bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of internet addiction among high school students in a rural Southern Karnataka, India—A cross-sectional study
Authors: Kumar S. J. Naresh , Ruhela Aaditya 
Published: April 2024

BACKGROUND:
According to the World Health Organization, there is an explosion in the use of electronic devices, the internet, and gaming platforms. In many countries, it is a significant public health concern, prompting calls to identify adequate public policy. We aimed to investigate the prevalence of internet addiction (IA) among high school students and to assess the relationship between the internet addiction level of high school students and their demographic features with internet use.

MATERIALS AND METHODS:
A cross-sectional study was conducted among 424 high school children studying in eighth standard–tenth standard. Among 121 public and private high schools listed by the BEO (Block Education Officer) Office in Kolar Taluk four high schools were selected by lottery method from July 2021 to August 2021. The Internet Addiction Test (IAT) by Young was used to assess the intensity of internet usage.

RESULTS:
The mean IAT score of study participants was 29.6. The mean age of the study population was 14.4 ± 0.84 years. The odds of internet addiction among female students were 4.5 times higher than among male students. The majority (91.5%) of the students had used the internet for educational purpose and the other common reasons for internet usage is social media (43%), entertainment (43%), and gaming purpose (21%).

CONCLUSION:
The prevalence of IA among high school students is 14.6% with the moderate-risk population was 12.5% and the high-risk population was 2.1%. Students using the internet for both academic and non-academic purposes were more internet addicted. The real challenge is to have control over the usage of social sites—the amount of time being spent and the type of activities adolescents are doing online.
Evaluation of antenatal care utilization and its effects on obstetric and newborn outcomes at a public and private hospital of Karnataka: A comparative study
Authors: Motappa Rohith , Shetty Pratham , Acharya Srivatsa 
Published: April 2024

BACKGROUND:
Neonatal outcomes and perinatal mortality are directly and significantly impacted by the use of appropriate antenatal care (ANC) during pregnancy. The objective of this study is to evaluate the association between the use of prenatal services and maternal and newborn outcomes in both public and private healthcare settings.

MATERIALS AND METHODS:
This study was carried out in two tertiary healthcare setups in Mangaluru, Karnataka: Government Lady Goschen Hospital (LGH) and Kasturba Medical College Hospital (KMCH) Attavar. Data were collected from 150 women who were a part of the study. Microsoft Excel was used to compile the data, and SPSS version 25 was used to analyze it.

RESULTS:
We found that 58 out of 90 women admitted to LGH went for ANC check-ups at least four times during their gestation period and the rest of them went eight times or more, compared to just 3 out of the 60 women admitted at KMCH who went at least four times, whereas the rest went eight or more. The number of checks the mother takes appears to affect the term of the gestation with fewer preterm seen in patients who have come for a minimum of eight ANC visits, a higher risk of abnormal weight gain during pregnancy, and a lower risk of giving birth to preterm babies.

CONCLUSION:
The study reveals that private healthcare setups offer more antenatal services, including hospital visits, routine testing, supplements, and doctor advice. The number of antenatal visits is a significant difference between public and private healthcare setups. The public setup requires a minimum of four antenatal care visits, while the updated 2016 version requires eight. The number of antenatal visits affects both mother's and neonatal outcomes. A higher number of visits leads to fewer preterm births and a higher risk of abnormal weight gain. Education also influences the frequency of antenatal visits. The study suggests increasing the frequency of prenatal care visits and improving public education on this matter.
Perception of undergraduate medical students on learning physiology: A descriptive cross-sectional study in a medical school of South India
Authors: Ashwathy VT , Avanthi E , Narayanam Harini , Lokesh BN 
Published: April 2024

BACKGROUND:
Understanding the various principles in physiology is very important for medical students to apply their knowledge in clinical practice. Most of the students learn physiology just to clear exams. There is a need to understand the student’s perception on the significance of learning physiology in medical colleges, its role in clinical practice, research, and the subject of career choice.

MATERIALS AND METHODS:
A descriptive cross-sectional questionnaire-based study was conducted in a medical college in Karnataka, India. A total of 100 medical students studying in year 2 MBBS were enrolled into the study. Responses were collected, validated, and analyzed to understand the perception.

RESULTS:
All the participants (100%) felt physiology is an important subject in the medical curriculum and 93% of participants felt physiology knowledge was essential to become a better doctor. It was observed that 48% of the participants were interested in pursuing research in physiology and only 24% of the participants agreed on considering physiology as a carrier option.

CONCLUSIONS:
Medical students perceived physiology as an important and interesting subject in the medical curriculum. However, only few of the students were inclined to do research in physiology and agreed on pursuing physiology as a carrier option. The scope of study in physiology is vast due to the large variety of interdisciplinary topics included in different systems. Subsequent decrease in job opportunity, lack of awareness of research opportunities, and lower pay scale in the medical colleges in India lead to less interest in students for considering physiology as a carrier option.
Cardiovascular autonomic evaluation and body fat analysis in COVID-19-recovered patients in Dakshina Kannada, India
Authors: Balakrishnan Grrishma , Bangera Shobith , Balasubramaniyam Kalpana , Thalanjeri Padmini , Beeran Nabeel , Uppinakudru Gurunandan , Soofi Anwar Amemar 
Published: April 2024

BACKGROUND:
The pandemic, coronavirus disease 2019 (COVID-19) has led to a heavy toll on the human health. The aim of this study was to determine the influence of body fat distribution, evolving long-term effect on autonomic function, and its correlation with Chalder Fatigue Severity Score in post-COVID-19-recovered individuals of Indian ethnicity.

MATERIALS AND METHOD:
A case–control study was conducted in the Department of Physiology on 31 cases and 29 age- and gender-matched controls. Cardiovascular evaluation including heart rate variability (HRV), galvanic skin response (GSR), body fat analysis, and Chalder Fatigue Severity Score was performed on the study participants. The continuous variables of basal anthropometric parameters, GSR values, HRV indices, and body fat parameters are expressed as mean and standard deviation (SD).

RESULTS:
Diastolic blood pressure (DBP) was significantly increased among cases (P = 0.04). GSR (average) for cases is higher when compared to controls and was borderline significant (P = 0.05). There were no statistically significant differences in the HRV parameters. Cases showed significantly higher body fat distribution as compared to the control group indicating increased susceptibility of the obese population to COVID-19. Chalder’s post-COVID-19 Fatigue Severity Score of cases showed a negative correlation with LF:HF and RMSSD but it was not statistically significant.

CONCLUSION:
In our study, we conclude that there was a significant increase in DBP and GSR (average) with significantly higher visceral fat percentage, body fat percentage, subcutaneous fat percentage, skeletal muscle percentage, and trunk fat percentage in cases as compared to the control group suggestive of higher propensity of obese individuals suffering from COVID-19 and resulting in dysautonomia as compared to the controls.
Delays in receiving Alteplase and related factors in patients with stroke referred to Shahid Beheshti Hospital in Kashan-Iran in 2020-2021
Authors: Sirousinejad Zahra Sadat , Dianati Mansour , Kheiran Mahdi , Sooki Zahra 
Published: April 2024

BACKGROUND:
The benefits of using Alteplase are time-dependent. This study aimed to evaluate delays between the onset of symptoms and the administration of Alteplase and related factors in patients with acute ischemic stroke (AIS).

MATERIALS AND METHODS:
In this cross-sectional study, 60 AIS patients receiving Alteplase were selected by census sampling from July 2020 to July 2021 from the eligible patients referred to Shahid Beheshti Hospital in Kashan, Iran. The data collection tool was a researcher-made questionnaire containing demographic information, time periods from the onset of symptoms to the injection of Alteplase, and associated factors. The required information was collected from the patients, their relatives, their health records, and Kashan Emergency Medical Service (EMS) information system. Data were analyzed in SPSS-16.

RESULTS:
Eighty-five percent of the 60 patients participating in the study were transferred to the hospital by EMS ambulances. The mean time intervals between different phases were as follows: Onset-To-Door (OTD) time 81.35 ± 33.76 minutes; Door-To-CT (DTC) scan time 16.12 ± 17.46 minutes; Door-To-Needle (DNT) time 51.30 ± 26.14 minutes; and the overall Onset-To-Needle (ONT) time 133.75 ± 39.17 minutes. Also, the mean ONT in people transferred by EMS was about 129 minutes, and the longest prehospital delay in these patients was related to the time between the arrival of the EMS ambulance to the hospital. Marital status and geographical location where the stroke had occurred showed a significant relationship with prehospital delay and pre-hospital notification (PHN) by EMS But there was no relationship between underlying diseases or economic status and prehospital delays; also, the patient’s diastolic blood pressure at the time of receiving Alteplase showed a significant relationship with in-hospital delay.

CONCLUSION:
The findings of the study showed that the majority of people trust and use EMS ambulances to transfer to the hospital and the time spent in different stages, from the onset of symptoms to the injection of the thrombolytic drug, was in an acceptable range in the patients.
Economic impact of government health expenditure: An application of the computable general equilibrium model to the Iran
Authors: Mohammad-Pour Saeed , Barkhordari Sajjad , Tabatabaei Sharareh Majdzadeh , Hadian Mohammad 
Published: April 2024

BACKGROUND:Considering the increase in health expenses and the government’s role in health financing, this study investigated the economic impact of increases in the share of the health sector in the government budget while taxes remain unchanged and government spending is fixed.MATERIAL AND METHODS:The economic model used in this study was a macroeconomic Computable General Equilibrium (CGE) model. This model was calibrated using a 2011 Social Accounting Matrix (SAM) Of Iran. The CGE model was solved with non-linear programming using the General Algebraic Modeling System package, version 2.50. The effect of this simulation on the government budget deficit, the production of different sectors of the economy, and the employment rate was investigated.RESULTS:Based on our fundings the elasticity of substitution in the agricultural and industrial sectors is higher than in the health and service sector. Also, the biggest decrease in production occurred in the industry, agriculture, and service sectors, respectively. With the doubling of the share of government spending in the health sector, the employment rate of this sector has increased by 40.9%, but the highest decrease in the ignition rate is related to the service sectors (−2.7%), agriculture (−0.23%), and industry (−0.14%).CONCLUSION:Increasing the share of government spending in the health sector in comparison with other sectors of the economy, provided that government spending is maintained in general, leads to a decrease in production and economic welfare. It seems that the Iranian government should seek to increase the sources of health financing and the share of government expenditures in the health sector with other ways in order to improve the health level of the society and have a positive effect on other economic sectors.
A comparative analysis of stress, anxiety, and social well-being of working mothers and stay-at-home mothers during the covid pandemic
Authors: Nadri Zahra , Torabi Fatemeh , Pirhadi Masoume 
Published: April 2024

BACKGROUND:
The role of mental health is crucial in maintaining the dynamism and productivity of any given society. In contemporary times, a significant proportion of the workforce is comprised of women and mothers. Working in healthcare facilities, where exposure to pathogenic agents is an everyday nuisance, can have detrimental effects on mothers’ stress and anxiety levels. Furthermore, such exposure can also endanger the health of both the family and society. Conversely, the employment of mothers could positively impact their social well-being. The primary objective of this study is to assess and compare the stress, anxiety, and social well-being scores of mothers employed in healthcare facilities and stay-at-home mothers during the COVID pandemic.

MATERIALS AND METHODS:
This study is a cross-sectional analysis of 246 mothers, equally divided into two groups: Mothers who work in health centers and stay-at-home mothers (123 individuals in each group). The study was conducted from 2021 to 2022, a multistage sampling method was utilized and two questionnaires were administered: The DASS 21 (21 questions) and the social well-being questionnaire (48 questions). The data were analyzed using SPSS 18, and descriptive and analytical tests (Independent Samples T-Test, Mann-Whitney) were employed.

RESULTS:
The mean age was 35.7 ± 7.1 for working mothers and 34.3 ± 6.3 for stay-at-home mothers. The average stress score for employed mothers was 5.72 ± 4.7, and for stay-at-home mothers, it was 7.16 ± 4.3, which indicates a statistically significant difference in stress levels between the two groups (P = 0.04). However, the two groups had no significant difference in the mean anxiety score (P = 0.08). The mean score for social well-being was 165.5 ± 18.4 for working mothers and 162.17 ± 21.2 for stay-at-home mothers. This difference was not statistically significant (P = 0.18). Except for the social acceptance dimension (P = 0.003), no statistically significant differences were observed in the social well-being dimension between the two groups.

CONCLUSION:
The social acceptance of working mothers appears to be greater than that of stay-at-home mothers. Higher social acceptance suggests that they hold a more positive outlook on people and are at ease in social situations, which may have helped to alleviate their stress and anxiety.
Role of handgrip strength in predicting the quality of life in older adults: A cross-sectional study
Authors: Eskandarzadeh Masoumeh , Mansour-Ghanaei Roya , Pourghane Parand , Chaboki Bahare Gholami 
Published: April 2024

BACKGROUND:
Quality of life (QOL) is a vital component in assessing the standard of living for seniors. Hand grip strength (HGS) is a widely used measure to diagnose muscle strength decline that often occurs due to age-related loss of skeletal muscle mass and function. This study focuses on the HGS in predicting the QOL of older adults who are referred to retirement centers in Guilan Province.

MATERIALS AND METHODS:
In 2021, a cross-sectional analytical study was conducted among 115 older adults who were residing in retirement centers located in Guilan Province, Northern Iran. The participants were selected using a two-stage sampling method, where three retirement centers were randomly chosen followed by convenience sampling from each center. The selected retirement centers were situated in Langrod, Sowme’eh Sara, and Rasht cities in the east, west, and center of the province, respectively. The data were collected through a demographic information questionnaire, QOL scale (CASP-19), and HGS measurement using a dynamometer.

RESULTS:
Of the participants, 57.4% were male, 51.3% had middle income, and 96.5% were categorized as young elderly. The mean overall QOL score was found to be 37.026 ± 6.123, while the mean HGS level was 31.74 ± 7.45 and 18.48 ± 5.13 among males and females, respectively. There was a significant association between the level of education and QOL (P = 0.002). Moreover, there was a positive and significant correlation between HGS and QOL (r = 0.54, P = 0.001). The results of the multiple linear regression identified HGS as a predictor of QOL (Adj R2 = 0.44, βHGS = 0.79).

CONCLUSION:
Given that HGS has been identified as a predictor of QOL in older adults, improving this factor through exercise can lead to enhancement in their QOL. Therefore, regular sports exercises can be recommended as a means of improving HGS and subsequently enhancing the QOL of older adults.
Effective factors in planning, implementation, and management of educational program evaluation in medical sciences: A practical guide
Authors: Salajegheh Mahla 
Published: April 2024

BACKGROUND:Educational program evaluation is a complex issue, and it is essential to have knowledge of the potential challenges and solutions during the whole process. The present study aimed to identify the influential components in planning, implementation, and evaluation management of educational programs in medical sciences and then provide an applied guide to guarantee the best possible evaluation by evaluators of educational programs.MATERIALS AND METHODS:This descriptive study was conducted in three steps. First, the effective components in planning, implementation, and evaluation management of educational programs in medical sciences were reviewed. Second, experts’ opinion was asked through a focus group discussion regarding the mentioned components. Third, regarding the complied applied guide, the opinions of 40 medical educationist and program evaluation experts were investigated using a checklist.RESULTS:An applied guide for planning, implementation, and evaluation management of educational programs in medical sciences consists of eight stages: determining the evaluation questions and standards, determining the type of information required, determining resources to collect information, determining methods and tools to collect information, determining data analysis methods, determining the timing and frequency of reporting, determining the appropriate ways of reporting, and determining strategies to maintain the cooperation of data sources.CONCLUSION:The spread of educational programs in medical sciences universities leads to an increasing need for program evaluation to provide evidence of their effectiveness and improvement. The present research provided an applied guide to make the evaluation of educational programs feasible by using a set of concepts, principles, methods, theories, and models.
Psychometric evaluation of a new instrument to hookah tobacco smoking-related factors in the Iranian female university students based on the Extended Parallel Process Model
Authors: Zamani-Alavijeh Fereshteh , Heidari Zahra , Mostafavi Firoozeh , Bashirian Saeed , Makvandi Zeinab , Kelishadi Roya 
Published: April 2024

BACKGROUND:
The higher prevalence of hookah tobacco smoking (HTS) has become worrisome in women. Thus, it is essential to identify and measure the perceptions associated with this unhealthy behavior as well as the type of response to risk messages to design the effective programs. This study aimed to psychometric evaluation of a new instrument, named the Extended Parallel Process Model-Hookah Tobacco Smoking Questionnaire (EPPM-HTSQ), for female university students.

MATERIAL AND METHODS:
This methodological study was conducted in 2019–2020 in central and western Iran. The first version of the instrument was developed with 97 items. Face, Content, and construct validity methods were used to assess the EPPM-HTSQ validity. The data viability for factorability was guided through Kaiser-Meyer-Olkin (KMO) measure of sample adequacy (Values >0.7) and Bartlett’s test of Sphericity (P < 0.05). The Exploratory Factor Analysis (EFA) method with varimax rotation and SPSS software was performed to identify the main factors of the questionnaire and interpretable factors. The internal consistency and external reliability were determined. The test–retest was used for evaluating the stability of tools.

RESULTS:
During the assessment of the face and content validity 71 items remained in the questionnaire. EFA led to the extraction of nine dimensions: “Focusing on superior rewards,” “Response Efficacy,” “Perceived physical threat,” “Perceived social threat,” “Self-efficacy,” “Fear control,” “Attitude,” “Fear,” and “Intention” Kaiser-Meyer-Olkin (KMO) test (0.957) and Bartlett’s test (P < 0.001). Cronbach’s alpha (0.871–0.951) and ICC (0.985–0.998) were approved for scale dimensions.

CONCLUSION:
Important findings of the present study were the development and validation of the EPPM-HTSQ for measuring EPPM variables in relation to HTS; introducing a new variable “focusing on superior rewards”; as well as, the new classification of the concept of “perceived threat.” The final version of the EPPM-HTSQ is a valid and reliable tool, but it is suggested to be re-evaluated in other studies with different populations and sample sizes.
Relationship between professional self-concept and perceived organizational support with family functioning in nurses in Isfahan, Iran
Authors: Sahraian Leila , Alavi Mousa , Ghaedi-Heidari Fatemeh 
Published: April 2024

BACKGROUND:
Vocational issues affect nurses’ family functioning in long term. So the purpose of this study is to investigate the relationship between professional self-concept and perceived organizational support with nurses’ family functioning.

MATERIALS AND METHODS:
This descriptive correlational study conducted in hospitals affiliated to Isfahan University of Medical Sciences and 250 nurses who met the inclusion criteria participated in this study. The samples were selected conveniently from December 2022 to August 2022. To collect data, Cowin’s professional self-concept questionnaire, Eisenberger’s perceived organizational support questionnaire, and Epstein’s family function measurement were used. Data collection was done in one step and cross-sectional. Descriptive statistics and inferential methods of data analysis consisted of Pearson’s correlation coefficient and multiple linear regression were used. Data were analyzed with statistical package for the social sciences (SPSS) version 22.

RESULTS:
One of the six dimensions of professional self-concept consisted of staff relations significantly predicted the family function of nurses (P = .004). No significant relationship was found between perceived organizational support and nurses’ family function (P = .825).

CONCLUSION:
Promoting the healthcare organizations’ human climate may improve nurses’ wellbeing and hereby their family functioning which could further improve quality of healthcare services. It may be worthwhile to suggest supporting interpersonal and interprofessional relationships to ensure a healthy professional life for the nurses.