Journal of Education and Health Promotion

Abstract INTRODUCTION: Motivation is directly involved in women’s childbearing decision. Considering
the lack of information about reproductive‑age women’s childbearing motivations with preferences
and actual child number in Iran, this study was conducted to determine the relationship between
childbearing motivations with the fertility preferences and actual child number of reproductive‑age
women.
MATERIALS AND METHODS: The participants in this descriptive–correlational study were 844
reproductive‑age women (aged 15–49 years) who were married for the first time and came from
a wide range of areas in Mashhad. Multistage and convenience samplings were applied and the
data were collected using Miller’s childbearing motivation and fertility preferences and actual child
number questionnaire.
RESULTS: The results of the study reveal that positive‑ and negative‑childbearing motivation were
correlated with preferences (P < 0.001) but were not correlated with actual child number. Furthermore,
the interactional variable derived by a combination of positive and negative motivations showed a
significant relationship with the ideal and actual child number (P < 0.05).
CONCLUSIONS: Childbearing motivations affect the fertility preferences in reproductive‑age women
but do not appear to have any influence on the actual child number. Furthermore, the interactional
variables affect the ideal and actual child number.

Abstract BACKGROUND: Patients with cancer often delay seeking medical advice in developing
countries. In India, only 20%–30% of cancers are being diagnosed in Stages I and II.
Screening for red flag symptoms of cancer can be used to identify high‑risk individuals in the
community.
METHODOLOGY: A community‑based cross‑sectional study was conducted in February 2017
among 302 participants in one of the service areas of Jawaharlal Institute of Postgraduate Medical
Education and Research urban health center selected by universal sampling. Data on the presence
of red flag symptoms of cancer (persistent cough, persistent change in bowel/bladder habits,
nonhealing ulcer, persistent difficulty in swallowing, unexplained weight loss, unexplained lump,
persistent unexplained pain, unexplained bleeding, and change in the appearance of mole) and
presence of risk factors were collected through interviews. The collected data were entered using
EpiData version 3.0.
RESULTS: The mean (standard deviation) age of the study participants was 44 (11) years and 50.6%
of them were male. At least one red flag symptom of cancer was present in 22 (7.3%) individuals;
9 (2.8%) had unexplained pain, 4 (1.3%) had change in bowel habits, 4 (1.3%) had change in bladder
habits, 3 (1%) had cough, 3 (1%) had nonhealing ulcer, 2 (0.6%) had unexplained bleeding, 1 (0.3%)
had difficulty in swallowing, 1 (0.3%) had weight loss, 1 (0.3%) had lump, and 1 (0.3%) had change
in the appearance of mole.
CONCLUSION: Screening for red flag symptoms of cancer is an easy tool that can be used in the community
to identify high‑risk individuals, which will facilitate early diagnosis of cancer.

Abstract INTRODUCTION: Life satisfaction and its determinants in married women are essential for the
development of proper preventive programs. The aim of this study was to examine the relationship
between the communication skills, self‑efficacy, and self‑esteem with life satisfaction in married women.
SUBJECTS AND METHODS: This cross‑sectional, descriptive study was conducted on married
women who were selected by multistage random sampling, in Naien city health centers. Data
were collected using the Satisfaction With Life Scale (SWLS), General Self‑Efficacy Scale (GSE),
Rosenberg Self‑esteem Scale (RSE), and revised version of communication skills test. The data
were analyzed using the SPSS version 20 by descriptive statistics. Pearson correlations and multiple
regression analyses were used.
STATISTICAL ANALYSIS USED: Pearson correlations and multiple regression analyses and
ANOVA were used.
RESULTS: According to the regression analysis test, 35.8% of the total variance in life satisfaction
was accounted for by self‑efficacy, communication skills, and self‑esteem. Pearson correlations
demonstrated that all correlations between the variables were statistically significant. In
particular, self‑efficacy, communication skills, and self‑esteem had positively correlated with life
satisfaction (P < 0.05).
CONCLUSIONS: General self‑efficacy highly correlated with life satisfaction in married women.
Therefore, in order to increase life satisfaction in married women, it is necessary to focus more on
self‑efficacy promotion strategies.

Abstract BACKGROUND: Intramuscular (IM) injection is one of the causes of anxiety and pain in patients,
using new techniques and creating a pleasant experience is of the legal and ethical duties of nurses.
We aimed to investigate comparison of skin traction, pressure, and rapid muscle release with
conventional method on IM injection pain.
MATERIALS AND METHODS: This clinical trial investigated 28 patients (56 samples) who required
Methocarbamol injection. Two 5 cc Methocarbamol were injected for each patient by the conventional
and innovative methods. In the innovative technique, after applying skin traction and imposing deep
pressure to the muscle, the needle was inserted at a 90° in the muscle and injected after aspiration.
However, this deep pressure was not applied in the conventional method. The pain was measured
using visual analog scale. STATA software version 12 was used for statically analysis. P < 0.05 was
considered statistically significant.
RESULTS: The findings showed pain intensity in innovative method and conventional method was
1.17 ± 0.75 and 2.78 ± 1.61, respectively. The difference was statistically significant (P = 0.001). The
minimum pain intensity in innovative method was 0 and maximum was 4, meanwhile in conventional
injection, the lowest and highest pain intensity was 0 and 6 respectively.
CONCLUSION: The results of this study showed that innovative method can be used as a substitute
for conventional method to reduce IM injection pain.

Abstract BACKGROUND: Dengue is the most common life‑threatening arboviral infection contributing to
92 million infections worldwide. India alone contributes for 34% of the global burden. Success of
dengue control depends largely on adequate knowledge and good practices of preventive measures.
However, there is a need to find the existing awareness among the general population, especially
in rural areas. Thus, our present study was done to determine the awareness, attitude, and practice
measures regarding dengue fever in rural Tamil Nadu.
MATERIALS AND METHODS: A community‑based cross‑sectional survey was done among 303
individuals belonging to the selected village in rural Tamil Nadu during November 2016. Information
regarding sociodemographic details and awareness, attitude, and practice toward dengue were
collected using a semi‑structured questionnaire. Adequacy of knowledge and attitude was summarized
as proportion with 95% confidence interval.
RESULTS: Among 303 participants, 204 (67.3%) were above 30 years of age; 196 (64.6%) were
females; 255 (84.1%) were ever married; 149 (49.1%) were employed and most of them 93 (30.6%)
were educated up to secondary level; 103 (33.9%) belonged to the Class 4 socioeconomic status.
About 33.3% (95% confidence interval [CI]: 28.2–38.8) of the study participants had adequate
knowledge and 56.1% (95% CI: 50.5–61.6) had positive attitude toward dengue prevention. About
57.7% (95% CI: 52.1–63.2) were practicing preventive measures.
CONCLUSION: The current study found that only one‑third of the participants had adequate
knowledge regarding dengue but more than half of them had positive attitude toward dengue
prevention and practicing mosquito control measures. Hence, large‑scale information, education,
and communication campaigns need to done at frequent intervals for rural population.

Abstract AIM AND BACKGROUND: Women are among vulnerable groups and susceptible to mental
health problems during any disaster. Therefore, the current study aims to identify the mental health
information needs of women during disasters.
METHODS: This is a qualitative study carried out using content analysis method through
semi‑structured interviews with 27 participants in cities of Tehran, Isfahan, and Mashhad during the
year 2018.
RESULTS: The summary of the findings indicated 8 components and 25 subcomponents for health
information needs of women during disasters. These information needs included primary needs and
secondary needs such as psychological, social, cultural, support and rescue, policy‑making, media
coverage, and environmental needs.
CONCLUSION: The findings of this study can be used by authorities and policy‑makers during
disasters and rescue efforts for the female population and can help improve the general health
status of the society.

Abstract BACKGROUND: Breast cancer is the most frequently diagnosed cancer and the leading cause
of cancer death in females’ worldwide. Pakistan has higher incidence of the disease than the
neighboring countries and one in every nine Pakistani women suffers from breast cancer which is
one of the highest incidence rate in Asia. Numerous risk factors such as nulliparity, family history,
genetic mutations, increasing age, early menarche, and late menopause are associated with the
development of breast cancer. Lack of awareness and the preexisting myths regarding this disease
have led to the detection of breast cancer at a later stage.
OBJECTIVE: The main objective of this study is to determine the frequency of adequate breast
cancer knowledge and its level among nonmedical women of Karachi coming to attend general
surgery outpatient clinics.
METHODS: A cross‑sectional Study was conducted in Outpatient Clinics, Department of General
Surgery, Civil Hospital, Karachi. The sample of 250 females with nonmedical background was gathered
from December 27, 2016 to June 26, 2017. Adequate breast cancer knowledge was divided into
three criteria such as poor, fair, and good knowledge. Chi‑square test was applied. P ≤ 0.05 was
considered as statistically significant.
RESULTS: The mean age was 35.63 ± 9.56 years. Mean knowledge score was 5.24 ± 2.92.
Overall, 42% of participants were found with adequate breast cancer knowledge whereas 58% of the
participants had inadequate knowledge. Based on the study questionnaire, 38% had poor knowledge,
40.4% had fair knowledge, and 21.6% had good knowledge. Significant association was observed
with age, monthly family income, education status, and occupation.
CONCLUSION: The results showed lack of adequate knowledge. A high proportion (58%) of
nonmedical females had inadequate knowledge about breast cancer.

Abstract Esthetics is a vital social concern. The loss of any part of the body can be an extremely discouraging
occasion in a person’s life. Loss of an eye because of tumors, congenital abnormalities, and trauma
is one such troublesome situation. Eye prosthesis boosts the morale and makes the life socially
acceptable. A correctly placed ocular prosthesis should reestablish the normal opening of the eye,
support the eyelids, reestablish a degree of movement, and be satisfactorily held and esthetically
satisfying. A customized acrylic eye fulfills all these requirements. In the current article, a new and
economic technique was used to duplicate corneal prominence using a clear acrylic shell. The
characterization was further done to give a life‑like appearance to the eye prostheses.

Abstract BACKGROUND: Cardiopulmonary resuscitation (CPR) is a procedure performed in an emergency
when the heart stops. Early initiation of CPR can save many lives. Thus, the aim of the present
study was to assess the level of awareness toward CPR in a community‑based study in
Northern Saudi Arabia.
MATERIALS AND METHODS: This is a cross‑sectional survey conducted in the city of Hail,
Northern Saudi Arabia. Data about CPR were obtained from 442 Saudi volunteers living in the city of Hail.
RESULTS: A family history of ischemic heart disease was indicated in 148/442 (33.5%) of the
participants. On asking the participants whether they have previous information about CPR, about
258/442 (58.4%) persons indicated “Yes,” 118/442 (26.6%) replied “May be,” and the remaining
66/442 (15%) replied “No.”
CONCLUSION: The study showed a high level of awareness about CPR, which might be attributed to
the majority of highly educated participants. Effective and sustainable public CPR training programs
are needed to be implemented to preserve better knowledge and awareness of CPR in the general
population.

Abstract AIM AND BACKGROUND: Studies show that the risk of musculoskeletal disorders (MSDs) among
computer users is more than the other occupations. The present study aimed to determine the effect
of educational intervention based on the “stages‑of‑change” model on practicing the correct posture
to reduce MSDs among computer user staff of Tehran University of Medical Sciences (TUMS).
METHODS: This is a quasi‑experimental study which was carried out on 176 staff of TUMS. The
study population was divided into two case and control groups, each including 88 participants.
A self‑structured as well as a standard questionnaire was used to collect the data. Data then were
analyzed using descriptive and analytical tests.
RESULTS: There was no significant difference between both groups in terms of mean score of
stages of change, perceived benefits and barriers, self‑efficacy, and processes of change before
the intervention. However, the mean score of these variables increased for case group 3 months
after the intervention. In addition, case group participants reported lower MSDs in their neck, lower
back, elbow, and knee compared to control group.
CONCLUSION: Ergonomic educational intervention based on the “stages‑of‑change” model has a
positive impact on reduction of MSDs. Therefore, these disorders can be decreased through reducing
working hours, changing the work conditions in accordance with ergonomic principles, dedicating
some time for staff exercise, and holding educational courses for the personnel.

Abstract BACKGROUND: Mental health problems such as cognitive impairment, depression, anxiety, and sleep
disorders arising out of senility, neurosis, and living conditions are common in the geriatric population.
OBJECTIVE: The objective of this study was to estimate the prevalence of mental illness and to describe
their sociodemographic factors in the rural geriatric population and see their association with other factors.
METHODOLOGY: A community‑based cross‑sectional study was done on individuals aged more
than 60 years. The study instruments were predesigned semi‑structured questionnaire, Folstein’s
Mini–Mental Status Examination Scale for assessing dementia in cognitive functioning and Yesavages
Geriatric Depression Scale to estimate the prevalence of depression and to assess the activities
of the daily living by Barthel index and the anxiety were assessed based on the perception of the
participants while conducting the interview.
RESULTS: A total of 415 individuals participated, out of them 199 (47.9%) were males and
216 (52.1%) were females. Prevalence of mental illness was 217 (52.2%) with one or the other type
of mental illness. The prevalence of cognitive impairment was 47.7% and depression according to
Geriatric Depression Scale >5 was 27.7%. The remaining 62 (14.9%) had dementia and 30 (7.2%)
had anxiety disorder as the mental illness. The socio‑demographic factors such as age more than
70 years, female gender, illiterates, living in joint family, middle and lower socio‑economic class,
financially totally dependent and had poor and unfair relationship with the family members were
strongly associated with the mental illness and it was statistically significant with P < 0.05.
CONCLUSION: Measures should be taken to support the elders, establish community elderly
societies, advisory offices, and services to help the elderly. The sequence of social interventions
required for the management of the elderly psychological problems.

Abstract INTRODUCTION: Falls are the most common cause of injuries in elderly population. This study
aimed to determine the quality of prehospital emergency services (EMS) for the elderly falls in 2017.
MATERIALS AND METHODS: This cross‑sectional study was carried out at the Pre‑hospital
Emergency Center of Kashan in 2017. The sample consisted of elderly people who had reported fall
incidents in EMS. The questionnaire consisted of 7 areas with 54 items. Data collected by descriptive
and inferential statistics of Friedman and Mann–Whitney were analyzed by SPSS v. 16 software.
RESULTS: The number of elderly people was 150 (58% female) and the average age was
68.22 ± 6.75 years. Most falls (88.65%) occurred at home. The average performance scores (between
0 and 2) were as follows: assessment of the scene of the incident (1.51), primary assessment of the
elderly (1.46), airway management (1.64), circulation management (1.78), fixation (1.82), secondary
and continuous assessment (1.59), and patient transfer (1.68). It was found that secondary assessment
and transfer of the male patients were significantly higher in quality than female patients (P < 0.05).
CONCLUSIONS: In this research, the quality of care in all areas was reported to be desirable. It is
recommended that the weaknesses of each area are investigated and the necessary strategies are
taken into account such as staff training, changes in data collection forms, and training for the elderly.

Abstract BACKGROUND: Regarding the high prevalence of substance abuse and its serious complications,
the necessity of assessing factors assuming to make tendency toward substance abuse is justifiable.
MATERIALS AND METHODS: The statistical population consisted of all car drivers referred to traffic
department in 2015 in Kermanshah. In this descriptive study of correlation type, 846 risky drivers from
referrals to traffic department were randomly selected. Data were analyzed through NEO personality
inventory, general health questionnaire, and discriminant analysis.
RESULTS: Discriminant analysis was used to analyze data. Standard coefficients of discriminant
function revealed that depression, social functionality, physical symptoms, neurosis, and anxiety
symptoms were of the highest role in discriminant function while agreeableness and conscientiousness
had the least role in discriminant function and its success. The discriminant analysis also showed
that linear combination of above variables is able to explain about 75.5% of variance of difference
between two groups (P < 0.0001).
CONCLUSIONS: Regarding the results of this study, it is proposed that the role of personality
characteristics as well as mental health in tendency toward substance abuse could be appreciated
and included in preventive and treatment programs held for people with methamphetamine abuse.

Abstract INTRODUCTION: Maintaining family stability is an important principle, and sexual satisfaction is
an important component of family stability. Disturbance in it is a threat to the survival and stability
of the family. Emotional intelligence and spiritual intelligence are psychological variables that affect
marital satisfaction or dissatisfaction. The aim of this study was to determine the relationship between
spiritual and emotional intelligence and sexual satisfaction of married women.
METHODS: A cross‑sectional correlation study was conducted on 200 married women referring to
Lar health centers in 2017. Sampling was available in a way. The research units completed the King
Spiritual Intelligence Questionnaire, Shoot Emotional Intelligence Questionnaire, Sexual Satisfaction
and Beck Depression if they had inclusion criteria and written consent. Finally, the data were analyzed
by Spearman statistical tests.
RESULTS: The results of the Spearman test showed that there is a positive and significant
relationship between emotional intelligence and sexual satisfaction (P = 0.001), with increased
emotional intelligence and sexual satisfaction. The results of the study of emotional intelligence
components showed that only the emotional adjustment component had a significant relationship
with sexual satisfaction. The results also showed that there is a significant relationship between
spiritual intelligence and sexual satisfaction and the components of transcendental consciousness,
transcendental alertness, and personal meaningfulness with sexual satisfaction (P = 0.001).
CONCLUSION: According to the results of this study and given that one of the duties of midwives is
to provide counseling on sexual health, they can raise individual awareness, or group or educational
classes, through awareness‑raising campaigns for women, improving sexual relations and following
are family health. midwives can enhance their spiritual intelligence, emotional intelligence, women’s
awareness, and sexual intercourse through counseling sessions (individually, in groups, or classes).
All of the above can be a source of family health.

Abstract INTRODUCTION: It has been perceived that there is a lack of community exposure and active learning
in the community for the first‑year undergraduates in Community Medicine. This study is designed
to evaluate an early community exposure given to the students to help overcome these lacunae.
METHODOLOGY: In this study, the first‑year students (n = 44) were provided an early community
exposure and evaluated to understand their perceptions by a prevalidated, pre‑ and post exposure
questionnaire. The community exposure was given to the students by allocating them families in
community with designated tasks A core group of mentors monitored the students and scored
the students on every visit. Attendance of students, scores marked by the mentors, and pre‑ and
postexposure responses were used to evaluate the impact of community exposure.
RESULTS: A total of 44 students were evaluated in this study. A total of 22 h (36.6%) were dedicated
to community‑based learning in the 1st year. A positive response was observed in the postexposure
responses with regard to the understanding of the subject and interest in the subject in comparison
to preexposure responses (P < 0.05). A statistically significant difference was observed in the first
and final visit scores by the mentors with respect to communication skills, elicitation of history, team
spirit, and attitude toward community (P < 0.00001).
CONCLUSIONS: Students were exposed to the concept of community service and inculcated an
interest in public health. Early community exposure of medical undergraduate students is important
in developing better working skills in the community.

Abstract BACKGROUND AND AIM: Mental health issues including depression and anxiety are common
in pregnancy worldwide. This study aimed to identify factors associated with mental disorders in a
sample of Iranian pregnant women.
MATERIALS AND METHODS: A cross‑sectional study was conducted among pregnant women
referred to a prenatal‑care clinic in an urban area, Isfahan, Iran. The questionnaires in this study
included the General Health Questionnaire and additional structured questionnaires exploring
sociodemographic, obstetric, and economic risk factors and empowerment for decision‑making
regarding pregnancy, parenting, financial authority, trust, and confidence in health‑care staff.
Regression analysis was performed to assess the impact of the number of variables on the likelihood
of the presence of mental health problems.
RESULTS: Overall, 54.2% and 11.7% of the women had anxiety and depression, respectively. No
statistically significant associations were reported between anxiety and depression and obstetric
characteristics such as gestational age, parity, abortion, previous infertility, unwanted pregnancy,
and the screening test results . According to the logistic regression analysis, the predictors of
depression and anxiety were acknowledging psychological changes in pregnancy and empowerment
for decision‑making regarding pregnancy and parenting and financial authority (P < 0.05).
CONCLUSIONS: probably, women’s empowerment on becoming aware of psychological changes
during pregnancy and making decisions on pregnancy, parenting, and financial authority is the factor
affecting the mental health of pregnant women.

Abstract INTRODUCTION: Health literacy is an important issue in public health. Individuals with low health
literacy skills often have poorer health knowledge and health status than those with higher literacy
level. Research documented on the assessment of oral health literacy in health settings and its
association with oral health outcomes for adolescents was scarce.
AIMS AND OBJECTIVES: The aim of this study is to assess oral health literacy about oral health
status among adolescents attending pre‑university colleges in Mysore , India.
MATERIALS AND METHODS: A cross‑sectional study was conducted over a period of 2 months
among 401 adolescents attending pre‑university colleges. Rapid Estimate of Adult Literacy in Medicine
and Dentistry‑20 (REALMD‑20) and the WHO oral health assessment pro forma for adults (2013)
were used. Data were analyzed using SPSS version 22 and tests employed were Chi‑square test,
ANOVA, and multiple linear regression.
RESULTS: Mean REALMD‑20 score was 10.31 ± 5.7. The study participants belonging to
science course (12.69 ± 5.0) and private pre‑university colleges (11.76 ± 5.8) had significantly
higher REALMD‑20 scores. Mean decayed, missing, and filled teeth among the study participants
was (0.42 ± 0.9). Type of college, course, dental history, and number of dental visits was significantly
associated with oral health literacy while oral health parameters were not significantly associated.
CONCLUSION: Oral health literacy was not significantly associated with oral health status. However,
long‑term studies are recommended to validate the results of the present study.

Abstract OBJECTIVE: The present study assessed the feasibility, effectiveness, and students’ attitude toward
histology teaching using WhatsApp.
MATERIALS AND METHODS: We conducted 6 months of histology teaching session on a “Histology
learning WhatsApp group” consisting of 250 1st‑year medical graduate students at Dr. S.N. Medical
College, Jodhpur. A teacher posted a digital image of histology slides created using a mobile camera; a
slide diagram sketched using hematoxylin and eosin pencil, identification points, and detail description
of slide followed by discussion of queries. The feasibility was measured by adequate enrollment of
students in the WhatsApp group, drop‑out rate during the teaching period, acceptability of the by
students based on their feedback, and perception of the teacher. To study the effectiveness, we
conducted an online test pre‑ and posttests after every 2 months. The Student’s attitude WhatsApp
learning was assessed using the prevalidated feedback questionnaire.
RESULTS: All the 1st‑year medical graduate students admitted in the year 2016 enrolled and most
of them were actively participated in the discussion conducted on WhatsApp group with zero dropout
rate. Students’ feedback indicated that students enjoyed learning using WhatsApp with better
participation than traditional teaching method. Students liked anytime, anywhere learning using
WhatsApp and it helped them to clear doubts. The statistical difference between average pre‑ and
posttest scores (6.54 ± 2.33 and 16.37 ± 3.32, respectively) were statistically significant.
CONCLUSIONS: We conclude that histology teaching using WhatsApp learning group is feasible,
effective, and student‑friendly method. It should be used more frequently to complement traditional
teaching.

Abstract OBJECTIVES: Knowledge, attitudes, and behaviors are essential factors in fostering an environment
that positively influences organ donation rates. Thus, the present study aimed to assess the impact
of intervention (classroom education) on knowledge, attitude, and practices on organ donation.
MATERIALS AND METHODS: A questionnaire‑based interventional study was conducted among
112 dental house surgeon students, Hyderabad. A 27‑item self‑administered questionnaire was
distributed to students as a pretest and collected back after completion. Then, a session on organ
donation was delivered in a lecture hall setting instilling the basic facts about organ donation. Posttests
using the same questionnaire were filled after the intervention and 2 weeks later.
RESULTS: Responses on knowledge obtained from the subjects showed significant changes in
several key areas from baseline to postintervention and at follow‑up. More than 50% of study subjects
had a positive attitude regarding organ donation. There was a significant increase in the number
of subjects who pledged/signed to donate an organ (before ‑ 14.3%, postintervention ‑ 50%, and
at follow‑up ‑ 60.7%; P < 0.05). Pairwise comparison revealed a significant increase in the mean
knowledge, attitude, and practice scores at postintervention and at follow‑up of 2 weeks in comparison
to the baseline scores. Female subjects and subjects following Hindu religion had good knowledge,
positive attitude, and good practice.
CONCLUSION: The one brief educational intervention had significantly increased perceived
knowledge of organ donation and positively influenced attitude and practices to organ donation
among dental students.

Abstract BACKGROUND: Nursing students are generally trained to acquire the knowledge, skills, and
approaches required for solving problems and contradictions in life and at work. In fact, problem‑solving
skills are the core of effective nursing activities. Therefore, the aim of this study is to evaluate the
effectiveness of problem‑solving training on the promotion of emotional intelligence in nursing students.
MATERIALS AND METHODS: This interventional case–control study used a pretest‑posttest design.
All senior nursing students (n = 43) attending the seventh semester of their undergraduate studies at
Hazrat Fatemeh School of Nursing and Midwifery of Shiraz University of Medical Sciences were recruited
in the present study. The participants were randomly allocated to either the intervention group (n = 20)
or the control group (n = 23). The collected data were analyzed with SPSS software version 16.
RESULTS: While the mean standardized scores of Emotional Quotient Inventory of the two
groups were not significantly different before the intervention, the scores were significantly higher
in the intervention group both immediately and 2 months after the intervention. Comparison of the
standardized emotional intelligence scores revealed the intervention group to have significantly
higher mean scores immediately and 2 months after the intervention compared to baseline
scores (105.87 ± 9.82 and 109.44 ± 9.56 vs. 101.22 ± 10.93; P < 0.001). Such significant differences
were absent in the control group.
CONCLUSION: Using the results of this research in nursing education, it is possible to improve the
level of nurses’ knowledge and personal skills and to increase the level of services and increase
the satisfaction of the clients.

Abstract INTRODUCTION: Hospitals are one of the most important institutions in providing health‑care
services. Highly experienced specialists, advanced technology, and decisive decisions about patients’
deaths and lives are all gathered in a dynamic and unique organization called Hospital. A huge portion
of human, financial, and equipment resources are allocated to teaching hospitals; however, these
hospitals are always faced with a lack of funding. The purpose of this study was to investigate the
financial challenges of teaching hospitals and providing solutions.
MATERIALS AND METHODS: A qualitative study was conducted using face‑to‑face interviews
with a purposeful sample of 37 top and middle managers in the level of the Ministry of Health, its
universities, teaching hospitals, and its affiliated departments in Tehran. Thematic analysis approach
was used to analyze the data by applying MAXQDA10 software.
RESULTS: Six themes among the reasons for financial challenges in teaching hospitals were
insufficient funding for the educational and research sections and paying more attention to treatment,
increased financial burden due to presence of medical student, indigent patients, disability in budget
managing due to their dependence on medical universities, relative autonomy of hospitals, and
payment systems. Among other factors, there are also insurance problems arisen from increased
deductions on bills due to insurance astringency and delayed payment.
CONCLUSION: The findings of the present study indicated that the major financial challenges
of teaching hospitals faced severe financial problems, which had a negative effect on their entire
activities and led to weakness in the implementation of their missions. Considering budget division
among three defined missions of teaching hospitals (treatment, research, and education), the largest
share of budget was allocated to treatment. Therefore, an appropriate and definite budget division
is suggested to improve the allocation of resources to all three missions and to enhance staff’s and
patients satisfaction.

Abstract INTRODUCTION: Self‑regulation and educational performance are among the most important topics
to be discussed in schools and universities. The present study aimed to the relationship between
self‑regulation and educational performance among daughter students of police officers in Birjand
City, Iran (public and Payame Noor) in 2017.
MATERIALS AND METHODS: This research is a correlational cross‑sectional study. In total,
200 female students were selected using random sampling method. The Ryan and Connell’s
Self‑Regulation Questionnaire and Durtaj’s educational performance scale were used to collect data.
The data were analyzed using the Pearson correlation coefficient.
RESULTS: The results showed that there is a significant correlation between self‑regulation and
educational performance among students of Payame Noor University, whereas it is not significant
for public university students.
CONCLUSION: We can provide students with effective and useful tips to improve their academic
achievement and performance by teaching them self‑regulation skills. Therefore, the cornerstone
of educational achievement in students should be in that way to achieve the desired educational
performance and also increase their self‑regulation.

Abstract AIM: The aim of this study was to assess the impact of lecture attendance on the academic
performance of 3rd BDS students at the DMIMS‑U, Sawangi (M), Wardha. This project investigated
and correlated the difference between faculty and student perceptions regarding attendance and
final performance, including factors thought to influence student attendance.
MATERIALS AND METHODS: Participants from a single university were included in the present
retrospective observational study. The study was conducted in April 2016; 77 3rd BDS students
(2012 Batch) and teaching staff of SPDC willing to voluntarily participate were included and divided
into two groups such as Group A and Group B. Student and faculty perceptions were obtained using
Likert scale having 15 closed‑ended and 3 open‑ended questions. Questioner was made related to
factors affecting the attendance in class, type of source available for study, awareness about topic,
and faculty approach. Comparison between perception of students and faculty regarding attendance
and final performance was done using Mann–Whitney U‑test. P < 0.05 was considered statistically
significant.
RESULTS: Quantitative analyses revealed significant differences between faculty and student
perceptions on most of the project variables. Qualitative analyses reinforced those findings and
suggested that faculty misunderstood what factors actually influence student attendance. The results
suggest that there is a substantial disconnect between faculty and student perceptions regarding the
importance of class attendance and highlighted areas for faculty to influence student attendance.
CONCLUSION: Motivation is the major factor causing students to attend the lectures. Unfortunately,
not all students are motivated to study and learn. New styles of teaching may need to be looked into.
This needs to be further investigated on large sample size.

Abstract OBJECTIVES: This study aimed to evaluate the role of nonsurgical periodontal therapy in improving
glycemic control among type 2 diabetes mellitus (T2DM) patients.
MATERIALS AND METHODS: Adult T2DM patients with mild‑to‑moderate periodontal disease,
reporting to a tertiary care diabetes center in South India, from January to June 2014, were enrolled
in the study. Medical management of T2DM along with diet and physical exercise was an inclusion
criterion. Patients with factors affecting periodontal health and an inability to follow‑up were excluded
from the study. All patients underwent nonsurgical periodontal therapy (scaling, root planing, and
irrigation of chlorhexidine [0.12%]). Periodontal status and glycated hemoglobin A1c (HbA1c) were
assessed preoperatively and 6 months posttreatment. Dental status, diabetic history, and demographic
characteristics were recorded to evaluate confounding roles.
RESULTS: A total of 266 T2DM patients (91 females/175 males; mean age
47.65  ±  5.93  years/range 25–55  years), fulfilling the inclusion criteria, were enrolled. The mean
pre‑ and post‑treatment HbA1c levels were respectively, 8.44 ± 1.87 and 7.98 ± 1.81, with a mean
reduction of 0.46 ± 0.26 (P < 0.001). Significant HbA1c reduction (P < 0.001) was observed in patients
with good pretreatment glycemic control (0.54 ± 0.26; 7.9%), regular follow‑up (0.51 ± 0.28; 6.2%),
and good oral hygiene (0.60 ± 0.49; 8.0%).
CONCLUSION: Nonsurgical periodontal therapy is associated with significant HbA1c reduction
among T2DM patients with mild‑to‑moderate periodontitis after a 6‑month follow‑up period.