7 articles
Oral health is an essential component of overall health and well-being. The levels of knowledge, attitudes, and behaviors related to oral health are key determinants in the prevention of dental and periodontal diseases. Assessing these aspects across different population groups is crucial for identifying specific educational needs and developing effective strategies for the promotion and maintenance of oral health.
Data from scientific publications indexed in PubMed, Hinari, SpringerLink, NCBI, and Medline databases were analyzed. The selection criteria included current evidence regarding oral health knowledge, attitudes, and practices among different population groups. Observational, cross-sectional, descriptive and quantitative studies, as well as meta-analyses published between 2005 and 2026, were included.
The vast majority of the adult population (>90%) demonstrated a high level of oral health knowledge; however, fewer than half exhibited positive attitudes and appropriate behaviors necessary for proper oral care. Among adolescents, the proportion of individuals with satisfactory oral health knowledge ranged from 59% to 77%, while positive attitudes ranged from 57% to 92%. Female adolescents showed significantly better knowledge, attitudes, and behaviors related to oral health compared with their male counterparts. Dental students demonstrated higher levels of oral health knowledge and more positive attitudes than students from other academic disciplines, with significant improvements observed alongside academic progression and increasing clinical experience. They were better trained in toothbrushing techniques, reported a higher frequency of toothbrushing, used supplementary oral hygiene products more frequently, had a lower prevalence of gingival diseases, and attended preventive dental check-ups more regularly.
Although oral health knowledge is generally satisfactory, it is not always reflected in appropriate oral health behaviors. The implementation of oral health education programs at all educational levels is essential for improving oral hygiene practices and promoting the overall health of the population.
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.
Surgery exposes professionals to significant physical and psychological risks, including intense exertion, prolonged static postures, and repetitive gestures, often leading to musculoskeletal pain. International studies report prevalence rates above 90%, linked to long procedures and poor ergonomics, alongside exposure to biological and chemical hazards, radiation, toxic smoke, and chronic stress. In the Republic of Moldova, occupational health in the medical sector is underexplored, with no tools tailored to surgeons. This study aims to develop and validate the first nationally standardized questionnaire to assess these risks and support public health policies.
The study used a sequential mixed-methods design: a qualitative phase to identify domains and indicators, followed by a quantitative phase for psychometric testing. Four domains were defined: working conditions, occupational factors, general health, and psycho-emotional state. The questionnaire was refined from 70 to 47 items after expert review and validation, with internal consistency (Cronbach’s α) and content validity (I-CVI, modified Kappa) assessed. It was pre-tested on 52 surgeons, and data were analyzed using SPSS 27 (p<0.05).
Content validation revealed S-CVI/Ave values ranging from 0.934 to 1.00 and S-CVI/UA values from 0.738 to 1.00, with all domains exceeding the accepted threshold for relevance and clarity, except for one domain, which fell slightly below the recommended level for unanimous agreement. I-CVI values ranged from 0.857 to 1.00 (relevance) and 0.847 to 1.00 (clarity), while κ* indices were all rated as "excellent". Based on expert feedback, 24 questions were revised and 15 were removed. Overall internal consistency was very good (α = 0.808), with section values ranging from 0.769 to 0.864, the highest being for "Psycho-emotional state" (α = 0.864). The pre-test sample comprised 52 surgeons, mostly male (57.7%), with a mean age of 44.92 years, predominantly from urban areas (92.3%). Respondents generally found the questions clear but noted some lengthy formulations, repetitiveness, and sensitive items. These observations contributed to optimizing the final version of the instrument.
The final questionnaire meets the initial theoretical dimensions and shows strong psychometric properties, with high validity and internal consistency. The tool is comparable to established instruments and suitable for assessing surgeons’ health and occupational risks, with potential for wider use.
Osteoporosis remains a major public health issue, particularly affecting the elderly, and is characterized by decreased bone mass and deterioration of bone structure, increasing the risk of severe fractures. The development of specific and precise tools that allow for the identification and estimation of the influence of modifiable factors on the development of osteoporosis is an important step in early intervention for at-risk individuals.
The initial version of the questionnaire was created to identify modifiable factors contributing to the development of osteoporosis, including the type and frequency of drinking water consumption, water quality, knowledge about its mineral composition, dietary preferences, alcohol and tobacco use, physical activities, and stressful situations. The questionnaire initially contained 65 questions, organized into three sections. Five experts reviewed the content validity, evaluating the clarity, cultural and linguistic relevance, structure, and coherence of the questions. The feedback led to adjustments, reducing the questionnaire to 52 questions. A pre-test was conducted with 30 adults from the Republic of Moldova, confirming the validity and internal consistency of the questionnaire, with a Cronbach’s Alpha coefficient of 0.768.
To ensure content validity, experts evaluated the questionnaire, and based on their comments and suggestions, semantic and syntactic reformulations and modifications were made. As a result, 13 questions were eliminated, reducing the second version of the questionnaire to 52 questions. During the pre-testing stage, the order and content of the questions were deemed appropriate by the respondents. The average time required to complete the questionnaire was 14.19 minutes (SD ± 1.567), with a minimum of 11.90 minutes and a maximum of 17.33 minutes. The sample used in the pre-testing stage included 30 respondents, the majority of whom (93.3%) were women. The respondents’ ages ranged from 25 to 72 years, with a mean age of 50.37 ± 2.6 years. The distribution of respondents was balanced between urban (53.3%) and rural (46.7%) areas. Regarding education level, 56.6% had higher education, 26.7% had secondary vocational education, and 16.7% had no higher education.
The study demonstrated that the new questionnaire is a valid and reliable instrument for assessing the impact of modifiable risk factors on morbidity due to osteoporosis. Ongoing research is necessary to refine and further validate the questionnaire within the broader population.
Contemporary society reflects a clear trend towards delayed motherhood, raising significant concerns in the management of pregnancy and childbirth in women of advanced reproductive age. In this context, the mode of delivery and associated risks for this age category require increased attention. Birth methods have been thoroughly examined to identify risks and influencing factors within this specific cohort.
A descriptive cross-sectional study was conducted on a sample of 528 women. Data were collected using a pre-tested semi-structured questionnaire, and respondents were divided into three groups based on the mode of delivery: vaginal delivery, planned cesarean section, and emergency cesarean section. Sociodemographic, anthropometric, medical, and obstetric characteristics were analyzed using linear regression. Statistical analyses included descriptive and inferential statistics (Chi-square), with a 95.0% confidence interval.
The analysis revealed statistically significant variations in the mode of delivery based on maternal age (p=0.013) and paternal age (p=0.001), with an increased rate of cesarean sections at more advanced ages. Significant variations were also found in relation to area of residence (p=0.003), education level (p=0.001), nature of work (p=0.028), GP appointments (p=0.020), number of GP appointments(p<0.001), number of obstetrician appointments (p=0.032), time of informing on risk factors (p=0.005), parity (p<0.001), multiple pregnancies (p=0.016), mode of first delivery (p<0.001), pregnancy complications (p=0.003), delivery complications (p<0.001), gestational age at birth (p=0.017), Apgar scores at 1 and 5 minutes (p<0.001).
Advanced reproductive age has been associated with a higher risk of cesarean section compared to vaginal delivery. The influence of age is modulated by various sociodemographic, medical, and obstetric characteristics, including area of residence, education level, history of cesarean section, parity, pregnancy and delivery complications, pre-existing chronic conditions, antenatal care and provision of information on risk factors.
With the complexities of contemporary healthcare systems and the paramount importance of high-quality patient care, Simulation-Based Medical Education (SBME) has emerged as a pivotal innovation in the process of training healthcare professionals. This study explores the integration of SBME in undergraduate medical education to bridge the gap between theoretical knowledge and clinical practice, thereby preparing students with the necessary competencies for effective healthcare delivery.
Employing a narrative review approach, this study meticulously examined relevant literature from multiple databases, including Google Scholar, PubMed, and MedEdPublish. Following objectives, we chose the sources that were best suited to explore our research questions, focusing on keywords such as „simulation”, „undergraduate medical education”, „simulation-based medical education”, „theoretical frameworks”, „procedural framework” „curriculum design”, „training efficacy”, and „training evaluation” with no restriction for the date of publications.
The review identified foundational educational theories underpinning SBME, such as Experiential Learning Theory and Adult Learning Theory, and traced the evolution of simulation methods from simple anatomical models to sophisticated high-fidelity simulators and virtual reality technologies. Various simulation techniques, including task trainers, manikins, and standardized patients, were analyzed for their educational value. Significant benefits of SBME, such as enhanced safety, repeatability, and adaptability, were highlighted alongside challenges like high costs and limited access. Comparative analysis revealed SBME's advantages over traditional clinical education, particularly in learning efficiency and scalability.
SBME represents a transformative approach in undergraduate medical education, offering a dynamic and interactive learning environment that significantly enhances clinical skills, critical thinking, and confidence. Despite its challenges, the integration of simulation-based methodologies into medical curricula is essential for addressing the evolving needs of medical training and improving patient care outcomes. Future research should focus on longitudinal studies to assess the long-term impact of SBME on clinical practice and explore the integration of emerging technologies to enhance the efficacy and accessibility of simulation-based training.