Association of quality of life with physical activity, depression, and demographic characteristics and its predictors among medical students

Managing drug therapy-related problems and assessment of chronic diabetic wounds

Type 2 diabetes mellitus (T2DM), responsible for most diabetes cases recorded worldwide, increases the risk of chronic wounds and amputation. Patients with T2DM appear to be more susceptible to delayed wound healing due to their treatment adherence. This review explores the specifics of polypharmacy, side effects, possible drug interactions and the importance of medication adherence for therapeutic efficacy. We discuss the effects of anti-diabetes medications on wound healing as well as the role that biofilms and microbial infections play in diabetic wounds. Inconsistent use of medications can lead to poor glycaemic control, which negatively affects the healing process of diabetic foot ulcers. Managing chronic wounds represents a substantial portion of healthcare expenditures. Biofilm-associated infections are difficult for the immune system to treat and respond inconsistently to antibiotics as these infections are slow growing and persistent. Additionally, we emphasize the critical role pharmacists play in enhancing patient adherence and optimizing diabetes treatment by offering comprehensive coverage of drugs associated with problems related to pharmacological therapy in type 2 diabetes.

Multidisciplinary advances in kombucha fermentation, health efficacy, and market evolution

Kombucha, a fermented tea beverage, has seen a significant rise in global popularity. This increase is attributed to its reported health benefits and extensive cultural heritage. The comprehensive review examines kombucha through microbiology, biochemistry, and health sciences, highlighting its therapeutic potential and commercial viability. Central to kombucha production is the symbiotic culture of bacteria and yeasts (SCOBY), which regulates a complex fermentation process, resulting in a bioactive-rich elixir. The study examines the microbial dynamics of SCOBY, emphasizing the roles of various microorganisms. It focuses the contributions of acetic acid bacteria, lactic acid bacteria, and osmophilic yeasts, including genera such as Saccharomyces, Schizosaccharomyces, Zygosaccharomyces, Brettanomyces/Dekkera, and Pichia. These microorganisms play crucial roles in producing bioactive compounds, including organic acids, polyphenols, and vitamins. These bioactive compounds confer therapeutic properties to kombucha. These properties include antioxidant, antimicrobial, anti-inflammatory, antidiabetic, antihypertensive, cancer prevention, hepatoprotective, and detoxifying effects. The review also explores the growing market for kombucha, driven by consumer demand for functional beverages and opportunities for innovative product development. It emphasizes the necessity of standardized production to ensure safety and validate health claims. Identifying research gaps, the review highlights the importance of clinical trials to verify therapeutic benefits. Ultimately, this study integrates traditional knowledge with scientific research, providing directions for future studies and commercial expansion, emphasizing the role of kombucha in health and wellness.

Feasibility assessment of crowdsourcing slogans for promoting household waste segregation in India: a cross-sectional study

Introduction

Crowdsourcing is an emerging technique to engage or access a wider set of experts and multiple stakeholders through online platforms, which might effectively be employed in waste management. Therefore, we assessed the feasibility of the crowdsourcing method to provide an alternative approach that can improve household waste segregation using an "online-slogan-contest".

Methods

The contest was promoted via targeted emails to various governmental and non-governmental organizations and through social media platforms for around 4 weeks (25 days). The entries were received through a Google form. The slogans were assessed by the experts and analyzed using content analysis methods.

Results

Total 969 entries were received from different geographic regions in India. Of that, 456 were in English and 513 in Hindi. Five themes of waste segregation emerged from the received slogans: (1) Community awareness, responsibility, and support, (2) Significance of household waste segregation, (3) Use of separate dustbins, (4) Health and well-being, and (5) Environment and sustainability.

Discussion

Crowdsourcing approaches can be used by local authorities for improving waste management approaches and are recommended as these involve a wider audience within a short time frame. Moreover, this approach is flexible and integrating crowdsourcing approaches strengthens our understanding of existing waste management activities.

Differences in Effort, Reward, Grit, Burnout, and Continuous Exercise Intention: Assessing the Effort-Reward Imbalance among Korean Athletes

Although studies have shown that an imbalance between effort and reward in the workplace negatively affects an individual's physiological and mental health, few have looked at how this imbalance may affect the mental state of athletes. Therefore, this study aimed to evaluate the importance of the effort-reward imbalance (ERI) in athletes by examining whether psychological variables would differ depending on the ERI. To accomplish this, 795 registered collegiate athletes were recruited. Of them, 227 and 230 responses with the ERI in the bottom and in the top 30% of the ERI scale were selected to compare groups with a high and a low ERI. Athletes completed a self-reported 64-item questionnaire (general characteristics: 5; effort: 14; rewards: 14; grit: 12; burnout: 15; and continuous exercise intention: 4 items). Data analysis included reliability and validity using the Jamovi and SPSS/AMOS software. The results showed no significant differences in effort, reward, grit, burnout, and intention to continue to exercise based on gender, weekly training frequency, and hours of training per day. There were differences in effort, reward, grit, burnout, and intention to continue exercising based on the presence of a professional league. Additionally, differences were found in effort, reward, grit, burnout, and intention to continue exercising between the low and high ERI groups. There was a clear difference between the mental state of those who were satisfied with their effort and reward, and those who were not. However, given that the two groups spent approximately the same amount of time exercising each week, the difference may have been more a function of the psychology of athletes than an actual difference in effort and reward. As our findings confirmed that the level of the ERI in athletes is related to their mental state, further research is necessary to identify and control factors that affect the ERI in athletes.

The Effect of the Application of the Team-STEPPS-Based Preceptorship Guidance Model on the Competence of Nursing Students

Objective

Student competence is an important topic of discussion during the implementation of counseling in the clinic. The purpose of this study was to analyze the effect of the Team-STEPPS-based preceptorship guidance model on student competency.

Methods

A comparative study was used to analyze the quantitative data. Participants were clinical practice students at "Ngudi Waluyo" Public Hospital with a total of 92 registered students divided into treatment and control groups. The Wilcoxon Signed Rank Test and the Mann-Whitney U-Test were used to assess differences between the intervention and control groups.

Results

There were post-test differences between the intervention group and the control group, namely clinical competence p-value (0.003), nursing management p (0.000), technical competence p (0.008), self-management p (0.000), and care-oriented patients p (0.000).

Conclusion

The Team-STEPPS-based preceptorship guidance model is very important in increasing student competency, not only in mastering clinical competence, but also in mastering technical skill competencies, nursing management, self-management, and patient-oriented care skills, and therefore, can increase student independence.

The impact of health education interventions on HPV vaccination uptake, awareness, and acceptance among people under 30 years old in India: a literature review with systematic search

Background

The HPV vaccine is used as one of the main prevention tools for HPV-related cancers globally, yet it is not part of the Indian National Immunization program. In light of the introduction of the indigenous vaccine, we examine the effectiveness of health education about uptake, acceptance, and awareness.

Methods

Research was performed in the following databases: PubMed, CINAHL, Scopus, and Embase to identify studies between 2008 and 2022. Studies were included if: they were conducted in India including primary data research and health education intervention, and participants were between 9 and 29 years old.

Results

Out of the 10.952 results, 7 studies were included. Four studies focused on adolescent girls, aged from 9 to 20 years old, and 3 on university students aged from 17 to 26 years. Five studies were implemented in urban areas and 2 in rural areas. Health education interventions proved to be effective in increasing uptake, awareness, and acceptance of the HPV vaccine. The barriers included among others: cost, lack of awareness, and cultural barriers.

Conclusion

Observations from this study outline immediate action for policymakers to educate and encourage the young population toward HPV vaccination. Future programs should be aimed at different population groups and be adjusted according to their special characteristics and needs. Attention should be given to the male population and marginalized groups. The involvement of various stakeholders proved to be beneficial, and it is highly recommended.

Relationship between depression and quality of life among students: a systematic review and meta-analysis

The objectives of this systematic review were to estimate the prevalence of depression and to identify the relationship between depression and quality of life (QOL) among high school and university students. Literature search was performed in the Scopus, Embase, PubMed, Scielo, CINAHL and Web of Science databases, following the PRISMA methodology. The results were presented through descriptive approaches and meta-analysis. Thirty-six studies met the eligibility criteria, and twenty-six were included in the meta-analysis. The prevalence of depressive symptoms was 27% (95% CI 0.21-0.33) among students, being high school and university students was 25% (95% CI 0.14-0.37) and 27% (95% CI 0.20-0.34), respectively, and most studies have shown that depression was associated with low QOL. Among the limitations of the study is the difficulty of generalizing the results found, considering the large sample of health students. New studies should be conducted considering the severity, duration, and patterns of depressive symptoms in high school and university students, to better understand the relationship between depression and QOL.

The moderating role of information technology governance in the relationship between board characteristics and continuity management during the Covid-19 pandemic in an emerging economy

The main aim of the current study is to investigate the relationship between governance characteristics, information technology governance, and continuity management during Covid-19 in an emerging economy. The study also examines the moderating role of information technology governance in the relationship between governance characteristics and business continuity management. The quantitative approach is used by utilising a survey questionnaire. A sample of 232 questionnaire surveys has been collected from the board of directors, top and middle management executives, external auditors, information technology experts, and some other respondents. The results were estimated using structural equation modelling. The results indicate that information technology governance has a statistically significant effect on business continuity. Board size, board independence, audit committee independence, audit committee diligence, and external audit have a statistically significant positive effect on information technology governance. Further, the results indicate that information technology governance significantly moderates the effect of board size, board independence, board diligence, audit committee independence, audit committee diligence, and external audit on business continuity. However, information technology governance does not moderate the relationship between board committees and business continuity, which indicates less board involvement in information technology governance. The current research provides insight into the role of information technology governance in business continuity management during crises. The present study provides a unique contribution as it investigates the relationship between corporate governance characteristics, information technology governance, and business continuity management during Covid-19, providing empirical evidence from an emerging country.

A systematic review of the available literature on the use of social media in brain tumor

Purpose

The use of social media is one of the new technological options that has been recommended as a potential new strategy for delivering high-quality, high-value cancer prevention and management services. Despite the increasing use of social media, little research has been done on the use of social media in brain tumors. Therefore, this systematic review aims to provide a comprehensive review of the use of social media in brain tumor research.

Design/methodology/approach

A systematic search was performed in PubMed, Scopus and Web of Science from inception to August 1, 2022. English full-text articles evaluating social media use, benefit or content in brain tumor were considered.

Findings

Sixteen documents satisfied the inclusion criteria and were included in the final analysis. Most of the included studies (n = 11/16) were conducted and published by researchers in the USA. In terms of social media platform, most studies focused on Twitter (8/16, 50%) and YouTube (8/16, 50%), followed by Facebook (6/16, 37.5%) and Instagram (4/16, 25%). Most studies (n = 7/12) analyzed the content of brain tumor information provided on social media, followed by patients’ use of social media (n = 3/12) and the quality of information on social media (n = 3/12). The other three articles also examined patient recruitment, crowdfunding and caregiver use of social media.

Practical implications

By identifying the use, benefits and content of social media platforms in different settings, patients, clinicians and policymakers can better benefit from harnessing the power of social media in different ways, leading to improved health-care services.

Originality/value

To the authors knowledge, this is the first study to systematically examine social media use, benefits and content status in brain tumors.

Food safety interventions in low- and middle-income countries in Asia: A systematic review

Effective and sustainable interventions are necessary for long-term improvement of food safety. This review provides a summary of food safety interventions evaluated in selected low- and middle-income countries in Asia between 2000 and 2020. A systematic screening of published articles from PubMed and CabDirect databases was carried out with the aid of Rayyan QCRI software. A total of 25 studies were considered in the review. A 'before and after' study design was the most frequently used design (64%), while five studies (20%) used a randomized control trial (RCT) design. Interventions applied focused on training to improve knowledge, attitudes, and practices (KAP) towards safe food (60%) or on specific technologies (40%). Nine of the 25 studies were specific on the value chain considered: cattle (1), poultry (1), pigs (4) and fish value chains (3). Except for one study, all interventions reported some level of success; 17 were rated as having a high level of success, defined differently across studies. However, there is a clear evidence gap for the efficacy and cost-effectiveness of food safety interventions in market settings, both consumer- and vendor-facing. A rigorous and standardized assessment of intervention effectiveness and sustainability is recommended, to not only identify areas of improvement, but also to ensure scaling of interventions with demonstrated evidence of success and sustainability.

Breathing exercise for hypertensive patients: A scoping review

Background: Non-pharmacological management of hypertension includes weight loss, alcohol and sodium restriction, regular exercise, and relaxation. In people with overweight hypertension, systolic blood pressure (SBP) and diastolic blood pressure (DBP) can be decreased via exercise and weight loss together. Breathing exercises are one method of relaxing. Objectives: The aim of this scoping review is to map the information that is currently available about the advantages of breathing exercises in decreasing blood pressure in hypertension patients. Methods: This scoping review adheres to Arksey and O'Malley's framework, which entails identifying review questions, seeking pertinent evidence, choosing pertinent studies, mapping data, and discussing, concluding, and reporting the findings. The PRISMA flowchart is used to show how the evidence search process works. Results: As a result, 339 articles in total were retrieved from the three databases. 20 papers total were included in this review after screening. In 14 of the 20 investigations, participants with stage 1 and stage 2 essential hypertension, two with pre-hypertension, and four with Isolated Systolic Hypertension (ISH) were studied. The respondents' ages ranged from 18 to 75. The systolic blood pressure declined by 4-54.22 mmHg, while the diastolic blood pressure dropped by 3-17 mmHg. Conclusion: Slow breathing can be used as an alternate, non-pharmacological therapy for hypertension individuals to reduce blood pressure. Systematic Review Registration: (https://osf.io/ta9u6/).

Perceived Stress, Sexual and Marital Satisfaction among Married Healthcare Workers in Nigeria

Background: Marital and sexual satisfaction are essential for conjugal bliss and harmony. However, stress in the workplace can influence sexual and marital satisfaction of couples. There is dearth of information about level of sexual and marital satisfaction among healthcare workers in Nigeria, as well as the connections between stress, sexual and marital satisfaction among healthcare workers.  Purpose: This study assessed inter-relationship between perceived stress, sexual and marital satisfaction among married healthcare workers.Methods: This descriptive cross-sectional study adopted a quantitative approach among 150 consented healthcare workers recruited using a simple random sampling technique. Instruments for data collection included the Perceived Stress Scale, Enrich Marital Satisfaction questionnaire and Pinney Sexual Satisfaction Inventory. The Pearson correlation was used to ascertain relationships and linear regression was done to predict influence of one variable on the other.Results: Perceived level of stress of the healthcare workers was low [16.9(0.001)] and mean sexual satisfaction (SS) was poor [78.93(23.68)]. Also, 49.3% were found to be the dissatisfied maritally. Perceived stress showed a positive correlation with marital satisfaction (MS) (r=0.48, p<0.01). However, stress negatively correlated with participants’ SS with partners (r=-0.51, p<0.01). Similarly, general SS positively correlated with MS (r=0.32, p<0.01). Predictors of MS included perceived stress (β=0.614, p=0.01), age differences with spouse (β=0.30, p=0.01), number of children (β=-0.24, p=0.01), and family type (β=-0.21, p=0.05).Conclusion: Only half of the participants in this study are maritally satisfied. Marital satisfaction increases with sexual satisfaction. Stress is correlated with reduced sexual satisfaction of the participant, and as number of children increases, marital satisfaction reduces. Couples should be encouraged to give birth to moderate number of children to improve marital satisfaction.

Incivility in online learning environment: Perception of dental students and faculty

OBJECTIVES

The objectives of this study were to assess the extent of incivility and perception of dental students and faculty regarding uncivil behaviors in the online learning environment.

METHODS

Incivility in online environment (IOLE) survey was used to collect data from dental students (n = 232) and faculty (n = 35) at Margalla Institute of Health Sciences, Rawalpindi, Pakistan from September to December 2021. A 4- point Likert scale was used for respondents to indicate their perceptions regarding incivility in IOLE, and a list of students' and faculty's uncivil behaviors. Descriptive analysis, chi-square test, and Spearman's correlation coefficient were used for data analysis. The level of significance was kept at ≤0.05.

RESULTS

The majority of the students reported online incivility as either "a moderate or serious problem" (n = 103, 72.0%), and the majority of faculty (n = 12, 56%) reported incivility as "no to a mild problem" (p = 0.018). Both students and faculty agreed that students are more likely to engage in uncivil behavior in OLE as compared to faculty. Various forms of rude/threatening comments and posting ambiguous or vague responses that do not add meaning to the online discussion were considered uncivil student behaviors by both students and faculty (p ≤ 0.05). Assigning grades without providing useful feedback and threatening to fail students for not complying with faculty's demands were perceived as uncivil faculty behaviors (p ≤ 0.05). Female students and students with less self-reported expertise in online learning had greater mean scores for faculty uncivil behaviors (p ≤ 0.05).

CONCLUSION

Incivility exists in OLE in dentistry with the more likely engagement of students in uncivil behaviors. With the increasing use of online platforms for education in dentistry, there is a need for further research and training courses for both students and faculty to reduce the extent of incivility and create a healthy and conducive learning environment.

A Simulation-Based Clinical Nursing Education Framework for a Low-Resource Setting: A Multimethod Study

Simulation-based clinical education is a useful strategy for teaching, learning, and assessing clinical competence in health professions education. However, the use of simulation-based clinical nursing education (SBCNE) in low-resource settings such as Ghana has been hampered by the lack of a context-specific framework to guide its design, implementation, and evaluation. This study sought to develop a context-specific framework to guide the design, implementation, and evaluation of SBCNE in a low-resource setting. The study employed a sequential multimethod design, comprising a scoping review; qualitative descriptive design (situational analysis) made up of two parts–focus group discussions (FGDs) with post-registration nurses and nursing students, and semi-structured interviews with nurse educators; and narrative synthesis of the scoping review and situational analysis data, used to develop a draft SBCNE framework for a low-resource setting. The draft SBCNE framework was evaluated by stakeholders of nursing education and practice using nominal group discussions. The framework is comprised of five constructs (context, planning, design, community of learning, and outcomes). The user-centric, comprehensive, context-specific SBCNE framework has the potential to enhance the implementation of simulation in nursing education and the development of clinical competence in a low-resource setting. As a result, we urge nursing leaders and nurse educator unions to take the lead in lobbying regulatory bodies, the central government, and their development partners to provide the necessary financial support and resources for the implementation of the framework and adoption of SBCNE in low-resource settings.

Online Learning Phenomenon: From the Perspective of Learning Facilities, Curriculum, and Character of Elementary School Students

This article aimed to describe the online learning phenomenon from the perspective of learning facilities, curriculum, and students’ characters in schools and the correlation among those three variables. This research employed a qualitative descriptive method. The data were collected through interviews, observations, and questionnaires. The research subject was the fifth-grade class of an elementary school in Palembang, which consisted of 19 students’ parents, 8 teachers, and 47 students. The findings showed that almost half of the total number of students experienced limitations in online learning facilities, most elementary school teachers could not develop curriculum and online learning models, and the online learning phenomenon triggered a decline in the students’ characters.

Impact of the Pandemic on the Teaching and Research Staff at a Technological University in Spain: Deepening the Gender Gap

The alteration of the educational model caused by the COVID-19 pandemic has not affected all university faculty equally. This work explores the academic, digital and gender inequalities caused by the pandemic on the teaching and research staff of a technological university for STEM (Science, Technology, Engineering and Mathematics) disciplines in Spain, the Universitat Politècnica de Catalunya—BarcelonaTech (UPC). The study considers an anonymous survey with a non-probabilistic voluntary sample (n = 355). The results of the survey reveal that, over these months, the teaching and research staff of the university, regardless of gender, has significantly increased its academic activity due especially to the number of hours devoted to virtual teaching compared to its teaching dedication in a situation of normalcy. This study shows that the lockdown has strongly affected women who are more vulnerable to crisis. In particular, the negative impact on research has been higher in female faculty staff from the UPC, who already face disparities regarding promotion and, during lockdown, stated more difficulties with household work reconciliation. From the results of this study, it is possible to conclude that the COVID-19 pandemic has deepened the gender gap in the academic field.

Chamomile (Matricaria chamomilla L.): A Review of Ethnomedicinal Use, Phytochemistry and Pharmacological Uses

Matricaria chamomilla L. is a famous medicinal plant distributed worldwide. It is widely used in traditional medicine to treat all kinds of diseases, including infections, neuropsychiatric, respiratory, gastrointestinal, and liver disorders. It is also used as a sedative, antispasmodic, antiseptic, and antiemetic. In this review, reports on M. chamomilla taxonomy, botanical and ecology description, ethnomedicinal uses, phytochemistry, biological and pharmacological properties, possible application in different industries, and encapsulation were critically gathered and summarized. Scientific search engines such as Web of Science, PubMed, Wiley Online, SpringerLink, ScienceDirect, Scopus, and Google Scholar were used to gather data on M. chamomilla. The phytochemistry composition of essential oils and extracts of M. chamomilla has been widely analyzed, showing that the plant contains over 120 constituents. Essential oils are generally composed of terpenoids, such as α-bisabolol and its oxides A and B, bisabolone oxide A, chamazulene, and β-farnesene, among other compounds. On the other hand, M. chamomilla extracts were dominated by phenolic compounds, including phenolic acids, flavonoids, and coumarins. In addition, M. chamomilla demonstrated several biological properties such as antioxidant, antibacterial, antifungal, anti-parasitic, insecticidal, anti-diabetic, anti-cancer, and anti-inflammatory effects. These activities allow the application of M. chamomilla in the medicinal and veterinary field, food preservation, phytosanitary control, and as a surfactant and anti-corrosive agent. Finally, the encapsulation of M. chamomilla essential oils or extracts allows the enhancement of its biological activities and improvement of its applications. According to the findings, the pharmacological activities of M. chamomilla confirm its traditional uses. Indeed, M. chamomilla essential oils and extracts showed interesting antioxidant, antibacterial, antifungal, anticancer, antidiabetic, antiparasitic, anti-inflammatory, anti-depressant, anti-pyretic, anti-allergic, and analgesic activities. Moreover, the most important application of M. chamomilla was in the medicinal field on animals and humans.

Internet Gaming Disorder in Children and Adolescents with Attention Deficit Hyperactivity Disorder

Although Attention Deficit Hyperactivity Disorder (ADHD) has been related to an increased risk for behavioral addictions, the relationship between ADHD and Internet Gaming Disorder (IGD) is still debated. The aim of this study is to address this topic by exploring the prevalence of IGD in a consecutive sample of ADHD youth, compared to a normal control group, and by assessing selected psychopathological and cognitive features in ADHD patients with and without IGD. One hundred and eight patients with ADHD (mean age 11.7 ± 2.6 years, 96 males) and 147 normal controls (NC) (mean age 13.9 ± 3.0 years, 114 males) were included in the study and received structured measures for IGD. In the ADHD group, 44% of the sample were above the IGD cut-off, compared to 9.5% in the NC group. ADHD patients with IGD presented with greater severity and impairment, more severe ADHD symptomatology, more internalizing symptoms, particularly withdrawal/depression and socialization problems, and more prominence of addiction and evasion dimensions. A binary logistic regression showed that the degree of inattention presented a greater weight in determining IGD. These findings may be helpful for identifying, among ADHD patients, those at higher risk for developing a superimposed IGD.

The Effectiveness of Product Sustainability Claims to Mitigate Negative Electronic Word of Mouth (N-eWOM)

The purpose of this study is to investigate the role of negative electronic word-of-mouth (N-eWOM) messages on attitudes, subjective norms, perceived behavior control (PBC), and the intention to purchase sustainable dairy products. This study also investigates the moderating role of product sustainability claims to reduce the effect of N-eWOM on customers. It comprises two experiments on college students (n = 120; 90) who have at least two accounts on different social media platforms. We use both qualitative and quantitative techniques. The model was developed and tested on data collected from questionnaires. The results of Study 1 suggest that N-eWOM reduces purchase intentions, attitudes, subjective norms, and PBC. High N-eWOM reduces purchase intention more than the low N-eWOM. Study 2 found that with high N-eWOM, product sustainability claims (congruent or incongruent) moderate the effect of N-eWOM on attitudes, subjective norms, PBC, and purchase intention. Purchase intention is higher when a product sustainability claim is congruent. These novel findings contribute to our understanding of ways to mitigate the impact of N-eWOM by taking preventive actions, such as making product sustainability claims.

Novel Evidence-Based Combination of Plant Extracts with Multitarget Mechanisms of Action for the Elimination of Hot Flashes during Menopause

Hot flashes are considered the most bothersome complaint during menopause. Although hormone therapy is an effective option to relieve hot flashes, it has been associated with significant side effects. The aim of our study is to suggest a novel combination of different plant extracts with distinct mechanisms of action against hot flashes. We selected the rhizome of Glycyrrhiza glabra L. (Fabaceae), the rhizome of Actaea racemosa L. (Ranunculaceae), the aerial parts of Hypericum perforatum L. (Hypericaceae) to produce extracts rich in bioactive phytochemicals and the seed oil of Oenothera biennis L. (Onagraceae). We investigated their estrogenic and antioxidant potential and their inhibitory effect against prostaglandin D2 receptor 1 (DP1) as a novel mechanistic pathway for vasodilation in hot flashes, alone or in combination. The phytochemical footprint of the extracts was analyzed using HPLC-PDA and UPLC-HRMS. We observed that the tested extracts possess different mechanisms of action. A. racemosa exerts a beneficial activation of the estrogen receptor, H. perforatum possesses the highest antioxidant capacity and the seed oil of O. biennis inhibits the DP1 receptor. The triple combination in the optimal doses pertains to efficacy against all three mechanisms of action, serves as a multitarget plant-based therapy and could serve as a novel strategy for the alleviation of hot flashes in postmenopausal women.

Listen to Me! - A Mixed-Methods Study of Thoughts and Attitudes Towards Participation in Pulmonary Telerehabilitation Among People with Severe and Very Severe COPD Who Declined Participation in Pulmonary Rehabilitation

INTRODUCTION

Pulmonary rehabilitation (PR) is a key standard treatment for people with chronic obstructive pulmonary disease (COPD) with documented effect on symptom relief, improved physical function, and quality of life. However, referral, uptake and adherence rates remain low. Pulmonary telerehabilitation (PTR) is a safe and effective alternative to conventional PR. This study explores associations, thoughts and attitudes towards PTR in patients with COPD who decline referral to outpatient hospital-based routine PR.

METHODS

A mixed-methods study with integration of survey data (n=84) and semi-structured interviews (n=9).

RESULTS

We found a significant association between belief of effect of PTR and willingness to participate. Increasing age was significantly associated with reduced odds of daily use of central processing unit (CPU) or tablet. One-third of the participants were undecided about potential participation in PTR. Qualitative findings highlight that participants perceived participating in PTR as more convenient and had preferences for individualized, supervised, and monitored rehabilitation.

CONCLUSION

Those willing to participate in a PTR program believed in the benefits, were comfortable with technological devices, had preferences for exercising at home, and saw opportunities in the social setting. Future PTR programs should include monitoring, preferably managed by a familiar health care professional (HCP).

Role of the Media in Health-Related Awareness Campaigns on Perception of COVID-19: A Pre-post Study in the General Population of Pakistan

Medical preparedness and community education are the most valuable preventive tools for combatting the COVID-19 pandemic. This study aims to assess the role of media public health awareness campaigns on the knowledge of the general population about COVID-19 in Rawalpindi, Pakistan. A quantitative study using a pre-post design among 384 respondents was conducted. A structured questionnaire was administered to the participants twice: The first response (t₁) from participants was filled in during the 1st week in February 2020 before any confirmed cases were reported in the country, and the second response (t₂) was completed 1 month after the first case detection in Pakistan (March 2020). Media health awareness campaigns were launched just after the detection of the first case in Pakistan. Exposure to the media and knowledge relating to COVID-19 increased over time. Whereas, only a quarter of respondents judged the isolation of suspected cases in quarantine to be important to prevent the spread of infection in society at t₁, more than half did so at t₂. Socio-demographic characteristics were not significantly associated with knowledge (gains). However, more frequent use of electronic media is associated with greater knowledge gains from t₁ to t₂. The findings of this study provide evidence that awareness and knowledge related to COVID-19 symptoms and preventive measures increased significantly over time. The increased frequency of following the media indicates that health awareness campaigns are important for enhancing the knowledge of the general public regarding COVID-19.

Occupational exposure to particulate matter during blackboard teaching and its deposition in the airways of human lungs

PURPOSE

This study aims to estimate the teachers' exposure to particulate matter (PM) during a chalk and talk class considering various exposure conditions and to determine the deposition pattern of PM in human airways.

MATERIALS AND METHODOLOGY

The study was carried out in three steps, viz., questionnaire survey, exposure measurement, and dosage calculation. Exposure to chalk dust during teaching was measured for 40 teachers in terms of PM of different size range (PM 10, PM 2.5, and PM 1) while using different brands of chalks. Deposition in lungs was determined using Multiple Path Dosimetry model for four subject categories, viz., adult men, elderly men, adult women, and elderly women.

RESULTS

The average exposure during teaching activity was 498, 85, and 30 µg/m³ of PM 10, PM 2.5, and PM 1, respectively. Chalks which are made of calcium carbonate with high density of packing emitted lesser PM 10. Results showed no significant difference in the exposure to PM by teachers while writing at different relative heights of the board. The highest total deposition of PM in lung was observed for elderly women. The deposited mass per unit area was the highest for adult women in all the three sizes of PM.

CONCLUSION

This study showed that there was no significant difference in exposure to PM while using normal and dustless chalks. The exposure level suggests that there is a strong need to either shift to smart classes or to improve the technology in chalk production in such a way that it produces less dust and limit the exposure to teaching professionals.

The use of metacognitive strategies for undisrupted online learning: Preparing university students in the age of pandemic

The primary objective of this study is to evaluate the relationship between the use of metacognitive strategies and learning performance in online learning among university students. The global lockdown due to the Covid-19 global pandemic outbreak has resulted in major interruptions in students' learning and education at all levels around the world. One of the consequences of university closures is that students suddenly find themselves having a lot more responsibility for their learning. Surprisingly, many students are not fully equipped with the relevant skills to excel in online learning despite being born into technology. Students are not aware of how to look inward to examine how they learn and to judge which methods are effective especially when faced with new forms of learning online because they lack metacognitive skills. Metacognition is crucial to the talent of learning. Although many researchers affirmed that metacognitive skills are crucial in any learning, a study on the impact of the use of metacognitive strategies on learning performance is still rudimentary. The study was carried out with 770 university IT students who have taken at least one online learning course. Data was collected using a self-administered instrument that was adapted from multiple sources. Three hypotheses were formulated and structural equation modeling was employed to conduct path modeling analysis. The findings from this study affirmed that students who use metacognitive strategies in online learning are indeed capable of evaluating their understanding of the course content and are capable of adding more effort in regulating their learning process. In view of the findings, this study will be useful for course instructors and students to establish practices on how to utilise metacognitive strategies to enhance students' learning performance as those lacking in metacognition may find themselves at a huge disadvantage.