Publications by authors named "Rahul Nair"

55 Publications

Factors influencing the utilization of dental services in East Java, Indonesia.

F1000Res 2020 3;9:673. Epub 2020 Jul 3.

Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Despite high levels dental issues and insurance coverage in the East Java province Indonesia, the utilization of dental services is still low. This research aims to test some indicators for dental service utilization among East Java residents. A secondary analysis was undertaken using data on the East Java province from the Indonesian Basic Health Research 2013, which included 90,551 randomly selected respondents aged 5-100 years old. Socio-demographic characteristics (age, sex, education and residential location), dental behavior (tooth brushing habit), and clinical (dental) condition were self-reported through a questionnaire. Multivariable models were generated to estimate prevalence ratios (PR), and 95% confidence intervals (95%CI). Prevalence of dental service utilization during the last 12 months in East Java province is only 9 %. Respondents 25-50 years old showed the highest utilization of dental services. Being male, having lower education and living in a district (as opposed to municipalities) were indicators for having lower utilization of dental treatment (PR [95% CI] = 0.81 [0.79-0.84], PR [95% CI] = 0.89 [0.86-0.93] and PR [95% CI] = 0.91 [0.88-0.95], respectively). Respondents with poor tooth brushing habit showed lower utilization of dental services. Having teeth was associated with higher utilization of dental treatment (PR [95% CI] = 1.39 [1.16-1.66). Age, sex, education and residential location influence the utilization of dental services among Indonesia's East Java residents. Poor tooth brushing habits and being edentulous are also indicators of lesser utilization. These results call for urgent public health interventions to increase equitable dental care services utilization.
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http://dx.doi.org/10.12688/f1000research.23698.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082568PMC
July 2020

Ultra-thin structures of manganese fluorides: conversion from manganese dichalcogenides by fluorination.

Phys Chem Chem Phys 2021 May;23(17):10218-10224

Department of Photonics, Izmir Institute of Technology, 35430, Izmir, Turkey.

In this study, it is predicted by density functional theory calculations that graphene-like novel ultra-thin phases of manganese fluoride crystals, that have nonlayered structures in their bulk form, can be stabilized by fluorination of manganese dichalcogenide crystals. First, it is shown that substitution of fluorine atoms with chalcogens in the manganese dichalcogenide host lattice is favorable. Among possible crystal formations, three stable ultra-thin structures of manganese fluoride, 1H-MnF2, 1T-MnF2 and MnF3, are found to be stable by total energy optimization calculations. In addition, phonon calculations and Raman activity analysis reveal that predicted novel single-layers are dynamically stable crystal structures displaying distinctive characteristic peaks in their vibrational spectrum enabling experimental determination of the corresponding phases. Differing from 1H-MnF2 antiferromagnetic (AFM) large gap semiconductor, 1T-MnF2 and MnF3 single-layers are semiconductors with ferromagnetic (FM) ground state.
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http://dx.doi.org/10.1039/d1cp00293gDOI Listing
May 2021

Economic evaluations in the treatment and evaluation of patients with periodontal disease: A critical review.

J Clin Periodontol 2021 May 25;48(5):679-694. Epub 2021 Mar 25.

Saw Swee Hock School of Public Health, National University of Singapore, Singapore City, Singapore.

Aim: To evaluate the types and quality of reporting of economic evaluations carried out in the clinical management of periodontal disease over 32 years from 1987 to 2019.

Material And Methods: A systematic search of articles from 1987 to 2019 was conducted using PubMed, Web of Science, The Cochrane Central Register of Controlled Trials, Health Technology Assessment Database and Embase. The quality of the economic evaluations was assessed based on the Consolidated Health Economic Evaluation Reporting Standard checklist. Due to considerable between-study heterogeneity, a meta-analysis was not performed.

Results: Twenty one publications were included. 11 studies used cost-effectiveness analysis, five used cost-minimization analysis, four used cost-utility analysis and two used cost-benefit analysis. Comparators, choice of health outcomes, estimating resources and costs were fully reported in all studies. Many studies had inadequate reporting in terms of estimating resources and costs, choice of health outcomes, characterizing heterogeneity and study perspective.

Conclusions: There has been an increase in health economics studies in the field of clinical periodontology over the past decade. Several studies did not report study perspective, and the health outcomes chosen were not relevant for some studies. Future studies should follow an economic evaluation checklist for high-quality reporting and consistency.
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http://dx.doi.org/10.1111/jcpe.13456DOI Listing
May 2021

Neuroimmunomodulation by estrogen in health and disease.

AIMS Neurosci 2020 30;7(4):401-417. Epub 2020 Oct 30.

Inspire Laboratory, Institute of Advanced Research in Health Sciences, Tamil Nadu Government Multi Super Speciality Hospital, Omandurar Government Estate, Chennai-600002, India.

Systemic homeostasis is maintained by the robust bidirectional regulation of the neuroendocrine-immune network by the active involvement of neural, endocrine and immune mediators. Throughout female reproductive life, gonadal hormones undergo cyclic variations and mediate concomitant modulations of the neuroendocrine-immune network. Dysregulation of the neuroendocrine-immune network occurs during aging as a cumulative effect of declining neural, endocrine and immune functions and loss of compensatory mechanisms including antioxidant enzymes, growth factors and co-factors. This leads to disruption of homeostasis and sets the stage for the development of female-specific age-associated diseases such as autoimmunity, osteoporosis, cardiovascular diseases and hormone-dependent cancers. Ovarian hormones especially estrogen, play a key role in the maintenance of health and homeostasis by modulating the nervous, endocrine and immune functions and thereby altering neuroendocrine-immune homeostasis. Immunologically estrogen's role in the modulation of Th1/Th2 immune functions and contributing to pro-inflammatory conditions and autoimmunity has been widely studied. Centrally, hypothalamic and pituitary hormones influence gonadal hormone secretion in murine models during onset of estrous cycles and are implicated in reproductive aging-associated acyclicity. Loss of estrogen affects neuronal plasticity and the ensuing decline in cognitive functions during reproductive aging in females implicates estrogen in the incidence and progression of neurodegenerative diseases. Peripherally, sympathetic noradrenergic (NA) innervations of lymphoid organs and the presence of both adrenergic (AR) and estrogen receptors (ER) on lymphocytes poise estrogen as a potent neuroimmunomodulator during health and disease. Cyclic variations in estrogen levels throughout reproductive life, perimenopausal surge in estrogen levels followed by its precipitous decline, concomitant with decline in central hypothalamic catecholaminergic activity, peripheral sympathetic NA innervation and associated immunosuppression present an interesting study to explore female-specific age-associated diseases in a new light.
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http://dx.doi.org/10.3934/Neuroscience.2020025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701372PMC
October 2020

Prehospital Frailty and Screening Criteria for Palliative Care Services in Critically Ill Older Adults: An Observational Cohort Study.

J Palliat Med 2021 Feb 23;24(2):252-256. Epub 2020 Jun 23.

Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Bronx, New York, USA.

The use of formalized criteria (or triggers) for palliative care services (PCSs) has been associated with increased use of PCSs in the intensive care unit (ICU). To explore the utility/validity of frailty as a trigger for providing PCSs. This is a prospective cohort study. Older adults (age ≥50 years) admitted to ICUs were enrolled. We measured frailty using the Clinical Frailty Scale. We reviewed electronic health records for the presence/absence of six evidence-based triggers, the use and quality of specialty palliative care (SPC), and markers of primary palliative care (PPC). We used descriptive statistics to describe the differences in PPC, SPC, and six-month mortality by frailty and by the presence/absence of triggers. In a study population of 302 older adults, mean (standard deviation) age 67.2 years (10.5), 151 (50%) were frail and 105 (34.8%) had ≥1 trigger for PCSs. Of the 151 (55.6%) frail patients, 84 had no triggers for PCSs, despite a 46.4% six-month mortality in this group. Patients with ≥1 trigger had higher rates of SPC than those without (39.1% vs. 18.3%,  < 0.001); frail patients also had higher SPC than nonfrail patients (32.5% vs. 18.5%,  = 0.006). Patients with ≥1 trigger had higher rates of PPC than those without (66.7% vs. 44.2%,  < 0.001); no statistically significant difference in PPC was found by frailty (56.3% vs. 47.7%,  = 0.134). The rates of PCSs and six-month mortality by frailty are consistent with frailty being a valid trigger for PCSs in ICUs; the high prevalence of frailty relative to triggers suggests that ways to increase PCSs would be needed.
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http://dx.doi.org/10.1089/jpm.2019.0678DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840303PMC
February 2021

Depression symptoms and recurrent aphthous stomatitis-Evidence from a population-based study in Indonesia.

Oral Dis 2020 Jul 21;26(5):948-954. Epub 2020 Feb 21.

Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Objectives: This study aims to report the prevalence and distribution of recurrent aphthous stomatitis (RAS) among Indonesian adults and to test the relationship between symptom of depression and RAS.

Methods: Data from the 2007 Indonesia Family Life Survey (IFLS 2007) were analysed to assess the association between symptom of depression and RAS. The prevalence of RAS in the previous month was self-reported. Symptom of depression was measured using the 10-item Center for Epidemiologic Studies Depression (CES-D) scale. The distribution of RAS according to age, sex and level of stress was also presented in the bivariate analysis. Multivariable logistic regression models were fitted to test associations between symptom of depression and RAS, controlling for age, sex and the stress level.

Results: The previous month prevalence of RAS in Indonesian population was 12%. The adjusted odds ratios (ORs) from the logistic regression models indicate that, for each unit increase in the CES-D depression score (range: 0-30), there was a 9% increase in the odds of having RAS (OR: 1.09, 95%CI: 1.08-1.10). Being older and being male was related with lower prevalence of RAS.

Conclusions: A higher score of depression was related to a higher prevalence of RAS. This association was persistent even after controlling for age, sex and the level of stress.
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http://dx.doi.org/10.1111/odi.13303DOI Listing
July 2020

Brief Report: Psychometric Properties of the Ability in Behavior Assessment and Interventions for Teachers-Revised (ABAIT-R).

J Autism Dev Disord 2020 Mar;50(3):1081-1087

Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen K, Denmark.

Given the importance of competencies in functional behavior assessment (FBA) and behavioral interventions among teachers for managing problem behaviors among children with autism spectrum disorder (ASD) and other developmental disabilities, a previously reported ability in behavior assessment and interventions for teachers (ABAIT) needed improvements in the multiple-choices by adding a 'don't know' option. This study reports on the psychometric properties of this revised scale (ABAIT-R) among 102 special educators assessed using Rasch models. It was found that the model had good fit and a wide spread of difficulties (3.63 to - 2.60). ABAIT-R had good targeting (over 85%) and high reliability (0.79). The assumptions of the model were met recommending sufficiency for the use of summated score from ABAIT-R among teachers.
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http://dx.doi.org/10.1007/s10803-019-04286-5DOI Listing
March 2020

Degrees of xerostomia? A Rasch analysis of the Xerostomia Inventory.

Community Dent Oral Epidemiol 2020 02 12;48(1):63-71. Epub 2019 Nov 12.

Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.

Objective(s): The global demographic changes resulting in an ageing population require attention on xerostomia, as its prevalence appears to increase with age. The Xerostomia Inventory (XI) is a 11-item instrument developed to evaluate the symptoms and behavioural components of xerostomia, while a shortened 5-item version named Summated Xerostomia Inventory (SXI) was later proposed. The aim of the present study was to evaluate the construct validity of the XI and whether the SXI can provide a shortened version. Since previous studies focused only on dimensionality and reliability, we employed modern psychometric methodology to investigate properties such as differential item functioning (DIF) and targeting.

Study Design: The XI was applied to 164 middle-aged to older adults who participated in a randomized controlled trial to investigate the effects of alcohol-containing mouth rinse in Singapore. The psychometric properties of the XI were investigated with the Rasch model (Partial Credit Model). Overall model fit was evaluated with a summary chi-square statistic. Item fit was evaluated with the Fit Residual, and values between -2.5 and 2.5 are considered acceptable. DIF by sex was evaluated through a two-way ANOVA of the residuals.

Results: After collapsing the categories of "Hardly ever" and "Fairly often", the test of global fit (χ (30) = 34.32, P = .27) indicated overall fit to the Rasch model. Since Fit Residuals were between -2 and 2, the fit of individual items was also adequate. No DIF was found between men and women, and targeting was adequate (μ = -0.56).

Conclusion: The current study expanded the evidence on the XI and SXI validity and provides new implications for practice: a 3-point categorization ("Never," "Occasionally" and "Very often") should be preferred rather than the original 5-point categorization; the XI and SXI scores can be compared between men and women and will reflect true differences in xerostomia rather than measurement bias.
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http://dx.doi.org/10.1111/cdoe.12504DOI Listing
February 2020

Pediatricians' Self-Efficacy Affects Frequency of Giving Oral Health Advice, Conducting Oral Examination, and Prescribing Referrals.

J Dent Child (Chic) 2019 Sep;86(3):131-138

Dr. Tong is an adjunct senior lecturer, Faculty of Dentistry, National University Centre for Oral Health, Singapore.

To assess the role of pediatricians' self-efficacy on frequency of enquiring about dental visits, conducting oral examinations, and prescription of referrals to dentists.
Pediatricians and pediatric medicine residents in public hospitals in Singapore completed a self-administered written questionnaire between April and October 2015. Participants' demographics, training, knowledge of oral health, perceived importance of oral health, and confidence in health-promoting behaviors were assessed. Self-efficacy related to oral health, including frequency of enquiring about dental visits, conducting oral examinations, and prescribing dental referrals, was measured. Generalized linear models were used for bivariate and multivariable analyses.
A total of 122 responses were analyzed out of 227 that were sent out (response rate: 53.7 percent). Confidence in oral health knowledge was related to the frequency of enquiring about dental visits (relative risk [RR] = 0.74; 95 percent confidence interval [95% CI] = 0.55 to 1.00; =0.047). Confidence in identification of caries was related to frequency of examination for oral diseases (RR=0.62; 95% CI=0.49 to 0.79; <0.001). Confidence in giving oral health advice was related to referral of children with special needs (B=0.30; 95% CI=0.07 to 0.53; =0.01) and those without (B=0.42; 95% CI=0.23 to 0.61; <0.001).
Pediatricians' self-efficacy was strongly associated with the frequency with which they advised, examined, and referred children for oral-health-related reasons. (J Dent Child 2019;86(3):131-8).
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September 2019

Frailty, Acute Organ Dysfunction, and Increased Disability After Hospitalization in Older Adults Who Survive Critical Illness: A Prospective Cohort Study.

J Intensive Care Med 2020 Dec 13;35(12):1505-1512. Epub 2019 Oct 13.

Department of Medicine, Division of Critical Care Medicine, 2013Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.

Purpose: We aimed to describe the association between prehospital frailty (PHF), acute organ dysfunction (AOD), and posthospital disability (PHD) outcome in older adults admitted to the intensive care unit (ICU).

Methods: In a prospective observational cohort study, we assessed PHF using the Clinical Frailty Scale (CFS) and assessed the level of AOD using Sequential Organ Failure Assessment (SOFA) scores on ICU day 1. We assessed Activities of Daily Living disability levels through to 6 months after discharge and used generalized estimating equations (log link and negative binomial family) to determine the independent association of PHF and AOD with PHD.

Results: Of the 302 patients enrolled, 221 (73.1%) survived the hospitalization. Prehospital frailty was associated with PHD (adjusted incident rate ratio [aIRR] 95% confidence interval [95% CI] per unit increase in CFS 1.38 [1.15-1.67], = .001). Total day 1 SOFA score was weakly associated with PHD, (aIRR [95% CI] 1.05 [1.00-1.10], = .037) while day 1 SOFA neurologic score was strongly associated with PHD (aIRR [95% CI] 1.42 [1.24-1.62] per unit increase in SOFA neurologic score, < .001), and these effects were independent of PHF and other premorbid factors.

Conclusions: Both PHF and early acute brain dysfunction are important factors associated with increasing PHD in older adults who survive critical illness.
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http://dx.doi.org/10.1177/0885066619881115DOI Listing
December 2020

Two-Dimensional Covalent Crystals by Chemical Conversion of Thin van der Waals Materials.

Nano Lett 2019 Sep 26;19(9):6475-6481. Epub 2019 Aug 26.

Department of Physics , University of Antwerpen , Groenenborgerlaan 171 , B-2020 Antwerpen , Belgium.

Most of the studied two-dimensional (2D) materials have been obtained by exfoliation of van der Waals crystals. Recently, there has been growing interest in fabricating synthetic 2D crystals which have no layered bulk analogues. These efforts have been focused mainly on the surface growth of molecules in high vacuum. Here, we report an approach to making 2D crystals of covalent solids by chemical conversion of van der Waals layers. As an example, we used 2D indium selenide (InSe) obtained by exfoliation and converted it by direct fluorination into indium fluoride (InF), which has a nonlayered, rhombohedral structure and therefore cannot  possibly be obtained by exfoliation. The conversion of InSe into InF is found to be feasible for thicknesses down to three layers of InSe, and the obtained stable InF layers are doped with selenium. We study this new 2D material by optical, electron transport, and Raman measurements and show that it is a semiconductor with a direct bandgap of 2.2 eV, exhibiting high optical transparency across the visible and infrared spectral ranges. We also demonstrate the scalability of our approach by chemical conversion of large-area, thin InSe laminates obtained by liquid exfoliation, into InF films. The concept of chemical conversion of cleavable thin van der Waals crystals into covalently bonded noncleavable ones opens exciting prospects for synthesizing a wide variety of novel atomically thin covalent crystals.
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http://dx.doi.org/10.1021/acs.nanolett.9b02700DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6814286PMC
September 2019

Self-Limiting Growth of Two-Dimensional Palladium between Graphene Oxide Layers.

Nano Lett 2019 Jul 13;19(7):4678-4683. Epub 2019 Jun 13.

Department of Physics , University of Antwerpen , Groenenborgerlaan 171 , B-2020 Antwerpen , Belgium.

The ability of different materials to display self-limiting growth has recently attracted an enormous amount of attention because of the importance of nanoscale materials in applications for catalysis, energy conversion, (opto)electronics, and so forth. Here, we show that the electrochemical deposition of palladium (Pd) between graphene oxide (GO) sheets result in the self-limiting growth of 5-nm-thick Pd nanosheets. The self-limiting growth is found to be a consequence of the strong interaction of Pd with the confining GO sheets, which results in the bulk growth of Pd being energetically unfavorable for larger thicknesses. Furthermore, we have successfully carried out liquid exfoliation of the resulting Pd-GO laminates to isolate Pd nanosheets and have demonstrated their high efficiency in continuous flow catalysis and electrocatalysis.
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http://dx.doi.org/10.1021/acs.nanolett.9b01733DOI Listing
July 2019

Psychometric properties of the Child Oral-care Performance Assessment Scale.

Community Dent Oral Epidemiol 2019 10 30;47(5):424-430. Epub 2019 May 30.

ARCPOH, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia.

Objectives: This study aimed to assess the psychometric properties of Child Oral-care Performance Assessment Scale (COPAS).

Methods: Items for the instrument were developed and pilot tested. This questionnaire was implemented in the Australian National Child Oral Health Study 2012-2014, whose aims included the assessment of oral care performance. This nationally representative sample of 23 538 respondents with complete data was divided into five groups: a main validation group and four cross-validation groups, using blocked randomization. Two scales were constructed, full scale with 37 items (COPAS) and a partial scale with a subset of 31 items (COPAS-Partial). Internal consistency was assessed using Cronbach's alpha. Construct validity was assessed using correlation coefficients, and structural validity was ascertained in the main validation group and confirmed in the cross-validation groups using structural equation models.

Results: Cronbach's alpha for COPAS was 0.95, and for COPAS-Partial was 0.94. The convergent validity of global satisfaction with oral care and the subscales was r = 0.29-0.51, and that with the overall scales was r = 0.59 for COPAS and r = 0.59 for COPAS-Partial. COPAS (Root mean squared error of approximation (RMSEA) = 0.06, Comparative fit index (CFI) = 0.90, Tucker-Lewis index (TLI) = 0.89, and Coefficient of determination(COD) = 0.99) and COPAS-Partial (RMSEA = 0.07, CFI = 0.91, TLI = 0.90, COD = 0.97) had adequate fit. Structural invariance was present (P-value = 0.97).

Conclusion: There was acceptable structural validity, construct validity and internal consistency in the models tested for COPAS and COPAS-Partial. COPAS has potential use in the evaluation of the delivery of dental services to children.
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http://dx.doi.org/10.1111/cdoe.12476DOI Listing
October 2019

RAPD markers for screening shoot gall maker ( Swinhoe) tolerant genotypes of amla ( L.).

J Genet Eng Biotechnol 2017 Dec 27;15(2):323-330. Epub 2017 Jul 27.

Department of Plant Biotechnology, School of Biotechnology, Madurai Kamaraj University, Palkalai Nagar, Madurai 625 021, Tamil Nadu, India.

Linn. is the most important medicinally useful tree crop in Asian Subcontinent and is severely infested by Swinhoe, known as shoot gall maker (SGM). This pest tunnels the shoots of seedlings and actively growing branches of trees and develops gall, leading to stunted growth, unusual branching and death of actively growing shoots. Our study revealed that trees possessing smooth bark were free from the attack of this pest than those with rough bark surface. Unfortunately, this character is not detectable either at seedling stage or during early growth of trees in the orchard. RAPD genetic fingerprinting of trees possessing smooth and rough bark revealed distinguishable and highly reproducible DNA banding pattern between the two genotypes. Of the 20 RAPD primers tested, five of them produced distinguishable RAPD bands between rough and smooth barked genotypes of . Trees with smooth bark produced five unique RAPD bands with molecular weight ranging from 350 bp to 1500 bp and those with rough bark produced six RAPD bands (350 bp-650 bp) to utilize these DNA bands as potential DNA marker for screening tolerant genotypes of this crop against SGM. The utility of this finding in genetic improvement of this tree crop against SGM is discussed.
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http://dx.doi.org/10.1016/j.jgeb.2017.07.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296637PMC
December 2017

Development and Validation of the Ability in Behavior Assessment and Interventions for Teachers Using Delphi Technique and Rasch Analysis.

J Autism Dev Disord 2019 May;49(5):1976-1987

Adelaide Dental School, ARCPOH, University of Adelaide, Floor/Room WS9105.14, North Terrace, Adelaide, Australia.

Functional Behavior Assessment (FBA) and behavior interventions have been effective in the management of challenging behavior among children with developmental disabilities including autism spectrum disorders. Research suggests the need for valid measurement instruments for verifying, calibrating and scoring competence in FBA and behavior interventions. The validation for the Ability in Behaviour Assessment and Interventions for Teachers (ABAIT) adopted the Delphi method for developing consensus followed by the application of Rasch Measurement Model (RMM). RMM among 292 special educators reported appropriate infit (0.84-1.11), outfit (0.94-1.05), and item separation reliability (0.99), though some items reported low point-biserial correlation. The ABAIT was developed with expert consensus and was found to have a suitable fit with RMM.
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http://dx.doi.org/10.1007/s10803-019-03887-4DOI Listing
May 2019

Cytomorphological Spectrum of Thyroiditis: A Review of 110 Cases.

J Thyroid Res 2018 1;2018:5246516. Epub 2018 Mar 1.

Department of Pathology, Dr. D. Y. Patil Medical College, Pimpri, Pune 411018, India.

Introduction: Different types of thyroiditis may share some parallel clinical and biochemical features. Timely intervention can significantly reduce morbidity and mortality.

Aim: Aim of this study is to find the frequency of various thyroiditis, study the cytomorphological features and correlate with clinical findings including radiological findings, thyroid function test, and anti-thyroid peroxidase antibodies (Anti-TPO antibodies).

Materials And Methods: The study included consecutive 110 cases of thyroiditis. Detailed cytomorphological features were studied and correlated with ultrasonography findings, thyroid function test, anti-thyroid peroxidase antibodies (anti-TPO) and histopathological features where thyroidectomy specimens were received for histopathological examination.

Results: The majority were Hashimoto's thyroiditis ( = 100) and females ( = 103). Other forms of thyroiditis were Hashimoto's thyroiditis with colloid goiter ( = 5), De Quervain's thyroiditis ( = 3), and one case each of postpartum thyroiditis and Hashimoto's thyroiditis with associated malignancy. The majority of patients were in the age group of 21-40 ( = 70) and the majority ( = 73) had diffuse enlargement of thyroid. The majority of patients were hypothyroid ( = 52). The serum anti-TPO antibodies were elevated in 47 patients out of 71 patients. In the 48 patients who underwent ultrasonography, 38 were diagnosed as having thyroiditis. The most consistent cytomorphological features seen in fine-needle aspiration smears of Hashimoto's thyroiditis were increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells.

Conclusion: The diagnostic cytological features in Hashimoto's thyroiditis are increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells. FNAC remains the "Gold Standard" for diagnosing Hashimoto's thyroiditis. Clinical history, thyroid function, and biochemical parameters are the key for diagnosis of other forms of thyroiditis.
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http://dx.doi.org/10.1155/2018/5246516DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852904PMC
March 2018

Critical review of the validity of patient satisfaction questionnaires pertaining to oral health care.

Community Dent Oral Epidemiol 2018 08 30;46(4):369-375. Epub 2018 Mar 30.

ARCPOH, Adelaide Dental School, University of Adelaide, Adelaide, SA, Australia.

Objectives: Review the validation process reported for oral healthcare satisfaction scales that intended to measure general oral health care that is not restricted to specific subspecialties or interventions.

Methods: After preliminary searches, PUBMED and EMBASE were searched using a broad search strategy, followed by a snowball strategy using the references of the publications included from database searches. Title and abstract were screened for assessing inclusion, followed by a full-text screening of these publications. English language publications on multi-item questionnaires that report on a scale measuring patient satisfaction for oral health care were included. Publications were excluded when they did not report on any psychometric validation, or the scales were addressing specific treatments or subspecialities in oral health care.

Results: Fourteen instruments were identified from as many publications that report on their initial validation, while five more publications reported on further testing of the validity of these instruments. Number of items (range: 8-42) and dimension reported (range: 2-13) were often dissimilar between the assessed measurement instruments. There was also a lack of methodologies to incorporate patient's subjective perspective. Along with a limited reporting of psychometric properties of instruments, cross-cultural adaptations were limited to translation processes.

Conclusions: The extent of validity and reliability of the included instruments was largely unassessed, and appropriate instruments for populations outside of those belonging to general adult populations were not present.
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http://dx.doi.org/10.1111/cdoe.12377DOI Listing
August 2018

Evolution of Synonymous Codon Usage Bias in West African and Central African Strains of Monkeypox Virus.

Evol Bioinform Online 2018 9;14:1176934318761368. Epub 2018 Mar 9.

Department of Biotechnology, Vignan's University, Guntur, India.

The evolution of bias in synonymous codon usage in chosen monkeypox viral genomes and the factors influencing its diversification have not been reported so far. In this study, various trends associated with synonymous codon usage in chosen monkeypox viral genomes were investigated, and the results are reported. Identification of factors that influence codon usage in chosen monkeypox viral genomes was done using various codon usage indices, such as the relative synonymous codon usage, the effective number of codons, and the codon adaptation index. The Spearman rank correlation analysis and a correspondence analysis were used for correlating various factors with codon usage. The results revealed that mutational pressure due to compositional constraints, gene expression level, and selection at the codon level for utilization of putative optimal codons are major factors influencing synonymous codon usage bias in monkeypox viral genomes. A cluster analysis of relative synonymous codon usage values revealed a grouping of more virulent strains as one major cluster (Central African strains) and a grouping of less virulent strains (West African strains) as another major cluster, indicating a relationship between virulence and synonymous codon usage bias. This study concluded that a balance between the mutational pressure acting at the base composition level and the selection pressure acting at the amino acid level frames synonymous codon usage bias in the chosen monkeypox viruses. The natural selection from the host does not seem to have influenced the synonymous codon usage bias in the analyzed monkeypox viral genomes.
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http://dx.doi.org/10.1177/1176934318761368DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846927PMC
March 2018

Critical review of willingness to pay for clinical oral health interventions.

J Dent 2017 Sep 27;64:1-12. Epub 2017 Jun 27.

University of Adelaide, ARCPOH, Adelaide Dental School, Level 9, AHMS Building, Adelaide, SA 5005, Australia. Electronic address:

Objectives: This critical review aimed to identify, consolidate and evaluate the quality of Willingness to Pay (WTP) studies applied to clinical contexts in the field of dentistry.

Methods: PubMed and Web of Science databases were systematically searched for relevant publications. Screening and data extraction was then performed. Primary literature in English-language were included to assess the WTP for oral health interventions, when the valuations were applied to a clinical measure. Twenty-six publications met the inclusion criteria.

Results: WTP was elicited mainly via face-to-face interviews (13 publications) and questionnaires (12 publications). The majority (24) of publications selected an out-of-pocket payment vehicle. Eleven publications adopted a bidding method, nine publications adopted an open-ended format, and the remaining six studies adopted a payment card or choice method. Pre-testing was reported in only nine publications, and few studies accounted for starting point bias. Eight of 11 publications found that higher incomes were associated with higher WTP values. The female gender, a younger age and higher education levels were associated with a higher WTP in select studies.

Conclusions: Only a small minority of the studies used strategies to avoid well documented biases related to WTP elicitation. Cost versus benefit of many clinical scenarios remain uninvestigated.

Clinical Significance: WTP studies in dentistry may benefit from pre-testing and the inclusion of a script to minimise hypothetical bias. They may also be better conducted face-to-face and via a shuffled payment card method. Income levels, and potentially education levels, gender and age, should be assessed for their influence on WTP values.
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http://dx.doi.org/10.1016/j.jdent.2017.06.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558873PMC
September 2017

Agnihotra Yajna: A Prototype of South Asian Traditional Medical Knowledge.

J Acupunct Meridian Stud 2017 Apr 9;10(2):143-150. Epub 2016 Nov 9.

Administrative Office, Aushmath Biosciences, Door No: 2/1, Devaraj Corner, Vadavalli Post, Coimbatore District, Tamil Nadu 641 041, India.

This study conceptualizes the principle of agnihotra yajna. The perusal of ancient and modern literature reveals that the functioning of the human body is impossible without maintaining an energetic continuum driven by sunlight. The seven major chakras existing over the spinal cord help to maintain this energetic continuum. Agnihotra yajna is proposed to balance the chakra system as a whole by minimizing entropy. Offerings of natural elements to fire lit in a copper pyramid during agnihotra liberate various volatile compounds having potent pharmacological actions. Attempts were made to enhance the efficacy of fumes by incorporating two to three pieces of coconut endosperm and "navadhanya" (nine grains) to the conventional fire oblations. This investigation clearly demonstrates that the purpose behind the practice of agnihotra yajna is "letting incessant flow of energy (LIFE)" through our meridian lines and acupuncture points. The volatile organic compounds in smoke were analyzed using the gas chromatography-mass spectrometry method, and the results are discussed.
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http://dx.doi.org/10.1016/j.jams.2016.11.002DOI Listing
April 2017

Tunable sieving of ions using graphene oxide membranes.

Nat Nanotechnol 2017 07 3;12(6):546-550. Epub 2017 Apr 3.

National Graphene Institute, University of Manchester, Manchester M13 9PL, UK.

Graphene oxide membranes show exceptional molecular permeation properties, with promise for many applications. However, their use in ion sieving and desalination technologies is limited by a permeation cutoff of ∼9 Å (ref. 4), which is larger than the diameters of hydrated ions of common salts. The cutoff is determined by the interlayer spacing (d) of ∼13.5 Å, typical for graphene oxide laminates that swell in water. Achieving smaller d for the laminates immersed in water has proved to be a challenge. Here, we describe how to control d by physical confinement and achieve accurate and tunable ion sieving. Membranes with d from ∼9.8 Å to 6.4 Å are demonstrated, providing a sieve size smaller than the diameters of hydrated ions. In this regime, ion permeation is found to be thermally activated with energy barriers of ∼10-100 kJ mol depending on d. Importantly, permeation rates decrease exponentially with decreasing sieve size but water transport is weakly affected (by a factor of <2). The latter is attributed to a low barrier for the entry of water molecules and large slip lengths inside graphene capillaries. Building on these findings, we demonstrate a simple scalable method to obtain graphene-based membranes with limited swelling, which exhibit 97% rejection for NaCl.
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http://dx.doi.org/10.1038/nnano.2017.21DOI Listing
July 2017

Platelet volume indices as predictive biomarkers for diabetic complications in Type 2 diabetic patients.

J Lab Physicians 2017 Apr-Jun;9(2):84-88

Department of Pathology, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pimpri, Pune, Maharashtra, India.

Background: Platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) are the indicators of increased platelet activity and can be considered as potential biomarkers for diabetic complications.

Purpose: To study PVI in Type 2 diabetics with and without complications in comparison to nondiabetic patients.

Materials And Methods: A case-control study was conducted on 300 Type 2 diabetics and 200 nondiabetics. Detailed clinical history regarding duration, hypertension, and complications was taken. PVI was obtained using automated cell counter. Fasting blood glucose, hemoglobin A1c, lipid profile, creatinine were also obtained. Diabetics were further categorized into patients with complications and without complications. Statistical analysis was performed by Statistical Package for the Social Sciences Version 17 (Chicago, IL) Student's -test and ANOVA test.

Results: Platelet count was significantly decreased in diabetics (P = 0.005). MPV was significantly increased in diabetic patients with complications as compared to diabetics without complications and nondiabetic group (P < 0.0001). PDW showed statistically significant difference between diabetics with and without complications and nondiabetics (P < 0.0001). However, no statistically significant difference was observed in platelet-large cell ratio (P-LCR) among all the three study groups. We found statistically significant correlation of MPV with diabetic retinopathy (P = 0.000), nephropathy (P = 0.005), and diabetic foot (P = 0.048). PDW was significantly increased in diabetic retinopathy (P = 0.035) and nephropathy (P = 0.007). P-LCR had no statistically significant correlation with diabetic complications.

Conclusion: MPV and PDW are predictive biomarkers of diabetic vascular complications. They are more significant in microvascular complications than macrovascular complications.
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http://dx.doi.org/10.4103/0974-2727.199625DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320886PMC
April 2017

Interim therapeutic restoration approach versus treatment under general anaesthesia approach.

Int J Paediatr Dent 2017 Nov 5;27(6):551-557. Epub 2017 Mar 5.

Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore, Singapore.

Background: Although dental treatment under general anaesthesia (GA) remains the long-established approach for treating anxious children, treatment under GA presents with increased risks, costs and parental acceptability issues. Interim therapeutic restoration (ITR) has been proposed as an alternative approach.

Aim: To compare the incidence and types of failures between children managed with the ITR approach and those managed under GA within 12 months of treatment completion.

Design: A retrospective cohort study of children who received dental treatment utilizing the ITR approach was compared to children treated under GA. Age, gender and dental disease matching was done. Statistical analyses were carried out with Independent t-test and chi-square analyses.

Results: A total of 132 children (GA = 66, ITR = 66) were included, and the groups did not differ in terms of initial age, sex, dmft and initial behaviour score. ITR group had a significantly higher rate (P < 0.001; 95% CI: [0.21 to 0.97]) of restorative failure and visits required when compared to the GA group. There were no difference for incidence of pain (P = 0.55; 95% CI: [-0.074 to 0.10]) and behaviour scores (P = 0.46) between the two groups at the 12-month visit.

Conclusions: ITR approach may be a viable alternative to the GA approach when treating paediatric dental patients.
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http://dx.doi.org/10.1111/ipd.12296DOI Listing
November 2017

Differences in willingness to pay for an extraction, a filling, and cleaning teeth at various levels of oral health-related quality of life, as measured by oral impacts on daily performance, among older adults in Singapore.

Singapore Dent J 2016 Dec;37:2-8

Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore. Electronic address:

Objective: To examine the differences in Willingness to pay (WTP) for an extraction, a filling, and cleaning of teeth among older adults with varying levels of Oral Health-related Quality of Life (OHQoL).

Background: OHQoL has been used extensively to measure utilities as reported by individuals of interest. Currently there are no reports that examine the WTP of individuals at various levels of OHQoL.

Methods: A convenience sample of adults 60 years or older were recruited. Besides other domains, questionnaires were used to assess WTP (extraction, filling, and cleaning of teeth), OHQoL (using Oral Impacts on Daily Performance-OIDP), McArthur scale, and access to care.

Results: Tamil ethnicity was related to higher WTP for an extraction (mean ratio, 1.63-3.98; 95% Confidence Interval [CI]), increase of age in years was related to lower WTP for extraction (mean ratio, 0.96-1.00 [95%CI]) and increasing OIDP score was related to lower WTP for extractions (mean ratio, 0.80-0.99 [95%CI]). Tamil ethnicity was associated with higher WTP for fillings (mean ratio, 2.69-6.44 [95%CI]); higher age in years was associated with lower WTP for fillings (mean ratio, 0.94-0.99 [95%CI]), and higher OIDP scores was trending to be associated to lower WTP for filling (mean ratio, 0.80-1.00 [95%CI]). Tamil Ethnicity was also associated with higher WTP for cleaning (mean ratio, 2.14-7.19 [95%CI]), higher age in years was also associated with cleaning (mean ratio, 0.94-0.99 [95%CI]).

Conclusion: Individuals with higher OIDP scores tended to have lower WTP for extraction, filling and cleaning; with significant differences reported for extraction.
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http://dx.doi.org/10.1016/j.sdj.2016.10.003DOI Listing
December 2016

Testing reliability and validity of oral impacts on daily performances for Chinese-speaking elderly Singaporeans.

Gerodontology 2016 Dec 6;33(4):499-505. Epub 2015 Mar 6.

Oral Science, Faculty of Dentistry, National University of Singapore, Singapore.

Objective: To cross-culturally adapt the oral impacts on daily performance (OIDP) and assess its reliability and validity on Chinese-speaking community dwelling elderly Singaporeans.

Background: There are no previous reports of valid oral health-related quality of life instruments for elderly Singaporeans or perceived conditions associated with impacts reported in OIDP among the Singaporean elders.

Methods: The OIDP was translated from English to Chinese and then back translated. The OIDP questionnaire along with questions related to overall quality of life and self-rated dental health was administered to 202 Chinese-speaking elderly Singaporeans by trained interviewers, and it was repeated after 1 month. Test-retest reliability was assessed using intraclass correlation coefficient; internal consistency was established using Cronbach's alpha, and construct validity using correlation coefficients with self-reported oral health-related and global quality of life measures. In addition, Kruskal-Wallis tests assessed differences in the OIDP score between different subjective health and global quality of life groups.

Results: The median age of participants was 75 years. About 19% reported oral impacts and difficulty eating was the most prevalent oral impact. Internal consistency was good with a Cronbach's alpha of 0.75, and the intraclass correlation coefficient was 0.75 (0.67-0.81). OIDP was significantly correlated with all measures of self-reported oral health and global ratings of quality of life, with correlation coefficients ranging between 0.15 and 0.52. Groups with worse perceptions about their health and quality of life had significantly higher OIDP scores.

Conclusion: The OIDP showed successful reliability and validity for its use among Chinese-speaking older Singaporeans.
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http://dx.doi.org/10.1111/ger.12192DOI Listing
December 2016

Evolution of Synonymous Codon Usage in the Mitogenomes of Certain Species of Bilaterian Lineage with Special Reference to Chaetognatha.

Bioinform Biol Insights 2016 22;10:167-84. Epub 2016 Sep 22.

Aushmath Biosciences, Administrative office, Devaraj Corner, Vadavalli Post, Coimbatore, Tamil Nadu, India.

Chaetognatha is a minor phylum, comprising transparent marine invertebrates varying in size from 0.5 to 12 cm. The exact phylogenetic position of Chaetognatha in Metazoa has not been deciphered as some embryological characteristics place chaetognaths among deuterostomes and some morphological characteristics place these among protostomes. In this study, the major factors that drive synonymous codon usage bias (SCUB) in the mitogenomes of representative species of Chaetognatha and chosen species of other closely related phyla were analyzed. Spearman's rank correlation analyses of nucleotide contents suggested that mutational pressure and selection were acting in all examined mitogenomes but with varying intensities. The quantification of SCUB using effective number of codons vs. GC composition at the third codon position (GC3) plot suggested that mutational pressure due to GC compositional constraints might be one of the major influencing forces driving the SCUB in all chaetognaths except Sagitta enflata. However, neutrality plots revealed no significant correlation between GC3 and cumulative GC content at first and second codon positions (GC12) in all other species, except in Daphnia pulex. The parity rule 2 bias plot showed that significant compositional differences existed between C and G, as well as between A and T, contents in most of the protein-coding genes (PCGs) and, comparatively, A and T contents were used more proportionally than C and G contents in all chosen mitogenomes. Chi-square analysis revealed the presence of putative optimal codons in all species, except in S. enflata. The correspondence analysis identified that mutational pressure and selection act on the mitogenomes of the selected chaetognaths and other phyla with varying intensities. The cluster analysis based on relative synonymous codon usage (RSCU) values revealed that RSCU variations in the PCGs of mitogenomes of chaetognaths are more comparable with those of protostomes. Apart from mutational pressure and selection, certain unknown selective forces might be acting on the PCGs in the analyzed mitogenomes as the phenomenon of SCUB could not be explained by mutational pressure, by selection, or by both.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034883PMC
http://dx.doi.org/10.4137/BBI.S38192DOI Listing
September 2016

Factors influencing the inclusion of oral health education in individualized education plans of children with autism spectrum disorders in Singapore.

Int J Paediatr Dent 2017 Jul 1;27(4):255-263. Epub 2016 Aug 1.

ARCPOH, School of Dentistry, University of Adelaide, Adelaide, SA, Australia.

Background: Prevention of oral diseases in children with autism spectrum disorder (ASD) is possible via incorporation of oral health education (OHE) into individualized education plans.

Objectives: To assess (i) whether training can improve teachers' oral heath knowledge, (ii) whether OHE is taught to children with ASD, and (iii) factors associated with teachers' perceived barriers to the implementation of OHE.

Design: Teachers working in special schools were recruited. Two pre-tested questionnaires were administered, before and after a training session. The effectiveness of the intervention was evaluated. Teachers were also surveyed on their teaching of caries prevention and perceived barriers of teaching OHE.

Results: There was a significant increase in knowledge scores post-intervention (P < 0.001). Teachers were more likely to incorporate OHE into their teaching if trained by dental professionals (P = 0.022) and provided teaching materials (P = 0.001). Teachers' level of baseline OHE knowledge was a predictor and significantly negatively associated with levels of perceived overall and personal barriers (both P < 0.001).

Conclusion: OHE is included in the curriculum of the schools surveyed, but this is very limited. The training programme increased teachers' oral health knowledge competence scores. Levels of knowledge, lack of training, and teaching materials are barriers to incorporating OHE in their teaching curriculum.
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http://dx.doi.org/10.1111/ipd.12257DOI Listing
July 2017

Correlates of attitudes and perceived behavioural control towards oral care provision among trained and untrained nursing home caregivers in Singapore.

J Clin Nurs 2016 Jun 27;25(11-12):1624-33. Epub 2016 Apr 27.

Oral Sciences, School of Dentistry, NUS, Singapore.

Aims And Objectives: To investigate the perspectives of nursing home caregivers towards oral care and the determinants of their attitudes and perceived behavioural control.

Background: There are few studies analysing nursing home caregivers' perspectives on the provision of oral care and factors correlated with these perspectives.

Design: Cross-sectional study.

Methods: Interviewer-administered survey questionnaires were completed by caregivers from five nursing homes in Singapore (n = 94). The rating-scale questionnaire items explored caregivers' attitudes, subjective norms and perceived behavioural control, as guided by the theory of planned behaviour. Demographic characteristics, oral care training received, years of work experience, oral hygiene behaviour and dental visit frequency of the caregivers, as well as organisational characteristics such as a requirement for oral care and the number of patients under their care, were obtained.

Results: Caregivers had very positive attitudes towards the provision of oral care. Half of the caregivers lacked confidence in providing oral care without harming the patients and this was not different by oral care training received. Multivariable linear regression analysis found that receiving oral care training and having a requirement by the nursing home to provide oral care were related to higher attitude scores but not perceived behaviour control. Having more residents under their care and on-the-job caregiver training were associated with lower perceived behavioural control.

Conclusions: This study found that nursing home caregivers had positive attitudes towards providing oral care, but more modest perspectives about their ability to perform that behaviour.

Relevance To Clinical Practice: These findings have useful implications for the oral care training of nursing home caregivers. While attitudes towards the importance of oral care may be positive among nursing home caregivers, our study suggests that future interventions should include practical skills training for oral care management and consider organisational strategies for encouraging oral care provision.
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http://dx.doi.org/10.1111/jocn.13162DOI Listing
June 2016

Adult perceptions of dental fluorosis and select dental conditions-an Asian perspective.

Community Dent Oral Epidemiol 2016 Apr 12;44(2):135-44. Epub 2015 Nov 12.

Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore.

Objective: To compare lay people's perceptions with regard to various levels of dental fluorosis and select dental defects versus normal dentition.

Methods: Adults rated digitally created photographs made showing lips (without retraction) and teeth depicting the following conditions: no apparent aesthetic defects (normal, Thylstrup- Fejerskov score 0 - TF0), 6 levels of fluorosis (TF1-6), carious lesions (two cavitated and one noncavitated), malocclusions (Class II, Class III, anterior open bite and greater spacing), extrinsic staining and an incisal chip. The photographs were displayed on colour-calibrated iPads(™) . Participants used a self-administered questionnaire to rate their perceptions on (Item 1) how normal teeth were, (Item 2) how attractive the teeth were, (Item 3) need to seek correction of teeth, (Item 4) how well the person took care of their teeth and (Item 5) whether the person was born like this. Data from Item 5 were excluded due to low reliability.

Results: Ratings for Item 1 showed that TF1-4 was similar or significantly better than TF0. For Item 2, TF1 and TF4 were significantly better than TF0, with TF2 and TF3 being similar. For Item 3, there was significantly lower need to seek correction with TF2 and TF4 versus TF0, whereas TF1 and TF3 were similar to TF0. TF5 and TF6 were rated significantly lower than TF0 for Item 1 and Item 2, and significantly higher rating for Item 3 (need to seek correction). Ratings for Item 4 were similar, with TF1, TF2 and TF4 being rated significantly higher than TF0, and TF5 and TF6 being rated lower. Cavitated caries and staining were generally perceived as being significantly less favourable than TF6, with higher need to seek correction as well. Noncavitated carious lesion and incisal chip were rated similar to TF0. Cavitated carious lesions were rated aesthetically similar or significantly worse than TF0 and TF6.

Conclusions: Severe fluorosis (TF5 and 6) was perceived to be less aesthetically pleasing and received higher ratings for need to seek correction than normal teeth. Mild-to-moderate fluorosis (TF1-4) showed similar or better aesthetic perceptions and similar or lower need to seek correction, when compared to normal teeth (TF0). Easily visible cavitated dental caries was rated worse than teeth with severe fluorosis (TF6) and normal teeth (TF0).
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http://dx.doi.org/10.1111/cdoe.12197DOI Listing
April 2016

Oral health status and complete denture status of independent-living Singaporean elderly residing in a community home.

Singapore Dent J 2014 Dec;35:9-15

Discipline of Oral Sciences, Faculty of Dentistry, National University of Singapore, 11 Lower Kent Ridge Road, Singapore 119083, Singapore. Electronic address:

Aim: Past studies have examined the oral health status of elderly Singaporean adults residing in long term care facilities and living in residential housing but no oral health research has been conducted on elderly Singaporeans residing in community homes. The aim of this paper is to report on the oral health status and complete denture status of a group of free living (community dwelling) elderly in Singapore from the AWWA Community Home for Senior Citizens, and investigate the relation between the clinical findings and demographic data.

Materials And Methods: This research used a cross-sectional design and was conducted in the month of December 2011. Consenting residents of the AWWA home who were over the age of 60 participated in this study. Sampling strategy was census. Two calibrated interviewers collected demographic information from the participants and four calibrated dentists conducted extra-oral and intra-oral soft tissue examinations along with assessment of dentition, periodontal and denture status.

Statistical Analysis: All data were input into Microsoft Excel 2010(™) and analysed in SPSS 21.0(™). Descriptive analysis and bivariate analysis were performed on the demographic factors and other variables of interest. The Spearman׳s test, Mann-Whitney U and Chi-Square test were used to examine the correlation between the clinical findings and age, gender and education level respectively.

Results: Among the 70 participants, two subjects (2.9%) had complete dentition, 34 (48.6%) were partially dentate, and 34 (48.6%) had no teeth. The mean number of teeth among the partially dentate participants was 11.28 while the mean number of anterior, posterior and total occlusal contacts were 1.61, 2.17 and 3.78 respectively. The mean number of decayed teeth (DT) and filled teeth (FT) were 2.81 and 0.25, giving a mean DFT score of 3.06. The mean Root Caries Index was 0.13. Periodontal examination revealed that only 5 (13.9%) individuals had healthy periodontal tissues, while 2 (5.6%) had the highest score of 1, 9 (25.0%) had the highest score of 2, 11 (30.6%) had the highest score of 3 and 7 (19.4%) had the highest score of 4. Amongst the partially dentate, 14 had dentures and 20 had none. There were 34 edentulous participants and 23 had at least one denture while 11 did not have any complete dentures. The most frequent unsatisfactory finding for complete dentures was inadequate retention of the mandibular dentures. When the dentures were grouped into those that were satisfactory and those that had at least one unsatisfactory factor, 11 of the 26 maxillary dentures and 17 of the 23 mandibular dentures fell to the latter category. Analysis revealed that there was a correlation between age and the number of teeth with a correlation coefficient of -0.43 (p=0.01) and age with the mean DFT, -0.33 (p=0.05).

Conclusion: The findings of this study revealed a high treatment need for this group of elderly.
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http://dx.doi.org/10.1016/j.sdj.2014.07.002DOI Listing
December 2014