bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and predictors of diarrhea among children under five in Ghana
Authors: Kombat Marian Yenupini , Kushitor Sandra Boatemaa , Sutherland Edward Kofi , Boateng Millicent Ofori , Manortey Stephen 
Published: January 2024

Abstract
Background
Globally, childhood diarrhea is a major public health concern. Despite numerous interventions that have been put in place to reduce its incidence over the years, childhood diarrhea remains a problem and is the fourth leading cause of child mortality in Ghana. This study examined the predictors of diarrhea among children under the age of five in Ghana.

Methods
Data from the 2014 Ghana Demographic and Health survey, a cross-sectional survey, was used for the purpose of this study. A total of 2,547 children under the age of five were included in this study. Logistic regression analysis was performed to establish the factors associated with childhood diarrhea and ascertain explanatory variables.

Results
The prevalence of diarrhea was 11.7%. Male children (13.4%) and those living in rural areas (12%), particularly in the Brong Ahafo region (17%) recorded the highest prevalence of diarrhea. Children aged 6 to 35 months of age, maternal age and education, sex of children and region of residence were the predictors of diarrhea among children under the age of five years in this study.

Conclusion
To lessen the prevalence of diarrhea among children under five in Ghana, existing interventions must be evaluated in the context of the predictors identified. Based on observations deduced from this study, the Ministry of Health, Ghana Health Service and other health regulatory agencies should intensify monitoring and awareness in the various regions, particularly in the transition and savannah zones on the causes, risk factors, and methods of preventing diarrhea in children under five. Various stakeholders including government and non-governmental organizations should take into account the predictors of diarrhea identified in the design of interventions to effectively reduce morbidity and mortality associated with childhood diarrhea.
Smartphone addiction prevalence, patterns of use, and experienced musculoskeletal discomfort during the COVID-19 pandemic in a general Iranian population
Authors: Mokhtarinia Hamid Reza , Torkamani Maryam Heydari , Farmani Nasim , Gabel Charles Philip 
Published: January 2024

Abstract
Background
Smartphone usage is an essential everyday tool in Iran, however problematic use has escalated and become a concern for the Iranian health policy system, particularly during and following the COVID-19 Pandemic. This study’s aim was investigation of the prevalence of smartphone addiction, patterns of use, and the relationship to specific demographic characteristics and associated musculoskeletal disorders during the COVID-19 pandemic.

Methods
A descriptive-analytical correlational study recruited participants from a population of convenience (n = 2344) who were smartphone owners with > 1 year of use. For demographic information an electronic self-report questionnaire collected age, sex, marital status, usage for daily hours, and patterns. To assess addiction levels, the ‘Smartphone Addiction Scale-short version’ (SAS-SV) patient-reported outcome measure was used (cut-off = 31). For experienced discomfort, the Extended Nordic Musculoskeletal Questionnaire (ENMQ) was used.

Results
The participants (female = 66.6%, n = 1561, mean age = 29.07 ± 12.34 years, range 6–60 years) smartphone use averaged 5.75 ± 3.44 h/day. The general prevalence of smartphone addiction was 46.16% (females = 46.06%, males = 46.36%; married = 44.5%, single = 47.63%). School students had the greatest addiction (53.2%) and those with a higher education to or above a Master’s degree were the lowest (39.38%). The highest pattern of use was for social networks at 89.1% of participants (female = 88.34%, male = 90.54%). The areas of highest reported discomfort were the eyes (43.5%) and neck (43.3%). A significant correlation was found between smartphone addiction and hours of daily usage, and the amount of usage increased during the COVID-19 pandemic period.

Conclusion
A high level of smartphone addiction in the Iranian population was found to have occurred during the COVID-19 pandemic. Those most affected were unmarried individuals and school students, with the predominant areas being the eyes and neck. Health decision-makers should consider these findings when developing recommendations and plans for public health, particularly those focused on students.
Build angle effect on 3D-printed dental crowns marginal fit using digital light-processing and stereo-lithography technology: an in vitro study
Authors: Farag Engy , Sabet Ahmed , Ebeid Kamal , El Sergany Omar 
Published: January 2024

Abstract
Background
The effect of 3D printing technology and build angle on the marginal fit of printed crowns is unclear. The objective of this research was to use digital light processing (DLP) and stereo-lithography (SLA)-based 3D printing to construct single restorations with varied build angles and to analyze the crowns′ marginal fit.

Methods
A prepared resin first molar was scanned utilizing an optical scanner. Three build orientations were used to construct the specimens: 0, 45, and 90º. DLP and SLA technology were used to produce the casting patterns. A digital microscope was used to measure the marginal gaps. The effect of build orientation was statistically analyzed by using Two-way ANOVA followed by pair-wise Tukey test.

Results
Two-way ANOVA revealed a significant effect of printer technology and build angle on the marginal discrepancy of 3D printed crowns (p < 0.001). One-way ANOVA revealed that SLA printers (55.6 [± 13.59]) showed significantly better mean [± SD] marginal discrepancy in µm than DLP printers (72 [± 13.67]) (p < 0.001). Regarding build angle, one-way ANOVA revealed significant differences between the different angles. Tukeys post-hoc test revealed that 0° (48.5 [± 9.04]) had the significantly smallest marginal discrepancy followed by 45° (62.5 [± 8.05]) then 90° (80.5 [± 8.99]) (p < 0.001).

Conclusion
The build orientation affects the marginal discrepancy of single crowns manufactured utilizing DLP and SLA.
Taiwanese family members’ bereavement experience following an expected death: a systematic review and narrative synthesis
Authors: Liang Hui-Ju , Xiong Qian , Remawi Bader Nael , Preston Nancy 
Published: January 2024

Abstract
Background
Bereavement experience is shaped by cultural and social contexts. No systematically constructed reviews were identified to explore the bereavement experience for people who are influenced by Chinese culture valuing filial piety and mutual dependence. This review aimed to systematically review the bereavement experience of Taiwanese family members living in Taiwan following an expected death.

Methods
MEDLINE, PsycINFO, CINAHL, China Academic Journal Database, and Chinese Electronic Periodical Services were searched with no date restrictions from inception to 20 October 2022. The methodological rigour of studies was assessed using Hawker’s appraisal tool. A narrative synthesis approach using Popay’s work was employed to synthesise the findings of the studies. Studies investigating Taiwanese family members’ bereavement experiences were included. We excluded papers studying bereavement through the death of a child.

Results
Searches retrieved 12,735 articles (after de-duplication), 17 of which met the inclusion criteria and were included for synthesis: English [9] and Chinese [8], published between 2006 and 2021. The studies varied in quality with scores ranging from 22 to 33 out of 36. The studies differed in the relationship between participants and the deceased, the bereaved time frames, and the definitions of bereavement. Most studies focussed on family members of cancer patients receiving specialist palliative care. Three bereavement theories and four tools were used. Risk factors of bereavement outcomes included family members feeling less prepared for death and deaths where palliative sedative therapy was used. Protective factors were higher caregiving burden and longer caregiving periods. Four themes regarding Taiwanese bereavement experience were generated: multiple impacts of death; problem-based coping strategies; importance of maintaining connections; influential religious beliefs and rituals.

Conclusion
Continuing the relationship with the deceased is a key element of Taiwanese bereavement experience and it is influenced by religious and cultural beliefs. Suppressing or hiding emotions during bereavement to connect with the deceased and maintain harmonious relationships needs to be acknowledged as culturally acceptable and encouraged by some religions in Taiwan. The findings could be potentially relevant for other Chinese populations, predominantly Buddhist countries or other East Asian societies. The role of preparing for death in bereavement outcomes is little understood and requires further research.
Family caregivers’ preferences for support when caring for a family member with cancer in late palliative phase who wish to die at home – a grounded theory study
Authors: Nysaeter Toril Merete , Olsson Cecilia , Sandsdalen Tuva , Hov Reidun , Larsson Maria 
Published: January 2024

Abstract
Background
Family caregivers are essential in end-of-life care for cancer patients who wish to die at home. The knowledge is still limited regarding family caregivers needs and preferences for support and whether the preferences change during the patient’s illness trajectory. Therefore, the aim was to explore family caregivers’ preferences for support from home care services over time when caring for a family member with cancer at the end of life who wished to die at home.

Methods
A qualitative method was applied according to Grounded Theory. Data was collected longitudinally over the illness trajectory by means of repeated individual interviews (n = 22) with adult family caregivers (n = 11). Sampling, data collection and data analysis were undertaken simultaneously in line with the constant comparative method.

Results
The findings are captured in the core category “hold out in duty and love”. The categories “having control and readiness for action” and “being involved in care” describe the family caregivers’ preferences for being prepared and able to handle procedures, medical treatment and care, and to be involved by the healthcare personnel in the patient’s care and decision making. The categories “being seen and confirmed” and “having a respite” describe family caregivers’ preferences for support according to their own needs to be able to persevere in the situation.

Conclusion
Despite deterioration in the patient’s illness and the increasing responsibility family caregiver struggle to hold out and focus on being in the present. Over time together with deterioration in the patient’s illness and changes in the situation, they expressed a need for more intense and extensive support from the home care services. To meet the family caregivers’ preferences for support a systematic implementation of a person-centred care model and multicomponent psycho- educational interventions performed by nurses can be proposed. Moreover, we suggest developing a tool based on the conceptual model generated in this study to identify and map family caregivers’ needs and preferences for support. Such a tool can facilitate communication and ensure person-centred interventions.
ChatGPT sits the DFPH exam: large language model performance and potential to support public health learning
Authors: Davies Nathan P , Wilson Robert , Winder Madeleine S , Tunster Simon J , McVicar Kathryn , Thakrar Shivan , Williams Joe , Reid Allan 
Published: January 2024

Abstract
Background
Artificial intelligence-based large language models, like ChatGPT, have been rapidly assessed for both risks and potential in health-related assessment and learning. However, their applications in public health professional exams have not yet been studied. We evaluated the performance of ChatGPT in part of the Faculty of Public Health’s Diplomat exam (DFPH).

Methods
ChatGPT was provided with a bank of 119 publicly available DFPH question parts from past papers. Its performance was assessed by two active DFPH examiners. The degree of insight and level of understanding apparently displayed by ChatGPT was also assessed.

Results
ChatGPT passed 3 of 4 papers, surpassing the current pass rate. It performed best on questions relating to research methods. Its answers had a high floor. Examiners identified ChatGPT answers with 73.6% accuracy and human answers with 28.6% accuracy. ChatGPT provided a mean of 3.6 unique insights per question and appeared to demonstrate a required level of learning on 71.4% of occasions.

Conclusions
Large language models have rapidly increasing potential as a learning tool in public health education. However, their factual fallibility and the difficulty of distinguishing their responses from that of humans pose potential threats to teaching and learning.
Effects of 3S business intelligence systems for nursing students: a repeated-measures randomized control trial
Authors: Lim Ji-Young , Kim Seulki , Kim Juhang , Kim Seonhee 
Published: January 2024

Abstract
Background
The growing need for healthcare services as a result of a consistently rising prevalence of chronic diseases and rapid population aging calls for a new set of activities and practices. Therefore, we developed a program—3S (Simple, Smart, and Speed) Business Intelligence Systems (3S-BIS), which is an ERP software system that helps nursing business to support nursing entrepreneurship —and analyzed its effects on nursing students.

Methods
A repeated-measures randomized controlled trial was performed with two groups: experimental (n = 29) and control (n = 30) groups. The former group underwent the five-day 3S-BIS education program. Each session comprised four components: lectures 1 and 2, simulation case study, and debriefing. Post-tests were performed immediately post-intervention and four and eight weeks later. The effectiveness was measured using the following variables: simulation design assessment, evaluation of educational practices in simulation, education satisfaction, self-efficacy for learning, and entrepreneurship. The differences before and after intervention between the experimental and control groups were analyzed using the Friedman test. The Mann–Whitney U test was used for comparisons between groups at each time point, and the Wilcoxon signed-rank test was used for comparisons within groups at each time point.

Results
Post-intervention (8 weeks after intervention), the experimental group demonstrated higher simulation design assessment (z = -3.88, p =  < .001), evaluation of educational practices in simulation (z = -3.34, p = .001), education satisfaction (z = -3.11, p = .002), self-efficacy for learning (z = -3.04, p = .002), and entrepreneurship (z = -2.15, p = .031) compared to controls. Furthermore, simulation design assessment score in the experimental group significantly differed between T1 (immediately after intervention) and T0 (baseline), and between T3 (8 weeks after intervention) and T0. Evaluation of educational practices in the simulation, education satisfaction, and self-efficacy also significantly differed between T1 and T0, and between T3 and T0. Entrepreneurship significantly differed between T3 and T2 (4 weeks after intervention), and between T3 and T0.

Conclusions
The 3S-BIS program contributes to enhancing nursing start-up competency. Subsequent studies should evaluate the effects of the program on nurses who work in home healthcare services.
Key factors affecting health promoting behaviors among adolescents: a scoping review
Authors: Tabrizi Jafar Sadegh , Doshmangir Leila , Khoshmaram Najibeh , Shakibazadeh Elham , Abdolahi Hosein Mashhadi , Khabiri Roghayeh 
Published: January 2024

Abstract
Background
Health-promoting behaviors have been noticed recently as one of the most critical factors in raising life expectancy, which can be formed during adolescence. Thus, the current scoping review aimed to identify the key factors affecting health-promoting behaviors among adolescents.

Methods
In this scoping review, we searched multiple English online databases, including PubMed, Web of Science, Science Direct, ProQuest, and Scopus, for articles published between 1977 and 2020. All eligible studies describing health-promoting behaviors in adolescents were included. We followed the JBI guideline for conducting a scoping review and increasing the study’s rigor. Extracted data were synthesized through inductive approaches.

Results
A total of 3199 articles were identified during the first phase. After the screening process, 20 articles were found eligible for final inclusion. Educational factors (individualized education and school health promotion programs), Economic factors (income, economic incentives and national health insurance), Social factors (support system, responsibility and peers), Spiritual, Psychological and Personal factors (gender, family structure, patterns of living, and medical problems) were found effective in health-promoting behaviors among adolescents.

Conclusions
Health-promoting behaviors among adolescents require careful consideration. The current review identified some fundamental factors affecting health-promoting behaviors in adolescents. Based on the findings, it is recommended that policymakers and healthcare providers develop several interventions based on identified factors to increase adolescent’s health-promoting behaviors among adolescents.
First trans-diagnostic experiences with a novel micro-choice based concentrated group rehabilitation for patients with low back pain, long COVID, and type 2 diabetes: a pilot study
Authors: Kvale Gerd , Søfteland Eirik , Jürgensen Marte , Wilhelmsen-Langeland Ane , Haugstvedt Anne , Hystad Sigurd William , Ødegaard-Olsen Øystein Theodor , Aarli Bernt Bøgvald , Rykken Sidsel , Frisk Bente 
Published: January 2024

Abstract
Background
The health care is likely to break down unless we are able to increase the level of functioning for the growing number of patients with complex, chronic illnesses. Hence, novel high-capacity and cost-effective treatments with trans-diagnostic effects are warranted. In accordance with the protocol paper, we aimed to examine the acceptability, satisfaction, and effectiveness of an interdisciplinary micro-choice based concentrated group rehabilitation for patients with chronic low back pain, long COVID, and type 2 diabetes.

Methods
Patients with low back pain > 4 months sick-leave, long COVID, or type 2 diabetes were included in this clinical trial with pre-post design and 3-month follow-up. The treatment consisted of three phases: (1) preparing for change, (2) the concentrated intervention for 3–4 days, and (3) integrating change into everyday life. Patients were taught and practiced how to monitor and target seemingly insignificant everyday micro-choices, in order to break the patterns where symptoms or habits contributed to decreased levels of functioning or increased health problems. The treatment was delivered to groups (max 10 people) with similar illnesses. Client Satisfaction Questionnaire (CSQ-8)) (1 week), Work and Social Adjustment Scale (WSAS), Brief Illness Perception Questionnaire (BIPQ), and self-rated health status (EQ-5D-5L) were registered at baseline and 3-month follow-up.

Results
Of the 241 included participants (57% women, mean age 48 years, range 19–84), 99% completed the concentrated treatment. Treatment satisfaction was high with a 28.9 (3.2) mean CSQ-8-score. WSAS improved significantly from baseline to follow-up across diagnoses 20.59 (0.56) to 15.76 (0.56). BIPQ improved from: 22.30 (0.43) to 14.88 (0.47) and EQ-5D-5L: 0.715 (0.01) to 0.779 (0.01)), all P<0.001.

Conclusions
Across disorders, the novel approach was associated with high acceptability and clinically important improvements in functional levels, illness perception, and health status. As the concentrated micro-choice based treatment format might have the potential to change the way we deliver rehabilitation across diagnoses, we suggest to proceed with a controlled trial.

Trial registration
ClinicalTrials.gov NCT05234281
Impact of some heavy metal accumulation in different organs on fish quality from Bardawil Lake and human health risks assessment
Authors: Zaghloul Ghada Y. , Eissa Hoda A. , Zaghloul Amira Y. , Kelany Mahmoud S. , Hamed Mohamed A. , Moselhy Khalid M. El 
Published: January 2024

AbstractBardawil Lake is a unique aquatic ecosystem that provides a habitat for various fish and other marine organisms. This study aimed to analyze the quality of fish species to prove that this lake is free of pollution, not other Egyptian lakes, due to the accumulation of some heavy metals (Cd, Pb, Cu, and Zn) in various tissues of fish species that were caught from this lake. Thirty-five fish samples were caught during the Spring of 2018 from seven different species: Mugil cephalus, Liza auratus, Sparus aurata, Dicentrarchus labrax, Siganus rivulatus, Anguilla angilla, and Solae solea. The Association of Official Analytical Chemists methods using a spectrophotometer determined the biochemical composition. In contrast, atomic absorption spectrometry (AAS) was employed to determine the heavy metals expressed by µg/g wet weight. Results exposed that the accumulation of essential micronutrient (Cu, Zn) content was higher than toxic elements (Cd & Pb) in muscles in order to Zn > Cu > Pb > Cd. Muscles < gills < liver in order of all metals except Pb with order muscles < liver < gills. The metals studied in the muscles were lower than those set by the WHO and the EU standards. The carcinogenic risk with lower allowable limits of 1 × 10–6 to 1 × 10–4 in both normal and high consumption groups; target and total target hazard quotients (THQ & HI) in muscles were < 1. The biochemical composition level was highest in the liver, except for protein, which was highest in muscle for all fish species. There is no evidence of harmful contaminants in the muscular tissue of the fish sampled from Bardawil Lake, although fishing activity. However, customers should know that health concerns may be associated with overeating fish.