bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of health belief model-based educational intervention on colorectal cancer screening behavior at South Khorasan, Iran
Authors: Khazaei Shahrbanoo , Salmani Fatemeh , Moodi Mitra 
Published: February 2024

BACKGROUND:
Colorectal cancer is the most common cancer of the gastrointestinal tract. Health beliefs play an important role in the development of health behaviors. In this study, the effect of educational intervention based on Health Belief Model on colorectal cancer screening behavior was investigated.

MATERIALS AND METHODS:
This study was performed as a randomized controlled intervention. The study population was 50–70-years old in Khosf city. Initially, 120 eligible populations were randomly divided into intervention and control groups (60 people in each group). The data collection tool was a standard colorectal cancer screening questionnaire that was completed before, immediately, and 3 months after the intervention. The intervention consisted of eight 60-min training sessions. The collected data were analyzed using SPSS19 software and statistical tests.

RESULTS:
The mean age of the intervention and control groups was 63.53 ± 5.67 and 57.73 ± 5.77 years. In terms of mean scores of knowledge, perceived susceptibility, perceived severity, and perceived barriers were homogeneous before intervention. After the intervention, the mean score of the model constructs showed significant changes, which was statistically significant (P < 0.05). The rate of occult blood test in stool 3 months after training reached 90% in the intervention group and 15% in the control group.

CONCLUSIONS:
The results of this study showed that by taking measures to reduce perceived barriers as well as increase knowledge, perceived susceptibility, severity, benefits and self-efficacy, the rate of participation in occult blood testing in feces can be significantly increased.
Development of sexual health promotion package in pregnancy
Authors: Alizadeh Shiva , Ozgoli Giti , Riazi Hedyeh , Majd Hamid Alavi 
Published: February 2024

BACKGROUND:
The World Health Organization recommendation requires the development and use of effective, brief, clear, and evidence-based education packages to improve health-care outcomes. No comprehensive sexual health improvement package exists for the pregnancy period in the Iranian health system. This study aimed to develop a package to promote sexual health in pregnancy.

MATERIALS AND METHODS:
The present study is a qualitative study, which was conducted in 2019 in Tehran, Iran. Sexual health package during pregnancy was developed based on the National Institute for Health and Clinical Excellence (NICE) steps. The first step included reviewing of international guidelines, strategies, handbooks, education packages, and articles in this regard. The package was developed in the second step. In the third step, quality assessment was performed using expert opinion with the Appraisal of Guidelines for Research and Evaluation Instrument II (AGREE II) tool, and validation was performed using Delphi method.

RESULTS:
Package content was designed in two sections: for midwives and health-care providers and for pregnant mothers in three sessions (in each trimester of pregnancy). The quality assessment using the AGREE II guidelines revealed excellent quality (>89%). The package was validated based on expert opinion (>95%).

CONCLUSION:
The sexual health promotion package during pregnancy was designed with high quality and validity based on NICE steps. It is recommended, midwives be performed this designed and validated package in routine pregnancy care to promote the couple's sexual health.
Forecasting Iran national health expenditures
Authors: Kazemian Mahmood , Abdi Zhaleh , Meskarpour-Amiri Mohammad 
Published: February 2024

BACKGROUND:
Forecasting the future trend of health expenditures is an important step toward sustainable financing of health-care systems. This study aims to develop a conceptual framework for forecasting Iran health spending growth.

MATERIALS AND METHODS:
At first, we concentrated on the general model and conceptual framework of health expenditure projection by reference to a broad literature review and smart classifications of the origins of health spending and indicators. At the second step, we developed a time series modeling for econometric estimation and forecasting national health expenditure without restrictive assumptions except for current laws and regulatory environment. In the third step, we tested the accuracy of model by forecasting Iran real per capita health expenditures (2017–2025).

RESULTS:
The results of the literature review represented a distinct classification of the origins of health spending and indicators, applicable to any health system and health spending projection model. Furthermore, the model of expenditure forecasting shows the power of certainty of no spurious estimation, assessment of the normal state of a health system, and test of the accuracy of forecasting results. The projection by the Iranian health system database showed that the real per capita health spending will grow 43 percent till 2025 in the absence of any unforeseen disturbance in the future.

CONCLUSIONS:
The presented model provides estimates that are compatible with actual trends of health spending and can be applied to forecast health expenditure in the near future. The forecasted image of Iran's health spending growth implies that health authorities need to concentrate more on the growth rate of the health budget and its fiscal space in the near future.
Contributing factors of willingness and hesitancy regarding acceptance of COVID-19 vaccine in primary care settings
Authors: Jha Sweety Suman , Paul Bobby , Das Rahul , Chattopadhyay Biswadip , Lahiri Arista 
Published: February 2024

BACKGROUND:
For any effective vaccination strategy, the willingness of the beneficiaries and its contributing factors are important. This study was conducted among the health-care workers (HCWs) and community members to find the perceptions regarding the COVID-19 vaccine and understand the influencers and the barriers of vaccine acceptance.

MATERIALS AND METHODS:
A qualitative study was conducted from October 2020 to December 2020 in two primary care settings in an urban area. Eighteen in-depth interviews (IDIs) after taking consent were conducted with the help of IDI guide developed and validated beforehand by the experts. IDIs were done among the ten community members and eight HCWs selected conveniently. Data collection were continued till data saturation when no new information yielded from the interviews. Thematic analysis was performed.

RESULTS:
All the participants were hopeful about availability of the vaccine. The key influencers identified for promoting willingness to accept the vaccine among both the groups were opinion of the health-care providers, colleagues’ and other people's acceptance of the vaccine, effectiveness of vaccine on other people, and perceived risk of the disease. Fear of adverse reactions was the most important barrier among all the respondents. The prevalent perception was that other preventive practices and vaccine together can only be the best solution to prevent COVID-19 illness. The HCWs perceived that acceptance of vaccine among the community members would be good overall but apprehended some initial difficulties. Mass campaign to promote COVID-19 vaccination and sensitization events are the need of the hour.

CONCLUSIONS:
Since opinion of health-care personnel emerged as an important influencer of vaccine acceptance, mass campaign and sensitization programs spearheaded by the health-care providers can bring about change by increasing the vaccine acceptance among the beneficiaries at large. Re-enforcement regarding practice of preventive measures should be made among the population irrespective of the vaccination status.
Attitudes and knowledge of pregnant women about oral health
Authors: Gavic Lidia , Maretic Ana , Putica Sanda , Tadin Antonija 
Published: February 2024

BACKGROUND:
This cross-sectional study aimed to evaluate attitudes and knowledge regarding oral health and infant oral health among pregnant women.

MATERIALS AND METHODS:
The study involved 325 pregnant women in the Republic of Croatia who completed an anonymous online questionnaire (Google forms) from January to June 2019. The questionnaire was divided into three parts. The first part contained questions about the demographic data experience about oral health in pregnancy. The second part was related to the knowledge of the relationship between oral health and pregnancy. The third section consisted of questions related to knowledge about the oral health of children at the earliest age. The results were analyzed with descriptive statistics, Spearman correlation analysis, and Chi-square test.

RESULTS:
The women are mostly informed about oral health in pregnancy from their dentists (53.54%) and least from their general doctors (4%). In pregnancy, gingival bleeding was observed by 52.31% of respondents and tooth mobility by 12.31%. The Chi-square test found that there was a difference in attitude regarding the age at which they should stop breastfeeding between respondents who had their first pregnancy and those who already had children. Only 9.23% of respondents are aware that breastfeeding can cause tooth decay.

CONCLUSION:
Pregnant women in the Republic of Croatia do not have sufficient knowledge, and they are neither aware of the importance of oral health during pregnancy nor infant oral health.
Acceptance of COVID-19 vaccine among healthcare workers before the launch of vaccine in India
Authors: Dkhar Sabira Aalia , Jeelani Asif , Quansar Ruqia , Salim Khan S. Muhammad 
Published: February 2024

BACKGROUND:
COVID-19 has led to significant morbidity and mortality globally in addition to unprecedented disruption in economic activities. Vaccination against it is considered to be the only sustainable way out of this pandemic. The study was conducted to estimate vaccine acceptance among doctors in India using an online survey.

MATERIALS AND METHODS:
A cross-sectional study using a purposive sampling method was conducted two weeks before vaccine rollout. A pretested questionnaire developed using Google forms was shared by social media groups targeting doctors only.The questions collected information regarding socio-demographic details, knowledge, attitude and practices towards COVID-19 vaccination. Data was downloaded and analysed using SPSS-v23. Chi-square test and fisher exact test was used and P < 0.05 was considered significant.

RESULTS:
A total of 511 records were included in the final analysis of which 340 (66.53%) reported to be either definitely or probably willing to accept COVID-19 vaccine. One third of respondents were working in COVID-19 designated hospitals (37.2%), 30% were posted in non COVID-19 hospitals, 25.1% had no direct contact with COVID-19 patients while 7.7% doctors were involved in testing COVID-19 diagnosis. Subjects who perceived a higher risk of contracting COVID-19, those who perceived that vaccine would be effective against COVID-19 and those who felt that vaccine will not have any serious side effects were more likely to accept the vaccine.

CONCLUSION:
There is an urgent need to address any apprehensions regarding COVID-19 vaccines. A tailored and intensified advocacy program for doctors is needed before the launch of vaccine.
Developing an artificial neural network for detecting COVID-19 disease
Authors: Shanbehzadeh Mostafa , Nopour Raoof , Kazemi-Arpanahi Hadi 
Published: February 2024

BACKGROUND:
From December 2019, atypical pneumonia termed COVID-19 has been increasing exponentially across the world. It poses a great threat and challenge to world health and the economy. Medical specialists face uncertainty in making decisions based on their judgment for COVID-19. Thus, this study aimed to establish an intelligent model based on artificial neural networks (ANNs) for diagnosing COVID-19.

MATERIALS AND METHODS:
Using a single-center registry, we studied the records of 250 confirmed COVID-19 and 150 negative cases from February 9, 2020, to October 20, 2020. The correlation coefficient technique was used to determine the most significant variables of the ANN model. The variables at P < 0.05 were used for model construction. We applied the back-propagation technique for training a neural network on the dataset. After comparing different neural network configurations, the best configuration of ANN was acquired, then its strength has been evaluated.

RESULTS:
After the feature selection process, a total of 18 variables were determined as the most relevant predictors for developing the ANN models. The results indicated that two nested loops' architecture of 9-10-15-2 (10 and 15 neurons used in layer 1 and layer 2, respectively) with the area under the curve of 0.982, the sensitivity of 96.4%, specificity of 90.6%, and accuracy of 94% was introduced as the best configuration model for COVID-19 diagnosis.

CONCLUSION:
The proposed ANN-based clinical decision support system could be considered as a suitable computational technique for the frontline practitioner in early detection, effective intervention, and possibly a reduction of mortality in patients with COVID-19.
Investigating the effectiveness of innovative intervention based on compassion, awareness, resilience, and empowerment on burnout in nurses of two educational hospitals in Isfahan
Authors: Safaeian Alireza , Tavakolifard Negah , Roohi Azita 
Published: February 2024

BACKGROUND:
Burnout is a syndrome of emotional exhaustion, depersonalization, and low professional efficacy that health workers, especially nurses, experience the highest rates of this. Burnout causes stress and negative attitude towards work and feeling unable to perform tasks in the person. The purpose of this study was to investigate the effect of a method called compassion, awareness, resilience, and empowerment (CARE) on nurses’ burnout.

MATERIALS AND METHODS:
This study was a semi-experimental study with control group, the statistical population in this study was nurses of Kashani Hospital in Isfahan as intervention group and nurses of Al-Zahra Hospital as control group. The samples were selected by stratified sampling. For both groups before and after and 3 months after the intervention, the burnout questionnaire (Maslach Burnout Inventory) was completed. The intervention was performed in 5 sessions of 90 min 1 day a week. Data were analyzed by SPSS version 25 software (IBM Inc., USA) and independent t-test, repeated measures analysis of variance and Chi-square test and Friedman test, significance level was set at P < 0.05.

RESULTS:
The comparison of mean and intensity of burnout and two dimensions of emotional exhaustion and depersonalization showed a difference between the two groups and this difference was statistically significant (P < 0.05). Mean of Individual performance also had a statistically significant difference between the two groups (P < 0.05), but its intensity did not change.

CONCLUSION:
CARE method can be effective in burnout of nurses and it can be used as a practical method. This training program can be implemented both preservice and in-service for health workers.
The association between sexual health literacy and sexual function of women in Iran
Authors: Dehghankar Leila , Panahi Rahman , Khatooni Marzieh , Fallah Somayeh , Moafi Farnoosh , Anbari Mohammad , Siboni Fatemeh Samiei 
Published: February 2024

BACKGROUND:
Considering the importance of sexual health literacy in promoting individual sexual health and ultimately improving family and social health as well as the effect of health literacy on sexual function, this study was designed and conducted to determine the association between sexual health literacy and sexual function among women.

MATERIALS AND METHODS:
This was a cross-sectional study. A total of 420 women referring to health centers were entered into the study using one-stage cluster sampling method. Data collection tools included a demographic questionnaire, Iranian Adult Sexual Health Literacy Assessment Questionnaire, and the Persian version of the Female Sexual Function Assessment Questionnaire (FSFI). Data were collected and entered into SPSS 22 and logistic regression.

RESULTS:
The results of the logistic regression test showed that the variable of sexual health literacy was effective on women's sexual function (P = 0.021) so that the chances of having a desirable sexual function in women with excellent were 4.222 times more than women with inadequate health literacy; the variables of employment status, level of education, duration of marital life, and the number of sexual intercourses per recent week were the factors affecting women's sexual function (P < 0.05).

CONCLUSION:
The results of this study pointed out the existence of an undesirable level of sexual function and a desirable level of sexual health literacy among participating women. Hence, designing and implementing the training plans to promote sexual function among these women is necessary.
Effect of operational exercises on nurses’ competence in dealing with disaster
Authors: Aliakbari Fatemeh , Pirani Tahereh , Heidari Mohammad , Kheiri Soleiman 
Published: February 2024

BACKGROUND:
It is necessary to assess the level of preparedness to reduce the side effects of disasters, so regarding to the role of nurses in responding to the disasters, this is of particular importance. Holding a maneuver and exercises is one of the ways to increase the level of capability and assess the level of readiness, so the aim of the current study was to investigate the impact of the implementation of the operational exercises program on the competency of nurses in disaster response in 2020.

MATERIALS AND METHODS:
The present study is a quasi-experimental study in two groups, in which seventy nurses of hospitals affiliated to Shahrekord University of Medical Sciences were selected by census and randomly divided into two groups. Before the intervention, a native questionnaire to assess the competence of nurses in the disaster response was completed. Then, the empowerment program including educational workshop, tabletop, and operational maneuvers were performed. Immediately and 3 months after the intervention, the questionnaires for both groups were completed, and the data were analyzed using SPSS 21 through descriptive-analytical statistical tests.

RESULTS:
The results showed that the mean score of nurses’ competence in all domains of management, ethics, personal, team work, and technical immediately and 3 months after the intervention in the intervention group increased significantly (P = 0.001), while in the control group, these changes were not significant (P > 0.05).

CONCLUSION:
According to the results of a recent study, the implementation of the empowerment program and the implementation of maneuvers as a part of the process of preparing nurses to deal with disasters have been effective. Therefore, it is suggested to use periodic maneuvers in in-service training programs to improve the level of competence of nurses.
Stress level of dentists during COVID-19 pandemic in hot spots of Tamil Nadu
Authors: Sushanthi S. , Indumathy M. , Balasubramaniam Arthi , Santhosh Kumar M. P. 
Published: February 2024

BACKGROUND:
The novel 2019 COVID-19 spreads by respiratory and aerosols, and this elevates the risk of dentistry during this pandemic. Widespread disease, in a short time, creates stress and has a psychological impact. The aim of this study was planned to assess the stress level of the dentists living or practicing or studying in hot spots which could help to understand mental status among the general dentists during COVID-19 lockdown.

MATERIALS AND METHODS:
This cross-sectional study was conducted during the period of August 10 to August 25, 2020, on an Internet platform after getting consent from the dentists and practitioners using the Perceived Stress Scale (PSS). Chi-square association was used. Parametric tests such as independent t-tests and one-way ANOVA were also used. In all instances, P < 0.05 was considered statistically significant.

RESULTS:
This study had a total response from 1044 dental students and dentists residing in hot spot zones in Tamil Nadu. Out of them, 68.4% were female and 31.6% were male. 37.9% of the participants were dental practitioners and 32.5% were undergraduate students. There is a significant association between age groups and PSS, work style, and PSS. There is no significant association between gender and PSS and degree and PSS.

CONCLUSION:
This study shows that levels of distress were higher than expected during the COVID-19 pandemic among the dentists and majority of the respondents have moderate-to-high-stress levels. As the unlock has been started throughout the country, it is the right time to work with the authorities and focus on formulating protocols for disinfection and sterilization and work on treating the patients with exact safety measures for the welfare of the patients.
The effect of “Elder Care by Elderly People Program” on life satisfaction and quality of life among institutionalized senior citizens
Authors: Salmannezhad Mohsen , Momtaz Yadollah Abolfathi , Sahhaf Robab , Rassafiani Mehdi , Foladi Shiva Hosseini 
Published: February 2024

INTRODUCTION:
Improving participation in life meaningful roles is one of the most important predictors of quality of life (QOL) and life satisfaction (LS) in later life. The purpose of this study was to investigate the effect of Elder Care by Elderly People (ECP) on LS and QOL among institutionalized senior citizens.

MATERIAL AND METHOD:
This was an interventional study involving a targeted sample of 36 older adults in Ghods nursing home in Tehran in 2018. WHOQOL-OLD 24-item and LS 40-item questionnaires were used to measure LS and Olathe repeated-measures ANOVA and descriptive was employed to obtain the objectives.

RESULTS:
The participants were 36 older adults in Ghods nursing home. The mean age of older adults was 67.27 (standard deviation [SD] = 7.6), of whom about 77.8% were male. The mean score of QOL increased from 74.38 (SD = 13.09) pre intervention to 83.72 (SD = 11.43) 2 months post intervention, with most significant change of 9.3 QOL points between pre intervention and 2 months post intervention alone (P < 0.01). Similarly, LS increased from 114.19 (SD = 26.93) pre intervention to 133.94 (SD = 20.49) 2 months post intervention, with most significant change of 19.7 LS points between pre intervention and 2 months post intervention alone (P < 0.001).

CONCLUSIONS:
The results of this study showing the evidence of the positive impact of the ECP Programmed for the elderly, therefore, it is suggested that the programmer is evaluated in future studies.