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Objective: The principal aim of this randomized clinical trial (RCT) was to test the effectiveness in the prevention of Early Childhood Caries (ECC) through an educational intervention program with the use of a printed guide for pediatricians and parents both designed by pediatric dentists. Materials and methods: After ethical approval, the first step was to design the educational guides, which were based on the information obtained from a focus group with pediatricians (n = 3), phone interviews with mothers to toddlers' (n = 7), and the best evidence available about children's oral health. For the RCT, 309 parents with their 10-12 months old children were randomly allocated to either the intervention or the control group. Parents in the intervention group received oral health education from the pediatricians supported by the printed guides. Parents in both groups received an oral health kit with a toothbrush and toothpaste at the first visit as well as at each 6-month follow-up visit. After 18 months the children were evaluated using ICDAS criteria. Results: At baseline, data were available from 309 children (49.8% girls). The mean age of the children was of 10.8 months (SD = 0.8) and 69.3% had not had their teeth brushed with toothpaste. After 18 months, a total of 28 (22%) children in the intervention group and 44 (24%) in the control group were clinically examined. Regarding the number of tooth surfaces with caries lesions, the children in the intervention group had a mean of 6.50 (SD = 6.58) surfaces, while the children in the control group had a mean of 5.43 (SD = 4.74) surfaces with caries lesions. This difference was not significant (p = 0.460). Conclusion: The RCT showed no effectiveness in caries-progression control. Despite this result, this study managed to identify barriers that do not allow pediatricians from offering parents adequate oral health recommendations. With this learning, it is possible to work on collaborative programs with pediatricians that over time likely will increase dental health by controlling for ECC.

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Although virtual reality (VR) usage has become widespread in the last decade, its adoption has been hampered by experiences of user discomfort known as cybersickness. The present study, in line with the "2020 cybersickness R&D agenda", sought to provide a broad examination of the cybersickness phenomenon, assessing its pervasiveness, latent trajectories, impacts on the VR experience, and predictor variables. The study was composed of 92 participants living in the Dominican Republic with ages ranging from 18 to 52 years (M = 26.22), who experienced a 10-min VR immersion in two environments designed for psychotherapy. The results indicated that cybersickness was pervasive, with 65.2% of the participants experiencing it, and 23.9% severely. Additionally, the latent trajectories of cybersickness were positive and curvilinear, with large heterogeneity across individuals. Cybersickness also had a substantive negative impact on the user experience and the intentions to adopt the VR technology. Finally, motion sickness susceptibility, cognitive stress, and recent headaches uniquely predicted greater severity of cybersickness, while age was negatively related. These combined results highlight the critical role that cybersickness plays on the VR experience and underscore the importance of finding solutions to the problems, such as technological advancements or special usage protocols for the more susceptible individuals. Supplementary Information: The online version contains supplementary material available at 10.1007/s10055-022-00636-4.

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BACKGROUND/INTRODUCTION: Psychological and physical well-being of health personnel has been significantly affected by COVID-19. Work overload and continuous exposure to positive COVID-19 cases have caused them fatigue, stress, anxiety, insomnia and other detriments. This research aims: 1) to analyze whether the use of cognitive reevaluation and emotional suppression strategies decreases and increases, respectively, stress levels of health personnel; 2) to quantify the impact of contact with patients with COVID-19 on stress levels of medical staff. METHOD: Emotion regulation strategies (cognitive reevaluation and emotional expression) and stress levels were evaluated in 155 Dominican physicians who were treating people infected with COVID-19 at the moment of the study (67.9% women and 32.1% men; mean age = 34.89; SD = 9.26). In addition, a questionnaire created by the researchers quantified the impact that contact with those infected had on their stress levels. RESULTS: Contact with patients with COVID-19 predicts increased use of emotion suppression strategies, although is not associated with the use of cognitive reevaluation. These findings lead to an even greater increase in stress on health care providers. CONCLUSIONS: Contextual contingencies demand immediate responses and may not allow health personnel to use cognitive re-evaluation strategies, leaning more towards emotion suppression. However, findings regarding high levels of stress require the implementation of intervention programs focused on the promotion of more functional emotion regulation strategies. Such programs may reduce current stress and prevent post-traumatic symptoms.

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A common method to collect information in the behavioral and health sciences is the self-report. However, the validity of self-reports is frequently threatened by response biases, particularly those associated with inconsistent responses to positively and negatively worded items of the same dimension, known as wording effects. Modeling strategies based on confirmatory factor analysis have traditionally been used to account for this response bias, but they have recently become under scrutiny due to their incorrect assumption of population homogeneity, inability to recover uncontaminated person scores or preserve structural validities, and their inherent ambiguity. Recently, two constrained factor mixture analysis (FMA) models have been proposed by Arias et al. (2020) and Steinmann et al. (2021) that can be used to identify and screen inconsistent response profiles. While these methods have shown promise, tests of their performance have been limited and they have not been directly compared. Thus the objective of the current study was to assess and compare their performance with data from the Dominican Republic of the Rosenberg Self-Esteem Scale (N = 632). Additionally, as this scale had not yet been studied for this population, another objective was to show how using constrained FMAs could help in the validation of mixed-worded scales. The results indicated that removing the inconsistent respondents identified by both FMAs (≈8%) reduced the amount of wording effects in the database. However, whereas the Steinmann et al. method only cleaned the data partially, the Arias et al. (2020) method was able to remove the great majority of the wording effects variance. Based on the screened data with the Arias et al. method, we evaluated the psychometric properties of the RSES for the Dominican population, and the results indicated that the scores had good validity and reliability properties. Given these findings, we recommend that researchers incorporate constrained FMAs into their toolbox and consider using them to screen out inconsistent respondents to mixed-worded scales.

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Fear to contamination is an easy-to-provoke, intense, hard-to-control, and extraordinarily persistent fear. A worsening of preexisting psychiatric disorders was observed during the COVID-19 (coronavirus disease 2019) outbreak, and several studies suggest that those with obsessive-compulsive disorder (OCD) may be more affected than any other group of people. In the face of worsening OCD symptoms, there is a need for mental health professionals to provide the support needed not only to treat patients who still report symptoms, but also to improve relapse prevention. In this line, it is recommended to improve alternative strategies such as online consultations and digital psychiatry. The aim of this study is to develop augmented reality (AR) stimuli that are clinically relevant for patients with cleaning OCD and assess their efficiency to obtain emotionally significant responses. Four AR stimuli were developed: a plastic bag full of garbage, a piece of bread with mold, a dirty sports shoe, and a piece of rotten meat. All stimuli were shown to a clinical group (17 patients with cleaning OCD) and a control group (11 patients without OCD). Relevant results were the design of the AR stimuli. These stimuli were validated with the statistical difference in perceived anxiety in the meat stimuli between the clinical and control groups. Nevertheless, when looking at effect sizes, all stimuli present effect sizes from small (plastic bag) to large (meat), with both shoe and bread between small and medium effect sizes. These results are a valuable support for the clinical use of these AR stimuli in the treatment of cleaning OCD.

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INTRODUCTION: The factor structure of the Positive and Negative Affective Schedule (PANAS) is still a topic of debate. There are several reasons why using Exploratory Graph Analysis (EGA) for scale validation is advantageous and can help understand and resolve conflicting results in the factor analytic literature. OBJECTIVE: The main objective of the present study was to advance the knowledge regarding the factor structure underlying the PANAS scores by utilizing the different functionalities of the EGA method. EGA was used to (1) estimate the dimensionality of the PANAS scores, (2) establish the stability of the dimensionality estimate and of the item assignments into the dimensions, and (3) assess the impact of potential redundancies across item pairs on the dimensionality and structure of the PANAS scores. METHOD: This assessment was carried out across two studies that included two large samples of participants. RESULTS AND CONCLUSION: In sum, the results are consistent with a two-factor oblique structure.

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INTRODUCTION: Rubber dam isolation is considered as an essential component of modern adhesive dentistry. However, dental students do not always use it due to several barriers they face on their clinical practice. The aim of this study was to design and validate a questionnaire based on the COM-B model to measure students' implementation of rubber dam isolation in restorative treatments with adhesive materials. MATERIALS AND METHODS: A 7-item questionnaire was developed based on the COM-B model, with questions measuring the Capability, Opportunity (Relevance and Resources), and Motivation to perform rubber dam isolation (Behaviour). Content validation of the questionnaire was conducted by experts in aesthetic/restorative dentistry that assessed the clarity, coherence and relevance of the questions. The final survey was administered to a dental student population from three large private universities in the Dominican Republic. Descriptive analysis, t tests, polychoric correlations and a path analysis were carried out to establish the validity of the instrument. RESULTS: A total of 382 students from three universities completed the questionnaire. According to the COM-B path model, the significant predictors of the implementation of rubber dam isolation were Capability and Motivation for University A, Motivation and Opportunity-Resources for University B, and Opportunity-Relevance and Capability for University C. CONCLUSIONS: The RDIS is a very short, easy to administer and valid questionnaire that can be applied by the universities to determine where they need to focus their interventions to achieve better rubber dam isolation implementation by their students.

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Growth Mixture Modeling (GMM) has gained great popularity in the last decades as a methodology for longitudinal data analysis. The usual assumption of normally distributed repeated measures has been shown as problematic in real-life data applications. Namely, performing normal GMM on data that is even slightly skewed can lead to an over selection of the number of latent classes. In order to ameliorate this unwanted result, GMM based on the skew t family of continuous distributions has been proposed. This family of distributions includes the normal, skew normal, t, and skew t. This simulation study aims to determine the efficiency of selecting the "true" number of latent groups in GMM based on the skew t family of continuous distributions, using fit indices and likelihood ratio tests. Results show that the skew t GMM was the only model considered that showed fit indices and LRT false positive rates under the 0.05 cutoff value across sample sizes and for normal, and skewed and kurtic data. Simulation results are corroborated by a real educational data application example. These findings favor the development of practical guides of the benefits and risks of using the GMM based on this family of distributions.

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OBJECTIVE: To design and validate a questionnaire to measure caries management based on the Capability, Opportunity, and Motivation Behavior model (COM-B) and the International Caries Classification and Management System (ICCMS™). METHODS: A combination of Cariology and Psychology experts developed a 79-item pool that measured the COM-B components according to the ICCMS™ caries management recommended behaviours. After face and content validation and a pilot study, two samples of Colombian dentists participated: clinicians (n = 277) and clinical-practice educators (n = 212). RESULTS: Using parallel analysis and exploratory structural equation modelling (ESEM), the questionnaire was reduced to a 47-item 5-factor instrument that demonstrated good internal consistency and validity properties, including a robust factor structure, measurement invariance across samples and high predictive validity of ICCMS™ recommended behaviours. Scales' mean scores showed that dentists were conducting recommended behaviours "most-of-the-time" (Behavior), showed high confidence in their ability to conduct these behaviours (Capability) and considered recommendations as highly relevant (Opportunity-Relevance), while their appraisals of the available resources (Opportunity-Resources) and remuneration (Motivation) were notably lower. CONCLUSION: Overall, the findings highlight the practical utility of the COM-B ICCMS™ Questionnaire in understanding the potential antecedent variables that may explain dentists' behaviours related to caries diagnosis and management and in suggesting avenues for achieving a positive change in their behaviour.

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AIMS AND OBJECTIVES: To conduct a thorough psychometric assessment and validation of a Spanish-adapted version of the Scale of Oral Health-Related Outcomes for 5-Year-Old-Children (SOHO-5). MATERIALS AND METHODS: The sample consisted of 69 children aged 6 and 7 years attending a public school from a low-income community in the Dominican Republic. Outcomes consisted of SOHO-5 test scores and caries lesion severity scores, with the latter measured according to the International Caries Detection and Assessment System criteria. The IBM SPSS Statistics 20 and Mplus 7.4 programs were used for the statistical analyses. RESULTS: A confirmatory factor analysis revealed an excellent fit for the theoretical one-factor structure of the SOHO-5, with all the items having high loadings on this latent factor. In addition, the SOHO-5 was able to significantly explain a large amount of variance (37%) in caries lesion severity (P < 0.001), while its scale scores had good internal consistency reliability (Cronbach's alpha [α] = 0.85, 95% confidence interval [CI] 0.79-0.90). Further, the SOHO-5 could identify children with moderate and extensive caries lesions (area under the receiver operating characteristic curve = 0.82, 95% CI 0.70-0.94, P < 0.001). CONCLUSIONS: The current findings highlight the good psychometric properties and criterion-related validity of the Spanish-adapted SOHO-5 for young children who come from impoverished backgrounds.