Behavior Management Research Articles

Anxiety Disorders, Anxious Symptomology and Related Behaviors Associated With Migraine: A Narrative Review of Prevalence and Impact.

The purpose of this study was to review the literature on the relationship between migraine, anxiety and related disorders, anxious symptomology and related behaviors. Generalized anxiety, other anxious disorders and migraine are comorbid. In addition, anxious symptomology and behaviors are common in people with migraine even if they do not meet diagnostic criteria or threshold. Anxiety including diagnosed disorders such as generalized anxiety, phobias, panic disorder, as well as behaviors such as catastrophizing, avoidance behaviors, and higher fear of headache/migraine or anxiety sensitivity are comorbid and/or common in migraine. Anxiety is associated with negative outcomes such as migraine progression, medication overuse, stigma and migraine-related disability. The association between migraine, anxiety, and fear and avoidance behaviors has an extensive empirical basis. Awareness of the high prevalence of comorbidity and symptomology as well as the negative outcomes associated with anxiety and related symptoms and behaviors is important in the comprehensive management of people with migraine. Better understanding the relationship between migraine and anxiety symptoms and behaviors and their effects on outcomes is essential to provide more effective treatment for people with migraine. The review emphasizes the necessity of screening and more comprehensive evaluation in patients with migraine using psychological diagnostic tools. Thus, prevention and management of anxiety, fear, and anxiety-related behaviors in the context of migraine management may be considered an essential treatment goal and strategies may include non-pharmacological and pharmacological approaches.

Referral Rates for School Threat Assessment

ABSTRACTAlthough behavioral threat assessment and management (often shortened to “threat assessment”) has become widely used in US schools, no studies have systematically examined how frequently schools conduct threat assessments and how threat assessment rates vary as a function of student and school demographics. Of particular concern is that students with disabilities receive threat assessments at disproportionately high rates. This study examined the 1‐year frequency of threat assessments in a statewide sample of 611 elementary, 341 middle, and 269 high schools reporting 15,301 threat assessments, of which 41% concerned students with disabilities. We identified threat assessment rate differences associated with student grade, gender, race/ethnicity, and disability status. We further examined the association between threat assessment rates and school‐level demographic characteristics including racial/ethnic composition, prevalence of economically disadvantaged students, and proportion of students with a disability. To place these results in context, we compared findings for threat assessment with out‐of‐school suspension rates. We discuss reasons why students with disabilities might be referred for BTAM at a high rate and recommend practices for assuring their educational rights and needs are safeguarded. Evolving school threat assessment policies should recognize the practice demands placed on school staff to evaluate a substantial number of students.

Case Study of a Broken Instrument in a Primary Tooth and Literature Review

Background: Root canal treatment is an important element of dental treatment, and broken instruments are one cause of endodontic treatment failure. Broken instruments are rarely reported in primary teeth because of their inherently wider and relatively straighter root canals. We describe a case of a patient with a broken instrument in a primary tooth and reviewed the literature across three databases. Case presentation: A boy aged 7 years and 2 months was referred to our hospital because of pain persisting despite multiple dental treatments. Radiographic examination revealed a broken instrument in the maxillary right primary second molar. The patient experienced dental fear, so the treatment proceeded with the use of behavioral management and nitrous oxide, after which his pain disappeared. At the age of 9 years and 2 months, eruption of the successive permanent teeth was confirmed, and no pathological findings were observed except enamel hypoplasia. We undertook a literature review across three databases and found only two articles about broken instruments in primary teeth, neither of which described the eruption of the permanent teeth. All three cases involved primary molars. Conclusions: We removed a broken instrument from the root of a primary molar and performed root canal treatment, resulting in a good outcome for the primary molar until it was replaced with successive permanent teeth. Although rare, broken instruments in the roots of primary molars do occur, and care should be taken during root canal treatment of primary molars.

Effectiveness and cost-effectiveness of interventions to increase knowledge and awareness of attention deficit hyperactivity disorder: a systematic review.

Various interventions, including caregiver education, psychoeducation, teacher and clinician training and behavioral management embedded with education, are available to enhance awareness and knowledge among caregivers, teachers, and clinicians. This review synthesizes evidence on the effectiveness and cost-effectiveness of interventions to increase ADHD awareness and knowledge for caregivers, clinicians, and teachers. Peer-reviewed literature was identified through the systematic searches of six databases: MEDLINE Complete, APA PsycInfo, CINAHL Complete, ERIC, Global Health and EconLit. Two independent reviewers completed a two-stage screening process and quality assessment. Results are presented as a narrative synthesis. Economic evaluation study cost data were converted for comparability. Of the 5963 results, 28 studies were included. Most interventions were found to be effective in increasing the awareness and knowledge of ADHD among caregivers, clinicians, and teachers. Clinician knowledge and capacity to assess, diagnose and treat ADHD were improved. Of the economic evaluation studies, interventions were promising in parent education, and behavioral management and psychosocial therapy interventions were found to be cost-effective. The review provides important insights about effective and cost-effective interventions to increase ADHD awareness and knowledge. These insights are critical to effectively plan services/interventions for families and children with ADHD. Further research in economic evaluation of interventions is needed to assist policy-decision making.

Effectiveness of Digital Mental Health Interventions in the Workplace: Umbrella Review of Systematic Reviews.

There is potential for digital mental health interventions to provide affordable, efficient, and scalable support to individuals. Digital interventions, including cognitive behavioral therapy, stress management, and mindfulness programs, have shown promise when applied in workplace settings. The aim of this study is to conduct an umbrella review of systematic reviews in order to critically evaluate, synthesize, and summarize evidence of various digital mental health interventions available within a workplace setting. A systematic search was conducted to identify systematic reviews relating to digital interventions for the workplace, using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). The review protocol was registered in the Open Science Framework. The following databases were searched: PubMed, Web of Science, MEDLINE, PsycINFO, and Cochrane Library. Data were extracted using a predefined extraction table. To assess the methodological quality of a study, the AMSTAR-2 tool was used to critically appraise systematic reviews of health care interventions. The literature search resulted in 11,875 records, which was reduced to 14 full-text systematic literature reviews with the use of Covidence to remove duplicates and screen titles and abstracts. The 14 included reviews were published between 2014 and 2023, comprising 9 systematic reviews and 5 systematic reviews and meta-analyses. AMSTAR-2 was used to complete a quality assessment of the reviews, and the results were critically low for 7 literature reviews and low for the other 7 literature reviews. The most common types of digital intervention studied were cognitive behavioral therapy, mindfulness/meditation, and stress management followed by other self-help interventions. Effectiveness of digital interventions was found for many mental health symptoms and conditions in employee populations, such as stress, anxiety, depression, burnout, and psychological well-being. Factors such as type of technology, guidance, recruitment, tailoring, and demographics were found to impact effectiveness. This umbrella review aimed to critically evaluate, synthesize, and summarize evidence of various digital mental health interventions available within a workplace setting. Despite the low quality of the reviews, best practice guidelines can be derived from factors that impact the effectiveness of digital interventions in the workplace. OSF Registries osf.io/rc6ds; https://doi.org/10.17605/OSF.IO/RC6DS.

Glucose Lowering through Weight management (GLoW): a randomised controlled trial of the clinical and cost effectiveness of a diabetes education and behavioural weight management programme vs a diabetes education programme in adults with a recent diagnosis of type 2 diabetes.

UK standard care for type 2 diabetes is structured diabetes education, with no effects on HbA1c, small, short-term effects on weight and low uptake. We evaluated whether remotely delivered tailored diabetes education combined with commercial behavioural weight management is cost-effective compared with current standard care in helping people with type 2 diabetes to lower their blood glucose, lose weight, achieve remission and improve cardiovascular risk factors. We conducted a pragmatic, randomised, parallel two-group trial. Participants were adults (≥18 years) with overweight or obesity (BMI≥25 kg/m2) and recently diagnosed with type 2 diabetes (≤3 years), recruited from 159 primary care practices in England. We randomised participants to a tailored diabetes education and behavioural weight management programme (DEW; delivered by Weight Watchers) or to current standard care diabetes education (DE; Diabetes Education and Self Management for Ongoing and Newly Diagnosed [DESMOND] programme), using a computer-generated randomisation sequence in a 1:1 allocation stratified by gender and diabetes duration, unknown to those collecting and analysing the data. Participants could not be blinded due to the nature of the interventions. Participants completed assessments at 0, 6 and 12 months. The primary outcome was 12 month change from baseline in HbA1c. We also assessed bodyweight, blood pressure, cholesterol (total, HDL, LDL), glucose-lowering medication, behavioural measures (physical activity, food intake), psychosocial measures (eating behaviour, diabetes-related quality of life, wellbeing) and within-trial and modelled lifetime cost effectiveness. We randomised 577 participants (DEW: 289, DE: 288); 398 (69%) completed 12 month follow-up. We found no evidence for an intervention effect on change in HbA1c from baseline to 12 months (difference: -0.84 [95% CI -2.99, 1.31] mmol/mol, p=0.44) or 6 months (-1.83 [-4.05, 0.40] mmol/mol). We found an intervention effect on weight at 6 (-1.77 [-2.86, -0.67] kg) and 12 months (-1.38 [-2.56, -0.19] kg). Participants in DEW had a higher likelihood of achieving diabetes remission than participants in DE (6 months: RR 2.10 [95% CI 1.03, 4.47]; 12 months: RR 2.53 [1.30, 5.16]). DEW was cost-effective compared with DE in within-trial and lifetime analyses, in the latter generating an incremental cost effectiveness ratio of £2290 per quality-adjusted life year gained. A commercial behavioural weight management programme combined with remote dietary counselling after diagnosis of type 2 diabetes did not improve HbA1c up to 12 months post intervention in this trial. The intervention could help people achieve weight loss and be cost-effective compared with current standard National Health Service care. ISRCTN 18399564 FUNDING: National Institute for Health and Care Research (NIHR; RP-PG-0216-20010), Medical Research Council (MC_UU_00006/6), NIHR Cambridge Biomedical Research Centre (NIHR203312).

P1213 The role of stress in dietary choices and disease outcomes in Inflammatory Bowel Disease

Abstract Background The role of nutrition in managing Inflammatory Bowel Disease (IBD) is widely discussed, yet its interplay with stress-related factors influencing eating behaviour and disease management remains complex. Stress-induced eating behaviours, such as increased comfort foods consumption, may exacerbate symptoms and hinder effective disease management, impacting clinical outcomes and quality of life. This study, part of EU-funded MiGut-Health project, assesses the relationship between stress, eating behaviours, and disease management in IBD patients, focusing on comfort food consumption, psychological food involvement, and disease-related factors, including health engagement, stool consistency, and disease activity. Methods In August 2024, a cross-sectional study was conducted applying an online survey to a cohort of 2,276 adult IBD patients across Italy. The survey included validated scales: the Patient Health Engagement Scale (PHE-s), Psychological Food Involvement Scale (PFIS), Perceived Stress Scale (PSS-10), Salzburg Stress Eating Scale, Inflammatory Bowel Disease Symptom Inventory (IBDSI-SF), and Bristol Stool Chart, along with items on Comfort Food Consumption. Data analysis involved descriptive analysis and independent samples t-test. Results Participants reported moderate perceived stress (mean=17.3 ± 7.75), with 35.5% indicating increased comfort food consumption when stressed, primarily chocolate (23.2%), sweet snacks (22.0%), and savoury snacks (21.0%). Individuals with high stress (32.6%) were more likely to consume fast food (mean=0.4 ± 0.66, p < 0.001) and sweetened beverages (mean=0.7 ± 1.21, p < 0.001). They placed greater importance on comfort food groups for managing stress (mean=2.7 ± 1.17 vs 2.5 ± 1.14, p < 0.001). Disease activity was notably higher in the high-stress group (mean=29.2 ± 15.61 vs. 16.8 ± 11.66, p < 0.001), alongside looser stool consistency (mean=4.8 ± 1.59 vs. 4.3 ± 1.45, p < 0.001). High-stress patients also demonstrated lower health engagement (mean=2.1 ± 0.68 vs. 2.6 ± 0.74, p < 0.001) and reduced psychological food involvement (mean=4.1 ± 1.17 vs. 4.4 ± 1.09, p < 0.001). Conclusion Stress significantly shapes eating behaviours and disease management in IBD patients. High stress correlates with increased comfort foods consumption, reduced psychological food involvement, and poorer disease outcomes, including heightened symptoms, looser stool consistency, and diminished health engagement. These findings highlight the complex relationship between stress and disease-related factors, suggesting the need for integrated interventions targeting stress management to improve dietary behaviours and overall disease management in IBD.

Effects of a Behavior Intervention Based on the Recurrence Risk Perception and Behavioral Decision Model for Ischemic Stroke Patients: A Randomized Controlled Trial.

Behavioral management is essential to preventing recurrence after stroke, but its adherence is limited worldwide. We aimed to assess the impact of the behavior intervention based on the Recurrence risk perception and Behavioral decision Model for ischemic stroke patients' health behavior. This study was a single-blind, randomized, controlled trial with a 3-month follow-up. The outcome measures were the perception of the risk of stroke recurrence, behavioral decision, and health behavior. A total of seventy participants were randomized to the intervention group (n = 35) or control group (n = 35). The former received a twelve-week theory-based intervention in addition to the routine education, while the control group received only the routine education. The generalized estimating equations results indicated that the intervention group had significantly greater improvements in perception of the risk of stroke recurrence compared to the control group at all T1 (B = 0.13, 95% CI: 0.03 to 0.23), T2 (B = 0.18, 95% CI: 0.07 to 0.28), and T3 (B = 0.16, 95% CI: 0.07 to 0.25) after adjusting for stroke frequency. Statistically significant improvements were found in behavioral decision for the intervention group compared with the control group at T2 (B = 0.25, 95% CI: 0.09 to 0.41) and T3 (B = 0.26, 95% CI: 0.10 to 0.43). Results also showed a significantly higher increase in health behavior at T1 (B = 0.29, 95% CI: 0.09 to 0.48) and T2 (B = 0.22, 95% CI: 0.04 to 0.40). The intervention can improve the perception of the risk of stroke recurrence, behavioral decision, and health behavior in ischemic stroke patients. IMPLICATIONS: This study provides a reference point for promoting healthy behaviors in patients with ischemic stroke. A recurrence risk perception and behavioral decision model-based intervention was deemed to be feasible and useful in practice. PATIENT OR PUBLIC CONTRIBUTION: Patients and their caregivers agreed to participate in the study and shared their experiences of participating in research with us.

If They Talk, Will You Listen? How Youth Perspectives Should Inform Behavior Management Practices Towards Sustainable School Climate Improvement

Student behavior management remains a pivotal area of consideration for pre- and in-service secondary teachers and administrators alike. Hoping to gain deeper insight into the intersection between student behavior and school climate an action research methodology is employed to invite students into the debate as active school stakeholders. A case study from one inner city high school engaged 25 youth participants in a 6-week long focus group to learn about the research process through the creation and analysis of three arts-based data collection methods: timeline, relational map, and photovoice. Student led analysis of the data demonstrated that student behavior is inextricably linked to the quality of the social aspect of school climate. Healthy school climates which inspire positive student engagement and behavior are ones which: 1) foster positive student-staff relationships; 2) incorporate pedagogical practices which allow for student voice and choice; and 3) encourage the opportunity for redemption following infractions. While restorative measures are presented as effective ways to promote positive student behavior and healthy school climates, stakeholders wishing to authentically transform school systems are cautioned to reflect deeply on power and privilege to dismantle traditional structures for sustainable growth.

Posttraumatic Stress Disorder and Weight Loss in Male and Female Active-duty Service Members: A Weight Management Study.

Overweight and obesity are critical public health concerns with relevance to U.S. military personnel, as active duty service members must meet physical fitness and body composition standards. Biological sex and posttraumatic stress disorder (PTSD) diagnosis may affect service members' weight management efforts, but it is unclear what contribution each of these factors independently or in combination have on weight loss. Addressing this gap in knowledge, the current study used multilevel models to examine the effects of sex and self-reported PTSD diagnosis on change in weight of active duty Navy service members (n = 178, 61% female, 24% PTSD) over the course of and after a behavioral weight management intervention. On average, participants' weights decreased significantly during the intervention (P < .001), and there was a significant sex-by-PTSD interaction effect such that male participants without a self-reported PTSD diagnosis and female participants with a self-reported PTSD diagnosis lost significantly more weight during the intervention than their counterparts (P = .015). The main effects of sex and self-reported PTSD diagnosis on weight change during the intervention were nonsignificant (P's ≥ .24). While weight remained stable on average during the follow-up period (P = .28), female sex marginally predicted weight loss during the follow-up period (P = .07), whereas self-reported PTSD diagnosis and the sex-by-PTSD interaction were not significant (P's ≥ .16). These results highlight the importance of considering both sex and PTSD diagnosis as factors that together may influence the efficacy of behavioral weight management programs for active duty service members. NCT01757847.

Reducing children’s anxiety and pain in dental environment using an eye massage device combined with natural sounds—a randomized controlled trial

This study evaluated the efficacy of an eye massage device that uses acupressure points combined with natural sounds to reduce anxiety and pain in children receiving dental anesthesia for the first time. A total of 105 children aged between 8 and 10 years whose dental treatment required inferior alveolar nerve block (IANB) injection participated in this randomized controlled clinical trial. The participants were randomly divided into three groups: Group A: eye massage with natural sounds; Group B: eye massage only; and Group C (control group): traditional behavior management techniques. Anxiety and pain were assessed before, during, and after anesthesia using the Children’s Fear Scale (CFS), Wong-Baker pain rating scale (WBS), the Face-Legs-Activity-Cry-Consolability (FLACC) observational pain assessment scale, and pulse rate as a physiological scale. Anxiety and pain significantly decreased in groups A and B compared with those in the control group (p < 0.05), with group A showing a greater decrease in pulse rate and objective pain assessed during injection via the FLACC scale than group B (p < 0.05); however, no significant difference was noted between groups A and B regarding the data recorded after anesthesia using the WBS and CFS (p > 0.05). Changes in pulse rate and anxiety levels (CFS) measured before and after the procedure in each group revealed a significant decrease in fear and pulse rate in group A and no significant change in group B, whereas group C showed a significant increase in pulse rate and fear at the end of the procedure. Eye massage with natural sounds can effectively alleviate children’s anxiety in the dental setting and reduce pain related to anesthesia, and the combination of these two interventions has the best relaxation effect on children.

Landscape of Cyclic Vomiting Syndrome: From Bedside to Bench, Past to Present.

Investigations into mechanisms of cyclic(al) vomiting syndrome (CVS) began at the bedside more than a century ago. The modern era started with the formation of the Cyclic Vomiting Syndrome Association in 1993 that helped initiate robust efforts in education, advocacy, family physician conferences, scientific symposia, dedicated clinical programs, therapeutic guidelines, and research. Even today, bedside clues continue to emerge with the recent description of cannabinoid hyperemesis syndrome (CHS) and subsequent evidence of a perturbed endocannabinoid system. The clinical picture of CVS has evolved from that of a straightforward emetic disorder related to migraine requiring short-term antiemetics or prophylactic anti-migraine therapy, to a complicated, heterogenous one with multiple comorbid associations (anxiety, dysautonomia) and endophenotypes (migraine, Sato, CHS). This expanded view has important therapeutic implications which necessitate managing the comorbidities which can in turn impact the disease itself and proffered promising evidence that behavioral management (meditation) and vagal neuromodulation appear efficacious with few untoward effects, perhaps by reestablishing autonomic (parasympathetic) balance. The pathophysiologic picture now appears to be inscribed on an autonomic polyvagal design but multiple additional pathways interact, some confirmed (NK1, CB1, HPA axis, PPM1D gene, biological calendar, estrogen), and others, possible (TRPV-1, CGRP, GDF-15, mitochondrial dysfunction, impaired cation transport). CVS and its cousin CHS continue to challenge clinicians and perplex investigators and in the current era require not only a critical mass of specific pathway expertise but also syncretic biopsychosocial thinking to integrate these disparate threads. We may have reached such a tipping point at this Symposium.

Efficacy of Traditional, Complementary, and Integrative Medicine in Pain and Psychological Distress Management for Pediatric Palliative Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Traditional, complementary, and integrative medicine (TCIM) is being increasingly used to manage symptoms in patients with palliative needs. However, there is a lack of evidence to guide its use in the pediatric palliative care (PPC) setting. This study aimed to synthesize and evaluate the current evidence on the effectiveness of TCIM in reducing pain and psychological distress in PPC. Four English electronic databases were searched for randomized controlled trials (RCTs) published between January 2000 and August 2023. The standardized mean difference (SMD) was used to report the pooled magnitude of the treatment effect. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the quality of the evidence for each treatment outcome. Thirty RCTs were included. The interventions were massage (n = 9), music therapy (n = 6), hypnosis (n = 3), acupuncture, aromatherapy, and other TCIM modalities. Compared with the control interventions, music therapy significantly decreased pain (SMD: -1.07; 95% CI: -1.64 to -0.50; P < 0.05; I2 = 72%) and relieved anxiety (SMD: -0.75; 95% CI: -1.35 to -0.15; P < 0.05; I2 = 74%); massage significantly decreased pain (SMD: -0.74; 95% CI: -1.46 to -0.02; P < 0.05; I2 = 83%) and relieved anxiety (SMD: -0.61; 95% CI: -1.21 to -0.01; P < 0.05; I2 = 71%). Hypnosis had significant effects on procedure-related anxiety, pain, and behavioral distress management (P < 0.05). The quality of evidence was rated as "moderate" for the efficacy of music therapy in alleviating pain and anxiety and "low" for the efficacy of all of the other interventions. Existing evidence supports the therapeutic benefits of music therapy, massage, and hypnosis on relieving pain and anxiety symptoms in the PPC setting, though the evidence is of low-to-moderate quality.

Hyperlocal marketing: conceptual representation status, technological foundations and directions of development.

Hyperlocal marketing is a modern format of interacting with customers in the offline segment of retail and services, aimed at increasing sales by optimising strategies for promoting specific products. In conditions of market saturation, traditional marketing methods become less effective, so the use of new approaches allows companies to attract customers on a point-to-point basis and adapt their offers to specific locations and audience needs. Over the past decade, interest in hyperlocal marketing as a business development tool has grown in Russia, and at the same time it has become almost entirely expressed exclusively in practical terms. Its scientific implementation has not yet been recorded. The purpose of this study is to systematise the existing concepts and technologies in the field of hyperlocal marketing in order to identify its current state and prospects for development. Within the framework of the defined vector, both the technological prerequisites and requirements of this tool for ensuring the basic process in the field of offline retailing are considered, and an empirical basis for the inductive-deductive analysis of the subject field for the formation of patterns of consumer behaviour management and optimisation of the marketing policy of business agents is formed. In the course of the work, it was found that hyperlocal marketing in retail is highly dependent on the development of the Internet of Things (IoT). The use of such technologies can improve customer interaction, increase service levels and predict consumer behaviour patterns. Based on the considered instrumental and technological solutions discussed above, companies are able to create personalised marketing strategies and optimise business processes to maximise profits.

Evaluation of Auricular Acupressure on Myopia Prevention among Children Aged 6–12 Years with Pre-Myopia in China: Study Protocol of a Prospective Multi-Center Randomized Controlled Trial

Background: The increasing prevalence of myopia among Chinese children and adolescents, especially at younger ages, has emerged as a significant concern in recent years. Pre-myopia is a key period for myopia prevention and control in children and adolescents. Previous studies suggested auricular acupressure (AA) therapy might offer a viable approach to prevent and slow down myopia progression. Nonetheless, these studies lack robust, high-quality, large-scale, multi-center evidence to conclusively support such assertions. The purpose of this research is to evaluate the efficacy, safety, and economic benefits of AA therapy in preventing myopia in Chinese children aged 6–12 years with pre-myopia. Methods: The single-blind, multi-center, parallel-group, randomized controlled trial will involve 318 pre-myopic children from 20 different centers across China. After recruitment, these participants will be randomly assigned to two groups (the AA group and the control group) at a 1:1 ratio. The AA group will receive auricular point sticking therapy along with health education for a period of 24 weeks, while the control group will be provided the sham AA treatment and routine health education. The assessments of outcomes will be conducted at the start of this study, and then after 4, 8, 12, and 24 weeks. The primary outcome is the change in spherical equivalent refraction at various follow-up times. The secondary outcomes include the number of myopia cases, uncorrected visual acuity, axial length, corneal curvature radius, accommodation amplitude, retinal and choroidal thickness, and eye behavior management. In addition, the cost-effectiveness analysis will be used as the evaluation index for economic assessment. Discussion: The results of this research will provide evidence on the efficacy, safety, and economic benefits of AA therapy in preventing myopia among children aged 6–12 years with pre-myopia in China.

Effectiveness of an External Cooling and Vibrating Device vs Counterstimulation in Reducing Discomfort of Inferior Alveolar Nerve Block in Pediatric Dental Patients: A Single-blinded Randomized Controlled Trial.

Pain management in pediatric patients during dental procedures is very important. Here, the traditional method of behavior management is compared with novel methods. To compare and determine the effectiveness of an external cooling and vibrating device vs counterstimulation with the conventional technique in reducing the fear and discomfort of pediatric dental patients aged 5-7 years during inferior alveolar nerve block (IANB). The study population consisted of children aged 5-7 years, rated as positive (+) or negative (-) on the Frankl behavior rating scale, who reported to the Department of Pediatric and Preventive Dentistry and required dental procedures in posterior teeth that warranted the use of IANB.Anxiety measurement was conducted by both objective and subjective means. The subjective measures included Wong-Baker Faces Pain Rating Scale (WBFPRS), as chosen by the patient, and Face, Legs, Activity, Cry, Consolability Scale (FLACC), as recorded by the observer, while the objective measure was pulse rate, recorded by a pulse oximeter.Group A: External cooling and vibrating device (Buzzy).Group B: Counterstimulation group.Group C: Control group. The WBFPRS score and FLACC score reduced following the intervention in the counterstimulation group, indicating a reduction in pain perception and anxiety compared to the application of Buzzy and the conventional technique. Counterstimulation was the most effective in reducing pain perception and anxiety during the administration of IANB. The injection of local anesthetic remains one of the painful and fear-inducing procedures in pediatric dentistry. This study provides evidence that counterstimulation is effective in reducing pain perception and anxiety during the administration of IANB. Ponnan V, Santhakumar M, Thekke Veetil AK. Effectiveness of an External Cooling and Vibrating Device vs Counterstimulation in Reducing Discomfort of Inferior Alveolar Nerve Block in Pediatric Dental Patients: A Single-blinded Randomized Controlled Trial. Int J Clin Pediatr Dent 2024;17(12):1335-1339.

Health behaviours and mobile intervention use in patients recruited from general practitioners' practices in rural Bavaria.

Introduction: Individuals living in rural areas report poorer health outcomes, including obesity, compared to individuals living in urban areas. Amongst others, this is due to restricted access to opportunities for healthy eating and physical activity. Interventions are urgently needed to address this gap. It is yet unclear whether digital interventions are suited for this purpose. The present dataset provides information on adults residing in rural Germany regarding their health status, perceived access to opportunities for healthy eating and physical activity, and digital device ownership and intervention use. Materials and methods: A pen-and-paper survey was conducted in winter 2022/2023 among patients of five general practitioners' practices in rural Bavaria. Materials and data are openly available for future use. Data description: The dataset contains responses from N = 273 individuals (54.9% women, 44.8% men, 0.4% diverse; age M = 51.3, SD = 16.7; BMI M = 29.1, SD = 15.9). On average, 30.6 participants failed to respond to any given item (SD = 33.0; range 1-136). Eighty-four percent had access to the internet and a computer and 91.4% owned a smartphone, but the majority (58.5%/ 84.2%) had no prior experience with mobile physical activity or dietary interventions, respectively. Discussion: This dataset provides insights into barriers and facilitators to healthy eating and physical activity in rural populations and digital (health) technology use. It provides starting points for behavioural weight management interventions in rural areas.

Novel Scent Enrichment Enhances Socio-Sexual and Olfactory Behaviors in Zoo-Housed Gentle Lemurs.

The Alaotran gentle lemur (Hapalemur Alaotrensis) is one of the most endangered primates in the world and shows a low success rate in captive breeding programmes. We tested a novel scent enrichment, made up of a synthesized mixture likely conveying information about female fertility, on four unsuccessful breeding pairs (n = 8 subjects) living at the Jersey, Birmingham, London (United Kingdom) and Mulhouse (France) zoos. We evaluated the effects of the scent enrichment on behavior (515 h of observation) and fecal endocrinology (cortisol and testosterone measurements) (n = 180 samples) comparing pre- enrichment, enrichment and post- enrichment phases. We found a small effect by sex on olfactory behaviors related to the enrichment. We also found that both male and female sexual behaviors significantly increased during the enrichment. Conversely, we did not find any significant change related to enrichment in cortisol and testosterone levels, whilst some effect by the zoo environment. Our results show little effectiveness by the scent enrichment as the lemur hormone levels did not change significantly and the lemurs continued to fail to reproduce following the enrichment. Nevertheless, our findings highlight that biologically relevant scent may trigger natural species-specific behaviors, with potential implications for enhancing behavioral health and management of zoo-based endangered lemur species.

The Relationship Between Teacher Training in Emotional Intelligence and Classroom Behavior Management in Nigeria

Emotional intelligence (EI) is increasingly recognized as a critical skill for teachers in managing classroom behavior and fostering effective student engagement. This study outlines a strategic roadmap for integrating EI into teacher training programs in Nigeria, addressing systemic gaps, cultural relevance, and sustainability. Key components include policy reforms to mandate EI training, development of localized and adaptable modules, and collaborative partnerships among governments, NGOs, and academic institutions. Barriers such as lack of institutional support, financial constraints, and societal attitudes are also examined. The proposed framework emphasizes the transformative potential of EI in improving classroom dynamics, enhancing teacher effectiveness, and creating inclusive learning environments. This paper aims to provide a foundation for educators and policymakers to implement EI as a core component of teacher education.

Parental Acceptance of Moderate Sedation and Associated Techniques for Behavior Management in Saudi Arabia: A Cross-Sectional Study.

This study aimed to evaluate the acceptance of moderate sedation (MS) as a behavior guidance technique (BGT) method among Saudi parents, and also assess their acceptance of other BGTs, including parental separation, papoose board (PB), and nitrous oxide (N2O), used in conjunction with MS. This cross-sectional study was conducted at the Dental University Hospital, King Saud University, Riyadh, Saudi Arabia. It involved Saudi parents of children aged 3-5 years undergoing dental treatment with MS, alongside additional BGTs such as parental separation, PB, and N2O. Parents completed a questionnaire with demographic details and a post-treatment acceptance survey evaluating their satisfaction with the MS. Descriptive statistics were used for demographic information and parental acceptance. Chi-square and Fisher's exact tests analyzed the association between parental acceptance and background characteristics. A total of 85 parents were included in the study. Among these parents, 77 (90.59%) accepted MS, reporting minimal distress during dental treatment, and 78 (91.76%) would choose MS again. The PB received strong support from 79 (92.94%) of parents, with 83 (97.65%) finding it useful for child protection. However, 43 (50.59%) of parents felt uncomfortable with parental separation during therapy. Over 90% of Saudi parents showed high acceptance of MS and PB as BGTs. The study also revealed that 50.59% of parents were uncomfortable with being separated from their children during treatment. These findings highlight the need for strategies that can accommodate family involvement in pediatric dentistry, ultimately improving parental satisfaction.