Web-based information on oral dysplasia and precancer of the mouth - Quality and readability

OBJECTIVES: The numbers of individuals with oral cancer are increasing. This cancer is preceded by oral epithelial dysplasia (OED). There remains no detailed study of the online information presently available for patients with OED or indeed what information such patients may require to be appropriately informed regarding their condition. Hence, the aim of the present study is to assess the patient-oriented web content with respect to OED. METHODS: The first 100 websites yielded from nine searches performed using different search terms and engines were considered. These were assessed for content, quality (DISCERN instrument, Journal of the American Medical Association benchmarks, and Health on Net seal) and readability (Flesch Reading Ease Score and Flesch-Kincaid Grade Level). RESULTS: There was a general scarcity of OED content across the identified websites. Information about authors, sources used to compile the publication, treatment, and shared decision were limited or absent. Only 6% and 27% of the websites achieved all the four JAMA benchmarks and HON seal, respectively. The average readability level was at 10th grade (US schools), which far exceeds the recommended levels of written health information. CONCLUSION: At present patients seeking information on OED are likely to have difficulty in finding reliable information from the Web about this disorder and its possible impact upon their life. Further work is thus required to develop a web-based resource regarding OED that addresses the shortfalls demonstrated by the current study

Psychosocial impacts of oral epithelial dysplasia

BACKGROUND: The psychosocial impact of receiving the diagnosis of oral epithelial dysplasia, which presents up to 3.5% increased annual risk of mouth cancer, remain unknown. Using validated instruments, the present study aimed to investigate the prevalence and existing correlations between anxiety, depression and dental anxiety symptoms and burden on oral health-related quality of life. METHODS: A clinical cohort of 82 patients with oral dysplasia was asked to complete the Hospital Anxiety and Depression Scale, the Modified Dental Anxiety Scale and the shortened version of the Oral Health Impact Profile. Spearman's correlation coefficient and regression analyses were performed. RESULTS: The participants' scores were in keeping with the presence of anxiety, depression and emotional distress symptoms in 30%, 16%, and 26%, respectively. However, 69% experienced anxiety related to procedures that may be required as part of long-term management of oral dysplasia (e.g. local anaesthetic injection). The oral-health related quality of life scores showed 41.5% reporting a recent daily problem due to their oral or dental health. Significant correlations [p > 0.05] were found among and between all of the used instruments. Being a female with oral dysplasia also predicted increased odds of indicating higher anxiety and dental anxiety scores than males [p > 0.05]. CONCLUSION: Oral dysplasia can adversely impact on the psychosocial well-being of affected persons. Establishing a causal relationship between the measured variables may, however, be challenging and would need further longitudinal studies

Information needs and oral epithelial dysplasia: development and psychometric evaluation of a novel instrument

Objectives: Oral epithelial dysplasia (OED) can lead to significant information needs (IN) related to the risk of cancer development, the need for long‐term monitoring and potential intervention. The present study aimed to develop and perform preliminary psychometric testing for a novel IN instrument specific to OED. / Subjects and methods: Patients diagnosed with OED were invited to complete the Oral Epithelial Dysplasia Informational Needs Questionnaire (ODIN‐Q), which was developed based on a known theoretical framework and with items generated via expert input and the literature. Face validity and content validity were initially assessed prior to finalisation of the tool. ODIN‐Q was tested for internal consistency and test–retest reliability along with construct validity. / Results: ODIN‐Q consists of 35 items, categorised under six domains, and rated by dual 4‐point Likert scales (amount of information received and degree of importance). Internal consistency (Cronbach's alpha) was rated “excellent” for the scale (0.93) and both subscales (0.92/0.94). For test–retest reliability, moderate agreement was found (κ = 0.49–0.53). Regarding construct validity, a significant but limited relationship was found between ODIN‐Q and the Krantz Health Opinion Survey. / Conclusion: ODIN‐Q showed adequate psychometric properties of reliability and validity. Further validation is, however, needed to assess its structural validity and responsiveness

Patient informational needs concerning oral epithelial dysplasia

Patient education through clinician-patient health information exchange is essential in the clinical care of people with chronic and pre-malignant diseases such as, perhaps, the oral epithelial dysplasia (OED). The literature review found a knowledge gap on what information an individual with OED may want or considered important, a lack of specific instrument that can be used to assess the patient’s information needs (IN) and a shortage of studies available on whether individuals with OED would exhibit higher prevalence of symptoms, that can be experienced with cancer-linked conditions, including the anxiety and depression, dental anxiety and poorer oral health-related quality of life (OHQoL) compared to the general population or those with other chronic diseases. Thus, the study aimed to (1) assess what information patients would find when they search the Internet, (2) identify instruments that can be helpful to develop an IN instrument, (3) develop and determine the psychometric properties of the new IN instrument for OED (ODIN-Q), (4) assess the IN about OED using ODIN-Q, (5) determine the patient-clinician concordance on this information, (6) assess the prevalence of anxiety and depression, dental anxiety and OED impact on OHQoL and (7) develop and assess a patient information leaflet on OED. The analyses of the web indicated a shortage of content with the presented content being of low quality, poor understandability and actionability and challenging to read. The newly developed IN instrument (ODIN-Q) showed adequate psychometric properties and indicated that 52% of patients had unmet IN. Clinicians predicted the highest important information to patients. However, they exhibited poor prediction on its importance. The prevalence rates for symptoms of anxiety, depression and emotional distress at 30%, 16% and 26%, respectively. While dental anxiety levels were like those in a general population, OHQoL scores were notably higher. The newly developed leaflet was found to be acceptable and readable by most of the respondents

NMR spectroscopic investigation of benzothiazolylacetonitrile azo dyes : CR7 substitution effect and semiempirical study

Ebead et al. had reported in the synthesis and the UV-Visible solvatochromism combined with semiempirical calculations to study the tautomerism of 1,3-benzothiazol-2-ylacetonitrile azo dyes [1]. In this study, 1,3-ben zothiazol-2-ylacetonitrile azo dyes (1-6) have been resynthesized, one and two dimensional H-1 and C-13 NMR, as well as absorption and emission spectra, were collected and interpreted. The obtained results were used to clarify the tautomerization phenomenon of these dyes. Predominantly, these dyes exist in Z-hydrazone form reinforced through intramolecular hydrogen bonding in deuterated chloroform. Substituents (R) in carbon7 (CR7) are the key player of the changes in H-1 and C-13 NMR chemical shifts, also in the absorption and emission wavelengths of benzothiazole azo dyes. Also, the relative photoluminescence quantum yields (PL QY) of these dyes (1-6) were estimated and related to the nature of substituents. Finally, PM6 semiempirical calculations were employed to confirm the preferred geometric structure and experimental NMR, absorption, and emission results

A Novel Electrochemical Sensor for Detection of Nicotine in Tobacco Products Based on Graphene Oxide Nanosheets Conjugated with (1,2-Naphthoquinone-4-Sulphonic Acid) Modified Glassy Carbon Electrode

A simple electrochemical sensor for nicotine (NIC) detection was performed. The sensor based on a glassy carbon electrode (GCE) was modified by (1,2-naphthoquinone-4-sulphonic acid)(Nq) decorated by graphene oxide (GO) nanocomposite. The synthesized (GO) nanosheets were characterized using X-ray diffraction (XRD), Raman spectroscopy, scanning electron microscope (SEM), transmission electron microscope (TEM), FT-IR, and UV-Visible Spectroscopy. The insertion of Nq with GO nanosheets on the surface of GCE displayed high electrocatalytic activity towards NIC compared to the bare GCE. NIC determination was performed under the optimum conditions using 0.10 M of Na2SO4 as a supporting electrolyte with pH 8.0 at a scan rate of 100 mV/s using both cyclic voltammetry (CV) and differential pulse voltammetry (DPV). This electrochemical sensor showed an excellent result for NIC detection. The oxidation peak current increased linearly with a 6.5–245 µM of NIC with R2 = 0.9999. The limit of detection was 12.7 nM. The fabricated electrode provided satisfactory stability, reproducibility, and selectivity for NIC oxidation. The reliable GO/Nq/GCE sensor was successfully applied for detecting NIC in the tobacco product and a urine sample

Association of Oral and General Health with Nutritional Status of Older Adults Attending Two Medical Centers in Riyadh, Saudi Arabia: A Cross-Sectional Study

Malnutrition could profoundly affect older adults’ oral health and quality of life, whereas oral health might, in turn, impact dietary intake and nutritional status. The present study aimed to investigate the association between general and oral health and nutritional status among older adults attending nutrition clinics at two main medical centers in Riyadh, Saudi Arabia. A cross-section study was carried out among adult patients (≥60 years) who attended a geriatric clinic or nutrition clinic at King Khalid University Hospital or King Abdulaziz Medical City, Riyadh. A validated clinician’s Mini Nutritional Assessment Short-Form (MNA-SF), Oral Health Impact Profile-5 (OHIP-5), and 36-Item Short Form Survey (SF-36) were collected from each participant. A total of 261 participants with a mean age of 72.14 (±8.97) years were recruited. Diabetes (71%) and hypertension (80%) were present in the majority of patients. The overall MNA-SF score was (10 ± 3). Based on the categorization of the MNA-SF score, 65.9% were classified as malnourished or at risk of malnutrition. Participants with OHIP-5 scores higher than the median (>5) were more likely to be malnourished than those with scores at or lower than 5 (p < 0). The adjusted odd ratio for the MNA-SF score categories indicated that for a one-unit increase in the total SF-36 score, the odds of the malnourished category are 0.94 times less than the risk of malnutrition and normal nutritional status, with OR 0.97 (95% CI 0.94–0.95). Malnutrition or being at risk of malnutrition is likely associated with poor general and oral health. Healthcare providers need to incorporate dietitians into care plans to promote the nutritional health of older adults