Self-perceived Need Research Articles

Associations between oral health impacts attributed to malocclusion and normative and self-perceived orthodontic treatment need in Turkish adolescent patients.

In the socio-dental approach, the integration of normative oral health-related quality of life (OHRQoL) and behavioral propensity measures should be considered when assessing treatment needs and planning oral services. Therefore, this study aimed to evaluate the relationship between oral health impacts attributed to malocclusion and normative and self-perceived orthodontic treatment needs in adolescent patients and to determine the clinical, sociodemographic, and behavioral factors affecting their OHRQoL. This cross-sectional study was conducted using a convenience sample size of 105 adolescent patients aged 11-14 years who were referred to the Orthodontics Clinic in the Faculty of Dentistry, Istanbul. Data were collected using clinical examinations and a self-reported questionnaire, including the condition-specific Child Oral Impact on Daily Performances (CS-COIDP) attributed to malocclusion and sociodemographic, clinical, and behavioral factors. The index of complexity, outcome, and need (ICON), gingival index, and Decayed, Missing, Filled Teeth index was used to assess oral health status. Descriptive statistics and bivariate and multivariate regression analyses were used for the data analyses. A total of 70 patients (66.7%) reported at least one impact. Furthermore, 47% of the adolescents had very difficult and difficult complexity grades. The most affected performances were "emotional (52.4%) and smiling (40%)". No significant differences were found in the total CS-COIDP scores according to caries experience; however, the gingival status was associated with the total OHRQoL. Lower tooth brushing frequency, increased malocclusion complexity, and subjective treatment need were the most important predictors of worse OHRQoL, accounting for 39.3% of the variance in the scores. ( R2 = 0.422; p < 0.001) CONCLUSIONS: Oral health professionals should consider oral behaviors, malocclusion complexity, and subjective treatment need when planning orthodontic treatment plans. Integrating ICON, CS-COIDP, and behavioral assessment will help identify adolescents who should be prioritized for treatment.

Impact of malocclusion and oral habits on oral health-related quality of life and sleep disturbance in young adults : Across-sectional study.

The aim of this study was to investigate the impact of malocclusion and oral habits on oral health-related quality of life and sleep disturbance in young adults. Across-sectional study was conducted with asample of 213 young adults aged 18-30years. Dental occlusion data were assessed through clinical examination. Aquestionnaire was used to collect data on oral habits. Outcomes were collected using the Oral Health Impact Profile (OHIP-14) and Mini Sleep Questionnaire. Anterior open bite (adjusted odds ratio [OR] = 2.41, 95% confidence interval [CI] = 1.02-5.67, p = 0.044), swallowing disorders (adjusted OR = 2.39, 95% CI = 1.13-5.05, p = 0.022), and sleeping on hands were associated with anegative impact on oral health-related quality of life. Females (adjusted OR = 2.61, 95% CI = 1.10-6.17, p = 0.029), teeth grinding (adjusted OR = 2.78, 95% CI = 1.08-7.14, p = 0.034), biting lips or cheeks (adjusted OR = 4.28, 95% CI = 1.49-12.29, p = 0.007), and self-perception of need for orthodontic treatment (adjusted OR = 7.88, 95% CI = 2.12-29.30, p = 0.002) were associated as arisk for sleep disturbances. The findings suggest that oral habits and some types of malocclusions can impact oral health-related quality of life. In addition, sleep disturbances were associated with agreater need for orthodontic treatment and ahabit of grinding teeth in young adults.

Gender differences in cost-related unmet healthcare needs: a national study in Turkiye

BackgroundUnmet healthcare needs are a complex and multifaceted issue, influenced by individual, socioeconomic, and healthcare system factors. This study aimed to investigate the determinants influencing cost-related unmet healthcare needs within the Turkish population, emphasizing a comprehensive analysis of gender disparities in accessing healthcare services.MethodsThis secondary analysis scrutinizes the 2019 Turkiye Health Survey data of 16,976 individuals aged 15 and older. The dependent variables included cost-related unmet medical, dental, and prescribed medication, and mental services. The independent variables were considered under a three-domain approach for the determination of health service utilization, developed by Andersen. Logistic regression models with predisposing, enabling, and need factors were run for any self-perceived cost-related unmet need for each sex and overall population. Another six regression models for both sexes were run for each subgroup of indivuals with unmet healthcare needs.ResultsThe study revealed that 15.4% of individuals cannot access healthcare due to financial constraints, with 16.8% for women and 13.5% for men. The highest level of unmet needs is associated with accessing dental care services for both sexes. According to multivariate analyses, the unmet need for both sexes decreases with older age and higher education level, and it is greater for those who have difficulties communicating in Turkish. By adding enabling and needs factors, the odds ratios of education decreased for men, while education became nonsignificant for women. Having chronic disease impacts unmet needs for both sexes. However, the inability to perform daily activities due to health problems was not a significant factor for men. Poorer household income increases overall unmet needs. Education is a determinant of both medical and mental care needs.ConclusionsThis pioneering study illuminates the multifaceted gender disparities in cost-related unmet healthcare needs across Turkiye, reflecting the intertwined issues of access influenced by a complex interplay of factors. Our findings underscore the significance of adopting an intersectional approach to address health inequalities.

HIV Pre-exposure Prophylaxis Awareness, Eligibility and Intention in Men Who Have Sex with Men and Transgender Women: a cross-sectional study in Colombia 2020 - 2021

Background: Despite overwhelming evidence supporting the efficacy and effectiveness of Pre-Exposure Prophylaxis (PrEP) in HIV prevention, its adoption has been marginal. In Colombia, more information about eligibility, awareness, and intentions to use PrEP in target populations and how these relate to social determinants is needed. Aim: to assess PrEP awareness, the motivational cascade, and the social conditions related to the cascade. Methods: A cross-sectional study in a non-probabilistic sample was conducted between April 2020 and February 2021 among 552 Men with Sex with Men (MSM) and 158 Transgender Women (TGW). We used the Poisson regression to explore the associations between PrEP eligibility, awareness, and elements of the motivational PrEP cascade (willingness, intention, and self-perceived need to take) and their sociodemographic characteristics. Results: 51.2 % of the participants were aware of PrEP, 58.7 % were willing to use it, 45 % were self-perceived as PrEP candidates, and 56.2 % intended to take it.TGW were less likely to be aware but more willing to use PrEP than the sample of MSM interviewed face-to-face. Low education was related to low PrEP awareness and low income to low willingness to start PrEP. Conclusions: These results support the pertinence of the cascade concept to describe the stage of the target population regarding eligibility and motivation to take it. To accelerate PrEP implementation, efforts are needed to increase awareness among MSM and TGW with focalized strategies for those with low socioeconomic status.

Reliability and self-perception of semi-automatically assessed orthodontic treatment need in elderly patients undergoing supportive periodontal therapy – a cross-sectional study

ABSTRACT Purpose Patients with periodontitis, who currently make up a large proportion of the adult population, show high interest in orthodontic therapy. It is therefore important to recognize and assess orthodontic treatment need in these patients. The index of orthodontic treatment (IOTN) is an established tool to determine malocclusions clinically and digitally. Materials and methods A semi-automatic IOTN-assessment using OnyxCeph3TM was performed on patients undergoing supportive periodontal therapy (SPT). Intra- and inter-rater reliability were investigated using intra-class-coefficient (ICC). Self-perceived aesthetic by patients and perception by the investigator according to the aesthetic component (AC) were compared to both each other and normative need, measured by the dental health component (DHC). Periodontitis stage and grade and the possibility of an orthodontic treatment were determined. Results The mean age of the 64 included patients in this study was 62.1 years (SD ± 8.6; min-max 45–81) at the time of the examination. Self-related AC was different to the investigator’s assessment (ICC: = 0.474; 95%-CI: [0.262, 0.643]). Normative treatment need compared to self-perceived treatment need resulted in poor reliability (ICC: = 0.098; 95%-CI: [−0.071, 0.298]). Comparison of IOTN between investigators showed moderate reliability for AC (ICC: = 0.618; 95%-CI: [0.331, 0.799]) and an excellent reliability for DHC (ICC: = 0.932; 95%-CI: [0.863, 0.967]). AC Intra-rater reliability was considered good (ICC: = 0.796; 95%-CI: [0.613, 0.898]). Orthodontic treatment was possible in 48 of the 64 patients. Conclusion Semi-automated IOTN-assessment showed satisfying inter- and intra-rater reliability, but patients’ self-perceived dental aesthetics differed from the dentist’s assessment as well as from the normative treatment need.

Determinants of medical care-seeking behavior for musculoskeletal conditions during US: Marine Corps training: A thematic analysis.

Musculoskeletal injuries (MSK-I) are a well-documented problem in military populations and a leading contributor to disability across military services. However, only a portion of Service members who sustain MSK-I report it to medical providers. Although several studies have identified barriers to seeking medical care in military populations, less is known about what motivates Service members to seek care for MSK-I. To describe determinants of medical care-seeking behavior for MSK-I and/or musculoskeletal pain (MSK-P) in recently-enlisted Marines during military training. Qualitative Study. School of Infantry-West (SOI-W), US Marine Corps Base XXX, XXX. 1,097 US Marines entering Infantry Training Battalion or Marine Combat Training at SOI-W. Participants completed written surveys at entry to (baseline) and graduation from SOI-W. Closed-ended question responses were used to calculate MSK-I/MSK-P and care-seeking frequencies. Open-ended responses describing determinants of care-seeking behavior were analyzed using inductive thematic analysis. Ten percent of participants self-reported sustaining MSK-I during basic training, while 14% self-reported sustaining MSK-I in SOI-W training. A greater proportion reported seeking medical care for their MSK-I/MSK-P during basic training compared to SOI-W training. The thematic analysis resulted in three main themes that describe drivers and barriers for seeking medical care: 1) Self-perceived need for medical care; 2) Prioritizing military training; and 3) Training-specific influences. Understanding determinants of care-seeking behavior is valuable when designing intervention strategies to promote early MSK-I treatment. Our findings add to previous research to elucidate reasons underlying the decisions about care-seeking for MSK-I/MSK-P. Interventions, including educational strategies and direct approaches, like embedding medical providers within units, to minimize barriers to seeking medical care in the military may reduce the burden of MSK-I/MSK-P on Service members throughout their military careers.

Comparison of knowledge, self-perception about malocclusion and orthodontic treatment need amongst undergraduate dental students

ABSTRACT Introduction Perception regarding malocclusion and esthetics is affected by knowledge, age, race, gender, social background, and exposure. This study compares knowledge and awareness of undergraduate dental students regarding malocclusion, its impact on oral and mental health, and students’ self- perceived need for orthodontic treatment. Material and Methods A multi-centre cross-sectional study evaluated 424 questionnaires. They were assessed and compared on knowledge, awareness, and self-perception regarding malocclusion. Results were reported in percentages and compared using chi-square test. Results Most of the respondents were females, (82.1%). 4th year students were most aware about malocclusion’s effects on caries (86.8%), plaque (98.1%) and gingivitis (85.8%), p-value was significant, 0.000. Mostly, 3rd year students favoured well-aligned teeth, 91.5%, (p = 0.431); 2nd year students mostly, regarded aligned teeth important for esthetics (96.2%) p = 0.042; 4th year students mostly reported self-perceived need for orthodontic treatment, 43.4% (p = 0.048) and thought malocclusion affected one’s self-esteem 86.8% (p = 0.031), acceptance amongst peers 51.9% (p = 0.000) and mental health 52.8% (p = 0.000). Conclusion Knowledge and self-perception regarding malocclusion did not have a direct relation with the level of education of the dental students studied.

Individual and Contextual Factors Associated with Adolescents' Self-Perceived Need for Treatment.

The present study aimed to investigate associations between the self-perceived dental treatment need and clinical factors, familial characteristics, and school context in adolescents. A cross-sectional study was conducted with a representative sample of 746 students aged 15 to 19 years in a medium-sized city in Brazil. Data collection involved the use of a sociodemographic questionnaire, an oral health questionnaire, and the Family Adaptability and Cohesion Scales (FACES III) instrument. Clinical examinations were performed by two trained and calibrated examiners (Kappa > 0.80) using the Nyvad criteria. A robust logistic regression analysis for complex samples was performed using a multilevel approach (α = 5%). The individual factors associated with the self-perceived treatment need were dental pain (OR = 1.08; 95% CI: 1.01-1.16), the loss of the first molars (OR = 1.09; 95% CI: 1.03-1.15), and disengaged family cohesion (OR = 1.15; 95% CI: 1.01-1.31). In terms of context, attending a public school was associated with the self-perceived treatment need (OR = 1.17; 95% CI: 1.02-1.33). Thus, the individual factors of toothache, tooth loss, and a disengaged family, as well as the school context, exerted an influence on the self-perceived treatment need.

Self-perception of need to replace dentures and oral health-related quality of life

Aim: With the significant increase in life expectancy over the last decades, it is important to understand how oral health can impact the oral health-related quality of life of older adults. This study aimed to investigate the association between need to replace dentures and oral health-related quality of life (OHRQoL) among older adults belonging to a Cohort in southern Brazil. Methods: This cross-sectional study was conducted with data from the 2019 Pelotas Elderly Cohort. The OHRQoL was assessed using the GOHAI. Need to replace dentures was self-report using a question dichotomized into yes/no. In the statistical analysis, unadjusted and adjusted models estimate from linear regression models were calculated. The significance level adopted was 5%. Results: A total of 493 older adults were included. On the GOHAI questionnaire, the mean score was 32.74 (SD±0.16). Individuals considering need of prosthesis replacement were 47.89%. Report of need to replace dentures was associated to lowest mean on the GOHAI score (β -1.14; 95%CI - 1.80; -0.478, and on the physical (β -0.56; 95%CI - 0.94 -0.17) and psychosocial (β -0.48; 95%CI - 0.74; -0.22) dimensions. Conclusion: Our findings highlight the importance of also considering subjective measures of oral health in the dental care of older adults, since reporting the need for denture replacement, regardless of the reason, was associated with a worse oral health-related quality of life, including physical and psychosocial aspects.

Low Self-Perceived Need for PrEP and Behavioral Indications of MSM Who Recently Refused Daily PrEP: A Mixed Methods Study in Three U.S. Cities.

Pre-exposure prophylaxis (PrEP) reduces sexual risk for HIV transmission by 99% when used appropriately, but remains underutilized among gay, bisexual, and other men who have sex with men (MSM). In this mixed-method study, we describe reasons for PrEP refusal associated with low self-perceived need for PrEP among MSM who recently declined daily oral PrEP when offered by a provider. Data are from a quantitative behavioral survey of MSM (N = 93) living in Atlanta, Chicago, and Raleigh-Durham, who also either responded to an in-depth interview (n = 51) or participated in one of 12 focus groups (n = 42). Themes of low self-perceived need for PrEP were: low self-perceived risk for HIV acquisition (33% of respondents); confidence in remaining HIV-negative (35%); using condoms (81%); limiting number of partners and choosing partners carefully (48%); asking partners about their HIV status before having sex (45%); engaging in safer sexual positions or oral sex (28%); being in a monogamous relationship or exclusivity with one partner (26%); and regular HIV testing (18%). Low self-perceived risk for HIV acquisition and high confidence in other prevention strategies were important factors related to low self-perceived need in MSM refusing daily oral PrEP when offered. Providers should continue to discuss the benefits of PrEP as a safe and highly effective option for HIV prevention.

Determinants of Staff Intent to Leave Health Care During the COVID-19 Pandemic.

Objectives. To identify potential drivers of health care worker attrition. Methods. We conducted a survey of 1083 nonphysician health care workers in a large urban health system in New York City from September to October 2022. Results. The results of a multivariable logistic regression analysis revealed that higher odds of intending to leave health care were significantly associated with male gender, registered nurse profession, burnout, self-perceived mental health service need, and verbal abuse from patients or visitors, whereas lower odds were seen among those reporting greater emotional well-being and a better workplace culture. A relative importance analysis indicated that burnout was the strongest correlate of intention to leave (22.5% relative variance explained [RVE]), followed by subjective emotional well-being (16.7% RVE), being a registered nurse (12.3% RVE), poorer perceived workplace culture (9.5% RVE), and male gender (5.9% RVE). Conclusions. Overall, our findings suggest the need for well-coordinated interventions that address both individual- and system-level factors in an effort to improve retention. Public Health Implications. Our results indicate a need for interventions targeting workplace culture, staff burnout, and mental health service provision. (Am J Public Health. 2024;114(S2):S200-S203. https://doi.org/10.2105/AJPH.2024.307574).

Effect of Over-the-counter Whitening Toothpaste and Mouthwash in Orthodontics: A Literature Review.

To summarize and analyze all the available literature on the use of over-the-counter toothpaste and mouthwashes with whitening agents and their possible effects on orthodontic treatment. Tooth color change frequently occurs during orthodontic treatment and represents a self-perceived need. According to the patient's perspective, there is a preference for the use of toothpaste and mouthwashes with some whitening effect. An electronic bibliographic search in English was carried out until June 2022, in PubMed, Scopus, and Web of Science databases. Randomized or nonrandomized clinical trials and experimental laboratory studies were included. A total of 57 papers were obtained from an electronic search and 11 studies were included in the review. Outcomes such as strength force elastomeric, color stability, frictional resistance, ion release, shear bond strength (SBS), and adhesive remnant index (ARI) were evaluated. Toothpaste and mouthwashes with whitening action did not have a favorable effect on most of the outcomes evaluated. In some cases regular toothpaste showed a better effect and in other cases, there were no differences with the control group. Only in the outcome release of ions from wires to whitening effect in teeth with or without attached brackets, they have a better performance. Due to the unfavorable effects of over-the-counter whitening toothpaste and mouthwashes on orthodontic materials and appliances, their use should be justified during treatment. Chinchay-Ruesta S, Ortiz-Pizarro M, Rodríguez-Díaz DR, et al. Effect of Over-the-counter Whitening Toothpaste and Mouthwash in Orthodontics: A Literature Review. Int J Clin Pediatr Dent 2023;16(S-3):S311-S316.

Relationship between Gerotranscendence and Oral Health-Related Quality of Life among Elderly Population in Tertiary Care Hospital, Wardha, Maharashtra: A Cross-sectional Study

Introduction: Gerotranscendence represents a shift in metaperspective, transitioning from a materialistic and rational outlook to a more cosmic and transcendent one. This phase fosters resilience in older individuals, enabling them to overcome the challenges and despondency associated with ageing, thereby promoting a positive embrace of the ageing process. Remarkably, individuals with high levels of gerotranscendence, even in the presence of poor oral health, demonstrate the capacity to cope and adapt to their circumstances. This adaptive capability may contribute to an enhancement in their self-reported Oral Health-Related Quality of Life (OHRQoL). Aim: To evaluate the relationship between gerotranscendence and OHRQoL among the elderly population in the Vidarbha region. Materials and Methods: This cross-sectional study was conducted over a 6-month period from March 2023 to August 2023 in collaboration with the Department of Prosthodontics and the Department of Public Health Dentistry at the Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra on 350 participants. The study included volunteers aged ≥70 years, residing in homes or old age homes, and those visiting tertiary healthcare centers. Methodologically, data collection employed a self-made organised proforma. Oral examinations were conducted using Type III inspections with a mouth mirror. Gerotranscendence was assessed using the Gerotranscendence Scale Type 2 (GST2), which was validated and translated into Marathi. The Geriatric OHRQoL was evaluated using the Geriatric Oral Health Assessment Index (GOHAI), also translated into Marathi. The study used Chi-square tests for categorical variables and Pearson’s and Spearman’s tests for correlation analyses. Results: The average gerotranscendence score was 23.45 (95% confidence interval [CI]: 22.96, 23.94), reflecting a mid-level of gerotranscendence, indicating that the gerotranscendence score was neither low nor high. According to Pearson’s and Spearman’s correlation tests, the gerotranscendence score was significantly positively correlated with age and self-perceived need for treatment. The mean GOHAI score was 40.16 (95% CI: 39.55, 40.76). A substantial positive association between the GOHAI and self-perceived need for treatment was found using Pearson’s and Spearman’s correlation tests. When comparing gerotranscendence and GOHAI, Pearson and Spearman correlation tests revealed a significant positive association (p&lt;0.001). Conclusion: Gerotranscendence was significantly positively correlated with OHRQoL, independent of objective oral status. Despite having poor oral health, elderly individuals with high levels of gerotranscendence may be better able to handle and adapt to their circumstances, which could result in an improvement in self-reported OHRQoL.

Comparing approaches to determining poor oral health among older adults in a national survey.

To compare the clinical validity of the three approaches in residential care facility residents. In NZ residential care facilities, the interRAI assessment tool is used by trained registered nurses for assessing oral status when new residents are admitted, but its validity has been questioned. Although Locker's global oral health item has been used to measure oral health in surveys and health services research, it is not routinely used in care facilities, yet its clinical validity has been demonstrated in population-based samples. Self-perceived oral health need may also be useful. Using a secondary analysis of clinical and self-reported data from a national survey of nursing home residents (the 2012 New Zealand Older People's Oral Health Survey, or OPOHS), we compared the validity of Locker's item, the interRAI tool and self-reported treatment need for identifying three key clinical indicators of poor oral health among dentate older adults; those were coronal caries (3+ teeth affected), root caries (1+ teeth affected) and xerostomia. Analyses were conducted using STATA, and survey weighting was used to obtain estimates for a source population of 25-843 individuals. The prevalence of 3+ teeth with coronal caries was 28.7% (23.9, 34.0), the prevalence of 1+ teeth with root caries was 33.7% (28.7, 39.0), the prevalence of xerostomia was 23.1% (18.4, 28.3). Marked gradients in prevalence risk ratio were seen across different categories of Locker's global oral health item and the interRAI assessment tooth for coronal caries and xerostomia. Locker's global oral health item gave a better fitting model and was more discriminative in detecting coronal caries than the interRAI assessment tool (Lockers AIC = 0.76, interRAI AIC = 0.81). None of the approaches was particularly discriminative for root surface caries experience. Self-reported approaches are discriminative for poor oral health. Standardised assessment tools used in residential care facilities should consider including a self-assessment component such as Locker's global oral health item.

Evaluating the dissociation between drivers’ self-perceived and objective need for vehicle assistance during obstacle avoidance tasks

Driver-assistance systems are becoming more commonplace; however, the realized safety benefits of these technologies depend on whether a person accepts and adopts automated driving aids. One challenge to adoption could be a preference-performance dissociation (PPD), which is a mismatch between a self-perceived desire and an objective need for assistance. Research has reported PPD in driving but has not extensively leveraged driving performance data to confirm its existence. Thus, the goal of this study was to compare drivers’ self-reported need for vehicle assistance to their objective driving performance. Twenty-one participants drove on a simulated road and traversed challenging, real-world roadway obstacles. Afterwards, they were asked about their preference for automated vehicle assistance (e.g., steering and braking) during their drive. Overall, some participants exhibited PPD that included both over- and underestimating their need for a particular type of automated assistance. Findings can be used to develop shared control and adaptive automation strategies tailored to particular users and contexts across various safety-critical environments.

Heterogeneity in Unmet Treatment Need and Barriers to Accessing Mental Health Services Among U.S. Military Service Members with Serious Psychological Distress.

The goal of the current study is to examine heterogeneity in mental health treatment utilization, perceived unmet treatment need, and barriers to accessing care among U.S. military members with probable need for treatment. Using data from the 2018 Department of Defense Health Related Behavior Survey, we examined a subsample of 2,336 respondents with serious psychological distress (SPD; past-year K6 score ≥ 13) and defined four mutually exclusive groups based on past-year mental health treatment (treated, untreated) and self-perceived unmet treatment need (recognized, unrecognized). We used chi-square tests and adjusted regression models to compare groups on sociodemographic factors, impairment (K6 score; lost work days), and endorsement of treatment barriers. Approximately 43% of respondents with SPD reported past-year treatment and no unmet need (Needs Met). The remainder (57%) met criteria for unmet need: 18% endorsed treatment and recognized unmet need (Treated/Additional Need); 7% reported no treatment and recognized unmet need (Untreated/Recognized Need); and 32% reported no treatment and no unmet need (Untreated/Unrecognized Need). Compared to other groups, those with Untreated/Unrecognized Need tended to be younger (ages 18-24; p = 0.0002) and never married (p = 0.003). The Treated/Additional Need and Untreated/Recognized Need groups showed similar patterns of treatment barrier endorsement, whereas the Untreated/Unrecognized Need group endorsed nearly all barriers at lower rates. Different strategies may be needed to increase appropriate mental health service use among different subgroups of service members with unmet treatment need, particularly those who may not self-perceive need for treatment.

Which dental and psychosocial factors may predict bullying occurrence in adolescence?

Cohort study. 639 preschool children at baseline (T1) and 429 adolescents at follow-up (T2). Oral health conditions (untreated dental caries, dental trauma and malocclusion, sense of coherence (SOC), self-perception of dental treatment needs, general and dental bullying. Chi-square test, t-test, structural equation modeling, goodness of fit. Untreated dental caries and low socioeconomic status impacted the occurrence of both general and dental bullying. SOC and self-perceived dental treatment need were also important factors in the occurrence of bullying. The oral health condition that most impacted bullying episodes both directly and indirectly was untreated dental caries. Socioeconomic status was also an important cumulative predictor of the occurrence of episodes of bullying.

Patient's attitudes and perceptions around attending oncology consultations following surgery for colorectal cancer: A qualitative study.

Background: The oncology consultation following surgery for colorectal cancer (CRC) is usually the first step in the receipt of chemotherapy. Non-compliance with this consultation results in non-receipt of recommended chemotherapy, when appropriate, and worse clinical outcomes. This study sought to explore South African patients' attitudes and perceptions around attending scheduled oncology consultations following their CRC surgery. Methods: Semi-structured qualitative interviews were conducted with patients who had surgery for CRC at a quaternary South African hospital and who had to decide whether they would return for an oncology consultation. The "Model of health services use" informed the design of the interview guide, which included questions on factors that impact health seeking behavior. Demographics of participants, CRC disease stage, and compliance with scheduled oncology consultations were also collected. Descriptive statistics were used to analyse the quantitative data, while deductive thematic analysis was used to analyse the qualitative data. Results: Seven participants were interviewed. The median age was 60.0 years and four participants (57.1%) were female. Black African, White, and Asian participants accounted for 85.7% of the study sample. Most participants had stage III CRC (71.4%). The oncology consultation no-show rate was 14.3%. Participant's knowledge and beliefs around CRC proved to be an important predisposing factor that influenced follow-up decisions. Family support and religion were cited as important enabling factors. Travel costs to the hospital and frustrations related to the clinic appointment booking/scheduling process were cited as important disabling factors. Lastly, the participant's self-perceived need for additional oncology care also appeared to influence their decision to return for ongoing oncology consultation after the initial surgery. Conclusion: Several contextual factors can potentially influence a patient's compliance with a scheduled oncology consultation following CRC surgery. A multipronged approach which addresses these factors is required to improve compliance with oncology consultations.

Digital Adherence Technologies and Mobile Money Incentives for Management of Tuberculosis Medication Among People Living With Tuberculosis: Mixed Methods Formative Study.

Although there is an increasing use of digital adherence technologies (DATs), such as real-time monitors and SMS reminders in tuberculosis medication adherence, suboptimal patient engagement with various DATs has been reported. Additionally, financial constraints can limit DAT's utility. The perceived usefulness and the design mechanisms of DATs linked to mobile money financial incentives for tuberculosis medication management remain unclear. The aim of this study is to describe the perceived usefulness and design mechanisms for a DAT intervention called My Mobile Wallet, which is composed of real-time adherence monitors, SMS reminders, and mobile money incentives to support tuberculosis medication adherence in a low-income setting. This study used mixed methods approaches among persons with tuberculosis recruited from the Tuberculosis Clinic in the Mbarara Regional Referral Hospital. We purposively sampled 21 persons with tuberculosis aged 18 years and older, who owned cell phones and were able to use SMS text messaging interventions. We also enrolled 9 participants who used DATs in our previous study. We used focus group discussions with the 30 participants to solicit perceptions about the initial version of the My Mobile Walletintervention, and then iteratively refined subsequent versions of the intervention following a user-centered design approach until the beta version of the intervention that suited their needs was developed. Surveys eliciting information about participants' cell phone use and perceptions of the intervention were also administered. Content analysis was used to inductively analyze qualitative data to derive categories describing the perceived usefulness of the intervention, concerns, and design mechanisms. Stata (version 13; StataCorp) was used to analyze survey data. Participants expressed the perceived usefulness of the My Mobile Wallet intervention in terms of being reminded to take medication, supported with transport to the clinic, and money to meet other tuberculosis medication-related costs, all of which were perceived to imply care, which could create a sense of connectedness to health care workers. This could consequently cause participants to develop a self-perceived need to prove their commitment to adherence to health care workers who care for them, thereby motivating medication adherence. For fear of unintended tuberculosis status disclosure, 20 (67%) participants suggested using SMS language that is confidential-not easily related to tuberculosis. To reduce the possibilities of using the money for other competing demands, 25 (83%) participants preferred sending the money 1-2 days before the appointment to limit the time lag between receiving the money and visiting the clinic. DATs complemented with mobile money financial incentives could potentially provide acceptable approaches to remind, support, and motivate patients to adhere to taking their tuberculosis medication. ClinicalTrials.gov NCT05656287; https://clinicaltrials.gov/ct2/show/NCT05656287.

Characteristics of older cyclists with self-perceived needs for improvement in cycling competence: SiFAr trial

Key Summary PointsAimTo explore characteristics of community-dwelling cyclists aged 65 years and older with a self-perceived need to increase cycling competence.FindingsThe majority (68%) of this collective reported being unsafe when cycling and 41% had a bicycle fall in the past year. More than half of the participants showed at least one limitation in each of the measured cycling skills required for safe cycling.MessageKnowledge about cycling behavior, bicycle type and cycling competence of older cyclists facilitates the planning of intervention programs and road safety campaigns to prevent mobility losses and accidents.