Background Obstructive sleep apnea syndrome is a common disorder characterized by repeated upper airway obstruction during sleep. Oral appliance therapy is a noninvasive treatment option commonly recommended for patients who are intolerant to continuous positive airway pressure. This study aimed to evaluate the treatment outcomes of oral appliance therapy in patients with obstructive sleep apnea syndrome and to examine the relationship between therapeutic effectiveness and patient characteristics, including age, disease severity, and body mass index.

Methods A total of 42 patients diagnosed with obstructive sleep apnea syndrome and treated with oral appliance therapy were retrospectively analyzed. The treatment effect was assessed using the apnea–hypopnea index measured before and after therapy (by polysomnography or portable monitoring). Effective treatment was defined as a post-treatment apnea–hypopnea index of <15 events per hour and a ≥ 50% reduction from baseline.

Results The mean apnea–hypopnea index decreased significantly from 27.6 ± 15.7 to 10.3 ± 8.7 events per hour following oral appliance therapy, with a mean improvement in AHI of 59.6%. Effectiveness was achieved in 66.7% of patients. A significant overall improvement was observed. Reductions in the apnea–hypopnea index were seen across age, severity, and body mass index (BMI) strata. However, only three patients had BMI ≥30 kg/m²; hence, BMI-stratified findings for this subgroup are descriptive and no inferential testing was conducted.

Conclusion Oral appliance therapy was effective in reducing the apnea–hypopnea index in a broad range of patients, including those traditionally considered less responsive because of advanced age, obesity, or severe disease. These findings suggest a potential role for oral appliance therapy as an alternative to continuous positive airway pressure treatment within the examined strata (age, severity, and BMI), particularly when continuous positive airway pressure therapy is not feasible. Larger prospective studies are warranted.

Background In Indonesia, stunting remains a health issue among children aged < 5 years, with a prevalence of 36.8% in 2021, the highest prevalence of malnutrition in the said age group, and the quality of drinking water consumed being one of the main causes. This study aimed to identify the quality of drinking water and determine the risk factors for stunting.

Methods This study was conducted at four Primary Health Care work areas in an urban city between July and October 2022 using a cross-sectional study design with 172 under-fives, 106 of whom had drinking water-related stunting. The sampling methods employed were two-stage, including cluster and purposive sampling. Data collection included anthropometric measurements, interviews, and collecting drinking water samples. This study used the logistic regression test for multivariate analysis.

Results The results showed that 93.6% of the drinking water was positive for microbiological agents, whereas analysis of heavy metals in drinking water revealed concentrations within acceptable limits as defined by standard drinking water quality regulations. Multivariate analysis showed that exposure to microbiologically contaminated drinking water was significantly associated with a higher risk of stunting. Children exposed to contaminated drinking water had a 3.3 times higher risk of stunting (OR 3.328; 95% CI 1.681–6.587). Additional confounding factors such as children over 23 months of age, history of infectious disease, low birth weight, and poor hygiene practices also contributed to increased stunting risk.

Conclusion This study highlights the significant role of drinking water quality in the incidence of stunting among children under five. The high prevalence of microbiological contamination in household drinking water was strongly associated with increased stunting risk. Children exposed to contaminated water were over three times more likely to experience stunting. While concentrations of heavy metals remained within safe limits, additional confounding factors including child age, history of infectious disease, low birth weight, and poor hygiene practices further exacerbated the risk. These findings underscore the urgent need for integrated public health interventions focusing on water safety, hygiene education, and early childhood care to effectively reduce stunting prevalence in urban communities.

Background A shared sense of professionalism among healthcare professionals enhances team-based care through interprofessional collaboration. This study aimed to develop a reliable and valid scale for assessing healthcare professionals’ professionalism.

Methods This study targeted 1,162 healthcare professionals aged ≥ 20 years, including physicians, dentists, nurses, pharmacists, clinical laboratory technologists, radiologic technologists, physical therapists, occupational therapists, and speech-language-hearing therapists. A preliminary 90-item scale was developed, and an anonymous self-administered questionnaire survey was conducted. Construct validity was examined through item, exploratory, and confirmatory factor analyses. Reliability and criterion-related validity were assessed using Cronbach’s alpha coefficient and Pearson’s correlation analyses, respectively.

Results A lot of 393 responses were received (response rate: 33.8%). Responses from 347 participants without missing data were analyzed (valid response rate: 88.3%). Item and exploratory factor analyses produced a preliminary model of 36 items across five factors: Factor 1, “Practice Based on Advanced Skills and Knowledge;” Factor 2, “Understanding Patients and Their Surrounding Environment;” Factor 3, “Contribution to Health, Medical, and Welfare Policy;” Factor 4, “Implementation of Team-Based Medical Care;” and Factor 5, “Adherence to Ethics.” Confirmatory factor analysis and model modifications were conducted based on the modification indices in collaboration with three researchers. Finally, a five-factor model consisting of 32 items was constructed. The model fit indices were as follows: comparative fit index = 0.885, goodness of fit index = 0.764, adjusted goodness of fit index = 0.731, and root mean square error of approximation = 0.085. Cronbach’s alpha coefficient for the entire scale was 0.972, ranging from 0.884 to 0.950 across the five factors. The correlation coefficient between the model and the Vocational Identity Scale for Company Employees was 0.355.

Conclusion The findings provide evidence for the reliability and validity of the scale for healthcare professionals.

Background COVID-19 pandemic-related changes have increased mental health problems of essential workers. However, little is known about its impact on direct support professionals (DSPs) working at facilities for people with disabilities. This study examined the resilience and related factors, including psychological distress, burnout, depression, among DSPs working during the COVID-19 pandemic, including those in facility with cluster occurrences in Japan.

Methods We conducted an online survey from May 18 to June 9, 2021, targeting staff at Social Welfare Corporation Shirane Gakuen, a cluster facility. An additional survey was conducted on May 24, 2021, through Yahoo! Crowd Sourcing, targeting individuals who worked at disability support facilities categorized as non-cluster facilities. We obtained 108 and 95 responses, respectively, including 76 and 16 DSPs. The following instruments were used: Maslach Burnout Inventory-General Survey, Bidimensional Resilience Scale, Kessler 6-item Psychological Distress Scale, and Patient Health Questionnaire-9. Multiple regression analysis was conducted to examine associations between resilience and related factors.

Results The prevalence of severe psychological distress, burnout, and depression among DSPs within the COVID-19 cluster facility was 11.8%, 69.7%, and 29.0%, respectively. In the non-cluster facilities, the prevalence was 37.5%, 68.8%, and 62.5%, respectively. A positive association between acquired resilience factors and burnout was observed (coefficient = 2.35, 95% CI 0.38 to 4.31). However, no significant association was observed between acquired resilience factors and the interaction term of COVID-19 cluster occurrences at the workplace and burnout (coefficient = –2.03, 95% CI –6.97 to 2.90).

Conclusion This study demonstrated that the acquired resilience factors of Japanese DSPs was linked with increased burnout during the COVID-19 pandemic, regardless of the COVID-19 cluster occurrences. As burnout intensifies, DSPs may cultivate acquired resilience, and programs enhancing these factors may help alleviate their burnout and promote well-being.