Search

INTRODUCTION: Quality Standards (QS) are an important priority in European drug policy, although the extent of their application remains unclear. The FENIQS-EU project (Further ENhancing the Implementation of Quality Standards in drug demand reduction across Europe) was set up to foster the use of QS. The objective of this paper is to present the main findings of the first 18 months of this project. METHODS: A multi-method study design was used to assess the application of QS. It consisted of: 1) an online survey and brief interviews with key stakeholders in various areas of drug demand reduction across Europe; 2) the development of criteria and selection of examples of inspiring practices; 3) a Delphi study to reach consensus around successful QS implementation strategies. RESULTS: QS have been implemented in the prevention domain, with the European Drug Prevention Quality Standards being the most commonly implemented standards. In the treatment/social reintegration domain, national standards and the Standards and Goals of Therapeutic Communities are most commonly used, while the EU Council conclusions on the implementation of minimum quality standards are primarily applied in the field of harm reduction. In total, 14 inspiring examples of practice were selected. Three rounds of a Delphi study resulted in consensus on successful implementation strategies, covering five core themes: collaboration, communication, support structure, education, and funding. DISCUSSION: Despite the recognition that the implementation of QS is important, these efforts vary across European countries and are unevenly spread across DDR areas. CONCLUSION: This paper focuses on the relevance of QS availability, and emphasises key factors influencing successful implementation. [ABSTRACT FROM AUTHOR]

Objectives: Work-family conflict is a growing problem worldwide, because of changing work-family demographic trends and the spread of technology. Empathy, as the ability to understand and share the feelings of other people, is the essential component of emotional intelligence that plays a crucial role in healthcare settings. This study aimed to assess the level of emotional empathy and investigate its relationship with work-family role conflicts among dental medicine doctors.  Materials and methods: In this study participated 589 doctors of dental medicine from Croatia, Serbia, Bosnia and Herzegovina. The questionnaire included general and demographic data, the Emotional Empathy Scale questionnaire and the Work and Family Role Conflict Assessment Scale questionnaire.  Results: The research results indicate no significant association between empathy and conflict between work and family roles (R = 0.032, p = 0.435). Women have achieved significantly higher scores in Emotional Empathy Scale (p ≤ 0.001), while there was no difference in Work and Family Role Conflict Assessment Scale according to gender (p = 0.194). A difference in emotional empathy was observed depending on where the respondents were employed (p = 0.045) and depending on the specialisation of the dental medicine (p = 0.021).  Conclusion: Female doctors of dental medicine demonstrated higher emotional empathy while the work-family role conflict is experienced equally by both genders.

The vastus lateralis muscle is one of the four muscles that make up the quadriceps femoris muscle, and it is also the largest of them. Some studies have shown that patients experience lower quality of life and muscle weakness after surgical treatment of thigh muscles in order to perform reconstructive surgery of the head and neck. The aim of our study was to assess the quantitative and qualitative function of the lower extremities using an isokinetic dynamometer and a validated questionnaire on subjective difficulties in patients who underwent reconstructive surgery with the vastus lateralis free flap. Fourteen participants aged 20-70 years who suffered from malignant tumor in the head and neck region. The free vastus lateralis flap was used for reconstruction. All patients underwent isokinetic dynamometric measurement with the isokinetic dynamometer to test the isokinetic functions of the thigh muscles after surgery. In addition, subjective assessment of the lower extremities was performed using the validated questionnaire Lower Extremity Functional Scale. All isometric dynamometer measurements of the donor leg were compared with those of the unoperated leg. Peak torque and average power were significantly lower in the operated leg compared with the unoperated leg after 60°/s extension (p = 0.018 for peak torque, p = 0.021 for average power) and 180°/s extension (p = 0.019 for peak torque, p = 0.015 for average power). On the other hand, there was no statistically significant difference in dynamometer measurements after 60°/s flexion (p = 0.700 for peak torque, p = 0.854 for average power, and 180°/s flexion (p = 0.634 for peak torque, p = 0.571 for average power). The median value for the LEFS was 65.5 (40.00-71.25). The results of this study showed that there is a significant deterioration regarding the biophysical properties of the operated leg after harvesting vastus lateralis free flap., Competing Interests: Declarations of competing interest None., (Copyright © 2023 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Quality standards have been recognized as an important tool for improving the quality of drug use prevention, treatment, and harm reduction services and for bridging the gap between science and practice. The aim of this paper is to describe the state of implementation of quality standards in drug demand reduction in the European Union and to identify barriers, needs, and challenges to implementation and future pathways. Between June and November 2021, an online survey (n = 91) and follow-up interviews (n = 26) were conducted with key informants - experts in drug demand reduction and quality assurance. Data were analyzed using descriptive statistics and thematic analysis. The survey showed that most countries have implemented the European Drug Prevention Quality Standards (EDPQS) in the prevention domain and the Minimum Quality Standards (MQS) in drug demand reduction. A variety of standards are applied in the treatment area and the EQUS minimum quality standards are widely known. The application of quality standards is least reported in the harm reduction service area. Mentioned challenges and barriers to implementation included lack of funding, unrecognized importance of evaluation, professional competencies, and system fragmentation. Mentioned supportive factors included appropriate materials and training, as well as political support and professional networks. The study shows that quality standards are inconsistently implemented in all areas of drug demand reduction. According to respondents, implementation could be improved by advocating for the need to implement quality standards, ensuring sustainable funding for interventions, and providing education and training.

Background and Objectives: Substance use in women is associated with unique psycho-social and physical vulnerabilities and poses complex challenges during pregnancy and motherhood. Gender-sensitive drug policy which considers the needs of women and their children could address these concerns. The objectives of this study were: (1) to systematically explore national-level drug policies' sensitivity and responsiveness to women, pregnant women, and children; and (2) to examine the adherence of drug policies with international guidelines for gender sensitivity in drug policy., Methods: The research team was diverse professional backgrounds and nine countries. A summative content analysis of national drug policy documents, action plans, and strategies was performed. Specific documents focusing on women, pregnancy, and children were analysed. Specific themes and how frequently they appeared in the documents were identified. This quantification was an attempt to explore usage indicating the relative focus of the policies. A thematic map was developed to understand how national-level drug policies conceive and address specific concerns related to women who use drugs. We adapted the UNODC checklist for gender mainstreaming to assess policies' adherence to international guidelines., Results: Twenty published documents from nine countries were reviewed. The common themes that emerged for women, pregnancy, and children were needs assessment, prevention, treatment, training, supply reduction, and collaboration and coordination. Custody of children was a unique theme for pregnant women. Specific psycho-social concerns and social reintegration were special themes for women, whereas legislation, harm reduction, research, and resource allocation were children-specific additional themes. For women-specific content analysis, special issues/concerns in women with drug misuse, need assessment, and prevention were the three most frequent themes; for the children-specific policies, prevention, training, and treatment comprised the three most occurring themes. For pregnant women/pregnancy, prevention, treatment, and child custody were the highest occurring themes. According to ratings of the countries' policies, there is limited adherence to international guidelines which ensure activities are in sync with the specific needs of women, pregnant women and their children., Conclusion: Our analysis should help policymakers revise, update and adapt national policies to ensure they are gender-responsive and address the needs of women, pregnant women and their children., (© 2023. Evans Medical Foundation, Inc. and BioMed Central Ltd.)

Objectives : To provide safe and effective local anesthesia, dentists must have knowledge of neuroanatomy, anesthesia agents, techniques, equipment, and proper use of local anesthetics. This study aims to explore the knowledge, practices, and confidence regarding local anesthetics and anesthetic techniques in dentistry. Material and Methods : The online cross-sectional questionnaire was conducted via social media, and yielded 441 responses from across the country (69.8% women and 30.2% men; 70.7% general dentists; and 29.3 specialists). The data collected included sociodemographic characteristics, knowledge, and practices pertaining to the usage of local anesthesia. The questionnaire also documents their self-assessed confidence level in applying different local anesthetic techniques and experiences with adverse reactions. The obtained data were processed by description and using a generalized linear model for regression. Results : The respondents had a median knowledge score of 6 out of a possible 14 points regarding local anesthetics in dental medicine, and their median self-confidence level in the successful application of various techniques of local anesthesia was 54 out of a maximum of 85 points. The results showed that a higher knowledge level was associated with the female gender (OR 1.83, CI 1.13-2.98, p = 0.014) and specialization in oral surgery (OR 7.04, CI 1.71-29.07, p = 0.007). In contrast, a lack of confidence in using various local anesthetic techniques was also associated with the female gender (OR 0.63, CI 0.41-0.99, p = 0.047) and specialization in orthodontics (OR 0.16, CI 0.03-0.88, p = 0.035). Of the respondents, 81.4% (n = 371) experienced a local complication, and 42.2% (n = 186) experienced a systemic complication during local anesthesia. The complications experienced cannot be associated with a lack of knowledge or self-confidence ( p > 0.05). The majority of respondents (364 of the 441 total-82.5%) expressed interest in receiving further education on the topic of local anesthesia. Conclusions : The research results show that the dentists involved in the study have poor knowledge of local anesthetics and moderate self-reported confidence levels in using various local anesthetic techniques. Moreover, dentists' self-confidence in applying different techniques of local anesthesia is not related to their knowledge. Therefore, it would be necessary for dentists to undergo a continuing dental education program that enables them to enhance their skills and knowledge in local anesthesia.

Objective: Eagle syndrome or styloid process syndrome is a clinical condition of complex aetiology. Since, as a consequence of vascular compression,due to the length of the styloid process and its nearness to the internal carotid artery,it can lead to vertigo. Vertigo may be the only symptom of stylocarotid syndrome and it is extremely challenging diagnose.To the best of our knowledge, this is the first study that measures the lengths of styloid process on the Croatian population's,and possible influence of styloid process length on isolated vertigo of unknown aetiology., Methods: This study included 829 subjects who were divided into two groups.The first group was the control group, consisting of 800 subjects.The second group, study group, consisted of 29 subjects who suffered from the vertigo of unknown aetiology., Results: The statistically significant difference between the study and the control group was observed in the length of the styloid process, and in the closest distance of the styloid process from the carotid artery., Conclusions: The prolonged styloid process and its close association with the internal carotid artery may affect vertigo of unknown aetiology and should be clinically and radiographically investigated in cases of unexplained vertigo as an isolated and only symptom within stylocarotid syndrome., Competing Interests: Competing interests None declared., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Objectives: Although titanium-based implants are considered bioinert, it has been found that they are subject to corrosion and wear. This study aimed to evaluate the cytotoxic and genotoxic potential of two implant systems in gingival epithelial cells., Material and Methods: Gingival swabs were taken three times from 91 subjects. The first swab was taken before dental implant placement, the second swab 90 days after dental implant placement and the third swab 21 days following the healing abutment placement. DNA damage was analyzed using the micronucleus test. Tested dental implants with corresponding healing abutments were Ankylos and Dentium SuperLine., Results: Of all scored forms of cytogenetic damage in gingival cells of individuals after implementation of tested dental implant systems, only an increase in the number of binucleated cells (P ≤ 0.001) was significant in contrast to control values for both tested implant systems, 90 days after dental implant placement and 21 days following the healing abutment placement., Conclusion: It may be concluded that there are no titanium-based implant dependent cytogenetic damage in gingival epithelial cells. A slight increase in cytogenetic damage has been observed but it is of no biological relevance and might be associated with healing abutment induced effect., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare.

Objectives: Swelling, pain and trismus after the surgical removal of the mandibular third molars are the most common and expected postoperative complications. The aim of this cross-sectional study was to assess the association of those postoperative complications and BMI after surgical removal of the mandibular third molars., Material and Methods: 84 patients who required the surgical removal of their lower third molar were enrolled in this study and were divided into 4 groups dependent on their BMI. Data were tested by one-way analysis of variance (Welch's ANOVA). The differences were tested by the intragroup using the Games-Howell test., Results: The effect of BMI on pain had a statistically significant difference within the first 24 postoperative hours: 4 hours (p=0.014), 6 hours (p=0.034, p=0.049), 12 hours (p= 0.00.P=0.023), and 24 hours (p=0.010). For swelling and trismus in the exception on first postoperative day between underweight and normal weight groups (p=0.026), and underweight and overweight groups (p=0.014) no statistically significant correlation was found., Conclusion: BMI has an impact on a patient's early postoperative recovery., Competing Interests: Conflict of interest: The authors report no conflict of interest and the article is not funded or supported by any research grant.

Objectives: To assess the whitening efficiency and patient satisfaction after usage of commercially available toothpastes with the different whitening ingredients., Materials and Methods: This randomized controlled trial study comprised 161 participants who were randomly divided into eight groups based on used whitening or control/conventional toothpaste (Colgate Max Expert White [CMEW], n = 20; Signal Daily White [SDW], n = 20; Himalaya Sparkly White Herbalis [HSWH], n = 20; Signal White System [SWS], n = 20; Rembrandt Deeply White + Peroxide [RDWP], n = 20; Splat Extreme White [SEW], n = 20; Splat White Plus [SWP], n = 21; and Kalodont Multi Repair [control], n = 20). Tooth color and color change were evaluated using a spectrophotometer (CIELAB coordinates, ΔE ab *, ΔE 00 , whiteness index change [ΔWID]). Measurements were performed at baseline, 30 days and 60 days after the beginning of treatment, and 30 days after completing treatment - follow-up. Side effects and satisfaction with the whitening outcome were reported throughout the questionnaire., Results: The results for ΔL*, Δa*, and Δb* showed an increase in lightness and decrease in yellowness for all tested whitening toothpastes compared to the control group after 30 days of use (p ≤ 0.05). Also, significant tooth color difference (ΔE ab *, ΔE 00 ) and whiteness index change (ΔWI D ) were recorded for all tested whitening toothpastes 30 days and 60 days from the beginning of use (p ≤ 0.05). Toothpaste containing a combination of urea peroxide and enzyme ingredients (SEW) demonstrated the highest and the longest whitening effect., Conclusions: Whitening toothpastes can show perceptibly whitening effect after a short time of usage, but without a long-lasting impact., Clinical Relevance: Toothpaste containing a combination of enzymes and peroxides showed the best whitening performance compared to those containing only enzymes, peroxides, or abrasives., Trial Registration: ClinicalTrials.gov: NCT04460755., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: Pain and trismus are the most common postoperative complications following a surgical removal of the lower third molar. This randomized, double-blind, placebo-controlled clinical trial evaluated the effect of orally administrated magnesium on postoperative pain and trismus after surgical removal of the lower third molars., Materials and Methods: The study was conducted on 80 participants who were divided into two groups. Each group took different oral forms of magnesium citrate. Participants in both groups had their two lower molars surgically removed. For one randomly selected third molar, participants received either magnesium citrate tablets or lozenges. For the surgical removal of the lower third molar of the opposite side, the participants received either placebo tablets or lozenges. The data were analyzed using the Wilcoxon signed-ranked test, the Mann-Whitney U test, and the Spearman rank-order correlation with the level of significance set at p < 0.05. This manuscript was written in accordance with the Consort recommendation., Results: The results show a statistically significant lower pain level at all tested times (24 h, 48 h, and 72 h postoperatively) for participants who used magnesium preparations in lozenges (p = 0.012, p = 0.013, and p ≤ 0.001) as well as in tablet form (p ≤ 0.001) compared to placebo. The results also show a statistically significant greater mouth opening ability at all tested times (24 h, 48 h, and 72 h postoperatively) between magnesium preparations and the placebo (p ≤ 0.001)., Conclusion: Orally administered magnesium (either lozenges or tablets) before and after a lower third molar surgical removal significantly reduces pain intensity and the degree of trismus in the postoperative period., Clinical Relevance: Based on the results of the study, oral magnesium could be used in the oral and maxillofacial surgery to reduce postoperative complications after surgical removal of the lower third molars., Trial Registration: This study is registered on http:clinicaltrials.gov under protocol no. NCT03398382.

Objectives: This study assessed the frequency of nuclear morphological changes in gingival epithelial cells, as a biomarker for DNA damage, in individuals with periodontitis, before and after implementation of periodontal therapy, and compared the morphology to those with healthy periodontal tissues., Materials and Methods: Exfoliated gingival cells were taken from 30 participants without periodontal destruction in any teeth and 30 participants with periodontitis before and after 45 and 90 days following treatment. Nuclear morphological changes were analyzed using the micronucleus test., Results: Compared with the healthy volunteers, those with periodontitis had a significant increase in the number of cells with nuclear broken eggs (P = 0.048), condensed chromatin (P = 0.015), karyolysis (P < 0.001), or binuclei (P < 0.001). In the periodontitis group, the pretreatment frequencies of cells with micronuclei (P = 0.008), binuclei (P < 0.001), karyolysis (P = 0.038), nuclear buds (P = 0.005), and condensed chromatin (P = 0.015) were significantly higher than 90 days after treatment., Conclusion: Our observations suggest that periodontal disease increases the frequency of nuclear morphological changes in gingival epithelial cells and that the implementation of periodontal therapy was associated with a reduction of that number., Clinical Relevance: The micronucleus test could serve as a tool for estimating genotoxic damage in assessing the success of periodontal therapy.

Purpose: This is a cross-sectional study to assess the incidence of micronuclei and other nuclear morphological changes in buccal epithelial cells of dental technicians., Materials and Methods: The study was conducted on 45 dental technicians versus 2 control groups: 50 dentists and 50 dental assistants. DNA damage was analyzed in exfoliated buccal mucosa cells by micronucleus assay. The differences in the frequency of detected types of cytogenetic damage between experimental groups were analyzed by applying 2-way ANOVA with Tukey's HSD post-hoc test., Results: Dentists and dental assistants have significantly lower incidence of micronucleated cells than technicians (mean ± SD: 0.68 ± 0.74, 0.58 ± 0.81, and 1.58 ± 2.07; p = 0.031 and p = 0.015, respectively), and this trend also holds for karyolitic cells (0.10 ± 0.30, 0.20 ± 0.49, and 1.42 ± 1.25; p < 0.001 and p < 0.001, respectively), condensed chromatin (0.16 ± 0.37, 0.14 ± 0.35, and 0.76 ± 0.98; p < 0.001 and p < 0.001, respectively), and pyknotic cells (0.04 ± 0.20, 0.08 ± 0.27, and 0.96 ± 1.24; p < 0.001 and p < 0.001, respectively)., Conclusion: Cytogenetic biomarkers in dental technician buccal mucosa are increased compared with control groups. This increase may be associated with more extensive exposure to potentially harmful components of the materials used in everyday dental practice., (© 2018 by the American College of Prosthodontists.)