bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Perspectives of Adolescents on Smoking Habits as a Reference for the Prevention Program
Authors: Fithria Fithria , Adlim Muhammad , Jannah Syarifah Rauzatul , Tahlil Teuku 
Published: March 2020

Abstract
Background: Religious factor has been used in tobacco control campaign but due to different perception among the Muslim scholars that might induce on the followers then, the control program strategics is still interesting to study. This qualitative research is, therefore aimed to explore the perspective of Muslim adolescents on smoking habits, as a reference in developing effective prevention intervention programs.Methods: Three Focus Group Discussion (FGD) sets, consisting of a total of 24 junior high school students were the main source data for this phenomenological qualitative study. The discussion guide was developed by researchers, based on the reviewed literature and validated by experts. The research finding was analyzed by using an inductive-content method with systematical steps based on the stages of qualitative data analysis.Results: Adolescent perspectives on smoking were grouped into two themes that were (a) perception, which encompasses three sub-themes consisting of smoking as the social habit, the contradictive feeling, and the Islamic perspective, (b) Smoking-related factors involving peer pressure, the parents’ smoking status, curiosity and masculinity.Conclusion: The results indicated that adolescents consider smoking as a social habit with the existence of contradictive feelings. Their Islamic perspective believes that smoking is preferable but not forbidden by religion thought. The smoking habit also was stimulated by pressure from their smoker-peer, immitating their smoker-parents, being curiosity and feeling masculinity. We suggested the health proffesionals who intersted in developing smoking prevention programs to consider about the adolescent perspective about smoking habit. So, the prevention program will be more effective and culturally appropriate for adolescents.
Identifying Community Physical Activity and Health Resources by Utilizing Members of a Physical Activity Network
Authors: Sedney Cara L. , Haggerty Treah , Zizzi Sam , Dekeseredy Patricia 
Published: March 2020

Abstract
Background: Back pain is one of the leading causes of health care expenditure in the US and is linked to an increased body mass index. Many evidence-based modalities for the prevention and treatment of back pain closely mirror recommendations for weight loss and include physical activity and health maintenance activities (PAHM). Collaboration was sought with the West Virginia Physical Activity Network (WVPAN) leadership to ascertain community assets, and perceptions of the use of PAHM in the treatment of back pain by WVPAN members. Methods: Participants for the study were recruited from the West Virginia Physical Activity Network. This grassroots organization is filled with volunteers from various sectors who have either signed up via email or liked the WVPAN Facebook page. This network was purposely selected as the study population because of the statewide reach and their familiarity with resources in their local communities. A brief survey instrument was designed to gather their scaled perceptions about various treatment modalities related to back pain, and to gather their local knowledge related to specific providers in their communities. In addition, participants were given a free text box to list any local assets or resources for the nine treatments listed, and county of residence, and the nature of their connection to the physical activity network. Descriptive analyses were used to describe overall patterns of survey data. The qualitative data were compiled manually by the research team to show themes of specific treatments mentioned across different parts of the state. Results: Participants overwhelmingly supported physical therapy, flexibility training, yoga, and core strengthening as treatments for back pain. The majority of respondents were “undecided” about other treatments such as cognitive behavioral therapies and acupuncture. Conclusions: The implementation of PAHM interventions in communities could help treat patients with back pain, and may reduce reliance on the pharmacological treatment for back pain. The current study’s data support the feasibility of such approaches in many West Virginia counties. Also, local resources, needs, and context can be gleaned from community leader surveys utilizing previously developed infrastructure for PAHM promotion. Key Words: physical activity, capacity building, rural health, collaborative research
The effects of socio-cultural factors on medical college students' self-rated health status and health-promoting lifestyles in Eritrea: A cross-sectional study
Authors: Abraham Isayas Afewerki , Zhang Xufu , Dagnew Zewdi Amanuel , Tesfamariam Eyasu H. , Beraki Ghirmay Ghebreigziabher , Achila Oliver Okoth , Dai Ying-chun 
Published: March 2020

Abstract
Background: Sub-optimal health status (SHS) and unhealthy lifestyle among college students have become a major focus for research on public health worldwide. Hence, this study was designed to assess the effects of socio-cultural factors on medical college students' self-rated health status (SRH) and health-promoting lifestyles (HPL) in Eritrea.Methods: A descriptive cross-sectional study was conducted at Orotta School of Medicine (OSM), using a self-administered questionnaire. Data was collected from all medical students who had fulfilled the inclusion criteria using Sub-Optimal Health Measurement Scale (SHMS V1.0) and Health-Promoting Lifestyle Profile-II (HPLP-II) scale questionnaires. Independent samples t-test, ANOVA, Chi-square test, Pearson’s correlation coefficient and Binary multivariate logistic regression were performed. Data analysis was undertaken using SPSS version 22.Results: The overall SRH was significantly higher among college students with BMI of 25 to 29.9 (M=88.23, SD=6.28) as compared to <18.5 (p=0.027) and 18.5 to 24.9 (p=0.027). Moreover, physiological subscale of SRH was significantly related to gender (M males= 88.96 Vs M females= 85.41, p=0.001) and monthly stipend (M income = 89.52 Vs M no-income = 87.28, p=0.040). On the other hand, physical activity of HPL was found to vary by gender (M males= 2.12 Vs M females=1.87, p=0.005) and alcohol consumption (M drinkers= 2.22 Vs M non-drinkers = 1.99, p=0.016). Nutrition differences of HPL were observed in BMI of 25 to 29.9 (M =2.40, p=0.028), internship students (M=2.15, p=0.027), and monthly income (M=2.11, p=0.029). The overall SRH was significantly correlated with the overall HPL (r=0.493, p<0.001). In-addition, students who had good and excellent HPL had self-rated themselves as almost five times (AOR=4.97, 95% CI: 1.28, 19.32), and were 3.73 times (AOR=3.73, 95% CI: 1.09, 12.80) healthier than those who had poor HPL, respectively.Conclusions: Based on our study, gender, BMI and monthly stipend play a major role in the SRH whereas gender, alcohol consumption, BMI, study year and monthly stipend play a major role in the HPL. Moreover, there was a significant correlation between SRH and HPL in this study. Therefore, our findings provide evidence that support the role of socio-cultural influences’ on SRH and HPL of medical students.
Our First Review in 12 Years: An Evaluation of Effectiveness of Root Cause Analysis in Hong Kong Public Hospitals
Authors: Kwok Andy Yick Ting , Mah Alastair Pui Yan , Pang Katherine Mo Ching 
Published: March 2020

Abstract
Background: To evaluate the effectiveness of root cause analysis (RCA) and propose possible ways to enhance its effectiveness in Hong Kong public hospitals. Methods: A retrospective cross-sectional study was performed across 43 public hospitals and institutes in Hong Kong, reviewing RCA reports of all Sentinel Events and Serious Untoward Events within a two-year period. The incident nature, types of root causes and strengths of recommendations were analysed. The RCA recommendations were categorised as ‘strong’, ‘medium’ or ‘weak’ strengths utilizing the US’s Veteran Affairs National Center for Patient Safety action hierarchy. Results: A total of 214 reports from October 2016 to September 2018 were reviewed. These reports generated 504 root causes, averaging 2.4 per RCA report, and comprising 282 (49%) system, 233 (46%) staff behavioural and 22 (4%) patient factors. There were 658 recommendations identified in the RCA reports with an average of 3.1 per RCA. Of these, 18 (2%) recommendations were rated strong, 116 (15%) medium and 626 (82%) weak. Most recommendations were related to ‘training and education’ (466, 61%), ‘additional study/review’ (104, 14%) and ‘review/enhancement of policy/guideline’ (39, 5%). Conclusions: This study provided insights about the effectiveness of RCA across all public hospitals in Hong Kong. The results showed a high proportion of root causes were attributed to staff behavioural factors and most of the recommendations were weak. The reasons include the lack of training, tools and expertise, appropriateness of panel composition, and complicated processes in carrying out large scale improvements. The Review Team suggested conducting regular RCA training, adopting easy-to-use tools, enhancing panel composition with human factors expertise, promoting an organization-wide safety culture to staff and aggregating analysis of incidents as possible improvement actions.
Study of Influential Factors of Provincial Health Expenditure -Analysis of Panel Data After the 2009 Healthcare Reform in China
Authors: Hou Ji-Fei , Zhang Yun , Liu Yan-Zheng , Li Jing , Wang Yue 
Published: March 2020

Abstract
Background Healthcare Expenditure(HE) has increased substantially in all countries. Since the health system reform and health policy environment differ from each country, it is necessary to analyze the motivations of HE in a specific country. Methods The objective of this study is to analyze the influential factors of Provincial total HE (PTHE) per capita in China by using panel data across 31 provinces(including provinces, autonomous regions, and municipalities, all called provinces in here) from 2009-2016 at the country level. Generalized Method of Moments (GMM) and robust estimators were used to identify the influential factors of PTHE per capita. Results Economic factors explain most of the variation of PTHE per capita. But Out-Of-Pocket Payments(OOP) as a percentage of Total Health Expenditure(THE) is associated with PTHE per capita negatively and Government Health Expenditure(THE) as a percentage of Gross Domestic Product(GDP) have no statistical significance. The results also show that health expenditure in China reacts more to the rate of infectious diseases compared with the Proportion of the Population Aged 65 and Over (POP65), which impacts PTHE per capita positively. As for the number of beds per 10,000 population and mortality, their coefficients are small with no statistical significance. Conclusions In response to these ﬁndings, we conclude that the impact of the increasing OOP diminish the PTHE. Furthermore, we do not get a significant correction between health outcomes and health supply with PTHE. Policymakers should consider providing comprehensive health services by an accountable care organization to achieve cost savings while ensuring high-quality care.
Factors contributing to physician overwork in 80 Saiseikai hospitals of Japan
Authors: Yamaguchi Naohito , Mochida Yuji , Matsubara Satoru , Sumitani Shigeru 
Published: March 2020

Abstract
Background Physician overwork and burnout is a prevalent problem worldwide that is hazardous to both the physician’s health and healthcare quality and safety in hospitals. The aim of this study was to estimate how much time physicians spend on various work activities and to what extent these activities contribute to the total number of working hours, so as to find an effective way to reduce the number of overtime hours. Methods Surveys were conducted on fulltime physicians of 80 Saiseikai hospitals. For those activities showing a significant positive association with the number of total working hours, the hospital-based time for one patient-day, which is the daily number of hours spent by all physicians in the hospital for one patient, was analyzed in association with the number of patient-days per physician in the hospital. The time spent by a physician for each work activity was also analyzed in association with the number of patient-days per physician, after controlling for sex, age, department and position as covariates. Results Analysis of 1,837 physicians showed that most work activities had a significant positive association with the total number of working hours. In general, the time spent on direct and indirect inpatient services were greater than other work activities. The hospital-based time for one patient-day showed a significant inverse association with the number of patient-days per physician in all work activities, except that of working in surgical operation room. On the other hand, individual physicians tended to spend a similar amount of time regardless of the number of patient-days per physician in the hospital. In hospitals with a relative shortage of physicians, physicians tended to spend less time on each patient, whereas in hospitals with a relative surplus of physicians, physicians tended to spend more time, presumably more than necessary, on patient services. Conclusion Improvement in efficiency, such as by reducing the time interval between patient services, seems promising in hospitals with a relative surplus of physicians. Time could also be saved by implementing newer methods of information technology or by shifting a part of tasks to other health professionals and clericals.
Pre-hospital delay in patients with myocardial infarction: an observational study in a tertiary care hospital of northern Bangladesh
Authors: Rafi Md. Abdur , Sayeed Md. Zahidus , Sultana Papia , Aik Saw , Hossain Golam 
Published: March 2020

Abstract
Background: Delayed hospital presentation is a hindrance to the optimum clinical outcome of modern therapies of Myocardial infarction (MI). This study thus aims at finding the factors associated with prolonged pre-hospital delay and the impact of this delay on in hospital treatment outcome of MI patients of Northern Bangladesh. Methods: This cross sectional study was conducted in December 2019 in cardiology ward of a 1000 bed tertiary care hospital of Bangladesh. Socio demographic data, clinical features and patients’ health seeking behavior was collected in a structured questionnaire from the patients diagnosed as STEMI or non-STEMI. Median with interquartile range (IQR) of pre hospital delay were calculated and compared between different groups. Patients were classified into two groups, those who admitted within 6 hours and those who admitted after 6 hours. Chi-square (χ²) test and multivariate logistic regression were used to estimate the determinants associated with delayed hospital admission. Effect of pre-hospital delay was determined using univariate and multivariate logistic regression. Results: 337 patients was enrolled in the study and their median (IQR) pre-hospital delay was 9.0 (13.0) hours. 39.5% patients admitted in the specialized hospital within 6 hours. In logistic regression, determinants of pre-hospital delay were patients age (for <40 years aOR 2.43, 95% CI 0.73-8.12; for 40 to 60 years aOR 0.44, 95% CI 0.21-0.93), family income (for lower income aOR 5.74, 95% CI 0.89-37.06; for middle income aOR 14.22, 95% CI 2.15-94.17), distance from primary care center £5 km (aOR 0.42, 95% CI 0.12-0.90), predominant chest pain (aOR 0.15, 95% CI 0.05-0.48), considering symptoms as non-significant (aOR 17.81, 95% CI 5.92-53.48), referral from primary care center (for government hospital aOR 4.45, 95% CI 2.03-9.74; for private hospital OR 98.67, 95% CI 11.87-820.34) and not having family history of MI (aOR 2.65, 95% CI 1.24-5.71). Risk of in hospital death was almost 4 times higher who admitted after 6 hours in multivariate logistic regression (OR 4.64, 95% CI 1.87-11.50). Conclusion: Delayed hospital admission after onset of MI is more common in Bangladesh compared to developed countries. Appropriate measures should be taken by policy makers to improve this situation.
Results of GPOH-HD-2003 study in treatment of Hodgkin’s lymphoma in children and adolescents in the Morozovskaya Children’s Clinical Hospital
Authors: Naumova A. S. , Tiganova O. A. , Ilyenko L. I. , Lavrukhin D. B. , Kondratchik K. L. , Baybak O. I. , Bronin G. O. , Maltseva M. A. , Makhmudova G. N. , Makhortykh T. Zh. , Mutorova O. Yu. , Nepokulchitskaya N. V. , Sapelkina T. S. , Tomilin I. Ya. , Fuks O. Yu. , Shershakova E. A. 
Published: March 2020

Relevance. Hodgkin’s lymphoma (HL) is a rare clonal neoplasm of lymphatic tissue. In the structure of malignant neoplasms in children HL accounts for 4–6 % and for 16 % in adolescents. Now children and adolescents with confirmed histology of HL in the Department of Oncology and Hematology, Morozovskaya Children’s Clinical Hospital, treated with the GPOH-HD-2003 protocol. The authors of the article presented the experience of treatment children and adolescents with HL according to recommendations of GPOH-HD-2003 in the Department of Oncology and Hematology, Morozovskaya Children’s Clinical Hospital.Patients and methods. From January 1, 2003 until December 31, 2018, 62 patients (35 boys, 27 girls) received therapy according to recommendations of GPOH-HD-2003 study. Age of patients ranges from 4.7 to 17.6 years, mean age was 13.3 years. All patients are allocated to three treatment groups (TGs) based on staging, in TG-1 were 2 patients, in TG-2 – 30 patients, in TG-3 – 30 patients. TG-1 patients received two courses of for induction: OEPA for boys and OPPA for girls. TG-2 and TG-3 patients received further two or four cycles COPP (girls) or COPDAC (boys), respectively. After chemotherapy all patients received initially involved-field irradiation with 19.8 Gy.Results. CTCEA grade 1 or 2 hematotoxicity was the most common recorded adverse reaction in the OEPA regimen for boys, grade 3 or 4 hematotoxicity – in the OPPA regimen for girls. Also hematotoxicity was more pronounced with COPP than COPDAC. Overall (OS), event-free (EFS) and relapse-free (RFS) survival rates at 5 years were 100 % for the period of the observation time (the median observation time was 48.12 months). No treatment-related deaths, relapses or second malignancies were recorded during this period.Conclusion. OS, EFS and DFS rates indicates high efficiency and low toxicity of GPOH-HD-2003 study regardless of the initial stage.
Cold Atmospheric Plasma as a Novel Therapeutic Tool for the Treatment of Brain Cancer
Authors: Adhikari Manish , Adhikari Bhawana , Adhikari Anupriya , Yan Dayun , Soni Vikas , Sherman Jonathan , Keidar Michael 
Published: March 2020

Background:
Studies from the past few years revealed the importance of Cold Atmospheric Plasma
(CAP) on various kinds of diseases, including brain cancers or glioblastoma (GBM), and hence coined a new
term ‘Plasma Medicine’ in the modern world for promising therapeutic approaches. Here, we focus on the efficacy
of CAP and its liquid derivatives on direct interactions or with specific nanoparticles to show pivotal roles in
brain cancer treatment.

Method:
In the present review study, the authors studied several articles over the past decades published on the
types of CAP and its effects on different brain cancers and therapy.

Results:
A growing body of evidence indicates that CAP and its derivatives like Plasma Activated Media/ Water
(PAM/PAW) are introduced in different kinds of GBM. Recent studies proposed that CAP plays a remarkable
role in GBM treatment. To increase the efficacy of CAP, various nanoparticles of different origins got specific
attention in recent times. In this review, different strategies to treat brain cancers, including nanoparticles, are
discussed as enhancers of CAP induced targeted nanotherapeutic approach.

Conclusion:
CAP treatment and its synergistic effects with different nanoparticles hold great promise for clinical
applications in early diagnosis and treatment of GBM treatment. However, results obtained from previous studies
were still in the preliminary phase, and there must be a concern over the use of optimal methods for a dosage of
CAP and nanoparticles for complete cure of GBM.
Dietary Baicalin Zinc Supplementation Alleviates Oxidative Stress and Enhances Nutrition Absorption in Deoxynivalenol Challenged Pigs
Authors: Zha Andong , Cui Zhijuan , Qi Ming , Liao Simeng , Chen Lixin , Liao Peng , Tan Bie 
Published: March 2020

Background:
Deoxynivalenol contamination is increasing worldwide, presenting great challenges to food
security and causing great economic losses in the livestock industry.

Objective:
This study was conducted to determine the protective effect of baicalin zinc as a dietary supplement on
pigs fed with a deoxynivalenol contaminated diet.

Methods:
A total of 40 weaned pigs (21 d of age; 6.13 ± 0.42 kg average BW) were randomly assigned (10
pigs/group) to 4 dietary treatments: basal diet (Con group), basal diet + 4 mg/kg DON (DON group), basal diet +
5 g/kg BZN (BZN group), and basal diet + 5 g/kg BZN + 4 mg/kg DON (DBZN group) for a 14-d period. Seven
randomly-selected pigs from each treatment were killed for blood and tissue sampling.

Results:
The results showed that piglets challenged with DON exhibited significantly reduced levels of ADG, ADFI,
and F/G (p < 0.05). BZN supplemented diets significantly suppressed the protein expression of p-Nrf2, p-NF-kB, and
HO-1 in the jejunum of DON challenged piglets (p < 0.05). In liver, DON markedly increased the mRNA expression
of P70S6K and HSP70 in piglets fed the basal diet, but significantly reduced that of HO-1, NQO-1, NF-kB,
AMPKα2 and HSP70 in piglets fed the BZN supplemented diet (p < 0.05). Dietary supplementation with BZN
markedly increased the T-AOC level of serum in weaned piglets (p < 0.05). In jejunum, dietary supplementation with
BZN activated the mRNA expression of ZIP4 in piglets (p < 0.05), BZN supplementation significantly suppressed
the activity of sucrose and increased the protein concentration in chyme (p < 0.05).

Conclusion:
BZN can play a protective role by reducing oxidative stress and enhancing nutrient absorption in pigs
fed DON-contaminated diets.