Psychometric Properties of the Haitian Creole Brief Religious Coping Scale (RCOPE) with a Sample of Adult Haitians Impacted by the 2010 Earthquake.

The current study investigated the psychometric properties of the Haitian Creole version of the Brief Religious Coping Scale (Brief RCOPE). A total of 256 adult survivors of the 2010 earthquake in Haiti completed the Brief RCOPE and measures of posttraumatic stress disorder symptoms, resilience, general coping, and posttraumatic growth. The results showed the Brief RCOPE to have excellent internal consistency reliability α = .94 and α = .85 for the positive religious coping and negative religious coping, respectively. Confirmatory factor analysis showed construct validity for the Brief RCOPE subscales. The results also showed evidence of convergent validity of the Brief RCOPE in relation to measures of positive spiritual change and religion. Independent t-tests revealed statistically significant gender differences in scores on the positive religious coping subscales as women scored higher than men. These findings suggest that the psychometric properties of the Haitian Creole version of the Brief RCOPE are adequate for the assessment of religious coping with Haitian adults exposed to a natural disaster.

Relationship of trust on selected health information sources and COVID-19 vaccine acceptance among older adults / The Health Sciences Journal

Introduction@#In order to suppress the COVID-19 virus, several vaccines have been developed. The administration of COVID-19 vaccines entails its acceptance. However, misinformation and vaccine uncertainty are main factors that affect vaccine acceptance. This study aimed to determine the most trusted health information source, the most frequently accessed health information source, and health literacy of older adults within Metro Manila. @*Methods@#This study employed a quantitative non-experimental design utilizing correlational and descriptive approaches. Convenience sampling was utilized via Facebook to recruit participants. The survey was adapted from four different questionnaires and went through reliability testing and expert validation. @*Results@#The researchers collected responses from a total of 123 participants. The participants were noted to have an overall high level of acceptance for the COVID-19 vaccine ( 4.10, SD ± 0.22). The study revealed that doctors were the highly trusted health information source (( =3.69, SD ± 1.30), followed by government health agencies (( =3.18, SD ± 0.73), whereas religious organizations and leaders (( =2.45, SD ± 0.48) were the least trusted sources. However, despite being the least trusted source, religious organizations and leaders were shown to be positively related (p=0.049) and highly predictive of COVID-19 vaccine acceptance. The most frequently accessed health information source, health workers, have a weak correlation (r=.323) and were found to be significantly positively related (p=0.008) and highly predictive of the acceptance of the COVID-19 vaccine. The credibility of health information sources is likely to influence their selection, influencing decisions and behaviors.

Lived experiences of Filipino Red Cross volunteer nursing students in COVID-19 vaccination programs / The Health Sciences Journal

INTRODUCTION@#Student volunteers in COVID-19 vaccination activities help augment the health care workforce. However, there is a lack of literature that explores student volunteerism in the Philippines. This paper analyses the shared meanings of the lived experiences of volunteer nursing students during a pandemic.@*METHODS@#Student nurses who had joined Red Cross vaccination activities were recruited by purposive sampling and interviewed online using a pilot-tested interview guide with open-ended questions. Participants were recruited until data saturation. The data collected was analyzed using Colaizzi’s Seven-Step Method.@*RESULTS@#The study has identified two main themes that describe the phenomenon of student- nurse volunteerism during COVID-19 vaccination programs: 1) personal motivation and 2) perceived benefits and outcomes. There were four sub-themes under personal motivation - desire for personal growth, intrinsic altruism, past experiences and involvement in volunteer work, and opportunity for advocating against vaccine hesitancy. Perceived benefits and outcomes had two sub-themes - sense of fulfillment in the act of volunteering and opportunity for actual nurse-patient interaction. @*CONCLUSION@#The findings from the study suggest that, despite the lack of experience of working as frontliners during the COVID-19 vaccination programs, nursing students volunteered due to personal motivations and perceived benefits and outcomes.

Oral epidemiological examination - protocol: the National Study of Adult Oral Health 2017-18.

The National Study of Adult Oral Health (NSAOH) 2017-18 aimed to collect data on population oral health status of the Australian adult population. This complex nation-wide project required reliable data collection procedures. The NSAOH 2017-18 Oral Epidemiological Examination Protocol has been developed based on internationally accepted examination procedures. Examiners have been trained and calibrated in using the protocol. Details of the clinical examination components are provided. Examiner reliability has been tested and presented.

Dental fluorosis in the Australian adult population.

BACKGROUND: The use of fluoride involves a balance between protection against caries and risk of dental fluorosis. Prevalence and trend of dental fluorosis in the adult population are not frequently reported. OBJECTIVE: To describe the prevalence of dental fluorosis in the Australian adult population. METHOD: Data from the National Study of Adult Oral Health (NSAOH) 2004-06 and 2017-18 were used. Prevalence of fluorosis was reported using data from the NSAOH 2017-18. Case definitions of fluorosis were as follows: having a TF score of 2+ (TF2+) or a TF score of 3+ (TF3+) on one or more maxillary central incisors. Synthetic cohorts were constructed by year of birth allowing for time trend analysis. RESULTS: One in ten Australian adults were found to have dental fluorosis at TF2+. The prevalence of TF3 + was low. Time trend analysis revealed an increase in the prevalence and severity of fluorosis among those born during 1970s to 1980s decade. Such prevalence declined among those who were born after measures were introduced in early 1990s to reduce exposure to discretionary fluorides. CONCLUSION: The prevalence of dental fluorosis in the Australian adult population was found to be related to population-level changes in fluoride exposure.

National Study of Adult Oral Health 2017-18: root caries.

BACKGROUND: The prevalence of root caries in Australia is expected to increase due to an ageing population and increase in tooth retention. This report presents findings from the Australian National Study of Adult Oral Health 2017-18. METHODS: A stratified random sample of 15 731 Australians aged ≥15 years participated in a telephone or online survey. Of those, 5022 dentate people underwent an oral assessment. Carious root surfaces were defined as ≥1 mm of affected dentine/cementum. Prevalence was defined as the percentage with ≥one natural tooth with untreated caries on root surfaces. Severity was measured as the mean number of root surfaces with caries. RESULTS: Prevalence of untreated root caries in the Australian adult dentate population was 8.2% and increased with increasing age (range 2%-17.8%). Men (9.3%) compared to women (7.2%), people living in remote (18.0%) versus regional (9.3%) and major cities (7.6%), and those with the lowest household income (15.4%) compared to middle (7.6%) and highest tertile (3.2%) had untreated root caries. The average number of decayed or filled root surfaces in the Australian adult population was 1.1 (95% CI 0.9, 1.2). CONCLUSIONS: Root caries was associated with older age, living outside a major city and lower income.

Socioeconomic and psychosocial associations with oral health impact and general health.

BACKGROUND: There is debate whether both subjective and objective measures of socioeconomic status (SES) are needed to predict health, and whether these factors are explained by psychosocial characteristics. The aims were to investigate the association of socioeconomic and psychosocial variables with oral health impact and general health utility. METHODS: A random sample of 45- to 54-year-olds from Adelaide, South Australia, was surveyed by self-complete questionnaire in 2004-2005. Oral health impact was assessed using OHIP-14 and general health utility by EQ-5D. SES was determined using objective (income, education) and subjective (McArthur scale) measures. Psychosocial variables comprised social support, health self-efficacy, well-being, coping and affectivity. RESULTS: Data were collected from 879 participants (response rate = 43.8%). Both objective and subjective socioeconomic status measures were associated with OHIP and EQ-5D scores. Higher income and subjective social status were both associated (P < 0.05) with less oral health impact (ß = -0.28 and ß = -0.73, respectively) and better general health utility (both with ß = 0.01, respectively). Psychosocial variables accounted for a relatively large percentage of variance in OHIP (20.7%) and EQ-5D (21.9%) scores. CONCLUSIONS: For both oral health impact and general health utility, objective SES was significant in the presence of subjective SES. Psychosocial variables had important independent associations with both oral and general health.

Solanum melongena (Eggplant) Crude Anthocyanin Extract and Delphinidin-3- glucoside protects Caenorhabditis elegans against Staphylococcus aureus and Klebsiella pneumoniae

Background and Objectives@#During infection, Reactive oxygen species (ROS) signaling is activated to protect the cells from invading microorganisms. However, a high level of ROS may also damage the host tissue. The anthocyanin delphinidin is known to have a strong antioxidant activity that protects cells from oxidative damage. This study explored the potential of crude anthocyanin extract from the fruit of Solanum melongena (Eggplant) and Delphinidin-3-glucoside in enhancing the innate immunity in Caenorhabditis elegans against Staphylococcus aureus and Klebsiella pneumoniae.@*Methodology@#Caenorhabditis elegans was used to study innate immune response because it lacks adaptive immunity. First, the sublethal concentration of S. melongena crude anthocyanin extract (SMCAE) and Delphinidin-3-glucoside (D3G) in C. elegans was determined. The sublethal concentration of SMCAE and D3G was used to supplement the nematodes during its exposure to S. aureus and K. pneumoniae. The survival rate was then observed until day five post-L4. SMCAE and D3G were also tested for probable antimicrobial activity against Staphylococcus aureus and Klebsiella pneumoniae. @*Results and Conclusion@#This study found that both SMCAE and D3G showed no inhibitory effect on the growth of the bacteria. However, both SMCAE and D3G enhanced the survival of the nematode when exposed to S. aureus and K. pneumoniae. Overall, this study indicates that the anthocyanin delphinidin in S. melongenacrude extract protected the C. elegans against S. aureus and K. pneumoniaeinfection through its antioxidant activity.

Dental knowledge and dental service utilization: A 2-year follow-up study.

OBJECTIVES: To investigate associations of dental knowledge with dental service utilization over 2 years in South Australians aged 45-54 years. METHODS: In 2004-2005, a random sample of 2469 adults aged 45-54 years from Adelaide, South Australia, who were selected from the Australian electoral roll was surveyed. The outcome variables were the numbers of visits and dental services received over 2 years. Data were analysed using log-binomial and Poisson regression. Statistical significance was determined at P < .05. RESULTS: The response rates were 43.8% in the study group (n = 879) and 50.7% in the comparison group (n = 107). Oral examinations were conducted on 709 persons (81% of study group participants). Dental services data were collected from approximately 60% of participants at the end of years 1 and 2. After adjusting for sex, education, health card status, toothbrushing and inadequate dentition, higher caries knowledge and periodontal knowledge scores were associated with higher percentages of persons making dental visits (prevalence ratio, 95% CI: 1.2, 1.1-1.3 and 1.1, 1.0-1.3), and lower rates of extraction (rate ratio, 95% CI: 0.2, 0.1-0.4 and 0.4, 0.3-0.7) and endodontic services (0.5, 0.3-0.9 and 0.5, 0.3-0.7). Higher caries knowledge was associated with lower rates of fillings (0.8, 0.7-0.9) and denture services (0.1, 0.0-0.6), while higher periodontal knowledge was associated with higher numbers of visits (1.3, 1.2-1.5), and prophylaxis services (1.4, 1.1-1.8) and crowns (1.7, 1.1-2.5). CONCLUSION: South Australians aged 45-54 years with higher dental knowledge had lower rates of invasive treatment over 2 years. These findings warrant policy initiatives that highlight the importance of dental knowledge in improving oral health.

Comparison of comprehensive and abstinence-only sexuality education in young African American adolescents.

The purpose of this study was to identify predictors of sexual behavior and condom use in African American adolescents, as well as to evaluate the effectiveness of comprehensive sexuality and abstinence-only education to reduce adolescent sexual behavior and increase condom use. Participants included 450 adolescents aged 12-14 years in the southern United States. Regression analyses showed favorable attitudes toward sexual behavior and social norms significantly predicted recent sexual behavior, and favorable attitudes toward condoms significantly predicted condom usage. Self-efficacy was not found to be predictive of adolescents' sexual behavior or condom use. There were no significant differences in recent sexual behavior based on type of sexuality education. Adolescents who received abstinence-only education had reduced favorable attitudes toward condom use, and were more likely to have unprotected sex than the comparison group. Findings suggest that adolescents who receive abstinence-only education are at greater risk of engaging in unprotected sex.

Work-Family Conflict Modifies the Association of Smoking and Periodontal Disease.

PURPOSE: The aims of the study were to assess the association of periodontal loss of attachment with smoking and work-family conflict and assess whether work-family conflict modifies the association of smoking and periodontal disease. METHOD: A random sample of 45-54 year olds from metropolitan Adelaide, South Australia, was surveyed by mailed self-complete questionnaire during 2004-2005. Oral examinations were performed on persons who responded to the questionnaire, providing an assessment of periodontal status. RESULTS: A total of 879 responded (participation rate = 43.8 %), with n = 709 oral examinations (completion rate = 80.7 %). Prevalence of periodontal loss of attachment (LOA) of 6+ mm was higher (p < 0.05) for smokers (23.8 %) compared to non-smokers (7.8 %) among employed adults. The adjusted prevalence ratio for LOA 6+ mm was prevalence ratio (PR) = 4.9 (95 % CI 2.2-8.8) for smokers, and there was a significant interaction (p < 0.05) between smoking status and work-family conflict. CONCLUSION: Work-family conflict modified the association of smoking with periodontal disease. Higher levels of work interfering with family were associated with higher levels of periodontal LOA for smokers compared with non-smokers.

Oral Health Impact among Rural-dwelling Indigenous Adults in South Australia.

AIMS: The aim of this study was to describe the impact of oral health conditions among a convenience sample of Indigenous Australian adults and compare findings with nationally representative data. METHODS: Data were obtained from the Indigenous Oral Health Literacy Project (IOHLP) based in South Australia. Nationally representative data were obtained from the National Survey of Adult Oral Health (NSAOH). The impact of oral disease was measured using the shortened form of the oral health impact profile, OHIP-14. All data were standardised by age group and sex utilising Census data. RESULTS: For each OHIP-14 measure the impact was greater for IOHLP participants. There was considerable variation in the degree of difference between IOHLP and NSAOH participants for individual OHIP-14 items. CONCLUSION: High levels of effects of oral health conditions were reported by rural-dwelling Indigenous adults. This may exacerbate the health and social disadvantage experienced by this marginalised group.

Oral Health Impact among Rural-dwelling Indigenous Adults in South Australia.

AIMS: The aim of this study was to describe the impact of oral health conditions among a convenience sample of Indigenous Australian adults and compare findings with nationally representative data. METHODS: Data were obtained from the Indigenous Oral Health Literacy Project (IOHLP) based in South Australia. Nationally representative data were obtained from the National Survey of Adult Oral Health (NSAOH). The impact of oral disease was measured using the shortened form of the oral health impact profile, OHIP-14. All data were standardised by age group and sex utilising Census data. RESULTS: For each OHIP-14 measure the impact was greater for IOHLP participants. There was considerable variation in the degree of difference between IOHLP and NSAOH participants for individual OHIP-14 items. CONCLUSION: High levels of effects of oral health conditions were reported by rural-dwelling Indigenous adults. This may exacerbate the health and social disadvantage experienced by this marginalised group.

Work-Family Conflict and Oral and General Health-Related Quality of Life.

BACKGROUND: The characteristics of the work environment and relationships with family roles may impact on health and be of public health significance. PURPOSE: The aims were to investigate the cross-sectional association of work-family conflict with oral- and general health-related quality of life, and well-being. METHOD: A random sample of 45-54-year olds from Adelaide, South Australia, was surveyed by self-complete questionnaire in 2004-2005 (n = 879, response rate = 43.8%). Health-related quality of life was measured with the OHIP-14 and EQ-VAS instruments, and well-being by the Satisfaction With Life Scale. RESULTS: In adjusted analyses controlling for sex, income, education, tooth brushing frequency and social support, the higher Family Interferes with Work (FIW) tertile and the middle tertile of Work Interferes with Family (WIF) were associated with more oral health-related impacts as measured by OHIP-14 in relation to problems with teeth, mouth or dentures (Beta = 1.64, P < 0.05 and Beta = 2.85, P < 0.01). Both middle and higher tertiles of WIF were associated with lower general health (Beta = -4.20 and -5.71, P < 0.01) and well-being (Beta = -1.17 and -1.56, P < 0.01). CONCLUSION: Work-family conflict was associated with more oral health impacts and lower general health and well-being among employed middle-aged adults. This supports the view of work-family conflict as a psychosocial risk factor for health outcomes spanning function, health perceptions and well-being, and encompassing both oral health and general health.

Development and evaluation of the Stages of Change in Oral Health instrument.

OBJECTIVES: Oral health personnel are limited in their ability to assess the readiness of patients to make changes to improve oral health. We aimed to develop and test the Stages of Change in Oral Health (SOCOH) model, a scaled index of the stages of change - pre-contemplative, contemplative or active - with particular emphasis on pregnancy. MATERIALS AND METHODS: Items were collected in a self-report questionnaire conducted among a convenience sample of 446 mothers (age range: 14-43 years) pregnant with Aboriginal children in South Australia, Australia. Scales representing openness (four items; Cronbach's alpha = 0.73), value (four items; Cronbach's alpha = 0.71), inconvenience (six items; Cronbach's alpha = 0.79) and permissiveness (four items; Cronbach's alpha = 0.66) were developed. Participants were categorised according to the Stages of Change model and were evaluated against key self-reported oral health outcomes. RESULTS: Some 11.9% of participants were classified as pre-contemplators, 46.4% as contemplators and 41.7% as active. A higher proportion of active participants had a higher education, last visited a dentist less than a year previously, had no dental fear, owned a toothbrush, brushed the previous day, used toothpaste, had no difficulties paying a $100 dental bill, self-reported their dental health as 'excellent' and in the previous 12 months did not experience dental pain, embarrassment related to their dental appearance or difficulties eating food. CONCLUSIONS: The SOCOH model offers an internally consistent and valid instrument for detailed assessment of the readiness for change in regarding oral health behaviours in pregnancy and has potential benefits for clinical decision making and research.

Self-reported racism and experience of toothache among pregnant Aboriginal Australians: the role of perceived stress, sense of control, and social support.

OBJECTIVES: We hypothesized that the psychosocial factors perceived stress and sense of personal control mediated the relationship between self-reported racism and experience of toothache. We hypothesized that social support moderated this relationship. METHODS: Data from 365 pregnant Aboriginal Australian women were used to evaluate experience of toothache, socio-demographic factors, psychosocial factors, general health, risk behaviors, and self-reported racism exposure. Hierarchical logistic regression models estimated odds ratios (ORs) and 95 percent confidence intervals (CIs) for experience of toothache. Perceived stress and sense of personal control were examined as mediators of the association between self-reported racism and experience of toothache. Social support was examined as a moderator. RESULTS: Self-reported racism persisted as a risk indicator for experience of toothache (OR 1.99, 95 percent CI 1.07-3.72) after controlling for age, level of education, and difficulty paying a $100 dental bill. The relationship between self-reported racism and experience of toothache was mediated by sense of control. The direct effect of self-reported racism on experience of toothache became only marginally significant, and the indirect effect was significant (ß coefficient=0.04, bias-corrected 95 percent CI 0.004-0.105, 21.2 percent of effect mediated). Stress was insignificant as a mediator. Social support was insignificant as a moderator. CONCLUSIONS: The findings indicate that high levels of self-reported racism were associated with experience of toothache and that sense of control, but not perceived stress, mediated the association between self-reported racism and experience of toothache among this sample of pregnant Aboriginal Australian women. Social support did not moderate the association between self-reported racism and experience of toothache.

Self-efficacy and self-rated oral health among pregnant aboriginal Australian women.

BACKGROUND: Self-efficacy plays an important role in oral health-related behaviours. There is little known about associations between self-efficacy and subjective oral health among populations at heightened risk of dental disease. This study aimed to determine if low self-efficacy was associated with poor self-rated oral health after adjusting for confounding among a convenience sample of pregnant women. METHODS: We used self-reported data from 446 Australian women pregnant with an Aboriginal child (age range 14-43 years) to evaluate self-rated oral health, self-efficacy and socio-demographic, psychosocial, social cognitive and risk factors. Hierarchical entry of explanatory variables into logistic regression models estimated prevalence odds ratios (POR) and 95% confidence intervals (95% CI) for fair or poor self-rated oral health. RESULTS: In an unadjusted model, those with low self-efficacy had 2.40 times the odds of rating their oral health as 'fair' or 'poor' (95% CI 1.54-3.74). Addition of socio-demographic factors attenuated the effect of low self-efficacy on poor self-rated oral health by 10 percent (POR 2.19, 95% CI 1.37-3.51). Addition of the psychosocial factors attenuated the odds by 17 percent (POR 2.07, 95% CI 1.28-3.36), while addition of the social cognitive variable fatalism increased the odds by 1 percent (POR 2.42, 95% CI 1.55-3.78). Inclusion of the behavioural risk factor 'not brushing previous day' attenuated the odds by 15 percent (POR 2.11, 95%CI 1.32-3.36). In the final model, which included all covariates, the odds were attenuated by 32 percent (POR 1.80, 95% CI 1.05, 3.08). CONCLUSIONS: Low self-efficacy persisted as a risk indicator for poor self-rated oral health after adjusting for confounding among this vulnerable population.

Aberrantly activated AREG-EGFR signaling is required for the growth and survival of CRTC1-MAML2 fusion-positive mucoepidermoid carcinoma cells.

Salivary gland tumors (SGT) are a group of highly heterogeneous head and neck malignancies with widely varied clinical outcomes and no standard effective treatments. The CRTC1-MAML2 fusion oncogene, encoded by a recurring chromosomal translocation t(11;19)(q14-21;p12-13), is a frequent genetic alteration found in >50% of mucoepidermoid carcinomas (MEC), the most common malignant SGT. In this study, we aimed to define the role of the CRTC1-MAML2 oncogene in the maintenance of MEC tumor growth and to investigate critical downstream target genes and pathways for therapeutic targeting of MEC. By performing gene expression analyses and functional studies via RNA interference and pharmacological modulation, we determined the importance of the CRTC1-MAML2 fusion gene and its downstream AREG-EGFR signaling in human MEC cancer cell growth and survival in vitro and in vivo using human MEC xenograft models. We found that CRTC1-MAML2 fusion oncogene was required for the growth and survival of fusion-positive human MEC cancer cells in vitro and in vivo. The CRTC1-MAML2 oncoprotein induced the upregulation of the epidermal growth factor receptor (EGFR) ligand Amphiregulin (AREG) by co-activating the transcription factor CREB, and AREG subsequently activated EGFR signaling in an autocrine manner that promoted MEC cell growth and survival. Importantly, CRTC1-MAML2-positive MEC cells were highly sensitive to EGFR signaling inhibition. Therefore, our study revealed that aberrantly activated AREG-EGFR signaling is required for CRTC1-MAML2-positive MEC cell growth and survival, suggesting that EGFR-targeted therapies will benefit patients with advanced, unresectable CRTC1-MAML2-positive MEC.

Water fluoridation and the association of sugar-sweetened beverage consumption and dental caries in Australian children.

OBJECTIVES: We examined demographic and socioeconomic differences in the consumption of sugar-sweetened beverages (SSBs), its association with dental caries in children, and whether exposure to water fluoridation modifies this association. METHODS: In a cross-sectional study, we used a stratified, clustered sampling design to obtain information on 16 508 children aged 5 to 16 years enrolled in Australian school dental services in 2002 to 2005. Dental staff assessed dental caries, and parents completed a questionnaire about their child's residential history, sources of drinking water, toothbrushing frequency, socioeconomic status (SES), and SSB consumption. RESULTS: Children who brushed their teeth less often and were older, male, of low SES, from rural or remote areas consumed significantly more SSBs. Caries was significantly associated with greater SSB consumption after controlling for potential confounders. Finally, greater exposure to fluoridated water significantly reduced the association between children's SSB consumption and dental caries. CONCLUSIONS: Consumption of SSBs should be considered a major risk factor for dental caries. However, increased exposure to fluoridated public water helped ameliorate the association between SSB consumption and dental decay. These results reconfirm the benefits of community water fluoridation for oral health.

Predicting high achievers in the University of Adelaide, Australia, Bachelor of Oral Health program, 2002-09.

The Bachelor of Oral Health (B.O.H.) commenced at the University of Adelaide in 2002. The degree was formed by combining the Diploma in Dental Therapy and the Diploma and Advanced Diploma in Dental Hygiene. This preliminary study measured the predictive value of the selection criteria against students' academic performance at the end of each enrollment year of the B.O.H. program. Predictive indicators were prior academic achievement (i.e., tertiary entrance ranking [TER], university grade point average, or Special Tertiary Admissions Test scores) and the admission cognitive test score (i.e., Undergraduate Medical Admissions Test [UMAT] and Oral Assessment [OA] ranking). Predictive indicators were compared with the students' level of academic achievement across the three-year program. The aim of this study was to determine if prior academic achievement, cognitive test scores, and oral assessment predicted high level of academic achievement for B.O.H. students. The TER was found to be a strong predictor for academic performance after controlling for age, gender, type of applicant, and student preference in the first year along with older students (>25 years) and a higher UMAT score. Raising the TER cut-off for entry to the program should be considered, along with less emphasis on the OA and UMAT, because such a change would have little impact on achievement and would increase the pool of applicants.