Tag: statistics

J Dent Educ. 2026 Apr 11. doi: 10.1002/jdd.70228. Online ahead of print.

ABSTRACT

PURPOSE/OBJECTIVES: Dental education is undergoing a digital transformation, yet the adoption of immersive technologies such as haptic virtual reality (HVR) remains limited. This study aimed to map global adoption trends, barriers, and opportunities for equitable integration of HVR in dental curricula.

METHODS: A 73-item global survey (July-August 2025) was distributed to dental educators across 57 countries via professional networks and social media. The mixed-methods instrument, validated by experts, assessed simulation methods, usage, barriers, and perceptions. Descriptive and exploratory inferential statistics (e.g., one-way ANOVA, Kruskal-Wallis, and chi-square tests) were used to analyze quantitative data, while thematic analysis was used to analyze qualitative responses. Ethical approval was granted by a university ethics review board (No. 13/2023).

RESULTS: Responses from 130 educators (115 institutions, 57 countries) showed traditional methods (phantom heads, n = 118; benchtop exercises, n = 84) dominating (∼80% clinical training time), while HVR (n = 42, primarily in undergraduate programs) and mixed reality (n = 14, primarily in undergraduate programs) were less prevalent, especially in postgraduate programs (10% HVR use). Barriers in implementing HVR simulators were mainly external, with a lack of resources (66.3%) and resistance from staff and students (21.3%), while personal barriers such as technological limits (9.0%), lack of training (2.2%), and lack of evidence (1.1%) were less common (total n = 89). Countries with higher socioeconomic status were found to use HVR more in undergraduate education than the less well-off countries (p = 0.002).

CONCLUSION(S): Immersive technologies remain underutilized in dental education, particularly at the postgraduate level, creating potential gaps in clinical preparedness. Strategic integration, collaboration, and sustainability-focused adoption may enhance equity and clinical readiness, informing accreditation and policy reforms.

PMID:41964327 | DOI:10.1002/jdd.70228

J Dent Educ. 2026 Apr 11. doi: 10.1002/jdd.70230. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to compare dental students’ subjective user experience of digital versus conventional axiography following structured teaching interventions, using the User Experience Questionnaire (UEQ).

METHODS: A total of 47 dental students (26.37 ± 3.81 years; 33 female) participated in a standardized seminar consisting of theoretical instruction and hands-on training in digital axiography using the ZEBRIS system. After completion of the course, the students evaluated both methods using the validated German version of the UEQ, covering six user experience scales. Internal consistency was assessed using Cronbach’s alpha, as well as Guttman’s lambda-2. Differences between digital and conventional axiography were analyzed using Wilcoxon matched-pairs signed-rank tests.

RESULTS: Digital axiography received higher mean UEQ scores across all scales, with particularly positive ratings in the hedonic dimensions of Stimulation and Novelty. These differences were statistically significant (p < 0.001). Pragmatic dimensions (Perspicuity, Efficiency, and Dependability) showed no significant differences between the two methods.

CONCLUSION: Digital axiography was perceived more positively by dental students than conventional axiography regarding the hedonic user experience. While both methods demonstrated comparable pragmatic qualities, the digital workflow offered added motivational value. These findings support the integration of digital axiography as an additional component alongside conventional techniques in dental education to enhance not only the learning experience but also preparedness for contemporary clinical practice.

PMID:41964326 | DOI:10.1002/jdd.70230

J Rural Health. 2026 Mar;42(2):e70145. doi: 10.1111/jrh.70145.

ABSTRACT

PURPOSE: Rural Veterans face persistent barriers to care, often exacerbated by health care workforce shortages. Although recruitment initiatives are important, retaining providers in rural areas is equally critical to sustaining access and continuity of care. This rapid scoping review examined how “rural workforce retention” is defined and measured in the peer-reviewed literature and synthesized recommended reporting elements to improve clarity and comparability.

METHODS: Six bibliographic databases were searched (2014-2025) for English-language studies of rural health care in the United States, Canada, the United Kingdom, and Australia using terms related to rural workforce retention. Data were extracted on definitions of retention, time frames, and measurement approaches.

FINDINGS: Of 2392 abstracts screened, 268 met inclusion criteria. Among these, 172 (64%) lacked a retention definition. Of the remaining 96, nearly half (45%) measured retention using providers’ intentions to stay or leave; others relied on turnover or continued rural practice. More than half (61%) specified a retention timeframe, most often retrospectively (41/59; 69%). Substantial heterogeneity across definitions, time horizons, and data sources led to the development of a reporting checklist outlining key conceptual, temporal, and methodological elements for retention research.

CONCLUSIONS: Inconsistent and incompletely reported measures of rural workforce retention limit evaluation and scalability of effective strategies. Research should explicitly define retention, specify a measurable time frame, and clearly report key conceptual and methodological elements to enable comparison across settings. For the Veterans Health Administration (VHA) and other rural systems, clear retention metrics are essential to ensure workforce stability and sustain access to high-quality care for rural Veterans.

PMID:41964317 | DOI:10.1111/jrh.70145

J Rural Health. 2026 Mar;42(2):e70140. doi: 10.1111/jrh.70140.

ABSTRACT

PURPOSE: To determine the association between adult tobacco/nicotine product use over time and residence location (urban, suburban, town, rural), controlling for demographics.

METHODS: Data from Waves 4-7 (2016-2023) of the Population Assessment of Tobacco and Health (PATH) study (N = 18,590 adults) were analyzed using survey-weighted logistic regression to evaluate location and time differences in likelihoods of current, daily, and established use of combustible tobacco, electronic nicotine delivery systems (ENDS), smokeless products, and poly use (≥2 products).

FINDINGS: Compared to those residing in urban locations, suburban residents were less likely to report current (adjusted odds ratio (aOR) = 0.88), daily (aOR = 0.73), and established combustible products use (aOR = 0.77); town residents were more likely to use these products currently (aOR = 1.20) and daily (aOR = 1.42), and rural residents were more likely to use daily (aOR = 1.25) and report established use (aOR = 1.33). Rural residents had a lower likelihood of current ENDS use (aOR = 0.90), compared with those in urban locations. Compared with urban residents, current smokeless products use was more likely among rural residents (aOR = 1.63) and less likely among those in suburban locations (aOR = 0.74). Participants living in suburban (vs. urban) locations were less likely to use ≥2 products currently (aOR = 0.89) or daily (aOR = 0.79), while rural residents were more likely to engage in daily poly use (aOR = 1.39). Time was a significant factor in all models, with fluctuating patterns across waves.

CONCLUSIONS: These findings highlight nuanced geographic differences in tobacco/nicotine product use patterns beyond simple urban-rural comparisons, informing efforts to eliminate tobacco/nicotine use disparities.

PMID:41964313 | DOI:10.1111/jrh.70140

Nurs Open. 2026 Apr;13(4):e70541. doi: 10.1002/nop2.70541.

ABSTRACT

BACKGROUND: Internationally qualified nurses (IQNs) form a critical part of the global health workforce, yet persistent structural inequities continue to limit their recognition and career mobility. Health systems in developed countries rely on IQNs to address shortages, but structural bias, credential hierarchies, and historically embedded knowledge valuation systems impede the full utilisation of their specialty skills. While regulatory standards are designed to protect patient safety, misalignment between global education systems and local recognition frameworks can inadvertently produce inequitable outcomes.

AIM: To explore how IQNs transfer and apply their specialty skills within the Australian health system and to identify the equity-oriented facilitators and barriers that shape this process.

DESIGN: A meta-synthesis of a sequential explanatory mixed-methods research program, underpinned by a pragmatic and explicit equity framework informed by principles of fairness, transparency, and recognition of global competence.

METHODS: Four interconnected studies (online surveys, interviews, and focus groups) were conducted with IQNs and recruiting managers across Australia. Phase 3 involved a meta-synthesis of findings from Phases 1 and 2, which were previously published, using joint display analysis and meta-inference generation to examine structural, organisational, and individual determinants of specialty skill utilisation.

RESULTS: Findings across four primary empirical studies reported in six peer-reviewed publications reveal that IQNs bring advanced specialty expertise that can enhance care quality and equity. However, system-level constraints, including recruitment bias, fragmented transition pathways, and inconsistent recognition of international qualifications, restrict their impact. Equity-focused transition programs and inclusive leadership development for both IQNs and recruiting managers emerged as critical mechanisms for change.

CONCLUSION: Harnessing IQNs’ specialised skills is not only a workforce imperative but a matter of justice. Balancing regulatory standards for patient safety with equitable recognition practices will enable nurses to act as agents of transformative change.

PATIENT OR PUBLIC CONTRIBUTION: The study involved 115 participants (n = 71 IQNs; n = 44 recruiting managers) whose lived experiences illuminate the urgent need for inclusive policy reform and equity-driven workforce transformation.

PMID:41964306 | DOI:10.1002/nop2.70541

Orthod Craniofac Res. 2026 Apr 10. doi: 10.1111/ocr.70122. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the dentoalveolar effects on the upper first premolars after two maxillary expansion protocols-rapid maxillary expansion (RME) and alternate rapid maxillary expansion and constriction (Alt-RAMEC)-before and 6 months after treatment.

MATERIALS AND METHODS: Cone-Beam Computed Tomography (CBCT) images of 20 patients who underwent maxillary expansion with the Hyrax appliance under two activation protocols were evaluated. Dental and alveolar measurements at the premolar region (tooth length, alveolar bone level and thickness) were measured before (T1) and after expansion (T2). Intra- and inter-examiner reliability was determined using Intraclass Correlation Coefficients. Statistical analyses included the Shapiro-Wilk test and Student’s t-tests for paired and independent samples. Statistical significance was set at 5%.

RESULTS: A significant increase in interpremolar distances was observed, both in the radicular and coronal levels (4.29 mm and 4.97 mm), with greater coronal than root distance. This was more evident in the Alt-RAMEC group. Alveolar thickness showed an average reduction of 0.54 mm after expansion.

CONCLUSIONS: The expansion effects of the two protocols were similar in the premolar region, resulting in a reduction in alveolar thickness. A tendency for greater tooth inclination and root reduction was observed after the Alt-RAMEC protocol.

TRIAL REGISTRATION: IRB: 42856915.1.0000.5336.

PMID:41964302 | DOI:10.1111/ocr.70122

Transfusion. 2026 Apr 10. doi: 10.1111/trf.70172. Online ahead of print.

ABSTRACT

BACKGROUND: Low Titer Group O Whole Blood (LTOWB) use has expanded to include patients with non-traumatic bleeding etiologies. While a large body of evidence supports a potential survival benefit of LTOWB in trauma patients, data demonstrating the safety and efficacy of LTOWB in non-trauma patients are lacking.

STUDY DESIGN AND METHODS: Non-trauma adult patients at two hospitals who received at least one unit of LTOWB were included in the study. Patient demographics, transfusion and laboratory data, diagnoses, mortality, and hospital length of stay were collected between January 1, 2018, and June 30, 2024. LTOWB recipients were further stratified by O versus non-group O blood group, and laboratory markers of renal failure and hemolysis were compared between these two groups.

RESULTS: A total of 319 unique patients with 320 LTOWB transfusion episodes were included. The most common indications for transfusion were gastrointestinal and cardiovascular bleeding (266/320, 83%). In-hospital survival at 24 h and 30 days posttransfusion was 75% and 53%, respectively. There was no statistically significant difference in markers of hemolysis between group O and non-group O LTOWB recipients. There were no reported transfusion reactions.

DISCUSSION: In non-trauma settings, LTOWB was most commonly utilized in patients with gastrointestinal and cardiovascular bleeding. LTOWB is a safe alternative to component therapy in non-trauma adult populations. However, additional studies are needed to focus on efficacy and clinical outcomes in non-trauma patients that receive LTOWB for severe hemorrhage.

PMID:41964300 | DOI:10.1111/trf.70172

Pain Res Manag. 2026;2026(1):e8822463. doi: 10.1155/prm/8822463.

ABSTRACT

BACKGROUND: Toradol, a potent nonsteroidal anti-inflammatory drug, is widely used for perioperative analgesia, especially in orthopedic surgeries. Postmarketing surveillance is crucial due to its extensive clinical application. This study aimed to investigate adverse events (AEs) associated with Toradol using the FDA Adverse Event Reporting System (FAERS), analyze the association strengths of key AEs, and provide clinical references.

METHOD: FAERS data from 2004 Q1 to 2017 Q4 were analyzed, including reports where Toradol was the primary suspect drug. Disproportionality analyses were conducted using ROR, PRR, BCPNN, and EBGM algorithms to detect safety signals.

RESULT: Among 377 eligible reports, key AEs included immune system disorders (anaphylactic reaction, ROR = 16.28), renal and urinary disorders (oliguria, ROR = 25.57), and gastrointestinal disorders (erosive duodenitis, ROR = 231.08). Notably, 29.86% of reports were from consumers, with a lower proportion from healthcare professionals. Most AEs (73.10%) occurred within 7 days of administration; rare but severe events, including deafness and cardiorespiratory arrest, were also identified.

CONCLUSION: Our findings, derived from hypothesis-generating signal detection analyses, provide real-world safety data on Toradol, highlighting high-risk AEs and reporting biases. Enhanced vigilance and monitoring, especially in high-risk populations, are imperative. However, these signals require confirmation through prospective, controlled studies to establish causality.

PMID:41964289 | DOI:10.1155/prm/8822463

Nurs Open. 2026 Apr;13(4):e70543. doi: 10.1002/nop2.70543.

ABSTRACT

AIM: This study aims to examine the relationships among cultural intelligence, teamwork cognition and teamwork attitude, which are deep-seated factors influencing teamwork among nursing students.

DESIGN: This was a cross-sectional survey study.

METHODS: Convenient sampling was used to select 301 nursing students from a nursing college in Shanghai for this investigation. The data collection utilized a self-made general information questionnaire, cultural intelligence scale, teamwork attitude scale and teamwork cognition scale. Statistical methods such as t-tests, Pearson correlation analysis and structural equation modeling were employed for the analysis of the mediating effects.

RESULTS: The scores for nursing students were (4.45 ± 0.79) for cultural intelligence, (3.84 ± 0.78) for teamwork attitude and (3.85 ± 0.63) for teamwork cognition. Cultural intelligence showed a positive correlation with both teamwork cognition and attitude (r = 0.639, 0.507, both p < 0.01). Teamwork attitude partially mediated the association between cultural intelligence and teamwork cognition (β = 0.42, p < 0.01), with direct and indirect effects of 0.32 and 0.42, respectively.

CONCLUSIONS: Cultural intelligence was positively associated with teamwork cognition among nursing students, and teamwork attitude may partially mediate this association. These findings suggest that strengthening cultural intelligence and teamwork attitude may support teamwork cognition in nursing education. However, because of the cross-sectional design, these findings should be interpreted as correlational rather than causal. No Patient or Public Contribution.

PMID:41964286 | DOI:10.1002/nop2.70543

J Investig Med. 2026 Apr 10:10815589261444738. doi: 10.1177/10815589261444738. Online ahead of print.

ABSTRACT

BACKGROUND: In clinical practice, effectively managing agitation and hemodynamic stability during general anesthesia awakening remains challenging, despite their importance for patient safety and recovery.

PURPOSE: This study aimed to expound the effect of dexmedetomidine combined with anesthesia awakening nursing on agitation and hemodynamics in patients under general anesthesia during awakening period.

STUDY TYPE: A prospective studyPopulation: Ninety patients who underwent general anesthesia surgery were selected and divided into a control group (dexmedetomidine+routine nursing care) and an intervention group (dexmedetomidine+anesthesia awakening nursing), with 45 cases in each group.Assessment technique(s) or outcome(s):The post-anesthesia recovery room stay and awakening time, VAS score, the occurrence of agitation during the awakening period, and incidence of adverse reactions were compared.

STATISTICAL TESTS: Categorical data were expressed as rates or percentages; measurement data were expressed as mean ± standard deviation. Differences were significant at P < 0.05 (two-sided).

RESULTS: Intervention group patients had shorter recovery room stay (29.98±6.88 vs. 37.78±6.58 min) and recovery time (8.52±0.99 vs. 10.62±0.99 min) versus controls (P<0.05). VAS scores were lower at 2 hours (4.53±0.63 vs. 5.58±0.54) and 6 hours post-surgery (2.47±0.69 vs. 4.49±0.51). Anesthesia recovery agitation (13.33% vs. 37.78%) and postoperative adverse reactions (11.11% vs. 44.44%) were reduced (all P<0.05).

DATA CONCLUSION: Dexmedetomidine combined with anesthesia awakening care can enhance sedation scores, reduce pain levels, and have a minimal impact on patients’ hemodynamics, ultimately improving the quality of awakening. This approach also leads to higher patient satisfaction with care, making it a promising option for clinical promotion and application.

PMID:41964271 | DOI:10.1177/10815589261444738