bluuebunny/crossref_metadata_2025 huggingface dataset:
Social determinants of health: Awareness and attitude of students and professors in medical sciences universities
Authors: Mohammadi Farzaneh , Samouei Rahele
Published: May 2024

BACKGROUND:

Considering the obvious and important role of social determinants of health on health outcomes and the mission of medical universities in explaining it, the aim of this study was to determine the awareness and attitude of the medical universities students and professors toward social determinants of health.

MATERIALS AND METHODS:

This descriptive-survey study was conducted on the students and professors of Isfahan and Kashan Universities of Medical Sciences in fields related to social determinants of health and at different educational levels in the years 2020–2021. Data were collected by a researcher-made questionnaire of awareness and attitude. Data were reported by descriptive statistics using Statistical Package for Social Sciences (SPSS) 20.

RESULTS:

The average percentage of correct answers to awareness questions was 44% by professors and 33.3% by students. The overall mean score of professors' attitude toward social determinants of health was 2.48 and students' attitudes were 2.65 out of 5. Professors' awareness about social determinants of health was more than students and their attitude was less positive than students.

CONCLUSION:

Considering that a significant percentage of effective factors in health outcomes are social determinants of health and bearing in mind that universities, especially medical universities in providing healthcare, maintaining, improving, and promoting the health of the community, and also training the necessary human resources in the health sector to provide services play an important role, officials and decision-makers in the Ministry of Health and universities should decide to define this issue in the educational curriculum as well as holding related workshops.
Comparison of the effect of Continuous Positive Airway Pressure (CPAP) and Bi-Level Positive Airway Pressure (BiPAP) on hemodynamic parameters in Covid-19 patients: A clinical trial
Authors: Nikbin Razieh , Beydokhti Tahereh Baloochi , Moghaddam Kokab Basiri , Rohandeh Zohreh
Published: May 2024

BACKGROUND:

The most prevalent clinical sign for COVID-19 patients are respiratory diseases such that the criteria for clinical screening and care of the patients in most countries, including Iran, are based on the three primary symptoms, i.e., fever, cough, shortness of breath, or difficulty breathing. The purpose of the current study was to compare the effect of continuous positive airway pressure and bi-level positive airway pressure on hemodynamic parameters in COVID-19 patients.

MATERIALS AND METHODS:

It was a clinical trial conducted on 46 COVID-19 patients admitted to Imam Hassan Hospital in Bojnourd in 2022. This study included patients selected through convenient sampling and then through Permuted block randomization, who were assigned to continuous positive airway pressure (CPAP), and Bi-Level Positive Airway Pressure (BiPAP) groups. Patients were compared in terms of the severity of their COVID-19 disease in both groups and were divided equally in each disease severity. After determining their type of respiratory aid use, the patient's hemodynamic status (systolic blood pressure, diastolic blood pressure, pulse, arterial oxygen saturation, and temperature) was examined beforehand, immediately after 1 hour, 6 hours, and then daily up to 3 days of CPAP/BiPAP at a specific time. Data collection tools were demographic data questionnaires and information on patients' diseases. A checklist was also used to record the main variables of the research. The collected data were put into SPSS software version 19. To analyze the data, the Kolmogorov-Smirnov normality test was used to evaluate the normality of quantitative variables. As a result, it was found that the data had a normal distribution. Repeated measures of ANOVA and independent t-tests were employed to compare quantitative variables in the two groups at different times. In this study, a significance level of 0.05 was considered.

RESULTS:

There was a significant difference in terms of systolic blood pressure, diastolic blood pressure, respiration rate, pulse rate, oxygen saturation, and temperature in the two groups of patients at 1 day, 2 days, and 3 days after use (P < 0.05).

CONCLUSION:

The results displayed better performance of CPAP than BiPAP in the parameters of systolic blood pressure, diastolic blood pressure, respiration rate, pulse rate, oxygen saturation, and temperature in COVID-19 patients. Therefore, in necessary cases, it is recommended to use a CPAP mask.
Evaluation of Moroccan medical students' experience of online learning during the COVID-19 pandemic
Authors: Damoun Narjisse , Amekran Youssra , Taiek Nora , El hangouche Abdelkader Jalil
Published: May 2024

BACKGROUND:

Due to the COVID-19 pandemic, online learning has become the main method of instruction. This study aimed to evaluate Moroccan medical students' perceptions of medical online learning experience and to list its probable related advantages and barriers.

MATERIALS AND METHODS:

A cross-sectional study on 400 medical students randomly selected from the different national medical institutions was conducted. A questionnaire evaluating the online learning experience during the pandemic was distributed via institutional e-mails. Statistical analyses were carried out using Statistical Package for the Social Sciences (SPSS).

RESULTS:

51.2% of students were satisfied with the online learning experience and reported several benefits including no need to travel (35.8%), cost savings (20.7%), and flexibility of home studying (32.3%). Technical issues related to the use of platforms or internet connection, limited interaction between students and their instructors, and lack of motivation were the major barriers to online learning. Moreover, results also showed a significant difference when comparing the attendance frequency between presential classes and online learning (i.e., before vs. during the COVID-19 pandemic) (P < 0.001).

CONCLUSIONS:

The experience of medical online learning was reported in our study to be associated to several advantages and disadvantages. Hence, students' perceptions should be considered to evaluate and improve the quality of this instructional method for a successful and more active approaches implementation.
Effects of Yoga therapy in teaching oral hygiene practice and tooth brushing skills in patients with Parkinson's disease: A qualitative study
Authors: Raj Ritesh , Verma Abhishek , Singh Rohit , Kumar Amit , Prakash Anshu , Anand Santosh
Published: May 2024

BACKGROUND:

Parkinson's disease is a chronic neurodegenerative disorder associated with heterogeneous symptoms. Though it is characterized by means of four distinct motor symptoms such as resting tremors, muscular rigidity, bradykinesia, and postural instability. These patients also have deficits in fine motor skills while performing simple tasks such as brushing their own teeth, taking bath, remembering small details, and writing skills. The study aimed to qualitatively evaluate the effectiveness of Yoga therapy in teaching oral hygiene practice and subsequently, on tooth brushing skills in patients who were diagnosed with Parkinson's disease.

MATERIALS AND METHODS:

This qualitative study was conducted on 100 patients diagnosed with Parkinson's disease. Institutional ethical committee permission was obtained prior to commencing the study. Written informed consent was obtained from patients or their caregivers before conducting this study. Detailed clinical history was recorded and gender characteristics were noted down. In the present study, there were 67 female and 33 male participants. Yoga exercises were taught to Parkinson's patients by a qualified yoga instructor. Improvements in toothbrushing skills were noted down by a single operator and oral hygiene status was analyzed using gingival index and plaque index on follow-up durations at 1, 2, 3, and 6 months. Yoga exercises comprised of warming up, stretching, yoga breathing exercises or pranayama, and/or relaxation process. Statistical analysis was performed by use of IBM SPSS Version 20.0. (IBM Corp., Armonk, NY) software designed for Windows. Intra-group comparison between categorical variables was done by statistical test-paired student 't-test'.

RESULTS:

On comparing plaque indices, the mean ± SD plaque index at 1st, 2nd, 3rd, and 6th months were 1.89 ± 0.02, 1.72 ± 0.01, 1.42 ± 0.12, and 0.56 ± 0.02, respectively. Mean ± SD gingival index scores at 1st month, 2nd month, 3rd month, and 6th-month durations, scores were 1.76 ± 0.06, 1.57 ± 0.12, 1.23 ± 0.02, and 0.76 ± 0.01, respectively. Statistical significance difference was noted on comparing the indices scores.

CONCLUSION:

Yoga practice has been shown to improve toothbrushing skills and oral hygiene in Parkinson's disease patients.
Mobile technology acceptance among undergraduate nursing students instructed by blended learning at selected educational institutions in South India
Authors: Shanmugapriya Kannan , Seethalakshmi Avudaiappan , Zayabalaradjane Zayapragassarazan , Rani Nagasubramanian Ravi Vanitha
Published: May 2024

BACKGROUND:

Mobile phones have become a widely accepted learning mode due to the impact of COVID-19. This study explores the mobile technology acceptance, among nursing students at selected educational institutions in South India.

MATERIALS AND METHODS:

Quantitative cross-sectional descriptive design. First-year 176 B.Sc. nursing students who underwent blended learning were selected by the purposive sampling method. The tool “Technology Acceptance Model” was used to collect responses. Bivariate analysis was used to determine the relationship between the demographic and study-related variables with the mobile technology acceptance using SPSS version 25.0.

RESULTS:

The majority 73.9% of the students belonged to the age group of 18–19 years, females 76.7% and, 98.9% were unmarried. Among the constructs of TAM, a mean (SD) value of 22.08 (2.26) was found for material (mobile device audio/video) characteristics the mean (SD) value was 22.08 (2.26), attitude about use 17.58 (1.95), behavioral intention 17.46 (1.78) and system characteristics 17.21 (2.27). The mobile technology acceptance revealed that 126 (71.6%) strongly agreed, 49 (27.8%) agreed, and 1 (0.6%) was neutral with a mean (SD) of 105.19 (8.68), respectively. A positive correlation was found between the system characteristics, material characteristics, perceived ease to use, perceived usefulness, attitude about the use, behavioral intention with a P value <0.001. There was a statistically significant association between Mobile technology acceptance and time spent by the students for independent studies shown the Chi-square value of 12.7, with P value <0.05.

CONCLUSION:

Nursing students had a positive acceptance and behavior toward smartphone use.
Iranian health financing system challenges to promote health outcomes: Qualitative study
Authors: Jabbari Alireza , Zakeri Ali , Saghafi Fatemeh , Hadian Marziye
Published: May 2024

BACKGROUND:

Adequate health financing system should have key criteria and characteristics such as risk distribution over time, risk accumulation, sustainable resource provision, and resource allocation based on meeting essential needs. Weakness of the tariff system, lack of attention to strategic purchasing, inefficient allocation of manpower, and a weak payment system are among the problems within the Iranian financing system. Given the weaknesses of the current health financing system, it seems necessary to identify challenges and provide effective solutions to address them.

MATERIALS AND METHODS:

This qualitative study was conducted to explore the views of a group of 32 major policymakers and planners in the various departments and levels of the Ministry of Health, Universities of Medical Sciences, Medical System Organization, and Health Insurance Organization in Iran (n= 32), selected through purposive sampling. The data was collected through in-depth and semi-structured interviews and analyzed using Graneheim and Lundman's conventional content analysis methods. The trial version of MAXQDA 16 software was used to manage the coding process.

RESULTS:

Based on the results of data analysis, a total of 5 categories and 28 subcategories were obtained. In this study, five main categories were obtained through the content analysis method, including (1) stewardship; (2) providing services; (3) production of resources; (4) collecting resources; and (5) purchasing and allocation of resources.

CONCLUSION:

It is suggested that those in charge of the health system, following the reform of the organization of the health system, move toward the improvement and widespread implementation of the referral system and that clinical guidelines be carefully compiled. Also, appropriate motivational and legal tools should be used to implement them. However, insurance companies need to make cost, population, and service coverage more effective.
The effect of instructing mothers in attachment behaviors on short-term health outcomes of premature infants in NICU
Authors: Abbasinia Narges , Rad Zahra Akbarian , Qalehsari Mojtaba Qanbari , Gholinia Hemmat , Arzani Afsaneh
Published: May 2024

BACKGROUND:

The birth of a pre-mature infant and subsequent hospitalization and separation from the family can impair maternal and neonatal attachment and quality of maternal care. This study aimed to assess the effect of instructing mothers in attachment behaviors on short-term health outcomes of pre-mature infants admitted to neonatal intensive care units (NICUs).

MATERIAL AND METHODS:

In this quasi experimental study, 80 mothers of pre-mature infants who were admitted to NICUs at two referral health centers in northern Iran were studied in two groups in 2018. Attachment behaviors were taught to mothers in the test group during four consecutive sessions. Mother–infant attachment behaviors were evaluated at both the beginning and the end of this study using a checklist derived from Avant's Maternal Attachment Assessment Strategy. Moreover, infants' short-term health consequences were investigated in two groups. SPSS 18 statistical software was used for data analysis.

RESULTS:

On average, it took respectively 34.90 ± 12/65 and 31/15 ± 14/35 days for the infants in the control and the intervention group to reach full oral feeding and 38/5 (38/4–42/11) and 37 (31/85–42/14) days to gain the minimum weight required for discharge. Moreover, the mean length of stay for the infants in the control and the intervention group was 41/80 ± 13/86 and 39/02 ± 16/01 days, respectively (P > 0/05).

CONCLUSION:

Instructing mothers in attachment behaviors clinically improved short-term health-related outcomes. Hence, this intervention is recommended to be incorporated in the care program for mothers with pre-mature infants.
Childbearing decisions and related factors in the COVID-19 pandemic: A narrative review study
Authors: Safdari – Dehcheshmeh Faranak , Noroozi Mahnaz , Memar Soraya , Taleghani Fariba
Published: May 2024

The COVID-19 pandemic has had considerable consequences in many areas of life, including the social area and childbearing plans. The present narrative review aimed to examine the childbearing decisions and its related factors during the COVID-19 pandemic. This review was conducted by searching in scientific databases, including Web of Science, Science Direct, Google Scholar, Scopus, Cochrane, PubMed, ProQuest, Scientific Information Database (SID), Iranian Research Institute for Information Science and Technology (IranDoc) and Iranian Journal Database (Magiran) in June 2022. The search resulted in 111 sources, of which 16 were in line with the research objective. Couples have mainly cancelled or delayed their previous plans related to childbearing decisions. There are two groups of direct and indirect factors related to childbearing decisions during the COVID-19 pandemic: The former includes (1) well-being-related factors such as economic conditions, interpersonal relationships and gender roles in terms of task division; and (2) health-related factors, including health emergencies and physical and psychological health. The latter includes factors such as social distancing and social media. Based on the results, governments should facilitate childbearing by adjusting existing policies, addressing economic insecurity and protecting the livelihoods of those affected by the crisis. Health policymakers and planners must also prioritize women's access to reproductive health services in a safe environment while promoting equity in access. It is also necessary to promote the quality and quantity of indirect care and virtual counseling based on the needs of women in crisis.
Prevalence of self-medication among the elderly: A systematic review and meta-analysis
Authors: Rafati Shideh , Baniasadi Tayebeh , Dastyar Neda , Zoghi Ghazal , Ahmadidarrehsima Sudabeh , Salari Nasibeh , Rafati Foozieh
Published: May 2024

BACKGROUND:

Self-medication is the use of unprescribed drugs to treat a disease. Elderly self-medication can be more dangerous compared to other age groups because of changes in organ functions that occur due to senescence. This study aimed to estimate the prevalence of self-medication in the elderly, its related factors, and common drugs used in this regard.

MATERIALS AND METHODS:

Electronic databases such as PubMed, Scopus, and Web of Science were searched between January 2016 and June 2021. The search strategy was built on two core concepts: “self-medication” and “aged”. The search was limited to original articles in the English language. A random effect model was used to estimate the pooled prevalence of self-medication. Heterogeneity among studies was assessed using both the I2statistic and the χ2test. Also, a meta-regression model was used to investigate the potential sources of heterogeneity of the studies.

RESULTS:

Out of 520 non-duplicate studies, 38 were included in the meta-analysis. Self-medication in the elderly ranged from 0.3% to 82%. The pooled proportion of self-medication was 36% (95% CI: 27%–45%). The result of the χ2test and the I2index (P< 0.001, I2= 99.90%) revealed notable heterogeneity among the included studies in the meta-analysis. The meta-regression showed a significant association between the sample size (adjusted β = −0.01;P= 0.043) and the pooled proportion of self-medication.

CONCLUSION:

The prevalence of self-medication in the elderly is high. Education through mass media to raise awareness about the dangers of self-medication can help solve this problem.
Investigating the effect of Swedish massage with chamomile oil on labor pain and anxiety of primiparous women: A clinical trial
Authors: Eskandari Fatemeh , Mousavi Parvaneh , Valiani Mahboubeh , Ghanbari Saeed , Iravani Mina
Published: May 2024

BACKGROUND:

Labor pain and fear of childbirth increase anxiety and stress in pregnant women. Therefore, the present study was conducted with the aim of determining the effect of Swedish massage with chamomile oil on pain and anxiety in a clinical trial.

MATERIALS AND METHODS:

The present study is a clinical trial on 159 women who were referred to 22 Bahman Hospital in Masjid Sulaiman City in 2021. The samples were randomly divided into three groups (Swedish massage with and without chamomile oil and control group). Pain intensity was assessed using the McGill Pain Scale and anxiety was assessed using the Vandenberg Anxiety Questionnaire. The data were analyzed with SPSS-20 software at a significance level of 0.05. Descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (Chi-square, Fisher's exact, analysis of variance, and paired t) were used for data analysis.

RESULTS:

There were no significant statistical differences between the three groups in terms of obstetric and demographic information (P > 0.05). There was no significant relationship between the studied groups before the intervention in terms of labor pain intensity (P = 0.9) and anxiety (P-value = 0.426). After the intervention, the intensity of labor pain and mother's anxiety was significantly lower in the two intervention groups compared to the control group, and it was lower in the Swedish massage group with chamomile oil than the other two groups (P < 0.001).

CONCLUSION:

In the present study, Swedish massage with and without chamomile oil led to a decrease in pain intensity and anxiety. As a result, this method can be used as an effective method to reduce the intensity of pain and anxiety of pregnant mothers.
The double-edged sword of emotions in medical education: A scoping review
Authors: Toufan Nahid , Omid Athar , Haghani Fariba
Published: May 2024

Emotions are universal in academic and clinical settings. A student is likely to hope for success, maybe be worried about failure, or may feel comfortable after an exam. These feelings undoubtedly affect his/her motivation, effort, academic performance, and progress. This study aimed to investigate the role of emotion in the learning and performance of medical students and its mechanism. This study was a scoping review conducted in 2022 to examine the role of emotions in medical education. The three databases PubMed, ERIC, and Science Direct and the search engine Google Scholar were searched using the following keywords: “emotion,” “medical student,” “teaching,” “learning,” and “medical education.” English articles published from 2010 to 2022 were reviewed, and finally, 34 articles that met the inclusion criteria were reviewed. Review of the selected articles showed that there was a significant relationship between the cognitive system and emotions in the brain. The conceptual framework of the relationship between cognition and emotion can be explained in the form of dimensional and discrete views of emotions and based on cognitive load theory. Emotions affect cognition with the four mechanisms of memory, cognitive resources, cognitive strategies, and motivation and can be effective in learning self-regulation, clinical reasoning, and academic achievement of medical students. Emotions in medical education is a double-edged sword. In other words, it is highly recommended to divide emotions into activating and inactivating, instead of dividing them into positive and negative ones. In this context, medical educators can use the positive aspects of nearly all emotions to improve the quality of their teaching.
Development, implementation, and evaluation of a program to expand the nurse's roles in colorectal cancer prevention: A mixed-methods protocol study
Authors: Hashemi Narges , Bahrami Masoud , Tabesh Elham
Published: May 2024

BACKGROUND:

Nurses play an important role in cancer prevention. However, studies conducted on nurses' roles, in the field of cancer prevention in Iran, are very limited. This study will identify the role of nurses and designs, implements, and evaluates a program to expand their role in the prevention of colorectal cancer (CRC).

MATERIALS AND METHODS:

This exploratory mixed-methods study will be performed using quantitative–qualitative methods in three consecutive stages. In the first phase, a qualitative study will be conducted to identify the potential and actual roles of nurses in Iran using in-depth semi-structured interviews. Participants will be selected by purposive and snowball sampling, followed by a literature review; the actual and potential roles of nurses at the primary, secondary, and tertiary levels of CRC prevention in Iran and around the world will be extracted. And the actual role is determined. In the second phase, the roles of nurses will be prioritized using the modified Delphi method, and the program will be designed. In the third phase, the part of the program will be implemented as a quasi-experimental intervention, and the effect of the intervention will be evaluated.

CONCLUSION:

Developing a program can provide some evidence for promoting nurses' position in cancer prevention. Moreover, it is expected that this program promotes knowledge and empowerment and the position of nurses to provide primary, secondary, and tertiary cancer prevention. The entry of nurses into the field of cancer prevention leads to better quality care and more cost-effectiveness.
Interpersonal relationships, subjective health, psychological well-being, and quality of life among older adults in south India: Evidence from a population-based study
Authors: Manchana Varalakshmi
Published: May 2024

BACKGROUND:

Subjective health and well-being are closely linked with quality of life (QoL) in older adults. Self-reported health, happiness, satisfaction with life and interpersonal relationships, social support, loneliness, and social isolation make robust indicators for the psychological well-being of older adults. This study aimed to explore subjective health, psychological well-being and associated factors, and their relationship with QoL in older adults.

MATERIALS AND METHODS:

This was a cross-sectional, community-based survey that included adults aged 60 years and above (n = 260) who were living in selected communities. A semi-structured questionnaire was used to collect data on self-reported health, happiness, satisfaction with family and marital relationships, and felt loneliness and isolation. The relationship between psychological well-being and QoL was identified. Data analysis was carried out by descriptive and analytical statistical applications using Statistical Package for the Social Sciences (SPSS) version 20 at P ≤ 0.05.

RESULTS:

Study findings showed that a significant number of older adults (56%) reported poor general health; 56.4% of men and 59.2% of women were “not at all happy” with their family and interpersonal relationships, and 13.5% of respondents were not at all happy in general. Self-reported health (0.277**) and happiness (0.506**) were positively correlated with the psychological domain of QoL (P ≤ 0.01).

CONCLUSIONS:

The study findings identified the interrelationship between changing family and social relationships and psychological well-being of older adults, which is an immediate public health concern. Inadequate social support and deficient quality of interpersonal relationships predispose loneliness and isolation in later life. Strategies to promote social support and age-friendly social and healthcare resources are urgent needs for healthy aging.
The effect of web-based family-centered empowerment program in preventing the risk factors of substance abuse in students' parents; application of the health promotion model
Authors: Mehri Seyed M. , Hashemian Masoumeh , Joveini Hamid , Sharifi Nader , Rakhshani Mohammad H. , Assarroudi Abdolghader
Published: May 2024

BACKGROUND:

The age of onset of substance abuse among adolescents has recently decreased worldwide. Parents play an important role in preventing their children from drug abuse. This study aimed to investigate the effect of web-based family-centered empowerment program in preventing the risk factors of substance abuse in students' parents, using the health promotion model (HPM).

MATERIAL AND METHODS:

This interventional study was based on 118 parents of high school students in Sabzevar, Iran (2019). Multi-stage random sampling was used to divide the participants into the experimental (n = 65) and control (n = 65) groups. The data were collected through a researcher-made questionnaire based on Pender's HPM. A website was designed to perform all stages of the study. The web-based educational intervention was performed for the experimental group. Both groups completed the questionnaires 2 months after the educational intervention. The data were analyzed using t-test, paired t-test, regression, correlation, and analysis of covariance.

RESULTS:

There was a significant difference between the scores of prior related behavior, perceived benefits of action, activity-related effect, situational influences, competitors, and commitment in the parents of the experimental group compared to the control group after the educational intervention (P-value < 0.05). Moreover, a significant difference was observed between preventive behaviors of substance abuse and the mean score of perceived barriers to action, perceived self-efficacy, interpersonal influences, and role model in the parents of the experimental group compared to the control group after the educational intervention (P-value < 0.05).

CONCLUSION:

Overall, designing an educational intervention based on the constructs of Pender's HPM could be an effective strategy for promoting preventive behaviors of substance abuse in parents.
Correlation of polypill and blood pressure level: A systematic review of clinical trials
Authors: Omrani Hamidreza , Bahremand Mostafa , Keshavarzi Fatemeh , Solouki Leila , Zereshki Ehsan
Published: May 2024

BACKGROUND:

High blood pressure (BP) is considered as the most important risk factor for cardiovascular disease (CVD). The main aim of this study was to investigate the effect of polypill on BP by reviewing clinical trial studies.

MATERIALS AND METHODS:

In this systematic review study, online databases such as PubMed, Scopus, and Web of Science databases with no limited time were systematically searched until July 10, 2020. Clinical trial studies published in English that examined the effect of polypill on BP were included. BP was the main outcome investigated.

RESULTS:

Eleven original articles with a population of 17,042 people were reviewed. The polypill drugs studied in this study had different compounds. Compared to conventional care, treatment with polypill compounds has a positive and significant effect on lowering BP (P < 0.05).

CONCLUSION:

Our finding confirmed that polypills could reduce BP in patients. It seems that changing routine care and replacing it with a polypill strategy could facilitate the achievement of BP control goals.
Essential factors and key features in designing active aging programs and their outcomes: A narrative review study
Authors: Shahla Ayoubi-Mahani , Ziba Farajzadegan , Maryam Eghbali-Babadi , Mahrokh Keshvari , Jamileh Farokhzadian
Published: May 2024

With an increase in the older adult population, many countries have designed programs to promote active aging. Thus, knowledge of the factors and features of these programs is necessary to design a comprehensive active aging program. This study aimed to review the active aging programs focusing on the extraction of essential factors, key features, and outcomes of these programs. This narrative review was carried out to examine the conducted active aging programs. Through systematic searches of databases within the time limit of 2002–2021, articles were identified and assessed against inclusion and exclusion criteria. Using the findings, three sections were developed: (1) essential factors in designing programs that consist of older adults' participation, health maintenance and, promotion, leisure time, and technology use; (2) key features of the program, include affordability, voluntary participation, intergenerational consideration, social networks and government support, lifelong learning and teaching, cross-sectoral and inter-professional collaboration, and an enabling-supportive environment; (3) the program outcomes, include increasing awareness and knowledge, activities and participation, quality of life, life satisfaction in various psychological dimensions of well-being, and physical, mental, cognitive, and behavioral health in older adults. Some gaps were identified. Consequently, future planners are recommended to address older adults' sexual health, community culture, and gender in addition to other key features and essential factors in designing active aging programs to promote older adults' health.
Development and implementation of a self-directed learning readiness scale for undergraduate health professional students
Authors: Dulloo Puja , Singh Suman , Vedi Neeraj , Singh Praveen
Published: May 2024

BACKGROUND:

To motivate students toward the path of lifelong learning, it is important to train them for a self-directed learning (SDL) approach, where they identify the need of learning the content as well as look forward to attaining the learning outcome, independently. The level of readiness for SDL will allow the learner to be self-disciplined, self-organized, an effective team builder and communicator, a self-assessor, and a self-reflector, thus being a self-learner with the ability to accept and give constructive feedback. The aim of the study was to develop, validate, and implement the SDL readiness scale for health professional students.

MATERIALS AND METHOD:

The readiness scale of 43 items was used in four sub-titles (awareness, learning strategies, and style, motivation, team building) was developed using the Delphi method with 12 experts and was implemented for the medical students at Karamsad, Gujarat as a cross-sectional survey after a pilot trial scale from May 2021 to September 2021, using mean, the standard deviation for each item, and arrived sub-titles. The ANOVA test was used to find differences in readiness scores as per different years of the medical program.

RESULT:

The result demonstrates that the maximum score was obtained for the first-year medical student (149.89 ± 24.72), which dropped in year 2 (136.35 ± 32.26) but increased by the final year (147.67 ± 56.66), although not as high as the initial joining year. However, a statistically significant difference per gender was identified for a few items of the scale [(items 24 (P < 0.034), 26 (P < 0.0005), 37 (P < 0.035), and 40 (P < 0.013)]. The logistic regression analysis showed no statistical significance for the DSVS-self-directed learning readiness scale (SDLRS) score and demographic variables.

CONCLUSION:

The outcome of the study strongly suggests training/sensitization sessions for students to highlight the importance of a SDL approach in a digital millennium. Moreover, a longitudinal follow-up needs to be conducted for the readiness score of the students based on the developed scale and subsequent training sessions need to be organized for students as well as faculty for better outcomes for the students toward SDL sessions.
Perception of Nepalese nursing students toward E-learning in Nepal
Authors: Das Nikita , Chaudhary Gautam P. , Yadav Sima , Yadav Usha , Yadav Asha K. , Chaudhary Sabina , Pandey Jitendra
Published: May 2024

BACKGROUND:

E-learning is the delivery of learning and training through digital resources. Although e-learning is based on formalized learning, it is provided through computers, tablets, and even cellular phones those are connected to the Internet. This makes it easy for users to learn anytime, anywhere, with few, if any restrictions.

MATERIAL AND METHODS:

A cross-sectional study was done, and data was obtained through an online survey method from September 14, 2020 to October 08, 2020. Questions were created in “Google Forms.” The targeted population was all nursing students from all over Nepal. There were a total of 365 respondents. A pilot study was done on 10 students. After the pilot study, the same question was distributed to all the respondents.

RESULTS:

Almost half (40.8%) got disturbed in their online class because of electricity; around half of the respondents (41.9%) are disturbed in their online class because of Internet problems. Moreover, around half of the respondents (44.4%) use the data pack daily, and 38.6% use the data sometimes.

CONCLUSION:

The study concludes that most students suffered from Internet disturbance and electricity problems during online classes. Because of electricity and Internet problems, most students feel anxious during class, and most of the students are not able to attend classes. Most students are compelled to use data packs for online classes. However, the course may not be completed if the problems arising during online classes are not solved.
Developing a module for early clinical exposure: Experience of five years
Authors: Kumar Pananghat A. , Govindarajan Sumitra , Ramalingam Sudha , Kumar Prasanna N.
Published: May 2024

BACKGROUND:

Preclinical students often fail to appreciate the clinical relevance of basic sciences during the first year of undergraduate medical training, leading them to lose interest in the subject, and preventing them from achieving the desired goals. In order to rectify this gap in the curriculum, Medical Council of India (MCI) in 2011 published a document announcing curricular strategies including Early Clinical Exposure (ECE) to effectively modify the Indian system of education. Lack of proper guidance prevented many institutions from implementing ECE. Since our institution had run a similar program of “Clinical Observership” as early as 2001, we were able to implement ECE in an efficient way.

MATERIALS AND METHODS:

Early clinical exposure was implemented as a structured program, with the participation of 10 clinical departments since 2013. Feedback from the students, soon after ECE and also from the batch of CRRIs, who had undergone this program while they were preclinical students amply support the effectiveness of ECE in its contents and methods of implementation. Manual content analysis was performed on open comments. After reading the responses, they were broken down to meaning units, and these were then condensed. The condensed meaning units were labeled with codes. The codes were grouped into categories. Themes were derived from the categories.

RESULTS:

Out of the 70 CRRIs, 52 responded to the questionnaire. All the CRRIs except one said that ECE was very helpful during their clinical postings and internship period. They suggested that the number of hours of posting should be increased and also reiterated the fact that a greater number of clinical departments could be included in the program. Though the beneficial effects were felt in all the domains of learning, the most remarkable impact was felt in the affective domain, wherein changes are not easy to come by.

DISCUSSION:

Recently, National Medical Council has come out with plans of including ECE in the syllabus with strict time schedule. It is felt that the faculty will find our experience of running the program for the past five years helpful in implementing this program, for the fullest benefit of the preclinical students.
Experiences and challenges of nursing education in response to the COVID-19 pandemic: A qualitative study in Iran
Authors: Pourvakhshoori Negar , Karami Kimia , Sigaroudi Abdolhossein Emami , Adib Masoomeh , Salari Arsalan , Bazyar Jafar , Hosseini Seyed Ali
Published: May 2024

BACKGROUND:

The preparedness of nurses in the COVID-19 pandemic, will be of great importance when it comes to the unknown future of the pandemic and other similar ones. Identifying their problems can lead to better planning, preparation, and management. This study aims to explore Iranian nurses' experience of their preparedness challenges to give an effective response to the pandemic.

MATERIALS AND METHODS:

A qualitative content analysis approach using semi-structured interviews was employed to explore nurses' preparedness experiences. 28 nurses were interviewed, after transcription of the interviews, a content analysis using constant comparison was performed for data analysis based on Graneheim and Lundman approach.

RESULTS:

The results of the study can be summarized in 6 main categories and 14 subcategories, such as the necessity of continuing educational workshops, the necessity of holding exercises in the same environment, the importance of familiarity with the pandemic, the importance of educating all those involved in providing services in the pandemic, the need for providing immersive education for the pandemic and the need for planning and practice concerning the pandemic.

CONCLUSION:

When nurses receive more support, they can have their best performance. up-to-date training can prepare nurses more effectively, which will, in turn, make prepared nurses available, maximize their efficiency, and minimize their adverse mental consequences. Nurse managers may support nurses and increase hospital resilience in such emergencies. Nurses indicated some issues including managers' support, workplace culture, education, physical space, access to PPE, and willingness to provide the best care. These findings can be helpful in the management of the pandemic and preparing nurses as a large group of healthcare workers. Necessary training, along with the provision of adequate resources, should be programmed to support this effective group of health providers.
Standard workload-based estimation of nursing manpower requirement in the ICU of a tertiary care teaching hospital: A time and motion study
Authors: Rani Ritu , Sharma Suresh K. , Gupta Manoj K.
Published: May 2024

BACKGROUND:

The safety of patients remain at risk due to a higher workload and lower nurse-to-patient ratio. However, in India, most hospitals still adhere to long-known nurse staffing norms set by their statutory or accreditation bodies. Therefore, the present study was undertaken to recommend a standard workload-based estimation of nursing manpower requirement in the ICU of a tertiary care teaching hospital.

MATERIALS AND METHODS:

It was a descriptive, observational, time and motion study was conducted in the medicine ICU of a tertiary care teaching hospital. Data collection was done by using demographic and clinical profile sheet of patients, NPDS-H dependency assessment scale, time and activities record sheet, and WHO WISN tool. The nurses' activities were observed by nonparticipatory and non-concealment technique. Data analysis was done using descriptive statistics and the WHO WISN tool.

RESULTS:

The bed occupancy rate and the average length of stay in the medicine ICU were 93.23% and 7.18 days respectively. Distribution of dependency level of the medical ICU patients was very high (41.67%), low-high (33.33%), and medium-high (25.0%) dependency level. Considering available resources and workload in tertiary care hospitals in India, the study recommended a nurse-to-patient ratio of 1:1.2 in each shift for the medicine ICU of a tertiary care hospital.

CONCLUSION:

The study suggested minimum nurse-to-patient ratio in medical ICU should be 1:1.2 with provision of power to ICU incharge nurse to allocate nurses according to the workload in different shifts. Also, nurse staffing norms in hospitals need to be estimated or selected with serious consideration of health care demands when employing nurse staffing norms.
Gangrenous Cholecystitis
Authors: Adenuga Adedire Timilehin
Published: May 2024

Gangrenous cholecystitis (GC) depicts gallbladder (GB) wall necrosis which occurs following prolonged acute cholecystitis that ultimately causes impairment in blood supply. GC is more common in the elderly and in patients with comorbidities. These patients may present with vague symptoms which may be confused with other conditions. Blood work may show elevated white cell count, and computed tomography may show lack of enhancement of the GB wall, air within the lumen or wall, and pericholecystic abscess. These patients would require proper resuscitation and an emergent cholecystectomy. This is the case report of a 75-year-old diabetic woman who presented acutely with a history of right upper abdominal pain and imaging finding of GC. She had an emergency subtotal cholecystectomy performed with good outcome.
Gall bladder perforation with contained bilioma
Authors: Anand Krishnanand , Goyal Sakshi , Tiwari Amit , Dave Pranav Kumar
Published: May 2024

Gall bladder perforation (GBP) is a rare and potentially life-threatening complication of acute cholecystitis. The main cause of GBP is cholecystitis with or without cholelithiasis and is often associated with high morbidity and mortality. It is subdivided into three categories, whereas the development of biloma is extremely rare. We report an interesting case of GBP after acute calculous cholecystitis causing subhepatic bilioma formation who presented in emergency with pain in the right upper abdomen and fever.
Primary Hepatic Neuroendocrine Tumour
Authors: Inuganti Renuka Venkata , Boregowda Chaitra , Vaddati Tejeswini , Potti Ramya
Published: May 2024

Primary hepatic neuroendocrine tumors (PHNETs) are infrequent and rarely cause carcinoid syndrome unlike metastatic deposits in the liver from primary neuroendocrine tumors (NETs) in other parts of the gastrointestinal system. There are only about 61 cases of PHNET reported in the literature. We present a case of a 30-year-old woman with a PHNET in the left lobe of the liver for which a lobectomy was successfully done. This case was subjected to a thorough workup to exclude an occult extra hepatic NET.
Intestinal tuberculosis complicated by pulmonary embolism and deep vein thrombosis
Authors: Abdulla Mansoor C.
Published: May 2024

Venous thromboembolism (VTE) secondary to tuberculosis (TB) is a rare complication that can occur either at the time of presentation or later in the course of the disease. A 24-year-old woman was admitted with low-grade fever, abdominal pain, abdominal distension, and loose stools for one and half months. She was evaluated and diagnosed with abdominal TB. On the second day of admission, she had a sudden onset of the right lower limb edema with pain followed by breathlessness. Contrast-enhanced computed tomography of the thorax showed a thrombus in the left pulmonary artery. She was treated with low-molecular-weight heparin and started on anti-TB drugs. She was continued on oral anticoagulation with warfarin. We describe a patient who developed pulmonary embolism and lower limb deep vein thrombosis secondary to abdominal TB without paraaortic lymphadenopathy and a negative procoagulant workup, which was not reported previously. The mechanisms of VTE in TB are complex and may need further studies in the future, which may help the clinicians develop appropriate strategies for treatment.
HBsAg Loss among a Cohort of Nigerians with chronic hepatitis B virus infection
Authors: Adekanle Olusegun , Ijarotimi Oluwasegun , Umenze Ikenna Kenechi , Ndububa Dennis A.
Published: May 2024

Background:

Chronic hepatitis B (CHB) virus is an infection that has lasted for 6 months or more without a complete resolution. Nigeria has a hyper-endemic CHB infection rate. There are few or no reports of HBsAg loss among Nigerians on treatment for CHB. We therefore report seven cases of CHB that cleared HBsAg with treatment from the Obafemi Awolowo University Teaching hospital Ile-Ife, Nigeria.

Materials and Methods:

Case records of patients that cleared HBsAg during follow-up treatment in the gastrointestinal clinic were reviewed and information on biodata, prescribed medication, duration of treatment, and hepatitis B viral quantity among others were extracted and presented in a table and as percentages.

Results:

Seven patients had lost HBsAg among our treated cases; they were five males and two females. Duration of treatment ranged from 6 months to about 4 years. All were HBeAg negative. Serum HBV-DNA ranged from 22 to 3.2 × 106 IU/mL at the start and was not detectable at the end of treatment. Anti-HBs were detectable in three cases. Serum alanine aminotransferase (ALT) reduced significantly in five cases. Tenofovir disoproxil fumarate (TDF) was prescribed in four cases, one had PEGylated interferon (PegIFN), and two other cases switched between TDF and PegIFN.

Conclusion:

Antivirals for CHB are effective and HBsAg loss may follow undetectable viral suppression. Antivirals are therefore beneficial among Nigerians who are infected with CHB.