Medical Sciences University Research Articles

A Quantitative Cross-Sectional Study on the Behavioral Intentions of Polish Medical and Healthcare Students Regarding Interprofessional Collaboration in Their Future Clinical Practice

Background/Objectives: Since the importance of robust theory-driven research is emphasized in medical education and little data are available on the intentions of medical and healthcare students regarding interprofessional collaboration, this study aimed to analyze the behavioral intentions of Polish medical and healthcare students to undertake interprofessional collaboration in their future work. This study follows the assumptions of the theory of planned behavior, including analysis of the students’ attitudes, subjective norms, and perceived behavioral control in this regard. Methods: Data were collected from March to July 2023 on the population of students at Poznan University of Medical Sciences (Poland) using a questionnaire developed using dedicated manuals on the theory. Results: The students demonstrated generally positive behavioral intentions and attitudes, with a mean total attitude score of 103.13 ± 33.31 in a possible range of −231 to 231. Their sense of social pressure to engage in interprofessional collaboration was weak to moderate positive, as indicated by their total subjective norm score equal on average to 57.01 ± 42.98 in a possible range of −189 to 189, or mixed when evaluated directly. Furthermore, even though they presented a neutral or moderately positive direct assessment of their perceived behavioral control, its indirect measure was weak to moderately negative, with a mean total perceived behavioral control of −80.78 ± 59.21 in a possible range of −231 to 231. Conclusions: The findings suggest that students’ perceptions of mixed social pressure and the presence of barriers or obstacles to collaboration may negatively impact their perceived ease and willingness to collaborate, even despite their initially positive attitudes towards it.

Educational needs of midwifery students in medical ethics: A qualitative study.

Background: Ethics education is a basic part of midwifery education program. However, there is no evidence to show that ethics education has been able to meet the educational needs of midwifery students. Purpose: This study aimed to explore the educational needs of students for ethics in midwifery program with a focus on the course of history, ethics, and rules of midwifery. Research design and participants: The present study is qualitative descriptive content analysis research, exploring midwifery students' needs of ethics education in bachelor's degrees. We conducted in-depth semi-structured interviews with 11 undergraduate midwifery students, seven midwives working in hospitals and health centers, and seven midwifery faculty members in Urmia University of Medical Sciences. The participants were selected using a purposeful sampling method and invited to join the study from December 2021 to June 2022. The sampling continued until data saturation. Findings: Content analysis identified four categories and associated subcategories: 1. "The client's rights": respecting the dignity of clients, confidentiality, the client's right to choose and make decisions; 2. "Legal and ethical requirements of fertility": abortion, alternative treatment for infertility, domestic violence; 3. "Communication skills": communication with the client, communication with clients' caregivers and communication with colleagues; and 4. "ethical principles in research": compliance with ethical principles in the research process and ethical principles in publishing research findings. Ethical considerations: The study was approved by the Ethics Committee of Urmia University of Medical Sciences. Before filling the questionnaires, written informed consent was obtained from the participants. The participants were assured of the confidentiality of personal information. Conclusion: The educational needs of midwifery students can be met by providing theoretical and practical training on respecting the pregnant mother, communication skills, legal and ethical aspects of the reproductive period, and incorporating ethical principles in related courses.

The Role of Academic Motivation in Self-Regulation, Goal Orientation, and Passion Among Medical Students with Self-Handicapping Behaviors

Background: Self-handicapping behaviors, characterized by creating obstacles or excuses to avoid failure, can hinder academic success. Understanding how academic motivation mediates the relationship between self-handicapping behaviors and academic performance is crucial for supporting medical students. Objectives: This study aimed to investigate the relationships between academic self-regulation, goal orientation, passion, and self-handicapping behaviors among medical students, with academic motivation as a potential mediator. Methods: The present study employed a descriptive, correlational approach to examine the relationships between variables within a structural equation modeling (SEM) framework. The population consisted of all undergraduate medical students with self-handicapping behaviors at Jundishapur University of Medical Sciences in 2022. The sample comprised 204 medical students selected using purposive sampling, who completed the Academic Passion Scale, Goal Orientation Scale, Academic Self-Regulation Scale, and Academic Motivation Scale. Structural equation modeling was used to analyze the model with AMOS 24. Results: The SEM analysis revealed that the proposed model had a good fit to the data (CFI = 0.96, RMSEA = 0.05). The results further demonstrated that goal orientation directly enhanced students' academic passion, while academic self-regulation did not have a direct impact. However, strong self-regulation indirectly increased passion by fostering academic motivation (P < 0.001). Similarly, goal orientation also worked indirectly through motivation to enhance academic passion (P < 0.05). Conclusions: This study underscores the importance of goal setting and academic motivation in fostering academic passion among medical students with self-handicapping behaviors. While academic self-regulation strategies may not directly translate to academic passion, they can contribute indirectly by fostering academic motivation. Educators and practitioners can promote academic passion and address self-handicapping behaviors in medical students by encouraging goal orientation, academic motivation, self-regulation, and providing support for overcoming challenges.

The Effect of Adding Agomelatine to Escitalopram in the Treatment of Major Depressive Disorder

Major Depressive Disorder (MDD) is a psychiatric illness that imposes a high cost on the patient and the community. Over the past few decades, a variety of treatments have been used to treat depression. One of the most common treatments for depression is medication. Today, specific serotonin reuptake inhibitors are the first line of treatment for major depression. Another drug that has been considered in the treatment of depression is agomelatine.Objective of this study was to evaluate the effect of adding agomelatine to Escitalopram in treatment of major depressive disorder.Materials and methods. This study was a double-blind randomized clinical trial with before and after designs (b and a). In this study, 70 patients with MDD referred to psychiatric clinics affiliated with Yazd University of Medical Sciences were studied. Patients were randomly divided into two groups of 35 patients (agomelatine + Escitalopram and Escitalopram + placebo) and were treated for 12 weeks. Depression Scale was the Hamilton Depression Inventory and was assessed before treatment, 1, 2, and 3 months after treatment. Variables such as gender, age, marital status, level of education, occupation, and duration of illness were also collected. The data were entered into SPSS version 18 software and analyzed using statistical tests.Results. Of the 70 patients studied, 31 (44.3%) were male and 39 (55.7%) were female. There was not significant difference between gender distribution (p=0.810), marital status(p=0.789), job (p=0.651) and educational level (p=0.794). Also, no significant difference was found between the mean variables: age (p=0.563) and duration of depression (p=0.958). There was a statistically significant difference between the mean score of depression 2 months after treatment (p=0.10) and 3 months after treatment (p=0.023) in the two groups. Also the mean depression score after treatment compared to before, was significantly lower in both groups (p=0.000). Also, no significant difference was found between the frequency of drug side effects in the two groups (p=0.970).Conclusion. Adding agomelatine to Escitalopram is more effective than mood-boosting depression as a result of depression or depressive disorder alone.Future researchers in the field of MDD treatment could consider investigating the long-term effects and comparative efficacy of combining agomelatine with other antidepressants beyond Escitalopram to further enhance treatment outcomes for patients with MDD.

Integration of social determinant of health in patient’s history-taking in medical education: an educational scholarship and action research study: phase I

Background and objectiveOne of the most important aspects of health is social health. Addressing social health and social accountability is possible by education of social determinants of health (SDH) to medical students. The aim of current study is to integrate the SDH variables to patient’s history-taking in medical education during clerkship stage as an action research and scholarship in education. Pediatric patients were selected as the target population for this study.MethodsThe present study is an action-research including three phases of the program's design, implementation, and evaluation. The present paper reports the results of phase I including the following steps; rapid scoping review and expert panel for development of history-taking form. The goal of this phase was to prepare an SDH checklist for history-taking in the Pediatrics Ward of Firoozabadi Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran. The checklist of history-taking was evaluated in terms of measurability, feasibility, priority, and clarity using a 5-choice Likert scale.ResultsAccording to the results of the scoping review and consensus-based methods, the preliminary version of the program was prepared including the SDH history-taking checklist. A total of 21 items were selected after two expert panel rounds. The overall absolute agreement was 0.704 (95% CI: 0.587 – 0.793) which was significantly higher than 0.5 (P < 0.001). The range of scores was 3.5 – 4.83 (out of five).ConclusionWe developed a SDH history-taking form including nine domains and 21 items. This form should be piloted and evaluated by an expert panel in the next phases. The present phase of the project proposed a consensus-based program for the imputation of SDH education in the education program of medical students. The reason for the importance of choosing children is that social factors in the group of children can have a greater impact considering the long life ahead and being in the growing age. After the implementation and evaluation phases, this program may be imputed in the medical education curriculum.

The impact of mindfulness on academic achievement of students with the mediating role of adaptability: a structural equation modeling approach

IntroductionExamining the factors influencing students’ academic achievement can lead to improved educational planning and enhanced teaching and learning outcomes. The aim of this study was to investigate the impact of mindfulness on academic achievement with the mediating role of adaptability among students at Jiroft University of Medical Sciences in southern Iran in 2024.MethodsThis descriptive-analytical cross-sectional study was conducted on 290 students from various fields at Jiroft University of Medical Sciences in southern Iran from January to April 2024. To select these 290 individuals, a stratified sampling proportional to size was first carried out based on the year of university entry and field of study. After the sample size was determined for each entry year and field of study, students were randomly selected using their student numbers and a random number table. The data collection instruments were the standard mindfulness, academic achievement, and adaptability questionnaires. Descriptive tests and structural equation modeling using the Partial Least Squares (PLS) method were employed for data analysis, utilizing Smart PLS3 and SPSS26 software.ResultsThe findings indicate that students’ mindfulness positively affects their academic achievement (p < 0.001, β = 0.59). Additionally, mindfulness positively influences students’ adaptability (p < 0.001, β = 0.65). The results also show adaptability positively impacts students’ academic achievement (p = 0.001, β = 0.57). Finally, students’ mindfulness has a significant positive effect on their academic achievement through the mediating role of adaptability (p < 0.001).DiscussionAccording to the results, a favorable state of mindfulness and adaptability among students can improve academic achievement. Therefore, it is recommended that university administrators facilitate the enhancement of students’ mindfulness and adaptability by organizing relevant courses and workshops. This approach can contribute to their academic progress.

Effectiveness of gamification-based teaching in approach to eye trauma: a randomized educational intervention trial

IntroductionOphthalmology education is evolving with the use of new teaching approaches. Teaching based on gamification is one of the new developments in health professions education. This study was conducted to investigate the effect of gamification-based virtual reality on the learning outcome of students regarding the highly important topic of approach to eye trauma.Materials and methodsThis randomized educational intervention trial with a control group was conducted at Kermanshah University of Medical Sciences (KUMS). A total of 10 ophthalmology residents and 60 medical students were recruited in this study (each group comprised 5 residents and 30 medical students). Individuals were randomly divided into two teaching groups gamification method (intervention group) and lecture-based method (Control group). Data were collected through questionnaires and tests and analyzed by SPSS-26 software using descriptive and analytical statistics.ResultsResidents and medical students evaluated the usability of this method to be favorable (132.72 ± 10.17). In resident students (16.80 ± 2.58, 13.60 ± 1.14, P ≤ 0.05) and medicine students (17.27 ± 4.50, 15.20 ± 0.71, P ≤ 0.05), the mean score of learning outcome score in the intervention group was higher than the control group.ConclusionGamification-based teaching is an effective educational strategy that can be used as a complementary educational tool for teaching ophthalmology residents and medical students.

Tumor Metastasis to the Oral Soft Tissues and Jaw Bones: A Retrospective Study and Review of the Literature.

Metastasis to the oral soft tissues and jaw is rare and accounts for 1%-3% of maxillofacial malignancies. These lesions usually occur in the context of an extensive malignant tumor with a poor prognosis. Archived cases from the Oral and Maxillofacial Pathology Department of the Faculty of Dentistry and two hospital centers of Mashhad University of Medical Sciences were examined. Inclusion criteria were cases with available records of pathologically confirmed metastatic lesions of the oral cavity with or without diagnosed primary malignancy. Metastatic lesions in the oral cavity and jaw were found in 18 patients, including seven women and 11 men, with a mean age of 49.5 years. Metastatic lesions were more common in the jaw (66%) and particularly in the mandible (38%) than elsewhere. In the case of soft tissue metastases, the gingiva was more affected than other sites. The primary tumor was most commonly in the kidney in men and in the breast in women (36%-28%). In addition, the diagnosis of a metastatic lesion led to the detection of the primary tumor elsewhere in six out of 18 cases (33.3%). Early diagnosis of the lesions is challenging, given the absence of specific signs or symptoms, which, in some cases, nonetheless resemble inflammatory, benign, reactive lesions. Therefore, dentists play a crucial role in diagnosing such lesions, as they lead to the discovery of hidden distant primary tumors. Biopsy should always be considered for suspicious lesions, even if the probability is very low.

Effect of holistic reflective learning program on development of nursing students’ professional competency in geriatric clinical practice: a quasi-experimental study

BackgroundReflection is a core competency in geriatric nursing, and reflective learning is an effective approach in nursing education and pracice. An internship program is a transition course that enhances the knowledge, skills, and attitudes of aspiring nursing students in real clinical work. In geriatric clinical setting, nursing internship students require a broad understanding of professional competency that integrates reflective learning with clinical practice to deal with geriatric patient problems and equip them with the knowledge, attitudes, and skills needed to provide quality of care. However, there is a lack of studies examining the effect of holistic reflective learning on professional competency development among nursing internship students in geriatric settings.AimThis study aimed to investigate the effect of professional holistic reflective learning on professional competency development among nursing internship students caring for hospitalized older adults in medical-surgica wards.DesignThis study employed a quasi-experimental pretest–posttest design, where 160 participants were grouped into control and intervention groups. This study was conducted at two nursing schools under the Mashhad University of Medical Sciences in Iran in 2020. Baseline information was collected from both groups, followed by a pretest and follow-up assessment. The intervention group received a Blended Professional Holistic Reflective learning program, while the control group received conventional learning(undertaking professional clinical practice as a usual treatment and submitted reflective logbooks),, which included standard lectures and group discussions.MethodsParticipants were selected based on specific inclusion and exclusion criteria. The selection process was non-randomized and unblinded. The participants were equally divided, with 80 in the control group and 80 in the intervention group. Baseline data, including demographic characteristics, were collected. Pretest data were collected for both groups using the Geriatric Nursing-Specific Mini-CEX (GN-Specific Mini-Clinical Evaluation Exercise), an instrument designed to assess nursing students' professional competency in geriatric nursing practice. The intervention was delivered through a combination of in-person and online sessions over four mounts. Posttest data and follow-up, were collected similarly to the pretest. Data were analyzed using SPSS version 22, and potential confounding variables were controlled for in the analysis.ResultsThe study included a total of 160 nursing internship students, with no exclusions. At baseline, no significant differences were observed between the intervention and control groups in terms of professional competency (PC) and its dimensions, except for age, which was adjusted as a covariate in the analyses. The intervention group showed a significant improvement in PC and its various domains (communication skills, physical examination, clinical judgment, health education, professionalism, and organizational efficacy) over time. The Generalized Estimating Equation (GEE) analysis confirmed significant interaction effects between time and group for all PC dimensions (p < 0.05). Post-test comparisons revealed that the intervention group scored 2.4 points higher than the control group in overall PC (p < 0.001), with sustained improvements in the follow-up phase. Significant within-group improvements were also found across all PC dimensions for both groups from pre-test to follow-up (p < 0.05).ConclusionsThe study found that the professional holistic reflective learning program was effective in developing professional competency among nursing internship students. The blended teaching–learning approach (face-to-face and online) during workshops and geriatric clinical practice is a practical, cost-effective, and time-efficient learning program during students' clinical practice in geriatric settings. Nurse educators are recommended to implement holistic reflective learning during clinical education.

Outcomes of acetaminophen infusion on visual analogue scale with varying pain intensity during labour, A randomized controlled trial

Objective: Acetaminophen (Paracetamol) is the most widely used analgesic. We aimed to determine its efficacy in labour with varying pain intensity, to make labour less painful for women. Methods: This randomized controlled trial was conducted on primigravida’s in their active phase of first stage of labour at Pharmacology department of Army Medical College, National University of Medical Sciences in collaboration with Gynecology department of Pak Emirates Military hospital, Rawalpindi. It was a registered trial with trial number of IRCT20220308054220N1. Duration of study was from May 2022 to October 2022. Patients were divided into two groups, Group-I received two doses of I/V 100 ml normal saline whereas Group-II received I/V two doses of 1000 mg acetaminophen in 100 ml normal saline. Calculated sample size was 130, 65 in each group. Visual analogue scale was used as a tool for data measurement. Data was analysed using split plot anova test. Results: Mean VAS in acetaminophen infusion group was found to be less than placebo for 1st dose, but this effect was apparent only one hour after 2nd dose intervention. The difference in means between groups was statistically significant only for 1st dose with p-value of 0.003 (for second dose p-value 0.21). In acetaminophen infusion group, for both doses mean VAS decreased as an immediate effect of drug, but then it increased with time. The difference in VAS between intervals had p-value of &lt;0.001 for 1st dose and 0.005 for 2nd dose. Conclusion: Acetaminophen is an effective non opioid labour analgesic in active phase of first stage of labour. doi: https://doi.org/10.12669/pjms.40.10.8425 How to cite this: Najeeb W, Komal N, Noor M, Khan MA, Chaudry A. Outcomes of acetaminophen infusion on visual analogue scale with varying pain intensity during labour, A randomized controlled trial. Pak J Med Sci. 2024;40(10):2163-2169. doi: https://doi.org/10.12669/pjms.40.10.8425 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Antifungal Potential of Struchium sparganophora (Antsbush): A Promising Candidate for Treating Candidiasis and Cryptococcosis

Aims: The incidence of Candidiasis and Cryptococcosis, and the emergence of acquired antifungal resistance have increased rapidly. This study aimed to evaluate the effectiveness of S. sparganophora leaf extracts against C. albicans and C. neoformans; and to determine whether there was any difference between the antifungal effects of S. sparganophora leaf extracts and two conventional antifungal agents (AFAs). Study Design: Experiment-based study. Place and Duration of Study: S. sparganophora leaves was obtained from a site in Kimbia, Berbice River, Guyana; identified by the Biodiversity Centre and tested at the Main Laboratory at the College of Medical Sciences, University of Guyana during January- August 2023. Methodology: Dried pulverised leaves were macerated using different solvents and concentrated using a rotary evaporator. Sterile filter paper discs were soaked in different concentrations of the various extracts. Antifungal discs were placed on Sabouraud’s Dextrose Agar plates seeded with fungi. All plates were incubated and zones of inhibitions (ZOIs) were measured and expressed as mean ± SD. Results: S. sparganophora leaf extracts showed large ZOI especially at the 100 mg/ml concentrations against all organisms tested. The largest ZOI was seen for the hexane extract against C. neoformans (35.5±5 mm) and C. Albicans In-House B (18.5±3.5 mm) at 100 mg/ml concentrations. No ZOI was observed against the AFA fluconazole by C. albicans In-House B, while large ZOI were observed with the hexane and ethyl acetate extracts at 100 mg/ml concentrations. Statistical analysis showed correlation between the ZOI and concentrations, ZOI and solvent extract, and ZOI and type of fungi. Conclusion: In conclusion, S. sparganophora leaf extracts have great antifungal activity and in some cases showed greater activity when compared to conventional AFAs.

Clinical Manifestations and Molecular Identification of Giardia duodenalis in Pediatric and Adolescent Cancer Patients in Southwestern Iran.

This study aimed to investigate the clinical and molecular characteristics of Giardia duodenalis (G. duodenalis) infection and identify potential risk factors in children and teenagers with malignancies in Shiraz, southwestern Iran. A total of 200 fresh fecal samples were collected from children and adolescents suffering from 32 different cancer types at Amir, Nemazee, and Saadi hospitals affiliated with Shiraz University of Medical Sciences between October 2021 and May 2022. Direct microscopy using saline and iodine wet mount was conducted, and all fecal samples were rechecked by SSU-PCR. Subsequently, a specific fragment of the tpi gene was amplified on all samples for prevalence, sequencing, and assemblage identification. Our study found a 4% (8/200) prevalence of G. duodenalis using microscopy and PCR. The molecular findings were consistent with the microscopic results. All eight positive samples with SSU-rRNA gene were also detected as positive with tpi gene and were correctly sequenced. Among the examined cancer patients, two assemblages were identified: A [sub-assemblage AI (2/8, 25%) and sub-assemblage AII (3/8, 37.5%)] and B [sub-assemblage BIV (3/8, 37.5%)]. Notably, patients were more vulnerable to G. duodenalis infection after receiving at least 8 treatment episodes (p < 0.05) and displaying gastrointestinal symptoms (p > 0.05). The demographic characteristics of cancer patients with G. duodenalis infection and the statistical conclusions were separately detailed. The small sample size and low prevalence rate in this study hindered precise epidemiological conclusions. Nonetheless, the results suggest that G. duodenalis infection among cancer patients in Shiraz city originates from humans, without any specific animal groups (C-H) involved.

Structural Equation Modeling of Suicidal Ideation and Behavior: A Three-Step Theory Perspective

Background: Suicide, defined as the intentional act of self-inflicted death, constitutes a significant global public health burden. Every year, over 700,000 individuals worldwide die by suicide. Studies in Iran have reported an alarming prevalence of suicidal behavior among students, with estimates of suicide attempts ranging from 1.8% to 3.5%, and suicidal ideation rates fluctuating between 6.2% and 42.7%. This complex phenomenon is influenced by a wide array of factors. A major challenge to effective suicide prevention strategies is the limited understanding of the mechanisms that lead from suicidal ideation to actual suicide attempts. Objectives: This study aimed to investigate the relationships between suicidal ideation, suicidal behaviors, and the constructs of the three-step theory within a student population. Methods: A cross-sectional design was employed, with convenience sampling enrolling 260 students from Zanjan University of Medical Sciences. Students consented to participate and completed various questionnaires, including the Beck Suicide Ideation Scale (BSSI), the Inventory of Motivations for Suicide Attempts (IMSA), the Suicidal Behaviors Questionnaire-Revised (SBQ-R), the Symptom Checklist-25 (SCL-25), the Acquired Capability for Suicide Scale (ACSS), and a single-item suicide attempt question. The participants ranged in age from 18 to 52 years (mean: 23.62, standard deviation: 5.48), with 75% of the sample being female, and 85% single. Data analysis was conducted using SPSS 24 and AMOS 24 software. Results: Correlation analysis revealed that psychic pain, hopelessness, and low belongingness were significantly and directly correlated with both suicidal ideations and behaviors (all P-values &lt; 0.05). Structural equation modeling results demonstrated that the combination of pain and hopelessness directly predicted suicidal ideation (β = 0.318, P &lt; 0.001) and low belongingness (β = 0.867, P &lt; 0.001). These factors indirectly predicted suicidal behavior through suicidal ideation, capability for suicide, and low belongingness (β = 0.406, P &lt; 0.001). Additionally, suicidal ideation was a strong direct predictor of suicidal behavior (β = 0.556, P &lt; 0.001), and low belongingness directly predicted suicidal behaviors (β = 0.226, P &lt; 0.001). However, the capability for suicide did not statistically predict suicidal behavior within this student sample. Conclusions: The findings support the validity of the three-step theory in a student population. Pain, hopelessness, and low belongingness were significant predictors of suicidal ideation and attempts among students, while the capability for suicide did not predict suicidal behavior in this context. These results provide a novel perspective by confirming the applicability of the three-step theory in a non-clinical student population, offering valuable insights into the interrelations of the model’s key components.

Studying the Relationship between the Teaching Status of Research Methods, Biostatistics Courses and, Academic Research Skills, from the Graduates Point of View

Introduction: This study aimed to evaluate the relationship between passing biostatistics and research methods courses and academic research skills in graduates. Methods: This cross-sectional study included 633 graduates during 2016-2022 from Iran University of Medical Sciences, Tehran, Iran. The explanatory factors were passing biostatistics and research methods courses and having statistical consultant. The outcomes were the duration of preparing proposal and thesis, and paper publication. Univariate and multiple logistic regression was used to estimate the odds ratio (OR) with %95CI. Significance level was set to 0.05 Results: 433 (68.4%) were female, and 371 (58.6%) were married. The mean±SD age of the graduates was 34.5±7.06 years. 413 (65.2%) were graduates from MSc and MPH and 128 (20.2%) from PhD. For Masters and MPH, the odds of prolonging the duration of preparing the proposal for who had Biostatistical consultant in their research team was 40% lower than the graduates who had no Biostatistical consultant (OR=0.6[95%CI:(0.39,0.91], P=0.01). In PhD graduates, the odds of prolonging the duration of preparing the proposal for who passed research methods course was 2.94 (1.06, 8.2) times than that of did not pass (P=0.03). Passing Biostatistics course was associated with lower odds of prolonging the duration of preparing thesis (OR=0.3[95% CI: (0.1, 0.86)], P=0.04). The odds of paper publication was marginally associated with research methods workshop participation (OR=3.7[95%CI: (0.82, 16.74], P=0.09) in PhD graduates. Conclusion: Passing Biostatistics and research methods courses and presence of a statistical consultant in the students’ thesis team were associated with shortened proposal or thesis preparation duration, and having publications from thesis more likely.

Indirect estimation of the prevalence of type 2 diabetes mellitus in the sub-population of Tehran: using non-laboratory risk-score models in Iran

BackgroundThe prevalence of type 2 diabetes mellitus (T2DM) in the population covered by the Tehran University of Medical Sciences is unclear but crucial for healthcare programs. This study aims to validate four non-laboratory risk-score models, the American Diabetes Association (ADA) Risk Score, Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK), Finnish Diabetes Risk Score (FINDRISC), and TOPICS Diabetes Screening Score, for identifying undiagnosed diabetes and indirectly estimate the prevalence of T2DM in a subset of the Tehranian population using the selected model.MethodsThis research consisted of two main parts. In the first part, non-laboratory risk-score models to identify undiagnosed T2DM were validated using Iranian data from STEPs 2016 survey. The model performance was evaluated through the Area Under the Curve (AUC) and calibration via the observed-to-expected (O/E) ratio. Additional independent data from STEPs 2011 survey in Iran were utilized to test the model results by comparing indirect prevalence estimates with observed estimates. In the second part, the prevalence of T2DM was estimated indirectly by applying the selected model to a representative random sample from a Tehranian population telephone survey conducted in 2023.ResultsAmong the different models used, AUSDRISK showed the best performance in both discrimination (AUC (95% confidence interval (CI)): 0.80 (0.78, 0.81)) and calibration (O/E ratio = 1.01). After updating the original model, there was no change in the AUC value or calibration. Additionally, our findings indicate that the indirect estimates are nearly identical to the observed values in STEPs 2011 survey. In the second part of the study, by applying the recalibrated model to a subsample, the indirect prevalence of undiagnosed diabetes and T2DM (95% CI) were estimated at 4.18% (3.87, 4.49) and 11.1% (9.34, 13.1), respectively.ConclusionGiven the strong performance of the model, it appears that indirect method can provide a cost-effective and simple approach to assess disease prevalence and intervention effectiveness.Graphical

The Association Between Mental Health Literacy of Parents and Referral of Children and Adolescents to Mental Health Service Centers

Background: Mental health literacy refers to an individual’s knowledge and beliefs about mental health, which can aid in the detection, management, and prevention of mental illnesses. Prompt diagnosis of mental disorders is crucial for timely intervention and treatment. This study aims to investigate the mental health literacy and help-seeking behaviors of parents with children and adolescents under the age of 18. Methods: In this descriptive-analytical study, a cross-sectional design was utilized, and a surveying method was employed. A total of 134 parents of children and adolescents under 18, who were referred to the mental health service centers at Iran University of Medical Sciences and private psychiatric clinics in 2019 and 2020, participated in the study through convenient sampling. Two psychiatrists evaluated the psychiatric disorders of the children, and the parents completed the General Health Questionnaire-28 (GHQ-28) and the Mental Health Literacy Questionnaire. The collected data were analyzed using SPSS version 24. Results: The results of the one-way analysis of variance indicated that the total score of mental health literacy significantly differed among groups with varying levels of maternal education (p=0.001). Conclusion: This study underscores the impact of maternal education on mental health literacy among parents. Notably, parents with higher levels of education exhibited greater mental health literacy. It is essential to consider these findings in developing targeted interventions to improve mental health literacy among parents from diverse educational backgrounds. Further research should explore effective strategies for increasing awareness and knowledge about mental health in communities with varying levels of education.

The Psychometric Properties of the Persian Version of the Relaxation, Meditation, and Mindfulness Experiences Questionnaire Utilized Among Patients with Cancer: A Cross-Sectional Study in Iran.

Mindfulness is increasingly recognized as an effective strategy for managing chronic illnesses and improving mental well-being in cancer patients. This study sought to adapt and validate a Persian version of Relaxation, Meditation, and Mindfulness Experiences Tracker Questionnaire trait month 3.1″ (P-RMMtm 3.1) for use with Iranian cancer patients. This cross-sectional study was conducted in several hospitals affiliated with Kerman University of Medical Sciences in southeastern Iran. Validity and reliability tests were administered between March and December 2023. Results showed strong psychometric properties, with a six-factor solution explaining 72.387% of the variance. The identified factors were mindful transcendence, mindful relaxation, mindful emotion, mindful focus/awareness, mindful quiet, and mindful action. Confirmatory factor analysis indices were generally satisfactory (χ2/d.f. = 2.253, RMSEA = 0.079, GFI = 0.833, CFI = 0.923, and IFI = 0.924). Cronbach's alpha values for the RMMtm 3.1 factors ranged from 0.802 to 0.89. In conclusion, the Persian version of RMMtm 3.1 is a reliable instrument for assessing relaxation, meditation, and mindfulness experiences in Iranian cancer patients. Its concise format makes it suitable for future research with this population.

Anthropometric indices growth references (length, Weight and Head Circumferences) of children aged 0–24 months in North-East of Iran by GAMLSS

BackgroundGrowth references play a crucial role in the screening, evaluation, and surveillance of children, aiding in the early identification of the requirement for diverse growth-promoting interventions. Variations in human growth across distinct ethnic cohorts arise from genetic disparities, lifestyle variances, nutritional diversity, and diverse social and environmental contexts. Consequently, the selection of growth references markedly influences the prevalence of developmental disorders and nutritional imbalances in children. The study aims to assess the growth percentile of children in the north-east of Iran and establish population-specific reference charts for length, weight, and head circumference spanning from birth to 24 months.MethodsThis cross-sectional population-based research conducted in the north-east of Iran, from 2016 to 2023. The Data extracted from the electronic health records of Mashhad University of Medical Sciences. All apparently healthy children aged from birth to 24 months who were measured at least once by health staff at the ages of birth,1,2,4,6,7,9,12,15,18,24 months were included. The target population of the study were 479,089 children (96.21%), encompassing 233,565 girls (48.75%) and 245,524 boys (51.25%). Gender-specific percentile curves for length, weight, and head circumference concerning age, as well as weight concerning length, were derived using the GAMLSS approach.ResultsFrom the anthropometric information of 479,089 children (245,524 boys and 233,565 girls), growth charts were constructed. In comparison to the standard WHO chart, Iranian neonates displayed lower weight across all percentiles during the first month after birth, exhibited decreased head circumference at the 3rd percentile, and boys showed reduced length across all percentiles. After this age, Iranian children demonstrated increased weight, length, and head circumference.ConclusionsThis research introduces the inaugural large-scale endeavor for indigenous reference charts. Through the noted distinctions from the international reference, the utilization of this novel resource offers the potential to enhance the surveillance of children’s growth within the area. Moreover, by accurately assessing growth anomalies such as underweight, stunting, and wasting, it expands the domain of impactful policies in this sphere. Simultaneously, it enables the exploration of the secular trend of children’s growth in the forthcoming years.

Parents’ perception of challenges of caring of children with Epidermolysis bullosa: a qualitative study

ObjectiveThe present study was investigate parents’ experiences of children with Epidermolysis bullosa. So, this descriptive phenomenological qualitative study was conducted on 17 parents of children with EB from five hospitals affiliated with the University of Medical Sciences, west of Iran. Data was collected through semi-structured interviews. COLAIZZI’s method was also used to analyze the data.ResultsThree main themes were extracted in this study: invasion of psychological crisis, alive but no living, and comprehensive support, including 10 categories. The parents of these children are the target of psychological crises that severely reduce their quality of life. In this regard, they need extensive support to improve their living conditions. Therefore, it is suggested to provide cultural and institutional contexts in which all components of the children’s dignity are emphasized.

A Quality Gap Analysis of Educational Services among Iranian Medical Students Using the SERVQUAL Method

Introduction The quality gap in educational services among the students of Shahroud University of Medical Sciences in the year 2023 was evaluated using the SERVQUAL method. Methods In this cross-sectional study, 334 participants were selected through a multi-stage random sampling method, and 316 responded to the standard SERVQUAL questionnaire. Results The majority, 181 students [57.3%], had a strong interest in their field of study. The mean scores for the current status [perceptions] and the optimal status [expectations] of educational service quality were 3.27±0.66 and 4.41±0.63, respectively. There was a significant difference between the current and optimal status across all SERVQUAL dimensions. The largest gaps were in the dimensions of Responsiveness, Empathy, and Tangibles, followed by Assurance and Reliability. The comparison of mean scores for the educational service quality gap across variables, such as gender, academic semester, and interest in the field of study, indicated significant differences among these groups. Conclusion By assessing the status of educational services from the student's perspective, this study aims to provide valuable information to policymakers and university senior management to enhance the educational service system. Educational and incentive strategies, along with careful monitoring and planning according to different dimensions of service quality, can be effective in improving the system.