Efficacy of Hypnosis on Dental Anxiety and Phobia: A Systematic Review and Meta-Analysis

Hypnosis is a commonly used therapy option in dentistry and medicine for fear and pain reduction. Nevertheless, it is viewed very critically, as there is still insufficient evidence for a treatment effect. Specific phobia of dental treatment and dental anxiety are prevalent conditions that can cause an oral health impairment. This paper critically reviews 19 clinical trials aimed at reducing dental anxiety and fear avoidance in adults, published in peer-reviewed journals between 1979 and 2021. The search identified 257 papers; 223 were selected after removing duplicates. A total of 188 articles were excluded after title and abstract evaluation; 35 full text articles were assessed for eligibility. Another 10 papers were discharged after full text evaluation, as these were case reports and questionnaires. Six papers were discharged due to the lack of a comparable scale to measure dental anxiety. The following treatment techniques were reviewed: various forms of cognitive-behavioral therapy (CBT), relaxation training, benzodiazepine premedication, self-hypnosis by audio therapy, hypnotherapy, hypnosis, and nitrous oxide sedation. CBT delivered in a variety of formats, including one-session treatment, showed the most evidence for the efficacy of reducing anxiety. A wide heterogeneity of methods allowed only the inclusion of five studies to the performed meta-analysis, showing contrasting results for the application of hypnosis. The main reason for this issue is the great variety in methods used, making a distinct assessment of hypnotic interventions difficult. However, the results of the systematic review are promising in that hypnosis can also be regarded as powerful and successful method for anxiety reduction, while there are also studies with a small or even slightly negative effect. Therefore, further research is needed. Within the limitations of the current study, a more consistent use of methods to examine anxiety for hypnosis research is recommended

The Open Data Kit suite, Mobile Data Collection technology as an opportunity for forest mensuration practices

This paper examines the potential for using Mobile Data Collection (MDC) as an effective database supported technology to substantially improve forest mensuration practices. Open source Open Data Kit (ODK) procedures and tools were used during a survey campaign that initiated a local forest monitoring process in the Marganai forest (Sardinia). The ODK suite is practical to use and its procedures allow authoring and use of digital survey forms without users needing software development expertise. Form design enables a high degree of customization to be achieved by means of specifying a wide range of data flow control mechanisms. ODK has proved to be a valid tool for data coherence and completeness improvements. As forestry’s contribution to regional Gross Domestic Product has dramatically decreased, forest mensuration practices have been reduced. Meeting the increased need to monitor environmental assets such as forests requires these practices to be re-evaluated. If regional public institutions took an active part in the process of enhancing forest mensuration, by contributing with open database systems acting as repositories and knowledge engines, support for MDC tools like ODK would potentially be a great opportunity to disseminate the use of the system and boost its development

Forest Protection Unifies, Silviculture Divides: A Sociological Analysis of Local Stakeholders' Voices after Coppicing in the Marganai Forest (Sardinia, Italy)

Today, a forest is also understood as a real social actor with multiple-scale influences, capable of significantly conditioning the social, economic, and cultural system of a whole territory. The aim of this paper is to reconstruct and interpret the population's perception of the silvicultural activities related to traditional use of forest resources of the southwestern Sardinian Marganai State Forest. The "Marganai case" has brought to the attention of the mass media the role of this forest and its silviculture. The research was carried out via semi-structured interviews with the main stakeholders in the area. The qualitative approach in the collection and analysis of the information gathered has allowed us to reconstruct the historical-cultural and social cohesion function that the forest plays in rural communities. The results highlight that the main risks concern the erosion of the cultural forest heritage due to the abandonment of the rural dimension (mainly by the new generations, but not only), with the consequent spread of deep distortions in the perception, interpretation, and necessity of forestry activities and policy

Comparisons between glucose analogue 2-deoxy-2-((18)F)fluoro-D-glucose and (18)F-sodium fluoride positron emission tomography/computed tomography in breast cancer patients with bone lesions

To compare 2-deoxy-2-((18)F)fluoro-D-glucose((18)F-FDG) and (18)F-sodium ((18)F-NaF) positron emission tomography/computed tomography (PET/CT) accuracy in breast cancer patients with clinically/radiologically suspected or known bone metastases

Convergence Insufficiency, Accommodative Insufficiency, Visual Symptoms, and Astigmatism in Tohono O’odham Students

Purpose. To determine rate of convergence insufficiency (CI) and accommodative insufficiency (AI) and assess the relation between CI, AI, visual symptoms, and astigmatism in school-age children. Methods. 3rd–8th-grade students completed the Convergence Insufficiency Symptom Survey (CISS) and binocular vision testing with correction if prescribed. Students were categorized by astigmatism magnitude (no/low: <1.00 D, moderate: 1.00 D to <3.00 D, and high: ≥3.00 D), presence/absence of clinical signs of CI and AI, and presence of symptoms. Analyses determine rate of clinical CI and AI and symptomatic CI and AI and assessed the relation between CI, AI, visual symptoms, and astigmatism. Results. In the sample of 484 students (11.67 ± 1.81 years of age), rate of symptomatic CI was 6.2% and symptomatic AI 18.2%. AI was more common in students with CI than without CI. Students with AI only (p=0.02) and with CI and AI (p=0.001) had higher symptom scores than students with neither CI nor AI. Moderate and high astigmats were not at increased risk for CI or AI. Conclusions. With-the-rule astigmats are not at increased risk for CI or AI. High comorbidity rates of CI and AI and higher symptoms scores with AI suggest that research is needed to determine symptomatology specific to CI

The Presence of Women in the Dental Profession: A Global Survey.

OBJECTIVES The aim of this research was to acquire knowledge about the female dental workforce, identifying factors to pursue specialty training and career choices and working in dental institutions/associations. METHODS An original online questionnaire was developed, validated (n = 22), and sent to 189 member associations in 133 countries of the Women Dentists Worldwide section of the FDI World Dental Federation. RESULTS In all, 3232 female dentists from 81 countries participated. Results were divided into 5 geographic areas by continent. Difference in proportion amongst questionnaire items was evaluated with χ2 test or Fisher exact test. Ordinal multinomial linear regression analysis was performed to evaluate the association of questionnaire items with total work experience in dentistry (in years), motivation to study dentistry, type of specialisation, working hours per week, perception of female dentists about working hours, sex-based inequalities, job security after maternity leaves, as well as involvement in political organisations within their country of residence and their role in dental associations. A majority of participating female dentists are self-employed (57.7%), and 60.0% have 10 to 30 years of experience. The most popular form of practice is the single private practice (29.7%), followed by the group private practice (28.8%). Further, 44.8% work 31 to 40 h/wk, 29.1% part-time up to 30 h/wk, and 26.0% more than 40 h/wk. CONCLUSIONS Women are still poorly represented in professional organisations, and few are officers in representative assemblies, members of the board, or president. Family life with children influences perceptions and has an impact on professional life, especially in academia and political/professional associations, so that taking on leadership positions poses additional challenges

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81&nbsp;years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

A double-blind randomized clinical trial on the suggestive effect of anxiety management questionnaires in dental emergencies.

OBJECTIVE Dental anxiety is widespread among both children and adults. To diagnose dental anxiety, standardized anxiety questionnaires are recommended. Based on the suggestive nature of the questionnaires, the study aimed to find out whether asking respondents about personal coping strategies before dental treatment influences their anxiety. METHODS This prospective, double-blind, randomized controlled clinical trial included a total of 158 patients of a university dental clinic on emergency service. The intervention group (n = 82) received the Coping with Anxiety Questionnaire (CAQ) and the control group (n = 76) the Hierarchical Anxiety Questionnaire (HAF). State anxiety scores were assessed by using the State-Trait Anxiety Inventory (STAI) before and after the completion of each questionnaire. RESULTS Anxiety decreased in the intervention group (CAQ) (p < 0.001) and increased in the control group (HAF) (p < 0.001). CONCLUSION Within the limitations of the current study, a diagnostic tool of a standardized questionnaire for the assessment to assess personal coping strategies decreased state anxiety in comparison to a questionnaire assessing anxiety. CLINICAL TRIAL REGISTRATION https://www.drks.de, German Trials Register (DRKS00032450)