title: Effect of magnification loupes on dental hygiene student posture. Rayyan—a web and mobile app for systematic reviews Evaluation of ergonomic factors and postures that cause muscle pains in dentistry students’ bodies Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study Working postures of dentists and dental hygienists. The effect of magnification loupes on the performance of preclinical dental students. Assessment of dental student posture in two seating conditions using RULA methodology – a pilot study Assessment of study quality for systematic reviews: a comparison of the Cochrane Collaboration Risk of Bias Tool and the Effective Public Health Practice Project Quality Assessment Tool: methodological research. Effect of magnification lenses on student operator posture. Work-related musculoskeletal disorders among Brazilian dental students.
abstract: The chair-side work posture of dental hygienists has long been a concern because of health-related problems potentially caused or exacerbated by poor posture . The purpose of this study was to investigate if using magnification loupes improved dental hygiene students ' posture during provision of treatment . The treatment chosen was h and -scaling , and the effect of the timing of introduction of the loupes to students was also examined . Thirty-five novice dental hygiene students took part in the study . Each student was assessed providing dental hygiene care with and without loupes , thus controlling for innate differences in natural posture . Students were r and omized into two groups . Group one used loupes in the first session and did not use them for the second session . Group two reversed this sequence . At the end of each session , all students were videotaped while performing scaling procedures . Their posture was assessed using an adapted version of Branson et al. 's Posture Assessment Instrument ( PAI ) . Four raters assessed students at three time periods for nine posture components on the PAI . A paired t-test compared scores with and without loupes for each student . Scores showed a significant improvement in posture when using loupes ( p<0.0001 ) , and these improvements were significantly more pronounced for students starting loupes immediately on entering the program compared with students who delayed until the second session ( p<0.1 ) . These results suggest a significant postural benefit is realized by requiring students to master the use of magnification loupes as early as possible within the curriculum Background Synthesis of multiple r and omized controlled trials ( RCTs ) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions . Filtering of search es is time consuming , and no single method fulfills the principal requirements of speed with accuracy . Automation of systematic review s is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making . We developed Rayyan ( http://rayyan.qcri.org ) , a free web and mobile app , that helps expedite the initial screening of abstract s and titles using a process of semi-automation while incorporating a high level of usability . For the beta testing phase , we used two published Cochrane review s in which included studies had been selected manually . Their search es , with 1030 records and 273 records , were uploaded to Rayyan . Different features of Rayyan were tested using these two review s. We also conducted a survey of Rayyan ’s users and collected feedback through a built-in feature . Results Pilot testing of Rayyan focused on usability , accuracy against manual methods , and the added value of the prediction feature . The “ taster ” review ( 273 records ) allowed a quick overview of Rayyan for early comments on usability . The second review ( 1030 records ) required several iterations to identify the previously identified 11 trials . The “ suggestions ” and “ hints , ” based on the “ prediction model , ” appeared as testing progressed beyond five included studies . Post rollout user experiences and a reflexive response by the developers enabled real-time modifications and improvements . The survey respondents reported 40 % average time savings when using Rayyan compared to others tools , with 34 % of the respondents reporting more than 50 % time savings . In addition , around 75 % of the respondents mentioned that screening and labeling studies as well as collaborating on review s to be the two most important features of Rayyan . As of November 2016 , Rayyan users exceed 2000 from over 60 countries conducting hundreds of review s totaling more than 1.6 M citations . Feedback from users , obtained mostly through the app web site and a recent survey , has highlighted the ease in exploration of search es , the time saved , and simplicity in sharing and comparing include-exclude decisions . The strongest features of the app , identified and reported in user feedback , were its ability to help in screening and collaboration as well as the time savings it affords to users . Conclusions Rayyan is responsive and intuitive in use with significant potential to lighten the load of review ers Background Work-related musculoskeletal disorders commonly experienced by dental professionals are one of the main occupational health problem affecting their health and well-being . This study was conducted to evaluate  ergonomic factors and profession-related postures  and also investigate relationship between demographic factors and work condition with pain in dental students . Material and Methods 60 freshman and sophomore dentistry students were r and omly chosen as the subjects of control group , and 60 of 5th and 6th-year students were selected as the members of exposure group . Data related to the subjects such as sex , doing exercise , severity of musculoskeletal pain were obtained through question naire . Students ’ postures were directly observed while treating patients and they were scored by REBA method . Data were analyzed by SPSS software using Man-Whitney , Kruskal-Wallis , Spearman and Kendall correlation tests . Results 80.8 % of the subjects were not aware of the correct ergonomic postures for dental procedures . Severity of musculoskeletal pain in the exposure group ( 15.9± 4.2 ) was significantly higher than the control group ( 10.5 ±3.2 ) , ( p < 0.001 ) . Risk of the most subjects ( 84 % ) was at the medium level . Students who were more involved in clinical activities experienced more muscular pains . Conclusions The musculoskeletal disorders are probable prolonged in working hours in static positions , incorrect work postures , implying more force and even tools and instruments . Therefore , students who are aware of ergonomic principals of their own profession would be able to maintain their health through activities and lifelong . Key words : Posture , dentistry , students , musculoskeletal pain OBJECTIVE To study the relation between neck pain and work related neck flexion , neck rotation , and sitting . METHODS A prospect i ve cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies . Work related physical load was assessed by analysing objective ly measured exposure data ( video recordings ) of neck flexion , neck rotation , and sitting posture .  Neck pain was assessed by a question naire . Adjustments were made for various physical factors that were related or not related to work , psychosocial factors , and individual characteristics . RESULTS A significant positive relation was found between the percentage of the working time in a  sitting position  and neck pain , implying an increased risk of neck pain for workers who were sitting for more than 95 % of the working time ( crude relative risk ( RR ) 2.01 , 95 % confidence interval ( 95 % CI ) 1.04 to 3.88 ; adjusted RR 2.34 , 95 % CI 1.05 to 5.21 ) . A trend for a positive relation between neck flexion and neck pain was found , suggesting an increased risk of neck pain for people working with the neck at a minimum of 20 ° of flexion for more than 70 % of the working time ( crude RR 2.01 , 95 % CI 0.98 to 4.11 ; adjusted RR 1.63 , 95 % CI 0.70 to 3.82 ) . No clear relation was found between neck rotation and neck pain . CONCLUSION Sitting at work for more than 95 % of the working time seems to be a risk factor for neck pain and there is a trend for a positive relation between neck flexion and neck pain . No clear relation was found between neck rotation and neck pain A joint study was conducted by a manufacturer of dental stools in the Midwest of the United States and Marquette University to measure the occupational postures of dentists and dental hygienists . The postures of 10 dentists and 10 dental hygienists were assessed using work sampling and video techniques .  Postural data of the neck , shoulders and lower back were recorded from video and categorized into 30-degree intervals : o ( neutral posture of respective joint ) , 30 , 60 and 90 degrees . Each subject 's postures were observed while they were treating patients during a four-hour period , during which 100 observations of postures were recorded at r and om times . Compared to st and ing , dentists and dental hygienists were seated 78 percent and 66 percent of the time , respectively . Dentists and dental hygienists flexed their trunk at least 30 degrees more than 50 percent of the time . They flexed their neck at least 30 degrees 85 percent of the time during the four-hour duration , and their shoulders were elevated to the side of their trunk ( abducted ) at least 30 degrees more half of the time . The postures of the trunk , shoulders , and neck were primarily static . This data base of postures can be used by dental professionals and ergonomists to assess the risk dentists and dental hygienists are exposed to musculoskeletal disorders , such as low back pain or shoulder tenosynovitis , from deviated joint postures . They could use these data to select dental furniture or dental devices that promote good body posture , i.e. , reduce the magnitude and duration of deviated joint postures , which , in theory , would decrease the risk of musculoskeletal disorders OBJECTIVE optical magnifying devices such as magnification loupes are increasingly used in clinical practice and educational setting s. However , scientific evidence to vali date their benefits is limited . This study assessed the effect of dental magnification loupes on psychomotor skill acquisition during a pre clinical operative dentistry course . METHOD AND MATERIAL S the performance of first-year dental students was assessed during an Advanced Simulation Course ( AS ) using virtual reality-based technology ( VRBT ) training . The test group consisted of 116 dental students using magnification loupes ( + MAG ) , while students not using them ( -MAG , n = 116 ) served as the control . The following parameters were evaluated : number of successfully passing preparation procedures per course rotation , amount of time per tooth preparation , number of times students needed computer assistance and evaluation , and amount of time spent in the computer assistance and evaluation mode per procedure . Data were collected on each student through VRBT during the preparation procedure and stored on a closed network server computer . Unpaired t tests were used to analyze mean differences between the groups . In addition , student acceptance of magnification loupes was measured and evaluated through survey interpretation . RESULTS + MAG students completed more preparations , worked faster per procedure , and used the computer-assisted evaluation less frequently and for shorter periods , therefore displaying greater overall performance . The survey revealed a high degree of student acceptance of using magnification . CONCLUSION dental magnification loupes significantly enhanced student performance during pre clinical dental education and were considered an effective adjunct by the students who used them Objectives To assess dental students ' posture on two different seats in order to determine if one seat predisposes to a difference in working posture . Design A between-subject experimental design was selected . Setting The study was undertaken at the University of Birmingham School of Dentistry in 2006 . Subjects ( material s ) and methods Sixty second year dental students at the University of Birmingham who were attending their fi rst classes in the phantom head laboratory were r and omly selected and allocated to two different seats ( 30 Bambach Saddle Seats and 30 conventional seats ) . Students were trained in the use of the seats . After ten weeks , the students were observed , photographs were taken by the research er and these were assessed using Rapid Upper Limb Assessment ( RULA ) . Main outcome measures The posture of the students was assessed using the RULA . Each student was given a risk score . A Mann Whitney test was used for statistical analysis . Results The results indicated that the students using the conventional seat recorded signifi cantly higher risk scores ( p < 0.05 ) when compared with the students using Bambach Saddle Seat , suggesting an improvement in posture when using the Bambach Saddle Seat . Conclusion RULA has identifi ed that dental students using a Bambach Saddle Seat were able to maintain an acceptable working posture during simulated dental treatment and this seating may reduce the development of work-related musculoskeletal disorders BACKGROUND The Cochrane Collaboration is strongly encouraging the use of a newly developed tool , the Cochrane Collaboration Risk of Bias Tool ( CCRBT ) , for all review groups . However , the psychometric properties of this tool to date have yet to be described . Thus , the objective of this study was to add information about psychometric properties of the CCRBT including inter-rater reliability and concurrent validity , in comparison with the Effective Public Health Practice Project Quality Assessment Tool ( EPHPP ) . METHODS Both tools were used to assess the method ological quality of 20 r and omized controlled trials included in our systematic review of the effectiveness of knowledge translation interventions  to improve the management of cancer pain . Each study assessment was completed independently by two review ers using each tool . We analysed the inter-rater reliability of each tool 's individual domains , as well as final grade assigned to each study . RESULTS The EPHPP had fair inter-rater agreement for individual domains and excellent agreement for the final grade . In contrast , the CCRBT had slight inter-rater agreement for individual domains and fair inter-rater agreement for final grade . Of interest , no agreement between the two tools was evident in their final grade assigned to each study . Although both tools were developed to assess ' quality of the evidence ' , they appear to measure different constructs . CONCLUSIONS Both tools performed quite differently when evaluating the risk of bias or method ological quality of studies in knowledge translation interventions for cancer pain . The newly introduced CCRBT assigned these studies a higher risk of bias . Its psychometric properties need to be more thoroughly vali date d , in a range of research fields , to underst and fully how to interpret results from its application A distinct body of literature supports the association between clinical postures of the dental practitioner and work-related musculoskeletal disorders ( WRMD ) . Several aids or devices have been tested to improve clinical posture in the interest of decreasing WRMD . The use of magnification lenses while performing dental procedures may increase the quality of work and decrease the likelihood of musculoskeletal problems . To date , only anecdotal and personal opinions had existed regarding the benefits of using magnification lenses , and no empirical evidence had authenticated the contention that use of magnification lenses exerts a positive change in operator posture . The objective of this study was to assess the effect magnification lenses had on the posture of dental hygiene students . Using a r and omized crossover design , research ers videotaped nineteen senior dental hygiene students performing an intra-oral procedure with and without the use of magnification lenses . The tapes were then evaluated by a panel of five dental hygiene educators calibrated in the use of Branson 's Posture Assessment Instrument ( PAI ) . Results of a paired t-test indicate that the posture of the students while wearing magnification lenses was more acceptable ( p=.019 ) than when wearing traditional safety glasses . Results of this study indicate a quantifiable change in acceptability of posture for clinicians wearing magnification lenses  and suggest that the use of such lenses in dental education may be warranted The aim of this analytical cross-sectional study was to evaluate the presence of work-related musculoskeletal disorders ( WMSD ) among dental students in two Brazilian dental schools . The sample included 227 r and omized subjects from fifth to ninth semesters who were developing clinical activities . Each student signed an informed consent form . A self-reporting question naire was used to obtain data on the practice of physical exercise , the presence of pain during or soon after treating patients , and the adoption of preventive measures related to clinical activities . Results were analyzed using the Statistical Package for Social Sciences 13.0 . The chi(2 ) test was used to identify associations between variables . The presence of pain during or after clinical work was reported by 173 participants ( 76.2 percent ) . Statistically significant differences were found between gender and the occurrence of pain . Pain was present during clinical activities ( p=0.006 ) and imposed limitations on the work routine ( p=0.011 ) . Among those who practice d physical exercise , eighty-eight ( 74.6 percent ) reported pain . The high percentage of pain reported by dental students suggests the value of review ing work conditions in dental practice s in order to minimize the exposure of all workers to WMSD
target: CONCLUSIONS Based on a limited number of studies , the use of ergonomic saddle seats and dental loupes leads to improved working postures .
  The use of loupes appears to relieve shoulder , arm and h and pain .
  However , their effect on neck pain is scarce .
  None of the studies reported on the effect of the saddle seats on musculoskeletal pain .
background: OBJECTIVES Musculoskeletal disorders affect a high percentage of dentists , dental hygienists and therapists .
  Static and awkward working postures are considered as major risk factors .
  Proper seat selection and use of magnification loupes are promoted for their ergonomic benefits .
  The aim of this review was to evaluate the existing empirical evidence on the effect of the above interventions on ( i ) correction of poor posture and ( ii ) reduction in musculoskeletal pain .