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PURPOSE: Patient's expectations of treatment outcome are one of the key determinants of satisfaction. The aim of this study was to evaluate orthognathic patients' expectations of the outcome of orthognathic treatment. METHODS: This study was a cross-sectional qualitative study involving in-depth interviews with patients with dentofacial deformities. Patients who were about to commence orthognathic treatment were recruited from new-patient clinics. Inclusion criterion were patients of any ethnicity 16 years or older who were about to commence orthognathic treatment to correct a dentofacial deformity. Exclusion criteria were patients who had previously received orthognathic treatment, who were younger than 16 years, and those with congenital craniofacial anomalies or acquired defects. The data were analyzed using a framework approach to management and critical qualitative theory, which involved identifying the main themes and subthemes. RESULTS: Eighteen adult patients 18 to 40 years old were interviewed; 9 were women and 9 were men. Most were Caucasian and 6 were from the black and minority ethnic group. Participants' expectations could be divided broadly into 2 main categories: expectations of actual physical changes and expectations of the effects that these physical changes would indirectly have on them (nonphysical changes). In addition, a typology of patients, based on expectations, was identified, whereby patients could be classified as metamorphosizers, pragmatists, shedders, or evolvers, together with implications and suggestions for practice. CONCLUSIONS: These findings represent a new insight into the complex issues of managing patient expectations and satisfaction. The clinical relevance of identifying expectations is not just to ration treatment or identify those who will make good or bad candidates for treatment, but to be able to offer them additional support to enhance satisfaction with the outcome. This highlights the need for a qualitative methodology to complete the full circle of evidence-based practice. [ABSTRACT FROM AUTHOR]

The assessment of quality of life is becoming increasingly important in dentistry. This may be measured using two groups of instruments: generic and condition-specific. OBJECTIVES: This paper describes the processes of validity and responsiveness testing of a condition-specific quality of life measure for patients who present with severe dentofacial deformity requesting orthognathic treatment (the so-called Orthognathic Quality of Life Questionnaire). The development of the instrument is described in a previous paper. METHOD: The OQLQ was tested for validity using a visual analogue scale and also the Short-Form 36 health survey questionnaire. Responsiveness was tested using longitudinal data obtained before, during and after orthognathic treatment. RESULTS AND CONCLUSIONS: The OQLQ shows good evidence of validity and responsiveness. This, together with previous evidence of good reliability, suggests that the instrument may prove useful in both clinical trials and in quality assurance. [ABSTRACT FROM AUTHOR]

The assessment of quality of life is becoming increasingly important in clinical research. Its importance in dentistry has been realised only relatively recently. Health-related quality of life is concerned with the aspects of quality of life that relate specifically to an individual's health. This may be measured using two groups of instruments: (i) generic measures, which provide a summary of health-related quality of life and sometimes generate a single index measure of health or (ii) condition-specific measures, which focus on a particular condition, disease, population or problem and are potentially more responsive to small, but clinically important, changes in health. OBJECTIVES: The aim of this study was to develop a condition-specific quality of life measure for those patients with severe dentofacial deformity who were requesting orthognathic treatment and to assess the reliability of this instrument. METHOD: Instrument content was derived through a literature review and interviews with clinicians and patients. The resulting instrument was tested for internal consistency and test-retest reliability. RESULTS AND CONCLUSION: The instrument was found to divide into four clinically meaningful domains. Internal consistency and test-retest reliability were good. Patient acceptance of the questionnaire was also encouraging. [ABSTRACT FROM AUTHOR]

The cost-utility approach is a method of economic evaluation, which assigns a ratio of cost to benefit, based on utility values of the health state in question. It allows efficient use of health care resources and is a useful method in that it permits comparison of a wide range of medical interventions, including those which are life saving and those that improve quality of life. This study obtained utility values for dentofacial deformity from orthognathic patients and members of the general public using three recognized methods - rating scale (RS), standard gamble (SG), and time trade-off (TTO). There were no significant differences between the utility values for the two groups of respondents. Method agreement between the TTO and the SG (the 'gold standard') was better than that between the RS and SG. In addition, the SG and TTO were found to have greater repeatability than the RS. [ABSTRACT FROM AUTHOR]

PURPOSE: Inferior dental nerve paresthesia is a well-known risk of orthognathic surgery, but little is known about the effects of altered sensation in day-to-day life. Therefore the aim of this study was to assess the impact of altered sensation after orthognathic treatment. PATIENTS AND METHODS: The study was divided into 2 parts: the first phase involved semistructured, in-depth interviews with 13 post-treatment orthognathic patients who presented with altered sensation affecting the lower lip. In the second part of the study, the data from the interviews were used to develop a questionnaire that was distributed to 40 post-orthognathic patients (75% completion [n = 30]). The results were analyzed by use of descriptive statistical methods. RESULTS: In both stages of the study, common descriptors used to describe the altered sensation were 'tingling' and 'numb.' The majority of patients were aware of the neurosensory disturbance when touching their lips, face, or jaw, and patients also expressed difficulties knowing when food was left on their lip. It was noted that patients who were aware of the altered sensation all of the time expressed the greatest distress in their everyday life. When it came to emotions associated with the altered sensation, the majority of patients were disappointed, but few were upset or angry. CONCLUSIONS: The impact of altered sensation due to inferior dental nerve damage after orthognathic surgery varied from patient to patient, but altered sensation had a significant effect on the majority of patients' everyday lives. The information obtained from this study makes an important contribution to the informed consent process. [ABSTRACT FROM AUTHOR]

This questionnaire-based study investigated the psychological profile of orthognathic patients prior to starting treatment and compared the findings with a control group of non-patients. Comparison of the data used multivariate multiple regression analysis where outcome variables and independent variables were studied simultaneously. Some differences were found in the psychological profile of the orthognathic patient. They displayed higher levels of state anxiety (P <0.001), higher numbers of individuals in their social support network (P <0.05), and lower body image and facial body image (P <0.001). Self-esteem was also found to be lower, but only at borderline levels of significance (P = 0.052). [ABSTRACT FROM AUTHOR]

Introduction: The curricula for UK dental specialty training have recently been under review and until 2024, completion of a research component during training in Dental Public Health, Oral Microbiology and Orthodontics has been mandatory (with an alternative route for Orthodontics involving the submission of two scientific papers for those trainees not wishing to undertake a higher degree). Anecdotally, some trainees in other dental specialties choose to undertake higher degrees alongside specialty training., Aims: The aims were to investigate how many dental specialty registrars study for higher degrees alongside specialty training, and whether undertaking a higher degree alongside specialty training has an impact on completion of training, research skills, research experience, patient care and career opportunities., Materials and Methods: This was a cross-sectional study design, involving the distribution of an online, anonymous questionnaire-based survey to UK dental specialty registrars in November and December 2022., Results: In total, 38 questionnaires were completed, representing a 7.7% response rate of the entire dental specialty registrar cohort in the UK and 42% of those who received it. Most respondents (76.3%) were either studying or had completed a clinically relevant higher degree prior to specialty training. Most respondents (76.3%) reported that the higher degree increased career opportunities and gave them additional skills., Conclusions: Dental specialty trainees who responded to this survey perceived the higher degree to be beneficial in terms of preparing for exams, gaining skills in critical appraisal and for increasing future career opportunities., (© 2024 The Author(s). European Journal of Dental Education published by John Wiley & Sons Ltd.)

Self-cues such as one's own name or face attract attention, reflecting a bias for stimuli connected to self to be prioritized in cognition. Recent evidence suggests that even external voices can elicit this self-prioritization effect; in a voice-label matching task, external voices assigned to the Self-identity label 'you' elicited faster responses than those assigned to 'friend' or 'stranger' (Payne et al., Br. J. Psychology, 112, 585-610). However, it is not clear whether external voices assigned to Self are prioritized over participants' own voices. We explore this issue in two experiments. In Exp 1 (N = 35), a voice-label matching task comprising three external voices confirmed that reaction time and accuracy are improved when an external voice cue is assigned to Self rather than Friend or Stranger. In Exp 2 (N = 90), one of the voice cues was replaced with a recording of the participant's own voice. Reaction time and accuracy showed a consistent advantage for the participant's own-voice, even when it was assigned to the 'friend' or 'stranger' identity. These findings show that external voices can elicit self-prioritization effects if associated with Self, but they are not prioritized above individuals' own voices. This has implications for external voice production technology, suggesting own-voice imitation may be beneficial., (© 2024 The Author(s). British Journal of Psychology published by John Wiley & Sons Ltd on behalf of The British Psychological Society.)

Introduction: Increased preoperative anxiety may have an adverse impact on the patient experience. This qualitative study therefore aimed to explore those factors affecting anxiety in the approach to orthognathic surgery., Methods: A total of 28 orthognathic patients who had completed their presurgical orthodontic treatment and were within 8 weeks before their surgery underwent one-to-one in-depth interviews. The interviews explored their experience in the preoperative period, with the focus on aspects relating to anxiety. Interviews were audio-recorded and transcribed verbatim, and data were then analyzed using a thematic framework approach., Results: Eight themes and associated subthemes were identified. The first theme related to time and described the approach to the surgery and the transience of the side effects. The second theme discussed control and how the need for control may affect anxiety; the third focused on fear related to the surgery and the element of "the unknown." The fourth theme highlighted the importance of trust between patients and clinicians, whilst the fifth focused on information and its delivery, which was crucial for managing uncertainty. The sixth theme centered on expectations about the surgery and the patient's ability to cope, and the seventh discussed coping strategies that were effective in alleviating anxiety. The final theme focused on the benefits of a strong, effective support system in reducing anxiety. No distinct typologies emerged from the data. Recommendations for consideration by clinicians are presented., Conclusions: The findings provide a novel insight into the multifactorial nature of preoperative anxiety in orthognathic patients and also highlight the important role of the clinical team in creating a supportive environment to help reduce patient anxiety., (Copyright © 2024 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

This study tests whether developments in self-knowledge and autobiographical memory across early to late childhood are related. Self-descriptions and autobiographical memory reports were collected from 379 three- to eleven-year-old predominantly white Scottish children, M age  = 90.3 months, SD = 31.1, 54% female. Episodic memory was measured in an enactment task involving recall and source monitoring of performed and witnessed actions. The volume and complexity of self-knowledge and autobiographical memory reports increased with age, as did source monitoring ability and recall bias for own actions. Regression analyses and structural equation modeling confirmed a close association between these developments. These results inform our theoretical understanding of the development of the self-memory system in childhood, which may contribute to the gradual offset of childhood amnesia., (© 2024 The Author(s). Child Development published by Wiley Periodicals LLC on behalf of Society for Research in Child Development.)

Birds' bills are their main tactile interface with the outside world. Tactile bill-tip organs associated with specialized foraging techniques are present in several bird groups, yet remain understudied in most clades. One example is Austrodyptornithes, the major seabird clade uniting Procellariiformes (albatrosses and petrels) and Sphenisciformes (penguins). Here, we describe the mechanoreceptor arrangement and neurovascular anatomy in the premaxillae of Austrodyptornithes. Using a wide phylogenetic sample of extant birds (361 species), we show that albatrosses and penguins exhibit complex tactile bill-tip anatomies, comparable to birds with known bill-tip organs, despite not being known to use tactile foraging. Petrels (Procellariidae, Hydrobatidae and Oceanitidae) lack these morphologies, indicating an evolutionary transition in bill-tip mechanosensitivity within Procellariiformes. The bill-tip organ in Austrodyptornithes may be functionally related to nocturnal foraging and prey detection under water, or courtship displays involving tactile stimulation of the bill. Alternatively, these organs may be vestigial as is likely the case in most palaeognaths (e.g. ostriches and emu). Ancestral state reconstructions fail to reject the hypothesis that the last common ancestor of Austrodyptornithes had a bill-tip organ; thus, tactile foraging may be ancestral for this major extant clade, perhaps retained from a deeper point in crown bird evolutionary history.

The self-memory system depends on the prioritization and capture of self-relevant information, so may be disrupted by difficulties in attending to, encoding and retrieving self-relevant information. The current study compares memory for self-referenced and other-referenced items in children with ADHD and typically developing comparison groups matched for verbal and chronological age. Children aged 5-14 (N = 90) were presented with everyday objects alongside an own-face image (self-reference trials) or an unknown child's image (other-referenced trials). They were asked whether the child shown would like the object, before completing a surprise source memory test. In a second task, children performed, and watched another person perform, a series of actions before their memory for the actions was tested. A significant self-reference effect (SRE) was found in the typically developing children (i.e. both verbal and chronological age-matched comparison groups) for the first task, with significantly better memory for self-referenced than other-referenced objects. However, children with ADHD showed no SRE, suggesting a compromised ability to bind information with the cognitive self-concept. In the second task, all groups showed superior memory for actions carried out by the self, suggesting a preserved enactment effect in ADHD. Implications and applications for the self-memory system in ADHD are discussed., (© 2024 The Authors. British Journal of Developmental Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Objectives: To evaluate the characteristics and content of YouTube™ videos created by patients undergoing orthodontic fixed appliance treatment and to assess the content accuracy of these videos., Design: A mixed-methods quantitative and qualitative study., Data Source: YouTube™ webpage., Methods: The term 'braces' was used to search for relevant videos on the YouTube™ webpage between 18 August and 30 August 2020, with no limits imposed regarding how long the video had been available on YouTube™. Videos were included if they were made by patients and were predominantly about patients' experiences during treatment with labial fixed appliances. The main themes/subthemes of the included videos were identified. A checklist was then developed to assess accuracy of the video content for two of the main themes and the videos were assessed against the checklist., Results: The video search identified 350 videos, of which 64 were selected as potentially eligible; 41 were subsequently excluded as they related primarily to the bond up/debond experience or had minimal information about orthodontics. This meant that 23 videos were ultimately included for analysis. Six main themes were identified in the videos: problems with fixed appliances, effects of fixed appliances, oral hygiene maintenance, dietary advice, treatment duration/appointment frequency and auxiliaries used with fixed appliances. From the 23 videos, 20 were assessed against the checklist for content accuracy related to two selected themes: oral hygiene maintenance and dietary advice. The majority of videos had low content accuracy scores, indicating that important and relevant content was generally missing., Conclusion: Several included videos focused on oral hygiene maintenance and dietary advice associated with fixed appliances; however, the content was incomplete and not always accurate. This is concerning to the profession, and it is therefore recommended that clinicians consider collaborating with patients to produce videos that are patient-centred and that also contain accurate information., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: To understand patients' motivations for pursuing treatment, to appreciate what information patients seek and to explore potential factors affecting decision making in adults considering, undergoing or who have had orthodontic treatment in the private sector., Design: Cross-sectional questionnaire study., Setting: Online questionnaire., Participants: A total of 209 (83% women, 16% men, 1% preferred not to say) completed responses were received., Methods: Once piloted, the final survey was made available online to adults in the United Kingdom (UK) and Republic of Ireland (RoI) who were either considering having orthodontic treatment, currently undergoing treatment or had recently completed treatment in the private sector., Results: The most commonly selected motivating factor was to 'improve the appearance of my teeth' (82%). The information sought related predominantly to treatment duration (64%), potential end results (56%), types of appliances that were available (55%) and cost (52%). The two most commonly reported social factors that had influenced participants to consider treatment were 'seeing myself on social media' (31%) and 'it is more socially acceptable to have braces' (31%)., Conclusion: While this area remains relatively underexplored in the literature, it is crucial to develop a comprehensive understanding due to the increasing number of adults seeking orthodontic treatment. This study not only reinforces the existing knowledge regarding adults seeking orthodontic treatment, such as the predominant role of aesthetics as a motivating factor, but also introduces some novel insights. Specifically, we highlight the influence of social factors on decision-making processes and the importance of effectively communicating the duration of treatment to patients., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This study investigates the self-reference effect (SRE) with an ownership memory task across several age groups, providing the first age exploration of implicit ownership memory biases from adolescence to older adulthood ( N  = 159). Using a well-established ownership task, participants were required to sort images of grocery items as belonging to themselves or to a fictitious unnamed Other. After sorting and a brief distractor task, participants completed a surprise one-step source memory test. Overall, there was a robust SRE, with greater source memory accuracy for self-owned items. The SRE attenuated with age, such that the magnitude of difference between self and other memory diminished into older adulthood. Importantly, these findings were not due to a deterioration of memory for self-owned items, but rather an increase in memory performance for other-owned items. Linear mixed effects analyses showed self-biases in reaction times, such that self-owned items were identified more rapidly compared with other owned items. Again, age interacted with this effect showing that the responses of older adults were slowed, especially for other-owned items. Several theoretical implications were drawn from these findings, but we suggest that older adults may not experience ownership-related biases to the same degree as younger adults. Consequently, SREs through the lens of mere ownership may attenuate with age., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Research overviews may be undertaken to identify gaps in the literature, evaluate existing systematic reviews (SRs), and summarize evidence. This paper aims to profile overviews that have been conducted in orthodontics and related interventions since 2012 and to evaluate the degree of overlap among these overviews., Methods: Overviews published between January 1, 2012 and June 20, 2023 were identified using an electronic search involving Google Scholar and PubMed. A descriptive summary was produced, and citation matrices were used to evaluate the percentage of overlap between overviews using corrected covered area and covered area. This was classified as slight, moderate, high, or very high., Results: A total of 35 overviews were identified across a wide range of topics. Eight overviews included <10 SRs; 21 had 10-20 SRs; and 6 included >20 SRs (median no. of SRs per overview, 15; range, 3-62). Meta-analysis was conducted in only 5 overviews. Overlap between overviews on the same topic ranged from slight (2.7%) to very high (53.8%)., Conclusions: Almost all overview topics address treatments and their effects, with a wide variation in the number and quality of SRs included. There is considerable overlap in some orthodontic overviews, suggesting unnecessary duplication and research waste. Researchers should be encouraged to focus on primary data collection to add more high-quality data to SRs, which will ultimately enhance the yield from secondary and tertiary orthodontic research., (Copyright © 2023 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Background: Conjunctivitis is a frequent symptom in pediatric emergency departments; however, the etiology of conjunctivitis is difficult to clinically differentiate., Objective: Our study objective was to evaluate the test performance characteristics of leukocyte esterase (LE) test strips in diagnosing bacterial conjunctivitis., Methods: Patients aged from 3 months through 21 years presenting to an emergency department with symptoms of conjunctivitis were prospectively enrolled from September 2018 to March 2020. A swab of the affected eye was applied to the LE test strip and another swab was sent for culture processing. The primary outcome was the association between LE test results and eye culture results., Results: We enrolled 189 patients. Overall, 117 eye cultures (62%) were positive. The sensitivity and specificity of LE testing was 96% (95% CI 90-98%) and 14% (95% CI 7-25%), respectively. Positive predictive value was 64% (95% CI 57-71%) and negative predictive value was 67% (95% CI 39-87%)., Conclusions: The LE test strip had limited ability to differentiate bacterial conjunctivitis from other etiologies., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Self-cues such as personal pronouns are known to elicit processing biases, such as attention capture and prioritisation in working memory. This may impact the performance of tasks that have a high attentional load like mathematical problem-solving. Here, we compared the speed and accuracy with which children solved numerical problems that included either the self-cue "you," or a different character name. First, we piloted a self-referencing manipulation with N  = 52, 7 to 11 year-olds, testing performance on addition and subtraction problems that had either a single referent ("You"/"Sam") or more than one referent. We took into account operation and positioning of the pronoun and also measured performance on attention and working memory tasks. We found a robust accuracy advantage for problems that included "you," regardless of how many characters were included. The accuracy advantage for problems with a self-pronoun was not statistically associated with individual differences in attention or working memory. In our main study (9 to 11 year-olds, N  = 144), we manipulated problem difficulty by creating consistently and inconsistently worded addition and subtraction problems. We found significantly higher speed and accuracy for problems that included "you." However, this effect varied by task difficulty, with the self-pronoun effect being strongest in the most difficult inconsistently worded, subtraction problems. The advantage of problems with a self-pronoun was not associated with individual differences in working memory. These findings suggest that self-cues like the pronoun "you" can be usefully applied in numerical processing tasks, an effect that may be attributable to the effects of self-cues on attention., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Orthognathic treatment is an important treatment modality to manage severe dentofacial discrepancies. Patients awaiting orthognathic surgery often experience increased anxiety, which may adversely affect post-operative recovery and treatment satisfaction. This study investigated the effects of a number of factors on pre-operative anxiety in orthognathic patients. Seventy patients prospectively recruited from three orthognathic centres in the UK completed a pre-operative questionnaire that included validated scales for measuring anxiety, social support, resilience, and coping styles. Sociodemographic data and satisfaction with the information provided by the clinical team were also elicited from the questionnaire. Univariable analysis showed that social support from a significant other ( p = 0.026), resilience ( p < 0.001), and satisfaction with the information provided by the clinical team ( p = 0.002) were significantly associated with reduced anxiety, whilst avoidance coping ( p < 0.001) and coping through seeking social support ( p = 0.006) were significantly related to increased anxiety. With the exception of coping by seeking social support, these relationships retained significance in a multivariable regression analysis. Neither gender nor ethnicity moderated the effects of social support on pre-operative anxiety. These findings suggest potential avenues for clinicians to address with future interventions to reduce pre-operative anxiety. Further qualitative research may provide greater clarity on the relationship between these variables and anxiety.

Pervasive gender gaps in academic subject and career choices are likely to be underpinned by social influences, including gender stereotypes of competence in academic and career domains (e.g., men excel at engineering, women excel at care), and model-based social learning biases (i.e., selective copying of particular individuals). Here, we explore the influence of gender stereotypes on social learning decisions in adolescent and adult males and females. Participants (Exp 1: N = 69 adolescents; Exp 2: N = 265 adults) were presented with 16 difficult multiple-choice questions from stereotypically feminine (e.g., care) and masculine (e.g., engineering) domains. The answer choices included the correct response and three incorrect responses paired with a male model, a female model, or no model. Participants' gender stereotype knowledge and endorsement were measured, and adolescents (Exp. 1) listed their academic subject choices. As predicted, there was a bias towards copying answers paired with a model (Exp.1: 74%, Exp. 2: 65% ps < .001). This resulted in less success than would be expected by chance (Exp. 1: 12%, Exp. 2: 16% ps < .001), demonstrating a negative consequence of social information. Adults (Exp 2) showed gender stereotyped social learning biases; they were more likely to copy a male model in masculine questions and a female model in feminine questions (p = .012). However, adolescents (Exp 1) showed no evidence of this stereotype bias; rather, there was a tendency for male adolescents to copy male models regardless of domain (p = .004). This own-gender bias was not apparent in female adolescents. In Exp 1, endorsement of masculine stereotypes was positively associated with selecting more own-gender typical academic subjects at school and copying significantly more male models in the male questions. The current study provides evidence for the first time that decision-making in both adolescence and adulthood is impacted by gender biases., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Cunningham et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Survival and reproduction of endotherms depend on their ability to balance energy and water exchange with their environment, avoiding lethal deficits and maximising gains for growth and reproduction. At high environmental temperatures, diurnal endotherms maintain body temperature (Tb) below lethal limits via physiological and behavioural adjustments. Accurate models of these processes are crucial for predicting effects of climate variability on avifauna. We evaluated the performance of a biophysical model (NicheMapR) for predicting evaporative water loss (EWL), resting metabolic rate (RMR) and Tb at environmental temperatures approaching or exceeding normothermic Tb for three arid-zone birds: southern yellow-billed hornbill (Tockus leucomelas), southern pied babbler (Turdoides bicolor) and southern fiscal (Lanius collaris). We simulated metabolic chamber conditions and compared model outputs with thermal physiology data collected at air temperatures (Tair) between 10 and 50°C. Additionally, we determined the minimum data needed to accurately model diurnal birds' thermoregulatory responses to Tair using sensitivity analyses. Predicted EWL, metabolic rate and Tb corresponded tightly with observed values across Tair, with only minor discrepancies for EWL in two species at Tair≈35°C. Importantly, the model captured responses at Tair=30-40°C, a range spanning threshold values for sublethal fitness costs associated with sustained hot weather in arid-zone birds. Our findings confirm how taxon-specific parameters together with biologically relevant morphological data can accurately model avian thermoregulatory responses to heat. Biophysical models can be used as a non-invasive way to predict species' sensitivity to climate, accounting for organismal (e.g. physiology) and environmental factors (e.g. microclimates)., Competing Interests: Competing interests The authors declare no competing or financial interests., (© 2023. Published by The Company of Biologists Ltd.)

Objective: To explore the experiences of young people and their parents regarding the impact on school performance due to time away from school for orthodontic appointments and to explore their views about a possible extension to the current service., Design: A qualitative study using semi-structured interviews., Setting: UK district hospitals., Participants: A total of 11 pairs of interviewees: young people undergoing fixed appliances and their parents., Methods: Semi-structured interviews were conducted with young people and their parents. The interviews were audio recorded and transcribed verbatim. A framework approach was used to analyse the data., Results: A thematic analysis of the data identified five main themes which were as follows: (1) expectations of the treatment process and appointments; (2) impact of school absences and treatment; (3) appointments; (4) implications for young people, parents and others; and (5) satisfaction with treatment. These themes were then further subdivided and analysed., Conclusion: Young people and their parents felt that attending appointments for orthodontic treatment had minimal impact on a young person's school performance. However, some young people did engage in coping mechanisms in order to ensure this was the case. Young people and their parents advised they were satisfied with the process of the treatment despite the time missed at school/work. Some young people and their parents saw a real benefit to appointments that could be fitted into a 'NHS seven-day' service model, but this did not apply to all interviewees.

Climate change and urbanisation are among the most pervasive and rapidly growing threats to biodiversity worldwide. However, their impacts are usually considered in isolation, and interactions are rarely examined. Predicting species' responses to the combined effects of climate change and urbanisation, therefore, represents a pressing challenge in global change biology. Birds are important model taxa for exploring the impacts of both climate change and urbanisation, and their behaviour and physiology have been well studied in urban and non-urban systems. This understanding should allow interactive effects of rising temperatures and urbanisation to be inferred, yet considerations of these interactions are almost entirely lacking from empirical research. Here, we synthesise our current understanding of the potential mechanisms that could affect how species respond to the combined effects of rising temperatures and urbanisation, with a focus on avian taxa. We discuss potential interactive effects to motivate future in-depth research on this critically important, yet overlooked, aspect of global change biology. Increased temperatures are a pronounced consequence of both urbanisation (through the urban heat island effect) and climate change. The biological impact of this warming in urban and non-urban systems will likely differ in magnitude and direction when interacting with other factors that typically vary between these habitats, such as resource availability (e.g. water, food and microsites) and pollution levels. Furthermore, the nature of such interactions may differ for cities situated in different climate types, for example, tropical, arid, temperate, continental and polar. Within this article, we highlight the potential for interactive effects of climate and urban drivers on the mechanistic responses of birds, identify knowledge gaps and propose promising future research avenues. A deeper understanding of the behavioural and physiological mechanisms mediating species' responses to urbanisation and rising temperatures will provide novel insights into ecology and evolution under global change and may help better predict future population responses., (© 2023 The Authors. Global Change Biology published by John Wiley & Sons Ltd.)

Purpose: Childhood cancer survivors report self-monitoring for and worrying about symptoms of disease recurrence and secondary cancers, although symptom-related worry is associated with poorer health-related quality of life. This survey captured pediatric oncologists' beliefs and communication practices regarding symptom self-monitoring for childhood cancer survivors., Methods: Using a closed-loop snowball sampling technique, pediatric oncologists completed an online survey regarding the importance of symptom self-monitoring for off-therapy patients, the degree to which symptom self-monitoring was perceived to cause stress and worry, and communication practices., Results: 196 pediatric oncologists (White [78%]; female [64%]; M age = 47 years) from every continent except Antarctica participated. Oncologists believed it is important for off-therapy patients to self-monitor for symptoms of cancer recurrence (90%) and treatment late effects (94%), although some noted that recurrence (30%) and late effects (55%) are typically detected by routine surveillance before symptoms appear. Oncologists varied in their beliefs that off-therapy patients do (31%) or do not (31%) worry unnecessarily about symptoms of recurrence. Two thirds (62%) of oncologists reported often/always discussing with off-therapy patients which symptoms could indicate cancer recurrence, whereas fewer than half (43%) often/always discussed which symptoms were unlikely to indicate recurrence. Oncologists identified a need for education regarding how to communicate around symptom self-monitoring and the potential utility of a screening tool to identify those who worry excessively., Conclusion: Despite nearly universal belief that their off-therapy patients should self-monitor for symptoms of disease recurrence and late effects, a substantial proportion of pediatric oncologists do not counsel patients on symptom self-monitoring. Since nearly one-third believe that off-therapy patients worry unnecessarily about symptoms of recurrence, improving patient education regarding which symptoms are and are not medically concerning could decrease stress and improve health-related quality of life for pediatric cancer survivors.

Animal tolerance towards humans can be a key factor facilitating wildlife-human coexistence, yet traits predicting its direction and magnitude across tropical animals are poorly known. Using 10,249 observations for 842 bird species inhabiting open tropical ecosystems in Africa, South America, and Australia, we find that avian tolerance towards humans was lower (i.e., escape distance was longer) in rural rather than urban populations and in populations exposed to lower human disturbance (measured as human footprint index). In addition, larger species and species with larger clutches and enhanced flight ability are less tolerant to human approaches and escape distances increase when birds were approached during the wet season compared to the dry season and from longer starting distances. Identification of key factors affecting animal tolerance towards humans across large spatial and taxonomic scales may help us to better understand and predict the patterns of species distributions in the Anthropocene., (© 2023. The Author(s).)

Cooperative breeding, where more than two individuals invest in rearing a single brood, occurs in many bird species globally and often contributes to improved breeding outcomes. However, high temperatures are associated with poor breeding outcomes in many species, including cooperative species. We used data collected over three austral summer breeding seasons to investigate the contribution that helpers make to daytime incubation in a cooperatively breeding species, the Southern Pied Babbler Turdoides bicolor , and the ways in which their contribution is influenced by temperature. Helpers spent a significantly higher percentage of their time foraging (41.8 ± 13.7%) and a significantly lower percentage of their time incubating (18.5 ± 18.8%) than members of the breeding pair (31.3 ± 11% foraging and 37.4 ± 15.7% incubating). In groups with only one helper, the helper's contribution to incubation was similar to that of breeders. However, helpers in larger groups contributed less to incubation, individually, with some individuals investing no time in incubation on a given observation day. Helpers significantly decrease their investment in incubation on hot days (>35.5°C), while breeders tend to maintain incubation effort as temperatures increase. Our results demonstrate that pied babblers share the workload of incubation unequally between breeders and helpers, and this inequity is more pronounced during hot weather. These results may help to explain why recent studies have found that larger group size does not buffer against the impacts of high temperatures in this and other cooperatively breeding species., Competing Interests: The authors declare there are no conflicts of interest. Data Availability: Analyses reported in this article can be reproduced using the data provided by Bourne et al. (2023)., (© The Author(s) 2023. Published by Oxford University Press on behalf of the International Society for Behavioral Ecology.)

Introduction: The need to extract permanent teeth as part of orthodontic treatment has been keenly debated over many decades. Changes in the frequency of extraction have been well documented; however, we continue to lack an understanding of what influences clinicians' decisions regarding extracting permanent teeth., Methods: Purposive sampling was undertaken to obtain representative views from primary care practitioners across Great Britain with a range of experience representing genders and wide geographic distribution. Twenty participants (9 female, 11 male) took part in in-depth, qualitative, 1-to-1 interviews based on a piloted topic guide. Interviews were conducted via video conferencing software with audio recording and verbatim transcription. Thematic analysis was performed with discussion and agreement to identify the main themes., Results: Five main themes were identified: (1) patient-related factors, such as age and features of the malocclusion, (2) operator factors, including the level of experience, (3) setting, with regard to geographic location and method of remuneration, (4) mechanical approaches, including variations in appliance systems; and (5) self-directed ongoing education, including both formal continuing professional development and informal learning from peers. These factors acted as barriers, enablers, or both in relation to nonextraction treatment., Conclusions: Five key influences on extraction decisions among orthodontists in Great Britain were identified. Extraction choices appear to be influenced by various interrelated factors, evolving over time and with increased experience., (Copyright © 2022 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Pre-operative anxiety may adversely affect post-operative recovery and treatment satisfaction. This systematic review assessed the impact of social support on pre-operative anxiety in elective surgery patients. MEDLINE via Ovid, Embase, PsycINFO, Web of Science, CINAHL Plus, Emcare and LILACS were searched for publications (1950-2021). Fourteen studies were included for descriptive analysis and five for meta-analysis. The pooled estimate in the meta-analysis was r  = -0.372 (95% CI: -0.578 to -0.122). Stronger social support was weakly associated with reduced pre-operative anxiety, but the quality of available evidence was low. The findings suggest potential benefit in enhancing utilisation of support networks before elective surgery.

Mental distress in medical learners and its consequent harmful effects on personal and professional functioning, a well-documented concern, draws attention to the need for solutions. The authors review the development of a comprehensive mental health service within a large and complex academic medical education system, created with special attention to offering equitable, accessible, and responsive care to all trainees. From the inception of the service in January 2017, the authors placed particular emphasis on eliminating obstacles to learners' willingness and ability to access care, including concerns related to cost, session limits, privacy, and flexibility with modality of service delivery. Development of outreach initiatives included psychoeducational programming, consultation services, and cultivation of liaison relationships with faculty and staff. Significant utilization of clinical services occurred in the first year of the program and increased further over the course of 4 academic years (2017-2021); with a 2.2 times increase in trainees served and a 2.4 times increase in visits annually. In the 2020-2021 academic year, 821 medical learners received services (for a total 5,656 visits); 30% of all medical students and 25% of house staff and fellows sought treatment in that year. In 2021, 38% of graduating medical school students and 27% of graduating residents and fellows had used mental health services at some point in their training. Extensive use of services combined with very high patient satisfaction ratings by medical learners within this system demonstrate the perceived value of these services and willingness to pursue mental health care when offered a resource that is cognizant of, and responsive to, their unique needs. The authors reflect on potential factors promoting utilization of services-institutional financial support, outreach efforts, and design of services to increase accessibility and reduce barriers to seeking treatment-and propose future areas for investigation., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Association of American Medical Colleges.)

The current study demonstrates the abolishment of the Ownership Self Reference Effect (OSRE) when elaborate details of a distant other-referent are provided. In a 2 (High versus Low information) × 2 (Self versus Other) experimental design, we tested the capacity for the SRE to be modulated with social saliency. Using a well-established ownership paradigm (Collard et al., 2020; Cunningham et al., 2008; Sparks et al., 2016), when the other was made socially salient (i.e. details and characteristics about the other were provided to the participant prior to encoding), no SRE emerged, such that self-owned and other-owned items were recalled with comparable accuracy. In contrast, when the other was not salient (i.e., no details about them were provided), participants accurately recalled a higher proportion of self-owned items, demonstrating a typical SRE in source memory. The degree of self- or other- referencing was not related to measured variables of closeness, similarity or shared traits with the other. Although the SRE is an established and robust effect, the findings of the current study illustrate critical circumstances in which the self is no longer prioritised above the other. In line with our predictions, we suggest that the self has automatic attributed social salience (e.g. through ownership) and that enhancing social salience by elaborating details of the other, prioritisation can expand to encapsulate an other beyond the self and influence incidental memory., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2022. Published by Elsevier Inc. All rights reserved.)

Ibises (order: Pelecaniformes, family: Threskiornithidae) are probe-foraging birds that use 'remote-touch' to locate prey items hidden in opaque substrates. This sensory capability allows them to locate their prey using high-frequency vibrations in the substrate in the absence of other sensory cues. Remote-touch is facilitated by a specialised bill-tip organ, comprising high densities of mechanoreceptors (Herbst corpuscles) embedded in numerous foramina in the beak bones. Each foramen and its associated Herbst corpuscles make up a sensory unit, called a 'sensory pit'. These sensory pits are densely clustered in the distal portion of the beak. Previous research has indicated that interspecific differences in the extent of sensory pitting in the beak bones correlate with aquatic habitat use of ibises, and have been suggested to reflect different levels of remote-touch sensitivity. Our study investigates the interspecific differences in the bone and soft tissue histology of the bill-tip organs of three species of southern African ibises from different habitats (mainly terrestrial to mainly aquatic). We analysed the external pitting pattern on the bones, as well as internal structure of the beak using micro-CT scans and soft tissue histological sections of each species' bill-tip organs. The beaks of all three species contain remote-touch bill-tip organs and are described here in detail. Clear interspecific differences are evident between the species' bill-tip organs, both in terms of bone morphology and soft tissue histology. Glossy Ibises, which forage exclusively in wetter substrates, have a greater extent of pitting but lower numbers of Herbst corpuscles in each pit, while species foraging in drier substrates (Hadeda and Sacred Ibises) have more robust beaks, fewer pits and higher densities of Herbst corpuscles. Our data, together with previously published histological descriptions of the bill-tip organs of other remote-touch foraging bird species, indicate that species foraging in drier habitats have more sensitive bill-tip organs (based on their anatomy). The vibrations produced by prey (e.g., burrowing invertebrates) travel poorly in dry substrates compared with wetter ones (i.e., dry soil vs. mud or water), and thus we hypothesise that a more sensitive bill-tip organ may be required to successfully locate prey in dry substrates. Furthermore, our results indicate that the differences in bill-tip organ anatomy between the species reflect complex trade-offs between morphological constraints of beak shape and remote-touch sensitivity requirements, both of which are likely related to each species' foraging behaviour and substrate usage. Our study suggests that structures in the bone of the bill-tip organ could provide valuable osteological correlates for the associated soft tissues, and consequently may provide information on the sensory ecology and habitat usage of the birds in the absence of soft tissues., (© 2022 The Authors. Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.)

Background: Anthropogenic food sources (AFSs) are widespread in human-transformed landscapes and the current scale at which they occur drives ecological change at the individual, population, and community levels. AFSs are exploited extensively by common ravens, Corvus corax. Understanding how raven populations use AFSs can provide insight into their ecological responses to AFSs., Methods: We equipped 81 ravens in the Austrian Alps with GPS-transmitters over a period of 2.75 years. Using these tracking data, we investigated how cohort differences (i.e., age, sex, and origin) and seasonal changes influence raven movement patterns (i.e., occurrence distribution and maximum daily displacement) and AFS-use (i.e., number of AFSs visited and probability of being present at any AFS) at 45 extensively exploited sites., Results: We found that proxies for experience and dominance, inferred by age (i.e., juvenile versus adult) and origin (i.e., wild-caught versus captive-bred-released) cohorts, influenced movement patterns and the number of AFSs visited. However, all individuals were equally likely to be present at AFSs, highlighting the importance of AFSs for non-breeders in the study population. Seasonal changes in environmental conditions that affect energetic demands, the availability of natural and anthropogenic food, and foraging competition,  influenced individuals' occurrence distributions and AFS-use. We found that under harsher conditions in autumn and winter, individuals ranged wider and depended on AFSs to a larger degree. However, contrary to expectation, they were less likely to be present at AFSs in these seasons compared to spring and summer, suggesting a trade-off between time spent moving and exploiting resources. We attribute the small ranging movements exhibited by non-breeders in spring and summer to the presence of highly territorial and socially dominant breeders. As breeders mostly stay and forage within their territories during these seasons, competition at AFSs decrease, thereby increasing the likelihood of individuals being present at any AFS., Conclusions: We emphasize that movement and AFS-use differ according to cohort differences and the seasonality of the environment. Our results highlight that predictable AFSs affect foraging strategies among non-breeding ravens. The extent of AFS-exploitation among non-breeding ravens in our study emphasize the potential of AFSs in shaping raven movement and resource-use., (© 2022. The Author(s).)

Objective: Scan-related anxiety ("scanxiety") refers to the fear, stress, and anxiety in anticipation of tests and scans in follow-up cancer care. This study assessed the feasibility of Ecological Momentary Assessment (EMA) for real-world, real-time capture of scanxiety using patients' personal smartphone., Methods: Adolescent and Young Adult survivors of childhood cancer were prompted to complete EMA surveys on a smartphone app three times per day for 11 days (33 surveys total) around their routine surveillance scans. Participants provided structured feedback on the EMA protocol., Results: Thirty out of 46 contacted survivors (65%) enrolled, exceeding the preregistered feasibility cutoff of 55%. The survey completion rate (83%) greatly exceeded the preregistered feasibility cutoff of 65%. Participants generally found the smartphone app easy and enjoyable to use and reported low levels of distress from answering surveys. Participants reported significantly more daily fear of cancer recurrence (FCR) and negative affect in the days before compared to the days after surveillance scans, aligning with the expected trajectory of scanxiety. Participants who reported greater FCR and scanxiety using comprehensive measures at baseline also reported significantly more daily FCR around their surveillance scans, indicating validity of EMA items. Bodily threat monitoring was prospectively and concurrently associated with daily FCR, thus warranting further investigation as a risk factor for scanxiety., Conclusions: Findings indicate the feasibility, acceptability, and validity of EMA as a research tool to capture the dynamics and potential risk factors for scanxiety., (© 2022 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.)