bluuebunny/crossref_metadata_2025_split huggingface dataset:
Policy analysis of cervical cancer prevention in Iran based on the policy triangle model
Authors: Pirani Narges , Jafari Mehdi , Motlagh Ali G. , Pourasghari Hamid 
Published: November 2023

BACKGROUND:
Widespread use of screening in high-income countries has led to a significant reduction in cervical cancer mortality. Most low- and middle-income countries still have poorly organized screening programs. This study aimed at policy analysis of prevention and early detection of cervical cancer in Iran, a middle-income country.

MATERIALS AND METHOD:
This qualitative retrospective study, extended by the health policy triangle model, was conducted from July 2020 to September 2021. A sample of this study consisted of 43 participants, including 16 key policy experts; nine 11 senior health system managers, 13 executives, and 3 clients selected purposefully. Data were collected through semi-structured interviews using the interview guide and analyzed using a framework analysis method based on the policy triangle model in MAXQDA2020.

RESULTS:
Nine themes, 15 subthemes, and 36 codes were extracted based on the 4 dimensions of the model; stakeholder analysis challenges, including conflict of interest and decision-making challenges. Moreover, the most important policy process challenges indicated the weakness of monitoring and evaluation systems and weakness of using scientific principles in policy making. Weakness of organizational and intersectoral structure and weakness of executive management were obtained among the challenges in the context analysis. Finally, the most important challenges related to content analysis are weaknesses in applying scientific principles in policy making, including weaknesses in standard operating procedures, and low use of HTA capacity in developed guidelines.

CONCLUSION:
A wide range of economic, social, and cultural problems can affect cervical cancer prevention policies. Several strategies are suggested to overcome these challenges, including allocating separate funds to cancer prevention programs, using structures to sustain prevention programs, designing, and using them to improve public awareness.
The predictors of the intention to receive Covid-19 vaccine using the health belief model and theory of planned behavior in South Khorasan province
Authors: Khazir Zahra , Kouhpeikar Hamideh , Rahaei Zohreh , Zareipour Moradali , Dashti Saeid , Gholamian Monireh 
Published: November 2023

BACKGROUND:Widespread vaccination coverage in the shortest time is one of the most effective ways for controlling the COVID-19 pandemic. Factors affecting people's intention to get the COVID-19 vaccine are of great importance. The present study aimed to investigate the predictors of the intention to receive the Covid-19 vaccine based on the constructs of the health belief model (HBM) and theory of planned behavior (TPB) in South Khorasan Province.MATERIALS AND METHODS:In this cross-sectional-analytical study, 320 people over 18 years in South Khorasan province were randomly selected by cluster sampling method in 2021. The data was collected by a researcher-made questionnaire, including demographic information (9 questions), and the constructs of the health belief model (19 questions), and the theory of planned behavior (13 questions), using the self-report method. Finally, data were analyzed usingt-test, ANOVA, linear regression, and Pearson correlation tests.RESULTS:The mean age of the study participants was 36.57 ± 11.56 with a range of 18-66 years. In the regression model, perceived susceptibility (β = 0.247,P= 0.003), perceived severity (β = 0.247,P= 0.003) from HBM, attitude (β = 0.247,P= 0.003), and perceived behavioral control (β = 0.247,P= 0.003) from TPB were significant predictors of the intention to get the Covid-19 vaccine. The constructs of the two models were able to explain 33% of the variance of the intention to receive the Covid-19 vaccine.CONCLUSIONS:The study findings reveal that HBM and TPB can predict factors affecting an individual's intention to receive the vaccine. The results can be utilized to design interventions with the aim of increasing vaccine uptake.
Assessment of the environmental risk factors associated with traumatic dental injuries among WHO index-aged children and adolescents
Authors: Khan Mohammad Kamran , Jindal Mahendra Kumar 
Published: November 2023

BACKGROUND:
Traumatic dental injuries (TDIs) are becoming a worldwide phenomenon owing to their variable prevalence, and their etiology is considered multifactorial and complex in interactions among various risk factors. These are preventable if risk factors are analyzed and interpreted in all possible scientific manners. The objective of this study was to assess the various environmental risk factors (places of occurrence of TDI) among World Health Organization (WHO) index-aged children and adolescents (12 and 15 years).

MATERIAL AND METHODS:
This was the epidemiological cross-sectional study conducted in Aligarh City, Uttar Pradesh, India, in the year 2018, with a sample size of 1000. Multistage random sampling technique was employed. Study data were collected by doing dental examination and structured interview with self-prepared pro forma in ten randomly selected sampling sites (schools) from different regions of the city. Subsequently, data were entered in an Excel sheet and then analyzed with the Chi-square test using the Statistical Package for the Social Sciences (SPSS) software.

RESULTS:
Overall, school (63; 46.7%) was found to be the most prevalent environmental risk factor for TDI followed by home (37; 27.4%), roadside (10; 7.4%), and playground (9; 6.7%). Fifteen (11.1%) affected individuals were not able to recall the place of the TDI incident, while 0.7% (1) had TDI occurrence in other places. Among 12-year index-aged children, home (15; 34.1%) was the most common place of TDI in rural regions, while school (27; 67.5%) was the most frequent place of TDI in urban regions. Among 15-year index-aged adolescents, school (19; 59.4%) was found to be the most common place in rural regions, whereas school (9; 47.4%) was the most frequent place of TDI in urban regions.

CONCLUSION:
Environmental factors, especially school premises, infrastructure, and playing facilities, need to be upgraded and built with an emphasis on a safer environment for children. Teachers, parents, and school children should be educated and made aware of the preventive measures for dental injuries in schools and homes. Appropriate safety gears should be mandatory to use among children and adolescents during outdoor sports and recreational activities.
The relationship between depression and sexual satisfaction: An equation model analysis
Authors: Khakkar Maedeh , Kazemi Ashraf 
Published: November 2023

BACKGROUND:
The relationship between depression and sexual satisfaction in middle-aged women has been reported previously. However, there is insufficient evidence that depression is related to sexual satisfaction or that sexual satisfaction is related to depression. This study evaluated the relationship between depression and sexual satisfaction in middle-aged women by evaluating the equation model analysis of the two models.

MATERIALS AND METHODS:
This cross-sectional study was conducted on 190 middle-aged women in Isfahan, Iran, in 2021. Sexual satisfaction dimensions were evaluated using self-report women's sexual satisfaction questionnaire. Also, the depression scale of the general health questionnaire was used to measure of the depression level. Research data were analyzed using a multivariate linear regression test. Also, the fit of the model was evaluated using Amos software.

RESULTS:
The results showed that depression score had an inverse relationship with sexual satisfaction in the relational concern dimension (Beta = −0.27, P = 0.006, CI: −0.11 to − 0.86). Model fit evaluation showed that the sexual satisfaction-depression model had a better fit than the depression-sexual satisfaction model (CMIN/DF = 1.123, P = 0.64).

CONCLUSION:
The results showed that depression in middle-aged women is related to the relational concern. It is necessary to consider counseling programs to solve sexual relationship concerns in middle-aged women's mental health promotion programs.
Relationship between spiritual intelligence and intolerance of uncertainty, anxiety and fear of Corona in the elderly
Authors: Maghool Ahmad , Bakhshi Mahmoud , Rastaghi Sedigheh , Rad Mostafa 
Published: November 2023

INTRODUCTION:
The COVID-19 pandemic has caused physical and psychological health problems in the elderly. Spiritual intelligence has an effect on health and healing. The aim of this study determining the relationship between spiritual intelligence and intolerance of uncertainty, anxiety, and fear of corona in the elderly.

METHODOLOGY:
A cross-sectional study was done on 207 elderly people who referred to comprehensive health service centers in Mashhad in 2022. The samples were selected based on the inclusion criteria using multistage and cluster sampling. To collect data, various questionnaires were used, including demographic characteristics (age, gender, marital status …), King's Spiritual Intelligence Questionnaire, Freestone's Intolerance of Uncertainty Questionnaire, Corona Anxiety Scale, and Coronavirus Fear Scale. Statistical analysis of variables was done using descriptive and analytical (independent t-test, Mann-Whitney, analysis of variance, linear regression) tests by means of STATA version 14.

RESULTS:
The average level of spiritual intelligence was 54.1. Participants reported a high level of intolerance of uncertainty (M = 79.2) and fear of corona (M = 14.09). Education, economic status, and marital status were the predictors of spiritual intelligence of the studied subjects (r = 0.24, P < .05). Spiritual intelligence and gender were also related to uncertainty intolerance (r = 0.12, P < .05). Another finding of the study was the superiority of variables of spiritual intelligence and gender in predicting the level of anxiety of corona compared to other variables (r = 0.17, P < .05).

CONCLUSION:
There was a relationship between spiritual intelligence, education, and gender with the level of fear and anxiety of corona. Therefore, planning and implementing educational projects based on increasing spiritual intelligence for the elderly with priority for elderly women and with a low level of literacy and income is recommended.
Effectiveness of SMART heart package on knowledge and practice regarding prevention of coronary artery disease among high-risk adults in selected urban community at Bangalore
Authors: Chaudhary Manisha , Balu Venkatesan , Sapkota Pratima , Kamei Sonia , Devi Yumnam Sushma 
Published: November 2023

BACKGROUND:
Coronary artery disease is the most common cause of cardiovascular disease. Smoking is one of the triggering factors for CAD, which increases mortality and morbidity rates. The aim of this study was to assess the impact of the SMART heart package on high-risk adults' knowledge and practice of coronary artery disease prevention.

MATERIAL AND METHOD:
A quasi-experimental research study was conducted in India from March 25 to April 23, 2022, through a house-to-house survey. This survey was conducted among 200 adults out of 159 high-risk adults who were identified by a screening tool, using a systematic random sampling technique to select 60 subjects for the study. A SMART heart package intervention was administered for selected high-risk adults. The pre-test and the post-test were conducted using self-administered structured questionnaires for knowledge and a non-observation checklist for practice. The data had been analyzed by the Statistical Package for Social Science (SPSS) version 20.0.

RESULTS:
The findings show that at the baseline level of knowledge and practice, the majority of the subjects had inadequate knowledge 43 (71.7%) and 51 (85.0%) had poor practice, whereas after administration of the SMART heart package, 29 (48.3%) of subjects had moderately adequate knowledge and 29 (48.3%) had average practice. At baseline, the mean score was 41.5%, which increased to 79.1% on knowledge and 37.2% to 72.5% on practice after the implementation of the intervention, which was statistically significant (P < 0.001).

CONCLUSION:
Hence, the SMART heart package was effective in increasing the level of knowledge and practice of CAD prevention among high-risk adults.
Innovative AETCOM session on health care as a right: Experience at the medical college in Puducherry
Authors: Sahanaa Chandar , Niranjan Rajasekar , Pradeep Kumar , Gopinath Samundeswari , Dhanasekar Elanchezhian , Vendhan Sengadhir , Maniradjou Vasanthakogilam , Konduru Rajesh Kumar , Phalsalkar Manjiri 
Published: November 2023

BACKGROUND:
Attitude, Ethics, and Communication (AETCOM) module 2.3 is effective in improving the communication skills of medical students, which in turn will prevent malpractices and litigations against doctors. Module 2.3, ‘Health Care as a Right,’ was aimed at introducing healthcare systems, access, equity in access, the impact of socio-economic situation in determining healthcare access, the role of doctors as key players, and the missing links in the health care systems to students.

MATERIALS AND METHODS:
A teaching and learning activity was developed for MBBS professional year 2 on AETCOM 2.3. The activities planned were an introduction to the topic, a short documentary film using AV aids, role play by the team, group discussion followed by role play by the students, reflective writing, and finally summarizing the session with a take-home message.

RESULTS:
The number of responses received in reflective writing was 114. The thematic analysis of qualitative responses was grouped into categories The facilitating factors were the availability of trained doctors and round-the-clock services, and the hindering factors were disrespect to patients, professional misconduct, long waiting time, etc. The suggestions to improve communication between the doctor and the patient were to listen politely and develop good rapport. The qualities of a good doctor were good communication skills, empathy, professional conduct, etc.

CONCLUSION:
This AETCOM session helped the students understand the healthcare delivery system in the country. It changed their attitude toward patients and improved their communication skills as they were soon-to-become doctors.
A study on measure of resilience and impact of demanding clinical training on young medical professional's burnout in a tertiary care hospital, Andhra Pradesh
Authors: Thomas K Roma , Reddy B Venkatashiva 
Published: November 2023

BACKGROUND:
The psychological state of medical students gaining concern on the part of medical institutions in several countries. Numerous studies are being conducted to study stress, burnout, and depression in medical students in India and globally. However, little is known about medical student resilience, particularly in India. The objectives of this study were to study the resilience, self-perceptions of stress coping skills, and burnout among medical students in clinical training in a tertiary care health center, to study factors associated with resilience among medical students in clinical training in a tertiary care health center and to study the relationship between resilience and self-perceptions of stress coping skills and symptoms of burnout.

MATERIALS AND METHODS:
This cross-sectional study was conducted in a tertiary healthcare hospital in district Guntur, Andhra Pradesh from November 2020 to December 2020, among 186 adult male and female medical students, aged more than 20 years, enrolled in the regular degree course and part of patient care or at least last three months. Participants were randomly selected and a structured questionnaire with Connor Davidson Resilience Scale 10 was used for interviewing. Descriptive and inferential statistics were conducted to measure associations between outcome and explanatory variables. We used multiple linear regression to examine the association between dependent and independent variables. A P value less than. 05 was considered significant.

RESULTS:
In the present study, 109 (58.0%) were females. The mean age of the study participants was 25.4 years (standard deviation 2.78). The mean score resilience score of the study participants using Connor Davidson Resilience Scale 10 was 25.1 (standard deviation 7.97). Of the total 44 (23.7%) of the study, participants reported the presence of burnout. A significant positive correlation was between resilience and self-perceptions of stress-coping skills with a Pearson Correlation coefficient of 0.393. Among the study participants, the mean resilience score was higher among those not having any symptoms of burnout. In the hierarchical stepwise multiple linear regression analysis, male gender (P value = .014), financial independence (P value = .044), and absence of burnout symptoms (P value = .004) were significantly associated with higher resilience scores. Psychiatric medicine usage was significantly associated with a lower resilience score with P < .05.

CONCLUSION:
Our study samples had higher resilience and lower burnout prevalence compared to the West. The stressful clinical event experienced by medical students demands training and innovative strategies to foster communication and teamwork skills among medical teams.
Role of robotics and artificial intelligence in oral health education. Knowledge, perception and attitude of dentists in India
Authors: Baby Deepak , John Lauabel , Pia Joseph Changankary , Sreedevi PV , Pattnaik Samarjeet J. , Varkey Anish , Gupta Shivam 
Published: November 2023

BACKGROUND:
Artificial intelligence or AI may be identified as the use of Personal Computers and/or machines in performing certain specific types of tasks that usually have the requirement of humanized knowledge. These specific tasks include acknowledgment of the problem, understanding disease dynamics, and determining the clinical diagnosis.

MATERIALS AND METHODS:
This cross-sectional and prospective study was conducted on Dental professionals who were practicing all across India after obtaining approval from the Institutional Ethical Board. A previously validated as well as pre-analyzed questionnaire form was distributed using electronic mail and through the use of social media with a briefly explained description of the study purpose and an informed consent form. The study questionnaire comprised “close-ended” queries that were then divided into foursections. All the study participants were then instructed to select any one option among all the provided answers. The entire study was completed within one month. Collected observations were entered within a Microsoft Excel 2007® master chart. Statistical analytical software tool SPSS version 20.0, IBM Corporation was employed. “Chi-square” test was performed for evaluating statistical association. A P value lesser than 0.05 was fixed with statistical significance.

RESULTS:
On analyzing the level of knowledge, 82.5% of subjects had knowledge of artificial intelligence while 11.4% had no knowledge and 6.1% had some knowledge of this tool. 69.1% were knowledgeable regarding the use of AI in lesional diagnosis, 12.8% had no knowledge regarding artificial intelligence for the diagnosis and 18.1% had no knowledge regarding AI in the diagnosis. 71% had knowledge concerning the use of AI for Imaging. Knowledge of AI in Oral Hygiene was seen in 54.3%. 91.2% of participants had knowledge of robotics use in Oral Surgery. 77% of dentists had knowledge regarding the use of AI for the enhancement of clinical practice. 95.5% had a higher ‘positive’ attitude toward the use of AI in academics. 69.1% of dentists had a positive attitude regarding AI incorporation in practice. 5% of dentists considered artificial intelligence better than human intelligence for diagnosis. 10% believed that disparities can exist between AI-based and human diagnosis.

CONCLUSION:
Positive correlations were noted between knowledge, attitude, and practice of AI among studied dentists.
Assessment of sympathovagal balance by HRV analysis in alcoholic and nonalcoholic fatty liver disease patients
Authors: Uchil Divyashree N. , Moosabba M. S , Kalpana B , Grrishma B 
Published: November 2023

BACKGROUND:
Heart rate variability (HRV) is the variation in the time intervals between continuous heartbeats also called interbeat intervals to give information related to the heart, blood pressure, gaseous exchange, and sympathetic and parasympathetic balance. Abnormalities in the conduction of the cardiac system alter the measurements of heart rate variability and lead to alteration in autonomic function with a higher risk of mortality. So, our objective includes the assessment of sympathovagal balance in AFLD and NAFLD patients.

MATERIALS AND METHODS:
The study included 78 alcoholic and 54 nonalcoholic fatty liver patients. A room temperature of 23°C with 25–35% humidity will be maintained in a recording room. Basal supine heart rate and BP will be recorded by the oscillometric method using an automated blood pressure monitor Omron MX3, India. Lead II ECG will be recorded for the next 5 minutes in total resting condition for short-term HRV analysis. Short-term HRV indices including time domain and frequency domain were recorded from each patient. Under time domain, SDNN, RMSSD, and average RR were noted. Under frequency domain, LF, HF, VLF, LF (nu), HF (nu), and LF/HF were calculated. The data were collected by using a 16-bit, power lab 8/30 data acquisition system (New South Wales, Australia) with acknowledge 3.8.2 software. Inferential analyses such as independent t-tests and Mann–Whitney tests were used to compare NAFLD and AFLD patient groups. Carl Pearson correlation analysis was performed to obtain a relationship between variables.

RESULTS:
SDNN in (ms) which represents the overall HRV found to be decreased in both alcoholic (32.84 ± 79.08) and nonalcoholic fatty liver disease (22.04 ± 13.85) compared to the normal range (50 ± 16)) from 27 studies. The value of RMSSD in (ms) was decreased in both alcoholic (17.00 ± 12.48) and nonalcoholic fatty liver disease patients (14.00 ± 9.44) with the normal range of (42 ± 15) from 15 studies. Pearson correlation analysis showed the age of AFLD patients significantly and positively correlated with average RR. Pearson correlation analysis for the age of NAFLD patients was significantly and positively correlated with the average RR, HF, SDNN, RMSSD, and LF.

CONCLUSION:
Altered autonomic activity was noted in both alcoholic and nonalcoholic fatty liver disease patients. An early prognosis of fatty liver is very necessary to prevent the disease progress into later fatal life-threatening stages.