bluuebunny/crossref_metadata_2025 huggingface dataset:
Cam or professor Lee? How instructor seniority and address term influence student perceptions in the United States
Authors: Wu Ru , Gardner Mary Jane , Todd Patricia R.
Published: April 2024

In this research, we explore the effect of college instructors' use of formal versus casual titles on student perceptions as a function of the instructors' academic ranks. We conducted two studies: the first surveying students to study their expectations and preferences of formality and rank, and the second using experimental manipulations of title formality and instructor rank to examine the effects on student perceptions of instructors and their classes. Our data indicate that a full professor is perceived more favourably than a graduate assistant when using a casual title (their first name). Conversely, the pattern goes the opposite when they use a formal title. These insights were assessed through course favourability and enrolment intention and were rooted in two fundamental individual traits: competence and approachableness. In addition, the effects are less pronounced for students with previous exposure to the course content, suggesting course experience as a moderator. This study offers guidance on student–instructor interactions and provides insights for educators in presenting themselves through different titles.
Leading tribal colleges and universities: Perspectives on the skills and experiences needed to lead indigenous higher education
Authors: Al‐Asfour Ahmed , Crocco Oliver , Shield Sandra White
Published: April 2024

The purpose of this study is to investigate the essential experiences and skills required for successful and effective leadership at Tribal Colleges and Universities (TCUs) in the United States. Utilizing Weick's seven properties of sensemaking as a framework, this study examines how participants developed their sensemaking abilities regarding their presidencies at TCUs. To conduct this research, a phenomenological qualitative research method was utilized, analysing 11 interviews with TCU presidents. The themes identified in this study included developing a vision plan that the Tribal community supports; learning to communicate with diverse stakeholders; understanding Tribal and non‐Tribal politics for fundraising and accreditations; and eliciting mentors from Tribal leaders and other TCU presidents. These findings have vital implications for individuals interested in pursuing leadership positions at TCUs, as they highlight emic perspectives on the skills and experiences necessary for success in these roles.
Impact of the COVID‐19 lockdown on the oral health behaviour of young children
Authors: Schuller Annemarie A. , Verlinden Deborah A. (Ashley) , Reijneveld Sijmen A. , Vermaire Jan H. (Erik)
Published: April 2024

Aim

Children up to the age of 10 are dependant primarily on their caregivers for oral care; COVID‐19 lockdowns may have disrupted this care. We therefore assessed whether the COVID‐19 lockdown affected routine parental oral care for their children.

Methods

A short online survey regarding oral health behaviour and changes in the home setting during the COVID‐19 lockdown was emailed to parents (n = 782, response 15%) participating in an existing study ‘Healthy Teeth All Aboard (HTAA)’.

Results

During the lockdown, 29% of parents reported that they skipped their children's toothbrushing more often than before the lockdown, and 49% of the children were allowed to consume sugary snacks or drinks more often. These behaviours were not significantly associated with socio‐economic status, country of birth of the mother, work situation of the parents, school attendance patterns or HTAA participation status.

Conclusion

The COVID‐19 lockdown affected the daily oral hygiene routines of children, potentially increasing caries risk.

Clinical Relevance

Dental professionals should be aware of the potential impacts on oral health in children in the circumstance of a new lockdown. Parents should be made aware of the oral health consequences of a lockdown.
Diode laser as an adjunctive treatment for periodontitis: Arandomized controlled trial
Authors: Alghafri Meera , Fadhul Israa , Shah Maanas , Hakam Abeer , Tawse‐Smith Andrew , Alsabeeha Nabeel H. M. , Atieh Momen A.
Published: April 2024

Objective

The aim of this randomized controlled trial was to assess clinical and patient reported outcomes of subgingival instrumentation (SI) with adjunctive use of diode laser (DL) versus SI alone in the treatment of periodontitis.

Methods

Participants requiring non‐surgical periodontal treatment were randomly allocated into two treatment groups: SI with DL or SI alone. Clinical parameters [full mouth bleeding and plaque scores (FMBS and FMPS), probing pocket depth and clinical attachment level] were recorded at baseline, three and 6 months post‐treatment. Visual analogue scale was used to evaluate postoperative participants' perception of pain, swelling, bleeding, bruising and root sensitivity. The impact of periodontal treatment on quality of life was assessed using the General Oral Health Assessment Index (GOHAI) at 6 months.

Results

A total of 22 participants with stage III/IV periodontitis completed the 6‐month follow‐up. SI with or without DL resulted in statistically significant reduction in FMBS, FMPS, PPDs, and percentage of PPDs of ≥5 mm at 3‐ and 6‐month follow‐up visits (p = 0.001 to <0.001). The participants in SI/DL group had a greater reduction in the percentage of deep PPDs (≥5 mm) compared to those receiving SI alone, but statistically significant differences between the two groups were not observed (16.40 ± 9.57 vs. 32.50 ± 38.76 at 3 months and 7.20 ± 6.86 vs. 19.50 ± 35.06 at 6 months). The difference in the mean total GOHAI scores was not statistically significant at 6 months with total GOHAI scores of 7.25 ± 2.45 and 5.40 ± 3.06 for SI and SI/DL groups, respectively.

Conclusion

Within the limitations of this study, the use of DL as an adjunct to SI in the treatment of stage III/IV periodontitis did not produce significant additional improvement in clinical parameters or patient reported outcomes in the 6‐month observation period.
Dental hygienists' knowledge, performance confidence and awareness of importance of assessing oral cancer risk factors
Authors: Lee Boguen , Mun Sojung
Published: April 2024

Objectives

To assess the knowledge, confidence and awareness of the importance of assessing oral cancer risk among dental hygienists working in Korea and to provide data for the development of theoretical and technical curricula related to oral cancer prevention tasks.

Methods

Questionnaires were distributed to 195 dental hygienists, recruited from an online posting. Survey questions were related to the study objectives and demographic characteristics of the participants. An independent t‐test and one‐way Analysis of Variance were performed to determine the relationships between study variables and participant demographic characteristics.

Results

Seventy‐five percent of the participants agreed that it is necessary to conduct oral cancer risk factor assessment for patients, while 46% agreed it was the duty of dental hygienists. The percentage of participants responding correctly to oral cancer risk factors and to oral cancer characteristics ranged from 98% to 31%. Participants with a master's degree or higher and those with oral cancer education experience were significantly (p < 0.003, p < 0.007, respectively) more aware of the importance of assessing oral cancer risk factors. Participants, who performed non‐treatment‐related work, had significantly (p < 0.046) greater performance confidence than that of clinicians. In addition, 52.5% of the participants had no prior education in oral cancer and 80.8% agreed that additional education and training were required.

Conclusions

To improve dental hygienists' knowledge of oral cancer risk factors, it is important to provide specific knowledge, and an educational curriculum is necessary that allows incorporating medical interviews, visual inspections and palpation for comprehensive assessments.
Effect of κ‐carrageenan on the physicochemical and structural characteristics of ready‐to‐eat Antarctic Krill surimi gel
Authors: Chen Jiawen , Hu Yadong , Gao Pei , Jiang Qixing , Yu Peipei , Yang Fang , Pan Mingxuan , Zhou Xinghu , Xia Wenshui
Published: April 2024

The impact of κ‐carrageenan on the physicochemical structural characteristics of ready‐to‐eat (RTE) Antarctic krill surimi gel (AKSG) was investigated. The modifications in chemical bonding, protein secondary structure, protein composition and microscopic morphology were compared in both gels with and without κ‐carrageenan. According to the findings, adding 4% (w/w) κ‐carrageenan could reduce the cooking loss of AKSG significantly (P < 0.05), enhance the WHC and textural quality of AKSG and RTE AKSG and increase the amount of hydrophobic and disulfide bonds so that the secondary structure of Antarctic krill proteins could be shifted to the β‐sheet. However, there was little impact on the composition of the protein molecules according to the SDS‐PAGE. In addition, the usage of κ‐carrageenan significantly alleviated the disruption of the protein gel network caused by high‐temperature and high‐pressure treatments (P < 0.05). Therefore, applying κ‐carrageenan could effectively enhance the gel quality of RTE AKSG.
Formulation and characterisation of low‐fat mozzarella cheese using basil seed mucilage: insights on microstructure and functional attributes
Authors: Akhtar Aqsa , Araki Tetsuya , Nei Daisuke , Khalid Nauman
Published: April 2024

Low‐fat mozzarella cheese (LFMC) consumption is growing as consumers seek healthy substitutes. However, the rubbery texture and poor meltability of LFMC makes it less appealing to consumers. This study evaluated the effect of basil seed mucilage (BSM) as a fat replacer in LFMC (2% fat). A comprehensive analysis of physicochemical, texture, microstructure, and sensory attributes was conducted to evaluate LFMC. BSM was added in concentrations (1%, 2.5%, and 5% (v/v)) during the formulation of LFMC. LFMC samples showed a considerable reduction in fat content, while the LFMC sample with 2.5% BSM (BT2) exhibited improved stretchability and meltability. According to the microstructure analysis, the LFMC three‐dimensional network can be filled with 2.5% (v/v) BSM. The shear and puncture force test reported that adding 5% (v/v) BSM mucilage increased the texture hardness over time. From the results, it can be concluded that 2.5% (v/v) BSM was considered best for improving meltability and stretchability, while 1% BSM (v/v) in LFMC was acceptable for sensory panellists.
Stigma towards a nursing specialty: A qualitative analysis of the perceptions of the addiction nursing workforce
Authors: Searby Adam , Burr Dianna , Abram Marissa D.
Published: April 2024

Addiction nurses are highly skilled providers of holistic care and ensuring workforce sustainability is key to providing quality care to a traditionally marginalised group of healthcare consumers. The aim of this study was to explore perceived stigma towards the addiction nursing speciality, addiction nursing (also known as alcohol and other drug nursing) and its impact on workforce sustainability, retention and recruitment. Secondary analysis of qualitative interview data with nurses (n = 50) and survey data (n = 337) was conducted as part of a workforce mapping exercise in 2019. COREQ reporting guidelines were used. After structural coding was applied, three themes emerged: stigma experienced by clients of alcohol and other drug treatment services, stigma experienced by addiction nurses and a lack of awareness of the specialty of addiction nursing itself. Participants overwhelmingly felt that these forms of stigma made addiction nursing less attractive to new entrants, particularly new nurses and posed a threat to the sustainability of the specialty. The findings from this study indicate that urgent attention is required to address stigma towards individuals who use alcohol and other drugs, and the nurses providing care for them. Furthermore, creating awareness of the addiction nursing specialty is paramount to ensure workforce sustainability and to improve care for individuals who use alcohol and other drugs. Beyond addiction nurses, our results indicate that stigma towards other specialties (such as mental health nursing) is a substantive barrier to workforce sustainability.
A country's efforts toward creating an advanced practice nurse in public health
Authors: Zlotnick Cheryl , Jabareen Raifa , Madjar Batya , Hazoref Rivka Hazan , Gens Ilana , Shachaf Sara
Published: April 2024

Aim

The study goal was to inform the creation of a blueprint for an advanced practice nurse (APN) in public health.

Background

No internationally accepted standard for an APN in public health exists. Activities of public health nurses (PHN) traditionally have centered on health promotion and disease prevention, but many have added other population‐based activities such as chronic and acute disease treatment.

Introduction

An APN in public health is needed to address the global challenges threatening the physical, social, and mental health of populations worldwide.

Methods

This qualitative study was comprised of six focus groups, each containing a different group of stakeholders (n = 40). Study results followed the requirements of the consolidated criteria for reporting qualitative research (COREQ).

Findings

Two major themes emerged: the APN role in public health and core expectations. From the APN role theme, four subthemes emerged on APN domains of public health practice and functions. From the core expectations theme, nine subthemes emerged on the APN's qualifications and behaviors.

Discussion

Agreement among stakeholders was found in the nine core expectations; however, among the four different visions of an APN in public health, two fit a population‐based model rather than the traditional PHN model.

Conclusions

A single APN role in public health is insufficient to address the breadth and complexity of today's global challenges as detailed by the sustainable development goals. Due to the interaction between health and the biopsychosocial environments, we need APNs with different areas of expertise.

Implication for nursing policy

Nurses working at universities, in public health services, and as healthcare policymakers are needed to create a multistage strategy that gradually introduces several different types of APNs in public health.
The association between psychological reactions, resilience, and work engagement among Palestinian critical care nurses in West Bank
Authors: Sawalma Abdelrahman Nedal , Malak Malakeh Z. , Asfour Bara Y. , Khader Imad Abu
Published: April 2024

Aim

This study aimed to assess the association between psychological reactions (e.g., stress, anxiety, and depression), resilience, and work engagement among Palestinian critical care nurses in the West Bank and examine the correlation of psychological reactions and resilience with work engagement.

Background

Work engagement is associated with psychological reactions and resilience, particularly among critical care nurses. There is a lack of studies on work engagement and these factors in Palestine.

Methods

A cross‐sectional, descriptive correlational design was adopted. A convenience sample consisting of 273 critical care nurses from private and governmental hospitals was recruited to participate. Depression, Anxiety, Stress Scale‐21 (DASS‐21), Connor–Davidson Resilience Scale‐25 (CDRS‐25), Utrecht Work Engagement Scale‐9 (UWES‐9), and demographic data were used to collect data during the period from March 20 to May 20, 2023.

Results

Findings demonstrated that 53.9% of the nurses reported mild‐to‐moderate levels of depression, 49.8% reported moderate‐to‐severe levels of anxiety, and 49.1% reported moderate‐to‐severe levels of stress. Additionally, 57.5% and 52.7% of them had low resilience and work engagement, respectively. Moreover, work engagement negatively correlated with depression (r = −0.796, P < 0.01), anxiety (r = −0.654, P < 0.01), and stress (r = −0.796, P < 0.01), while positively correlated with resilience (r = 0.42, P < 0.01) and gender (r = 0.121, P < 0.05). Depression, anxiety, stress, resilience, and gender were the main predictors of work engagement.

Discussion

The majority of the nurses suffered from depression, anxiety, and stress. Additionally, more than half of the participants had low resilience and work engagement. Moreover, increased depression, anxiety, and stress were correlated with decreased work engagement, while high resilience and gender as being female positively correlated with high work engagement.

Conclusion and implications for nursing and health policy

Policymakers and hospital administrators should develop interventions to improve critical care nurses’ resilience and minimize psychological reactions, which have a significant influence on work engagement. Future studies should be conducted to examine the effectiveness of these interventions.
Knowledge and management of molar–incisor hypomineralisation amongst dentists in The Netherlands
Authors: Papanikolaou Foteini , Hesse Daniela , Manton David J. , Bruers Josef J. , Garot Elsa , Bonifácio Clarissa Calil
Published: April 2024

Background

Molar–incisor hypomineralisation (MIH) is a frequently encountered dental condition in the clinical setting, and correct diagnosis can influence management outcomes.

Aim

To assess the knowledge of and attitudes towards the management of MIH amongst dentists in the Netherlands.

Design

The study was conducted as a cross‐sectional web survey. The questionnaire used included questions regarding respondent characteristics, awareness, knowledge and management of MIH and was distributed through the Royal Dutch Association for Dentistry (KNMT) to a random sample of 900 dentists. Variables were analysed using descriptive statistics, and differences between distinct groups of dentists were tested using the chi‐squared test.

Results

Respondents consisted of 76.6% general dental practitioners, 9.1% paediatric dentists and 14.3% differentiated (specialist) dentists, with a 25.6% overall response rate. The majority knew the term MIH and its clinical characteristics, and could distinguish MIH from other enamel defects. Regarding aetiological factors, 76.6% reported a genetic component. In an asymptomatic case, 47.3% reported non‐invasive treatments. In a mild symptomatic case, treatments from non‐invasive to invasive were reported (p < .05). In a severe symptomatic case, the majority reported invasive treatments. Two‐thirds of respondents were interested in further clinical training about MIH.

Conclusions

Most respondents knew the term MIH and its clinical characteristics and would like further clinical training about MIH.
Invertebrates from naturally brackish areas are less impacted by road salt and alternative deicers
Authors: Stander Rachel M. H. , Cahill Abigail E.
Published: April 2024

Road salt (NaCl) is the most common deicer used to melt snow and ice from roadways in cold climates, but its use results in runoff of sodium and chloride ions into sewers and into soil and freshwater ecosystems. Road salt causes harmful effects on wetland habitats, which host an abundance of macroinvertebrate species. Alternatives to road salt, such as beet juice, are commercially available, but their impact on invertebrates is less well studied. We examined the impact of road salt alternatives on four invertebrate species (Daphnia pulex, Eisenia fetida, Heterocypris sp., and Culicoides sp. larvae), some of which come from a naturally brackish area. Our expectation was that road salt alternatives (beet salt, molasses, pickle juice, and sand) would be less toxic to the animals than traditional road salt. This study comprised two experiments: the first exposed individuals of the four invertebrate species to road salt alternatives, and the second exposed the invertebrates to a range of road salt concentrations. Only individuals of D. pulex were negatively impacted by road salt. The other invertebrates were not significantly affected by any salt alternative, demonstrating interspecific differences in response to salt. Species found in naturally salty environments were more tolerant of both road salt and alternatives. This research shows species‐ and habitat‐specific responses to road salt alternatives, which has implications for municipalities looking to salt roads without negatively impacting freshwater ecosystems.
Parents' Trigger Tool for Children with Medical Complexity – PAT‐CMC: Development of a recognition tool for clinical deterioration at home
Authors: Genna Catia , Thekkan Kiara Ros , Geremia Caterina , Di Furia Michela , Cecchetti Corrado , Rufini Emilia , Salata Michele , Perrotta Daniela , Dall'Oglio Immacolata , Tiozzo Emanuela , Raponi Massimiliano , Gawronski Orsola
Published: April 2024

Aim

To develop a trigger tool for parents and lay caregivers of children with medical complexity (CMC) at home and to validate its content.

Design

This was a multi‐method study, using qualitative data, a Delphi method and a concept mapping approach.

Methods

A three‐round electronic Delphi was performed from December 2021 to April 2022 with a panel of 23 expert parents and 30 healthcare providers, supplemented by a preliminary qualitative exploration of children's signs of deterioration and three consensus meetings to develop the PArents' Trigger Tool for Children with Medical Complexity (PAT‐CMC). Cognitive interviews with parents were performed to assess the comprehensiveness and comprehensibility of the tool. The COREQ checklist, the COSMIN guidelines and the CREDES guidelines guided the reporting respectively of the qualitative study, the development and content validity of the trigger tool and the Delphi study.

Results

The PAT‐CMC was developed and its content validated to recognize clinical deterioration at home. The tool consists of 7 main clusters of items: Breathing, Heart, Devices, Behaviour, Neuro‐Muscular, Nutrition/Hydration and Other Concerns. A total of 23 triggers of deterioration were included and related to two recommendations for escalation of care, using a traffic light coding system.

Conclusion

Priority indicators of clinical deterioration of CMC were identified and integrated into a validated trigger tool designed for parents or other lay caregivers at home, to recognize signs of acute severe illness and initiate healthcare interventions.

Impact

The PAT‐CMC was developed to guide families in recognizing signs of deterioration in CMC and has potential for initiating an early escalation of care. This tool may also be useful to support education provided by healthcare providers to families before hospital discharge.

Patient or Public Contribution

Parents of CMC were directly involved in the selection of relevant indicators of children's clinical deterioration and the development of the trigger tool. They were not involved in the design, conducting, reporting or dissemination plans of this research.
Factors affecting environmental sustainability attitudes among nurses – Focusing on climate change cognition and behaviours: A cross‐sectional study
Authors: Chung Sophia J. , Lee Haeyoung , Jang Sun Joo
Published: April 2024

Aims

To investigate the relationship between climate change cognition and behaviours (awareness, concern, motivation, behaviours at home and behaviours at work), positive and negative future cognition, and environmental sustainability attitudes in nurses and to identify the factors affecting environmental sustainability attitudes.

Design

A cross‐sectional study.

Methods

In total, 358 nurses currently working in tertiary hospitals in Korea were recruited. Data were collected using an online questionnaire link from 1 August to 7 August 2022. Climate change cognition and behaviours were measured using the Korean version of the Climate, Health, and Nursing Tool. Positive and negative future cognition were measured using the Korean version of the Future Event Questionnaire. Environmental sustainability attitude was measured using the Korean version of the Sustainability Attitudes in Nursing Survey‐2. Multiple regression analysis was used to identify the factors affecting environmental sustainability attitudes.

Results

Motivation, concern and behaviours at work were factors affecting environmental sustainability attitudes. Motivation was a pivotal influencing factor. Better scores for environmental sustainability attitudes were specifically correlated with higher scores for motivation, concern and behaviours at work.

Conclusions

Nurses' motivation, climate change concern and pro‐environmental workplace practices should all be considered to improve their attitudes towards environmental sustainability.

Implications for the Profession and/or Patient Care

To enhance nurses' environmental sustainability attitudes and behaviours, nurse educators must educate them to increase their motivation for climate action.

Impact

Nurses are increasingly expected to contribute to environmental sustainability. Hence, awareness of climate change and environmental sustainability among nurses must be improved, and nursing engagement and action encouraged. Nurse educators and managers should explore barriers to pro‐environmental behaviour engagement among nurses, examine workplace cultures that encourage pro‐environmental behaviours and develop policies/regulations to develop more environmentally sustainable workplaces.

Reporting Method

We adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Patient or Public Contribution

Neither patients nor the public were involved in our research's design, conduct, reporting or dissemination plans. The nurses partook in this study exclusively as research participants and were not involved in any research process.
Anti‐inflammatory and immunoregulatory effects of colistin sulphate on human PBMCs
Authors: Chen Huiling , Yang Tianli , Xu Yiran , Liang Beibei , Liu Xianyong , Cai Yun
Published: April 2024

In previous studies, CST has been identified as having an immunostimulatory effect on Caenorhabditis elegans and macrophage of rats. Here, we further investigated its immunomodulatory effects on human peripheral blood mononuclear cells (PBMCs). LPS‐stimulated PBMCs inflammatory model was established. Flow cytometry was applied to measure phagocytosis of PBMCs. Cytokine mRNA and protein expression levels of LPS‐stimulated PBMCs with or without CST were measured by qRT‐PCR and ELISA. The transcriptomic profile of CST‐treated PBMCs was investigated by RNA‐sequencing. Gene Ontology (GO) and Kyoto Encylopedia of Genes and Genomes (KEGG) were applied to find potential signalling pathways. PBMCs showed a significant increase in phagocytic activity at 6 h after being incubated with CST at the concentration of 10 μg/mL. In the presence of LPS, CST maintained and promoted the expression of TNF‐α and chemokine CCL24. The content of pro‐inflammatory cytokines, such as IL‐1β, IL‐6 and IFN‐γ, which were released from LPS‐stimulated PBMCs, was reduced by CST at 6 h. Anti‐inflammatory cytokines, such as IL‐4, IL‐13 and TGF‐β1, were significantly increased by CST at 24 h. A total of 277 differentially expressed immune‐related genes (DEIRGs) were detected and cytokine‐cytokine receptor interaction was highly enriched. CST presented obvious anti‐inflammatory and immunoregulatory effects in LPS‐induced PBMCs inflammatory model not only by improving the ability of PBMCs to clear pathogens but also by decreasing pro‐inflammatory cytokines and increasing anti‐inflammatory cytokines. And the mechanism may be related to cytokine‐cytokine receptor interaction.
A One‐Parameter Diagnostic Classification Model with Familiar Measurement Properties
Authors: Madison Matthew J. , Wind Stefanie A. , Maas Lientje , Yamaguchi Kazuhiro , Haab Sergio
Published: April 2024

Diagnostic classification models (DCMs) are psychometric models designed to classify examinees according to their proficiency or nonproficiency of specified latent characteristics. These models are well suited for providing diagnostic and actionable feedback to support intermediate and formative assessment efforts. Several DCMs have been developed and applied in different settings. This study examines a DCM with functional form similar to the 1‐parameter logistic item response theory model. Using data from a large‐scale mathematics education research study, we demonstrate and prove that the proposed DCM has measurement properties akin to the Rasch and one‐parameter logistic item response theory models, including sum score sufficiency, item‐free and person‐free measurement, and invariant item and person ordering. We introduce some potential applications for this model, and discuss the implications and limitations of these developments, as well as directions for future research.
Implementation of a 4Ms approach in age‐friendly oral health care at an Academic Specialty Care Dental Clinic
Authors: Arany Szilvia , Cavalcanti Lia , Phildor Doris , Watson Gene E. , Kopycka‐Kedzierawski Dorota T. , Eliav Eli , Medina‐Walpole Annette , Caprio Thomas
Published: April 2024

Background

Implementing the Age‐Friendly Health System (AFHS) framework into dental care provides a significant opportunity to link oral health to healthy aging. This project aimed to implement the AFHS 4Ms (what matters, medications, mentation, and mobility) in the provision of oral health care. This article describes the planning, integration, training development, and outcome measurements supporting a 4Ms approach at an academic dental clinic.

Methods

The Eastman Institute for Oral Health (EIOH) implemented screening instruments based on the 4Ms framework recommended for ambulatory care clinics by the Institute for Health Care Improvement (IHI). These ambulatory instruments were integrated into the workflows of a Specialty Care Clinic through the development of a plan–do–study–act cycle, utilization of available clinic resources, and creation of interdisciplinary collaborations.

Results

This project demonstrated the feasibility of implementing an AFHS checklist and tracking forms in dental practice by integrating available resources and prioritizing the 4Ms elements. This effort necessitated interdisciplinary collaborations between dental, medical, and social service professionals. It also created a new age‐friendly focused education and training curriculum for dental residents and faculty.

Conclusions

This pilot project is the first to establish dental standards for AFHS implementation, adapting the 4Ms assessment and metrics to oral health. This AFHS underscores key oral health processes, including assessment, planning, and personalized oral health care, adapted to the unique needs of the older adult population, especially those with cognitive impairment.
The Association Between Unintended Pregnancy and Perinatal Outcomes in Low‐Risk Pregnancies: A Retrospective Registry Study in the Netherlands
Authors: van Tintelen Amke M.G. , Jansen Danielle E.M.C. , Bolt Sophie H. , Warmelink J. Catja , Verhoeven Corine J. , Henrichs Jens
Published: April 2024

Introduction

People with unintended pregnancies might be at increased risk of adverse perinatal outcomes due to structural factors, distress, or delayed prenatal care. Existing studies addressing this association yielded inconsistent findings. Using contemporary data from a large Dutch midwifery care registry, we investigated the association between unintended pregnancy ending in birth and neonatal outcomes, parental morbidity, and obstetric interventions. We extend previous research by exploring whether delayed initiation of prenatal care mediates these associations.

Method

This study used data (N = 9803) from a Dutch nationally representative registry of people with low‐risk pregnancies receiving primary midwife‐led care in the Netherlands between 2012 and 2020. Using logistic (mediation) regression analyses adjusted for potential confounders we investigated associations between unintended pregnancy and neonatal outcomes (low Apgar score, small for gestational age, and prematurity), parental morbidity (hypertension and gestational diabetes mellitus), and obstetric interventions (induction of labor, pain medication, assisted vaginal birth, and cesarean birth) and whether delayed initiation of prenatal care mediated these associations.

Results

Unintended pregnancies were associated with increased odds of low Apgar scores (odds ratio [OR], 1.68; 95% CI, 1.09 –2.59), preterm birth (OR, 1.27; 95% CI, 1.02‐1.58), small for gestational age (OR, 1.19; 95% CI, 1.00‐1.41), and induction of labor (OR, 1.14; 95% CI, 1.01‐1.28). Conversely, unintended pregnancy was associated with a decreased odds of cesarean birth (OR, 0.83; 95% CI, 0.71‐0.97). The timing of prenatal care initiation did not mediate any of these associations.

Discussion

Our findings suggest that people in primary midwifery‐led care with unintended pregnancies ending in birth are at increased risk for adverse perinatal health outcomes and that structural factors might underlie this link. Health care professionals and policy makers should attend to their own biases and offer nonjudgmental, tailored preventive preconception care and antenatal care strategies for people with higher vulnerabilities.
Experience of diet in patients with inflammatory bowel disease: A thematic synthesis of qualitative studies
Authors: Xiong Huan , Zhang Xu , Zeng Huiling , Xie Shanshan , Yi Shuanglian
Published: April 2024

Aim

To synthesise the dietary expesriences of patients with inflammatory bowel disease by reviewing relevant qualitative studies.

Background

Diet plays a crucial role in the development and progression of inflammatory bowel disease (IBD). There is no specific diet that can be recommended for all patients. We conducted a synthesis of qualitative studies to gain a comprehensive understanding of the dietary management experience of patients with IBD, aiming to provide better dietary guidance in the future.

Design

A qualitative synthesis was conducted following the Thomas and Harden method and reported following the ENTREQ statement.

Methods

Qualitative studies were systematically searched in five electronic databases: PubMed, PsycINFO, Embase, CINAHL, and Web of Science. There was no time limit for publication, and all database searches were up to 10 May, 2023. The Joanna Briggs Institute Qualitative Assessment and Review Instrument was utilised to appraise the quality of the included studies. Data for inclusion in articles were extracted and analysed using a thematic synthesis method.

Results

Six studies involving 119 patients were eventually included. The studies were conducted in six different countries. Four major themes were identified: the diet of patients with IBD is completely different from the normal one; manage symptoms and live with the disease by modifying diet; psychological adjustment to eating (be frustrated; worried and afraid; feel ashamed; growth and resilience); barriers and challenges (barriers from perceived social support; conflicts between diet and nutrition; challenges from food hedonism and cravings).

Conclusions

Patients with IBD highlighted the distinction between their diet and the normal diet. Dietary modifications were used as a way to manage symptoms and live with the disease. In addition to physical symptoms, patients experienced diet‐related psychological changes. Dietary modifications in patients with IBD encounters difficulties and challenges, necessitating prompt guidance and intervention.

(1) The implementation of dietary modifications in patients with IBD encounters numerous obstacles and complexities, necessitating prompt guidance and intervention.

Patient or Public Contribution

No patient or public contribution.

Registration

The protocol was registered with PROSPERO (CRD42023391545).
Exploration of decision aids to support advance care planning: A scoping review
Authors: Xu Ying , Han Ping‐ping , Su Xiao‐qin , Xue Ping , Guo Yu‐jie
Published: April 2024

Background

Advance care planning is a process through which people communicate their goals and preferences for future medical care. Due to the complexity of the decision‐making process, decision aids can assist individuals in balancing potential benefits and risks of treatment options.

Objective

While decision aids have the potential to better promote advance care planning, their characteristics, content and application effectiveness are unclear and lack systematic review. Therefore, we aimed to explore these three aspects and establish a foundation for future research.

Design

Scoping review.

Methods

This scoping review adheres to the framework proposed by Arksey and O'Malley and the PRISMA‐ScR list. Six English‐language databases were systematically searched from the time of construction until 1 December 2023. Two researchers conducted the article screening and data extraction, and the extracted data was presented in written tables and narrative summaries.

Results

Of the 1479 titles and abstracts, 20 studies fulfilled the inclusion criteria. Types of decision aids were employed, mainly websites and videos. Decision aid's primary components center around 11 areas, such as furnishing information, exploring treatment and care preferences. The main manifestations were a significant increase in knowledge and improved recognition of patients' target value preferences. Among the aids, websites and videos for advance care planning have relatively high content acceptability and decision‐making process satisfaction, but their feasibility has yet to be tested.

Conclusions

Decision aids were varied, with content focused on describing key information and exploring treatment and care preferences. Regarding application effects, the aids successfully facilitated the advance care planning process and improved the quality of participants' decisions. Overall, decision aids are efficient in improving the decision‐making process for implementing advance care planning in cancer and geriatric populations. In the future, personalised decision aids should be developed based on continuous optimization of tools' quality and promoted for clinical application.

Reporting Method

The paper has adhered to the EQUATOR guidelines and referenced the PRISMAg‐ScR checklist.

No Patient or Public Contribution

This is a review without patient and public contribution.

Registration: https://doi.org/10.17605/OSF.IO/YPHKF, Open Science DOI: 10.17605/OSF.IO/YPHKF.
Preoperative prediction of metastatic pheochromocytoma and paraganglioma using clinical, genetic, and biochemical markers: A cohort study
Authors: Park Seung Shin , Ahn Chang Ho , Lee Seunghoo , Lee Woochang , Kim Won Woong , Lee Yu‐Mi , Kim Su Jin , Sung Tae‐Yon , Lee Kyu Eun , Kim Jung Hee , Lee Seung Hun , Koh Jung‐Min
Published: April 2024

Background

The prevalence of metastatic pheochromocytoma and paraganglioma (PPGL) is approximately 15%–20%. Although there are indicators to assess metastatic risks, none of them predict metastasis reliably. Therefore, we aimed to develop and validate a scoring system using clinical, genetic, and biochemical risk factors to preoperatively predict the metastatic risk of PPGL.

Methods

In the cross‐sectional cohort (n = 180), clinical, genetic, and biochemical risk factors for metastasis were identified using multivariate logistic regression analysis, and a novel scoring system was developed. The scoring system was validated and compared with the age, size of tumor, extra‐adrenal location, and secretory type (ASES) score in the longitudinal cohort (n = 114).

Results

In the cross‐sectional cohort, pseudohypoxia group‐related gene variants (SDHB, SDHD, or VHL), methoxytyramine >0.16 nmol/L, and tumor size >6.0 cm were independently associated with metastasis after multivariate logistic regression. Using them, the gene variant, methoxytyramine, and size of tumor (GMS) score were developed. In the longitudinal cohort, Harrell's concordance index of the GMS score (0.873, 95% confidence interval [CI]: 0.738–0.941) was higher than that of the ASES score (0.713, 95% CI: 0.567–0.814, p = 0.007). In the longitudinal cohort, a GMS score ≥2 was significantly associated with a higher risk of metastasis (hazard ratio = 25.07, 95% CI: 5.65–111.20). A GMS score ≥2 (p < 0.001), but not ASES score ≥2 (p = 0.090), was associated with shorter progression‐free survival.

Conclusion

The GMS scoring system, which integrates gene variant, methoxytyramine level, and tumor size, provides a valuable preoperative approach to assess metastatic risk in PPGL.
Risk factors associated with symptoms of temporomandibular disorders among women with hypermobile Ehlers–Danlos syndrome: Questionnaire‐based study in Finland and Sweden
Authors: Yekkalam Negin , Novo Mehmed , Tyrberg Mårten J. , Sipilä Kirsi
Published: April 2024

Background

Generalized joint hypermobility as a characteristic feature of Ehlers–Danlos syndromes (EDS) is among the factors contributing to temporomandibular disorders (TMD).

Objective

To evaluate the prevalence of TMD symptoms and their risk factors among women born in Sweden or Finland who were 27‐ to 78‐year‐olds with diagnosed hypermobile EDS (hEDS).

Methods

A cohort of women with confirmed hEDS (n = 185) was constructed from the members of the National EDS Associations in both countries. Based on questionnaire data, frequency of independent variables in terms of socio‐demographic, general health and oral health‐related factors, comorbid symptoms and psychological distress for self‐reported TMD symptoms as the dependent variables, were calculated first. Prevalence ratios (PR) and their 95% confidence interval (95% CI) were estimated for the association between independent and dependent variables.

Results

Nearly all participants reported TMD symptoms (98%) with TMD pain (95%), TMJ clicking (90%) and jaw fatigue (80%) as the most common symptoms and TMJ crepitation (63%) and luxation (44%) as the least common symptoms. Risk factors for TMD among 27‐ to 50‐year‐olds participants were Finland as a country of birth, living alone and self‐reported worst pain in the body (not the joints). The respective risk factors among the 51‐ to 78‐year‐olds were Finland as a country of birth, family history of EDS, tinnitus and regularly taking contraceptives.

Conclusions

Among adult women with confirmed hEDS, socio‐demographic and health‐related factors and comorbid symptoms were significantly associated with TMD but with differences regarding age group. Therefore, management of TMD requires a multidisciplinary approach among the affected.
Visual psychosocial profiling of Chinese temporomandibular disorder pain patients and correlations with somatosensory function
Authors: Wang Yang , Zhao Yanping , Xie Qiufei
Published: April 2024

Background

Psychosocial function of Chinese temporomandibular disorders (TMD) pain patients and the correlation with somatosensory function has not been sufficiently studied.

Objective

The study aims at assessing the psychosocial function of Chinese TMD pain patients by visualisation method and evaluating the correlations with somatosensory function quantitatively.

Methods

The Symptom Checklist 90 (SCL‐90) questionnaire and standardised quantitative sensory testing (QST) were administered to 70 Chinese TMD pain patients and age‐ and gender‐matched healthy controls (HCs). Of these, 40 TMD arthralgia patients received QST before and after medication. Psychosocial and somatosensory parameters were transformed into standardised scores. Differences within groups were assessed through t tests. Correlations between psychosocial and somatosensory profiles were explored through correlation analyses with Bonferroni correction for multiple comparisons.

Results

100% of the Chinese TMD pain patients exhibited psychosocial distress in contrast to HCs. Anger and hostility showed negative correlation with the thermal nonnociceptive parameter (thermal sensory limen, p =.002) and nociceptive parameters (cold pain threshold and pain pressure threshold, p<.001). Correlation analysis indicated that cold detection threshold was negatively correlated with somatization and mechanical pain sensitivity had a negative correlation with anger and hostility through medical treatment (p <.001).

Conclusions

Visual psychosocial profiles provided an easy overview of psychosocial function in Chinese TMD pain patients. Anger and hostility was associated with increased thermal nonnociceptive and nociceptive sensitivity to stimuli. Psychosocial distress might be negatively associated with TMD treatment response which indicated a possible need for psychological intervention during treatment.
Basal differentiation and expression status of SOX2 and KLF4 in basal layers are prognostic factors for disease‐specific survival in oral squamous cell carcinoma
Authors: Murakami Kazuhiro , Kamiakito Tomoko , Kawata Hirotoshi , Kosami Koki , Nakaya Takeo , Noguchi Tadahide , Mori Yoshiyuki , Tanaka Akira
Published: April 2024

Background

Basal differentiation in oral squamous cell carcinoma is usually detected at invasive sites. However, its significance as a prognostic value has been poorly investigated.

Methods

COL17 was selected as a basal differentiation marker because of its stable expression in the basal‐like cells of oral squamous cell carcinoma. Sixty‐five cases of oral squamous cell carcinoma were subclassified into COL17‐high (30 cases) and ‐low (35 cases) types, and the prognostic value was analyzed by Cox regression analysis. In addition, the stem cell markers such as SOX2, KLF4, MYC as well as the stem cell‐related markers BMI1, EZH2, and YAP and its paralog TAZ, were immunohistochemically analyzed. Their prognostic values were investigated along with their COL17 status by Cox regression analysis.

Results

No significant difference was observed between the COL17‐high and ‐low groups in the disease‐specific survival and recurrence‐free survival in oral squamous cell carcinoma. When the COL17‐high and ‐low categories were combined with the SOX2, KLF4, EZH2, or YAP/TAZ status in the basal layers, together with gender and age as covariates, the hazard ratios reached 3.3, 3.7, 2.8, and 3.1, respectively. In addition, multivariate analysis, including COL17, SOX2, and KLF4, with gender and age as covariates, showed a significantly poor prognosis for disease‐specific survival.

Conclusion

Based on the relatively high hazard ratios, it is indicated that basal differentiation and the expression status of SOX2 and KLF4 in the basal layers are prognostic factors for oral squamous cell carcinoma.
Pubertal status and body image: An inquiry into experiences of adolescents in Ghana and Kenya
Authors: Mahama Sheriffa , Weichold Karina , Fehmer Nora , Mvungu Eunice N. , Natsuaki Misaki N.
Published: April 2024

The current study uses a mixed method design to investigate Kenyan and Ghanaian adolescents' experiences of puberty, and the relations between gender, country of origin, pubertal status, and body image appraisals (N = 86; Ghana = 46, Kenya = 40, 52.9% female aged 13 and 14). Qualitative results revealed seven major themes; puberty means a universal period of growth and transition into adulthood but also evokes negative emotions of shame, anxiety, and embarrassment, being in sync with peers during puberty is important and knowing that others in their lives similarly experience puberty is reassuring. Quantitative results revealed significant gender and country differences in pubertal status and body image. Ghanaian adolescents had more advanced pubertal status and more positive body image appraisals compared to Kenyan adolescents. Moderation analysis results revealed that for the Kenyan sample, post‐pubertal males had less favorable body image appraisals than their counterparts who were still pre pubertal whilst for females, post‐pubertal girls had more favorable body images than their counterparts. No such effects were observed with the Ghanaian sample. The findings highlight the need for context considerations in understanding body image during the pubertal transition to help identify relevant protective factors for possible interventions. The results affirm the importance of positive body image promotions for adolescents within the African context and suggest the need for much more comprehensive sex education with gender‐specific components to help allay fears about puberty, thus preventing the development of possible adaptation problems.