bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opioid versus non-opioid postoperative pain management in otolaryngology
Authors: Keane Allison , Jardine Kayla , Goldenberg David , Pradhan Sandeep , Zhu Jay , Mansour Jobran , Knoller Hadas , Eshel Ron , Talmi Yoav P. , Vaida Sonia , Slonimsky Guy 
Published: August 2023

Abstract
Background
The opioid epidemic in the United States has had devastating consequences, with many opioid-related deaths and a significant economic toll. Opioids have a significant role in postoperative pain management. Here we aim to analyze differences in postoperative opioid and non-opioid pain medications regimens following common otolaryngological surgeries between two large tertiary care medical centers: the Milton S. Hershey Medical Center, USA (HMC) and The Chaim Sheba Medical center, Israel (SMC).

Methods
A retrospective chart review of patients undergoing common otolaryngological procedures during the years 2017–2019 was conducted at two tertiary care centers, one in the U.S. and the other in Israel. Types and doses of postoperative pain medications ordered and administered during admission were analyzed. Average doses ordered and administered in 24 h were calculated. Opioid medications were converted to a standardized unit of morphine milliequivalents (MME). Chi-square test and Wilcoxon rank-sum test were used to compare the groups.

Results
The study included 204 patients (103 U.S., 101 Israel). Patient demographics were similar except for a longer length of stay in Israel (p < 0.01). In the U.S., 95% of patients were ordered opioids compared to 70% in Israel (P < 0.01). In the U.S., 68.9% of patients ordered opioids received the medications compared to 29.7% in Israel. The median opioid dose ordered in the U.S. was 45MME/24 h compared to 30MME/24 h in Israel (P < 0.01), while median dose received in the U.S. was 15MME/24 h compared to 3.8MME/24 h in Israel (P < 0.01). Opioid prescriptions at discharge were given to 92% of patients in the U.S. compared to 4% of patients in Israel (p < 0.01). A significantly higher number of patients in the U.S. were prescribed acetaminophen and ibuprofen (p < 0.0001). Dipyrone was prescribed to 78% of patients in Israel.

Conclusions
HMC demonstrated a significantly more permissive approach to both prescribing and consuming opioid medications for postoperative pain management than SMC for similar, common otolaryngological surgeries. Non-opioid alternatives and examining the cultural and medical practice-based differences contributing to the opioid epidemic should be discussed and reevaluated.
Measuring leprosy case detection delay and associated factors in Indonesia: a community-based study
Authors: Dharmawan Yudhy , Korfage Ida J. , Abqari Ulfah , Widjanarko Bagoes , Richardus Jan Hendrik 
Published: August 2023

Abstract
Background
Leprosy is a public health burden in Indonesia with a high number of new cases every year and a high proportion of disability among new cases. Case detection delay (CDD) can contribute to ongoing transmission and increased disability chances among leprosy patients. This study aimed to establish the CDD of leprosy and the factors associated with detection delay in Indonesia.

Method
Community-based study with a cross-sectional design. Data were collected through interviews about sociodemographic and behavioral factors, anticipated stigma, and duration of CDD. Leprosy classification and case detection methods were obtained from health service records. A random sample was taken of 126 leprosy patients registered between 1st October 2020 and 31st March 2022 in the Tegal regency in the Central Java Province. Data were analysed by descriptive and analytical statistics using multiple linear regression.

Results
The mean CDD, patient delay, and health system delay were 13.0 months, 9.7 months, and 3.2 months, respectively. Factors associated with longer CDD are younger age (below 35 years), male, found through passive case detection, and not having a family member with leprosy. Factors associated with longer patient delay were being younger (below 35 years), being male, not having a family member with leprosy, and anticipated stigma of leprosy. It was not possible to reliably identify factors associated with health system delay.

Conclusion
CDD in leprosy should be reduced in Indonesia. The Indonesian National Leprosy Control Program (NLCP) is advised to adopt an integrated intervention programme combining active case detection with targeted health education to reduce CDD and thereby preventing disabilities in people affected by leprosy.
Development and evaluation of the psychometric properties of a digital questionnaire for the self-management of health and well-being in the postpartum period
Authors: Bully Paola , Artieta-Pinedo Isabel , Paz-Pascual Carmen , García-Álvarez Arturo ,   Ema-Q Group, Alvarez Sonia , Amorrortu Pilar , Blas Mónica , Cabeza Inés , Estalella Itziar , Fernández Ana Cristina , Gutiérrez de Terán-Moreno Gloria , Legarra Kata , Lozano Gorane , Maquibar Amaia , Moreno-López David , Mulas Mª Jesús , Pérez Covadonga , Rodríguez Angela , Sáenz de Santamaría Mercedes , Sánchez Jesús , Villanueva Gema , Espinosa Maite 
Published: August 2023

Abstract
Background
Despite the fact that the Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030) recognises the special importance of care for women during the postpartum period, thus highlighting the need to identify and measure any condition that may affect the welfare of pregnant women in any way, this is one of the most neglected stages in the health system. Given the absence in our area of global, efficient instruments, the objective of this study was to design a complete, specific measurement tool with good metric qualities in digital format for the evaluation of self-reported health and well-being during the puerperium, to conform to what was proposed by the ICHOM.

Methods
A cross-sectional study was carried out to evaluate the psychometric characteristics of a digital measurement tool. The development of the tool was carried out in 4 steps, following the recommendations of the International Test Commission. It was tested on 280 puerperas attending primary healthcare appointments in the Basque Healthcare System (Osakidetza), and they did the newly created survey, answering all the questions that had been selected as the gold standard. The average age of the women was 34.93 (SD = 4.80). The analysis of the psychometric characteristics was based on mixed procedures of expert judgment (a focus group of healthcare professionals, an item evaluation questionnaire and interviews with users) and quantitative evaluations (EFA, CFA, and correlation with gold standard, ordinal alpha and McDonald’s omega).

Results
The final version of the tool comprised 99 items that evaluate functional state, incontinence, sexuality, breastfeeding, adaptation to the role of mother and mental health, and all of these questions can be used globally or partially. It was found that the scores were valid and reliable, which gives metric guarantees for using the tool in our area.

Conclusions
The use of this comprehensive concise tool with good psychometric properties will allow women to take stock of their situation, assess if they have the necessary resources, in psychological and social terms, and work together with midwives and other healthcare professionals on the most deficient areas.
Health beliefs on type 2 diabetes: a methodological research for development and psychometric evaluation of “DIABA” (Diabetes-related Instrument to Assess Beliefs of Adolescents) health beliefs on type 2 diabetes
Authors: Dorosteh Ameneh Pooresmaeil , Ghaffari Mohtasham , Rakhshanderou Sakineh , Mehrabi Yadollah 
Published: August 2023

Abstract
Background
Several reports have shown an increase in the number of type-2 diabetics among adolescents creating an extra burden for this age group. However, there is no instrument assessing adolescents’ attitude toward this disease. This study aims at designing a psychometric tool for assessing adolescents’ health beliefs regarding type-2 diabetes.

Research design and methods
In this methodological research, 770 boy and girl adolescents (between 13 and 15) from Tehran participated through multistage sampling. The Inclusion criteria were: junior high school students, students’ willingness for participation and not suffering from type-1 or type-2 diabetes. The questionnaire was designed by extensive literature review and the related existing questionnaires, as well as considering the research team’s comments. The validity of the questionnaire was determined through face and content validity. The construct validity was determined through exploratory and confirmatory factor analysis. Reliability was measured via internal consistency coefficient (ICC) and internal consistency reliability was measured by Cronbach Alpha. SPSS 16 and EQS6.1 were used for data analysis.

Results
The pool of questions had 57 items, and by removing similar (23 questions) or inappropriate sentences (8 questions), a draft questionnaire with 26 questions was designed. No items were removed in the face validity phase. Based on the results of CVR and CVI, six items and 4 items in the exploratory factor analysis were removed. Finally, a questionnaire with 16 items in 4 dimensions of perceived self-efficacy, behavioral beliefs, perceived susceptibility and perceived severity was obtained. The results of confirmatory factor analysis confirmed the model. The internal consistency coefficient was confirmed measuring Cronbach Alpha at 0.78 and ICC = 0.73.

Conclusion
The questionnaire designed can be employed as a reliable and valid instrument to assess the psychological perceptions and health beliefs of adolescents with respect to type-2 diabetes.
Association between nickel exposure and body compositions in the United States: a population-based cross-sectional study
Authors: Su Xingyang , Zhang Zilong , Qiu Shi , Zeng Bin , Yang Mi , Huang Xinyi , Zou Xiaoli , Yang Lu 
Published: August 2023

Abstract
Background
Increasing body fat or decreasing muscle and bone mass were associated with worse health outcomes in the adult population. The effects of nickel exposure on body composition are not known. The aim of the current study was to investigate the relationship between urinary nickel levels and body compositions.

Materials and methods
Two thousand seven hundred sixty-two participants were included in the analysis from the National Health and Nutrition Examination Surveys of 2017–2018 after excluding participants who have missing data on urinary nickel and those with missing all body mass component data. We used weighted generalized linear models to explore the relationship between urinary nickel and body mass components under interpolating missing covariable values. Simultaneously, sensitivity analyses and subgroup analysis were conducted to verify stability of analysis result. Curve fitting and saturation effect analysis were used to explore the possible nonlinear relationship between urine nickel and body compositions.

Results
Among the 2,762 participants, the average urinary nickel level was 1.58 ug/L. The weighted generalized linear models, the sensitivity analyses and subgroup analyses found no significant linear relationship between urinary nickel and body compositions. For body weight, BMI, TLM, ALM, TRF, TOF and BMC, the urine nickel saturation effect values were 0.76, 0.74, 0.5, 0.67, 0.64, 0.48, and 0.45 ug/L, respectively. For each 1 ug/L rise in urinary nickel levels at levels below the turning point, body weight increases (β = 9.06, 95% CI = 2.75, 15.36, p = 0.01), BMI increases (β = 3.20, 95% CI = 1.36, 5.05, p =  < 0.001), TLM decreases (β = -47.39, 95% CI = -97.38, 2.59, p = 0.06), ALM decreases (β = -37.25, 95% CI = -63.25, -11.24, p = 0.01), TRF increases (β = 20.68, 95% CI = 1.50, 39.86, p = 0.03), TOF increases (β = 57.92, 95% CI = -0.12, 115.95, p = 0.05), and BMC decreases (β = -6.84, 95% CI = -12.64, -1.04, p = 0.02).

Conclusions
In summary, our study demonstrated that a dose–response relationship exists between urinary nickel and body compositions, with a low inflection point level of urinary nickel for the saturation effect.
Mental health and governmental response policy evaluation on COVID-19 based on vaccination status in Republic of Korea
Authors: Kim Dong-Kyu , Lee Inyup , Choi Chulhwan , Park Sung-Un 
Published: August 2023

Abstract
Background
The coronavirus disease (COVID-19) pandemic has continued since the outbreak in December 2019. People experience depression and anxiety due to government policies and restrictions on physical activity due to the COVID-19 pandemic. This study aimed to compare and analyze people’s experiences of COVID-19 blues, sports policy awareness, and participation intention according to their vaccination status.

Methods
This quantitative study used an online survey to collect demographic information, vaccination status, and variables. Data validity and reliability were verified through confirmatory factor analysis, and Cronbach’s alpha coefficients were calculated using SPSS/AMOS 23.0. Finally, this comparative study was conducted using multivariate analysis of variance to investigate the differences in the dependent variables between the groups.

Results
The vaccinated group had higher scores for all factors related to COVID-19 blues (F = 19.147; p < .05; partial η2 = .046) and government policy (market responsiveness: F = 5.669, p < .05, partial η2 = .014; policy performance: F = 6.997, p < .05, partial η2 = .017; policy satisfaction: F = 7.647, p < .05, partial η2 = .019), apart from the intention to participate in sports (F = .014, p > .05, partial η2 = .000); these results demonstrate that people with COVID-19 blues and relatively high confidence in government quarantine policies were more likely to be vaccinated. In addition, all participants gave sports-participation intention the highest rating, regardless of their vaccination status; this reflects the current situation, in which individual activities are limited.

Conclusions
This study analyzed the mental health of vaccinated and unvaccinated groups in Korean adult men, their perceptions of government policies, and their willingness to engage in physical activity. The findings are meaningful and highlight useful directions for future research. This study provides evidence which can help alleviate the mental damage caused by government quarantine policies and enable a better understanding of the COVID-19 pandemic.
The results of this study provide important data for understanding the COVID-19 pandemic.
Taking stock of population-level interventions targeting risk factors for hypertension and diabetes in Rwanda and South Africa: methodological reflections and lessons learnt from conducting a multi-component situational analysis
Authors: J Uwimana Nicol , JP Nganabashaka , KD Tumusiime , T Young , E Rehfuess , J Burns 
Published: August 2023

Abstract

Background
Hypertension and diabetes are on the rise both in Rwanda and South Africa. The responsibility for NCD risk factors cut across different sectors, which makes it complex to effectively manage. Policy-relevant intervention research is thus critical for addressing the NCD challenge. We conducted a situational analysis in both countries to identify and describe current population-level interventions targeting risk factors for diabetes and hypertension. This paper presents this methodology and shares challenges encountered, and lessons learnt in applying the methodology.

Methods
We describe a multi-component methodology for conducting a situational analysis, which included a desk review, stakeholder mapping, survey, key informant interviews, and a consultative workshop. This methodology was applied in a standardized manner in two African countries. Following the analysis, the authors held iterative team consultations to reflect on challenges and lessons learnt during this process.

Results
Key challenges and lessons learnt relate to i) stakeholder recruitment, engagement and retainment; ii) utilization and triangulation of multiple sources of data; and iii) evolving circumstances, particularly related to the Covid-19 pandemic. It proved challenging to recruit stakeholders outside the health sector and in the private sector, as they often do not consider themselves as making or influencing policies and thus were reluctant to engage. The difficulties with responsiveness were often overcome through face-to-face visits, an opportunity to explain the relevance of their participation. With regards to health sector stakeholders and all other stakeholders, continued engagement over prolonged periods of time also turned out to be challenging. Covid-19 restrictions were preserved to be an impediment throughout the conduct of the situational analysis, specifically in South Africa. The use of multi-stage mixed methods was found to be appropriate for addressing the study objectives, as each step yielded unique data, concepts, and perspectives that complemented the other data.

Conclusion

Conducting a situational analysis is crucial for understanding the current state of interventions and identifying opportunities for new interventions. The multi-component methodology used in two African countries was found to be feasible, appropriate, and informative. Others planning to conduct situational analysis may follow, adapt and improve upon our approach, reacting to the challenges encountered.
Yoga studio websites: are they an accurate first glance at the studio’s mission, values, and resources?
Authors: Dysart Anna , Barnett Jake , Harden Samantha M. 
Published: August 2023

Abstract
Background
Yoga, as an ancient and modern practice, increases physical, mental, emotional, spiritual, and social health. Yoga studio websites serve as a dissemination channel for studios to express their offerings, whom they employ, and whom they seek as clientele. Public health workers, physicians, researchers, and clinicians, can refer to existing studios to increase health among their patients or clients. The degree to which these websites can provide relevant information to these various stakeholder groups has yet to be defined.

Methods
A pragmatic, sequential mixed-methods study was employed with quantitative data extraction, summarized as means and proportions, to score the studio websites (N = 28), and semi-structured interviews (n = 6) analyzed using the rigorous and accelerated data reduction (RADaR) technique, to confirm website content and staff intention. To explore urban and rural characteristics, yoga studios in southwest Virginia and Los Angeles were selected for inclusion.

Results
Overall, community-based yoga studios websites included information on the type, duration, cost, and COVID mitigation strategies. The most common class duration was 60 min. Rural Southwest Virginia studios offered 8.5 classes per week whereas those in urban Los Angeles offered 24.2 classes per week. All studios used iconography and images to invite racial, ethnic, age, and body type and ability diversity. While studios in both areas specified that there were 200- and 500-hour registered yoga teachers, many of the instructor biographies did not include information on their training. Although only preliminary, the interviews (n = 6) confirmed that the websites generally represented the feel, intention, and offerings of the studio and that the primary purpose of the studio was to build relationships and ensure people felt comfortable in the space.

Conclusion
Website information was related to studio offerings and values; however, discussion with management or visiting the studio may provide a richer picture of the yoga practices offered in the space. Further suggestions for website content are provided.
Pregnant women’s perception on the health effects of household air pollution in Rural Butajira, Ethiopia: a phenomenological qualitative study
Authors: Shine Sisay , Tamirie Mulugeta , Kumie Abera , Addissie Adamu , Athlin Simon , Mekonnen Hussen , Girma Eshetu , Molla Mitike , Kaba Mirgissa 
Published: August 2023

Abstract
Background
Household air pollution is the major public health problem in developing countries. Pregnant women spent the majority of their time at home and are the most affected population by household air pollution. Exploring the perception of pregnant women on adverse health effects is important to enhance the mitigation strategies. Therefore, this study aim to explore the pregnant women’s perceptions about health effects of household air pollution in rural Butajira, Ethiopia.

Methods
A phenomenological qualitative study design was conducted among 15 selected pregnant women. All interviews were carried out at the participants´ house and audio-recorded while housing and cooking conditions were observed and appropriate notes were taken for each. The collected data were transcribed verbatim and translated into the English language. Then, the data were imported into Open code software to manage the overall data coding processes and analyzed thematically.

Results
Study participants perceived that respiratory problems such as coughing, sneezing and asthma and eye problem were the major health problem caused by household air pollution among pregnant women. Study participants also mentioned asphyxiated, abortion, reduces weight, and hydrocephalus was caused by household air pollution on the foetus. Study participants perceived that financial inability, spouse negligence, autonomy and knowledge level of the women were the barriers to tackling household air pollution. Study participant also suggested that opening the door and window; using improved cookstove and reduce workload were the perceived solution for household air pollution.

Conclusions
This study explores pregnant women’s perceptions on health effects of household air pollution. The finding of this study was important to deliver suitable intervention strategies to mitigate household air pollution. Therefore, educating the women on way of mitigating household air pollution, improving existing structure of the house and minimize the time to stay in the kitchen is important to mitigate household air pollution exposure.