Dental education changed by COVID-19: Student's perceptions and attitudes.

BACKGROUND: Dental students have encountered changes in the teaching format amid the SARS CoV-2 pandemic. This study aims to evaluate the attitudes of dental students of one medical university toward online courses and compare them with those of non-dental students amid the SARS CoV-2 pandemic. METHODS: A cross-sectional survey with a self-report online questionnaire was conducted at the medical university in May 2020 in Taipei. Students from the School of Dentistry, School of Dental Technology, and School of Oral Hygiene Study were enrolled in our survey. RESULTS: In total, 473 students responded to the survey, 318 (67.2%) of whom were dental students. Overall, 366 (77%) students agreed with the change to online learning. Only 10.4% of students thought that dental professional courses with a laboratory format could be changed to online courses. Dental students were significantly more worried than non-dental students about being infected with COVID-19 and about the COVID-19 pandemic continuing. CONCLUSIONS: In conclusion, changing to online learning seems to be perceived as feasible by students. However, more discussion about changing dental professional courses with a laboratory format to online courses considering the attitudes from students is needed.

The impact of COVID-19 on knowledge, attitude, and infection control behaviors among dentists.

BACKGROUND: This study seeks to elucidate the impact of COVID-19 on knowledge, attitude, and infection control behaviors among dentists. METHODS: Changes in knowledge, attitude, and infection control behaviors reported in 2020 (COVID-19 period) were compared to the historical control of the non-COVID-19 period in 2018. A proportional random sampling method was used to select the study samples from 400 dental institutions. The response rate was 69% in 2018 and 62.8% in 2020. A total of 276 dentists in 2018 and 251 dentists in 2020 responded to this questionnaire. Multiple logistic regression was used to assess the associations between factors and recommended infection control practices. RESULTS: High rates of correct COVID-19 knowledge (94.76%), fears of being infected with the virus (94%) and use of personal protective equipment (mask, glove and protection gown; 95%) were reported. We found that knowledge regarding environmental infection control, HIV transmission, and the window of HIV transmission were significantly higher in the post-COVID-19 period compared with the pre-COVID-19 period. High compliance rates of wearing mask, gloves and protection were reported. The number of dentists wearing a hair cap and a protective eye mask/face shield during the pandemic significantly increased compared with that noted before the COVID-19 pandemic. Factors associated with the use of a hair cap and an eye mask/face shield differed between the pre- and post-COVID-19 periods. The factors associated with compliance regarding environment infection control also differed between the pre- and post-COVID-19 periods. CONCLUSION: The significant impact of COVID-19 on the knowledge, attitude, and infection control behaviors among dental care workers was observed in the current study. In particular, the use of hair caps and protective eye mask or face shields as well as environmental disinfection protocols has significantly improved. Trial registration TMU-JIRB: N201804006.

Impact of oral potentially malignant disorder subtypes on all-cause and cause-specific mortality in males.

OBJECTIVES: To quantify the effect of oral potentially malignant disorder (OPMD) subtypes on mortality from oral cancer and type 2 diabetes among areca nut chewers and/or cigarette smokers. MATERIALS AND METHODS: A retrospective cohort design was devised to follow 14,749 men attending community-based screening program for oral cancer between 1998 and 2000 and followed until 2010. The Cox proportional hazards regression model was applied to assess the effect of OPMD on death. RESULTS: A total of 1,291(8.75%) patients were detected as OPMD. Among those free of T2DM at baseline, the elevated risk for death from T2DM was noted for OSF (aHR = 3.62, 95% CI: 1.25-10.51) and erythroplakia (aHR = 5.01, 95% CI: 1.17-21.45). The elevated risk for all-cause death for OPMD was mainly explained by deaths from oral cancer and T2DM but not other causes of death. CONCLUSIONS: Oral potentially malignant disorder, particularly OSF and erythroplakia, in male cigarette smokers and/or areca nut chewers led to an incremental elevated risk of T2DM mortality in the way of being distal to the occurrence of T2DM, implying that early detection and prevention of OPMD may not only reduce oral cancer mortality but also result in the reduction of T2DM mortality.

Prevalence and factors associated with postpartum depression among Bhutanese mothers: a cross-sectional study.

PURPOSE: This study investigated the prevalence of postpartum depression (PPD) and explored associated factors among mothers attending postnatal care in Bhutan. METHODS: A cross-sectional study was conducted from August to November 2023 at a national referral hospital in Thimphu, the capital city of Bhutan. In total, 314 mothers were recruited. Sociodemographic, psychosocial, obstetric, and infant-related data were collected using questionnaires. The Edinburgh Postnatal Depression Scale, with a threshold of ≥11, was employed to screen for PPD, and logistic regression was used to test the potential factors. RESULTS: The prevalence of PPD was 14.97%. Mothers with a perceived change in body image (adjusted odds ratio [AOR], 4.40; 95% confidence interval [CI], 1.91-10.17; p=.001), perceived heightened stress after delivery (AOR, 3.74; 95% CI, 1.45-9.67; p=.006), poor relationship with inlaws (AOR, 2.57; 95% CI, 1.24-5.30; p=. 011), and negative birth experience (AOR, 2.42; 95% CI, 1.17-5.00; p=.016) demonstrated significantly higher odds of developing PPD. However, mothers with a higher monthly family income (Bhutanese ngultrum [Nu.] 20,000 to <50,000; AOR, 0.35; 95% CI, 0.13-0.92; p=.033), ≥Nu. 50,000 (AOR, 0.37; 95% CI, 0.13-1.07, p=.067) compared to

Role of literacy, fear and hesitancy on acceptance of COVID-19 vaccine among village health volunteers in Thailand.

BACKGROUND: The roles of literacy, fear and hesitancy were investigated for acceptance of COVID-19 vaccine (AV) types among village health volunteers (VHVs) in Thailand. MATERIALS AND METHODS: A cross-sectional study was conducted using an unidentified online questionnaire to assess literacy, fear and hesitancy of COVID-19 vaccine acceptance among Thai VHVs between 1 and 15 October 2021. The questionnaire was developed based on the HLVa-IT (Health Literacy Vaccinale degli adulti in Italiano) for vaccine literacy (VL), using an adult Vaccine Hesitancy Scale (aVHS) for COVID-19 vaccine hesitancy (VH) and Fear of COVID-19 scale (FCoV-19S) for the distress of COVID-19 vaccine. The effects of VL, VH and vaccine fear (VF) on AV were estimated using multivariable logistic regression. RESULTS: A total of 5,312 VHVs completed the questionnaire. After adjustment with variables in the multivariable analysis, the VL score was insignificantly associated with increased vaccination (aOR = 1.002; (95%CI: 0.994-1.01)), while VF and VH significantly decreased the chance of vaccination, aOR = 0.966 (95%CI: 0.953-0.978) and aOR = 0.969; (95%CI: 0.960-0.979), respectively and VF and VH were negatively associated with AV for all types of vaccine preference, with VL showing a reverse relationship only for mRNA-based vaccines. CONCLUSION: VL may not increase AV among VHVs. To increase attitudes toward receiving COVID-19 vaccination in Thailand, the government and health-related organizations should instigate policies to significantly reduce VF and VH among Thai VHVs.

Survival of Cancer Patients with Co-Morbid Tuberculosis in Thailand.

BACKGROUND AND OBJECTIVE: We aimed to investigate the survival time and its related factors among cancer patients with co-morbid tuberculosis (TB) in Thailand. METHODS: We conducted this retro-prospective cohort study on cancer patients without co-morbid TB using the data from population-based cancer registry of Khon Kaen, TB databases from the Khon Kaen Central Hospital, and the Region 7 Office of Disease Prevention and Control from 2001 to 2015 to determine the onset of TB after cancer. The cancer patients were then followed up until 2017 to assess their survival status. The Kaplan-Meier method, log-rank test, and Cox proportional hazard regression were used to estimate cumulative survival curves, compare various survival distributions, and adjusted hazard ratios. RESULTS: Lung, head and neck, and liver cancers led to a  significantly different survival time between patients with and without co-morbid TB. After adjustment, it was found that patients suffering from lung, head and neck, or liver cancer and co-morbid TB had significantly lower risk of death than those without co-morbid TB. Based on the stratified analysis, lung cancer patients with distant metastasis and co-morbid TB had 3.01-fold and 2.99-fold significantly increased risk of death compared to those without co-morbid TB. CONCLUSION: We found that cancer patients with co-morbid TB were at lower risk of death compared with those without co-morbid TB. In addition to cancer stage, it seems that cancer comorbidity with TB could modify the risk of death for lung cancer patients.There is a need for further studies to support our findings including other related risk factors. 
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Sex Differences in the Heterogeneous Dynamic Incidence of Oral Cancer: A Comparison between Taiwan and Thailand.

BACKGROUND: This study aims at investigating differences in oral cancer (OC) incidence trends between two populations in Taiwan and Thailand. METHODS: We used the population-based cancer registry data from Taiwan (1979-2016) and Khon Kaen (KK), Thailand (1985-2016). We performed joinpoint analyses to detect the trend change points for the OC incidence and to quantify the time trends in both sexes and regions. Age-period-cohort curves were plotted to explain the incidence trends. RESULTS: In Taiwan, the estimated annual increases in OC were approximately 6.0% in males, although the increase slowed after 2009, and 2.6% in females. In KK, the OC incidence steadily decreased by -2.5% per year in females, but there was no obvious change in males. A strong period effect observed in those aged 45-69 years in Taiwanese males resulted in a peak incidence in the middle age group. Decreased period and cohort effects were observed in females in KK. CONCLUSIONS: Taiwanese males are the predominant sex affected by OC in Taiwan, and the trend has decelerated since 2009. Age, period, and cohort effects were different between males and females in the two regions.

Smoking cessation advice from healthcare professionals helps those in the contemplation and preparation stage: An application with transtheoretical model underpinning in a community-based program.

INTRODUCTION: The efficacy of smoking cessation intervention has been proven with randomized controlled trials. Our study aims to elucidate the effects of the delivery method of smoking cessation advice on the process of stage of changes with transtheorectical model underpinning in a community setting. METHODS: A total of 436 subjects were recruited in a quasi-experimental untreated control design study, with 46 receiving advice from healthcare professionals (HCP group) and 390 in the control group, in 2003, Nantou, Taiwan. A discrete time Markov model was used to quantify the multi-state process of smoking cessation in light of the transtheorectical model. Multiple polytomous logistic regression models were simultaneously applied to different transitions. RESULTS: The estimated forward transition probabilities were higher in the HCP group compared to their counterparts in the control group. On the other hand, the backward transition probabilities were smaller in the HCP group. After adjusting for confounding factors, HCP had a 4.3-fold (95% CI: 2.21-8.46) odds ratio of moving forward from the contemplation stage, and 2.4-fold odds ratio (95% CI: 1.03-4.42) from the preparation stage. Elderly people were more reluctant to change from precontemplation (AOR=0.50; 95% CI: 0.34-0.74) and contemplation (AOR=0.58; 95% CI: 0.44-0.84), but once in the preparation stage, they were more likely to take action (AOR=1.28; 95% CI: 1.01-1.83). For those in the preparation stage, longer smoking years had a negative effect on taking action (AOR=0.74; 95% CI: 0.52-0.99), but cessation advice from others enhanced the likelihood to take action (AOR=1.36; 95% CI: 1.01-1.99). CONCLUSIONS: The direct advice on smoking cessation from healthcare professionals enforced the net forward transition towards smoking cessation, especially the transition from contemplation and preparation. The proposed Markov regression model assessed the net effect of different intervention approaches allowing for the simultaneous consideration of multiple transitions and the effects of other confounders.

Effect of metabolic syndrome on incidence of oral potentially malignant disorder: a prospective cohort study in Taiwan.

OBJECTIVES: We aimed to assess the effect of metabolic syndrome (MetS) on incident oral potentially malignant disorder (OPMD). DESIGN: We conducted a prospective cohort study of the Changhua community-based integrated screening (CHCIS) programme and nationwide oral cancer screening programme during the period between 2005 and 2014. SETTING: CHCIS, Taiwan. PARTICIPANTS: We enrolled 17 590 participants aged 30 years and older. MAIN OUTCOMES AND MEASURES: We assessed the impact of MetS on the outcome measured by incident OPMD. RESULTS: The incidences of OPMD among subjects with and without MetS were 7.68 ‰ and 5.38 ‰, respectively. After adjusting for confounders, subjects with MetS exhibited a statistically greater risk of developing OPMD compared with those who were free of MetS by 33% (adjusted rate ratio, aRR=1.33, 95% CI 1.14 to 1.55). Individual components of MetS still remained significant, including central obesity (aRR=1.22, 95% CI 1.04 to 1.44), hypertriglyceridaemia (aRR=1.26, 95% CI 1.07 to 1.49) and hyperglycaemia (aRR=1.20, 95% CI 1.02 to 1.41). Central obesity and hypertriglyceridaemia were also statistically associated with a subtype of OPMD, namely, leukoplakia. CONCLUSION: The temporal influence of MetS on the risk of incident OPMD was noted in our prospective cohort study. Therefore, promoting an MetS prevention and control programme might reduce the occurrence of OPMD and oral cancer.

Lack of Association between an XRCC1 Gene Polymorphism and Colorectal Cancer Survival in Thailand.

BACKGROUND: Colorectal cancer (CRC) is one of the most common causes of death worldwide and in Thailand. The X-ray repair cross-complementary protein 1 (XRCC1) is required for efficient DNA repair. The effects of this gene on survival in colorectal cancer remain controversial and have not been reported in Thailand. The aim of this study was to investigate the association of the XRCC1 gene with survival of colorectal cancer patients in a Thai population. MATERIALS AND METHODS: Data and blood samples were collected from 255 newly diagnosed and pathologically confirmed CRC patients who were recruited during the period 2002 to 2006 and whose vital status was followed up until 31 October, 2014. Real-time PCR-HRM was used for genotype identification. The Kaplan-Meier method, the log-rank test, and Cox proportional hazard regression were used to estimate cumulative survival curves and compare various survival distributions and adjusted hazard ratios. RESULTS: Most of the cases were males, and the median age was 55 years. The median survival time was 2.43 years. The cumulative 1-, 3-, 5-, 7-, and 10 year survival rates were 76.70%, 39.25%, 26.50%, 16.60% and 3.56%, respectively. After adjustment, female gender, ages 50-59 and ≥ 60 years, tumour stage III+IV, a signet-ring cell carcinoma, and poor differentiation had significant associations with increased risk of CRC death. While the XRCC1 Arg/Arg homozygote appeared to be a risk factor for CRC death, the association was not significant. CONCLUSIONS: The genetic variant in the XRCC1 may not be associated with the survival of CRC patients in Thailand. Further studies are needed to verify our findings.

Prevalence and Factors Associated with Oral Pre-Malignant Lesions in Northeast Thailand.

BACKGROUND: Oral cavity cancer (OCC) is one of the most common cancers worldwide. No studies have reported on the prevalence and epidemiologic risk factors of oral premalignant lesions (OPLs) in Thailand. The purpose of this study was to investigate the prevalence of OPLs and associated factors in Roi Et Province, Thailand. MATERIALS AND METHODS: To investigate the prevalence of OPLs, a cross-sectional descriptive study was conducted in which 2,300 subjects over 40 years of age were recruited and screened for the prevalence of OPLs. To identify factors associated with OPLs, a matched case-control study was used in which the subjects were 102 cases with OPL and 102 matched controls without OPLs. The studies were conducted in Roi Et Province during the period 1 February, 2014, to 30 April, 2014, and the data were collected by the use of a structured interview questionnaire and by extraction of information from medical records. Data analyses involved the use of descriptive statistics, McNemar's test, and conditional logistic regression. RESULTS: The overall prevalence of OPLs was 3.8%, and no-one was diagnosed with more than one type of OPL. The factors found to be associated with a statistically significant higher risk of an OPL were betel nut chewing, smoking, and alcohol consumption. The associations with these factors were strong, especially for betel nut chewing and smoking. CONCLUSIONS: The habits of betel nut chewing, smoking, and alcohol use are confirmed as factors associated with OPLs in a population of Roi Et Province, Thailand. Campaigns to reduce such risk healthy behaviour are needed, but whether any actual decrease will prevent the eventual transformation of an OPL into an OCC remains an open question.