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Self-determination theory's (SDT) dual process model claims that parental autonomy support relates positively to child well-being, while psychologically controlling parenting is linked positively to child ill-being. We tested these claims using a combination of one-stage and univariate meta-analytic structural equation modeling with moderation (k = 238; n = 1,040, N = 126,423). In the univariate models, parental autonomy support was linked positively with child well-being, r = 0.30, 95% CI [0.26, 0.33], whereas parental psychological control was positively linked with child ill-being, r = 0.26, 95% CI [0.23, 0.28]. Consistent with SDT's dual process model, the one-stage model that controlled for the intercorrelations between predictors showed that parental autonomy support and psychological control had distinct links to child wellness outcomes. Parental autonomy support was linked positively with child well-being, even when accounting for psychological control, r = 0.26, 95% CI [0.20, 0.31], and parental psychological control was positively linked to child ill-being, controlling for autonomy support, r = 0.20, 95% CI [0.17, 0.23]. Crucially, the beneficial effects of parental autonomy support and the costs of psychological control applied across regions, degrees of national individualism and cultural hierarchy, as well as child developmental periods and sexes. These results help move the field beyond debates about whether autonomy is beneficial toward questions about manifestations of autonomy across groups and variations in its optimal support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Background: Dental caries is the world's most prevalent noncommunicable disease, disproportionately affecting children from low-income families and rural geographic areas. Methods: The CariedAway 3.0 study was a cluster-randomized pragmatic non-inferiority trial comparing silver diamine fluoride (SDF) to sealants and atraumatic restorations (ART) for the prevention and control of dental caries. All participants also received fluoride varnish. Analysis consisted of mixed-effects logistic regression for caries prevalence and weighted least squares and mixed-effects negative binomial regression for caries incidence. A non-inferiority margin of 10% for the difference between groups was used. Dental caries was defined as an ICDAS score of four or greater. Results: A total of 3345 children were enrolled across 35 schools; however there was a large proportion of children who were noncompliant and received external dental care over the course of the trial. In adjusted analyses of compliant participants (n=1083; 543 in the SDF group and 540 in the sealant and ART group), there was no difference in the weighted risk difference between treatment groups (B=0.003, 95% CI = -0.0001, 0.0008). The odds of caries prevalence was elevated in the SDF group in longitudinal analyses (OR = 1.35, 95% CI = 0.86, 2.11) but was not significant and was below the non-inferiority margin. There were no significant differences between groups for caries incidence in adjusted models (IRR = 1.19, 95% CI = 0.81, 1.74). Results for intent to treat analyses were similar to that of per-protocol. Discussion: In this school-based clinical trial, the prevalence of dental caries in children treated with SDF and fluoride varnish was non-inferior compared to those treated with sealants, ART, and fluoride varnish, although the overall risk was slightly higher. Unfortunately, a high rate of dropout and participant noncompliance was observed, likely due to the impacts of COVID-19 on study procedures. As a result, observed effects may be unreliable beyond the short-term. Trial Registration: NCT03448107.
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Understanding the shared and divergent mechanisms across antidepressant (AD) classes and probiotics is critical for improving treatment for mood disorders. Here we examine the transcriptomic effects of bupropion (NDRI), desipramine (SNRI), fluoxetine (SSRI) and a probiotic formulation (Lacidofil®) on 10 regions across the mammalian brain. These treatments massively alter gene expression (on average, 2211 differentially expressed genes (DEGs) per region-treatment combination), highlighting the biological complexity of AD and probiotic action. Intersection of DEG sets against neuropsychiatric GWAS loci, sex-specific transcriptomic portraits of major depressive disorder (MDD), and mouse models of stress and depression reveals significant similarities and differences across treatments. Interestingly, molecular responses in the infralimbic cortex, basolateral amygdala and locus coeruleus are region-specific and highly similar across treatments, whilst responses in the Raphe, medial preoptic area, cingulate cortex, prelimbic cortex and ventral dentate gyrus are predominantly treatment-specific. Mechanistically, ADs concordantly downregulate immune pathways in the amygdala and ventral dentate gyrus. In contrast, protein synthesis, metabolism and synaptic signaling pathways are axes of variability among treatments. We use spatial transcriptomics to further delineate layer-specific molecular pathways and DEGs within the prefrontal cortex. Our study reveals complex AD and probiotics action on the mammalian brain and identifies treatment-specific cellular processes and gene targets associated with mood disorders.
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People's motivational processes, well-being, and performance are likely to be facilitated through the support of others. Self-determination theory argues that interpersonal supports for autonomy, competence, and relatedness are crucial to achieve these outcomes. In the present study, we provide a comprehensive examination of this formulation based on a meta-analytic database consisting of 4,561 effect sizes from 881 independent samples (N = 443,556). Our results indicate that supports for autonomy, competence, and relatedness were strongly positively related with the satisfaction of these basic needs and strongly negatively related to their frustration. Interpersonal supports for basic needs were strongly positively related with subjective well-being and exhibited small to moderate positive associations with performance. Moderation analyses showed general stability of effects across cultures, although correlations of autonomy support to autonomous motivation weakened as a function of individualism. The opposite pattern was observed for the correlation between relatedness support and intrinsic motivation. Some effects also declined as a function of sample age and lag in measurements. We also find that competence- and relatedness-supportive behaviors explained incremental variance in basic need satisfaction even after controlling for the more established effects of autonomy support. In addition, lateral need supports explained incremental variance in basic need satisfaction after controlling for vertical sources of support. In sum, our results are consistent with the premise that to support optimal motivation, well-being, and performance, a broad set of behaviors that nurture all three basic needs, together with different sources of interpersonal support, should be considered to yield the most benefit. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Importance: Dental caries is the world's most prevalent noncommunicable disease and a source of health inequity; school dental sealant programs are a common preventive measure. Silver diamine fluoride (SDF) may provide an alternative therapy to prevent and control caries if shown to be noninferior to sealant treatment. Objective: To determine whether school-based application of SDF is noninferior to dental sealants and atraumatic restorative treatment (ART) in the prevalence of dental caries. Design, Setting, and Participants: The Silver Diamine Fluoride Versus Therapeutic Sealants for the Arrest and Prevention of Dental Caries in Low-Income Minority Children (CariedAway) study was a pragmatic noninferiority cluster-randomized clinical trial conducted from February 2018 to June 2023 to compare silver diamine fluoride vs therapeutic sealants for the arrest and prevention of dental caries. Children at primary schools in New York, New York, with at least 50% of the student population reporting as Black or Hispanic and at least 80% receiving free or reduced lunch were included. This population was selected as they are at the highest risk of caries in New York. Students were randomized to receive either SDF or sealant with ART; those aged 5 to 13 years were included in the analysis. Treatment was provided at every visit based on need, and the number of visits varied by child. Schools with preexisting oral health programs were excluded, as were children who did not speak English. Of 17â¯741 students assessed for eligibility, 7418 were randomized, and 4100 completed follow-up and were included in the final analysis. Interventions: Participants were randomized at the school level to receive either a 38% concentration SDF solution or glass ionomer sealants and ART. Each participant also received fluoride varnish. Main Outcomes and Measures: Primary study outcomes were the prevalence and incidence of dental caries. Results: A total of 7418 children (mean [SD] age, 7.58 [1.90] years; 4006 [54.0%] female; 125 [1.7%] Asian, 1246 [16.8%] Black, 3648 [49.2%] Hispanic, 153 [2.1%] White, 114 [1.5%] multiple races or ethnicities, 90 [1.2%] other [unspecified], 2042 [27.5%] unreported) were enrolled and randomized to receive either SDF (n = 3739) or sealants with ART (n = 3679). After initial treatment, 4100 participants (55.0%) completed at least 1 follow-up observation. The overall baseline prevalence of dental caries was approximately 27.2% (95% CI, 25.7-28.6). The odds of decay prevalence decreased longitudinally (odds ratio [OR], 0.79; 95% CI, 0.75-0.83) and SDF was noninferior compared to sealants and ART (OR, 0.94; 95% CI, 0.80-1.11). The crude incidence of dental caries in children treated with SDF was 10.2 per 1000 tooth-years vs 9.8 per 1000 tooth-years in children treated with sealants and ART (rate ratio, 1.05; 95% CI, 0.97-1.12). Conclusions and Relevance: In this school-based pragmatic randomized clinical trial, application of SDF resulted in nearly identical caries incidence compared to dental sealants and ART and was noninferior in the longitudinal prevalence of caries. These findings suggest that SDF may provide an effective alternative for use in school caries prevention. Trial Registration: ClinicalTrials.gov Identifier: NCT03442309.
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Tratamiento Restaurativo Atraumático Dental , Caries Dental , Compuestos de Amonio Cuaternario , Compuestos de Plata , Niño , Humanos , Femenino , Masculino , Fluoruros Tópicos/uso terapéutico , Selladores de Fosas y Fisuras/uso terapéutico , Caries Dental/epidemiología , Caries Dental/prevención & control , PrevalenciaRESUMEN
OBJECTIVE: Further investigate the application of self-determination theory (SDT) to experiences of solitude by examining the effects of recalling intrinsic versus non-intrinsic memories. BACKGROUND: SDT research indicates that recalling memories associated with intrinsic goals (e.g., personal growth, relationships, altruism) enhances present moment wellness by satisfying basic psychological needs. METHOD: Two studies were conducted with American adults. Study 1 included 465 participants (age = 49.49 [SD = 19.01], 49.46% female) and Study 2 comprised 490 participants (age = 54.16 [SD = 18.89], 51.84% female). Both studies assessed the impact of recalling intrinsic versus non-intrinsic memories prior to a five-minute solitude session. RESULTS: Study 1 found intrinsic memories were linked to more basic psychological need satisfaction than non-intrinsic memories, but both memory types resulted in similar wellness improvements. Contrary to expectations, Study 2 revealed extrinsic memories (e.g., wealth, fame, image) led to the highest basic psychological need satisfaction and least need frustration compared to intrinsic and neutral memories, with all memory conditions showing similar wellness gains. CONCLUSIONS: Solitude appears beneficial regardless of memory content. While different memories vary in need satisfying quality, this does not seem to impact the benefits of solitude. These findings suggest further exploration is needed before developing a "solitude skill set" for use during inevitable periods of solitude.
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OBJECTIVES: To measure rates of potentially inappropriate pathology testing in the hospital setting. METHODS: Retrospective cross-sectional study in hospital setting from July 2021 to December 2021. We examined 3 potentially inappropriate uses: overordering, selection errors, and unnecessary repeat testing. Overordering included vitamin D and lipids (rarely required in acute hospital care). Selection error was the ratio of iron studies to standalone ferritin requests. Unnecessary repeats included any repeat vitamin D, lipids, iron, or ferritin in an episode of care or C-reactive protein (CRP) repeated within 3 days and N-terminal pro-brain natriuretic peptide (NT-proBNP) within 7 days and repeated previously abnormal CRP and NT-proBNP tests. Costs of inappropriate tests were estimated using the Australian Medicare Benefits Schedules. RESULTS: Among 55,904 test requests, 15% (n = 8120) were potentially inappropriate. Vitamin D was frequently ordered (n = 4498), as were lipids (n = 2872). Ratio of iron studies to standalone ferritin was 36. Of 19,233 repeat CRPs, 36% (n = 6947) were within 3 days and 62% (n = 179) of repeat NT-proBNPs were within 7 days of the first test. For initially abnormal tests, 89% of CRPs and 97% of NT-proBNPs remained abnormal. Inappropriate test costs accounted for 12% to 30% of costs. CONCLUSIONS: Frequent potential inappropriate use and selection of pathology tests was observed in South Australian hospitals.
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Programas Nacionales de Salud , Péptido Natriurético Encefálico , Anciano , Humanos , Estudios Retrospectivos , Estudios Transversales , Australia del Sur , Australia , Péptido Natriurético Encefálico/metabolismo , Proteína C-Reactiva/análisis , Ferritinas , Fragmentos de Péptidos , Hospitales , Vitamina D , Hierro/metabolismo , Lípidos , BiomarcadoresRESUMEN
BACKGROUND AND OBJECTIVES: The poor mental health of adults living in aged care needs addressing. Improvements to nutrition and exercise are important, but mental health requires a psychological approach. Self-determination theory finds that autonomy is essential to wellbeing while experiences of being controlled undermine it. A review of existing quantitative data could underscore the importance of autonomy in aged care, and a review of the qualitative literature could inform ways to promote autonomy and avoid control. Testing these possibilities was the objective of this research. RESEARCH DESIGN AND METHODS: We conducted a mixed-methods systematic review of studies investigating autonomy, control, and indices of optimal functioning in aged care settings. The search identified 30 eligible reports (19 quantitative, 11 qualitative), including 141 quantitative effect sizes, 84 qualitative data items, and N = 2,668. Quantitative effects were pooled using three-level meta-analytic structural equation models, and the qualitative data were meta-synthesized using a grounded theory approach. RESULTS: As predicted, the meta-analysis showed a positive effect of aged care residents' autonomy and their wellness, r = 0.33 [95% CI: 0.27, 0.39], and a negative effect of control, r = -0.16 [95% CI: -0.27, -0.06]. The meta-synthesis revealed seven primary and three sub-themes describing the nuanced ways autonomy, control, and help seeking are manifest in residential aged care settings. DISCUSSION AND IMPLICATIONS: The results suggest that autonomy should be supported, and unnecessary external control should be minimized in residential aged care, and we discuss ways the sector could strive for both aims.
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BACKGROUND: The sustainability of school-based oral health programs depends on the utilization of effective, efficient treatments and the availability of a trained clinical workforce. The objective of this study was to determine whether registered nurses are comparable to dental hygienists in the application and effectiveness of silver diamine fluoride (SDF) and fluoride varnish (FV) for the prevention of dental caries. METHODS: CariedAway was a school-based study of SDF and FV versus dental sealants and atraumatic restorations. Within the SDF + FV arm, participants were treated by either a licensed dental hygienist or a registered nurse, both under the supervision of a paediatric dentist. Although initial treatment assignment in CariedAway was randomized, assignment to provider was not. The proportion of children who remained caries free after 2 years was assessed for non-inferiority using two-group proportion tests, adjusting for the clustering effect of schools. RESULTS: A total of 417 children with no untreated caries at baseline were analysed including 298 treated by hygienists and 119 by nurses. The proportion of children who remained caries free after 2 years was 0.81 and 0.80 for those treated by hygienists and nurses, respectively, for a difference of 0.01 (95% CI = -0.07, 0.098) and within the pre-determined non-inferiority margin. CONCLUSIONS: Nurses may be effective in treating children with silver diamine fluoride and other fluoride varnishes in school-based oral health programs.
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BACKGROUND: Poor oral health is significantly associated with absenteeism, contributing to millions of lost school hours per year. The effect of school-based dental programs that address oral health care inequities on student attendance has not yet been explored. METHODS: CariedAway was a longitudinal, cluster-randomized, noninferiority trial of minimally invasive medicines for caries used in a school-based program. We extracted data on school absenteeism and chronically absent students from publicly available data sets for years before, during, and after program onset (2016-2021). Total absences and the proportion of chronically absent students were modeled using multilevel mixed-effects linear and 2-limit tobit regression, respectively. RESULTS: In years in which treatment was provided through a school-based caries prevention program, schools recorded approximately 944 fewer absences than in nontreatment years (95% CI, -1,739 to -149). Averaged across all study years, schools receiving either treatment had 1,500 fewer absences than comparator schools, but this was not statistically significant. In contrast, chronic absenteeism was found to significantly decrease in later years of the program (b, -.037; 95% CI, -.062 to -.011). Excluding data for years affected by COVID-19 removed significant associations. CONCLUSIONS: Although originally designed to obviate access barriers to critical oral health care, early integration of school-based dental programs may positively affect school attendance. However, the observed effects may be due to poor reliability of attendance records resulting from the closing of school facilities in response to COVID-19, and further study is needed. PRACTICAL IMPLICATIONS: School-based caries prevention may also improve educational outcomes, in addition to providing critical oral health care. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT03442309.
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COVID-19 , Caries Dental , Humanos , Absentismo , Caries Dental/epidemiología , Caries Dental/prevención & control , Susceptibilidad a Caries Dentarias , Reproducibilidad de los Resultados , Estudiantes , Estudios LongitudinalesRESUMEN
Introduction: Digital technologies have the capacity to impact psychological wellbeing in both positive and negative ways. Improving technologies with respect to wellbeing requires nuanced understanding of this impact and reliable ways to measure it. Here, we aim to further this understanding by investigating the relations between psychological needs and people's evaluations of technologies (with respect to satisfaction, usability, and measures of value). Method: Across two studies with 1,521 participants, we improved and validated four scales that were first put forward as part of the METUX model of technology interaction. These scales measure psychological needs in the life, behavior, task, and interface spheres of experience. We applied these scales to four separate technologies (Facebook, TikTok, Blackboard, and Moodle), and examined the relationships between people's need satisfaction and frustration in the four spheres of experience and their overall evaluations of the technologies. Results and discussion: Each of the four scales had good psychometric properties across the four technologies. For each sphere of experience, psychological need satisfaction and frustration were associated with standard measures of usability and user satisfaction, and correlation patterns supported the METUX model and its approach to differentiating spheres of technology experience.
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Importance: Dental caries is the most common global childhood disease. To control caries, the Centers for Disease Control and Prevention recommends school-based caries prevention, and the World Health Organization lists glass ionomer cement and silver diamine fluoride as essential medicines for oral disease. Objective: To determine the noninferiority of silver diamine fluoride with fluoride varnish vs traditional glass ionomer sealants with fluoride varnish after 2 years when provided to children via a school-based health care program. Design, Setting, and Participants: The CariedAway study is an ongoing single-blind, cluster randomized, noninferiority trial conducted between February 1, 2019, and June 1, 2023, among 2998 children in 47 New York City primary schools. Children aged 5 to 13 years of any race and ethnicity were recruited from block-randomized schools. Inclusion criteria for schools were a student population of at least 50% Hispanic or Latino or Latina ethnicity and/or Black race and at least 80% of students receiving free or reduced-cost lunch. Statistical analysis is reported through March 2022. Interventions: Children received a single application of silver diamine fluoride with fluoride varnish or an active comparator of glass ionomer sealants and atraumatic restorations with fluoride varnish. Main Outcomes and Measures: Primary outcomes were caries arrest and incidence after a 2-year follow-up, assessed using mixed-effects multilevel models and clustered 2-sample proportion tests. The noninferiority margin was 10%. Intention-to-treat analysis was performed using multiple imputation. Results: A total of 2998 children (1566 girls [52.2%]; mean [SD] age at baseline, 6.6 [1.2] years; 1397 Hispanic or Latino or Latina children [46.6%]; 874 [29.2%] with untreated dental caries) were recruited and treated from September 16, 2019, to March 12, 2020. Follow-up observations were completed for 1398 children from June 7, 2021, to March 2, 2022. The mean (SE) proportion of children with arrested caries was 0.56 (0.04) after experimental treatment and 0.46 (0.04) after control treatment (difference, -0.11; 95% CI, -0.22 to 0.01). The mean (SE) proportion of patients without new caries was 0.81 (0.02) after experimental treatment and 0.82 (0.02) after control treatment (difference, 0.01; 95% CI, -0.04 to 0.06). Analysis of imputed data for the full sample did not deviate from per-protocol analyses. There were no adverse events. Conclusions and Relevance: In this randomized clinical trial, silver diamine fluoride with fluoride varnish was noninferior to sealants and atraumatic restorations with fluoride varnish for caries arrest and prevention. Results may support the use of silver diamine fluoride as an arresting and preventive agent in school-based oral health programs. Trial Registration: ClinicalTrials.gov Identifier: NCT03442309.
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Caries Dental , Fluoruros Tópicos , Estados Unidos , Niño , Femenino , Humanos , Fluoruros Tópicos/uso terapéutico , Método Simple Ciego , Caries Dental/prevención & control , Susceptibilidad a Caries DentariasRESUMEN
Measuring subjective well-being as a key indicator of national wellness has increasingly become part of the international agenda. Current recommendations for measuring well-being at a national level propose three separate dimensions: evaluative well-being, experiential well-being, and eudaimonia. Whereas the measurement of the first two dimensions is relatively standardized, the third category has remained undertheorized, lacking consensus on how to define and operationalize it. To remedy the situation, we propose that the third dimension should focus on psychological functioning and the identification of key psychological factors humans generally need to live well. A key part of psychological functioning is the satisfaction of basic psychological needs-specific types of satisfying experiences that are essential for psychological health and well-being. Psychological needs as a category provides a parsimonious set of elements with clear inclusion criteria that are strongly anchored in theory and our current understanding of human nature-and could thus form a core part of the third, "eudaimonic" dimension of well-being. The needs for autonomy, competence, and relatedness have especially received broad empirical support. Accordingly, national accounts of well-being should include measures for key psychological needs to gain an enriched and practically useful understanding of the well-being of the citizens.
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Salud Mental , Autonomía Personal , Humanos , Encuestas y Cuestionarios , Satisfacción PersonalRESUMEN
Self-determination theory holds that the intrinsic and extrinsic content of people's aspirations differentially affect their wellness. An evidence base spanning nearly 30 years indicates that focusing on intrinsic goals (such as for growth, relationships, community giving, and health) promotes well-being, whereas a focus on extrinsic goals (such as for wealth, fame, and beauty) deters well-being. Yet, the evidence base contains exceptions, and some authors have argued that focusing on extrinsic goals may not be universally detrimental. We conducted a systematic review and used multilevel meta-analytic structural equation modeling to evaluate the links between intrinsic and extrinsic aspirations with indices of well-being and ill-being. Across 92 reports (105 studies), 1,808 effects, and a total sample of N = 70,110, we found that intrinsic aspirations were linked positively with well-being, r = 0.24 [95% CI 0.22, 0.27], and negatively with ill-being, r = -0.11 [-0.14, -0.08]. When the variety of extrinsic aspiration scoring methods were combined, the link with well-being was not statistically significant, r = 0.02 [-0.02, 0.06]. However, when extrinsic aspirations were evaluated in terms of their predominance in the overall pattern of aspiring the effect was universally detrimental, linking negatively to well-being, r = -0.22 [-0.32, -0.11], and positively to ill-being, r = 0.23 [0.17, 0.30]. Meta-analytic conclusions about the associations between goal types and wellness are important because they inform how individuals could shape aspirations to support their own happiness and how groups and institutions can frame goals such that their pursuit is for the common good. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Objetivos , Motivación , Humanos , Estados Unidos , Autonomía PersonalRESUMEN
OBJECTIVES: Evidence for affordable and pragmatic programmes to address the burden of untreated tooth decay in children in low- and middle-income settings is limited. This study aimed to (1) assess the effect of a government-run, school-based daily group toothbrushing programme compared to standard school-based oral health education on the incidence of dental caries and odontogenic infections in Filipino children over a period of 3 years; and (2) assess the additional preventive effect of on-demand oral urgent treatment (OUT) and weekly fluoride gel application. METHODS: A cluster-randomized trial was conducted in Camiguin, Philippines. Schools in three regions were randomly assigned to one of three intervention groups: The Essential Health Care Programme (EHCP), which includes daily toothbrushing with fluoride toothpaste; EHCP plus twice-yearly access to on-demand urgent oral treatment (EHCP + OUT) and EHCP plus weekly application of high-concentrated fluoride gel (EHCP + Fluoride). Schools in a nearby province with a similar child population were selected as external concurrent control group. Clinical oral examinations were performed by calibrated dentists from a random sample of 682 seven-year-old students who were examined at baseline and over the following 3 years. Outcome variables were the number of decayed primary teeth, the number of decayed, missing and filled permanent teeth (DMFT) and surfaces (DMFS), and the number of permanent teeth with pulpal involvement, ulcerations, fistula or abscess (PUFA). Data were analysed using multilevel mixed-effects negative binomial regression. RESULTS: Three years after implementation, increments in dental caries and odontogenic infections in permanent teeth did not significantly differ between the EHCP and control group, yet the incidence of DMFT was lower by 22% in children receiving EHCP. Compared to controls, children receiving EHCP + Fluoride had a significantly lower increment of DMFT, DMFS and PUFA by 40%, 40% and 47%, respectively. Children receiving EHCP + OUT had lower incidence rates of DMFT and DMFS than control children by 23% and 28%, respectively. A lower incidence rate was also found for PUFA, but the effect was not statistically significant. CONCLUSIONS: Findings suggest that the weekly application of fluoride gel and urgent oral treatment, in addition to daily school-based toothbrushing with fluoride toothpaste, are realistic and effective strategies to lower the burden of dental caries in Filipino children. Implementation challenges may explain why no substantial caries-preventive benefits were demonstrated for school-based toothbrushing only. Intervention compliance should be considered in future programme implementation and evaluation research.
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Caries Dental , Fluoruros , Humanos , Caries Dental/epidemiología , Caries Dental/prevención & control , Pastas de Dientes/uso terapéutico , Cepillado Dental , Dentición Permanente , Índice CPORESUMEN
AIM: The aim of this study was to digitally measure the dimensional changes in an irreversible hydrocolloid impression material (alginate) resulting from varying storage times under optimal storage conditions. MATERIALS AND METHODS: A single type V dental stone control cast was used to make 25 alginate impressions using perforated stock trays. The impressions were randomly assigned into five groups of five samples each (n=5 per group) with varying storage times: Group 1, poured at 15 minutes; Group 2, poured at one hour; Group 3, poured at 24 hours (one day); Group 4, poured at 72 hours (three days); Group 5, poured at 168 hours (seven days). All impressions were stored in sealed Ziploc® plastic bags with a wet paper towel (100% relative humidity) at room temperature and stored according to the assigned group storage times. All impressions were poured in type V dental stone according to the manufacturer's instructions. The casts were scanned with a digital 3D desktop scanner and saved as electronic stereolithography (.stl) files. Each .stl file of the scanned casts were superimposed on the .stl file of the control cast using Geomagic® Control X™ software. Three preselected fixed comparison measuring points (CMP) on each cast were compared to the control cast. Point one (CMP1) was on the midfacial surface of central incisor. Point two (CMP2) and point three (CMP3) were on the mesiobuccal proximal marginal ridge areas of third molars. The discrepancies between the files at each point were analysed with colour maps, and quantified (Table 1). The tolerance was set at ±10µm. CMP scores were analysed using one-way analysis of variance (ANOVA) and Kruskal-Wallis (K-W) non-parametric H tests. RESULTS: Average gap distances across groups ranged from 0.04mm (seven-day group) to 0.06mm (one hour and 24-hour groups). Colour maps indicated increased dimensional change with increased storage time up to one day. After three days, shrinkage up to 139µm was measured. ANOVA results for CMP1 (F[4,20] = 1.65, p = 0.020) and CMP3 (F[4,20] = 0.44, p = -0.78) were not statistically significant. Similarly, K-W results for CMP2 were not significant (χ2= 3.62, p = 0.46). CONCLUSIONS: Under optimal storage conditions, there were no significant dimensional changes in casts poured from alginate up to seven days.
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Alginatos , Técnica de Impresión Dental , Humanos , Coloides , Materiales de Impresión Dental , Modelos DentalesRESUMEN
Financial knowledge and sound financial decision making are now broadly recognized to be important determinants of both personal and societal prosperity, but research has yet to examine how distinct qualities of motivation may be associated with the way people manage their money. In two studies we applied the framework of Self-Determination Theory (SDT) to examine people's autonomous (volitional) and controlled (pressured) motivation for understanding and managing their finances, as well as their amotivation (lack of motivation) for doing so, and the differential associations these motives have with financial knowledge and financial well-being. American participants (Study 1, N = 516; Study 2, N = 534) completed detailed demographic surveys and questionnaires assessing the financial variables of interest. As hypothesized, SDT's motivational constructs were associated with financial outcomes over and above participants' age, gender, income, household wealth, and educational attainment. Autonomous motivation was positively associated with a host of positive financial behaviors and characteristics (e.g., saving/investing and financial self-efficacy, well-being, and self-awareness). Controlled motivation was negatively associated with financial well-being. Amotivation was positively associated with overspending and negatively associated with financial self-efficacy and well-being. These findings support the relevance of SDT's framework in this domain and suggest that interventions aimed at promoting financial knowledge and wellness may benefit by adopting evidence-supported strategies for optimizing more autonomous motivations and addressing amotivations.
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We investigated how satisfaction of the basic psychological needs at work was associated with the psychological and physical wellbeing of Indigenous and non-Indigenous employees both within and outside of the workplace. Participants included 1,146 Indigenous (n = 559) and non-Indigenous Australians (60.9% female), aged 18 to 81 years (Mage = 43.54) who were recruited through their employer or online advertisements. Structural equation modelling (SEM) was used to analyse the data, and Indigenous status and occupation type were investigated as moderators. Results revealed that independent of income, autonomy satisfaction was related to better physical and psychological health, satisfaction of the need for relatedness was associated with increased family and community thriving, and competence satisfaction was linked to decreased psychological distress. Results also showed that autonomy, competence, and relatedness need satisfaction was lower among Indigenous employees compared to non-Indigenous employees. Moderation analyses suggested that relatedness at work was especially important for non-Indigenous employees' connection with their community, as were high levels of competence satisfaction for Indigenous employees. These findings are discussed in the context of self-determination theory and the implications for organizations wanting to improve the wellbeing of their Indigenous and non-Indigenous workforce.
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INTRODUCTION: Disparities in care of older adults in cancer treatment trials and emergency department (ED) use exist. This report provides a baseline description of older adults ≥65 years old who present to the ED with active cancer. MATERIALS AND METHODS: Planned secondary analysis of the Comprehensive Oncologic Emergencies Research Network observational ED cohort study sponsored by the National Cancer Institute. Of 1564 eligible adults with active cancer, 1075 patients were prospectively enrolled, of which 505 were ≥ 65 years old. We recruited this convenience sample from eighteen participating sites across the United States between February 1, 2016 and January 30, 2017. RESULTS: Compared to cancer patients younger than 65 years of age, older adults were more likely to be transported to the ED by emergency medical services, have a higher Charlson Comorbidity Index score, and be admitted despite no significant difference in acuity as measured by the Emergency Severity Index. Despite the higher admission rate, no significant difference was noted in hospitalization length of stay, 30-day mortality, ED revisit or hospital admission within 30 days after the index visit. Three of the top five ED diagnoses for older adults were symptom-related (fever of other and unknown origin, abdominal and pelvic pain, and pain in throat and chest). Despite this, older adults were less likely to report symptoms and less likely to receive symptomatic treatment for pain and nausea than the younger comparison group. Both younger and older adults reported a higher symptom burden on the patient reported Condensed Memorial Symptom Assessment Scale than to ED providers. When treating suspected infection, no differences were noted in regard to administration of antibiotics in the ED, admissions, or length of stay ≤2 days for those receiving ED antibiotics. DISCUSSION: We identified several differences between older (≥65 years old) and younger adults with active cancer seeking emergency care. Older adults frequently presented for symptom-related diagnoses but received fewer symptomatic interventions in the ED suggesting that important opportunities to improve the care of older adults with cancer in the ED exist.
Asunto(s)
Servicio de Urgencia en Hospital , Neoplasias , Anciano , Antibacterianos , Estudios de Cohortes , Humanos , Neoplasias/terapia , Dolor , Estudios Prospectivos , Estados UnidosRESUMEN
Within the solitude literature, two discrete constructs reflect different perspectives on how time spent alone is motivated. Self-determined motivation for solitude reflects wanting time alone to find enjoyment and gain meaningful benefits from it, whereas preference for solitude concerns wanting time for oneself over others' company regardless of reasons for why time alone is wanted. We investigated two personality characteristics: introversion from Big-Five personality theory and dispositional autonomy from self-determination theory. In two diary studies university students completed personality measures and reported about their experiences with time spent alone over a period of seven days. Across both studies, contrary to popular belief that introverts spend time alone because they enjoy it, results showed no evidence that introversion is predictive of either preference or motivation for solitude. Dispositional autonomy-the tendency to regulate from a place of self-congruence, interest, and lack of pressure-consistently predicted self-determined motivation for solitude but was unrelated to preference for solitude. These findings provided evidence supporting the link between valuing time spent alone with individual differences in the capacity to self-regulate in choiceful and authentic way.