‘It’s the Same Thing as Giving Them CPR Training’: Rural Emergency Responders Perspectives on Naloxone

Most states in the US have implemented Good Samaritan Laws (GSLs) that provide legal protections for anyone calling law enforcement and first responders trained to administer naloxone and reverse overdoses. Despite these laws, some bystanders are reluctant to call the authorities, prompting requests to increase naloxone access and administration training among lay persons. This study examines the perceptions of emergency first responders in a frontier and remote (FAR) state to understand their job responsibilities and perceptions of layperson naloxone administration training. This study includes 22 interviews with law enforcement, EMS and/or fire personnel, members of community organizations responsible for responding to opioid overdoses. The study finds widespread support for layperson naloxone training and administration throughout Montana due to rural first responders’ inability to meet the needs of residents and an overall lack of resources to address substance use. This study adds to the literature because of it focuses on first responders in a frontier and remote area (FAR) that would benefit from layperson naloxone education and administration training due to its geographic expansiveness and the area’s overall lack of resources. A harm reduction approach that trains laypeople to administer naloxone might be FAR residents’ best chance for survival after an opioid overdose.

Smile Aesthetics Acuity of Lay-persons verses Dental Professionals

Objective: To compare and evaluate the perception of smile aesthetics by lay-persons and dental specialists. Study Design: Cross-sectional study Place and Duration of Study: Department of Orthodontics, Bacha Khan College of Dentistry/Medical Teaching Institute, Mardan from 1st April 2020 to 31st July 2021. Methodology: Eighty participants were assessed for their smiles through photographical imaging to assess each photographic image of smile (frontal view) and categorized them as very good, good, average or bad. Results: The mean age was 20.59±3.1 years with 59 females and 21 males. The laypeople assessed smile under categories of very good (60%) or good with a least number of people categorizing it average or bad. Contrary to this the dentist perception about smile aesthetic was completely reveres. Conclusion: There is an obvious variance between perception of laypeople and dentists with dentist being more analytical and judgmental. Key words: Incisors, Smile, Aesthetic, Smile arc

User-Guided Design of a Digital Tool for Health Promotion and Radiation Protection: Results from an Internet Needs Survey

Background: Digital tools can be powerful and effective in connecting people with life-saving and health-promoting support when facing a health crisis. To develop a digital application for radiation protection and health promotion for evacuees returning home after the Fukushima nuclear accident, we conducted a needs assessment survey and explored the association of people’s eHealth literacy (eHL) level with their digital tool knowledge, attitudes, and practice (KAP). Methods: From 339 responses to an online survey, data from 264 lay persons were analyzed. The KAP items were those used in a prior EU project, and eHL levels were assessed with a Japanese version of the eHealth Literacy Scale. Results: Multivariable analyses showed significant associations between eHL and the digital tool KAP for radiation protection (knowledge: adjusted odds ratio (aOR) = 1.10; attitude: 1.06; practice: 1.10) and for health promotion (knowledge: aOR = 1.13; attitude: 1.06; practice: 1.16). Conclusions: People with a higher eHL had a more positive KAP. For those with a lower eHL, we are formulating easy-to-understand explanations to promote the utilization of the digital tool and enthusiasm for future community-oriented digital tools.

Implicit Metaethical Intuitions: Validating and Employing a New IAT Procedure

Philosophical arguments often assume that the folk tends towards moral objectivism. Although recent psychological studies have indicated that lay persons’ attitudes to morality are best characterized in terms of non-objectivism-leaning pluralism, it has been maintained that the folk may be committed to moral objectivism implicitly. Since the studies conducted so far almost exclusively assessed subjects’ metaethical attitudes via explicit cognitions, the strength of this rebuttal remains unclear. The current study attempts to test the folk’s implicit metaethical commitments. We present results of a newly developed Implicit Association Test (IAT) for metaethical attitudes which indicate that the folk generally tend towards moral non-objectivism on the implicit level as well. We discuss implications of this finding for the philosophical debate.

‘Exertion is not connected to success’: everyday Yoruba discourse of work and success

Work hard, work smart, make the right connections, get the right education, invest wisely – yet after doing all the supposedly right things, success remains elusive to many. For a few, however, who may or may not have done exactly these things, success seems to come effortlessly. Some are very fortunate and others not so much. The lack of correspondence between exertion and success or work and good fortune is an issue that confronts lay persons and professionals alike. Focusing on Yoruba people, I discursively present lay Yoruba persons’ apprehension and common-sense view of this conundrum as reflected in their contextualized language use and supported by other ‘mundane’ information from day-to-day life. By looking at their everyday language, it is possible to deduce their reality as socially constructed in their discourses and gain insight into how they reconcile individual exertions with a view that asserts determinism. Further, I will suggest that the basis of the Yoruba conventional knowledge system informing their utterances and actions pertaining specifically to people's earthly fortunes lies in their origination narrative and original life quest, the essence of which remains inarguable even if temporarily pliable. The popular saying ‘iṣẹ́ o kan oríire’, exertion does not relate to success, is used as a point of departure and sense contained in their orature – situational utterances, pithy proverbs, aphorism and anecdotes – to tease out the Yoruba ordinary meaning of success/fortune and how it is acquired, relative to individuals’ earthly journey and preoccupation. Based on the sampled day-to-day utterances, individual life, it seems, unfolds as presumably scripted, despite apparent avowal and disavowal of ordination in people's pronouncements. Orí (head) retains its position at the summit, assenting – or not – to earthly endeavours.

Aesthetic evaluation of lip position with respect to profile divergence: A silhouette based study.

Objective: To determine the mean attractiveness and score of lip position that is rated by orthodontists and lay persons in different levels of profile divergence as seen in silhouette images. Study Design: Cross-sectional survey. Setting: Punjab Dental Hospital/de’Montmorency College of Dentistry, Lahore. Period: January 2020 to July 2020. Material & Methods: Lay people were selected from the hospital and orthodontic postgraduate trainees were selected from the college. An ideal profile image was constructed and converted to silhouette. By changing position of subnasale and soft tissue pogonion horizontally in relation to true vertical line, divergence of profile was changed and 3 forms of straight/normal profile were created. Three sets of profiles were created (1 anterior divergent, 2 straight divergent, 3 posterior divergent) and each set consisted of 5 images with different degrees of lip protrusion. Results: There were 50% of both genders in orthodontists and 48% males and 52% females in lay person with mean ages 28.74±2.55 and 34.66±7.30 years respectively were part of the study. There was significant difference found between orthodontists and lay person for anterior divergent profile with normal position (4.54±0.61 and 4.68±0.47 with P<0.05). Conclusion: The normal lip position is viewed as the most ideal position; however the same does not have any significant bearing to the straight divergent profile, in which the assessments of various groups were uncertain.

The Preferences of the Ideal Veneer Smile Design of a Saudi Sample in Riyadh

Esthetic is considered a prime concern for both the practitioners and patients in the area of dentistry. Dentists should thoroughly understand the factors like beauty, harmony, balance, and proportion as are they perceived by the societies while planning treatment. Aim: The aim of the study is to evaluate how different gender, age groups, marital status, educational level, and previous cosmetic dental experience of the Saudi dental professionals and the laypersons will influence the selection of an ideal veneer smile design with various shapes of anterior maxillary teeth to their esthetic preferences. Methods: The present survey-based study included 282 dental professionals and lay persons as the sample. The patient and the treating doctor were administered the questionnaire and were further asked to rank the images in terms of score and order of preference. They were asked to put a checkmark on the five cells visual analogue scale (VAS) next to each image to define attractiveness, considering that, on the VAS, one indicated the least attractive and 5 showed the most attractive veneer smile design. Results: Out of 282 participants 106 were male and were 176 female participants. The participant ages were between 16 and 53 years. To find the association between categorical variables, the Mann-Whitney U test was used (with statistical significance set at 0.05). When the responses were compared between the dentist and non-dentist, there was only a statistically significant difference (0.013) for picture 11 among all the 12 pictures responses. Conclusion: The Dental professionals and laypersons showed more similarities than differences when esthetic dental values were considered. Dental professionals were more critical than laypersons. Keywords: Veneer, Dentists, Smile

Preference measurement in health using experiments

This contribution has three objectives. First, it seeks to justify the use of the economic criterion, “Provision of health care in accordance with the preferences of current and potential patients” for guiding decisions concerning the adoption of costly innovation in health. Next, it proposes the measurement of these preferences in the guise of willingness to pay (WTP) values through Discrete Choice Experiments (DCEs). Third, it purports to examine two popular arguments against accepting lay persons´ preferences, viz. that they are unwilling or unable to express preferences with regard to health and health care, and that their preferences are unstable, depending on the current state of health. Both of these arguments are refuted by the findings of four DCEs designed to measure WTP for attributes of health insurance and of the treatment of diabetes, respectively [Zweifel in J Regul Econ 29(3): 319–332, 2006; MacNeil Vrooman and Zweifel in Eur J Health Econ 12(1): 87–95, 2011; Sennhauser and Zweifel in: Jakovlijevic M (ed.), Health Economics and Policy Challenges in Global Emerging Markets. NOVA Publishers, Hauppauge NY, 2016].

Impact of the COVID-19 pandemic on mental health: potentially vulnerable groups and comorbidities

The coronavirus 2019 (COVID-19) pandemic is an unprecedented emergency situation with significant stressors causing adverse impacts on mental health across the globe. Certain individuals are potentially more vulnerable during the outbreak, in particular those with medical vulnerabilities to COVID-19, eg, elderly, living with chronic illnesses, as well as individuals with pre-existing mental health issues such as anxiety disorders, depression, suicidality, and loss/grief. Additionally, individuals with persistent post-acute COVID-19 symptoms, eg, long haulers, are also a vulnerable population. During this international crisis, pandemic-related stressors, such as isolation/quarantine, lockdown, social distancing, homeschooling, loss of income or employment, and/or loss of loved ones could negatively affect these vulnerable subgroups and their overall life functioning. This paper aims to aid in the management of this international emergency by identifying potentially vulnerable subgroups because of the COVID-19 pandemic and by providing recommendations related to appropriate mental health referrals/interventions. This paper also aspires to enhance the knowledge of first responders and lay persons about vulnerability factors to readily help individuals struggling with mental health issues during the pandemic.

PERCEPTION OF ALTERED SMILE ESTHETIC AMONG DENTISTS, STUDENTS AND LAYPERSONS USING DIGITAL PHOTOGRAPHS: A COMPARATIVE STUDY

Objective: To investigate whether there is any difference in the perception of altered smile esthetics among dentist, students and layperson. Study Design: Comparative cross sectional study. Place and Duration of Study: Armed Forces Institutes of Dentistry Rawalpindi, from Jan to Jun 2019. Methodology: A total of 120 individuals were selected among which 40 were dentists, 40 were students and 40 lay persons to evaluate smile on given questioner. An individual was photographed in frontal posed smile using a digital camera at natural head position. The photograph was digitally manipulated with minor changes and only desired area of face was framed using Adobe Photoshop CC 2018 software to generate a control and ideal smile. Series of photographs were generated by doing modifications to evaluate five variables including Smile arc, Gingival display, Buccal corridor, Midline shift and Midline diastema. The each group was also asked to rate attractiveness each picture on 5 points Visual Analog Scale (VAS) from 1- Most attractive to 5- Least attractive. Results: The p-value was for midline diastema and midline shift was <0.01. Most of the study population was females 75 (62.5%) and the mean age of participants was 27.51 ± 5.42. Significant difference was observed at VAS in flat smile arc, nil buccal corridor, mid-line shift and midline diastema by study groups. Conclusion: Perception of midline diastema and midline shift differs significantly among dentists, students and lay persons.