bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of chlorpyrifos oral exposure on the histomorphometric and kidney function in Wistar rat
Authors: Sakinah Elly Nurus , Wisudanti Desie Dwi , Abrori Cholis , Supangat Supangat , Ramadhani Laily Rahmah , Putri Indis Suyanto , Pamungkas Galang Cahyo , Arrobani Muhammad Hanif , Rahmadina Risa , Dirgantara Pandego Wahyu 
Published: July 2024

Abstract:

BACKGROUND:
Chlorpyrifos belongs to a broad-spectrum organophosphate insecticide that has high toxicity, is metabolized in the liver by the oxidation reaction, and can inhibit acetylcholinesterase activity. Acetylcholinesterase inhibition generates the reactive oxygen species and induces oxidative stress, which ultimately results in cellular damage like in the kidney. Examining blood urea nitrogen (BUN) levels, creatinine, and kidney histopathology is an appropriate indicator to assess the toxicity of chlorpyrifos to the degree of damage to cells and kidney tissue.

MATERIALS AND METHODS:
This research used to determine the effect of duration of exposure to chlorpyrifos and dose–response relationships is important for early detection of the effects of chlorpyrifos toxicity on health. The research study was a true experimental (completely randomized design) consisting of 30 subjects divided into 5 groups. Controlled Group (K1) given 1 mg/kg BW Tween 20 and NaCl 0, 9% until the 56th day. The chlorpyrifos exposed group (P1, P2, P3, and P4) was given chlorpyrifos 5 mg/kg BW for 7, 14, 28, and 56 days. After the treatment, BUN and creatinine levels were measured, and microscopic changes in the kidney were analyzed. The results of BUN, creatinine, and kidney histopathologic were analyzed using the analysis of variance statistical test.

RESULTS:
The data result showed that compared to the control group, there were significant increases of BUN and creatinine (P = 0.013 and P = 0.003). Histopathological examinations of kidney glomerulus diameter were also smaller compared to the control group (P = 0.00). All the data measurement indicates significant differences compared to the control group.

CONCLUSIONS:
We concluded that sub-chronic oral exposure to chlorpyrifos at low doses can damage the kidneys and cause kidney failure.
Out-of-pocket expenses and healthcare service utilisation among maintenance haemodialysis patients: A study at a tertiary care hospital in Udupi, Karnataka
Authors: Ramesan Anandhu K. , D’Souza Brayal , Sekaran Varalakshmi Chandra 
Published: July 2024

Background:
Financial burdens faced by patients in India suffering from chronic kidney disease (CKD) are linked to healthcare access and inadequate insurance coverage. This study analyses out-of-pocket expenses and explores their healthcare utilisation patterns.

Materials and Method:
This time-bound hospital-based cross-sectional study was conducted in a tertiary care hospital in Udupi district, Karnataka, among patients who have undergone haemodialysis (HD) treatment for at least a year. Following ethics approval and CTRI registration, informed consent was obtained from all the patients prior to data collection.

Result:
The study involved 109 HD patients. The direct medical and non-medical costs incurred by HD patients were Rs 9,400 (IQR = 13,700) and Rs 3,200 (IQR = 2,000), respectively. The monthly health-related OOPE was Rs 16672.0 (IQR = 14,630.0). Overall, 103 (94.5%) individuals had been hospitalised since they began HD, and 50.5% of patients were hospitalised within the past year. On linear regression analysis, it was observed that the joint monthly income (β 0.134, 95% CI 0.007 - 0.182, P value = 0.048), number of dialyses per week (β 1.14, 95% CI 7541.5 - 16551.07, P value < 0.001), and social security (β −1.02, 95% CI −13463.0 - 7982.56, P value < 0.001) exhibited significant correlations and served as predictors for household out-of-pocket expenditure (HROOPE) experienced by the patients.

Conclusion:
The study concludes that people receiving HD incur a considerable financial cost. Additionally, the CKD population uses healthcare services at a notable rate, including frequent hospital stays, visits to outpatient departments (OPDs), and emergency treatment, underscoring the pressing need for an increase in insurance coverage.
Nomophobia and its impact on mindfulness and self-efficacy among nurses: An analytical cross-sectional study in the institution of national importance, Western India
Authors: Sharma Karitika , Parihar Aashish , Sharma Suresh K. , Nebhinani Naresh , Mudakavi Irasangappa B. 
Published: July 2024

BACKGROUND:
The interaction between people and advanced information and communication technologies results in behavioral addictions, one of them is nomophobia. In a health care setting, nurses constitute a significant proportion of healthcare workers. Therefore, discovering the level of nomophobia and its impact on constructs such as mindfulness and self-efficacy is very important as this might affect the psychological and physical well-being of nurses, which can impact the quality of patient care. The study aimed to assess the level of nomophobia and its relationship with mindfulness and self-efficacy of nurses.

METHODS AND MATERIAL:
An analytical cross-sectional study was carried out in a tertiary care hospital. A total of 420 nurses were selected using a convenience sampling technique. Self-structured questionnaire was used to assess socio-demographic characteristics and mobile phone use. Standardized questionnaires were administered in pen and paper format for measuring nomophobia, mindfulness, and self-efficacy. Statistical Package for Social Sciences (SPSS) version 20.0 was used. Karl Pearson’s correlation coefficient and Chi-square test were employed to analyze the data.

RESULTS:
The majority of nurses (99.5%) had nomophobia. About half of them (53.3%) had a moderate level of nomophobia. Nearly half of nurses had high level of mindfulness (52.6%) and self-efficacy (53.3%) respectively. Further, nomophobia was found to be negatively correlated with mindfulness (r = -0.289) and self-efficacy (r = -0.278).

CONCLUSION:
Nomophobia poses a risk to the mindfulness and self-efficacy of nurses. Continuing education should focus on awareness programs emphasizing good practices in the use of current technologies.
Assessing the impact of a respiratory care bundle on health status and quality of life of chronic obstructive pulmonary disease patients in Jordan: A quasi-experimental study
Authors: Saifan Ahmad R. , Elshatarat Rami A. , Sawalha Murad A. , Khraim Fadi , Ibrahim Ateya M. , Zaghamir Donia E. , Saleh Zyad T. , Hamdan Khaldoun M. , AbuRuz Mohannad E. , Al-Bashaireh Ahmad M. 
Published: July 2024

BACKGROUND:
This study aimed to evaluate the effectiveness of a respiratory care bundle, including deep breathing exercises, incentive spirometry, and airway clearance techniques, on the quality of life (QoL) of chronic obstructive pulmonary disease (COPD) patients in Jordan.

MATERIALS AND METHODS:
A quasi-experimental study design and convenience sampling method was used to recruit 120 COPD patients, with 54 in the intervention group and 66 in the control group. The intervention group received additional respiratory care bundle training, while the control group received only discharge instructions and an education program. The St. George’s Respiratory Questionnaire (SGRQ-C) was used to assess participants’ QoL before and after the intervention. Independent t-tests, paired t-tests, and analysis of covariance (ANCOVA) analysis were used to analyze the data.

RESULTS:
The study found no significant differences between patients’ characteristics, health status, and SGRQ-C scores between the two groups at baseline. After the intervention, there were statistically significant differences in all SGRQ-C subscales, which were lower in the intervention group compared to the control group. The paired t-test showed significant reductions in all SGRQ-C symptoms components (t = 7.62, P < .001), activity component (t = 7.58, P < .001), impact component (t = 7.56, P < .001), and total scores post-intervention (t = 7.52, P < .001) for the intervention group. The ANCOVA analysis showed significant differences in scores of SGRQ-C components and total scores (f = 11.3, P < .001) post-intervention between the two groups.

CONCLUSION:
The study’s findings suggest that providing additional respiratory care bundle training for COPD patients can significantly improve their QoL, as measured by the SGRQ-C scores. The respiratory care bundle intervention was effective in reducing COPD symptoms and improving the QoL of COPD patients. Healthcare providers should consider implementing respiratory care bundles as part of COPD management to improve patients’ outcomes.
Evaluation of Emergency Severity Index (ESI) triage quality by nurses and associated factors in Iran
Authors: Razavian Ali , Mohamadirizi Shahla , Heydari Farhad , Nasr-Esfahani Mohammad 
Published: July 2024

INTRODUCTION:
The triage process of patients in emergency departments is done by nurses in Iran. it is necessary to pay attention to the ability of nurses in patients’ triage in order to have a correct picture of the status of the emergency department, so the aims of this study is to investigate the quality of nurses’ triage using the Emergency Severity Index (ESI) method and related factors.

MATERIALS AND METHODS:
This is a descriptive study which was performed on all 900 patients referring to the emergency department during 12 months from 2019 to 2020 in the Triage unit of two trauma center hospitals affiliated to Isfahan university of medical sciences. Data collection tools included patients’ demographic, nurses’ demographic and occupational checklist, and ESI Triage Form. To analyze the data, SPSS software was used, descriptive and analytic statistics were used, P < 0.05 was considered statistically significant.

RESULTS:
No significant difference was observed between the quality level of triage by nurses and physicians (P > 0.05), the results of independent t-test showed that nurses in the over triage group have a higher average age and work experience. In the under triage level, the frequency of female nurses was significantly higher than male nurses (P < 0/05).

CONCLUSION:
Accurate and fast triage of patients is the key to successful performance in the emergency department. Therefore correct implementation of triage and identifying the need for nurses for training and identifying existing deficiencies are of utmost importance.
Internalization of multicultural education in improving students’ multicultural competence
Authors: Mardhiah Mardhiah , Ginting Dafid , Mumfangati Titi , Meisuri Meisuri , Fatmawati Endang , Jannah Misbahul , Siyono Siyono , Haris Muhammad , Saputra Nanda 
Published: July 2024

BACKGROUND:
This article aims to describe multicultural education in improving students’ multicultural competence. It is very important to teach multicultural values in the school environment to help students understand the importance of mutual respect. Multicultural education is very significant for its application in Indonesia, in the midst of racial, religious, cultural, and customs diversity.

MATERIALS AND METHODS:
This study uses a qualitative research approach with the Meta-Synthesis method to map research results from several kinds of literatures. The number of articles studied in this research was 27 articles. School is the most effective place in developing students’ multicultural competence; therefore, schools must implement learning that prioritizes multicultural principles without discriminating against cultural, racial, linguistic, and cultural backgrounds of students.

RESULT:
The results of this study indicate that 1). The concept of multicultural education applied in schools is able to increase students’ multicultural competence and 2). Students are more open to dealing with existing differences. As for the results of research in an elementary school education environment which is the object of research, this is based on the importance of multicultural education being implemented from an early age.

CONCLUSION:
Multicultural education is very important to increase awareness and tolerance among students. By internalizing multicultural education, students can interpret differences as a matter of course and make students more open to others both in the school environment and in the community environment.
Effectiveness of “Rule of Seven” intervention in improving control status in diabetes mellitus protocol of a randomized controlled trial
Authors: Singhal Kritika , Taywade Manish , Patro Binod K. , Pal Debkumar , Behera Priyamadhaba , Mishra Abhisek K. 
Published: July 2024

BACKGROUND:
We developed the “rule of seven” intervention because different targets related to diabetes control can somehow be calculated by multiplication of seven. This study aimed to evaluate the effectiveness of the “rule of seven” in improving glycemic control in patients diagnosed with diabetes by measuring fasting plasma glucose and 2 hours postprandial plasma glucose.

MATERIALS AND METHODS:
This two-arm randomized controlled trial will compare the effectiveness of the “rule of seven” intervention in achieving glycemic control in diabetes mellitus patients. The patients in the control arm will receive routine patient counseling related to diabetes mellitus. Patients registered with the noncommunicable disease (NCD) clinics of All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Community Health Center (CHC) Tangi, and CHC Mendhasala will be recruited consecutively during clinic hours after fulfilling eligibility criteria and obtaining written informed consent. The sample size was estimated as 426 in each group. The ethical permission was obtained from the Institutional Ethics Committee (IEC) and prospectively registered in the Clinical Trial Registry of India (CTRI/2023/07/055522).

DISCUSSION:
After the intervention, we will find out the change in knowledge regarding parameters related to glycemic status; discover the change in biochemical parameters after 1, 3, and 6 months; and conclude whether those changes are statistically significant or not.
Mind mapping to enhance critical thinking skills in respiratory therapy education
Authors: Turkestani Faisal A. , Zipp Genevieve P. , Nufaiei Ziyad Al , Zhranei Raid Al , Alhadian Fahad , Hakeem Jameel , Ismaeil Taha , Algarni Saleh S. , Al-Ahmari Ayedh D. , Homoud Mazen 
Published: July 2024

BACKGROUND:
The objective of this study was to investigate the use of mind maps as an active teaching strategy to enhance critical thinking skills (CTSs) among respiratory therapy (RT) students in Saudi Arabia.

MATERIALS AND METHODS:
A total of 86 participants from two RT programs in Saudi Arabian Universities, King Saud bin Abdulaziz University for Health Sciences and The Batterjie Medical College, were randomly assigned to either the mind map group (MMG) or the standard note-taking group (SNTG). With the quasi-experimental design and quantitative method, mean comparisons were made between the groups using an independent t-test.

RESULTS:
There was no significant change between the pre-SNTG and post-SNTG as measured by the health sciences reasoning test (HSRT) after 15 weeks of standard note-taking (SNT). However, it showed the difference between the pre-MMG and post-MMG (P = .02) as measured by the HSRT after 15 weeks of intervention. There was also a significant change between the post-MMG and SNTG (P = .04) as measured by the HSRT, where the MMG had higher scores. However, the study had limitations, which conceded to the failure of participants in the test and the subjectivity of respondents where they were excluded from the study; also, for generalizability of the result, the study should have been taken beyond Riyadh and Jeddah.

CONCLUSION:
Prior to this study, the effectiveness of mind mapping (MM) in the respiratory discipline has not yet been explored. It found that mind mapping was effective at improving CTS, while SNT was not, as measured by pre- and post-test HSRT scores. This was the first investigation into MM’s impact on CTS within respiratory therapy education.
The effect of family-centered education on posttraumatic stress symptoms in mothers of premature infants hospitalized in the NICU
Authors: Rajabzadeh Zahra , Yoosefi Naser , Navidian Ali , Kordsalarzehi Fatemeh 
Published: July 2024

BACKGROUND:
Premature infant hospitalization in the neonatal intensive care unit (NICU) is considered a traumatic event for mothers. It is critical to provide instructions and support to couples to help them emotionally adapt and reduce posttraumatic stress. The aim of the present study was to determine the effect of family-centered education on posttraumatic stress in mothers of premature infants hospitalized in the NICU.

MATERIALS AND METHODS:
The present study was a quasiexperimental study. The parents of 80 premature infants admitted to the NICU ward of a hospital in southeastern of Iran in 2020 were divided into two groups of 40 intervention and control. The intervention group received five sessions of family-centered program on daily basis with an average of 60 minutes per session; sessions were held in the presence of both couples and for each couple separately. The control group received only training and usual care. Six weeks after intervention, information was collected using the posttraumatic stress disorder checklist. Data were analyzed using the paired t-test, independent t-test, Chi-square test, and covariance analysis.

RESULTS:
The intervention and control groups’ mean posttraumatic stress scores before family-centered care were 49.65 ± 8.73 and 55.45 ± 10.39, respectively. Six weeks after the intervention the score decreased significantly to 32.75 ± 6.05 and 44.82 ± 6.53. Also, the mean score changes in the intervention group (-16.90 ± 7.69) were significantly higher than those in the control group (-10.63 ± 6.12).

CONCLUSIONS:
Family-centered education has a positive effect on reducing the severity of posttraumatic stress in mothers of premature infants admitted to NICU.
A comprehensive interventional program for promoting sexual function in postmenopausal women: Protocol for a mixed methods study
Authors: Moradi Maryam , Noroozi Mahnaz , Mostafavi Firoozeh , Beigi Marjan 
Published: July 2024

BACKGROUND:
Menopause is a natural event in women’s life that leads to physical, psychological, and social consequences. A fundamental health concern in postmenopausal women is problems with their sexual function. This study aims to design an interventional program to promote sexual function in postmenopausal women.

MATERIALS AND METHODS:
This sequential exploratory mixed methods study will be conducted in three phases. The first phase will be a qualitative study with a content analysis approach. The participants will be selected using a purposive sampling in Isfahan, Iran. The data will be collected through in-depth interviews and field notes and analyzed using conventional content analysis. In the second phase, the intervention will be designed and finalized to promote sexual function in postmenopausal women using the results of qualitative study and literature review, asking experts’ opinions, and holding specialized panels. In the third phase, the intervention will be implemented (in the form of a quasi-experimental study) and the effect of the intervention will be determined. In this phase, the data will be collected using the female sexual function index. Finally, an appropriate interventional program will be presented.

CONCLUSION:
It is hoped to promote sexual function in postmenopausal women by conducting this study and implementing an appropriate interventional program that is culturally sensitive. If it is proved that the intervention is effective, a basis for health policy–making to promote sexual health in postmenopausal women can be provided by presenting evidence and increasing the knowledge in this field of health.
Do patients need additional coverage for chronic ailments? Insights from hospital data
Authors: Sugunan Aswin , Pillai K Rajasekharan , D’souza Brayal , George Anice 
Published: July 2024

BACKGROUND:Eliminating financial barriers and improving healthcare accessibility pertain to be key elements of the United Nation’s sustainable development goals. These have directed health policymakers to advocate private health insurance as a health promotion strategy to enable patients to obtain absolute and affordable medical care when needed. Against this backdrop, the current study investigates the coverage trend and financial risk-protective nature of private health insurance plans.MATERIALS AND METHOD:We examined 12 months’ hospital billing data of private health insurance holders with cancer, cardiac, neurological, and renal diseases. The billing and insurance claim data of 5002 patients were extracted from the billing section of a tertiary care teaching hospital located in southern India from April 2022 through March 2023. Five per cent of patients from each disease condition were selected through proportionate random sampling for analysis (n= 250). The cost incurred and reimbursement trend under various cost heads were investigated by examining the cost incurred by the patient during the hospitalization and comparing it with the amount reimbursed by the insurance company.RESULTS:The scrutiny exhibits that private health insurance fails to provide comprehensive coverage, resulting in under-insurance among subscribers. Reimbursement received for each cost category is also discussed. To the best of our knowledge, this is the first study that has used institutional data instead of large survey data or patient data.CONCLUSION:The research concludes by soliciting policymakers, healthcare providers, and insurers to develop strategies to enhance the affordability and accessibility of healthcare to promote health and wellness.
Investigating the depression, anxiety, and stress-related factors in near-miss mothers
Authors: Amiri Marjan , Kohan Shahnaz , Heidari Zeinab 
Published: July 2024

BACKGROUND:
Life-threatening complications during pregnancy and childbirth could have an impact on the physical and mental health of mothers. The present research aimed to investigate the factors related to depression, anxiety, and stress among mothers who have survived maternal near-miss situations.

MATERIALS AND METHODS:
This is a descriptive-analytical study, and the data have been collected cross-sectionally. Near-miss mothers who had given birth within the past year were selected through the census method (having at least one criterion of the clinical, laboratory, and management standard of the World Health Organization). The Depression, Anxiety, and Stress Scale (DASS-21) and a demographic questionnaire on personal, family, fertility, and care information were filled out by these mothers.

RESULTS:
One hundred fifty-four near-miss mothers were investigated. The findings indicated that lack of social support, domestic violence, and marital dissatisfaction leads to a significant increase in the mean score of depression among near-miss mothers. In addition, according to the findings, an unemployed spouse, low level of education, lack of social support, recent unintended pregnancy, high blood pressure, and bleeding during pregnancy result in a significant increase in the mean score of stress among near-miss mothers. The findings also showed that domestic violence, a history of infertility, heart disease, and bleeding complications significantly increase anxiety in near-miss mothers.

CONCLUSION:
Considering the high levels of depression, anxiety, and stress in near-miss mothers, it is of utmost importance to pursue and check up on their mental health, as they are one of the most vulnerable groups in society. It is crucial to provide them support long after discharge to reintegrate these mothers into normal living as per the present study’s findings.