Exploring gamified learning for inculcating patient safety concepts in dentistry: A mixed-methods study.

INTRODUCTION: Freshly graduated dentists transition from a supervised undergraduate school clinic into their workplace with limited knowledge on patient safety goals. Many studies have demonstrated benefits of using gamified media in clinical education, but no research has yet been conducted to find out its application in teaching patient safety concepts in dentistry. This study therefore aimed to find out the value of gamified learning in inculcating patient safety concepts in dentistry. MATERIALS AND METHODS: This mixed-methods study was conducted on general dentists working in NDCS with a post-bachelor's degree graduation work experience of ≤5 years using a conceptual framework consisting of pre/post-knowledge assessment, game data and game performance review. A pre-intervention knowledge test was conducted before a gamified learning educational intervention involving participants assuming the role of a clinician avatar managing different clinical scenarios in a game. After the intervention, participants completed an online survey. Focus group interviews were then organised to find out more about their game experience. A post-intervention knowledge test was also conducted. RESULTS: Quantitative results showed a significant improvement in test scores of participants after gamified learning. Qualitative feedback of the gamified learning experience was largely positive with majority of participants finding it beneficial though it also revealed some negative aspects and areas of improvement to work on. CONCLUSION: Gamified learning was valuable in improving knowledge and enhancing learning of patient safety in this study group and has the potential for greater educational benefits given more funding to improve on the game prototype.

Impact of pain-related temporomandibular disorders on jaw functional limitation, psychological distress and quality of life in postoperative class III East Asian patients.

OBJECTIVES: This cross-sectional study determined the prevalence of painful TMD and its impact on jaw function, psychological status and oral health-related quality of life (OHRQoL) in postoperative Chinese patients. It also assessed factors influencing OHRQoL of these patients. MATERIALS AND METHODS: Subjects were recruited from the National Dental Centre Singapore dentofacial deformity registry. Invitations to participate in the study were sent to patients who sought treatment from March 2011 to November 2017. Patients who consented were directed to an online link to complete a series of questionnaires based on the Diagnostic Criteria for TMD (DC-TMD) and the orthognathic quality of life questionnaire (OQLQ). RESULTS: The subjects (n = 99) had a mean age of 25.2 ± 6.0 years and postoperative time of 29.4 ± 22.7 months. 18.2% were found to suffer from pain-related TMD postorthognathic surgery and these patients (n = 18) had significantly higher median JFLS-8 score than those without TMD pain (p = 0.008). Time since surgery was significantly associated with OHRQoL (p = 0.00000026). CONCLUSIONS: Prevalence of painful TMD and psychological distress was low while prevalence of jaw functional limitation was moderately high in postoperative class III Chinese patients. CLINICAL RELEVANCE: Painful TMD impacted jaw function especially when subjects open wide enough to drink, yawn, talk and smile but had no significant consequence on psychological status and OHRQoL.

Effects of bicuspid extractions and incisor retraction on upper airway of Asian adults and late adolescents: A systematic review.

OBJECTIVES: This systematic review aimed to assess the effects of bicuspid extractions and incisor retraction on airway dimension, hyoid position and breathing of adults and late adolescents. METHODS: The review was conducted according to PRISMA guidelines. Eight databases including PubMed, EMBASE, Web of Science and Scopus were searched to August 2018. Minimum age of participants was 16 years. The intervention was dual-arch bicuspid extractions with incisor retraction. Outcomes were airway dimension, hyoid position and breathing assessment. RESULTS: All nine publications meeting inclusion criteria were from Asia. They were divided into three Asian subregions. All East Asian lateral cephalometric studies reported anteroposterior airway narrowing at the oropharynx and sometimes the hypopharynx. However, the narrowing was small, comparable to measurement errors, and highly variable. Two out of three East Asian computed tomography (CT) studies described reductions in airway dimensions. The single functional breathing study showed increased simulated flow resistance after incisor retraction in East Asians. South Asian studies had mixed findings, with some reporting significant airway narrowing. The single study from West Asia found no significant airway or hyoid changes. CONCLUSIONS: Airway response to bicuspid extractions and incisor retraction varied substantially when assessed with cephalometry. CT measurements present larger effect sizes and smaller variations, providing stronger evidence of airway narrowing. Orthodontic extractions for incisor retraction may be more frequently indicated in Asia, and East Asians seem particularly susceptible to airway narrowing and postero-inferior hyoid movement with incisor retraction. Better designed CT studies are needed for confirmation due to small effect size and large variability.

Association between temporomandibular disorders and pubertal development: A systematic review.

The aim of this systematic review (SR) was to determine the association between temporomandibular disorders (TMDs) and pubertal development. Due to the inadequacy of the conventional PICO (Population, Interventions, Comparisons and Outcome) format used for intervention-based SRs, the Joanna Briggs Institute's guidelines for synthesising evidence related to associations with a focus on aetiology were adopted. A search of the PubMed and LIVIVO databases covering the period from January 1980 to May 2018 yielded four publications, which fulfilled the inclusion criteria. Analysis of articles based on the Pubertal Development Scale showed that TMD prevalence increases with pubertal development. Although no sex difference in TMD prevalence and diagnosis was observed, more females reported TMD anamnestic variables, including accounts of temporomandibular pain during pubertal maturity. The higher prevalence of depression and somatisation during pubertal development may contribute to more TMD symptom reporting in females. More prospective studies incorporating standardised methods for diagnosing TMDs and detecting comorbid psychosocial and somatic problems are desired to further elucidate the relationship between TMDs and pubertal development.

Outcomes of therapeutic TMD interventions on oral health related quality of life: A qualitative systematic review.

OBJECTIVES: This systematic review aims to determine the impact of temporomandibular disorder (TMD) therapeutic interventions on patients' oral health related quality of life (OHRQoL) and to recommend approaches that improve QoL. DATA SOURCES: A systematic search of the literature was performed between January 2007 and October 2017 to identify articles on TMD interventions and OHRQoL. Randomized controlled trials, and retrospective and prospective cohort studies that mentioned dedicated tools for measurement of OHRQoL changes in TMD patients after therapeutic interventions were included. Abstracts of studies that did not mention any form of measurement of OHRQoL in their treatment outcome were excluded. The initial screening yielded 171 articles. After evaluation of abstracts and full text articles, five articles fulfilled all selection criteria and were included. Most TMD treatment interventions seem to improve QoL to some extent, but no single treatment modality can be advocated as the sole approach to managing TMD. CONCLUSION: Psychotherapy, occlusal appliance therapy, arthrocentesis, and orthodontics/orthognathic surgery (in subjects with severe malocclusion) appear to improve OHRQoL of TMD patients. Recommendation on the best TMD intervention for improving QoL could not be made due to the diverse TMD subtypes and non-disease specific OHRQoL instruments employed. More studies incorporating TMD-specific OHRQoL measures and targeting explicit TMD subtypes based on internationally accepted diagnostic criteria are warranted in this area of research.

Combining a Multi-Agent System and Communication Middleware for Smart Home Control: A Universal Control Platform Architecture.

In recent years, the smart home field has gained wide attention for its broad application prospects. However, families using smart home systems must usually adopt various heterogeneous smart devices, including sensors and devices, which makes it more difficult to manage and control their home system. How to design a unified control platform to deal with the collaborative control problem of heterogeneous smart devices is one of the greatest challenges in the current smart home field. The main contribution of this paper is to propose a universal smart home control platform architecture (IAPhome) based on a multi-agent system and communication middleware, which shows significant adaptability and advantages in many aspects, including heterogeneous devices connectivity, collaborative control, human-computer interaction and user self-management. The communication middleware is an important foundation to design and implement this architecture which makes it possible to integrate heterogeneous smart devices in a flexible way. A concrete method of applying the multi-agent software technique to solve the integrated control problem of the smart home system is also presented. The proposed platform architecture has been tested in a real smart home environment, and the results indicate that the effectiveness of our approach for solving the collaborative control problem of different smart devices.

Orthognathic treatment of dentofacial disharmonies: its impact on temporomandibular disorders, quality of life, and psychosocial wellness.

AIM: The objective of this literature review was to assess the effect of orthognathic surgical treatment on temporomandibular disorders (TMD), quality of life (QoL), and psychosocial wellness. METHODS: Journal articles and systematic reviews published in English between 1982 and 2015 were searched using PubMed, MEDLINE, and Cochrane database using the search terms "orthognathic," "temporomandibular disorders," "quality of life," and "psychosocial." The articles were then reviewed and discussed. RESULTS: Both objective and subjective parameters play a role in orthognathic treatment outcome satisfaction and QoL. Psychological factors and TMD exerted a stronger influence on patients' QoL more than objective treatment outcome measures. CONCLUSION: A paradigm shift in clinical mindset from solely objective measures to a more holistic, patient-centric approach of addressing patients' expectations and improving QoL is warranted when treating patients with dentofacial disharmonies.

Corrigendum to "A Study of Success Rate of Miniscrew Implants as Temporary Anchorage Devices in Singapore".

[This corrects the article DOI: 10.1155/2015/294670.].

[Multi-dimensional Clinical Profile for Functional Gastrointestinal Disorders and Diagnostic and Therapeutic Approaches of Chinese Medicine].

Functional gastrointestinal disorders (FGIDs) are manifested as digestive symptoms, but relative symptoms cannot be confirmed by traditional inspection methods. In 2015 Rome Foundation put forward the conception of multi-dimensional clinical profile (MDCP) for FGIDs, which emphasized multi-dimensional assessment of disease state and aimed to develop individualized treatment program. Chinese medicine also has multi-dimensional thoughts in diagnosis and treatment and has much in com- mon with MDCP in refining diagnosis, attaching importance to psychological factors and spirits, seeking biomarkers, and so on. The correlation between multi-dimensional diagnostic and therapeutic thoughts in Chinese medicine and MDCP was explored by combining functional dyspepsia as focal point.

[Development of a handy-type monitoring system for cardiovascular haemodynamic functions based on the volume-compensation and electrical admittance method].

A handy-type monitoring system for cardiovascular haemodynamic functions based on the volume-compensation and electrical admittance method is developed. In this system, the inconvenient and discomfort due to cuff occlusion of the biological segment for BP measurement is improved by developing a new device using a local pressurization method, the stability for the physiological information detection is improved by developing a new detecting system, and the noise during detection using the system is greatly reduced by using a newly developed nozzle-flapper type electro-pneumatic converter. Also, for electrical admittance cardiography to estimate CO, the applicability of a two-compartment coaxial cylindrical model and the optimal position of a spot-electrode array that is used to replace the conventional band-electrode are discussed in this research. Experimental result shows that the monitoring system should satisfy non-invasive BP and CO measurement on beat by beat, and the comfort of measurement is significantly improved.

[An instantaneous blood pressure measuring system at the wrist based on the volume-compensation method].

An instantaneous blood pressure measuring system at the wrist based on the volume-compensation method is developed, and the characteristics and accuracy of the system is evaluated. The radial artery at the wrist is used as the detecting object, and a pad-type cuff as well as a newly designed electro- pneumatic converter is used in the system. Also, the comparative experiments between the system and the invasive blood measuring device (direct method) indicated that, the results obtained from the two methods are well correlated not only in rest condition, but also in a stressful condition. Therefore, the system is capable of non-invasive measuring instantaneous blood pressure in the radial artery.