bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design, implementation, and evaluation of a CPOE system in a cancer care setting: A case study on the gastric cancer patients
Authors: Afrash Mohammad Reza , Kianersi Shirin , Bahadori Mohammadkarim 
Published: May 2024

BACKGROUND:
Chemotherapy is a complex, multi-disciplinary, and error-prone process. Information technology is being increasingly used in different health care settings with complex work procedures such as cancer care to enhance the quality and safety of care. In this study, we aimed to develop a computerized physician order entry (CPOE) for chemotherapy prescribing in patients with gastric cancer and to evaluate the impact of CPOE on medication errors and order problems.

MATERIALS AND METHODS:
A multi-disciplinary team consisting of a chemotherapy council group and system design and implementation team was formed for chemotherapy process evaluation, requirement analysis, developing computer-based protocols, and implementation of CPOE. A before and after study was conducted to evaluate the impact of CPOE on the chemotherapy process and medication errors and problem orders. To evaluate the level of end-user satisfaction, an ISO Norm 9241/110 usability questionnaire was chosen for the evaluation.

RESULTS:
Before the implementation of the CPOE system, 37 medication errors (46.25%) and 53 problem orders (66.25%) were recorded for 80 paper-based chemotherapy prescriptions. After implementation of the CPOE system, 7 (8.7%) medication errors and 6 (7.5%) problem orders were recorded for 80 CPOE prescriptions. The implementation of CPOE reduced the medication error by 37.55% and the problematic order by 58.75%. The results for usability evaluation indicate that the CPOE was within the first class of the ISONORM level rating; this shows that a CPOE is with very high satisfaction and a very high functionality rate.

CONCLUSION:
Developing a CPOE system significantly improved safety and quality of the chemotherapy process in cancer care settings by reducing the medication error, deleting unnecessary steps, improving communication and coordination between providers, and use of updated evidence-based medicine in direct chemotherapy orders. However, the CPOE system does not prevent all medication errors and may cause new errors. These errors can be human-related factors or associated with the design and implementation of the systems.
Development and validation of breastfeeding and dietary education package for women with gestational diabetes mellitus
Authors: Shuhaimi Farhanah Ahmad , Abdul Hamid Syahrul Bariah , Md Yazid Nurul Ainfarhanah 
Published: May 2024

BACKGROUND:Recent findings show that a longer breastfeeding duration and proper dietary management could lower the risk of postnatal diabetes. An excellent and interactive education module on breastfeeding and diet may effectively improve breastfeeding practices and dietary knowledge among women with gestational diabetes mellitus (GDM). Therefore, this study delves into developing and validating the content of Breastfeeding and Dietary Education Package (BFDEP) for women with GDM.METHOD:The development of the module involved three phases: need assessment, module development, and validation. Six experts deployed a content validity index (CVI) to evaluate three areas of the module, including objectives, structure or presentation, and relevance. Sixteen women with GDM were involved in the face validation process by assessing the “literacy presentation,” “illustrations,” “material is sufficiently specific,” and “quality of information.”RESULTS:Generally, I-CVI, S-CVI/Ave, and S-CVI/UA of the objectives, structure or presentation, and relevance revealed an excellent level of content validity. No alteration was needed for the domains of objective and relevance (S-CVI/Ave: 1.0, S-CVI/UA: 1.0). However, a minor revision was required in the structure or presentation domain (S-CVI/Ave: 0.98, S-CVI/UA: 0.90). The experts also thought that some module pages were wordy, and a change of font color was needed. The module was thus modified accordingly. For face validation, “literacy presentation” and “material is sufficiently specific” had a 99% positive response, while “illustrations” and “quality of information” had 100% positive feedback.CONCLUSION:A BFDEP with excellent content validity was developed and can be implemented to improve breastfeeding practices and dietary knowledge among women with GDM.
The live experience of coronavirus disease with emphasis on its psychological effects and consequences
Authors: Omidian Morteza , Rahmati Amin , Sepehrtaj Seyedeh Samaneh 
Published: May 2024

BACKGROUND:
The aim of this study was to investigate the living experience of coronary patients in Shiraz and the peak prevalence of the second stage in summer. This study could further examine these experiences in broader groups in subsequent studies. Identifying the psychological causes and effects of this disease with the help of patients involved in some countries has been considered.

MATERIALS AND METHODS:
The method, which was used in this study, was a qualitative method and content analysis. Participants in this study were 13 patients with COVID-19, some of whom were members of the medical staff. The participants were selected purposefully. The semi-organized interview with the participants continued until the theoretical saturation was reached.

RESULTS:
After extracting the codes, researchers classify them, and then the results were examined in more depth and categorized. About 120 extracted codes were classified into seven general categories; three of them were directly related to psychological issues. The other four of them were related to the subject of psychological effects and consequences.

CONCLUSION:
In general, during the interview process, it was proved that the more severe the symptoms of the disease, the psychological experiences of confronting the disease because of its outbreak, and the processes of coping with it were deeper.
The experience of Saudi respiratory therapists dealing with COVID-19 patients: A qualitative study
Authors: Al Nufaiei Ziyad F. , Alluhibi Reem H. , Almoshaigeh Sama N. , Alzahrani Raghad M. , Baaqeel Wed O. , Al Zhranei Raid M. , Al-Shareef Ali S. , Zipp Genevieve P. 
Published: May 2024

BACKGROUND:
Healthcare professionals have fought hard to restrain the COVID-19 pandemic by providing high-quality care for their infected patients, but in doing so they have developed fears of becoming sick and feelings of isolation and loneliness. The lived experience of respiratory therapists (RTs) in Saudi Arabia who works with these infected patients needs further investigation. The study sought to describe the experiences and coping strategies of Saudi RT managing patients with COVID-19.

MATERIALS AND METHODS:
The study utilized qualitative research methods, specifically employing a phenomenological research design. A total of 25 Saudi RT (RTs) who were in direct contact with COVID-19 patients were selected after they agreed to participate in this study. The study followed a one-on-one semi-structured interview process using the Zoom platform. This qualitative data collection technique focuses on the participants' lived experiences and feelings to discover shared patterns. The data were analyzed via an inductive approach.

RESULTS:
Six themes were found in the RT perceptions including stress while treating COVID patients, managing the fear of catching of Covid 19, feelings towards COVID-19 patients, challenges faced by female RTs, workplace experiences, and excessive workload.

CONCLUSIONS:
RTs feelings dramatically changed throughout the COVID-19 pandemic. All the RTs have developed a self-copying style that has helped them improve their psychosocial behavior to face the pandemic. During the outbreak, frontline RTs' positive and negative emotions intertwined and coexisted. Negative emotions predominated in the beginning, while good feelings emerged gradually. Self-coping methods and psychosocial development were significant factors in RTs mental health while caring for COVID-19 patients.
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.