Susana J. Calderon

This study examines the relationship between selected socio-demographics and digital health literacy on diabetes knowledge among older adults in the United States. Cross-sectional study. The eHealth Literacy Scale and the Short Diabetes Knowledge Instrument were used. Descriptive statistics, Pearson's r, point-biserial correlation coefficient, Kendall's tau, ANOVA, and Poisson regression were used for data analysis. The mean age was 71. The mean sum score for digital health literacy was 28.32 (SD = 7.95; range, 8-40), and the mean score for diabetes knowledge was 8.8 (SD = 2.3; range, 2-13). The education level, annual income, number of digital devices, and digital health literacy have a significant relationship with diabetes knowledge. Ethnicity, marital status, living arrangement, and health insurance status significantly correlated with diabetes knowledge. The findings can be used as preliminary evidence in developing diabetes education and age-friendly interventions for marginalized older adults, allowing better access to digitally formatted health knowledge. Nurses should be knowledgeable about the impact of digital health literacy on diabetes knowledge for older adults. Nurses and healthcare providers should assess patients' digital literacy levels as part of routine diabetes care and guide the older adults to gain the ability to utilize digital health information resources. Given that diabetes is a chronic illness, older adults should be able to manage it independently, and nurses play a pivotal role in supporting their effective self-care and providing age-tailored health education and interventions.

With a median caseload of 750–1,000 clients, school nurses face setting-specific challenges involving multiple, competing demands. This necessitates effective prioritization to prevent missed opportunities to provide appropriate care. This integrative review synthesizes the current state of the literature related to prioritization among school nurses in the United States. Three themes were identified relating to prioritization among school nursing: knowledge, attitudes and values; self-efficacy and intention to act; and the nursing process. The prioritization behavior of school nurses can be facilitated by organizational and community collaboration and strong evidence-based practice recommendations. High workloads and inadequate resources among school nurses are the most consistently cited barriers to effective prioritization. Additional research on how to improve effective prioritization among school nurses for the improvement of population health outcomes is needed.

Objective: This study aims to discover the most current trends, impacts, and challenges of using IoT devices and smart technologies in oral health. Method: A modified systematic mapping method was used to generate and answer five research questions. Twelve databases were queried to identify published literature from 2017 to 2023. Abstract screening and full-text review were conducted to identify studies meeting inclusion criteria. The Pandas library in Python Version 3.9.19 and a Fibonacci series were used to identify keyword trends in abstracts. Full-text analysis was conducted to synthesize findings relevant to the impacts and challenges of IoDT. Results: A total of 958 unduplicated articles were identified from the literature databases. After review, 33 articles were included. Publications related to IoDT are rapidly increasing over the last 7 years and keywords relating to toothbrushing were the most common. The most common research strategy was design and creation, followed by experimental methods. Design and creation of smart technologies in oral health are in a phase of measurement optimization using IoT which is being used for prevention, early detection, monitoring, and treatment of dental disease as well as silent communication devices. Challenges in IoDT continue to include measurement accuracy and user acceptability. Conclusions: Research in IoDT is predicted to continue to advance rapidly. Dental providers and public health agencies can look to this research to develop best practices. However, more research on how IoDT can facilitate desirable outcomes in a cost-effective and user-friendly way is needed.

Poor oral hygiene and excessive consumption of soda are among the main drivers of systemic health issues in adolescents in the United States. This non-randomized pilot clinical trial focused on the effects of a health text message system and smartphone-based intervention on adolescent tooth-brushing behavior and dietary choices, with a convenience sample of 94 participants aged 12 to 14 years old. A group of 75 participants agreed to use a tooth-brushing app and received a health text message; the other group of 15 agreed to use the tooth-brushing app, but did not receive a health text message. Saliva specimens were collected directly before and at the end of each experiment; changes in the salivary presence of cariogenic bacteria over the duration of the study were evaluated and compared with the demographics and behavioral variables. Within the text message group, 5% of participants increased the frequency of daily tooth brushing. Within the non-intervention group, 29% of participants increased the frequency of their daily tooth brushing. There were reductions in the total salivary bacteria and total streptococci in both groups (p < 0.001), but no change in the presence of cariogenic Mutans streptococci. Raising adolescents’ consciousness of oral health behavior resulted in marginal to moderate improvements to oral hygiene and dietary choices, as well as reductions in total salivary bacteria.

Translational research is the integration of 2 broad categories of biomedical science—basic science and applied science. However, in dentistry, this effort has been concentrated among a few researchers and must expand to keep pace with other disciplines. This commentary discusses the ongoing challenges faced by translational researchers (particularly early-career investigators) as they conduct oral and dental research, disseminate work, and contribute to science in general. This commentary also provides some recommendations/initiatives that could potentially address or alleviate these challenges. Knowledge Transfer Statement: The challenges and recommendations outlined in this commentary will serve as steppingstones to process the concepts of translational science, facilitate training for future scientists, and serve as an approach for the early investigators in the field of translational science.

Objectives: To identify and evaluate innovation strategies with urgent and emergency applications in Brazilian literature. Methods: This was a systematic review of the literature. The PRISMA statement was followed at all stages of this study. The selection of articles was carried out in the databases PubMed / Medline, Web of Science, VHL (Medline, Lilacs, IBECS, BDENF) and SciELO library without a specific date. The PICOS strategy: “patient, intervention, comparison, results and study design” was followed and the search carried out resulted in the selection of ten articles. Results: The main findings were theses, articles with themes extracted from master's theses and integrative literature reviews, in which new instruments and applications for care practice were validated, which were evaluated by the nursing team. It is worth mentioning that care, in all its dimensions, requires continuous updating, allowing a range of possibilities to expand knowledge in the area. Conclusion: The study allowed us to understand that the insertion of technology, although little reported in the literature, causes a mixture of feelings in the daily care, since it allows autonomy and practicality of professionals. It is worth mentioning that care, in all its dimensions, requires continuous updating, allowing a range of possibilities to expand knowledge in the area.

By age 17, almost 80% of US children have dental caries resulting from cariogenic bacteria that could be reduced with tooth brushing. This cross-sectional, correlational pilot study aims to understand the association between tooth brushing and oral microbiota in children. Oral specimens and survey data were collected from a convenience sample of 16 children, aged 7–12, and attending a community dental clinic. Descriptive statistics were used to analyze sample characteristics and tooth brushing behavior. Biospecimens were analyzed using Polymerase Chain Reaction (PCR) amplification and 16S ribosomal RNA (rRNA) gene sequencing. Beta diversity measures were compared across tooth brushing groups using Permutational Analysis of Variance (PERMANOVA) and Analysis of Similarities (ANOSIM) tests in R. The frequency of tooth brushing in this sample was once a day (brush1; 43.8%), twice a day (brush2; 43.8%), or more than twice a day (12.6%). Major phyla found in the subjects’ upper and lower teeth were the following: Proteobacteria, Fusobacteria, Firmicutes, Bacteroidetes, and Actinobacteria. The relative abundance of Actinobacteria was significantly lower in brush2 as compared to brush1 (p = 0.001), whereas the relative abundance of Proteobacteria was significantly higher (p = 0.025). The association between tooth brushing frequency and microbiome beta diversity was significant (p = 0.005 by PERMANOVA and p = 0.002 by ANOSIM). This study demonstrates that tooth brushing frequency could affect the proportional composition of the oral microflora. Additional research on the implication of these changes is warranted.

Informed by grounded theory, this study explored adolescent oral health behaviors to determine what factors influence them and to develop a substantive theory explaining the social process behind the behaviors identified. Multiple types of data were collected and analyzed simultaneously: demographic and oral health questionnaires, 16 individual interviews, eight small group discussions, field notes, and investigator memoing. Participants were 37 Midwestern adolescents aged 13–18, and most were White or African‐American females 14 years of age whose parents had at least a high school education. While more than half reported using mouthwash and brushing their teeth regularly, almost all participants described their behavior in terms of relationships, confidence, and attractiveness rather than health. Top motivators were habits learned as children and the desire to be attractive or “kissable.” To reflect teens' understanding of “healthy” as good‐looking, and their primary concern not with having healthy teeth but with being attractive to peers, our model of the basic social process of adolescent oral health behavior is called “Look at my Pearly White Teeth.” Understanding the actual motivations behind adolescent oral health behavior can help public health administrators develop more effective interventions, especially for teens who did not learn healthy habits as children.

While most states allow minors 12 years and older to consent to services for contraception, prenatal care, or sexually transmitted infections, the same adolescents are required to have parental consent for even preventive oral health care. Many adolescents are denied access to preventive oral health care because of the challenge of securing parental consent for care when parents are unwilling, unable, or unavailable to consent. Our purpose is to examine the barriers to preventive oral health care for U.S. adolescents related to parental consent laws, explore the issues surrounding these laws, and recommend policy changes. We explain the current range and status of consent laws across the country and arguments for parental consent law as it now stands. We discuss the difficulty of applying general medical consent law to preventive oral health care, neuroscience research on cognitive capacity among adolescents, and the distinction between parental consent and adolescent assent. We recommend replacing required “opt-in” consent with simpler “opt-out” consent; developing a tool for assessing adolescent decision-making capacity; advocating for consent laws that apply specifically to preventive oral health care; and empowering school nurses to lead local, state, and nationwide policy and legislation efforts.