Are COVID-19 patients given adequate instructions about toothbrush hygiene? A cross-sectional study.

OBJECTIVE: The aim of this study was to evaluate toothbrush hygienic practices, whether subjects with a positive COVID-19 test received instructions about toothbrush hygiene, and to determine if carriers of SARS CoV-2 were assigned separate bathrooms during home isolation. METHODS: Data were collected by an anonymous online questionnaire. Variables of interest included toothbrush hygiene practices, receiving instructions on toothbrush handling if tested positive for COVID-19, and being assigned separate bathrooms during home isolation. RESULTS: From November 2020 through April 2021; 755 responded (472 [62.5%] females, 269 [35.6%] males, 14 [1.85%] did not specify their gender). 14 (4.1%) of 341 respondents who reported a positive result of a COVID-19 test received instructions about how to maintain their toothbrush during home isolation. The majority of subjects (74.4%) reported the use of water to wet their toothbrush before brushing, this practice was significantly more common among young subjects (p < 0.001). 58.6% wash all parts of the toothbrush after use while 38.8% wash the head of the toothbrush, and 1.6% place the toothbrush in an antiseptic. 53% used separate bathrooms during isolation, this was significantly associated with age group (p = 0.006) and higher monthly income (p = 0.02). CONCLUSIONS: The majority of participants with a positive result of the COVID-19 test were not given explicit instructions about toothbrush handling. Less than half reported good toothbrush hygienic practices. Higher monthly income was significantly associated with using a separate bathroom during home isolation. Providing explicit instructions about toothbrush hygiene is recommended to reduce the spread of contagious diseases such as COVID-19.

Public Trust in Dentists among Arabic Populations.

Objective: To investigate public trust in dentists, fear of dentists, factors related to trust, and the impact of the COVID-19 pandemic on the trust in dentists. Materials and Methods: We used an Arabic online anonymous survey to collect data from a random population of 838 adults to investigate public trust in dentists, the factors they perceive to affect trust, their perception of key factors in the dentist-patient relationship, fear of dentists, and the impact of the COVID-19 pandemic on the level of their trust in the dentists. Results: Eight hundred thirty-eight subjects with a mean age of 28.5 responded to the survey (595 (71%) females, 235 (28%) males, and 8 (1%) did not specify their gender). More than half trust their dentist. The COVID-19 pandemic did not decrease trust in dentists according to 62.2%. There were significant gender differences in reporting fear of dentists (p < 0.001) and in the perception of factors affecting trust (p=0.028). Honesty was chosen by 583 (69.6%), competence by 549 (65.5), and dentist's reputation by 443 (52.9%). Conclusions: The findings of this study show that the majority of the public trust dentists, more females reported fear of dentists, and the majority perceived honesty, competence, and reputation as key factors affecting trust in the dentist-patient relationship. The majority reported that the COVID-19 pandemic did not have a negative impact on their trust in dentists.

Dentists' Habits of Antibiotic Prescribing May be Influenced by Patient Requests for Prescriptions.

Objective: This study evaluates dentists' antibiotic prescribing habits and the frequency of facing patient pressure for prescriptions. Methods: An online anonymous survey was used to collect data on antibiotic prescribing practices, including prescribing unnecessary antibiotics if requested by patients. Results: The study population included 345 dentists; 227 (65.8%) were females and 118 (34.2%) were males. 54 (15.7%) reported that they prescribed unnecessary antibiotics more than once per week, 47 (13.6%) once per month, 135 (39.1%) rarely, and 109 (31.6%) never prescribed unnecessary antibiotics. 117 (33.9%) reported being pressured by patients to prescribe unnecessary antibiotics more than once per week. 110 (31.9%) reported being pressured by patients to do so at least once per month. There was a statistical difference between the two genders (P < 0.001) in reporting that patients pressured them to prescribe antibiotics when antibiotics were not necessary for treatment or prophylactic purposes and in prescribing unnecessary antibiotics sometimes if requested by a patient (P=0.008). In addition, there was a statistical difference in dentists' confidence in their knowledge and practice in the area of antibiotic prescribing (P < 0.001). Conclusions: The results show that unnecessary antibiotic prescribing by dentists can be influenced by patient pressure.

Disinfection of dental impressions: knowledge and practice among dental technicians.

Background: Dental impressions are a common source for transmission of infection between dental clinics and dental labs. Dental impressions can be cross-contaminated by patient's saliva and blood, which then cross-infect the dental casts poured from the impressions. Objective: To evaluate the current practices of disinfection of dental impressions and their protocols and to assess the knowledge of cross-infection control among dental technicians in Jordan. Method: Dental technicians (n=85) completed a self-administered questionnaire about their practices of disinfection for dental impressions. Results: The distribution of dental technicians was 63.8% fixed prosthodontics, 23.5% removable prosthodontics, 7.8% orthodontics, and 4.8% maxillofacial prosthodontics. The majority of the laboratories did not have instructions related to disinfection of impressions. About 50% of technicians were vaccinated against HBV. About 44.7%, and 42.9% of labs reported that they never disinfect alginate or silicon impressions, respectively. In addition, the majority of lab owners (53%) believed that the dentist should disinfect the impressions before shipping them to dental laboratories, while (45%) believed that disinfecting the impressions is the responsibility of the dental assistant. Moreover, about 38% of this study population reported not using gloves in their labs. In those labs were disinfection was used, 51% used spray disinfection whereas 32.6% used immersion disinfection. The cost of disinfectant was ranked as the most important factor (51.3% of the cases) for the dental technician to choose the disinfectant followed by its effectiveness. Conclusion: Dental technician practices in impression disinfection was not satisfactory, therefore, education programs about impression disinfection are needed.

Rewarding the quantity of peer review could harm biomedical research.

Voluntary peer review is generally provided by researchers as a duty or service to their disciplines. They commit their expertise, knowledge and time freely without expecting rewards or compensation. Peer review can be perceived as a reciprocal mission that aims to safeguard the quality of publications by helping authors improve their manuscripts. While voluntary peer review adds value to research, rewarding the quantity or the volume of peer review is likely to lure academics into providing poor quality peer review. Consequently, the quantity of peer review may increase, but at the expense of quality, which may lead to unintended consequences and might negatively affect the quality of biomedical publications. This paper aims to present evidence that while voluntary peer review may aid researchers, pressurized peer review may create a perverse incentive that negatively affects the integrity of the biomedical research record. We closely examine one of the proposed models for rewarding peer review based on the quantity of peer review reports. This article also argues that peer review should remain a voluntary mission, and should not be prompted by the need to attain tenure or promotion.

Is Biomedical Research Protected from Predatory Reviewers?

Authors endure considerable hardship carrying out biomedical research, from generating ideas to completing their manuscripts and submitting their findings and data (as is increasingly required) to a journal. When researchers submit to journals, they entrust their findings and ideas to editors and peer reviewers who are expected to respect the confidentiality of peer review. Inherent trust in peer review is built on the ethical conduct of authors, editors and reviewers, and on the respect of this confidentiality. If such confidentiality is breached by unethical reviewers who might steal or plagiarize the authors' ideas, researchers will lose trust in peer review and may resist submitting their findings to that journal. Science loses as a result, scientific and medical advances slow down, knowledge may become scarce, and it is unlikely that increasing bias in the literature will be detected or eliminated. In such a climate, society will ultimately be deprived from scientific and medical advances. Despite a rise in documented cases of abused peer review, there is still a relative lack of qualitative and quantitative studies on reviewer-related misconduct, most likely because evidence is difficult to come by. Our paper presents an assessment of editors' and reviewers' responsibilities in preserving the confidentiality of manuscripts during the peer review process, in response to a 2016 case of intellectual property theft by a reviewer. Our main objectives are to propose additional measures that would offer protection of authors' intellectual ideas from predatory reviewers, and increase researchers' awareness of the responsible reviewing of journal articles and reporting of biomedical research.

Responsible Conduct of Human Subjects Research in Islamic Communities.

In order to increase understanding of the ethical implications of biomedical, behavioral and clinical research, the Fogarty International Center, part of the United States National Institutes of Health, established an International Research Ethics Education and Curriculum Development Award (R25) to support programs in low- and middle-income countries. To develop research ethics expertise in Jordan, the University of California San Diego fellowship program in collaboration with Jordan University of Science and Technology provides courses that enable participants to develop skills in varied research ethics topics, including research with human subjects. The program provides a master's level curriculum, including practicum experiences. In this article we describe a practicum project to modify an existing introduction to human subjects research for a US audience to be linguistically and culturally appropriate to Arabic-speaking-Islamic communities. We also highlight key differences that guided the conversion of an English version to one that is in Arabic. And finally, as Institutional Review Boards follow the ethical principles of the Belmont Report in evaluating and approving biomedical and behavioral human subjects research proposals, we provide observations on the conformity of the three ethical principles of the Belmont Report with Islam.

Should Authors be Requested to Suggest Peer Reviewers?

As part of a continuous process to explore the factors that might weaken or corrupt traditional peer review, in this paper, we query the ethics, fairness and validity of the request, by editors, of authors to suggest peer reviewers during the submission process. One of the reasons for the current crisis in science pertains to a loss in trust as a result of a flawed peer review which is by nature biased unless it is open peer review. As we indicate, the fact that some editors and journals rely on authors' suggestions in terms of who should peer review their paper already instills a potential way to abuse the trust of the submission and publishing system. An author-suggested peer reviewer choice might also tempt authors to seek reviewers who might be more receptive or sympathetic to the authors' message or results, and thus favor the outcome of that paper. Authors should thus not be placed in such a potentially ethically compromising situation, especially as a mandatory condition for submission. However, the fact that they do not have an opt-out choice during the submission process-especially when using an online submission system that makes such a suggestion compulsory-may constitute a violation of authors' rights.

Establishing Sensible and Practical Guidelines for Desk Rejections.

Publishing has become, in several respects, more challenging in recent years. Academics are faced with evolving ethics that appear to be more stringent in a bid to reduce scientific fraud, the emergence of science watchdogs that are now scrutinizing the published literature with critical eyes to hold academics, editors and publishers more accountable, and a barrage of checks and balances that are required between when a paper is submitted and eventually accepted, to ensure quality control. Scientists are often under increasing pressure to produce papers in an increasingly stringent publishing environment. In such a climate, timing is everything, as is the efficiency of the process. Academics appreciate that rejections are part of the fabric of attempting to get a paper published, but they expect the reason to be clear, based on careful evaluation of their work, and not on superficial or unsubstantiated excuses. A desk rejection occurs when a paper gets rejected even before it has entered the peer review process. This paper examines the features of some desk rejections and offers some guidelines that would make desk rejections valid, fair and ethical. Academics who publish are under constant pressure to do so quickly, but effectively. They are dependent on the editors' good judgment and the publisher's procedures. Unfair, unsubstantiated, or tardy desk rejections disadvantage academics, and editors and publishers must be held accountable for wasting their time, resources, and patience.

Fortifying the Corrective Nature of Post-publication Peer Review: Identifying Weaknesses, Use of Journal Clubs, and Rewarding Conscientious Behavior.

Most departments in any field of science that have a sound academic basis have discussion groups or journal clubs in which pertinent and relevant literature is frequently discussed, as a group. This paper shows how such discussions could help to fortify the post-publication peer review (PPPR) movement, and could thus fortify the value of traditional peer review, if their content and conclusions were made known to the wider academic community. Recently, there are some tools available for making PPPR viable, either as signed (PubMed Commons) or anonymous comments (PubPeer), or in a hybrid format (Publons). Thus, limited platforms are currently in place to accommodate and integrate PPPR as a supplement to traditional peer review, allowing for the open and public discussion of what is often publicly-funded science. This paper examines ways in which the opinions that emerge from journal clubs or discussion groups could help to fortify the integrity and reliability of science while increasing its accountability. A culture of reward for good and corrective behavior, rather than a culture that protects silence, would benefit science most.

How are Editors Selected, Recruited and Approved?

The editors of scholarly journals have a duty to uphold and promote the highest standards of ethical conduct of research. They also have a responsibility to maintain the integrity of the literature, and to promote transparency and honesty in reporting research findings. In the process of screening manuscripts they receive for possible publication, editors have the obligation to report infractions to the institutions of offending authors, and request an investigation. Since editors can reject a paper on ethical grounds, they can be considered to be the guardians of ethics who should express high ethical standards in conducting and publishing their own research. An examination of several publishers' websites reveals no such requirement or clear selection criteria for journal editors. Therefore, we aim to discuss the factors that publishers, in a broad sense, should consider when selecting editors for scholarly journals and believe that such criteria should be made public to ensure accountability. This would restore some of the eroding public trust in disseminated research, fortify confidence in the composition and qualification of members of an editorial board, and help to protect the reputations of publishers and editors.