Length Of Clinical Experience Research Articles

Therapist self-disclosure in teletherapy early in the COVID-19 pandemic: Associations with real relationship and traumatic distress.

The usefulness of therapists' self-disclosure (TSD) in psychotherapy remains controversial, and little is known regarding the potential risks and benefits of TSD in times of global crisis such as the COVID-19 pandemic and in teletherapy. We examined two independent samples of therapists (N = 1705; Study 1) and patients (N = 772; Study 2) on their perceptions of increases in TSD during the transition to teletherapy early in the COVID-19 pandemic (spring 2020). Approximately 20% of therapists and 14% of patients reported perceptions of definite increases in TSD. Therapists' top reasons for increased TSD were therapists' heightened distress and an effort to connect with patients in teletherapy. Importantly, therapist perceptions of their increased TSD were positively related to subjective vicarious trauma, real relationship, psychodynamic theoretical orientation and negatively with humanistic orientation, but not with age, race/ethnicity, length of clinical experience, working alliance, or professional self-doubt. Patients' perceptions of increased TSD were positively related with patient pandemic-related traumatic distress and their own self-disclosure, but not with patient-reported therapeutic relationship variables. Longitudinally, patients' perceptions of TSD increases predicted higher pandemic-related traumatic distress at 3-month follow-up, after controlling for their baseline traumatic distress and other variables. These results highlighted that increased TSD in teletherapy may be a potential marker for heightened distress in both patients and therapists during a global crisis and a transition to teletherapy. The findings also contrasted the literature and emphasized that therapists, but perhaps not patients, may have considered increased TSD as a reflection of genuine therapeutic connection.

Perceived Relationship Between Horizontal Violence and Patient Safety Culture Among Nurses.

Despite the value of undertaking patient safety culture, its association with horizontal violence in nursing workplace is still understudied. This study aimed to investigate the association between the perceived patient safety culture and its relationship with horizontal violence among nurses working in Jordan. A cross-sectional correlational design was used. Nurses working in major governmental hospitals in Jordan were conveniently recruited to complete an online self-administered questionnaire, which included the following tools: Hospital Survey on Patient Safety Culture and Negative Behaviours in Healthcare (NBHC) Survey. The survey was designed to measure attitudes and perceptions on patient safety culture at multiple levels of a healthcare organization with ten dimensions. The Negative Behaviours in Healthcare (NBHC) survey was developed as an adaptation of the Lateral Violence in Nursing Survey (LVNS) with 25 items and two open-ended questions. A total of 330 nurses responded to the questionnaire. Nurses moderately perceived patient safety culture (HSOPS mean = 3.5, SD = 1.1). Low incidence of horizontal violence was claimed (mean = 2.1, SD = 1.1). However, it was associated with moderate negative correlation with patient safety culture (r = -0.53, p < 0.001). Regression model revealed that patient safety culture explained an additional 53% of the variance of horizontal violence after controlling the effects of age and length of clinical experience (R-square change: 0.560, SE: 19.7, P: 0.001, CI: 1.21-1.57). Despite its low incidence, patient safety culture was found influential to the horizontal violence based on the perspectives of nurses in Jordan. Patient safety culture can be incorporated with other factors that contribute to the development of horizontal violence in nursing workplace.

Exploring the benefits of full-time hospital facility dogs working with nurse handlers in a children's hospital.

To examine the benefits of full-time hospital facility dogs (HFDs) working with qualified nurse handlers for inpatients in a pediatric medical facility. A questionnaire survey on the evaluation of HFD activities was conducted in a hospital that had introduced HFDs for the first time in Japan and has been using them for 9 years. Of the 626 full-time medical staff, 431 responded, of which 270 who observed HFD activities were included in the analysis. The Questionnaire contained 20 questions, and nine questions were selected for presentation in this paper because they focused on the situations in which HFD activities were thought to have a strong impact on inpatients. A comparison of the respondents' evaluations for each question was made, and differences in the respondents' attributes (such as profession, length of clinical experience and experience of dog ownership) for those items were examined. The impact of HFDs in terminal care was ranked highest among the respondents. Similarly, HFDs increased patient cooperation for clinical procedures. The responses to these two items did not differ statistically depending on the respondents' attributes. The results imply that patients were more cooperative even for highly invasive examinations and procedures with the support of HFD activities. Healthcare providers considered that HFDs were useful, especially for providing support during the terminal phase and for gaining patients' cooperation for procedures. The fact that the handler was a nurse and the HFD team worked full-time may have enhanced the effectiveness of the program.

Missed nursing care before and during the COVID-19 pandemic: A comparative cross-sectional study.

AimThis study aimed to compare perception of nurses about missed care for the patients before and during the coronavirus disease 2019 (COVID‐19) in Jordan. It also examined how nurses differed in terms of the type of missed care and the factors that contributed to it before and during the COVID‐19 pandemic. Additionally, socio‐demographic factors, including gender, educational level, length of clinical experience, work position, age, and type of shift, were examined to evaluate their association with missed nursing care.BackgroundMissed nursing care refers to omission of any aspect of required patient care. Missed care lowers patient satisfaction and also leads to adverse hospital outcomes.MethodsWe adopted a cross‐sectional design among 260 nurses working in medical/surgical wards and intensive care units. Views of 130 nurses before COVID‐19 were compared with views of 130 nurses during the COVID‐19 pandemic. We used the Arabic version of the MISSCARE survey. Data were collected between November 2019 and May 2020.ResultsDuring COVID‐19, nurses had significantly higher satisfaction levels and lower levels of absence and intention to leave than nurses before the COVID‐19 pandemic. Differences were observed between nurses’ perceptions of missed care before and during the COVID‐19 pandemic. It was observed that missed nursing care increased during COVID‐19. The inadequate number of staff nurses was the main reason for missed care activities among both groups. Additionally, age and shift type were significantly associated with an increased reason for missed nursing care among both groups.Conclusion and implications for nursingNurses reported higher satisfaction levels and fewer absences and planned departures during this period. Nurse managers should pay attention by maintaining high satisfaction levels and formulating appropriate policies to reduce missed care levels and thus improve patient care quality.

Indonesian pediatricians’ knowledge of Rome IV criteria and their therapeutic approach to infantile colic

Background Infantile colic is a functional gastrointestinal disorder (FGID) that occurs in approximately 20% of infants under 6 months. Even though this condition is self-limiting, inappropriate therapy affects the baby’s future quality of life. Therefore, it is essential for physicians, especially pediatricians, to employ a correct diagnosis based on the currently accepted Rome IV criteria and an appropriate therapeutic approach.&#x0D; Objective To assess the gaps in Indonesian pediatricians’ understanding of infantile colic according to Rome IV criteria, their therapeutic approach in managing the condition, and associated factors.&#x0D; Methods We randomly selected 131 pediatricians from the Jakarta Chapter of the Indonesian Pediatric Society to complete a questionnaire aimed at assessing their knowledge on the diagnosis of and therapeutic approach to infantile colic. The questionnaire was scored on a scale of 0 to 20. We evaluated the association between questionnaire scores and their association with several variables, including years of clinical experience, accreditation of pediatric residency institution, type of hospital, and guidelines used.&#x0D; Results Out of the 131 pediatricians selected, 75 (57.3%) had used the Rome IV criteria. The mean knowledge score of those participants was 14.24 (SD 3.32) out of 20. Mean therapeutic approach score of all participants was 11.50 (SD 2.80) out of 16 points. There was no significant association between either knowledge or therapeutic approach score with length of clinical experience, accreditation of pediatric residency institution, hospital type, or guidelines used.&#x0D; Conclusions Most surveyed pediatricians who have used the Rome IV criteria have fairly good knowledge of infantile colic. Overall, pediatricians also have a fairly sound therapeutic approach to infantile colic. However, with mean scores of approximately 70% of the maximum score, education is needed to improve on these areas. Knowledge of and therapeutic approach to infantile colic are not associated with length of clinical experience, accreditation of pediatric residency institution, hospital type, or guidelines used.

Educational demographics of orthopaedic surgery department chairs.

Becoming chair of an academic clinical department is a tremendous achievement that takes many years of experience and clinical excellence. The purpose of this study was to determine the educational demographics of current orthopaedic surgery department chairs in the United States. A complete list of orthopaedic surgery residency programs was obtained from the Accreditation Council for Graduate Medical Education (ACGME) 2019-2020 list of residency programs. Department chairs were identified through an online search. Educational data, including where the department chair went to medical school, residency, fellowship, and type of fellowship completed were obtained. A total of 145 orthopaedic department chairs were identified. The most attended medical schools by department chairs were Baylor (6 of 145, 4.1%) and Northwestern (6 of 145, 4.1%). The University of Rochester was the most common orthopaedic residency attended (9 of 145, 6.2%) and Harvard was the most common orthopaedic clinical fellowship (20 of 133, 15.0%). On average, it took 17.9 years from completion of clinical training to being named department chair. This study provides insight into the academic credentials, length of clinical experience, and research productivity of current orthopaedic surgery department chairs. Certain training programs may be more likely to produce department chairs and, in general, an orthopaedic surgeon is more likely to become chair at an institution where he/she previously trained. Finally, research productivity is clearly an important factor in becoming chair, as most chairs have high h-indices and a consistent track record of research excellence.

Age and gender differences in diagnostic decision-making of early heart failure: results of a mixed-methods interview-study using video vignettes

ObjectivesMen and women at any age show similar symptoms and signs of heart failure (HF). Since early HF symptoms are ambiguous, doctors may overlook HF as possible cause and misinterpret...

Frame analysis of psychotherapists’ perspectives on the development of psychological disorders

The development of psychological disorders has been explained by several psychological theories and remains under debate. Psychotherapists, however, have insights into the emergence and development of psychological disorders that stem from both theory and practice. The constantly evolving field of psychotherapy prompts reconsideration, specifically when psychotherapists’ views on the development of disorders impacts their treatment approach. In addition, theoretical orientation and years of clinical experience, while known to influence psychotherapists’ viewpoints also merit further study. Applying Erving Goffman’s frame analysis, semi structured interviews with psychotherapists were conducted to determine their perspectives on the emergence of mental disorders. Biological, environmental, and psychological factors were mentioned both separately and in combination by the therapists. These factors, or frames, were then analyzed in relation to the therapists’ therapeutic approaches and length of clinical experience. The analysis showed that the frames employed by the therapists were influenced by several therapeutic orientations. Moreover, therapists with more than ten years of clinical experience mentioned a combination of factors slightly more often than single factors alone. In sum, the findings showed that therapists perceived the development of mental disorders as highly complex and as an outcome of multiple factors. War was also mentioned as an environmental factor in the development of mental disorders. As this finding was clearly a country-specific environmental factor, future studies should explore the possible role of country-specific environmental factors in different countries.

Predictors of missed infection control care: A tri-partite international study.

AimThis study aimed to quantify types and frequencies of missed infection control care and to develop a theoretical model for estimating nurses’ consensus scores about this form of missed care.DesignA non‐experimental research design using self‐audit data was selected to collect information about the types and frequencies of missed infection control care from nurses employed in hospitals located in three different countries. Data collection commenced mid‐year 2018.MethodsA multivariate approach was used to apply the consensus scores of 1.911 internationally based nurses in the missed opportunities for maintaining infection control.Results/findingsThirteen variables exert direct effects on the nurses’ total scores underpinning missed infection control care. These include the methods used to prevent hospital‐acquired infections, surveillance and hand hygiene practices. Significant nurses’ demographic factors also included their countries of origin, employment status, employer type, job retention intentions, work intensity, length of clinical experience and staff development attendance.ConclusionIn magnitude of importance and having the largest effect on missed infection control care is missed care related to reducing hospital‐acquired infections followed closely by surveillance. Missed infection control care can be quantified, and variances in its practices can be accounted by exploring the nurses’ differing demographic factors, including the nurses’ country of origin.ImpactVariations in missed infection control care can be accounted for across three countries. While ward hygiene is underestimated by staff as a mechanism to minimize nosocomial infections, infection control surveillance remains the key to reducing hospital‐acquired infections. The study's outcomes invite the use of an ongoing, whole‐of‐organization approach to infection control with scrutiny being needed for improved staff adherence particularly with hand hygiene.

Pain Neurophysiology Knowledge Enhances Attitudes toward Biopsychosocial Management of Low Back Pain among Japanese Physical Therapists.

ABSTRACTObjectives:The aim of the current study was to investigate whether a postgraduate academic degree, longer clinical experience, and pain neurophysiology knowledge influence attitudes toward the balance between biomedical and biopsychosocial management of low back pain (LBP).Methods:Ninety Japanese physical therapists completed the revised Neurophysiology of Pain Questionnaire (revised NPQ), the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) questionnaire, and a survey on their degree qualifications and clinical experience. Their attitudes toward the balance between biomedical and biopsychosocial management of LBP were assessed using the mean biomedical scale scores divided by the mean biopsychosocial scale scores of the PABS-PT. Multiple regression modeling of the attitudes toward the balance between biomedical and biopsychosocial management of LBP was carried out using three independent variables: possession of an undergraduate or postgraduate academic degree, length of clinical experience, and the score on the revised NPQ.Results:Of the 90 therapists, 72 had an undergraduate degree and 18 also had a postgraduate degree. Only the revised NPQ score (β=−0.364, P <0.001) was a statistically significant contributing factor to attitudes toward the balance between biomedical and biopsychosocial management of LBP (R2=0.14). Neither having a postgraduate degree (β=0.017, P=0.871) nor the length of clinical experience (β=−0.107, P=0.303) had a significant effect.Conclusions:This study demonstrated that pain neurophysiology knowledge, but not the possession of a postgraduate academic degree or the length of clinical experience, promotes attitudes toward biopsychosocial management of LBP among Japanese physical therapists.

Cross-sectoral inter-rater reliability of the clinical frailty scale \u2013 a Danish translation and validation study

BackgroundFocus on frailty status has become increasingly important when determining care plans within and across health care sectors. A standardized frailty measure applicable for both primary and secondary health care sectors is needed to provide a common reference point. The aim of this study was to translate the Clinical Frailty Scale (CFS) into Danish (CFS-DK) and test inter-rater reliability for key health care professionals in the primary and secondary sectors using the CFS-DK.MethodsThe Clinical Frailty Scale was translated into Danish using the ISPOR principles for translation and cultural adaptation that included forward and back translation, review by the original developer, and cognitive debriefing. For the validation exercise, 40 participants were asked to rate 15 clinical case vignettes using the CFS-DK. The raters were distributed across several health care professions: primary care physicians (n = 10), community nurses (n = 10), hospital doctors from internal medicine (n = 10) and intensive care (n = 10). Inter-rater reliability was assessed using intraclass correlation coefficients (ICC), and sensitivity analysis was performed using multilevel random effects linear regression.ResultsThe Clinical Frailty Scale was translated and culturally adapted into Danish and is presented in this paper in its final form. Inter-rater reliability in the four professional groups ranged from ICC 0.81 to 0.90. Sensitivity analysis showed no significant impact of professional group or length of clinical experience. The health care professionals considered the CFS-DK to be relevant for their own area of work and for cross-sectoral collaboration.ConclusionThe Clinical Frailty Scale was translated and culturally adapted into Danish. The inter-rater reliability was high in all four groups of health care professionals involved in cross-sectoral collaborations. However, the use of case vignettes may reduce the generalizability of the reliability findings to real-life settings. The CFS has the potential to serve as a common reference tool when treating and rehabilitating older patients.

Developing a fidelity measure of early intervention programs for children with neuromotor disorders.

To describe the development of an intervention-specific fidelity measure and its utilization and to determine whether the newly developed Sitting Together and Reaching to Play (START-Play) intervention was implemented as intended. Also, to quantify differences between START-Play and usual early intervention (uEI) services. A fidelity measure for the START-Play intervention was developed for children with neuromotor disorders by: (1) identifying key intervention components, (2) establishing a measurement coding system, and (3) testing the reliability of instrument scores. After establishing acceptable interrater reliability, 103 intervention videos from the START-Play randomized controlled trial were coded and compared between the START-Play and uEI groups to measure five dimensions of START-Play fidelity, including adherence, dosage, quality of intervention, participant responsiveness, and program differentiation. Fifteen fidelity variables out of 17 had good to excellent interrater reliability evidence with intraclass correlation coefficients (ICCs) ranging from 0.77 to 0.95. The START-Play therapists met the criteria for acceptable fidelity of the intervention (rates of START-Play key component use ≥0.8; quality ratings ≥3 [on a scale of 1-4]). The START-Play and uEI groups differed significantly in rates of START-Play key component use and quality ratings. The START-Play fidelity measure successfully quantified key components of the START-Play intervention, serving to differentiate START-Play from uEI.

Challenges in the Recognition and Management of Acute Kidney Injury by Hospitals in Resource-Limited Settings

IntroductionAcute kidney injury (AKI) is prevalent in low- and middle-income countries (LMIC) and is associated with significant morbidity and mortality, particularly among hospitalized patients. Successful strategies for the prevention and management of AKI in these countries are dependent on the capacity of primary care centers to provide optimal initial management of patients at risk for this disorder.MethodsFrom December 2018 to February 2019, using mixed methods, we assessed hospital capacity and the knowledge of clinicians relevant to the prevention, diagnosis, and management of AKI in Rwanda. A checklist based on Kidney Disease: Improving Global Outcomes (KDIGO) guidelines and clinical vignette-based assessment tool were used to assess hospital capacity and provider knowledge base, respectively. Data were analyzed using stata 13 with findings reported as simple frequencies or means with standard deviation. Multivariate analysis was used to assess factors associated with a higher knowledge score among clinicians.ResultsTen hospitals and 193 health care providers from sites throughout Rwanda participated in the survey. Surveyed hospitals were equipped with basic general medical equipment but were deficient in diagnostic tools and medical supplies that would allow the diagnosis and nondialytic management of AKI. Although 20% of the hospitals could offer hemodialysis services, peritoneal dialysis services were nonexistent. With regard to knowledge base, the health care providers demonstrated significant deficiencies in the diagnosis and management of AKI. The mean knowledge score for all health providers was 6.3 (±1.5) of a maximum of 11, with a mean (±SD) score for doctors, nurses, and midwives of 6.3 ± 2.05, 6.4 ± 1.3, and 6.08 ± 1.2, respectively. On multivariate analysis, the length of clinical experience and age of the respondents were significantly associated with participants’ knowledge score.ConclusionThis study documents significant barriers to providing optimal management of AKI in primary health care settings in Rwanda, a resource-limited setting. These include lack of specialized medical personnel, significant knowledge gaps among primary health care providers, suboptimal diagnostic capacity, and limited treatment options for detection and management of AKI.

Clinical Practice Patterns for Postoperative Water Balance After Pituitary Surgery

Objective: Abnormalities of water and sodium balance, including diabetes insipidus and the syndrome of inappropriate antidiuretic hormone (SIADH), are common complications of transsphenoidal surgery. Postoperative practice patterns vary among clinicians, and no consensus guidelines exist to direct their monitoring and management. We aimed to identify and compare practice patterns regarding the evaluation and management to these postoperative complications. Methods: A questionnaire was utilized to capture demographic data and practice habits in the postoperative setting. Respondents were members of the Pituitary Society, an international organization comprised of clinicians and researchers dedicated to the study of pituitary disease. Results: Eighty-six respondents completed at least part of the survey. The geographic distribution of respondents was roughly even between American and non-American practitioners. The majority of respondents practiced at academic institutions (67.4%), worked in multidisciplinary teams (88.4%), and possessed significantly greater than 10 years of clinical experience (71%). Compared to non-American practitioners, American practitioners described a shorter length of stay postoperatively (P<.001) and prescribed more restrictive volume recommendations for postoperative SIADH (P = .0035). Early career clinicians (less than 10 years in practice) checked first postoperative sodium level earlier than later career clinicians (P = .010). Conclusion: Water and sodium dysregulation are common following transsphenoidal surgery, but their management is not well-standardized in clinical practice. We created a questionnaire to define and compare practice patterns. Most respondents practice in academic settings in multidisciplinary teams. The length of clinical experience did not significantly impact practice habits. Practice location influenced length of stay postoperatively and fluid restriction in SIADH. Abbreviations: AVP = arginine vasopressin; DI = diabetes insipidus; LOS = length of stay; SIADH = syndrome of inappropriate antidiuretic hormone.

Factors related to hospital nurse intention to leave: Does striving for work-life balance and sense of coherence affect wishes to stay in the organization?

The aim of this study is to identify relationships between striving for work-life balance (S-WLB), sense of coherence (SOC), and intention to leave among hospital nurses. In August of 2017, we conducted a self-administered questionnaire survey to 2239 nurses at nine public hospitals. The questionnaire included demographic factors, work environmental factors, organizational factors, striving for worklife balance, a 13-item SOC, the Maslach Burnout Inventory, and intention to leave. We carried out a multiple regression analysis with intention to leave as the dependent variable and others as independent variables. We obtained valid responses from 1368 full-time employed nurses (61.1%). The mean age of respondents was 36.38 ± 10.18 years, and the length of clinical experience 13.4 ± 9.65 years. The mean total score of the intention to leave was 14.58 ± 5.09. As a result of the multiple regression analysis, the SWLB and the SOC were found to be statistically related to the intention to leave even after controlling for the confounding factor of burnout. In addition, the satisfaction of desire level for the actual working assignment at the workplace was a significant independent factor. In this study, the full-time nursing staff had a low intention to leave score when they had a high score in the SWLB and the SOC. It was also found that the level of satisfaction with appointment to a desired assignment is a significant factor in the intention to leave. In establishing an attractive workplace for nursing staff, it is important to create a workplace environment and supports to be able to properly evaluate workplace satisfaction after assignments are made while taking into account individual S-WLB and SOC functions.

Experience in Rehabilitation Medicine Affects Prognosis and End-of-Life Decision-Making of Neurologists: A Case-Based Survey

BackgroundOutcome predictions in patients with acute severe neurologic disorders are difficult and influenced by multiple factors. Since the decision for and the extent of life-sustaining therapies are based on the estimated prognosis, it is vital to understand which factors influence such estimates. This study examined whether previous professional experience with rehabilitation medicine influences physician decision-making.MethodsA case vignette presenting a typical patient with an extensive brain stem infarction was developed and distributed online to clinical neurologists. Questions focused on prognosis, interpretation of an advanced directive, whether to withdraw life-sustaining treatments and information on prior rehabilitation experience from the survey respondent.ResultsOf the participating neurologists, 77% opted for the withdrawal of life-sustaining therapies (n = 70; response rate: 14.8%). This decision was not affected by age, gender, or length of clinical experience. Neurologists with experience in rehabilitation medicine tended to estimate a more positive prognosis than neurologists without, but this result was not significant (p = .13). There was an association between the intervention chosen and previous experience in rehabilitation; neurologists with experience in rehabilitation medicine opted significantly more often (31.8%) for continuing life-sustaining treatments than neurologists without such experience (8.7%, p = .04).ConclusionOur results indicate that there are subjective factors influencing decisions to limit life-sustaining treatments that are based on previous professional experience. This finding emphasizes the variability and cognitive bias of such decision processes and should be integrated into future guidelines for specialist training on end-of-life decision-making.

Cross-cultural adaptation, face validity and reliability of the Model of Human Occupation Screening Tool to Brazilian Portuguese

Introduction: The Model of Human Occupation Screening Tool (MOHOST) was developed in the UK and measures the occupational participation. Until its translation, there were no standardised instruments in Brazil of a similar nature. Objectives: To describe the translation and cross-cultural adaptation process of the MOHOST for Brazil, its face validity and test-retest reliability among occupational therapists. Method: A translation agreement was established allowing the assessment to be translated and honed after a back translation. An expert committee was formed of ten occupational therapists to test face validity of the instrument with 50 occupational therapists. Statistical analysis was employed to investigate whether the occupational therapists’ understanding of the MOHOST was linked to their length of clinical experience. The test-retest reliability was examined among a sample of eight adults with physical disabilities. Results: The cross-cultural adaptation of the Brazilian MOHOST has been completed. A significant correlation (p=0.04) was found between years of professional experience and greater understanding of the MOHOST items. The MOHOST presented very high reliability in the test-retest (r>0.900). Conclusion: A Brazilian translation of the MOHOST has face validation and test-retest reliability. Future studies addressing this instrument’s psychometric properties of validity and inter-rater reliability are recommended.

Relationship Between Resilience and Self-Rated Health in Dental Hygiene Students and Registered Dental Hygienists.

The aim of this study was to investigate whether two aspects of resilience-acquired and innate resilience-were related to self-rated health status in registered dental hygienists and students. In May through July 2017, 405 students at three dental hygiene programs and 85 registered dental hygienists, all in Fukuoka prefecture in Japan, were invited to participate in a survey including three scales: the Bidimensional Resilience Scale (BRS) to assess innate and acquired resilience, the Stress Response Scale-18 (SRS-18) to assess daily stress responses, and the Sense of Coherence 13-item scale (SOC-13) to assess the sense of coherence. Information about self-rated health status and number of years of clinical experience was also collected. Respondents were 398 students (98.2% response rate) and all 85 dental hygienists (100% response rate). The cohort with a self-rated "healthy" status scored higher on total scale and each domain of the BRS, SRS-18, and SOC-13 scales than the cohort with other self-rated health statuses. These three scales and self-rated health status were significantly correlated with each other. When innate resilience increased by one point, average self-rated health was 1.14-fold higher. In contrast, when the depression/anxiety domain score of SRS-18 increased by one point, self-rated health was 0.84-fold lower. The number of years of clinical experience was also negatively correlated with self-rated health. For these participants, innate resilience was a significant predictor of better self-rated health. To maintain the health of dental hygienists and students, it is important to understand their innate resilience as well as stress responses related to depression/anxiety factors and length of clinical experience.

Fragile X-Associated Disorders in Serbia: Baseline Quantitative and Qualitative Survey of Knowledge, Attitudes and Practices Among Medical Professionals.

We conducted a knowledge, attitude, and practice (KAP) survey of fragile X-associated disorders (FXD) in Serbia in order to obtain baseline quantitative and qualitative KAP data on fragile X mental retardation 1 gene (FMR1) pre- and full mutations (PM, FM). The survey's 16-item questionnaire included a knowledge component (12/16), such as self-assessment knowledge (SAK) and factual knowledge (FK, 2/5 questions for PM, FXTAS and FXPOI). Education-directed attitudes in the FXD field and FMR1 DNA testing practices had 4/16 items, including brief case vignettes of FXTAS and FXPOI, respectively. The study's cohort consisted of primary care physicians (referred to as “physicians” in the rest of the text) throughout Serbia (n = 284, aged 26–64 years, 176/284, 62.2% in Belgrade, Serbia) and senior medical students (n = 245, aged 23–30 years; 33.5% males) at the Belgrade School of Medicine. Strikingly, half of the survey respondents indicated “not having any” knowledge for the fragile X gene premutation and FXD. Physicians were more likely to indicate “not having any” knowledge than students (41.2% of physicians vs. 13.1% of students, P < 0.05). Roughly half of the students had “minimal knowledge” (53.5 vs. 30.5% of physicians, P < 0.05). Low FK was common in the cohort, as few physicians had “all correct answers” (7.5 vs. 3.7% of students, P < 0.05; 16.5 vs. 9.5% of students for the 2/5 premutation-related questions). Statistical analyses identified physicians' practice setting and length of clinical experience as predictors of the lack of FK on questions related to FXD. Physicians were more likely than students to indicate “strongly agreed” to expand their knowledge of the gene premutation and FXD (90.9 vs. 66.7% of students, P < 0.01). However, students more frequently indicated that they are willing to recommend DNA testing in their future practices than physicians (93.5 vs. 64.8% of physicians, P < 0.001). In conclusion, there is a major gap in knowledge regarding fragile X gene PM and FXD among the study's participants in Serbia. The study's informative-educational survey serves as an initial step in the process of enhancing the KAP of medical professionals with regards to the fragile X gene premutation and FXD.

Influence Of Dentist Gender And Clinical Experience On The Selection Of Posterior Restorative Dental Material: A Preliminary Study

Introduction: Dentist-related factors are one of the major influences on the material selection for restoration of carious and non-carious tooth surface loss. There were conflicting results regarding the impact of dentists' gender and age or length of clinical experience on restorative material selection for posterior dentition. The aims of this study were to determine the influence of gender and clinical experience on posterior restorative material selection among private dental practitioner in Malaysia. Materials and Methods: This is a cross sectional study, and a selfadministered questionnaire was distributed randomly using a simple random method, among general private dental practitioner in Kuala LUMPur. Data gathered then analysed using SPSS version 21.0 and alpha error was set at p10 years working experience) were inclined to choose tooth coloured restorative material over amalgam at 87% and 83.9% respectively. Chi square test revealed non-significant difference in the material selection with relation to gender (p=0.852) and clinical experience (p=0.748). Conclusion(s): The dental practitioner's gender and clinical experience in this study has no influence on the material selection for posterior restorations.