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Fyles F, FitzMaurice TS, Robinson RE, Bedi R, Burhan H, Walshaw MJ. Dynamic chest radiography: a state-of-the-art review. Insights Imaging 2023; 14:107. [PMID: 37332064 DOI: 10.1186/s13244-023-01451-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/14/2023] [Indexed: 06/20/2023] Open
Abstract
Dynamic chest radiography (DCR) is a real-time sequential high-resolution digital X-ray imaging system of the thorax in motion over the respiratory cycle, utilising pulsed image exposure and a larger field of view than fluoroscopy coupled with a low radiation dose, where post-acquisition image processing by computer algorithm automatically characterises the motion of thoracic structures. We conducted a systematic review of the literature and found 29 relevant publications describing its use in humans including the assessment of diaphragm and chest wall motion, measurement of pulmonary ventilation and perfusion, and the assessment of airway narrowing. Work is ongoing in several other areas including assessment of diaphragmatic paralysis. We assess the findings, methodology and limitations of DCR, and we discuss the current and future roles of this promising medical imaging technology.Critical relevance statement Dynamic chest radiography provides a wealth of clinical information, but further research is required to identify its clinical niche.
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Affiliation(s)
- Fred Fyles
- Respiratory Research Group, Liverpool University Hospitals Foundation Trust, Liverpool, UK
- Clinical Sciences Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Thomas S FitzMaurice
- Department of Respiratory Medicine, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK.
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
| | - Ryan E Robinson
- Respiratory Research Group, Liverpool University Hospitals Foundation Trust, Liverpool, UK
- Clinical Sciences Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Ram Bedi
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Hassan Burhan
- Respiratory Research Group, Liverpool University Hospitals Foundation Trust, Liverpool, UK
- Clinical Sciences Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Martin J Walshaw
- Department of Respiratory Medicine, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
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2
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Elgamri A, Bridge G, Bedi R. Empowering women: a public health strategy to end infant oral mutilation in Africa. Br Dent J 2022; 233:988-989. [DOI: 10.1038/s41415-022-5390-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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3
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Shivakumar O, Ghazy A, Kousios A, Bedi R, Charif R, Duncan N. POS-139 SIGNIFICANT REDUCTION IN MORBIDITY FROM RECURRENT URINARY TRACT INFECTIONS IN RENAL TRANSPLANT PATIENTS WITH CONVENIENT ORAL ANTISEPTIC METHENAMINE HIPPURATE. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.07.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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4
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Bedi R, Atkinson J. Blood Culture Contamination in a Community Hospital- less than 2% is achievable. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction/Objective
Blood cultures are commonly obtained to evaluate the presence of bacteria or fungal infection in a patient’s bloodstream. The presence of living microorganisms circulating in the bloodstream is of substantial prognostic and diagnostic importance. A positive blood culture indicates a reason for the patient’s illness and provides the etiological agent for antimicrobial therapy. Collection of blood culture is an exact process that requires time, the proper order of draw, and following of correct protocol. The busy Emergency department that requires multiple demands for nurse’s time, turnover of staff, rushing from one task to another can result in the improper collection and false-positive blood cultures. The national benchmark is set at 3% by the American Society of Clinical Microbiology (ASM) and The Clinical and Laboratory Standard Institute (CLSI). False-positive blood culture results in increased length of stay and unnecessary antimicrobial therapy, resulting in an increased cost burden to the hospital of about $5000 per patient.
Methods/Case Report
At our 150-bed community hospital, 26 beds Emergency Department, we have come a long way in reduction of our blood culture contamination rates from upwards of 4% to less than 2%, far lower than the national benchmark.
Results (if a Case Study enter NA)
NA
Conclusion
There are multiple devices available from various manufacturers claiming to reduce blood culture contamination. These devices do reduce blood culture (BC) contamination but at an added cost of the device. The rate of BC can be reduced and less than 3% is achievable by materials available in the laboratory. We have achieved this by providing training to every new staff by demonstration and direct observation, providing everything required for collection in a kit, using proper technique, the inclusion of diversion method that involves the aseptic collection of a clear tube before collecting blood cultures, and following up monthly on any false positive blood cultures.
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Affiliation(s)
- R Bedi
- Laboatory, AMITA St. Francis Hospital, Evanston, Illinois, UNITED STATES
| | - J Atkinson
- Laboatory, AMITA St. Francis Hospital, Evanston, Illinois, UNITED STATES
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5
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FitzMaurice TS, Mccann C, Bedi R, Nazareth D, Walshaw MJ. Assessing Diaphragm Motion Using Dynamic Chest Radiography: a Case Series. Imaging 2020. [DOI: 10.1183/13993003.congress-2020.3368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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FitzMaurice TS, Mccann C, Shackcloth M, Bedi R, Nazareth D, Walshaw M, Mohan K. Using Dynamic Chest Radiography to Assess the Impact of Endobronchial Valve Treatment on Lung Volumes and Diaphragm Motion in Severe Emphysema. Imaging 2020. [DOI: 10.1183/13993003.congress-2020.3362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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7
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Hunsberger J, Simon C, Zylberberg C, Ramamoorthy P, Tubon T, Bedi R, Gielen K, Hansen C, Fischer L, Johnson J, Baraniak P, Mahdavi B, Pereira T, Hadjisavas M, Eaker S, Miller C. Improving patient outcomes with regenerative medicine: How the Regenerative Medicine Manufacturing Society plans to move the needle forward in cell manufacturing, standards, 3D bioprinting, artificial intelligence-enabled automation, education, and training. Stem Cells Transl Med 2020; 9:728-733. [PMID: 32222115 PMCID: PMC7308637 DOI: 10.1002/sctm.19-0389] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/12/2020] [Accepted: 02/24/2020] [Indexed: 02/06/2023] Open
Abstract
The Regenerative Medicine Manufacturing Society (RMMS) is the first and only professional society dedicated toward advancing manufacturing solutions for the field of regenerative medicine. RMMS's vision is to provide greater patient access to regenerative medicine therapies through innovative manufacturing solutions. Our mission is to identify unmet needs and gaps in regenerative medicine manufacturing and catalyze the generation of new ideas and solutions by working with private and public stakeholders. We aim to accomplish our mission through outreach and education programs and securing grants for public-private collaborations in regenerative medicine manufacturing. This perspective will cover four impact areas that the society's leadership team has identified as critical: (a) cell manufacturing and scale-up/out, respectively, for allogeneic and autologous cell therapies, (b) standards for regenerative medicine, (c) 3D bioprinting, and (d) artificial intelligence-enabled automation. In addition to covering these areas and ways in which the society intends to advance the field in a collaborative nature, we will also discuss education and training. Education and training is an area that is critical for communicating the current challenges, developing solutions to accelerate the commercialization of the latest technological advances, and growing the workforce in the rapidly expanding sector of regenerative medicine.
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Affiliation(s)
- Joshua Hunsberger
- Regenerative Medicine Manufacturing SocietyWinston‐SalemNorth CarolinaUSA
| | - Carl Simon
- National Institute of Standards and TechnologyGaithersburgMarylandUSA
| | | | | | | | - Ram Bedi
- University of WashingtonSeattleWashingtonUSA
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FitzMaurice T, Bedi R, Hawkes S, Peat R, Lomax S, McCann C, Nazareth D, Walshaw M. S04.6 Dynamic Chest Radiography (DCR) in cystic fibrosis: initial experience. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30188-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Before 2002, there had been a long-term stalemate between private water companies and District Health Authorities across England. Between 2002 and 2005 the team in the Office of the Chief Dental Officer used leadership and advocacy skills to overcome political barriers, introducing the Water Act 2003 and a Statutory Instrument in 2005 providing indemnity for water companies. This legislation was key in removing obstacles towards the expansion water fluoridation across England.
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Affiliation(s)
- V Wordley
- Global Child Dental Fund, London, UK
| | - R Bedi
- King's College London, London, UK.
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10
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FitzMaurice TS, McNamara PS, Nazareth D, McCann C, Bedi R, Shaw M, Walshaw M. Utility and validity of dynamic chest radiography in cystic fibrosis (dynamic CF): an observational, non-controlled, non-randomised, single-centre, prospective study. BMJ Open Respir Res 2020; 7:7/1/e000569. [PMID: 32217535 PMCID: PMC7206905 DOI: 10.1136/bmjresp-2020-000569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Dynamic chest radiography (DCR) uses novel, low-dose radiographic technology to capture images of the thoracic cavity while in motion. Pulmonary function testing is important in cystic fibrosis (CF). The tolerability, rapid acquisition and lower radiation and cost compared with CT imaging may make DCR a useful adjunct to current standards of care. METHODS AND ANALYSIS This is an observational, non-controlled, non-randomised, single-centre, prospective study. This study is conducted at the Liverpool Heart and Chest Hospital (LHCH) adult CF unit. Participants are adults with CF. This study reviews DCR taken during routine CF Annual Review (n=150), validates DCR-derived lung volumes against whole body plethysmography (n=20) and examines DCR at the start and end of pulmonary exacerbations of CF (n=20). The primary objectives of this study are to examine if DCR provides lung function information that correlates with PFT, and lung volumes that correlate whole body plethysmography. ETHICS AND DISSEMINATION This study has received the following approvals: HRA REC (11 December 2019) and LHCH R&I (11 October 2019). Results are made available to people with CF, the funders and other researchers. Processed, anonymised data are available from the research team on request. TRIAL REGISTRATION NUMBER ISRCTN 64994816.
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Affiliation(s)
- Thomas Simon FitzMaurice
- Adult CF Unit, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK .,Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Paul Stephen McNamara
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK.,Institute in the Park, Alder Hey Children's Hospital, Liverpool, UK
| | - Dilip Nazareth
- Adult CF Unit, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK.,Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Caroline McCann
- Department of Radiology, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK
| | - Ram Bedi
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - Matthew Shaw
- Research Department, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK
| | - Martin Walshaw
- Adult CF Unit, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK.,Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
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11
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Frankel AH, Kazempour-Ardebili S, Bedi R, Chowdhury TA, De P, El-Sherbini N, Game F, Gray S, Hardy D, James J, Kong MF, Ramlan G, Southcott E, Winocour P. Management of adults with diabetes on the haemodialysis unit: summary of guidance from the Joint British Diabetes Societies and the Renal Association. Diabet Med 2018; 35:1018-1026. [PMID: 30152585 DOI: 10.1111/dme.13676] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/12/2018] [Indexed: 12/29/2022]
Abstract
Diabetic nephropathy remains the principal cause of end-stage renal failure in the UK and its prevalence is set to increase. People with diabetes and end-stage renal failure on maintenance haemodialysis are highly vulnerable, with complex comorbidities, and are at high risk of adverse cardiovascular outcomes, the leading cause of mortality in this population. The management of people with diabetes receiving maintenance haemodialysis is shared between diabetes and renal specialist teams and the primary care team, with input from additional healthcare professionals providing foot care, dietary support and other aspects of multidisciplinary care. In this setting, one specialty may assume that key aspects of care are being provided elsewhere, which can lead to important components of care being overlooked. People with diabetes and end-stage renal failure require improved delivery of care to overcome organizational difficulties and barriers to communication between healthcare teams. No comprehensive guidance on the management of this population has previously been produced. These national guidelines, the first in this area, bring together in one document the disparate needs of people with diabetes on maintenance haemodialysis. The guidelines are based on the best available evidence, or on expert opinion where there is no clear evidence to inform practice. We aim to provide clear advice to clinicians caring for this vulnerable population and to encourage and improve education for clinicians and people with diabetes to promote empowerment and self-management.
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Affiliation(s)
- A H Frankel
- Imperial College Healthcare NHS Trust, London, UK
| | - S Kazempour-Ardebili
- Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Iran
| | - R Bedi
- Imperial College Healthcare NHS Trust, London, UK
| | | | - P De
- Birmingham City Hospital (Sandwell and West Birmingham Hospitals NHS Trust), Birmingham, UK
| | | | - F Game
- Derby Teaching Hospitals NHS Foundation Trust and University of Nottingham, UK
| | - S Gray
- East and North Herts NHS Trust, UK
| | - D Hardy
- East and North Herts NHS Trust, UK
| | - J James
- University Hospitals of Leicester NHS Trust, UK
| | - M-F Kong
- University Hospitals of Leicester NHS Trust, UK
| | - G Ramlan
- North Middlesex University Hospital NHS Trust, UK
| | | | - P Winocour
- Queen Elizabeth II Hospital, Welwyn Garden City, UK
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12
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Coffey S, Lewandowski AJ, Garratt S, Meijer R, Lynum S, Bedi R, Paterson J, Yaqub M, Noble JA, Neubauer S, Petersen SE, Allen N, Sudlow C, Collins R, Matthews PM, Leeson P. Protocol and quality assurance for carotid imaging in 100,000 participants of UK Biobank: development and assessment. Eur J Prev Cardiol 2017; 24:1799-1806. [PMID: 28925747 DOI: 10.1177/2047487317732273] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Ultrasound imaging is able to quantify carotid arterial wall structure for the assessment of cerebral and cardiovascular disease risks. We describe a protocol and quality assurance process to enable carotid imaging at large scale that has been developed for the UK Biobank Imaging Enhancement Study of 100,000 individuals. Design An imaging protocol was developed to allow measurement of carotid intima-media thickness from the far wall of both common carotid arteries. Six quality assurance criteria were defined and a web-based interface (Intelligent Ultrasound) was developed to facilitate rapid assessment of images against each criterion. Results and conclusions Excellent inter and intra-observer agreements were obtained for image quality evaluations on a test dataset from 100 individuals. The image quality criteria then were applied in the UK Biobank Imaging Enhancement Study. Data from 2560 participants were evaluated. Feedback of results to the imaging team led to improvement in quality assurance, with quality assurance failures falling from 16.2% in the first two-month period examined to 6.4% in the last. Eighty per cent had all carotid intima-media thickness images graded as of acceptable quality, with at least one image acceptable for 98% of participants. Carotid intima-media thickness measures showed expected associations with increasing age and gender. Carotid imaging can be performed consistently, with semi-automated quality assurance of all scans, in a limited timeframe within a large scale multimodality imaging assessment. Routine feedback of quality control metrics to operators can improve the quality of the data collection.
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Affiliation(s)
- Sean Coffey
- 1 Division of Cardiovascular Medicine, University of Oxford, UK.,2 Department of Medicine, University of Otago, New Zealand
| | | | | | - Rudy Meijer
- 4 Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands
| | - Steven Lynum
- 5 Panasonic Healthcare Corporation of North America, USA
| | - Ram Bedi
- 6 Department of Bioengineering, University of Washington, USA
| | | | - Mohammad Yaqub
- 8 Institute of Biomedical Engineering, University of Oxford, UK
| | - J Alison Noble
- 8 Institute of Biomedical Engineering, University of Oxford, UK
| | - Stefan Neubauer
- 1 Division of Cardiovascular Medicine, University of Oxford, UK
| | - Steffen E Petersen
- 9 William Harvey Research Institute, Queen Mary University of London, UK
| | - Naomi Allen
- 3 UK Biobank, UK.,10 Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, UK
| | - Cathie Sudlow
- 3 UK Biobank, UK.,11 Centre for Clinical Brain Sciences, University of Edinburgh, UK
| | - Rory Collins
- 3 UK Biobank, UK.,10 Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, UK
| | | | - Paul Leeson
- 1 Division of Cardiovascular Medicine, University of Oxford, UK
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13
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14
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Joury E, Alghadban M, Elias K, Bedi R. Impact of providing free preventive dental products without health workers' counselling on infants' tooth-brushing and bottle-feeding termination practices: a randomised controlled trial. Community Dent Health 2017; 33:213-217. [PMID: 28509517 DOI: 10.1922/cdh_3841joury05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 01/05/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate the impact of an integrated oral health promotion intervention, within the Syrian national immunisation programme, which provided free preventive dental health products, without health workers' counselling, on one-year-old infants' tooth-brushing and bottle-feeding termination practices. RESEARCH DESIGN a randomised controlled parallel-group trial. SETTING A maternal and child health centre in Sweida city, Syria. PARTICIPANTS 92 mothers of one-year-old infants, attending an infant vaccination clinic, were allocated into three groups: Test, Control One and Control Two. INTERVENTIONS The Test group received an oral health promotion package including an infant oral health pamphlet, a baby toothbrush, fluoride toothpaste (1,000 mg/L) and a trainer cup, without health workers' counselling. Control One received only the pamphlet, whilst Control Two received no intervention. MAIN OUTCOME MEASURES after one month, the presence of old plaque on infants' primary teeth was checked, to assess tooth-brushing behaviour. Also, a mothers' self-completed questionnaire was administered to assess bottle-feeding use. RESULTS The response rate was 100% and the attrition rate was zero. There were differences in tooth-brushing and bottle-feeding termination practices between the three groups (P⟩0.001). Infants in the Test group were less likely to have old plaque and more likely to stop bottle-feeding than their counterparts in the two control groups. There were no differences in the abovementioned outcomes between the two control groups. CONCLUSIONS Providing free preventive dental health products, without health worker's counselling, in an integrated oral health promotion intervention, was an effective measure to promote infants' tooth-brushing and bottle-feeding termination practices. These findings should be supported by long-term follow up studies.
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Affiliation(s)
- E Joury
- Oral Medicine Department, Faculty of Dentistry, Damascus University, Syria; Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St Thomas's Hospitals, London, UK
| | - M Alghadban
- Oral Medicine Department, Faculty of Dentistry, Damascus University, Syria
| | - K Elias
- Eastman Dental Institute, University College London, UK
| | - R Bedi
- Centre for International Child Oral Health, King's College London, UK
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15
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Kaplan H, Thompson RC, Trumble BC, Wann LS, Allam AH, Beheim B, Frohlich B, Sutherland ML, Sutherland JD, Stieglitz J, Rodriguez DE, Michalik DE, Rowan CJ, Lombardi GP, Bedi R, Garcia AR, Min JK, Narula J, Finch CE, Gurven M, Thomas GS. Coronary atherosclerosis in indigenous South American Tsimane: a cross-sectional cohort study. Lancet 2017; 389:1730-1739. [PMID: 28320601 PMCID: PMC6028773 DOI: 10.1016/s0140-6736(17)30752-3] [Citation(s) in RCA: 202] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 02/16/2017] [Accepted: 02/22/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Conventional coronary artery disease risk factors might potentially explain at least 90% of the attributable risk of coronary artery disease. To better understand the association between the pre-industrial lifestyle and low prevalence of coronary artery disease risk factors, we examined the Tsimane, a Bolivian population living a subsistence lifestyle of hunting, gathering, fishing, and farming with few cardiovascular risk factors, but high infectious inflammatory burden. METHODS We did a cross-sectional cohort study including all individuals who self-identified as Tsimane and who were aged 40 years or older. Coronary atherosclerosis was assessed by coronary artery calcium (CAC) scoring done with non-contrast CT in Tsimane adults. We assessed the difference between the Tsimane and 6814 participants from the Multi-Ethnic Study of Atherosclerosis (MESA). CAC scores higher than 100 were considered representative of significant atherosclerotic disease. Tsimane blood lipid and inflammatory biomarkers were obtained at the time of scanning, and in some patients, longitudinally. FINDINGS Between July 2, 2014, and Sept 10, 2015, 705 individuals, who had data available for analysis, were included in this study. 596 (85%) of 705 Tsimane had no CAC, 89 (13%) had CAC scores of 1-100, and 20 (3%) had CAC scores higher than 100. For individuals older than age 75 years, 31 (65%) Tsimane presented with a CAC score of 0, and only four (8%) had CAC scores of 100 or more, a five-fold lower prevalence than industrialised populations (p≤0·0001 for all age categories of MESA). Mean LDL and HDL cholesterol concentrations were 2·35 mmol/L (91 mg/dL) and 1·0 mmol/L (39·5 mg/dL), respectively; obesity, hypertension, high blood sugar, and regular cigarette smoking were rare. High-sensitivity C-reactive protein was elevated beyond the clinical cutoff of 3·0 mg/dL in 360 (51%) Tsimane participants. INTERPRETATION Despite a high infectious inflammatory burden, the Tsimane, a forager-horticulturalist population of the Bolivian Amazon with few coronary artery disease risk factors, have the lowest reported levels of coronary artery disease of any population recorded to date. These findings suggest that coronary atherosclerosis can be avoided in most people by achieving a lifetime with very low LDL, low blood pressure, low glucose, normal body-mass index, no smoking, and plenty of physical activity. The relative contributions of each are still to be determined. FUNDING National Institute on Aging, National Institutes of Health; St Luke's Hospital of Kansas City; and Paleocardiology Foundation.
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Affiliation(s)
- Hillard Kaplan
- Department of Anthropology, University of New Mexico, Albuquerque, NM, USA.
| | - Randall C Thompson
- Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Benjamin C Trumble
- School of Human Evolution and Social Change, and Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
| | | | | | - Bret Beheim
- Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Bruno Frohlich
- National Museum of Natural History, Smithsonian Institution, Washington, DC, USA; Dartmouth College, Hanover, NH, USA
| | | | | | - Jonathan Stieglitz
- Institute for Advanced Study in Toulouse, Toulouse, France; Department of Anthropology, University of New Mexico, Albuquerque, NM, USA
| | | | - David E Michalik
- University of California, Irvine School of Medicine, Irvine, CA, USA; Miller Women's and Children's Hospital Long Beach, CA, USA
| | - Chris J Rowan
- Renown Institute for Heart and Vascular Health, Reno, NV, USA; University of Nevada, Reno, NV, USA
| | - Guido P Lombardi
- Laboratorio de Paleopatologia, Catedra Pedro Weiss, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ram Bedi
- Department of Bioengineering, University of Washington, Seattle WA, USA
| | - Angela R Garcia
- Department of Anthropology University of California Santa Barbara, Santa Barbara, CA, USA
| | - James K Min
- Weill Cornell Medical College and the NewYork-Presbyterian Hospital, NY, USA
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Caleb E Finch
- University of Southern California Leonard Davis School of Gerontology, Los Angeles, CA, USA; Dornsife College, University of Southern California, Los Angeles, CA, USA
| | - Michael Gurven
- Department of Anthropology University of California Santa Barbara, Santa Barbara, CA, USA; Long Beach Memorial, Long Beach, CA, USA
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McAdoo S, Masoud S, Bedi R, Cairns T, Lightstone L. P06 OFATUMUMAB FOR B CELL DEPLETION THERAPY IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS WHO ARE INTOLERANT OF RITUXIMAB. Kidney Int Rep 2016. [DOI: 10.1016/j.ekir.2016.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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17
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Heidari E, Bedi R, Makrides NS, Dickinson C, Newton T. Planning for future provision of dental services in prison: an international proposal of two systems. Br Dent J 2016; 217:177-82. [PMID: 25146804 DOI: 10.1038/sj.bdj.2014.704] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2014] [Indexed: 11/09/2022]
Abstract
This article describes a proposal for the future organisation of the delivery of dental and oral health services for prisoners. This vision is based on an analysis of the existing prison dental programmes in England and the United States (Federal Bureau of Prisons, [FBOP]), together with discussions from two key individuals from both countries who championed changes to prison dental services and have published in the field of prison dental services. Both countries have similar visions. Some of the suggested work has already been addressed in the past (for example, introduction of state of the art dental facilities in the UK prison setting), some are in process (for example, electronic patients' records) and some may be addressed in the near future (for example, prisoners' involvement with the services provided for them). Some of the expressed visions for the future in this article are driven by evidence-based literature and dental workforce policy.
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Affiliation(s)
- E Heidari
- Senior Specialist Clinical Teacher, King's College London Dental Institute, Floor 26, Tower Wing. Guy's Hospital, Great Maze Pond, London, SE1 9RT
| | - R Bedi
- Head, International Centre for Child Oral Health Director, Global Child Dental Health Taskforce, Wellington House, 133-155 Waterloo Road, London, SE1 8UG
| | - N S Makrides
- Chief Dentist for Federal Bureau of Prisons, Washington, United States
| | - C Dickinson
- Consultant in Special Care Dentistry, King's College London Dental Institute, Floor 26, Tower Wing. Guy's Hospital, Great Maze Pond, London, SE1 9RT
| | - T Newton
- Professor of Psychology as Applied to Dentistry, King's College London Dental Institute, Floor 26, Tower Wing. Guy's Hospital, Great Maze Pond, London, SE1 9RT
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van der Veer SN, Labriola L, Fluck R, Jager KJ, Coentrao L, Kleophas W, Ravani P, van Biesen W, Mandolfo S, Acconcia P, Bucci R, Corradi B, Farina M, Corbett R, Ashby D, Edwards C, Prout V, Singh S, Bedi R, Duncan N, Roca-Tey R, Ramirez de Arellano M, Gonzalez-Oliva JC, Samon R, Ibrik O, Roda A, Viladoms J, Jankovic A, Damjanovic T, Djuric Z, Popovic J, Dimkovic N, Kirkpantur A, Turkvatan A, Balci M, Kirbas I, Mandiroglu S, Afsar B, Mandiroglu F. Vascular access. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
INTRODUCTION Modern dentistry has become increasingly invasive and sophisticated. Consequently the risk to the patient has increased. The aim of this study is to investigate the types of patient safety incidents (PSIs) that occur in dentistry and the accuracy of the National Patient Safety Agency (NPSA) database in identifying those attributed to dentistry. METHODS The database was analysed for all incidents of iatrogenic harm in the speciality of dentistry. A snapshot view using the timeframe January to December 2009 was used. The free text elements from the database were analysed thematically and reclassified according to the nature of the PSI. Descriptive statistics were provided. RESULTS Two thousand and twelve incident reports were analysed and organised into ten categories. The commonest was due to clerical errors - 36%. Five areas of PSI were further analysed: injury (10%), medical emergency (6%), inhalation/ingestion (4%), adverse reaction (4%) and wrong site extraction (2%). DISCUSSION There is generally low reporting of PSIs within the dental specialities. This may be attributed to the voluntary nature of reporting and the reluctance of dental practitioners to disclose incidences for fear of loss of earnings. A significant amount of iatrogenic harm occurs not during treatment but through controllable pre- and post-procedural checks. CONCLUSION Incidences of iatrogenic harm to dental patients do occur but their reporting is not widely used. The use of a dental specific reporting system would aid in minimising iatrogenic harm and adhere to the Care Quality Commission (CQC) compliance monitoring system on essential standards of quality and safety in dental practices.
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Affiliation(s)
- S Thusu
- Centre for International Child Oral Health, King's College London, 26-29 Drury Lane, London, WC2B 5RL.
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Ready D, Bedi R, Mullany P, Wilson M. Penicillin and amoxicillin resistance in oral Veillonella spp. Int J Antimicrob Agents 2012; 40:188-9. [PMID: 22695292 DOI: 10.1016/j.ijantimicag.2012.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 03/30/2012] [Accepted: 04/03/2012] [Indexed: 10/28/2022]
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Bedi R. Commentary on: An investigation of the nature of research into dental health in prisons: a systematic review. Br Dent J 2008. [DOI: 10.1038/sj.bdj.2008.527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Conway DI, Quarrell I, McCall DR, Gilmour H, Bedi R, Macpherson LMD. Dental caries in 5-year-old children attending multi-ethnic schools in Greater Glasgow--the impact of ethnic background and levels of deprivation. Community Dent Health 2007; 24:161-165. [PMID: 17958077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To examine levels of dental caries of 5-year-olds attending multi-ethnic schools in Greater Glasgow and to explore the effects of deprived backgrounds and ethnic identity on their dental health. DESIGN Between October 2001 and February 2002 a cross-sectional dental epidemiology survey of a sample of 721 5-year-olds was undertaken in schools having at least 25 per cent of pupils from black or minority ethnic groups. Background data on participating children were obtained from school records, including: ethnic origin, mothers' ability to speak English, religion, and demographics. Statistical analyses included two way analysis of variance to determine the effect of ethnicity after adjusting for socio-economic factors. RESULTS Complete data were available for 649 (90%) children. The sample broadly divided into white (52%), Pakistani (33%), and other minority ethnic groups (15%). Based on repeat observations, diagnosis reliability was good (Kappa = 0.77). The caries experience of Pakistani children (d3mft = 4.1; 95% CI 3.6 to 4.6) was significantly higher (p < 0.001) than the white children (d3mft = 2.3; 95% CI 1.9 to 2.6). Only 25% (95% C1 17 to 34) of the Pakistani children had no obvious decay, significantly lower (p < 0.001) than their white contemporaries (48%, 95% CI 39 to 58). Pakistani ethnic origin was associated with significantly higher levels of dental caries (p < 0.001), after adjusting for socio-economic deprivation. CONCLUSION Children from deprived backgrounds have worse dental caries levels than their affluent counterparts and, over and above this effect, minority ethnic children of Pakistani background have higher levels than their white peers.
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Affiliation(s)
- D I Conway
- Dental Public Health Unit, Level 8, University of Glasgow Dental Hospital and School, 378 Sauchiehall Street, Glasgow G2 3JZ, UK.
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Eaton KA, de Vries J, Widström E, Gait TC, Bedi R, Meyers I, Feldman CA, Hobson R. 'Schools without walls?' Developments and challenges in dental outreach teaching - report of a recent symposium. Eur J Dent Educ 2006; 10:186-91. [PMID: 17038009 DOI: 10.1111/j.1600-0579.2006.00411.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
During the 2004 annual meeting of the International Association for Dental Research, the Education Research Group held a symposium on dental outreach teaching. After a brief introduction, which reviews relevant aspects of the relatively sparse literature, this paper summarises the proceedings, the themes and conclusions that emerged and the research issues that were identified. It aims to describe aspects of current practice around the world and to promote future discussion. Presenters gave details of outreach programmes for dental undergraduates in Australia, Finland, Malaysia (and Southeast Asia), the United Kingdom and the United States. From these presentations four themes emerged. They were: reasons for the introduction of outreach teaching, its perceived beneficial effects, organisational issues, educational issues. The reasons included a recognition of the need to educate dental undergraduates as members of 'care teams' in the environments and communities where they were ultimately like to work and the current shortage of both suitable patients and teachers (faculty) in many dental schools. A wide range of potential benefits and some disadvantages were identified. The organisational issues were, in the main, seen to relate to finance and administration. The educational issues included the need to train and monitor the performance of teachers at outreach clinics and to assess the performance of the undergraduates whilst at the outreach locations. It was concluded that new technology made it easier to teach at a distance and it was possible to create a dental 'school without walls'. It was recognised that few evaluations of dental outreach teaching have been carried out and that there were many research questions to be answered, including: whether it should be a voluntary or compulsory part of the undergraduate curriculum, how long it should last and what type of outcomes should be assessed.
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Affiliation(s)
- K A Eaton
- Eastman Dental Institute, University College London, London, UK.
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Ready D, Pratten J, Roberts AP, Bedi R, Mullany P, Wilson M. Potential role of Veillonella spp. as a reservoir of transferable tetracycline resistance in the oral cavity. Antimicrob Agents Chemother 2006; 50:2866-8. [PMID: 16870789 PMCID: PMC1538667 DOI: 10.1128/aac.00217-06] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Twelve out of 96 Veillonella spp. isolated from oral samples harbored tetracycline resistance genes. The most common resistance gene was tet(M). A tet(M)-positive Veillonella dispar strain was shown to transfer a Tn916-like element to four Streptococcus spp. by conjugation at a frequency of 5.2 x 10(-6) to 4.5 x 10(-5) per recipient.
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Affiliation(s)
- D Ready
- Microbiology, Eastman Dental Hospital, UCLH NHS Foundation Trust, London WC1X 8LD, UK.
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Ready D, Lancaster H, Mullany P, Bedi R, Wilson M. Antibiotic resistance in the cultivable plaque microbiota of children from different ethnic groups. Int J Antimicrob Agents 2006; 27:376-82. [PMID: 16647841 DOI: 10.1016/j.ijantimicag.2006.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2006] [Accepted: 02/17/2006] [Indexed: 11/20/2022]
Abstract
The presence of ampicillin-, penicillin-, erythromycin- and tetracycline-resistant bacteria in the dental plaque of White, South Asian and Japanese children was investigated. There was a high prevalence of antibiotic-resistant bacteria in children from diverse ethnic groups. The median percentage of the cultivable plaque microbiota that was resistant to tetracycline was greater in South Asian (2.9%, range 0.1-17.5%) and Japanese (7.7%, range 1.3-56.2%) children than in White children (0.7%, range 0-5.6%), suggesting that ethnic differences exist in the oral load of tetracycline-resistant bacteria (P<0.01). Multiresistant bacteria were frequently isolated, with 42% of isolates exhibiting resistance to two or more antibiotics. This study has demonstrated that antibiotic-resistant bacteria can be readily isolated from the plaque microbiota of children from different ethnic groups.
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Affiliation(s)
- D Ready
- Eastman Dental Hospital, UCLH NHS Foundation Trust, 256 Gray's Inn Road, London WC1X 8LD, UK.
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Abstract
OBJECTIVE There are more than 2,000 new cases of mouth cancer each year in Britain. Early detection is important yet little is known about population awareness of this disease and ability to recognise early signs, particularly among high risk groups. This study aimed to address this issue. METHODS Data were collected by means of household survey. A total of 3,384 adults were questioned using a national probability sample. Respondents provided information on demographic characteristics, smoking status, and frequency of alcohol use. They were asked whether they had heard of mouth cancer. Their knowledge of early signs and risk factors was assessed. RESULTS Whereas 95.6% of respondents said they had heard of mouth cancer, their awareness of early signs was low; for example, only 33.8% recognised that white patches in the mouth were a sign. The large majority understood that smoking and chewing tobacco were risk factors (84.7% and 80.1% respectively) but only 19.4% recognised alcohol use as a risk factor. In multiple logistic regression analyses controlling for relevant demographic factors, smokers and those with more frequent alcohol consumption were less likely to recognise early signs. CONCLUSIONS Awareness of early signs of mouth cancer is low and lower in people who as a result of their behaviour are at higher risk. There is a need to raise awareness in those at most risk.
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Affiliation(s)
- R West
- Department of Epidemiology and Public Health, University College London, 2-16 Torrington Place, London WC1E 6BT.
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Abstract
OBJECTIVE This study examined the constituents of smokeless tobacco products available in the UK and compared them with products available in India, Sweden, and the USA. METHODS Seven UK brands of smokeless tobacco, including a tooth cleaning powder, and four international brands of smokeless tobacco were tested for a range of toxins and known carcinogens, such as tobacco specific N-nitrosamines (TSNA), as well as nicotine availability. RESULTS Ten of the 11 brands tested had detectable levels of tobacco specific nitrosamines, which are proven carcinogens, and levels varied 130-fold. All had detectable levels of benzo(a)pyrene, another proven carcinogen (with around 175-fold variation) and several toxic metals (with nearly 150-fold variation). Nicotine availability varied in the UK products from 0.1 mg/g to 63.2 mg/g. All the tobacco products tested are likely to be hazardous to users' health, but the data indicate that it should be possible to reduce key toxins to non-detectable levels. CONCLUSIONS Smokeless tobacco products should be regulated and standards set for maximum levels of toxins and carcinogens.
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Affiliation(s)
- A McNeill
- Department of Epidemiology and Public Health, University College London, London, UK
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Sayegh A, Dini EL, Holt RD, Bedi R. Oral health, sociodemographic factors, dietary and oral hygiene practices in Jordanian children. J Dent 2005; 33:379-88. [PMID: 15833393 DOI: 10.1016/j.jdent.2004.10.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2004] [Revised: 10/11/2004] [Accepted: 10/12/2004] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To investigate the association between oral health, in terms of dental caries and gingivitis, and sociodemographic factors, dental plaque, oral hygiene behaviours, infant feeding and dietary practices in 4-5-year-old Jordanian children. METHODS Two-stage random sampling procedure was used to select children enrolled in kindergartens in Amman, Jordan. Clinical examinations were carried out by one examiner. Mothers completed questionnaires relating to sociodemographic factors, oral hygiene behaviours, infant feeding and dietary practices of the children. RESULTS About 67% of the children had caries, 31% had dmft greater than 4 and 66% had gingivitis. Of the children who had been wholly breast-fed, 86% had been fed on demand. Mothers of children attending kindergartens with the lowest tuition fees were more likely to have breast-fed their children on demand and for more than 18 months (prolonged breast feeding) compared to those attending kindergartens with higher fees. Savory snacks were consumed by 82%, confectionery by 76% and teas with sugar by 42% of the children. Multivariate analysis showed age, dental plaque, sleeping beside the mother, use of comforters and selected dietary habits to have an independent effect on caries prevalence. Dental plaque and prolonged breast feeding exerted an independent effect on caries severity and gingivitis. The strongest association with gingivitis was dental plaque. CONCLUSIONS In Jordan as elsewhere health promotion strategies need to be targeted to mothers from less advantaged backgrounds. Messages about infant breast feeding should emphasise that the method is beneficial to the oral health of the children if appropriately used.
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Bedi R, Gulati N, McGrath C. A study of satisfaction with dental services among adults in the United Kingdom. Br Dent J 2005; 198:433-7. [PMID: 15870803 DOI: 10.1038/sj.bdj.4812198] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2002] [Accepted: 04/06/2004] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To determine satisfaction with dental care services among the UK adult population, and to assess their knowledge regarding the dental complaints procedure. METHODS A national survey involving a multi-stage random sampling procedure with face-to-face home interviews of 5,385 UK residents was conducted in 1999. RESULTS The response rate was 69% and 3,739 adults took part in this study. Majority of people (89%) were satisfied with the quality of care they received. Only 2% (76) had actually complained, although 10% (388) had felt like complaining in the past. One third (32%, 1,188) did not know to whom to complain if they had a problem. Among those who knew whom to contact, over a third (36%, 1,359) would contact somebody outside the practice, while another third (31%, 1,169) would contact their dentist or dental practice. CONCLUSION Overall most people are satisfied with the quality of dental care they receive. However, 2% have complained and 10% have felt like complaining about their dentist/ dental care. In general, knowledge of the complaints procedure and whom to contact appears fragmented.
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Affiliation(s)
- R Bedi
- WHO Collaborating Centre for Disability, Culture and Oral health, National Centre for Transcultural Oral Health, Eastman Dental Institute for Oral Health Care Sciences, University of London.
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Luo Y, Zeng XJ, Du MQ, Bedi R. The prevalence of dental erosion in preschool children in China. J Dent 2005; 33:115-21. [PMID: 15683892 DOI: 10.1016/j.jdent.2004.08.007] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2004] [Revised: 08/19/2004] [Accepted: 08/24/2004] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To describe the prevalence of dental erosion and associated factors in preschool children in Guangxi and Hubei provinces of China. METHODS Dental examinations were carried out on 1949 children aged 3-5 years. Measurement of erosion was confined to primary maxillary incisors. The erosion index used was based upon the 1993 UK National Survey of Children's Dental Health. The children's general information as well as social background and dietary habits were collected based on a structured questionnaire. RESULTS A total of 112 children (5.7%) showed erosion on their maxillary incisors. Ninety-five (4.9%) was scored as being confined to enamel and 17 (0.9%) as erosion extending into dentine or pulp. There was a positive association between erosion and social class in terms of parental education. A significantly higher prevalence of erosion was observed in children whose parents had post-secondary education than those whose parents had secondary or lower level of education. There was also a correlation between the presence of dental erosion and intake of fruit drink from a feeding bottle or consumption of fruit drinks at bedtime. CONCLUSION Erosion is not a serious problem for dental heath in Chinese preschool children. The prevalence of erosion is associated with social and dietary factors in this sample of children.
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Affiliation(s)
- Y Luo
- Dental Public Health, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR, China
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Ready D, Lancaster H, Qureshi F, Bedi R, Mullany P, Wilson M. Effect of amoxicillin use on oral microbiota in young children. Antimicrob Agents Chemother 2004; 48:2883-7. [PMID: 15273096 PMCID: PMC478491 DOI: 10.1128/aac.48.8.2883-2887.2004] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Dental plaque samples from 40 children were screened for the presence of bacteria resistant to amoxicillin. Fifteen children had used amoxicillin and 25 had not used any antibiotic in the 3 months prior to sample collection. All (100%) of the children harbored amoxicillin-resistant oral bacteria. The median percentage of the total cultivable oral microbiota resistant to amoxicillin was 2.4% (range, 0.1 to 14.3%) in children without amoxicillin use and 10.9% (range, 0.8 to 97.3%) in children with amoxicillin use, with the latter value being significantly higher (P < 0.01). A total of 224 amoxicillin-resistant bacteria were isolated and comprised three main genera: Haemophilus spp., Streptococcus spp., and Veillonella spp. The biodiversity of the amoxicillin-resistant microbiota was similar among the isolates from children with and without previous antibiotic use. The amoxicillin MIC at which 90% of the isolates were inhibited for isolates from children who had used amoxicillin in the previous 3 months was higher (64 mg liter(-1)) than that obtained for the isolates from subjects who had not used antibiotics (16 mg liter(-1)). The majority of the amoxicillin-resistant isolates (65%) were also resistant to at least one of the three antibiotics tested (penicillin, erythromycin, and tetracycline), with resistance to penicillin (51% of isolates) being the most frequently encountered. However, significantly more (P < 0.05) of the amoxicillin-resistant isolates from subjects with previous amoxicillin use were also resistant to erythromycin. This study has demonstrated that a diverse collection of amoxicillin-resistant bacteria is present in the oral cavity and that the number, proportions, MICs, and resistance to erythromycin can significantly increase with amoxicillin use.
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Affiliation(s)
- D Ready
- Department of Microbiology, Eastman Dental Hospital, University College London Hospitals NHS Trust, London WC1X 8LD, United Kingdom.
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Alkhatib MN, Holt R, Bedi R. Aesthetically objectionable fluorosis in the United Kingdom. Br Dent J 2004; 197:325-8; discussion 321. [PMID: 15454999 DOI: 10.1038/sj.bdj.4811651] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2003] [Accepted: 11/18/2003] [Indexed: 11/08/2022]
Abstract
OBJECTIVES A cross-sectional national survey to explore perceptions of dental fluorosis and to determine the proportion of people regarding fluorosis as aesthetically objectionable at differing levels of defect. METHODS A survey using a multistage stratified random probability sample of 6,000 UK adult households. Face-to-face interviews were carried out using a structured questionnaire and photographs of different levels of dental fluorosis. Respondents were interviewed about the parameters of satisfaction, attractiveness and need for treatment for dental fluorosis. RESULTS The proportion of respondents perceiving teeth as unattractive, unsatisfactory and requiring treatment increased with increasing severity of dental fluorosis. Using agreement between the three negative perceptions as a measure, 14% of the sample perceived mild dental fluorosis as aesthetically objectionable, 45% at moderate level and 91% at severe levels. CONCLUSION Negative perceptions of dental fluorosis were lower than reported previously. Three parameters were included in the approach to estimate aesthetically objectionable fluorosis which may provide a more realistic measure than those used previously. The nature of the index and the sample included suggest that findings of this survey provide a reasonable indicator of the likely impact of water fluoridation. Findings may have important implications for fluoridation policies in the United Kingdom and elsewhere.
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Affiliation(s)
- M N Alkhatib
- Dental Public Health, Guy's King's & St Thomas' Dental Institute, Floor 2, Caldecot Road, Denmark Hill Campus, London SE5 9RW, UK
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Abstract
AIMS To determine the prevalence of perceived tooth discolouration in the United Kingdom and to investigate socio-demographic variations and satisfaction with own tooth colour. METHODS A national cross-sectional questionnaire study was carried out using a multistage random probability sample. Assessment of people's perceptions of their own tooth colour was conducted by asking study participants to match colour to the closest of a set of photocards demonstrating different levels of tooth discolouration. A separate question asked how satisfied they were with their tooth colour. Information on socio-demographic characteristics of the population were gathered at the same time. ANALYSIS Data was coded and entered into SPSS software. Descriptive statistics were used to determine the prevalence of perceived discolouration and satisfaction with own tooth colour. Bivariate and regression analyses were performed to explore the effect of socio-demographic variations. RESULTS The self-assessment exercise was completed for 3215 subjects. Half of the study population perceived their tooth colour to be normal and 6% perceived that they had severe discolouration, the remainder reported themselves to have levels of tooth discolouration between these two extremes. Satisfaction with tooth colour decreased with increased discolouration. Sex, age, income and smoking, had statistically significant effects on the prevalence of perceived discolouration (P< 0.01). CONCLUSIONS Half of the people in this study perceived themselves to have tooth discolouration. Results suggest that the general public is concerned about dental appearance in terms of tooth colour, indicated by public dissatisfaction with relatively mildly discoloured teeth. Findings may suggest that a further increase in the demand of tooth whitening services and cosmetic dentistry in general is likely. The changing emphasis and level of perceived dissatisfaction need to be taken into account in planning dental services. Evidence based approaches are needed for the appropriate management of patients who demand treatment of mild discolouration.
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Affiliation(s)
- M N Alkhatib
- Department of Dental and Public Health, Guy's King's & St. Thomas Dental Institute, London, UK.
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Raina V, Bhutani M, Bedi R, Sharma A, Deo S, Shukla NK, Mohanti BK, Rath G. Analysis of early breast cancer (EBC) cases at IRCH, AIIMS, New Delhi. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- V. Raina
- Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - M. Bhutani
- Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - R. Bedi
- Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - A. Sharma
- Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - S. Deo
- Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - N. K. Shukla
- Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - B. K. Mohanti
- Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - G. Rath
- Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Sharma A, Bedi R, Shukla NK, Raina V, Mohanti BK, Deo SVS, Bedi NS, Garg P, Thulkar S, Rath GK. Does chemotherapy improve survival in gall bladder cancer? J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. Sharma
- Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
| | - R. Bedi
- Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
| | - N. K. Shukla
- Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
| | - V. Raina
- Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
| | - B. K. Mohanti
- Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
| | - S. V. S. Deo
- Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
| | - N. S. Bedi
- Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
| | - P. Garg
- Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
| | - S. Thulkar
- Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
| | - G. K. Rath
- Institute Rotary Cancer Hospital, AIIMS, New Delhi, India
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Abstract
OBJECTIVES To assess the content validity of traditional oral health status scales as measures of oral health related quality of life (OHQOL), based on a general public's perception of the most important ways in which oral health affects quality of life (QoL). METHODS A nationwide United Kingdom study involving a random probability sample of 1778 adults. Data were collected by face-to-face interviews in participants homes. RESULTS Most 75% (1332) perceived oral health as being important to QoL. Among them, 53% (699/1332) identified oral health's importance to QoL as being in a positive manner. Existing scales predominantly fail to include this dimension. The general public ranked oral health's importance to QoL through a range of physical, social and psychological domains. Most frequently though affecting eating or comfort; domains considered by all instruments. Other domains/ways are presented. It is apparent that even when some of the multidomain scales are employed, they frequently omit items that the public perceives as being most important to QoL. CONCLUSION The study raises concerns about the appropriateness of utilising many of the existing oral health status scales as measures of OHQOL because the concepts do not appear to be interchangeable.
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Affiliation(s)
- C McGrath
- Periodontology & Dental Public Health, Prince Philip Dental Hospital, University of Hong Kong, Hospital Road, Hong Kong, PR China.
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Ready D, Bedi R, Spratt DA, Mullany P, Wilson M. Prevalence, proportions, and identities of antibiotic-resistant bacteria in the oral microflora of healthy children. Microb Drug Resist 2004; 9:367-72. [PMID: 15000743 DOI: 10.1089/107662903322762806] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The aims of this study were to determine the prevalence, proportions and identities of oral bacteria resistant to six antibiotics in 35 children (4-5 years old) who had not received antibiotics during the previous 3 months. Ampicillin-, penicillin-, erythromycin-, and tetracycline-resistant bacteria were harbored by 35 (100%), 34 (97%), 35 (100%), and 34 (97%) children, respectively. None of the children harbored metronidazole-resistant anaerobic bacteria or Gram-positive vancomycin-resistant bacteria. The median percentage of the oral microflora resistant to each of the antibiotics was ampicillin 1% (range 0.1-23), erythromycin 13% (1-45), penicillin 1% (0-14), and tetracycline 2% (0-88). A total of 432 antibiotic-resistant isolates were recovered that comprised 18 genera and 47 species. Ampicillin resistance was widely distributed throughout different genera and species, whereas tetracycline resistance was predominately found in the streptococci. Multiresistant bacteria were frequently isolated with 28% of isolates exhibiting resistance to two or more antibiotics. Veillonella spp., traditionally considered susceptible to penicillin and ampicillin, were found frequently to be resistant to these two antibiotics. This study demonstrates that a diverse collection of antibiotic-resistant pathogenic, opportunistic, and nonpathogenic bacteria can be readily isolated from, and in some subjects dominate, the oral microflora of primary school children in the absence of recently administered antibiotics.
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Affiliation(s)
- D Ready
- Eastman Dental Hospital, University College London Hospitals NHS Trust, London, UK.
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McGrath C, Bedi R. Can dentures improve the quality of life of those who have experienced considerable tooth loss? J Prosthet Dent 2004. [DOI: 10.1016/j.prosdent.2004.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
The aim of this study is to document reasons for tooth loss in disadvantaged Jordanians who seek free dental care at the University Hospital/Dental Clinics. A 4-year (1998-2001) prospective study was undertaken involving 2200 randomly selected patients from this subpopulation. Of their 3069 lost teeth, 46.9% were lost due to caries and its sequel; 18% were lost because of periodontal disease; 8% were lost for a combination of caries and periodontal disease; 19.4% for pre-prosthetic reasons; 4% for orthodontic reasons; 2.8% for eruption problems and 0.7% due to trauma. Logistic regression analysis for reasons of tooth loss in this sector revealed that caries and its sequel was the predominant cause of tooth loss in patients <or=40 years of age whereas periodontal extractions were predominant for the above 40-year-old group. In addition, the most frequently extracted teeth, due to caries, were lower first and second molars while lower incisors were most commonly extracted for periodontal disease. Premolars were extracted for orthodontic reasons, upper incisors for trauma, third molars for eruption problems and canines for pre-prosthetic reasons. In conclusion, dental caries was the main reason for removal of teeth in adults attending the University of Jordan free dental casualty clinic. Therefore, in order to reduce the rate of dental extractions in this sector of the Jordanian population, efforts should focus on prevention and treatment of caries. Efforts should also be made to change the values and beliefs of this sector towards the importance of natural dentition.
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Affiliation(s)
- A Sayegh
- Department of Oral Surgery, Oral Medicine and Periodontology, Faculty of Dentistry/University of Jordan, Amman, Jordan
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McGrath C, Alkhatib MN, Al-Munif M, Bedi R, Zaki AS. Translation and validation of an Arabic version of the UK oral health related quality of life measure (OHQoL-UK) in Syria, Egypt and Saudi Arabia. Community Dent Health 2003; 20:241-5. [PMID: 14696744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
OBJECTIVE The aim of this study was to translate and evaluate the performance of an oral health related quality of life measure--an Arabic version of OHQoL-UK in three middle eastern countries: Syria, Egypt and Saudi Arabia. BASIC RESEARCH DESIGN Following forward and backwards translation of OHQoL-UK into Arabic and pilot testing the Arabic version among focus groups, a questionnaire containing the instrument was administered to 1,000 adults from the three Arab countries. In addition, the study participants were interviewed about their oral health status, experience of oral health problems in the past year, self-rating of oral health and also some socio-demographic information was collected. RESULTS Among the three study populations, variations in OHQoL-UK scores were apparent in relation to socio-demographic factors (p<0.01), self-reported number of teeth possessed (p<0.001) and experience of oral health problems in the past year (p<0.01) which supports the construct validity of the instrument. Furthermore, variations in OHQoL-UK scores were apparent in relation to self-rating of oral health status (p<0.01) which supports the criterion validity of the measure. The internal reliability of the instrument was high in the three groups with Cronbach alpha values of above 0.90, indicating good internal consistency. CONCLUSION The Arabic version of OHQoL-UK, an index of oral health related quality of life demonstrated satisfactory construct validity, criterion validity and internal reliability in Syria, Egypt and Saudi Arabia. This provides further evidence of the instrument's psychometric properties and its cross cultural use.
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Affiliation(s)
- C McGrath
- Periodontology & Public Health, Prince Philip Dental Hospital, University of Hong Kong, SAR, China.
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Abstract
- The aim of this study was to determine the prevalence of traumatised permanent teeth among sensory (visual (VI) and hearing (HI)) impaired children attending special schools in Riyadh, Saudi Arabia. All the dental injuries involved incisor teeth, and trauma was noted in 33 (6.7%) children attending government schools (control group) compared to 7 (9%) VI children and 24 (11.4%) HI children. Differences in the dental trauma only reached statistical significance between the HI and control group (P < 0.05). Gender differences were only apparent in the HI group, with males having higher levels of traumatised teeth. In addition, HI children aged 11-12 years were more prone to trauma than children in the control group of the same age (P < 0.05). In conclusion, sensory impaired children do have a tendency for more dental trauma. However, this was only statistically significant for HI children. Whereas a gender difference was most noticeable for the HI group, with males having higher levels of trauma, this was noticeable by its absence among VI children.
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Affiliation(s)
- M AlSarheed
- Department of Transcultural Oral Health, Eastman Dental Institute for Oral Health Care Sciences, University College London, UK
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Al-Sarheed M, Bedi R, Hunt NP. Orthodontic treatment need and self-perception of 11-16-year-old Saudi Arabian children with a sensory impairment attending special schools. J Orthod 2003; 30:39-44; discussion 22. [PMID: 12644606 DOI: 10.1093/ortho/30.1.39] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
AIM To determine the self-perception and need for orthodontic treatment in young sensory [visual (VI) and hearing (HI)] impaired children attending special schools in Riyadh, Saudi Arabia. Also, to determine if gender and social class background influence the rating and self-perception of malocclusion among the children. LOCATION Riyadh, Saudi Arabia. DESIGN A prospective study on orthodontic treatment need in sensory impaired children. SUBJECTS Seventy-seven VI, 210 HI, and 494 control (C) children aged 11-16 years. METHOD The aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) was determined using the standard 10 pictures for the C group and HI with a modified version (tactile graphic) for VI. The dental health component (DHC) and AC of IOTN were used to allocate each child to no need, borderline need and definite need for treatment subgroups. RESULTS Sixty-five per cent of VI, 21.8 per cent HI, and 18.7 per cent of the C were perceived to be in need of orthodontic treatment. However, 55.8 VI, 43 per cent HI and 34 per cent C were rated for treatment need based upon the AC. The difference between the examiner and the child's rating of treatment need was found to be statistically significant among the HI and control children (P < 0.001). CONCLUSION The VI children who were scored for treatment by the examiner as having need for treatment had similar perceptions of their treatment need irrespective of their social background. Male VI children had a higher DHC score, but both VI and HI males had a higher normative and self-perceived need based on AC.
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Affiliation(s)
- M Al-Sarheed
- Department of Transcultural Oral Health, Eastman Dental Institute for Oral Health Care Sciences, London, UK
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Dini EL, McGrath C, Bedi R. An evaluation of the oral health quality of life (OHQoL) instrument in a Brazilian population. Community Dent Health 2003; 20:40-4. [PMID: 12688603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVES To translate and evaluate the performance of a Brazilian Portuguese version of the United Kingdom Oral Health related Quality of Life instrument, OHQoLUK, in assessing the impact of oral health on quality of life among a Brazilian adult population. DESIGN Following forward-backwards translation the 16-item OHQoLUK measure was administered to adults utilising municipal dental health services in Araraquara, São Paulo, Brazil. The instrument's psychometric properties, validity and reliability, were assessed. RESULTS The response rate was 72% (323/450). OHQoLUK scores were associated with self-reported oral health status including number of teeth present (p < 0.001), denture status (p < 0.01) and self-reported dental attendance pattern; time (p < 0.05) and reason for last dental visit (p < 0.001), supporting the construct validity of the measure. In addition, OHQoLUK scores were associated with self-ratings of oral health (p < 0.0001) and perceived need for dental treatment (p < 0.001), supporting it's criterion validity. Internal reliability was high: Cronbach's alpha = 0.96, while the agreement for each of the 16 OHQoLUK items (Kappa values) ranged from 0.57 to 0.87. CONCLUSION The Brazilian Portuguese version of OHQoLUK measure of oral health related quality of life performed well, exhibiting good validity (face, construct and criterion) and reliability (internal and external). This confirms the sound psychometric properties of the OHQoLUK measure and the applicability of the Portuguese version among a Brazilian population.
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Affiliation(s)
- E L Dini
- WHO Collaborating Centre for Disability, Culture and Oral Health, National Center for Transcultural Oral Health, Eastman Dental Institute for Oral Health Care Sciences, University College London, UK.
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Abstract
OBJECTIVES The aims of this study were to establish normative age-gender values for the UK oral health related quality of life measure (OHQoL-UK) in Britain and to provide a local reference for its interpretation. In addition, to identify key factors associated with oral health related quality of life in the UK. MATERIALS AND METHODS A national survey conducted with the assistance of the Office for National Statistics involving a random probability sample of 2,718 households. Participants were interviewed about their oral health status. The impact of oral health on quality of life was measured using the 16 item OHQoL-UK measure. RESULTS The response rate was 68% (1,838/2,718). The majority (75%, 1,378/1,838) perceived their oral health as affecting their life quality and did so across a wide range of domains. Age-gender norm values are presented. Variations in OHQoL-UK scores were apparent in relation to socio-demographics: age (P<0.05), social class (P<0.01), and self-reported oral health status: number of teeth possessed (P<0.01). CONCLUSIONS The impact of oral health on the life quality of Britons was substantial, in both positive and negative ways and associated with socio-demographic and oral health (self-reported) factors. National norm values presented should provide a reference source for meaningful interpretation of similar data and local studies.
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Affiliation(s)
- C McGrath
- Faculty of Dentistry, Prince Dental Hospital, University of Hong Kong, Hospital Road, Hong Kong.
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Sayegh A, Dini EL, Holt RD, Bedi R. Caries prevalence and patterns and their relationship to social class, infant feeding and oral hygiene in 4-5-year-old children in Amman, Jordan. Community Dent Health 2002; 19:144-51. [PMID: 12269460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVES To investigate the relationship between social class, infant feeding, oral hygiene, and prevalence and patterns of caries in 4-5-year-old Jordanian children. METHOD Two-stage random sampling procedure was used to select children enrolled in kindergartens in Amman, Jordan. Clinical examinations were carried out by one examiner. Mothers completed questionnaires relating to social class, infant feeding and the oral hygiene habits of the children. RESULTS Sixty-seven per cent of the children had caries; 30% had the more extensive pattern involving molars and incisors. When the significant variables were taken into account, age, social class, sleeping with the mother, use of comforter and confectionery at bed/night time were shown to be independent risk factors for caries experience. Bottle-feeding at nap/bed/night time was associated with caries in incisors and caries in incisors and/or canines. Never being breast-fed, being breast-fed for more than 18 months, being breast-fed at nap/bed/night time showed a negative association with caries confined to molars although this showed a positive association with the more extensive pattern of the disease. CONCLUSIONS Education for mothers about appropriate breast and bottle-feeding practices should be considered in health promotion strategies.
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Sayegh A, Dini EL, Holt RD, Bedi R. Food and drink consumption, sociodemographic factors and dental caries in 4-5-year-old children in Amman, Jordan. Br Dent J 2002; 193:37-42. [PMID: 12171204 DOI: 10.1038/sj.bdj.4801478] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate the association between type of food and drink consumption, sociodemographic factors and prevalence and severity of caries in 4-5-year-old Jordanian children. METHOD Two-stage random sampling procedure was used to select children enrolled in kindergartens in Amman. Clinical examinations were carried out by one examiner. Mothers completed a questionnaire relating to sociodemographic factors and food and drink consumption. RESULTS Snack foods were consumed by a high percentage of children. Amongst the most popular 'high in NME sugar snacks', confectionery was reported to be regularly consumed by 76% and biscuits and cakes by 71% of them. More than 50% had carbonated drinks. Children from a lower social class, attending a kindergarten with lower tuition fees had more dessert, squashes and more teas with sugar. When all variables were considered, consumption of confectionery was independently associated with caries prevalence and consumption of teas with sugar was independently associated with caries severity. CONCLUSION The types of foods and drinks consumed as snacks by young Jordanian children were similar to those of Western countries. In the absence of more widespread oral health promotion measures and in the presence of high prevalence and severity of caries,the oral health of Jordanian children is a matter of concern.
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Abstract
OBJECTIVES This study was designed to identify association between self reported dental attendance patterns and family structure in the UK. DESIGN A national study involving 666 women with dependent children. SETTING Home interviews were undertaken exploring time and reason for last dental visit. In addition, numerous sociodemographic and service related characteristics were collected. RESULTS Bivariate analysis identified that family structure was associated with respondents' self reported dental attendance patterns: marital status (p<0.01), number of children (p<0.05), and age of children (p<0.05). When the combined effects of age, family structure, income, educational attainment, working status, and service factors (difficulty obtaining a NHS dentist and time taken to get an appointment) on dental attendance were explored, family structure emerged as a very important predicator of service use. Notably, young (age 16-34) single mothers and those with more than two children were less likely to have attended the dentist within the past year for reasons other than a dental emergency compared with older (age 35 or more), mothers from a two parent family and those with one or two children. CONCLUSION Family structure is associated with self reported dental attendance patterns. Young single mothers with more than two children may be failing to monitor their oral health appropriately.
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Affiliation(s)
- C McGrath
- WHO Collaborating Centre for Disability, Culture and Oral Health, National Centre for Transcultural Oral Health, Eastman Dental Institute for Oral Health Care Sciences, University of London, UK.
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