Journal of Education and Health Promotion

Assessment of Iranian orthodontists’ practice with regard to the prevention and treatment of white spot lesions

. Faezeh Eslamipour; . Majid Shahmoradi; . Vashnad Farhadi

Volume 7, Issue 2 , May and June 2017, Pages 1-5

Abstract

  INTRODUCTION: White spot lesions (WSLs) are common adverse effect of orthodontic treatment,which can be prevented and treated by orthodontists. This study was conducted to assess Iranianorthodontists’ ...  Read More INTRODUCTION: White spot lesions (WSLs) are common adverse effect of orthodontic treatment,which can be prevented and treated by orthodontists. This study was conducted to assess Iranianorthodontists’ practice regarding the prevention and treatment of WSLs in their patients.METHODS: In this cross‑sectional study, 109 Iranian orthodontists were selected from the IranianAssociation of Orthodontists’ directory by cluster sampling. For data collection, a questionnaire wasdesigned and its validity and reliability was confirmed (Cronbach’s α =0.85). The questionnaireincluded eight general questions and eight questions about practice with regard to the preventionand treatment of WSL. Data were analyzed by descriptive tests, ANOVA test, and t‑test in SPSS 20software. P < 0.05 was considered statistically significant.RESULTS: The mean score of orthodontists’ practice was 7.62 (range: 0–8), and 94.4% of theparticipants were rated as good, while 3.7% and 1.9% were rated as moderate and weak, respectively.Women’s score was significantly higher than that of men (P = 0.001). With increasing participants’age, their practice has been improved (P = 0.001), but there was no significant relation between yearsof experience and their practice (P = 0.230). Nearly 94.4% of the orthodontists prescribed fluorideproducts. Toothpastes and fluoride mouth rinses were the most common prescribed products (34%).CONCLUSIONS: With regard to Iranian orthodontists’ practice, it was fortunate to note that majorityof the respondents were taking care of their patients with regarding to the prevention and treatmentof WSLs. For enhancing their competencies, it is recommended to plan educational courses whichare useful for promoting their knowledge and practice about new products and procedures used forthe prevention and treatment of WSLs.

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Reported influences of backpack loads on postural deviation among school children: A systematic review

. Balamurugan Janakiraman; . Hariharasudhan Ravichandran; . Senait Demeke; . Solomon Fasika

Volume 7, Issue 2 , May and June 2017, Pages 1-11

Abstract

  BACKGROUND: Nowadays, a large number of students experience spinal pain quite early in life dueto heavy school bag loads. Moreover, external forces in the form of school bags may influence ...  Read More BACKGROUND: Nowadays, a large number of students experience spinal pain quite early in life dueto heavy school bag loads. Moreover, external forces in the form of school bags may influence thenormal growth, development of children and adolescents, and also maintenance of alignment of theirbodies, which can pose a huge threat to postural integrity under external load. Awareness about theappropriate load and placement of backpack is thought to be important in reducing musculoskeletalcomplications among children’s.METHODS: A systematic review of randomized controlled trials (RCTs) was conducted to determinethe influence of postural deviations due to backpack load among school children’s. Electronic databaseswere searched, and a reference list of retrieved articles were relevant to postural changes among schoolchildren with the backpack were screened. Reviewers graded the papers according to Lloyd‑Smith’shierarchy of evidence scale. Papers were quality appraised using a modified Crombie tool.RESULTS: Twelve papers were identified for inclusion in this review. Methodological differencelimited our ability to collate evidence.CONCLUSION: Most of the articles recommended that backpack load limit for school children shouldbe 10–15% of body weight. However, the appropriate load limit for school children is limited due tolack of articles, the low hierarchy of evidence, and small sample size. This review constrains the useof published literature to inform good load limit of school pack among the school children.

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A randomized trial to promote physical activity during pregnancy based on health belief model

. Mahnaz Shafieian; . Ashraf Kazemi

Volume 7, Issue 2 , May and June 2017, Pages 1-6

Abstract

  BACKGROUND: The positive effects of physical activities during pregnancy are totally recognizedbut due to lack of knowledge and negative aspect toward it, physical activities decrease ...  Read More BACKGROUND: The positive effects of physical activities during pregnancy are totally recognizedbut due to lack of knowledge and negative aspect toward it, physical activities decrease throughoutthe pregnancy period. To find the appropriate model to enhance physical activity during pregnancy,the education that are focused on health belief constructs about physical activity during pregnancy,were assessed.MATERIALS AND METHODS: This was a semi‑experimental study conducted on 90 pregnantwomen in their first trimester that were divided into two groups of control and intervention.After assessing health belief model (HBM) constructs and measuring the duration of severe/moderate‑intensity) physical activity through a questionnaire, participants were divided intotwo groups of 45. The intervention group received education about physical activity based onHBM and the control group received dental health education. In the second trimester again, theconstructs of HBM and the duration of physical activities were evaluated. Significant level wasset at P < 0.05.RESULTS: Data analysis showed that level of perceived susceptibility/severity and perceivedbenefits and also the level of appealing physical activity (P < 0.05), had a significant increase inthe intervention group after the education, but the mean of the severe/moderate‑intensity physicalactivity with did not rise to 150 min/week.CONCLUSION: Study results showed that education based on HBM could lead to an increase inphysical activity during pregnancy by increasing the level of health beliefs in pregnant women, butthis increase does not reach the adequate level.

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Evaluating combined effect of noise and heat on blood pressure changes among males in climatic chamber

. Habibollah Dehghan; . Mohamad Taghi Bastami; . Behzad Mahaki

Volume 7, Issue 2 , May and June 2017, Pages 1-6

Abstract

  INTRODUCTION: Exposure to noise and heat causes individuals to experience some changes inthe function of cardiovascular system in workplaces. This study aimed to find the combined effectof ...  Read More INTRODUCTION: Exposure to noise and heat causes individuals to experience some changes inthe function of cardiovascular system in workplaces. This study aimed to find the combined effectof heat and noise on systolic and diastolic types of blood pressure in experimentally controlledconditions.METHODS: This quasi‑experimental study was performed with 12 male students in a climatic chamberin 2014. Blood pressure including systolic and diastolic was measured in the following conditions:15 min after rest in exposure to heat (40°C, relative humidity [RH]: 30%), exposure to noise with75, 85, and 95 dB rates in thermal comfort condition (22.1 ± 0.9 wet‑bulb globe temperature), andcombined exposure to heat (40°C, RH: 30%) and noise with 75, 85, and 95 dB. Friedman test wasused to analyze the data.RESULTS: The mean change of systolic blood pressure was different significantly before and afterexposure to heat and noise levels including 75, 85, and 95 dB (P = 0.015, P = 0.001, P > 0.001,P = 0.027, respectively). Although systolic and diastolic blood pressures changed drastically, it wasnot significantly different in simultaneous exposure to heat and noise.CONCLUSION: Both systolic and diastolic blood pressures decreased in exposure to heat,while exposure to different levels of noise elevates systolic and diastolic blood pressures.However, when exposed to a combination of heat and noise, subtle changes of blood pressurewere traced, which can be characterized as average, considering heat‑only and noise‑onlytension situations.

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Awareness and perceptions regarding common cancers among adult population in a rural area of Puducherry, India

. Arumugam Mariappan Veerakumar; . Sitanshu Sekhar Kar

Volume 7, Issue 2 , May and June 2017, Pages 1-7

Abstract

  BACKGROUND: Awareness regarding cancer signs and symptoms and their screening and treatmentmethod was low in India.OBJECTIVES: To assess the awareness level of common cancers, perception ...  Read More BACKGROUND: Awareness regarding cancer signs and symptoms and their screening and treatmentmethod was low in India.OBJECTIVES: To assess the awareness level of common cancers, perception regarding preventionand treatment of common cancers, association between sociodemographic variables with theawareness level of common cancers in the adult population.MATERIALS AND METHODS: A cross‑sectional study was conducted among 299 adults from thefield practice areas of Our Rural Health Centre, Puducherry, during April–May 2014. Using systematicrandom sampling, 299 adults were interviewed through a pretested semi‑structured questionnaire.Data were entered into EpiData version 3.1 and were analyzed by Statistical Package for SocialSciences version 20. Chi‑square test was used.RESULTS: Nearly, 64% were in the age group of ≥40 years, the majorities werefemales (56.2%) and 64% were in lower socioeconomic class. Symptoms reported majoritieswere unusual bleeding (41.6%), followed by nagging cough (34.1%). Risk factors reportedmajorities were smoking (65%), chewing tobacco (59%) followed by alcohol use (46.5%).Only 10% reported cancer could be diagnosed early and 27% perceived cancer could bepreventable. Only 6% perceived cancer could be cured fully. The adequate awareness levelregarding lung and oral cancer were 14%, but breast and cervical cancer were <5%. Theyounger age group (<40 years) had more adequate awareness level compared to age group≥40 years (P < 0.05).CONCLUSION: The awareness level of common cancers was very poor. Vigorous health educationprogram should improve the status of early diagnosis and proper treatment for common cancerssuch as oral, breast, and cervical cancer.

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Hospital managers’ attitude and commitment toward electronic medical records system in Isfahan hospitals 2014

. Maryam Jahanbakhsh; . Saeed Karimi; . Akbar Hassanzadeh; . Maliheh Beigi

Volume 7, Issue 2 , May and June 2017, Pages 1-5

Abstract

  INTRODUCTION: Electronic medical record system (EMRS) is a valuable system for safe accessto the patient’s data and increases health care quality. Manpower is one of the requirements ...  Read More INTRODUCTION: Electronic medical record system (EMRS) is a valuable system for safe accessto the patient’s data and increases health care quality. Manpower is one of the requirements forEMRS, among which manager is the most important person in any hospital. Taking into accountmanager’s positive attitude and good commitments, EMRS will be implemented successfully. Assuch, we decided to assess manager’s attitude and commitment toward EMRS in Isfahan hospitalsin the year of 2014.AIM: This article aimed to determine the hospital managers’ attitude and commitment toward theimplementation of EMRS.MATERIALS AND METHODS: The present article is an applied analytic study. Research societyconsisted of the managers of all the hospitals in Isfahan that include hospitals affiliated to IsfahanUniversity of Medical Sciences, private, and social security hospitals. This study was done in 2014.Data collection tools included a questionnaire for which reliability and validity were determined. Datawere analyzed by means of SPSS 20.RESULTS: Average score for the managers’ attitude toward EMRS in the city of Isfahan was 77.5out of 100 and their average score for commitment was 74.7. Manager’s attitude in social securityhospitals was more positive than the private and governmental ones (83.3%). In addition, the amountof commitment by the managers in social security hospitals was higher than the same in private andgovernmental hospitals (86.6%).CONCLUSION: At present, managers’ attitude and commitment in Isfahan hospitals toward EMRSare very high and social security hospitals show more readiness in this respect.

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Effect of green tea on metabolic and hormonal aspect of polycystic ovarian syndrome in overweight and obese women suffering from polycystic ovarian syndrome: A clinical trial

. Hatav Gasemi Tehrani; . Maryam Allahdadian; . Farzane Zarre; . Hanie Ranjbar; . Fateme Allahdadian

Volume 7, Issue 2 , May and June 2017, Pages 1-5

Abstract

  BACKGROUND AND OBJECTIVE: Polycystic ovarian syndrome (PCOS) is the common cause ofOligo‑ovulation. This syndrome causes long‑term metabolic issues as well as increase the risk ...  Read More BACKGROUND AND OBJECTIVE: Polycystic ovarian syndrome (PCOS) is the common cause ofOligo‑ovulation. This syndrome causes long‑term metabolic issues as well as increase the risk ofdiabetes type 2, hypertension, dyslipidemia, and cardiovascular disease. The current research aimedto study the effect of green tea on weight and hormonal changes of women suffering from PCOS.METHODS: This two group, double‑blind, randomized clinical trial was conducted in Isfahan city.Overweight women suffering from PCOS (n = 60) were randomly divided into two groups. Greentea was prescribed to the experimental group, and placebo was prescribed to the control group.Free testosterone hormones and fasting insulin were compared in both groups at the beginning and12 weeks after the study commencement. The weight of participants of both groups was also measuredbefore and after the study. The statistical data were analyzed by SPSS software and paired t‑test.RESULTS: The paired t‑test showed that there was no significant difference in the mean weightof both groups before the intervention (P = 0.812), but the difference was significant after theintervention (P = 0.031). There was no significant difference in the mean fasting insulin of both groupsbefore the intervention (P = 0.352), but the difference was significant after the intervention (P < 0.0001).Moreover, there was no significant difference in the mean free testosterone level of both groups beforethe intervention (P = 0.638), but the difference was significant after the intervention (P < 0.0001).CONCLUSION: The consumption of green tea by overweight and obese women suffering from PCOSleads to weight loss, a decrease in fasting insulin, and a decrease in the level of free testosterone.

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Knowledge, attitude, and practice of urban Gujarati type 2 diabetics: Prevalence and impact on disease control

. Jayesh Dalpatbhai Solanki; . Nidhi Shaileshbhai Sheth; . Chinmay J. Shah; . Hemant B. Mehta

Volume 7, Issue 2 , May and June 2017, Pages 1-7

Abstract

  CONTEXT: Type 2 diabetes is the modern epidemic wherein patient care needs multiple approaches,education, and self‑awareness being one of them. There are some knowledge, attitude, ...  Read More CONTEXT: Type 2 diabetes is the modern epidemic wherein patient care needs multiple approaches,education, and self‑awareness being one of them. There are some knowledge, attitude, andpractice (KAP) studies from India but very few relating it with disease control.AIMS: We tried to study KAP of treated type 2 diabetics and its correlation with glycemic control.SETTINGS AND DESIGN: Cross‑sectional KAP study.SUBJECTS AND METHODS: We formulated KAP questionnaires in the form of KAP ‑ 10 pointsfor each and total 30. We recruited 200 type 2 diabetics (96 males, 104 females) treated by MDphysicians with known current glycemic status. They were asked KAP questionnaires one toone by a direct interview in local language and results were associated with various factors andglycemic control.RESULTS: KAP score on was average 19 out of 30 in type 2 diabetics having mean age 58 years,mean duration 9 years. KAP score was unaffected by gender, occupation, duration of disease butsignificantly affected by current age, and education level. Only 40% patients had good glycemiccontrol who scored better KAP than poor glycemic. There was positive correlation between KAPscore and glycemic control, with significance for only glycosylated hemoglobin and not fasting bloodsugar, postprandial blood sugar.CONCLUSIONS: Physician treated type 2 diabetics of our region had moderate KAP score, affectedby age, education which suggested to affect glycemic control. Lacunae in knowledge regardingincurability of disease, attitudes toward complication, self‑care, and good practices like walking,enriching knowledge need improvement so as an optimum glycemic control.

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Effectiveness of a program on evidence‑based dentistry in dental students

. Naghmeh Feyzi Najaf; . Imaneh Asgari

Volume 7, Issue 2 , May and June 2017, Pages 1-5

Abstract

  INTRODUCTION: Evidence‑based dentistry (EBD) is an approach to oral healthcare by combiningthe best scientific evidence and clinical diagnostics, clinical expertise of the dentist, ...  Read More INTRODUCTION: Evidence‑based dentistry (EBD) is an approach to oral healthcare by combiningthe best scientific evidence and clinical diagnostics, clinical expertise of the dentist, and the patient’streatment needs and preferences. The aim of the present study is to evaluate the effectiveness ofan education program on EBD offered in a community‑dentistry course in improving knowledge andattitudes of students in this regard.STUDY METHODS: By a quasi‑experimental study design, 64 senior dental students of IslamicAzad University of Khorasgan recruited in a controlled trial. All of the students were randomized asintervention (32) and control (32) groups. A course‑based educational program on EBD was randomlyassigned to one group. Actual knowledge, self‑assessed knowledge, and attitudes, before and aftereducation, were measured in both groups. A questionnaire consisted of 40 items developed by theresearcher was used after confirming its validity and reliability. The difference between mean scoresat two timelines were measured and compared in three fields by paired t‑test and independent t‑testanalysis via SPSS version 20 software.RESULTS: While the mean scores of actual and self‑assessed knowledge and attitude were notsignificantly different between two groups at the beginning of the program (P > 0.05), the meanscores of all fields in the intervention group were significantly more than those of the control groupafter education (P < 0.001). The effect size of intervention was 86%, 62%, and 57% in three fields,respectively. There was not a significant difference between mean scores of three fields in the controlgroup, after the intervention.CONCLUSION: Due to the poor knowledge and attitudes of students and improved knowledge andattitudes of the intervention group after education, the education program seems to be effective.Durability of educational impact and evaluating evidence‑based performance can be studied in thefuture.

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Empowerment in breastfeeding as viewed by women: A qualitative study

. Zeinab Heidari; . Shahnaz Kohan; . Mahrokh Keshvari

Volume 7, Issue 2 , May and June 2017, Pages 1-7

Abstract

  BACKGROUND: The positive effect of breastfeeding on health is globally accepted. However,breastfeeding has not yet practiced at a favorite level. Empowerment of mothers is an importantfactor ...  Read More BACKGROUND: The positive effect of breastfeeding on health is globally accepted. However,breastfeeding has not yet practiced at a favorite level. Empowerment of mothers is an importantfactor for continuing breastfeeding. This study was conducted to explore women’s perception ofempowerment in breastfeeding.METHODS: The present qualitative study was conducted in conventional content analysis method.Thirty‑four semi‑structured deep interviews were conducted with 18 mothers, four key family members,and 12 other personnel involved in breastfeeding counseling services.RESULTS: Analysis of participants’ descriptions led to the emergence of five main categories: Enoughknowledge and skill for breastfeeding, feeling adequacy in breastfeeding, overcoming breastfeedingproblems, informed belief in the value of breastfeeding, and perceiving comprehensive support forbreastfeeding.CONCLUSION: in participants’ point of view, empowerment in breastfeeding can be formedthrough an acquisition of “Enough knowledge and skill for breastfeeding” as well as assuranceabout the proper quality and quantity of mother’s milk. As well as overcoming breastfeedingproblems will lead to stabilization empowerment in breastfeeding. In addition, data analysisshowed that informed belief in the value of breastfeeding strengthens the empowerment inbreastfeeding and presence of perceived comprehensive support for breastfeeding facilitatesempowerment in breastfeeding continuance. Thus, comprehensive plans should be designingfor promoting breastfeeding.

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The proportion of unmet costs considering inpatients billing of selected hospitals, after 2014 Health System reform implementation in Isfahan Province

. Parnaz Naghdi; . Mahan Mohammadi; . Mohammad Ali Jahangard; . Alireza Yousefe; . Noora Rafiee

Volume 7, Issue 2 , May and June 2017, Pages 1-5

Abstract

  INTRODUCTION: Since 2013, in Iran’s health care, the contribution of direct payments for health‑careservices was estimated more than 50 % of all expenditures. In May 2014, Iran’s ...  Read More INTRODUCTION: Since 2013, in Iran’s health care, the contribution of direct payments for health‑careservices was estimated more than 50 % of all expenditures. In May 2014, Iran’s health‑care reform wasestablished to improve health services quality and reduce patients’ out‑of‑pocket payments <10% inurban and 5% in rural areas. Therefore, the purpose of this study is to investigate unmet costs (thosewhich are not covered either by the insurance companies nor the recent reform coverage mentionedin Sections 1.2.2 and 1.2.1, Article 6 of the Health Minister Reform Guideline) in the inpatient billingswithin the first 5 months from the reform implementation.METHODS: This study was conducted as a cross‑sectional research in the second half of 2014 onthe selected hospitals in Isfahan Province. Data were collected by investigating 97,000 inpatients’billing records issued by 28 hospitals affiliated to Isfahan University of Medical Sciences usingcensus method.RESULTS: Findings of the study showed that the average of unmet costs paid by the inpatientsconstituted 21.8% of the total billing costs in 28 hospitals, and the average unmet costs paid by eachpatient was 1,903,832 Rials.CONCLUSION: Considering the definition of unmet cost in the context of health‑care reformguideline and hospitals’ problems in providing some costly services, drugs, and medicalequipment (that were not covered by insurance organizations and the reform scheme) withinthe obligations of the reform, it is necessary to review these obligations and further interact withinsurance companies about expanding the coverage to some costly services required by thepatients.

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The effect of bibliotherapy on the psychological capital of the staff of the School of Management and Medical Informatics of Isfahan University of Medical Science

. Ahmad Papi; . Zahra Mosharraf; . Firoozeh Zare Farashbandi; . Rahele Samouei; . Akbar Hassanzadeh

Volume 7, Issue 2 , May and June 2017, Pages 1-6

Abstract

  BACKGROUND: Bibliotherapy is defined as using dynamic interaction along with reading a book inorder to help the people to increase their cognitive understanding. This study aims to ...  Read More BACKGROUND: Bibliotherapy is defined as using dynamic interaction along with reading a book inorder to help the people to increase their cognitive understanding. This study aims to investigate theeffect of bibliotherapy on the psychological capital of the employees of the Department of Managementand Medical Informatics of Isfahan University of Medical Science.MATERIALS AND METHODS: This is an applied study using a semi‑empirical method. Thestatistical population consists of all nonfaculty employees of the target department (70 people).Twenty eight people were randomly selected and divided into experiment and control groups andanswered the psychological capital questionnaire. The data gathering tool was the psychologicalcapital questionnaire of Luthans. The experiment group underwent six 2‑h sessions of bibliotherapywhere the control group underwent no interference. Both groups answered the questionnaire again1‑month after the final bibliotherapy session. The information was analyzed using descriptive(average and frequency distribution) and analytical (independent t‑test, paired t‑test, Chi‑squaretest, and Mann–Whitney U‑test) with the help of SPSS 20 software.RESULTS: The findings showed no meaningful distinction average scores of the physiological capitalof both groups before interference. However, the average physiological capital score and an averagescore of each factor in the experiment group was meaningfully higher than that of the control groupafter the bibliotherapy sections.CONCLUSION: The results showed that bibliotherapy is a suitable method for increasing thepsychological capital of the employees of different organizations which will in turn provide both theemployees themselves and the organization with material and spiritual gains.

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Digital games as an effective approach for cancer management: Opportunities and challenges

. Marjan Ghazisaeidi; . Reza Safdari; . Azadeh Goodini; . Mahboobeh Mirzaiee; . Jebraeil Farzi

Volume 7, Issue 2 , May and June 2017, Pages 1-8

Abstract

  OBJECTIVE: Cancer is one of the most preventable and common chronic diseases that haveeconomic, social and psychological burden for patients, families, and the society. Cancer can bemonitored ...  Read More OBJECTIVE: Cancer is one of the most preventable and common chronic diseases that haveeconomic, social and psychological burden for patients, families, and the society. Cancer can bemonitored by new information technology. Digital games as a uniquely powerful interaction toolsupport optimal care management program operation in all dimensions. The aim of this review articleis to describe opportunities and challenges of this new modern technology on the delivery of cancercare services in cancer management domains for cancer care improvement.METHODS: This study was un‑systematic (narrative) review article. In this research, 50 full‑textpapers and reports had been retrieved, studied exactly, and arranged based on study aims. Wesearched papers based on specific and relevant keywords in research databases including PubMed,ScienceDirect, Scopus, and Google scholar.CONCLUSION: In cancer management domain, digital games are as an effective medium forhealth education and intervention, disease self‑management training, attention distraction to relievepain, enhance clinical outcomes, improvements in lifestyles, and physical and psychosocial activitypromotion when active participation and behavior rehearsal are required for cancer patient. In spiteof potential benefits of new technology, sometimes people confront various challenges such associal isolation, unusual anxiety, and disorder in physiological times of body, low physical activities,decrease academic performance, increase aggressive behavior, and physical pain. These problemscan be partly overcome by proper planning, good design, and usage of suitable and continuousmonitoring.

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Comparing two instructional methods of role playing and lecture on primigravida females, decision about type of delivery

. Zahra Abedian; . Maryam Navaee; . Hossein Jafari Sani; . Saeed Ebrahimzadeh

Volume 7, Issue 2 , May and June 2017, Pages 1-7

Abstract

  INTRODUCTION: Each mother has the legal right to decide about her delivery, but this decisionshould be made based on scientific knowledge. Instructions during pregnancy help to choose ...  Read More INTRODUCTION: Each mother has the legal right to decide about her delivery, but this decisionshould be made based on scientific knowledge. Instructions during pregnancy help to choose theproper type of delivery. This study conducted aimed to compare two instructional methods of roleplaying and lecture on primigravida decision about type of delivery.SUBJECTS AND METHODS: In this single‑blind clinical trial 67 primigravida, 34–36 week wereselected using multi‑stage sampling and assigned into two groups randomly. Decision‑making(before, 2‑week after, and at admission in maternity department) was tested by a questionnaire. Inrole‑playing group, advantages and disadvantages of two type delivery were presented by role‑playingin 90‑min by three scenarios. In lecture group, it was also presented in a 90‑min lecture. Data wereanalyzed by mean difference test, Fisher test, independent and paired t‑test.RESULTS: Two groups showed a significant difference in terms of decision at admission tomaternity department (P = 0.000). 75% of lecture group and 100% of role‑playing group selectednormal delivery. Postintervention knowledge score in lecture group was 18 ± 5.3 and in role‑playinggroup 17.1 ± 4.0. Percent of change in knowledge scores in two groups was significant (P = 0.001).Participants’ attitude, before and after the intervention, in both groups was significant (P < 0.05).Mean difference of pre‑ and post‑test in relation to two groups’ knowledge and attitude scores wasnot significant (P > 0.05).CONCLUSION: In this research, lecture was more effective in raising knowledge level, and roleplaying was more effective in raising decision to vaginal delivery and reducing elective caesareansection. It is therefore suggested to use both teaching methods altogether for pregnant women todecrease the rate of unnecessary cesarean.

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Measurement of the levels anxiety, self‑perception of preparation and expectations for success using an objective structured clinical examination, a written examination, and a preclinical preparation test in Kerman dental students

. Mahsa Kalantari; . Nazila Lashkari Zadeh; . Raha Habib Agahi; . Nader Navabi; . Maryam Alsadat Hashemipour; . Amir Hossein Gandjalikhan Nassab

Volume 7, Issue 2 , May and June 2017, Pages 1-7

Abstract

  STATEMENT OF THE PROBLEM: Examinations have an important role in evaluating students’learning outcomes and their mastery of a subject. Passing or failing an examination can havefar‑reaching ...  Read More STATEMENT OF THE PROBLEM: Examinations have an important role in evaluating students’learning outcomes and their mastery of a subject. Passing or failing an examination can havefar‑reaching consequences for the students. Therefore, it is not surprising that international studiesconsistently show that dental students report examinations and grades among the highest rankingstressors in dental schools.PURPOSE: The aim of this research was to measure the levels of anxiety, self‑perception ofpreparation and expectations for success using an objective structured clinical examination (OSCE),a written examination and a preclinical preparation test, and to examine the effects of the threepredictive variables on the outcomes of assessments.MATERIALS AND METHODS: The present research is a cross‑sectional study. The population underconsideration was students of Kerman Dental School in 2013. Examination anxiety was measuredwith Spielberger’s state anxiety inventory. Preparation for the assessment (I am fully prepared = 4,I am prepared = 3, I’m not prepared = 2, I’m not fully prepared = 1) and expectation to succeed (I amquite successful = 4, I am successful = 3, I’m not successful = 2, I’m not quite successful = 1) werequantified with Likert scale. The questionnaire was completed during an OSCE, a written examination,a preclinical crown and bridge preparation test and a nonexamination situation.RESULTS: The study population consisted of 138 4th, 5th, and 6th year Kerman dental students (65 malesand 73 females). The results showed that all the assessment methods induced a significant increasein state anxiety compared to baseline levels with the highest anxiety levels reported during anOSCE (62.4 ± 8.1, P = 0.04) and a written examination (48.8 ± 9.2, P = 0.04). The preparation levelsin females were significantly higher than those in males in OSCE (P = 0.03) and written (P = 0.04).CONCLUSION: State anxiety was high in all the three assessment methods. OSCE induced moreanxiety than other assessment formats. However, anxiety was not predictive of performance outcomesin contrast to preparation and expectation to succeed, which were good predictors of the outcomescores. Also, this study showed that despite a better answer to the assessment of (I prepared myselfwell for the test), the students showed high levels of state anxiety.

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Effect of health education on awareness about oral cancer and oral self‑examination

. Kamaljeet Singh; . Deepak Sharma; . Manmeet Kaur; . Krishan Gauba; . Jarnail S. Thakur; . Rajesh Kumar

Volume 7, Issue 2 , May and June 2017, Pages 1-6

Abstract

  CONTEXT: Oral cancer is preceded by visible changes in the oral mucosa. These lesions can bedetected by oral self‑examination, but awareness about oral cancer is still low in developing ...  Read More CONTEXT: Oral cancer is preceded by visible changes in the oral mucosa. These lesions can bedetected by oral self‑examination, but awareness about oral cancer is still low in developing countries.AIM: To evaluate the effect of health education on awareness about oral cancer and oralself‑examination.SETTINGS AND DESIGN: Quasi‑experimental trial was conducted in an urban resettlement colonyof Chandigarh, India.MATERIALS AND METHODS: A brochure having information and pictorials on oral lesions wasused for conducting health education sessions on a one‑to‑one basis in the household settingamong 85 males in age group 15–59 years during 2013, and each participant was encouragedto perform an oral self‑examination. Study participants were interviewed about their awarenesson oral cancer and oral self‑examination before‑ and after‑health education using a pretestedinterview schedule.STATISTICAL ANALYSIS: Awareness items were scored, and mean change in awareness scorewas computed. Paired t‑test was used for testing statistical significance.RESULTS: Thirty‑three percent of the study participants were current smokers, 25% consumedalcohol, and 9.4% chewed tobacco. The awareness scores after health education increasedsignificantly from 5.3 to 6.7 (P < 0.05), and 34% of the tobacco or alcohol users expressed theirintention to quit these habits, and two persons actually quit tobacco chewing. Out of the 77 studyparticipants who performed oral self‑examination, nine were able to detect lesions, and one wasfound to have submucous fibrosis.CONCLUSIONS: Health education intervention was able to initiate a favorable behavior change inthe community. Hence, oral self‑examination programs should be promoted.

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Determinants of physical activity in middle‑aged woman in Isfahan using the health belief model

. Habibollah Hosseini; . Razieh Moradi; . Ashraf Kazemi; . Maryam Sadat Shahshahan

Volume 7, Issue 2 , May and June 2017, Pages 1-7

Abstract

  INTRODUCTION: Nowadays with respect to the automation of the lifestyle, immobility statisticsin middle‑aged women has increased and they are at risk for complications of immobility. ...  Read More INTRODUCTION: Nowadays with respect to the automation of the lifestyle, immobility statisticsin middle‑aged women has increased and they are at risk for complications of immobility. One ofthe models used to identify factors associated with physical activity is Health Belief Model utilizedin different age and different cultural backgrounds and different results have been obtained fromthose studies. The purpose of this study was to investigate the factors affecting on physical activityin middle‑aged women using Health Belief Model.MATERIALS AND METHODS: This descriptive‑correlation study was conducted on 224 middle‑agedwomen referring to health centers in Isfahan. Health Belief Model structures including perceivedsusceptibility and severity, perceived barriers and benefits, and self‑efficacy were measuredby questionnaire and physical activity was assessed using the international physical activityquestionnaire. Collected data were analyzed using descriptive statistics and Pearson correlationcoefficient test and regression analysis.RESULTS: There wasn’t significant correlation between perceived susceptibility (P = 0.263, r = 0.075)and perceived severity with physical activity duration (P = 0.127, r = 0.058) but there was positiveand weak correlation between physical activity duration with perceived benefits (P = 0.001 andr = 0.26) and perceived self‑efficacy (P = 0.001, r = 0.54) and had weak and inverse correlation withperceived barriers (P = 0.001, r = ‑0.25). Regression analysis also showed that from among all theHealth Belief Model structures just self‑efficacy structure has influenced on behavior independentlyand other structures are affected by it.CONCLUSION: The obtained results implied on a correlation between benefits, barriers and perceivedself‑efficacy with and moderate physical activity. Therefore it is necessary to develop appropriateeducational programs with emphasis on structures of Health Belief Model that has the maximumimpact on physical activity in middle‑aged women.

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Sexual function and quality of life in diabetic women referring to health care centers in Mashhad

. Mahin Tafazoli; . Azam Parnan; . Elham Azmoude

Volume 7, Issue 2 , May and June 2017, Pages 1-7

Abstract

  CONTEXT: Quality of life (QOL) is one of the important indexes of health and well‑being promotionin the diabetic patients. Based on numerous studies, these patients have a lower QOL, ...  Read More CONTEXT: Quality of life (QOL) is one of the important indexes of health and well‑being promotionin the diabetic patients. Based on numerous studies, these patients have a lower QOL, comparedto nondiabetic individuals. In addition, a higher prevalence of sexual function disorder has beenreported in their population that can have a negative effect on their QOL.AIMS: This study aimed to investigate the association between sexual function and QOL in diabeticwomen referring to health care centers in Mashhad during 2013–2014.SETTINGS AND DESIGNS: In this correlational study, the association between sexual function andQOL in 90 diabetic women with type two diabetes referring to health care centers in Mashhad during2013–2014 was investigated.SUBJECTS AND METHODS: Data were collected by Rosen female sexual function index and shortform‑36 questionnaires.STATISTICAL ANALYSIS USED: Data were analyzed by mean comparison and Spearmancorrelation coefficient statistical test through SPSS 16.RESULTS: Subjects’ mean sexual function score was 21.7 ± 6.30. Based on the finding, 25.6% of thesubjects suffered from sexual function disorder. Subjects’ mean score of QOL was 58.75 ± 1616.24.There was a significant association between an overall score of sexual function and its subscales,with their QOL and two dimensions of overall physical and psychological and mental health scores(P < 0.005).CONCLUSIONS: Sexual function is one of the important and associated aspects of QOL in diabeticpatients. Designing and evaluation of the interventions with the goal of an improvement in this variableplays a notable role in the promotion of these patients’ QOL. However, with regard to limited researchin this field, further studies on this association are suggested.

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Smoking history and Alzheimer’s disease risk in a community‑based clinic population

. Erin K. Saito; . Natalie Diaz; . Julia Chung; . Aaron McMurtray

Volume 7, Issue 2 , May and June 2017, Pages 1-4

Abstract

  BACKGROUND: The relationship between cigarette smoking and development of Alzheimer’sdisease (AD) is not fully determined, and previous reports disagree, with some studies suggestingan ...  Read More BACKGROUND: The relationship between cigarette smoking and development of Alzheimer’sdisease (AD) is not fully determined, and previous reports disagree, with some studies suggestingan increased relative risk and others a decreased odds ratio. Consequently, we wanted to determineif the prevalence of past cigarette smoking observed in a community‑based clinic sample of patientswith AD would be more consistent with the expected value obtained from a model using either anincreased relative risk or a decreased odds ratio to estimate the effect of smoking on developmentof AD.MATERIALS AND METHODS: Retrospective cross‑sectional analysis of all patients treated for ADin a community‑based Neurology Clinic during a 2‑year period. Estimates of expected past smokingprevalence were calculated based on published values for either an increased relative risk or adecreased odds ratio and compared to the past smoking prevalence observed in the clinic sample.RESULTS: The observed past smoking prevalence in the clinic population was 29.17%.The expected past smoking prevalence calculated using the increased relative risk was30.07% (95% confidence interval [CI] = 27.67–32.32%), and using the decreased odds ratio was12.54% (95% CI = 6.32–24.81%).CONCLUSION: The observed past smoking prevalence among the patients being treated for ADin a community‑based clinic falls within the expected 95% CI for the increased relative risk modeland outside of the expected 95% CI for the decreased odds ratio model. These results supportthe contention that the relationship between cigarette smoking and development of AD is the bestcharacterized by an increased relative risk.

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Awareness of health warnings and factors predicting awareness and perceived effectiveness of pictorial health warnings on tobacco products among adults in rural Puducherry, India

. Anindo Majumdar; . S. Ganesh Kumar; . Ramya Selvaraj

Volume 7, Issue 2 , May and June 2017, Pages 1-9

Abstract

  BACKGROUND: Limited information exists in India about the awareness and perception of thepeople regarding pictorial health warnings (PHWs) and text warnings on tobacco products, moreso ...  Read More BACKGROUND: Limited information exists in India about the awareness and perception of thepeople regarding pictorial health warnings (PHWs) and text warnings on tobacco products, moreso from rural areas. Objectives were to report the awareness of these warnings, factors predictingawareness and perceived effectiveness of PHWs, and understanding of their content in a ruralpopulation.MATERIALS AND METHODS: A community‑based cross‑sectional study was conducted intwo villages (chosen randomly out of total four) in the rural field practice area of a tertiary careteaching hospital in Puducherry. Households were selected by systematic random sampling. Allpersons ≥18 years and residing in the area for at least 6 months were included. Data regardingawareness and perception of participants was collected through a semi‑structured interviewschedule.RESULTS: A total of 428 participants were recruited; 197 (46%) were male, and 231 (54%) werefemale. The mean age of the participants was 38.9 (standard deviation 15.0) years. Awarenessof PHWs and text warnings was 39.5% (169/428) and 21% (90/428), respectively. Only 11.2%participants perceived PHWs as effective. Most (45%) of the participants had a vague understandingof the content of PHWs. On multivariate logistic regression, male gender, current tobacco use, andbetter education emerged as predictors of greater awareness of PHWs. Extended family predictedgreater perceived effectiveness of PHWs, whereas, high socioeconomic class and middle schoolcompletion predicted lower perceived effectiveness of PHWs.CONCLUSION: Awareness and perceived effectiveness of adults in rural Puducherry regardingPHWs were low. There is a need to create awareness through education and using meaningful,larger pictures.

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Diabetes management with a care coordinator improves glucose control in African Americans and Hispanics

. Wayne S. Rawlins; . Michele A. Toscano-Garand; . Garth Graham

Volume 7, Issue 2 , May and June 2017, Pages 1-8

Abstract

  BACKGROUND: The purpose of this study was to evaluate diabetes control, as measured byhemoglobin A1c (HbA1c) improvements among African American and Hispanic patients receivingconventional ...  Read More BACKGROUND: The purpose of this study was to evaluate diabetes control, as measured byhemoglobin A1c (HbA1c) improvements among African American and Hispanic patients receivingconventional clinical treatment combined with a bilingual diabetes educator using culturally andlinguistically appropriate educational materials. This study also sought to estimate the healthcare costsavings resulting from any A1c improvements and assess the cost‑effectiveness of this approach.MATERIALS AND METHODS: This was a multistage, face‑to‑face observational study undertakenin Texas, United States and focused on 153 African American and Hispanic patients with poorblood glucose control (baseline A1c >8.0%). For two years, a bilingual care coordinator motivatedpatient behavior changes that could lead to improvements in glucose control. The primaryevaluation measure was change in %HbA1c, with secondary measures being change in bloodpressure (BP) and low‑density lipoprotein (LDL). We also sought to gauge the program’s potentialcost‑effectiveness.RESULTS: Within the study group, A1c levels decreased over the study period from a mean of10.0% to 8.4%. The same group saw no statistically significant improvement (reduction) in bloodconcentrations of LDL. The African American subgroup had a small reduction in systolic BP whilechanges for non‑White Hispanics were not statistically significant. The average A1c reductionrealized in this observational study provided estimated cost savings that are nearly twice pilotexpenditures.CONCLUSIONS: Combining standard diabetes care with a bilingual educational care coordinatorresults in significant reductions in mean A1c (−1.6% HbA1c) in patients with poorly controlled bloodglucose and African American/non‑White Hispanic heritage, an intervention that also was shown tobe cost‑effective. This may be an effective model for improving diabetes care in provider practices.

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