bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dosimetric analysis of patients receiving radiotherapy with VMAT technique in localized prostate cancer and its correlation with side effects
Authors: Akay Sıtkı U. , Çetin İlknur A. , Bekiroğlu Gülnaz N. 
Published: November 2022

ABSTRACT

Aim:
The aim was to study the relationship between dosimetric data of localized prostate cancer patients who have been treated with curative radiotherapy (RT) and gastrointestinal (GIS), genitourinary (GUS), anal and sexual side effects, and whether there was a difference between dosimetric data and clinical findings between risk groups.

Methods:
Eighty-seven patients who received curative radiotherapy for localized prostate cancer between 2014 and 2019 were included in the study. Dosimetrically; whether there was a relationship between V30, V40, V50, V60, V65, V70, V75 for rectum and bladder; D90 for the penile bulb, V72, V74, V76 for the bulbomembranous urethra, V30, V45, V53, Dmax for the anus, and V45 (cc) for the intestine data and the side effects were analyzed. It was evaluated whether there was a relationship between testosterone values and sexual side effects. The Kolmogorov–Smirnov test, one-way analysis of variance (ANOVA) (F-test), and paired-sample t-test were used as statistical methods. For statistical significance, P < 0.05 was accepted.

Results:
The mean age of the patients was 69 (50–86), the mean Prostat specific antigen (PSA) (ng/dL) before RT was 25.1 (0.9–339), the median RT dose was 76 Gy (74–78 Gy), and the mean follow-up period was 38.2 months. PTVmax, PTVmean, PTVmin, bladder V40, bladder V50, rectum V30, rectum V40, rectum V50, and intestinal V45 (cc) were determined as dosimetric data showing differences between risk groups. A statistically significant relationship was found between rectum V30 (P = 0.017), V60 (P = 0.019), V65 (P = 0.008), V70 (P = 0.007), and V75 (P = 0.034) and chronic GIS side effects. G2 GIS side effects were observed in four patients (4.6%) in the entire patient group during the acute period. A statistically significant relationship was found between the patients receiving hormonotherapy (P = 0.021) and testosterone values at the last control (P ≤ 0.001) and chronic sexual side effects.

Conclusion:
Attention should be paid to the rectum V30, V60, V65, V70, and V75 values to minimize the long-term GIS side effects in patients who have undergone RT. Testosterone level and ADT status affect chronic sexual toxicity.
Pediatric low-grade glioma and neurofibromatosis type 1: A single-institution experience
Authors: Ruggiero Antonio , Attinà Giorgio , Campanelli Anastasia , Maurizi Palma , Triarico Silvia , Romano Alberto , Massimi Luca , Tamburrini Gianpiero , Verdolotti Tommaso , Mastrangelo Stefano 
Published: November 2022

ABSTRACT

Background:
Neurofibromatosis type 1 (NF1)-related gliomas appear to have a clinical behavior different from that of sporadic cases. The purpose of the study was to investigate the role of different factors in influencing the tumor response rate of children receiving chemotherapy for their symptomatic glioma.

Methods:
Between 1995 and 2015, 60 patients with low-grade glioma (42 sporadic cases and 18 cases with NF1) were treated. Patients with brainstem gliomas were excluded. Thirty-nine patients underwent exclusive or postsurgical chemotherapy (vincristine/carboplatin-based regimen).

Results:
Disease reduction was achieved in 12 of the 28 patients (42.8%) with sporadic low-grade glioma and in 9 of the 11 patients (81.8%) with NF1, with a significant difference between the 2 groups (P < 0.05). The response to chemotherapy in both the patient groups was not significantly influenced by sex, age, tumor site, and histopathology, although disease reduction occurred more frequently in children aged under 3 years.

Conclusions:
Our study showed that pediatric patients with low-grade glioma and NF1 are more likely to respond to chemotherapy than those with non-NF1.
A cross-sectional study of epidemiological determinants for Covid-19 infection among nurses of a tertiary care hospital
Authors: Shah Anuradha K. , Sawant Dattaprasad A. , Sadawarte Deepika M. , Dakshit Kosturi 
Published: November 2022

BACKGROUND:
All health care workers including nurses are working in the frontline against coronavirus disease 2019 (Covid-19), which keeps them at high risk of getting infected. This study was conducted to identify risk factors for Covid-19 infection and compliance to Covid appropriate behavior among nurses.

MATERIAL AND METHODS:
A cross-sectional study was conducted on 150 nurses in a tertiary care hospital attached to a medical college in Mumbai, from April 2020 to December 2020. Data were collected telephonically using an interviewer-administered pre-validated, semi-structured questionnaire. Data entry and analysis were performed using SPSS version 21.0.

RESULTS:
The mean age of the nurses was 38.19 ± 12.14 years. The majority (80.7%) were exposed to Covid-19 while taking active care of Covid patients; a total of 108 (72%) were symptomatic at the time of testing; dietary modifications because of fear of Covid were performed by 121 (80.2%); 92.77% used the appropriate personal protective equipment (PPE) category according to the workplace; 121 (80.77%) followed all steps of donning and doffing at all times, and 19 (12.77%) reported a breach in PPE. A greater proportion of nurses working in Covid duties opted for hospital isolation than home isolation (p = 0.003). Risk factors such as sleep, shift duty, shift pattern, food timing, mode of travel, and type of PPE during travel were also found to be significantly associated with work type – Covid versus non-Covid (p < 0.05).

CONCLUSIONS:
Use of workplace appropriate PPE, proper donning and doffing facilities, duty shifts with a fixed duration, adequate hand hygiene practices, and regular food intake with adequate sleep can prevent Covid-19 infection at the workplace among nurses.
Utilization of elderly health promotion services during COVID 19 in Iran
Authors: Zahirian Moghadam Telma , Zandian Hamed , Shirin Bonyad Hadi 
Published: November 2022

BACKGROUND:
The outbreak of COVID-19 pandemic has made it difficult for older adults to utilize ordinary elder services. This cross-sectional study investigated the status of feeling the need, seek, and utilization of health promotion services among older adults in Ardabil, Iran, covered by the country's comprehensive health system during the pandemic.

MATERIALS AND METHODS:
This descriptive-analytical and cross-sectional study was conducted on 739 elderly people in Ardabil province. Cluster random sampling method was used for sampling. Data were gathered by referring trained individuals to the place of residence of the selected older adults Questionnaires were consisted of three parts: demographic information, household's economic status, and feeling the need, seek, and utilization from health promotion services. Multivariate logistic regression was used to separately model the need, seeking for, and utilization of health promotion services in STATA ver. 14.

RESULTS:
The mean age of the older adults in this study was 68.88 ± 4.72 years. The results indicate that men showed significantly greater need, seek for, and utilization of health promotion services during COVID- 19 than women. According to the results, people over the age of 80 had 4.08 times (95% confidence interval [CI]: 1.99–12.60) more need and utilization of health services than the older adults under 65 years. The results also indicate that use of health promotion services was significantly associated with being married (3.74, 95% CI: 1.22–2.62), having primary insurance and supplementary insurance (1.92, 95% CI: 1.21–3.12), and obesity (2.05, 95% CI: 1.13–3.76) in P < 0.05 level. Based on the results, people with chronic disease and obesity were more likely to utilize health promotion services.

CONCLUSION:
Findings suggest that the access and utilization of inpatient and outpatient health services by the elderly in the COVID-19 pandemic has somewhat decreased, which could be due to the fear of the disease being referred to health centers by the elderly. Hence, enabling conditions such as parental health care were major factors affecting health-seeking habits among the Iranian elder population.
Effect of cognitive–behavioral training on fear of childbirth and sleep quality of pregnant adolescent slum dwellers
Authors: Khojasteh Farnoosh , Afrashte Mahdie , Khayat Samira , Navidian Ali 
Published: November 2022

BACKGROUND:
Fear of childbirth is a common problem during pregnancy, which can give rise to sleep disorders and diminish sleep quality. This study aimed to determine the effect of cognitive–behavioral training on fear of childbirth and sleep quality of pregnant adolescent slum dwellers who visited the slum health centers of Zahedan city, Iran, in 2020.

MATERIALS AND METHODS:
This quasi-experimental study was conducted in 2020 on 100 pregnant adolescent slum dwellers between 11 and 19 years old at 24–28 weeks pregnant. Multi-stage sampling was used and the participants were randomly divided into an intervention and a control group. The intervention group received four sessions of cognitive–behavioral training at weekly intervals. The control group only received routine care. The Wijma Delivery Expectancy/Experience Questionnaire and the Pittsburgh Sleep Quality Index were filled before and 4 weeks after the training course. The data were analyzed in SPSS 21 using independent t-test, paired t-test, Fisher's exact test, and Chi-squared test. and covariance. A P value of < 0.05 was considered significant.

RESULTS:
After the intervention, the fear of childbirth significantly decreased (P = 0.004), and sleep quality significantly improved (P = 0.001) in the intervention group compared with the control group. The results of analysis of covariance to control the significant effect of pre-test scores showed that the mean score of fear of childbirth (P = 0.03) and mean score of sleep quality (P = 0.001) in the two groups after the intervention was statistically significant.

CONCLUSION:
The results showed that in addition to reducing fear of childbirth, cognitive–behavioral training improved the sleep quality of women in the intervention group. Therefore, this training could be used as an easy and accessible method without complications to improve women's health.
Disaster planning approaches in Iran's health system
Authors: Mohajervatan Ali , Atighechian Golrokh , Khankeh Hamid Reza , Raeisi Ahmad Reza , Tavakoli Nahid 
Published: November 2022

BACKGROUND:
Disaster planning and management pose a serious challenge to most countries. These challenges point to insufficient planning to deal with these events. Therefore, it is necessary to pay attention to the methods and characteristics of the decision-making approaches in these events. In this study, we tried to identify most appropriate approaches for the Iranian health system by studying disaster planning approaches.

MATERIALS AND METHODS:
This study was conducted using mixed methods in 2020–2021 in two phases: qualitative and quantitative. First, we reviewed at the research literature. Our goal was to identify studies that suggested approaches to disaster planning. The next step in this study was a qualitative study using semi-structured interviews. Participants in qualitative phase included managers and employees from different parts of the Iranian health system from the provinces of Golestan, Fars, Khuzestan, Lorestan, Kerman, Sistan, and Baluchestan.

RESULTS:
By combining approaches taken from literature reviews and qualitative study, four main approaches were identified. The results of our study have shown that disaster response planning approaches include function, risk assessment, capability, and futuristic base.

CONCLUSION:
This study provides complete overview of disaster planning approaches that enable health professionals to use them to develop response plans. Our findings indicate that in complex and large-scale events such as floods and pandemics, it is necessary to combine the introduced methods for operational planning.
Developing patient safety standards for health-care quality promotion in neonatal intensive care units
Authors: Shahkolahi Zahra , Irajpour Alireza , Jafari-Mianaei Soheila , Heidarzadeh Mohammad 
Published: November 2022

BACKGROUND:
Neonatal intensive care unit (NICU) is one of the accident-prone settings in the health-care system. There is a series of structural and process threats to the safety of infants hospitalized in this unit, which can be prevented by taking the right actions. For this purpose, developing standards based on current knowledge, available resources, and the context that provides care can determine patient injury prevention requirements. Likewise, it can be a source for national development and application of related guidelines and protocols. This study aims to develop patient safety standards in the NICUs of Iran.

MATERIALS AND METHODS:
This mixed-methods study will apply the exploration, preparation, implementation, and sustainment framework to develop patient safety standards. In each phase of this framework, a set of activities take place. Exploration is based on the world health organization model to develop standards. Determining the validity and applicability of standards will be done in Phase 2 (Preparation) and Phase 3 (Implementation), respectively. Since the long-term effects are not desired, the fourth phase (Sustainment) will not be considered.

DISCUSSION:
Patient safety standards from this study will contribute to efficient and effective, equitable, and high-quality health-care delivery. The application of them will further promote patient safety and the quality of medical care in Iranian NICUs.
Comparison of the effect of two educational methods based on mindfulness and cognitive emotion strategies on psychological well-being and anxiety of eighth-semester midwifery students before the final clinical trial
Authors: Noroozi Mahnaz , Mohebbi-Dehnavi Zahra 
Published: November 2022

BACKGROUND:
Midwifery services help maintain and improve the health of the community. However, a comprehensive examination reduces students’ psychological well-being by creating anxiety. For this purpose, the present study was conducted to determine and compare the effect of two educational methods based on mindfulness and cognitive emotion strategies on psychological well-being and anxiety of eighth-semester midwifery students before the final clinical trial.

MATERIALS AND METHODS:
This study was a quasi-experimental three-group study with available sampling method that was performed on 30 eighth-semester midwifery students of the School of Nursing and Midwifery of Isfahan University of Medical Sciences in 2020–2021. Data collection tools were psychological well-being and Test Anxiety Questionnaire. Two intervention groups were trained for eight sessions. The control group did not receive any training program. The data collected by SPSS version 22 software were analyzed by analytical statistical tests of ANOVA and least significant difference post hoc test.

RESULTS:
The results showed that there was a statistically significant difference between the three groups in terms of components of test anxiety and psychological well-being. Furthermore, emotion regulation training and mindfulness-based training reduced test anxiety and increased students’ psychological well-being before the comprehensive test (P = 0.001).

CONCLUSION:
It is recommended that educational programs be considered before the comprehensive examination to promote the mental health and success of these students.
Online assessment in two consequent semesters during COVID-19 pandemic
Authors: Abedi Farshid , Eghbali Batool , Akbari Narjes , Sadr Ehsan , Salmani Fatemeh 
Published: November 2022

BACKGROUND:
Education and assessment have changed during the COVID-19 pandemic so that online courses replaced face-to-face classes to observe the social distance. The quality of online assessments conducted during the pandemic is an important subject to be addressed. In this study, the quality of online assessments held in two consecutive semesters was investigated.

MATERIALS AND METHODS:
One thousand two hundred and sixty-nine multiple-choice online examinations held in the first (n = 535) and second (n = 734) semesters in Birjand University of Medical Sciences during 2020–2021 were examined. Mean, standard deviation, number of questions, skewness, kurtosis, difficulty, and discrimination index of tests were calculated. Data mining was applied using the k-means clustering approach to classify the tests.

RESULTS:
The mean percentage of answers to all tests was 69.97 ± 19.16, and the number of questions was 34.48 ± 18.75. In two semesters, there was no significant difference between the difficulty of examinations (P = 0.84). However, there was a significant difference in the discrimination index, skewness, and kurtosis of tests (P < 0.001). Moreover, according to the results of the clustering analysis in the first semester, 43% of the tests were very hard, 16% hard, and 7% moderate. In the second semester, 43% were hard, 16% moderate, and 41% easy.

CONCLUSION:
To evaluate the tests’ quality, calculating difficulty and discrimination indices is not sufficient; many factors can affect the quality of tests. Furthermore, the experience of the first semester had changed characteristics of the second-semester examinations. To enhance the quality of online tests, establishing appropriate rules to hold the examinations and using questions with higher taxonomy are recommended.
The effect of case-based e-learning on academic performance and problem-solving ability in nursing students
Authors: Rezaee Rita , Haveshki Fateme , Barati-Boldaji Reza , Mehrabi Manoosh 
Published: November 2022

BACKGROUND:
Case-based learning is a modern learning approach, aims to prepare students for practical skills. In the present study, we aimed to determine the effectiveness of case-based e-learning (CBEL) on the academic performance and problem-solving ability of nursing students.

MATERIALS AND METHODS:
In this pre- and post-test study, census sampling method was used to select 128 nursing students who had nutrition courses during 2015–2017 at (blinded). Before and after the educational intervention, the students completed the problem-solving inventory including problem-solving confidence (PSC), approach-avoidance style (AA), and personal control (PC) and a scientific test for evaluating academic function. Continuous variables before and after the intervention and categorical variables were analyzed using paired t-test and Chi-square test, respectively.

RESULTS:
The mean scores of PSC, AA, and PC decreased after the intervention (P < 0.001). The mean scientific score of the students improved after the intervention (P < 0.001).

CONCLUSION:
This study showed that the CBEL method had a positive effect on the ability to solve the learning problems and the academic performance of the students and can be used to train nurses to improve their ability to confront clinical problems in the future.
Knowledge, attitudes, and sociodemographic factors related to COVID-19 among older people living in the community in Malaysia
Authors: Syed Elias Sharifah Munirah , Rohinmi Nur Rasyidah 
Published: November 2022

BACKGROUND:
Although older people are at a higher risk of COVID-19 infection, there is a lack of research that focuses on COVID-19 in older people in Malaysia. Therefore, the aim of this study was to assess the level of knowledge and attitudes related to COVID-19, and to identify the association of sociodemographic background with knowledge and attitudes towards COVID-19 among older people.

MATERIALS AND METHODS:
This is a cross-sectional study involving 382 older people living in the community in Malaysia. Data was collected using convenience sampling through an online questionnaire that consisted of three parts: sociodemographic details, knowledge, and attitude related to COVID-19.

RESULTS:
The overall correct rate of knowledge was 77.3%, indicating that participants had slightly good knowledge related to COVID-19. The participants showed a positive attitude with a mean score of 26.0 (SD = 5.0). There were significant associations between knowledge and education level (P = 0.00) and marital status (P = 0.02). Marital status was significantly associated with attitude towards COVID-19 (P = 0.03). A weak positive correlation was found between knowledge and attitude (r = 0.17, P = 0.00) suggesting that an increase in knowledge will increase the positive attitude among older people.

CONCLUSION:
Older people reported good knowledge and positive attitudes towards COVID-19. The Malaysian government should provide relevant health education for those with lower education levels and divorced or widowed to improve knowledge and attitudes towards COVID-19.
Health-promoting behaviors in staff and students of Ardabil University of Medical Sciences
Authors: Dargahi Abdollah , Gholizadeh Helia , Poursadeghiyan Mohsen , Hamidzadeh Arbabi Yousef , Hamidzadeh Arbabi Mohammad Hossein , Hosseini Javad 
Published: November 2022

BACKGROUND:
The staff of health and dentistry schools can play an important role in encouraging students and their clients to adopt health and preventive behaviors. The aim of this study was to compare health-promoting behaviors in staff and students of health and dental schools in Ardabil University of Medical Sciences (ARUMS).

MATERIALS AND METHODS:
This cross-sectional descriptive-analytical study was conducted in 2021. The research population was staff and students of health and dental schools. Staff sampling was by census and students were sampled by simple random sampling. The data collection tool was a questionnaire whose validity and reliability had been confirmed in previous studies. Data analysis was performed using descriptive and analytical statistics tests using SPSS version 20 software. Linear regression was performed using stepwise method.

RESULTS:
The results showed that the mean score of the individuals was 99.2 ± 20.24. In the leveling, the behaviors of 33 people (17.55%) were appropriate, desirable and good, and the health-promoting behaviors, 154 people (82.45%), were moderate and low. The correlation between age, gender, marital status, and workplace of the individuals with health-promoting behaviors was not statistically significant (P > 0.05). The output of stepwise regression analysis showed that the variables were significant and could predict the scores of health-promoting behaviors.

CONCLUSIONS:
Health-promoting behaviors in <20% of students and staff are desirable, and in more than 80% of them are moderate and poor. Therefore, educational administrators should use these results in curriculum planning to increase health-promoting behaviors of students and staff. The score of health-promoting behaviors is related to the above-mentioned areas, but the relationship may not be linear.