Understanding the reasons for not getting the COVID‑19 vaccine can help to increase acceptability and tackle vaccine hesitancy and consequently reach high coverage for this new vaccine. Using an ecological approach, the reasons for not getting the vaccine in the Iranian population was investigated.

METHODS AND MATERIAL:

 This study was conducted from October to December 2021 on 426 participants who had not received the COVID‑19 vaccine. The following subsets of questions were included in the questionnaire: intrapersonal level factors, interpersonal level factors, group and organization, and society and policy‑making. Multivariable logistic regression was used, and the odds ratio (OR) and 95% confidence intervals (CIs) were estimated for vaccine hesitancy (dependent variable) according to the reasons for not getting COVID vaccine scores (independent variable) using multivariable logistic regression in 3 different models, including Model 0: unadjusted, Model 1: adjusted for age, gender, and underlying disease, and Model 2: adjustment for age, gender, underlying disease, education, place of living, income, marital status, and employment.

A significant difference was found regarding gender between likely and not likely groups (P = 0.016). A significant association was observed between the vaccine hesitancy and interpersonal (unadjusted model: OR = 0.833 (CI: 0.738–0.942), P for trend = 0.003; model 1: OR = 0.820 (CI: 0.724–0.930), P for trend = 0.002; model 2: OR = 0.799 (CI: 0.703–0.909), P for trend = 0.001) and group and organization (unadjusted model: OR = 0.861 (CI: 0.783–0.948), P for trend = 0.002; model 1: OR = 0.864 (CI: 0.784–0.952, P for trend = 0.003; model 2:OR = 0.862 (CI: 0.781–0.951, P for trend = 0.003). There was no significant association between vaccine hesitancy and intrapersonal and society and policy‑making (P > 0.05).

We found that a high score of “interpersonal” and “group and organization” factors were associated with lower intention to COVID vaccine. Moreover, women had higher vaccination intentions than men.

Epilepsy is one of the major neuron‑damaging neurological disorders. Generalized tonic‑clonic seizure (GTCS) is the commonest one. Refractory patterns cannot be controlled by simple monotherapy with antiepileptic drugs (AEDs). Valproic acid (VPA) is one of the widely prescribed AEDs but it may not control many cases up to its maximum tolerable doses. In this study, we have seen the safety and efficacy of clobazam to control seizure in the adult population as an add‑on drug over valproate, in cases of valproate uncontrolled seizures.

Patients on VPA monotherapy but not responding to it were recruited after applying inclusion and exclusion criteria and clobazam was added. There were two follow‑ups at the interval of 6 months each. Seizure frequency and quality of life inventory in epilepsy‑31 items (QOLIE‑31) score were recorded to denote efficacy, and the occurrence of any adverse effect was also noted to elicit safety.

Out of 101 patients, 78 were male and 23 were female. The most common age group was 18–30 y. Seizure frequency from 2.99 ± 0.95 decreased significantly on the third visit to 0.25 ± 0.43. QOLIE‑31 scores of seizure worry, overall quality, emotional well‑being, and cognition improved in the second follow‑up. Fatigue, somnolence, and weight gain were the major side effects.

Clobazam could be a good choice as an add‑on in GTCS not controlled with VPA monotherapy. Clobazam definitely reduces seizure frequency and seizure worry and improves cognitive function and overall quality of life.

The aim of this study was to compare the effectiveness of head trauma management education by the scenario method versus lecturing on clinical decision‑making by pre‑hospital emergency staff.

This was an educational trial on 60 pre‑hospital emergency staff, performed in Saveh in 2020–2021. The participants fulfilling inclusion criteria entered the study and were randomly allocated to two groups: scenario (n = 30) and lecture (n = 30). Clinical decision‑making scores for head trauma patient management were determined at the beginning and end of the study using a researcher‑made questionnaire. Data were analyzed using descriptive and inferential statistics and SPSS software version 16.

At post‑intervention, the mean score of clinical decision‑making was 75.28 ± 11.7 in the scenario group and 68.55 ± 11.91 in the lecture group. The results of the independent t‑test showed that the mean score of clinical decision‑making was significantly higher in the scenario group compared with the lecture group (p = 0.04). The results of paired t‑test showed a significant increase in the mean score of clinical decision‑making in both groups after the intervention (p < 0.05); however, the mean of increment was higher in the scenario group (9.77 ± 7.63) than in the lecture group (1.79 ± 3).

Regarding the impact of scenario‑based education on learners’ intellectual abilities and creativity, it seems that this type of education can be an appropriate alternative to traditional educational methods. Therefore, it is suggested to incorporate this method in the training programs of pre‑hospital emergency staff.

Type 1 Diabetes Mellitus T1DM is a chronic disease, mainly observed in children or young adults, with a significantly increased incidence in young children. To enable diabetic children and adolescents to lead a healthy life and manage their disease effectively, right from diagnosis, they must benefit from therapeutic patient education TPE whose first stage is an educational diagnosis. This study aimed to identify the educational needs of T1DM children and adolescents through an educational diagnosis.

METHODS AND MATERIAL:

 A qualitative study was conducted with T1DM children and adolescents, aged 8 to 18, at the pediatric department. This qualitative study was conducted through semi‑structured face‑to‑face individual interviews based on a guide with 20 participants in 2022. The internationally recognized ethical research principles were respected and ethical approval was obtained. Data analysis were carried out according to the principles of the reflexive approach of thematic analysis.

The interviews’ thematic analysis revealed five educational themes: Knowledge about T1DM and its complications risks, measures and attitudes for disease monitoring and therapy management, crisis and short‑term complications management, diet and physical activity management, and adaptation of daily life to the disease and treatment constraints.

The educational diagnosis is an essential TPE step to identify the educational needs of children and adolescents with T1DM, and to set up if needed, an educational program allowing them to develop the required skills. Hence, the health policy in Morocco should integrate the TPE approach systematically in T1DM patients’ care.

Falling in the elderly causes a variety of issues such as dependence, decreased self‑efficacy, depression and limitation in daily activities, hospitalization and imposition of costs on the individual and society. The aim of this study was to investigate the prevention of falls in the elderly at home by applying the Precaution Adoption Process Model.

In this quasi‑experimental study, 200 elderly people participated, 100 of whom were in the intervention group and 100 in the control group. The sample was provided via stratified random sampling. The data collection instruments were a researcher‑made questionnaire including demographic details, as well as the Precaution Adoption Process Model (PAPM) questionnaire. Educational intervention was performed during four 45‑minute sessions, following which the data was analyzed through SPSS 20 software and was evaluated based on the Chi‑squared, Mann–Whitney U, Wilcoxon, and Fisher’s exact tests.

Investigating the distribution of participants in the phases of the PAPM indicated that most participants of both the intervention and control groups were in the passive fall prevention phase before treatment. However, after the intervention, most participants of the intervention group were in the active phases of fall prevention, while there were not any significant changes in the control group. Moreover, comparing the mean of the structures of knowledge, sensitivity, severity, benefits, perceived self‑efficiency, and the cues to action in terms of preventing falls after the intervention, showed a significant increase in these structures in the intervention group compared to the control group (P < 0.001). Eventually, the findings of the study showed a significant decrease in the percentage of falls of the participants of the intervention group compared to that of the control group after the intervention (P = 0.004).

Educational intervention on the basis of the PAPM promoted the elderly precaution from passive phases to active phases of preventing falls, thereby resulting in a decrease in the number of falls of elderly people.

Health is a paramount issue in every society. Children’s lives are more dominated by two main environments, which are the home and the school. Children’s health is most affected when they encounter disease‑laden environments; hence, schools have high influence in their health. Schools also serve as health promoting agencies and have a strong bidirectional relationship between a child’s holistic wellbeing and education. Children are the best teachers who have the charisma to be influential change agents in reciprocating what is taught to them as healthy behavior. This paper is focused on the child‑to‑child approach in disseminating the importance of health among school‑age children and the importance of molding them into change agents. The objective is to systematically review all literature works answering the question “Is Child‑to‑Child approach effective in disseminating health information’s among school children?”. Using critical appraisal skills program (CASP) framework and a data extraction form, articles were retrieved from different databases, including Scopus, CINAHL, PubMed, ProQuest, and EBSCOHost. These articles were published between 2003 and 2020. After critically appraising 85 articles based on the inclusion criteria, only 16 were found appropriate for addressing the purpose of this review. Major results of the review were that each of the studies had tested the effectiveness of the child to child approach using different health education topics such as prevention of worm infestation, eating behaviors, first aid measures, hand hygiene practices, importance of Vitamin A, and eye care. Studies reported that this approach empowered children with better health related knowledge and practice. This paper concludes that child‑to‑child approach plays an important role in disseminating health to children either as siblings, peer groups, and to parents.

Some residents of the Persian Gulf Coastline (PGC) areas are circular migrants due to geo‑commercial issues. They have a higher risk of HIV infection and non‑disclosure of their HIV/AIDS status. These people who live with HIV (PLHIV) are considered as the bridge population for HIV transmission to general population, especially adolescents. This study sought to investigate the knowledge and behavior of adolescents regarding HIV/AIDS prevention and transmission in a less‑developed, high‑risk area located along the PGC.

In this cross‑sectional study, using multistage cluster random sampling, 1450 students were invited to complete a standardized questionnaire previously used in a 2013 Iranian national high‑risk behaviors survey. The prevalence of adequate knowledge, condom use, and stigmatization of HIV/AIDS and their 95% confidence intervals (CIs) were estimated. Adjusted odds ratios (ORs) were estimated using ordinal logistic regression.

Totally, 17.09% (CI: 15.0–19.3) of the students had adequate knowledge. Social networks and the internet were the most important sources of information (20.9%, CI: 18.6–23.3). Socioeconomic status (OR: 2.0, 95% CI: 1.7–2.3), gender (0.6, CI: 0.5–0.8), residential area (0.08, CI: 0.05–0.1), and using social networks and the internet as the main sources of information (1.5, CI: 1.1–1.9) were correlated to the level of knowledge. Furthermore, 29.8% (CI: 27.2–32.5) of the students respected the social rights of PLHIV, and 12.6% (CI: 10.7–14.6) reported condom use.

HIV/AIDS‑related education is needed in the PGC. Such education should be focused on males, students from marginalized areas, and people with lower socioeconomic status. Social networks and the internet may be the most effective way to improve people’s knowledge about HIV/AIDS.

Child sexual abuse is a global concern for families and societies. Therefore, child protection from sexual harassment is of particular importance. The present study aimed to investigate the concept of sexual self‑care in children.

The present research is a qualitative study conducted with a content analysis approach. The study participants include 39 child sex education specialists, parents of children aged 4–7 years, adolescents who were sexually abused in childhood, and those with no experience of sexual abuse in childhood. The participants were selected through purposive sampling method. Different people’s interpretations of the concept of sexual self‑care in children were explored using semi‑structured and face‑to‑face interviews, which continued until the saturation of concepts. Data were analyzed using the Graneheim and Lundman method. Guba and Lincoln’s criteria were used to strengthen the validity and transferability of the data.

Sexual self‑care in children was identified from participants’ viewpoints in the study. This self‑care includes three main components and six subcomponents of (1) knowledge about privacy, risk situation, and trustworthy people, (2) attitude and perception of risk, and (3) behavioral skills in self‑protection (i.e., post‑injury reaction).

Further injuries can be prevented by improving the level of awareness, forming the right attitude, and strengthening children’s behavioral skills toward sexual self‑care. Such issues, which are representatives of privacy, risk situations, and self‑protection ability, can improve children’s sexual self‑care skills.

Approximately one‑fourth of individuals who seek treatment in outpatient medical settings have Medically Unexplained Physical Symptoms (MUPS), a prevalent medical ailment. Patients with MUPS have a considerable functional impairment, and a lower quality of life, and may also have co‑occurring psychiatric conditions.

Eleven Focus Group Discussions (FGDs) (four virtual and seven face‑to‑face) were conducted with patients, caregivers, and healthcare professionals in 2021 in a tertiary care hospital in New Delhi. Thematic analysis was carried out using QSR Nvivo software.

A total of 36 participants were recruited in the study, including patients with MUPS (n = 12), caregivers (n = 10), and healthcare professionals (n = 14) dealing with the patients of MUPS. Three themes were identified: burden of MUPS, symptom profile of patients with MUPS, and psychological profile of patients with MUPS. These were further categorized into eight sub‑themes: prevalence, symptoms, course of illness, improvement with treatment, duration of symptoms, attribution of symptoms, psychological impact, and coping strategies.

The study helped us to gain insight into the characteristics and experiences of patients, caregivers, and healthcare professionals dealing with MUPS in an Indian setup. Greater awareness of MUPS and training of care providers about the occurrence, management, and referral of MUPS can be beneficia.

Abortion is can led to certain psychological problems that may decreased self‑esteem, and concerns about future fertility. Abortions have multiple psychological consequences such as grief, anxiety, depression, and post‑traumatic stress. The purpose of this study is to examine the effect of cognitive behavioral counseling intervention on women in post‑abortion period.

This research was a randomized, controlled trial study that was conducted on 168 women during the post‑abortion period at the Khalill Azad Center of Larestan (Iran), where the women were selected randomly from February 2019 to January 2020. Data were collected using post‑abortion grief questionnaire. All women in the post‑abortion period answered the perinatal grief scale questions at the beginning of the intervention, immediately after the intervention and three months after the end of the intervention. Data were analyzed through descriptive statistics and repeated measures analysis of variance (ANOVA) with time and group were used to evaluate the effect of intervention.

By using repeated measures ANOVA, the comparison of the mean score of grief in the two groups indicated that the scores decreased over time and it was lower in the intervention group. The mean score of grief between the intervention and control groups at the end of the intervention was 67.59 ± 13.21 and 75.42 ± 12.7, respectively (P < 0.001). Mean post‑abortion grief score in the intervention and control groups three months after the intervention were 59.41 ± 13.71 and 69.32 ± 12.45, respectively (P < 0.001).

According to results of this study, it can be concluded that the use of cognitive behavioral counselling can reduce post‑abortion grief intensity or prevent the occurrence of complicated grief. Therefore, this method can be used as a preventive or therapeutic approach to control post‑abortion grief and other psychological disorders.

The National Family Health Survey of India (NFHS‑5) revealed a lapse in the advancement of mitigating anemia despite free supplementation of iron–folic acid tablets (IFAT) and improvement in IFAT coverage during pregnancy. The local sociocultural beliefs and community perspective toward IFAT are pivotal in reducing the gap between IFAT coverage and consumption. Hence, we proposed the study to assess adherence to IFAT among rural pregnant women and explore the associated factors.

The present study was conducted as a mixed‑methods study with a sequential exploratory design in a rural setting of the Model Rural Health Research Unit (MRHRU) from October 2020 to May 2021. Ten focus group discussions (FGDs; 8 – antenatal women, 1 – mother/ mother‑in‑law, and 1 – health care worker) were conducted, and framework analysis was done to identify themes followed by a quantitative survey with a semi‑structured questionnaire among antenatal women (n = 236). Logistic regression was used to analyze factors associated with adherence.

The major themes that emerged from FGDs were the sociocultural factors (gender norms, communal fallacies), lack of awareness, and drug‑related factors (unpalatability, misperceptions, and experienced side effects). Around 57% were adherent to IFAT. Side effects experienced on IFAT intake (P = 0.001, OR = 2.33), misconceptions regarding IFAT, like weight gain in IFAT use (P = 0.001, OR = 2.86), a big baby with IFAT use (P = 0.000, OR = 5.93) negatively influenced adherence.

The significant gaps between IFAT coverage and consumption surrounded the unpleasant odor and stench of IFAT, side effects, lack of individualized counseling, and misperceptions regarding IFAT use.

Emergency medical technicians (EMTs) play a pivotal role in the management and treatment chain of emergency patients and their health outcomes. Knowing the clinical reasoning pattern in prehospital procedures is of particular importance that can help to develop a correct clinical decision‑making process in this group. Therefore, this study aimed to clarify the clinical reasoning in EMTs and evaluate its compliance with the “illness script” theory.

This descriptive–analytical study was conducted in 2021 at Hormozgan University of Medical Sciences (HUMS) by involving EMTs in two groups of experts and novices. To collect and analyze participants’ mental script‑based information, the “think aloud” method was used. In the content analysis of extracted protocols, two main steps were considered: 1) preparing a suitable map to compare the protocol with the base pattern and 2) quantifying the relationship between the protocol and the base pattern. Statistical Package for the Social Sciences (SPSS)‑21 software, the Shapiro–Wilk test, and the independent t‑test were used for analyzing quantitative data.

After exploring the concordance of the clinical reasoning of EMTs with the base pattern, results showed that the components of Enabling condition and Management were consistent with the illness script strategy. Pathophysiology and Diagnosis components did not conform to the base pattern. Regarding Signs and Symptoms, these were significantly different from the classic pattern of illness script. A new component called Contextual insight was suggested for this pattern. Generally, on comparing the clinical script content of experts and novices, only two components of Pathophysiology and Diagnosis did not show any significant difference (P > 0.05) between these two groups.

Results of evaluating the clinical reasoning of the under‑study groups showed that in some components of the pattern, they practiced as in other medical groups, but in relation to some components, this was not the case. It is due to the different nature of the prehospital conditions. Also, there is a need to add new components to the base model, which should be considered in distinguishing between expert and novice EMTs.

Practicing self‑care is a requisite for nurses as they face the extreme physical, mental, and emotional challenges presented by the pandemic era. This study aimed to examine factors that contribute to self‑care‑self‑regulation (SCSR) and investigate the mediation effect of psychological and physical health in the relationship between work stress and SCSR among registered nurses in the United States.

This cross‑sectional study was conducted on the data collected from 386 registered nurses who completed an online survey over a 3‑week period during the COVID‑19 pandemic (April 19 to May 6, 2020). The survey assessed demographic and work‑related characteristics, work stress, depressive mood, self‑rated health, and SCSR. The model was tested with depressive mood as the first mediator and self‑rated health as the second mediator. The potential serial mediation effect was analyzed using PROCESS macros adjusting for covariates.

The sequential indirect effect of work stress on SCSR through depressive mood and self‑rated health in series was significant, while its direct effect was not.

The findings of the path analysis demonstrate that psychological and physical health status is important to promote self‑care behaviors when nurses experience high work stress.

The internship is a program for transition of nursing students to the clinical setting. This study was conducted to describe and interpret the experiences of nursing students from the internship program.

This was an interpretative phenomenological study following Van Menen’s approach in six steps. Twelve nursing students were selected from 12 different universities in Iran from April to August 2020. Data was collected through 15 in‑depth interviews (three supplementary interviews) over the course of 25–90 min and verbatim transcriptions. Data were analyzed with MAXQDA version 10 software. The researcher used four Guba and Lincoln criteria to obtain a rigorous study.

In this study, three main themes and eight subthemes were extracted. The main themes included “professional identity development,” “moving toward professional self‑efficacy,” and “developing coping strategies for workplace adversities.” The subthemes were “promoting the cognition of profession,” “acceptance among colleagues as a nurse,” “accepting professional roles,” “self‑awareness of weaknesses in patient care,” “self‑reliance,” “advancing clinical skills,” “adopting effective coping strategies,” and “avoiding tension in clinical settings.”

Nursing internship students have experienced moving toward professionalization with professional identity and self‑efficacy development, and they succeeded in clinical challenges by learning coping approaches.

Nurses are internationally recognized to be largest group of registered and regulated practitioner in the health workforce of any country. There is an increase in number of critically ill patients seeking optimal care, and this rapidly increases the demand for the critical care nurses at the end of life. Caring for a critically ill patient creates anxiety and emotional exhaustion and may sometimes lead to burnout. So, it is imperative for the nurses to have an optimistic approach while caring patients in the ICU. The aim of the study was to assess the attitude of the nurses caring critically ill patients and to determine the association of the level of attitude with the selected personal variable. The study was conducted at ICUs of tertiary care hospital by using descriptive research design.

METHODS AND MATERIAL: 

A cross‑sectional descriptive study was conducted in ICUs of tertiary care hospital from October to December 2018. The sample was selected by total enumeration technique. Data was collected from 60 critical care nurses with the help of self‑structured five‑point Likert scale to assess the attitude of nurses. Descriptive statistics and inferential statistics were used for data analysis such as mean, frequency, percentage, standard deviation, and Chi‑square test.

Majority (81.7%) of the nurses were having favorable attitude toward caring the critically ill patients, and there was no significant association of the attitude score with the selected personal variable at P < 0.05.

Majority of critical care nurses have favorable attitude. If they have supportive environment at workplace, their willingness to work toward quality care will improve further.

The premenstrual syndrome happens periodically and affects both the individual and family. The aim of this study was to determine the effect of the health education program on reducing premenstrual syndrome in high school girls in Ilam.

This experimental study was conducted in girls’ high schools in Ilam, in 2017–2018. In total, 120 students were enrolled in the study (intervention group = 61 and control group = 59) and selected through convenience sampling. In this study, a standard Premenstrual Symptoms Screening Tool (PSST) was used to diagnose students with premenstrual syndrome or Premenstrual Dysphoric Disorder (PMDD). The educational program for the intervention group was held in four sessions of 30 min for 4 consecutive weeks. The obtained data were analyzed by the SPSS statistical software at a significance level of less than 0.05.

The results showed a significant difference in the proportion of cases with moderate and severe PMS and PMDD between intervention and control groups in follow‑up (P < 0.001). However, these proportions were not significantly different between the two groups in the baseline.

According to the results, the educational program can be recommended as an effective intervention for girls with moderate‑to‑severe premenstrual symptoms and premenstrual dysphoric disorder.

There is a strong need for transformation in our assessment systems from one that evaluates performance based on levels of training to another that focuses on professional competence to meet the expected requirements for the practice of the profession. The aim of this study is to validate for the first time a Spanish version of a new tool for assessing the professional performance of residents by nurses newly developed in the Ottawa Hospital (O-RON).

After the author's written authorization, the original O-RON form was translated and cross-culturally adapted. Then we conducted a prospective observational study in two cardiology centers in the city of Buenos Aires. The validity of the tools was evaluated by the ability of the instrument to discriminate the level of experience of the residents according to their post-graduate year level. Data is expressed as percentages and frequencies of the qualifications obtained in the different questions. The chi-square test was used to assess the significance of the differences obtained. A generalizability test was used to evaluate reliability. Feasibility was defined as a minimum of 4 assessments per resident per evaluation round. Satisfaction of evaluators was assessed using a survey with a 10-point scale designed by the authors.

A total of 838 evaluations were performed. Regarding validity, the 15-item form could significantly discriminate the experience of the residents according to their postgraduate year level (P ˂ 0,005). Thirty evaluations per resident are required to obtain reliable results. The tool is feasible to implement and an average of 4.55 assessment per resident per evaluation round were achieved throughout the entire experience. This value remained stable during the 8 rounds (1st: 4.65; 2nd: 4.34; 3rd: 4.47; 4th: 6.17; 5th: 4.56; 6th: 4.08; 7th: 4.36; 8th: 3.91). The levels of satisfaction among the evaluators were acceptable.

The Spanish version of the O-RON form can provide residents with a valuable source of feedback from the eyes of nurses on important aspects of their professional training. This tool, positively assessed by the raters, significantly discriminates residents' experience. Its implementation is feasible in our environment, and it is user-friendly, though it requires a considerable number of assessments to achieve high reliability.

Genus Galanthus (Amaryllidaceae) is an early spring flowering bulbous plant. Galanthus species contain alkaloids that have shown pharmacological activity. Galanthamine is an alkaloid that was extracted from Galanthus and other Amaryllidaceae. Owing to its acetylcholinesterase (AChE) inhibitory activity, galanthamine is used and marketed to treat Alzheimer’s disease (AD). The aim of the present study, while introducing the botanical and pharmacological characteristics and various aspects of the medicinal plant Galanthus, is to emphasize the effect of this plant in the treatment of AD. In this web‑based study in 2021, articles indexed in scientific databases in English language, including ISI Web of Knowledge, PubMed, Scopus, MedLib, Medknow, SID, ISC, and also articles and e‑books published in Springer, Elsevier, John Wiley and Sons, and Taylor and Francis were evaluated from 1990 to 2021, using the following keywords: “Galanthus” “galanthamine,” “Alzheimer’s disease.” Amaryllidaceae‑type alkaloids possess an anticholinesterase activity. The most studied Galanthus alkaloid, galanthamine, is a long‑acting, selective, reversible, competitive inhibitor of AChE and an allosteric modulator of the neuronal nicotinic receptor for acetylcholine (ACh). Owing to its AChE inhibitory activity, galanthamine is used to treat certain stages of AD. Galantamine can act as a parasympathomimetic agent, especially as a reversible cholinesterase inhibitor. Galantamine is not structurally associated with other AChE inhibitors. Hence, its proposed mechanism of action involves the reversible inhibition of AChE, preventing hydrolysis of ACh that results in an increased concentration of ACh at cholinergic synapses.

So far, several protocols have been used for the treatment of coronavirus disease‑2019 (COVID‑19). In this study, we aimed to study the effect of interferon on the treatment of hypoxemia caused by COVID‑19.

This was a quasi‑experiment with a nonequivalent group design. All participants were admitted to Shahid Beheshti Hospital, Qom province. In total, 60 patients were enrolled in the study, and inclusion criteria were age over 18 years, positive PCR test result, pulmonary involvement in computed tomography (CT) scan, and SpO2 level below 93%. Individuals were divided into two control (hydroxychloroquine + lopinavir/ritonavir [Kaletra]) and intervention (hydroxychloroquine + lopinavir/ritonavir [Kaletra] + interferon‑β 1a [recigen]) groups. The data were analyzed in Stata/SE 14.2 using Chi‑square, t‑test, and Mann-Whitney U test.

The mean ± standard deviation (SD) age of patients was 63 ± 16.12 years and 43.3% were male. In terms of outcome variables, 20% of patients in the intervention group and 53.3% of subjects in the control group died and this difference was significant (P = 0.007). According to the quick sequential organ failure assessment (qSOFA) score, the severe cases were 16.7% in the intervention group and 50% in the control group (P = 0.006). In addition, the median days of hospitalization were 11.5 days—significantly higher than those in the control group (5.5 days) (P < 0.001).

Based on the results of this study, the use of interferon in the treatment of COVID‑19 can improve health and reduce the severity of the disease and mortality.

If the data elements needed for patient registries are not identified, designing and implementing them can be very challenging. Identifying and introducing a Data Set (DS) can help solve this challenge. The aim of this study was to identify and present a DS for the design and implementation of the upper limb disability registry.

This cross‑sectional study was conducted in two phases. In the first phase, to identify the administrative and clinical data elements required for registry, a comprehensive study was conducted in PubMed, Web of Science, and Scopus databases. Then, the necessary data elements were extracted from the studies and a questionnaire was designed based on them. In the second phase, in order to confirm the DS, the questionnaire was distributed to 20 orthopedic, physical medicine and rehabilitation physicians and physiotherapists during a two‑round Delphi. In order to analyze the data, the frequency and mean score of each data element were calculated. Data elements that received an agreement more than 75% in the first or two‑round Delphi were considered for the final DS.

A total of 81 data elements in five categories of “demographic data”, “clinical presentation”, “past medical history”, “psychological issues”, and “pharmacological and non‑pharmacological treatments” were extracted from the studies. Finally, 78 data elements were approved by experts as essential data elements for designing a patient registry for upper limb disabilities.

In this study, the data elements necessary for the design and implementation of the upper limb disability registry were suggested. This DS can help registry designers and health data administrators know what data needs to be included in the registry system in order to have a successful design and implementation. Moreover, this standardized DS can be effective for integrating and improving the information management of people with upper limb disabilities and used to accurately gather the upper limb disabilities data for research and policymaking purposes.

In India, women with GDM are at an increased risk of developing type 2 diabetes mellitus (T2DM). Despite this, the rate of postnatal blood glucose monitoring is low, and the reasons are not well known. Hence, our study explored the barriers and facilitating factors associated with T2DM postnatal screening six weeks after delivery.

We conducted a qualitative study among 21 mothers with GDM in obstetrics and gynecology department, women and child hospital (WCH), JIPMER, from December 2021 to January 2022. Mothers with GDM were selected purposively between 8 and 12 weeks after delivery to explore the barriers and facilitating factors associated with postnatal screening six weeks after getting mobile call reminders and health information booklet interventions. In‑depth interviews were transcribed; manual content analysis with deductive and inductive coding was done.

We identified two themes; three categories and subcategories that illustrated barriers and five categories that illustrated facilitators to postnatal blood glucose monitoring. Lack of awareness and misconceptions about GDM, knowledge practice gap, lack of family support, and perception of health system failure by mothers with GDM were barriers to postnatal blood glucose monitoring. Concerns about health, standard advice on postnatal screening, information in health education booklet, mobile reminders, and family support were found to be facilitators.

We found several barriers and facilitating factors that showed mobile call reminders and booklet interventions had improved postnatal blood glucose monitoring. Our qualitative study has strengthened the findings of the previous RCT, and it would provide more insights to develop further interventions which we must focus on improving postnatal blood glucose monitoring.

The surgical and medical options for management of pregnancy termination procedures are acceptable in practice but differ in clinical efficacy, costs, and patient experiences, and deciding what the best method is not clear always. This study aimed to compare clinical efficacy, outcomes, and patient acceptance of dilatation and curettage (D and C) versus medical abortion using misoprostol for first trimester of gestation in Iranian context.

A prospective, multicenter, quasi‑experimental research conducted from July 2021 to January 2022. The primary outcomes were the rate of composite complications or complete abortion. Data were analyzed with SPSS 18 using descriptive statistics, independent t‑test, analysis of variance and non‑parametric tests. Secondary outcomes were quality of life using EQ5D questionnaire, estimated blood loss, pelvic infection, pain level, hospital stay, and acceptability of intervention and relative risk as the effect size.

Finally, 168 patients were included in this study. The composite complication rate among medical abortion patients is significantly more than that of surgical abortion patients (39.3% vs. 4.76%). The relative risk calculated 8.25 (3.05–22.26 CI). Medical abortion patients have experienced higher levels of ongoing bleeding, pain, and symptoms of pelvic infection. The higher level of acceptance has been reported by surgical group patients in comparison to the medical group patients (85.7% vs. 59.5%). Quality of life scores for surgical and medical group estimated 0.6605 and 0.5419, respectively.

Surgical method of abortion using D and C is a very safe and highly successful option in comparison to the medical method using misoprostol alone and is associated with better clinical outcomes, acceptance, and quality of life in first trimester of pregnancy among Iranian women.

Despite the fact that mental illness is among the ten top diseases with the highest burden, the health services required by these patients do not have adequate insurance coverage. The purpose of this study is to develop the attributes and levels of mental health insurance services using a discrete choice experiment (DCE).

This study involved a qualitative phase of the DCE that was conducted in Iran in 2020‑2021 and included several stages. First, during a literature review, the attributes and levels were determined. Then, the attributes of health insurance were identified and weighed through virtual and in‑person interviews with 16 mental health insurance professionals and policymakers in this field who were selected by purposive sampling. Finally, after a few sessions, through review studies, interviews, and a group of the expert panel, attributes and levels were finalized.

This study showed that coverage of inpatient services, outpatient services, place of receiving services, use of online internet services, limitation of services, and monthly premiums were the most important attributes of mental health insurance services.

To promote mental health insurance, policymakers and health insurance organizations should pay attention to premiums to be commensurate with the payment of people, packages of mental health services, and the ability of people to pay in appropriation with inflation. Identifying these attributes can determine people’s willingness to pay and preferences for mental health insurance and lead to better planning for more comprehensive coverage for patients and increase the desirability of individuals in receiving services.

Autism is a group of developmental disorders of the nervous system, the main manifestations of which are defects in social interactions and communication, as well as repetitive behaviors and limited interests. The etiology of autism is not limited to a single factor. Therefore, the aim of this study was to compare the relationship between pregnancy and childbirth factors and autism in healthy children and children with autism.

The present study was a cross‑sectional study that was performed on 200 children in Isfahan in 2021. The instrument in this study was a researcher‑made questionnaire. The collected data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 22 software.

The results of data analysis between the two groups with Mann–Whitney U test showed that there was a significant relationship between maternal age at delivery, father’s age at delivery, gestational age at delivery, interval between pregnancies, and the length of hospital stay (P ≤ 0.05). Also, the results of data analysis with Chi‑squared test showed that there is a significant relationship between the two groups in terms of economic status, place of residence, multiple pregnancies, neonatal sex, and disease in infancy (P ≤ 0.05).

The results of this study showed that economic status, place of residence, multiple pregnancies, sex of the baby, and disease in infancy can be effective factors for this disease. According to the results of the study, by considering the factors related to autism, many cases can be adjusted and corrected as much as possible before attempting to conceive.

Hospital‑generated waste materials commonly labeled as “Biomedical waste” (BMW) is a kind of remnant that includes infectious and non‑infectious materials and their appropriate disposals are controlled as per the guidelines of Biomedical Waste Management (BMWM) Amendment Rules, 2018, Government of India. Periodic assessment on BMWM among healthcare workers (HCWs) is mandated to ensure quality assurance, which may be helpful during pandemic times.

The study was conducted with ethical clearance by using a validated questionnaire (using Cronbach’s α) covering knowledge, attitude, and practices (KAP) derived based on recent BMWM 2018 guidelines. The responses in context to KAP were checked by the study conductors, appropriate statistical analysis was done and discussed at end of each session.

Nearly 279 HCWs participated in the study and cast their responses. Knowledge and attitude domain on BMWM showed statistical significance whereas varied responses were observed with practices among the health professional workers with health professional physicians having an edge over other HCWs involved in the processes with varying attrition factors.

The present study proves novelty by extensively analyzing KAP among HCWs on BMWM in general with special emphasis on laboratory biosafety norms. The study emphasizes that BMWM should be a continuous process and that all HCWs handling BMW must undergo regular training and assessment with questionnaire surveys. Multi‑tasking and cumulative efforts must be formulated to attain translational synergy in the stream of KAP of BMWM, which could be attained by incorporating BMWM in the health science curriculum.

Childbirth preparation classes are incredibly useful for midwifery students as future medical personnel. Nowadays, given the outbreak of Covid‑19 pandemic and as mobile applications are extensively welcomed, virtual space can be used for education in the area of childbirth preparation classes. Given the lack of an application for childbirth preparation classes, this study will be conducted to design, implement and validate such an application to improve the performance of midwifery students in the areas of pregnancy and safe delivery.

The present study will be conducted in three phases. In the first phase, content will be provided to Information Technology experts based on the content of the national guidelines for physiological delivery in Iran, and the application will be designed and validated for the use of midwifery students, then develop app for other medical students, midwives and physicians. In the second phase, the assessment will be based on Kirkpatrick’s model. In the third stage, develop app for other medical students, midwives and physicians based on the results of the first and second phase. SPSS version 17 will be used in this phase for analysis of data through descriptive and analytical tests.

Owing to the expansion of virtual space and the outbreak of Covid‑19 pandemic, design, validation, and evaluation of an application for childbirth preparation classes is an exceptionally significant necessity which contributes to the process of educating midwifery students.

Osteoarthritis of the knee causes pain and gait disturbances, as well as a distinct gait pattern. Patients with knee OA have decreased range of motion (ROM) and increased ground reaction force. OA reduces stride length and walking speed.

To determine the effect of a multi‑component exercise program on pain‑related gait adaptations among individuals with osteoarthritis of the knee joint and to compare the effect of multi‑component exercises with traditional exercises on pain‑related gait adaptations among individuals with osteoarthritis of the knee joint.

This was an experimental study done between 120 patients having knee OA, of both genders, and between the age group of 50–65 years. These individuals were residents of the city of Karad and they were randomly divided into group A (conventional/traditional) and group B (experimental). A pretest assessment was done and the treatment was given for 6 weeks. The later posttest assessment was done and further statistical tests like paired and unpaired t tests were used.

Among the 120 subjects with OA knee, the age group of 60–65 years (44%) was found to be commonly affected. Thirty‑nine were males (32.5%) and 81 were females (67.5%). Fifty‑eight subjects (48%) were found to be commonly overweight. Thirty‑two subjects (27%) had Genu Valgum deformity, and 88 subjects (73%) had Genu Varum deformity at the knee joint. The Pvalue within both group A and group B was found to be statistically significant for the entire outcome measures used for assessment. The pretest vs post test values of the WOMAC scale for patients with knee OA within both groups were found to be extremely significant (P < 0.0001). As for the MMT score in these patients, the Knee Flexors of Group A were not significant for right side (P = 0.7088) as well as for left side (P = 0.083) and in Group B they were extremely significant (P < 0.0001) for both sides. For the ROM scores within both groups, Knee Flexion of Group A for both sides was found to be extremely significant (P < 0.0001) for both sides. And for the pretest vs posttest values of within the groups’gait parameters among these patients with OA knees, for cadence both groups B were found to be extremely significant (P < 0.0001). The stride length for Group A was found to be very significant (P = 0.0060) and for Group B it was (P < 0.0001).Also, the P values of the various outcome measures between both groups were found to have statistical significance of their own.

Effect of Multi‑Component Exercise Program on Pain‑Related Gait Adaptations Among Individuals with Osteoarthritis of the Knee joint was found to be significant in pain reduction, improving strength, range of motion, and the gait parameters such as an increase in cadence, stride length, step length and decrease in the step width.

After kidney transplantation, older adults encounter numerous problems which can negatively affect their self‑care self‑efficacy. According to studies, behavior modeling training has an effect on patient’s self‑care. Therefore, the present study was conducted to determine the effect of implementing health promotion strategies on self‑care self‑efficacy in older adults undergoing kidney transplantation.

This quasi‑experimental study was conducted on 60 older adults undergoing kidney transplantation in Tehran’s Shahid Doctor Labbafinejad Hospital in 2020. Patients were randomly divided into intervention and control groups by using block randomization method. For the patients of the intervention group, the educations were provided based on the model of individual health promotion strategies in eight sessions (i.e., 8 weeks, one session per week) for 40–60 minutes. The subjects of the control group received only their routine care. The two groups completed on‑line the self‑care self‑efficacy questionnaire, before, immediately after and one month after the intervention. The results were analyzed by Chi‑square, t‑test and repeated measures analysis of variance in SPSS v19.

According to the results, no significant difference was observed between the two groups in terms of demographic characteristics and the mean score of self‑care self‑efficacy before the intervention (P > 0.05). The mean score of self‑care self‑efficacy (P = 0.001) and some of its dimensions including stress reduction (P = 0.01) and adaptability (P = 0.01) was significantly different in the two groups in the three time intervals. Moreover, the two dimensions of decision making (P = 0.07) and enjoying the life (P = 0.20) were not significant.

According to the results, education based on health promotion strategies can effectively improve self‑care self‑efficacy and some its dimensions. Therefore, teaching health promotion strategies as a low‑cost and simple method can positively affect self‑care self‑efficacy in older adults undergoing kidney transplantation.

Human papillomavirus (HPV) is known as the common sexually transmitted disease and the cause of cervical cancer. The HPV test is being proposed as the primary screening tool for cervical cancer. This study aimed to identify barriers and facilitators of screening based on the social marketing model in designing interventions and planning to increase HPV screening.

This qualitative directed content analysis was conducted between December 2020 to September 2021 to identify the key concepts of social marketing theory (i.e., the four P’s: product, price, place, and promotion) in Mashhad, Iran. Semistructured interviews were fulfilled with 24 individuals (10 women with HPV and 14 key informants) after obtaining participants’ consent, who were initially purposively sampled and snowball sampling was then used to facilitate further recruitment. Data analysis was carried out simultaneously with data collection.

Following the code extraction, four main categories (themes) and 10 subcategories extracted. Subcategories included knowledge on screening, screening benefits, and motivational factors for screening (product), individual inhibitors, environmental inhibitors, and facility problems related to price, place of service delivery, and service delivery channels (place) and health promotion and education.

Lack of knowledge about HPV and screening, negative attitudes toward sexually transmitted diseases, taboo about sexual issues in society, fear of the reaction of spouse and family members, lack of proper policies and information and communication challenges, high costs of screening, access barriers to facilities such as difficult transportation have been challenges of health systems. It is suggested that HPV screening as a standard method for detection of cervical cancer be considered and the barriers to access are removed.

Exposure of nursing students to constant work pressure, stress, and emotional turmoil during both clinical and theoretical sessions of nursing training often leads to academic burnout among them. The aim of the study was to determine the presence of academic burnout among undergraduate nursing students and the association of academic burnout with age, gender, year of nursing program, residence location, and relaxation technique practice.

A descriptive survey design was used, and data were collected from 266 undergraduate nursing students from Udupi Taluka, South India. Baseline information was collected through a demographic proforma, and Oldenburg Burnout Inventory for Students was used for assessing academic burnout. A stratified proportionate sampling technique was used to select the study sample. The data were collected from April 2021 to May 2021. Descriptive and inferential statistics were used for the analysis by using Statistical Package for the Social Sciences (SPSS) version 16.

The study revealed that most of the participants had high levels of academic burnout (163, 61.7%), emotional exhaustion (165, 62%), and disengagement (173, 65%). Moreover, academic burnout was significantly associated with age (χ2 = 8.669, P = 0.012) and relaxation technique practice (χ2 = 9.263, P = 0.002). Additionally, disengagement was significantly associated with gender (χ2 = 9.956, P = 0.002), residence location (χ2 = 7.032, P = 0.027), and relaxation technique practice (χ2 = 8.729, P = 0.003).

Based on the findings of the study, we recommend that the faculty and administrators of nursing institutes must incorporate strategies for the prevention or reduction of academic burnout in the nursing curriculum.

The world has been severely affected by the COVID‑19 pandemic in terms of loss of lives, health, and its socioeconomic consequences; however, the true magnitude and extent of the damage from COVID‑19 is still elusive till date. With the advent of many efficacious vaccines, one of the most effective ways to get to grips with the pandemic is mass vaccination. However, due to vaccine hesitancy (VH), it remains a colossal challenge globally thereby causing serious threat to the pandemic response efforts. This review intends to identify evaluated interventions and evidence to support recommendation of specific strategies to address VH from an Indian context. A systematic review was conducted to synthesize relevant literature around the evaluation of strategies to tackle VH for effectiveness or impact in India. Electronic databases were searched using specific keywords and predefined inclusion–exclusion criteria. A total of 133 articles were screened, 15 were assessed for eligibility, and two were included in the final review. There is a paucity of research on evaluation of vaccine hesitancy interventions in India. Evidence is not strong enough to recommend one specific strategy or intervention. Together, a permutation of multicomponent and tailored interventions has been found most effective in repressingVH in India.

Musculoskeletal pain (MSP) is common among medical students across the world. The present study was done to estimate the prevalence of MSP among medical students in the state of Sikkim, India, and to assess perceived stress levels among medical students and its association with MSP.

A cross‑sectional study was carried out at a private medical college in the state of Sikkim, India. Fifty students each from the third, fifth, seventh, and ninth semesters were included in the study. Students were asked to complete a questionnaire that included data regarding lifestyle habits and activities, the modified Nordic scale for MSP, perceived stress score (PSS‑10), and Oswestry disability index (ODI) questionnaire.

The majority (73%) of the participants reported one or more episodes of MSP in the past 12 months and 50% of them had pain in the past 7 days. No significant association was found between MSP and lifestyle habits, mean time spent on physical activities and sedentary behavior. The perceived stress level was significantly higher among those with MSP in the past 12 months (19.7 ± 5.6) (P‑0.021), as well as in those who had MSP in the past 7 days (20.8 ± 5.5) (P‑0.001). Severe pain was significantly associated with a higher perceived stress score (23 ± 5) (P‑0.003). Students who had MSP in the past 12 months as well as in past 7 days had a higher quality of life score (9.8 ± 10.6, P‑0.039 and 13 ± 10.9, P‑0.000, respectively).

The majority of our medical students have experienced musculoskeletal pain in the past 12 months, which is significantly associated with perceived stress and quality of life.

Critical thinking has been acknowledged as a key component of clinical decision‑making and professional competency. Therefore, it is of great importance to reflect on how critical thinking is acquired and investigate its determinants, including self‑esteem, in nursing education. The present study was thus to assess the correlation between critical thinking and self‑esteem in nursing students.

This descriptive correlational study was fulfilled in 2019 on 276 nursing students selected via the random sampling method. For this purpose, Ricketts’ Critical Thinking Disposition Questionnaire and Eysenck’s Self‑Esteem Scale were employed to collect the data, which were then analyzed using the SPSS Statistics (ver. 22) software along with independent‑samples t‑test, Pearson correlation coefficient, and one‑way analysis of variance, considering the significance level of P < 0.05.

The study findings showed a significant correlation between critical thinking and self‑esteem (r = 0.529, P < 0.001) as well as self‑esteem and critical thinking dispositions, that is, commitment, perfectionism, and creativity (r = 0.40, P < 0.001). Moreover, these dispositions had a significantly increasing trend during various academic years, but the difference was not significant with regard to perfectionism (P < 0.001).

Given the positive correlation between self‑esteem and critical thinking, commitment, perfectionism, and creativity in nursing students, it is essential to develop self‑esteem skills in such students, using appropriate approaches to boost self‑esteem as one of the important missions of higher education systems. As well, a lack of perfectionism during academic years confirms that it is possible that determinants other than educational environments, for example, families, are involved. Therefore, managers are suggested to hold meetings with parents and nursing students.

Nursing profession requires diverse skills, and emotional intelligence (EI) plays a role in helping them adapt to adverse situations as a part of their work environment. The study objective was to determine the prevalence of EI with its associated factors among the nursing professionals from selected four tertiary care hospitals in Bangalore.

This was a multicentric, cross‑sectional study done among nurses with more than 1 year of work experience, who were randomly selected from tertiary care hospitals in Bangalore. Data was collected, both online and offline, owing to the ongoing COVID‑19 pandemic, and the Emotional Intelligence Scale was used following obtaining informed consent. Data analysis included mean, associations, and regression.

Out of the total 294, the mean age of the study participants was 27 ± 4.92 years. A total of 75 (25.5%) had poor EI. Although there were not any significant association between the specialty and EI subscales, a significant association was found to be present between total years of work experience and all five subscales of EI: self‑awareness (P = 0.009), social regulation (P = 0.004), motivation (P = 0.012), social awareness (P = 0.008), and social skills (P = 0.049), respectively. Logistic regression showed a significant finding where nursing staff with more work experience had a higher EI (OR 0.012, 95% CI 1.288–8.075) than those with less work experience.

The prevalence of poor EI among nursing professionals was 25%, and EI scores increased with increasing work experience, and this was found to be significant. Thereby, EI building workshops/training, as a part of the nursing curriculum, may help improve their quality of care and resilience in demanding work environments.