bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study protocol of the Our Futures Vaping Trial: a cluster randomised controlled trial of a school-based eHealth intervention to prevent e-cigarette use among adolescents
Authors: Gardner Lauren A. , Rowe Amy-Leigh , Stockings Emily , Champion Katrina E. , Hides Leanne , McBride Nyanda , Allsop Steve , O’Dean Siobhan , Sunderland Matthew , Lee Yong Yi , Mihalopoulos Cathy , Freeman Becky , Leung Janni , McRobbie Hayden , Stapinski Lexine , Lee Nicole , Thornton Louise , Debenham Jennifer , Teesson Maree , Newton Nicola C. 
Published: April 2023

Abstract
Background
Effective and scalable prevention approaches are urgently needed to address the rapidly increasing rates of e-cigarette use among adolescents. School-based eHealth interventions can be an efficient, effective, and economical approach, yet there are none targeting e-cigarettes within Australia. This paper describes the protocol of the OurFutures Vaping Trial which aims to evaluate the efficacy and cost-effectiveness of the first school-based eHealth intervention targeting e-cigarettes in Australia.

Methods
A two-arm cluster randomised controlled trial will be conducted among Year 7 and 8 students (aged 12–14 years) in 42 secondary schools across New South Wales, Western Australia and Queensland, Australia. Using stratified block randomisation, schools will be assigned to either the OurFutures Vaping Program intervention group or an active control group (health education as usual). The intervention consists of four web-based cartoon lessons and accompanying activities delivered during health education over a four-week period. Whilst primarily focused on e-cigarette use, the program simultaneously addresses tobacco cigarette use. Students will complete online self-report surveys at baseline, post-intervention, 6-, 12-, 24-, and 36-months after baseline. The primary outcome is the uptake of e-cigarette use at 12-month follow-up. Secondary outcomes include the uptake of tobacco smoking, frequency/quantity of e-cigarettes use and tobacco smoking, intentions to use e-cigarettes/tobacco cigarettes, knowledge about e-cigarettes/tobacco cigarettes, motives and attitudes relating to e-cigarettes, self-efficacy to resist peer pressure and refuse e-cigarettes, mental health, quality of life, and resource utilisation. Generalized mixed effects regression will investigate whether receiving the intervention reduces the likelihood of primary and secondary outcomes. Cost-effectiveness and the effect on primary and secondary outcomes will also be examined over the longer-term.

Discussion
If effective, the intervention will be readily accessible to schools via the OurFutures platform and has the potential to make substantial health and economic impact. Without such intervention, young Australians will be the first generation to use nicotine at higher rates than previous generations, thereby undoing decades of effective tobacco control.

Trial registration
The trial has been prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12623000022662; date registered: 10/01/2023).
Knowledge, attitudes, and factors associated with vegetarianism in the Saudi Population
Authors: Azhar Wedad , Aljabiri Sanaa , Bushnaq Taqwa , Azzeh Firas S. , Alyamani Reema A. , Alkholy Sarah O. , Alhassani Walaa E. , Abusudah Wafaa F. , Qadhi Alaa , Bukhari Hassan M. , Bakr Elsayed H. , Ghafouri Khloud 
Published: April 2023

AbstractBackgroundIn recent years, there has been great interest in the dietary practices of vegetarians in addition to an increasing awareness of the potential benefits of vegetarian diets. However, there are insufficient data on the spread of vegetarianism in Arab countries. The aim of this study was to investigate knowledge and attitudes about vegetarianism and associated factors in the Saudi population and to understand the reasons for its growing prevalence.MethodThis is a cross-sectional study began in May 2020 and ended in September 2020. Researchers distributed the questionnaire electronically through social media. Data were collected electronically and exported to Excel by the researchers .The electronic questionnaire comprised three sections: sociodemographic questions, reasons for following a vegetarian diet, and beliefs and knowledge about vegetarianism.ResultsThere were 3,035 responses, of which 80.2% of respondents were female and 19.8% were male. Participant were aged 18–65. Vegetarians represented 37.5% (15.7% semivegetarians, 8.1% pescovegetarians, 64.3% lacto-ovo-vegetarians, and 11.3% vegans), and the rest were nonvegetarians. The majority of the vegetarian participants (92.9%) had a low vegetarianism knowledge level. Health issues, followed by ethical and environmental concerns, were the most common motivators for adopting a vegetarian diet; these reasons were cited by 72.5%, 59.3%, and 47.9% of participants, respectively. Factors associated with increased vegetarianism were engaging in exercise for half an hour to two hours, while factors associated with decreased vegetarianism were male, aged 51–64 years, being married, having a higher education, working in the health sector, being a housewife, and having an income between 5,000 and 10,000 SR/month.ConclusionVegetarianism appears to be a growing phenomenon among the Saudi population. Increased awareness of health issues and the desire to live a healthy lifestyle might be the strongest motives. This study offers an opportunity to better understand vegetarianism in Saudi Arabia along with the possibility of expanding vegetarian food choices for the general public.
Iranian medical students’ tendency to migrate and its associated factors
Authors: Taherahmadi Mohammad , Khabaz Mafinejad Mahboobeh , Sayarifard Azadeh , Akbari Sari Ali , Farahani Parisa 
Published: April 2023

Abstract
Background
Medical staff migration is one of the challenges for both developed and developing countries affecting society’s health and welfare, which limits access to equity. Therefore, this study was designed and conducted to investigate the tendency to migrate and the factors affecting it among medical students of the Tehran University of medical sciences, Tehran, Iran, in 2019.

Methods
This cross-sectional study was performed among 472 medical students using a valid questionnaire which was designed after reviewing the literature and using the opinions of experts. The tendency to migrate and its associated factors were analyzed and reported using the Pearson correlation test, independent t-test, one-way ANOVA test, Tukey post-hock test, and Kruskal–Wallis non-parametric test.

Results
According to this study, the tendency to migrate was 6.13 ± 2.82 out of 10. While there was no significant relationship between age, marital status, medical educational phase and the tendency to migrate (p > 0.05); There was a significant relationship between willingness to migrate with variables of gender (p = 0.027), pre-university study region (p < 0.001), father’s academic degree (p = 0.007), mother’s academic degree (p < 0.001), having the relative abroad (p < 0.001), foreign trip experience (p < 0.001), foreign language skills (p < 0.001), number of published articles (p = 0.005) and Iran’s National Elite Foundation membership (p = 0.039).

Conclusions
Females, elites, and those with higher socioeconomic state, previous exposure to foreign countries, the ability to speak foreign languages, and research activity are more likely to migrate. Considering the high tendency to migrate among Iranian medical students, urgent and severe strategies must be undertaken to solve this social and health problem.
Examining the effects of student-centered flipped classroom in physiology education
Authors: Lu Chunmei , Xu Jie , Cao Yang , Zhang Ying , Liu Xiaoyu , Wen Haixia , Yan Yan , Wang Jiao , Cai Minghui , Zhu Hui 
Published: April 2023

AbstractBackgroundThe flipped classroom approach has gained increasing popularity in medical education. Physiology is a basic medical course that studies the phenomena and laws of human life activities, and is a crucial link course connecting preclinical courses and clinical courses. However, there is a paucity of data showing the effectiveness of the flipped classroom model for the entirety of physiology course in medical undergraduate students.Method131 sophomore students with clinical medicine major at Harbin Medical University were recruited and they were randomly allocated into two groups: the control group which was subjected to traditional lecture teaching (n = 69), and the experimental group which was subjected to flipped classroom teaching (n = 62). To assess the effect of flipped teaching, the usual performance and final exam scores were used to evaluate the physiology learning effectiveness of students. The correlation between the usual performance and final exam scores by Pearson method was also conducted in the two teaching groups. After course completion, an anonymous questionnaire survey was conducted among the subjects of flipped classroom group to assess students’ opinion regarding the flipped classroom teaching.ResultsOur results showed that the usual performance and final exam scores of students in the flipped classroom were both significantly higher than that in the traditional teaching class (P < 0.05). Moreover, our results also showed that the usual performance of students was significantly correlated with the final exam scores in the flipped classroom (r = 0.3945,P < 0.01), but not in the traditional teaching group (r = 0.1522,P = 0.2119). The results of questionnaire survey showed that 77.58% of the students believed flipped classroom teaching improved their knowledge acquisition. 70%~86% of students perceived that flipped classroom enhanced their learning abilities, including self-study ability, collaborative learning and problem-solving skills, and clinical thinking ability. In addition, about 60% of students acknowledged the teaching design and teaching environment, more students’ engagement and presentation of group learning in the flipped classroom.ConclusionThe flipped classroom teaching significantly improved students’ learning effectiveness in physiology course, as indicated by final exam score and usual performance. It also promoted higher-order ability-set acquisition and allowed a rationalized formative evaluation system.
Health Sciences students’ experience of COVID-19 case management and contact tracing in Cape Town, South Africa
Authors: Zweigenthal Virginia , Perez Gonda , Wolmarans Karen , Olckers Lorna 
Published: April 2023

Abstract
Background
COVID-19 has challenged health and higher education systems globally. Managing the epidemic in Cape Town, South Africa (SA), required partnerships with universities and setting up of de novo systems for mass case and contact tracing (C&CT). Health sciences, predominantly medical students, as well as social work and psychology students formed the core of this telephone-based work over the 18 months when SARS-CoV-2 caused severe disease.

Methods
This qualitative study aimed to elicit students’ motivations for becoming involved in C&CT, their experiences, and recommendations for C&CT and curricula. After Cape Town’s first COVID-19 wave, six on-line focus groups comprising 23 students were conducted, and a further four were conducted with 13 students after the second wave. As the researchers were predominantly educators previously involved in undergraduate health sciences education, the study’s purpose was to reflect on students’ experiences to make educational and health system recommendations.

Results
Students were largely motivated to mitigate the impact of the epidemic on society and support people affected by COVID-19, as well as hone their professional skills. While these motivations were realised, students also needed to learn new skills – to autonomously work remotely, using novel communication strategies to engage those affected and use virtual groups to connect with colleagues. They managed responsibilities within the healthcare systems that did not always work smoothly, distressed cases who were financially insecure, difficult employers, and language barriers. They were prepared through training, and supported by virtual, yet effective teamwork and debriefing opportunities. Although the work was sometimes physically and emotionally exhausting, students found the work personally meaningful. They embraced public health’s role to protect population and individuals’ health.

Conclusion
New teaching and learning practices adopted due to Covid-19 lockdowns enabled this digital C&CT project. It facilitated students to become confident, work autonomously and navigate challenges they will encounter as young professionals. The programme demonstrated that novel opportunities for rich student learning, such as in telehealth, can be embedded into public health and clinical functions of health services in contexts such as in SA, deepening partnerships between the health services and universities, to mutual benefit.
Potentialities and limitations of Interprofessional Education during graduation: a systematic review and thematic synthesis of qualitative studies
Authors: Rodrigues da Silva Noll Gonçalves Jéssica , Noll Gonçalves Rodrigo , da Rosa Saulo Vinicius , Schaia Rocha Orsi Juliana , Santos de Paula Karoline Maria , Moysés Samuel Jorge , Werneck Renata Iani 
Published: April 2023

Abstract
Background
Rapid demographic, epidemiological, technological, cultural/behavioural, and educational transitions, as they become more complex, demand new integrated and complementary professional skills and abilities. Interprofessional Education (IPE) is a promising alternative to deal with these changes, especially in courses in the health area. This systematic review was to explore the potentialities and limitations of IPE, from the perspective of undergraduate students, through a thematic synthesis of qualitative studies.

Methods
A thematic synthesis of qualitative studies was conducted. The question elaborated for this review was: “What is the impact of interprofessional education on the teaching and learning of students in the health area inserted in Higher Education Institutions?”. The search strategy was performed in the electronic databases PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), Cochrane Library, and Scientific Electronic Library Online (SciELO). In addition, searches were carried out in grey literature on the ERIC platforms, ProQuest Disserts and Theses, and Academic Google. The assessment of the quality of the studies was carried out using the Critical Appraisal Skills Programme tool. Data were summarized through thematic synthesis. From the databases, 8,793 studies were identified. After standardized filters procedures, critical summaries, and assessment of relevance to the eligibility criteria, 14 articles were included.

Results
The synthesis of the studies revealed the potential of this teaching approach, arranged in three analytical themes: learning from each other and about them; the value of education and interprofessional practice; patient-centred health care. On the other hand, some limitations were also identified, such as barriers related to EIP; the difficulties related to teaching methodologies.

Conclusion
Overcoming the identified limitations can enhance the results of the IPE, in view of its impact on the education of students and on the health care of the population.
Interactive Patient Safety and Quality Improvement capstone during transition-to-residency program: virtual and in-person focused workshop for EPA 13
Authors: Chen Catherine , Coppola Kristen M. , Weber Paul , Parikh Payal 
Published: April 2023

AbstractIdentifying systems failures and contributing to a safety culture is the Association of American Colleges (AAMC’s) thirteenth Entrustable Professional Activity (EPA). While most curricula teach Patient Safety (PS) and Quality Improvement (QI) principles, student participation in live QI/PS activities remains limited. This workshop enabled late Clerkship phase students to apply these Health Systems Science (HSS) principles to real adverse patient event cases through team-based simulation.This 3-h capstone included both a didactic review of QI, PS, and TeamSTEPPS® tools and an experiential component where student-led interactive small group discussions were augmented by resident and faculty preceptors. Collaboratively, students composed an adverse patient event report, conducted a Root Cause Analysis (RCA) during role-play, and proposed error prevention ideas after identifying systems problems. In April 2020, the in-person workshop became fully virtual due to the COVID-19 pandemic.A statistically significant increase in ability to identify Serious Safety Events, Escalation Chain of Command, and define a Plan-Do-Study-Act (PDSA) cycle was observed. Comfort with RCA increased from 48 to 87% and comfort with TeamSTEPPS® principles increased from 68% to 85.5%This novel capstone provided students with the tools to synthesize HSS concepts through problem-solving processes and recognize EPA 13’s importance. Their increased capability to identify appropriate chain of command, escalate concerns, and recognize serious adverse patient events also has training and practice readiness implications.
Sexual harassment as experienced by nurses from selected healthcare facilities in Ghana
Authors: Mohammed Aliu , Ansah Edward Wilson , Apaak Daniel 
Published: April 2023

Abstract
Background
Workplace Sexual Harassment (WSH) remains a major occupational health hazard to many nurses globally. Despite the negative impact of WSH on health and safety of nurses, there are limited studies exploring sexual harassment experiences of nurses in the line of duty in Low- and middle-income countries (LMICs) including Ghana.

Aim
This study aimed at exploring the lived sexual harassment experiences among nurses working in healthcare facilities in the Central Region of Ghana.

Method
This study used a qualitative interpretive phenomenological approach (IPA). Data from 24 participants, 13 participants’ written descriptive narratives of sexual harassment experiences (via online) and 11 telephone interviews were analysed concurrently using the IPA.

Results
Participants experienced verbal, non-verbal and physical forms of sexual harassment, often perpetrated by physicians, colleague workers, and patients. Most victims reacted passively to the acts sexual harassment and cases are often not reported despite the negative impact on victims’ health. While some participants dealt with sexual harassment by accepting the behaviour as an inevitable part of their job, others either quit or intend to quit the job to avoid the harassers. Most participants are unaware of any workplace measure such as policy that addresses sexual harassment in the health sector in Ghana.

Conclusion
This study highlights the problems of sexual harassment against nurses in the healthcare sector in Ghana, and calls for urgent development of measures such as a sexual harassment policy to prevent occurrence and promote effective resolution of sexual harassment within the healthcare sector in the country. Sexual harassment against nurses could be hampering quality healthcare delivery in the region.
The moderating effect of cultural competence educational needs on the relationship between transcultural self-efficacy and cultural competence in Korean public health nurses
Authors: Han Young-Ran , Jeong Yeo-Won 
Published: April 2023

Abstract
Background
In an increasingly multicultural society, cultural competence and transcultural self-efficacy of public health nurses is important for providing culturally congruent care for client from diverse cultural background. To improv this, it is needed tailored and effective educational program based on the cultural competence educational needs. This study investigated the moderating effect of cultural competence educational needs on the relationship between transcultural self-efficacy and cultural competence.

Methods
This cross-sectional study recruited 217 public health nurses in Korea using convenience sampling from August 2018 to January 2019. A direct questionnaire was used to collect data. Study variables were analyzed using descriptive statistics, correlation, and the Hayes PROCESS macro (Model 1) moderation model.

Results
The mean scores for transcultural self-efficacy, cultural competence educational needs, and cultural competence were 62.33 ± 11.08, 58.19 ± 15.08, and 97.96 ± 17.09, respectively. Transcultural self-efficacy and cultural competence educational needs were positively associated with cultural competence. In the tested model, cultural competence educational needs had a conditional moderating effect on the relationship between transcultural self-efficacy and cultural competence. The positive association between transcultural self-efficacy and cultural competence was significant at low, medium, and high levels of cultural competence educational needs and stronger for those with high needs.

Conclusions
Cultural competence educational needs may be an important determinant of cultural competence among public health nurses. To effectively increase cultural competence, transcultural self-efficacy should be increased by education programs tailored by cultural competence educational needs.
Gender similarities and differences in the perception of caring among nurses during the COVID-19 pandemic: a mixed-methods study
Authors: Tong Lai Kun , Zhu Ming Xia , Wang Si Chen , Cheong Pak Leng , Van Iat Kio 
Published: April 2023

AbstractBackgroundCaring is the essence and core of nursing. Current studies on the effect of gender on nurses’ perception of caring have been inconsistent. Most of these studies were quantitative and conducted before the COVID-19 pandemic. The study aimed to explore the gender similarities and differences in nurses’ perception of caring during the COVID-19 pandemic.MethodsIn 2020, a cross-sectional mixed-method study was conducted in 11 cities in China using structured online questionnaire (n = 8030) and face-to-face individual interview (n = 42). Data collection tools included the Caring Dimensions Inventory and semi-structured interview.ResultsIn stepwise multivariable linear regression analysis, female nurses scored 1.93 points higher on caring than male nurses, after completely controlling for the other factors. The interview results showed that both male and female nurses agreed that caring was to deal with three kinds of relationships, namely nurses and people, nurses and themselves, nurses and society. There were gender differences in the connotation of caring between nurses and themselves, but not in the connotations of caring between other relationships. The ranking of the importance of caring connotations among these relationships showed no gender difference except between nurses and themselves.ConclusionThe quantitative findings suggest that gender influences nurses’ perception of caring. The qualitative findings demonstrate that nurses regard themselves as both recipients and implementers of caring. The qualitative results indicate nurses of different genders have similarities and differences in their perception of caring, and the biggest difference lies in the relationship between nurses and themselves.