Are Dentists Hypocrites? Oral Self-care Habits and Self-reported Oral Health Status among Dentists and Non-dentists in Croatia.

Objectives: Dentists provide dental care to their patients and educate them on their oral hygiene and how to maintain oral health. This paper aimed to determine whether dentists are hypocritical when advising their patients on oral hygiene procedures and dental treatments because they do not apply to themselves what they recommend to others. Material and methods: This is a self-reported study conducted through an online survey questionnaire completed by 1001 participants, of whom 551 were non-dentists and 450 dentists. This is the first study on oral hygiene habits and oral status among dentists in Croatia. This research included almost 10% of the total number of working dentists in Croatia. Results: In terms of dental hygiene habits, dentists brushed, flossed and used interdental brushes more frequently, and they also changed toothbrushes more frequently, whereas they attended check-ups less frequently. Dentists also reported a smaller number of teeth with cavities, a greater number of teeth with fillings, a greater number of extracted teeth, and a greater number of dental crowns, but a smaller number of healthy teeth compared to general population. However, dentists had a much higher proportion of participants over 30 years of age, and when sub-analysis of participants over 30 years of age was performed, dentists had a greater number of healthy teeth compared to the general population. Conclusions: The results showed that dentists are aware of the importance of their oral health and that they do not pay attention only to their oral hygiene habits, but also apply advice they give their patients. Therefore, they cannot be considered hypocritical.

Evaluating dental student self-assessment across preclinical anatomy waxing and operative exercises.

PURPOSE/OBJECTIVE: A career in healthcare is built on the foundations of continuous self-reflection and self-assessment. Previous studies have solely compared student self-assessment to faculty grades in a single discipline. The objective of this study was to investigate whether associations of a student's self-assessment skills exist across multiple disciplines in the predoctoral setting. METHODS: Sixty-five students from two class years at the Harvard School of Dental Medicine completed preclinical competency exams in dental anatomy waxing and operative dentistry. The difference between the student's self-assessment score and average faculty grade for each exercise was calculated as the student‒faculty (S-F) gap, which served as a proxy to determine how students evaluate their work. Regression analysis was performed to assess associations between wax-up and preclinical operative S-F gaps. RESULTS: Mean S-F gaps for waxing and preclinical operative procedures were positive (5.7 ± 6.1 and 7.6 ± 6.7, respectively). Additionally, students in the lower quartile tended to overestimate performance to a greater degree than their peers in the upper quartile. Furthermore, the waxing S-F gaps were positively associated with S-F gaps of each operative procedure, particularly with the combined operative exercise S-F gaps, where a statistically significant association was seen (coefficient = 0.28; p = 0.04). CONCLUSION(S): Previously, we identified a negative correlation between students' self-assessment skills (S-F gaps) and their preclinical performance. In this study, we further demonstrated an association of S-F gaps in two fundamental exercises: wax-up and operative dentistry. This underscores the roles of S-F gaps as possible indicators of students' preclinical and clinical performance, and it holds potential to become a widely standardized and applicable calculation that may help evaluate the effectiveness of the dental curricula and optimize student learning.

Ten years of hand hygiene excellence: a summary of outcomes, and a comparison of indicators, from award-winning hospitals worldwide.

BACKGROUND: Hand hygiene is a crucial measure for the prevention of healthcare-associated infections (HAIs). The Hand Hygiene Excellence Award (HHEA) is an international programme acknowledging healthcare facilities for their leadership in implementing hand hygiene improvement programmes, including the World Health Organisation's Multimodal Improvement Strategy. This study aimed at summarising the results of the HHEA campaign between 2010 and 2021 and investigating the relationship between different hand hygiene parameters based on data from participating healthcare facilities. METHODS: A retrospective analysis was performed on datasets from HHEA forms, including data on hand hygiene compliance, alcohol-based handrub (ABHR) consumption, and Hand Hygiene Self-Assessment Framework (HHSAF) scores. Descriptive statistics were reported for each variable. The correlation between variables was inspected through Kendall's test, while possible non-linear relationships between hand hygiene compliance, ABHR consumption and HHSAF scores were sought through the Locally Estimated Scatterplot Smoothing or logistic regression models. A tree-structured partitioning model was developed to further confirm the obtained findings. RESULTS: Ninety-seven healthcare facilities from 28 countries in three world regions (Asia-Pacific, Europe, Latin America) were awarded the HHEA and thus included in the analysis. HHSAF scores indicated an advanced hand hygiene promotion level (median 445 points, IQR 395-480). System change (100 [95-100] points) and institutional safety climate (85 [70-95] points) showed the highest and lowest score, respectively. In most cases, hand hygiene compliance was above 70%, with heterogeneity between countries. ABHR consumption above 20 millilitres per patient-day (ml/PD) was widely reported, with overall increasing trends. HHSAF scores were positively correlated with hand hygiene compliance (τ = 0.211, p = 0.007). We observed a positive correlation between compliance rates and ABHR consumption (τ = 0.193, p < 0.001), although the average predicted consumption was stable around 55-60 ml/PD for compliance rates above 80-85%. Logistic regression and partitioning tree analyses revealed that higher HHSAF scores were more likely in the high-ABHR consumption group at cut-offs around 57-59 ml/PD. CONCLUSION: Ten years after its inception, the HHEA proves to be a valuable hand hygiene improvement programme in healthcare facilities worldwide. Consistent results were provided by the different hand hygiene indicators and the HHSAF score represents a valuable proxy measure of hand hygiene compliance.

Development and Evaluation of a New Self-Administered Near Visual Acuity Chart: Accuracy and Feasibility of Usage.

Background: Visual acuity (VA) assessments are crucial in ophthalmology but traditionally rely on in-clinic evaluations. The emergence of telemedicine has spurred interest in creating dependable self-administered VA tests for use beyond standard clinical environments. This study evaluated the practicality and validity of a self-administered near VA card test against traditional Snellen and Rosenbaum Pocket Vision Screener (RPVS) methods for home monitoring and enhancing clinical workflow. Methods: In a cross-sectional study, a near VA card (Hadassah Self-Visual Acuity Screener (HSVA)) was developed with written and videotaped instructions for self-use. Patients with a minimal best-corrected VA (BCVA) of 1.0 LogMAR in at least one eye were recruited from ophthalmology and optometry clinics. Outcomes included the mean BCVA difference between the self-administered values and those obtained by the examiner, and correlations between BCVA values obtained by the Snellen, RPVS, HSVA, and previous distance BCVA methods according to the patients' electronic medical records. Results: A total of 275 participants (mean age: 42.5 ± 19.4 years; range: 18-89 years; 47% female) were included. Test-retest reliability analysis of the HSVA demonstrated a very good correlation and repeatability (n = 38 patients; Rs = 1.0; p < 0.001). Accuracy analysis revealed the mean LogMAR BCVA values of an additional 237 patients obtained by the Snellen, RPVS, and HSVA methods were similar (p = 0.10). The self-test BCVA results obtained by the HSVA agreed with the masked examiner-tested VA results (n = 67 patients; p = 0.17; Rs = 0.87; ICC = 0.96). Similar results were obtained when stratification by median age (42 years) was performed. Bland-Altman analysis of the HSVA and RPVS methods demonstrated a good agreement. To assess whether the HSVA could predict the VA results in the clinically used charts, multivariate analysis was used and revealed that the HSVA predicted the RPVS results (ß = 0.91; p = 0.001; R2 = 0.88), and the self-test HSVA predicted the Snellen VA results within two lines (ß = 0.93; p = 0.01; R2 = 0.36). Conclusions: The home-based HSVA assessment exhibited high test-retest reliability, accuracy, and alignment with clinical-standard VA tests. Its efficacy in self-testing mirrored examiner-conducted VA assessments and accurately predicted Snellen VA outcomes, indicating the HSVA's suitability for self-monitoring in chronic ocular conditions or when access to conventional examinations is limited. The utility of self-administered VA tests may extend beyond ophthalmology and optometry, potentially benefiting primary care, emergency medicine, and neurology. Further research is needed to explore and validate the practical applications of remote VA testing.

Promise of Composite Pain Index as a single pain outcome for sickle cell disease across the lifespan.

BACKGROUND: This study aimed to validate a Composite Pain Index (CPI) as a single pain outcome measure for sickle cell disease (SCD) across the lifespan from 8 years of age. PROCEDURE: This prospective, cross-sectional study included 55 participants with SCD who completed the PAINReportIt tool and Adolescent Pediatric Pain Tool (APPT) in random order during outpatient visits to derive respective CPI scores for comparison. RESULTS: Of the 55 participants with SCD, 46 (84%) had HgbSS, eight (15%) HgbSC, and one (2%) HgbSß0+. The mean age of all participants was 17.5 ± 2.6 years, and 28 (51%) were female, 52 (95%) were Black, 42 (98%) were non-Hispanic, and 39 (71%) had a ninth grade or higher education. Correlation analyses between the APPT and PAINReportIt revealed positive associations for the number of pain sites (r = .57, p < .001), pain intensity (r = .46, p < .001), pain quality (r = .74, p < .001), and pain pattern (r = .34, p = .01). Patients' mean CPI scores derived from the PAINReportIt was slightly higher than the APPT; 34.2 (SD = 14.7) and 30.0 (SD = 19.0), respectively. Regression analyses showed that the APPT CPI significantly predicted the PAINReportIt CPI (B = .497, t(53) = 6.051, p < .001). This finding holds true even when accounting for the order of measurement or patient's age. CONCLUSION: The initial validation of CPI as a single pain outcome measure represents a significant advancement in pain assessment for SCD. Further validation is warranted for the CPI as a measure is for both clinicians and researchers to enable longitudinal pain assessment from age 8 years across the lifespan as children age into adult care.

Trainee anaesthetist self-assessment using an entrustment scale in workplace-based assessment.

The role of self-assessment in workplace-based assessment remains contested. However, anaesthesia trainees need to learn to judge the quality of their own work. Entrustment scales have facilitated a shared understanding of performance standards among supervisors by aligning assessment ratings with everyday clinical supervisory decisions. We hypothesised that if the entrustment scale similarly helped trainees in their self-assessment, there would be substantial agreement between supervisor and trainee ratings. We collected separate mini-clinical evaluation exercises forms from 113 anaesthesia trainee-supervisor pairs from three hospitals in Australia and New Zealand. We calculated the agreement between trainee and supervisor ratings using Pearson and intraclass correlation coefficients. We also tested for associations with demographic variables and examined narrative comments for factors influencing rating. We found ratings agreed in 32% of cases, with 66% of trainee ratings within one point of the supervisor rating on a nine-point scale. The correlation between trainee and supervisor ratings was 0.71, and the degree of agreement measured by the intraclass correlation coefficient was 0.67. With higher supervisor ratings, trainee ratings better correlated with supervisor ratings. We found no strong association with demographic variables. Possible explanations of divergent ratings included one party being unaware of a vital aspect of the performance and different interpretations of the prospective nature of the scale. The substantial concordance between trainee and supervisor ratings supports the contention that the entrustment scale helped produce a shared understanding of the desired performance standard. Discussion between trainees and supervisors on the reasoning underlying their respective judgements would provide further opportunities to enhance this shared understanding.

Association of healthy eating index and self-rated health in adults living in Tehran: a cross-sectional study.

BACKGROUND: Self-rated health (SRH) has been identified in many studies as a valid predictor of mortality and healthcare utilization. There is limited research on SRH and dietary intake. This study aimed to investigate the association between healthy eating index (HEI) and SRH in adults living in Tehran. METHODS: This cross-sectional study was carried out among 850 adult men and women aged 20-59 years who visited health centers in Tehran from 2021 to 2022. Dietary intake was assessed using a validated and reliable semiquantitative food frequency questionnaire with 168 food items, and SRH was assessed with one question: "In general, how do you rate your health?". We categorized SRH into excellent/very good, good, and fair/poor. In the descriptive statistics part, we used mean ± standard deviation or number (ratio) for quantitative and qualitative variables, respectively. The chi-squared test and one-way analysis of variance were used to calculate the percentage and mean for demographic characteristics across tertiles of SRH. An analysis of covariance was used to compare the means of energy, macronutrients, the HEI, and its component variables across the tertiles of SRH. RESULTS: The final sample included 795 participants (68.2% female; mean ± standard deviation age: 44.81 ± 10.62 years) whose 40% reported excellent/very good SRH, and 30% reported good and fair/poor SRH separately. There was no association between body mass index, physical activity, education, health status, smoking, and sleep duration with SRH. After adjustment, the total HEI score and its component scores did not differ across the tertiles of SRH status. However, participants with good SRH had a higher intake of total energy (mean difference (MD): 180.33 Kcal, P value < 0.001), total fat (MD: 8.15 gr, P value = 0.002), and total carbohydrates (MD: 20.18 gr, P value = 0.004) than those with fair/poor SRH. CONCLUSION: According to our findings, fair/poor SRH was associated with a lower consumption of total energy, total fat, and total carbohydrates in Iranian adults. Additional observational studies would be necessary to clarify these findings.

Implementation of the e-IPOS in Home Palliative Cancer Care: A Quasiexperimental Pilot Study.

INTRODUCTION: Electronic patient-reported outcome measures (e-PROMs) offer advantages in palliative cancer care, including rapid completion, improved data quality and direct storage, improving clinical decision-making. The electronic Integrated Palliative Care Outcome Scale (e-IPOS) in this context enables thorough self-assessment by patients, enhancing symptom management and self-reflection of their current situation. AIM: To evaluate the feasibility of implementing the e-IPOS in home palliative cancer care. OUTCOMES: The primary outcomes included the enrollment consent rate, study retention rate, e-IPOS completion rate and response completeness, and the number of clinical assessments and interventions performed during home visits. The secondary outcomes were the number of unscheduled visits and patients' perceived quality of life. DESIGN: A two-group quasiexperimental clinical pilot study. The control group received standard palliative care, the intervention group received standard care along with weekly e-IPOS completion during home visits. Both groups were enrolled for 4 weeks. SETTING/PARTICIPANTS: Adults with advanced cancer from the home palliative care unit of the Istituto Nazionale dei Tumori of Milan. RESULTS: Twenty-three patients were enrolled (74.19%), and 20 completed the study (drop-out: 13.04%). 82.5% of the expected e-IPOS responses were received, of which 96.9% were fully complete. In the intervention group, the Wilcoxon test showed an increase in identified needs and documented interventions (P < .05) and a decrease in unscheduled visits (P < .05). CONCLUSION: It is feasible to recruit people via home palliative care for an e-IPOS implementation study. Future fully powered studies should investigate the feasibility and assess patients' perceptions of its use to better understand its clinical benefits.

Self-assessment scale of auditory verbal hallucinations (SAVH): A novel tool for patients with schizophrenia.

BACKGROUND: A scale for self-assessment of auditory verbal hallucinations (SAVH) was developed for patients, and this study aimed to validate the scale by investigating its psychometric properties. METHODS: Forty one patients with schizophrenia or schizoaffective disorders (DSM-5) self-assessed their hallucinations using nine SAVH questions. Each question was scored from 0 to 5, indicating the severity of the symptoms. Patients were also evaluated with the Brief Psychiatric Rating Scale (BPRS), Auditory Hallucination Rating Scale (AHRS), and Birchwood Insight Scale (BIS). The psychometric properties of the SAVH were assessed by the face, internal consistency, construct, convergent and discriminant validities. RESULTS: SAVH scores were used to examine the psychometric properties. Cronbach's α and Guttman's Lambda-6 were 0.67 and 0.73 respectively. Significant correlations were observed between SAVH and AHRS total scores, as well as BPRS hallucinatory behavior subscores. No significant correlations were found between total SAVH scores and (i) levels of insight or (ii) negative BPRS subscores. Factor analysis on SAVH revealed three factors accounting for 59.3 % of the variance. Most patients found the questions clear, appropriate, and of adequate length. CONCLUSIONS: SAVH demonstrated good psychometric properties, suggesting its utility in assessing auditory verbal hallucinations (AVH). This self-assessment could be valuable in evaluating AVH treatment efficacy, monitoring AVH, and empowering patients.

Biopsychosocial complexity in patients scheduled for elective TKA surgery: A feasibility pilot study with the INTERMED self-assessment questionnaire.

OBJECTIVE: Primary aim; to determine the feasibility of implementation of the INTERMED Self-Assessment (IM-SA) in adult patients scheduled for total knee arthroplasty (TKA). Secondary aim; to measure biopsychosocial complexity, referral to psychiatry or psychology in cases of complexity and to gain insight into the relation between biopsychosocial complexity and length of stay (LOS), method of discharge (MOD) and polypharmacy. METHODS: A feasibility study was conducted with 76 participants in a general hospital in the Netherlands. Feasibility was determined by the number of completed questionnaires, time spent completing the questionnaire and the attitude of staff and patients towards the IM-SA. A cut off point ≥19 on the IM-SA was used to determine the prevalence of biopsychosocial complexity. A case file study was performed to check if referral to psychiatry or psychology had taken place. The Spearman's Rank Correlation Coefficient or Phi was used to determine if there was a relation between biopsychosocial complexity and LOS, MOD and polypharmacy. RESULTS: All participants completed the IM-SA. The average time spent completing the questionnaire was 11.46 min (SD 5.74). The attitude towards the IM-SA was positive. The prevalence of biopsychosocial complexity was 11.84%. Referral to psychiatry or psychology did not take place. There was no relation between complexity and LOS (Spearman's rho (r) = 0.079, p = 0.499, MOD (Phi = 0.169, p = 0.173) and polypharmacy (Phi = 0.007, p = 0.953). CONCLUSION: Biopsychosocial complexity can be identified in TKA patients during the pre-operative phase by using the IM-SA. Implementation of the IM-SA in a Dutch general hospital is feasible.

Voice self-assessment in individuals with Parkinson's Disease as compared to general voice disorders.

BACKGROUND: Individuals with Parkinson's Disease (IwPD) often fail to adjust their voice in different situations, without awareness of this limitation. Clinicians use self-report questionnaires that are typically designed for individuals with General Voice Disorders (GVD) in the vocal assessment of IwPD. However, these instruments may not consider that IwPD have a reduced self-perception of their vocal deficits. This study aimed to compare self-reported vocal symptoms and voice loudness between IwPD and GVD. METHODS: 28 IwPD and 26 with GVD completed the Voice Symptom Scale (VoiSS) questionnaire to evaluate their voice self-perception. Vocal loudness (dB) was also assessed. Univariate and multivariate analyses were used to compare the outcomes from these measures between the two groups. Principal Component Analysis and Hierarchical Clustering Analysis were applied to explore data patterns related to voice symptoms. RESULTS: IwPD reported significantly fewer vocal symptoms than those with GVD in all VoiSS questionnaire domains. Multivariate principal component analysis found no significant correlations between VoiSS scores and participant similarities in voice measures. Despite experiencing hypophonia, IwPD scored lower in all VoiSS domains but still fell in the healthy voice range. Hierarchical Clustering Analysis grouped participants into three distinct categories, primarily based on age, vocal loudness, and VoiSS domain scores, distinguishing between PD and GVD individuals. CONCLUSIONS: IwPD reported fewer vocal symptoms than GVD. The voice self-assessment seems to be unreliable to assess vocal symptoms in IwPD, at least regarding loudness. New self-report instruments tailored to PD individuals are needed due to their particular voice characteristics.

Reliability, validity and acceptability of an online clinical reasoning simulator for medical students: An international pilot.

INTRODUCTION: Clinical reasoning skills are essential for decision-making. Current assessment methods are limited when testing clinical reasoning and management of uncertainty. This study evaluates the reliability, validity and acceptability of Practicum Script, an online simulation-based programme, for developing medical students' clinical reasoning skills using real-life cases. METHODS: In 2020, we conducted an international, multicentre pilot study using 20 clinical cases with 2457 final-year medical students from 21 schools worldwide. Psychometric analysis was performed (n = 1502 students completing at least 80% of cases). Classical estimates of reliability for three test domains (hypothesis generation, hypothesis argumentation and knowledge application) were calculated using Cronbach's alpha and McDonald's omega coefficients. Validity evidence was obtained by confirmatory factor analysis (CFA) and measurement alignment (MA). Items from the knowledge application domain were analysed using cognitive diagnostic modelling (CDM). Acceptability was evaluated by an anonymous student survey. RESULTS: Reliability estimates were high with narrow confidence intervals. CFA revealed acceptable goodness-of-fit indices for the proposed three-factor model. CDM analysis demonstrated good absolute test fit and high classification accuracy estimates. Student survey responses showed high levels of acceptability. CONCLUSION: Our findings suggest that Practicum Script is a useful resource for strengthening students' clinical reasoning skills and ability to manage uncertainty.

Development of a Voice Handicap Index for Clergymen: An Investigation of Its Validation and Reliability.

OBJECTIVE: This study aims to is to develop a disorder-specific patient-reported outcome measure to be used in Islamic clergymen with voice disorders and to investigate its validity and reliability. METHODS AND PROCEDURES: Employing an exploratory sequential mixed-methods design, this study conducted in two phases. Initially, semistructured interviews were conducted with 10 clergymen experiencing voice disorders. Subsequently, the questionnaire underwent rigorous validation, encompassing content, construct, and criterion validity assessments, in addition to test-retest reliability and internal consistency analyses. The index was administered to a sample of 110 male clergy, including imams, muezzins, and Quran course teachers, with an age range from 19 to 61years. RESULTS: Construct validity was established through factor analysis, resulting in a final 23-item scale categorized into two factors: physical-functional and emotional. Known group validity demonstrated a significant distinction between the study and control groups. Criterion validity reinforced the index's validity, displaying a correlation coefficient of 0.758 between the Voice Handicap Index for Clergymen and the well-established Voice Handicap Index. The questionnaire exhibited commendable internal consistency, with a Cronbach's Alpha (α) coefficient value of 0.971. Test-retest reliability analysis exhibited strong consistency, with a Pearson correlation coefficient of 0.863. CONCLUSIONS: It is recommended that the developed valid and reliable handicap index in the present study be included in the voice assessment batteries of Islamic clergymen with voice complaints with the clinical and research purposes. In future studies, the validity of the questionnaire can be investigated more by examining the difference between the Voice Handicap Index for Islamic Clergymen (CVHI) scores obtained before and after treatment. Identifying a cut-off point that discriminates between dysphonic and normophonic clergymen may allow the use of the CVHI as a screening tool for this population.

Do You See What I See? A Comparison of CCC and Self-Assigned Milestones Across Military Medical Specialties.

BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to complete competency-based assessments of medical trainees based on nationally established Milestones. Previous research demonstrates a strong correlation between CCC and resident scores on the Milestones in surgery, but little is known if this is true between specialties. In this study, we investigated a variety of specialties and sought to determine what factors affect self-assessment of milestones. In addition, a post-hoc analysis was completed on the COVID-19 pandemic effects on self-evaluation. METHODS: This is an IRB approved observational study on prospectively collected self-evaluation milestone data that is used within each ACGME program's Clinical Competency Committees. Medical trainees within the San Antonio Uniformed Services Health Education Consortium were approached for possible participation in this study with permission from program directors. RESULTS: There was no significant difference between self-assessments and CCC-assessments based on self-identified gender or residency type (surgical versus nonsurgical) for any milestone domain. Within the postgraduate year (PGY) groups, the PGY5 and PGY6 tended to rate themselves higher than CCC. Chiefs (Internal Medicine PGY2/3, and General Surgery PGY5/6) tended to be more accurate in scoring themselves than the interns (PGY1) within the milestone of Interpersonal Skills and Communication (chiefs 0.5 vs. interns 0.62, p = 0.03). On post hoc analysis of self-rating, during the first wave of the COVID 19 pandemic, Post-Covid residents were more likely to underrate themselves in Systems-Based Practice compared to the Pre-Covid cohort (-0.49 vs 0.10; p = 0.007) and more likely to rate themselves higher in Professionalism (-0.54 vs. -0.10, p = 0.012). CONCLUSION: Unique to this study and our institution, there was no gender difference found in self vs CCC evaluations. With the change in learning environment from COVID, there was also a change in ability for some learners to self-assess accurately. As medical educators, we should understand the importance of both encouraging learners to practice self-assessment as well as give feedback to trainees on their progress. We also need to educate our faculty on the use of milestones for assessment to create a true gold standard in the CCC.

Multilevel analysis of positive emotional induction: Which is the role of gender and valence on cognitive control processes?

How emotions are processed affects people's cognition and behavior. One of the most used measures to study the physiological component of emotions is heart rate (HR), where greater HR variation (range) implies greater emotional processing. Several investigations established the importance of gender modulation of these processes due to the different cultural treatment given to emotions among genders. However, very heterogeneous results are reported today, and few studies incorporated these parameters when investigating emotion modulation of cognitive processes according to individual factors. The present work consists of two studies. In a pilot study, 97 young adults, through the Self-Assessment Manikin (SAM), ranged the valence and arousal to select two positive and neutral videos. The second study analyses the role of gender and valence in the variation of subjective (SAM) and physiological (HR) indicators of emotional processing associated with performance in two cognitive tasks (Stroop and Tower of London) under two different emotional conditions. Participants were 60 adults, who were randomly assigned to positive or neutral video visualization, and their HR was registered. There was a tendency for women to have higher HR during positive videos than in neutral. While the subjective reports indicated variances in the appraisal of the videos, the heart rate did not exhibit differences across the experimental conditions. Few studies integrate emotional and cognitive components, and include physiological and subjective measures of emotional processing. These findings illustrate the importance of including various measures of emotional and cognitive processing.

Relationship between oral health and depression: data from the National Health Survey 2016-2017.

OBJECTIVE: To evaluate the relationship between oral health status, self-perception of oral health, and depression. METHODS: This cross-sectional study included 2953 individuals that were ≥ 18 years of age and participated in the Chilean National Health Survey (NHS), 2016-2017. Information on oral, dental, and mental health, and the presence or absence of depressive symptoms was collected. Secondary data analysis was carried out using STATA and included logistic regression models adjusted for sex, age, and educational level. The analyses factored in the expansion weights to estimate representative prevalences of the entire population. RESULTS: Participants experiencing frequent dental or prosthesis-related discomfort while speaking (OR: 1.57; 95% CI: 1.01-2.43) were related with exhibiting suspected depression. Removable upper denture users were at a higher risk of exhibiting suspected (OR: 2.04; 95% CI: 1.11-3.74) than those not using them. Participants diagnosed with depression in the past 12 months had a similar number of teeth (median = 24) compared to those without depression (median = 25) (OR: 0.99; 95% CI: 0.96-1.02). CONCLUSION: Experiencing dental or prosthesis-related difficulties in speaking is related to suspected depression or a diagnosis of depression. These findings highlight the importance of developing comprehensive healthcare approaches that consider mental health in the context of oral health.

Real world fracture prediction of fracture risk assessment tool (FRAX), osteoporosis self-assessment tool for Asians (OSTA) and one-minute osteoporosis risk test: An 11-year longitudinal study.

Introduction: Fractures affect people's quality of life especially in the elders. One of the most important risk factors is osteoporosis. There are many screening tools to predict osteoporosis and fractures. We aimed to compare the predictive validity of three commonly used screening tools: fracture risk assessment tool (FRAX), osteoporosis self-assessment tool for Asians (OSTA) and one-minute osteoporosis risk test. Among them, OSTA and one-minute osteoporosis risk test were originally developed to predict osteoporosis risks and FRAX was to predict fracture risks. Methods: This is an 11-year longitudinal study. We enrolled 708 senior people from health examinees in Taiwan in 2010. A standardized questionnaire and blood tests were provided. Annual telephone interview was conducted to assess the real fracture status. We calculated risk scores of FRAX, OSTA, and one-minute osteoporosis risk test and compared with real-world fracture records. Results: The mean age of the participants were 74.9 (SD 6.4). There were 356 (50.3 %) men. From 2010 to 2020, a total of 105 (14.8 %) persons suffered from fractures. Compared to people without fractures, people with fractures had higher FRAX major osteoporotic fracture risk scores (14.0 % ± 7.6 % vs.11.3 % ± 5.7 %), higher hip fracture risk scores, and higher OSTA risk (5.9 % ± 1.4 % vs. 5.3 % ± 1.3 %). Cox regression analysis showed that hazard ratios for fracture of high FRAX risk was 1.53 (95 % confidence interval (CI) 1.05-2.21), and for high OSTA risk was 1.37 (95 % CI 1.04-1.82). Conclusions: Only OSTA and FRAX scores were satisfactory in predicting 10-year fractures.

Nurses retrospective view on nursing education: A repeated cross-sectional study over three decades.

Background: As the healthcare landscape undergoes transformative shifts due to factors like ageing demographics, technological innovations, rapid global dissemination of infectious diseases, and imperatives for accessible, cost-effective care, a pressing need emerges for the contemporisation of nursing education. Notably, there is a paucity of research delving into nurses' introspective evaluations of their educational experiences after their immersion in professional settings. Objective: This study aimed to examine nurses' evaluations of their educational background over 30 years and identify relationships between their assessments and their demographic. Design: The study embraced a recurrent cross-sectional survey methodology, encompassing three distinct quantitative cross-sectional evaluations conducted in the years 1999, 2009, and 2021. Context/participants: The cohort for this inquiry consisted of nurses stationed in Estonian general hospitals and inpatient departments of developmental plan institutions, each with at least one year of professional experience. Cumulatively, 832 nurses were engaged across three sequential evaluations: Study I (n = 463), Study II (n = 198), and Study III (n = 171). Methods: Data procurement was executed via a structured survey, with subsequent analytical procedures encompassing descriptive and correlational methodologies. Results: A discernible augmentation in the educational calibre of nurses was observed with each successive evaluation. This escalation concomitated enhanced positive assessments in areas like evidence-informed education, skill development, and autonomous operational capabilities. Yet, a critical appraisal persisted concerning their competencies in navigating complex patient interactions and addressing socio-religious dilemmas. Conclusions: The merit of this investigation lies in its illumination of nursing education's evolution, as perceived retrospectively by nurses who have operationalized their academic learnings in real-world scenarios. Their vantage point, inherently informed by practice, uniquely positions them to earmark avenues of refinement. This exploration paves the way for enrichments in nursing education, spotlighting the imperative of equipping nurses to adeptly manage intricate situations.

Special Education Teachers' Self-Assessed Voice Health Regarding Voice Use Habits.

OBJECTIVES: Special education teachers (SETs) work with students with disabilities. To get and keep these students' attention during the lesson, they may use their voices with high loudness and frequent pitch changes. These situations can be tiring for their voices and affect their vocal health. This study aimed to compare SETs' voice fatigue, reflux symptoms, and self-assessments according to their voice use habits in their work and social lives. METHODS: A total of 208 SETs were included. A Teacher Voice Use Habits Questionnaire was developed by considering the literature, taking expert opinion, and conducting a pilot study. In addition, the Vocal Fatigue Index (VFI), Voice Handicap Index-30 (VHI-30), and Reflux Symptom Index (RSI) were used. One-way ANOVA, Mann-Whitney U, Kruskal Wallis-H, and Pearson correlation analyses were performed. RESULTS: Of SETs, 37.5% reported frequent hoarseness, and 65.4% reported voice fatigue during/at the end of the day. Those who answered "yes" to the questions about talking loudly at home, having the television on at home, feeling stressed in the work environment, eating and drinking before going to bed at night, smoking, having frequent colds, talking loudly during the day, and voice fatigue during/at the end of the day had significantly higher scores in all scales. Those who used their voice for more than 6hours were found to have significantly higher scores on the VFI and RSI. In all scales, the scores of those who made very frequent long phone calls were significantly higher. CONCLUSION: According to the SETs' reports, it was concluded that they did not comply with the rules of vocal hygiene, although they used their voices for a long time. This situation should be considered an occupational health problem in schools, and it may be helpful to screen this group's voice disorders and design preventive programs.

Assessing learning gains of pharmacy students in communications, ways of thinking, and intercultural skills through self-assessment.

BACKGROUND AND PURPOSE: Intercultural and Global Health Issues was developed to address learning outcomes in communication, ways of thinking, intercultural personal skills, and intercultural knowledge. The aim of this study was to assess learning gains of pharmacy students through self-assessment. EDUCATIONAL ACTIVITY AND SETTING: Course design, learning outcomes, objectives, and activities were created to meet the expected educational outcomes. A revised rubric was created from the American Association of Colleges and Universities (AACU) Valid Assessment of Learning in Undergraduate Education rubrics on Intercultural knowledge, Information literacy, and Creative thinking. Students completed self-assessments at the beginning and end of the course. Ward hierarchical clustering, paired sample t-tests, and independent t-tests analyzed multidimensional data in two clusters. FINDINGS: Cluster 1 (C1) students reported pre-course capstone performances for cultural self-awareness, problem solving, and access and use of information ethically and legally. Post-course scores for C1 students statistically increased for all AACU domains reaching capstone performances for intercultural competence, creative thinking, and information literacy. Cluster 2 (C2) students reported capstone performance levels for all AACU domains from the beginning to the end of the course. All students reported achievement of self-efficacy, creative thinking, and cultural competency at the end of the course. There was no statistically significant difference in course learning outcome scores for C1 and C2 students. SUMMARY: Students achieved embedded learning outcomes of ways of thinking, communication, interpersonal skills, and intercultural knowledge as demonstrated from self-assessments. Course activities aided students' demonstration of self-efficacy, creative thinking, and intercultural knowledge.