Evaluation of the Impact of Oral Health on the Daily Activities of Users of the National Health System.

BACKGROUND: the integration of dentistry services in the Unified Health System in Brazil (SUS) is essential in primary care assistance. OBJECTIVE: we aimed to develop a tool for improving demand flowby evaluating the impact of oral health on the daily activities of users of the Family Health Unitusing the Oral Impacts of Daily Performance (OIDP)tool. METHODS: In Barretos, Brazil, a cross-sectional study was conducted at a Family Health Unit (FHU)including patients over 12 years old. Oral health impact was assessed using the Oral Impacts of Daily Performance (OIDP) tool, and family risk was measured with the Coelho-Savassi scale. RESULTS: 430 participants, including 411 adults and 19 young people, were recruited. Of the adults, 31% had an average OIDP score of 16.61. For young people, 53% reported an impact (average OIDP score: 28.61). Family risk (R1) was prevalent in 57.9% of young people and 53.3% of adults. Among adults, different activities were affected by risk: smiling without embarrassment (risk level 2), enjoying contact with people (risk level 3), and performing one's job or social role (risk level 1). Emotional state (R3) had the lowest OIDP score (p = 0.029). CONCLUSION: implementation of the OIDP scale in clinical practice enhances healthcare planning and ensures better-quality and equitable services, thus emphasizing comprehensive oral healthcare within the SUS.

Representações sociais sobre maternidade na reprodução humana assistida: discursos de mulheres inférteis / Social representations of motherhood in assisted human reproduction: discourses of infertile women / Representaciones sociales de la maternidad en la reproducción humana asistida: relatos de mujeres infértiles

Este trabalho tem o objetivo de analisar as concepções de maternidade para mulheres inférteis de diferentes níveis socioeconômicos que estão em tratamento de reprodução assistida. Trata-se de um estudo qualitativo, descritivo, que utilizou como instrumento uma entrevista semiestruturada e contemplou temas como o significado de família, desejo/expectativas sobre filho e gestação e expectativas sobre a maternidade. Participaram da pesquisa 48 mulheres inférteis acima de 35 anos que usam tecnologias de reprodução assistida de alta complexidade em instituições privada e pública. Os dados foram tratados pela análise de conteúdo em que emergiram os temas: representações sociais da família; representações sociais da maternidade; expectativas com a gestação e os modelos maternos; e o filho imaginado. As participantes representaram a família de forma positiva, como um sistema de suporte, de fundação e origem de amor, configurando-a como um laço social. Por outro lado, as concepções de família com base na consanguinidade também estiveram presentes, representando a família pela perpetuação da espécie e pela importância do laço biológico. A maternidade foi marcada por significativa idealização, sendo vista como um papel gratificante e de realização da feminilidade. O peso da cobrança social para procriar também foi sentido como um dever a cumprir e que, na impossibilidade de se realizar, gera sentimentos de inferioridade, menos-valia, impotência e inadequação perante a sociedade, o que reforça o estigma da infertilidade. Tais resultados apontam a importância de reflexões sobre o papel da mulher na nossa cultura, visto que a maternidade é ainda utilizada como medida para o sucesso ou fracasso feminino. Faz-se necessário também refletir sobre a possibilidade da maior inserção do trabalho psicológico na reprodução assistida, visto a carga emocional e social envolvidas nesse processo.(AU)

This study aimed to analyze the conceptions of motherhood for infertile women from different socioeconomic levels who are undergoing assisted reproduction treatment. This is a qualitative and descriptive study that used a semi-structured interview as an instrument and included topics such as the meaning of family and desires/expectations about the child, pregnancy, and motherhood. A total of 48 infertile women over 35 years of ages using high-complexity assisted reproductive technologies in private and public institutions participated in this research. The data were treated by content analysis in which the following themes emerged: family social representations; social representations of motherhood; expectations with pregnancy and maternal models; and the imagined son. Participants represented the family in a positive way as a support system and the foundation and origin of love, embracing the family as a social bond. On the other hand, the family concepts based on inbreeding were also present, representing the family by perpetuation of the species and the importance of biological bonds. Motherhood was marked by significant idealization, being seen as a gratifying role and the fulfillment of femininity. The weight of the social demand to procreate was also felt as a duty to be fulfilled that, in the impossibility of carrying it out, generates feelings of inferiority, worthlessness, impotence, and inadequacy toward society, which reinforce the stigma of infertility. Results point to the necessary reflections on the role of women and our culture since Motherhood is still used as a measure of female success or failure. They also point to a reflection on the possibility of greater inclusion of psychological work in assisted reproduction given the emotional and social burden involved in this process.(AU)

Este estudio tuvo como objetivo analizar las concepciones de maternidad de mujeres infértiles, de diferentes niveles socioeconómicos, que se encuentran en tratamiento de reproducción asistida. Se trata de un estudio cualitativo, descriptivo, que utilizó como instrumento una entrevista semiestructurada e incluyó temas como el sentido de la familia, deseos/expectativas sobre el hijo y el embarazo y expectativas sobre la maternidad. Participaron en la investigación un total de 48 mujeres infértiles, mayores de 35 años, usuarias de tecnologías de reproducción asistida de alta complejidad en instituciones públicas y privadas. Los datos se sometieron a análisis de contenido del cual surgieron los temas: representaciones sociales familiares; representaciones sociales de la maternidad; expectativas con el embarazo y modelos maternos; hijo imaginado. Las participantes representaron a la familia de manera positiva, como sistema de apoyo, fundamento y origen del amor, configurándola como vínculo social. Por otro lado, también estuvieron presentes las concepciones familiares basadas en la consanguinidad, representando a la familia para la perpetuación de la especie y la importancia del vínculo biológico. La maternidad estuvo marcada por una importante idealización, vista como un rol gratificante y de realización de la feminidad. También se sintió el peso de la demanda social de procrear como un deber que cumplir y que, ante la imposibilidad de realizarlo, genera sentimientos de inferioridad, desvalorización, impotencia e inadecuación en la sociedad, lo que refuerza el estigma de la infertilidad. Por tanto, son necesarias reflexiones sobre el papel de la mujer en nuestra cultura, ya que la maternidad se sigue utilizando como medida del éxito o fracaso femenino. También se reflexiona sobre la posibilidad de una mayor inclusión del trabajo psicológico en la reproducción asistida dada la carga emocional y social que implica este proceso.(AU)

A Formação do Psicanalista e os Princípios de Seu Poder / The Psychoanalyst's Education and the Principles of its Power / La Formación del Psicoanalista y los Principios de su Poder

Este artigo se propõe a elaborar, a partir da formação do psicanalista e da política da psicanálise, a articulação entre os campos psicanalítico e da saúde mental. Para isso, parte-se do alerta de Freud quanto ao risco de a psicanálise figurar como uma técnica a mais, no rol das especialidades médicas, somado às questões colocadas por Franco Basaglia para a Psiquiatria e a Psicanálise. Compreende-se que tanto os questionamentos de Basaglia, quanto as justificativas dadas por Lacan em seu retorno a Freud, têm como possível elo o alerta quanto ao risco de reduzir o tratamento dispensado para sujeitos em situação de intenso sofrimento psíquico, bem como a formação ofertada no interior das instituições psicanalíticas, a um mero exercício de adequação social. Nesse sentido, indicamos ser a política do psicanalista, com seu radical compromisso com a perspectiva de não redução da Psicanálise à oferta de um tratamento que negue a condição de falta-a-ser do sujeito, uma perspectiva possível para situar o psicanalista frente ao aparelhamento das instituições, sejam as de saúde mental, sejam aquelas que atravessam a formação do psicanalista, como a Universidade e as Escolas de Psicanálise.

This article proposes to elaborate from the education of psychoanalysts and the politics of psychoanalysis, the articulation between the psychoanalytic and mental health fields. To that end, it starts with Freud's warning about the risk of psychoanalysis appearing as one more technique in the list of medical specialties, added to the questions raised by Franco Basaglia to Psychiatry and Psychoanalysis. It is understood that both Basaglia's questions and the justifications given by Lacan in his return to Freud have as a possible link the alert regarding the risk of reducing the treatment given to subjects in situations of intense psychic suffering, as well as the education offered in the within psychoanalytic institutions, to a mere exercise of social adequacy. In that sense, we indicate that the psychoanalyst's policy, with his radical commitment to the perspective of not reducing Psychoanalysis to the offer of a treatment that denies the subject's condition of lack-to-be, is a possible perspective to place the psychoanalyst in the face of the rigging of institutions, whether those of mental health or those that permeate the education of psychoanalysts, such as the University and Schools of Psychoanalysis.

Ese artículo se propone elaborar, a partir de la formación del psicoanalista y de la política del psicoanálisis, la articulación entre los campos psicoanalíticos y de la salud mental. Para eso, partimos de la alerta de Freud cuanto al riesgo del psicoanálisis engendrar como una técnica a más en el rol de las especialidades médicas, sumado a las cuestiones planteadas por Franco Basaglia para la Psiquiatría y el Psicoanálisis. Se entiende que tanto los cuestionamientos de Basaglia, cuanto las justificativas ofrecidas por Lacan en su retorno hacia Freud tienen como posible enlace la alerta cuanto, al riesgo en reducir el tratamiento dispensado para los sujetos en situación de intenso sufrimiento psíquico, así como la formación ofrecida en el interior de las instituciones psicoanalíticas, a un simples ejercicio de adecuación social. En ese sentido, indicaremos ser la política del psicoanalista, con su radical compromiso con la perspectiva de la no reducción del Psicoanálisis a una oferta de un tratamiento que niegue la condición de falta-a-ser del sujeto, una perspectiva posible para situar el psicoanalista frente al preparo de las instituciones, sean de salud mental, sean aquellas que atraviesan la formación del psicoanalista, como la Universidad y las Escuelas de Psicoanálisis.

An Embarrassment of Riches: Three FDA-Approved Bispecific Antibodies for Relapsed Refractory Multiple Myeloma.

SUMMARY: In the past year, three new bispecific antibodies have received accelerated FDA approval for the treatment of relapsed/refractory multiple myeloma. In this article, we review the available data for these three agents, teclistamab, elranatamab, and talquetamab, and discuss practical considerations for their use in clinical settings while the medical community awaits randomized phase III clinical trial datasets comparing them to standard-of-care regimens.

Empathic embarrassment towards non-human agents in virtual environments.

Humans feel empathic embarrassment by witnessing others go through embarrassing situations. We examined whether we feel such empathic embarrassment even with robot avatars. Participants observed a human avatar and a robot avatar face a series of embarrassing and non-embarrassing scenarios. We collected data for their empathic embarrassment and the cognitive empathy on a 7-point Likert scale. Both empathic embarrassment and cognitive empathy were significantly higher in the embarrassed condition compared to the non-embarrassed condition with both avatars, and the cognitive empathy was significantly higher with the human avatar. There was a tendency of participants showing a higher level of skin conductance while watching the human avatar go through embarrassing situations compared to the robot avatar. A following experiment showed that the average plausibility of the embarrassed condition was significantly higher with the human avatar compared to the robot avatar. However, plausibility scores for emotion were not significantly different among the conditions. These results suggest that humans can feel empathic embarrassment as well as cognitive empathy for robot avatars while cognitive empathy for robot avatars is comparatively lower, and that part of the empathic difference between human and robot avatars might be due to the difference of their plausibility.

French validation of the Quality of life in Essential Tremor Questionnaire (QUEST) and the Essential Tremor Embarrassment Assessment (ETEA).

Two scales have been developed and validated in English to evaluate the impact of tremor on daily life, namely Quality of life in Essential Tremor Questionnaire (QUEST) and Essential Tremor Embarrassment Assessment (ETEA). The psychometric properties of the French version of these two scales were assessed for 117 patients with head tremor. Both scales showed excellent acceptability, very good internal consistency (Cronbach's alpha coefficient>0.8) and reproducibility (Lin concordance coefficient>0.8), satisfactory external validity and satisfactory sensitivity to change. In conclusion, the French versions of QUEST and ETEA are comprehensive, valid and reliable instruments for assessing patients with head tremor.

Creating the conditions for psychological safety and its impact on quality coach-athlete relationships.

In this study, we investigated the notion that giving voice to athletes is an important aspect to creating a psychologically safe environment which can then feed into maintaining good quality coach-athlete relationships where every athlete feels heard, valued, and connected. 379 athletes completed a multi-section questionnaire that assessed their (a) capacity to be open and manage conflict with their coaches, (b) perceptions of psychological safety within their team or group, and (c) perceptions of the coach-athlete relationship quality. Structural equation modelling revealed that openness and conflict management positively predicted psychological safety which, in turn, positively predicted coach-athlete relationship quality. Psychological safety was found to explain the association between athletes' communication (i.e., capacity to be open, honest and transparent as well as manage interpersonal conflict effectively) and coach-athlete relationship quality regardless of athletes' gender. These findings highlighted that if athletes have the capacity to have candid discussions and can navigate conflict with their coaches, then it is possible to feel psychologically safe and thus able to engage in risky interpersonal interactions (e.g., raise concerns, admit mistakes) within their group context without fear of intimidation and humiliation. Furthermore, it was revealed that such a psychologically safe group environment fostered athletes' trust and respect, as well as commitment and cooperation with their coach. The discussion provides links to theory, research and practice.

An Applied Linguistics Study of How Students Prevent Embarrassments and Impositions During Interactive Examination OSCEs.

OBJECTIVE: To assess the effectiveness of politeness strategies used by pharmacy students to avoid embarrassing or imposing on others during objective structured clinical examinations. METHODS: A total of 19 objective structured clinical examinations video recordings of 10 students (participants) interacting with mock patients were examined using the framework of Politeness Theory (PT). All relevant participant acts (speech activities) were coded using PT into (1) type of face threatening acts (ie, potentially sensitive situations-as regarded by PT) and (2) politeness strategies used to mitigate them. Conversation Analysis was then used to examine the effectiveness of conversational strategies by judging the 'patient' responses to these strategies. RESULTS: Most acts had the potential to impact patients' negative face needs (ie, desire to act autonomously, eg, upon the practitioner making a request), positive face needs (ie, desire to be liked, eg, upon the practitioner making a diagnosis), or both. Despite applying a variety of positive politeness strategies (eg, avoiding disagreement, or expressing understanding) to prevent embarrassment to the patient, and negative politeness strategies (eg, being indirect, using hedging, or minimizing the imposition) to avoid directly imposing on them, "dispreferred responses" showed participants mostly focused on avoiding impositions, corresponding to what they have been taught, rather embarrassments. CONCLUSION: Participants were less aware that discussing sensitive topics could cause embarrassment to patients, with the potential to upset them. Developing teaching and evaluation methods to consider patients' face needs could help in assessing and improving pharmacy students' communication skills.

Menstruation behaviour influencer model: a grounded theory of menstrual experiences of shame, embarrassment, stigma and absenteeism among pubescent girls in semi-urban and rural secondary schools in Enugu State, Nigeria.

Introduction: severally, studies had identified menstrual-associated shame, embarrassment, stigma, and absenteeism among pubescents in school with resultant challenges on their bio psycho-social functioning. However, what is not clear is the contribution of the home and school to the experiences. The objectives of the study were to explore the experiences with menstruation and menstrual hygiene management; explore the experiences with menstrual-associated shame, embarrassment, stigma, and absenteeism among participants; explore the bio-psycho-social issues associated with the experiences; understand the meaning of the experiences and propose a mid-range theory that explains the influences on pubescents´ menstrual behaviours. Methods: constructivist grounded theory design was used to explore the experiences of 20 purposively recruited pubescents from rural and semi-urban secondary schools. In-depth Interviews, focused group discussions, key informant interviews, and observations were employed to collect data until data saturation. Open and focused coding was conducted to identify emerging themes and sub-themes. These themes were returned to participants and literature for verification. Results: four (4) categories and eleven (11) sub-categories emerged from the data and formed four (4) themes that influence pubescents´ menstrual behaviour. They include: 1) individuals´ bio-physiological status, knowledge of menstrual health and menstrual characteristics; 2) regimenting school through strict rule enforcement, punishment/motivation, forced participation, and compliance; 3) scheduling academic activities/examination, sporting and other extra curricula activities; and 4) providing menstrual support by individual and institutional efforts to pubescents. Based on the relationship with other themes, the menstrual behaviour influencer model was proposed. Conclusion: menstrual influencers require the interaction between menstrual support and menstrual enablers by institutions for positive menstrual behavior. Failure to achieve this balance will lead to menstrual-associated shame, embarrassment, stigma, absenteeism, and school drop-out.

Opioid Prescription Denials by Community Pharmacies for Cancer-Related Pain: A Case Series.

Pain is one of the most common symptoms experienced by patients living with cancer. Guidelines recommend opioids as the mainstay in the management of cancer-related pain. However, the opioid epidemic has resulted in policymakers recommending limitations on opioid prescribing which led to community pharmacies implementing various parameters. These restrictions have created barriers for patients with cancer-related pain attempting to fill opioid prescriptions from their community pharmacies. Additionally, in the setting of the opioid epidemic, there have been reports of systemic bias within community pharmacies, leading to experiences with embarrassment and shame for patients with cancer-related pain. This case series presents specific examples of community pharmacies declining to fill opioid prescriptions for patients with cancer-related pain and associated patient suffering.

Possible sexual dysfunction in traumatically injured clients: improving the approach at initial assessment.

AIM: To explore the perceived barriers experienced by rehabilitation case managers to discussing sexual function with clients after a traumatic injury, at the point of initial assessment. Study design: Small-scale semi-structured interviews were conducted to inform baseline measures for a service improvement proposal within the author's employing company. A qualitative phenomenological methodology was used for the interpretation of the data, with application of framework analysis. FINDINGS: Case managers within the company do not routinely ask clients about issues of sexual dysfunction at the initial assessment of rehabilitation needs. Identified inhibitors included the client's age, cultural background, the presence of other people during the assessment, embarrassment for either party, or any apparent reservations about the assessment process for the client. These echoed findings from the wider healthcare literature. Prompts to initiating conversations were also identified, including the nature of injury or the openness of the client. CONCLUSION: In their holistic assessment of clients' rehabilitation needs, and as part of the development of the therapeutic relationship, case managers are ideally situated to encourage conversations concerning issues of sexual dysfunction with clients, having the opportunity to signpost them to the most appropriate support or to facilitate referrals for treatment.

Social distance of bystanders affects people's embarrassment via changing fear of negative evaluation and feelings of attachment security.

BACKGROUND: Embarrassment is a self-conscious emotion with important social functions, but it is not well understood. The perception of bystanders is considered a precondition for embarrassment, which makes it unique from other self-conscious emotions. Studies have shown that socially close bystanders can reduce individuals' embarrassment. However, whether and how the embarrassment of individuals varies with the changes in social distance between them and their bystanders remained unclear, which indicates the key characteristics of embarrassment. METHODS: The current research consists of two studies. Study 1 tested whether participants' embarrassment systematically varied with social distance by setting up three levels of social distance: close friends (i.e., short), casual friends (i.e., medium), and strangers (i.e., long), based on 159 participants. With two full mediation models, study 2 investigated whether and how the fear of negative evaluation and state attachment security mediated the influence of social distance on embarrassment based on 155 participants. CONCLUSIONS: The current findings revealed that the social distance between bystanders and protagonists systematically influenced the embarrassment of protagonists and this effect occurred via two parallel pathways, i.e., by increasing the fear of negative evaluation and by reducing state attachment security. The findings not only showed the unique role of bystander characteristics on embarrassment, but also two cognitive processes behind this unique self-conscious emotion: fearing negative evaluation and seeking attachment for security.

Ethnic inequities in health in Aotearoa New Zealand-an international embarrassment.

Nil.

"Anger, embarrassment, less than a woman": the emotional impact of Black women's sexual pain.

Limited research has examined the emotions Black women report when thinking about sexual pain. To fill this gap in the literature, we explored the types of emotions that emerged when N = 126 premenopausal Black women thought about pain during sex. Open-ended responses to the following research question were analyzed: "What feelings emerge when you think about sexual pain?" Structural tabular thematic analysis was used to find commonalities in participants' responses. Findings indicated five families, or categories, of emotions: self-judgment, anger/disgust, sadness, anxiety, and emotions felt somatically. Additionally, women's reports were predominantly within the feeling state and cognitive appraisal components of emotion. Implications for health providers and therapists are discussed.

Body Image Perception and the Effect of Different Educational Programs on Embarrassment in Patients Undergoing Colonoscopy.

PURPOSE: Colonoscopy is recognized as a safe and effective tool for detecting colorectal cancer. However, patients may experience discomfort and embarrassment arising from their body image, with the prejudice that health care professionals will have negative thoughts about their bodies. This study was carried out to determine the effect of the perception of body image and education given with different educational programs on the feeling of embarrassment in patients who were scheduled to undergo colonoscopy. DESIGN: Quasi-experimental study with pre-test, post-test. METHODS: The population of this quasi -experimental study with pre-test, post-test, and experimental groups consisted of 184 patients who underwent colonoscopy for the first time at the endoscopy department of a university hospital. FINDINGS: No statistically significant difference in the mean Colonoscopy Embarrassment Scale (CES) pre-test scores was found between the groups (P > .05). The mean CES post-test scores of the video group were lower than those of the other groups, with a statistically significant difference (P < .05). Comparing the intragroup CES pre-test and post-test mean scores, the mean CES post-test scores were found to be lower in all three groups, with a statistically significant difference between the groups (P < .05). Although a statistically weak negative correlation was found between the body image mean scores and the pre-test CES mean scores of the booklet and video groups, no correlation was observed in the control group. CONCLUSIONS: The body image perception was found to affect the sense of embarrassment in patients undergoing colonoscopy, and the mean embarrassment scores decreased with planned training programs.