Methods Helping Dentists to Detect Dental Fear

OBJECTIVES

Dental fear is common and yet often remains unrecognised. COVID-19 has challenged health care since 2020. This study aimed to evaluate patients' self-reported dental fear and detection of dental fear by the dentists. Another aim was to validate a colour code instrument for estimating dental fear. The influence of COVID-19 on fear and attendance was assessed.

METHODS

A cross-sectional survey was conducted in the primary urgent dental care of Oulu, Finland, in spring 2020 and 2021 after the first (T1) and third waves (T2) of the pandemic. Data were obtained for analyses using the Modified Dental Anxiety Scale (MDAS), Facial Image Scale (FIS), and a new "traffic light" colour code for dental fear (CCF). The influence of COVID-19 on dental fear and attendance was assessed with structured and open-ended questions. The questionnaires were completed by 273 anonymous participants.

RESULTS

Of the participants, 167 (61.2%) visited dental care during T1 and 106 (38.8%) during T2. Their mean age was 45.1 years. An MDAS score of 19 or above, indicating severe fear, was reported by 10.6% of the participants. Of those with severe dental fear, 87% chose the red colour in the CCF "traffic light" system. The association between dentists' and participants' estimation of dental fear was weak (P < .001) and agreement with the red code was nonexistent (Cohen's kappa value = -0.035). MDAS scores of the younger participants were higher than those of the older ones after the first wave (T1) (P = .021). COVID-19 had the strongest influence on dental attendance and dental fear of those having the most severe self-reported dental fear as measured by the MDAS.

CONCLUSIONS

Colour-coded traffic lights seem valid for screening severe dental fear and are easy and quick to use. They could be useful tools especially since recognising dental fear seems difficult for dentists. The COVID-19 pandemic has complicated dental care for the most fearful individuals.

Evaluation of diabetic peer support in Malawi

Background

Type 2 diabetes is a major health concern worldwide and requires urgent attention from health care providers and policy makers. Due to shortage of health care workers in low-income countries, peer support programs have been viewed as a viable option in management of diabetes and have shown to be effective in sub-Saharan Africa.

Objective

The aim of this study is to assess and evaluate the Kamuzu Central Hospital (KCH) diabetic peer support program's (DPSP) impact 4 years after its establishment by assessing knowledge, self-efficacy and behaviours of DPSP members compared to non-members.

Methodology

This is a cross-sectional study done among diabetic patients attending clinics between 12th August and 25th September 2018 at KCH. Self and interviewer-administered questionnaires (designed based on validated survey instruments) were used. The participants (n=176) were recruited consecutively after consenting.

Results

Results showed DPSP members were more knowledgeable regarding the effects of skipping meals and sweet juice on blood glucose and conditions not associated with diabetes. In terms of self-efficacy and behaviour changes, DPSP members believe that they are more able to correct hypoglycaemia, to communicate their concerns to health workers and to perform daily foot exam compared to non-members.

Conclusion

The KCH (Lilongwe) Diabetes Peer Support program has positively impacted its members and should be scaled up to engage all diabetic patients in Malawi. Ongoing training for peer supporters is necessary to update and reinforce management, knowledge and skills, and to ensure fidelity in program implementation.

Emergency management and internal audit of emergency preparedness of pre-hospital emergency care

One of the negative components of international travel is the higher likelihood of emergencies that affect a large number of people (mass negative impact on health), for example the transmission of infectious diseases, as e.g. SARS CoV-2 pandemic. The frequency and sources of mass-casualty incidents are currently changing dynamically, especially with the onset of terrorist attacks and large-scale natural disasters. Health services and emergency medical service (EMS) take part in addressing these emergencies. For this reason, this paper deals with the EMS emergency preparedness in the Czech Republic for an emergency events with a large number of affected people. EMS in the Czech Republic are not provided by the state but by individual regions. EMS in the Czech Republic do not have central management, nor do they use uniform data documentation. The investigation of the current situation has shown that the attitudes of EMS in individual regions of the Czech Republic to the tasks of emergency preparedness for mass casualty incidents are not identical. The current method of evaluating improvements in the quality of EMS emergency preparedness lacks consistency and is not comprehensively supervised. To tackle this, the paper presents an internal audit methodology for assessing the level of emergency preparedness of the emergency medical services. The authors therefore defined the decisive criteria and indicators assessing the quality level of EMS emergency preparedness at major disaster with multiple victim incident. When developing the methodological procedure of the preparedness evaluation, an algorithm was chosen, based on the gradual verification of the evaluation criteria and indicators by an expert group. Some findings and recommendations based on a research carried out in EMS in individual regions of the Czech Republic are presented.

Evaluation of the reporting quality of observational studies in master of public health dissertations in China

Backgrounds

Master of public health (MPH) plays an important role in Chinese medical education, and the dissertations is an important part of MPH education. In MPH dissertations, most are observational studies. Compared with randomized controlled trial (RCT), observational studies are more prone to information bias. So, the reporting of the observational studies should be transparent and standard. But, no research on evaluating the reporting quality of the MPH dissertation has been found.

Methods

A systematic literature search was performed in the Wanfang database from January 1, 2014 to May 31, 2019. The Strengthening the Reporting of Observation Studies in Epidemiology (STROBE) statement was adopted to evaluate the reporting quality of the selected studies. Articles that met the following criteria were selected: (1) observational studies, including cross-sectional studies, case-control studies, and cohort studies; (2) original articles; (3) studies on humans, including both adults and children.

Results

The Median of compliance to individual STROBE items was 74.79%. The mean (standard deviation) of STROBE score was 14.29 (1.84). Five items/sub-items were 100% reported (“reported” and “partly reported” were combined): background, objectives, study design, report numbers of individuals at each stage, and key result. Fifteen items/sub-items were reported by 75% or more. Reporting of methods and results was often omitted: missing data (6.67%), sensitivity analyses (3.63%), flow diagram (15.15%), and absolute risk (0%). Logistic regression analysis indicated that cohort studies (OR = 3.41, 95% CI = 1.27–9.16), funding support (OR = 4.37, 95% CI = 1.27–9.16) and more published papers during postgraduate period (OR = 3.46, 95% CI = 1.40–8.60) were related to high reporting quality.

Conclusion

In short, the reporting quality of observational studies in MPH’s dissertations in China is suboptimal. However, it’s necessary to improve the reporting of method and results sections. We recommend that authors should be stricter to adhere STROBE statement when conducting observational studies.

Evaluating the demographic and clinical minimum data sets of Iranian National Electronic Health Record

BACKGROUND

Designing a standard data set is necessary to overcome the dispersion of data among different health information systems. The objective of this study was to evaluate the current demographic and clinical minimum data sets (MDSs) of Iranian National Electronic Health Record (known as SEPAS) and to identify most necessary data elements.

METHODS

Data were collected using a list of current demographic and clinical data of SEPAS and a self-administered questionnaire. All faculty members of six health related fields and the hospital authorities, and IT and HIM administrators of 6 hospitals in Kerman University of Medical Sciences were invited to participate in this study. The content validity of the questionnaire was confirmed by six medical informatics and HIM experts and the reliability was determined by Cronbach's alpha (α =0.95). SPSS v18 was used to generate descriptive statistics.

RESULTS

Survey results indicated that 15 data elements should become mandatory elements of MDS for communicating data to SEPAS. These elements include patient's name, surname, father's name, nationality, cell number, job, residential address, residence place, passport number (for non-Iranian patients), diagnosis date, death time, death place and the unit of the hospital where the patient died. Moreover, participants suggested 33 additional demographic and clinical data elements to be communicated mandatorily to SEPAS.

CONCLUSION

The results of this study showed that the minimum data sets of Iranian national electronic health record needs to be revised. Using the proposed MDSs by this study can improve the quality and efficiency of information and reduce redundancy by adding necessary data and preventing communication of unnecessary data. The method employed in this study can be used for investigating, refining and completing the MDSs of other health information systems.

A comprehensively quantitative method of evaluating the impact of drought on crop yield using daily multi-scale SPEI and crop growth process model

The quantitative evaluation of the impact of drought on crop yield is one of the most important aspects in agricultural water resource management. To assess the impact of drought on wheat yield, the Environmental Policy Integrated Climate (EPIC) crop growth model and daily Standardized Precipitation Evapotranspiration Index (SPEI), which is based on daily meteorological data, are adopted in the Huang Huai Hai Plain. The winter wheat crop yields are estimated at 28 stations, after calibrating the cultivar coefficients based on the experimental site data, and SPEI data was taken 11 times across the growth season from 1981 to 2010. The relationship between estimated yield and multi-scale SPEI were analyzed. The optimum time scale SPEI to monitor drought during the crop growth period was determined. The reference yield was determined by averaging the yields from numerous non-drought years. From this data, we propose a comprehensive quantitative method which can be used to predict the impact of drought on wheat yields by combining the daily multi-scale SPEI and crop growth process model. This method was tested in the Huang Huai Hai Plain. The results suggested that estimation of calibrated EPIC was a good predictor of crop yield in the Huang Huai Hai Plain, with lower RMSE (15.4 %) between estimated yield and observed yield at six agrometeorological stations. The soil moisture at planting time was affected by the precipitation and evapotranspiration during the previous 90 days (about 3 months) in the Huang Huai Hai Plain. SPEI_G90 was adopted as the optimum time scale SPEI to identify the drought and non-drought years, and identified a drought year in 2000. The water deficit in the year 2000 was significant, and the rate of crop yield reduction did not completely correspond with the volume of water deficit. Our proposed comprehensive method which quantitatively evaluates the impact of drought on crop yield is reliable. The results of this study further our understanding why the adoption of counter measures against drought is important and direct farmers to choose drought-resistant crops.

Updates in Perioperative Care: Ideas from the Human Field

The article focuses mainly on appropriate patient preparation for an anesthetic episode. Special attention is given to evaluate the environmental situation for optimal adjustment to reduce stress before the anesthetic event. During the anesthetic event, special attention must be paid regarding monitoring and, evaluating the patient during and after the anesthetic episode.