Objectives: Moral sensitivity and moral judgment are key factors influencing ethical decision-making in the clinical practice of dental hygienists. This study utilized a dilemma discussion in a dental hygiene ethics class to assess changes in the moral sensitivity and moral judgment of students and to examine the implications of these changes. Methods: The study included 46 sophomore students from the Department of Dental Hygiene who were enrolled in a dental hygiene ethics course during the second semester of 2021. The class employed the dilemma discussion method in the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model-based Development Beyond Learning (DBL) dental hygiene ethics curriculum. This approach aimed to help dental hygienists develop professional ethics and make sound ethical judgments. To evaluate the degree of change in moral perception before and after the dilemma discussion class, a predesigned questionnaire was administered twice—once in the first week and again in the 15th week of the course. Results: Moral sensitivity increased following the dental hygiene ethics course. Although moral judgement did no show a statistically significant change, students demonstrated a noticeable shift toward deeper consideration in their ethical reasoning. Conclusions Dental hygiene programs should explore diverse instructional designs and activities to foster ethical competencies. This study provides insights that may contribute to improving the ethical thinking skills of future dental hygienists.

Objective: To analyze costs and cost-effectiveness of transforaminal endoscopic thoracic discectomy (TETD) for the treatment of symptomatic thoracic disc herniation (TDH) and compare it with open microdiscectomy (MD). Methods: This retrospective cohort study included patients who underwent TETD or MD for symptomatic TDH and had a minimum follow-up of 1 year. Cost analysis included direct costs (primary and secondary hospital costs), indirect costs (lost wages due to work absence), total costs (direct + indirect), and cost-effectiveness (cost per quality-adjusted life year [QALY] and incremental cost-effectiveness ratio [ICER]). Clinical outcomes included patient-reported outcome measures (Oswestry Disability Index [ODI], 36-item Short Form health survey [SF-36]), QALY gained, and reoperation and readmission rates at 1 year. TETD and MD groups were compared for outcome measures. Results: A total of 111 patients (57 TETD, 54 MD) were included. The direct ($6,270 TETD vs. $7,410 MD, p < 0.01), indirect costs ($1,250 TETD vs. $1,450 MD, p < 0.01), total costs ($7,520 TETD vs. $8,860 MD, p < 0.01), and cost per QALY ($31,333 TETD vs. $44,300 MD, p < 0.01) were significantly lower for TETD compared to MD. ICER of TETD was found to be -$33,500. At 1 year, TETD group showed significantly greater improvement in ODI (46% vs. 36%, p < 0.01) and SF-36 (64% vs. 53%, p < 0.01) and significantly greater QALY gained (0.24 vs. 0.2, p < 0.01) compared to MD group. No significant difference was found in reoperation and readmission rates. Conclusion TETD demonstrated significantly better clinical outcomes, lower overall costs, and better cost-effectiveness than MD in appropriately selected patients of symptomatic TDH.

Objective: To analyze costs and cost-effectiveness of transforaminal endoscopic thoracic discectomy (TETD) for the treatment of symptomatic thoracic disc herniation (TDH) and compare it with open microdiscectomy (MD). Methods: This retrospective cohort study included patients who underwent TETD or MD for symptomatic TDH and had a minimum follow-up of 1 year. Cost analysis included direct costs (primary and secondary hospital costs), indirect costs (lost wages due to work absence), total costs (direct + indirect), and cost-effectiveness (cost per quality-adjusted life year [QALY] and incremental cost-effectiveness ratio [ICER]). Clinical outcomes included patient-reported outcome measures (Oswestry Disability Index [ODI], 36-item Short Form health survey [SF-36]), QALY gained, and reoperation and readmission rates at 1 year. TETD and MD groups were compared for outcome measures. Results: A total of 111 patients (57 TETD, 54 MD) were included. The direct ($6,270 TETD vs. $7,410 MD, p < 0.01), indirect costs ($1,250 TETD vs. $1,450 MD, p < 0.01), total costs ($7,520 TETD vs. $8,860 MD, p < 0.01), and cost per QALY ($31,333 TETD vs. $44,300 MD, p < 0.01) were significantly lower for TETD compared to MD. ICER of TETD was found to be -$33,500. At 1 year, TETD group showed significantly greater improvement in ODI (46% vs. 36%, p < 0.01) and SF-36 (64% vs. 53%, p < 0.01) and significantly greater QALY gained (0.24 vs. 0.2, p < 0.01) compared to MD group. No significant difference was found in reoperation and readmission rates. Conclusion TETD demonstrated significantly better clinical outcomes, lower overall costs, and better cost-effectiveness than MD in appropriately selected patients of symptomatic TDH.

Objective: To analyze costs and cost-effectiveness of transforaminal endoscopic thoracic discectomy (TETD) for the treatment of symptomatic thoracic disc herniation (TDH) and compare it with open microdiscectomy (MD). Methods: This retrospective cohort study included patients who underwent TETD or MD for symptomatic TDH and had a minimum follow-up of 1 year. Cost analysis included direct costs (primary and secondary hospital costs), indirect costs (lost wages due to work absence), total costs (direct + indirect), and cost-effectiveness (cost per quality-adjusted life year [QALY] and incremental cost-effectiveness ratio [ICER]). Clinical outcomes included patient-reported outcome measures (Oswestry Disability Index [ODI], 36-item Short Form health survey [SF-36]), QALY gained, and reoperation and readmission rates at 1 year. TETD and MD groups were compared for outcome measures. Results: A total of 111 patients (57 TETD, 54 MD) were included. The direct ($6,270 TETD vs. $7,410 MD, p < 0.01), indirect costs ($1,250 TETD vs. $1,450 MD, p < 0.01), total costs ($7,520 TETD vs. $8,860 MD, p < 0.01), and cost per QALY ($31,333 TETD vs. $44,300 MD, p < 0.01) were significantly lower for TETD compared to MD. ICER of TETD was found to be -$33,500. At 1 year, TETD group showed significantly greater improvement in ODI (46% vs. 36%, p < 0.01) and SF-36 (64% vs. 53%, p < 0.01) and significantly greater QALY gained (0.24 vs. 0.2, p < 0.01) compared to MD group. No significant difference was found in reoperation and readmission rates. Conclusion TETD demonstrated significantly better clinical outcomes, lower overall costs, and better cost-effectiveness than MD in appropriately selected patients of symptomatic TDH.

Objectives: Moral sensitivity and moral judgment are key factors influencing ethical decision-making in the clinical practice of dental hygienists. This study utilized a dilemma discussion in a dental hygiene ethics class to assess changes in the moral sensitivity and moral judgment of students and to examine the implications of these changes. Methods: The study included 46 sophomore students from the Department of Dental Hygiene who were enrolled in a dental hygiene ethics course during the second semester of 2021. The class employed the dilemma discussion method in the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model-based Development Beyond Learning (DBL) dental hygiene ethics curriculum. This approach aimed to help dental hygienists develop professional ethics and make sound ethical judgments. To evaluate the degree of change in moral perception before and after the dilemma discussion class, a predesigned questionnaire was administered twice—once in the first week and again in the 15th week of the course. Results: Moral sensitivity increased following the dental hygiene ethics course. Although moral judgement did no show a statistically significant change, students demonstrated a noticeable shift toward deeper consideration in their ethical reasoning. Conclusions Dental hygiene programs should explore diverse instructional designs and activities to foster ethical competencies. This study provides insights that may contribute to improving the ethical thinking skills of future dental hygienists.

Objectives: Moral sensitivity and moral judgment are key factors influencing ethical decision-making in the clinical practice of dental hygienists. This study utilized a dilemma discussion in a dental hygiene ethics class to assess changes in the moral sensitivity and moral judgment of students and to examine the implications of these changes. Methods: The study included 46 sophomore students from the Department of Dental Hygiene who were enrolled in a dental hygiene ethics course during the second semester of 2021. The class employed the dilemma discussion method in the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model-based Development Beyond Learning (DBL) dental hygiene ethics curriculum. This approach aimed to help dental hygienists develop professional ethics and make sound ethical judgments. To evaluate the degree of change in moral perception before and after the dilemma discussion class, a predesigned questionnaire was administered twice—once in the first week and again in the 15th week of the course. Results: Moral sensitivity increased following the dental hygiene ethics course. Although moral judgement did no show a statistically significant change, students demonstrated a noticeable shift toward deeper consideration in their ethical reasoning. Conclusions Dental hygiene programs should explore diverse instructional designs and activities to foster ethical competencies. This study provides insights that may contribute to improving the ethical thinking skills of future dental hygienists.

Objective: To analyze costs and cost-effectiveness of transforaminal endoscopic thoracic discectomy (TETD) for the treatment of symptomatic thoracic disc herniation (TDH) and compare it with open microdiscectomy (MD). Methods: This retrospective cohort study included patients who underwent TETD or MD for symptomatic TDH and had a minimum follow-up of 1 year. Cost analysis included direct costs (primary and secondary hospital costs), indirect costs (lost wages due to work absence), total costs (direct + indirect), and cost-effectiveness (cost per quality-adjusted life year [QALY] and incremental cost-effectiveness ratio [ICER]). Clinical outcomes included patient-reported outcome measures (Oswestry Disability Index [ODI], 36-item Short Form health survey [SF-36]), QALY gained, and reoperation and readmission rates at 1 year. TETD and MD groups were compared for outcome measures. Results: A total of 111 patients (57 TETD, 54 MD) were included. The direct ($6,270 TETD vs. $7,410 MD, p < 0.01), indirect costs ($1,250 TETD vs. $1,450 MD, p < 0.01), total costs ($7,520 TETD vs. $8,860 MD, p < 0.01), and cost per QALY ($31,333 TETD vs. $44,300 MD, p < 0.01) were significantly lower for TETD compared to MD. ICER of TETD was found to be -$33,500. At 1 year, TETD group showed significantly greater improvement in ODI (46% vs. 36%, p < 0.01) and SF-36 (64% vs. 53%, p < 0.01) and significantly greater QALY gained (0.24 vs. 0.2, p < 0.01) compared to MD group. No significant difference was found in reoperation and readmission rates. Conclusion TETD demonstrated significantly better clinical outcomes, lower overall costs, and better cost-effectiveness than MD in appropriately selected patients of symptomatic TDH.

Objectives: Moral sensitivity and moral judgment are key factors influencing ethical decision-making in the clinical practice of dental hygienists. This study utilized a dilemma discussion in a dental hygiene ethics class to assess changes in the moral sensitivity and moral judgment of students and to examine the implications of these changes. Methods: The study included 46 sophomore students from the Department of Dental Hygiene who were enrolled in a dental hygiene ethics course during the second semester of 2021. The class employed the dilemma discussion method in the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model-based Development Beyond Learning (DBL) dental hygiene ethics curriculum. This approach aimed to help dental hygienists develop professional ethics and make sound ethical judgments. To evaluate the degree of change in moral perception before and after the dilemma discussion class, a predesigned questionnaire was administered twice—once in the first week and again in the 15th week of the course. Results: Moral sensitivity increased following the dental hygiene ethics course. Although moral judgement did no show a statistically significant change, students demonstrated a noticeable shift toward deeper consideration in their ethical reasoning. Conclusions Dental hygiene programs should explore diverse instructional designs and activities to foster ethical competencies. This study provides insights that may contribute to improving the ethical thinking skills of future dental hygienists.

Objective: To analyze costs and cost-effectiveness of transforaminal endoscopic thoracic discectomy (TETD) for the treatment of symptomatic thoracic disc herniation (TDH) and compare it with open microdiscectomy (MD). Methods: This retrospective cohort study included patients who underwent TETD or MD for symptomatic TDH and had a minimum follow-up of 1 year. Cost analysis included direct costs (primary and secondary hospital costs), indirect costs (lost wages due to work absence), total costs (direct + indirect), and cost-effectiveness (cost per quality-adjusted life year [QALY] and incremental cost-effectiveness ratio [ICER]). Clinical outcomes included patient-reported outcome measures (Oswestry Disability Index [ODI], 36-item Short Form health survey [SF-36]), QALY gained, and reoperation and readmission rates at 1 year. TETD and MD groups were compared for outcome measures. Results: A total of 111 patients (57 TETD, 54 MD) were included. The direct ($6,270 TETD vs. $7,410 MD, p < 0.01), indirect costs ($1,250 TETD vs. $1,450 MD, p < 0.01), total costs ($7,520 TETD vs. $8,860 MD, p < 0.01), and cost per QALY ($31,333 TETD vs. $44,300 MD, p < 0.01) were significantly lower for TETD compared to MD. ICER of TETD was found to be -$33,500. At 1 year, TETD group showed significantly greater improvement in ODI (46% vs. 36%, p < 0.01) and SF-36 (64% vs. 53%, p < 0.01) and significantly greater QALY gained (0.24 vs. 0.2, p < 0.01) compared to MD group. No significant difference was found in reoperation and readmission rates. Conclusion TETD demonstrated significantly better clinical outcomes, lower overall costs, and better cost-effectiveness than MD in appropriately selected patients of symptomatic TDH.

Objectives: As community-oriented public health in oral healthcare for older adults becomes increasingly emphasized, research into community-based oral function rehabilitation interventions is emerging. This study examined the feasibility of community adoption of a previously developed oral function rehabilitation exercise program using an expert-crafted Delphi survey. Methods: An eight-expert panel was formed to develop a Delphi survey instrument and conduct a survey based on the results of previous studies. To test the community applicability of oral function rehabilitation exercises derived from this systematic review, we asked questions related to ‘independent performance’, ‘education applicability for caregivers’, ‘facility program applicability’, ‘intervention methods’, and ‘outcome indicators’. Results: Except for ‘pharyngeal exercise’ and ‘salivation exercise’, the five main exercises met the validity criteria for ‘independent performance’, ‘education applicability for caregivers’, and ‘facility program applicability’. The validity of dental hygienists as intervention providers obtained consensus from the experts with a CVR value of 0.75 or higher, an agreement of 0.75-0.85, and a convergence of 0.5. Conclusions The application of oral function rehabilitation exercises in a community setting is feasible, and the dental community should be willing to promote it so that it can be provided to many community-dwelling older adults in the future. In addition, the use of dental hygienists as intervention providers is appropriate. However, their training as intervention providers for oral function rehabilitation exercises may need to be strengthened.