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Development of entrustable professional activities for competency-based prosthodontic specialty training programmes
No full textOBJECTIVES: This study aimed to develop and validate a set of Entrustable Professional Activities (EPAs) for prosthodontics specialty training using a structured multi-step approach.METHODS: An initial list of EPAs was generated through a comprehensive literature review, examination of prosthodontics competency standards, and an asynchronous online nominal group technique involving national prosthodontists and a dental education expert. This process was used to develop and confirm the EPA set. The EPAs were then evaluated for quality and structure using the Equal rubric, resulting in the refinement and confirmation of relevant EPAs. Subsequently, a two-round modified Delphi method was employed, engaging prosthodontics educators from multiple countries in a consensus-building process. In the modified Delphi rounds, panellists reviewed a predefined list of EPAs and provided quantitative ratings and qualitative comments on indispensability (Round 1-2), title clarity (Round 1-2), specification/limitations (Round 1-2), information supporting entrustment decisions (Round 2), and expected entrustment level at each stage of training (Round 2). Based on median ratings and content validity index analysis the EPAs were revised accordingly. Aggregated scores for each EPA and synthesised group feedback for consensus development were provided in Round 2.RESULTS: The expert group confirmed 11 of the 20 initially identified EPAs. All 11 preliminary EPAs reflected activities that were deemed essential to the clinical practice of prosthodontists. Based on median ratings and content validity index analysis, 8 EPAs needed revision. A high degree of consensus among experts was reached in the second Delphi round. The final set of 11 EPAs provide a succinct and comprehensive overview of the core tasks of specialist prosthodontists.CONCLUSION: This study developed 11 EPAs for prosthodontics specialty training programmes, representing an essential first step toward developing a structured assessment system for prosthodontic trainees.CLINICAL SIGNIFICANCE: This study provides a further step towards competency-based specialty training in prosthodontics.</p
Sharing common measures of the environment across continents: Challenges and opportunities for global studies of aging
No full textObjectives: Environmental exposures are modifiable risk factors for accelerated aging, but research is frequently limited to individual countries due to inconsistent exposure assessment. Cross-national data provides broader perspectives but adds methodological complexities. This study evaluated spatial and temporal patterns of five environmental measures assigned to older adult pseudopopulations in eight countries to highlight opportunities and challenges for aging epidemiologic studies.Methods: Through the Gateway to Global Aging Data project, we harmonized measures of air pollution (PM2.5, NO2, O3) and natural spaces (greenspace, blue space) for longitudinal aging cohorts in Brazil, Chile, England, India, Ireland, Mexico, Northern Ireland, and the United States. Global exposure data (1990-2021) derived from satellite observations, spatiotemporal models, and deterministic simulations were linked to 10,000 population-weighted points representing adults >50 years per country. We characterized urbanicity and area-level deprivation and examined spatial/temporal patterns to inform environmental aging research.Results: Exposure levels and variability differed within and between countries. Greenspace and NO2 exhibited high within-country variation (200% higher within-country vs. between-country standard deviations), while PM2.5 and O3 had larger across-country differences (300% higher between-country than within-country standard deviation). Temporal trends were generally consistent across countries, though unique patterns emerged (e.g., increasing PM2.5 and O3 levels in India and a radical drop in greenspace in Chile). Correlations were most consistent between NO2, greenspace, and area-level deprivation, though they varied (0.1 to 0.7).Discussion: Harmonized measures facilitate cross-country comparisons of environmental exposures but require careful consideration of confounding by place and time and differential measurement to ensure robust inferences
Selecting measures of visual function to classify diabetic retinopathy status: a cross-sectional study
No full textAim: To identify combinations of up to three visual function tests with the best performance for classifying diabetic retinopathy (DR) severity stage. To describe in detail the measurements from a comprehensive set of visual function tests. Methods: 1901 eyes (1032 participants) underwent nine visual function tests. Fundus, ultra-widefield and optical coherence tomography images were graded for DR and diabetic macular oedema (DMO). Three classification tasks were set: (1) distinguishing diabetes mellitus (DM) no DR from healthy with no DM, (2) DR no DMO from DM no DR and (3) DR with DMO from DR no DMO. Ensemble machine learning models for all one-way, two-way and three-way combinations of visual function variables were compared using area under the curve (AUC). Results: The top 30 models for each task achieved high accuracy, with AUC ≥0.94. For task 1, 17/30 top models contained distance visual acuity. Pelli-Robson contrast sensitivity and low luminance visual acuity also featured highly. For task 2, 19/30 models contained mesopic microperimetry. Near visual acuity, matrix microperimetry and reading index featured highly. For task 3, 17/30 models contained distance visual acuity. Smith-Kettlewell low luminance near visual acuity and near visual acuity featured highly. In a subset of eyes where perimetry was not performed, reading index featured in 22, 21 and 22 of the top models for tasks 1, 2 and 3 respectively. Conclusions: These findings will enable researchers and those planning clinical trials to select the best combination of visual function tests for distinguishing stages of diabetic eye disease
Preconception care for men: a scoping review of knowledge, behaviours and interventions
No full textAim: This scoping review mapped quantitative evidence on men’s preconception care (PCC) focusing on: (1) knowledge, (2) behaviours and attitudes, (3) reproductive intentions and (4) outcomes of educational or counselling interventions. The review also sought to identify evidence gaps and inform future policies and practices to enhance male engagement in reproductive health. Methods: Quantitative studies involving men aged ≥18 years from high- and upper-middle-income countries were included. Studies focusing on couples, non-English-language publications, qualitative research, reviews and commentaries were excluded. Quantitative designs were prioritised to map measurable determinants and outcomes of engagement in PCC. Searches were conducted across seven databases in September 2025, following the PRISMA-ScR framework. No critical appraisal was performed, consistent with scoping review methodology. Results: Fourteen studies (n=18 733 men) were included, most of which were observational. Findings indicated low fertility awareness, inconsistent engagement in preconception behaviours, and minimal use of supplements or healthcare services. Differences were noted by age, education and fatherhood status. One intervention improved knowledge but did not address systemic barriers. Conclusions: Men remain underrepresented in PCC. Gender-transformative, system-level reforms integrating men into primary care, health education and public messaging are needed. Future research should test context-specific, equity-oriented interventions to promote inclusive PCC for all
The social ecology of adolescent mental health in humanitarian settings
No full textThe social-ecological context of adolescent mental health, particularly adolescents living through humanitarian crises, is understudied. There is a pressing need for such research to inform the development of contextualised systemic interventions for this population. This study investigated the social ecological stressors and risk- and protective-factors experienced by adolescents and their families in crisis-hit Lebanonto inform a contextually grounded systemic psychosocial support intervention. A whole-family systems approach grounded in the Social-Ecological Model was usedwith a qualitative design to capture the lived experiences of dolescents. Interviews were conducted with 46 Lebanese and Syrian adolescents (48% female, mean age = 13.8 years, SD = 1.65), their families (N = 42 caregivers, 60% mothers), andexperienced providers (N = 5) in Lebanon. Transcripts were analysed using Reflexive Thematic Analysis which highlighted six interconnected themes (25 sub-themes) that characterised the life experience of adolescents at each identified systems level.Themes ranged from adolescent mental health and interpersonal relationships to living conditions and access to basic human rights and services. Gender and nationality exerted cross-cutting influences across themes. Findings are discussed drawing on social ecology, systems theory, and liberation psychology. Results highlight a clear need for interventions to involve families and caregivers, and consider adolescents in their social ecological contexts. This approach could better address the needs ofadolescents, by supporting adolescent development, enhancing mental health andwell-being, reducing community and social isolation, and, more broadly, advocating for social equity, justice, and human rights
A near-field extension of the 3GPP geometry-based stochastic channel model for sub-Thz communications
No full textMany conventional radio channel models, such as 3GPP TR 38.901, assume far-field conditions and rely on the plane wave approximation. However, as antenna arrays grow in size and link distances decrease, near-field propagation effects become significant, particularly at sub-THz frequencies. This letter proposes an initial extension to the 3GPP channel model to incorporate near-field characteristics at these frequencies. The approach models both line-of-sight and non-line-of-sight paths using exact geometric distances. An image-theory-based method is introduced to model specular reflections. The extended model maintains consistency with the existing 3GPP framework while enhancing modeling accuracy in the near-field
Beyond the desert and the veil? The translation of Saudi Arabia in three anglophone memoirs
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