Enablers of and Barriers to Perinatal Mental Healthcare Access and Healthcare Provision for Refugee and Asylum-Seeking Women in the WHO European Region: A Scoping Review.

Perinatal mental health is a growing public health concern. Refugee and asylum-seeking women are particularly susceptible to experiencing perinatal mental illness and may encounter a range of challenges in accessing healthcare. This scoping review sought to identify the enablers of and barriers to healthcare access and healthcare provision for refugee and asylum-seeking women experiencing perinatal mental illness in the WHO European Region. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was applied. Nine databases and six grey literature sources were initially searched in April 2022, and an updated search was completed in July 2023. The search identified 16,130 records, and after the removal of duplicates and the screening process, 18 sources of evidence were included in this review. A data extraction table was used to extract significant information from each individual source of evidence, which was then mapped to the seven dimensions of the candidacy framework. Empirical (n = 14; 77.8%) and non-empirical (n = 4; 22.2%) sources of evidence were included. The literature originated from seven countries within the WHO European Region, including the United Kingdom (n = 9; 50%), Germany (n = 3; 16.7%), Denmark (n = 2; 11.2%), Norway (n = 1; 5.6%), Greece (n = 1; 5.6%), Sweden (n = 1; 5.6%), and Switzerland (n = 1; 5.6%). The results indicate that, although enablers and barriers were apparent throughout the seven dimensions of candidacy, barriers and impeding factors were more frequently reported. There was also a notable overall lack of reported enablers at the system level. Unaddressed language barriers and lack of attention to the diversity in culturally informed perceptions of perinatal mental illness were the main barriers at the individual level (micro-level) to identifying candidacy, navigating healthcare systems, and asserting the need for care. The lack of culturally appropriate alignment of healthcare services was the key organizational (meso-level) barrier identified. The wider structural and political contexts (macro-level factors), such as lack of funding for consultation time, focus on Western diagnostic and management criteria, and lack of services that adequately respond to the needs of refugee and asylum-seeking women, negatively influenced the operating conditions and wider production of candidacy. It can be concluded that there are multilevel and interconnected complexities influencing access to and provision of perinatal mental healthcare for refugee and asylum-seeking women.

Co-ensiled rice straw with whole sugar beet and its effect on the performance of lactating cows.

This study investigated the effect of co-ensiled rice straw (RS) with whole sugar beet (SB) on lactating cows' performance. Ensiled rice straw (ERS) as control (CGS) was incorporated with immersed corn grains (CG) for 24 h, while the 2nd and 3rd ensiled RS (LSB and HSB) contained SB substituted of 50 and 100% of CG on an energy basis (total digestible nutrients, TDN), respectively. In the experimental diets, D1, D2, and D3, which include CGS, LSB, and HSB provided ad-libitum, respectively, while a concentrated feed mixture (2% of body weight) was offered. The population of lactic acid bacteria was slightly higher with fed HSB, relative to LSB and CGS. The OM, CP, EE, NFC, and TCH contents of CGS were slightly higher than LSB and HSB, while the opposite happened with the aNDFom, and ADFom contents. The digestibility of DM, OM, aNDFom, and ADFom of the D3 group was higher (P < 0.05) than in D1 and D2. The D3 recorded the highest values (P < 0.05) of silage consumption, and palatability. Milk production, fat-corrected milk (FCM), and energy-corrected milk (ECM) were (P < 0.05) higher for cows fed D3 compared with D1 and D2. Fat, protein, lactose, and total solids were trending on the same track. The feed conversion ratio (FCR) of cows fed diet D3 was better than cows fed D1 diet. The level of glucose in the blood increased (P < 0.05) significantly with feeding on HSB than LSB, which was significantly (P < 0.05) higher compared to CGS. In conclusion, co-ensiling of RS with the whole SB plant consider a good method to improve its nutritional value.

Factors influencing the impact of randomized clinical trials on dental implants: A bibliometric analysis.

OBJECTIVE: To analyze bibliometrics, characteristics, and the risk of bias of randomized controlled trials (RCTs) on dental implants published in six high-impact factor journals and to identify factors contributing to citation number. MATERIALS AND METHODS: A systematic electronic search was conducted in four databases (PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials) to identify RCTs on dental implants published in six dental journals between 2016 and 2017. Twenty-five bibliometric variables and paper characteristics were extracted to evaluate their contribution to the citation count. Risk of bias analysis was performed using the RoB2 tool. Negative binomial regression was used to examine the effects of predictor variables on the Citation count. Significance level was set to 5%. RESULTS: A total of 150 RCTs included received a cumulative citation count of 3452 until July 2022. In the negative binomial regression analysis, open-access RCTs exhibited 60% more citations, and RCTs that presented statistical significance received 46% more citations. Conversely, first author affiliations from Africa, Asia and Oceania continents showed 49% fewer citations than publications from Europe. Regarding the risk of bias, 73.3% of the RCTs had some concerns, while 26% were deemed to have a high risk of bias. Only one RCT (0.07%) showed a low risk of bias. CONCLUSION: Within the limitation of the study, factors such as open access, statistically significant results, and country influence the number of citations received by the RCTs on dental implants.

Effect of Thickness and Bonding Technique on Fatigue and Fracture Resistance of Feldspathic Ultra-Thin Laminate Veneers.

OBJECTIVES: To evaluate the fatigue and fracture resistance of ultra-thin laminate veneers (UTLV) with two different thicknesses and two different bonding protocols. MATERIALS AND METHODS: A total of 64 flat enamel surfaces were assigned to either 0.2 or 0.4 mm UTLV. The UTLV were further subdivided and assigned to one of two bonding techniques: adhesive resin cement(RC( or preheated restorative resin composite (HC) (n = 16). Eight samples were fatigued with 750,000 mechanical cycles and 8,000 thermal cycles between 5 and 55°C in a chewing simulator, and the failure mode was evaluated using a stereomicroscope and SEM. The other eight samples from each group were loaded to failure in a universal testing machine to test the fracture resistance. Fisher's exact Probability test was used to analyze the fatigue test results, and two-way analysis of variance and Bonferroni's test were used to analyze the fracture resistance test results. RESULTS: The difference in fatigue resistance between failure proportions in different groups was statistically different (p < 0.05). The 0.4-mm-thick UTLV had similar results regardless of the bonding technique, while 0.2-mm-thick UTLV only showed comparable results when cemented with preheated HC. No statistically significant difference was found in fracture resistance between the tested groups (p > 0.05). CONCLUSION: The Bonding technique and the thickness of the UTLV had impacted fatigue resistance but had no significant effect on the fracture resistance. bonding of UTLV with preheated composite increases their fatigue resistance. Different testing approaches delivered different results.

Service User and Service Provider Perceptions of Enablers and Barriers for Refugee and Asylum-Seeking Women Accessing and Engaging with Perinatal Mental Health Care Services in the WHO European Region: A Scoping Review Protocol.

There is a need to understand the specific perinatal mental health care needs of migrant subgroups who often have differing health care needs and specific barriers to accessing and engaging with health care services. It is important to have evidence about the WHO European context given the rising numbers of refugees and asylum seekers in the region. The aim of this scoping review is to map the factors that enable and prevent access and engagement of refugee and asylum-seeking women with perinatal mental health care services in the WHO European Region, from the perspectives of service providers and service users. The database search will include PsycINFO, Cochrane, Web of Science, MEDLINE, EMBASE, CINAHL complete, Scopus, Academic Search Complete, and Maternity and Infant Care (OVID). Search results will be exported to an online tool that provides a platform to help manage the review process, including title, abstract, and full-text screening and voting by reviewers independently. Data concerning access and engagement with health care services will be mapped on to the candidacy framework. Systematically searching evidence within the WHO European region and examining this evidence through the candidacy lens will help develop a more comprehensive and a deeper conceptual understanding of the barriers and levers of access and engagement with perinatal mental health care services, whilst identifying gaps in existing evidence. Exploring factors that influence access and engagement for refugee and asylum-seeking women from the perspective of key stakeholders in the service provision and/or service utilisation of perinatal mental health care services will add a more comprehensive understanding of the recursive relationship between service provision and use.