a tertiary care dental hospital through a comprehensive strategy.

An exploratory study was conducted in three phases. Structured training was organized for all security guards (n = 25) along with pre‑ and post‑assessment using a validated questionnaire. All the patients and attendants entering the hospital were screened for tobacco products by security guards. Those patients who were carrying tobacco products to the hospital (n = 107) were interviewed using a validated questionnaire. Opinions of key observers (n = 223) who witnessed the event were also recorded. Descriptive statistics (means, frequency distribution) and inferential statistics (Chi‑square test) were calculated.

At the baseline, only 20% security guards were aware about tobacco legislations, whereas after 1 month, more than 80% security guards were aware about the laws. Around two‑third of study participants of both the groups were aware of COTPA Section 4. Approximately 33.6% of tobacco users and 58.4% of key observers were aware of COTPA Section 6b. Forty tobacco users in the study availed tobacco cessation services of the hospital.

Every staff should be a torch bearer of tobacco control. The study highlights a comprehensive approach of integrating hospital staff and linking vital cessation services by implementing Sections of COTPA.

The COVID‑19 pandemic has become a major problem for education systems. This study was conducted to investigate the effect of educational intervention based on the self‑efficacy theory of high‑school students in adopting preventive behaviors of COVID‑19.

This quasi‑experimental study was performed on Hazrat Zahra and Shahed high‑school students in Jahrom (southern Iran) in 2021. In total, 160 students (80 each in the intervention group and the control group) were selected by multistage random sampling. Data collection tools included a demographic information questionnaire and self‑efficacy in adopting preventive behaviors from COVID‑19 researcher‑made questionnaire. Questionnaires were completed by all participants before and 3 months after the educational intervention. The educational intervention was performed for 6 weeks by using an educational program based on Bandura self‑efficacy theory. The intervention was performed during 12 sessions of face‑to‑face training in the classroom (two 1‑h sessions per week), distributing educational packages and sending educational videos through cyberspace. Data were analyzed using Chi‑square test, independent t test, paired t test, and linear regression.

After the educational intervention, a significant difference was observed in the intervention group before and after the educational intervention (P = 0.018) and between the intervention and the control groups (P = 0.001) in the self‑efficacy in adopting preventive behaviors from COVID‑19 score. Also, the average self‑efficacy score of students increased with an increase in parental education level and a history of COVID‑19 in family members.

Educational intervention based on self‑efficacy theory was shown as an effective method to improve students’ self‑efficacy in adopting preventive behaviors from COVID‑19.

The rapid and widespread of COVID‑19 has caused distress and havoc among people in all walks of life. Such impact has been more pronounced among HCWs. We sought to examine how health care workers (HCWs) knowledge about COVID‑19 and perceived anxiety can influence preventive practices.

In this cross‑sectional study a multiple regression analysis was applied to examine the relationship between knowledge, anxiety, and preventive practices among 267 participants work in different settings in a variety of health care organizations in different regions in Saudi Arabia. To estimate potential associations, a multiple regression analysis was applied. Standardized beta‑coefficients and their 95% confidence intervals were estimated to examine the outcome variable and the predictors’ associations.

Our findings shows that HCWs had high levels of knowledge about COVID‑19, perceived anxiety, and preventive practices. In examining the relation between HCWs characteristics and their knowledge about COVID‑19, older HCWs have been shown to have higher knowledge compared to younger HCWs. Finally, the model to estimate the impact of knowledge about COVID‑19 and perceived anxiety on preventive practice showed that both have a significant impact.

HCWs tendency to adhere to preventive practices is related to their levels of knowledge and perceived anxiety. Such a relationship can inform administrators and policymakers in the health care field to design health promotion campaigns to ensure all HCWs are aware of the nature of communicable diseases and the risk they might entail.

In 2019, the COVID‑19 pandemic posed a major challenge to the world. Since the world is constantly exposed to communicable diseases, comprehensive preparedness of countries is required. Therefore, the present systematic review is aimed at identifying the preparedness components in COVID‑19. In this systematic literature review, PubMed, Scopus, Web of Science, ProQuest, Science Direct, Iran Medex, Magiran, and Scientific Information Database were searched from 2019 to 2021 to identify preparedness components in COVID‑19. Thematic content analysis method was employed for data analysis. Out of 11,126 journals retrieved from searches, 45 studies were included for data analysis. Based on the findings, the components of COVID‑19 preparedness were identified and discussed in three categories: governance with three subcategories of characteristics, responsibilities, and rules and regulations; society with two subcategories of culture and resilience; and services with three subcategories of managed services, advanced technology, and prepared health services. Among these, the governance and its subcategories had the highest frequency in studies. Considering the need to prepare for the next pandemic, countries should create clear and coherent structures and responsibilities for crisis preparedness through legal mechanisms, strengthening the infrastructure of the health system, coordination between organizations through analysis and identification of stakeholders, culture building and attracting social participation, and service management for an effective response.

A non‑stress test (NST) is an essential diagnostic test performed during pregnancy to assess fetal well‑being. It is a recording of fetal movements besides fetal heart rate, indicating fetal biophysiological well‑being. As maternal physiology is altered in various positions, apt positioning during the NST is essential for accurate results while ensuring maternal comfort. This study aims to evaluate the effect of different maternal positions, left lateral and semi‑fowler’s, on NST reactivity, maternal blood pressure, heart rate, and comfort in pregnant women while performing the NST.

This crossover study evaluated 50 healthy pregnant women between 32 and 40 weeks of gestation with no obstetric complications for the effect of maternal positions on maternofetal physiological parameters and comfort. The NST was performed for 20 min in each position with a washout period of 10 min. The maternofetal physiological parameters were recorded by a calibrated sphygmomanometer and the electrocardiograph interpretations. The maternal comfort was assessed using a maternal comfort rating scale (MCRS) for each position after the NST. Relevant descriptive and inferential statistics are applied to compute the results.

Statistically, there was a significant difference in the mean maternal blood pressure and heart rate between the left lateral and semi‑fowler’s positions at 0 and 20 min (P = 0.001), whereas within the groups, in the same position at 0 and 20 min, no significant difference was found. There was no significant difference in NST reactivity (P = 0.79) in different positions. There was no significant difference between the MCR scores of women in either of the positions (Z = −1.64, df = 49, P = 0.100).

Semi‑fowler’s position demonstrated favorable maternal blood pressure and heart rate during the NST in the third trimester of pregnancy, though it was clinically not significant. There was no significant difference in the comfort of women in both positions. Hence, either of the positions can be implemented in practice as an alternative position while performing the NST, based on the women’s preference.

BACKGROUND AND

Cardiovascular diseases (CVDs) are the most important cause of death in Iran and the Kermanshah province. One of the most important problems that cardiovascular patients are dealing with is the psychological consequences of their illness. This study aimed at investigating the effectiveness of Meaning‑Centered Group Psychotherapy (MCGP) intervention in improving spiritual well‑being and reducing anxiety in cardiovascular patients.

The study population included all patients referred to specialized cardiovascular centers in Kermanshah province in 2019. The participants consisted of 30 patients who were randomly assigned into experimental and control groups after the primary and secondary screening. The experimental group received routine treatment + MCGP (8 weeks and 90–120 min per session) and the control group only received routine treatment. The dependent variables were assessed by Spiritual Well‑Being Scale and Beck Anxiety Inventory before and after receiving the treatment and 2 months after the treatment. ANCOVA and multivariate analysis of covariance were applied to the data through SPSS‑22. IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.

The results of covariance analysis showed that MCGP increased spiritual/existential well‑being and decreased anxiety in the experimental group (P < 0.001), while no significant difference was traced in the control group.

The findings of this randomized controlled trial provide good evidence for the effectiveness of MCGP as a treatment to improve the psychological and spiritual/existential distress in patients with CVDs.

Treatment adherence is one of the behaviors associated with type 2 diabetes that predicts whether it will be successfully treated or develop complications and become uncontrolled. This study aimed to determine factors affecting nonadherence to treatment among diabetic patients with limited health literacy from the perspectives of patients, their families, and healthcare providers.

This qualitative study with a content analysis approach was conducted on 84 eligible type 2 diabetes patients with limited health literacy and poor adherence to treatment, as well as their families and healthcare providers using a purposive sampling method, in Kerman city in 2021. Interviews were conducted using a semistructured interview guide with a broad, open‑ended question to provide a general history of the disease separately. The interviewer asked participants to identify the perceived barriers to treatment nonadherence. Each interview lasted 45–60 min. MAXQDA version 20 and inductive content analysis were used to code and analyze extracted data.

Four major themes emerged from the patients’ perspectives as “financial problems,” “individual factors,” “problems related to medication availability,” and “healthcare providers’ poor practices.” Two major themes were classified from the perspective of patients’ families as “financial problems” and “Individual factors,” and four major themes were identified from the viewpoint of healthcare providers including “financial problems,” “individual factors,” “scarcity and medication availability,” and “poor practice of the healthcare provider.” These mentioned barriers were confirmed regarding treatment nonadherence among study participants.

Study findings revealed different factors of treatment nonadherence among diabetic patients with limited health literacy. Therefore, these factors should be considered in tailoring promotive educational and supportive interventions. Considering the importance of adherence to treatment patients, planning empowerment family‑based interventions focusing on health literacy improvement seems necessary

The interaction between medical students and frontline healthcare workers is one of the crucial components of community medicine. The interaction of medical students with frontline healthcare workers provides multiple opportunities. Medical students like to understand their job responsibilities and their involvement in implementing the various national health programs at the community level. Innovation is required to train our medical students better and enhance their learning. A learning and teaching innovation was developed by us to provide insight into the various roles and involvement of frontline healthcare workers in the community. One innovation is the A‑Z activity calendar of frontline healthcare workers in teaching and learning in medical education.

Job satisfaction is one of the most important issues related to human resources in the organization which can reduce organizational productivity. In this regard, occupational health is an important science related to the health of the workforce in any organization, paying attention to it will help health promotion. The aim of the present study was to determine the relationship between the status of occupational health management and job satisfaction among farmers with a health promotion approach.

This cross‑sectional study was conducted in 2020. The number of 209 farmers from all villages of Zabol was included by census method. Data were collected using a researcher‑made questionnaire that consisting of three sections of demographic information, occupational safety and health status, and standard job satisfaction questionnaire. At first, the validity and reliability of the questionnaire were evaluated. In addition, 5–10 staff working in Agricultural Jihad Organization were asked about the content, clarity, and simplicity of the questionnaire terms. Content validity index and content validity ratio indexes were calculated as 0.68 and 0.83 for occupational health management and 0.69 and 0.83 for job satisfaction questionnaires, respectively. Instrument reliability was also assessed using the Cronbach’s alpha coefficient, which was 0.872. Finally, after verifying the validity and reliability of the instrument, a questionnaire was used to collect the research data. Shapiro–Wilk, Wilcoxon, and Spearman correlation tests were used to analyze the findings. The collected data were analyzed using SPSS software version 19. Armonk; NY, USA: IBM Corp.

The results of the study indicate that occupational health management was at a moderate to a high level (3.701) and job satisfaction (3.381) was at a moderate to a high level. The standard regression coefficient between occupational health management and job satisfaction was obtained as 0.571. With a confidence of 95%, it can be stated that occupational health management in Zabol city under the supervision of jihad‑e‑agriculture organization has a significant impact on farmers’ job satisfaction. In addition, the research findings confirmed a positive and significant relationship between occupational health management and job satisfaction of employed farmers and showed that the implementation of occupational safety and health programs in the jihad‑e‑agriculture organization can affect the job satisfaction of farmers.

According to the evaluation of research findings, job satisfaction and occupational health management in the Agricultural Jihad Organization are relatively favorable among farmers in Zabol city. It was argued that there is a relationship between occupational health management and job satisfaction, that the implementation of programs related to occupational safety and health management system such as Health and Safety Executive will promote health.