Revista de Științe ale Sănătății din Moldova : Moldovan Journal of Health Sciences 2026 Vol. 13, Issue 1

Developing and validating a questionnaire on knowledge and attitudes in health research ethics

Thu, 01 Jan 2026 00:00:00 GMT

Developing and validating a questionnaire on knowledge and attitudes in health research ethics Paladi, Adriana; Mîța, Valentin; Șaptefrați, Lilian Introduction. Research ethics and integrity are fundamental for safeguarding human participants and ensuring trustworthy scientific practices. Understanding researchers’ knowledge, attitudes, and perceptions regarding ethical standards is important for all health researchers, but particularly relevant for early-career researchers. While several international instruments exist to evaluate specific aspects of research ethics, such as plagiarism, organizational climate, or responsible conduct of research, a multidimensional and contextually relevant tool is required. Materials and methods. A comprehensive questionnaire was developed to assess ethical knowledge, attitudes toward research resources and institutional integrity measures, and self-perceived ethical competencies among doctoral students in the health sciences. Item formulation was guided by international standards, including the Declaration of Helsinki, the European Code of Conduct for Research Integrity, and Good Clinical Practice guidelines. The development process included a content validity assessment by 10 experts and a psychometric evaluation of the collected data from 274 doctoral students. Exploratory factor analysis (EFA) was applied to determine the latent structure of the questionnaire, and internal consistency was assessed using Cronbach’s alpha. Results. EFA revealed a six-factor structure explaining 64.5% of the total variance. The factors measured: (I) perceived importance of research resources, (II) self-perceived ethical competencies, (III) implemented institutional measures for research integrity, (IV) ethical principles and moral responsibilities, (V) perceived accessibility of research resources, and (VI) importance of institutional integrity measures. Factor loadings were generally high, and internal consistency was good to excellent, with Cronbach’s alpha values ranging from 0.738 to 0.989. These findings indicate that the questionnaire captures multidimensional aspects of research ethics and integrity. Conclusions. The developed questionnaire represents a robust, valid, and reliable instrument for assessing ethical knowledge and attitudes among researchers in health sciences. It can serve as an internal audit tool to evaluate research integrity climate, researcher satisfaction with available resources, and implementation of institutional policies. Moreover, it provides a foundation for designing targeted training programs and professional development initiatives aimed at improving ethical competencies.

The role of odontogenic infection in the onset and evolution of focal disease

Thu, 01 Jan 2026 00:00:00 GMT

The role of odontogenic infection in the onset and evolution of focal disease Ciobanu, Sergiu; Marcu, Diana; Roman, Ion; Musteață, Olesea Introduction. The focal disease is a pathological condition characterized by a wide variety of functional disorders and organic tissue alterations, due to chronic foci of infection, from which various microbes, microbial toxins, and toxic products of septic tissue disintegration originate. According to the percentage distribution, 90% of the foci of the body are located in the cephalic region, and 10% in the rest of the body [17]. Research has shown that on the list of foci of infection, those in the oral cavity are in first place, with 93% of active foci being caused by teeth and their pathologies. Important clinical criteria that mark this fundamental difference of the odonto-periodontal focal infection include the profile of local inflammation, the level of the tissue hypersensitivity process, the level of the microbial load in the focus and, no less importantly, the reactivity of the body. Material and methods. The present study is a retrospective clinical observational study and included 87 patients with foci of odontogenic infection, classified according to the frequency of pathologies encountered and the virulence of microbial pathogens as follows: with periodontal disease - 35 patients (gingivitis - 11 patients and 24 patients with different stages of periodontitis); with endodontic pathologies - 27 patients (pulpitis - 5 patients and periapical lesions - periodontitis (Pt) - 22 patients); with dental caries of varying severity - 19 patients, and 6 patients with oral mucosa pathologies. Results. Through clinical observations, it was found that with the removal of the foci of infection, the “vegetative alarm symptoms” begin to disappear, some of them even very quickly, such as causeless fatigue. At the same time, symptoms that have been present for a longer period, such as long-term depressive states and memory disorders in patients with periodontal disease–particularly severe periodontitis with a major microbial load–and lesions of the oral mucosa, decreased more slowly, over a period of 1-3 months. The 100% disappearance of symptoms in the case of carious lesions and oral mucosa lesions demonstrates the direct relationship between the foci of infection and the patient’s general health. In relation to periodontal disease and periapical lesions (over 90% of symptoms have subsided), the remaining clinical signs are related to the increased bacterial load and the virulence of the pathogens. Conclusions. The identification, evaluation, and elimination of foci of odontogenic infection play an important role in aggravating already existing systemic conditions, thus triggering focal disease. The role of the dentist in the prophylaxis of focal disease is primary in the detection and elimination of foci of odontogenic infection. In the prophylaxis of focal disease, doctor-patient cooperation is very important, and no less important is collaboration with general medicine specialists.

Evolution of maxillary expansion in patients with cleft lip and palate

Thu, 01 Jan 2026 00:00:00 GMT

Evolution of maxillary expansion in patients with cleft lip and palate Railean, Silvia; Poștaru, Cristina; Melnic, Svetlana; Bordeniuc, Gheorghe Introduction. The craniofacial orthodontist who is part of the multidisciplinary team evaluating children with cleft lip and palate plays an important role in examining the development of dental occlusion. Early surgical interventions in children with cleft lip and palate frequently cause occlusion disorders with a prevalence of anterior crossbite in 62%. The expansion of the maxilla is important for normalizing the morphology and correct symmetrical tooth eruption. The aim is to evaluate the evolution of maxillary expansion in patients with cleft lip and palate. Material and methods. This study included 20 patients with cleft lip and palate, including 8 girls and 12 boys aged 6-12 years, with a mean age of 9.35 years. Unilateral cleft lip and palate was present in 16 patients, bilateral cleft lip and palate – 2 patients, and clefts of the hard and soft palate – 2 patients. The study models were scanned, and the maxillary dimensions were examined using a 3D Dolphin Imaging program before and after maxillary slow expansion over an average of 12.2 months. Results. Clinical evaluation of patients with cleft lip and palate showed crossbite occlusion. Of these patients, anterior and posterior crossbite occlusion was present in 11 (55%) patients, anterior crossbite occlusion in 3 (15%) patients, unilateral posterior crossbite occlusion in 3 (15%) patients and bilateral in 3 (15%) patients. In the transverse plane, the size of the upper jaw increased statistically significantly (p = 0.002), but in the sagittal plane we found a statistically significant elongation of the upper jaw (p < 0.05) following slow expansion treatment with a removable orthodontic appliance over an average of 12.2 months in patients with cleft lip and palate. Conclusions. Slow maxillary expansion treatment during the mixed dentition period in patients with cleft lip and palate was found to be more effective in the sagittal plane than in the transverse plane.

Development and testing of a questionnaire: assessment of occupational risk factors in surgeons

Thu, 01 Jan 2026 00:00:00 GMT

Development and testing of a questionnaire: assessment of occupational risk factors in surgeons Vîlcova, Ana; Ferdohleb, Alexandru; Spinei, Larisa; Paraschiv, Angela; Deleu, Raisa; Ciobanu, Elena Introduction. Surgery exposes professionals to significant physical and psychological risks, including intense exertion, prolonged static postures, and repetitive gestures, often leading to musculoskeletal pain. International studies report prevalence rates above 90%, linked to long procedures and poor ergonomics, alongside exposure to biological and chemical hazards, radiation, toxic smoke, and chronic stress. In the Republic of Moldova, occupational health in the medical sector is underexplored, with no tools tailored to surgeons. This study aims to develop and validate the first nationally standardized questionnaire to assess these risks and support public health policies. Material and methods. The study used a sequential mixed-methods design: a qualitative phase to identify domains and indicators, followed by a quantitative phase for psychometric testing. Four domains were defined: working conditions, occupational factors, general health, and psycho-emotional state. The questionnaire was refined from 70 to 47 items after expert review and validation, with internal consistency (Cronbach’s α) and content validity (I-CVI, modified Kappa) assessed. It was pre-tested on 52 surgeons, and data were analyzed using SPSS 27 (p<0.05). Results. Content validation revealed S-CVI/Ave values ranging from 0.934 to 1.00 and S-CVI/UA values from 0.738 to 1.00, with all domains exceeding the accepted threshold for relevance and clarity, except for one domain, which fell slightly below the recommended level for unanimous agreement. I-CVI values ranged from 0.857 to 1.00 (relevance) and 0.847 to 1.00 (clarity), while κ* indices were all rated as “excellent”. Based on expert feedback, 24 questions were revised and 15 were removed. Overall internal consistency was very good (α = 0.808), with section values ranging from 0.769 to 0.864, the highest being for “Psycho-emotional state” (α = 0.864). The pre-test sample comprised 52 surgeons, mostly male (57.7%), with a mean age of 44.92 years, predominantly from urban areas (92.3%). Respondents generally found the questions clear but noted some lengthy formulations, repetitiveness, and sensitive items. These observations contributed to optimizing the final version of the instrument. Conclusions. The final questionnaire meets the initial theoretical dimensions and shows strong psychometric properties, with high validity and internal consistency. The tool is comparable to established instruments and suitable for assessing surgeons’ health and occupational risks, with potential for wider use.