Journal of Education and Health Promotion

Effectiveness of a collaborative model in improving maternal and child health outcomes among urban poor in Chandigarh, a North Indian city

. Madhu Gupta; . Madhur Verma; . Krishna Chaudhary; . MD. Abu Bashar; . Chering Bhag; . Rajesh Kumar

Volume 12, Issue 5 , June 2022, Pages 1-11

Abstract

  BACKGROUND: To ascertain the effectiveness of a collaborative model between the Departmentof Community Medicine and state health department to improve MCH outcomes among the urbanpoor ...  Read More BACKGROUND: To ascertain the effectiveness of a collaborative model between the Departmentof Community Medicine and state health department to improve MCH outcomes among the urbanpoor in Chandigarh.MATERIALS AND METHODS: A quasi‑experimental study was conducted from 2011–12 to 2015–16in the intervention and control areas. A collaboration was established between the state healthdepartment and the Department of Community Medicine of an autonomous institute. The interventionand control areas were mainly inhabited by the poor migrant population. Critical elements of an efficientcollaboration such as the early engagement of partners, clearly stated purpose with common goals,effective communication, and no financial conflict were implemented in the intervention area. MCHprogram’s implementation was strengthened through supportive supervision, enhanced communityengagement, male partner involvement, tracking of high‑risk pregnant women, and identification ofproblem families. Trend analysis of MCH indicators was done. The difference‑in‑difference (DID)analysis was done to measure the net effect of the intervention.RESULTS: All the MCH indicators improved significantly in the intervention area compared to thecontrol area (P < 0.05). DID analysis depicted a net increase in the early registration of pregnanciesby 18%, tetanus toxoid immunization by 9.2%, and fully immunized children by 8.6%. There was alsoan improvement in the maternal mortality ratio by 121.1 points, infant mortality rate by 2.2 points,and neonatal mortality rate by 2.6 points in the intervention area.CONCLUSION: An innovative, collaborative model between the state health department and theDepartment of Community Medicine effectively improved the MCH outcomes in Chandigarh.

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Identifying strategies for dealing with the aging population from the perspective of health system experts: A qualitative study

. Rahele Samouei; . Mahmoud Keyvanara

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND AND AIM: Given the growing trend of aging and the limited resources of the healthsystem, the lack of long‑term prior government planning, and reduced growth of the productive ...  Read More BACKGROUND AND AIM: Given the growing trend of aging and the limited resources of the healthsystem, the lack of long‑term prior government planning, and reduced growth of the productive forceof society, identifying strategies for planning and action to deal with future aging is very important.In this regard, the study was conducted to identify strategies for dealing with the aging populationfrom the perspective of health system experts.METHODS: The qualitative content analysis study was performed on 29 Iranian male and femaleexperts in the aging and health scope from Isfahan, Tehran, Tabriz, and Babol who purposefullyparticipated in the semi‑structured interview. Data were classified by qualitative content analysis.RESULTS: Two concepts emerged according to the participated experts’ opinions, regarding thestrategies of the Iranian health system in dealing with future aging: “executive policy” strategies,including “design, planning and implementation,” “evaluation and standardization,” “strengtheningdemand‑driven” and “modeling national and international experiences,” “preventive policies”strategy, which includes “Focus on prevention,” “Focus on values and competencies,” “Educationalempowerment,” “Knowledge‑based empowerment,” “Empowerment of age‑related groups,”“Economic empowerment,” and “Social support.”CONCLUSION: The diversity and breadth of the mentioned strategies indicate the necessityof comprehensive readiness and adaptation of health services to the elderly conditions andcharacteristics. Purposeful planning and timely implementation of programs and policies to betteraddress the health system with future aging will be possible by using practical strategies.

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Individual counseling in mothers bereaved by pregnancy loss: A randomized clinical trial

. Mahmonir Haghighi; . Khatereh Oladbaniadam; . Hamideh Mohaddesi; . Javad Rasuli

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: The loss of a pregnancy can result in grief, guilt, self‑doubt, anxiety, andpost‑traumatic stress disorder (PTSD). Considering the side effects mentioned for mental ...  Read More BACKGROUND: The loss of a pregnancy can result in grief, guilt, self‑doubt, anxiety, andpost‑traumatic stress disorder (PTSD). Considering the side effects mentioned for mental healthand the fact that the symptoms will linger if left untreated and even adversely affect the subsequentpregnancies. The current study was designed to assess the impact of individual counseling on stress,anxiety, and depression in mothers with pregnancy loss.MATERIALS AND METHODS: The study commenced 100 women who experienced pregnancy loss(in Urmia/2018-2019); they were enrolled using convenience sampling and block randomization. Theintervention group received four individual counseling sessions (weekly sessions with a duration of1 h) based on Warden’s principles. The control group received routine care. The Depression AnxietyStress Scale (DASS‑42) was filled out at baseline, the pre‑ and post‑intervention. Analyses wereperformed using the Chi‑square, paired, or individual t‑tests, when necessary. P value < 0.05 wasconsidered significant.RESULTS: There were no significant differences regarding socio‑demographic characteristics andclinical features between groups at baseline. Intra‑group analysis showed that all outcome measuresin the intervention group were significantly improved. According to inter‑groups analysis, a significantassociation was found between pre‑test and post‑test in the intervention group (P < 0.05).CONCLUSION: Results of this study can clarify the psychological effects of pregnancy loss in thesemothers and help the officials and responsible parties to plan the treatment and rehabilitation of thesewomen and include them in the healthcare system.

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Exploring the reproductive health needs of men in the preconception period: A qualitative study

. Zeinab Rabiei; . Mohammad Shariati; . Naser Mogharabian; . Rahim Tahmasebi; . Ashraf Ghiasi; . Zahra Motaghi

Volume 12, Issue 5 , June 2022, Pages 1-9

Abstract

  BACKGROUND: Male reproductive health is a necessary pillar of childbearing. If a reproductive healthassessment is conducted in the preconception period, the chance of a healthy pregnancy ...  Read More BACKGROUND: Male reproductive health is a necessary pillar of childbearing. If a reproductive healthassessment is conducted in the preconception period, the chance of a healthy pregnancy can increase.This qualitative study aimed to explore men’s reproductive health needs before conception in Iran.MATERIALS AND METHODS: This research was a qualitative study conducted in Bushehr city, Iranto explore men’s reproductive health needs from April 2021 to November 2021. 30 semistructuredinterviews were conducted with married men, women, healthcare providers, and specialists individuallyin the health centers. The sampling method used in this study was purpose‑based with maximumvariety. All interviews were digitally recorded and transcribed verbatim in Persian and analyzedusing directional content analysis. MAXQDA software version 12 was used to facilitate data analysis.RESULTS: From the data analysis, 2 themes, 15 categories, and 38 subcategories emerged. Thethemes included evaluation and health promotion recommendations. It consisted of 10 categories:reproductive life plan evaluation, medical history evaluation, family and genetic history evaluation,social history evaluation, sexual health evaluation, medication evaluation, laboratory evaluation,physical examination, lifestyle evaluation, and mental health evaluation. Health promotionrecommendations included five categories: nutritional recommendations, stress management,avoiding harmful behaviors, protective measures against harmful exposure, and need for education.CONCLUSIONS: Our results showed that men need a comprehensive evaluation of reproductivehealth and recommendations to improve their health in the preconception period. Our study findingscan inform healthcare providers to increase men’s participation in reproductive health.

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A review on attraction factors of science and technology parks to firms in health sector

. Abbas Mohammadzadeh; . Shaghayegh Haghjooy Javanmard

Volume 12, Issue 5 , June 2022, Pages 1-13

Abstract

  BACKGROUND: Over the past few years, a rapidly growing number of science and technologyparks (STPs) in health sector have emerged across the world. There has been little discussion ...  Read More BACKGROUND: Over the past few years, a rapidly growing number of science and technologyparks (STPs) in health sector have emerged across the world. There has been little discussion inthe literature to show how STPs could make an attractive environment to absorb and retain potentialfirms. This is even more challenging for specialized STPs in health sector. The aim of this study isto identify the attractive factors for firms in a STP in health sector.MATERIALS AND METHODS: A scoping review method was undertaken to review the literatureon seven databases (ScienceDirect, Scopus, ProQuest, Google Scholar, EconPapers, PubMed,and ISI Web of Science) for peer‑reviewed articles published until 2019. The search results werescreened against the inclusion of criteria to ensure they met the objectives. The eligible papers werethen assessed on the basis of the full text, and finally the results were extracted.RESULTS: The attractive factors for firms and talents in multidimensional STPs and those in healthsector are extracted and summarized. The attractive factors of multidimensional STPs, whichincludes health sector firms, and those specialized in health sector are summarized in three maincategories; factors created by government and universities, and factors related to STP policies andthose expected by the firms.CONCLUSION: To make STPs attractive for firms in health sector, there is a list of factors thatare required to be done not only by STP itself, but also by the national and local government andindustries. It is important to consider the factors that are expected by the firms to be implemented.The results of this study suggest that making STPs attractive for health sector firms needs closecollaboration between government, universities, related industries, and STPs all together.

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Challenges and opportunities in the implementation of competency-based medical education – A cross-sectional survey among medical faculty in India

. Shivkumar Gopalakrishnan; . A. Precilla Catherine; . Sangeetha Kandasamy; . Harissh Ganesan

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: In India, competency‑based medical education (CBME) is gaining foothold totransform the medical student into a doctor fulfilling community and societal needs. With that ...  Read More BACKGROUND: In India, competency‑based medical education (CBME) is gaining foothold totransform the medical student into a doctor fulfilling community and societal needs. With that endin view the teaching faculty are getting sensitized and trained by the National Faculty DevelopmentProgram (FDP). We aimed to assess the awareness about FDP among teaching faculty in medicalcolleges and study the attitude and perceived barriers to implementation of CBME.METHODOLOGY: A cross‑sectional, electronically distributed, questionnaire‑based study wasconducted among medical faculty in India. The questionnaire identified participants’ awareness,attitude, and perceived barriers to CBME. Descriptive analysis was employed for continuous variablesand internal comparison employing Chi‑square test with α <0.05 for statistical significance.RESULTS: Among 251 participants 90.2% faculties from private institutes had undergone FDP asagainst 71% from Government sector (P = 0.008). We observed that 92.4% were aware, 80.2%had undergone Curriculum Implementation Support Program and 95.2% did agree that CBME willimprove the medical education system. Major challenges perceived were high student to facultyratio (67.7%), ill developed infrastructure (41.4%) and difficulties in assessment (41.1%). The popularsolutions suggested were to increase faculty strength (73.7%), improve infrastructure (69.3%), extraremuneration (35.9%) and increase administrative support (30.7%). There was significant differenceof opinions between teaching faculty of government and private sector (P = 0.017).CONCLUSION: Most of the medical faculty are aware of the need and have acquired a positiveattitude towards enforcement of CBME. However, significant barriers do exist in the form of manpowerand resources which need to be addressed.

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The effect of decision‑aid‑based counseling on cervical cancer screening behavior among women: An interventional study

. Elnaz Malekzadeh; . Roghaiyeh Nourizadeh; . Azizeh Farshbaf‑Khalili; . Esmat Mehrabi; . Sevil Hakimi

Volume 12, Issue 5 , June 2022, Pages 1-8

Abstract

  BACKGROUND: Performing appropriate and regular screening can effectively reduce cervical cancerand mortality rate, however, the available evidence suggests that women’s participation ...  Read More BACKGROUND: Performing appropriate and regular screening can effectively reduce cervical cancerand mortality rate, however, the available evidence suggests that women’s participation in cervicalcancer screening remains low in middle‑ and low‑income countries, and that it is necessary to identifyappropriate intervention methods to change behavior. The present study was designed to determinethe effect of decision‑aid‑based counseling on cervical cancer screening behavior among women.MATERIALS AND METHODS: This trial study was conducted on 154 women with no history of Papsmear during the past 3 years and refers to Tabriz health care centers. The participants were assignedto the intervention (decision aid based counseling) and control (routine health education) groupsthrough randomized block design with block sizes of 4 and 6 and a 1:1 allocation ratio. The datawere collected using the sociodemographic and fertility characteristics, stages of change checklist,and shared decision‑making (SDM) and decisional conflict (DC) questionnaire before and 6 monthsafter the intervention by interview and then, analyzed by SPSS24 software. The independent t‑test,ANCOVA tests were used.RESULTS: A significant difference was observed between the two groups in terms of changing thestages of cervical cancer screening behavior 6 months after the intervention. As after the intervention,the frequency of individuals entered the preparation or action stage was more than the controlgroup (P = 0.001). The mean score of SDM in the intervention group was significantly higher than thecontrol group after intervention ([45.49 ± 1.18] vs. [27.56 ± 1.18] [Mean Difference (MD): 17.92; 95%confidence interval [CI]: 14.59–21.25; P < 0.001]). The mean score of DC in the intervention groupwas significantly lower than the control group after intervention ([29.16 ± 1.09] vs. [34.14 ± 1.09] [MD:−4.97; 95% CI: 1.09–8.04; P < 0.002]).CONCLUSIONS: This study revealed that evidence‑based information communicated between clientsand clinicians has very important role in clients’ health‑related behavior. It is recommended, healthcare providers apply decision‑aid‑based counseling for promoting the cervical cancer screeningbehavior among women.

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Academic burnout among trainee teachers during the COVID-19 pandemic: Effect of sociodemographic factors

. Abdelmounaim Bouhaba; . Youssef El Madhi; . Abdelmajid Soulaymani; . Hinde Hami

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: The trainee teacher seems to be more and more faced with frustration andstress during the training phase, caused by accumulation of requirements and duties, making themsusceptible ...  Read More BACKGROUND: The trainee teacher seems to be more and more faced with frustration andstress during the training phase, caused by accumulation of requirements and duties, making themsusceptible to the risk of burnout. The purpose of this work is to study the academic burnout of traineeteachers at the Rabat‑Sale‑Kenitra region’s Regional Center for Education and Training Professionsduring the COVID‑19 pandemic.MATERIALS AND METHODS: Seven hundred thirty‑nine trainee teachers responded to aself‑questionnaire comprising the Maslach Burnout Inventory–Student Survey scale in its Frenchvalidated version, as well as stress factors during the academic year 2020–2021. Both inferentialand descriptive methods of data analysis were used to represent the effect of sociodemographicvariables on burnout levels during the COVID‑19 pandemic.RESULTS: In agreement with the literature, most of trainee teachers show moderate and high levelsof academic exhaustion; the main stressors presented are financial instability and training overload,and the level of study influences the scale of burnout among trainee teachers.CONCLUSION: The result of this study can serve as a predictor of academic burnout amongMoroccan trainee teachers.

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Investigating the effectiveness of psychological interventions in response to stress, anxiety, and depression in coronavirus disease 2019 patients: A systematic review

. Fatemeh Rahmati; . Robabe Khalili

Volume 12, Issue 5 , June 2022, Pages 1-8

Abstract

  Coronavirus disease 2019 (COVID‑19) has caused different kinds of psychological consequences.Identifying and providing psychological plans and protocols can be effective in promoting ...  Read More Coronavirus disease 2019 (COVID‑19) has caused different kinds of psychological consequences.Identifying and providing psychological plans and protocols can be effective in promoting patients’mental health. The study was conducted to investigate the effect of psychological interventions inresponse to stress, anxiety, and depression in COVID‑19 patients. The present study was performedbased on a systematic review. The studies were done by using different combinations of keywordsin databases such as Science Direct, ProQuest, PubMed, and Google scholar search engines andin Persian databases such as Magiran, SID, Iranmedex from July 25 to September 7, 2020. Outof 4533 articles that were found after extensive search, 9 articles were evaluated and qualitativelyanalyzed for data extraction with the 2010 consort checklist. The final articles were from differentcountries of China, the USA, France, Italy, and Iran and were about COVID‑19 patients and theirhealth‑care providers. Interventions ranged from relaxation, music therapy to mental health andextensive psychological skills including adaptation methods, mindfulness and self‑care, and crisismanagement. Anxiety was the highest and then stress and depression were the next indicators. Theresults showed a positive effect of these interventions on stress, anxiety, depression, and even thequality of life, sleep and family and child function. The number of studies in this field is increasing. Wesee a variety of psychological and educational interventions every day. It is hoped that by designingstandard protocols for psychological intervention, effective steps can be taken to improve the mentalhealth of patients and health‑care providers.

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Marketing training strategies that pharmaceutical sales managers use to reduce unethical behavior

. Aseel Bin Sawad; . Kate Andrews

Volume 12, Issue 5 , June 2022, Pages 1-11

Abstract

  BACKGROUND: Some pharmaceutical company sales representatives are using bribes to encourageincreasing medication prescriptions. In 2012, GlaxoSmithKline paid $3 billion on a felony ...  Read More BACKGROUND: Some pharmaceutical company sales representatives are using bribes to encourageincreasing medication prescriptions. In 2012, GlaxoSmithKline paid $3 billion on a felony chargerelated to bribing doctors to prescribe the company’s medications. Using Hunt and Vitell’s generaltheory of marketing ethics, the purpose of this qualitative multiple case study was to explore strategiessome sales managers in the pharmaceutical industry used to improve marketing training to reduceunethical sales representative behavior.MATERIALS AND METHODS: Data were collected from company reports and documents providedby sales managers and semistructured interviews with five sales managers of different pharmaceuticalcompanies in the northeast region of the United States. Data were analyzed using thematic analysisand Yin’s 5‑step process of compiling, disassembling, reassembling, interpreting, and concludingthematic data analysis.RESULTS: Three themes emerged from data analysis: developing ethical standards, developingorganizational policy, and implementing training and development programs. A key recommendation isthat pharmaceutical sales managers identify ethical standards to inculcate in their business practicesto achieve ethical marketing training that can result in sales representatives’ ethical behavior. Theimplications for positive social change include the potential for sales managers to develop strategiesto reduce unethical behavior in the pharmaceutical industry.CONCLUSION: Reducing unethical behavior may lead to more trust between patients and physicians,improving patient satisfaction and promoting prosperity for the community through enhancing thequality of health care.

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Sexual health promotion interventional program for women undergoing breast cancer treatment: Protocol for a mix‑methods study

. Sanaz Zangeneh; . Mitra Savabi-Esfahani; . Fariba Taleghani; . Mohammad Reza Sharbafchi; . Mehrdad Salehi

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: Women undergoing breast cancer treatment, especially those of reproductive age,experience sexual health challenges. The aim of this study is to design an interventional ...  Read More BACKGROUND: Women undergoing breast cancer treatment, especially those of reproductive age,experience sexual health challenges. The aim of this study is to design an interventional programfor promoting the sexual health of women undergoing breast cancer treatment.MATERIALS AND METHODS: This is a mixed qualitative‑quantitative exploratory study consistingof four phases. In the first phase, the needs and strategies for promoting sexual health of Iranianwomen with breast cancer in Isfahan city will be identified through a qualitative study. The patients willbe selected using purposive sampling method and the data will be collected through semi‑structuredinterviews. In the second phase of the study, the relevant literature will be reviewed. In the third phase,the initial version of the program will be designed based on the results of qualitative study and reviewof literature, the appropriate strategies are prioritized by the members of the panel of experts, andthen, the final interventional program is prepared. In the fourth phase, the designed interventionalprogram will be conducted as a quasi‑experimental study in two groups of intervention and controland the effectiveness of the program on sexual quality of life, sexual satisfaction, and sexual functionof women undergoing breast cancer treatment will be evaluated. The type of the intervention will beselected based on the results of the previous phases and the opinion of the expert panel.CONCLUSIONS: The results of this study are expected to contribute to the design of an interventionalprogram based on the needs of women undergoing breast cancer treatment and promote health andmeet the sexual health needs of breast cancer patients.

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Asynchronous E‑learning after Synchronous E‑learning in the Pathology Course. When is the proper time for this transition?

. Evangelia Manou; . Evgenia Charikleia Lazari; . Geοrgia Eleni Thomopoulou; . Georgios Agrogiannis; . Nikolaos G. Kavantzas; . Andreas C. Lazaris

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: Recordings of live streaming e‑lessons of pathology at medical school of Nationaland Kapodistrian University of Athens, Greece are uploaded to the e‑class portfolio ...  Read More BACKGROUND: Recordings of live streaming e‑lessons of pathology at medical school of Nationaland Kapodistrian University of Athens, Greece are uploaded to the e‑class portfolio of each studentenrolled in the course. We measured the number of views each video received and noticed that thisnumber exceeded the number of enrolled students. Our main aim was to investigate the correlationbetween the upload of an educational video and the views it got so as to determine when the propertime is for professors to e‑share or upload an educational video for the students.MATERIALS AND METHODS: We measured the number of views of the recorded e‑lessons whenall videos were uploaded, with a frequency of 15 days. We used analysis of variances statisticalanalysis to find the significance of the amount of time each video had been uploaded on the virtualplatform of the course. We also applied t‑tests to assess the significance of alteration of the numberof views related to the amount of time until the examinations.RESULTS: Time was a statistically significant factor in the impact of an educational video. Thetwo‑factor analysis without interaction measured P ≃ 0.001, proving the strong correlation betweentime and the increase of views. As the examination date was approaching, there was a statisticallysignificant increase in the number of views of the videotaped e‑lessons. Almost 50% of the views ofeach of the videos took place in the two‑week examination period of the course.CONCLUSIONS: The educational videos that contained the core learning concepts of the pathologycourse should be uploaded first. The complex learning points of the pathology course must beavailable at the beginning of the semester. Additionally, recordings of videos covering the complexlearning points of the course should be uploaded as an additional tool of asynchronous e‑learningfor the students who choose to watch their former e‑lessons to prepare for the examinations.

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Psychometric properties of the Persian version of the “Intergenerational Relationship Quality Scale for Aging Parents and Their Children”

. Maryam Torabian; . Reza Fadayevatan; . Nasibeh Zanjari; . Mahshid Foroughan; . Gholamreza Ghaedamini Harouni

Volume 12, Issue 5 , June 2022, Pages 1-8

Abstract

  BACKGROUND: Investigating the status of intergenerational relationships of elderly parents withtheir adult childen is very important in examining issues related to the status of the ...  Read More BACKGROUND: Investigating the status of intergenerational relationships of elderly parents withtheir adult childen is very important in examining issues related to the status of the elderly suchas well being and quality of life and other aspects of elderly life. Giveeen the significance of thetopic, the current study aimed to examine the psychometric properties of the Persian version of“Intergenerational Relationship Quality Scale for Aging Parents and Their Children” (IRQS‑AP).MATERIALS AND METHODS: A total of 463 community‑dwelling elders (aged 60 years or older)in Tehran participated in this study through multistage cluster sampling method. To investigatereliability, the construct and convergent validity of the IRQS‑AP, confirmatory factor analysis (CFA),and interclass correlation coefficient were done.RESULTS: The content validity index was 0.84 for the entire tool. In the CFA, we found the instrumenthad a four-factor structure and adequate internal consistency. The scale had a significant and positivecorrelation with the two measures of loneliness and depression. Furthermore, Cronbach’s alpha wasestimated at 0.77, and the high value of the interclass correlation was 0.82.CONCLUSION: The IRQS‑AP is a valid and reliable scale that can be used to examine the statusof intergenerational relationship quality in Iranian elder population.

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Adverse effects associated with the use of N95 mask among health‑care workers at the COVID‑19 care units: A cross‑sectional study in Sulaimani city, Iraq

. Saad Abdulrahman Hussain; . Naza Mohammed Ali Mahmood; . Trefa Mohammed Ali Mahmood; . Neega Aras Mohammed Salih; . Zainab Saad Abdulrahman

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: Health‑care workers have to use the N95 mask as a part of the protection kit duringthe COVID‑19 pandemic. The adverse effects of such practice are not fully elucidated. ...  Read More BACKGROUND: Health‑care workers have to use the N95 mask as a part of the protection kit duringthe COVID‑19 pandemic. The adverse effects of such practice are not fully elucidated. The study aimsto evaluate negative impacts of N95 face masks on health‑care personnel at COVID‑19 care units.MATERIALS AND METHODS: One hundred and twenty‑two health‑care workers (aged 20–58 years)from various health‑care settings in Sulaimani, Iraq, from January to August 2020, were enrolled inthis prospective, cross‑sectional study. The physiological variables (blood pressure, heart rate, andoxygen saturation) were recorded before putting on the N95 mask and postremoval of the mask. Theincidence of adverse effects such as headache, difficulty breathing, redness, irritation, and dizzinesswere also reported as a number and percent at the end of the work shift.RESULTS: There was a statistically significant difference in the physiological parameters afterremoval of the mask compared with baseline. Only diastolic pressure was significantly lower in thoseworking >6 h when compared to those working 1–6 h. The changes in physiological markers werepoorly and nonsignificantly associated with the duration of wearing the mask. Moreover, 67.2%–70.5%of the participants complain of headaches and breathing difficulties, while 45.9%–51.6% reportedsigns of itching, redness, and irritation. However, health‑care workers who put on the face mask >6 hshowed signs of headache, breathing difficulties, and itching at the exposed areas higher than thoseworking for 1–6 h.CONCLUSION: N95 mask negatively impacts the physiological variables of health‑care providers.The adverse effects may lead to excessive exhaustion after long shifts in the intensive care unitduring treatment of COVID‑19 patients. 

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Health protection challenges of slums residents during the COVID‑19 pandemic, according to the social determinants of health framework: A case study of Kerman city in Iran

. Mohammad Hossein Mehrolhassani; . Vahid Yazdi‑Feyzabadi; . Noora Rafiee; . Sara Ghasemi

Volume 12, Issue 5 , June 2022, Pages 1-10

Abstract

  BACKGROUND: Coronavirus disease‑2019 (COVID‑19) pandemic can aggravate the healthproblems in slum areas. The present study intends to examine the challenges of health protection ...  Read More BACKGROUND: Coronavirus disease‑2019 (COVID‑19) pandemic can aggravate the healthproblems in slum areas. The present study intends to examine the challenges of health protection ofslum’s residences during the COVID‑19 pandemic with the Social Determinants of Health perspective,in Kerman city in Iran.MATERIALS AND METHODS: The present study was a qualitative content analysis. Data werecollected by purposeful sampling in‑depth and semi‑structured interviews with 16 people. Theinterviews were conducted (from October to December 2020) with the local representatives of theslum’s residents, health‑care workers, managers of facilitation offices, and welfare social servicecenters that are located in slum areas (Interview’s guide is attached). The textual material fromthe interviews was entered into the MAXQDA software and directed content analysis was used toanalyze the data.RESULTS: Data analysis led to the identification of 4 categories (Sociocultural, Situational,Economical, and Physical environment) and 12 subcategories: Sociocultural: lack of awareness,begging culture, low trust in disease control programs, low bottom‑up planning, and increasingviolence; Situational: decreasing donors’ activities and canceling important meetings; Economical:unemployment, decreasing in income, and increasing limitations of many institutions in providingresources; and Physical environment: inadequate space and inappropriate conditions in some housesand alleys for people protection against Corona viruses.CONCLUSIONS: Slum residents have faced many challenges during the COVID‑19 pandemic.These challenges can affect the health of slum and other urban dwellers. Multidisciplinary thinkingand actions are needed. Increase awareness and engagement slum residents in control diseaseprograms should be considered.

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Cognitive style and working memory among adolescents with specific learning disability

. Monica Daniel; . Romate John; . Eslavath Rajkumar; . Allen Joshua George; . John Abraham

Volume 12, Issue 5 , June 2022, Pages 1-8

Abstract

  BACKGROUND: In a world where education directly influences the quality of life of an individual,educational handicaps are a grave issue that plagues the lives of those affected. The ...  Read More BACKGROUND: In a world where education directly influences the quality of life of an individual,educational handicaps are a grave issue that plagues the lives of those affected. The current studyaims to find out whether there is a difference in the cognitive style and working memory capacityamong adolescents with specific learning disability (SLD) in comparison to their age‑matchedequivalent group without SLD. The study also targets to find out if there exists any relationshipbetween cognitive style and working memory.MATERIALS AND METHODS: A total of sixty participants were selected (thirty adolescents withlearning disability and thirty age‑matched adolescents without learning disability) from Bangaloredistrict of Karnataka and Thrissur district of Kerala using purposive sampling method. The tools usedwere the Indian adaptation of Embedded Figures Test by Nigam (1997) and the Wechsler IntelligenceScale for Children‑Fourth Edition by Wechsler (2003).RESULTS: The results showed that there exists a significant difference in cognitive style dimensions offield dependence and independence between adolescents with learning disability (M = 11.6, standarddeviation [SD] = 6.52) and adolescents without learning disability (M = 25.2, SD = 7.33) as well as inthe working memory capacity between adolescents with learning disability (M = 66.7, SD = 19.26)and adolescents without learning disability (M = 102, SD = 14.93) groups under study (p < 0.01).The results also indicate that there exists no significant relationship between cognitive style andworking memory.CONCLUSION: Adolescents with SLD was found to be field dependent and has low workingmemory capacity than adolescents without learning disability. The results reflect the need fordeveloping cognitive interventions to enhance working memory capacity and cognitive style forhelping adolescents with learning disability in all areas of their functioning, such that the societybenefits as a whole.

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Complementary and alternative medicine use in infertility: A review of infertile women’s needs

. Farangis Sharifi; . Robab Latifnejad Roudsari

Volume 12, Issue 5 , June 2022, Pages 1-11

Abstract

  The use of complementary and alternative medicine (CAM) is common in infertile women in differentcountries. The purpose of the current study was to review the infertile women’s ...  Read More The use of complementary and alternative medicine (CAM) is common in infertile women in differentcountries. The purpose of the current study was to review the infertile women’s needs in relationto CAM use. This narrative review was conducted through searching English databases includingScopus, PubMed, Embase, Web of Science, Cochrane library as well as Persian databases consistedof SID, and Magiran. The used keywords included “CAM/therapy, needs, and Infertility.” All studiespublished in English peer‑reviewed journals from conception to October 2020, which examined theinfertile women’s needs in the field of CAM use were included in the review. In the process of dataextraction, two researchers screened the title, abstract, and full text of the articles. Out of the 2166articles reviewed, 29 articles including six qualitative and mixed methods studies, four review, and 19quantitative studies met the inclusion criteria. The results showed that infertile women have differentneeds in six domains consisted of educational and informational needs, the need for psychologicalcounseling, supportive needs, the need for CAM use counseling, the need to treatment consistent withwomen’s culture and demands, and the need to the integration of CAM with conventional medicine.Awareness of infertile women’s needs toward CAM use can help health policymakers and plannersin designing and implementing counseling services in accordance with the demands and cultureof infertile couples. It also helps to develop a coherent program to integrate the use of CAM in theclassical infertility treatment.

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Efficacy of capacity building educational interventions in the management of obstetric complications: A systematic review

. Santhoshkumari M; . Hepsibah Sharmil S

Volume 12, Issue 5 , June 2022, Pages 1-11

Abstract

  BACKGROUND: Delay in the diagnosis and management of obstetric complications lead to raisedmortality rate. This can be curtailed by appropriate implementation of the educational interventionamong ...  Read More BACKGROUND: Delay in the diagnosis and management of obstetric complications lead to raisedmortality rate. This can be curtailed by appropriate implementation of the educational interventionamong the health‑care providers. Hence, this review aimed to identify the literature evidence of theefficacy of various educational interventions training in the management of obstetric complications.MATERIALS AND METHODS: We searched PUBMED, Web of Science, SCOPUS, Google Scholar,Cochrane, and maternity care databases with studies published from 2011 to 2021 for identifyingstudies related to this educational intervention review using MeSH terms and free terms. The searchprocess was also done on the websites of the World Health Organization and the reproductive healthlibrary in the English language. From the 1823 abstracts reviewed, 16 studies were included (15quasi‑experimental, 01 randomized clinical trial, and 01 exploratory research design). We identifiedstudies that included skill assessment of nurses, midwives, auxilliary nurse‑midwives (ANMs), medicalstudents, interns, and doctors after implementing various educational interventions.RESULTS: According to the findings of this literature, achieving enhanced nursing management ofobstetric complications has been developed. Especially, it suggests through better nursing trainingand education and also by providing sufficient resources, time, and coordination with obstetricspecialists, nurses and midwives will be able to implement their care roles, which include properdiagnosis, appropriate intervention, advanced care, client education, and psychological support. Theefficacy of each educational intervention varies and depends on the participants’ understanding,interest, and the advancement of the teaching‑learning method used.CONCLUSION: This systematic review reveals abroad and logical move towards the evaluation ofvarious educational interventions in the field of obstetric complications. Among all the educationalinterventions implemented, mobile application, and simulation‑based training play a major rolein improving the knowledge and skills of health‑care providers in the management of obstetriccomplications.

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To study the knowledge about the handling of biomedical waste among health‑care workers in a COVID‑19 hospital setting

. Sukhbir Singh; . Vrinda Tom; . Ramesh Verma; . Ishwanti Malik; . Madan Gopal Vashist; . Pushpa Dahiya

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: The unexpected increase in COVID‑19‑related waste and its inappropriate disposalhad blown up the threat of retransmission of this infection and adversely impacted the ...  Read More BACKGROUND: The unexpected increase in COVID‑19‑related waste and its inappropriate disposalhad blown up the threat of retransmission of this infection and adversely impacted the environment.The aim of this study was to evaluate the existing knowledge about the handling of biomedicalwaste (BMW) in the COVID‑19 Hospital setting among health‑care workers (HCWs).MATERIALS AND METHODS: It was a prospective cross‑sectional study done for 3 months, i.e.,October 2020–December 2020 among nursing professionals across all seniority posted in COVIDhospital. A pretested questionnaire comprised 20 questions was used as a study tool.RESULTS: The response rate of our study was 94%. The mean age of respondents was 33.97 years,and the mean length of service was 8.32 years. The study revealed that the respondents had amean knowledge score of 12.21 (Median 12, standard deviation 2.129 and 95% confidence intervalof 11.92–12.51).CONCLUSIONS: There is consensus among the researchers/scholars that COVID‑BMW hazardsare much more significant than regular BMW. Therefore, its awareness among the HCWs can be apanacea for safer handling of BMW generated in COVID Hospital.

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Comparison of the effect of bioterrorism education through two methods of lecture and booklet on the knowledge and attitude of nurses of Shams Al‑Shomus Nezaja Hospital

. Masoud Khoshnudi; . Fahime Ghadamgahi; . Gholamreza Najjarzade; . Farzane Habibi Mud; . Nahid Aghaei; . No’man Arab; . Seyyed‑Javad Hosseini‑Shokouh; . Atabak Nikbakht

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: Today, considering the importance of bioterrorism, it may be time to assess therisk of bioterrorism as an important priority. Nurses, as the broadest group of therapy group, ...  Read More BACKGROUND: Today, considering the importance of bioterrorism, it may be time to assess therisk of bioterrorism as an important priority. Nurses, as the broadest group of therapy group, arevery influential in this regard.General aim: To determine the impact of bioterrorism education throughtwo methods of lectures and booklets on the knowledge and attitude of nursing staff. Practical Aim:Minimizing the damage caused by bioterrorism attacks by empowering nursing staff.MATERIALS AND METHODS: This two-group semiexperimental intervention study was performed as abefore and after education intervention with the participation of 80 nursing staff of Shams Al-Shomus NezajaHospital affiliated to Health Administration of Islamic Republic of Iran Army Ground Forces. The studypopulation included all hospital nursing staff in 2021. The inclusion criteria included having a willingnessand informed consent to participate in the study and exclusion criteria included unwillingness to continuecooperation and failure to complete more than 10% of the questionnaire by the subject. This study wasperformed on 77 nurses in 2021. The nurses were divided into two groups: lecture and booklet. First,the pretest was completed by the nurses. After the educational intervention, both groups completed theposttest. Both groups then completed the questionnaire again after about 2 weeks. First, all the data weremeasured for normal distribution by the Kolmogorov–Smirnoff test. Statistical description was expressedfor the variables with normal distribution as the ratio of geometric mean ± standard error and for abnormalvariables as mean ± standard error. To compare the means of the studied quantitative variables, t-testand Wilcoxon matched-paired statistical tests were used. The significance level was considered <0.05.SPSS.16 and Graph Pad Prism 8.0.1 softwares were used to analyze the statistical data.RESULTS: Using both methods is effective in improving the level of knowledge and betterment attitude,but according to the paired t-test in comparison of the two groups, at intervals immediately after trainingand 2 weeks after training, a significant increase in the average knowledge score of the lecture groupStatistically shows (P < 0.001). However, the analysis of attitude scores was performed between thetwo groups of lectures and booklets, which did not show statistically significant changes between them.CONCLUSIONS: One of the most important issues in the performance of medical staff in bioterrorismattacks is useful, effective, correct, and sufficient training. According to the results of the presentstudy,bioterrorism training leads to increasing the level of knowledge and betterment the attitude ofnurses in the field of bioterrorism. Therefore, the inclusion of training courses in medical centers,especially military medical centers, is necessary and sensitive.

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Awareness and understanding of COVID‑19 among pregnant woman in northern India

. Manisha Jhirwal; . Pratibha Singh; . Charu Sharma; . Priyanka Kathuria; . Shashank Shekhar; . Satya Prakash Meena

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: The severe acute respiratory syndrome coronavirus (SARS‑CoV‑2) has becomea public health concern worldwide. It is important for pregnant women to know about the mode ...  Read More BACKGROUND: The severe acute respiratory syndrome coronavirus (SARS‑CoV‑2) has becomea public health concern worldwide. It is important for pregnant women to know about the mode oftransmission, symptoms, and preventive measures against COVID‑19. The aim of this study wasto evaluate the awareness and outlook of pregnant women and practical measures taken by themagainst COVID‑19.MATERIALS AND METHODS: This cross‑sectional questionnaire‑based study was conducted for1 month (June 10, 2020– July 10, 2020) in the Department of Obstetrics and Gynecology, All IndiaInstitute of Medical Sciences, Jodhpur, Rajasthan, India. A prevalidated questionnaire was given to109 pregnant women to assess the knowledge, attitude, and practice acquired against COVID‑19infection. The Chi‑square test or Fischer’s exact test was used to compare categorical data.RESULTS: Among 109 participants, 103 (94.5%) had good knowledge, 4 (3.7%) had averageknowledge and 2 (1.8%) had poor knowledge about COVID‑19. Majority of them had a positiveattitude for the protective measures taken for the prevention of disease.CONCLUSIONS: Since there is no valid treatment for COVID‑19, prevention is the only key to curvethis infection. In the present study, 94.5% pregnant women had overall good knowledge score aboutthe ode of transmission, symptoms, and preventive measures against COVID‑19.BACKGROUND: The severe acute respiratory syndrome coronavirus (SARS‑CoV‑2) has becomea public health concern worldwide. It is important for pregnant women to know about the mode oftransmission, symptoms, and preventive measures against COVID‑19. The aim of this study wasto evaluate the awareness and outlook of pregnant women and practical measures taken by themagainst COVID‑19.MATERIALS AND METHODS: This cross‑sectional questionnaire‑based study was conducted for1 month (June 10, 2020– July 10, 2020) in the Department of Obstetrics and Gynecology, All IndiaInstitute of Medical Sciences, Jodhpur, Rajasthan, India. A prevalidated questionnaire was given to109 pregnant women to assess the knowledge, attitude, and practice acquired against COVID‑19infection. The Chi‑square test or Fischer’s exact test was used to compare categorical data.RESULTS: Among 109 participants, 103 (94.5%) had good knowledge, 4 (3.7%) had averageknowledge and 2 (1.8%) had poor knowledge about COVID‑19. Majority of them had a positiveattitude for the protective measures taken for the prevention of disease.CONCLUSIONS: Since there is no valid treatment for COVID‑19, prevention is the only key to curvethis infection. In the present study, 94.5% pregnant women had overall good knowledge score aboutthe mode of transmission, symptoms, and preventive measures against COVID‑19.

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Assessment of medication administration of nurses in medical cardiac wards and its relationship with some demographic characteristics: An observational study

. Hajar Najafi; . Sedigheh Farzi; . Mohammad Javad Tarrahi; . Sima Babaei

Volume 12, Issue 5 , June 2022, Pages 1-5

Abstract

  BACKGROUND: Unsafe medication administration and medication errors pose a threat to medicationsafety. Safe medication is one of the most important nursing practices that plays an important ...  Read More BACKGROUND: Unsafe medication administration and medication errors pose a threat to medicationsafety. Safe medication is one of the most important nursing practices that plays an important rolein preventing medication errors. The aim of this study was to assess the medication administrationof nurses in cardiac wards and its relationship with some demographic characteristics.MATERIALS AND METHODS: The present study was conducted as an observational study in 2021with the 60 nurses who working in the medical cardiac wards of one selected hospital affiliated withthe Isfahan University of Medical Sciences. Data were collected using three‑part tools (demographicinformation, medication checklist (55 items), and documentation checklist (8 items). The checklistwas completed by the observer after observing the nurses’ medication administration. Data analysiswas conducted using descriptive and inferential statistics in the SPSS software (version 16, SPSSInc., Chicago, IL, USA). A P < 0.05 was considered statistically significant.RESULTS: The mean total score of the principles of injection and oral medication administrationwere 82.53 ± 10.75 and 75.76 ± 9.62, respectively. The mean score of the principles of injectionand oral medication administration in the morning shift was significantly higher than the eveningand night shifts (P < 0.001). The relationship between the mean score of the principles of injectionmedication (r = 0.234, P = 0.067), oral medication (r = 0.222, P = 0.083), and the nurses’ workexperience no significant. The rate of adherence to the principles of medication administration in thepremedication administration stage was higher than during and after drug administration.CONCLUSION: Although the mean score of medication administration of nurses in the medicalcardiac wards was at the desired level, it is necessary to monitor and plan by nursing managers toimprove medication administration. Reducing the number of night shifts, adhering to accreditationprograms in the hospital, continuous monitoring of nurses in terms of compliance with the principlesof medication are among the proposed solutions to improve the safe medication in nurses.

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Impact of online education due to the pandemic among college students: Knowledge, Attitude and Practices analysis with structural equation modeling

. Hajar Najafi; . Sedigheh Farzi; . Mohammad Javad Tarrahi; . Sima Babaei; . Ida Shekinah S; . Priyadharshini Chinnasamy; . Deepsheka K; . Venkatesan Singaram

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  Pandemic 2019 is observed in all sectors of the world which had caused a huge disruption in theeducation system in India as well as worldwide adding challenges to student’s life. ...  Read More Pandemic 2019 is observed in all sectors of the world which had caused a huge disruption in theeducation system in India as well as worldwide adding challenges to student’s life. We aimed toprovide an outline on E‑Learning and the difficulties experienced by students of various colleges inthe southern parts of India and to conduct knowledge, attitude and practices (KAP) analysis basedon student’s perception regarding E‑learning by collecting an online survey, 346 valid questionnaireswere retrieved. In order to evaluate the association between the variables of KAP, structural equationmodeling was used for data analysis. The influencing factors of KAP were observed to know theeffect of the pandemic on E‑learning from the model. The result finding moderately fit the collecteddata and reveals a good fit of the model in the means of satisfying the threshold values.

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Presenting a conceptual model for designing hospital architecture with a patient‑centered approach based on the patient’s lived experience of sense of place in the therapeutic space

. Mansour Pagiri Ghalehnoei; . Mohammad Massoud; . Mohammad H. Yarmohammadian

Volume 12, Issue 5 , June 2022, Pages 1-11

Abstract

  BACKGROUND: In recent years, among managers and designers of health‑care spaces, therehas been a growing tendency to move toward hospital design by combining patient perceptionsand ...  Read More BACKGROUND: In recent years, among managers and designers of health‑care spaces, therehas been a growing tendency to move toward hospital design by combining patient perceptionsand expectations of the physical environment of the care area. The main idea of this study wasto present a conceptual model of hospital architecture in our country with a patient‑centeredapproach based on some factors that were affecting the sense of place. This model determinedthe architectural features of treatment spaces from a patient’s lived experience that could have apositive mental effect on patients as well. The main question of the research was how to adapt theobjective perception to the patient’s mental perception to create a sense of place in the hospitalspace?MATERIALS AND METHODS: This research was qualitative with a phenomenological approach,conducted between July and December 2020. Purposeful sampling consisted of 23 patients, 13 malesin the male surgery unit and 10 females in the gynecology unit, who were interviewed in‑depth. Theywere hospitalized for at least 3 days in two hospitals (Dr. Pirooz in Lahijan and Ghaem in Rasht).The data were analyzed by the Colaizzi method.RESULTS: The results consisted of 530 primary codes, 57 subthemes, and 7 main themes. The mainthemes were hospital location, access to hospital, hospital identity, hospital dependency, hospitalattachment, human interactions in the hospital, and hospital evaluation.CONCLUSION: The hospital form guided the patient, and the hospital function directed and obviatedthe patient’s needs. The healing environment and human interactions with it caused the patient tobe satisfied with the hospital environment.

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Evaluation of cancer awareness, cancer education, and prevention intervention techniques among university‑level students in the United States and India

. Adam D. Burke; . Jared W. Burns; . Swati Chakraborty; . Tanima Saha; . Amitabha Ray; . Daniel M. Borsch

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: Cancer is one of the leading causes of death globally. A considerable number ofdifferent cancer types may be preventable, using primary intervention techniques, such as ...  Read More BACKGROUND: Cancer is one of the leading causes of death globally. A considerable number ofdifferent cancer types may be preventable, using primary intervention techniques, such as healtheducation, cancer awareness, behaviors and lifestyle modifications. The present study conducted acomparative assessment of cancer awareness among undergraduate students of the United Statesand India.MATERIALS AND METHODS: Students from an Institution in India (KC) (55 females, 33 males),and an Institution in the United States of America (SHU) (226 female, 58 male) during 2019–2020participated in this study. Participants (n = 372) across all majors and all years (first throughfourth year) completed an online questionnaire and answered the questions on their demographiccharacteristics (e.g., gender, age, and location), academic status (e.g., year of study, major),multiple‑choice questions about cancer knowledge, and opinion questions (e.g., “where would youfind info,” “should therapies be free”). Student responses were collected using Qualtrics SurveySoftware. Excel was used to analyze responses. We conducted statistical Χ2 tests for independenceto determine whether there is a statistically significant difference between the expected frequenciesand the observed frequencies in one or more categories of a contingency table, with a significanceof ɑ = 0.01. While small sizes due to the small institutions and the response pool, we note that weachieved the necessary “n” for all tests reported.RESULTS: Our research shows a few important statistically significant differences, includingknowledge of cancer and breast lumps is dependent on location, ranking of global cancer deaths isdependent on location, and that cancer knowledge is dependent on the information source. All forΧ2 tests with P < 0.001.CONCLUSIONS: Further encouragement of education for young people in various aspects ofcancer and cancer prevention, as well as information facility and sources of reliable data, could behelpful for improving the overall health and primary prevention. A thorough assessment is neededto understand the responsible factors for the observed cancer knowledge variations among studentsof two different places.

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Identification of change leadership dimensions and components in medical science education to move toward the third‑generation universities: A qualitative study

. Ghobad Ramezani; . Shoaleh Bigdeli; . Yadolah Zarezadeh; . Zohreh Sohrabi

Volume 12, Issue 5 , June 2022, Pages 1-11

Abstract

  BACKGROUND: Change is a multidimensional and pervasive issue in the modern world, andorganizations are constantly changing in social, cultural, political, economic, and technological ...  Read More BACKGROUND: Change is a multidimensional and pervasive issue in the modern world, andorganizations are constantly changing in social, cultural, political, economic, and technological fields.Change leadership is a model that employs a combination of leadership styles to keep the employeesand the organization prepared for learning and continuous growth. This study aims to identify thedimensions and components of change leadership in medical sciences education to move towardthird‑generation universities through a qualitative approach.MATERIALS AND METHODS: The present study was an applied explorative qualitative study.Participants included the experts in the field of management and key informants in the field of changeleadership and third‑generation universities who were selected through purposive sampling. Theresearch tool was semi‑structured interviews aimed at the identification of dimensions and componentsof the change leadership. Interview‑guided questions were about change leadership to move towardthe third‑generation universities followed by probing questions. Colaizzi content analysis techniquewas used to analyze the data.RESULTS: Data from interview transcript analysis resulted in the identification of 335 initial codes,13 subcategories, and 3 categories or dimensions. The main categories included “change leadershiproles and specifications,” “providing a context and preparing for change,” and “change leadershipprocess and path.” Each of the main dimensions included several components.CONCLUSION: The importance of leadership in the process of change is since change entails theestablishment and institutionalization of new systems and structures which is impossible withoutan effective leadership style. Leaders have high expectations of their followers and inspire themto strive toward organizational goals and facilitate the realization of the shared vision throughencouraging them. As a leadership paradigm for organization performance improvement capableof encouraging employees and building an organizational culture in which ethical procedures areconsidered behavioral norms, change leadership seeks to predict the environment changes so thatit can move in accordance with them.

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Quality of life and empowerment among women

. Purnima Kundu; . Linu Sara George; . Renjulal Yesodharan

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: Few women in history were respected by society because of their contributionsto the field of science, arts, politics, and so on, but in general, women are deprived of their ...  Read More BACKGROUND: Few women in history were respected by society because of their contributionsto the field of science, arts, politics, and so on, but in general, women are deprived of their rightsand being refrained from decision‑making in major areas of individual and family life. This researchtried to investigate the degree of empowerment and quality of life (QOL) of the women to find outthe relationship between empowerment and QOL of women.MATERIALS AND METHODS: An exploratory survey was carried out among 210 purposively selectedmarried women aged between 20 and 49 years in a selected municipality area of West Bengal.Data were obtained by one‑to‑one interviews using Women Empowerment Interview Schedule andWHOQOL Scale BREF.RESULTS: The mean total QOL score of the women was found as 98.59 ± 13.61. The transformedscores in the physical, psychological, social relation, and environmental domains were 74.92 ± 14.97,66.58 ± 15.78, 81.00 ± 18.07, and 65.28 ± 17.99, respectively. The degree of empowerment wascalculated as 64.71 ± 6.79. Among the women, 5% had poor, 62% had medium, and 33% had ahigh degree of empowerment. A weak positive correlation (r = 0.325, P = 0.001) was found betweenQOL and empowerment. Significant associations were established between empowerment andeducation (Fisher’s exact = 13.975 [0.007]) and education gap with husband (Fisher’s Exact = 8.68,P 0.069). Multiple regression analysis between empowerment dimensions and QOL shows thatpersonal or family dimensions, including health, are a significant predictor for the QOL (P < 0.01).CONCLUSION: Most of the women had medium degree of empowerment. Increased degree ofempowerment improves their QOL of women. Women should be aware of their rights that canenhance the empowerment in different dimensions of life.

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Economic evaluation of medical versus surgical strategies for first trimester therapeutic abortion: A systematic review

. Saeed Husseini Barghazan; . Mohamad Hadian; . Aziz Rezapour; . Setare Nassiri

Volume 12, Issue 5 , June 2022, Pages 1-10

Abstract

  Pregnancy termination and abortion‑related complications are well‑established problems amongwomen at reproductive age and resulted in significant morbidity and mortality. Accordingly, ...  Read More Pregnancy termination and abortion‑related complications are well‑established problems amongwomen at reproductive age and resulted in significant morbidity and mortality. Accordingly, asystematic study was performed to investigate the economic evaluation studies results on costsand benefits of medical and surgical abortion methods. PubMed, Web of Science, Scopus, Embase,Cochrane library, ProQuest, and ScienceDirect databases as well as Google scholar were searchedthrough June 2021. Original full‑text English language studies that performed an economic evaluationanalysis comparing medical and surgical methods of pregnancy termination were included in thisreview. A critical quality assessment was conducted utilizing the Consolidated Health EconomicEvaluation Standards checklist. The latest web‑based tool adjusted the estimates of costs expressedin one specific currency and price year into a specific target currency (the year 2020 $US). Overall,538 records were retrieved, and 20 studies were deemed eligible for qualitative synthesis. Amongthe reviewed studies, three studies investigated cost‑minimization analysis, three studies investigatedcost‑utility analysis, and 14 studies investigated cost‑effectiveness analysis. The directly comparisonof medical with surgical abortion was most frequently studied. Medical abortion saved US$ 6 to US$2373 per patient’s costs. Medical abortion was cost‑effective and cost‑saving option in compare tothe surgical abortion across all perspectives (the incremental cost effectiveness ratio ranged fromUS$ 419 to US$ 4,044). Quality scores of included studies ranged from 54% to 100%, and 70% ofstudies received a score of above 85% and had “excellent” quality. According to the results, based onvarious economic and clinical effectiveness decision‑making criteria used in different studies of healtheconomic evaluation, the majority of research provided evidence on the advantage of pharmaceuticalmethods compared to surgical methods, as well as the advantages of using combinations therapycompared to single therapeutic interventions.

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COVID‑19: Distance learning to empower educators and health assistants in rural areas

. Maria do Carmo Barros de Melo; . Priscila Menezes Ferri; . Monica Maria Almeida de Vasconcelos; . Zilma Silveira Nogueira Reis; . Solange Cervinho Bicalho Godoy; . Vitória Andrade Palmeira; . Gabriel Rocha; . Rosalia Morais Torres; . Unaí Tupinambás

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: Educators and health assistants can act as key players in controlling the pandemic.In general, they are respected by the community, especially in rural areas, and can help ...  Read More BACKGROUND: Educators and health assistants can act as key players in controlling the pandemic.In general, they are respected by the community, especially in rural areas, and can help guide andraise the population’s awareness of preventive measures. The objective of this paper is to evaluatethe results in knowledge progress of an e‑learning course offered to educators and health assistantsby a public university and to analyze the profile and satisfaction of the participants.MATERIALS AND METHODS: A single group pre‑ and post‑test design based on a questionnaire,interventional, study was conducted in the period from April 20th to June 20th. All participants of thecourse answered sociodemographic and satisfaction questionnaire and a pre‑ and post‑test. Datawere descriptively arranged and regarding the distribution and comparison of means and frequency,paired t‑test for group comparisons. P < 0.05 was statistically significant. Data were collected fromthe Moodle® teaching platform, without identifying the participants.RESULTS: A total of 674 participants were enrolled in the five groups, and 583 concluded thecourse (86.5%). The reasons for those who did not access the entire course (n = 47) were: Lack oftime, difficulty in accessing the internet, and lack of experience with distance learning courses. On theevaluation of the course platform, from the tutors in general and the degree of satisfaction in severalquestions, participants marked maximum grades. The comparison between pre‑ and post‑proficiencyscores showed increased proficiency of the enrolled groups (P < 0.0001).CONCLUSIONS: The course contributed to the training of health assistants and educators, preparingthem to act in a participatory way in the prevention and control of the pandemic. The course waswell evaluated and there was a progression of knowledge by the participants.

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Evaluating the usability of a national health information system with heuristic method

. Hamid Bouraghi; . Sorayya Rezayi; . Shahrzad Amirazodi; . Ehsan Nabovati; . Soheila Saeedi

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: Hospital Statistics and Information System is one of the most important healthinformation systems in Iran used in all hospitals in this country. Usability problems can reduce ...  Read More BACKGROUND: Hospital Statistics and Information System is one of the most important healthinformation systems in Iran used in all hospitals in this country. Usability problems can reduce thespeed and precision of users when interacting with this system. This study aimed to identify theusability problems of a national health system called “AVAB”.MATERIALS AND METHODS: This descriptive cross‑sectional study was conducted in 2020, andthree experts evaluated the usability of this system independently by the heuristic evaluation method.Nielsen’s usability principles were used to identify usability problems and to classify their severity.RESULTS: A total of 86 unique problems were identified. The highest number of problems wererelated to the two principles of “help and documentation” and “match between system and the realworld” with 23 and 11 usability problems, respectively. The lowest number of problems were relatedto the two principles of “visibility of system status” and “help users recognize, diagnose, and recoverfrom errors,” each with three problems. 58.1% of the identified problems were in the group of majorand catastrophic problems.CONCLUSIONS: With the help of heuristic evaluation method, a significant number of usabilityproblems of Hospital Statistics and Information System were identified. Most of the identified problemswere major and catastrophic, and it is necessary to solve these problems by the designers anddevelopers of this system.

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‘Perceptions’ and ‘practices’ to antibiotic usage among diabetic patients receiving care from a rural tertiary care center: A mixed‑methods study

. Manjunath Inchara; . Mahendra M. Reddy; . Nagesh Ramya

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: Contribution to antibiotic resistance can happen at two interfaces – doctorprescribing antibiotics inadvertently or patient’s usage of antibiotics inadvertently. ...  Read More BACKGROUND: Contribution to antibiotic resistance can happen at two interfaces – doctorprescribing antibiotics inadvertently or patient’s usage of antibiotics inadvertently. This study wasconducted among diabetic inpatients in a rural tertiary health center in Kolar, South India, to assessthe various practices related to antibiotic use and to explore the possible reasons for these practiceswith regard to antibiotic use.MATERIALS AND METHODS: An exploratory sequential mixed‑methods study was conductedwith an initial cross‑sectional quantitative study followed by qualitative in‑depth interviews duringAugust–September 2019. A pretested semi‑structured questionnaire was used to capture thesociodemographic, disease‑, and treatment‑related characteristics and practices related to antibioticuse. An open‑ended interview guide was used to conduct in‑depth interviews. The practices toantibiotic use were reported using frequency (percentage). Manual descriptive content analyses weredone by two investigators separately to identify codes under the broad topic “reasons for adoptedpractices with regard to antibiotic use.”RESULTS: Of the 152 diabetic inpatients interviewed, 20 (13.2%) felt that antibiotics are safe drugsand can be used commonly. Among these inpatients, seven (4.6%) knew that antibiotics can killbacteria and four (2.6%) perceived ‘antibiotic resistance’ as a big problem in India. The practiceof checking the expiry date before using antibiotics was seen in 21 (13.8%) and 44 (29%) of themfinished the full course of antibiotics. A total of six codes were identified under the broad theme of“reasons for adopted practices with regard to antibiotic use” among diabetic inpatients.CONCLUSIONS: Less than one‑third of them completed the antibiotic course given by the doctor, andalmost everyone was ready for over‑the‑counter purchase of antibiotics offered by the pharmacist.The reasons for such practices were mostly attributed to the “partial drug purchases” and “incompleteadvice by the doctor.” There is an urgent need to plan and deliver an interventional package to enhancethe knowledge and inculcate good antibiotic usage practices among these high‑risk populations.

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Exploring the influence of scheduled meetings on physiological indicators of hospitalized patients satisfaction facing acute myocardial infarction in the intensive care unit

. Marzieh Najafi; . Hakimeh Mohammadzadeh; . Nasrin Heydarian; . Mohammad Rostami; . Tooba Ebadi Fard Azar; . Fatemeh Mahmoodi; . Fakhreddin Chaboksavar; . Gholamreza Garmaroudi

Volume 12, Issue 5 , June 2022, Pages 1-8

Abstract

  BACKGROUND: Satisfaction of patients is among the top priorities of health‑care providers. Meetingwith families is essential for patients who are admitted to various wards, although ...  Read More BACKGROUND: Satisfaction of patients is among the top priorities of health‑care providers. Meetingwith families is essential for patients who are admitted to various wards, although it has been restrictedfor many reasons such as its impact on physiologic indicators. This present research study aimedto exploring the influence of scheduled meetings on physiological indicators of hospitalized patientssatisfaction facing acute myocardial infarction in the intensive care unit.MATERIALS AND METHODS: This study was a nonrandomized clinical trial with a control groupconducted in the cardiac care unit ward of Hamadan’s Ekbatan Hospital. Sixty patients with acutemyocardial infarction were chosen through convenient sampling and assigned to intervention (plannedmeeting) and control (routine meeting) groups in a nonrandomized manner. Data were collected bya researcher‑made questionnaire of patient satisfaction and the observatory checklist of physiologicindicators and then analyzed in IBM SPSS Statistics v23.RESULTS: The total mean score of satisfaction did not significantly differ between the twogroups (P = 0.921). The satisfaction of patients for “the conduct of visitors” was significantly higherin the intervention group (P = 0.005). During the study, no meaningful difference was found betweenthe two groups for physiologic indicators (P > 0.05), while these indicators, except for blood O2saturation, were meaningfully increased in the control group during routine meetings (P < 0.05).CONCLUSION: Planned meetings did not promote total satisfaction of patients with meetings, butimproved some aspects of satisfaction, such as the conduct of visitors. The planned meeting isrecommended as an alternative for a routine meeting, as it did not affect the physiologic indicatorsof patients in the intervention group.

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The correlates of physical activity during COVID‑19 pandemic among Indonesian young adults: A longitudinal study

. Novita Intan Arovah

Volume 12, Issue 5 , June 2022, Pages 1-8

Abstract

  BACKGROUND: Social distancing policy during the COVID‑19 pandemic may affect physical activitylevels. This study aimed to compare physical activity levels before and during the pandemic ...  Read More BACKGROUND: Social distancing policy during the COVID‑19 pandemic may affect physical activitylevels. This study aimed to compare physical activity levels before and during the pandemic and toexplore physical activity correlates among Indonesian young adults.MATERIALS AND METHODS: This longitudinal study was conducted before the pandemic (n = 141)in September 2019 and was followed by an online follow‑up survey during the pandemic(79% response rate) in September 2020. Physical activity was measured using the global physicalactivity questionnaire and was classified into “sufficient” and “insufficient.” The potential correlatesof physical activity were constructs from social‑cognitive theory and health belief model. Those weremeasured using a validated questionnaire in the follow‑up survey. Physical activity levels before andduring pandemics were compared using the Wilcoxon signed‑rank test. Simple logistic regressionswere used to assess the relationships between each potential correlate and physical activity statusduring the pandemic.RESULTS: Physical activity levels decreased significantly during the pandemic, mostly in thework‑related domain. Participants with favorable physical activity‑related constructs were more likelyto be physically active. The odds ratio ranged from 3.41 (95% confidence interval [CI] = 1.15–10.11)in participants with higher self‑efficacy to 4.50 (95% CI = 1.44–14.06) in those with higher outcomeexpectations of physical activity.CONCLUSION: A significant decline in physical activity during the COVID‑19 pandemic amongIndonesian young adults was confirmed. The application of behavioral change theories for explainingphysical activity status during the pandemic in this population is also supported. It is recommendedto incorporate these constructs to develop physical activity interventions in this target population.

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Is ignorance of the weekly iron and folic acid scheme among adolescents the deciding factor for its suboptimal utilization and ineffectiveness? A cross‑sectional study

. Surya Bali; . Yash Alok

Volume 12, Issue 5 , June 2022, Pages 1-8

Abstract

  INTRODUCTION: Targeting the huge burden of adolescent anemia, the Weekly Iron and Folic acidSupplementation (WIFS) was launched by the Government of India. Few studies have been doneto ...  Read More INTRODUCTION: Targeting the huge burden of adolescent anemia, the Weekly Iron and Folic acidSupplementation (WIFS) was launched by the Government of India. Few studies have been doneto assess the effective functioning of the program since its inception. The present study was doneto assess the knowledge WIFS among adolescents of Madhya Pradesh and the associated factors.MATERIALS AND METHODS: A cross‑sectional study was done in a total of six districts(3 districts where the national adolescent program was implemented and 3 districts where it was not)of Madhya Pradesh. Multistage stratified random sampling technique was used for the enrollment of3213 adolescent boys and girls, and a prestructured and validated tool was used to collect paperlessdata. Ethical approval and consent from the participants were obtained. Statistical analysis wasperformed using SPSS v21.RESULTS: It was observed that the knowledge of WIFS was more among adolescent girls (29.3%)as compared to adolescent boys (14.1%). More of the adolescent girls received Iron and folic acidtablets as compared to adolescent boys (60.8% girls vs. 24.1% boys). Mostly, the adolescents gotIron tablets from school followed by Anganwadi and PHC/CHC. Girls, rural location, literacy, belowpoverty line status, knowledge of anemia, adolescents who got iron and albendazole tablets, andadequate consumption of iron tablets (>4) were associated with higher knowledge of WIFS.CONCLUSION: The knowledge of WIFS was found to be less in adolescent boys. There is a hint ofthe fact that effective execution of the program among its beneficiaries leads to an automatic increasedknowledge of the program, at least among the beneficiaries. Thus, an indirect but significant indirectfinding is that the nationwide WIFS program needs to be put to greater focus among the adolescentboys, apart from its major focus on the female gender among most age groups.

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Three‑way summaries as a teaching–learning tool: Student perspective and impact on retention of learning

. Alpesh K. Chauhan; . Tejas M. Khakhkhar; . Neelesh R. Khuteta; . Gurudas D. Khilnani

Volume 12, Issue 5 , June 2022, Pages 1-4

Abstract

  BACKGROUND: “Three‑way summaries” (TWS) are a teaching–learning tool in which studentsrespond to a question or topic inquiry by three different summaries (10–15 ...  Read More BACKGROUND: “Three‑way summaries” (TWS) are a teaching–learning tool in which studentsrespond to a question or topic inquiry by three different summaries (10–15 words, 30–50 words,and 75–100 words). The aim of this study was to introduce TWS, to establish its impact on learningretention, and to identify students’ perception for TWS.MATERIALS AND METHODS: It was an educational interventional study. It was carried out in tworandomly allocated groups, Group A having TWS as intervention and Group B without TWS, followedby crossover of the groups. Participants were assessed using two multiple choice question (MCQ)tests, ten marks each (one immediately and second after 1 week) during both phases. Students’perception regarding TWS was assessed by questionnaire using Likert scale. Statistical analysiswas done by two‑tailed independent t‑test.RESULTS: Both groups’ performance deteriorate after 1 week, but it was affected more in Group Bwithout TWS (4.85 ± 1.89–4.70 ± 2.05, P = 0.05) as compared to Group A with TWS (5.30 ± 1.81–4.63± 1.90, P = 0.69). While in second phase, performance of the Group B with TWS improved moresignificantly (5.92 ± 2.24–6.83 ± 2.21, P = 0.04) in comparison with Group A without TWS (4.96 ±1.89–5.66 ± 2.35, P = 0.09). Most of the students liked TWS as an educational tool using Likert scale(72%–86% agreeing and strongly agreeing).CONCLUSIONS: TWS is highly acceptable teaching–learning tool which improves learning retention.

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How India has managed the COVID‑19 first and second waves?

. Rahul Pal; . Ashish Wasudeo Khobragade; . Mukulika Mandal

Volume 12, Issue 5 , June 2022, Pages 1-2

Abstract

    Read More

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Predictors of the intention to receive the COVID 19 vaccine by Iranians 18– 70 year old: Application of health belief model

. Roya Jahanshahi‑Amjazi; . Mohsen Rezaeian; . Mehdi Abdolkarimi; . Mostafa Nasirzadeh

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: In terms of public health, vaccination is considered as the most effective approachagainst the infectious diseases. Accepting and receiving the first vaccine produced as ...  Read More BACKGROUND: In terms of public health, vaccination is considered as the most effective approachagainst the infectious diseases. Accepting and receiving the first vaccine produced as an innovationmay not be easy. Therefore, the present study was conducted to investigate the predictors of intentionto receive COVID‑19 vaccine by Iranians aged 18–70 years based on the health belief model in 2021.MATERIALS AND METHODS: This descriptive study was performed on 2365 people aged18–70‑year old in Iran by random cluster sampling. Receipt of data was done electronicallyquestionnaire through the Porcelain system. Data were analyzed using SPSS software version 20using Chi‑square, one‑way analysis of variance, independent t‑test, and multiple regression analysisat a significance level of 0.05.RESULTS: The mean score of receiving the Iranian corona vaccine was 3.06 ± 1.30 out of 5 points.About 16.7% reported that they will definitely choose the Iranian vaccine. The highest correlationwas between the intention to receive the vaccine with self‑efficacy (r = 0.239, P < 0.001) and barriersto receiving the vaccine (r = −0.237, P < 0.001). Self‑efficacy (β = 0.114, P < 0.001), perceivedbarriers (β = −0.126, P < 0.001), and benefits of vaccine (β = 0.061, P = 0.022) were most importantpredictors the intention to receive the vaccine.CONCLUSION: Approximately 38% reported that they would definitely and probably not choose theIranian corona vaccine. Therefore, it is suggested that more information should be provided aboutthe features and benefits of domestically produced vaccines compared to foreign products.

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Perception of educational environment as a predictor of academic performance in physiotherapy students

. Manasi Desai; . Unnati Pandit; . Amruta Nerurkar; . Chhaya Verma

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: Students’ perception of their academic environment has a substantial influenceon their actions, academic accomplishments, satisfaction, goal attainment, and behavior. ...  Read More BACKGROUND: Students’ perception of their academic environment has a substantial influenceon their actions, academic accomplishments, satisfaction, goal attainment, and behavior. The studywas carried out to evaluate the perception of academic environment in physiotherapy students, andto identify the specific domains which could act as predictors of academic performance.MATERIALS AND METHODS: This descriptive, cross-sectional research was conductedover 12 months using total population sampling. Three hundred and forty-three (139 postgraduateand 204 final year) final year and postgraduate physiotherapy students from five colleges ofMumbai and Navi Mumbai, who conformed to the inclusion benchmarks, participated in the study.Perception of educational environment was evaluated using Dundee Ready Education EnvironmentMeasure (DREEM). Academic performance was evaluated using the percentage obtained in thelast university examination. Data were entered in MS Excel (©Microsoft, USA) and converted toStata Version 15.1© StataCorp, College Station, for further analysis. The mean values and standarddeviations for perception of educational environment were calculated and linear regression modelswere used to conduct multivariate analysis for each item in the questionnaire.RESULTS: The mean total DREEM score of physiotherapy students was 129.97 ± 22.72. Studentswhose Students’ Academic Self‑perception scores were in the “Feeling more on the positive side”category showed a 4.17 point increase in percentage scores as compared with those who reportedfeeling like a total failure/had many negative aspects to their academic self‑perception (95% confidenceinterval [CI]: 2.46, 5.89; P < 0.001). Students whose Students’ Perception of Learning (SPoL) scoreswere in the “Teaching highly thought of” category showed a 2.75 point increase in percentage scoresas compared with those who viewed teaching poorly/negatively (95% CI: 0.44, 5.06; P = 0.02).CONCLUSION: Physiotherapy students had a “more positive than negative” view of the academicenvironment; however, a few “problematic areas” need to be remediated. Efforts to improve students’academic self-perception may improve their academic performance since this was the strongestpredictor of their academic performance, followed by total DREEM scores and SPoL.

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A qualitative content analysis for determining indexes and factors affecting for evaluation of disaster exercises immediate feedback stage

. Hojjat Sheikhbardsiri; . Sahar Salahi; . Mahdieh Abdollahi; . Tayebe Ilaghinezhad Bardsiri; . Ali Sahebi; . Mohsen Aminizadeh

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: Taking exercise in health sector is one of the important steps to implement thedisaster risk management programs, especially preparedness phase. The present study aimed ...  Read More BACKGROUND: Taking exercise in health sector is one of the important steps to implement thedisaster risk management programs, especially preparedness phase. The present study aimed toidentify indexes and factors affecting successful evaluation of disasters preparedness exercises inhot wash stage.MATERIALS AND METHODS: This study was a qualitative content analysis. Data were collectedby purposeful sampling through in‑depth and semi‑structured individual interviews with 25 healthprofessionals in the field of disasters. The data were analyzed using directed content analysis methodby which the initial codes were extracted after transcribing the recorded interviews and immersingthem in the data analysis. The initial codes were reviewed, classified, and subdivided into severalstages to determine the main classes.RESULTS: The data analysis resulted in the production of 24 initial codes, 5 subcategories, 2 maincategories of “evaluation and exercise debriefing” and “modification of programs and promotion ofexercise operational functions” under the original theme of “exercise immediate feedback.”CONCLUSION: This study can be considered a suitable standard guide for health care organizationsto evaluate successfully disasters exercises in hot wash stage, maintain and promote theirpreparedness, and properly respond to disasters.

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Randomized controlled trial to study the efficacy and safety of ultrasound‑guided pectoral nerve block for superficial breast surgeries

. Nazia Nazir; . Anupriya Saxena; . Shipra Singh; . Shruti Jain

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: Our study aimed to compare pectoral nerve (PEC) block with local anesthetic (LA)infiltration for providing analgesia in superficial breast surgeries.MATERIALS AND METHODS: ...  Read More BACKGROUND: Our study aimed to compare pectoral nerve (PEC) block with local anesthetic (LA)infiltration for providing analgesia in superficial breast surgeries.MATERIALS AND METHODS: This prospective comparative randomized study included seventyAmerican Society of Anesthesiologists I and II female patients undergoing excision of fibroadenoma.In Group 1, the LA mixture was infiltrated in the desired planes. In Group 2, PEC I and PEC II blockswere performed under ultrasound guidance. Patients were observed at regular time intervals for painscores, time to first analgesic request, and the number of patients requiring rescue analgesia withthe cumulative analgesic requirement, hemodynamic changes, and any adverse events.RESULTS: The patients were comparable in demographic profile, duration of anesthesia, andhemodynamic parameters. NRS scores at all times after extubation were significantly lower in Group 2as compared to Group 1 (P < 0.0001). All patients in Group 1 required additional analgesia, whileonly two in Group 2 received rescue analgesia (P < 0.0001). The time to first analgesic request wassignificantly longer in Group 1 as compared to group 2 (9.5 + 0.70 h vs. 1.35 + 0.83 h) (P < 0.0001).The cumulative requirement of tramadol in Group 1 (96.88 ± 16.45 mg) was significantly higher thanin Group 2 (6.47 ± 26.38 mg) (P < 0.0001). No adverse event was reported in either group.CONCLUSION: PEC block is a useful method for achieving effective and long‑lasting analgesia. Itis an efficient and safe alternative to LA infiltration in patients undergoing fibroadenoma excision.

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Systematic review of women's knowledge, attitude, and practice towards breast cancer

. Zahra Meshkani; . Najmeh Moradi; . Ali Aboutorabi; . Sara Noman; . Ali Ghanbari Motlagh; . Mostafa Langarizadeh

Volume 12, Issue 5 , June 2022, Pages 1-11

Abstract

  The present study aims to systematically review the women’s knowledge, attitude, and practice (KAP)of breast cancer (BC) screening methods to get enough information for policymakers ...  Read More The present study aims to systematically review the women’s knowledge, attitude, and practice (KAP)of breast cancer (BC) screening methods to get enough information for policymakers to orient thescreening strategies. All English KAP studies on BC screening methods in five databases up to January2021 were included. The quality of the final articles was assessed using the STROBE checklist.The qualitative synthesis was performed. Out of 5574 retrieved articles, 28 were included. About64% of the articles were of high quality. Overall, there were poor knowledge, negative attitude, andlow practice between women. The educational programs and cultural plans can encourage regularscreening. Women’s excessive optimism to their BC risk should be eliminated by focusing on therisk of the disease, more.

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Post‑COVID‑19 menstrual abnormalities and infertility: Repercussions of the pandemic

. Sparsh Madaan; . Dhruv Talwar; . Neema Acharya; . Sourya Acharya; . Deepika Dewani

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  While battling the life‑threatening complications of COVID‑19, its effect on the menstrualcycle and infertility has been somewhat ignored. This brief review aims on highlighting ...  Read More While battling the life‑threatening complications of COVID‑19, its effect on the menstrualcycle and infertility has been somewhat ignored. This brief review aims on highlighting theimportance of menstrual abnormalities being experienced during the post‑COVID periodand to make the clinicians aware about what to expect in regard of menstrual abnormalitiesby learning from various studies that have been conducted worldwide. This review articlewas written with systematic literature review with the help of data search machine suchas PubMed, Scopus, Web of Sciences, and Google Scholar.A search strategy leads to theextraction of 160 related articles that after the removal of inappropriate and duplicatearticles, 33 articles were selected for the review. To find other potentially relevant articles,the references of the extracted articles were thoroughly examined. The search was carriedout using keywords including “COVID‑19,” “Menstrual abnormalities,” and “Infertility.”Using OR and AND, the keywords mentioned above were combined and then utilized inthe search box of the databases. Articles published from January 2020 to September 2021were included in this study. It includes worldwide data ranging from studies done in China,India, Ireland, Turkey, Jordan, and Germany. During the post‑COVID period, there is asignificant alteration in the sex hormones of females infected by COVID‑19 which maymanifest as menstrual cycle abnormalities such as decreased cycle length or prolongedmenstrual cycle bleeding. It may also manifest as infertility due to ovarian failure dueto suppression of ovarian function COVID‑19 a novel coronavirus which is presently apandemic has affected the world in manner reminding the world of 1918 Spanish flu.However, while battling the deadly pandemic, the clinicians should also be aware of therepercussions of the effect this infection has on multiple organs such as ovarian suppressionleading to infertility, oligomenorrhea, or menorrhagia.

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What do parents of children with autism spectrum disorder think about their quality of life? A qualitative study

. Samaneh Abolkheirian; . Roya Sadeghi; . Davoud Shojaeizadeh

Volume 12, Issue 5 , June 2022, Pages 1-9

Abstract

  BACKGROUND: Living with children with autism spectrum disorder (ASD) can affect differentaspects of parents’ physical and mental health and quality of life. This study aimed to ...  Read More BACKGROUND: Living with children with autism spectrum disorder (ASD) can affect differentaspects of parents’ physical and mental health and quality of life. This study aimed to identify parents’perceptions of their quality of life and factors influencing such perceptions and investigate how theycope with difficulties in their daily lives.MATERIALS AND METHODS: This study was conducted using a qualitative research design to gaininsight into how children with ASD may influence their parents’ quality of life. A total of 31 parentsand school counselors were selected by the snowball sampling method in autism schools in Tehranin the academic year 2018–2019. Semi‑structured interviews were used to collect the data. Eachinterview was held based on a preprepared guideline by the researchers. In‑depth questions werealso asked as needed. Finally, the data were analyzed using the content analysis approach.RESULTS: The participants reported a variety of difficulties and crises to cope with in their dailylives. The factors reported to decrease the quality of life were categorized into six main themes and20 subthemes. The main themes included “family interactions,” “parenting,” “daily living,” “health,”“financial issues,” and “community‑related.”CONCLUSIONS: Due to the diversity and multilevel factors affecting the quality of life of parentshaving children with ASD, it is essential to adopt a comprehensive approach with the participationof all stakeholders in the development, design, and implementation of future interventions.

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Social and behavioral determinants of early childhood caries: A cross‑sectional study within region of Ambala, Haryana

. Chaya Chhabra; . H. P. Suma Sogi; . Kumar Gaurav Chhabra; . Swati Rana; . Sarudhir Gupta; . Priyanka Sharma

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: Early childhood caries is like an epidemic, especially in the developing world,hence exploring its appropriate factors in causing the disease the need of the hour. Hence, ...  Read More BACKGROUND: Early childhood caries is like an epidemic, especially in the developing world,hence exploring its appropriate factors in causing the disease the need of the hour. Hence, the aimof the present study was to evaluate social and behavioral determinants of early childhood carieswithin the region of Ambala, Haryana.MATERIALS AND METHODS: The present survey elaborated oral examination among 398 studyparticipants within the age group of 4–5 years. Carious tooth was recorded using Gruebbel’s deft DEFTindex using clean mouth mirror and probe. A questionnaire comprising 21 questions in English aswell as Hindi was prepared. There was an interviewer who took the interview of parents or caregivers.The questionnaire consisted of questions which were aimed at gaining information regarding infantsfeeding practice, social factors, and dental health behavior. The results of the study were tabulated,and inferential statistics were applied using ANOVA test along with regression (multiple logistic)procedure.RESULTS: The occurrence of caries was affected by the behavioral factors such as breastfeedinghabits, bottle feeding habits, age of beginning of solid foods in children. There was no influence ofage of beginning of taking fluid from cup. Besides social factors like annual family income, educationof mothers, age of mother at the time of birth of children, age of children, order of children in thefamily had a significant effect over the occurrence and severity and extent of caries. Factors suchas gender of children and profession of mother did not have had a significant role in early childhoodcaries. Dental health habits such as tooth brushing frequency, brushing under supervision, frequencyof toothbrushing, quantity of toothpaste used had a significant effect over the frequency, and acerbityof caries in early infanthood.CONCLUSION: It can be concluded from this study that there is a significant correlation betweenseveral social and behavioral determinants and early childhood caries.

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Disaster risk management challenges in military hospitals: A qualitative study

. Somayeh Azarmi; . Amir Hosein Pishgooie; . Simintaj Sharififar; . Hamid Reza Khankeh; . Hejrypour Seyyed Ziya

Volume 12, Issue 5 , June 2022, Pages 1-8

Abstract

  BACKGROUND: Disaster can pose significant challenges to the health infrastructure in thecommunity. Hospitals are the central unit for providing health services in the disaster responseplan. ...  Read More BACKGROUND: Disaster can pose significant challenges to the health infrastructure in thecommunity. Hospitals are the central unit for providing health services in the disaster responseplan. With regard to the vital role of military hospitals in health response to disaster, this study wascarried out with the aim of investigating the disaster risk management (DRM) challenges in militaryhospitals in Iran.MATERIALS AND METHODS: The current study was qualitative research performed in 2020 inmilitary hospitals in Iran. Participants consisted of 12 managers and staff of the military hospitals inTehran and professionals in health in emergencies and disasters who were included in the study bythe purposive sampling technique. Semistructured individual interviews based on the interview guidewere exploited for the data collection, and a content analysis method was used to analyze them.RESULTS: DRM challenges in military hospitals were explained in the form of six categories:“management and leadership, planning, prevention and mitigation, preparedness, response, andrecovery” and 22 subcategories.CONCLUSION: Managers’ awareness of DRM challenges in hospitals, particularly military hospitals,and the design and implementation of solutions can lead to the promotion of hospital DRM andhospital preparedness to deal with disasters.

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New normal of academic virtual conference: Imperative during pandemic

. Arti Gupta; . Limalemla Jamir; . Rajeev Aravindakshan; . Dhrubajyoti J. Debnath; . S. Sathiyanarayanan; . Rakesh Kakkar

Volume 12, Issue 5 , June 2022, Pages 1-5

Abstract

  In COVID pandemic, attending the continuing medical education, workshops, and conferences withphysical attendance is not possible. We designed, developed, and hosted the first of its ...  Read More In COVID pandemic, attending the continuing medical education, workshops, and conferences withphysical attendance is not possible. We designed, developed, and hosted the first of its kind academicvirtual/online conference at par with an in‑person academic conference to disseminate the expertiseof the renowned subject experts along with researchers to present their research work due to theongoing pandemic. We, in this article, had summarized the most critical steps in order to make theprocess easier for first‑timers while providing our more comprehensive walkthroughs on each step.We choose a live session of the speakers on the Zoom meeting mode to retain the atmosphere ofa live conference. WhatsApp, Google (Google Meet and E‑mail), and Kahoot were other platformsto communicate with speakers, researchers, and participants to seamlessly participate. A numberof advantages in terms of protection for delegates/speakers and their families came from the VirtualConference on Nutrition and Health, restricting the spread of COVID‑19, low budget for organizers,economically much cheaper alternatives both for speakers and participants, dissemination ofknowledge, time productive, and meeting research paper presentation eligibility for a professionalcourse. When one is new to technology, try adding an innovative aspect as a starting point to futurevirtual and in‑person events, and seeing how it works is imperative. Ensuring Internet bandwidth,updated hardware, or webcam and/or microphone functionality at the participant end is critical.

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High school basic life support training: Is the trainer’s experience of cardiopulmonary resuscitation in the actual setting important? A randomized control trial

. Ali Sanati; . Ali Ansari Jaberi; . Tayebeh Negahban Bonabi

Volume 12, Issue 5 , June 2022, Pages 1-8

Abstract

  BACKGROUND: Although basic life support (BLS) has been taught in school by a varietyof professionals, it is still unclear that, whether the instructor’s previous cardiopulmonaryresuscitation ...  Read More BACKGROUND: Although basic life support (BLS) has been taught in school by a varietyof professionals, it is still unclear that, whether the instructor’s previous cardiopulmonaryresuscitation (CPR) experience is an important factor. This study aimed to compare the effect ofBLS training, based on trainer experience in actual situations, on knowledge and skills of secondaryhigh school students.MATERIALS AND METHODS: In this randomized controlled trial, 150 high school students wereselected based on the inclusion criteria and then assigned into two groups, (76 in Group A), and (74in Group B) randomly. Both groups were trained according to adult BLS: 2020 American HeartAssociation guidelines on mannequins in three 60 min in‑person training sessions. The knowledgeand skill scores were measured for both groups before, immediately, and 1 month after interventionby a questionnaire. Data were analyzed by the SPSS software version 22, using Chi‑square,Mann–Whitney U, repeated‑measure ANOVA tests, and statistically modeling at a significancelevel of 0.05.RESULTS: There were no significant differences between groups regarding demographiccharacteristics. The knowledge and skill scores in both groups increased significantly comparedto baseline immediately and 1 month after the intervention (P = 0.001). However, there was nosignificant difference in knowledge scores between groups (P = 0.076(. However, at the immediacyand 1 month after the intervention, the skill score in “Group A” was significantly higher than the“Group B” (P = 0.001).CONCLUSIONS: The trainer’s experience of CPR in the actual setting in the transfer of BLSknowledge is not important, but it improved Student’s BSL skill acquisition score.

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Exploring the role of dramatics in medical education through online listserv mediated mentoring and learning web sessions

. Rahul Bogam; . Priyadarshini Mishra

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: Online learning environments are becoming more frequent in teaching and learningthan ever before. Asynchronous learning provides “high degree of interactivity” ...  Read More BACKGROUND: Online learning environments are becoming more frequent in teaching and learningthan ever before. Asynchronous learning provides “high degree of interactivity” between participantsand helps them to reflect upon their ideas/thoughts, before sharing them with others leading to moreinsightful responses and in‑depth learning. Moderating an online discussion is an art and challengingtask, which needs meticulous planning and effective execution approaches. One of the majorchallenges in online discussion is to ensure active participation and interest among participants,and therefore, it reiterates the need for inclusion of interactive strategies to enable it meaningfuland effective. The present article is to share our experiences in moderating session on “Dramaticsin Medical Education” (DIME) as a part of ML web discussion of Foundation for Advancement inInternational Medical Education and Research (FAIMER) at one of the regional FAIMER institutesin India.MATERIALS AND METHODS: Thirty‑two FAIMER fellows participated in online discussion on DIME,supplemented with various engagement triggers including, sharing of real‑life situation case scenarios,motivational quotes, competitions and rewards, script writing, script editing exercises by using ForumTheatre method, discussion on uploaded academic videos on “YouTube,” use of mnemonics, etc.RESULTS: Online discussion yielded improved knowledge and positive attitudes of participantstoward DIME. Task‑based exercises within authentic or realistic situations, teamwork, and interactionsfacilitated active learning of participants.CONCLUSIONS: Appropriate planning, well coordination, and interactive strategies can fosterlearning and reflective abilities as well as develop favorable perceptions of learners toward virtualmode of teaching‑learning.

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Comparing the effects of demonstration, video display, and virtual social networks on nursing students’ learning of hemodialysis clinical skills: An interventional and comparative study

. Motahareh Musavi Ghahfarokhi; . Arezo Arzani‑Birgani; . Noorollah Taheri; . Fatemeh Maqsoodi

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: Applying new methods of clinical education seems to provide nursing studentswith educational opportunities. The present study aimed to compare the effectiveness of trainingthrough ...  Read More BACKGROUND: Applying new methods of clinical education seems to provide nursing studentswith educational opportunities. The present study aimed to compare the effectiveness of trainingthrough demonstration, video display, and virtual social space on the learning of clinical skills amongnursing students.MATERIALS AND METHODS: In this semi‑experimental research with posttest that was performedin 2019, thirty nursing students of the seventh semester were randomly assigned to three groups ofdemonstration, video display, and the social virtual space education with ten people in each group.The research was conducted in the hemodialysis ward of university hospitals. Each group was trainedand evaluated during 10 days with 5‑h sessions continuously. Participants’ skills were evaluatedusing eight self‑made, valid and reliable checklists, and the three groups were compared. For dataanalysis such as the means and standard deviations and inferential statistics, Mann–Whitney test,Kruskal–Wallis likelihood‑ratio, and Chi‑squared test in SPSS version 16 were used.RESULTS: The results indicated that practical skill levels in the group of virtual social network weresignificantly higher than the two groups of video display (P = 0.045) and demonstration (P = 0.03).In addition, the group of virtual space had significantly higher scores than those of the other twogroups only in two skills of “prime” and “disconnecting the patients from the machine” (P < 0.05).CONCLUSION: Proper use of networks and social virtual space for clinical training, along withconventional methods of learning, provides good learning opportunities and is affordable in termsof time, cost, and process.

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Learning gain in web (internet) sourced seminars versus textbook sourced seminars in postgraduate medical students

. Sugat A. Jawade; . Lalit S. Waghmare; . Bhushan S. Madke; . Adarshlata B. Singh; . Swapna S. Jawade

Volume 12, Issue 5 , June 2022, Pages 1-5

Abstract

  BACKGROUND: In the past, textbook or printed material was the only source of information formedical students or post-graduate students. After the introduction of internet, knowledge ...  Read More BACKGROUND: In the past, textbook or printed material was the only source of information formedical students or post-graduate students. After the introduction of internet, knowledge can beaccessed easily which is updated with various aids such as animation, videos which improve thelearning efficiency. This study was conducted to compare the learning efficiency between textbookbased seminar to that of internet-based seminar in postgraduate students of the department ofdermatology.MATERIALS AND METHODS: It was a non-randamized controlled study. The postgraduate studentsin the department of dermatology, Jawaharlal Nehru Medical college, DMIMS(DU),Sawangi (Meghe),Wardha, Maharashtra, India were divided into two equal groups by simple randomization methodby flipping the coin. Totally 20 seminar topics were divided into two groups (A and B) consistingof 10 seminars in each group. Postgraduate students assigned in group A were asked to prepareseminar solely from textbooks while in group B, students were asked to prepare seminar by referringinternet. Feedback form which consists of 7 points, i.e. appearance, completeness of preparation,clarity of presentation, appropriate use of audio visual aids, understanding of subject, ability toanswer questions, and overall performance were filled up from faculties and postgraduate studentsafter completion of each seminar. Pretest and post-test were filled up from postgraduate studentsbefore and after each seminar respectively. Learning gain was calculated by comparing the scoresof pretest and posttest. Paired t-test was used to compare results in the group and unpaired t-testwas used to compare results between the two groups.RESULTS: Faculties’ feedback on overall performance was higher (4.59 ± 0.15) in web-basedseminars as compared to in textbook-based seminars (3.85 ± 0.1) with significant P = 0.008.Furthermore, postgraduate students’ feedback showed statistical significant value of 0.02 in webbased seminars (4.65 ± 0.06) compared to textbook-based seminars (3.2 ± 0.06). Learning gainwas significantly higher in web-based seminar compared to textbook-based seminar with P = 0.02.CONCLUSION: It can be concluded that web-based learning can improve the learning efficiency inpostgraduate medical students.

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Exploration challenges of the implementers of Iran’s transformational innovation plan in medical education

. Mohammad Hasan Keshavarzi; . Javad Kojuri; . Habibolah Rezaei; . Ali Reza Safarpour

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: The Health System Reform Plan, especially in medical education, has undoubtedlycaused changes in the university. The continuation of this project requires recognizing the ...  Read More BACKGROUND: The Health System Reform Plan, especially in medical education, has undoubtedlycaused changes in the university. The continuation of this project requires recognizing the challengesconfronted by those in charge of its implementation. This study aimed to explore the challenges ofthe implementers of the Transformation and Innovation Plan in Medical Education in the universitiesof Macroregion 5.MATERIALS AND METHODS: The qualitative research was conducted using the content analysismethod. Semi‑structured interviews with health and medical education managers were used tocollect information. Participants were 11 educational leaders of universities who were selected bypurposeful sampling. Data collection continued until data saturation was reached. Data analysiswas performed continuously and simultaneously with data collection. The Graneheim and Lundmanmethods were used to analyze the data.RESULTS: From 11 interviews, one theme, five categories, and 12 subclasses were obtained. Fivecategories include lack of proper groundwork, weak leadership, structural problems, inability to fund,and inadequate monitoring.CONCLUSION: Innovation and transformation in medical education are one of the critical missionsand admirable actions of the Ministry of Health in the field of education, but a review of this plancan, in addition to identifying shortcomings and problems, pave the way for success, and progressin future programs.

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Online viva voce as a formative assessment method in forensic medicine during COVID‑19 pandemic

. G. N. Pramod Kumar; . A. N. Roopa Urs; . Malatesh Undi; . Shankar M. Bakkannavar

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: Conducting online classes and assessment during the COVID‑19 pandemic isnot without challenges. The world of medical education is adapting online training and assessmentbecause ...  Read More BACKGROUND: Conducting online classes and assessment during the COVID‑19 pandemic isnot without challenges. The world of medical education is adapting online training and assessmentbecause of COVID‑19 pandemic restrictions. The present study was conducted to assess thestudents’ perception regarding the process, difficulties encountered and perceived effectiveness ofonline assessment.MATERIALS AND METHODS: Online viva‑voce (theory and visual based) was conducted ina government medical college in Karwar, Karnataka, India using videoconferencing application(Google Meet) to 149 second MBBS students as a formative assessment in 2020 over 3 months.Ten students per day joined Google Meet, 10 questions were asked to each student and assessedusing a tutor marking system (on‑spot). A feedback questionnaire (Google Form) was administeredto students who attended online Viva‑Voce. Data was analysed using descriptive and inferentialstatistics (Student’s t‑test).RESULTS: Out of 149 students, 132 participated and responded to a feedback questionnaire.Majority of the participants (91%) agreed that questions covered all topics kept for viva, 82% ofthem felt it would be helpful for performance in final examinations. Thirty percent of students facednetwork issues at their places, 45% felt nervous while facing viva in the presence of other studentsand 35% of participants preferred online methods over traditional viva voce. Online viva voce canbe transparent (90%) and less biased (88%) if done in structured format.CONCLUSION: Online viva‑voce may become relevant and effective in medical educationassessment with transparent marking system for students’ performance.

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The quality of sleep and daytime sleepiness and their association with quality of school life and school achievement among students

. Zahra Ahmadi; . Shabnam Omidvar

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: Sleep quality is an important factor in adolescents’ health; physical as well aspsychological. The aim of this study was to determine sleep quality and daytime sleepiness ...  Read More BACKGROUND: Sleep quality is an important factor in adolescents’ health; physical as well aspsychological. The aim of this study was to determine sleep quality and daytime sleepiness and theireffect on the quality of school life (QSL) and achievement.MATERIALS AND METHODS: This cross‑sectional study was conducted in high schools. The datacollection was done on a random sample of 500 students from 15 to 19 years. The questionnairesincluded the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality and the EpworthSleepiness Scale to measure daytime sleepiness as well as QSL. Data were analyzed by SPSS25. Linear and logistic regressions were used to obtain adjusted and unadjusted odds ratios as wellas predictors.RESULTS: The mean PSQI score was 6.2 ± 2.4. It was realized that 377 participants (75.4%)were poor sleepers; 6.2% had excessive daytime sleepiness. There was a significant associationbetween age and quality of sleep (P < 0.04). No association between gender and quality of sleepor between the quality of sleep and school achievement was found. Linear regression exhibited asignificant relationship between the quality of sleep and daytime sleepiness (β = 0.218; t = 4.982,P = 0.000). There was a significant, inverse correlation between sleepiness and the total score ofQSL (P = 0.000). Stepwise linear regression analysis exhibited that daytime sleepiness (P = 0.002)and school achievement (P = 0.001) were predictors of QSL.CONCLUSION: According to the study results, sleepiness affects school performance and QSL,and on the other hand, daytime sleepiness is under the effect of sleep quality.

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Nurses in NICUs’ views on nosocomial infection prevention

. Shilpa Gulia; . Kiran Kaur; . Shankuntala Devi; . Sandeep Singh; . Kusum K. Rohilla

Volume 12, Issue 5 , June 2022, Pages 1-5

Abstract

  BACKGROUND: Basic infection control measures are required in India’s health‑care setting inNeonatal Intensive Care Units (NICUs) to lower the prevalence of hospital‑associated ...  Read More BACKGROUND: Basic infection control measures are required in India’s health‑care setting inNeonatal Intensive Care Units (NICUs) to lower the prevalence of hospital‑associated infections.The aim of the present study was to assess practices followed by nurses of NICUs for nosocomialinfection prevention.MATERIALS AND METHODS: From January to February 2020, a descriptive cross‑sectional studywas conducted. Participants in the study were chosen by total enumeration sampling technique,i.e., 60 nurses were included in this study who working in tertiary care institutions, India. The studyrespondents’ knowledge and practice for nosocomial infection control strategies were assessed byusing a 30‑item and 27‑item questionnaires, respectively. SPSS (version 23.0) was used to analyzethe data collected.RESULTS: Results showed that all nurses (100%) were females, belongs to the age group of26–35 years (82%), hold professional qualifications (34%) in GNM as well as post basic BSc nursing,married (72%), had 1–5 years of professional experience (66%), and working in the NICUs for1–3 years (74%). Most of nurses (55%) had never attended any session on nosocomial infectionprevention. Nurses of NICUs (70%) had just a moderate degree of understanding on nosocomialinfection prevention. Nurses’ practice showed good practise (60%) for nosocomial infection preventionin NICUs.CONCLUSIONS: The necessity to adopt health‑care policy about nosocomial infections and executionof regular training program to upgrade and refresh nurses’ knowledge and practices regardingfor nosocomial infection control measures is indicated to fill gap among knowledge and practicesconcerning nosocomial infection control and prevention.

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Metamotivation in medical students: Explaining motivation regulation strategies in medical students

. Ali Norouzi; . Maryam Alizadeh; . Dean Parmelee; . Saharnaz Nedjat; . Saiideh Norouzi; . Mohammad Shariati

Volume 12, Issue 5 , June 2022, Pages 1-8

Abstract

  BACKGROUND: Metamotivation is a process that students use to monitor their motivational statesto reach their academic goals. To date, few studies have addressed the ways that medical ...  Read More BACKGROUND: Metamotivation is a process that students use to monitor their motivational statesto reach their academic goals. To date, few studies have addressed the ways that medical studentsmanage their motivational states. This study aim to identify the motivational strategies of medicalstudents as they use the metamotivational process to monitor and control their motivational states.MATERIALS AND METHODS: This qualitative study uses directed content analysis of the narrativeresponses of 18 medical students to draft an in‑depth and semistructured interview protocol which wereconducted through WhatsApp due to social distance restrictions of COVID‑19. Data were collected,encoded, and analyzed using deductive content analysis approach descripted by Elo and Kyngäs.RESULTS: Seven main themes were extracted as the motivational strategies of medical studentsincluding “regulation of value,” “regulation of situational interest,” “self‑consequating,” “environmentalstructuring,” “efficacy management,” “regulation of relatedness,” and “regulation of situationalawareness.” In this study by identifying new strategies, we provide a broader framework ofmetamotivational strategies in the field of the progression of learners in medical education.CONCLUSION: Medical students use a variety of strategies to regulate their academic motivation. Tosustain and improve the motivation of medical students, identifying and strengthening metamotivationalstrategies is the first step.

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Impact of internet addiction during COVID‑19 on anxiety and sleep quality among college students of Bhubaneswar city

. Gunjan Kumar; . Payal Dash; . Avinash Jnaneswa; . Vinay Suresan; . Kunal Jha; . Shishirendu Ghosal

Volume 12, Issue 5 , June 2022, Pages 1-13

Abstract

  BACKGROUND: COVID‑19 initiated in December 2019 in Wuhan, China, and over a period oftime, the infection outspread across the world in a rapid pace. To protect the people and to furtherlimit ...  Read More BACKGROUND: COVID‑19 initiated in December 2019 in Wuhan, China, and over a period oftime, the infection outspread across the world in a rapid pace. To protect the people and to furtherlimit the spread of infection, lockdown was declared in most parts of the world including India.As all people were forced to stay indoors during this pandemic, internet was the only source ofentertainment whose overuse has side effects on anxiety and sleep quality. This study is aimed toknow the impact of Internet addiction during COVID‑19 on anxiety and sleep quality among collegestudents of Bhubaneswar city.MATERIALS AND METHODS: This was a web‑based cross‑sectional, questionnaire study. Itadministered 475 students from six colleges. The students were assessed by a proforma containingdemographic details, patterns of internet use, Youngs Internet Addiction Test, Generalised Anxietydisorder score, and the Pittsburgh Sleep Quality Index. Statistical analysis was done using SPSSversion 21.0 using Chi‑square test and Wilcoxon signed‑rank test.RESULTS: The mean age of the study group was 18.81 ± 1.189. Out of 475 students, 60.6% werefemale and 39.4% were male. 23.6% and 13.4% of recruited students had severe internet addictionand anxiety disorder, respectively. The mean global PSQI score in the study was 6.356 ± 1.88.About 84.6% of the students had poor global sleep quality score. All components of sleep qualitywere significantly associated (P = 0.000) with different degrees of internet addiction except sleepduration (P = 0.589) and efficiency (P = 0.767).CONCLUSION: Females were highly addicted than males. The study findings specified that students’excessive internet usage leads to anxiety, and affects mental health. Monitoring and controllingstudents’ internet addiction through informative sessions on how to use the Internet adequately isuseful.

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More than a year into the pandemic: Do higher education students still practice protective behaviors against COVID‑19?

. Judith S. Rabacal; . Samson M. Lausa; . Renante A. Egcas; . Ryan Michael F. Oducado; . Jerome V. Cleofas; . Khen A. Tamdang

Volume 12, Issue 5 , June 2022, Pages 1-8

Abstract

  BACKGROUND: The exponential increase of cases and the emergence of the new COVID‑19variants continue to be a challenge. It remains crucial to assess whether or not minimum healthstandards ...  Read More BACKGROUND: The exponential increase of cases and the emergence of the new COVID‑19variants continue to be a challenge. It remains crucial to assess whether or not minimum healthstandards against COVID‑19 are consistently followed. This study determined the higher educationstudents’ practice of protective measures against COVID‑19 of more than a year into the pandemic.MATERIALS AND METHODS: A questionnaire web survey, cross‑sectional study was conductedamong higher education students (n = 2309) of a public university in the Philippines. Data wereanalyzed using the SPSS software.RESULTS: Results indicated that students generally had a high practice of COVID‑19 preventivemeasures. However, only 45.9% always practice physical distancing measures, and only 35.9%always seek information related to COVID‑19 after more than a year into the pandemic. Female,married, graduate level, with a monthly family income of PHP 10,000 and above, and personalknowledge of someone who tested for COVID‑19 had a significantly higher practice of COVID‑19protective measures. Older age, higher general self‑reported health status, and higher intentionto comply with recommended protective health behaviors were significantly correlated with higherpractice of preventive measures against COVID‑19.CONCLUSION: After more than a year of being into the pandemic, students still practice preventivehealth behaviors, however, this is not done consistently. As the pandemic is still not over in the countryand many parts of the world, continuous monitoring and a reminder to practice minimum protectivehealth protocols are needed to mitigate and prevent the spread of COVID‑19.

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Psychometric analysis of Persian version of patient safety competency self‑evaluation in psychiatric wards

. Mahya Torkaman; . Marzieh Momennasab; . Shahrzad Yektatalab; . Mahin Eslami Shahrbabaki

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: Assessment of the patient safety competency is necessary for the growth of nursingand safe care profession as well as evaluation of the nurses’ educational needs. ...  Read More BACKGROUND: Assessment of the patient safety competency is necessary for the growth of nursingand safe care profession as well as evaluation of the nurses’ educational needs. The present studywas conducted to determine psychometric properties of the Persian version of the patient safetycompetency self‑evaluation (PSCSE) tool in Iranian psychiatric wards.MATERIALS AND METHODS: All nurses (n = 209) working in two psychiatric hospitals of Kerman,Iran, were included in the present cross‑sectional study using census method. This tool contains 41items: six items are related to knowledge, 14 items deal with attitude, and 21 items are about skilldimension. Psychometric properties of the questionnaire including its content and face validity werealso examined. The factor structure of the questionnaire was evaluated using exploratory factoranalysis. The internal consistency and reliability were assessed by test–retest method with an intervalof 14 days. Cronbach’s alpha and corrected item‑total correlation were used to measure reliability.RESULTS: The content validity index was 0.65 and the content validity ratio was 0.89. Item 14 wasremoved from the skill domain because it was not related to the psychiatric ward. According to theresults of factor analysis, there was a significant relationship between the questions and the relevantfactors. The correlation coefficient for test–retest with 14 days interval was intraclass correlationcoefficient = 0.92 for the whole instrument and 0.89, 0.89, and 0.92 for the domains of knowledge,attitude, and skill, respectively. The internal consistency coefficient (Cronbach’s alpha) of the wholetool was 0.95 and 0.95, 0.79, and 0.95 for the domains of knowledge, attitude, and skill, respectively.Finally, PSCSE Questionnaire was obtained with 40 items in dimensions of knowledge (6 items),attitude (14 items), and skills (20 items).CONCLUSION: Persian version of the nurses’ competency tool in ensuring patient safety in psychiatricwards has acceptable psychometric characteristics.

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Using logistic regression to develop a diagnostic model for COVID‑19: A single‑center study

. Raoof Nopour; . Mostafa Shanbehzadeh; . Hadi Kazemi‑Arpanahi

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: The main manifestations of coronavirus disease‑2019 (COVID‑19) are similarto the many other respiratory diseases. In addition, the existence of numerous uncertainties ...  Read More BACKGROUND: The main manifestations of coronavirus disease‑2019 (COVID‑19) are similarto the many other respiratory diseases. In addition, the existence of numerous uncertainties inthe prognosis of this condition has multiplied the need to establish a valid and accurate predictionmodel. This study aimed to develop a diagnostic model based on logistic regression to enhance thediagnostic accuracy of COVID‑19.MATERIALS AND METHODS: A standardized diagnostic model was developed on data of 400patients who were referred to Ayatollah Talleghani Hospital, Abadan, Iran, for the COVID‑19diagnosis. We used the Chi‑square correlation coefficient for feature selection, and logistic regressionin SPSS V25 software to model the relationship between each of the clinical features. Potentiallydiagnostic determinants extracted from the patient’s history, physical examination, and laboratoryand imaging testing were entered in a logistic regression analysis. The discriminative ability of themodel was expressed as sensitivity, specificity, accuracy, and area under the curve, respectively.RESULTS: After determining the correlation of each diagnostic regressor with COVID‑19 usingthe Chi‑square method, the 15 important regressors were obtained at the level of P < 0.05. Theexperimental results demonstrated that the binary logistic regression model yielded specificity,sensitivity, and accuracy of 97.3%, 98.8%, and 98.2%, respectively.CONCLUSION: The destructive effects of the COVID‑19 outbreak and the shortage of healthcareresources in fighting against this pandemic require increasing attention to using the Clinical DecisionSupport Systems equipped with supervised learning classification algorithms such as logisticregression.

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Psychological well‑being and coping strategies among secondary school teachers: A cross‑sectional study

. Chinthana Rajesh; . Lena Ashok; . Chythra R. Rao; . Veena G. Kamath; . Asha Kamath; . Varalakshmi Chandra Sekaran; . Virupaksha Devaramane; . V. Thippe Swamy

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  INTRODUCTION: Educators, academicians, and teachers are responsible for the development ofthe nation’s human capital. Teacher coping methods are becoming more widely recognized ...  Read More INTRODUCTION: Educators, academicians, and teachers are responsible for the development ofthe nation’s human capital. Teacher coping methods are becoming more widely recognized as a keyfactor in determining teacher effectiveness. The aim of this study was to identify the various copingstrategies adopted by high school teachers in Southern India.MATERIALS AND METHODS: A cross‑sectional study was conducted in government, aided, andunaided schools of Udupi, a coastal district in Southern India. A self‑administered questionnaire wasused to collect the data from 460 high school teachers chosen based on convenience sampling.The coping strategies were identified using a modified version of Brief COPE(Coping Orientation toProblems Experienced) Inventory (Carver, 1997). Data were entered using SPSS version 15 anddescriptive statistics was performed.RESULTS: The study found that teachers had moderate level of coping skills in all domains. The mostpopular coping techniques used by secondary school teachers were positive reframing, active coping,and planning; nevertheless, substance use was recognized as the least popular coping strategy.CONCLUSION: Positive reframing, active coping, and preparation were the most commonly usedcoping strategies by the teachers in the survey. Teachers are a vital resource who have received lessattention than they deserve for their psychological well‑being. A customized intervention programbased on their perceived needs could be a good place to start.

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Investigating the professional identity and resilience in nursing students during the COVID‑19 pandemic

. Seyedeh Roghayeh Jafarianamiri; . Mojtaba Qanbari Qalehsari; . Ali Zabihi

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: Professional identity includes the values and beliefs of a nurse that guide herthinking, action, and interaction with patients. The stressful conditions of the COVID‑19 ...  Read More BACKGROUND: Professional identity includes the values and beliefs of a nurse that guide herthinking, action, and interaction with patients. The stressful conditions of the COVID‑19 pandemicmay have affected nursing students’ resilience and attitudes toward their profession. Therefore, theaim of this study was to investigate the professional identity and resilience in nursing students duringthe COVID‑19 pandemic.MATERIALS AND METHODS: This cross‑sectional descriptive study was performed in November andDecember 2020 with the participation of all nursing students of Babol University of Medical Scienceswho spent at least one semester of internship in a hospital during the COVID‑19 pandemic. Datawere collected using demographic questionnaire, Connor‑Davidson resilience scale, and nursingstudents’ professional identity scale. Data analysis was performed using independent t‑test, ANOVA,and correlation tests at a significance level of 0.05.RESULTS: Nursing students in the 3rd, 5th, and 7th semesters have spent a minimum of 13 and amaximum of 151 days of internship during the pandemic period. The mean score of professionalidentity of nursing students was 61.86 ± 9.34 and their mean resilience score was 32.08 ± 13.54. Theresilience score of 92% of students was below 50. Professional identity was significantly stronger,and resilience was considerably higher in students who were satisfied with their profession and livedwith their families (P < 0.05). In other words, students with higher professional identity scores hadhigher resilience (r = 0.39, P = 0.000).CONCLUSION: Despite a good professional identity score, the resilience of nursing students duringthe COVID‑19 pandemic is low. Therefore, professors and the clinical education system shouldprovide more support for students in such stressful times as the COVID‑19 pandemic period.

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The relationship between empathy and personality traits in Saudi medical students

. Saba Yasien; . Fadwa Almuzaini

Volume 12, Issue 5 , June 2022, Pages 1-5

Abstract

  BACKGROUND: Empathy is regarded as a fundamental personal attribute for in-training and inpractice doctors. Several factors may play a significant role to facilitate or prevent the ...  Read More BACKGROUND: Empathy is regarded as a fundamental personal attribute for in-training and inpractice doctors. Several factors may play a significant role to facilitate or prevent the ability of doctors’empathy toward their patients. The objective of the present study is to investigate the relationship ofempathy with personality traits (extraversion, agreeableness, conscientiousness, neuroticism, andopenness to experience) among undergraduate medical students.MATERIALS AND METHODS: This study was based on a correlational, cross-sectional designand was conducted from January 2020 to April 2020. The sample consisted of 301 undergraduatemedical students studying in different medical colleges situated in Riyadh, Saudi Arabia. Personalinformation form, the big-five personality inventory, and the interpersonal reactivity index scales wereadministered. Obtained data were analyzed by applying several methods such as mean, standarddeviation, Mann–Whitney U test, Pearson’s correlation coefficient, and multivariable linear regression.RESULTS: Regression analysis revealed that personality dimensions accounted for 10–19% ofthe variance in scores of empathy sub-dimensions of perspective-taking, empathetic concern,fantasy, and personal distress. Agreeableness was found to be associated with empatheticconcern and perspective-taking. Openness to experience was found to be significantly related toperspective-taking and fantasy, whereas extraversion was negatively associated with perspectivetaking. Neuroticism had an association with personal distress, empathetic concern, and fantasy.Additionally, no gender difference was observed and students with people-oriented specialtypreferences showed significantly higher scores on empathy sub-domains than technology-orientedstudents.CONCLUSION: This study confirmed that personality dimensions play a notable role to predictempathetic behaviors among Saudi undergraduate medical students. This study would help to designindividualized strategies by incorporating personality dimensions in the training program to enhanceempathetic behavior among medical students.

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Designing the competency‑based training model of Iranian medical tourism

. Abbas Abbaspour; . Hamid Rahimian; . Nasrin Shaarbafchizadeh; . Amirhossein Maghari; . Zahra Danial

Volume 12, Issue 5 , June 2022, Pages 1-10

Abstract

  BACKGROUND: Despite the great comparative advantage of Iran in terms of infrastructure,technology, and human resources as well as the significance of medical tourism in the tourist ...  Read More BACKGROUND: Despite the great comparative advantage of Iran in terms of infrastructure,technology, and human resources as well as the significance of medical tourism in the tourist industry,in practice, the quality of human resources has received less attention. Consequently, this study wasconducted to design a model of competency‑based training for Iranian medical tourism.MATERIALS AND METHODS: This study was an exploratory mix, and the Delphi method andsemi‑structured interviews were used for the qualitative part of this study. In the second part, theanalytical method was utilized for the quantitative part of this study.RESULTS: The results indicated the main components of medical tourism to be public interactionsand private interactions and seven subcomponents. Medical Tourism’s Competency includes threemain components and seven subcomponents.CONCLUSION: Although some training separated and scattered is present in Iran’s medical tourism.However, Iran requires a comprehensive training model of which its design was explained in this paper.

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Factors associated and knowledge on road traffic accidents, rules among private university students in Chengalpattu district, Tamil Nadu, India – A cross‑sectional study

. G. Vijayakrishnan; . P. Priyadharshini; . Balaji Ramraj; . V. V. Anantharaman

Volume 12, Issue 5 , June 2022, Pages 1-6

Abstract

  BACKGROUND: Road traffic accidents (RTAs) are an emerging public health issue of global concerncausing 1.35 million deaths per year. They are the leading cause of death among 5–29 ...  Read More BACKGROUND: Road traffic accidents (RTAs) are an emerging public health issue of global concerncausing 1.35 million deaths per year. They are the leading cause of death among 5–29 years whocontribute to the future and current productive population of the country. The outcome of mortalityand permanent disability are public health concerns. We determined the factors associated with RTAsamong medical undergraduates and assessed their knowledge of road traffic rules.MATERIALS AND METHODS: This study had 500 medical undergraduates from a tertiary hospitallocated in Chengalpattu district, Tamil Nadu. Data were collected using questions from “Road safetyquestion bank” issued by Ministry of Road Transport and Highways, Government of India, sent asGoogle forms to students. Descriptive statistics were used and multivariate analysis was performedto identify risk factors associated with RTAs.RESULTS: The mean age of the students was 21.4 (standard deviation = 1.7) years. About 30.4%of students suffered from RTAs in the past 2 years. Practice of drunken driving and mobile phoneusage showed significant association with RTA occurrence (P < 0.001). Multiple logistic regressionrevealed that students crossing speed limits and jumping signals had 3.19 and 2.04 times morerisk of sustaining RTAs. Seventy‑five percent of students had good knowledge on road traffic rules.CONCLUSION: Nearly half the subjects have suffered RTA in the past 2 years. Students who overspeed, jumped signals and used mobile phones while driving sustained more RTAs. Overall, roadtraffic rules knowledge was satisfactory. Students need education on risky driving behaviors andaftermath of crashes.

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Designing the minimum data set of bipolar disorder: A basis for introducing the effective factors in managing, controlling, and monitoring the bipolar disorder

. Khadijeh Moulaei; . Kambiz Bahaadinbeigy; . Shahrzad Mazhari

Volume 12, Issue 5 , June 2022, Pages 1-10

Abstract

  BACKGROUND AND AIM: Bipolar disorder (BD) is one of the most challenging psychiatric disordersin the management area that can lead to functional, occupational, and cognitive disorders. ...  Read More BACKGROUND AND AIM: Bipolar disorder (BD) is one of the most challenging psychiatric disordersin the management area that can lead to functional, occupational, and cognitive disorders. Withoutproper care, this complication can lead to profound psychological challenges and even death. Theaim of this study is to design a minimum data set (MDS) for BD.MATERIALS AND METHODS: This descriptive cross‑sectional study was conducted in two steps.In the first step, a survey was conducted in PubMed, Web of Science, and SCOPUS databases toidentify the demographic, managerial, and clinical data elements. Then, the required data elementswere extracted from the studies by the data extraction form and used in a questionnaire. In thesecond step, to confirm the data element set, the designed questionnaire was distributed andcollected among 20 psychiatrists and subspecialists during a two‑stage Delphi technique. Descriptivestatistics (frequency and mean) were conducted to analyze the data.RESULTS: Totally, 112 managerial and clinical data elements in 14 categories were extracted fromthe studies. Based on the experts’ opinion and their consensus, 88 necessary data elements wereconsidered to bipolar MDS. “Medication nonadherence,” “history of suicide,” and “substance abuseand addiction” were the most important data elements.CONCLUSION: In this study, an MDS was designed for BD. Providing this MDS, in addition toimproving the clinical processes, it is possible to help electronic system designers and health datamanagers to know what information should be included in the health systems or any kind of self‑careor self‑management software to meet the information needs of these patients.

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Assessment of knowledge and awareness regarding intellectual property rights among the health‑care professionals in Belagavi city: A cross‑sectional study

. Apurva Prashant Deshpande; . Anil V Ankola; . Roopali Sankeshwari; . Sagar Jalihal; . Laxmi Kabra; . Deepika V Bhat; . Abhra Roy Choudhury

Volume 12, Issue 5 , June 2022, Pages 1-7

Abstract

  BACKGROUND: Intellectual property rights (IPRs) are increasingly becoming significant forsustainable growth of today’s knowledge‑based society. An inappropriate knowledge regarding ...  Read More BACKGROUND: Intellectual property rights (IPRs) are increasingly becoming significant forsustainable growth of today’s knowledge‑based society. An inappropriate knowledge regarding IPRcan fail to reserve rights for one’s intellectual creation. Hence this study was planned with an aim toassess knowledge, awareness, and practices regarding intellectual property rights in India amongstthe health-care professionals in Belagavi city.MATERIALS AND METHODS: A descriptive cross‑sectional study was conducted among thepostgraduate students and faculty of six health‑care professional institutions in Belagavi, Karnataka.A total of 724 responses were recorded using convenient sampling. Data was collected usingself‑administered validated questionnaire which included demographic details and total 20 questionspertaining to knowledge, awareness, and practices regarding IPR. Two‑point Likert scale was used.Descriptive statistics, Mann–Whitney U‑test, and Chi‑square test were applied.RESULTS: A total of 724 responses were recorded, 411 from postgraduate students and 313 fromfaculty of 6 health‑care professional institutions. It was observed that 24.3% and 39.3% of postgraduatestudents and faculty participants, respectively, had maximum knowledge while 35.5% of faculty and27.5% of postgraduate students had maximum awareness regarding IPR in India. Only 17.6% and10.2% of faculty and postgraduate students had previously attended workshops on IPR.CONCLUSION: The present study identified that both faculty and postgraduate students of health‑careprofession have less knowledge and awareness regarding IPR. However, both knowledge andawareness regarding IPR were better among faculty when compared to postgraduate students.Thus, the academic community requires a higher level of sensitization and exposure to IPR in India.

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