3 articles
Dental fluorosis is an oral condition with aesthetic, psychosocial, and, in some contexts, functional implications that may extend beyond the clinical appearance of enamel. Interest in patient-reported outcome measures has increased because clinical severity alone does not explain how children and adolescents experience fluorosis in daily life. This manuscript aims to synthesize the evidence on oral health-related quality of life and to assess the relevance of a condition-specific Oral Impacts on Daily Performance approach for dental fluorosis.
A narrative synthesis was prepared according to PRISMA-ScR guidance [REF]. The search framework was designed for PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, and the institutional repository of Nicolae Testemițanu State University of Medicine and Pharmacy. Core studies addressing dental fluorosis and oral health-related quality of life were extracted together with methodological papers on condition-specific OIDP, instrument adaptation, and Moldova-generated contextual literature. The methodological premises from the attached doctoral thesis on the Romanian adaptation of dental questionnaires were also integrated.
The evidence is heterogeneous. Mild dental fluorosis is often associated with no deterioration in oral health-related quality of life, while moderate to severe fluorosis is more consistently linked to worse quality-of-life outcomes. The most direct condition-specific OIDP evidence comes from a cross-sectional study in India showing significant correlations between fluorosis, CS-OIDP, and OHRQoL. A recent systematic review confirmed the mixed direction of results across 16 studies. Local Moldovan publications support the public health relevance of endemic fluoride exposure and the need for Romanian-language instruments adapted to this context.
The current evidence supports the methodological relevance of a fluorosis-adapted CS-OIDP instrument. A future Romanian adaptation should combine rigorous translation procedures, cognitive testing, and psychometric validation, while retaining clinical measures of fluorosis severity for discriminative analysis.
Adult epilepsy generates a burden that extends beyond seizure counts and includes adverse treatment effects, role restriction, emotional distress, and the social devaluation attached to the diagnosis. The methodological problem is not the absence of patient-reported measures, but the heterogeneity with which disease-specific quality-of-life and stigma instruments are selected, interpreted, and combined in adult studies.
A structured narrative methodological review was conducted using PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, and the institutional repository of the Nicolae Testemițanu State University of Medicine and Pharmacy. The synthesis focused on the Quality of Life in Epilepsy Inventory family, especially the 89-, 31-, 31-P, and 10-item forms, the adolescent 48-item comparator, and adult epilepsy stigma measures such as the Epilepsy Stigma Scale (ESS) variants, the Stigma Scale of Epilepsy (SSE), and the Epilepsy Self-Stigma Scale (ESSS). Special attention was given to publications from the Republic of Moldova and Romania because regional evidence is sparse but clinically relevant.
QOLIE-31 emerged as the most defensible adult comparative instrument because it balances breadth, feasibility, and international comparability. QOLIE-31-P was particularly useful for patient-centred and real-world designs, while QOLIE-10 served primarily as a screening instrument and QOLIE-89 retained value for comprehensive psychometric work. The 48-item version was methodologically informative but remained adolescent-oriented rather than a primary adult endpoint. Across the stigma literature, ESS, SSE, and ESSS were clearly not interchangeable because they capture overlapping but distinct constructs, including perceived stigma, felt stigma, and internalized self-stigma.
The working hypothesis was supported across international, regional, and Moldovan sources: the greater the clinical and psychosocial severity of epilepsy, the lower the epilepsy-specific quality of life. Seizure frequency, uncontrolled or drug-resistant epilepsy, polytherapy, adverse medication effects, depression, anxiety, and stigma were the most recurrent determinants of lower scores. For adult studies intended for Moldovan settings and the MJHS submission, QOLIE-31 or QOLIE-31-P, combined with one clearly defined stigma scale and a standardized set of severity variables, offers the strongest methodological balance.
In the context of increasing global consumption of bottled water, assessing its chemical composition and impact on public health becomes essential. Although perceived as a safe alternative, bottled water exhibits variability in its chemical composition, and advanced filtration methods can remove essential minerals. Consumers opt for bottled water due to its taste and convenience, yet awareness of associated risks remains limited. This study proposes the development and validation of a questionnaire to evaluate public perceptions of bottled water quality and its health impact, providing a valuable tool for public education and regulatory policies.
The questionnaire was developed to analyze consumer attitudes and behaviors regarding bottled water. Structured into four sections (socio-demographic data, consumption habits, perceptions of quality, and health impact), it underwent multiple validation stages. A panel of experts assessed the relevance of the questions, and a pilot study was conducted with a sample of 32 adults (aged 24-62) to evaluate validity and internal consistency using the Cronbach's alpha coefficient. Final validation was based on the feedback collected and statistical analysis performed using SPSS Statistics 27.
S-CVI/Ave and S-CVI/UA are indicators of questionnaire content validity, calculated based on item validity scores and the percentage of agreement among evaluators. The S-CVI/Ave and S-CVI/UA values exceeded the minimum standard of 0.80, while the I-CVI index ranged between 0.83 and 1.00, demonstrating excellent item validity. Following respondent feedback, 18 questions were revised, and 6 were removed, resulting in a second version with 61 items. The validity sample comprised 84.4% women and 15.6% men, aged 24 to 62 years. Most respondents considered the questions clear and easy to understand, although suggestions were made to improve clarity and avoid redundancy. Internal consistency was confirmed through the Cronbach's alpha coefficient, which was acceptable for most domains, except one, where the coefficient was below 0.70 but was retained due to the validity of the questions.
The questionnaire for assessing bottled water consumption was successfully validated, demonstrating content validity and internal consistency. Face validity ensured the clarity of the questions.