Evaluation of postgraduate foundation training for dental therapists: does participation enhance career prospects?

Objectives This study explored the value of dental therapy foundation training (DTFT) in the UK and how participation influenced career prospects.Aims To examine the efficacy of postgraduate foundation training for dental therapists (DTs) and evaluate whether participation increased clinical confidence. To investigate whether participation in the scheme enhanced career prospects and to determine barriers encountered by DTs in securing suitable positions, inclusive of COVID-19 restrictions.Methods The study used a survey incorporating open, closed, Likert-scale and multiple-choice questions. Quantitative data were analysed with IBM SPSS Statistics v26. Analysis of qualitative data was undertaken by two researchers. Final themes and subthemes were confirmed following round table discussions.Results A total of 94 survey responses were received: 61 from DTs who had not undertaken DTFT (Group A) and 33 who had undertaken DTFT (Group B). Most respondents were female (95%) with a mean age of 33.8 and 32.9 years, respectively. In total, 58.3% of Group A respondents did not believe that completing DTFT would have enhanced their career prospects, whereas 63.6% of Group B said that they gained a position as a result of completing DTFT. Participation in DTFT increased perceived clinical confidence in Group B and 81.8% were likely to recommend DTFT to their peers. A total of 12 major themes and 13 subthemes were identified.Conclusions DTFT schemes were considered a valuable educational experience which increased clinical confidence. Participation may have enhanced career prospects. Barriers were encountered by DTs when seeking work, regardless of participation in DTFT.

A new hope induction.

The experience of hope predicts a host of positive outcomes. However, to date, the psychology of hope has paid little attention to hope as an emotion, focusing instead on hope as a sense of effective goal pursuit. Seven studies (N = 3,357) tested various manipulations intended to induce hopeful feelings distinct from general positive mood. Images of infant's faces and tree saplings were found to successfully induce hopeful feelings, even when controlling for happiness, compared with adult faces or full-grown trees, respectively. Infant objects, paintings, or puppies did not produce the same effects. We discuss the necessity of studying the emotion of hope and potential directions with such a hopeful induction. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Target Happiness Attenuates Perceivers' Moral Condemnation of Prejudiced People.

Five experiments (combined N = 4,915) tested the prediction that the moral boost of happiness would persist for social targets with moral failings. In Studies 1 and 2, White and Black participants, respectively, judged happy (versus unhappy) racist targets more morally good. In Study 3, happy (versus unhappy) racist targets were judged more morally good and less (more) likely to engage in racist (good) behavior. Behavioral expectations explained the link between happiness and moral evaluations. Study 4 replicated Studies 1 to 3 in the context of sexism. In Study 5, happy (versus unhappy) targets who engaged in racially biased behavior were evaluated as more morally good, and this effect was explained by behavioral forecasts. Happiness boosts attributions of moral goodness for prejudiced people and does so via expectations for future behavior. Future directions are discussed.

Industry Perceptions and Experiences with the Access Consortium New Active Substance Work-Sharing Initiative (NASWSI): Survey Results and Recommendations.

The Access Consortium New Active Substance Work-Sharing Initiative, or "Access" for simplicity, allows regulatory authorities (RAs) of the Access Consortium countries to jointly review applications for the registration of new active substances or for new indications. Using a survey developed by the pharmaceutical industry trade associations of the five Access Consortium countries-Australia, Canada, Singapore, Switzerland, and the United Kingdom (UK)-this study gathered insights into the perceptions and experiences of the Access pathway held by affiliates of pharmaceutical companies. Understanding industry perceptions of Access is important for the success of the initiative, as participation is voluntary. Findings indicate that affiliates who participated in Access had mostly positive experiences with this pathway; most affiliates were satisfied with their interactions with the Access RAs and appeared willing to continue to participate in the initiative. Affiliates' reasons for not having yet participated in Access included a lack of opportunity to do so and perceived barriers, such as the Access pathway being too complicated to manage. Recommendations to improve Access cover six key areas: ensure predictability, increase guidance and transparency, streamline processes, maintain flexibility, increase harmonization, and advance RA-industry cooperation. This study should facilitate informed discussions among relevant stakeholders on how to improve Access to maximize efficiencies, accelerate approvals, and improve patient access to innovative medicines.

Outpatient visits and antibiotic use due to higher valency pneumococcal vaccine serotypes.

BACKGROUND: In 2022-2023, 15- and 20-valent pneumococcal conjugate vaccines (PCV15/PCV20) were recommended for infants. We aimed to estimate the incidence of outpatient visits and antibiotic prescriptions in U.S. children (≤17 years) from 2016-2019 for acute otitis media, pneumonia, and sinusitis associated with PCV15- and PCV20-additional (non-PCV13) serotypes to quantify PCV15/20 potential impacts. METHODS: We estimated the incidence of PCV15/20-additional serotype-attributable visits and antibiotic prescriptions as the product of all-cause incidence rates, derived from national healthcare surveys and MarketScan databases, and PCV15/20-additional serotype-attributable fractions. We estimated serotype-specific attributable fractions using modified vaccine-probe approaches incorporating incidence changes post-PCV13 and ratios of PCV13 versus PCV15/20 serotype frequencies, estimated through meta-analyses. RESULTS: Per 1000 children annually, PCV15-additional serotypes accounted for an estimated 2.7 (95% confidence interval 1.8-3.9) visits and 2.4 (1.6-3.4) antibiotic prescriptions. PCV20-additional serotypes resulted in 15.0 (11.2-20.4) visits and 13.2 (9.9-18.0) antibiotic prescriptions annually per 1,000 children. PCV15/20-additional serotypes account for 0.4% (0.2-0.6%) and 2.1% (1.5-3.0%) of pediatric outpatient antibiotic use. CONCLUSIONS: Compared with PCV15-additional serotypes, PCV20-additional serotypes account for >5 times the burden of visits and antibiotic prescriptions. Higher-valency PCVs, especially PCV20, may contribute to preventing pediatric pneumococcal respiratory infections and antibiotic use.

Insights From a Community-Based Strategy to Assess Tobacco and Vape Shop Retailers' Implementation of Tobacco 21 Law in El Paso, Texas.

In 2019, the United States Congress passed Tobacco 21 (T21) legislation that raised the minimum legal sales age for tobacco products from 18 to 21. However, although the federal legislation superseded weaker state laws that were already in place in some states, including Texas, local guidance for retailers was inconsistent. Given that retailers are ultimately responsible for policy implementation, the American Heart Association (AHA) initiated a process of assessing retailers knowledge and perceptions of the law through a survey targeting all tobacco retailers and accompanying ethnography of a subset of vape shops in El Paso, Texas. The process yielded lessons learned for assessment of community-based policy implementation including key considerations for personnel and process that are applicable to other community-based assessment processes. While AHA considered an in-person approach ideal, having an alternate online response option was necessary. In addition, a focused approach and in-depth understanding of the purpose was key to responsiveness of the retailers.

"That is Not Behavior Consistent With a Rape Victim": The Effects of Officer Displays of Doubt on Sexual Assault Case Processing and Victim Participation.

Despite the prevalence and severity of sexual violence, case attrition has been identified as a significant issue. Of the cases that are reported to police, only a small portion result in arrest, prosecution, or conviction. Research has revealed that much of this attrition occurs early in the process and that a number of theoretically supported legal (e.g., physical evidence, victim participation) and extralegal (e.g., demographics, victim credibility) factors influence how and whether a case progresses through the criminal justice system. However, few researchers have directly examined the impact of officer doubt on case processing. Whereas legal and extralegal factors represent case characteristics, doubt represents officer cognition about these characteristics. These perceptions can affect how victims are treated, how police investigate the case, and ultimately, the case's progression through the system. A random sample of sexual assault reports from one police department in a medium-sized jurisdiction in the western U.S. was drawn to examine the expression of officer doubt, as well as its impact on victim participation, arrest, and referral for prosecution while controlling for relevant legal and extralegal factors. The findings suggest that officer doubt is an important consideration in sexual assault case processing, independent of other legal and extralegal factors, and that it significantly impacts the likelihood of arrest and referral for prosecution. Consistent with previous research, police decision-making was also impacted by certain legal factors. Victim participation was not directly affected by officer doubt but it was predicted by extralegal factors. Implications for future sexual assault research and practitioner training are discussed.

We Have a Voice: An Examination of Intimate Partner Violence in a Native American Community.

Indigenous people experience a higher rate of intimate partner violence (IPV) than other racial/ethnic groups; however, limited research examines IPV among this population. In collaboration with a tribe in the western United States, this study surveyed a sample of indigenous people (N = 27) to learn about their experiences with victimization. Results show that respondents experienced high amounts of recent relationship and lifetime victimization, mostly consistent with previous literature. Additional issues and challenges emerged from the data, such as low reporting rates and service accessibility. These findings are contextualized within prior IPV literature, and we offer recommendations for future research.

Systems-Level Evaluation of Safe Routes to School Policies in El Paso, Texas: A Modeling Study on Health and Economic Outcomes.

Safe Routes to School (SRTS) policies are linked to physical health benefits for school-age children; however, few studies have assessed long-term impacts on cardiovascular disease (CVD). This study used systems science methods to predict long-term health and economic impact of SRTS among school-age children in El Paso County, Texas. We developed an agent-based model containing 2 modules: the pedestrian injury module and the CVD module. We simulated 10 000 school-age children under 2 scenarios-SRTS policies implemented and no SRTS policies implemented-and then calculated pedestrian injuries, pedestrian injury-related deaths, coronary heart disease (CHD) and stroke events, and health care costs. When SRTS policies were implemented, the model estimated 157 fewer CHD cases and 217 fewer stroke cases per 10 000 people and reduced CVD-related health care costs ($13 788 per person). The model also predicted 129 fewer pedestrian injuries and 1.3 injury-related deaths per 10 000 people and $2417 savings in injury-related health care costs. SRTS could save an estimated $16 205 per person in health care costs. This simulation shows SRTS in El Paso County could prevent pedestrian injuries among school-age children and protect cardiovascular health in the long term. Our findings provide evidence for practitioners and policy makers to advocate for SRTS policies at the local level.

Pediatric outpatient visits and antibiotic use attributable to higher valency pneumococcal conjugate vaccine serotypes.

Importance: Streptococcus pneumoniae is a known etiology of acute respiratory infections (ARIs), which account for large proportions of outpatient visits and antibiotic use in children. In 2023, 15- and 20-valent pneumococcal conjugate vaccines (PCV15, PCV20) were recommended for routine use in infants. However, the burden of outpatient healthcare utilization among U.S. children attributable to the additional, non-PCV13 serotypes in PCV15/20 is unknown. Objective: To estimate the incidence of outpatient visits and antibiotic prescriptions in U.S. children for acute otitis media, pneumonia, and sinusitis associated with PCV15- and PCV20-additional serotypes (non-PCV13 serotypes) to quantify potential impacts of PCV15/20 on outpatient visits and antibiotic prescriptions for these conditions. Design: Multi-component study including descriptive analyses of cross-sectional and cohort data on outpatient visits and antibiotic prescriptions from 2016-2019 and meta-analyses of pneumococcal serotype distribution in non-invasive respiratory infections. Setting: Outpatient visits and antibiotic prescriptions among U.S. children. Participants: Pediatric visits and antibiotic prescriptions among children captured in the National Ambulatory Medical Care Survey (NAMCS), the National Hospital Ambulatory Medicare Care Survey (NHAMCS), and Merative MarketScan, collectively representing healthcare delivery across all outpatient settings. Incidence denominators estimated using census (NAMCS/NHAMCS) and enrollment (MarketScan) data. Main outcomes and measures: Pediatric outpatient visit and antibiotic prescription incidence for acute otitis media, pneumonia, and sinusitis associated with PCV15/20-additional serotypes. Results: We estimated that per 1000 children annually, PCV15-additional serotypes accounted for 2.7 (95% confidence interval 1.8-3.9) visits and 2.4 (1.6-3.4) antibiotic prescriptions. PCV20-additional serotypes resulted in 15.0 (11.2-20.4) visits and 13.2 (9.9-18.0) antibiotic prescriptions annually per 1,000 children. Projected to national counts, PCV15/20-additional serotypes account for 173,000 (118,000-252,000) and 968,000 (722,000-1,318,000) antibiotic prescriptions among U.S. children each year, translating to 0.4% (0.2-0.6%) and 2.1% (1.5-3.0%) of all outpatient antibiotic use among children. Conclusions and relevance: PCV15/20-additional serotypes account for a large burden of pediatric outpatient healthcare utilization. Compared with PCV15-additional serotypes, PCV20-additional serotypes account for >5 times the burden of visits and antibiotic prescriptions. These higher-valency PCVs, especially PCV20, may contribute to preventing ARIs and antibiotic use in children.

Education of the public health workforce and the Sustainable Development Goals: An analysis of existing competency sets.

Objectives: This paper describes a project designed to quantify the extent to which existing competency frameworks used for educating the public health workforce contribute to achieving the Sustainable Development Goals (SDGs) directly relevant to public health. Study design: This was a qualitative study involving a content and thematic analysis and mapping of nine available public health competency sets against the World Federation of Public Health Association's Global Charter for the Public's Health and the SDGs. Methods: First, the SDG targets directly relevant to public health were selected, then mapped against the elements of the Global Charter to illustrate their alignment with aspects of public health practice. Next, competencies from each respective framework were mapped against the SDG targets, and the results quantified as to the coverage of the SDG targets by each of the frameworks. Results: Overall, very few competencies directly or fully covered the SDG targets in question, however, there were more competencies partially covering the targets. Except for one framework, many issues found in the SDG targets were not explicitly addressed by the competencies in most of the frameworks, namely, migration, human rights, violence, and food and water scarcity. Conclusions: Overall, urgent action is required to ensure public health competency frameworks are more in line with the SDGs and include public health issues that disproportionally affect low- and middle-income countries.

Clinical and Public Health Considerations for HPV Vaccination in Midadulthood: A Narrative Review.

Human papillomavirus (HPV) is an important cause of anogenital and oropharyngeal cancers, anogenital warts, and recurrent respiratory papillomatosis. Beginning in 2019, US guidelines recommended shared clinical decision-making (SCDM) for HPV vaccination among midadults (27-45 years). We conducted a narrative review of existing literature on HPV vaccination in midadults. The available evidence demonstrates that HPV vaccination in midadults is safe, efficacious, and likely to benefit both HPV-naïve midadults and those with previous infections. However, gaps in knowledge related to HPV vaccination have been identified among clinicians and midadult patients. Universal midadult HPV vaccination in the United States could avert 20 934-37 856 cancer cases over 100 years, costing $141 000-$1 471 000 per quality-adjusted life-year gained. Wide variation in these estimates reflects uncertainties in sexual behavior, HPV natural history, and naturally acquired immunity. Greater awareness among clinicians and midadult patients and broad implementation of SCDM may accelerate progress toward eliminating HPV-associated cancers and other diseases.

Regional Variation in Outpatient Antibiotic Prescribing for Acute Respiratory Tract Infections in a Commercially Insured Population, United States, 2017.

Background: Studies have shown that the Southern United States has higher rates of outpatient antibiotic prescribing rates compared with other regions in the country, but the reasons for this variation are unclear. We aimed to determine whether the regional variability in outpatient antibiotic prescribing for respiratory diagnoses can be explained by differences in prescriber clinical factors found in a commercially insured population. Methods: We analyzed the 2017 IBM MarketScan Commercial Database of commercially insured individuals aged <65 years. We included visits with acute respiratory tract infection (ARTI) diagnoses from retail clinics, urgent care centers, emergency departments, and physician offices. ARTI diagnoses were categorized based on antibiotic indication. We calculated risk ratios and 95% CIs stratified by ARTI tier and region using log-binomial models controlling for patient age, comorbidities, care setting, prescriber type, and diagnosis. Results: Of the 14.9 million ARTI visits, 40% received an antibiotic. The South had the highest proportion of visits with an antibiotic prescription (43%), and the West the lowest (34%). ARTI visits in the South are 34% more likely receive an antibiotic for rarely antibiotic-appropriate ARTI visits when compared with the West in multivariable modeling (relative risk, 1.34; 95% CI, 1.33-1.34). Conclusions: It is likely that higher antibiotic prescribing in the South is in part due to nonclinical factors such as regional differences in clinicians' prescribing habits and patient expectations. There is a need for future studies to define and characterize these factors to better inform regional and local stewardship interventions and achieve greater health equity in antibiotic prescribing.

Purpose maintained: Adverse childhood experiences and meaning in life.

OBJECTIVE: Three studies examined the relationship between adverse childhood experiences and meaning in life, focusing on the facets of meaning-coherence, significance, and purpose. METHOD: In Study 1 (N = 1804), college students rated adverse childhood experiences, global meaning in life, and its facets. In Study 2 (N = 822), noncollege adults rated childhood trauma, meaning in life facets, attachment style, mood, and neuroticism. In Study 3 (N = 380) college students wrote about a positive and negative childhood memory, rating the facets of meaning immediately after each writing task. RESULTS: In Studies 1-2, at the level of zero-order correlations, adverse childhood experiences related negatively to coherence, significance, and purpose. Controlling for the other facets, adverse childhood experiences remained negatively related to coherence and significance but were unrelated to purpose. Negative relationships between adverse childhood experiences and coherence and significance maintained controlling for covariates (Study 2). In Study 3, the predicted 3-way interaction showed that after recalling a negative childhood memory, adverse childhood experiences predicted lower significance and coherence but higher purpose. CONCLUSIONS: Adverse childhood experiences consistently predict lower feelings of coherence and significance but, accounting for these associations, are unrelated to purpose. Purpose may represent a motivational strength emerging out of childhood adversity.

Environmental exposure to non-steroidal anti-inflammatory drugs and potential contribution to eggshell thinning in birds.

Abnormally thin eggshells can reduce avian reproductive success, and have caused rapid population declines. The best known examples of this phenomenon are the widespread population crashes in birds, mostly raptors, fish eating birds, and scavengers, caused by the pesticide DDT and its isomers in the 1960s. A variety of other chemicals have been reported to cause eggshell thinning. Non-steroidal anti-inflammatory drugs (NSAIDs), which are extensively and increasingly used in human and veterinary medicine, may be one particularly concerning group of chemicals that demonstrate an ability to impair eggshell development, based both on laboratory studies and on their known mechanism of action. In this review, we outline environmental and wildlife exposure to NSAIDs, describe the process of eggshell formation, and discuss pathways affected by NSAIDs. We list pharmaceuticals, including NSAIDs, and other compounds demonstrated to reduce eggshell thickness, and highlight their main mechanisms of action. Dosing studies empirically demonstrated that NSAIDs reduce eggshell thickness through cyclooxygenase inhibition, which suppresses prostaglandin synthesis and reduces the calcium available for the mineralization of eggshell. Using the US EPA's CompTox Chemicals Dashboard, we show that NSAIDs are predicted to strongly inhibit cyclooxygenases. NSAIDs have been observed both in the putative diet of scavenging birds, and we report examples of NSAIDs detected in eggs or tissues of wild and captive Old World vultures. We suggest that NSAIDs in the environment represent a hazard that could impair reproduction in wild birds.

Smoke-Free Policy Adoption in Horizon City and El Paso Community College: A Strategic Campaign Approach That Turns a "No" Into a "Yes".

Coalitions in Horizon City in El Paso County, Texas and the El Paso Community College (EPCC) had previously attempted to pass smoke-free policies in 2008 and 2016, respectively; however, both policies failed to pass at those times. The coalitions refocused their activities and were successful in passing policies in EPCC in 2020 and in Horizon City in 2021. We employed a participatory case study method to understand what factors changed between the first and second attempts at smoke-free policy adoption in Horizon City and EPCC. Using the Advocacy Coalition Framework as a basis for analysis, we identified the role of coalitions, their beliefs, use of power resources, role of policy brokers, and external events. We identify best practices and make recommendations for coalitions seeking to adopt smoke-free policies in other locations.

Using machine learning to examine drivers of inappropriate outpatient antibiotic prescribing in acute respiratory illnesses.

Using a machine-learning model, we examined drivers of antibiotic prescribing for antibiotic-inappropriate acute respiratory illnesses in a large US claims data set. Antibiotics were prescribed in 11% of the 42 million visits in our sample. The model identified outpatient setting type, patient age mix, and state as top drivers of prescribing.

Meaning in Life and Coping With Everyday Stressors.

Meaning in life (MIL) has been proposed to improve coping and resilience. Yet MIL's association with coping has primarily been investigated in the context of extreme stressors and trauma, often using varied measures of MIL. Is MIL associated with varied coping strategies, coping self-efficacy, and distress in relation to commonly experienced, everyday challenges? Using diverse methodological designs, five studies (total N = 1,646) investigated the association between MIL and coping strategies/appraisals pertaining to varied challenging, stressful events. Across recalled (Studies 1 and 2), anticipated (Study 3), and experienced stressors (Studies 3-5), MIL was consistently associated with positive reinterpretation, proactive planning, coping self-efficacy, and stress. MIL was inconsistently related to threat/emotion-coping.

Antibiotic prescribing for acute gastroenteritis during ambulatory care visits-United States, 2006-2015.

OBJECTIVE: To describe national antibiotic prescribing for acute gastroenteritis (AGE). SETTING: Ambulatory care. METHODS: We included visits with diagnoses for bacterial and viral gastrointestinal infections from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey (NAMCS/NHAMCS; 2006-2015) and the IBM Watson 2014 MarketScan Commercial Claims and Encounters Database. For NAMCS/NHAMCS, we calculated annual percentage estimates and 99% confidence intervals (CIs) of visits with antibiotics prescribed; sample sizes were too small to calculate estimates by pathogen. For MarketScan, we used Poisson regression to calculate the percentage of visits with antibiotics prescribed and 95% CIs, including by pathogen. RESULTS: We included 10,210 NAMCS/NHAMCS AGE visits; an estimated 13.3% (99% CI, 11.2%-15.4%) resulted in antibiotic prescriptions, most frequently fluoroquinolones (28.7%; 99% CI, 21.1%-36.3%), nitroimidazoles (20.2%; 99% CI, 14.0%-26.4%), and penicillins (18.9%; 99% CI, 11.6%-26.2%). In NAMCS/NHAMCS, antibiotic prescribing was least frequent in emergency departments (10.8%; 99% CI, 9.5%-12.1%). Among 1,868,465 MarketScan AGE visits, antibiotics were prescribed for 13.8% (95% CI, 13.7%-13.8%), most commonly for Yersinia (46.7%; 95% CI, 21.4%-71.9%), Campylobacter (44.8%; 95% CI, 41.5%-48.1%), Shigella (39.7%; 95% CI, 35.9%-43.6%), typhoid or paratyphoid fever (32.7%; (95% CI, 27.2%-38.3%), and nontyphoidal Salmonella (31.7%; 95% CI, 29.5%-33.9%). Antibiotics were prescribed for 12.3% (95% CI, 11.7%-13.0%) of visits for viral gastroenteritis. CONCLUSIONS: Overall, ∼13% of AGE visits resulted in antibiotic prescriptions. Antibiotics were unnecessarily prescribed for viral gastroenteritis and some bacterial infections for which antibiotics are not recommended. Antibiotic stewardship assessments and interventions for AGE are needed in ambulatory settings.

The health and economic impact of the Tobacco 21 Law in El Paso County, Texas: A modeling study.

In December 2019, the US federal Tobacco 21 (T21) law passed to raise the minimum legal purchase age for tobacco products from 18 to 21 years. Preliminary evidence suggests that the T21 law will restrict youth access to tobacco products, leading to decreases in tobacco use over their lifetime. This study expands the science through the use of systems modeling by linking decreases in youth tobacco use in El Paso County, Texas, due to the T21 law implementation, to potential cardiovascular health (CVH) benefits and health care cost reductions. Using a smoking behavior and cardiovascular disease agent-based model, we projected the T21 law's long-term effects on smoking prevalence and CVH outcomes in El Paso County, Texas. The estimated smoking prevalence in El Paso County, Texas, decreased by 2.7% among 18-24 year olds and by 5.2% among 25-44 year olds in 20 years with T21 law implementation (p < 0.01 for both population groups). By reducing tobacco use, the T21 law could prevent 5.4 coronary heart disease events per 1,000 adults and 6.1 S events per 1,000 adults over a lifetime. The model estimated a reduction in lifetime health care costs from $42,929 per person without T21 law to $41,985 per person with the policy. This study provides further evidence for policymakers and communities to understand the potential health and economic impacts of the federal T21 law at the local level. Results emphasize the need for comprehensive policy implementation and enforcement to produce its intended impact on health outcomes.