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Burnout, stress, and wellbeing: The rising mental health crisis in UK dentistry in dental care professionals. A quantitative perspective
Get PDFResearch Aim
To determine if dental care professionals working in National Health Service (NHS) practices are more at risk of stress, wellbeing concerns and burnout than their private practice counterparts.
Introduction
In dentistry, stress, anxiety, and wellbeing concerns have been apparent for many years with burnout and poor mental health in dental registrants being described as early as the 1980s.
Methodology
An online platform-based questionnaire was used to administer the chosen scales. Data from 201 participants were analysed (N = 201). The sample consisted of 31 dental nurses and 170 dental hygienists and dental therapists.
Results and Conclusions
A one-way multivariate analysis of variance (MANOVA) determined that there was no statistically significant difference between private and mixed practice dental professionals on the combined scales F (3, 190) = 0.76, p = 0.59, Wilks Lambda = 0.97, partial eta squared = 0.12. Dental hygienists, dental therapists and dental nurses working in mixed private and NHS dentistry are not more susceptible to stress, wellbeing issues and anxiety than their private counterparts according to the data set. This suggests that there are other factors associated in the mental health concerns of registered dental care professionals raised by the literature examined. The feelings and frustrations of dental registrants are likely to have lasting consequences for the provision of dentistry if working practices and hierarchical conditions do not improve patient access to both private and NHS dentistry. More research into the stress, wellbeing and burnout levels across dental registrants would be beneficial to explore the effects on the entire dental team, with a focus on solely working in NHS provision
A novel reinforcement learning-based multi-operator differential evolution with cubic spline for the path planning problem
Get PDFPath planning in autonomous driving systems remains a critical challenge, requiring algorithms capable of generating safe, efficient, and reliable routes. Existing state-of-the-art methods, including graph-based and sampling-based approaches, often produce sharp, suboptimal paths and struggle in complex search spaces, while trajectory-based algorithms suffer from high computational costs. Recently, meta-heuristic optimization algorithms have shown effective performance but often lack learning ability due to their inherent randomness. This paper introduces a unified benchmarking framework, named Reda’s Path Planning Benchmark 2024 (RP2B-24), alongside two novel reinforcement learning (RL)-based path-planning algorithms: Q-Spline Multi-Operator Differential Evolution (QSMODE), utilizing Q-learning (Q-tables), and Deep Q-Spline Multi-Operator Differential Evolution (DQSMODE), based on Deep Q-networks (DQN). Both algorithms are integrated under a single framework and enhanced with cubic spline interpolation to improve path smoothness and adaptability. The proposed RP2B-24 library comprises 50 distinct benchmark problems, offering a comprehensive and generalizable testing ground for diverse path-planning algorithms. Unlike traditional approaches, RL in QSMODE/DQSMODE is not merely a parameter adjustment method but is fully utilized to generate paths based on the accumulated search experience to enhance path quality. QSMODE/DQSMODE introduces a unique self-training update mechanism for the Q-table and DQN based on candidate paths within the algorithm’s population, complemented by a secondary update method that increases population diversity through random action selection. An adaptive RL switching probability dynamically alternates between these Q-table update modes. DQSMODE and QSMODE demonstrated superior performance, outperforming 22 state-of-the-art algorithms, including the IMODEII. The algorithms ranked first and second in the Friedman test and SNE-SR ranking test, achieving scores of 99.2877 (DQSMODE) and 93.0463 (QSMODE), with statistically significant results in the Wilcoxon test. The practical applicability of the algorithm was validated on a ROS-based system using a four-wheel differential drive robot, which successfully followed the planned paths in two driving scenarios, demonstrating the algorithm’s feasibility and effectiveness for real-world scenarios. The source code for the proposed benchmark and algorithm is publicly available for further research and experimentation at: https://github.com/MohamedRedaMu/RP2B24-Benchmark and https://github.com/MohamedRedaMu/QSMODEAlgorithm
Density determination of CO2-Rich fluids within CCUS processes
Get PDFSince accurate density determination is a crucial parameter for carbon dioxide (CO2) fluid measurement and transportation pipeline designing, this study focuses on predicting the density of CO2-rich fluids in transportation pipelines for carbon capture, utilisation, and storage (CCUS) processes. In this regard, two supervised machine learning (ML) models, including the extra trees regressor (ETR) and Gaussian process regression (GPR), were developed using a diverse database of field-scale simulation samples. The models were compared based on their accuracy using statistical and graphical analysis. The GPR model performed better than the ETR model, achieving a smaller root mean square error (RMSE). The GPR model provides valuable insights for pipeline design, flow meter reliability, and uncertainty assessment in carbon storage. Experimental validation confirmed the robustness and practical applicability of the GPR model. This study demonstrates the potential of ML techniques to enhance the efficiency and reliability of CO2-rich fluid transportation in CCUS processes
Health benefits of Montmorency tart cherry juice supplementation in adults with mild to moderate Ulcerative Colitis; A placebo randomized controlled trial.
Get PDFAims: Ulcerative colitis (UC) significantly impacts individuals' self-perception, body image, and overall quality of life; while also imposing considerable economic costs. These challenges high-light the necessity for complementary therapeutic strategies with reduced adverse effects to support conventional pharmacological treatments. Among natural interventions, Montmorency tart cherries, noted for their high anthocyanin content have emerged as a natural an-ti-inflammatory agent for UC. The current trial aimed to investigate the effects of Montmorency tart cherry compared to placebo in patients with mild to moderate UC.
Materials & methods: Thirty-five patients with UC were randomly assigned to receive either placebo or Montmorency tart cherry of which they drank 60 mL per day for 6-weeks. The primary outcome, health related quality of life, measured via the Inflammatory Bowel Disease Quality of Life Questionnaire (IBDQ), and secondary measures, including other health-related question-naires, blood biomarkers and faecal samples, were measured before and after the intervention. Linear mixed-effects models were adopted to contrast the changes from baseline to 6-weeks be-tween trial arms. Effect sizes were calculated using Cohen’s d.
Results: There were significantly greater improvements in IBDQ (22.61 (95% CI = 5.24 to 39.99) d = 0.90) and simple clinical colitis activity index (− 3.98 (95% CI = − 6.69 to – 1.28) d = − 1.01) in the tart cherry trial arm compared to placebo. In addition, reductions in faecal calprotectin levels were significantly greater in the tart cherry trial arm compared to placebo (− 136.17 µg/g (95% CI = − -258.06 to – 4.28) d = − 1.14). Loss to follow-up (N=1) and adverse events (N=1) were low and compliance was very high in the tart cherry (95.8%) trial arm.
Conclusions: Given the profoundly negative effects of UC on health-related quality of life and its fiscal implications for global healthcare systems; this trial indicates that twice-daily tart cherry supplementation can improve IBD-related quality of life as well as severity of symptoms, and therefore may be important in the management of UC
Health state utilities associated with treatment burden in cystic fibrosis: a patient valuation study
Get PDFBACKGROUND
While recent advancements in the treatment of cystic fibrosis (CF) have improved survival, reducing high levels of treatment burden remains a priority issue for many people with CF (pwCF). However, economic evaluations of novel interventions may fail to capture their impact on treatment burden due to a lack of suitable outcome measures. This study aimed to estimate health state utilities (HSUs), for changes in treatment burden associated with different CF treatments.
RESEARCH QUESTION
What value do pwCF place on changes in treatment burden associated with intravenous antibiotic treatment of pulmonary exacerbations, inhaled medicines, and physiotherapy?
STUDY DESIGN
AND METHODS: Adults attending a specialist CF center were invited to participate in a web-based time trade-off interview. Participants valued their own health, and five health state vignettes describing varying levels of intensity of physiotherapy, inhaled, and IV antibiotic treatment. HSUs for additional instances of each treatment type were estimated using mixed effect linear regression models.
RESULTS
Fifty one people with CF completed the interview (median age, 30 years; range, 19-66); 53% were female; mean FEV(1) % predicted, 65% [SD, 20%]).
Mean utility scores for own health were very similar between the EQ-5D index value (0.81, SD 0.20) and the TTO value (0.82, SD 0.20), however limited concordance was observed at the individual level. Adjusted utility decrements associated with treatment burden were -0.037 (SE 0.008) for an additional annual IV antibiotic treatment, -0.029 (SE 0.014) for an additional daily physiotherapy session, and -0.019 (SE 0.013) for an additional daily inhaled medicine.
INTERPRETATION
Increasing treatment burden was associated with decreasing HSU values. The utility decrements associated with treatment burden changes suggest meaningful differences in health-related quality of life (HRQoL) for pwCF. These findings align with existing literature on the impact of treatment burden on HRQoL, and highlight the importance of considering treatment burden in economic evaluations of interventions in CF
(In)visible Working Mama Drama: From Excellent to ‘Good Enough’ Academia and (M)Others
Get PDFThe neoliberal, precarious, anatomized and audit-centric Academy produces an unfair burden on women academics. Academia, like many other organizational forms, demands
‘unwellness’. This essay argues that as well as intensifying the struggles of mothering academics like us, the pandemic also rendered us visible, forcing the body subject into view
and, in doing so, offering some (albeit small) resistance to the ‘anatomizing urge’ in Academia. Following discussions on agentic visibility, we propose the idea of agentic invisibility and a corresponding discussion of its loss during the pandemic. We argue that we could no longer choose to showcase what was excellent or to deliberately conceal what was
not. Engaging in agentic visibility and invisibility tactics became very difficult, and this had many downsides, including the loss of liminal spaces and the difficulties in our private lives that were suddenly on display. What we choose to focus on, though, is a more caring future. Through the work of Donald Winnicott, we suggest that the difficult and sometimes painful spaces created by the pandemic forced us to reject excellence and to accept the ‘good enough’ as a way of being that should be respected. In this essay, we contribute to discussions concerning the reformative mode of ordering used by homeworking mothers during the pandemic. Though we cannot and will not speak for others, we use our dual roles as mothering academics to illustrate broader problems for others who continue to be marginalised by academia and for those who simply seek a more balanced engagement with academia. We seek an acceptance of the ‘good enough’ for all people from those in power and from each other
A practical guide to living evidence: reducing the knowledge-to-practice gap
Get PDFLiving evidence involves continuous evidence surveillance to incorporate new relevant evidence into systematic reviews and clinical practice guideline recommendations as soon as it becomes available. Thus, living evidence may improve the timeliness of recommendation updates and reduce the knowledge-to-practice gap. When considering a living evidence model, several processes and practical aspects need to be explored. Some of these include identifying the need for a living evidence model, funding, governance structure, time, team skills and capabilities, frequency of updates, approval and endorsement, and publication and dissemination
Moving Beyond the Impasse: Importation, Deprivation, and Difference in Prisons
Get PDFThis theoretical article uses an intersectionality lens to show that, together, the importation and deprivation models can act as an important theoretical tool for understanding the lives of incarcerated people who deviate from the expected population of young, white, able-bodied, hearing males. We use examples from the lives of incarcerated d/Deaf people and incarcerated women to introduce a pain-difference continuum, where the extent to which someone differs from what is ‘expected' in prison correlates with the types of pains/deprivations they experience. We acknowledge the impact of imported oppression and coin the term “imported coping,” where people utilize pre-existing strategies to navigate prison's pains
The Role of Stewards of Trust in Facilitating Trust in Science: A Multistakeholder View
Get PDFTrust in science post-Covid appears to be a complex matter. On the one hand, the COVID-19 pandemic added value to the epistemic trustworthiness of scientific opinion and its potential to drive evidence-based policies, while it also spurred scientific distrust and societal polarization (e.g., vaccines), especially on social media. In this work we sought to understand the ways in which trust in science might be bolstered by adopting a multistakeholder perspective. This objective was achieved by considering stakeholders’ views on (a) how perceived key actors affect trust in science, and (b) what proposed actions can be taken by each actor identified. Data were collected using 16 focus groups and 10 individual interviews across different European contexts with general public (n = 66), journalists (n = 23) and scientists (n = 35), and were analysed using thematic analysis. Regarding how perceived key actors affect trust in science, participants viewed policymakers, media, scientific and social media actors as occupying a dual function (facilitators and hinderers of trust in science), and pointed to the value of multi-actor collaboration. Regarding what actions should be taken for enhancing trust in science, participants indicated the value of enhancing understanding of scientific integrity and practices, through science literacy and science communication, and also pointed to social media platform regulation. Implications stemming from the data are discussed, considering how multiple identified stewards of trust can contribute to an ecosystem of trust
159 Global Implementation and Impact of a Virtual Reality-Based Surgical Education Program
No full textIntroduction
Traditional surgical training is constrained by limited theatre access, hierarchical barriers, and inconsistent procedure variety. The Virtual Reality in Medicine and Surgery (VRiMS) programme addresses this with immersive virtual reality (VR) structured training through surgical videos with image overlays and anatomical models. Covering 350+ procedures, VRiMS has been implemented across the UK and over 10 low-income countries.
Aim
To assess the impact of VRiMS on procedural and anatomical confidence and evaluate its feasibility as a scalable surgical training tool.
Method
268 medical students and trainees received didactic lectures, VR surgical videos, and interactive anatomical models. Procedures included craniotomy (n=68), radial forearm free flap (n=53), mitral valve repair (n=42), fasciotomy (n=29), posterior knee approach (n=27), proximal humeral fracture repair (n=22), lateral canthotomy (n=13), abdominal aortic aneurysm repair (n=7), and rhinoplasty (n=7). Confidence (1–5 Likert scale) was assessed pre- and post-workshop using Wilcoxon signed-rank tests.
Results
76.5% (205) of participants had no prior experience with VR in medical education. Procedural confidence increased significantly from 1.71 ± 0.94 to 3.41 ± 0.95 (p<0.01), and anatomical confidence improved from 2.22 ± 1.04 to 3.62 ± 0.95 (p<0.01). Significant gains (p<0.05) were observed across most procedures (8 out of 9). 74.3% (199) rated VRiMS more effective than traditional surgical education, and the mean likelihood of recommending the workshop was 4.30 ± 0.88 out of 5.
Conclusions
VRiMS significantly enhances confidence in complex surgical procedures, demonstrating its potential to deliver scalable, impactful training globally. Planned development of 11 VRiMS hubs across Africa will improve global surgical education accessibility and address regional training needs