bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparative study on the health-promoting behaviors of patients with and without hypertensive heart disease in Iran
Authors: Baharvand Parastoo , Malekshahi Farideh , Gheydar Nafiseh 
Published: February 2024

BACKGROUND:
Health-promoting behaviors can affect the psychological and physical consequences of hypertension. For the prevention and control of hypertension, lifestyle modification has been recommended. This study aimed to investigate the health-promoting behaviors of patients with hypertensive heart disease in Iran and compare them with those of healthy people.

MATERIALS AND METHODS:
This was a descriptive comparative study with cross-sectional design. Participants were 141 patients with hypertensive heart disease (mean age = 39 ± 10.2 years) referred to the cardiac clinic of Madani Hospital in Khorramabad, Iran, and 141 healthy people selected from those referred to the hospital. The Persian version of the revised Health-Promoting Lifestyle Profile-II (HPLP-II) was used to evaluate the health-promoting behaviors of participants. After collecting data, they were analyzed in SPSS v. 22 software using descriptive statistics and statistical tests including independent t-test and one-way ANOVA.

RESULTS:
The overall HPLP-II score was 142.34 ± 30.48 in patients and 150.52 ± 37.07 in controls. The highest and lowest HPLP-II dimension scores in both groups were related to health responsibility and stress management dimensions. There was a significant difference between groups only in dimensions of nutrition (P = 0.017) and physical activity (P = 0.016), and in the overall score (P = 0.044), whose scores were lower in patients compared to controls. The difference in HPLP-II score of patients with different demographic characteristics (marital status, place of residence, gender, age, educational level, and occupation) was not statistically significant.

CONCLUSION:
Patients with heart disease caused by high blood pressure in Iran have poorer diet and physical activity compared to healthy people. Educational interventions with a focus on the importance of dietary regime and exercise are recommended for them.
COVID-appropriate facemask use
Authors: Das Arpita , Chattopadhyay Biswadip , Paul Bobby , Bandyopadhyay Lina , Bhattacharyya Madhumita 
Published: February 2024

BACKGROUND:
In the ongoing COVID-19 pandemic, facemask use has been the most feasible public health measure in preventing transmission of SARS-CoV2 with the dual benefit of controlling the source of infection and decreasing the risk of acquiring infection from infected people. Therefore, COVID-appropriate behavior regarding facemask use is imperative for controlling the pandemic. This study aimed to assess COVID-appropriate mask behavior and factors associated with it among the patients attending outpatient departments of a public health institute in West Bengal.

MATERIALS AND METHODS:
This cross-sectional study was done among 298 patients attending outpatient departments of Rural and Urban Health Units of a public health institute of Kolkata, during October 2020–February 2021. A pretested questionnaire and an observational checklist based on the World Health Organization guidelines were used to collect data. COVID-appropriate mask behavior was assessed by a five-point domain-wise scale, where good practice regarding facemask usage was considered when the score was three or more. Statistical analyses were done in SPSS 16.0.

RESULTS:
Good practices regarding COVID-19 appropriate mask-related activities were recorded among 30.2% of the study participants. No difficulties faced during or on wearing a mask (adjusted odds ratio [AOR] = 1.86, 95% confidence interval CI: 1.1–3.33) and higher socioeconomic status (AOR = 2.25, 95% CI: 1.22–4.15) were significantly associated with good practice regarding COVID-19 appropriate facemask usage.

CONCLUSION:
The magnitude of poor practice regarding COVID-appropriate mask-related behaviors is quite high among the study participants. Awareness regarding correct mask handling, storage, hygiene, disposal, and place of wearing from a reliable source would go a long way to curb the myths and misinformation surrounding mask usage and encourage COVID-appropriate mask behaviors among the general population.
Six-minute walk test and its predictability in outcome of COVID-19 patients
Authors: Klanidhi Kamal Bandhu , Chakrawarty Avinash , Bhadouria Shailendra S. , George Sudeep M. , Sharma Gaurav , Chatterjee Prasun , Kumar Vijay , Vig Saurabh , Gupta Nishkarsh , Singh Vishwajeet , Dey Aparajit Ballav , Mohan Anant , Bhatnagar Sushma 
Published: February 2024

BACKGROUND:
The world is worsely hit by the COVID-19 pandemic resulting in increased morbidity and mortality. Increased mortality has been observed in older adults with multiple comorbidities. Six-minute walk distance (6MWD) at admission can help us to guide the requirement of oxygen during hospital stay that can be used to determine which patient can be managed at home.

MATERIALS AND METHODS:
This study was a prospective observational study conducted on COVID-19 patients admitted at AIIMS, New Delhi, from October to December 2020. Patients aged more than 60 years were included in the study and underwent 6-min walk tests. Polypharmacy and multimorbidity were also assessed along with dyspnea which was measured on BORG scale. P < 0.05 was considered statistically significant. Statistical software STATA (version 14.2) was used for all the analyses.

RESULTS:
The mean age of the study population was 68.76 (7.4). Oxygen saturation prior to the 6-MWT was normal and has significantly higher than the post test (P ≤ 0.001). 6MWD was significantly correlated with pre values of oxygen saturation. 6MWD was observed more in patients who did not require oxygen during hospital stay. Self-reported dyspnea, pulse rate, oxygen saturation, and systolic blood pressure were significantly associated with the patients who had an oxygen requirement during the hospital stay.

CONCLUSION:
Self-reported dyspnea after 6MWT was found to be associated with oxygen requirement during hospital stay. Patients who have covered more distance in 6-min walk test have less oxygen requirement during hospital stay hence can be managed at home. This will reduce the health-care burden and will help to tackle the outburst during the ongoing pandemic.
Role of nongovernmental organizations in Iran's health system
Authors: Rajabi Mohanna , Ebrahimi Parvin , Aryankhesal Aidin 
Published: February 2024

BACKGROUND:
Nongovernmental organizations (NGOs) as entities out of the health sector can play various roles and functions at different levels of the health systems. The present study was conducted to investigate NGOs’ potential and actual functions in Iran's health system.

MATERIALS AND METHODS:
This exploratory study was carried out in two parts from April 2020 to December 2020 in Tehran, Iran. For the first part, the statute of 65 NGOs was used for document review, and in the second part, the required data were collected using semi-structured interviews with 26 key informants from the governmental sector and NGOs. Data were analyzed using the framework analysis method and MAXQDA software.

RESULTS:
According to data analysis, the results of this study were classified into two sections of NGOs’ current functions and expected functions in Iran's health system. The current functions of NGOs in Iran's health system include service delivery, educational, research, and information activities, financing, supportive and facilitation activities, and advocacy. Other functions in which NGOs could play a role include health system management, education, and service providing and support activities.

CONCLUSION:
In this study, the various roles of NGOs in Iran's health system were explained. NGOs can act actively as the consulting and executive hand alongside the public sector in the lowest to the highest levels of Iran's health system. Hence, health sector managers and policymakers must facilitate NGOs’ involvement in the health sector and use their capacities and capabilities to improve health and increase public access to health-care services.
Pulmonary function test
Authors: Mehrotra Vishal , Sambyal Sheenam , Mishra Gauri , Garg Kriti , Srivastava Rahul , Ishrat Saman 
Published: February 2024

INTRODUCTION:
The study aims to measure and compare pulmonary function tests (PFTs) in oral submucous fibrosis (OSMF) patients (smokers/nonsmokers) and normal individuals.

MATERIALS AND METHODS:
The study population included 150 participants that comprised 50 nonsmoker OSMF patients, 50 OSMF patients who smoke as well, and 50 patients with no deleterious habits. Spirometer was used to assess PFT.

RESULTS:
Results showed that a significant P value was obtained for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow rate (PEFR), and maximum voluntary ventilation (MVV) and also for the predicted values of FEV, FEV1, FEV1/FVC, PEFR, and MVV in OSMF (smokers/nonsmokers) study groups.

CONCLUSION:
Thus, the decrease in pulmonary function can be an alarming sign for restrictive type of pulmonary disease.
The effect of educational program (based on BASNEF model) on quality of life and adherence to treatment in patients with myocardial infarction in Shahrekord, Iran
Authors: Hatami Hadi , Dehkordi Ali Hassanpour , Tali Shahriyar Salehi , Lotfizadeh Masoud , Ganji Haifeh 
Published: February 2024

BACKGROUND:
Myocardial infarction (MI) is one of the most common cardiovascular diseases affecting quality of life and adherence to treatment. This study aimed at assessing the impacts of an educational program based on the Belief, Attitude, Subjective Norm, and Enabling Factors (BASNEF) Model on quality of life and adherence to treatment in patients with MI.

MATERIALS AND METHODS:
The present quasi-experimental study was conducted on eighty patients with MI admitted to hospitals affiliated to Shahrekord University of Medical Sciences in 2019, which were selected by the convenience sampling and then randomly divided into intervention and control groups. The intervention group received a BASNEF model-based educational-supportive intervention including three 45-min training sessions and three months' follow-up individually for each participant. Data were collected by Ferrans and Powers Quality of Life Index (QLI)-Cardiac Version, Modanloo Adherence to Treatment Questionnaire (MATQ) and questionnaire modified based on BASNEF model constructs. The collected data were analyzed using SPSS version. 22 software using the descriptive and analytical statistical test.

RESULTS:
The total score of the MATQ and its subscales had significantly improved in the intervention group after the intervention (P < 0.001). The total score of the QLI and its subscales had significantly improved in the intervention group after the intervention (P < 0.001) In addition, the mean scores of the model constructs had significantly improved after the intervention in the intervention group (P < 0.001).

CONCLUSION:
The results of this study showed that applying BASNEF model-based educational interventions can lead to improved quality of life and adherence to treatment in the patients with MI. Therefore, this model can be used to reduce the complications of MI.
Multiple-choice questions in assessment
Authors: Vegi Venkata Avinash Kumar , Sudhakar P. V. , Bhimarasetty Devi Madhavi , Pamarthi Kiran , Edara Lokesh , Kutikuppala L. V. Simhachalam , Suvvari Tarun Kumar , Anand Shubham 
Published: February 2024

BACKGROUND:
In curriculum reforms under Competency-Based Medical Education (CBME) introduced by the National Medical Commission, medical students are recognized as one of the stake holders. The well-designed multiple-choice questions (MCQs) help students in assessment as well as promote deep learning. The objective of this study is to assess the perceptions of the Indian medical students towards the examination patterns in their undergraduate curriculum with particular reference to MCQs.

MATERIALS AND METHODS:
An observational cross-sectional study was conducted among the medical colleges in India. A total of 7875 students took part in the study. The study instrument was a validated pretested self-administered questionnaire. The study was conducted as an online survey using the Google Forms platform. Inclusion criteria were students from all professional years as well as interns and those who were willing to participate in the study.

RESULTS:
For the question of initiation of MCQs as a tool for the assessment, many of the students (46%) expressed that it should start from the 1st MBBS itself. The majority of the students (85%) felt that MCQ oriented preparation will be helpful for MBBS professional (theory and practical) examinations. Most of the students (90.9%) preferred that the MCQs should be concept and case scenario based. To the question of whether the current system of the university theory examinations of essays and short notes be replaced in total with MCQs so that they are more prepared for NEXT and USMLE examination, 65.5% responded with an answer of yes.

CONCLUSION:
The findings of this study provide input to the regulatory authorities and other stakeholders responsible for designing and implementing the medical curriculum.
Inventory development to assess perceptions and metacognition of dental students toward learning in colleges in Pune, India
Authors: Nair Shruti P. , Shetiya Sahana Hegde , Agarwal Deepti , Rajpurohit Ladusingh 
Published: February 2024

BACKGROUND:
Dental education is considered a challenging and taxing program as on successful completion one is required to attain unique and diverse competencies. There is an established perception that students do not enjoy their experiences in the dental institution and they always demand for certain amendments. Therefore, a dental education perceptions and metacognition assessment tool (DEPMAT) was developed for Indian undergraduate and postgraduate dental students for assessing their learning in Deemed University versus Maharashtra University of Health Sciences in Pune, Maharashtra.

MATERIALS AND METHODS:
This cross-sectional study was conducted among students of four dental colleges of two types of universities in Pune, India, using a 31-item DEPMAT based on Dundee Ready Education Environment Measure and metacognition awareness inventory using five subscales. Psychometric properties were also tested for this new tool. Data were analyzed using the SPSS software.

RESULTS:
Of 512 participants, 498 (96.88%) students had duly returned the questionnaire. Cronbach's alpha coefficient value for reliability was found to be 0.87 which indicated good internal consistency and test-retest reliability was found to be kw = 0.76, which indicated substantial agreement. Significant difference was found among undergraduates in domains regarding their perception toward academics, infrastructure and learning environment, and health and stress.

CONCLUSION:
This study suggested that the general perception toward learning among final year postgraduate students was positive in both the universities. However, the perception of final year undergraduates toward learning was negative and students have suggested certain amendments in both the universities. This study also suggested the new tool was effective in assessing the attitude of practice of both undergraduate and postgraduate students.
Learning out of the box
Authors: Sannathimmappa Mohan Bilikallahalli , Nambiar Vinod , Aravindakshan Rajeev 
Published: February 2024

BACKGROUND:
Gamification involving application of elements of game play that provides unique opportunities to learners to sail through complex medical concepts is gaining importance in medical education. The current study was aimed at assessing the perception of medical students regarding checkerboard game in enhancing learning process.

MATERIALS AND METHODS:
The present prospective cross-sectional study was conducted at the microbiology department. The fifth-year medical students of the academic year 2018–19 were the participants. Pre- and post-test scores and self-administered questionnaire regarding effectiveness of the checkerboard game-based learning were used as assessing tools. The data were collected, tabulated, and statistically analyzed using SPSS version 20. The pre- and post-test scores of students were statistically analyzed using paired t test. A descriptive analysis on the 3-point Likert scale of effectiveness survey was measured and expressed in percentages.

RESULTS:
In total, 124 fifth-year medical students participated in the study. Majority (89.5%) of them liked the game, nearly 86% opined that game was enjoyable and created interest. Approximately 88% indicated game helped them to understand the topic, enhanced learning, and thus improved the knowledge. Most students (79%) also believed that game encouraged critical thinking and problem solving, while 75% felt that it improved their communication skills. Around 70% felt that game was also useful for exam preparation and nearly 90% recommended to use the game more frequently.

CONCLUSION:
From the results of the study, it can be concluded that checkerboard game-based learning method is effective in fostering learning process and cognition of medical students in the microbiology course.
Study of outcomes of delay in referral of patients with acute myocardial infarction
Authors: Shahbazpour Jafar , Abbasi Mohammad , Eskandari Narges , Aghaali Mohammad , Norouzadeh Reza 
Published: February 2024

BACKGROUND:Delay in seeking medical help in patients with acute myocardial infarction (AMI) challenges the patients in terms of diagnosis and treatment. This study aimed to evaluate the outcomes of delay referral (≥12 h) in patients with AMI.MATERIALS AND METHODS:In this retrospective cohort study, the medical records of 252 patients with AMI (2017–2019) admitted to Shahid Beheshti Hospital, Qom, Iran, was reviewed. Data collection tool was a researcher-made data sheet that included demographic characteristics, times, hospitalization costs, risk factors, history of heart disease, results of paraclinical tests, clinical information at the time of admission, and outcomes of delayed referral. Data were analyzed usingt-test, Chi-square, Kaplan–Meier estimator, log-rank test, Cox regression by STATA, and SPSS (version 25).RESULTS:The levels of troponin, creatine phosphokinase, lactate dehydrogenase were significantly higher in the delayed referral group (P< 0.05). After treatment, the cardiac ejection fraction was significantly different in the nondelayed referral (41.56 ± 9.16) and the delayed referral group (38.39 ± 11.01) (P< 0.001). There was no significant difference in the percentage of hospital deaths in the groups (P= 0.078).CONCLUSION:Delayed referral of patients with AMI is associated with decreased physiological cardiac function, which complicates recovery for these patients.
Attention deficit hyperactivity disorder and associated learning difficulties among primary school children in district Dehradun, Uttarakhand, India
Authors: Chawla Gurpreet Kaur , Juyal Ruchi , Shikha Deep , Semwal Jayanti , Tripathi Shailesh , Bhattacharya Sudip 
Published: February 2024

BACKGROUND:
Attention deficit hyperactivity disorder (ADHD) is a considerably common childhood-onset neurodevelopmental disorder, often associated with socio-behavioral and academic difficulties. There is an increased risk for development of a range of future problems such as psychiatric disorders, difficulties in employment, and relationships. The aim of this study was to know the prevalence and determinants of ADHD among primary school children in district Dehradun and to assess the learning difficulties and classroom behavior in these students.

MATERIALS AND METHODS:
In this cross-sectional study, overall, 228 students (aged 6–12 years) studying in a primary school were assessed for ADHD after seeking the written informed consent from their parents. The data were analyzed using Excel sheet and SPSS software (22.0 version). For all qualitative measures, frequency and percentages were calculated, and for quantitative measures, mean and standard deviation were calculated. For analysis of categorical values, Chi-square test was used. P < 0.05 was considered statistically significant.

RESULTS:
The prevalence of ADHD was found to be 11.8% based on the teacher tool only and 1.75% based on the parent and teacher tools combined. ADHD was found to be significantly more in males. Inattention was the most prevalent subtype of ADHD, and children screened positive for ADHD had significant learning difficulties at various levels.

CONCLUSION:
The possibility of ADHD in students with academic difficulties should not be ignored as children with ADHD usually face significant problems at school such as learning difficulties and have been shown to be at increased risk for a broad range of negative outcomes. Early identification and treatment of ADHD can significantly reduce the rates of some of these poor outcomes. Screening these children in the early years will help the parents, children, teachers, and community at large.
Relationship between fertility characteristics with spiritual intelligence and resilience in infertile couples
Authors: Mokhtari Fatemeh , Torabi Fatemeh , Pirhadi Masoume 
Published: February 2024

BACKGROUND:
Infertility and the use of assisted reproductive therapies affect infertile couples quality of life. Infertile couples face many physical, psychological, and financial challenges due to having a higher level of spiritual intelligence and resilience will help the infertile couple to adapt to infertility conditions and achieve their therapeutic goals. This study was aimed to determine the relationship between fertility characteristics and spiritual intelligence and resilience in infertile couples.

MATERIALS AND METHODS:
This was a cross-sectional study that was conducted in 2020 on 162 infertile couples referring to infertility centers in Isfahan who met the inclusion criteria. Samples were selected by convenience sampling method. Information was gathered using a questionnaire consists of three parts: demographic and fertility characteristics, spiritual intelligence, and resilience. Data were analyzed using descriptive and inferential statistical methods (t-test, Pearson's correlation coefficient, and Chi-square). P < 0.05 was considered statistically significant.

RESULTS:
Pearson's correlation coefficient showed that there was no significant relationship between resilience score and spiritual intelligence score with age, duration of marriage, and duration of treatment (P > 0.05). There was no significant relationship between resilience score and spiritual intelligence score and its dimensions with the level of education and economic status of the family (P > 0.05).

CONCLUSIONS:
There was no significant relationship between demographic and fertility factors with spiritual intelligence and resilience.