bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of self-medication among the elderly: A systematic review and meta-analysis
Authors: Rafati Shideh , Baniasadi Tayebeh , Dastyar Neda , Zoghi Ghazal , Ahmadidarrehsima Sudabeh , Salari Nasibeh , Rafati Foozieh 
Published: May 2024

BACKGROUND:Self-medication is the use of unprescribed drugs to treat a disease. Elderly self-medication can be more dangerous compared to other age groups because of changes in organ functions that occur due to senescence. This study aimed to estimate the prevalence of self-medication in the elderly, its related factors, and common drugs used in this regard.MATERIALS AND METHODS:Electronic databases such as PubMed, Scopus, and Web of Science were searched between January 2016 and June 2021. The search strategy was built on two core concepts: “self-medication” and “aged”. The search was limited to original articles in the English language. A random effect model was used to estimate the pooled prevalence of self-medication. Heterogeneity among studies was assessed using both the I2statistic and the χ2test. Also, a meta-regression model was used to investigate the potential sources of heterogeneity of the studies.RESULTS:Out of 520 non-duplicate studies, 38 were included in the meta-analysis. Self-medication in the elderly ranged from 0.3% to 82%. The pooled proportion of self-medication was 36% (95% CI: 27%–45%). The result of the χ2test and the I2index (P< 0.001, I2= 99.90%) revealed notable heterogeneity among the included studies in the meta-analysis. The meta-regression showed a significant association between the sample size (adjusted β = −0.01;P= 0.043) and the pooled proportion of self-medication.CONCLUSION:The prevalence of self-medication in the elderly is high. Education through mass media to raise awareness about the dangers of self-medication can help solve this problem.
Investigating the effect of Swedish massage with chamomile oil on labor pain and anxiety of primiparous women: A clinical trial
Authors: Eskandari Fatemeh , Mousavi Parvaneh , Valiani Mahboubeh , Ghanbari Saeed , Iravani Mina 
Published: May 2024

BACKGROUND:
Labor pain and fear of childbirth increase anxiety and stress in pregnant women. Therefore, the present study was conducted with the aim of determining the effect of Swedish massage with chamomile oil on pain and anxiety in a clinical trial.

MATERIALS AND METHODS:
The present study is a clinical trial on 159 women who were referred to 22 Bahman Hospital in Masjid Sulaiman City in 2021. The samples were randomly divided into three groups (Swedish massage with and without chamomile oil and control group). Pain intensity was assessed using the McGill Pain Scale and anxiety was assessed using the Vandenberg Anxiety Questionnaire. The data were analyzed with SPSS-20 software at a significance level of 0.05. Descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (Chi-square, Fisher's exact, analysis of variance, and paired t) were used for data analysis.

RESULTS:
There were no significant statistical differences between the three groups in terms of obstetric and demographic information (P > 0.05). There was no significant relationship between the studied groups before the intervention in terms of labor pain intensity (P = 0.9) and anxiety (P-value = 0.426). After the intervention, the intensity of labor pain and mother's anxiety was significantly lower in the two intervention groups compared to the control group, and it was lower in the Swedish massage group with chamomile oil than the other two groups (P < 0.001).

CONCLUSION:
In the present study, Swedish massage with and without chamomile oil led to a decrease in pain intensity and anxiety. As a result, this method can be used as an effective method to reduce the intensity of pain and anxiety of pregnant mothers.
Development, implementation, and evaluation of a program to expand the nurse's roles in colorectal cancer prevention: A mixed-methods protocol study
Authors: Hashemi Narges , Bahrami Masoud , Tabesh Elham 
Published: May 2024

BACKGROUND:
Nurses play an important role in cancer prevention. However, studies conducted on nurses' roles, in the field of cancer prevention in Iran, are very limited. This study will identify the role of nurses and designs, implements, and evaluates a program to expand their role in the prevention of colorectal cancer (CRC).

MATERIALS AND METHODS:
This exploratory mixed-methods study will be performed using quantitative–qualitative methods in three consecutive stages. In the first phase, a qualitative study will be conducted to identify the potential and actual roles of nurses in Iran using in-depth semi-structured interviews. Participants will be selected by purposive and snowball sampling, followed by a literature review; the actual and potential roles of nurses at the primary, secondary, and tertiary levels of CRC prevention in Iran and around the world will be extracted. And the actual role is determined. In the second phase, the roles of nurses will be prioritized using the modified Delphi method, and the program will be designed. In the third phase, the part of the program will be implemented as a quasi-experimental intervention, and the effect of the intervention will be evaluated.

CONCLUSION:
Developing a program can provide some evidence for promoting nurses' position in cancer prevention. Moreover, it is expected that this program promotes knowledge and empowerment and the position of nurses to provide primary, secondary, and tertiary cancer prevention. The entry of nurses into the field of cancer prevention leads to better quality care and more cost-effectiveness.
Interpersonal relationships, subjective health, psychological well-being, and quality of life among older adults in south India: Evidence from a population-based study
Authors: Manchana Varalakshmi 
Published: May 2024

BACKGROUND:
Subjective health and well-being are closely linked with quality of life (QoL) in older adults. Self-reported health, happiness, satisfaction with life and interpersonal relationships, social support, loneliness, and social isolation make robust indicators for the psychological well-being of older adults. This study aimed to explore subjective health, psychological well-being and associated factors, and their relationship with QoL in older adults.

MATERIALS AND METHODS:
This was a cross-sectional, community-based survey that included adults aged 60 years and above (n = 260) who were living in selected communities. A semi-structured questionnaire was used to collect data on self-reported health, happiness, satisfaction with family and marital relationships, and felt loneliness and isolation. The relationship between psychological well-being and QoL was identified. Data analysis was carried out by descriptive and analytical statistical applications using Statistical Package for the Social Sciences (SPSS) version 20 at P ≤ 0.05.

RESULTS:
Study findings showed that a significant number of older adults (56%) reported poor general health; 56.4% of men and 59.2% of women were “not at all happy” with their family and interpersonal relationships, and 13.5% of respondents were not at all happy in general. Self-reported health (0.277**) and happiness (0.506**) were positively correlated with the psychological domain of QoL (P ≤ 0.01).

CONCLUSIONS:
The study findings identified the interrelationship between changing family and social relationships and psychological well-being of older adults, which is an immediate public health concern. Inadequate social support and deficient quality of interpersonal relationships predispose loneliness and isolation in later life. Strategies to promote social support and age-friendly social and healthcare resources are urgent needs for healthy aging.
The effect of web-based family-centered empowerment program in preventing the risk factors of substance abuse in students' parents; application of the health promotion model
Authors: Mehri Seyed M. , Hashemian Masoumeh , Joveini Hamid , Sharifi Nader , Rakhshani Mohammad H. , Assarroudi Abdolghader 
Published: May 2024

BACKGROUND:
The age of onset of substance abuse among adolescents has recently decreased worldwide. Parents play an important role in preventing their children from drug abuse. This study aimed to investigate the effect of web-based family-centered empowerment program in preventing the risk factors of substance abuse in students' parents, using the health promotion model (HPM).

MATERIAL AND METHODS:
This interventional study was based on 118 parents of high school students in Sabzevar, Iran (2019). Multi-stage random sampling was used to divide the participants into the experimental (n = 65) and control (n = 65) groups. The data were collected through a researcher-made questionnaire based on Pender's HPM. A website was designed to perform all stages of the study. The web-based educational intervention was performed for the experimental group. Both groups completed the questionnaires 2 months after the educational intervention. The data were analyzed using t-test, paired t-test, regression, correlation, and analysis of covariance.

RESULTS:
There was a significant difference between the scores of prior related behavior, perceived benefits of action, activity-related effect, situational influences, competitors, and commitment in the parents of the experimental group compared to the control group after the educational intervention (P-value < 0.05). Moreover, a significant difference was observed between preventive behaviors of substance abuse and the mean score of perceived barriers to action, perceived self-efficacy, interpersonal influences, and role model in the parents of the experimental group compared to the control group after the educational intervention (P-value < 0.05).

CONCLUSION:
Overall, designing an educational intervention based on the constructs of Pender's HPM could be an effective strategy for promoting preventive behaviors of substance abuse in parents.
Correlation of polypill and blood pressure level: A systematic review of clinical trials
Authors: Omrani Hamidreza , Bahremand Mostafa , Keshavarzi Fatemeh , Solouki Leila , Zereshki Ehsan 
Published: May 2024

BACKGROUND:
High blood pressure (BP) is considered as the most important risk factor for cardiovascular disease (CVD). The main aim of this study was to investigate the effect of polypill on BP by reviewing clinical trial studies.

MATERIALS AND METHODS:
In this systematic review study, online databases such as PubMed, Scopus, and Web of Science databases with no limited time were systematically searched until July 10, 2020. Clinical trial studies published in English that examined the effect of polypill on BP were included. BP was the main outcome investigated.

RESULTS:
Eleven original articles with a population of 17,042 people were reviewed. The polypill drugs studied in this study had different compounds. Compared to conventional care, treatment with polypill compounds has a positive and significant effect on lowering BP (P < 0.05).

CONCLUSION:
Our finding confirmed that polypills could reduce BP in patients. It seems that changing routine care and replacing it with a polypill strategy could facilitate the achievement of BP control goals.
Development and implementation of a self-directed learning readiness scale for undergraduate health professional students
Authors: Dulloo Puja , Singh Suman , Vedi Neeraj , Singh Praveen 
Published: May 2024

BACKGROUND:
To motivate students toward the path of lifelong learning, it is important to train them for a self-directed learning (SDL) approach, where they identify the need of learning the content as well as look forward to attaining the learning outcome, independently. The level of readiness for SDL will allow the learner to be self-disciplined, self-organized, an effective team builder and communicator, a self-assessor, and a self-reflector, thus being a self-learner with the ability to accept and give constructive feedback. The aim of the study was to develop, validate, and implement the SDL readiness scale for health professional students.

MATERIALS AND METHOD:
The readiness scale of 43 items was used in four sub-titles (awareness, learning strategies, and style, motivation, team building) was developed using the Delphi method with 12 experts and was implemented for the medical students at Karamsad, Gujarat as a cross-sectional survey after a pilot trial scale from May 2021 to September 2021, using mean, the standard deviation for each item, and arrived sub-titles. The ANOVA test was used to find differences in readiness scores as per different years of the medical program.

RESULT:
The result demonstrates that the maximum score was obtained for the first-year medical student (149.89 ± 24.72), which dropped in year 2 (136.35 ± 32.26) but increased by the final year (147.67 ± 56.66), although not as high as the initial joining year. However, a statistically significant difference per gender was identified for a few items of the scale [(items 24 (P < 0.034), 26 (P < 0.0005), 37 (P < 0.035), and 40 (P < 0.013)]. The logistic regression analysis showed no statistical significance for the DSVS-self-directed learning readiness scale (SDLRS) score and demographic variables.

CONCLUSION:
The outcome of the study strongly suggests training/sensitization sessions for students to highlight the importance of a SDL approach in a digital millennium. Moreover, a longitudinal follow-up needs to be conducted for the readiness score of the students based on the developed scale and subsequent training sessions need to be organized for students as well as faculty for better outcomes for the students toward SDL sessions.
Perception of Nepalese nursing students toward E-learning in Nepal
Authors: Das Nikita , Chaudhary Gautam P. , Yadav Sima , Yadav Usha , Yadav Asha K. , Chaudhary Sabina , Pandey Jitendra 
Published: May 2024

BACKGROUND:E-learning is the delivery of learning and training through digital resources. Although e-learning is based on formalized learning, it is provided through computers, tablets, and even cellular phones those are connected to the Internet. This makes it easy for users to learn anytime, anywhere, with few, if any restrictions.MATERIAL AND METHODS:A cross-sectional study was done, and data was obtained through an online survey method from September 14, 2020 to October 08, 2020. Questions were created in “Google Forms.” The targeted population was all nursing students from all over Nepal. There were a total of 365 respondents. A pilot study was done on 10 students. After the pilot study, the same question was distributed to all the respondents.RESULTS:Almost half (40.8%) got disturbed in their online class because of electricity; around half of the respondents (41.9%) are disturbed in their online class because of Internet problems. Moreover, around half of the respondents (44.4%) use the data pack daily, and 38.6% use the data sometimes.CONCLUSION:The study concludes that most students suffered from Internet disturbance and electricity problems during online classes. Because of electricity and Internet problems, most students feel anxious during class, and most of the students are not able to attend classes. Most students are compelled to use data packs for online classes. However, the course may not be completed if the problems arising during online classes are not solved.
Developing a module for early clinical exposure: Experience of five years
Authors: Kumar Pananghat A. , Govindarajan Sumitra , Ramalingam Sudha , Kumar Prasanna N. 
Published: May 2024

BACKGROUND:
Preclinical students often fail to appreciate the clinical relevance of basic sciences during the first year of undergraduate medical training, leading them to lose interest in the subject, and preventing them from achieving the desired goals. In order to rectify this gap in the curriculum, Medical Council of India (MCI) in 2011 published a document announcing curricular strategies including Early Clinical Exposure (ECE) to effectively modify the Indian system of education. Lack of proper guidance prevented many institutions from implementing ECE. Since our institution had run a similar program of “Clinical Observership” as early as 2001, we were able to implement ECE in an efficient way.

MATERIALS AND METHODS:
Early clinical exposure was implemented as a structured program, with the participation of 10 clinical departments since 2013. Feedback from the students, soon after ECE and also from the batch of CRRIs, who had undergone this program while they were preclinical students amply support the effectiveness of ECE in its contents and methods of implementation. Manual content analysis was performed on open comments. After reading the responses, they were broken down to meaning units, and these were then condensed. The condensed meaning units were labeled with codes. The codes were grouped into categories. Themes were derived from the categories.

RESULTS:
Out of the 70 CRRIs, 52 responded to the questionnaire. All the CRRIs except one said that ECE was very helpful during their clinical postings and internship period. They suggested that the number of hours of posting should be increased and also reiterated the fact that a greater number of clinical departments could be included in the program. Though the beneficial effects were felt in all the domains of learning, the most remarkable impact was felt in the affective domain, wherein changes are not easy to come by.

DISCUSSION:
Recently, National Medical Council has come out with plans of including ECE in the syllabus with strict time schedule. It is felt that the faculty will find our experience of running the program for the past five years helpful in implementing this program, for the fullest benefit of the preclinical students.
Experiences and challenges of nursing education in response to the COVID-19 pandemic: A qualitative study in Iran
Authors: Pourvakhshoori Negar , Karami Kimia , Sigaroudi Abdolhossein Emami , Adib Masoomeh , Salari Arsalan , Bazyar Jafar , Hosseini Seyed Ali 
Published: May 2024

BACKGROUND:
The preparedness of nurses in the COVID-19 pandemic, will be of great importance when it comes to the unknown future of the pandemic and other similar ones. Identifying their problems can lead to better planning, preparation, and management. This study aims to explore Iranian nurses' experience of their preparedness challenges to give an effective response to the pandemic.

MATERIALS AND METHODS:
A qualitative content analysis approach using semi-structured interviews was employed to explore nurses' preparedness experiences. 28 nurses were interviewed, after transcription of the interviews, a content analysis using constant comparison was performed for data analysis based on Graneheim and Lundman approach.

RESULTS:
The results of the study can be summarized in 6 main categories and 14 subcategories, such as the necessity of continuing educational workshops, the necessity of holding exercises in the same environment, the importance of familiarity with the pandemic, the importance of educating all those involved in providing services in the pandemic, the need for providing immersive education for the pandemic and the need for planning and practice concerning the pandemic.

CONCLUSION:
When nurses receive more support, they can have their best performance. up-to-date training can prepare nurses more effectively, which will, in turn, make prepared nurses available, maximize their efficiency, and minimize their adverse mental consequences. Nurse managers may support nurses and increase hospital resilience in such emergencies. Nurses indicated some issues including managers' support, workplace culture, education, physical space, access to PPE, and willingness to provide the best care. These findings can be helpful in the management of the pandemic and preparing nurses as a large group of healthcare workers. Necessary training, along with the provision of adequate resources, should be programmed to support this effective group of health providers.
Standard workload-based estimation of nursing manpower requirement in the ICU of a tertiary care teaching hospital: A time and motion study
Authors: Rani Ritu , Sharma Suresh K. , Gupta Manoj K. 
Published: May 2024

BACKGROUND:
The safety of patients remain at risk due to a higher workload and lower nurse-to-patient ratio. However, in India, most hospitals still adhere to long-known nurse staffing norms set by their statutory or accreditation bodies. Therefore, the present study was undertaken to recommend a standard workload-based estimation of nursing manpower requirement in the ICU of a tertiary care teaching hospital.

MATERIALS AND METHODS:
It was a descriptive, observational, time and motion study was conducted in the medicine ICU of a tertiary care teaching hospital. Data collection was done by using demographic and clinical profile sheet of patients, NPDS-H dependency assessment scale, time and activities record sheet, and WHO WISN tool. The nurses' activities were observed by nonparticipatory and non-concealment technique. Data analysis was done using descriptive statistics and the WHO WISN tool.

RESULTS:
The bed occupancy rate and the average length of stay in the medicine ICU were 93.23% and 7.18 days respectively. Distribution of dependency level of the medical ICU patients was very high (41.67%), low-high (33.33%), and medium-high (25.0%) dependency level. Considering available resources and workload in tertiary care hospitals in India, the study recommended a nurse-to-patient ratio of 1:1.2 in each shift for the medicine ICU of a tertiary care hospital.

CONCLUSION:
The study suggested minimum nurse-to-patient ratio in medical ICU should be 1:1.2 with provision of power to ICU incharge nurse to allocate nurses according to the workload in different shifts. Also, nurse staffing norms in hospitals need to be estimated or selected with serious consideration of health care demands when employing nurse staffing norms.
HBsAg Loss among a Cohort of Nigerians with chronic hepatitis B virus infection
Authors: Adekanle Olusegun , Ijarotimi Oluwasegun , Umenze Ikenna Kenechi , Ndububa Dennis A. 
Published: May 2024

Background:
Chronic hepatitis B (CHB) virus is an infection that has lasted for 6 months or more without a complete resolution. Nigeria has a hyper-endemic CHB infection rate. There are few or no reports of HBsAg loss among Nigerians on treatment for CHB. We therefore report seven cases of CHB that cleared HBsAg with treatment from the Obafemi Awolowo University Teaching hospital Ile-Ife, Nigeria.

Materials and Methods:
Case records of patients that cleared HBsAg during follow-up treatment in the gastrointestinal clinic were reviewed and information on biodata, prescribed medication, duration of treatment, and hepatitis B viral quantity among others were extracted and presented in a table and as percentages.

Results:
Seven patients had lost HBsAg among our treated cases; they were five males and two females. Duration of treatment ranged from 6 months to about 4 years. All were HBeAg negative. Serum HBV-DNA ranged from 22 to 3.2 × 106 IU/mL at the start and was not detectable at the end of treatment. Anti-HBs were detectable in three cases. Serum alanine aminotransferase (ALT) reduced significantly in five cases. Tenofovir disoproxil fumarate (TDF) was prescribed in four cases, one had PEGylated interferon (PegIFN), and two other cases switched between TDF and PegIFN.

Conclusion:
Antivirals for CHB are effective and HBsAg loss may follow undetectable viral suppression. Antivirals are therefore beneficial among Nigerians who are infected with CHB.