Behavior change due to COVID-19 among dental academics-The theory of planned behavior: Stresses, worries, training, and pandemic severity

Effect of stressors during COVID-19 lockdown on malnutrition and health-risk behaviors among Jordanian college students: A cross-sectional study

A stressful condition such as the emergence of the coronavirus and its related lockdown measures might trigger alterations in college students' behaviors. This cross-sectional study aimed to identify the changes in college students' dietary and lifestyle behaviors during the lockdown and the effect of lockdown-related stressors on health-risk behaviors. A web-based survey was conducted among undergraduate college students in Jordan. Weight and height were reported by the students. The students' dietary and lifestyle behaviors and their changes during 1 month of the countrywide lockdown were assessed. The Perceived Stress Scale-4 was utilized to assess stress levels. Results indicated that 77.2% of the students reported weight changes. Notably, 45.9% increased their intake of unhealthy food, while and 38% opted for healthier food choices. Most students experienced alterations in physical activity (80.0%), screen time (86.2%), smoking, and sleep patterns (85.4%), with a higher tendency toward adopting health-risk behaviors. Perceptions of curfew-related stress were associated with distance learning-related stress (OR = 2.73, CI: 1.08-6.90, P = .034), and a greater change in physical activity (OR = 3.59, CI: 1.36-9.48, P = .010). Additionally, weight changes were associated with perception of other types of stressors (OR = 3.39, CI: 1.39-8.28, P = .007). Overall, there was a considerable increase in malnutrition and health-risk behaviors among students during the lockdown. Understanding students' responses to these stressful conditions and the role of stress in driving behavioral changes are crucial for developing interventions that enhance college students' adaptation to such changes and maintaining healthy dietary and lifestyle behaviors in the future.

Evaluation of Burnout among Medical Officers and Dental Surgeons in State Health Services using Maslach's Burnout Inventory during COVID-19: A Cross Sectional Study

Introduction

The Coronavirus disease 2019 (COVID-19) pandemic became a worldwide public health crisis. It leads to raised levels of burnout and anxiety among the people of the medical and dental fraternity, especially those involved in various duties related to COVID-19. The present research focused on evaluating the prevalence and predictors of burnout among medical officers and dental surgeons in Haryana's state dental health services.

Materials and Methods

A cross-sectional study was conducted to assess burnout among medical officers and dental surgeons involved in COVID-19-related duties in state health services. Maslach's burnout scale was used to evaluate burnout. It is a prevalidated and self-administered questionnaire with three domains, that is, emotional exhaustion (EE), personal accomplishment (PA) assessment, and depersonalization (DP). The Chi square test, Student's t test (unpaired), and analysis of variance (ANOVA) with post hoc analysis were done wherever applicable. Pearson's correlation analysis was used to check the relationship among EE, DP, and PA.

Results

A total of 200 study participants responded to the online survey. Nearly half of them (51%) were aged 25-34 years. The majority had service experience of up to 20 years (90%). Almost three-fourths (72%) of study participants performed duties for >8 h a day. Up to 86% reported that the second wave of COVID-19 caused increased burnout. Moderate-to-high degrees of occupational exhaustion (OE) and DP were reported among approximately 42% of study participants. Medical officers were reported to have statistically significantly higher levels of burnout compared to dental surgeons (P < 0.05).

Conclusion

Moderate levels of burnout were reported among half of the study participants, suggestive of the need to address the issues related to mental health of healthcare providers.

One year of COVID-19 in dental health services in Norway: psychological impact, risk perceptions and vaccination status

BACKGROUND

Increased psychological pressure on oral healthcare professionals (OHP) due to COVID-19 has been shown, yet little is known about the long-term psychological impacts. We aimed to study the psychological impact of COVID-19 and associated factors including perceived risk and preparedness and vaccination status among OHP in the first year after the lockdown period in Norway.

METHODS

A structured questionnaire sent electronically to dentists, dental hygienists and dental assistants inquired experiences and perceptions during the second year following the outbreak in Norway. The questionnaire comprised a COVID-19 fear scale and questions about risk perception, preparedness and vaccination status. Exploratory factor analysis (EFA) and Structural Equation Modeling (SEM) were used to assess psychological impact, perception of risk and preparedness according to vaccination status of the respondents.

RESULTS

The majority of the 708 respondents were female (92.8%), had ten or more years of work experience (67.1%), and worked in public dental clinics (95.9%). Fears and concerns related to COVID-19 were common, 72.6% feared getting infected and 85.4% feared infecting others. Of the 642 respondents who agreed that their workplaces handled the situation well, 55.6% were fully vaccinated. Three factors were retrieved from EFA: Insecurity, Instability and Infection. SEM showed that females were more concerned with Infection, and respondents with long clinical experience were less likely to express fear about Instability. Fully vaccinated individuals felt more insecure about becoming infected, and those agreeing that their workplaces handled the current situation well were concerned with Insecurity.

CONCLUSIONS

Despite widespread perception of adequate preparedness and high vaccine coverage, a considerable psychological impact and high levels of fear of COVID-19 were observed among the majority of OHP. Fully vaccinated individuals had a larger psychological burden than not fully vaccinated and those with unknown vaccination status. These findings can inform means and interventions to reduce negative impacts of fear in populations with a high psychological burden.

Hall technique versus conventional preformed metal crowns: can paediatric dentists tell the difference on radiographs?

PURPOSE

Hall technique (HT) preformed metal crowns (PMCs) are allegedly oversized compared to conventional (C) PMCs. To investigate paediatric dentists' (PDs) perception of HT-PMCs and perception/ability to identify HT or C-PMCs on bitewings radiographs.

METHODS

An online cross-sectional questionnaire including ten bitewings (five of each of HT/CPMCs) was sent to PDs across the globe. A PMC type score (from '10') was calculated. T test, Pearson's and Fischer's Chi-square, and Odd Ratios (OR) (p < 0.05).

RESULTS

A total of 476 PDs from around the world responded. Most (97%) used PMCs in their practice. Most (98.7%) knew of, and 79% used HT-PMCs. A clear opinion shift, towards supporting HT, over time was noted (OR 11.154 [95% confidence interval (CI) 6.006-20.715]. A majority (67%) thought that HT/C-PMCs were similar radiographically. Only five PMCs were identified correctly [mean score 4.9 (± 1.73)]. A minority who thought that HT/C-PMCs were dissimilar scored higher than those who thought they were similar (5.31 ± 1.22; 4.68 ± 1.9, respectively, p < 0.00001). Nobody identified all ten PMCs. HT-PMCs were 4.63 times more identifiable than C-PMCs [(OR 24.857 CI 15.059-41.028) and (OR 5.361 CI 3.089-9.304)] for HT-PMCs and CP-MCs, respectively (p < 0.0001).

CONCLUSIONS

PDs identified the PMC type in half of the bitewings. They perceived no clear radiographic difference between HT-PMCs and C-PMCs, but their chance of recognizing HT-PMCs was five times higher than C-PMCs. HT-PMC support was high.

Perceived academic stress during a pandemic: Mediating role of coping strategies

COVID-19 rampant has impacted almost all sections of society, and the repercussions were mostly negative experiences for people and have resulted by way of disruption in their daily routines. Academics is one such vital section that has suffered directly because of the inaccessibility of a comfortable educational procedure. Due to a shift in the form of education, most of the student community failed to obtain routine and regular education as the government entirely shuttered educational facilities to limit the spread of disease. In this light, this research attempted to examine the amount of academic stress experienced by students during the COVID-19 Pandemic and the strategies they have adopted to cope with this unheard type of uncertain situation. The findings of the study indicated substantial variations in Academic Stress, Exam Anxiety, and Coping Strategies across various demographic characteristics of the respondents. Another significant finding is that students from poor socio-economic backgrounds and those seeking post-graduate courses are more stressed. As an inference, it is also opined that to mitigate the impact of the COVID-19 crisis on student performance and psychological well-being, special focus, or techniques for accommodating exam environments by the student should be implemented. To minimize stress, the study also proposed efficient coping techniques to lower the amount of stress in various academic tasks.

Knowledge, Attitudes, and Perception as Predictors of COVID-19 Safety Practices of Ride-Hailing Operators in Ghana: A Cross-Sectional Study

Since its outbreak, health authorities have launched vigorous COVID-19 health promotion campaigns. This study assesses ride-hailing operators' COVID-19 knowledge, attitudes, and practices in Ghana, with the aim of engendering precautionary behaviour among the populace. A complementary mixed methods approach was adopted. This involved a cross-sectional survey of 1014 participants who were also allowed to share their COVID-19-related lived experiences qualitatively after successfully completing the survey. The aggregate correct knowledge score was 84%. Most respondents were frightful of the virus (96%), but the majority had faith in the COVID-19 protocols (87%). Thus, most participants reported high use of face masks (95%) and practise personal hygiene (92%). However, social media misinformation and the subsequent complacency have dissuaded some participants from complying with the safety protocols. The qualitative data also show evidence of high susceptibility to COVID-19. The perceived benefits of safe behaviour, including masking up, were equally high among drivers surveyed, albeit barriers to preventative behaviours remain rife. Therefore, this study emphasises the importance of sustaining and improving public awareness by highlighting the susceptibility of all demographic groups to the virus and the need to counteract misinformation on social media.

The Role of Social Media in Communication and Learning at the Time of COVID-19 Lockdown-An Online Survey

This study aimed to assess orthodontic postgraduate students' use of social media during the COVID-19 lockdown. Ninety-four postgraduate students (67 master's students and 27 doctoral students) were enrolled in the study and asked to fill in an online questionnaire by answering questions regarding their use of social media during the COVID-19 lockdown. The frequency distributions and percentages were calculated using SPSS software. The results showed that 99% of the students used social media. The most frequently used type of social media was Facebook, 94%, followed by YouTube, 78%, and Instagram, 65%, while Twitter and Linkedin were used less, and no one used Blogger. About 63% of the students used elements of social media to learn more about orthodontics staging, biomechanics, and various approaches in managing orthodontic cases. About 56% of students tried uploading and downloading scientific papers, lectures, movies, presentations, and e-books from social media, while communication with professionals and searches about orthodontic products were reported in 47% of students' responses. On the other hand, 43% of the responses favored sharing orthodontic information and posts for teaching and discussion purposes. Generally, social media plays leading roles in the communication with, learning of, sharing of information with, and supervision of patients from a far during the COVID-19 lockdown.

Social workers' adaptation in times of pandemic crisis: A Hong Kong case

Through the lens of the theory of planned behavior, this article explores how social workers adapt to a new situation due to the outbreak of the COVID-19 pandemic. Three focus group sessions were conducted with 23 social workers from child and youth, family, and elderly services in Hong Kong. Three major themes were generated: (1) repositioning the social work profession, (2) renegotiating contracts with funders, and (3) exploring novel intervention methods. Implications of the findings are discussed. To ensure social workers can respond effectively in crises, an evolving nature of the profession is advocated to enshrine its spirit to serve.

Impact of mental health, job insecurity, and COVID-19 symptoms on protective behavior changes among White, Black, and other minorities in the US

INTRODUCTION

Job insecurity such as loss of jobs or reduced wages has become a serious social problem in the US since COVID-19 started. Combined with psychological distress and experience of COVID-19 symptoms, the changes of people's protective behaviors vary across states in the US.

METHODS

This research investigated racial differences in the COVID-19 related factors among White, Black, and other minorities in the US, and examined how mental health mediated the impact of job insecurity on protective behaviors, and how the COVID-19 symptoms moderated the mediation effect of mental health. The 731 valid responses in a cross-sectional survey from May 23 to 27, 2020, in the US were analyzed with independent sample t-tests, Pearson's chi-square tests, and path analysis.

RESULTS

The findings showed that there were significant differences in job insecurity and Nonpharmaceutical Interventions (NPIs) practice among White, Black, and other minorities. Job insecurity was significantly negatively associated with NPIs practice and was significantly positively associated with mental health. Mental health significantly partially mediated the effect of job insecurity on NPIs practice, in that job insecurity is a better predictor of NPIs practice for individuals with worse mental health than that for individuals with better mental health. Experience of COVID-19 symptoms moderates the mediation effect of mental health on the relationship between job insecurity and NPIs practice, in that mental health is a better predictor of NPIs practice for individuals with a higher experience of COVID-19 symptoms than for individuals with a lower experience of COVID-19 symptoms.

DISCUSSION

The findings in this study shed lights on psychological and behavioral studies of people's behavior changes during a pandemic. The study indicates the importance of treating mental health to promote protective behaviors during a pandemic, as well as advocating for employees by identifying the needs for those whose jobs were negatively impacted the most.

The matching effect in persuasive communication about lockdown

Scientific literature about persuasion has shown that the effectiveness of persuasive communication may depend on the match between the affective or cognitive contents of the message and the affective [(Need for Affect (NFA)] or cognitive [Need for Cognition (NFC)] orientation of the recipient. The present work aims to contribute to studying this effect by considering the context of health-related communication during the SARS-CoV-2 infection. Specifically, we aim to demonstrate that, when the message is characterized by affective and cognitive contents having the same (congruent message) or different valence (incongruent message), the attitude toward the target (i.e., a new lockdown) will be guided by the valence of the contents matching the individual affective/cognitive orientation. A total of 1,003 participants took part in a 2 (Cognitive content message: Positive vs. Negative) × 2 (Affective content message: Positive vs. Negative) factorial design and answered an online questionnaire. Results show that people with high levels of NFA and low levels of NFC report attitudes toward lockdown consistent with the valence of the affective contents. Conversely, attitudes of people with high levels of NFC and low levels of NFA were not influenced by contents that matched their orientation (i.e., cognitive).

Education during the COVID-19 pandemic: the perception of Italian dental and medical students

BACKGROUND

During COVID-19 pandemic many dental and medical students continued their education from home. From several studies it emerges that students prefer face-to-face teaching, due to the better interaction with teachers, the least number of distractions and due to the negative effect of social isolation on the psychological aspect. The aim of this study was to evaluate the perception of Italian dentistry and medicine students about teaching and training in this scenario.

METHODS

Two online questionnaires were sent to medical and dental students of all Italian universities to investigate the limits and advantages of distance learning and the experience regarding the internship. A chi-square test was used to assess the association between gender, year of the course and region of residence (P<0.05).

RESULTS

One thousand one hundred thirty-eight students answered the first survey, and 292 the second one. Most students preferred face-to-face teaching due to the difficult to maintain attention during online lessons. Many students reported that the online internship was not adequate for their education.

CONCLUSIONS

Distance learning disadvantages are the greater number of sources of distraction, low level of interaction, and absence of the relationship with the patient during the practical training. Furthermore, isolation has strongly affected psychosocial balance of the students. The advantages are the greater comfort, the reduction of transport costs, the decrease in pollution, and the possibility of reviewing the lessons. Most Italian students considered appropriate to provide distance learning during the pandemic but believed that the best teaching method was teaching in presence.

Cross-cultural validation of the Worries about COVID-19 and its consequences Scale (W-COV) in adolescents and young people

The pandemic context presents remarkable psychological challenges for adolescents and young adults. The aim of the present work was to construct and study the psychometric properties of a scale in Spanish language (W-COV) to measure their worries related to the pandemic. Participants were 5559 people aged between 14 and 25 years old (M = 19.05; SD = 3.28). Self-report data were collected using a cross-sectional and cross-cultural design. Participants were from 5 Spanish-speaking countries. Instruments were W-COV to assess worries about COVID-19 and its consequences; DASS-21 for anxiety, depression and stress; and SWLS for life satisfaction. Exploratory, confirmatory and multi-group factor analyses were conducted to determine the factorial structure of the W-COV and its measurement invariance (configural, metric, scalar and error variance). Correlational and regression analyses were also performed to study convergent and predictive validity. The results suggest that W-COV presents a bifactorial structure: (1) a general factor of worries about COVID-19; and (2) three different factors: worries about health, economic and psychosocial consequences from COVID-19. The internal reliability indices Cronbach's α and Omega were adequate. With respect to the invariance results, the instrument can be used interchangeably in the five countries considered, in both genders and in two different age groups (12-17 and 18-25). Regarding validity, W-COV factors were positively associated with anxiety, depression and stress, and negatively predicted life satisfaction. In conclusion, W-COV is a reliable and valid instrument for researchers and health care professionals to assess the psychological impact of the pandemic on mental health of young Ibero-Americans.

Patient Safety Culture in Dentistry Analysis Using the Safety Attitude Questionnaire in DKI Jakarta, Indonesia: A Cross-Cultural Adaptation and Validation Study

OBJECTIVES

This study aimed to analyze a cross-cultural adaptation of the Safety Attitude Questionnaire (SAQ) for Indonesian dentists.

METHODS

A cross-sectional study was conducted on 250 general dentists in health services in Jakarta, Indonesia. The first step included cultural adaptation and translation, which was followed by the development of the tested questionnaire through expert agreement and by validity and reliability analysis using Spearman correlation coefficient, Cronbach α , and interclass correlation coefficient. The SAQ consisted of 30 items and 6 dimensions (safety climate, teamwork climate, job satisfaction, stress recognition, perception of management, and working conditions).Respondents were members of the Indonesian Dental Association who voluntarily filled out a Google-based questionnaire from September to October 2020.

RESULTS

A total of 250 respondents with a response rate of 16.4% demonstrated a total Cronbach α value of 0.897, whereas the value per item ranged from 0.890 to 0.905, which suggested an acceptable and good to very good internal consistency. The interclass correlation coefficient value varied from 0.840 to 1.000, which meant almost perfect agreement. The correlation coefficient of 30 questions items resulted in a total SAQ score ranging from 0.422 to 0.699 (moderate to strong correlation) and between 6 dimensions to total SAQ score ranging from 0.648 to 0.772 (strong correlation).

CONCLUSIONS

The Indonesian version of the SAQ exhibited good validity and very good reliability and potential to be used for evaluating dentists' patient safety culture in Indonesia.

The Impact of COVID-19 Pandemic on the Psychological Health and Dental Practice of Oral Healthcare Workers: A Scoping Review

This study aims to identify the impact of the COVID-19 pandemic on the psychological health and dental practice of oral health-care workers (OHCWs). The search for relevant literature was carried out online using PubMed, Web of science, and science direct databases from January 2020 to February 2021. Those articles were included that provided complete information about the impact of the COVID-19 pandemic on oral health-care workers during covid-19 and were original articles and reviews. Those articles were excluded from the current study that was not in English Language and involved case reports/book chapters/short communications. Finally, only 8 articles were selected for the scoping review considering that complete information regarding the provision of dental care in the time of COVID-19 was provided. Increased psychological distress (especially those with existing comorbidities) was noted among the OHCWs during this pandemic. They had enough knowledge about COVID-19 and showed concern regarding the future of dentistry. Either complete or partial closure of dental clinics had introduced financial constraints among them. However, the majority of them did not switch their profession. The institutions were not prepared for any such situation and no training was conducted to control the spread of COVID-19 infection. OHCWs are fully aware of the knowledge regarding COVID-19 and showed concerns for dentistry and dental health-care workers during this pandemic. Complete or partial closure of dental clinics has had adverse effects on the future of dentistry, economically as well as psychologically. Institutions need to upgrade and strengthen their systems to cater to any such situation efficiently. Proper counseling sessions should be conducted for the OHCWs to monitor, identify and treat the cases found.

Self-reported adaptability among postgraduate dental learners and their instructors: Accelerated change induced by COVID-19

It is forecasted that the skills and competencies necessary for post-pandemic success in higher education need to be founded upon adaptability, coping, and Self- Regulated Learning (SRL). It is worth investigating how stakeholders perceived their adaptability and coping with the accelerated change accompanying Coronavirus Disease of 2019 (COVID-19). Accordingly, the purpose of this study was to assess the self-reported adaptability of postgraduate dental learners and their instructors in the context of abrupt transition to distance learning induced by the pandemic. This study utilized a convergent mixed methods study design. The quantitative and qualitative data were concurrently collected from instructors and learners, using a tailor-made survey of items measured with a Likert-type scale, complemented with open-ended questions. The collected datasets were independently analyzed. Descriptive and inferential analysis were conducted using the quantitative data. Qualitatively, the researchers underwent a multi-staged thematic analysis. The generated information was then integrated using a joint model analysis. The percentage of the total average of self-reported adaptability for both groups of stakeholders was 81.15%. The instructors, with a mean of satisfaction of 17.94 (±1.76), rated their adaptability significantly higher than the learners, with a mean of satisfaction of 15.66 (±2.77) (p = 0.002). The thematic analysis resulted in two interrelated themes: Self and Environment. Within the Self theme, three subthemes surfaced: Cognitions, Emotions, and Behaviors. As for the Environment theme, it encapsulated two subthemes: Enablers and Impediments. The stakeholders perceived themselves to have adapted well to the transition, and SRL appeared as a cornerstone in the adaptation to the accelerated change accompanying COVID-19. There appeared to be an interplay between the cognitions, emotions, and behaviors on the level of the self as part of the adaptation process. Also, building upon existent models of SRL, this study uncovered that the stakeholders considered the environment to play a crucial role in their adaptation process. This highlights the importance of developing a climate that remains, despite external pressures, conducive to attaining learning and teaching goals. It is also crucial for university-level mental health promotion activities to proactively foster, among learners and instructors, adaptability, building 'academic resilience'.

Stress among dental students transitioning from remote learning to clinical training during coronavirus disease 2019 pandemic: A qualitative study

OBJECTIVES

To identify dental students' perceptions of stress over returning to in-person clinical training after remote learning required from the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

This was a qualitative observational study. The sample was composed of undergraduate students (n = 47) in the final year of São Paulo State University, School of Dentistry, Araraquara program. The data were collected using a questionnaire created in Google Forms. The data was analyzed using the discourse of the collective subject technique.

RESULTS

More than half of the students (63.8%) reported experiencing stress in the transition from remote learning to clinical training. According to the students, the main causes of this stress were fear of COVID-19 infection or contamination (31.5%) and insecurity in their clinical treatment skills after having gone so long without training (25.5%). Half of the students surveyed (51.1%) exhibited at least one stress-related symptom. For most of the students (70.2%), remote learning was insufficient to prepare them for returning to in-person clinical activities. Performing laboratory pre-clinical activities prior to clinical training was the suggestion most frequently cited by the students (25.5%), as a way to avoid some of the stress associated with their return to in-person learning. The main coping strategies adopted by the students upon their return to in-person learning were making the most of their clinical training, planning cases, and studying relevant topics before treating patients (48.9%).

CONCLUSION

The dental students perceived high levels of stress during the transition from remote learning to clinical training.

Burnout assessment among academic dental staff during COVID-19: Data from Arab countries

Purpose/objective

This study aimed to identify factors that were associated with high burnout and investigate the prevalence of burnout among academic dental staff during the COVID‐19 pandemic.

Method

A cross‐sectional online survey was carried out among academic dentists who are working in multiple dental schools in Arab countries. The Copenhagen Burnout Inventory was used to assess participants’ work‐related burnout. Logistic regression was used to assess the factors that increase the risk of burnout among academic dentists.

Results

Of the 254 participants who took part in the study, 141 were males (55.5%). The average age of the participants in the study was 42.1 years (standard deviation = 10.0). The prevalence of burnout among participants was 44.9% (n = 114). Using a fully adjusted logistic regression model, age (odds ratio [OR] = 1.05, 95% confidence interval [CI]: 1.01–1.09, p = 0.008) and gender (OR = 0.54, 95% CI: 0.31–0.94, p = 0.03) were significant variables associated with high overall burnout. Female individuals had a substantially reduced risk of experiencing high personal burnout than male participants (OR = 0.56, 95% CI: 0.32–0.98, p = 0.043) in the personal burnout subdomain. While in the patient's burnout subdomain, age (OR = 1.04, 95% CI: 1.00–1.08, p = 0.048), type of speciality (OR = 2.44, 95% CI: 1.02–5.83, p = 0.044), and teaching place (OR = 2.49, 95% CI: 1.21–5.11, p = 0.013) were associated with higher burnout.

Conclusion

This study concluded that gender and age are characteristics that increase the risk of higher burnout among academic dentists during the COVID‐19 pandemic.

Effect of COVID-19 on Dental Education: A Review

Corona Virus Disease (COVID-19) has become a pandemic and a real threat for those working in healthcare. It has affected dental professionals in education, research, and practice. This article intended to review the impact and brunt of COVID-19 outbreaks on dental education and research country wise and how it affected the three learning domains - cognitive domain, psychomotor domain and affective domain. A review was designed to identify the impact of the COVID-19 epidemic on dental education. A literature search was conducted using PubMed, Scopus and Google scholar databases. Studies in which teaching methods by virtual means were described and how it affected dental education during the pandemic all over the world were included. The search terms selected to search for literature were dental education, COVID-19, dental schools and dentistry. COVID-19 has caused a significant change in overall dental education in all the countries. It has affected dental education both negatively and positively. The pandemic caused disruption in learning leading to psychological distress. Even though many students preferred web-based learning, majority of them considered learning through online mode as a challenge. COVID-19 pandemic has enforced all the dental schools to modify their traditional way of teaching to an alternate mode of teaching to adapt to this current situation of the pandemic all over the world. It caused an everlasting impact on dental education, research along with practice. The dental institutes must be well prepared to face this pandemic by investing in educational software so that it leads to the evolution and advancement in the fields of virtual mode of teaching, in research and in preclinical training.

Effects of periodontal clinical database software in resident training during COVID-19 pandemic: a prospective observational study

BACKGROUND

Dental residents in Guangdong, China, had fewer medical practice opportunities because of the pandemic of COVID-19. This study aimed to evaluate whether a case-based learning (CBL) approach using a periodontal clinical database software (PCDS) could improve residents' achievement in the exam of the standardized residency training (SRT) program.

METHODS

Forty-four dental residents volunteered and completed this trial. Within 12 weeks, all residents admitted periodontal patients 5 days a week and participated in a case-based learning course using PCDS once a week. Two online case-based examinations were used to evaluate their diagnostic and therapeutic performance before and after training. The total accuracy rate of examinations and the accuracy rate of subitems were analyzed using paired samples T-test. The Bonferroni correction is used for multiple testing adjustments, and p < 0.05 was considered statistical significance.

RESULTS

After training, the total accuracy rate of SRT exams raised from 65 to 76%. There was a significant difference in the accuracy rate before and after training (Mean = 0.103, SD = 0.141, p < 0.001). The accuracy of radiographic examination (type of alveolar bone absorption and hard tissue lesion of tooth) and making treatment plan was significantly improved after training (p < 0.005). However, residents' performance in diagnosing periodontitis and predicting the prognosis of affected teeth was not improved.

CONCLUSIONS

The PCDS and CBL method effectively improved the residents' achievement in SRT examination, especially in identifying the type of resorption of alveolar bone and the hard tissue lesion of a tooth by radiographic examination and making an appropriate treatment plan for a periodontitis patient. More effective teaching approaches are needed to improve residents' accuracy of diagnosis of periodontitis using the 2018 classification in China.

Chronic Stress and Depression in Periodontitis and Peri-Implantitis: A Narrative Review on Neurobiological, Neurobehavioral and Immune-Microbiome Interplays and Clinical Management Implications

Besides the well-known systemic factors for periodontal and peri-implant diseases, additional co-factors, such as chronic stress and depression, may also affect disease onset and progression as well as treatment responsiveness. Neurobiological and neurobehavioral pathogenic links between chronic stress and depression, on the one side, and periodontitis and peri-implantitis, on the other side, which have been little investigated and principally related to necrotizing periodontal disease, have been reviewed, along with their putative interconnections with periodontal immune-microbiome balance. Rising evidence suggest that dysregulated neurobiological and neurobehavioral factors, as well as periodontal immune-microbiome unbalance, all related to chronic stress and depression, may crucially interact and thus represent contributing factors in the genesis and worsening not only of necrotizing periodontal lesions, but also of chronic periodontitis and peri-implantitis. Such potential interconnections may be even more relevant in recurrent and aggressive cases of periodontal and peri-implant disease, which are frequently refractory to therapy, and may, if corroborated, coherently pave the way for personalized prevention and treatment strategies, possibly targeting immune-microbiome unbalance and neurobehavioral factors and focusing on neurobiological ones, especially in chronically stressed and depressed subjects with periodontitis and peri-implantitis.

University Teachers During the First Lockdown Due to SARS-CoV-2 in Italy: Stress, Issues and Perceptions of Misconduct

With the spread of the pandemic and the introduction of measures aimed at its containment, it is necessary to understand in specific national contexts how home quarantine has affected the psychophysical well-being of academics, and their ability to maintain integrity. To this end we constructed an online questionnaire to investigate the levels of stress, well-being, and work-life balance in relationship with living and working conditions. Moreover, the questionnaire was designed to obtain information about the perceived occurrence, increase or decrease of misconduct in research (e.g., research misconduct by colleagues) and professional relationships (e.g., misbehaviors between colleagues, from students and toward students). The questionnaire was administered online by contacting faculty at three universities in Tuscany, Italy, asking them to relate their experience during the first lockdown (March-May 2020). Faculty members were invited to complete the questionnaire by their institutional e-mail account. The final sample consisted of 581 respondents. The results showed that inadequacies of the equipment, and particularly poor internet connection, were significantly correlated with main issues reported, such as relationships with students and research activities. Female teachers primarily suffered from stressful conditions, lacked well-being, and experienced work-life imbalance. Stress levels were related to perceptions of the frequency of misconduct and of an increase in their frequency during the period of home quarantine. Female professors, when compared to their male counterparts, perceived misconduct from students as increased and more frequent in the period of quarantine. Results point to a gender issue that is likely to arise from conditions of domestic activities imbalance and that increases stress and misconduct perception.

Brazilian dental students and COVID-19: A survey on knowledge and perceptions

OBJECTIVE

This study evaluated the knowledge and perceptions of Brazilian dental students about COVID-19 and the undergraduate clinical practice during the COVID-19 outbreak by a self-administered Web-based questionnaire.

METHODS

A social network campaign on Instagram was raised to approach the target population. The survey covered demographic and academic profile, general knowledge, preventive measures and perception about COVID-19. Descriptive statistics were used to identify frequencies and distributions of variables, which were compared by type of institution and current year of enrolment using the Chi-square or Fisher's exact tests (α = 0.05).

RESULTS

A total of 833 valid responses were received over 10 days. Students were able to identify the incubation period, main symptoms and contagious routes of the disease but struggled in recognising the name of the virus responsible for the pandemic. Hand washing before and after a dental appointment with a patient (97.7%) followed by the use of barriers to protect mucosa (97.2%) were the more frequently recognised measures to prevent COVID-19 spread in the dental office. As for the perception of COVID-19, 73.2% of the dental students perceived the disease as severe, whilst only 11.1% of them thought that COVID-19 is severe only for people presenting risk factors. Dental student's knowledge and perception were associated with the type of institution and year of enrolment.

CONCLUSION

In summary, the dental students demonstrated an acceptable general knowledge about COVID-19, but dental schools will need to address gaps in knowledge, preventive measures, and perceptions to ensure a safer return to in person activities.

The impact of the prolonged COVID-19 pandemic on stress resilience and mental health: A critical review across waves

The global public health crisis caused by COVID-19 has lasted longer than many of us would have hoped and expected. With its high uncertainty and limited control, the COVID-19 pandemic has undoubtedly asked a lot from all of us. One important central question is: how resilient have we proved in face of the unprecedented and prolonged coronavirus pandemic? There is a vast and rapidly growing literature that has examined the impact of the pandemic on mental health both on the shorter (2020) and longer (2021) term. This not only concerns pandemic-related effects on resilience in the general population, but also how the pandemic has challenged stress resilience and mental health outcomes across more specific vulnerable population groups: patients with a psychiatric disorder, COVID-19 diagnosed patients, health care workers, children and adolescents, pregnant women, and elderly people. It is challenging to keep up to date with, and interpret, this rapidly increasing scientific literature. In this review, we provide a critical overview on how the COVID-19 pandemic has impacted mental health and how human stress resilience has been shaped by the pandemic on the shorter and longer term. The vast literature is dominated by a wealth of data which are, however, not always of the highest quality and heavily depend on online and self-report surveys. Nevertheless, it appears that we have proven surprisingly resilient over time, with fast recovery from COVID-19 measures. Still, vulnerable groups such as adolescents and health care personnel that have been severely impacted by the COVID-19 pandemic do exist. Large interindividual differences exist, and for future pandemics there is a clear need to comprehensively and integratively assess resilience from the start to provide personalized help and interventions tailored to the specific needs for vulnerable groups.

Finding the positives from the COVID-19 pandemic: factors associated with posttraumatic growth among nurses in Hong Kong

BACKGROUND

Due to active involvement with patients for COVID-19 treatments, nurses are susceptible to adverse psychological outcomes amid the COVID-19 pandemic. Despite the distress, studies have suggested that nurses are able to experience positive changes (i.e. posttraumatic growth; PTG) during the pandemic. Research on other populations has also indicated that COVID-19-specific worries and work-related coping resources are associated with people's positive changes during the pandemic.

OBJECTIVE

This study examined how socio-demographic characteristics, COVID-19-related worries, and work-related variables (satisfaction with work and workplace pandemic guidelines) were associated with PTG among nurses in Hong Kong.

METHODS

Nurses (N = 1510) working in hospitals and community settings were recruited through nursing associations in Hong Kong between 8 August 2020 and 22 September 2020. They were invited to complete a cross-sectional survey measuring their sociodemographic characteristics, COVID-19 worries, and satisfaction with work and workplace pandemic-control measures.

RESULTS

Results from hierarchical regressions found that those working non-full-time (β = -0.06), affiliating with a religion (β = 0.24), having higher COVID-19-related worries and psychological distress (βs ranging from 0.12-0.15), and having higher work satisfaction (β = 0.14) were associated with higher PTG (ps < .05). Moreover, a significant interaction between psychological distress and satisfaction with workplace pandemic control guidelines emerged in explaining PTG (β = 0.08, p < .05), such that guideline satisfaction was only associated with higher PTG among those with higher distress (β = 0.09, p = .03), but not those with lower distress (β = -0.05, p > .05).

CONCLUSIONS

Nurses in Hong Kong did report positive changes amid the COVID-19 pandemic. Future studies could focus on the contributing factors of PTG to design for effective strategies to enhance resources for nurses to promote positive psychosocial outcomes.

COVID-19 Pandemic Driven Knowledge, Attitude, Clinical Practice, Distress Reactions, and Post-Traumatic Growth of Dental Care Providers in Riyadh City, Saudi Arabia: A Cross-Sectional Study

Objective:

The present study aimed to assess knowledge, attitude, clinical practices, distress reactions, and post-traumatic growth of dentists during the COVID-19 pandemic in Riyadh City.

Methodology:

An online questionnaire was developed to assess various dental professionals from both governmental and private sectors during the early COVID-19 outbreak in Riyadh City, Saudi Arabia. The questionnaire was framed to assess the demographic variables, knowledge, attitude, and clinical practices towards handling the COVID-19 pandemic. Furthermore, the general anxiety disorder-7 (GAD-7), worry questionnaire items, short form of post-traumatic growth inventory (PTGI-SF), and life satisfaction questionnaire items were developed to assess the anxiety, worries, post-traumatic growth, and life satisfaction of dental care providers following the traumatic events. Data were analysed using SPSS 22.0 and R environment ver.3.2.2. Continuous measurement results were presented as mean ± SD, and categorical measurements results were presented in number (%).

Results:

Our study's significant findings revealed that a majority of the dentists were in the age group of 21-30 and practiced general dentistry. The study participants in age groups 51–60 and 41–50 years old showed more liability in perceiving COVID-19 as an extremely dangerous disease than 31–40 and 21–30 age groups. The majority of respondents (63.4%) had an anxiety scale score of greater than 40, followed by 22.8% with scores 20-40 and 13.9% with scores less than 20, respectively. The mean scores for the GAD-7 and the worry items were 8.24 ± 3.21 and 13.92 ± 4.77, respectively. The data showed that most survey participants had adopted moderate post-traumatic changes during the pandemic, as evident by their mean score of 34.17 ± 3.40. The life satisfaction of the participants was neutral, as demonstrated by their mean score of 20.16 ± 4.03.

Conclusion:

This study’s findings delineated that the COVID-19 pandemic situation has influenced dentists' mental health, with a moderate level of anxiety, and worries among other psychological symptoms. Furthermore, there was adequate knowledge regarding the COVID-19 among dentists; however, the pandemic affected the financial conditions of the respondents. There was a moderate level of post-traumatic growth and neutral life satisfaction of the dental providers.

Knowledge, Perceived Risk, and Preventive Behaviors amidst Covid-19 Pandemic among Dental Students in Malaysia

PURPOSE

Coronavirus disease 19 (COVID-19) has affected dental education in Malaysia. However, studies on dental students' knowledge, perception, and behaviors with regards to COVID-19 are very limited. Thus, this study aims to determine the knowledge status, perceived risk, and preventive behaviors of dental students in Malaysia regarding COVID-19.

METHODS

A cross-sectional study was conducted among students from 13 dental schools across Malaysia using online questionnaires.

RESULTS

From 355 respondents, 93.5% obtained a high score of knowledge of COVID-19. Female respondents scored higher than males in perceived risks and preventive behaviors. Chinese respondents scored highest in knowledge, while Malay respondents had the highest perceived risk score. The mean preventive behavior score did not vary across ethnicity. On-campus students scored higher in knowledge and perceived risk whereas off-campus students practiced more preventive behaviors. Clinical students' knowledge score was higher than preclinical students. Final year students scored higher in knowledge and perceived risk compared to their juniors.

CONCLUSION

The majority of dental students have good knowledge and a high perceived risk of COVID-19, and they practiced most of the preventive behaviors. However, the latest information on this disease should be incorporated into dental schools' curriculums and updated periodically.

Psychological and Physical Distress in Italian People during COVID-19 Pandemic: One Year Later

The aim of this study was to evaluate the major life changes that Italian people experienced after one year of the COVID-19 pandemic. We assessed the psychological and physical impact of COVID-19 within one year of the pandemic situation, and its possible correlation with the positive COVID-19 trend in the Italian region. We invited Italian people to complete a cross-sectional, online survey within a three-week period from 14 March to 4 April 2021. The survey collected data on the participants' stress and physical levels, attitude, perceived control, norms, personal and professional backgrounds, and place of stay in the last year. We used Student's t-test and the software package GRETL for Windows to assess the association between the study outcome variables and the explanatory variables (stress, attitude, perceived control, and norms). All participants who declared a level of physical stress in their answer suffered from psychological stress, but not vice versa. The result to be highlighted is that this level of stress was found more in women and in the age range of 21-45 years.

The Impact of Information Sources on COVID-19-Related Knowledge, Attitudes, and Practices (KAP) among University Students: A Nationwide Cross-Sectional Study

COVID-19 is an emerging respiratory disease caused by a novel coronavirus accompanied by a tsunami of misinformation and fake news. This can weaken the public health responses by affecting the COVID-19-related knowledge, attitudes, and practices (KAP) of the public. Therefore, this cross-sectional study was designed during the early stage of the pandemic to evaluate the KAP of Palestinian university students and their commonly used information sources. We found that the most trusted information source among students was the World Health Organization (WHO), followed by the Palestinian Ministry of Health (MoH) briefings and healthcare workers, whereas social media was the most frequently used source of information. The participants exhibited a high level of COVID-19-related knowledge, having an average score of 8.65 (range: 0–10). In total, 76% avoided going to crowded places, and only 33% wore a mask while being outdoors. The vast majority (93%) checked the accuracy of COVID-19-related information before publishing it, 56% used the WHO and MoH briefings for fact-checking, and only 8% relied on healthcare workers. This was particularly the case for those who lived in refugee camps. This study provides an insight into the information sources used by Palestinian university students, the sources they trust, and the information formats they prefer. These results may help public health authorities to locate the information sources through which university students should be targeted. Efforts should be made to recommend healthcare workers as credible information sources. In this way, they will be able to prevent the spread of misleading information and provide high-quality information, especially within unconventional settings such as refugee camps.

Operational Implications and Risk Assessment of COVID-19 in Dental Practices

The unprecedented situation of the coronavirus pandemic has impacted the entire world, with dental practice being significantly affected. In this study, we aim to evaluate the operational implications and risk assessment of the coronavirus in dental practice. This observational study comprised the electronic distribution of two surveys, one to patients and the second to dental professionals. The first questionnaire consisted of demographics along with 15 closed-ended questions. The second questionnaire consisted of demographics along with 43 questions from eight domains: financial impact, psychological impact, patient satisfaction, hygiene, patient management, COVID-19 lockdown, perspective, and practicing dentistry after the COVID-19 pandemic. The statistical analysis was performed using SPSS-25. A linear regression test was applied to assess the effect of the dependent variable (patient's satisfaction with the dental practice) on independent variables (age, gender, education). The ANOVA test was applied to assess the effect of the independent variables (financial impact, psychological impact, patient satisfaction, hygiene, patient management, lockdown, perspective, and post-COVID-19) on the dependent variables (age, gender, education, experience of dentists, qualification of dentists). A total of 711 patients and dental professionals participated in this study, with a response rate of 88.87%. Approximately 67.9% of the patients felt comfortable in the dental clinic, with 74.5% being satisfied with the dental clinic's services. The majority (77.4%) of the dentists were psychologically affected. Many of the participants chose to use masks, gowns, respiratory equipment, and face shields for protection. Teledentistry was preferred by the majority of dentists in non-emergency cases. Many of the dentists chose alternative procedures to minimize the generation of aerosols. The majority of the dentists suggested changes in the dynamics of dentistry in the post-COVID era, such as the suggestion that the management of the finances of a dental practice along with infection control protocols should be practiced more optimally. Patients and dental professionals were well aware of the necessary precautionary measures required to combat the coronavirus, as well as the implications of different operational measures along with performing risk assessment, keeping in mind the changing dynamics of dentistry.

Impact of COVID-19 on dental education- a scoping review

BACKGROUND

A new corona virus called COVID-19 and its epidemic has affected health care systems in many ways. There have also been significant changes in dental education. The present study summarizes the findings about dental education resulting from a scoping review of COVID-19 and dentistry.

METHODS

First, a comprehensive search of five databases (Google Scholar, Medline through PubMed, Embase, Scopus, and Cochrane Central) was conducted with the keywords: COVID-19 and its equivalent terms, dentistry, education, oral, students, curriculum, and academics. Articles related to oral health and COVID-19 were searched. Then articles on the subject of dental education were screened and reviewed.

RESULTS

Of the 1389 articles investigating COVID-19 and dentistry, 135 articles were related to dental education and its relationship with COVID-19. The most articles in this field were from the United States, India, and Saudi Arabia. Most of the articles were cross-sectional and then review articles. Based on the review the articles were divided into two main categories of changes and concerns, and opportunities and solutions. Moreover, the following themes were extracted: teaching-learning quality and methods, study career and how students are prepared, infection control policies, theses, exams and assessments, financial and economic security, students and staff's mental health, school's policies and curricula, knowledge of students and staff about COVID-19.

CONCLUSIONS

Dental education now faces big challenges, some of which have never been experienced before. On the other hand, the epidemic has created opportunities for dental education as well. Most of these challenges and opportunities are the same around the world, and the findings of the present study can be a good help to overcome the challenges ahead as well as a good reference to find the right questions to be answered in future studies.

The Theory of Planned Behavior during the COVID-19 pandemic: A comparison of health behaviors between Belgian and French residents

The COVID-19 pandemic presents a global crisis and authorities have encouraged the population to promote preventive health behaviors to slow the spread of the virus. While the literature on psychological factors influencing health behaviors during the COVID-19 is flourishing, there is a lack of cross-national research focusing on multiple health behaviors. The present study overcomes this limitation and affords a validation of the Theory of Planned Behavior (TPB) as a conceptual framework for explaining the adoption of handwashing and limitation of social contacts, two health behaviors that highly differ in their nature. Specifically, we compare TPB model on these two protective behaviors among people living in Belgium (N = 3744) and France (N = 1060) during the COVID-19 sanitary crisis. Data were collected from March 18 until April 19, 2020, which corresponds to the spring lockdown and the first peak of the pandemic in these countries. Results indicated that more positive attitudes, greater social norms, increased perceived control and higher intentions were related to higher adherence to handwashing and limitation of social contacts, for both Belgian and French residents. Ultimately, we argued that the TPB model tends to manifest similarly across countries in explaining health behaviors, when comparing handwashing and limitation of social contacts among individuals living in different national contexts.

Anxiety sensitivity and intolerance of uncertainty are unique and interactive risk factors for COVID-19 safety behaviors and worries

Intolerance of uncertainty (IU) and anxiety sensitivity (AS) predict distress during the COVID-19 pandemic. However, little is known about how AS and IU jointly predict COVID-19 worries and behaviors. Structural equation modeling was used to examine the direct and interactive effects of AS and IU as related to COVID-19 worries and behaviors in two samples of community adults recruited in April 2020 (N = 642; M age = 38.50 years, SD = 10.00) and May 2020 (N = 435; M age = 34.92 years, SD = 14.98). In sample 1, there was a significant AS by IU interaction predicting COVID-19-related catastrophizing worries, stockpiling, and cleaning behaviors such that the relationship of AS to COVID-19-related behaviors was stronger at high levels of IU. However, although AS predicted some COVID-19 related worries and behaviors, AS and IU did not interact in sample 2. Across samples, AS was directly related to financial and health worries, whereas IU was not a significant predictor after controlling for AS. These findings suggest AS consistently impacts COVID-19 worries and behaviors, particularly among individuals with high IU. Brief interventions targeting AS and IU may help people cope during the COVID-19 pandemic and reintegrate following the pandemic.

Feeling Anxious Amid the COVID-19 Pandemic: Factors Associated With Anxiety Symptoms Among Nurses in Hong Kong

Background: The coronavirus (COVID-19) pandemic has increased the burden for the medical systems around the world. In Hong Kong, the pandemic not only affects the local populations, but also the healthcare workers. Healthcare workers, especially nurses, involving in COVID-19 treatments are highly susceptible to adverse psychological outcomes (e.g., anxiety symptoms). Studies have shown that socio-demographic characteristics, COVID-19-specific worries, and work settings-related variables are associated with healthcare workers' well-being during the COVID-19 pandemic. However, relevant studies for nurses in Hong Kong are limited. This study examined the psychosocial correlates of anxiety symptoms among nurses in Hong Kong.

Methods: Nurses (N = 1,510) working in hospitals and community settings were recruited through nursing associations in Hong Kong between August 8, 2020 and September 22, 2020. They were invited to complete a cross-sectional survey measuring their anxiety symptoms, sociodemographic characteristics, COVID-19-specific worries, and satisfaction with work and workplace pandemic-control guidelines.

Results: 17.2% of nurses reported moderate to severe levels of anxiety symptoms. Results from hierarchical regressions found that higher COVID-19-specific worries (contracting COVID-19, family members contracting COVID-19 due to their nursing work, insufficient protective equipment at workplace) (βs ranged from 0.07 to 0.20, ps < 0.01), higher perceived stigma of being a healthcare worker (β = 0.18, p < 0.001), and lower work satisfaction (β = −0.21, p < 0.001) were associated with higher anxiety symptoms.

Conclusion: A moderate proportion of nurses in Hong Kong did report levels of anxiety symptoms amid the COVID-19 pandemic. Futures studies could focus on the contributing factors of anxiety symptoms to design for effective strategies to promote nurses' well-being during pandemic situations.

Schoenberg N. COVID-19 and the impact on rural and black church Congregants: Results of the C-M-C project

The COVID-19 pandemic has had devastating effects on Black and rural populations with a mortality rate among Blacks three times that of Whites and both rural and Black populations experiencing limited access to COVID-19 resources. The primary purpose of this study was to explore the health, financial, and psychological impact of COVID-19 among rural White Appalachian and Black nonrural central Kentucky church congregants. Secondarily we sought to examine the association between sociodemographics and behaviors, attitudes, and beliefs regarding COVID-19 and intent to vaccinate. We used a cross sectional survey design developed with the constructs of the Health Belief and Theory of Planned Behavior models. The majority of the 942 respondents were ≥36 years. A total of 54% were from central Kentucky, while 47.5% were from Appalachia. Among all participants, the pandemic worsened anxiety and depression and delayed access to medical care. There were no associations between sociodemographics and practicing COVID-19 prevention behaviors. Appalachian region was associated with financial burden and delay in medical care (p = 0.03). Appalachian respondents had lower perceived benefit and attitude for COVID-19 prevention behaviors (p = 0.004 and <0.001, respectively). Among all respondents, the perceived risk of contracting COVID was high (54%), yet 33.2% indicated unlikeliness to receive the COVID-19 vaccine if offered. The COVID-19 pandemic had a differential impact on White rural and Black nonrural populations. Nurses and public health officials should assess knowledge and explore patient's attitudes regarding COVID-19 prevention behaviors, as well as advocate for public health resources to reduce the differential impact of COVID-19 on these at-risk populations.

The success rate of online illicit drug transactions during a global pandemic

Background and Aims

In the months following the onset of the COVID-19 pandemic, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA; 2020) observed an increased use of cryptomarkets, which led them to question whether cryptomarkets constituted a more convenient channel via which to distribute illicit drugs without any in-person contact. However, as more countries' borders closed, the likelihood is that cryptomarkets have been negatively impacted. We aim to measure and understand the success rate of transactions on cryptomarkets during the ongoing COVID-19 pandemic, through recourse to self-reported data that documents the outcome of cryptomarket transactions.

Methods

To collect self-reported data on cryptomarket transactions, we launched a platform where participants can enter information about their prior activities on cryptomarkets. The sample consists of 591 valid self-reports that were received between January 1st, 2020 and August 21st, 2020.

Results

The number of unsuccessful transactions increased concurrently with the global spread of the pandemic. Both the international and inter-continental nature of the transactions and the severity of the crisis in the vendor's country are significantly associated with delivery failure.

Conclusions

Drug cryptomarkets may have been disrupted due to the pandemic. The results lead to two opposing explanations for unsuccessful transactions. One explanation for the lower success rate is the inability of drug dealers to deliver on past promises that were made in good faith, while the second points towards opportunistic and abusive behaviour by drug dealers.

Prevalence of Anxiety, Depression, and Stress among Teachers during the COVID-19 Pandemic: A Rapid Systematic Review with Meta-Analysis

BACKGROUND

Since the beginning of the COVID-19 pandemic, teachers have been accumulating adverse psychological symptoms due to the closure of educational centers and the need to adapt to different teaching modalities.

METHODS

Medline and PubMed were searched for studies on the prevalence of depression, anxiety, stress, and burn-out in teachers, published from 1 December 2019 to 15 June 2021.

RESULTS

In total, eight studies were included in this study. The results show that teachers report levels of anxiety (17%), depression (19%), and stress (30%). In Asia, there has been more anxiety compared to other continents. Overall, anxiety has been higher among teachers in schools compared to universities. However, stress levels have been higher among teachers in universities compared to schools. Statistically, there were no significant differences regarding gender and age in any of the symptoms.

CONCLUSIONS

The results suggest that teachers at different educational levels are experiencing adverse psychological symptomatology during the COVID-19 pandemic, and that anxiety levels vary between different countries. However, more international studies are needed to fully understand the impact of the pandemic on teachers' mental health.

Dental Nurses' Mental Health in Germany: A Nationwide Survey during the COVID-19 Pandemic

Several studies have found a rise in the rate of psychological discomfort among healthcare personnel since the COVID-19 pandemic outbreak. In this study, we analyzed the relationship between psychological variables of anxiety, depression, stress, avoidance, intrusion and hyperarousal and several factors among German dental nurses. For this poll, dental nurses were asked nationwide to take part via an online-based survey from July 2020 to January 2021. This survey gathered data on demographics, as well as psychological assessments through the Impact of Events Scale-Revised (IES-R) instrument, and the Depression Anxiety Stress Scales (DASS-21). The correlations between DASS-21/IES-R ratings and sociodemographic data were investigated using univariate analyses (Kruskal-Wallis and Mann-Whitney U tests). Single comparisons were performed using the Dunn-Bonferroni post hoc test if a relevant test result was significant followed by multiple linear regressions. Furthermore, 252 dental nurses took part in the study and showed overall normal or mild results of all psychological variables. Having immune-deficiency or chronic diseases, employment at a dental practice, being married, having no children and seeing the pandemic as a financial threat were presented as significant risk factors (p ≤ 0.05) with higher DASS-21 and IES-R scores. These results emphasize the aspects that must be considered to safeguard German dental nurses' mental wellbeing during the crisis.

Safety of ChAdOx1 nCoV-19 Vaccine: Independent Evidence from Two EU States

Recent reports of thrombosis following AstraZeneca COVID-19 vaccine in young females (<55 years-old) led to temporary suspension and urgent investigation by the European Medicines Agency (EMA) that concluded that vaccine benefits still outweigh its side effects (SEs). Therefore, this study aims to provide early independent evidence on the vaccine SEs’ prevalence and their potential risk factors; a cross-sectional survey-based study was carried out between February and March 2021 in Germany and Czech Republic among healthcare workers who recently received the AstraZeneca COVID-19 vaccine. The study used a validated self-administered questionnaire composed of twenty-eight multiple-choice items covering demographic variables, medical anamneses, and local, systemic, oral, and skin related SEs of the vaccine. Out of the ninety-two included participants, 77.2% were females and 79.3% were from Germany. Their mean age was 35.37 ± 12.62 (19–64) years-old, 15.2% had chronic illnesses and 22.8% were receiving medical treatments. Overall, 94.6% of the participants reported at least one SE. The most common local SE was injection site pain (72.8%), and the most common systemic SEs were fatigue (73.9%), muscle pain (55.4%), chills (48.9%), feeling unwell (46.7%), nausea (45.7%), and headache (29.3%). The vast majority (91.9%) resolved within 1–3 days, and the below 35 years-old group was the least affected age group. The SEs’ frequency was insignificantly higher in females and previously infected participants; the vaccine safety for the elderly was supported by the early findings of this study. Chronic illnesses and medical treatments were not associated with an increased risk of SE incidence and frequency. No blood disorder SEs were reported in our sample. Further independent studies are highly required to evaluate the safety of the AstraZeneca vaccine and to explore whether gender or previous infection could be associated with the vaccine SEs.

Knowledge, Attitude, and Psychological Effect on Undergraduate/ Postgraduate Students in Lockdown COVID-19 Situation

BACKGROUND

Student psychological health has been an increasing concern. The COVID-19 pandemic situation has brought this vulnerable population into renewed focus.

OBJECTIVE

Our study aims to conduct a timely assessment of the effects of the COVID-19 pandemic on the mental health of college graduates and postgraduates.

METHODOLOGY

We conducted online survey with 550 students to understand the effects of the pandemic on their psychology and well-being. The data were analyzed through quantitative and qualitative methods.

RESULTS

Of the 550 students, 138 (71%) indicated increased stress and anxiety due to the COVID-19 outbreak. When asked about how the lockdown in COVID-19 situation affecting them, 97% said that it is severely affecting them. When asked about what the problems do you faced during online class, 5% said the Internet, 83.8% said noninteractive, and 11.2% said lack of explanatory mediums. When asked about number of hours spent on the Internet, 100% said more than 10 h. When asked about the activities to keep yourself busy during lockdown in COVID-19 situation, 37% said social media followed by 23% who mentioned cooking.

CONCLUSION

Due to the long-lasting pandemic situation and onerous measures such as lockdown and stay-at-home orders, the COVID-19 pandemic brings negative impacts on education. The findings of our study highlight the urgent need to develop interventions and preventive strategies to address the psychological health of college students.

Preventive Behaviors During the COVID-19 Pandemic: Associations With Perceived Behavioral Control, Attitudes, and Subjective Norm

Background: The coronavirus disease 2019 (COVID-19) is a highly contagious and potentially fatal infectious disease that has swept the globe. To reduce the spread, it is important to engage in preventive behaviors recommended by health authorities, such as washing your hands, wearing a face mask, and social distancing. Aim: In the present study, we draw from the Theory of Planned Behavior (TPB) to examine the associations between perceived behavioral control, attitudes, and subjective norm and whether people engage in eight different preventive behaviors. Methods: For each of the preventive behaviors (washing hands; using hand sanitizer; not touching your face; social distancing; wearing a face mask; disinfecting surfaces; coughing in your elbow; staying home if sick), we conducted separate logistic regressions predicting whether the participants (N = 2,256; age range = 1898 years) reported engaging in the behavior from their perceived behavioral control, attitudes, and subjective norm. Results: We found that perceived behavioral control, attitudes, and subjective norm had independent significant associations with each preventive behavior. Moderation analyses revealed that for most behaviors the associations with perceived behavioral control were stronger for older adults than for younger adults. Limitation: The present study was cross-sectional; future longitudinal studies and interventions are needed to disentangle directionality. Conclusion: Our findings suggest several ways to increase adherence to health behaviors that reduce the spread of coronavirus and other infectious diseases.

Evaluating the Practice of Preventive Behaviors and the Fear of COVID-19 among Dentists in Oradea Metropolitan Area after the First Wave of Pandemic; a Cross-Sectional Study

Dental clinics were suspected to be a hotspot for nosocomial transmission of COVID-19 due to the easy spread of the virus. The study investigated the preventive behaviors applied in dentistry settings and the level of fear of COVID-19 infection among dentists. A total of 83 respondents (34.94% male and 63.86% female) were included in the research. Sociodemographic data were collected, together with new institutional and personal rules regarding preventive behaviors. Fear of COVID-19 Scale was used to measure the fear of infection. Data was analyzed using SPSS (v.25, SPSS Inc., Chicago, IL, USA). During the first seven months of confinement, 3.9% of dentists were confirmed with COVID-19 and one fourth treated confirmed positive patients. A quarter of the doctors declared that they had periods when they lived away from home being afraid of transmitting the disease to their family members, and significant data were found in doctors being parents. The closure of dental offices had a negative impact on the financial situation of dentists, especially on those working in rural area offices. Many doctors encountered difficulties in purchasing protective suits and medical supplies, and more than half of the respondents (65.1%, N = 54) focused on the quality of protective suits when purchasing them. More than half of the dentists were trained how to use them. The score for fear of COVID 19 was similar to dentists from other countries. Respondents with chronic diseases were more prone to show higher level of anxiety when following the news and stories related to COVID-19 on TV, media, or social networks. One third of dentists mentioned that they had treated exclusively specific urgent dental problems since the onset of the pandemic and more than 13.3% declared that they refused to provide medical assistance to some specific pathologies because of the fear of infection. The results reflect new challenges and rules adopted by dentists in order to diminish the risk of infection and the impact of pandemic considering their psychological, familial, and financial context. Policymakers and professional associations around may benefit from these findings while formulating guidelines to support dentists during COVID-19 or any future pandemics.

Perspectives from Dentists, Dental Assistants, Students, and Patients on Dental Care Adapted to the COVID-19 Pandemic: A Cross-Sectional Survey

Dental care has been affected by SARS-CoV-2 (COVID-19) worldwide. In contrast to other dental clinics, the Justus-Liebig-University Giessen (Germany) decided not to limit dental treatment to emergencies alone, but to continue dental care for all patients, with increased safety measures. As such, health care professionals may be exposed to additional physical and mental stress. The aim of this study was to assess the perspectives of all persons involved in dental care (dentists, dental assistants, students, and patients) regarding the aspects of safety measures, anxiety about self-infection and infecting others, and other prospects in the period March to December 2020 using a questionnaire. Data collection was performed between 14 December 2020 and 23 January 2021. A total of 35 dentists (response rate of 79.5%), 23 dental assistants (65.7%), 84 students (80%), and 51 patients (21.8%) completed the survey. The patients did not notice any changes in the care received. Dentists and dental assistants reported a higher workload due to additional safety measures. The majority of dentists, students, and patients agreed that normal patient care was maintained. One-third of dental assistants would have preferred emergency treatment alone and expressed significantly higher anxiety about COVID-19 infection than all other groups (p < 0.05). In conclusion, all groups showed a predominantly positive perspective on dental care, and anxiety about self-infection and infecting others was especially low. However, additional measures are time-consuming and compound daily patient care. This concept, based on well-established infection control, might be a viable proposal for current and future pandemics.

The perception of COVID-19 among Italian dental patients: an orthodontic point of view

BACKGROUND

The present study aimed to investigate the patients' perception of the dental practice during the COVID-19 outbreak, and whether the pandemic will affect the attendance of orthodontic patients at the dental practice. An online questionnaire, including the Patient Health Questionnaire-4 (PHQ-4), was submitted to Italian dental patients with items about their perceived risks when going to the dentist, concerns about continuing orthodontic treatment, and the onset of temporomandibular disorders (TMD). Data were analyzed with a chi-square test and logistic regression analysis. The level of significance was set at P < 0.05.

RESULTS

A total of 1566 subjects completed the survey, including 486 who were under orthodontic treatment or who had a child in orthodontic treatment. A total of 866 participants (55.3%) thought the risk of contracting the COVID-19 infection was higher in a dental practice; this perception was associated with gender (women more than man), age (over 60 years old) and high levels of distress (P<0.001). However, 894 patients (57.1%) felt comfortable going back to the dentist. Most of the orthodontic patients (84%) would continue their treatment. After the lockdown, there was a slight increase in the frequency of TMD pain (356 versus 334).

CONCLUSIONS

Most of the participants believed that the dental practice is a place at greater risk of contracting COVID-19, even if they continue to go to the dentist. Gender, age, and the level of distress were associated with the increase in the fear of going to the dentist due to COVID-19. Because of the pandemic, 16% of patients undergoing orthodontic treatment would not return to the dental practice to continue their orthodontic treatment after the lockdown. The prevalence of TMD pain in the population increased due to the pandemic.

The Psychological Impact of the COVID-19 Pandemic on Dentists in Germany

Since the announcement of the coronavirus 2019 (COVID-19) outbreak as a pandemic, several studies reported increased psychological distress among healthcare workers. In this investigation, we examined the association between psychological outcomes and various factors among German dentists. Dentists from all German federal states were invited to participate in this study through a self-administered online questionnaire between July and November 2020. This questionnaire collected information on demographics, Depression Anxiety Stress Scales (DASS-21), and the Impact of Events Scale-Revised (IES-R) instrument. The associations displayed between demographic and psychological outcomes of depression, anxiety, stress, intrusion, avoidance, and hyperarousal were evaluated. Seven-hundred-and-thirty-two dentists participated in the survey and reported overall scores of (4.88 ± 4.85), (2.88 ± 3.57), (7.08 ± 5.04), (9.12 ± 8.44), (10.68 ± 8.88) and (10.35 ± 8.68) for depression, anxiety, stress, intrusion, avoidance, and hyperarousal, respectively. For females, being between 50-59 years of age, being immune deficient or chronically ill, working at a dental practice, and considering the COVID-19 pandemic a financial hazard were reported as significant associated factors (p < 0.05) with higher DASS-21 and IES-R scores. These findings underline the aspects which need to be taken into attention to protect the mental wellbeing of dentists in Germany during the crisis.

Kobra Surgery Simulator-A Possibility to Improve Digital Teaching? A Case-Control Study

Computer-aided simulations have long been of great importance in university teaching; however, to date, there is limited use of such simulations in the dental surgical sector. For this purpose, an oral surgery simulator, "Kobra", was implemented in student training and was evaluated for dental education. Dental students (group 1, third-year and group 2, fourth-year) and dentists of the faculty (control group) were trained to use the simulator. The outcomes for group 1 (apicoectomy of an upper lateral incisor with Kobra), group 2 (removal of an impacted lower wisdom tooth with Kobra) and the control group (both procedures with Kobra) were evaluated. For evaluation purposes, subjective parameters (improvement of practical skills, comparison between conventional training and Kobra simulation, and implementation of simulation-based teaching) and objective parameters (removal of bone, tooth substance and soft tissue measured while performing the Kobra simulation) were assessed using questionnaires with a scale ranging from 1-5. A total of 49 students (third-year n = 29, with 22 women and 7 men; fourth-year n = 20, with 17 women and 3 men) and 10 dentists (women n = 5 and men n = 5) participated. Compared to the Kobra simulation, the conventional training method with plastic models was still favored (the difference was non-significant). Compared to the dentists, the simulation data showed a less precise surgical performance of the students (the difference was not significant). The Kobra simulation may offer an additional method to conventional surgery training using plastic models, with benefits for students and faculty staff.

Perceived Preparedness of Dental Academic Institutions to Cope with the COVID-19 Pandemic: A Multi-Country Survey

Dental academic institutions are affected by COVID-19. We assessed the perceived COVID-19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics’ and institutional attributes, perceived preparedness, and availability of infection prevention and control (IPC) equipment. Principal component analysis (PCA) identified perceived preparedness components. Multilevel linear regression analysis assessed the association between perceived preparedness and fixed effect factors (academics’ and institutions’ attributes) with countries as random effect variable. Of the 1820 dental academics from 28 countries, 78.4% worked in public institutions and 75.2% reported temporary closure. PCA showed five components: clinic apparel, measures before and after patient care, institutional policies, and availability of IPC equipment. Significantly less perceived preparedness was reported in lower-middle income (LMICs) (B = −1.31, p = 0.006) and upper-middle income (UMICs) (B = −0.98, p = 0.02) countries than in high-income countries (HICs), in teaching only (B = −0.55, p < 0.0001) and in research only (B = −1.22, p = 0.003) than teaching and research institutions and in institutions receiving ≤100 patients daily than those receiving >100 patients (B = −0.38, p < 0.0001). More perceived preparedness was reported by academics with administrative roles (B = 0.59, p < 0.0001). Academics from low-income countries (LICs) and LMICs reported less availability of clinic apparel, IPC equipment, measures before patient care, and institutional policies but more measures during patient care. There was greater perceived preparedness in HICs and institutions with greater involvement in teaching, research, and patient care.

Let's Not Joke about It Too Much! Exposure to COVID-19 Messaging, Attitudes and Protective Behavioral Intentions

Our study evaluates the role of exposure to COVID-19 messaging in negativity towards COVID-19 and the intentions to engage in protective behaviors. Building on the theory of planned behavior (TPB), we derive a mediation model and test it in a sample of 737 participants (556 Romanians and 181 Kazakhs). The exposure to general information concerning COVID-19 positively predicts negative attitudes, negative emotions and the emergence of subjective norms in relation to COVID-19, as well as the likelihood of engaging in protective behavioral intentions. The exposure to humoristic communication, however, diluted the positive association between exposure to general information and negative attitudes, as well as negative emotions. The results support the overall predictions of the TPB and report positive associations between negative attitudes towards COVID-19, subjective norms and behavioral control on the one hand, and protective behavioral intentions on the other. Negative emotions significantly predict the likelihood of engaging in protective behaviors. Our results also show that older respondents tend to develop more negative attitudes towards COVID-19, yet they do not report stronger intentions to engage in protective behaviors than younger respondents. An important emergent result shows that time lapse seems to increase negativity towards COVID-19, yet it does not directly increase the likelihood of engaging in protective behaviors. Implications for public health communication related to COVID-19 are discussed.

Psychological Distress and Post-Traumatic Symptomatology Among Dental Healthcare Workers in Russia: Results of a Pilot Study

The spread of SARS-CoV-2 infection has increased the risk of mental health problems, including post-traumatic stress disorders (PTSD), and healthcare workers (HCWs) are at greater risk than other occupational groups. This observational cross-sectional study aimed to explore the symptoms of depression, anxiety, and PTSD among dental HCWs in Russia during the coronavirus disease 2019 (COVID-19) pandemic. The survey was carried out among 128 dental HCWs from three dental clinics of Ekaterinburg, Russia. The mean age of the sample was 38.6 years. Depression, anxiety, and stress were assessed using the Depression Anxiety and Stress Scale-21 (DASS-21); PTSD was assessed using the PTSD Symptom Scale-Self-Report (PSS-SR); subjective distress was assessed using the Impact of Event Scale-Revised (IES-R). The results indicated that 20.3-24.2% HCWs had mild to extremely severe symptoms of psychological distress, and 7.1-29.7% had clinical symptoms of PTSD. No differences between females and males were revealed. HCWs working directly with patients had significantly higher levels of PTSD symptoms and the risk of PTSD development compared to those working indirectly, whereas older HCWs had significantly higher levels of both psychological distress and PTSD symptoms compared to younger HCWs. Thus, dental HCWs are at high risk for psychological distress and PTSD symptoms during the COVID-19 pandemic.

Intention to provide tobacco cessation counseling among Indonesian dental students and association with the theory of planned behavior

BACKGROUND

Use of tobacco is a serious public health problem in Indonesia that requires a multidisciplinary approach by healthcare providers to address it. The study assessed the intentions of undergraduate students in dental schools to provide tobacco cessation counseling (TCC) and their association with the constructs of the theory of planned behavior (TPB).

METHODS

A cross sectional study was conducted in October 2019 using an electronic survey for dental students in Indonesian dental schools (n = 30). The survey assessed schools and students' characteristics and eleven statements assessed their perspectives toward TCC based on the TPB using a 5-point Likert scale. Principal component analysis (PCA) was used to identify components within the items of perspective. Multilevel linear regression analysis was used to assess the association between intention to provide TCC and the constructs of the TPB as identified in the perspectives' items using TPB controlling for confounders.

RESULTS

About 1288 students participated from 30 dental schools, 83.3% females with mean age = 21.5 years with average intention to provide TCC = 4.3 out of 5. They had above average positive attitude about provision of TCC being the dentist's role (mean = 3.8 out of 5). PCA identified two components: confidence in their own abilities and perception of favorable environment with average scores = 3.2 and 2.7 out of 5. Intention to provide TCC was significantly associated with more positive attitude recognizing TCC as a dentist's role (B = 0.10, P < 0.0001), greater confidence in skills to provide TCC (B = 0.17, P < 0.0001) and less perception of favorable environment supportive off providing TCC (B = - 0.20, P < 0.0001).

CONCLUSIONS

Indonesian dental students' intention to provide TCC can be explained by the constructs of the TPB. Development of dental curricula promoting professional responsibility toward TCC should be given attention. Improving students' attitude and confidence potentially may support their patients' efforts to quit smoking.