This qualitative study investigated academic challenges, supports and the role of readiness in academic adaptation of international students. 20 international students were recruited for data collection employing semi-structured interviews. The results showed that three types including academic challenges, socio-cultural challenges and language incompetency were affecting the academic adaptation process. In addition, three types of supports including university support, peer support and psychological motivation which helped international students cope with the challenges while readiness played a significant role in balancing challenges and supports. Pre-departure preparedness and on-campus orientation instilled readiness among international students. The study suggested that sending countries should make effective mechanism to prepare the students before their departure. It can include host country’s language, its education system, degree requirement, culture, climate and food etc. The study proposed theoretical model of academic adaptation of international students for future quantitative research.

Background Effectiveness of scaling and root planing (SRP) with/without adjunct probiotic (Lactobacillus reuteri) treatment towards the reduction in periodontal inflammatory parameters (clinical attachment loss [AL], marginal bone loss [MBL], plaque index [PI], and bleeding on probing [BOP] in shamma users and non‐users [controls] with chronic periodontitis [CP]) remains uninvestigated. The aim of the present randomized controlled trial was to compare the efficacy of SRP with and without adjunct probiotic therapy (PT) in the treatment of CP among shamma users and controls (individuals not using tobacco in any form). Methods The study was conducted in accordance with the Consolidated Standards of Reporting Trials guidelines. Patient demographics were recorded using a questionnaire. Therapeutically, patients were allotted into four groups as follows: 1) group 1: Shamma chewers that underwent SRP alone; 2) group 2: Shamma‐chewers that underwent SRP + PT; 3) group 3: Non‐chewers that underwent SRP alone; and 4) group 4: Non‐chewers that underwent SRP + PT. Periodontal parameters (PI, BOP, PD, clinical AL and mesial and distal MBL) were measured on all teeth except third molars at baseline and at 3‐ and 6‐month follow‐ups. Level of significance was set at P < 0.05. Results In total, 31, 32, 31, and 33 individuals were included in groups 1, 2, 3, and 4, respectively. Among shamma users, there was no significant difference in the scores of PI, BOP, PD, clinical AL and MBL when SRP was performed with/without adjunct PT. Amongst controls, SRP with adjunct PT was more effective in reducing PI (P < 0.05), BOP (P < 0.05) and PD (P < 0.05) at 3‐month follow‐up. There was no significant difference in periodontal parameters at 3‐ and 6‐month follow‐ups in patients that underwent SRP with and without adjunct PT. Conclusions Habitual shamma use compromises the outcome of SRP in patients with CP. Among patients that do not use any form of ST product, SRP is an effective treatment modality for the treatment of CP, and this relationship is independent of use of adjunct PT.

This article investigates acculturation stress among Pakistani students who are studying in Chinese universities, located in five provinces where international students are concentrated, with a mix-method approach. 203 students among 260 questionnaire recipients responded the online survey. When using the ASSIS (Acculturation Stress Scale for International Students) as instrument, the Principal Component Analysis Method and SPSS 20.0, we found that Pakistani students are under acculturative stress, 68.53%, 10.97% and 9.15% of them perceived discrimination, home sickness and perceived hate, and 5.25%, 3.11% and 2.58% of them fear, culture shock and guilt respectively. The qualitative segment of the study is consisted of 20 Pakistani students studying in 4 universities located in Wuhan city of Hubei capital enquiring through semi-structured interviews. The findings illustrate that Pakistani students in China are expressing their major concerns on culture shock, homesickness, food and language barriers while disconfirm ASSIS findings like perceived discrimination, hate, fear and guilt as factors responsible for acculturative stress. The study suggested that pre-departure orientation lectures about host country's cultural values and campus environment, and on-campus extra-curricular, cultural activities and maximum social interaction with local students can effectively acculturate students in new cultural setting, and can lower their acculturative stress.

ObjectivesEven though several effective vaccines are available to combat the COVID-19 pandemic, wide disparities in vaccine distribution, and vaccine acceptance rates between high- and low-income countries appear to be major threats toward achieving population immunity. Our global descriptive study aims to inform policymakers on factors affecting COVID-19 vaccine acceptance among healthcare workers (HCWs) in 12 countries, based on income index. We also looked for possible predictors of vaccine acceptance among the study sample.MethodsA structured questionnaire prepared after consultation with experts in the field and guided by the “Report of the SAGE working group on vaccine hesitancy” was administered among 2,953 HCWs. Upon obtaining informed consent, apart from demographic information, we collected information on trust in vaccines and health authorities, and agreement to accept a COVID-19 vaccine.ResultsAlthough 69% of the participants agreed to accept a vaccine, there was high heterogeneity in agreement between HCWs in low and lower-middle income countries (L-LMICs) and upper-middle- and high-income countries (UM-HICs), with acceptance rates of 62 and 75%, respectively. Potential predictors of vaccine acceptance included being male, 50 years of age or older, resident of an UM-HIC, updating self about COVID-19 vaccines, greater disease severity perception, greater anxiety of contracting COVID-19 and concern about side effects of vaccines.ConclusionsCOVID-19 vaccine acceptance among HCWs in L-LMICs was considerably low as compared to those from UM-HICs. The lowest vaccine acceptance rates were among HCWs from the African continent. This underlines the need for the implementation of country-specific vaccine promotion strategies, with special focus on increasing vaccine supply in L-LMICs.

Objective: The aim of this study was to evaluate factors affecting oral health related quality of life (OHRQoL) of patients using removable dental prosthesis. Methods: The present study employed a cross sectional analytical design. A total of 200 patients participated and interviewed using a cross sectional analytical design. In the first section of the questionnaire patients were asked about demographic data whereas the second part of the questionnaire assessed medical history, oral habits, smoking status, oral hygiene habits and frequency of dental visit. The questionnaire also collected information regarding patient’s removable prosthesis. Questionnaire of OHIP-DENT (Oral Health Impact Profile) was also employed to measure oral health quality of life (OHRQoL) on the domains of functional limitation (FL), physical pain (P1), psychological discomfort (P2), physical disability (D1), psychological disability (D2), social disability (D3) and handicap (H). Relationships between the demographic, socio-economic and education variables and others OHIP-EDENT scores were explored by comparing mean scores by applying ANOVA Results: The study participants comprised of 107 males (53.5%) and 93 females (46.5%). Regarding oral care, participants reporting to visit their dentist within one year were 40.0%. The highest score was recorded for the functional limitation (FL) domain (15.62±6.6), followed by social disability (D3) (15.23±5.06) and physical pain (P1) (14.28±4.8). The respective scores for physical (D1) and psychological disability (D2) and handicap (H) were 10.47±4.84, 11.32±5.38 and 12.45±4.50 respectively. Conclusions: Removable partial denture patients showed minimum problems with mastication, social compromise and functional discomfort. The oral health quality of life of removable denture patients is significantly influenced by patient education level, socio-economic status, medical conditions, smoking and tobacco use habits. doi: https://doi.org/10.12669/pjms.36.2.1257 How to cite this:Al-Deeb M, Abduljabbar T, Vohra F, Zafar MS, Hussain M. Assessment of factors influencing oral health-related quality of life (OHRQoL) of patients with removable dental prosthesis. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.1257 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Understanding business trails among promising aspirants may contribute to an actual motive for diminishing ecological tracks and escort to developing devotion toward deciding intentions across various entrepreneurial types and tiers solely from the sustainability domains. Therefore, this study endeavors to comprehend and seek to employ the Theory of Planned Behavior (TPB) to inspect the relationship between antecedents on sustainable enterprise intention and sustainable value creation. In this study, we used the convenience sampling method and the quantitative data of 1,070 respondents from Pakistan and China and applied a SmartPLS structural equation model and partial least square path modeling by mediational and multigroup analyses. Findings divulge that R2 (79.8%) value in the Pakistan sample of attitudes to sustainability, perceived entrepreneurial desirability (PED), and perceived entrepreneurial feasibility (PEF) was comparatively higher than in China. The R2 (75.6%) variance value on sustainable entrepreneurial intentions (SEI) was recorded higher in the Pakistani sample. However, the relationship of environmental values, self-efficacy, and extrinsic and intrinsic rewards show positive and significant mediational effects on both the economies of SEI. The findings disclosed an inconsistent character of extrinsic rewards, general self-efficacy, and job security depict negative significant impacts of aspirations on sustainable entrepreneurship (SE) among promising entrepreneurs on sustainability enterprises in both Pakistan and China. This study extends on existing entrepreneurship literature. Results supported the designed hypothesis and played a significant role in shedding light on an individual trait underpinning a career in a sustainable business start-up. The study looks at the issue from the viewpoint of sustainability domains. It seeks to determine the individual PED, PEF, and attitude toward sustainable entrepreneurship (ATSE) as the mediational variables. The study highlights the importance of work values in pursuing sustainability-oriented entrepreneurship programs for promising aspirants to improve their entrepreneurial skills and knowledge podium, which will encourage them to become sustainable future entrepreneurs. Furthermore, the study provides understandings for ratifying sustainable openings and debates the potential paths for sustainable business growth and opportunities among nascent entrepreneurs in both economies.

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