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The objective of this study was to examine the acceptance and awareness of mothers with children with special needs regarding their children's special situation. A qualitative exploratory approach was employed in this study. Between November 2023 and January 2024, in-depth individual interviews were conducted with 22 mothers of children with special needsFour primary themes emerged from the mothers included in the study regarding their acceptance and awareness of their children's special situation: Challenges, Transformation, Adaptation, and Mistakes. The Challenges theme encompasses the child who deviates from expectations, lack of information, stigma, lack of support, burden of care, inadequacy, and guilt. The Transformation theme encompasses the concept of the special child, increased responsibilities, attitude toward the social environment, and normal means of blessing. The Adaptation theme encompasses the sub-themes of treatment and care, family dynamics, spirituality, and social. The Mistakes theme encompasses the sub-themes of dependency on the child, dependency of the child, and allowing secondary gain. The parents demonstrated a willingness to accept and be aware of their children's special condition, which facilitated the process of transformation and adaptation. In order for parents to undergo the transformation process more expeditiously, it is necessary to enhance their acceptance and awareness. [ABSTRACT FROM AUTHOR]

Aim(s): To identify, synthesise and map systematic reviews of the effectiveness of nursing interventions undertaken in a neonatal intensive care unit or special care nursery. Design: This scoping review was conducted according to the JBI scoping review framework. Methods: Review included systematic reviews that evaluated any nurse‐initiated interventions that were undertaken in an NICU or SCN setting. Studies that reported one or more positive outcomes related to the nursing interventions were only considered for this review. Each outcome for nursing interventions was rated a 'certainty (quality) of evidence' according to the Grading of Recommendations, Assessment, Development and Evaluations criteria. Data Sources: Systematic reviews were sourced from the Cochrane Database of Systematic Reviews and Joanna Briggs Institute Evidence Synthesis for reviews published until February 2023. Results: A total of 428 articles were identified; following screening, 81 reviews underwent full‐text screening, and 34 articles met the inclusion criteria and were included in this review. Multiple nursing interventions reporting positive outcomes were identified and were grouped into seven categories. Respiratory 7/34 (20%) and Nutrition 8/34 (23%) outcomes were the most reported categories. Developmental care was the next most reported category 5/34 (15%) followed by Thermoregulation, 5/34 (15%) Jaundice 4/34 (12%), Pain 4/34 (12%) and Infection 1/34 (3%). Conclusions: This review has identified nursing interventions that have a direct positive impact on neonatal outcomes. However, further applied research is needed to transfer this empirical knowledge into clinical practice. Implications for the profession and/or patient care: Implementing up‐to‐date evidence on effective nursing interventions has the potential to significantly improving neonatal outcomes. Patient or public contribution: No patient or public involvement in this scoping review. [ABSTRACT FROM AUTHOR]

Introduction: There is no agreed taxonomy of the techniques used to support patients to receive professional oral healthcare. This lack of specification leads to imprecision in describing, understanding, teaching and implementing behaviour support techniques in dentistry (DBS). Methods: This review aims to identify the labels and associated descriptors used by practitioners to describe DBS techniques, as a first step in developing a shared terminology for DBS techniques. Following registration of a protocol, a scoping review limited to Clinical Practice Guidelines only was undertaken to identify the labels and descriptors used to refer to DBS techniques. Results: From 5317 screened records, 30 were included, generating a list of 51 distinct DBS techniques. General anaesthesia was the most commonly reported DBS (n = 21). This review also explores what term is given to DBS techniques as a group (Behaviour management was most commonly used (n = 8)) and how these techniques were categorized (mainly distinguishing between pharmacological and non‐pharmacological). Conclusions: This is the first attempt to generate a list of techniques that can be selected for patients and marks an initial step in future efforts at agreeing and categorizing these techniques into an accepted taxonomy, with all the benefits this brings to research, education, practice and patients. [ABSTRACT FROM AUTHOR]

Objective: To describe the characteristics of oral health interventions implemented in prison settings and explore the barriers and facilitators towards implementation. Methods: Following Joanna Briggs Institute scoping review methodology, six databases were searched including Medline (R), Emcare, Embase, AMED, Cochrane and PsycINFO. A total of 978 studies were returned and screened. The inclusion criteria were those studies conducted in a prison population, with an intervention to address oral health and published since 2000. Results: Ten studies published between 2008 and 2021 were included. All were conducted in high‐income countries. Three intervention types were identified: health education (n = 5), teledentistry (n = 3) and screening or triaging (n = 2). The barriers and facilitators to successful implementation were grouped into a framework of four overarching concepts. These included prison environment, population makeup, compliance and staffing. Clinical Significance: Evidence suggests that oral health interventions in prisons are focused on improving access to services and oral health messages. A range of drivers including the prison environment, staffing levels, recruitment and intervention compliance influence implementation and the success of interventions. [ABSTRACT FROM AUTHOR]

The occurrence of acute leukemia during pregnancy is a rare pathologic situation and requires a multidisciplinary approach that includes at least a hematologist, gynecologist, neurologist, or psychotherapist and sometimes even intensive care unit care. The difficulties in caring for such a patient are many, from determining the risk associated with continuing the pregnancy, to choosing diagnostic tools and therapy appropriate for such a situation, to considering the patient's wishes and preferences. Below, we present the approach for cases of acute leukemia in pregnancy diagnosed and treated at the Emergency University Hospital of Bucharest (SUUB), Hematology Department, between January 1, 2017 and December 31, 2022, during a 6-year period. [ABSTRACT FROM AUTHOR]

This paper addresses general aspects of burn-out and coping mechanisms in the context of the professional activity of workers in Social care (Child Protection). According to the National Authority for the Rights of Persons with Disabilities, Children and Adoptions (ANDPDCA, 2021), the main responsibilities of Child Protection are the evaluation and monitoring of the special protection measure for children and families. The evaluation and monitoring process involves all the workers in the multidisciplinary team, namely: social workers, psychologists, educators, nurses, etc. and also administrative support staff. [ABSTRACT FROM AUTHOR]

This paper addresses general aspects of burn-out and coping mechanisms in the context of the professional activity of workers in Social care (Child Protection). According to the National Authority for the Rights of Persons with Disabilities, Children and Adoptions (ANDPDCA, 2021), the main responsibilities of Child Protection are the evaluation and monitoring of the special protection measure for children and families. The evaluation and monitoring process involves all the workers in the multidisciplinary team, namely: social workers, psychologists, educators, nurses, etc. and also administrative support staff. [ABSTRACT FROM AUTHOR]

Patients with intellectual disabilities often fail to follow traditional tongue position instructions for panoramic radiographs resulting in missed pathology or unnecessary further radiation. This simple breathing technique is a new clinical instruction method for panoramic radiography developed to reduce the most common patient position error: patient failure to hold the tongue to the roof of the mouth. The technique is suitable for all patients including young patients and those with intellectual disabilities. The simple breathing technique uses 'tell‐show‐do' communication methods and does not mention the tongue but utilises the known tongue positions that occur during breathing and swallowing. This simple breathing technique instruction for panoramic radiography uses a demonstration of 'breathe‐in, breathe‐out, swallow, lips closed and hold still' to reduce the intensity of both the palatoglossal and pharyngeal airspaces on panoramic radiographs. This method, referred in this article as the simple breathing technique, can improve the diagnostic potential of panoramic radiographs and can be used with young children and patients with intellectual disabilities, and this slow breathing technique can help them further relax. [ABSTRACT FROM AUTHOR]

Late preterm infants (LPIs) represent a significant percentage of all neonates (6-8%), but there are limited published data on their postnatal management. Our aim was to compare the frequency of neonatal intensive care unit (NICU) admission and the breastfeeding rate of LPIs born at 35+0-36+6 weeks of gestation who were cared for by initial rooming in strategy rather than directly admitted to the special care unit (SCU) and, eventually, to the NICU. We carried out a retrospective study in the perinatal centers of Careggi University Hospital (CUH) and San Giovanni di Dio Hospital in Florence, Italy, where the first and second strategies were applied, respectively. Main outcomes were LPIs admission rate at SCU/NICU and breastfeeding rate at discharge. We studied 190 LPIs born at SGDH and 240 born at CUH. The admission rate in SCU (81 vs. 43%; P < 0.001) and NICU (20 vs. 10%; P = 0.008) was higher in SGDH than in CUH, as was the exclusive breastfeeding rate (36 vs. 22%; P < 0.001). However, infants who were assisted in rooming-in at CUH and infants with similar clinical characteristics at SGDH had similar mixed (60 vs. 69%) and exclusive (35 vs. 31%) breastfeeding rates.  Conclusion: Postnatal assistance of LPIs in rooming-in, eventually followed by admission in SCU/NICU based on their clinical conditions, allowed to safely halve their hospitalization. The assistance of infants in rooming-in did not negatively affect their breastfeeding rate. These results support the possibility of assisting LPIs in rooming-in. What is Known: • Late preterm infants represent a significant percentage of all neonates. • Early rooming-in and breastfeeding is recommended for late preterm infants. What is New: • Postnatal assistance of late preterm infants in rooming-in, followed when necessary by admission in neonatal units based on clinical conditions, allowed to safely avoid about half the number of hospitalizations in comparison with direct admission in neonatal units. • This strategy did not affect breastfeeding rate. Infants who were admitted to SCU/NICU after initial rooming-in had worst breastfeeding rate. [ABSTRACT FROM AUTHOR]

Aims: Disability is a key social determinant of health. The objective of this study was to test the association between disability status and irregular dental attendance among the Australian population, and to examine whether the observed association varied among adolescents. Methods: Data on 17 501 participants from The Household, Income and Labour Dynamics in Australia (HILDA) were analysed. The main outcome examined was irregular dental attendance (two or more years since last dental visit) with disability as the primary exposure. Multivariable logistic regression models were fitted to test the associations between disability and dental attendance pattern. Models were adjusted for age, gender, country of birth, region of residence, education and income. Analysis was repeated among adolescents (15‐ to 24‐year‐old) to examine for variations in observed association. Results: One in four participants reported having a disability. Unadjusted model showed that the odds for irregular dental attendance were 1.40 times greater (95%; CI, 1.30‐1.51) in those with disability than those without disability. After adjusting for all covariates, participants with disability had 1.20 times higher odds (95%; CI 1.10‐1.30) of irregular dental attendance than those without disability. Irregular dental attendance was 1.41 times greater (95%; CI 1.10‐1.80) in those with disability aged 15‐24 years than those without disability. Conclusions: Australian individuals with disability are more likely to have irregular dental attendance than those without. [ABSTRACT FROM AUTHOR]

Objectives: To undertake a realist review of carer‐led oral hygiene interventions for people with intellectual disabilities. This was run parallel with a Cochrane Review. Methods: Realist review methods were followed. This was characterized by an iterative process of developing and refining theories of how interventions might work, expressed as context‐mechanism‐outcome configurations. The steps included identifying candidate theories with local and international expert consultation before applying an iterative search strategy. Selection criteria were applied for screening of the abstracts and 10% of the included full texts were screened by the three review members, independently, to ensure adherence to the criteria. Data were extracted in NVivo and synthesized qualitatively to confirm, refute or refine theories about what works, why, in what circumstances and for whom. Results: Of the 697 potential sources, 112 studies progressed to full‐text screening, and 58 of those were included in the review. These 58 studies found evidence to support six theories about carer‐led oral hygiene interventions for people with intellectual disabilities, from a starting point of ten candidate theories. This realist review found evidence to support the contention that, in order for carer‐led oral hygiene interventions for people with ID to succeed, there is a need for adequate resources and a system‐level approach; involving carers in design and implementation; tailoring of training to suit carers' needs and work environments; clearly stating how interventions are expected to work; specifying goals with achievable steps for carers to follow; providing carers with support and feedback on their efforts; acknowledging the physical and emotional toll caring for people with intellectual disabilities has on the well‐being of carers; and repeating training. Conclusions: The theories from this realist review will direct future interventions by suggesting the mechanisms and contexts that are important to achieve the intended outcome of improved oral health for people with intellectual disabilities. These are, of course, propositions intended for testing, rather than proven. The parallel use of Cochrane and realist methods provides a unique richness to our hypothesis of what works, for whom, when and how. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the efficacy of the social story‐based intervention in promoting the oral health status among preschool children with special healthcare needs. Methods: The 24‐month randomized controlled trial recruited 306 children from centres that provided educational training for 2‐ to 6‐year‐old children who had special healthcare needs. The participants received standardized toothbrushing training and oral health education materials. The education materials for children in the test group were validated social stories, while materials for children in the control group were standard leaflets. Those materials were introduced in each training session and used at home by parents. Children's oral health status and oral health‐related behaviours were assessed before and after interventions. Data were analysed via generalized estimating equations, negative binomial regression and binary logistic regression. Results: There was no significant difference in caries experience among children in both groups after 24 months. However, children in the test group showed better oral hygiene status and better toothbrushing performance, and they were more likely to visit a dentist (OR = 2.00, 95% CI:1.15,3.49) than their peers in the control group. Caries progression was more likely to be observed among children who had low social skills or whose parents were not working full‐time. Children from high‐income families showed better oral hygiene status than their peers (Estimate = −0.11, 95%CI: −0.20,−0.01). Conclusion: Social stories could be used to improve oral health‐related behaviours among young children with SHCN. The efficacy of the intervention might be associated with children's adaptive skills and family socio‐demographic status. [ABSTRACT FROM AUTHOR]

Objectives: Psychiatric inpatients suffer from poorer oral health than the general population, and difficulties in accessing necessary dental treatment remain even when a dedicated dental service is available within the psychiatric hospital. The aim of this study was to identify barriers to access dental care from the point of view of dentists working within French psychiatric hospitals. Methods: The relatively small number of dentists working in psychiatric hospitals necessitated a qualitative approach. Semi‐structured interviews were conducted, recorded, transcribed and coded in a conventional content analysis approach. Results: Eight interviews were conducted. Six of the dentists interviewed were men, and two were women. Three of them worked full‐time in a psychiatric facility, while the other five worked partly in the hospital and partly in private practice. The average duration for interviews was 54 minutes (minimum 24 min, maximum 89 min). The interviews highlighted three dimensions of barriers to access to dental care. The first dimension was directly related to the patient. This may be linked to the patient's psychiatric disorder but not necessarily. This also encompasses refusal of care. A second dimension regrouped events related to the organization of the hospital (locally), such as communication issues between staff members within the dental office, and with other staff members from the psychiatric ward. A third dimension included difficulties related to the overall organization of the healthcare system, including financial issues and deinstitutionalization. Conclusions: In‐site dental consultations appear as an interesting tool to enhance access to oral care for psychiatric inpatients. However, difficulties remain from the dentists' perspective. [ABSTRACT FROM AUTHOR]

Introduction: Complete edentulism is an eventual oral health outcome and results from the combined pathology of dental caries, periodontal disease, or faulty method of rehabilitation due to reduced cost. Complete edentulism has a significant concern and leads to reduced quality of life (QoL) along with impact on general health. However, it has been observed that due to wider and better oral health services globally, edentulism rate is decreasing every decade. Edentulism is directly related to masticatory and nutritional problems, and some authors regard it as a good mortality indicator. Methodology: The sample population consisted of 100 individuals comprising 63 males and 37 females who fulfilled the inclusion criteria. Geriatric oral health assessment index (GOHAI) was administered by a single investigator at baseline (preinsertion) and also 6 and 12 months postdenture insertion. Sociodemographic data, including age and gender, were also collected. Results: It was observed that the overall oral health-related QoL (OHRQoL) scores of the sample improved significantly at 6 and 12 months postinsertion (P < 0.001) when compared to baseline scores. When GOHAI scores were compared individually for males and females (pre- and post-insertion), it was observed that there was statistically significant improvement in OHRQoL (male - pre = 25.02 ± 1.34 and post-12 months = 8.84 ± 1.26, P < 0.001, female - pre = 25.19 ± 0.88 and post-12 months = 9.05 ± 1.20, P < 0.001) postinsertion of denture in both the groups. Conclusion: OHRQoL in patients improved after complete denture rehabilitation. There was an upward shift in score for each item in GOHAI from preinsertion to 6 and 12 months postinsertion of dentures, reflecting improvement in OHRQoL of the sample. [ABSTRACT FROM AUTHOR]

Aims Whilst there is a considerable body of literature examining the pharmacology of conscious sedation, the social tasks required to successfully provide conscious sedation have not been reported. This paper discusses data regarding the interpersonal work integral to effective conscious sedation provision, from a larger qualitative study exploring how patients and clinicians engage with secondary care conscious sedation provided within the UK. Method Semi-structured interviews were conducted with 13 conscious sedation providers and nine patients within UK-based secondary care sedation settings. Digital audio-recordings were transcribed verbatim and subsequently analysed using a constant comparative method within NVivo Data Analysis Software. Results Four main themes of interpersonal work were reported by participants: displaying care, containing emotions, demonstrating competence and maximizing the effect. Conclusion This study shows that performing conscious sedation requires more than technical delivery, and involves the projection of attributes in a literal 'performance.' The importance of managing outward emotional appearance reflects previous dental research. The need to manage outward appearance, and the emotional impact this has, is of relevance to all clinicians. [ABSTRACT FROM AUTHOR]

Aim: Dental treatment is necessary in oncology patients since pre-existing oro-dental disease may influence cancer treatment and prognosis. This study investigated the applicability of two indices in reflecting the actual oral health status of 100 non-cancer patients who were admitted for dental complaints/routine controls. Methods: The radiographic examination results and the decayed, missed, filled teeth score represented the 'actual oro-dental status'. The simplified oral hygiene index was utilised for oral hygiene determination, and general oral health assessment index was used to establish the self-perceived oral health. Results: No correlation was observed between actual oro-dental status and the simplified oral hygiene index (p = 0.27), but the relationship between oro-dental status and general oral health assessment index was significant (p = 0.026). Items 9, 5 and 1 (How often were you concerned about problems with your teeth, gums or dentures? How often were you able to eat anything without feeling discomfort? How often did you limit the kinds or amounts of food you eat because of problems with your teeth or dentures?) presented correlation (r = −0.285, r = 0.268, and r = −0.248). Conclusion: Three items of GOHAI (Geriatric Oral Health Assessment Index) may be used to identify the requisite of dental treatment in patients and to aid in immediate dental treatment planning. [ABSTRACT FROM AUTHOR]

Objectives: The present study explored the objective and subjective oral health care needs and the association between both among Belgian adults with disabilities. Materials and methods: A two-stage sampling methodology was used to select a sample of adults (22-65 years old) with disabilities, from various types of residential settings, day care centers, and sheltered workplaces and spread over the ten provinces. Oral screenings were performed by 28 trained dentists; subjective oral health care needs were collected through questionnaires. Results: Seven hundred seven adults with disabilities were recruited; from 656 (93 %), permission was obtained for an oral examination. In 467 (78 %) and 407 (68 %) participants, dental plaque and calculus, respectively, were observed. In 343 (56 %) participants, untreated caries lesions (into dentine) were recorded; 203 (33 %) participants had 20 or less teeth. The prosthetic replacement of missing teeth was poor. Exactly 228 (40 %) participants stated that they had a problem in the oral region, and 264 (48 %) indicated that they were in need of an appointment with a dentist. Barriers to consult a dentist were reported by 244 (42 %); fear ( n = 87; 37 %), followed by financial and transportation problems (both, n = 68; 29 %), was the most frequently reported barrier. Conclusions: The preventive as well as curative oral care needs in Belgian adults with various forms of disabilities are very high. Clinical relevance: Efforts to tackle these vast oral health care needs should take into account the differences in needs and demands between subgroups and should comprise the improvement of access to proper care. [ABSTRACT FROM AUTHOR]

Background: Quality of life in elderly is a very sensitive issue. It is important to know if the dental problems, general health and dental treatment have an impact on the quality of life in elderly. The elderly population has a typical set of mind regarding their oral health. This study examines the trends in patients' behavioral patterns due to tooth loss, suggestive of some change in quality of life. Aims: The purpose of this study was to identify and acknowledge the problems of completely edentulous patients and their relationship to the Quality of Life (QOL). Also, the study was aimed at exploring the changes in global self-rated general health between the pre and post-treatment scores. Settings and Design: This is a randomized controlled clinical trial study which is done to evaluate the problems in the elderly and quality of life as long as their oral health is concerned. It is conducted on a group of people representing the elderly population with complete edentulism. Material and Methods: Sixty three patients with mean age 69.41 who needed dentures were investigated before and after 6 months of their treatment by administration of GOHAI (Geriatric Oral Health Assessment Index) scale. Comparison between Pre & Post-treatment values of various scores were done with McNemar-Bowker Test. Quantitative data was represented using Mean ± SD and Median, IQR (Interquartile range). Analysis of Pre & Post-treatment quantitative data was done using Wilcoxon Signed Rank Test. Results: The results of the present study showed GOHAI scores increased from 28.90 + 7.28 to 42.19 + 7.60 (p=highly significant). There was a significant change in the quality of life in elderly after their prosthodontic rehabilitation, though the self rated general health did not show any significant improvement. Conclusion: It is the responsibility of the entire dental fraternity to understand the needs of elderly associated to their oral health. It is important to evaluate and assess the psychological effects of tooth loss on their quality of life. A thorough investigation is necessary before and after the dental/prosthodontic care. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: The American Academy of Pediatrics recommends all preterm infants receive human milk. The objective of this study was to describe the use of human milk in advanced care neonatal units of US maternity hospitals. METHODS: We used Centers for Disease Control and Prevention's national Maternity Practices in Infant Nutrition and Care survey from 2007, 2009, and 2011 to analyze 2 questions to describe the prevalence of US advanced care (special/level 2 or intensive/level 3) neonatal units routinely providing human milk to infants, and the use of any donor milk in these units. RESULTS: In 2011, 30.8% of maternity hospitals reported that most infants (≥90%) were routinely provided human milk in advanced care units, compared with 26.7% in 2009 and 21.2% in 2007 (trend P < .001). States in the Northwest and Northeast had a higher prevalence of hospitals routinely providing human milk to >90% of infants in advanced care units. In 2011, 22.0% of maternity hospitals providing advanced care used banked donor milk, compared with 14.4% in 2009 and 11.5% in 2007 (trend P< .001). Most of this increase occurred in intensive care units (25.1% 2007 vs 45.2% 2011; trend P< .001). There was substantial geographic variation in the prevalence of advanced care units using donor milk; generally the prevalence was higher in the West and in states with a milk bank in the state or a neighboring state. CONCLUSIONS: The use of human milk in US advanced care neonatal units is increasing; however, only one-third of these units are routinely providing human milk to most infants. [ABSTRACT FROM AUTHOR]

Objectives To assess the impact of a multi-tiered oral health education programme on care staff caring for people with intellectual disability ( ID). Methods Postal questionnaires were sent to all care staff of a community-based residential care service for adults, randomly assigned to control and intervention groups. A specifically developed training programme was delivered to residential staff nominees, who then trained all staff within the intervention group. The control group received no training. Post-test questionnaires were sent to both groups. Paired-samples t-test was used to compare oral health-related knowledge ( K) and behaviour, attitude and self-efficacy ( BAS) scores. Results Of the initial 219 respondents, 154 (response rate between 40% and 35.8%, with attrition rate of 29.7% from baseline to repeat) returned completed questionnaires at post-test ( M = 8.5 months, range = 6.5-11 months). Control and intervention groups were comparable for general training, employment and demographic variables. In the intervention group, mean Knowledge Index score rose from K = 7.2 to K = 7.9 ( P < 0.001) and mean BAS scale score rose from BAS = 4.7 to BAS = 5.4 ( P < 0.001). There was no statistically significant increase in mean scores from test ( K = 7.0, BAS = 4.7) to post-test ( K = 7.2, BAS = 4.9) for the control group. Conclusions Mean scores regarding knowledge, attitude, self-efficacy and reported behaviour increased significantly at 8.5 months in staff where training was provided. The results indicate that a multi-tiered training programme improved knowledge, attitude, self-efficacy and reported behaviour amongst staff caring for people with ID. [ABSTRACT FROM AUTHOR]

Leroy R, Declerck D. Oral health-care utilization in adults with disabilities in Belgium. Eur J Oral Sci 2013; 121: 36-42. © 2012 Eur J Oral Sci Reports on oral health-service utilization among individuals with disabilities are very sparse. Nevertheless, such data are a prerequisite for the provision of proper care and for the development of optimal reimbursement schemes and may ultimately lead to better access to care. The objective of the present study was to provide data on oral health-care utilization in Belgian residents with disabilities and to compare these data with the utilization pattern of their peers without special needs. Data from the Permanent Sample of Socially Insured Persons, an anonymous representative sample of Belgian residents, were used. The database contained prospective data on oral and general health-care utilization and socio-demographic variables from 1,221 individuals with disabilities and from 131,877 individuals without disabilities, collected from 2002 to 2008. Overall, annual dental-attendance rates were very low and in those who attended, professional debridements, a cornerstone in preventive oral health care, were infrequently recorded. In adults with disabilities, significantly fewer radiographs, restorations, and endodontic treatments were recorded, whereas significantly more emergency visits were charged. Further research is indicated to evaluate whether this outcome points to high unmet oral-treatment needs. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the mechanical and chemical control of dental biofilm in patients with Down syndrome, using different experimental dentifrices. Material and Methods: Forty institutionalized children between ages 7 and 13 years in the mixed dentition phase participated in this study. An experimental cross-over, blind clinical trial was used, having the following protocols: fluoridated dentifrice (protocol G1); fluoridated dentifrice + chlorhexidine (protocol G2); fluoridated dentifrice + chlorhexidine + plaque-disclosing agent (protocol G3); and fluoridated dentifrice + plaque-disclosing agent (protocol G4). Each experimental stage lasted 10 days with a 15-day washout. The evaluated parameters were Plaque Index and gingival bleeding. Results: The initial clinical conditions between each stage were similar. Statistical differences were observed ( P < 0.001) for the clinical conditions evaluated before and after the treatments. The dentifrices containing plaque-disclosing agent, irrespective of their association with chlorhexidine, produced a greater reduction in the final plaque index. As for gingival bleeding, the dentifrice containing erythrosine and the one containing chlorhexidine produced similar results. The dentifrice containing an association of chlorhexidine and erythrosine gave the best results. Conclusion: With the methodology employed, it was possible to conclude that the combination of drugs (chlorhexidine, fluorine and erythrosine) within one dentifrice can be useful in controlling dental biofilm and in the reduction of gingival bleeding. [ABSTRACT FROM AUTHOR]

Like the general population, nurses become patients within the health care services available to them. They write anecdotal accounts of their experience and research the experience of their colleagues. This paper reports a small descriptive study of how the positions of senior nurses who experienced a life threatening condition influenced their illness trajectories. Eleven nurses in both New Zealand and Australia told stories of their experiences which focussed on intercessions/intervention by themselves, their family and the health care team. Themes identified were: looking after our own, the gaze of family and friends in advocacy and intercession, stereotypes of nurses as patients, senior nurses as vulnerable patients - existential healing through the small things, and senior nurses as knowledgeable people. Within these themes were narratives of special and meagre care. The authors conclude that all senior nurses should receive care that is regardful of who they are as senior nurses and vulnerable patients. [ABSTRACT FROM AUTHOR]

Objective: To assess prevalence figures for psychiatric disorders among institutionalized adolescents due to behavioural problems and/or delinquency. Method: Participants were recruited from consecutive referrals to/or treated at two Swedish adolescent units, SIS1 (n = 60) and SIS2 (n = 70) with ranging age of 12-20.3 years (mean age = 16.2; SD = 1.8) during 1 year. Clinical and diagnostic information was used to generate DSM-IV diagnoses. Results: One or several neuropsychiatric disorders were diagnosed in 53% of all subjects: 39% met DSM-IV diagnostic criteria for attention deficit/hyperactivity disorder (AD/HD), 15% for a pervasive developmental disorder (referred to as autism spectrum disorders, ASDs) and 8% had a mental retardation (referred to as a learning disability, LD). The collapsed prevalence for psychiatric disorders requiring specialist attention was 66%, counting severe depression and psychotic disorders but not substance use. About one in three of all adolescents in the study were given psychopharmacological treatment. Conclusion: Published studies and this clinical survey clearly indicate that systematic studies of mental health needs among institutionalized adolescents are warranted to form the basis of adequate treatment and support measures. [ABSTRACT FROM AUTHOR]

Dental anxiety of 60 extremely anxious dental patients enrolled in a special program, was measured multioperationally before and immediately after treatment, and 6 months later. The mean anxiety level was substantially lowered during the course of treatment, indicating a favourable effect of the program. After 6 months dental anxiety was still at the lower level. [ABSTRACT FROM AUTHOR]

The mean scores on five dental anxiety measurements of 60 patients suffering from extreme dental anxiety are compared with those of an equal-sized, matched group of regular dental attenders free from dental anxiety. Four of the measurements, especially Corah's DAS, appear to be suitable for distinguishing persons suffering from extreme dental anxiety. Also, persons with extreme dental anxiety appear to express their fear openly. [ABSTRACT FROM AUTHOR]