Search Results (358)

Background: Dental patient-centred outcomes are essential in clinical practice and research. To enhance feasibility, Oral Health-Related Quality of Life (OHRQoL) instruments often need to reduce administration time. In Serbia, longer OHIP versions exist (OHIP-14, OHIP-EDENT), but the ultrashort OHIP-5 has not yet been available. Aim: This cross-sectional study aimed to translate, culturally adapt, and evaluate the psychometric properties of the five-item Serbian version of the Oral Health Impact Profile (OHIP5-Srb). Materials and Methods: The OHIP5-Srb was translated using a standard forward–backward procedure. Participants were recruited between June and September 2025 using a convenience sampling approach. Psychometric testing—including internal consistency, exploratory (EFA), confirmatory factor analysis (CFA), and convergent and known-groups validity—was conducted on 236 participants (mean age 47.4 years). Test–retest reliability was evaluated in 35 dental students, and responsiveness in 45 patients undergoing dental treatment. Results: Cronbach’s alpha was 0.784, indicating adequate internal consistency. Test–retest reliability was excellent (mean ICC = 0.96; all inter-item correlations > 0.20). Convergent validity was supported by a strong negative correlation between OHIP5-Srb summary scores and a single-item measure of overall oral/dental health (Spearman’s rho = −0.861, p < 0.01). Known-group validity was confirmed by significant differences between removable denture wearers and individuals with natural teeth (and/or fixed partial dentures), after adjusting for age, and between participants perceiving a need for dental treatment and those who did not. EFA indicated a one-factor structure explaining 55.1% of variance. The one-factor model was confirmed by CFA and showed good fit (χ² = 15.08, df = 5; CFI = 0.97; TLI = 0.94; RMSEA = 0.092; SRMR = 0.04). Responsiveness analysis demonstrated significant decreases in OHIP5-Srb scores following various dental treatments. Conclusions: The OHIP5-Srb is unidimensional, reliable, valid, and responsive. Its brevity and robust psychometric properties make it suitable for assessing self-perceived oral health-related quality of life in the Serbian urban population, particularly when minimizing respondent burden is critical. Full article

In digital retail, where competition intensifies and customer expectations evolve rapidly, understanding the interplay among customer experience metrics is critical for strategic decision-making. Despite widespread adoption of feedback programmes, practitioners struggle to interpret how improvements in transactional ease, experiential quality, and satisfaction propagate across the customer journey to influence retention and growth. This study addresses this gap by examining the interrelations among Customer Effort Score (CES), Customer Experience (CX), Customer Satisfaction (CSAT), Customer Loyalty Index (CLI), and Net Promoter Score (NPS) within a unified framework. A quantitative, cross-sectional survey of recent online shoppers yielded 359 valid responses; the model was estimated with PLS-SEM. All hypothesised direct paths were positive and significant, evidencing a cascade from effort through experience and satisfaction to repurchase and recommendation intentions. Mediation analyses confirmed that CES and CX affect loyalty and advocacy indirectly via CSAT. Out-of-sample prediction validated predictive relevance. The study integrates transactional and relational indicators, establishes the empirical utility of single-item measures within PLS-SEM, and advances a portfolio view of CX metrics. Managerially, effort reduction and experience enhancement emerge as high-leverage interventions: improvements cascade through satisfaction to elevate loyalty and advocacy in digital retail. Full article

Background: Patients with multiple sclerosis (PwMS) frequently experience dysphagia, which affects their quality of life. The swallowing disturbance questionnaire (SDQ) has demonstrated potential in screening dysphagia in different disorders. The objective of this study was to evaluate the validity and reliability of the Persian version of SDQ in PwMS. Methods: In this cross-sectional study, 198 PwMS were enrolled. The translation of SDQ into Persian was performed using the forward–backward method. Participants completed both the SDQ and the Dysphagia in Multiple Sclerosis (DYMUS) questionnaires. Convergent validity was assessed using the Spearman correlation, construct validity was evaluated by principal component analysis (PCA), and reliability was assessed by Cronbach’s alpha. Screening ability was evaluated with receiver operating characteristic (ROC) curve analysis, using DYMUS as the reference measure. Results: The Persian SDQ showed high internal consistency (Cronbach’s alpha = 0.913) after removing one item. PCA revealed a single dominant factor accounting for 49.4% of the variance. The 14-item SDQ correlated strongly with both DYMUS (Spearman’s rho = 0.62, p < 0.001) and Expanded Disability Status Scale (EDSS) (Spearman’s rho = 0.388, p < 0.001). The area under the curve of 0.957 revealed high screening power with a sensitivity of 91.7% and a specificity of 88.9%. Conclusions: The Persian SDQ is a valid and reliable tool for early detection and quick monitoring of dysphagia in PwMS. Full article

Plastic is a key industrial innovation with wide ranging applications. However, its extensive production, consumption, and inadequate disposal practices have created a complex environmental challenge, resulting in escalating ecological and public health impacts. This study examines plastic waste management practices in the rural coastal communities of Kendwa, Nungwi, Paje, and Michamvi, located near tourist hotels in Zanzibar’s Northern and Southern districts, Tanzania. Structured interviews, observation checklists, and participatory workshops were used to assess the types of plastic waste generated and the level of community engagement in disposal practices. Findings indicate that single-use polyethylene terephthalate (PET) and high-density polyethylene (HDPE) packaging, particularly beverage bottles and other disposable items from hotels, dominate the waste stream. Nungwi and Kendwa demonstrate proactive responses, supported by a professional waste management company and NGO-led awareness programs promoting sustainable practices. In contrast, Paje and Michamvi continue to face challenges from tourism-linked waste, highlighting disparities in local management capacity. Despite positive initiatives in Nungwi and Kendwa, persistent littering remains a problem due to weak enforcement, limited infrastructure, and inconsistent community compliance. To address these gaps, the study recommends implementing waste bank programs alongside financial sustainability measures and community empowerment initiatives, to reinforce existing efforts and advance more sustainable waste management. Full article

(1) Background: Digital Elevation Models (DEMs) encompass digital bare earth surface representations that are essential for spatial data analysis, such as hydrological and geological modelling, as well as for other applications, such as agriculture and environmental management. However, available bare-earth DEMs can have limited coverage or accessibility. Moreover, the majority of available global DEMs have lower spatial resolutions (∼30–90 m) and contain errors introduced by surface features such as buildings and vegetation. (2) Methods: This research presents an innovative method to convert global DEMs to bare-earth DEMs while enhancing their spatial resolution as measured by the improved vertical accuracy of each pixel, combined with reduced pixel size. We propose the Joint Spatial Propagation Super-Resolution network (JSPSR), which integrates Guided Image Filtering (GIF) and Spatial Propagation Network (SPN). By leveraging guidance features extracted from remote sensing images with or without auxiliary spatial data, our method can correct elevation errors and enhance the spatial resolution of DEMs. We developed a dataset for real-world bare-earth DEM Super-Resolution (SR) problems in low-relief areas utilising open-access data. Experiments were conducted on the dataset using JSPSR and other methods to predict 3 m and 8 m spatial resolution DEMs from 30 m spatial resolution Copernicus GLO-30 DEMs. (3) Results: JSPSR improved prediction accuracy by 71.74% on Root Mean Squared Error (RMSE) and reconstruction quality by 22.9% on Peak Signal-to-Noise Ratio (PSNR) compared to bicubic interpolated GLO-30 DEMs, and achieves 56.03% and 13.8% improvement on the same items against a baseline Single Image Super Resolution (SISR) method. Overall RMSE was 1.06 m at 8 m spatial resolution and 1.1 m at 3 m, compared to 3.8 m for GLO-30, 1.8 m for FABDEM and 1.3 m for FathomDEM, at either resolution. (4) Conclusions: JSPSR outperforms other methods in bare-earth DEM super-resolution tasks, with improved elevation accuracy compared to other state-of-the-art globally available datasets. Full article

Background: 3D printing (3DP) workflow has made its entry in the upper limb prostheses (ULP) manufacturing process. Although it represents a valuable change in clinical practice, its implementation is not ubiquitous. Additional data are required to establish recommendations and unanimously accepted guidelines to facilitate clinical application. Objectives: Our study aimed to develop and validate a web-based multilingual survey investigating the sociodemographic and technical profiles and expertise of professionals and volunteers using 3DP for manufacturing ULP. Methods: We followed a multi-stage development and validation process, including item generation, experts’ review, cognitive testing and pre-testing among the population of interest (POI). Validity evidence was accumulated at each stage, with Content Validity and Face Validity measurements. The survey was available in French, English and Spanish and distributed through the REDCAP web-based platform. Results: The validated questionnaire comprised fifty-two primary questions, organized in nine sections. Experts’ evaluations demonstrated appropriate topic coverage and a high degree of relevance throughout the survey: most single item Content Validity Indexes (CVI) ranged from 0.87 to 1 and Average CVIs for survey sections reached between 0.86 to 1. The pre-test among the POI included 42 participants and led to limited questionnaire revisions. The final version of the survey was approved unanimously by all experts. Conclusions: The newly developed web-based survey demonstrated good evidence for validity. This instrument is an acceptable tool to investigate stakeholders using 3DP for manufacturing ULP and to further establish guidelines. Full article

Background: To examine the association between the number and location of missing teeth and oral health-related quality of life (OHRQoL) as well as self-assessed general health in a convenience sample of Austrian dental patients, and to evaluate the applicability of the OHIP-G 14 and OHIP-G 12 instruments in this context. Methods: An anonymous questionnaire was distributed to adult patients in the waiting area of a single Austrian dental practice. It included the German version of the OHIP-14, a visual analog scale (EQ-5D VAS) for self-assessed general health, and demographic questions. A dentist clinically assessed the number and location of missing teeth using the FDI tooth numbering system. Regression models were used to evaluate the impact of anterior and posterior tooth loss on both outcome measures. The role of tooth replacement was also explored. A sensitivity analysis was conducted using the OHIP-G 12, a modified version excluding two items from the OHIP-14. Results: OHRQoL was significantly associated with the number of missing anterior teeth, while self-assessed general health was associated only with missing posterior teeth. These associations were consistent across models using OHIP-G 14 and OHIP-G 12. Tooth replacement, as assessed, showed no significant influence on either outcome. Age initially correlated with both outcomes but lost significance after controlling for the number of missing teeth. Conclusions: The hypothesis that anterior tooth loss negatively affects OHRQoL was supported. The association between posterior tooth loss and general health perception was not expected and requires further investigation. The OHIP-G 12 proved to be a valid and efficient alternative in this setting. Full article

Background/Objectives. Patient-Reported Outcome Measures (PROMs) capture patients’ perspectives about their health status, quality of life, and medical care outcomes. LIMB-Q Kids is a validated PROM designed to assess health-related quality of life (HRQL) in children with lower limb differences. It evaluates physical, social, and psychological function; symptoms related to the leg, hip, knee, foot and ankle; leg-related distress, appearance, and school-related concerns. It has now been translated and culturally adapted from English to other languages. The aim of this study was to translate and culturally adapt LIMB-Q Kids to Hebrew. Methods. Following international guidelines, two independent forward translations from English to Hebrew were produced and reconciled into a single version. A backward translation was then compared with the original to identify discrepancies. This draft underwent cognitive debriefing interviews (CDIs) with 11 children (ages 8–15) having lower limb differences to assess comprehension and cultural relevance. Results. CDIs revealed general issues including lengthy or unclear text, high-level language, cultural unfamiliarity and duplication of descriptors. Specific to Hebrew, issues included gender inflections and the need for vowel diacritics to support younger, less proficient readers. Revisions to 14 items were made. Conclusions. A translation and cultural adaption (TCA) process led to a linguistically validated and culturally adapted Hebrew version of LIMB-Q Kids. It can now be used for the clinical follow-up of children with lower limb differences including pre- and post-operatively, and as an aid to decision-making for surgery. Full article

Background/Objectives: Burnout syndrome among nurses can significantly contribute to the nursing shortage, leading to high turnover and negative impacts on both nurses and patient care. The primary objective of this project was to evaluate the feasibility, acceptability, and preliminary effect of a mindfulness-based mobile application (MBMA) on burnout and well-being in emergency department (ED) nurses over four weeks. Methods: An EBPQI with a descriptive approach was taken to evaluate ED nurses’ burnout and well-being, which was measured with the Mini-Z Single Item (MZSI) and Nurses’ Well-Being Index (NWBI). We also asked three open-ended questions about their experience using the once-daily MBMA over the four-week period. Twelve participants from a mid-western hospital were recruited, and six completed both the pre-test and post-test surveys. Results: Results found no statistically significant improvement in burnout (p = 1.00) or well-being (p = 0.783). However, upon a secondary analysis using imputed data, a statistically significant improvement in burnout was found (p = 0.012). Among the six participants who completed the post-intervention, a significant and positive correlation between burnout and well-being was identified (r = 0.81, p = 0.048). Themes from qualitative responses included perceived helpfulness of MBMA tools, perceived usefulness, and lack of time for daily participation. Although statistical improvements were not observed, individual comments indicated that the tool was helpful; however, setting aside time to engage with it remained difficult. Conclusions: Findings from this project support the need for further research exploring the impact of individualized interventions specifically targeting ED nurses as well as organizational strategies aimed at those already experiencing burnout or impaired well-being. Full article

Counterfeiting poses a significant threat to global commerce, causing economic damage and jeopardizing consumer safety. This report addresses the critical need for advanced anti-counterfeiting measures. While often confused, authentication verifies an item’s genuineness, whereas anticounterfeiting is a broader strategy that includes authentication to deter counterfeit production. This report explores such technologies, which are primarily based on tangible objects and can be used as an anticounterfeiting measure. Such technologies, referred subsequently as “hardware-based anticounterfeiting techniques”, provides a critical line of defence in the fight against imitation of goods. This review covers diverse methods: electronic, mechanical, chemical, and marking techniques. The report emphasizes that no single technique is sufficient, advocating for a multi-layered approach. By combining these hardware solutions with complementary measures like supply chain monitoring, we can create a more resilient defense against counterfeiting. Full article

Marital relationship quality significantly influences health outcomes, but validated measurement tools for South Asian populations remain limited. To validate scales measuring trust, commitment, and satisfaction as key components of marital relationship quality among newly married women in Nepal, we conducted a two-wave psychometric validation study in rural Nawalparasi district. The study included 200 newly married women aged 18–25 years, with 192 participants (96% retention) completing 6-month follow-up. We assessed factor structure, internal consistency, test-retest reliability, and criterion validity of trust (eight items), commitment (five items), and satisfaction (seven items) scales using exploratory and confirmatory factor analysis. Exploratory factor analysis identified single-factor solutions for trust and commitment scales and a two-factor model for satisfaction. Confirmatory factor analysis confirmed these structures, with satisfaction comprising marital conflict/dissatisfaction (four items) and general satisfaction (two items) subscales. All scales demonstrated good internal consistency (Cronbach’s α: 0.79–0.96) and significant criterion validity correlations with relationship happiness (r = 0.63–0.72, p < 0.001). Test-retest reliability showed moderate to low stability (r = 0.21–0.51), likely reflecting genuine relationship changes in early marriage. The validated scales provide reliable tools for assessing relationship quality in South Asian contexts, enabling research on marriage-health associations and evidence-based interventions. Full article

From the psychology of sport, the impact of group cohesion on sports performance has been studied extensively; therefore, it is considered important to measure this variable to design interventions that improve collective work to achieve goals together. This study adapted and validated the Group Environment Questionnaire (GEQ) for Mexican university athletes. In a cross-sectional instrumental design, 226 athletes from various team sports completed the scale. Internal consistency statistics and confirmatory factor analyses Goodness-of-Fit Index (GFI), Comparative Fit Index (CFI), and Root Mean Square Error of Approximation (RMSEA) evaluated psychometrics. After removing three items with weak loadings, three structural models were tested as follows: (a) unidimensional, (b) task vs. social cohesion, and (c) attraction vs. integration. The unidimensional model showed the best fit (χ² = 177.33; GFI = 0.90; CFI = 0.92; RMSEA = 0.07) and high reliability, indicating that cohesion can be treated as a single overarching construct. Task items exhibited higher consistency than social items. In conclusion, the adapted version of the GEQ is a useful tool for the evaluation of cohesion in Mexican university sports, although it is recommended to improve social items and expand its application in different disciplines and competitive levels. Full article

Background/Objectives: Metal–ceramic crowns may be constructed using different techniques and coping materials. A systematic review analysing the coping material, method of construction, and instruments used for measuring the metal–ceramic crown marginal gap has not been completed. The aim of this systematic review was to appraise the literature relating to the instruments used for the in vitro marginal gap measurement of single pre-cemented metal–ceramic crowns and assess whether the crown coping material and method of coping construction influence the marginal gap. Methods: A systematic search was performed in November 2024 across the EBSCO Host, Scopus, PubMed, and Web of Science databases, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and specific eligibility criteria. The Joanna Briggs Critical Appraisal Checklist was used to assess article quality. Results: Fourteen studies evaluated marginal gaps in 402 crowns using the following techniques: direct view microscopy (eight studies), replica techniques (three studies), scanning electron microscopy (two studies), and profilometry (one study). The mean marginal gap for all the metal–ceramic crowns across all the studies was 65.97 ± 32.58 µm. The pre-cementation mean marginal gaps showed no significant difference between Computer-Aided Design–Computer-Aided Manufacturing (CAD-CAM) milled copings (87.95 ± 26.35 µm) and conventionally cast copings (90.45 ± 24.37 µm) (t = −0.197, p = 0.847). The mean marginal gaps varied significantly (F = 11.34, p < 0.001) by coping material: cobalt–chromium (Co-Cr) led to 84.28 µm, nickel–chromium (Ni-Cr) led to 70.98 µm, titanium led to 50.18 µm, and noble metal alloys led to 27.90 µm. Six studies addressed confounding factors and followed a standardised approach for measuring marginal gaps. Conclusions: Direct view microscopy was the most commonly used instrument for measuring the marginal gaps of single pre-cemented metal–ceramic crowns, yielding the smallest reported mean marginal gap of 75.00 ± 26.87 µm. Metal–ceramic crowns constructed with noble metal alloys exhibited the lowest mean marginal gaps. Metal–ceramic crowns constructed using conventional casting techniques presented similar marginal gaps to CAD-CAM crowns. Full article

Background: Gamification may enhance engagement and higher-order learning in health-care profession education, but evidence from undergraduate nursing programs—particularly in the Middle East—is limited. We evaluated whether integrating structured gamified activities into an anatomy and physiology course improves class engagement and knowledge-based critical thinking. Methods: In this pragmatic, nonrandomized, section-allocated quasi-experimental study at a single Saudi institution, 121 first-year female nursing students were assigned by existing cohorts to traditional instruction (control; n = 61) or instruction enhanced with gamified elements (intervention; n = 60) groups. The intervention (introduced mid-semester) comprised time-limited competitive quizzing with immediate feedback and aligned puzzle tasks. Outcomes were measured at baseline, mid-semester, and end-semester using a four-item Class Engagement Rubric (CER; scale 1–5) and a 40-item high-cognitive multiple-choice (MCQ) assessment mapped to course objectives. Analyses used paired and independent t-tests with effect sizes and 95% confidence intervals. Results: No attrition occurred. From baseline to end-semester, the intervention group had a mean CER increase of 0.59 points (95% CI, 0.42 to 0.76; p < 0.001)—approximately a 15% relative gain—and a mean MCQ increase of 0.30 points (95% CI, 0.18 to 0.42; p < 0.001), an ~8% relative gain. The control group showed no material change over the same interval. Between-group differences in change favored the intervention across CER items and for the MCQ outcome. Semester grade-point average did not differ significantly between groups (p = 0.055). Conclusions: Embedding a brief, structured gamification package within an undergraduate nursing anatomy and physiology course was associated with measurable improvements in classroom engagement and modest gains in knowledge-based critical thinking, with no detectable effect on overall semester GPA. Given the nonrandomized, single-site design, causal inference is limited. Multi-site randomized trials using validated critical-thinking instruments are warranted to confirm effectiveness and define dose, durability, and generalizability. Full article

Background and Objectives: Fears of cancer recurrence (FCR) represents one of the most common psychological problems in cancer patients. Therefore, valid and reliable measurement tools are needed to assess FCR in this population. The purpose of this study was to examine the psychometric properties of FCR scales (Fears of Cancer Recurrence-7 Item Version [FCR-7]; FCR-4 Item Version [FCR-4]; FCR-6 Item Version [FCR-6]) in Turkish hematological cancer patients. Materials and Methods: The study sample consisted of 239 hematological cancer patients undergoing treatment at four different state hospitals in Türkiye. Results: Confirmatory factor analysis results showed that all three scales had a single-factor structure (FCR-7: CFI = 0.981, TLI = 0.969, RMSEA = 0.071, SRMR = 0.028; FCR-4: CFI = 1.000, TLI = 1.001, RMSEA = 0.000, SRMR = 0.004; FCR-6: CFI = 0.981, TLI = 0.965, RMSEA = 0.087, SRMR = 0.028). The model allowing for correlated error terms between the first and second items provided the best fit. Research findings also indicated that the scales possessed strict measurement invariance across gender. Convergent and discriminant validity analyses also demonstrated expected associations between FCR scale scores and psychological well-being (r = −0.25 to −0.34) and psychological distress (r = 0.33 to 0.46) variables. The known-groups validity analysis indicated that the scales were effective at differentiating between groups and that they replicated the well-established finding from previous research that women report significantly higher levels of FCR than men (d = 0.42–0.47). Reliability analyses indicated that all three versions of the FCR scales had high internal consistency (Cronbach’s α = 0.91–0.93) and strong test–retest reliability (r = 0.85–0.87). Conclusions: Overall, the findings indicated that FCR-7, FCR-4, and FCR-6 are psychometrically sound, valid, and reliable instruments for assessing FCR in Turkish hematological cancer patients. These instruments can be used in clinical practice and research studies, as well as for evaluating intervention effectiveness in this population. Full article