The dental awareness and needs of a Parkinson's disease population

The dental awareness and needs of a population with Parkinson's disease were assessed by means of postal questionnaires sent to members of Parkinson's disease societies of Belfast and London. A total of 228 valid replies were received representing a response rate of 31%. Results showed that dental problems were reported often, xerostomia and burning sensation being at least twice that of the general population. Satisfaction with dental care was high although it was significantly reduced in those with loose dentures and burning sensation. The results of this study support a greater participation by dentists in the planning and provision of healthcare for sufferer of Parkinson's disease.     

Oral health and treatment needs in a non-institutionalized elderly population: Experience of a dental school associated geriatric clinic

The purpose of this study is to report oral and dental findings in a population of independent geriatric patients, who were treated at the Geriatric Dental Clinic, School of Dental Medicine, Tel Aviv University. The study group consisted of 221 patients, 31.2% males and 68.8% females. The mean age was 75.3 years. Of the patients, 75% were edentulous. The most frequent complaint was pain associated with wear of dentures, and the most frequent mucosal lesion was traumatic ulcer (51%). Most dentures were of poor quality (77%). The mean denture age was 9.7 years, increasing as the patient's age increased. Denture hygiene was good in 59%, fair in 11% and poor in 30%. The mean number of visits at the Geriatric Clinic was 5.5 per patient.     

Pattern of dental eruption,skeletal maturation and stress in a Medieval Population from Sudanese Nubia

The present research represents a comparison of dental and skeletal development as a means for determining nutritional stress in a Medieval Christian population from Nubia’sBatn el Hajar. The sample consists of 21 individuals from an early Christian (c 550–750) and 23 individuals from a late Christian cemetery (c mid-16th century) excavated from the site of Kulubnarti, Sudan. Ages at death ranged from 12 to 23 years. For the combined sample, a large majority (70.5%) of individuals had skeletal ages younger than their dental ages. However, a comparison of those individuals that could be sexed revealed that the pattern was not consistent for males and females. Females showed no difference between skeletal and dental age while males showed significant skeletal retardation. This pattern of sex differences is consistent with that observed for modern living children and subadults experiencing nutritional stress. A comparison by cemetry also suggests a reduction in stress from early to late Christian times with later Christians showing a closer correspondence between skeletal and dental ages. While not statistically significant, this apparent reduction is consistent with previous research on the subadult remains.     

General health, dental status and perceived dental treatment needs of an elderly population in Istanbul

doi: 10.1111/j.1741‐2358.2010.00363.x
General health, dental status and perceived dental treatment needs of an elderly population in Istanbul Background: Comprehensive data on the oral health status and dental treatment needs of the elderly population in Turkey are deficient. Objectives: This pilot study determined the general and dental health status, perceived medical and dental treatment needs of an elderly population dwelling in residential homes in Istanbul. Method: Subjects at three different residential homes, namely one belonging to the state and two supported by foundations in Istanbul (N=121, female: 63 and male: 58) were involved in this study. A detailed questionnaire was prepared and dental examinations were conducted. Information was collected related to age, education levels, financial status, current physical functional status, general health, mental health, previous dental history, current dental status, oral hygiene practices and denture hygiene of these elderly people. The prevalence of edentulism, the presence and type of dental prostheses, dental and denture status and denture cleanliness were further evaluated. Results: The three most prevalent reported general health problems were associated with genito‐urinary problems (24%) followed by cardiovascular (18%) and respiratory problems (14%) varying significantly between genders, with males suffering more from cardiovascular problems than females (p < 0.05). Females showed significantly higher gastrointestinal and orthopaedic problems than males (p < 0.05). Females were more frequently edentulous than males but denture hygiene was significantly better in females than in males (p < 0.05). Brushing frequency did not significantly increase denture hygiene (p = 0.6). More than one‐third of the subjects had not been to the dentist within the previous 5–10 years, mainly due to lack of demand, followed by the cost of the dental care and fear. More than two‐thirds of denture‐wearing subjects wore their dentures only during eating. Conclusions: There was significant perceived dental treatment and care need for the sample population of elderly studied.     

A cross-sectional analysis of the prevalence of dental anxiety and its relation to the oral health-related quality of life in patients with dental treatment needs at a university clinic in Switzerland

doi: 10.1111/j.1741‐2358.2011.00465.x A cross‐sectional analysis of the prevalence of dental anxiety and its relation to the oral health‐related quality of life in patients with dental treatment needs at a university clinic in Switzerland Objectives: The aim of this observational, cross‐sectional study was to analyse the relationship between dental anxiety (DA) and health‐related quality of life aspects associated with oral conditions of a population with dental treatment needs in Switzerland. Methods: The measurements of DA were collected by means of two questionnaires, the Dental Anxiety Scale (DAS) and a Visual Analogue Scale (VAS). Oral health‐related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP). The sample included 223 patients enrolled at a university clinic which specialises in oral prosthetic rehabilitation and temporomandibular disorders. Of them, 78.9% were at or above the age of 50. Results: No gender or age dependencies were observed. A comparison of answers regarding OHRQoL and DA revealed a significant interdependence (p = 0.0118); highly anxious patients were 3.55 times more likely to suffer from poor quality of life compared with less anxious ones. Conclusion: This cross‐sectional study of mostly elderly patients seeking dental treatment in Switzerland found that increased DA was associated with an impaired OHRQoL. The average DA was slightly higher than the results of other industrialised countries and the average OHRQoL was reduced.     

Use of genetic data, employment and insurance: an international perspective

In this paper, I will say first of all a few words on what is novel in the potential exclusionary use of genetic information in the domains of work or insurance and to what extent legal protection specifically relating to genetic discrimination may be justified. Subsequently, I will briefly examine some of the proposed restrictions on the collection of genetic information for purposes of selection and the scope for international consensus on the issue; in doing so, I will deal separately with employment and private insurance. Finally, I will raise the question whether these issues require international handling and which international steps could be envisaged.     

Public attitudes and needs around Kasungu National Park,Malawi

A survey of people's needs and attitudes around Kasungu National Park shows that there are 11 resources that the people want to utilize from the Park. Bee-keeping is the most popular activity. Others include collection of caterpillars, firewood, building materials and mushrooms. There is no significant difference in demand for all these resources between subsistence and commercial farmers (t=3.26, n=11, p>0.01). Also, the difference between commercial farmers and urban respondents is not significant (t=1.92, n=11, p>0.01). On the other hand significantly more commercial than subsistence farmers need land from the Park, while more subsistence than commercial farmers wish to harvest resources that satisfy basic needs (t=3.34, n=11, p<0.01). Therefore, we recommend that the Department should extend the resource use programme and diversify its activities. The main target communities should be the subsistence farmers in Chulu and Kaphaizi villages.Most respondents to the survey believe that bee-keeping and tree caterpillar collection are beneficial as a source of food and income. About 90% of the respondents would like to participate in these activities. This is a reflection of positive attitudes towards these activities and it is enough justification for encouragement of bee-keeping and caterpillar collection. Although the respondents' attitudes towards the project are not negative, we recommend the involvement of local people in all stages of future activities.     

Human and cattle population changes in deltaic West Bengal,India between 1967 and 1977

Humans and domestic animals in 14.94 square kilometers of rural West Bengal were intensively studied between 1967 and 1970. In 1977, 3.81 square kilometers (25.5%) of the same area was resurveyed and all humans and cattle enumerated. The human population has increased 10% from 1969 to 1977, but the total number of children in the younger age groups has actually diminished. The cattle population has decreased 3.7% since the 1969 census, but in 1977 there were 19% fewer working bullocks present. Other significant observations relative to the primary productivity and economics of the area are noted. This research was supported by a 1977–1978 Indo-American Fellowship Award from the Indo-U.S. Subcommission on Education and Culture.     

Impact of socio-demographic variables, oral hygiene practices, oral habits and diet on dental caries experience of Indian elderly: a community-based study

A number of factors influence the caries experience and the pattern of restorative care especially in the older age group. Objective: To evaluate the dental caries experience and restorative treatment needs of an elderly Indian population and to study the impact of socio‐demographic variables, oral hygiene practices, oral habits and dietary practices on them. Design: A community‐based study. Setting: An urban area in the south zone of Delhi and a cluster of four villages in its neighbourhood. Subjects: A total of 1240 elderly subjects, 716 urban and 524 rural, were included in the study. Results: Of the 1052 dentate elderly subjects, 676 (64.2%) had decayed teeth (66.7% root caries and 33.3% coronal caries), 69 (6.6%) had filled teeth and 17 (1.6%) had recurrent decay. Restorations were indicated in 233 (22.2%) subjects, endodontic treatment in 51 (4.8%) and extractions in 424 (40.3%). Urban–rural differences in caries experience were statistically significant. Multivariate regression analysis showed that dental caries was associated with literacy level, oral hygiene practices, oral health perception and diet, while previous restorative treatment was correlated only with location (urban–rural) and presence or absence of systemic diseases. Conclusion: Dental caries prevalence was high amongst the studied elderly population and significant differences were observed in those living in a rural compared with an urban setting. Only a small percentage of elderly had evidence of previous restorative treatment whereas their unmet treatment need was significant.     

Prevalence of dental myths,oral hygiene methods and tobacco habits in an ageing North Indian rural population

doi: 10.1111/j.1741‐2358.2010.00395.x
Prevalence of dental myths, oral hygiene methods and tobacco habits in an ageing North Indian rural population Background and objectives: Though increased emphasis is being given to expanding dental care facilities and awareness in Indian villages, the target population is unfortunately less literate and financially‐equipped compared to their urban counterparts. This study attempted to evaluate dental myths, oral hygiene methods and beliefs, and tobacco habits present in a rural ageing population. Material and methods: The study area consisted of a group of 10 villages, situated in the district of Lucknow, Uttar Pradesh, India. The sample comprised 681 people aged 50 years or above. The subjects were questioned about dental myths, tobacco habits and oral hygiene methods and then divided into groups on the basis of age, gender, and educational status. Mean values, standard deviation, chi‐square test, t‐test and p values were used to obtain inter‐group comparisons. Results: Forty percent of the subjects considered oral hygiene unnecessary, with 61% relying on simple mouth rinsing for maintaining oral hygiene, 48% either smoked and chewed tobacco or both and 81% had one or more dental myth. Conclusion: The results showed that the rural ageing population is deprived and a targeted programme to spread scientific dental practices to them is necessary.     

Environmental needs and social justice

Despite the growth in awareness and practical action to maintain biodiversity, environmental degradation and ecosystem destruction has continued at a high rate over the last 20 years. The roots of this lie in the predominant international economic order, underpinned by lifestyle demands for increased material consumption. Net flow of wealth from South (less developed) to North (more developed) nations has exacerbated a spiral of increased poverty and environmental degradation in the former. Global environmental conservation depends upon a radical change of direction with the principle of equity as the starting point. Notwithstanding the importance of continuing to add to local and small-scale conservation achievements, the prospect of radical change happening seems small, despite it being in the long-term self-interest of the North. The concept of equity is, apparently, unacceptable to Northern electorates.     

Nutritional needs for exercise in the heat

Although hot conditions are not typically conducive to optimal sports performance, nutritional strategies play an important role in assisting an athlete to perform as well as possible in a hot environment. A key issue is the prevention of hypohydration during an exercise session. Fluid intake strategies should be undertaken in a cyclical sequence: hydrate well prior to the workout, drink as much as is comfortable and practical during the session, and rehydrate aggressively afterwards in preparation for future exercise bouts. There is some interest in hyperhydration strategies, such as hyperhydration with glycerol, to prepare the athlete for a situation where there is little opportunity for fluid intake to match large sweat losses. Recovery of significant fluid losses after exercise is assisted by the simultaneous replacement of electrolyte losses. Carbohydrate (CHO) requirements for exercise are increased in the heat, due to a shift in substrate utilization towards CHO oxidation. Daily food patterns should focus on replacing glycogen stores after exercise, and competition strategies should include activities to enhance CHO availability, such as CHO loading for endurance events, pre-event CHO intake, and intake of sports drinks in events lasting longer than 60 min. Although CHO ingestion may not enhance the performance of all events undertaken in hot weather, there are no disadvantages to the consumption of beverages containing 4-8% CHO and electrolytes. In fact, the palatability of these drinks may enhance the voluntary intake of fluid. Although there is some evidence of increased protein catabolism and cellular damage due to production of oxygen radicals during exercise in the heat, there is insufficient evidence to make specific dietary recommendations to account for these issues.     

Standardised measures of needs,stigma and informal care in schizophrenia using a bottom-up,cross-cultural approach

Background There is a lack of instruments to measure the needs, stigma and informal care of people with schizophrenia that take account of sociocultural variation and patients'' and formal and informal carers'' opinions and experiences.Aims To develop questionnaires to measure stigma, needs and informal (non-professional) care for people with schizophrenia.Method We undertook the study in seven countries and in English, Spanish and Portuguese. We first held focus group discussions with patients, formal carers (professionals) and informal carers (family and friends) in Spain, the UK, Argentina, Brazil, Chile and Venezuela to elicit the main dimensions of needs, stigma and informal care. We then held nominal group discussions about these dimensions with patients, family members and professionals in Spain, Portugal and the UK, to develop the instruments.Results Three hundred and three people participated in 46 focus groups and results were discussed in three nominal groups, each involving eight participants. Three instruments were developed in this iterative process: needs for care (46 items), stigma (38 items) and informal care (20 items).Conclusions These instruments are based on service users'' and carers'' views and experiences and have cross-cultural validity. They will have application in assessment of outcomes for people with schizophrenia and their families.     

The Yad Sarah geriatric dental clinic, a different model

Introduction: There are not sufficient dental services for elderly people around the world. Yad Sarah is an Israel‐wide network of volunteers aiding sick, elderly, isolated and housebound people with an array of services aimed at making home care possible. It provides medical and social services to more than 380 000 elderly persons per year and in addition, lends medical equipment free of charge, has day rehabilitation centres, legal aid council for seniors, provides transportation for the disabled, meal deliveries and geriatric dental services. Materials and methods: The latter are equipped with five dental units (one mobile unit) and a dental laboratory. During the 5 years from 2000 to 2004 the dental services provided dental care for 3890 elderly patients with the main clinic located in Jerusalem. Patients pay an average of 70% of the cost price of their dental care, with the difference being subsidised by Yad Sarah. Of the 515 patients who applied for treatment in 2004, 54% possessed natural teeth in both jaws, 28% were fully edentulous, 12% were edentulous in the maxilla and 6% were edentulous in the mandible. Females applied for dental treatment more often than the male population. Older patients (75–101 years old) required oral care at their homes or at old age residences, more frequently than the younger age groups (60–74 years old). Conclusion: Dental treatment was administered by 70 volunteer dental surgeons, two certified dental hygienists and dental hygienist students. The clinical staff was provided with a comprehensive in‐service training in geriatric dentistry during the 3‐year service learning period. A survey in 2004 showed that 83% of the selected patients were satisfied, compared with 14% who were not. The reasons for satisfaction were, mainly, the personal relationship with the attending staff (41%) and the professional ability of the dental team (46%).