Job satisfaction and job content in Dutch dental hygienists

Objectives: This study compares the scope of practice of Dutch dental hygienists (DHs) educated through a 2- or 3-year curriculum ('old-style DHs') with that of hygienists educated through a new extended 4-year curriculum leading to a bachelor's degree ('new-style DHs'), with the aim to investigate whether an extended scope of practice positively affects perceived skill variety, autonomy and job satisfaction. Methods: The questionnaires were obtained from old-and new-style DHs (n = 413, response 38%; n = 219, response 59%, respectively), in which respondents had recorded their dental tasks, perceived skill variety, autonomy and job satisfaction. T-tests were used to analyse differences between old-and new-style DHs, and regression analyses were performed to assess the relation between scope of practice and skill variety, autonomy and job satisfaction. Results: New-style DHs have a more extended scope of practice compared with old-style DHs. Despite their more complex jobs, which are theoretically related to higher job satisfaction, new-style DHs perceive lower autonomy and job satisfaction (P < 0.05). Skill variety is the strongest predictor for DHs' job satisfaction (beta = 0.462), followed by autonomy (beta = 0.202) and caries decisive tasks, the last affecting job satisfaction negatively (beta = -0.149). Self-employment is the strongest significant predictor for autonomy (beta = 0.272). Conclusions: The core business of DHs remains the prevention and periodontology services. New-style DHs combine these tasks with extended tasks in the caries field, which can lead to comparatively less job satisfaction, because of a lower experienced autonomy in performing these extended tasks

Frailty, Quality of Life, and Loneliness of Aging in Native and Diasporic Chinese Adults

Background: Global migration has increased in the past century, and aging in a foreign country is relevant to the Chinese diaspora. Objective: With regard to migration, this study focuses on the places of aging as the context of older Chinese adults. This study aimed to describe the general health and wellbeing of this population with respect to their location. Design: This study has a cross sectional design. Setting and Participants: Participants were recruited who were “aging in place” from Tianjin, China (199 participants), and “aging out of place” from the Netherlands (134 participants). Data from April to May 2019 in China and November 2018 to March 2019 in the Netherlands were aggregated. Measurements: Frailty, QoL and loneliness were used in both samples. Results: T-tests and regression analyses demonstrated that social domains of frailty and QoL, as well as loneliness and frailty prevalence characterized the major differences between both places of aging. A correlation analysis and visual correlation network revealed that frailty, quality of life (QoL), and loneliness were more closely related in the aging out of place sample. Social domains of frailty and QoL, as well as the prevalence of loneliness and frailty, characterized the major differences between both places of aging. Conclusions: The findings indicate that frailty, QoL, and loneliness have a complex relationship, confirming that loneliness is a major detriment to the general wellbeing of older Chinese adults aging out of place. This study examined the places of aging of the larger Chinese population and allows a comprehensive understanding of health and wellbeing. The social components, especially loneliness, among the aging out of place Chinese community should receive more attention practice and clinical wise. On the other hand, frailty as well as its prevention is of more importance for the Chinese community aging in place

Expectations about recovery from acute non-specific low back pain predict absence from usual work due to chronic low back pain:a systematic review

Question: Do negative expectations in patients after the onset of acute low back pain increase the odds of absence from usual work due to progression to chronic low back pain? Design: Systematic review with meta-analysis of prospective inception cohort studies. Participants: Adults with acute or subacute non-specific low back pain. Outcome measure: Absence from usual work at a given time point greater than 12 weeks after the onset of pain due to ongoing pain. Results: Ten studies involving 4683 participants were included in the review. Participants with acute or subacute pain and negative expectations about their recovery had significantly greater odds of being absent from usual work at a given time point more than 12 weeks after the onset of pain: OR 2.17 (95% CI 1.61 to 2.91). The exclusion of five studies with the greatest risk of bias showed that the result was similar when more rigorous quality criteria were applied: OR 2.52 (95% CI 1.47 to 4.31). Conclusion: The odds that adults with acute or subacute non-specific low back pain and negative recovery expectations will remain absent from work due to progression to chronic low back pain are two times greater than for those with more positive expectations. These results were consistent across the included studies despite variations in the risk of bias. [Hallegraeff JM, Krijnen WP, van der Schans CP, de Greet MHG (2012) Expectations about recovery from acute non-specific low back pain predict absence from usual work due to chronic low back pain: a systematic review. Journal of Physiotherapy 58:165-172]

The effect of a forearm/hand splint compared with an elbow band as a treatment for lateral epicondylitis

The aim of the present study was to compare the effect of a new prefabricated Thamert forearm/hand splint with the effect of a simple elbow band as a treatment for lateral epicondylitis. Forty-three (43) patients that met the inclusion criteria were randomly assigned to the elbow band group and the splint group. They wore the orthotic devices for 6 weeks. Outcome measures were obtained at baseline and directly after the intervention. These outcome measures were maximal grip strength on the involved side with a pain scale from I to 10 to determine the extent of pain during gripping, and the Patient-Rated Forearm Evaluation Questionnaire (PRFEQ). Analysis of variances with repeated measures, a Mann Whitney test and multiple linear regression analysis were used to compare the two groups. Main effect for time was significant for maximal grip strength and sum scores on the PRFEQ, but no differences between groups were found, even when a distinction between acute and chronic symptoms was made. Change in pain score during gripping did not differ significantly between the groups. A multiple linear regression analysis showed that the use of the splint did not significantly contribute to the prediction of change in maximal grip strength and in overall PRFEQ. The conclusion is that the forearm/hand splint is not more effective than the elbow band as a treatment for lateral epicondyliti

Relationship between dyspnoea, pulmonry function and exercise capacity in patients with cystic fibrosis

AbstractThe median age of survival in patients with cystic fibrosis (CF) has improved considerably. Despite this improvement, deterioration of pulmonary function and decrease in exercise capacity are still the main problems for many patients. Although dyspnoea is a common complaint in CF patients, relatively little regard has been paid to this symptom. This study examined the relationship between dyspnoea, bicycle exercise capacity and pulmonary function in patients with CF.In 14 patients in a stable clinical condition, pulmonary function [forced expiratory volume in 1 s (FEV1), inspiratory vital capacity (IVC)], bicycle exercise capacity [maximum exercise capacity (Wmax)], subjective degree of dyspnoea during daily living [Medical Research Council (MRC) dyspnoea scale], and during exercise (Borg scale) were assessed.The mean (sd) age of the patients was 25 (6·8) years, FEV1 was 41 (19)% predicted, IVC was 63 (17)% predicted and FEV1IVC ratio was 47 (10)%; median (range) Wmax was 55 (0–79)% predicted. Bicycle exercise test performance appeared to be mainly determined by pulmonary function and MRC dyspnoea grade; multiple regression equation containing FEV1 and dyspnoea accounted for 76% of the variance in Wmax (% predicted) (Wmax= −7·9 dysp+1·1FEV1, +24). Exercise dyspnoea, assessed by the Borg scale, showed a significant linear correlation with minute ventilation. (V̇e), maximal voluntary ventilation (MVV) (%) (r=0·76; P<0·001). Medical Research Council dyspnoea score correlated relatively poorly with FEV1 (% predicted) (r= −0·17; n.s.) and IVC (% predicted) (r= −0·48; n.s.). Borg score at maximal exercise did not correlate with MRC dyspnoea score (r= −0·07). Borg50% score correlated significantly with MRC dyspnoea score (r= 0·61; P<0·05).These results show that dyspnoea has an influence on exercise capacity. Dyspnoea score showed a large inter-individual variation, not strongly related to pulmonary function. It is concluded that dyspnoea deserves more attention in CF patients and needs to be assessed in rehabilitation programmes and other intervention studies in these patients

COLECCIÓN JOSEFINA DE LA TORRE MILLARES [Material gráfico]

FORMA PARTE DE LA COLECCIÓN FOTOGRÁFICA DE JOSEFINA DE LA TORRE, CUYOS ARTEFACTOS FOTO-QUÍMICOS ESTÁN CUSTODIADOS EN LA CASA MUSEO DE PÉREZ GALDÓS.Copia digital. Madrid : Ministerio de Educación, Cultura y Deporte. Subdirección General de Coordinación Bibliotecaria, 201

Use of behaviour change techniques by direct support professionals to support healthy lifestyle behaviour for people with moderate to profound intellectual disabilities

Background: Behaviour change techniques (BCTs) can be employed to support a healthy lifestyle for people with intellectual disabilities. The aim of this study is to determine whether and which BCTs are used by direct support professionals (DSPs) for supporting healthy lifestyle behaviour of people with moderate to profound intellectual disabilities. Method: Direct support professionals (n = 18) were observed in their daily work using audio-visual recordings. To code BCTs, the Coventry Aberdeen London Refined (CALO-RE-NL) taxonomy was employed. Results: Direct support professionals used 33 BCTs out of 42. The most used BCTs were as follows: ‘feedback on performance’, ‘instructions on how to perform the behaviour’, ‘doing together’, ‘rewards on successful behaviour’, ‘reward effort towards behaviour’, ‘DSP changes environment’, ‘graded tasks’, ‘prompt practice’ and ‘model/demonstrate behaviour’. Conclusions: Although a variety of BCTs is used by DSPs in their support of people with moderate to profound intellectual disabilities when facilitating healthy lifestyle behaviour, they rely on nine of them

Patients with more severe symptoms benefit the most from an intensive multimodal programme in patients with fibromyalgia

PURPOSE: Patients with fibromyalgia (FM) experience symptoms over a long period of time impacting their quality of life (QoL). Patients are often treated in multimodal programmes that combine physical and cognitive treatment modalities. Purpose of this study was to identify prognostic factors of effectiveness of a multimodal programme. METHOD: A prospective study was performed with a group of 87 patients with FM who had participated in a multimodal programme. The Revised Illness Perception Questionnaire (IPQ) and the Fibromyalgia Impact Questionnaire (FIQ) were used. Criterion for clinically relevant improvement was a decline in total FIQ score of 12.5 points or more after the treatment programme. Investigated determinants of improvement of QoL were patient characteristics, illness perceptions (IP) and QoL at baseline. RESULTS: QoL of 34 patients with FM made a clinically relevant improvement after the programme. There was no difference in age, number of years with pain, number of years diagnosed or IP compared to the group that did not improve. The group of patients with an improved QoL after the programme reported severe impact on daily living, highest intensity of pain and most depression at baseline. CONCLUSIONS: Total FIQ score on QoL, intensity of pain, morning tiredness and depression can be used as prognostic factors to pre-select patients with FM for a multimodal treatment. IP were not adequate to predict treatment outcome. An intensive multimodal programme seemed most suitable for patients with severe symptoms and limitations