The aim of this study was to systematically review the available literature on the levels, causes, and impact of stress among dental students. The investigators searched eight electronic databases: Medline, Medline in process, Psychinfo, ERIC, Embase, Cochrane Library, Web of Science, and SCOPUS. Two independent reviewers conducted the selection, data extraction, and quality appraisal for included studies. The investigators then coded both quantitative and qualitative studies using similar codes and pooled results from studies that used the Dental Environment Stress questionnaire to demonstrate dental students' stress levels. The search initially identiied 4,720 studies, of which 124 studies were included in the inal qualitative synthesis and twenty-one were included in the meta-analysis. Evidence from this research showed that dental students experience considerable amounts of stress during their training. This stress is mainly due to the demanding nature of the training. In addition, studies suggest adverse effects of elevated stress on students' health and well-being. Most of the available literature is based on crosssectional studies; thus, future longitudinal studies are needed to follow students throughout their curriculum. In addition, further research needs to explore and test stress management interventions.
Purpose A government website is considered as an electronic government service delivery system (eGSDS). The authors look at this eGSDS from its process point of view. This study aims to expand the existing knowledge of e-government adoption, and to identify the significance of eGSDS process to user satisfaction. Design/methodology/approach This study uses a quantitative technique using data collected from 197 respondents. Structure equation modeling has been used to test the model and the proposed hypotheses. Findings The findings indicate that as the eGSDS process improves, a user’s perception of the government website’s ease of use increases, leading to increased perceived usefulness, which increases user satisfaction. The findings also indicate that eGSDS process has a significant impact on perceived usefulness and user satisfaction. This study provides evidence that the technological capabilities embedded in the government website processes are an important factor in determining e-government service quality and ultimately e-government user satisfaction. Research limitations/implications The sample used was sufficient for this study and allowed reasonable conclusions to be drawn, but cannot be considered representative of all e-government users in India. Further research may help to validate the findings and generalize the results to a wider population. This study extends the current literature that looks at e-government adoption. Academicians and information systems researchers may use these findings for further research. Practical implications The research provides evidence that the technological capabilities embedded in the eGSDS process are critical in adopting e-government services. Government or concerned agencies may consider eGSDS process attributes (e.g. navigation, searching and transacting) while designing e-government service to give improved experience to its user. Originality/value E-government websites have become an important point of contact with citizens for many public services. However, more study is needed to understand how Web-based technological capabilities of e-government services affect user satisfaction. This study is an attempt to explore the impact of the eGSDS process on e-government user satisfaction.
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains are increasingly recovered from nosocomial settings. We conducted a retrospective study of surgical site infections (SSI) during 2004 and 2005 to determine the prevalence of CA-MRSA; 57% of MRSA strains tested belonged to the USA300 genotype. CA-MRSA has become a prominent cause of SSI at our institution.
BackgroundPredictors of adverse events (AE) associated with nevirapine use are needed to better understand reports of severe rash or liver enzyme elevation (LEE) in HIV+ women.MethodologyAE rates following ART initiation were retrospectively assessed in a multi-site cohort of 612 women. Predictors of onset of rash or LEE were determined using univariate and multivariate analyses.Principal FindingsOf 612 subjects, 152 (24.8%) initiated NVP-based regimens with 86 (56.6%) pregnant; 460 (75.2%) initiated non-NVP regimens with 67 (14.6%) pregnant.LEENo significant difference was found between regimens in the development of new grade ≥2 LEE (p = 0.885). Multivariate logistic regression demonstrated an increased likelihood of LEE with HCV co-infection (OR 2.502, 95% CI: 1.04 to 6, p = 0.040); pregnancy, NVP-based regimen, and baseline CD4 >250 cells/mm3 were not associated with this toxicity.RashNVP initiation was associated with rash after controlling for CD4 and pregnancy (OR 2.78; 95%CI: 1.14–6.76), as was baseline CD4 >250 cells/mm3 when controlling for pregnancy and type of regimen (OR 2.68; 95% CI: 1.19–6.02 p = 0.017).ConclusionsCD4 at initiation of therapy was a predictor of rash but not LEE with NVP use in HIV+ women. Pregnancy was not an independent risk factor for the development of AEs assessed. The findings from this study have significant implications for women of child-bearing age initiating NVP-based ART particularly in resource limited settings. This study sheds more confidence on the lack of LEE risk and the need to monitor rash with the use of this medication.
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