The global distribution of oral and maxillofacial surgeons: a mixed-methods study.

Despite its role in treating the most dominant non-communicable diseases worldwide, the global workforce of oral and maxillofacial (OM) surgeons is not well-characterized. To address the current deficit in understanding of the global OM surgeon workforce and to elevate oral and maxillofacial surgery (OMS) in the global health discourse, we join other surgical specialties in evaluating global surgical capacity with a descriptive analysis of the distribution of OM surgeons worldwide. A mixed-methods study was implemented using a combination of literature review, in-country contacts, internet searches, and survey data. The survey was distributed globally from January to June 2022. Data regarding OM surgeon workforce estimates were obtained for 104 of 195 United Nations-recognized countries (53.3%). Among countries with available estimates, the median global workforce density was 0.518 OM surgeons per 100,000 population. Twenty-eight countries (26.9%) were reported to have two or fewer OM surgeons. The median OM surgeon workforce density for low-income countries was 0.015 surgeons per 100,000 population, compared to 1.087 surgeons per 100,000 population in high-income countries. low and middle-income countries countries have the least workforce density as well as the least data coverage. More work is needed to better understand the capacity of the global OM surgeon workforce and access to OMS care.

Outcomes of a nonaversive behavior intervention in intellectually impaired individuals using goal attainment scaling.

BACKGROUND: Intellectually impaired individuals with severe behavior problems pose a challenge to caregivers in treatment and management. The use of behavioral intervention techniques, for example, differential reinforcement of other behavior (DRO), has been shown the most effective with this client group type. Studies suggest that DRO is effective and may result in generalization of treatment effects. OBJECTIVES: To test which of three behavior interventions (DRO, mutual goal setting [MGS], and routine care) improve self-care behaviors in moderately intellectually impaired individuals with behavioral problems, and to examine whether the use of goal attainment scaling (GAS) in evaluating interventions reflects improvement in self-care behavior. METHOD: A quasi-experimental design with small-group and single-subject repeated measures were used. The participants (15 congenitally moderately intellectually impaired residents with inadequate self-care behaviors) were randomly assigned to one of the three interventions for fostering self-care behaviors. To evaluate the outcome of treatment, GAS was used. Staff in the DRO and MGS groups developed and evaluated rehabilitation plans with each participant. Participants in the DRO group, but not the MGS group, were positively reinforced immediately. Staff in the routine care group assisted residents. The intervention continued for 22 weeks; follow-up was 16 weeks. RESULTS: A change score was calculated from the GAS for each participant and group. The expected range of mean GAS scores for individuals and groups was between 23 and 77, with 23 (-2) representing less than and 77 (+2) much more than expected improvement. CONCLUSIONS: Findings showed DRO to be more effective than the other interventions in improving self-care behaviors. Comparisons of the GAS mean baseline and mean intervention scores in all three interventions demonstrated the actual improvement in the self-care behaviors.

The effect of Danquah Communication System (DanCS) boards on maladaptive behaviours among individuals with severe intellectual impairment and non-verbal communication skills.

There is evidence that some individuals with severe intellectual impairment who are non-verbal may, out of frustration, display such inappropriate behaviour as aggression and self-injury as a means of communicating their needs to caregivers. The purpose of this study was to develop an inexpensive augmented communication device and to teach individuals with multiple impairment to use this method to communicate their needs in order to reduce their aggressive behaviours. The Dan Communication System (DanCS) symbol boards were therefore designed with computerized voice interface to help the individuals communicate to caregivers by means of audio and visual signs. A working DanCS board has been successfully developed and can now be mass produced by a manufacturer. The DanCS board is illustrated and described. A measurement device called the Goal Attainment Scale (GAS) that focused on three target behaviours; pressing of symbols, control of aggression, and social interaction with caregivers, was used to evaluate progress in the participating subjects (N = 30). Results showed that the multiply impaired individuals in the study significantly improved in all the targeted behaviours through the use of the DanCS. Details of the study are reported.

The practice of behaviour therapy in West Africa: the case of Ghana.

The purpose of this report is to discuss the role of behavior therapy as an additional treatment model in the field of mental health in Ghana. The problems and achievements in its pioneer stage have been discussed. Ghanaian neurotics' concept of etiology of illness is profoundly rooted in cultural beliefs such as evil machination and cosmic forces. The profound role played by the traditional healers' definition of "mysterious illness" and treatment of neurotic symptoms has been modified since the introduction of behaviour therapy and this serves as a threat to the "healers". Analysing the findings so far one can recommend that behaviour therapy be included and emphasized in the future training of African psychiatrists and other mental health professionals in Africa in general and in Ghana in particular.