Journal of Education and Health Promotion

Practical Solutions for designing gamification during COVID‑19: Medical faculty member experience

. Nasrin Khajeali; . Mitra Amini; . Masomeh Kalantarion

Volume 12, Issue 7 , August 2022, Pages 1-2

Abstract

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The correlation between nursing students’ healthy lifestyle behaviors, cardiovascular disease risk factors’ knowledge level, and obsession symptoms

. Dilek Baykal; . Leman Kutlu; . Burcu D. Demir

Volume 12, Issue 7 , August 2022, Pages 1-8

Abstract

  BACKGROUND: Nursing students have a role in the awareness of risk factors in the developmentof healthy lifestyle behaviors. Nursing students’ awareness of disease risk factors ...  Read More BACKGROUND: Nursing students have a role in the awareness of risk factors in the developmentof healthy lifestyle behaviors. Nursing students’ awareness of disease risk factors plays a role indeveloping healthy lifestyle behaviors. Therefore, it was aimed to determine the relationship betweenthe effect of nursing students’ healthy lifestyle behaviors and cardiovascular disease risk factors’knowledge levels and obsessive–compulsive symptoms.MATERIALS AND METHODS: This was a descriptive cross‑sectional study. Two hundred andtwenty‑four students studying in the nursing departments of two foundation universities participatedin the study between April and October 2020. Sociodemographic information form, Health PromotingLifestyle Profile II (HPLP‑II), Cardiovascular Disease Risk Factors Knowledge Level (CARRF‑KL),and Maudsley Obsessive–Compulsive Inventory (MOCI) were applied to the students.RESULTS: It was found that the nursing students’ healthy lifestyle behaviors (123.53 ± 25.78) andcardiovascular risk factors’ knowledge level (21.08 ±± 2.70) were high. Obsessive–compulsivesymptoms (16.12 ± 6.22) were moderate. In the correlation of sociodemographic characteristics, itwas found that age correlated with the nutrition subdimension of CARRF‑KL and HPLP‑II, incomelevel correlated with HPLP‑II, place of residence correlated with HPLP‑II, CARRF‑KL, and MOCI, andhaving a health problem correlated with health responsibility. Income status, place of residence, andpresence of health problems were found to be correlated with HPLP‑II in all subdimensions in theregression analysis. In the regression analysis of HPLP‑II with CARRF‑KL and MOCI scales, it wasfound that it was significantly related to interpersonal relations, spiritual growth, stress management,and total score dimensions.CONCLUSION: Healthy lifestyle behaviors of nursing students are related to cardiovascular riskfactors’ knowledge level and obsession symptoms. In addition, some demographic characteristicsaffect healthy lifestyle behaviors.

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Immediate autonomic changes during right nostril breathing and left nostril breathing in regular yoga practitioners

. Varun Malhotra; . Ragini Srivastava; . Poovarasan Parasuraman; . Danish Javed; . Santosh Wakode; . Avinash Thakare; . Ananyan Sampath; . Ankita Kumari

Volume 12, Issue 7 , August 2022, Pages 1-9

Abstract

  BACKGROUND: The ancient Indian science of Yoga makes use of voluntary regulation of breathingto make respiration rhythmic and calm the mind. This practice is called pranayama. Nadisuddhipranayama ...  Read More BACKGROUND: The ancient Indian science of Yoga makes use of voluntary regulation of breathingto make respiration rhythmic and calm the mind. This practice is called pranayama. Nadisuddhipranayama means “purification of subtle energy paths,” inhalation and exhalation are throughalternative nostrils for successive respiratory cycles. Surya Anuloma‑Viloma pranayama means “heatgenerating breathing particle” when the respiratory cycle of inhalation and exhalation is completedthrough the right nostril exclusively. When completed through the left nostril alone, the practice iscalled “Chandra Anuloma‑Viloma pranayama,” which means a heat‑dissipating or cooling liberatingpractice. We compared the effect of right nostril breathing (RNA) and left nostril breathing (LNB)pranayama on heart rate variability.MATERIALS AND METHODS: The study was conducted at the Department of Physiology at an instituteof national importance, after obtaining necessary ethical approvals from the Institutional Ethics Committee.Twenty healthy kriya yogi volunteers (mean age: 44 years), who are regular practitioners for the last10–20 years, were inducted into the study. RNB pranayama starts with closing the right nostril with thethumb of the left hand followed by exhalation through the right nostril and inhaling slowly through thesame nostril. This forms one round of RNB pranayama. In contrast, inhalation through the left nostril andexhalation through the right nostril exclusively is called chandrabhedana pranayama (chandrabhedanameans moon‑piercing breath in Sanskrit) with a similar variation called Chandra Anuloma‑Vilomapranayama in which inhalation, as well as exhalation, is performed through the left nostril exclusively. Therecording of electrocardiogram (ECG) for heart rate variability (HRV) analysis was taken by heart ratevariability (Dinamika HRV‑Advanced Heart Rate Variability Test System, Moscow, Russia). The restingand during readings of heart rate variability parameters were compared and post hoc analysis was doneusing Bonferroni and Holm multiple comparisons for repeated measures.RESULTS: Time domain parameters: Standard deviation of normal to normal RR intervals (SDNN)and root mean square of successive NN interval differences (RMSSD) were increased at a high levelof statistical significance during both pranayama maneuvres. Frequency domain parameters: LF, LF/HF ratio increased significantly. Parasympathetic activity is represented by LF when the respirationrate is lower than 7 breaths per min or during taking a deep breath. Thus, when the subject is in astate of relaxation with slow and even breathing in both RNB—right nostril and Chandra—LNB, theLF values can be very high, indicating an increase in parasympathetic activity rather than an increasein sympathetic regulation.CONCLUSION: Our study is an acute study, where changes in HRV were seen after 5 min of RNBand LNB. However, statistically, there is not much difference in the immediate effects of the twopranayamas on heart rate variability in regular yoga practitioners.

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Effectiveness of educational intervention‑based compassion therapy on emotional regulation and self‑control after discharge of patients With COVID‑19

. Abbas Godrati Torbati; . Anahita Zandi; . Seddigheh Abbaspour

Volume 12, Issue 7 , August 2022, Pages 1-7

Abstract

  BACKGROUND: One of the important causes of anxiety in COVID‑19 disease is the inability toregulate emotion and lack of self‑control during threatening conditions. The psychotherapy ...  Read More BACKGROUND: One of the important causes of anxiety in COVID‑19 disease is the inability toregulate emotion and lack of self‑control during threatening conditions. The psychotherapy techniquehas been effective in reducing these symptoms. Therefore, this study attempted to evaluate theeffectiveness of compassion‑based therapy on emotion regulation and self‑control in patients withCOVID‑19 after discharge.MATERIALS AND METHOD: It was a quasi‑experimental pretest‑posttest study with a control group.The statistical population consisted of 30 men (15 in each group) who were in the quarantine periodof COVID‑19 disease. Available sampling was used and the participants were randomly assignedto experimental and control groups. In the experimental group, compassion‑based treatment wasperformed in 10 sessions of 90 min. Tanji’s self‑control questionnaire and Garnofsky’s EmotionRegulation questionnaires were used. Data analysis were performed using SPSS 21 software andmultivariate analysis of covariance.RESULTS: There was a significant difference between the mean scores of emotion regulation andself‑control variables in the experimental and control groups (P < 0.001). The effect of this treatmenton increasing the emotion regulation score was 49% and on increasing the self‑control score was 37%.CONCLUSION: Compassion‑based therapy can increase cognitive regulation and improve self‑controlin patients with COVID‑19 disease. It is suggested that this intervention can be used in psychologicaltreatment programs

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A qualitative approach to identify clinical uncertainty in practicing physicians and clinical residents

. Shoaleh Bigdeli; . Hamid Reza Baradaran; . Shirin Ghanavati; . Seyed Kamran Soltani Arabshahi

Volume 12, Issue 7 , August 2022, Pages 1-10

Abstract

  BACKGROUND: Clinical decision‑making is not only stressful to physicians, but also to patients andeven their companions. Thus, managing uncertainty in clinical decision‑making is ...  Read More BACKGROUND: Clinical decision‑making is not only stressful to physicians, but also to patients andeven their companions. Thus, managing uncertainty in clinical decision‑making is essential whichrequires knowing its origins. Therefore, this study aimed to understand determinants of uncertaintyin clinical decision‑making from the perspective of clinical physicians.MATERIALS AND METHODS: This is a qualitative study which is done during October to November2020. An in‑depth interview is performed with 24 specialists of clinical groups including obstetrics,surgery, internal medicine, and pediatrics, working in teaching hospitals affiliated to Iran Universityof Medical Sciences. All the interviews were recorded, transcribed and analyzed according to thesteps suggested by Graneheim and Lundman. The interviews were analyzed through comparativemethod. Then, the interviewer created initial codes, categories, and key concepts and sent them tofourteen physicians for member check.RESULTS: According to the participants’ view, determinants of uncertainty in clinical decision‑makingconsisted of three themes: individual determinants, dynamics of medical sciences, and diagnosticand instrumental constraint. Individual determinants can be related to the physician or patient. Thedynamics of medical sciences could be explained in two categories: variation of medical science andcomplexity. Diagnostic and instrumental constraint category could be also explained in subcategoriessuch as lack of efficient diagnostic tests and unknown etiology.CONCLUSION: To curb uncertainty, the more accessible way is considering interventional programswith a focus on individual determinants related to physicians, such as strengthening doctor–patientrelationships, and considering related mandatory retraining courses to reduce insufficient knowledgeof physicians.

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A model for implementing oral health‑promoting school: Integration with dental students’ educational curriculum: A protocol study

. Bahareh Tahani; . Imaneh Asgari

Volume 12, Issue 7 , August 2022, Pages 1-6

Abstract

  BACKGROUND: Schools are ideal setting for children’s oral health‑promoting programs. It is anintegrated model for oral health‑promoting schools (OHPS) with the capacities ...  Read More BACKGROUND: Schools are ideal setting for children’s oral health‑promoting programs. It is anintegrated model for oral health‑promoting schools (OHPS) with the capacities of dental school’scurriculum and dental students as workforces. In this protocol, the principle of planning andimplementation of the oral health program is described.MATERIALS AND METHODS: Based on the PRECEDE‑Policy, Regulatory, and OrganizationalConstructs in Educational and Environmental Development (PROCEED) planning model, a frameworkfor determining the potential predisposing, reinforcing, and enabling factors that could be interveningwas diagnosed. To adapt the phases of the planning model for integration of the “OHPS” principlesand the dental students’ curriculum, the following steps are supposed to be considered: Phases1–5 which are to assess the baseline data will include the assessment of children oral health statusand parents and teachers’ knowledge, attitude, and performance. Phase 6 or implementation phasewill be allocated to oral health education interventions for students, parents, and teachers, professionalscreening, prevention, and referral. Phase 7 or the process assessment phase will be to record thenumber of screened students, the amount of fissure sealant and fluoride provision, and percentageof trained parents and teachers. Phase 8 or the impact assessment phase will assess the students’improvement in knowledge and practice, decayed, missing, and filled teeth scores, teachers andmothers’ oral health attitudes and behaviors, and brushing and flossing behaviors. At the last, costanalysis of the program and long‑term monitoring of the interventions is suggested.CONCLUSION: In case that the effectiveness of this model is proven, it can be implemented by otherdental schools for the primary schools in their regions. Considering the number and distribution ofdental schools in the country, this model is executable as targeted population oral health promotionapproach in 6–12‑year‑old schoolchildren.

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Intentional self‑harm in individuals referred to consultation liaison psychiatry services in a tertiary care hospital

. Haamid Ismail; . Sabreena Qadri; . Arshad Hussain

Volume 12, Issue 7 , August 2022, Pages 1-4

Abstract

  BACKGROUND: Intentional self‑harm (ISH) is one of the most important entities of consultation‑liaisonpsychiatry. This study aimed to assess the clinical profile of individuals with ...  Read More BACKGROUND: Intentional self‑harm (ISH) is one of the most important entities of consultation‑liaisonpsychiatry. This study aimed to assess the clinical profile of individuals with intentional self‑harmreferred to consultation‑liaison (CL) psychiatric services in a tertiary care hospital.MATERIALS AND METHODS: The present study was a cross‑sectional hospital‑based study, inwhich purposive sampling was done for sample selection. A total of 60 subjects of ISH referred forevaluation in a tertiary care psychiatry hospital on specified days were recruited to the study afterobtaining informed consent. Demographic and clinical details such as the nature of the self‑harmattempt, method of attempt, number of attempts, the reason for the attempt, and regret/remorseabout the attempt were documented using the semi‑structured proforma.RESULTS: A total of 60 subjects were included in the study. About 80% of them were below theage of 30 years. The majority (80%) were females, 65% were from a rural background, 56.7% weremarried. The most common method of ISH was self‑poisoning. Interpersonal conflicts with familymembers (50%), followed by interpersonal conflicts with the spouse/partner (21.7%) were thecommonest reason/precipitating factors that lead to intentional self‑harm. Also, 45% of our studypopulation did not have any diagnosable psychiatric illness at the time of assessment, and the mostcommon psychiatric diagnosis was personality disorders (20%).CONCLUSION: Intentional self‑harm is common in young married females from rural backgrounds.Self‑poisoning is the most common method of deliberate self‑harm. More than half of the individualswere diagnosed with the psychiatric illness at presentation.

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The effectiveness of reality therapy on sexual satisfaction and marital intimacy of infertile women

. Esmat Jamshidi Koleshtajani; . Rozita Zabihi; . Mehrnaz Azad Yekta

Volume 12, Issue 7 , August 2022, Pages 1-7

Abstract

  BACKGROUND: Infertility is one of the most important challenges in the modern life that can damagethe sexual satisfaction and marital intimacy of couples. The present study was aimed ...  Read More BACKGROUND: Infertility is one of the most important challenges in the modern life that can damagethe sexual satisfaction and marital intimacy of couples. The present study was aimed to investigatethe effectiveness of reality therapy on sexual satisfaction and marital intimacy of infertile women.MATERIALS AND METHODS: This quasi‑experimental study was conducted with a pretest‑posttestdesign and follow‑up. The statistical population was infertile women who were referred to Imam SajjadShahriyar Hospital in 2019–2020. 15 infertile women selected by purposive sampling and underwentreality therapy (8 sessions of 90 min). Data were collected using index sexual satisfaction (ISS) andmarital intimacy questionnaire. Data analysis was performed using SPSS‑24 software, analysis ofvariance with repeated measures and post hoc Bonferroni test.RESULTS: The results of analysis of variance showed that there was a significant difference betweenthe scores of sexual satisfaction and marital intimacy in posttest and follow‑up stages compared topretest (P < 0.05).CONCLUSIONS: Based on the results, reality therapy can be used as an effective intervention toimprovement sexual satisfaction and marital intimacy of infertile women.

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Effect of webinars in teaching–learning process in medical and allied health science students during COVID‑19 pandemic: A cross‑sectional study

. Janani Sivaramalingam; . Kalai Selvi Rajendiran; . Monisha Mohan; . K. S. Premlal; . Santosh Kumar Yadhav; . D. V. Satyamurthy G; . Surendar Rangasamy; . M. Diravyaseelan; . Lendiwabang Jamir; . Durgesh Kumar Umaraj Pandey; . Surapaneni Krishna Mohan; . Ananda Vayaravel Cassinadane

Volume 12, Issue 7 , August 2022, Pages 1-9

Abstract

  BACKGROUND: COVID‑19 pandemic lockdown has brought all sectors to be dwindled withno exception of the academic system. Even professional courses like medical and allied healthacademic ...  Read More BACKGROUND: COVID‑19 pandemic lockdown has brought all sectors to be dwindled withno exception of the academic system. Even professional courses like medical and allied healthacademic courses were also not spared. The academic requirements were not met as required todo so. Webinar has become a good source of virtual platform acting as a bridge for attaining thegaps in accomplishing the curriculum to the students during these curfew times. Our study aimedto know the value of webinars on teaching–learning processes among the medical and allied healthscience students in India.MATERIALS AND METHODS: The study design is a cross‑sectional study with 2084 studentswho attended at least one webinar. An online survey questionnaire was sent, and the data werecollected on participant’s perspective on the effectiveness of webinar, post webinar assessmentby their satisfactory level of gain of information through webinars and their plan to apply in future.RESULTS: Participant’s perspective on effectiveness of webinar showed 66.7% of agreement withthe webinar use. In post webinar assessment, the use of webinar was in agreement with 69.9% of theparticipants. Furthermore, we observed a significant association with the gain of information in postwebinar assessment (P < 0.05) and a significant association with their plan to apply in future (P < 0.05).CONCLUSION: Our results showed that the students were satisfied with the webinar teaching andacknowledged it to be an effective tool in the teaching–learning process to gain new knowledge andwish to attend webinars in future as a part of their curriculum. Thus, webinars have a constructiveeffect in the teaching and learning process in professional courses during pandemic lockdown.

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Effectiveness of educational intervention on reducing oxidative stress caused by occupational stress in nurses: A health promotion approach

. Davoud Panahi; . Elham Akhlaghi Pirposhteh; . Bayan Moradi; . Mohsen Poursadeqiyan; . Ali Salehi Sahlabadi; . Amir Kavousi

Volume 12, Issue 7 , August 2022, Pages 1-8

Abstract

  BACKGROUND: Nursing is one of the most stressful occupations. Educational intervention regardingstress management can play an important role in reducing occupational stress among nurses ...  Read More BACKGROUND: Nursing is one of the most stressful occupations. Educational intervention regardingstress management can play an important role in reducing occupational stress among nurses Thepresent study aimed to determine the effectiveness of educational intervention on reducing oxidativestress caused by occupational stress in nurses: A health promotion approach in a hospital in westernIran.MATERIALS AND METHODS: The present interventional study was performed in 2019 among92 nurses working at the Kosar Hospital located in the city of Sanandaj in the country of Iran.Occupational stress was evaluated using the Osipow Occupational Stress Questionnaire. Oxidativestress was measured by taking blood samples and measuring the enzymatic activity of superoxidedismutase (SOD), malondialdehyde, and catalase (CAT) using SOD, malondialdehyde (MDA), andCAT kits. Educational intervention was carried out in the second stage. Three months after theintervention, data were taken again.RESULTS: The results of the present study indicated that there was a significant difference inoccupational stress between before and after the educational intervention (P < 0.05). A significantreduction in MDA (P = 0.038) and SOD (P = 0.048) was observed after educational intervention, butthis was not the case for CAT (P = 0.592). There was no significant correlation between occupationalstress with oxidative stress parameters before and after the educational intervention (P < 0.05). Nosignificant difference in occupational stress was observed between men and women. Among theoxidative stress parameters under evaluation, MDA was higher among men compared to womenand this was statistically significant.CONCLUSIONS: Educational intervention regarding occupational stress is effective in reducingoxidative stress among nurses. The group meetings teach stress management to the participantsand enable them to better manage their stress by utilizing their own capabilities. Thus, attention tothis issue is vital in maintaining the mental and physical health of nurses and, in turn, improves thequality of care rendered.

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Developing the breast cancer risk prediction system using hybrid machine learning algorithms

. Mohammad R. Afrash; . Azadeh Bayani; . Mostafa Shanbehzadeh; . Mohammadkarim Bahadori; . Hadi Kazemi‑Arpanahi

Volume 12, Issue 7 , August 2022, Pages 1-12

Abstract

  BACKGROUND: Breast cancer (BC) is the most common cause of cancer‑related deaths in womenglobally. Currently, many machine learning (ML)‑based predictive models have been established ...  Read More BACKGROUND: Breast cancer (BC) is the most common cause of cancer‑related deaths in womenglobally. Currently, many machine learning (ML)‑based predictive models have been established toassist clinicians in decision making for the prediction of BC. However, preventing risk factor formationeven with having healthy lifestyle behaviors or preventing disease at early stages can significantlylead to optimal population‑wide BC health. Thus, we aimed to develop a prediction model by using agenetic algorithm (GA) incorporating several ML algorithms for the prediction and early warning of BC.MATERIAL AND METHODS: The data of 3168 healthy individuals and 1742 patient case recordsin the BC Registry Database in Ayatollah Taleghani hospital, Abadan, Iran were analyzed. First, amodified hybrid GA was used to perform feature selection and optimization of selected features.Then, with the use of selected features, several ML algorithms were trained to predict BC. Afterward,the performance of each model was measured in terms of accuracy, precision, sensitivity, specificity,and receiver operating characteristic (ROC) curve metrics. Finally, a clinical decision support systembased on the best model was developed.RESULTS: After performing feature selection, age, consumption of dairy products, BC family history,breast biopsy, chest X‑ray, hormone therapy, alcohol consumption, being overweight, having children,and education statuses were selected as the most important features for prediction of BC. Theexperimental results showed that the decision tree yielded a superior performance than other MLmodels, with values of 99.3%, 99.5%, 98.26% for accuracy, specificity, and sensitivity, respectively.CONCLUSION: The developed predictive system can accurately identify persons who are at elevatedrisk for BC and can be used as an essential clinical screening tool for the early prevention of BC andserve as an important tool for developing preventive health strategies.

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Osteoporosis risk group: Screening for osteoporosis in dental clinics using panoramic radiographs

. Rajkumar Selvakumar; . Ajay Chandran; . Abhijit Patil; . Harini TC; . Shilpa Dandekeri; . Diksha Verma; . Suresh Babu J; . Swarnalatha C; . Abhishek S. Nayyar

Volume 12, Issue 7 , August 2022, Pages 1-7

Abstract

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

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Assessment of knowledge and practice of cardiovascular nurses regarding warfarin

. Maryam Ehsani; . Mansoureh Ashghali Farahani; . Shima Haghani; . Shiva Khaleghparast; . Mahboubeh Malekmohammadi Memar

Volume 12, Issue 7 , August 2022, Pages 1-7

Abstract

  BACKGROUND: Despite new anticoagulants’ developments, warfarin is still one of the mostcommonly used medicines, particularly in the cardiovascular system. One of the significant ...  Read More BACKGROUND: Despite new anticoagulants’ developments, warfarin is still one of the mostcommonly used medicines, particularly in the cardiovascular system. One of the significant challengeswith warfarin is the prevalence of dangerous side effects such as bleeding and drug and foodinteractions, which can negatively affect patients if not adequately controlled. As health‑care teammembers, nurses have a crucial role in prescribing this medicine and educating patients. In thisregard, this study was conducted to determine the knowledge and practice of nurses working in thecardiovascular wards regarding warfarin.MATERIALS AND METHODS: In this cross‑sectional, descriptive study, knowledge and practiceof 239 nurses working in the cardiovascular wards of teaching hospitals affiliated to Iran Universityof Medical Sciences have been investigated using European Cardiovascular Nurses Knowledgequestionnaire on anticoagulants and the checklist for high‑risk drugs safety instructions. The samplingwas performed through the stratified sampling method with proportional allocation. Data were analyzedusing the SPSS software version 16 through descriptive and inferential statistics (independent t‑test,one‑way analysis of variance, and Pearson correlation coefficient) (Inc., Chicago, IL, USA).RESULTS: The mean scores of knowledge (18.51 ± 3.87) and practice (10.53 ± 2.12) wereslightly higher than the median, and the lowest mean score was related to knowledge on druginteractions (7.62). The practice had a statistically significant relationship with knowledge (P ˂ 0.001).Regarding demographic variables, there was a statistically significant relationship between nurses’knowledge and the education level (P = 0.009) and nurses’ practice and age (P = 0.022), workexperience (P = 0.032), and work experience in cardiovascular wards (P = 0.036).CONCLUSIONS: Based on the findings of this study, the knowledge of nurses working in thecardiovascular wards about warfarin was not sufficient, and their practice was of poor quality. Nurses’lack of knowledge and improper practice can jeopardize drug safety in patients and cause seriousside effects such as bleeding. Proper training of nursing students and nurses about warfarin as ahigh‑risk drug, its side effects, and drug‑food interactions, and the emphasis on patient education inpatients receiving this medicine can effectively reduce the incidence of side effects.

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Improving diagnostic approaches to cerebrovascular disorders in patients with hypertensive encephalopathy

. Natalia Svyrydova

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

Abstract

  BACKGROUND: Modern research today proves an increase in the incidence of ischemic stroke.Risk factors for vascular disease have become more common among young people. Clinical studieshave ...  Read More BACKGROUND: Modern research today proves an increase in the incidence of ischemic stroke.Risk factors for vascular disease have become more common among young people. Clinical studieshave shown that hypertension, dyslipidemia, and diabetes are traditional risk factors among theelderly. The aim of the study was to improve diagnostic approaches to cerebrovascular disordersin patients with hypertensive encephalopathy (НE) by clarifying the development of pathogenesismechanisms, based on a comprehensive clinical study.MATERIALS AND METHODS: This qualitative study was carried by clinical and neurologicalexamination; neuropsychological examination (Mini‑Mental State Examination, abbreviatedmultifactorial personality questionnaire, Beck depression scale, Spielberger scale).RESULTS: The study was examined 351 patients (150 men, 201 women) with НE in hypertension of2 degrees. The clinical examination was performed according to a two‑stage method, which involvesthe establishment or exclusion of symptomatic hypertension. The study did not include patients withsecondary hypertension, diabetes mellitus, cardiac arrhythmias, and conduction disorders, heartfailure who suffered from acute cerebrovascular accident and myocardial infarction.CONCLUSION: The necessity of obligatory examination by a neurologist of patients with arterialhypertension for detection of manifestations of НE with the use of modern research methods, whichallows to prevent damage to target organs, and first of all – brain damage, has been proved.

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Challenges of prehospital aerial operations in response to earthquake hazards: A qualitative study

. Seyed Hossein Mousavi; . Hamidreza Khankeh; . Golrokh Atighechian; . Mohammad H. Yarmohammadian; . Mehrdad Memarzadeh

Volume 12, Issue 7 , August 2022, Pages 1-10

Abstract

  BACKGROUNDS: Due to the severity of the earthquake, it may need immediate treatment andtransfer of the injured people to advanced medical centers, as well as dispatch of the expert ...  Read More BACKGROUNDS: Due to the severity of the earthquake, it may need immediate treatment andtransfer of the injured people to advanced medical centers, as well as dispatch of the expert teamand specialized health equipment to the accident‑affected area. Aerial emergency is an importantresponsibility of the health care system in this situation. The study aimed to extract the prehospitalemergency challenges of Iran aerial operations emergency in response to the earthquake.MATERIALS AND METHODS: The study was qualitative content analysis with conventionalapproach. Sampling was done in a purposive method and data were collected through semi‑structuredinterview. The panel involved consists of 26 health professionals in medical emergencies. Recordedinterviews were transcribed into written and then conventional content analysis was used to derivecoding categories directly from the text data.RESULTS: Content analysis is provided 97 initial codes, 20 subcategories and 4 main categoriesincluding challenges of “response assessment,” “support,” ”pre‑hospital staff‑management,” and“response operation,” respectively.CONCLUSIONS: The results showed that the necessity to assess the affected area, staffing, andmanagement actions, including integrated operations command and the development of a dedicatedresponse plan, as well as the use of strategies inter‑organizational coordination in the responsephase to earthquake. This study also emphasized that providing standard equipment, support actions,and strengthening communication infrastructure, and updating the aerial emergency system shouldbe considered as one of the priorities of the emergency organization of Iran to provide a desiredresponse to the earthquake.

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The effect of convalescent plasma on the treatment of COVID‑19 patients in Ardabil, Iran

. Effat Iranijam; . Hassan Ghobadi; . Somaieh Matin; . Shahram Habibzadeh; . Hamed Zandian; . Jafar Mohammadshahi; . Shahnaz Fooladi; . Abdollah Dargahi; . Elham Safarzadeh; . Mohammad Negaresh; . Javad Hosseini; . Ali Hossein Samadi; . Saeed Hoseininia; . Hossein salehzadeh; . Sharareh Dezhkam

Volume 12, Issue 7 , August 2022, Pages 1-8

Abstract

  BACKGROUND: Infection with COVID‑19 has resulted in considerable mortality all around the world.This study aimed to investigate the effect of convalescent plasma on the treatment ...  Read More BACKGROUND: Infection with COVID‑19 has resulted in considerable mortality all around the world.This study aimed to investigate the effect of convalescent plasma on the treatment of hospitalizedpatients with COVID‑19 in Imam Khomeini Hospital at Ardabil, Iran.MATERIALS AND METHODS: In this quasi‑experimental clinical trial, patients over 18 years of agewith polymerase chain reaction‑positive COVID‑19 were admitted based on the clinical criteria ofrespiratory distress with hypoxia (O2 saturation <90) and tachypnea (R Relative Risk (RR) >24) withmoderate‑to‑severe lung involvement and in the 1st week of respiratory disease who were not intubatedwere nonrandomly assigned to two groups: convalescent plasma therapy (CPT) group (197 cases)and control group (200 cases). We used the Chi‑square, t‑test, Fisher’s exact test, and Pearson’scorrelation coefficient for statistical analysis.RESULTS: Analyses revealed that length of stay in hospital was significantly lower in the CPT groupas compared to the control group (P = 0.001). Twenty‑four cases (22.0%) in the CPT group and85 cases (78.0%) in the control group needed intubation. Furthermore, mortality was 17 cases (18.3%)in the CPT group and 76 cases (81.7%) in the control group, the difference of which was also foundto be statistically significant (P < 0.05).CONCLUSIONS: It seems that CPT can be used as an alternative treatment at the early stages ofCOVID‑19 to prevent the progress of the disease, reduce the need for intubation and consequentlythe length of stay in hospital, and finally, decrease mortality.

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The relationship between the big five personality traits and job satisfaction with virtual teaching among teachers of students with learning difficulties

. Jawzaa Hamoud Almutairi; . Abeer T Ahmed

Volume 12, Issue 7 , August 2022, Pages 1-6

Abstract

  BACKGROUND: Job satisfaction has been described to be an important for individuals as well asfor the society in general. However, several factors were introduced to be crucial for job ...  Read More BACKGROUND: Job satisfaction has been described to be an important for individuals as well asfor the society in general. However, several factors were introduced to be crucial for job satisfaction;one of the more influenced factors in satisfaction experiences is individual personality. The presentstudy aim is to identify the relationship between the five major traits of personality and job satisfactionwith virtual education among teachers of students with learning difficulties.MATERIALS AND METHODS: The research is a descriptive quantitative design. The researchpopulation consists of 94 male and female teachers who are involved in primary and intermediatepublic schools in Saudi Arabia. Data were then exposed to the analysis, namely, descriptive statistics,Pearson correlation, and Mann–Whitney U test to obtain the answers to the research questions atthe level of <0.05.RESULTS: Based on the results, the most common personality trait among the study sample isconscientiousness, while neuroticism was the least common among the five traits. It was also foundthat there are differences between males and females in all dimensions of job satisfaction with virtualeducation (satisfaction with the nature of work – the relationship with colleagues and bosses – therelationship with parents) and the overall score in favor of females, except for the dimension of therelationship with colleagues and superiors, where males and females are equal.CONCLUSION: The average score of the personality types and job satisfaction is moderate. Jobsatisfaction has a significant relationship with personality types. In addition, partial significantdifferences were found among the study variables. Given the importance of identifying teachers’personality in the workplace, reducing psychological and work factors effects in the educationalenvironment among teachers can be helpful to enhance their job satisfaction. The study therefor,enumerated implications and recommendations based on the findings.

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Online versus face‑to‑face metacognitive educational counseling program on anxiety and meta‑worry in women with a history of miscarriage: A randomized clinical trial

. Mina Ghiasi Shahamabadi; . Tahmineh Farajkhoda; . Hassan Zareei Mahmoodabadi

Volume 12, Issue 7 , August 2022, Pages 1-8

Abstract

  BACKGROUND: In the COVID‑19 outbreak, women with a history of miscarriage need more mentalhealth. Anxiety and meta‑worry as consequences of miscarriage, besides concerns due to ...  Read More BACKGROUND: In the COVID‑19 outbreak, women with a history of miscarriage need more mentalhealth. Anxiety and meta‑worry as consequences of miscarriage, besides concerns due to pregnancyduring coronavirus, show the necessity of appropriate online and face‑to‑face educational counseling.This study aimed to evaluate the effectiveness of online metacognitive educational counseling versusface‑to‑face method on anxiety and meta‑worry in these women.MATERIALS AND METHODS: In this randomized clinical trial, 80 women with a history ofmiscarriage, anxiety, and meta‑worry referred to Imam Jafar Sadegh hospital (labor, women wardand women clinic), Meybod, Iran, were selected conveniently and randomly assigned into twogroups (n = 20/each). The participants received 8‑session metacognitive educational counselingpackage online or face‑to‑face. Data were collected by Beck Anxiety Inventory, Wellz meta‑worryquestionnaire at baseline, week eight, and follow up as primary outcomes and analyzed via SPSSsoftware (Anova and Repeated measure statistic tests).RESULTS: Anxiety in the 12th week (online group 13.75 ± 3.59 vs. face to face 18.25 ± 5.91,P = 0.04) was statistical significantly less than baseline (respectively 22.15 ± 5.67 vs. 22.35 ± 4.93,P =  0.56); with fewer anxiety scores in the online group. Meta‑worry in the 12th week (onlinegroup 11.90 ± 2.59 vs. face to face 15.70 ± 4.06, P = 0.03) was statistically significant compared tobaseline (respectively 17.15 ± 2.70 vs. 18.50 ± 3.47, P = 0.36); with fewer meta‑worry scores in theonline group. Belief about worry in 12th week (online group 66.50 ± 14.60 vs. face to face 78.45 ± 9.27,P = 0.01) was statistical significantly less than baseline (respectively 85.50 ± 8.87 vs. 86.05 ± 8.85,P = 0.96); with less score of belief about worry in the online group.CONCLUSION: Online and face‑to‑face metacognitive educational counseling methods decreasedanxiety, meta‑worry, and belief about worry in women with miscarriage. But online educationalcounseling was more effective. Distance online counseling in COVID‑19 can help the mental healthof women with miscarriage.

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Self‑esteem and weight status of young adults: Findings from a pilot study

. Echu Liu; . Su‑Hsin Chang

Volume 12, Issue 7 , August 2022, Pages 1-7

Abstract

  BACKGROUND: Researchers have examined the association between self‑esteem and obesity inpast studies. However, most studies have focused on pediatric or adolescent populations. In ...  Read More BACKGROUND: Researchers have examined the association between self‑esteem and obesity inpast studies. However, most studies have focused on pediatric or adolescent populations. In thispilot study, we aim to explore the association of self‑esteem with weight status in young adults, agroup of individuals in a significant and pivotal period of their lives whose needs and challengeshave received little attention in previous studies.MATERIALS AND METHODS: Exactly 127 college juniors and seniors in the Midwest participatedin late 2017. For our survey, we collected the following information: body weight, height, self‑esteemscore from the state self‑esteem scale, grade point average, risk of eating disorders, sleep quality,nutritional behavior, lifestyle (smoking, frequency of exercise, alcohol drinking, average daily timewatching television, playing video games, and social media use), and demographic and socioeconomicbackground. We used logistic regression for our analysis.RESULTS: The logistic regression indicates that a one‑point increase in the self‑esteemscore was negatively associated with a young adult’s odds of having an unhealthy weight(being overweight or obese) by approximately 3%. Furthermore, soda drinking is a statisticallysignificant factor associated with weight status.CONCLUSIONS: This finding suggests self‑esteem is positively associated with a healthy weightin young adults. A larger‑scale study should be conducted in the future to validate this relationshipand better understand young adults’ needs.

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Health education and global health: Practices, applications, and future research

. Daliya S. Rizvi

Volume 12, Issue 7 , August 2022, Pages 1-7

Abstract

  Health education is a crucial consideration in the healthcare system and has the potential to improveglobal health. Recently, researchers have expressed interest in streamlining health ...  Read More Health education is a crucial consideration in the healthcare system and has the potential to improveglobal health. Recently, researchers have expressed interest in streamlining health education, utilizingdigital tools and flexible curriculums to make it more accessible, and expanding beyond disease andsubstance abuse prevention. They have also expressed interest in promoting global health throughhealth and safety promotion programs. Amidst the COVID‑19 pandemic, climate change, the refugeecrisis, and overpopulation, healthcare crises are erupting all over the world. A lack of health educationhas and will continue to have a profound impact on community healthcare indicators, particularly inlow‑income nations. Current priorities within the health education sector include digitization, equity,and infectious disease prevention. Studies and data from university journals and other academicdatabases were analyzed in a literature review. Health education programs have a significant positiveimpact on attitudes and behaviors regarding global health. Improving upon these programs by digitizingthem and expanding upon the scope of health education will help ensure that such interventions andprograms make a significant difference.

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Perceived behavioral control regarding regular physical activity and healthy diet: An observational study among school‑going adolescents in an urban area of West Bengal, India

. Sweety Suman Jha; . Madhumita Dobe; . Chandrashekhar Taklikar; . Arista Lahiri

Volume 12, Issue 7 , August 2022, Pages 1-6

Abstract

  BACKGROUND: Healthy children are the foundation for a healthy and developing nation. Perceivedbehavioral control (PBC), comprising control belief and perceived power, is a person’s ...  Read More BACKGROUND: Healthy children are the foundation for a healthy and developing nation. Perceivedbehavioral control (PBC), comprising control belief and perceived power, is a person’s perception ofthe ease or difficulty of performing the behavior of interest. For facilitating regular physical activity andregular healthy dietary practices among the adolescents, PBC is an important construct to developand implement appropriate interventions. The aim is to assess PBC to perform regular physicalactivity and regular healthy dietary practices and measure their statistical relationship among theschool‑going adolescents in an urban area in West Bengal.MATERIALS AND METHODS: A school‑based cross‑sectional study was conducted among 251adolescents aged 12–16 years after taking consent and assent for participation in the study. Datawere collected with self‑administered questionnaire on sociodemographic variables and the twodomains of PBC, i.e., control beliefs and perceived power, related to regular physical activity andregular healthy dietary practices. Each PBC total score was calculated by multiplying control beliefscore and perceived power score for each respondent. Partial correlation coefficient was calculatedbetween regular healthy dietary practices and regular physical activity.RESULTS: Among the total 251 responses analyzed, 34.7% and 27.5% students belonged to agegroup 14 and 15, respectively. It was observed that the mean (± standard deviation) score of PBCregarding regular healthy dietary practices was 100.7 (±27.7) and for regular physical activity was106.0 (±21.4). The correlation between PBC of regular healthy dietary practices and regular physicalactivity was 0.421 and was statistically significant.CONCLUSION: In case PBC score over any behavior is higher, behavioral intention and ultimatelychances of performing that particular behavior increases. Designing appropriate school‑based healthpromotion strategies can lead to healthier children fostering regular healthy dietary practices andregular physical activity in their homes and communities.

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Documenting the managerial experiences of Isfahan Khorshid educational and medical center in dealing with the coronavirus crisis

. Zohreh Abnilli; . Ramin Sami; . Masoud Ferdosi

Volume 12, Issue 7 , August 2022, Pages 1-9

Abstract

  BACKGROUND: One of the crises facing human beings is coronavirus disease. This diseasewas identified in December 2019 in Wuhan, China. With the death of two patients with respiratorycomplications ...  Read More BACKGROUND: One of the crises facing human beings is coronavirus disease. This diseasewas identified in December 2019 in Wuhan, China. With the death of two patients with respiratorycomplications in Qom Hospital on February 20, 1998, and the confirmation of their positive test, thearrival of COVID‑19 disease in Iran was officially confirmed and Khorshid Medical Center as the mainreception the Medical Center for patients with COVID‑19 from August 3, 2010. The purpose of thisstudy is to document the experiences of Khorshid Training Center in coronavirus crisis managementto improve crisis management knowledge.MATERIALS AND METHODS: This research was conducted qualitatively with grounded theorymethod in the period from March 1998 to the end of May 1999. The study population was KhorshidEducational and Medical Center. Sampling was done purposefully among medical staff, support, andhospital officials. The number of samples with the mentioned conditions reached 44 people. Datawere collected using a semi‑structured questionnaire and analyzed in the style of grounded theoryin the style of Strauss and Corbin.RESULTS: Data collected after sorting, analysis, conceptual analysis; they were coded andcategorized into four groups of challenges, weaknesses, strengths, and actions based on the specificobjectives of the research in 5 natures, reorganization, accident control system, medical equipmentand supplies, human resources, and clinical approaches.CONCLUSION: According to the points classified in the challenges and weaknesses, it was foundthat the hospital has faced several problems in corona crisis management. The management team,taking advantage of strengths in various areas, has taken effective measures to improve corona crisismanagement. It has led to the provision of appropriate services to the patients of the Medical Center.

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Analysis of surface contamination of severe acute respiratory syndrome coronavirus 2 in a health‑care setting in the context of the coronavirus disease‑2019 pandemic

. Amrish Kohli; . Kamna Singh; . Yangchen Dolma

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

Abstract

  BACKGROUND: Hospital‑onset coronavirus disease‑2019 (COVID‑19) infection has been reportedand is probably linked to ineffective implementation of infection prevention and control ...  Read More BACKGROUND: Hospital‑onset coronavirus disease‑2019 (COVID‑19) infection has been reportedand is probably linked to ineffective implementation of infection prevention and control measures.Contaminated surfaces and air are considered a key part of the transmission dynamics of severe acuterespiratory syndrome, Middle East respiratory syndrome, influenza, and other organisms in hospitals.This study aimed to assess the extent and persistence of surface contamination with COVID‑19.MATERIALS AND METHODS: It was a hospital‑based cross‑sectional study conducted for a periodfor 2 weeks from December 03, 2020, to December 16, 2020, in Kathua district of J and K, India. Theenvironmental samples were taken from the patient care area that included COVID isolation wardand intensive care unit (ICU) as per the guidelines of WHO Protocol “Surface sampling of COVID‑19:A practical “how to” protocol for health care and public health professionals after seeking copyrightpermission from the WHO. Universal standard precautions were strictly followed. Descriptive analysiswas done using the MS‑Excel and expressed in numbers and percentages.RESULTS: A total of 140 surface samples were taken, 70 each from the COVID ICU and isolationward. The results of ten samples from the ICU turned out to be positive and 20 samples were positivefrom the isolation ward. Eleven (78.6%) out of the 14 samples taken from the corners of the ICU andisolation ward were found to be positive.CONCLUSION: Our study revealed surface contamination in the hospital setting both in COVIDICU and isolation ward particularly from the corners of the COVID ICU and isolation ward followedby the samples taken from the linen. Strict adherence to COVID appropriate behavior, increasedfrequency of disinfection in high‑risk areas, and sensitization of the staff are mandatory to minimizethe infection risk.

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Case‑based learning: A ‘Case’ for restructuring anatomy education in Indian nursing curriculum

. Sebi Das; . Kumarasamy Appu Ponnusamy; . Apoorva Tripathi; . Judith Jaison; . Bertha A. D. Rathinam

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

Abstract

  BACKGROUND: Teaching anatomy in a clinical context can aid students in appreciating how thesubject will apply to their future career as nurses as well as in other administrative roles. ...  Read More BACKGROUND: Teaching anatomy in a clinical context can aid students in appreciating how thesubject will apply to their future career as nurses as well as in other administrative roles. Anatomyis voluminous, making it difficult to retain the factual information in the long run; therefore, this studyprimarily focuses on whether case‑based learning (CBL) with integrated anatomy learning canhelp in retention of the information over short as well as long spans of time. It also focuses on howprofitable would the students be with this different style of learning, and whether it can facilitate inbetter understanding of the basic and clinical concepts.MATERIALS AND METHODS: The current study was conducted in the Nursing College of All IndiaInstitute of Medical Sciences, Bhopal, India to integrate CBL and evaluate its effect compared to thehighly compartmentalized, didactic lectures among the nursing students. The extent of knowledgeretention was analyzed by conducting a series of tests before as well as after CBL intervention.Feedback and suggestions were obtained from the students by using the 5‑point Likert scale method.RESULTS: The post‑test scores of the students improved by 21% after the CBL. More than 85%of the students opined that CBL improves critical thinking, team work, self‑directed learning, andcommunication skills.CONCLUSION: CBL promotes effective short‑term retention and facilitates comprehension of keyconcepts. CBL also plays an important role in improving the professional skills of the students, whichotherwise is not taught, and equips them for their future careers.

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Psychological implications of Covid‑19 in healthcare workers

. Rashi Garg; . Neelam Gupta; . Shraddha Puri; . Naveen Kakkar

Volume 12, Issue 7 , August 2022, Pages 1-6

Abstract

  BACKGROUND: The Covid‑19 outbreak has led to an unprecedented burden on the healthcareinfrastructure. High morbidity and mortality rates have resulted in a state of stress and distress ...  Read More BACKGROUND: The Covid‑19 outbreak has led to an unprecedented burden on the healthcareinfrastructure. High morbidity and mortality rates have resulted in a state of stress and distress amongthe general population which has also impacted health professionals.AIMS: This study was conducted to identify mental health disturbances among health professionalsduring the Covid‑19 pandemic.MATERIALS AND METHODS: It was a cross‑sectional study, conducted in a Medical Collegein Himachal Pradesh, India. A self‑administered anonymized questionnaire was administered tothe healthcare workers. Mental health status was assessed using Patient Health QuestionnaireAnxiety‑Depression Scale (PHQ‑ADS). In addition, a 15‑item questionnaire was prepared to identifythe probable causes of stress in HCWs during the Covid‑19 Pandemic. A statistical analysis usedt‑test was used to find the significance of the correlation between the PHQ‑ADS score and theagreement score of different factors.RESULTS: The response rate for the questionnaire was 27%. Anxiety and depression were seen in29% of participants, ranging from mild (18.3%), moderate (4.7%), and severe (5.9%). Among females43.7% of the participants and among males, 13.1% had anxiety and depression. High PHQ‑ADSscores were seen in nursing staff (70%) and postgraduate students (30%), who were in the thirddecade of life. Most (81.7%) of the HCWs were concerned about transmitting the disease to theirnear ones. Fear of coming to the hospital and dealing with patients.CONCLUSION: Even sub‑threshold syndromes among HCWs need to be identified before theyevolve into overt diseases. The psychological needs of healthcare workers should be prioritized asthey are key players in the fight against Covid‑19.

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Exploring the effective elements on the personal and professional development among health‑care providers: A qualitative study

. Shervin Farahmand; . Elaheh Malakan Rad; . Fatemeh Keshmiri

Volume 12, Issue 7 , August 2022, Pages 1-9

Abstract

  BACKGROUND: A new domain of “personal and professional development” was introduced as a corecompetency of health‑care providers. This study aimed to explore the experiences ...  Read More BACKGROUND: A new domain of “personal and professional development” was introduced as a corecompetency of health‑care providers. This study aimed to explore the experiences of learners andfaculty members about what competencies or skills were essential for the professional developmentand success of health‑care providers.MATERIALS AND METHODS: This is a qualitative study using an inductive content analysis approachin 2019–2020. In the present study, 58 academic faculty members participated by purposeful samplingincluding ten associate professors (17.24%) and 24 assistance professors (41.37%), in addition to23‑year medical residents (20.65%) and 4th‑year nursing students (20.65%). Individual and groupinterviews were conducted. Data were analyzed by the inductive content analysis approach introducedby Graneheim and Lundman.RESULTS: The qualitative data were classified in 953 open codes and eight categories, which werefurther divided into four main categories: “socio‑emotional skills,” “life‑long learning skills,” “copingskills,” and “well‑being strategies.”CONCLUSIONS: The present results showed socioemotional and coping skills affect interpersonaland professional interactions that contributed to their improved health‑care providers’ capabilities.Participants also considered lifelong learning as influential in developing professional capabilitiesand keeping their knowledge and skills up‑to‑date for accountability to duties. Moreover, usingwell‑being strategies protects the mental and physical health of health‑care providers. These skillsare synergistic, and their combination can have a significant role in improving the personal andprofessional capabilities.

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The impact of lifestyle stressors, menstrual pattern, and cardiometabolic risk factors on young females with cholelithiasis

. Grrishma Balakrishnan; . Tubah Iqbal; . Gurunandan Uppinakudru; . Ryan Fernandes; . Shobith Bangera; . R. Aswini Dutt

Volume 12, Issue 7 , August 2022, Pages 1-8

Abstract

  BACKGROUND: Lifestyle and nutritional transitions in the society driven by globalization have ledto the rising burden of cholelithiasis. The present study was done to assess the impact ...  Read More BACKGROUND: Lifestyle and nutritional transitions in the society driven by globalization have ledto the rising burden of cholelithiasis. The present study was done to assess the impact of lifestyle,stress, menstrual pattern, and cardiometabolic risk factors on young females with cholelithiasis.MATERIALS AND METHODS: A hospital‑based case–control study was conducted on young femalesof 18–45 years. Cases and age‑matched controls were compared on their lifestyle parameters likedemography, marital status, occupation, educational status, family income, stress along with menstrualpattern, cardiometabolic parameters like anthropometric measures, blood pressure (BP), fastingblood sugar (FBS), and lipid profile. Chi‑square test and unpaired t‑test were used for the analysisof data using SPSS software, and P < 0.05 was considered statistically significant.RESULTS: The majority of the cases were from rural areas, married, homemakers leading acomparatively sedentary lifestyle consuming more red meat, less literate, and belonged to a lowereconomic group with significantly more stress compared to controls. The age of menarche, neither theregularity nor irregularity of the menstrual cycle (regular cycle 21–35 days), showed any difference,but cases had significantly more pregnancies and usage of oral contraceptives compared to controls.Waist–height ratio, systolic BP, FBS, triglyceride, low‑density lipoprotein (LDL), and very low-densitylipoprotein (VLDL) were significantly higher in cases. Cases had a 14.4 times more risk of developingmetabolic syndrome when compared with controls.CONCLUSION: Married, rural, less literate Indian women leading a sedentary lifestyle, consumingmore of red meat, and soft drinks with increased psychosomatic stress are more prone to developcholelithiasis. Women who use hormonal contraceptives have increased occurrence of cholelithiasisand they were more prone to develop metabolic syndrome. The need for the hour is health education,to implement simple lifestyle changes, thereby decreasing the incidence of cholelithiasis in youngfemales.

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Using instant messaging applications to promote clinical teaching of medical students

. Mohammadreza Saeedbakhsh; . Athar Omid; . Mahsa Khodadoostan; . Ahmad Shavakhi; . Peyman Adibi

Volume 12, Issue 7 , August 2022, Pages 1-9

Abstract

  BACKGROUND: The main purpose of this study was to evaluate the use of Telegram as an Instantmessaging application in clinical teaching of medical students, especially clinical ward ...  Read More BACKGROUND: The main purpose of this study was to evaluate the use of Telegram as an Instantmessaging application in clinical teaching of medical students, especially clinical ward rounds.MATERIALS AND METHODS: In this quasi‑experimental study, Telegram as an Instant messagingapplication was employed. To do this, a Telegram group entitled as “Lavender” was created and thenselected patients were divided between students and externs daily. After that, students and externswere asked to take medical histories, perform complete physical examinations, and then share theirdata in the Lavender group. Ultimately, to evaluate the effects of this intervention, two quantitativeand qualitative approaches were used.RESULTS: From the students’ point of view the highest average was associated with “Readinessfor teaching round” (3.71 ± 1.34) and the lowest average was related to “Time‑saving for studyingabout illnesses” (2.08 ± 1.44). In addition, medical trainees mentioned that reporting patients’ dailymedical histories and progress notes could create a reflective process. The suggestion made bymany medical trainees was to select and discuss simpler cases who have more teaching pointsfor them, while other trainees recommended focusing on common illnesses in the Lavender group.CONCLUSION: The use of messaging software applications such as Telegram in medical educationhas created a new paradigm, which could facilitate interpersonal interactions among trainees.

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Mini clinical evaluation exercise (Mini‑CEX): A tool for assessment of residents in department of surgery

. Pooja Batra; . Ravi Batra; . Niket Verma; . Pradeep Bokariya; . Shreyak Garg; . Sneha Yadav

Volume 12, Issue 7 , August 2022, Pages 1-6

Abstract

  BACKGROUND: The mini‑clinical evaluation exercise (mini‑CEX) is a formative assessment tooldesigned to provide feedback on skills essential to good medical care by observing an ...  Read More BACKGROUND: The mini‑clinical evaluation exercise (mini‑CEX) is a formative assessment tooldesigned to provide feedback on skills essential to good medical care by observing an actual clinicalencounter. However, the bigger advantage of mini‑CEX is the structured feedback that it provides tothe students as well as the faculty, thus helping them to make better decisions.MATERIALS AND METHODS: This study was a cross‑sectional observational study. Sixteen surgeryresidents volunteered for participation and five professors conducted sessions; hence, 80 mini‑CEXencounters. Seven core clinical skill assessments were done, and the performance was rated ona 9‑point scale (grouped into unsatisfactory, satisfactory, and superior). Immediate feedback tothe residents was given by the faculty. Delayed feedback from faculty and residents regarding theperception of mini‑CEX was taken. Statistical analysis was done using SPSS version 20 and analysisof variance (ANOVA) for inferential statistics.RESULTS: As planned, 80 (100%) mini‑CEX encounters were conducted. Surgery residents showedimprovement that was statistically significant in the competencies of medical interviewing skills,physical examination skills, humanistic qualities/professionalism, and counseling skills. Most of thefaculty (80%) were able to identify the gaps in the knowledge of students and areas of improvementfor their teaching. However, 60% of the faculty felt that it required more effort than traditional methods.The mean time taken by the assessor for observation and feedback to residents was 12.51 minand 5.68 min, respectively. The mean scores of evaluator satisfaction and resident satisfaction withmini‑CEX sessions were 6.04 and 7.49, respectively.CONCLUSIONS: Mini‑CEX improves the learning environment in residency and also leads toimprovement in medical interviewing skills, physical examination skills, humanistic qualities/professionalism, and counseling skills. It is done in the actual patient encounter and hence preparesthe resident better for dealing with patients in the future.

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Study of medical students’ learning approaches and their association with academic performance and problem‑solving styles

. Ghobad Ramezani; . Azam Norouzi; . Seyed Kamran Soltani Arabshahi; . Zohreh Sohrabi; . Atefeh Zabihi Zazoli; . Shahrzad Saravani; . Ghadir Pourbairamian

Volume 12, Issue 7 , August 2022, Pages 1-9

Abstract

  BACKGROUND: Learners have various processing and understanding of the environment and issuesand choose different strategies for problem‑solving considering learning and studying approaches.The ...  Read More BACKGROUND: Learners have various processing and understanding of the environment and issuesand choose different strategies for problem‑solving considering learning and studying approaches.The purpose of this study was to examine medical students’ learning approaches and their associationwith academic performance and problem‑solving styles.MATERIALS AND METHODS: This study was conducted using the descriptive‑correlational method.The statistical population comprised medical students of Iran University of Medical Sciences duringthe academic year of 2019–2020. Of them, 168 subjects were chosen based on simple randomsampling and Morgan Table. Study tools include the Standard Approaches and Study Skills Inventoryfor Students (ASSIST) Questionnaire, which includes 18 items and a Likert five‑choice spectrum,and includes a deep, superficial, and strategic approach. Its reliability was determined by Cronbach’salpha of 0.81. Problem‑Solving Style Questionnaire developed by Cassidy and Long was used. Thisinstrument included 24 items and 6 components, and its reliability equaled 0.83, which was theirgrade point average. Data were analyzed using normality tests, paired t‑test, Pearson correlationcoefficient, and regression through SPSS 16 software.RESULTS: Results implied the positive and significant relationship between deep‑strategic approaches,problem‑solving styles, and academic performance of medical students (P < 0.001); furthermore,there was no significant difference between learning approaches based on gender (P > 0.001), whilethere was a significant difference between two groups in terms of problem‑solving styles (P < 0.001).CONCLUSION: Because deep and strategic approaches predict academic performance andproblem‑solving styles, the diagnostic assessment must be done at the beginning of the educationalprocess to determine the type of learners’ approaches. Such an evaluation can be used to implementinstructional strategies and educational designs to improve the academic performance of students.

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Exploring Challenges of Access to Non‑Communicable Disease (NCD) Prevention, Treatment and Care: A Qualitative Study on People Living with NCDs (PLWNCDs) in West Bengal, India

. Sutapa Biswas; . Debayan Podder; . Sweety Suman Jha; . Prachi Kathuria; . Bobby Paul

Volume 12, Issue 7 , August 2022, Pages 1-9

Abstract

  BACKGROUND: People living with noncommunicable diseases (PLWNCDs) are oftendisproportionately affected due to adverse interaction with socioecological and biological factors.Hence, ...  Read More BACKGROUND: People living with noncommunicable diseases (PLWNCDs) are oftendisproportionately affected due to adverse interaction with socioecological and biological factors.Hence, it is imperative to learn from their lived experience to gain a greater understanding ofinteractions as well as explore their priorities and needs in accessing care and identify areas ofpriority action through multistakeholder engagement.MATERIALS AND METHODS: The qualitative study with grounded theory approach wasconducted between October and December 2020. An online key‑informant interview with the healthpolicymaker, virtual group discussion with eight PLWNCDs, and in‑depth telephonic interviewswith five PLWNCDs were conducted, after obtaining informed consent using interview guide,developed, and validated by the experts. Data collection continued till data saturation was achieved.Transcripts generated from the interview recordings were coded using hand‑code technique andanalyzed thematically.RESULTS: Challenges faced by PLWNCDs in accessing care were lack of empathy and supportfrom health‑care professionals, stigma, financial hardship, and hospital overcrowding. Caregiversemphasized on the felt need to involve civil society organizations (CSOs) in raising awareness towardnoncommunicable diseases (NCDs) at family, community, and policymaking levels. The need forhome‑based NCD care and rehabilitation centers was voiced by the PLWNCDs. Impediments towardeffective implementation of NCD policies were adoption of a “top‑down” approach, poor awarenessabout government health insurance schemes, skewed distribution of empanelled hospitals in andaround cities, nonavailability of qualified health‑care professionals in underserved areas, aggravatedallocation‑utilization disparity during COVID‑19 pandemic, and lack of robust information technologyinfrastructure to support access to telemedicine services.CONCLUSION: The collective role of governments, CSOs, and health‑care providers, along withmeaningful involvement of PLWNCDs, would help to create an enabling environment for overcomingthe challenges of access to care and thus achieve universal health coverage.

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A reproductive health‑care program for surrogate mothers: A mixed methods study

. Marjan Goli; . Shahnaz Kohan; . Seiied Mahdi Ahmadi Oloonabadi; . Ziba Farajzadegan; . Zeinab Heidari

Volume 12, Issue 7 , August 2022, Pages 1-8

Abstract

  BACKGROUND: Surrogacy has become an alternative family formation option for women who areunable to carry a pregnancy. There is no comprehensive care program despite the different nature ...  Read More BACKGROUND: Surrogacy has become an alternative family formation option for women who areunable to carry a pregnancy. There is no comprehensive care program despite the different nature ofthis pregnancy. The present study aimed to develop a reproductive health‑care program for surrogatemothers within the cultural and social context of Iran.MATERIALS AND METHODS: In the present sequential exploratory mixed methods study, firstthrough a qualitative approach surrogate mothers, care providers, and policy makers of reproductivehealth services were selected purposefully. Data were collected by using the in‑depth semi‑structuredinterviews and analyzed. A care program draft was designed by integrating results of the qualitativestudy and reviewing the literature and guidelines, then appropriateness of each proposed care wasassessed by a two‑Rounds Delphi technique (RAM), and the final reproductive health‑care programfor surrogate mothers was developed.RESULTS: The surrogate mothers’ reproductive health needs were summarized in four maincategories: surrogate mothers’ extra care, educational training, psychological support, and protectingagainst surrogacy`s social and familial consequences. The reproductive health‑care program forsurrogate mothers were developed in four sections: prepregnancy health screenings and legalcounseling; special care during embryo transfer until pregnancy confirmation; psychological supportand prenatal care of surrogacy until delivery and follow‑up postpartum care.CONCLUSION: Women face many challenges in surrogacy and need special care such as legalcounseling, reproductive health care, and psychological support. Implementation of this care programseems to help improve the reproductive health of these mothers.

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Asymptomatic bacteriuria of pregnant women in a tertiary care centre

. Meenakshi Totadhri; . Anandhi Lakshmanan; . Saraswathy M P; . Manisha S. Mane

Volume 12, Issue 7 , August 2022, Pages 1-7

Abstract

  BACKGROUND: Asymptomatic bacteriuria (ASB) is commonly seen during pregnancy due to thevarious morphological, hormonal, and physiological changes the body undergoes. If left undiagnosed,it ...  Read More BACKGROUND: Asymptomatic bacteriuria (ASB) is commonly seen during pregnancy due to thevarious morphological, hormonal, and physiological changes the body undergoes. If left undiagnosed,it can lead to conditions such as pyelonephritis and preterm delivery which could culminate in causingmaternal and fetal morbidity and mortality. Therefore, this study aims to determine the prevalence,risk factors, microbial profile, and antibiotic susceptibility patterns associated with ASB in a tertiaryhealthcare center.MATERIALS AND METHODS: A cross‑sectional study was carried out where 150 urine sampleswere obtained from pregnant women within the gestational age of 13–36 weeks. Randomizedstratified sampling was the method of sampling used. A questionnaire was also administered tothem to determine potential risk factors. The samples were cultured and identified using biochemicaltests. Antibiotic susceptibility tests were carried out by Kirby–Bauer disc diffusion method. Statisticalanalysis was carried out using Chi‑square test. The graphs and tables were generated using MicrosoftExcel and Word.RESULTS: Out of the 150 samples that were obtained, 8 samples had significant bacteriuria whichis a prevalence of 5.33%. Escherichia coli was the most frequently isolated organism accountingto 45% of the isolates. The other organisms that were isolated were Enterococcus, Klebsiellapneumoniae, Coagulase negative staphylococcus (CONS), Candida albicans, and Group BStreptococcus which measured to 11% of the total distribution each. In the antibiotic sensitivitytests, among the gram‑negative isolates, marked resistance to Ampicillin and Amoxycillin along withsensitivity to Cotrimoxazole and Nitrofurantoin. Of the gram‑positive isolates, there was sensitivityto Ampicillin and Nitrofurantoin. A positive correlation was seen between the age groups of 23–27and the prevalence of ASB.CONCLUSION: The prevalence of ASB in this study shows that ASB is not uncommon in thepopulation. Despite the World Health Organization (WHO) guidelines and National Health Missionrecommendations to make urine check‑ups a routine, it not carried out, possibly due to costimplications. However, it poses a risk for severe maternal and fetal outcomes and hence, should bescreened for on a regular basis. Thus, this study emphasizes the importance of screening pregnantwomen for ASB for promoting better maternal and fetal health.

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The effect of a coping program on mothers’ grief following perinatal deaths

. Leila Nournorouzi; . Roghaiyeh Nourizadeh; . Sevil Hakimi; . Khalil Esmaeilpour; . Leila Najmi

Volume 12, Issue 7 , August 2022, Pages 1-6

Abstract

  BACKGROUND: Mother–child attachment is formed from early stages of pregnancy and peaks inthe second trimester and continues until after childbirth. The fetal or neonatal death ...  Read More BACKGROUND: Mother–child attachment is formed from early stages of pregnancy and peaks inthe second trimester and continues until after childbirth. The fetal or neonatal death as a tragic eventcould lead to the grief experience among parents, especially mothers. The present study aimed todetermine the effect of a coping program on mothers’ grief following perinatal deaths.MATERIALS AND METHODS: This trial study was performed on 56 women with the experience ofperinatal death during the last 1–3 months with a score of Perinatal Grief Scale (PGS) ≥91, whowere referred to the health centers of Tabriz, Iran, from September 2020 to June 2021. Participantswere randomly assigned into the intervention and control groups through stratified blocking on thebasis of the stillbirth and neonatal death using Random Allocation Software with a block size of 4and 6 with a ratio of 1:1. The intervention group received a coping program individually during threesessions, once a week for 45–60 min. Data collection tools included the demographic and obstetriccharacteristic questionnaire and PGS. The data were analyzed using SPSS24. The groups werecompared through t‑test, and ANCOVA after adjusting the effect of baseline score.RESULTS: Prior to coping program, the mean standard deviation of the grief total score was108.32 (14.31) in the intervention group and 107.92 (6.65) in the control group (P = 0.89). Aftercoping program, the mean of the grief total score was 82.28 (16.72) in the intervention group and101.05 (12.78) in the control group. After adjusting the effect of baseline score and stratified factors,the mean of the grief total score in the intervention group was significantly lower than that in thecontrol group [Adjusted mean difference (AMD): −18.77, 95% confidence interval: −26.79 to − 10.75,P ≤ 0.001].CONCLUSION: Conducting a coping program during 1–3 months after experiencing perinatal deathsis effective in reducing the mothers’ grief reactions. It is recommended to evaluate the effectivenessof the same intervention after perinatal deaths for both parents with a longer follow‑up period infurther studies.BACKGROUND: Mother–child attachment is formed from early stages of pregnancy and peaks inthe second trimester and continues until after childbirth. The fetal or neonatal death as a tragic eventcould lead to the grief experience among parents, especially mothers. The present study aimed todetermine the effect of a coping program on mothers’ grief following perinatal deaths.MATERIALS AND METHODS: This trial study was performed on 56 women with the experience ofperinatal death during the last 1–3 months with a score of Perinatal Grief Scale (PGS) ≥91, whowere referred to the health centers of Tabriz, Iran, from September 2020 to June 2021. Participantswere randomly assigned into the intervention and control groups through stratified blocking on thebasis of the stillbirth and neonatal death using Random Allocation Software with a block size of 4and 6 with a ratio of 1:1. The intervention group received a coping program individually during threesessions, once a week for 45–60 min. Data collection tools included the demographic and obstetriccharacteristic questionnaire and PGS. The data were analyzed using SPSS24. The groups werecompared through t‑test, and ANCOVA after adjusting the effect of baseline score.RESULTS: Prior to coping program, the mean standard deviation of the grief total score was108.32 (14.31) in the intervention group and 107.92 (6.65) in the control group (P = 0.89). Aftercoping program, the mean of the grief total score was 82.28 (16.72) in the intervention group and101.05 (12.78) in the control group. After adjusting the effect of baseline score and stratified factors,the mean of the grief total score in the intervention group was significantly lower than that in thecontrol group [Adjusted mean difference (AMD): −18.77, 95% confidence interval: −26.79 to − 10.75,P ≤ 0.001].CONCLUSION: Conducting a coping program during 1–3 months after experiencing perinatal deathsis effective in reducing the mothers’ grief reactions. It is recommended to evaluate the effectivenessof the same intervention after perinatal deaths for both parents with a longer follow‑up period infurther studies.Keywords:Bereavement, grief, perinatal death, stillbirt

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A sequential exploratory study to develop and validate neutropenic nursing care bundle for neutropenic patients admitted in a tertiary care hospital, Uttarakhand

. Nitesh Dahiya; . Ruchika Rani; . Uttam K. Nath

Volume 12, Issue 7 , August 2022, Pages 1-10

Abstract

  BACKGROUND: Patients diagnosed with cancer and who undergo cancer treatment are at potentialrisk of bone marrow suppression leading to prolonged hospitalization, delay in treatment, ...  Read More BACKGROUND: Patients diagnosed with cancer and who undergo cancer treatment are at potentialrisk of bone marrow suppression leading to prolonged hospitalization, delay in treatment, andchemotherapy dose reductions, which ultimately results in significant morbidity and mortality. Thissequential exploratory study using a mixed‑method approach was aimed to develop and validate aneutropenic nursing care (NNC) bundle for neutropenic patients admitted in a tertiary care hospital,Uttarakhand.MATERIAL AND METHODS: This sequential exploratory study design with an instrumentdevelopmental model was used to develop the NNC bundle. It consisted of two phases: Qualitativephase and quantitative phase. In the qualitative phase, focused group discussion with eight oncologynurses was performed to derive themes related to neutropenic nursing care using conventionalcontent analysis. An extensive literature review was also performed on these themes to explore thecurrent pieces of evidence for item pool generation. In the quantitative phase, a preliminary draftbundle was developed, and two Delphi rounds (I and II) were carried out among the five experts forthe content validation of the NNC bundle and a final bundle was developed.RESULTS: Major domains identified for the bundle were hand hygiene, care of central and peripherallines, routine oral care, antiseptic bath, peri‑anal care, diet, and environmental hygiene. Thecontent validity index (CVI) of the bundle was found to be >80% for all the items with I‑CVI >0.8 andS‑CVI = 0.99 after conducting two rounds of Delphi.CONCLUSION: The present study has provided a set of valid written neutropenic nursing interventionsto prevent complications in neutropenic patients. The NNC bundle should be subjected to other levelsof evaluation that measure the bundle’s practicability and suitability for the intended field.

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