bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public-private partnership in Iranian hospitals
Authors: Etemadi Ghazaal , Rezayatmand Reza , Shaarbafchizadeh Nasrin 
Published: February 2023

BACKGROUND:
Nowadays, various strategies are applied by governments to control costs and finance hospitals and the health sector. Public-private partnership (PPP) option is one of these strategies. Considering the growing importance of hospitals in different communities and their problems, this study aimed to identify PPP challenges, opportunities and solutions in hospitals. This study aimed to identify the challenges and opportunities of PPP in the country's hospitals and then offered an appropriate solution to overcome these challenges.

MATERIALS AND METHODS:
This is a qualitative study and content analysis approach is undertaken. The participants were selected through purposive sampling and data were collected using a semi-structured interview with experts in the public and private health sector until the saturation point achieved. Data analysis was performed through the thematic analysis of expert's statements using MAXQDA. 10 software in this sector.

RESULTS:
According to the study results, 3 main themes (challenges, opportunities, and solutions), 10 sub-themes, and 32 codes were identified in relation to the public and private partnership. 4 sub-themes on challenges of PPP, 3 sub-themes on partnership opportunities and 3 sub-themes on challenges solutions were identified.

CONCLUSION:
The results of this study revealed that given the discussed challenges the most important challenge seems to be not evaluated outsourcings, incorrect usage of participatory models, and inadequate and inappropriate postoutsourcing supervision, however, it appears evaluated outsourcing backed with adequate supervision could solve many current hospitals’ problems.
Perceived stress and quality of life among frontline nurses fighting against COVID-19
Authors: Amjadi Sajedeh , Mohammadi Sepideh , Khojastehrad Ali 
Published: February 2023

BACKGROUND:
The coronavirus disease-2019 (COVID-19) crisis has changed many aspects of frontline nurses’ lives. Nurses caring for patients with COVID-19 reported experiencing significant psychological distress and work-related anxiety. This study aimed to assess the perceived stress and quality of life among frontline nurses fighting against COVID-19.

MATERIALS AND METHODS:
This web-based cross-sectional study was conducted on 322 frontline nurses fighting against COVID-19 in hospitals affiliated to Mazandaran University of Medical Sciences. Data were collected using the two following online questionnaires: the Perceived Stress Scale and World Health Organization Quality of Life-Brief. Data were compiled from October 23, 2020, to November 25, 2020. Data were analyzed using the independent sample t-test, Pearson's correlation test, and regression analysis test in the SPSS-21.

RESULTS:
Average perceived stress scores was 30.27 (standard deviation [SD] = 7.01). Average quality of life subscale scores consist of physical health, psychological health, social relationships, and environment were 57.71 (SD = 12.74), 44.3 (SD = 15.58), 45.61 (SD = 16.99), and 47.6 (SD = 18.11), respectively. There was an inverse significant association between all the subscales of quality of life and perceived stress (P = 0.008). Based on the multiple linear regression analysis, the variables of age, gender, marital status, and perceived stress were the significant predictors of quality of life subscales.

CONCLUSIONS:
Paying serious attention to addressing the concerns of frontline nurses, especially those who are at high risk, is necessary. It is recommended to take action as soon as possible to reduce the perceived stress and improve quality of life on nurses who care for patients with COVID-19.
Effect of video games on preoperative anxiety in 3- to-6-year-old of a sample of Iranian children undergoing elective surgery
Authors: Rostami Elham , Khanjari Sedigheh , Haghani Hamid , Amirian Houshang 
Published: February 2023

BACKGROUND:
As pediatric surgeries are rising and current methods to reduce perioperative anxiety are lacking in preschool children. The purpose of this study was to determine the effect of video games on preoperative anxiety in 3- to-6-year old of a sample of Iranian children undergoing elective surgery children.

MATERIALS AND METHODS:
In the current quasi-experimental pretest posttest design, after standard translation, the modified Yale preoperative anxiety scale was administered to 102 children undergoing surgery from December 2016 to August 2017 in Kermanshah, Iran. Children are assigned to an intervention or control group. Each child's anxiety was measured at two points at the time of arrival and after waiting for 20 min in the holding area. Data were analyzed by SPSS, version 22. The Chi-square, independent t-test, and paired t-test at the significance level of P < 0.05 were performed.

RESULTS:
There was no significant difference between the mean anxieties in control group (42.58 ± 18.54) and intervention group (46.11 ± 14.09) before the game (P = 0.282). However, after playing the video game in control groups (53.26 ± 18.00) and game groups (34.88 ± 10.81), there was a significant difference in favor of the video game (P < 0.001).

CONCLUSION:
Findings of the present study suggest that approved video game by experts to decrease mean preoperative anxiety in 3- to-6-year-old children. Therefore, video games recommended to be implemented at the preventive level in hospital.
Knowledge, attitudes, and perception toward human papillomavirus among health profession students
Authors: Aga Syed Sameer , Yasmeen Nusrath , Khan Muhammad Anwar , Hakami Alqassem Y. , Awadh Abdullah , Malli Israa Abdullah 
Published: February 2023

BACKGROUND:
Human papillomavirus (HPV) infection is the major risk factor for cervical cancer (CC) in women of reproductive age. Despite advances in treatment and prevention of CC by HPV vaccination, very few women utilize them because of a lack of awareness about HPV.

MATERIALS AND METHODS:
We conducted this cross-sectional study among Health Professions Students (HPS) at King Saud Bin Abdul Aziz University for Health Sciences, Jeddah. Data were collected using a predesigned and validated study questionnaire to assess the knowledge, attitude, and perception of HPS toward HPV.

RESULTS:
A total of 580 HPS responded to the survey; 128 (22.1%) were male, while 452 (77.9%) were female with the mean age ± standard deviation 20.36 ± 1.74 years. There was no significant difference between males and females related to screening of HPV and CC (82.8%; 82.3%). A minority (30.3%) of participants thought that HPV infection leads to CC, while 38.3% did not know about it. Furthermore, knowledge about HPV screening and vaccination was poor.

CONCLUSIONS:
Students from the college of medicine had more knowledge and awareness about HPV (34.9%, P < 0.001). Thus, it is important to implement effective education programs, curricular activities, and awareness campaigns for health professions to augment the learning process effectively.
Validity and reliability of the Persian version of the exercise self-efficacy scale in people with multiple sclerosis
Authors: Goldoust Faride , Abolhasani Maryam , Shakibazadeh Elham , Yaseri Mehdi , Garmaroudi Gholamreza 
Published: February 2023

BACKGROUND:
Exercise self-efficacy has been identified as one of the primary determinants of physical activity in people with multiple sclerosis (MS). Therefore, assessment of exercise self-efficacy is important to be measured with valid and reliable scale to provide tailored interventions.

MATERIALS AND METHODS:
The English version of the exercise self-efficacy scale was translated into Persian using a forward-backward translation approach. Factorial validity was conducted using the expletory factor analysis (EFA) and the confirmatory factor analysis (CFA). In addition, construct validity was performed using convergent and known-group validity. Reliability was evaluated by internal consistency and test-retest reliability. Participants were recruited from two hospitals (MS clinics).

RESULTS:
Expletory factor analysis identified a single factor structure which explained 64.7% variance in exercise self-efficacy scale (EXSE). CFA supported a single factor structure with a good model fit. Average variance extracted = 0.60 and composite reliability = 0.93 values confirmed the convergent validity. The known-group validity was verified with significant differences between subgroups. The Cronbach's alpha coefficient = 0.93 and intraclass correlation coefficient = 0.85 supported reliability of EXSE scale.

CONCLUSIONS:
Our findings provided sufficient evidence of validity and reliability for EXSE scale in people with MS. This measure can utilize by researchers and health-care providers in studies and clinical practice as a robust measure to assess exercise self-efficacy and to develop interventions in people with MS.
Prospective comparison of single encounter versus distributed laparoscopic training in novice learners
Authors: Arain Muhammad Abdullah , Begum Saleema , Shariff Amir H. , Khan Sadaf , Inam Pal K. M. , Khan Muhammad Rizwan , Ali Muhammad , Ringers Jan 
Published: February 2023

BACKGROUND:
The traditional model of teaching surgical skills on “real” patients using graded responsibility is being seriously questioned, and there is a paradigm shift toward exploiting simulators. There is a lack of clarity on the impact of using simulation as a teaching strategy in novice learners. The purpose of our study was to determine if the number and duration of training sessions influence the acquisition and retention of laparoscopic skills in naïve learners. There are some data to suggest that distributed training programs might have better outcomes, but the results are inconclusive. We designed a controlled trial at Aga Khan University, Karachi, with the hypothesis that students trained using the distributed method may have enhanced learning outcomes.

MATERIALS AND METHODS:
100 medical students were assigned in a 1:1 ratio to one of two groups. Group A underwent a single orientation and supervised practice session of 3 h duration. Group B underwent distributed teaching with three learning sessions of 1 h each spread over 3 consecutive weeks. Participant scores were analyzed before and after the intervention and at 3- and 6-month intervals using repeat measures of ANOVA.

RESULTS:
Pretest and immediate posttest scores were comparable between the two groups. The 3-month interval test showed significantly higher scores in Group B (difference = −2.90, P < 0.001). The 6-month interval test showed no differences in scores between the two groups (P = 0.178).

CONCLUSIONS:
Distributed teaching resulted in significantly enhanced scores at 3-month assessment. However, similar scores at 6 months suggest the need for repeated intervention.
Sociocultural, health knowledge, and health literacy among children ages 9–10 years in Thailand
Authors: Senahad Nopparat , Loahasiriwong Wongsa , Maneenin Naowarat 
Published: February 2023

BACKGROUND:
Health literacy (HL) enables a person to make good decisions regarding health care, disease prevention, and health promotion to maintain and improve health. In Thailand, most existing studies focus on adults’ HL rather than children. This research aimed to determine the influence of sociocultural and health knowledge on HL among children ages 9–10 years in Thailand.

MATERIALS AND METHODS:
A cross-sectional study was conducted among 1650 children aged 9–10 years. The respondents were recruited using multistage random sampling from 39 primary schools of 13 provinces in all four regions of Thailand. A self-administered structured questionnaire was used to collect the required data. The multilevel analysis was used to determine the association between sociocultural, health knowledge, and HL while controlling the effects of covariates. The result was presented as adjusted odd ratios and its 95% confidence interval (CI).

RESULTS:
Of the total 1650 respondents, 86.24% (95% CI: 84.49%–87.82%) had adequate and excellent levels of HL. The multivariable analysis indicated factors that were significantly associated with adequate and excellent levels HL including adequacy of per diem (adjusted odds ratio [adj. OR] = 6.78; 95% CI: 3.54–12.97) and had good relationship with teachers (adj. OR = 2.19; 95% CI: 1.55–3.09). Sources of health education which were received health education from parents (adj. OR = 3.51; 95% CI: 2.39–5.14), from teachers (adj. OR = 2.03; 95% CI: 1.43–2.89), and from the Internet (adj. OR = 1.83; 95% CI: 1.12–2.99) were also significantly associated with HL. Another significant factor was had good level of health knowledge (adj. OR = 1.86; 95% CI: 1.30–2.66) when control clustering effect of region, provinces, school, and classroom size.

CONCLUSIONS:
More than 85% of children ages 9–10 years in Thailand had adequate and excellence levels of HL. Sociocultural and health knowledge had influence on children HL.
The development and validation of an academic burnout questionnaire among Moroccan trainee teachers using the maslach burnout inventory-student survey
Authors: Abdelmounaim Bouhaba , Boumaaize Zineb , Elmadhi Youssef , Hami Hinde , Soulaymani Abdelmajid , Darif Hajar 
Published: February 2023

BACKGROUND:
Stress and burnout syndrome are more common for people who work in professions that include direct contact with humans, such as education and the medical field. To contribute to the prevention of this syndrome, the Maslach Burnout Inventory-Student Survey (MBI-SS) has been validated and used in different countries worldwide except for Morocco. The main purpose of this study is to develop and validate a special version of the MBI-SS scale to assess academic burnout among Moroccan trainee teachers during their training period.

MATERIALS AND METHODS:
A self-administered questionnaire was carried out to assess the sociodemographic factors and certain stressors of the interviewees as well as the MBI-SS. Two hundred fifty-five trainee teachers of the CRMEF (Regional Centre for Education and Training) participated to assess the validity of the MBI-SS scale in its French version and its three components during the academic year 2020/2021 of the Rabat-Salé-Kénitra region. The inferential method of data analysis was used by Cronbach's alpha to determine the overall reliability of the instrument as well as the three components of the assessment. After that, exploratory factor analysis was carried out.

RESULTS:
Sixty five percent of the participant were male, and most of them were between the ages of 20 and 30 years. The results demonstrated a satisfactory psychometric characteristic for its dimensions and validated the 3-dimensional structure of the MBI-SSM, yet they indicate the necessity to remove two items to guarantee their reliability. The Cronbach's alpha value of the MBI-SSM was greater than (0.7). The Cronbach's alpha also showed a good homogeneity for the three dimensions of the MBI-SSM, (0.853) for emotional exhaustion, (0.570) for cynicism, and (0.776) for academic efficacy.

CONCLUSIONS:
It is concluded that the MBI-SSM is determined to be an objective and a valid instrument and can be used to assess academic burnout in the Moroccan context.
Combined laparoscopic pouch and loop resizing as a revisional procedure for weight regain after primary laparoscopic one-anastomosis gastric bypass
Authors: Mouawad Christian , Dahboul Houssam , Chamaa Bilal , Kazan Daniel , Osseis Michael , Noun Roger , Chakhtoura Ghassan 
Published: February 2023

Introduction:
One-anastomosis gastric bypass (OAGB) presents a satisfactory long-term outcome in terms of weight loss, amelioration of comorbidities and low morbidity. However, some patients may present insufficient weight loss or weight regain. In this study, we tackle a case series evaluating the efficiency of the combined laparoscopic pouch and loop resizing (LPLR) as a revisional procedure for insufficient weight loss or weight regain after primary laparoscopic OAGB.

Materials and Methods:
We included eight patients with a body mass index (BMI) ≥30 kg/m2 with a history of weight regain or insufficient weight loss after laparoscopic OAGB, who underwent revisional laparoscopic intervention by LPLR between January 2018 and October 2020 at our institution. We conducted a 2 years’ follow-up. Statistics were performed using International Business Machines Corporation® SPSS® software for Windows version 21.

Results:
The majority of the eight patients were males (62.5%), with a mean age of 35.25 at the time of the primary OAGB. The average length of the biliopancreatic limb created during the OAGB and LPLR were 168 ± 27 and 267 ± 27 cm, respectively. The mean weight and BMI were 150.25 ± 40.73 kg and 48.68 ± 11.74 kg/m2 at the time of OAGB. After OAGB, patients were able to reach an average lowest weight, BMI and per cent of excess weight loss (%EWL) of 89.5 ± 28.85 kg, 28.78 ± 7.47 kg/m2 and 75.07 ± 21.62%, respectively. At the time of LPLR, patients had a mean weight, BMI and %EWL of 116.12 ± 29.03 kg, 37.63 ± 8.27 kg/m2 and 41.57 ± 12.99%, respectively. Two years after the revisional intervention, the mean weight, BMI and %EWL were 88.25 ± 21.89 kg, 28.44 ± 4.82 kg/m2 and 74.51 ± 16.54%, respectively.

Conclusion:
Combined pouch and loop resizing is a valid option for revisional surgery following weight regain after primary OAGB, leading to adequate weight loss through enhancement of the restrictive and malabsorptive effect of OAGB.
Age-appropriate Vaccination and its Determinants among Children <24 Months in Kano, Nigeria
Authors: Maizare Hajara I , Tsiga-Ahmed Fatimah Isma'il , Faruk Shahida Labaran , Ahmad Abdulmajid Yakubu , Abulfathi Aisha Aliyu 
Published: February 2023

Background:
Administration of vaccines at recommended ages and according to recommended intervals between doses of multi-dose antigens provides optimal protection, ultimately reducing the possibility of propagating the transmission of vaccine-preventable diseases. A sizable discrepancy in the median age at vaccination has been shown in Nigeria. This study assessed age-appropriate vaccination and related factors among children aged 0–23 months attending immunization clinics in the Kano metropolis.

Materials and Methods:
An adapted and pretested semi-structured interviewer-administered questionnaire was used to obtain information from a cross-section of 384 pairs of mothers/babies who presented to the immunization clinics of selected primary health centers within Kano metropolis.

Results:
The median ages at vaccination were 13, 49, 91, 122, and 282 days for BCG, pentavalent-1, pentavalent-2, pentavalent-3, and measles antigens, respectively. Proportions of children who had received age-appropriate vaccines were 83.8%, 81.6%, 64.9%, 60.4%, and 40.3% for BCG, pentavalent-1, pentavalent-2, pentavalent-3, and measles vaccinations, respectively. Children who were 4 months or older were 80% less likely to be age-appropriately vaccinated compared to those 3 months or younger (adjusted odds ratios [aOR]: 0.2, 95% confidence interval [CI]: 0.1–0.7). Furthermore, children with a previous experience of an adverse event following immunization were 50% less likely to be age-appropriate for the index vaccination (aOR: 0.5, 95% CI: 0.3–0.9).

Conclusion:
Many children in the Kano metropolis were not age-appropriately vaccinated. The measles vaccine had the least proportion of age-appropriately vaccinated children. Sensitization and health education of caregivers on timely vaccination cannot be overemphasized.
Knowledge, Attitudes, and Behaviors of Indian Medical Students and Health-Care Providers on COVID-19
Authors: Priyadarshini Bhagyajyoti , Swarup Shiba Sai , Swain Trupti Rekha , Behera Joshil Kumar , Kumar Naresh , Sandhya Kumari , Mondal Himel 
Published: February 2023

Background:
COVID-19 has created fear, misconception, and apprehensions among not just the public but also the present and future health-care providers. The COVID-19 pandemic has passed two waves, and currently, the third wave is waning.

Aim:
This study aimed to evaluate the knowledge, attitude, and practice toward COVID-19 among the health-care providers and medical students of India.

Materials and Methods:
This was a cross-sectional, observational study conducted with medical students, practicing doctors, nurses, ward attendants, and other health-care workers working all over India. The questionnaire used for the study was developed using the three-step modified Delphi method. It was prevalidated and standardized by conducting a pilot study. Then, the survey questionnaire was circulated via Google Forms. The collected responses were tested statistically by Kolmogorov–Smirnov test, Chi-square, and Spearman's rank correlation.

Results:
A total of 2211 (1137 medical students, 840 doctors, 126 nurses, 12 ward attendants, and 96 other health-care workers) respondents participated in the study. The mean score for knowledge was 5.93 ± 1.21, for attitude was 5.20 ± 0.84, and for practice was 2·38 ± 0·896. We found a significant positive correlation between knowledge and attitude, knowledge and practices, and attitude and practices.

Conclusion:
There is an average to a good level of knowledge, attitude, and practice toward COVID-19 among the medical students and health-care providers in India in the third wave of the COVID-19 pandemic. The positive correlation affirms that better knowledge can lead to a positive attitude. This ultimately helps build appropriate behavior.
Management of Diabetic Macular Edema Through Ayurveda: A Single Case Study
Authors: Garima Gupta  , Rajendra Kumar Soni  
Published: February 2023

Diabetic macular edema is one of the leading causes of visual acuity loss in people with diabetes. It produces blurry vision, particularly in the centre of the vision field, floaters and black spots in front of the eyes etc. The treatment recommended by modern science is laser photocoagulation and anti-VEGF injection, which is pricey and does not ensure visual reversal in the patient. In Ayurveda text, diabetic retinopathy and diabetic macular edema are not directly described but etiopathogenesis of eye diseases and Prameha gives an idea of possible correlation between these two diseases. So, DME resembles Timira (Pramehajanya). In Ayurveda, Timira has been explained in detail by our Acharyas. Clinical manifestations of Timira are Vihwal Drishti (blurred vision), Makshika Mashaka Kesha Jaala Pashyati (floaters), Tamasa Darshanam (Scotoma- black spots in front of eyes) and Nasa Akshi Yuktani Vipritani Vikshate (Metamorphopsia or distorted vision) which has similarity with features of DME. Material & Methods: In the present study, a female patient aged 51 years, visited the Shalakya Tantra OPD of National Institute of Ayurveda, Jaipur, with complaining of Blurriness of vision since 6 months and uncontrolled blood sugar level. Result: Blood sugar level was controlled and saw reduction in subjective and objective parameters. Discussion: Following an Ayurvedic drugs and routine will assist to slow the advancement of the condition, prevent further diabetes complications, and improve quality of life.
Metodologias ativas em Educação Musical
Authors: Cernev Francine Kemmer 
Published: February 2023

Este artigo tem por objetivo relatar a reflexão dos licenciandos em música sobre a prática norteada pelas metodologias ativas no curso superior à distância. A pesquisa ocorreu na disciplina Estratégias de Aprendizagem a Distância por meio da pesquisa ação. Participaram da pesquisa os 142 alunos matriculados na disciplina, a professora investigadora e o tutor da disciplina. Os pressupostos da aprendizagem colaborativa, motivação para aprender, estratégias de aprendizagem e metodologias ativas em educação pautaram as ações nas dinâmicas do ensino durante o curso da disciplina. Os resultados mostraram que a articulação de saberes, o diálogo e a mediação tecnológica puderam abrir perspectivas para motivação, capacitação e desenvolvimento musical por parte dos licenciandos em música. Em suma, a utilização de metodologias ativas amplia possibilidades no fazer musical de modo a promover e a apoiar a formação docente no ensino superior à distância.