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This article presents a grounded theory analysis of interviews with eight Black and nine white teachers in Nova Scotia, Canada. Patterned differences emerge between discourses used by Black versus ...

BACKGROUND The increase in the prevalence of Diabetes mellitus (DM) and its associated complications is proving burdensome to the South African (SA) health system. Understanding the role of comorbid diseases, such as periodontal disease (PD) and their effect on metabolic control in DM patients in SA will raise awareness to the importance of periodontal interventions in DM patients in SA. OBJECTIVE The aim of the review will be to determine how metabolic control of DM is affected by PD in a South African (SA) population. METHODS We will conduct a systematic review of the relationship between Periodontal disease and metabolic control in T2DM patients in a South African population. Cohort, cross-sectional and case-controlled studies will be considered in which the outcomes of interest are pre-specified. We will search the following sources; Google Scholar, EbscoHost, Science Direct, and National ETD Portal SA Theses and Dissertations for articles published in English. There will be no limit placed on the date of the publication. The reference list of articles will be reviewed for further inclusion of key articles. Two independent reviewers will do study selection, data extraction and quality analysis. All disputes will be resolved by discussion, and the full team will verify final decisions. RESULTS The systematic review protocol has been registered PROSPERO. A preliminary search was conducted using defined keywords. The review process should be completed by June 2021. CONCLUSIONS The review will determine periodontal disease’s effect on metabolic control in Type II DM in South Africa. In the process, the feasibility for future research in this area of interest will be defined. CLINICALTRIAL PROSPERO CRD42020221064

BACKGROUND Early childhood caries (ECC), is a common disorder characterized by the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces of primary teeth in children 71 months or younger. South Africa has a diverse population in terms of culture, education, income and occupation. This diversity is due to the consequences of historical racial discrimination, poverty, unemployment, lack of accessibility to health services and quality of education. These factors make South Africa unique, and the disease and risk profiles for this country differs from other countries in similar stages of development. For these reasons, it is important to identify what the unique maternal and infant risk factors of ECC are in the South African context. OBJECTIVE The purpose of this study is to determine the risk factors associated with the incidence/prevalence of early childhood caries (ECC) in South Africa in children under the age of 6 years. METHODS All cross-sectional and cohort studies documenting the risk factors associated with the prevalence and incidence of dental disease and severity (decayed, missing and filled scores) will be included. Seven databases will be searched for eligible studies and those included will be based on a pre-specified inclusion criteria. Only studies conducted on South African children who are aged 6 years and younger, where dental caries risk factors are documented will be included. There is no restriction on the time or language of publication. Included articles will be scrutinized for quality by using a risk of bias tool developed by the Joanna Briggs Institute. The results will be presented narratively, and if possible, a meta-analysis will be performed. RESULTS The protocol is registered with PROSPERO, CRD42020216455. The literature search was conducted in November 2020. CONCLUSIONS The results of this study will provide a framework to inform medical and dental personnel to highlight mothers and infants at risk from developing ECC. This framework may be used to prevent non-communicable diseases (NCDs) such as obesity and diabetes incidence in children. CLINICALTRIAL PROSPERO, CRD42020216455

BACKGROUND Young children are at the highest risk of developing dental caries as they at high risk for dental caries as they have a lack of autonomy over their diet and oral hygiene practices. Dental caries develops over time due to demineralization of tooth substance (enamel) resulting from acid production of bacterial metabolism from sugars. Early-onset of dental caries often results in asymptomatic presentation, but if left untreated, it can result in severe pain, infection and dentoalveolar abscesses. Early childhood caries (ECC) is defined as dental caries in children aged six years and younger and is a significant public health problem in South Africa. According to the Global Burden of Disease (GBD) study, untreated dental caries of primary teeth affects 532 million children. Untreated dental caries has many detrimental effects which can affect the physical development and reduce the quality of life of affected children. Furthermore, long term untreated dental caries can result in school absenteeism, low BMI and poor educational outcomes. OBJECTIVE The purpose of this study is to determine the prevalence and severity of ECC in South Africa in children under 6 years of age. METHODS All cross-sectional documenting the prevalence and severity of dental disease (decayed, missing and filled teeth scores) will be included. Various databases will be searched for eligible studies, and those included will be done by using prespecified inclusion criteria. Only studies conducted on South African children who are aged 6 years and under, will be included. There will be no restriction on the time nor language of publication. The quality of all eligible studies will be analyzed by a risk of bias tool developed by the Joanna Briggs Institute. The results will be presented narratively, and if possible, a meta-analysis will be conducted. RESULTS The protocol is registered with PROSPERO. The literature search was conducted in November 2018 and was repeated in November 2020. CONCLUSIONS The results of this study will be used to advise stakeholders of the prevalence and severity of dental disease in children less than 6 years of age in South Africa.

Background Diabetes is one of the leading causes of illness and death for African Americans and people of African descent throughout the United States and in the city and county of Sacramento, California. The involvement of families and communities in developing prevention strategies can increase the likelihood that behavioral changes will be sustained. Context Three member organizations of the African American Leadership Coalition (AALC) entered into a partnership with the University of California, Davis (UC Davis) to engage families in developing a process to identify barriers to diabetes and obesity prevention and reduction, exchange strategies, and create action plans for prevention. Methods The intervention comprised 3 phases: 1) coalition formation and training; 2) data collection, analysis, and dissemination of results; and 3) development of family and community action plans. Academic and community partners planned and implemented all project phases together. Outcomes Sources of information about diabetes and obesity were primarily doctors and the Internet; barriers were related to lack of time needed to prepare healthy meals, high food costs, transportation to fresh markets, motivation around healthy habits, and unsafe environments. Action plans addressed behavioral change and family cohesion. The group discussion format encouraged mutual support and suggestions for better eating and physical exercise habits. Interpretation This collaborative partnership model can strengthen existing group relationships or promote new affiliations that form the basis for future action coalitions. Participants worked both within and across groups to exchange information, stories of success and challenges, and specific health improvement strategies.

Individuals with osteogenesis imperfecta type III (OI III) are severely physically disabled due to frequent fracturing. Their disability poses numerous barriers that challenge their social development. Despite these limitations, several affected persons are able to rise above these problems and achieve success in their personal and professional life. This outcome is directly relevant to their psychosocial development.The achievements of five individuals with OI III living in Cape Town are highlighted in this article, as well as the challenges that they have experienced and continue to experience in their daily lives. The authors intend to promulgate understanding of the psychosocial circumstances of affected persons, thereby facilitating the deployment of appropriate efforts and resources to address these challenges.

Introduction Serious illness brings stressful changes for patients and carers. Consultation with our carers identified a ‘gap’ between medical and social care, indicating regular help within the home would sustain coping. Locally, reduced employment opportunities harnessed to Big Society thinking, means there is greater capacity for volunteers to bring their individual skills to support patients9 families. Aims ▶Introducing a new role whereby volunteers provide individualised carer support within the home. ▶Creating a robust and comprehensive training programme to support volunteer autonomy. Research methods ▶Informal interviews with carers. ▶Multi-disciplinary team9s identification of carers9 needs. ▶Qualitative research within hospice sector - indicating concern over health and safety issues. ▶Discussion and partnership with local Carer Liaison team. Results ▶A successful proposal to local NHS Trust secured full funding for 1 year. ▶Dedicated co-ordinator input enabled the implementation of a robust training programme and supporting policies. ▶Development of a comprehensive risk assessment covering a broad range of supportive activities for volunteers to undertake. ▶Family Friend volunteers express increasing confidence through required monthly support group meetings. Discussion With the project active for a full year, it has been formally evaluated with encouraging feedback. Volunteers state that they value working with greater autonomy and express increased role satisfaction. Carers have identified Family Friend support as contributory towards greater coping and confidence. The service9s success is attributed to our ability to identify a shortfall in carer support and our faith in skilled and trained volunteers to meet it. Conclusion The hospice believes that diversifying the volunteer role and providing enhanced training and supervision has increased satisfaction for volunteers, patients and families. This information could be used by hospices concerned about managing risk in home support volunteering.