Oral Health-Related Quality of Life Among Non-institutionalized Elderly in Malaysia: A Teaching Hospital-Based Survey.

Background In Malaysia, the Geriatric Oral Health Assessment Index (GOHAI) has been recognized as a vital instrument for evaluating oral health-related quality of life among the elderly population. Its integration into the National Health and Morbidity Survey (NHMS) in 2018 demonstrates the country's dedication to understanding and addressing the unique oral health challenges faced by older individuals. The NHMS, led by the Ministry of Health Malaysia, serves as a crucial platform for identifying and addressing healthcare needs, while also working towards achieving sustainable development goals. This study aimed to provide valuable information for stakeholders and researchers by investigating the relationship between quality of life related to oral health and demographic factors, with the ultimate goal of enhancing oral healthcare for older individuals. Objective The objective of this research was to identify the variables that impact the Oral Health-Related Quality of Life (OHRQoL) of non-institutionalized elderly individuals who visit the Klinik Pergigian Manipal University College Malaysia (MUCM). By utilizing the OHRQoL, dental practitioners can gain insight into the elderly's oral health-related quality of life, which is crucial information for dental healthcare providers to effectively reach out to and cater to the elderly at the institution. Methodology A cross-sectional design was employed, utilizing a non-probability sampling method to select eligible elderly individuals at the clinic. A validated questionnaire comprising 18 items covering sociodemographic details and the Geriatric Oral Health Assessment Index (GOHAI) was distributed to individuals above 60 years via printed forms. One way ANOVA, unpaired t-test and multiple linear regression analysis were performed to analyze the data. Results The overall mean GOHAI score among non-institutionalized elderly attending Klinik Pergigian MUCM was 48.38±9.33, indicating poor OHRQoL. The psychosocial impact domain had a mean score of 19.33±5.21, surpassing the pain and discomfort domain with a score of 10.73±2.82, highlighting the significant impact of psychosocial factors on poor oral health-related quality of life. Multiple linear regression analysis revealed no significant associations between OHRQoL and factors such as ethnicity, living arrangements apart from spouse and family, or tertiary education among older individuals after adjusting for confounding variables. Conclusions This study indicates that sociodemographic aspects have minimal impact on the OHRQoL of seniors. Further examination is needed to understand the economic aspects of tooth replacement options and preventive measures in this age group. To enhance the OHRQoL of older adults, especially those not living in facilities like nursing homes or assisted living centers, tailored oral healthcare plans and strategies are crucial. Interdisciplinary collaboration among mental health professionals, geriatric experts, and oral healthcare providers is crucial for empowering both healthcare practitioners and seniors to maintain optimal oral health.

Design and implementation of the Our Health Counts (OHC) methodology for First Nations, Inuit, and Metis (FNIM) health assessment and response in urban and related homelands.

OBJECTIVES: Methods for enumeration and population-based health assessment for First Nations, Inuit, and Metis (FNIM) living in Canadian cities are underdeveloped, with resultant gaps in essential demographic, health, and health service access information. Our Health Counts (OHC) was designed to engage FNIM peoples in urban centres in "by community, for community" population health assessment and response. METHODS: The OHC methodology was designed to advance Indigenous self-determination and FNIM data sovereignty in urban contexts through deliberate application of Indigenous principles and linked implementation strategies. Three interwoven principles (good relationships are foundational; research as gift exchange; and research as a vehicle for Indigenous community resurgence) provide the framework for linked implementation strategies which include actively building and maintaining relationships; meaningful Indigenous community guidance, leadership, and participation in all aspects of the project; transparent and equitable sharing of project resources and benefits; and technical innovations, including respondent-driven sampling, customized comprehensive health assessment surveys, and linkage to ICES data holdings to generate measures of health service use. RESULTS: OHC has succeeded across six urban areas in Ontario to advance Indigenous data sovereignty and health assessment capacity; recruit and engage large population-representative cohorts of FNIM living in urban and related homelands; customize comprehensive health surveys and data linkages; generate previously unavailable population-based FNIM demographic, health, and social information; and translate results into enhanced policy, programming, and practice. CONCLUSION: The OHC methodology has been demonstrated as effective, culturally relevant, and scalable across diverse Ontario cities.

RéSUMé: OBJECTIFS: Les méthodes de dénombrement et d'évaluation populationnelle de la santé des personnes des Premières Nations, des Inuits et des Métis (PNIM) vivant dans les villes du Canada sont sous-développées, ce qui laisse des lacunes dans les informations essentielles sur le profil démographique, la santé et l'accès aux services de santé. Le projet Notre santé compte (NSC) vise à collaborer avec les personnes des PNIM dans les centres urbains au moyen d'une évaluation de la santé des populations et d'une intervention « pour nous-mêmes, par nous-mêmes ¼. MéTHODE: La méthode NSC est conçue pour renforcer l'autodétermination autochtone et la souveraineté des données des PNIM vivant en milieu urbain par l'application délibérée de principes autochtones et de stratégies de mise en œuvre connexes. Trois principes imbriqués (« les bonnes relations sont fondamentales ¼; « la recherche en tant qu'échange de cadeaux ¼; et « la recherche comme vecteur de résurgence des communautés autochtones ¼) constituent le cadre de stratégies de mise en œuvre connexes : l'établissement et le maintien actifs de relations; la guidance, la participation et le leadership significatifs des communautés autochtones dans tous les aspects du projet; le partage transparent et équitable des ressources et des avantages du projet; et les innovations techniques, dont l'échantillonnage en fonction des répondants, les enquêtes de santé exhaustives et personnalisées, et les couplages avec les fonds de données de l'Institut de recherche en services de santé (ICES), pour produire des indicateurs d'utilisation des services de santé. RéSULTATS: L'approche NSC a réussi dans six agglomérations urbaines de l'Ontario : à renforcer la souveraineté des données et la capacité d'évaluation de la santé des populations autochtones; à recruter et à mobiliser de vastes cohortes représentatives des PNIM vivant en milieu urbain et sur les territoires connexes; à personnaliser des enquêtes de santé exhaustives et des couplages de données; à générer des informations démographiques, sanitaires et sociales non disponibles auparavant sur les populations des PNIM; et à traduire ces résultats en politiques, en programmes et en pratiques améliorés. CONCLUSION: Il est démontré que la méthode NSC est efficace, culturellement appropriée et modulable dans différentes villes de l'Ontario.

Perspectives of refugee parents and unaccompanied minors on initial health assessment and access to care.

To explore the needs, expectations, and experiences of asylum-seeking parents and unaccompanied minors under the age of 18 years on the initial health assessment for children and adolescents and access to care upon entry in the Netherlands, We conducted five semi-structured focus group discussions with asylum-seeking parents and unaccompanied minors, from Syria, Eritrea, Afghanistan, and other Middle-East and African countries, supported by professional interpreters. To triangulate findings, semi-structured interviews with health care professionals involved in care for refugee children were conducted. Transcripts of focus group discussions were inductively and deductively coded and content analyzed; transcripts of interviews were deductively coded and content analyzed. In total, 31 asylum-seeking participants: 23 parents of 101 children (between 0 and 18 years old), 8 unaccompanied minors (between 15 and 17 years), and 6 healthcare professionals participated. Parents and minors expressed that upon entry, their needs were met for vaccinations, but not for screening or care for physical and mental health problems. Parents, minors, and health professionals emphasized the necessity of appropriate information and education about health, diseases, and the health system. Cultural change was mentioned as stressful for the parent-child interaction and parental well-being.     Conclusion: The perspectives of refugee parents and unaccompanied minors revealed opportunities to improve the experience of and access to health care of refugees entering the Netherlands, especially risk-specific screening and more adequate education about health, diseases, and the Dutch health care system. What is Known: •  Refugees have specific health needs due to pre-flight, flight, and resettlement conditions. Health assessment upon entry was non-obligatory in the Netherlands, except for the tuberculosis screening. Health needs were not always met, and refugees experienced barriers in access to care. What is New: • The initial health assessment met the needs concerning vaccinations but mismatched the needs regarding physical and mental health assessment. Screening for specific risk-related diseases and mental health could enable refugee parents and minors to engage better with the health system.

Exploring adolescent mental health during the COVID-19 crisis - strengths and difficulties.

Introduction: The SARS-CoV-2 pandemic has significantly impacted children and adolescents, leading to mental health challenges. Knowledge on their resources and difficulties is crucial and there is a need for valid instruments to assess their psychosocial condition especially in this exceptional situation. We assessed psychopathological symptoms using the SDQ during the pandemic, comparing to pre-pandemic data. Our study aims to understand adolescents' strengths and difficulties amidst COVID-19, evaluating the SDQ's utility in crisis settings. Methods: Within the German school-based surveillance study ("B-Fast"), we assessed behavioral strengths and difficulties in 664 adolescents aged 11-17 years during the peak of the German COVID-19 pandemic using the validated Strengths and Difficulties Questionnaire (SDQ) for both external and self-assessed data collection. Data were collected between November 2020 and April 2021. We compared self-assessed SDQ-scores to pre-pandemic data from a comparable sample and examined adolescent classification as "normal" or "borderline/abnormal" based on both external and self-assessed SDQ subscale scores using established cut-off values. Additionally, we conducted sex and rater-based score comparisons. Results: In our study, we observed a significant worsening of "Emotional Symptoms" compared to pre-pandemic levels, while "Conduct Problems" and "Prosocial Behavior" showed improvement. Variations in classification to "normal" and "abnormal" emerged when applying German versus British cut-off values. Females scored higher on "Emotional Symptoms" while males scored higher on "Hyperactivity Symptoms." Correlations between external and self-assessed SDQ ratings ranged from 0.43 (p < 0.001) for "Prosocial Behavior" among girls to 0.62 (p < 0.001) for "Peer Problems" among boys, indicating moderate to high consistency. Discussion/conclusion: Our study contributes to understanding the psychosocial impact of the COVID-19 pandemic on German adolescents. Compared to other symptoms, we observed a particular worsening in "Emotional Symptoms" based on our data. Despite the moderate correlation between parental and self-reported evaluations, there appears to be a certain discrepancy in the perception of adolescent quality of life. Therefore, it seems prudent to assess both the external and self-reported evaluations and amalgamate the results from both parties to obtain a comprehensive problem profile of the individual. These findings underscore the importance of using country-specific cutoff values and reaffirm the utility of the SDQ as a valuable assessment tool, even within the unique circumstances posed by a pandemic.

Tobacco and nicotine use among active component U.S. military service members: a comparison of 2018 estimates from the Health Related Behaviors Survey and the Periodic Health Assessment.

This study compared estimates of the prevalence of and risk factors for tobacco and nicotine use obtained from the 2018 Health Related Behaviors Survey (HRBS) and Periodic Health Assessment (PHA) survey. The HRBS and the PHA are important Department of Defense sources of data on health behavior collected from U.S. military service members. While their collection methods differ, some survey questions are similar, which provides an opportunity to compare survey estimates. Active duty service members consistently reported a much lower prevalence of all types of tobacco and nicotine use on the PHA compared to the HRBS: cigarettes (11.1% vs. 18.4%), e-cigarettes (7.3% vs. 16.2%), chewing tobacco (9.7% vs. 13.4%), any tobacco or nicotine use (25.3% vs. 37.8%), and use of 2 or more tobacco or nicotine products (5.8% vs. 17.4%). Associations between tobacco and nicotine use as well as demographic and other behavioral variables were fairly similar, including age, sex, education, race and ethnicity, rank, and alcohol use. The associations with service branch, body mass index, and sleep were inconsistent. This results of this study suggest that the PHA can provide timely information on trends in military tobacco and nicotine use over time, but much higher estimates from the confidential, voluntary HRBS reported in this study suggest that the command-directed PHA may substantially underestimate the prevalence of all types of tobacco and nicotine use.

Evaluation of water ecological health of Yanhe River based on benthic fauna integrity index.

Yanhe River Basin is located in the hilly gully area of the Loess Plateau with serious soil erosion. Strong human activities in the middle and lower reaches lead to fragile ecological environment. Soil erosion status varies among different geomorphic units within the watershed (loess liang hilly and gully region, loess mao hilly and gully region, and broken platform region). In this study, we surveyed the benthic community from the Yanhe River Basin in April (spring) and October (autumn) of 2021. To evaluate the water ecological health status of the watershed and investigate the effects of different geomorphic units on the benthic integrity of the benthos, we constructed the benthic-index of biotical integrity (B-IBI) based on the biological data. We identified a total of 113 species of 73 genera in 4 phyla of benthic fauna, with aquatic insects as the dominant taxa in both seasons. Through screening 26 candidate indicators, we found that the spring B-IBI consisted of three indicators: relative abundance of individuals of dominant taxonomic units, family biotic index (FBI), and relative abundance of predator individuals, and that autumn B-IBI was composed of the number of taxonomic units of Ephemeroptera, FBI value, and the relative abundance of predator individuals. Results of the B-IBI evaluation showed that 83.3% of the sampling sites in the upper mainstem and tributaries were at a healthy condition, while only 28.6% sampling sites in the middle and lower mainstem and tributaries were at a healthy condition. In addition, the health status of the watershed was better in spring than in autumn. The Kruskal-Wallis nonparametric tests showed that benthic density, species number, and B-IBI percentile scores in the fragmented loess area were significantly higher in spring than in autumn, and significantly lower in autumn than in the loess liang hilly and gully region and loess mao hilly and gully region, being mainly caused by the increasing erosion due to the concentrated rainfall in wet season. Results of the redundancy analysis showed that key environmental factors affecting benthic community structure in spring were boulder substrate, chlorophyll-a, oxidation reduction potential, turbidity, conductivity, and dissolved oxygen, and were nitrate-nitrogen, oxidation reduction potential, and pH in autumn.

Health assessment of an electro-hydraulic servo pump control system for servomotor based on LGA deep neural network.

Due to its advantages of having a high power-to-weight ratio and being energy-efficient, the electro-hydraulic servo pump control system (abbreviated as EHSPCS) is frequently employed in the industrial field, such as the electro-hydraulic servo pump control (EHSPC) servomotor for steam turbine valve regulation control. However, the EHSPCS has strong nonlinearity and time-varying features, and the factors that cause system performance degradation are complex. Once a system failure occurs, it may lead to serious accidents, causing serious casualties and economic losses. To address the above issues, a system health assessment method based on LSTM-GRNN-ANN (LGA) deep neural network is proposed in this paper. Firstly, with oil volume gas content, servo motor air-gap flux density, and system leakage coefficient as the health assessment performance indicators, a health assessment performance index system for the EHSPCS is built, Furthermore, the system performance index threshold is set. Secondly, an LGA deep neural network is constructed by combining LSTM, GRNN and ANN, and a deep neural network based on the LGA is used to create an EHSPCS health assessment model. Subsequently, system feature parameter extraction, algorithm design, and parameter debugging are carried out. Finally, an EHSPCS experimental platform is established, typical system failure simulation experiments are designed, and comparative experimental analysis is conducted. The experimental findings demonstrate that the average accuracy of the system health assessment model based on the LGA deep neural network suggested in this paper is 96.37%, compared to 89.84%, 87.99% for LSTM and GRNN, which validates the accuracy of the system health assessment model based on the LGA deep neural network.

Possible association between oral health status and appetite loss in community-dwelling older adults.

This study aimed to evaluate the association between the oral health status and appetite in community-dwelling older adults. We enrolled 100 people aged ≥65 years who had participated in long-term care prevention projects between December 2018 and January 2019. Appetite was assessed using the Council on Nutrition Appetite Questionnaire score. The oral health status was assessed based on the number of teeth, occlusal condition, swallowing function, tongue coating, and the Oral Health Assessment Tool. A multiple linear regression analysis was performed with appetite as the dependent variable and each variable related to oral health status as an independent variable. The analysis was adjusted for sex, age, activities of daily living, cognitive function, smoking habit, and alcohol consumption. Dental pain was associated with poor appetite in community-dwelling older adults. No other oral health status parameter was associated with appetite. Thus, controlling dental pain is critical to prevent appetite loss while considering other factors.

Bodyweight Exercise of Lower and Upper Extremities for Female Patients with Rheumatoid Arthritis and the Timed Up-and-Go Test.

Objectives: At our hospital, orthopedic surgeons and physical and occupational therapists have developed bodyweight exercises for the lower and upper extremities (BELU) for rheumatoid arthritis (RA) patients, including walking [Timed Up-and-Go (TUG) test and figure-of-eight walking) and weight exercises. We aimed to clarify the effect of bodyweight exercise and the Health Assessment Questionnaire (HAQ) cut-off value for a TUG test result of 12 s (or longer) as a risk factor for a fall. Methods: All patients underwent BELU twice weekly at home for 6 weeks. We assessed the HAQ score, TUG time, and the strengths of quadriceps femoris, biceps brachii, handgrip, side pinch, and pulp pinch before and after the intervention. Results: We analyzed the data of 42 participants. The mean age was 67.0 ± 12.1 years. The mean Disease Activity Score-28 for rheumatoid arthritis with erythrocyte sedimentation rate was 2.91 ± 0.91. The mean HAQ score was 0.69 ± 0.62. The dominant quadriceps femoris, biceps brachii, pulp pinch, and side pinch strengths were significantly strengthened. TUG time was improved from 9.0 ± 3.0 s to 8.6 ± 3.2 s (P=0.009). The receiver operating characteristic analysis revealed the cut-off value of HAQ for a TUG time of 12 s (or longer) was 1.0 (AUC 0.903, 95% confidence interval 0.792-1.0). Conclusions: Bodyweight exercises strengthened the muscles in female patients with RA, resulting in improved TUG test results. An indicative HAQ cut-off value of 1.0 (or greater) was identified for a TUG test result of 12 s or longer.

Evaluation of Immunobiological Cold Chain Costs.

Background and Purpose: Studies assessing the costs of the immunobiological cold chain (CC) are scarce. Therefore, the factors that influence the allocation of resources in this process are not known. The objective of this study is to determine the cost of the immunobiological CC. Methods: The Health Economic Assessment study was carried out in Minas Gerais, Brazil, between 2021 and 2022. The unit of analysis was the municipal level of the CC. The perspective of the Public Health System (Sistema Único de Saúde) was considered as a funder, the year 2021 was considered as the time frame, and the period of 1 year was considered as the time horizon of the analysis. Direct medical, nonmedical, and indirect costs were included. A mixed technique was used involving micro- and macrocosting and sensitivity analysis to identify the influence of the main categories on the final cost. Results: The total cost was USD 20,014,545, with nonmedical direct costs being the most representative (61.24%). Human resources were the most influential items, representing 76.43% of the total cost. Conclusions: The most influential items should be those of greatest concern and planned by managers to make the CC more efficient.

Mitochondrial DNA levels in perfusate and bile during ex vivo normothermic machine correspond with donor liver quality.

Ex vivo normothermic machine perfusion (NMP) preserves donor organs and permits real-time assessment of allograft health, but the most effective indicators of graft viability are uncertain. Mitochondrial DNA (mtDNA), released consequent to traumatic cell injury and death, including the ischemia-reperfusion injury inherent in transplantation, may meet the need for a biomarker in this context. We describe a real time PCR-based approach to assess cell-free mtDNA during NMP as a universal biomarker of allograft quality. Measured in the perfusate fluid of 29 livers, the quantity of mtDNA correlated with metrics of donor liver health including International Normalized Ratio (INR), lactate, and warm ischemia time, and inversely correlated with inferior vena cava (IVC) flow during perfusion. Our findings endorse mtDNA as a simple and rapidly measured feature that can inform donor liver health, opening the possibility to better assess livers acquired from extended criteria donors to improve organ supply.

Novel herpesvirus in the critically endangered Galapagos pink land iguana.

Virus surveillance in wildlife is important to understanding ecosystem health, taxonomy, and evolution. Nevertheless, viruses in reptiles, and specifically in squamates, continue to be understudied. Herein, we conducted a health assessment on the critically endangered Galapagos pink land iguana (Conolophus marthae) and the vulnerable Galapagos land iguana (Conolophus subcristatus). We collected oral and/or cloacal swabs from 47 clinically healthy iguanas and tested for adenovirus (cloacal swabs, n = 47) and herpesvirus (oral swabs, n = 45) using broad-spectrum PCRs. Two out of 38 (5.3 %) Galapagos pink land iguanas tested positive for herpesvirus, while no herpesvirus was detected in all Galapagos land iguanas (n = 7). Both herpesviral sequences were identical between them and divergent (61.9 % amino acid identity) when compared to the closest herpesvirus sequences available in GenBank/EMBL/DDBJ. The genetic distance between this and other herpesviruses is consistent with its classification as a novel virus species. All iguanas were negative for adenovirus. This is the first description of a herpesvirus in iguanas of the Galapagos islands, and the first report of a potential pathogen for the iconic Galapagos pink land iguana. Further research is needed to understand the implications of this virus in the conservation and management of one of the most endangered iguana species in the world.

Assessing ecological health in a semi-arid basin: a case study of the Wei River Basin, China.

A healthy water ecosystem within a river basin is essential for maintaining ecological security, preserving species diversity, and ensuring sustainable socio-economic development. Unfortunately, human activities have significantly threatened the health of water ecosystems in various basins. Consequently, timely restoration and targeted protection of damaged river ecosystems have become crucial objectives in watershed management. As a prerequisite and cornerstone for river protection and management, assessing river ecological health has emerged as a primary focus in current research. In this study, we selected the Wei River Basin, a representative area of the Yellow River Basin, as our research subject. We identified multiple influencing factors, including society, biology, water quality, and habitat, which collectively impact this semi-arid region. To assess the overall impact of these factors on ecological health, we developed a comprehensive River Ecological Health Assessment Index (REHAI) system. The research findings indicate that the Wei River system, as a whole, is currently in a healthy state, while the Jing and Luo River systems are classified as sub-healthy. Furthermore, we observed variations within the Wei River system itself; the upper reaches of the Wei River exhibit higher levels of health compared to the middle reaches, whereas the water environment in the lower reaches is the most compromised. This degradation can be attributed to downstream subsidence, increased pollution, and rapid urbanization. By establishing a river ecosystem health assessment methodology and conducting a comprehensive evaluation of the health status of river ecosystems, this paper puts forward management recommendations for river basins. These findings provide a scientific basis for the sustainable utilization of water resources in river basins and promote the harmonious coexistence of humanity and nature.

Effect of light intensity on behaviour, health and growth of growing-finishing pigs.

The effect of light intensity has been explored in relation to endocrine functions and reproduction in pigs, but effects on health and behaviour are scarcely documented. The objective of this study was to evaluate the effects of different light intensities on behaviour, health and growth of growing-finishing pigs. An experiment was conducted on a commercial farm equipped with light-emitting diode-based luminaires creating four light intensity treatments: low (45 lux), medium (198 lux), high (968 lux) and spatial gradient of intensity (from 71 lux to 330 lux). Per treatment, 112 pigs were studied in two batches of eight pens. Once every two weeks behaviours such as exploration, positive and negative social interactions, play and abnormal behaviours were observed. Health issues were assessed weekly and included biting lesions, skin lesions, leg and respiratory disorders. The average daily gain over the experiment was calculated and after slaughter carcasses were inspected. Generalised linear mixed models were used for the analysis of behaviours, binary health scores, carcass abnormalities, ordinal logistic regression for multilevel health scores, and linear mixed models for average daily gain. Interactions between intensity and week were found for some behaviours (i.e., exploration, negative social interactions and abnormal behaviour) and health issues (i.e., tear stains, conjunctivitis, body lesions, bursitis and tail lesions). However, none of the treatments consistently outperformed another one. Light treatments did not affect pig growth and carcass abnormalities. These variable results support studies suggesting that pigs are adaptable to light intensities, and inconsistencies over weeks might have been caused by environmental factors that could not be controlled in a commercial farm setting. To conclude, tested light intensities had no clear effects on pig behaviour, health and growth.

Indigenous approaches to health assessment: a scoping review protocol.

BACKGROUND: Health assessment tools developed using mainstream or Western concepts have been widely used in clinical practice worldwide. However, even culturally adapted or culturally based tools may not be relevant in other social contexts if they are grounded in Western beliefs and perspectives. The application of mainstream assessment tools, when used in Indigenous populations, can lead to the inappropriate application of normative data and inaccurate or biased diagnosis of conditions as Indigenous concepts of health differ from Western biomedical concepts of health. Thus, considering the need for culturally meaningful, sensitive, safe, and unbiased health assessment approaches and instruments over recent years, tools have been developed or adapted by and with Indigenous populations in Australia, Aotearoa/New Zealand, Canada, and the United States. However, there is no existing systematic or scoping review to identify the methods and approaches used in adapting or developing health assessment tools for use with the Indigenous population in Australia, Aotearoa/New Zealand, Canada, and the United States. METHODS: In response to these gaps, we are working with a First Nations Community Advisory Group in Northern Ontario, Canada, to undertake a scoping review following the 2020 JBI methodology for scoping reviews. A systematic search will be conducted in PubMed, APA PsychINFO, CINAHL, MEDLINE, Web of Science, Bibliography of Native North Americans, Australian Indigenous Health info data set, and Indigenous Health Portal. Two reviewers will independently screen all abstracts and full-text articles for inclusion using criteria co-developed with an advisory group. We will chart the extracted information and summarize and synthesize the data. The summarized findings will be presented to a Community Advisory Group, including First Nations community partners, an Elder, and community members, and their feedback will be incorporated into the discussion section of the scoping review. DISCUSSION: This scoping review involves iterative consultation with the Indigenous and non-Indigenous scholars, First Nations Community Advisory Group, and community partners throughout the research process. This review aims to summarize the evidence on standard ethical approaches and practices used in Indigenous research while adapting or developing health assessment tools. It will inform the larger study focused on developing an Indigenous Functional Assessment tool. Further, it will seek whether the Indigenous ways of knowing and equitable participation of Indigenous people and communities are incorporated in the Indigenous research process. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework https://osf.io/yznwk .

Masticatory function and mortality among older adults living in long-term care facilities in Brazil.

OBJECTIVE: To investigate the association between mortality and masticatory function in older adults living in long-term care facilities (LTCFs), controlling for demographic and health covariates. BACKGROUND: Poor oral health has been associated with mortality; however, no previous study investigated whether objective and self-reported poor masticatory function is a predictor of early mortality in LTCFs. MATERIALS AND METHODS: Baseline characteristics of 295 participants were collected, including age, sex, polypharmacy, mobility, activities of daily living, frailty, nutritional status, and objective (masticatory performance - chewing gum) and self-reported masticatory function. The participants were followed-up with for 4 years to record the mortality data. Cox regression models were run to analyse the data (α = .05). RESULTS: During the 4-year follow-up, 124 (42.0%) participants died. Older adults with poor masticatory performance (hazard ratio [HR] = 1.59, 95% confidence interval [95% CI] = 1.07-2.36) and those who self-reported masticatory dysfunction (HR = 1.48, 95% CI = 1.01-2.16) were at higher risk of early death than those with good mastication. However, in a multivariate model including both objective and self-reported masticatory function, only the objective measurement remained associated with early death (HR = 1.52, 95% CI = 1.02-2.27). CONCLUSION: Poor masticatory performance seems to be associated with early death in older adults living in LTCFs, but they may have shared risk factors accumulated throughout life that were not covered by the study period.

Evaluating river health through respirogram metrics: Insights from the Weihe River basin, China.

Human activities pose a significant threat to rivers, requiring robust assessment methods for effective river management. This study focuses on the Weihe River Basin in Shaanxi province and introduces the respirogram as an innovative assessment technique. The respirogram allows the simultaneous assessment of river health from two important aspects: pollution levels and microbial status. Specifically, the in-situ respiration ratio (Rs/t) serves as an indicator of pollution, with higher Rs/t values correlating with increased pollution levels. Conversely, the recovery index (RI) measures microbial vitality, with values below 0.15 indicating greater microbial activity and recovery potential. Using predefined thresholds of Rs/t = 0.3 and RI = 0.15, water bodies were categorized into four types. For example, rivers with Rs/t > 0.3 and RI > 0.15 were identified as receiving sewage, characterized by high pollution and low microbial vitality. Similarly, different assessment criteria delineated urban rivers, natural rivers, and wastewater treatment plants. Based on these classifications, targeted engineering measures were proposed to enhance the self-purification capabilities of rivers of different statuses.

A Step Toward the Development of the First National Multi-Criteria Decision Analysis Framework to Support Healthcare Decision Making in Saudi Arabia.

OBJECTIVES: To assess the feasibility of implementing multi-criteria decision analysis (MCDA) and to select the criteria for preparing a national MCDA framework for health technology assessment of orphan drugs in the Kingdom of Saudi Arabia (KSA). METHODS: The study was conducted in 3 phases. In phase I, a targeted literature review was performed to gather relevant information on the implementation of MCDA in healthcare decision making. Phase II was a cross-sectional survey, conducted to obtain insights from different stakeholders and key opinion leaders on specific topics from the KSA perspective. Phase III included a round-table discussion involving experts to validate the results obtained in the phase II survey and further elaborate on specific requirements that may be critical for developing the first national MCDA framework in the KSA. RESULTS: All the key opinion leaders involved in the study acknowledged the importance of implementing MCDA in the KSA. The Ministry of Health was assigned the responsibility of chairing the MCDA decision process. The experts selected the quantitative, qualitative, and economic criteria to be considered for the MCDA framework. The stakeholders decided to initiate a pilot phase using the deliberative MCDA methodology for the assessment of orphan drugs based on the selected criteria for a period of 1 year and then reevaluate the need to adapt the pragmatic MCDA model. CONCLUSION: This article describes the novel initiative that examined the feasibility and process required for the development of the first MCDA framework in the KSA to support healthcare decision making.

The Internet is a scary place: How does evidence source and examinee race or ethnicity influence determinations of threat?

Violent rhetoric online is becoming increasingly relevant to the practice of forensic mental health assessment as examinee's virtual lives may transform into real-world acts of violence. With the rise of a diverse subculture of violent online communities, the aim of the present study was to inform how concerns with online sources of collateral data and racial/ethnic biases may influence determinations of violence potential. Using an experimental design, jury-eligible participants (N = 278) and forensic mental health experts (N = 78) were presented with mock Twitter (now referred to as X) posts that varied by data source (i.e., how information was accessed) and the examinee's race/ethnicity. Results showed no differences in participants' ratings of data credibility, how much weight they would place on the posts in a threat assessment, or how likely the examinee was to act violently against his intended target. Implications regarding the interpretation of social media evidence, relevant limitations, and future research are discussed.

Hematology and Serum Biochemistry of Coastal Seabirds Rehabilitated on the Southeastern and Southern Coast of Brazil.

Complete blood counts (n=566) and serum biochemistry (n=426) were assessed in seven coastal seabirds species that underwent rehabilitation along the southeastern and southern coast of Brazil from Saquarema, Rio de Janeiro State (22°56'16.44″S, 42°18'24.16″W) to Laguna, Santa Catarina State (28°29'43″S, 48°45'39.2″W), from August 2016 to August 2020. Blood samples were collected from four species of Charadriiformes, including Kelp Gull (Larus dominicanus, n=136), South American Tern (Sterna hirundinacea, n=25), Cabot's Tern (Thalasseus acuflavidus, n=17), and Common Tern (Sterna hirundo, n=14) as well as three species of Suliformes, the Brown Booby (Sula leucogaster, n=212), Magnificent Frigatebird (Fregata magnificens, n=104), and Neotropic Cormorant (Nannopterum brasilianum, n=58). The individuals were sampled as part of the protocol required before their release into the wild when considered healthy. This work aimed to establish the normal hematologic and biochemical reference values of those seabird species and, when possible, to analyze variations among age class and sex and to compare those with the available data in the literature. In addition, we provide the first baseline data for the South American Tern, Cabot's Tern, and Neotropic Cormorant. Baseline hematologic data are crucial for assessing health status of individuals and to support management and conservation actions, including release of seabirds into the wild.