Stress, Anxiety and Depression Among Dental Students in Times of Covid-19 Lockdown

Introduction: Dental students in their clinical training, face a higher risk of contracting the disease as well as experiencing adverse psychological outcomes. Therefore, this study came to evaluate the impact of COVID-19 and the lockdown on the mental health of dental students during the current pandemic. Methods: This is a cross-sectional study conducted among dental students during the first months of the COVID-19 pandemic to assess the levels of depression, anxiety, and stress using the standardized DASS-21 scale. In addition demographic, socio-economic, academic performance, source of information about COVID-19, and perception of on-line education difficulties were collected. Results: A total of 436 students completed the online survey (55.18% response rate). In the current sample, 48% (n=209), 76% (n=331) , 70% (n=305) showed different levels of stress, anxiety and depression. Students who stated that their family income was impacted by COVID-19 showed signs of depression X2 = 7.3, p=.007 and anxiety, X2=6.1, p=.013. Dental students who faced difficulties in switching to E-learning, reported different levels of depression, X2=14, p<.001, anxiety, X2=9, p=.003 and stress, X2=24, p<.001. Conclusions: In preparation for the next academic year, strategies to support the mental health of dental students in their clinical training and E-learning process should be in place.The authors would like to thank each anonymously participating dental student of Al-Quds University (Palestine) who contributed to making this work possible

Knowledge, Attitude and Practices of Using Dental Floss Among Dental Students at Al-Quds University

Introduction: Dental plaque is one of the major factors in the initiation and progression of dental caries, gingivitis and periodontal diseases. It has been reported that tooth brushing alone can clean only 3 surfaces of the tooth's five surfaces. Thus combining tooth brushing with interdental cleaning is crucial. Dental floss is one of the most effective interdental interventions that remove plaque between the teeth. Objectives: The aim of this study was to assess knowledge, attitude and practices related to the use of dental floss among dental students at Al-Quds University, Palestine. Methods: This is a cross-sectional study conducted among dental students from the Faculty of Dentistry at Al Quds University from first to the fifth year, to assess knowledge about the use of dental floss, attitude towards the importance of the use of dental floss and students' practice related to the use of dental floss. In addition, socio-demographic information was collected. Results: 292 students completed the survey, the sample was composed of 18.2% in 1st year, 16.1% in the 2nd year, 18.2% in the 3rd year, 22.3% in the 4th and 25.3% in the 5th year. Students who use dental floss, 33.3% believes that modern toothbrush is similar to dental floss, the relation of dental floss use with students who believed that modern toothbrushes with advanced bristle design remove interdental plaque similar to dental floss it was less, X2=6.2, p=0.01. Students who believed that the use of dental floss beside toothbrush daily is important to gingival health 55.2%, in relation of the use of dental floss X2 =5.6, p=0.02. 35% of students who use dental floss believed that the use of dental floss is difficult, with the use of dental floss X2 =20, p=0.05. 48.5% of students who use dental floss believe that dental floss is not given adequate importance in dental education, with the use of dental floss X2 =4.2, p=0.04. For knowledge results 58.2% of students who use dental floss know how to use dental floss with X2 =25, p<0.05. For practice results, students who use mouthwash, used dental floss more, X2=10.8, p=0.001. Conclusions: Al-Quds University dental students have adequate knowledge on how effective is using the floss as an adjunct to the toothbrush, we still should encourage the community and students to do so

Immunoglobulin-A and the pathogenesis of schistosomal glomerulopathy

Immunoglobin-A and the pathogenesis of schistosomal glomerulopathy. Several observations suggest that the evolution of schistosomal glomerulopathy into clinically overt and progressive disease may involve pathogenetic mechanisms other than simple glomerular deposition of parasitic antigens. In a previous study, IgA was suggested tobe a mediator of late glomerular lesions in this disease. This issue is further addressed in this work. The study includes 32 patients with hepatosplenic schistosomiasis, of whom 16 had overt glomerular involvement, along with four control groups: (a) 15 healthy volunteers; (b) 15 patients with simple intestinal mansoniasis; (c) 17 patients with non-schistosomal chronic liver disease; and (d) 21 subjects with primary nephrotic syndrome not associated with schistosomiasis. Routine assessment was done for all subjects including confirmatory tests for schistosomal infection, liver and renal function tests, hepatitis viral markers and abdominal ultrasonography. The total serum concentrations of IgG, IgM, IgA were measured, as well astheir respective circulating immune complexes, rheumatoid factors, anti-gliadin- and anti-DNA-antibodies. Liver and renal biopsies were obtained from the relevant groups and studied by light microscopy. Renal biopsies were also examined by immunofluorescence. Patients with simple intestinal schistosomiasis had a significant increase in IgM antigliadin antibodies. Those complicated with hepatosplenic involvement also had a significant increase in the mean IgG anti-gliadin antibodies, IgG rheumatoid factor and IgM anti-DNA activity. Cases further complicated by overt glomerular disease showed a distinct IgA predominance, mainly expressed in the serum anti-gliadin antibody pool and anti-DNA activity. This profile was essentially similar to that observed in control cirrhotics. There was a significant increase in the frequency of IgA glomerular deposits in renal biopsies obtained from patients with overt schistosomal glomerulopathy, in contrast to control nephrotics. The deposits were mainly mesangial, but were also encountered in subendothelial, subepithelial and peritubular locations. Their frequency was significantly higher with more advanced lesions as seen by light microscopy. The relevance of these data is discussed, leading to the following conclusions: (a) serum IgA-anti-gliadin and -anti-DNA antibodies, and glomerular IgA deposits are markers of significant renal involvement in patients with hepatosplenic schistosomiasis, (b) IgA may be involved in the pathogenesis of advanced glomerular pathology when superimposed on parasite-induced lesions, (c) There is a significant increase in serum auto-reactivity in hepatosplenic schistosomiasis, which may also have pathogentic implications, (d) Increased production by the inflammatory bowel lesions, impaired clearance by the fibrotic livers and probable switching of immunoglobulin synthesis are suggested to explain the observed IgA predominance in those who develop renal complications

Level of High Sensitivity in Reaction to Criticism among Gifted Students in Ajloun Governorate in Light of Some Variables

This study aims to explore the level of high sensitivity in response to criticism among gifted students in Ajloun Governorate, considering some variables such as gender, class, family educational level, and family economic level. To achieve its objectives, the researchers used a descriptive and analytical approach and utilized the high sensitivity scale developed by Alateaq in 2010, adapted to fit the Jordanian environment. The sample included 131 gifted students randomly selected from junior high to high school. The results showed that the level of high sensitivity was moderate. There were no statistically significant differences in the level of high sensitivity in response to criticism among the students in terms of gender and class variables. Furthermore, there were no differences based on the family educational and economic levels of the parents, except for some responses from students whose families had an income of 500 JOD or more. The study recommends implementing programs to address and provide the necessary consultation to help overcome the high sensitivity of these students

Upper airway dimensions and the skeletal parameters in orthodontic patients who developed moderate-severe COVID-19 symptoms during the pandemic

BACKGROUND: Large airway dimensions are associated with a rapid decline in the lung function and a higher risk of hospitalization. Therefore, the airway dimensions of healthy subjects who tested positive for coronavirus disease 2019 (COVID-19) may be associated with the severity of COVID-19 symptoms. OBJECTIVES: The objectives of this study were to measure the upper airway dimensions and the craniofacial skeletal parameters in patients who tested positive for COVID-19, to compare the upper airway dimensions and the craniofacial skeletal parameters between patients who developed no/mild symptoms and those with moderate-severe COVID-19 symptoms, and to assess any association of the skeletal relationships (anteroposterior (AP) and vertical) and the upper airway dimensions with the severity of COVID-19 symptoms in adult subjects. MATERIAL AND METHODS: A total of 204 orthodontic patients who tested positive for COVID-19 were evaluated. Of these, only 137 met the inclusion criteria. The sample was further subdivided into 2 groups based on the severity of symptoms: cases (moderate-severe symptoms; n = 56); and controls (asymptomatic/ mild symptoms; n = 81). The upper airway dimensions and the skeletal parameters were measured on lateral cephalograms. The nonparametric Mann-Whitney U test was used to detect differences between the cases and the controls. Binary logistic regression analysis was used to evaluate the association between the studied variables and the severity of symptoms. RESULTS: The cases had a reduced lower face height (LFH) and a reduced perpendicular distance from the hyoid bone to the line connecting the anteroinferior limit of the 3rd cervical vertebra (C3) and the retrognathion point (RGN) (HH1) as compared to the controls. Regression analysis revealed a significant association of LFH (p = 0.013), the vertical airway length (VAL) (p = 0.002) and HH1 (p = 0.021) with the severity of COVID-19 symptoms. CONCLUSIONS: The types of malocclusion were similar in the cases and the controls. Patients with reduced LFH and VAL, and a superiorly positioned hyoid bone in relation to the mandible developed more severe COVID-19 symptoms

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Work stress, work-family conflict, and psychological distress among resort employees: a JD-R model and spillover theory perspectives

The hospitality industry is well-known for its challenging and high-pressure work settings. In this context, employees commonly face a multitude of stressors originating from their roles and job responsibilities, which can significantly impact their psychological wellbeing. Hence, based on the job demands-resources (JD-R) model and the spillover theory, this study aims to empirically explore the direct and indirect effect of work stress (assessed by role overload, ambiguity, and conflict) on psychological distress among frontline employees in 3- and 4-star Egyptian resorts while considering the mediating influence of work-family conflict (WFC). Four hypotheses were put to the test through the application of the PLS-SEM 4.0 version (4.0.9.9). Based on the findings from 563 frontline employees who participated in this research, the study supports the four hypotheses affirming that work-related stressors significantly contributed to employees' psychological distress. Further, the findings highlighted that these stressors significantly spill over into employees' family lives, generating conflicts between work and family roles. In addition, the results emphasized the significance of WFC as a contributing factor to employees' psychological distress. Finally, the study concluded that WFC partially mediates the link between work stress and employees' psychological distress. Based on these findings, some theoretical and practical implications for hospitality scholars, resort management, and policymakers were suggested to enhance the employees' wellbeing and mitigate psychological distress in this vital sector

Elevated serum neutrophil elastase is related to prehypertension and airflow limitation in obese women

<p>Abstract</p> <p>Background</p> <p>Neutrophil elastase level/activity is elevated in a variety of diseases such as atherosclerosis, systolic hypertension and obstructive pulmonary disease. It is unknown whether obese individuals with prehypertension also have elevated neutrophil elastase, and if so, whether it has a deleterious effect on pulmonary function. Objectives: To determine neutrophil elastase levels in obese prehypertensive women and investigate correlations with pulmonary function tests.</p> <p>Methods</p> <p>Thirty obese prehypertensive women were compared with 30 obese normotensive subjects and 30 healthy controls. The study groups were matched for age. Measurements: The following were determined: body mass index, waist circumference, blood pressure, lipid profile, high sensitivity C-reactive protein, serum neutrophil elastase, and pulmonary function tests including forced expiratory volume in one second (FEV₁), forced vital capacity (FVC) and FEV₁/FVC ratio.</p> <p>Results</p> <p>Serum neutrophil elastase concentration was significantly higher in both prehypertensive (405.8 ± 111.6 ng/ml) and normotensive (336.5 ± 81.5 ng/ml) obese women than in control non-obese women (243.9 ± 23.9 ng/ml); the level was significantly higher in the prehypertensive than the normotensive obese women. FEV1, FVC and FEV1/FVC ratio in both prehypertensive and normotensive obese women were significantly lower than in normal controls, but there was no statistically significant difference between the prehypertensive and normotensive obese women. In prehypertensive obese women, there were significant positive correlations between neutrophil elastase and body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, high sensitivity C-reactive protein and negative correlations with high density lipoprotein cholesterol, FEV1, FVC and FEV1/FVC.</p> <p>Conclusion</p> <p>Neutrophil elastase concentration is elevated in obese prehypertensive women along with an increase in high sensitivity C-reactive protein which may account for dyslipidemia and airflow dysfunction in the present study population.</p