Search

Children could internalise blame for a death, suffer as much grief as adults, and express as much emotion as adults. Research on young children's perceptions of death has been conducted primarily in Western cultures. This paper is an exploration of Chinese 5-year-olds' understanding of death. Data analyses are mainly based on children's drawings and their description of the drawings. Children's drawings of issues related to death were analysed using the phenomenographic method to identify content-specific categories. It is shown through this study that Chinese 5-year-olds have an initial understanding of the biological, psychological, and metaphysical concepts of death. Findings of the current study highlight the importance of paying more attention to the impact of cultural practices and religion on children's understanding of death.

Objective: The aims of this study were (1) to investigate willingness to pay (WTP) for preventive and curative dental care procedures and (2) to determine the factors that influence older adults’ WTP for dental care. Methodology: Older, independently living adults from Singapore aged 60 years and older and eligible for government-subsidised dental care were nonrandomly recruited for this study. Data were collected using questionnaires and a clinical examination which recorded details of caries experience, number and distribution of posterior occluding contacts, prosthodontic status, and periodontal status. Using a contingent valuation method, participants were asked to rate WTP in Singapore dollars [SGD$] for 4 aspects of care: dental fillings, dental scaling, dental extraction, and disease prevention advice. Negative binomial regression was used to assess the relationship between the predictor variables associated with WTP for dental fillings, scaling, extraction, and preventive advice. Results: The mean value of WTP for a dental filling was SGD$30.23 (SGD$31.05), for scaling was SGD$30.28 (SGD$29.46), for dental extraction was SGD$35.08 (SGD$58.54). In a multivariate model, factors associated with higher WTPfees were as follows: (1) dental filling: age (younger), level of education (higher), and frequency of dental visits (regular); (2) scaling: level of education (higher), agree that dental problems affect overall health, and frequency of dental visits (regular); (3) dental extractions: age (younger), level of education (higher), frequency of dental visits (regular), and prosthodontic status (not wearing); (4) preventive advice: age (younger), gender (male), ethnicity (Chinese), level of education (higher), marital status (married), self-perceived oral health (good), and dental visits (regular). Conclusions: The findings of our study suggest that older adults are willing to pay most for extraction and least for preventive advice.

Introduction: Nurturing preventive-minded dental students has been a fundamental goal of dental education. However, students still struggle to regularly implement preventive concepts such as caries risk assessment into their clinical practice. The objective of this study was to identify areas in the cariology curriculum that could be revised to help address this. Methods: A total of 10 individuals participated and were divided into two focus group discussions. Thematic analysis was conducted, and key themes were identified based on their frequency of being cited before the final report was produced. Results: Three major themes emerged: (1) Greater need for integration between the pre-clinical and clinical components of cariology; (2) Limited time and low priority that the clinical phase allows for practising caries prevention; and (3) Differing personal beliefs about the value and effectiveness of caries risk assessment and prevention. Participants cited that while didactics were helpful in providing a foundation, they found it difficult to link the concepts taught to their clinical practice. Furthermore, participants felt that they lacked support from their clinical supervisors, and patients were not always interested in taking action to prevent caries. There was also heterogeneity amongst students with regards to their overall opinion of the effectiveness of preventive concepts. Conclusion: Nurturing preventive-mindedness amongst dental students may be limited by the current curriculum schedule, the prioritisation of procedural competencies, the lack of buy-in from clinical supervisors, and a perceived lack of relevance of the caries risk assessment protocol and should be addressed through curriculum reviews.

Background: No studies have evaluated the unique potential of nurse‐led silver diamine fluoride (SDF) application for children to bridge the gap in interprofessional collaboration. Aim: To investigate the attitudes, beliefs and perceptions of nurses regarding nurse‐led SDF application at the well‐child visit and identify possible barriers and make recommendations. Design: Mixed methods design involving a questionnaire and semi‐structured individual interviews were conducted. Results: All eligible nurses (n = 110) completed the questionnaire, and 16 were interviewed. Questionnaire responses highlighted that nurses were not confident in providing oral health services (score: <3 of 5) beyond oral hygiene advice (score: ≥3.9 of 5) but believed that they should be providing these services for individuals with difficulty accessing care. Interviews reflected that most nurses viewed oral health care as an important part of paediatric health but were limited by knowledge, time and manpower. Most were willing to expand their job scope to include SDF application with formal education and training, competency assessments and approaches to counter time limitations. Conclusion: Where nurses are already providing basic oral healthcare, nurse‐led SDF application could be the next step. Findings suggest that systemic changes should include strategies to empower and motivate nurses to apply SDF at the well‐child visit. [ABSTRACT FROM AUTHOR]

This longitudinal study examined the association between Chinese children's coping strategies and depressive symptoms within the context of the transition from preschool to primary school in Hong Kong. Research Findings: Principal component analyses of children's strategies for coping with stress during the transition to school revealed three factors: negative coping, positive coping, and distraction. Children's strategies were moderately stable over time, but the relationship between coping and depressive symptoms differed for boys and girls. Girls' positive coping strategies at Time 1 predicted fewer depressive symptoms at Time 2, whereas girls' use of distraction positively predicted later depressive symptoms. Boys' depressive symptoms at Time 1 predicted negative coping strategies at Time 2. The present findings show that distraction may not always be an effective way to help young children reduce depressive symptoms, and that coping strategies may have a greater impact on reducing later depression risk for girls than for boys. Practice or Policy: Implications for future studies and practices are discussed at the end of this paper. This study provides information for educators and government and non-government organizations in developing programs to help children with effective coping strategies during their first year at school.

Objectives: The aim of this study was to present key findings from the 2019 national adult oral health survey in Singapore (NAOHS). Methods: A multi‐stage stratified sampling method was used to recruit participants for a representative national adult oral health survey. A total of 12 212 households were randomly selected from the National Database on Dwellings in Singapore. Within each household eligible persons aged ≥65 years were automatically invited to participate while a Kish selection method was used to invite those between 21 and 64 years old. The survey comprised a face‐to‐face interview questionnaire and a clinical examination which recorded details of tooth loss, DMFT, DMFS and prevalence of periodontal disease according to the CPITN and the US CDC‐AAP classifications. Weighted analysis was performed to adjust for oversampling, non‐response and post‐stratification. Multivariate regression with backward stepwise selection was carried out to identify predictors of chronic periodontal disease and untreated dental caries. Results: Six hundred and sixty‐three participants completed both the questionnaires and the clinical examination. The prevalence of edentulousness was 2.7%. Of participants, 34.8% presented with untreated dental caries with a higher proportion found in those who were aged ≥60 years, of Malay ethnicity, living in 1–2‐room public housing and who only visited the dentist when there was a problem. Mean DMFS and DMFT indices were 24.7 and 7.9 respectively. Based on the CDC‐AAP classification, the prevalence of moderate–severe chronic periodontitis was 56.9% and increased with age, with a higher proportion in males. Participants with untreated dental caries were more likely to have moderate or severe periodontal disease. Conclusions: Survey findings showed high prevalence of dental caries and periodontal disease, at 34.8% and 77.6% respectively. A clear socio‐economic gradient in the distribution of tooth loss, untreated dental caries and moderate‐to‐severe periodontitis was observed. [ABSTRACT FROM AUTHOR]

Research shows that young children's understanding of death varies considerably by culture. The purpose of this study was to examine the concepts of death held by Chinese kindergarten children in Hong Kong. Eighty-three 4- to 5-year-olds were interviewed about their understanding of six death sub-concepts: inevitability, universality, irreversibility, biological cessation, psychological cessation and causality. Parents of 67 children completed questionnaires, providing demographic information and describing how they had spoken with their child about death. Results showed that most children understood inevitability and irreversibility and that an intermediate number understood universality and biological/psychological cessation. Understanding of causality was the most limited. Parental education and family size were positively associated with children's understanding of death, as were the experiences of losing a pet or a grandparent. Finally, children of parents who talked with them about afterlife showed the most advanced level of understanding in several areas. Implications for studies on young children's death concepts are discussed. [ABSTRACT FROM AUTHOR]

Objectives: To address the following research questions: (i) What is the current situation and future vision on oral healthcare service in nursing homes (NHs) in Singapore? (ii) What are the enablers to achieve the future vision? (iii) How do views differ between dentists with and without clinical experiences in NHs? Background: Oral healthcare services in NHs need to reflect the perspectives of a diverse range of stakeholders and establish shared goals, however there is scarce evidence of in‐depth dentists' insights. Material and methods: Dentists were purposively recruited. Focus group discussions with 4–5 participants each were conducted via teleconferencing. Data were analysed thematically. Results: The participants (n = 19, median 36.0 years) recognised the need of comprehensive reform of the oral healthcare paradigm in NHs: symptomatic care to preventive care, disease‐oriented care to person‐centred care and more active collaborative care. Overall, five domains of enabling factors emerged: (1) to improve general system of oral healthcare in NHs, (2) to increase the number of dentists engaging in NHs, (3) to improve the quality of dental practice, (4) to improve the quality of daily oral care and (5) to promote seniors' cooperative attitude to oral healthcare. There was a noticeable difference in the perception on how to encourage dentists to serve in NHs. Conclusion: There is a need for a comprehensive reform of the oral healthcare paradigm for seniors in NHs in Singapore. A multi‐tiered strategy using both top‐down and bottom‐up approaches is required. [ABSTRACT FROM AUTHOR]

Recent research suggests that children may encounter aggressive behaviour during the transition from preschool to school. Yet, relatively few longitudinal studies have been conducted on children's perceptions of aggressive behaviour in the transition from preschool to school. This study aims to fill a major gap in the literature by exploring Chinese children's perceptions and experiences of aggressive behaviour, and their ways of coping with aggression, at three points in time: during the last month at preschool (Time 1), the first three months of Year 1 at school (Time 2) and the last month of Year 1 (Time 3). The present study also examines the role gender plays in 79 Chinese children's perceptions of aggressive behaviour, as depicted in their drawings and accompanying narratives. The children mainly reported physical and verbal aggression rather than relational aggression. The findings provide robust data for understanding how children cope with aggression at school.

This study explores (1) how parental and teacher scaffolding and children's coping strategies contribute to children's adjustment during the transition from preschool to school; and (2) how children's perception of stress and coping are constructed over time. The sample included 216 six-year-old children, their parents and teachers. The parents, teachers and children reported that many children encountered social stress and being incompetent at school, and most of the children used either direct problem-solving or seeking social support to cope with stress, but had not used emotion-focused coping strategies learnt at preschool. Compared with the parents' and teachers' responses, the children reported more incidences of social stress. Compared with the children's responses, more parents and teachers reported children being incompetent in learning or self-help skills at school. Implications of the study were discussed at the end of the article.

It is well known that pregnancy is under the constant influence of hormonal, metabolic and immunological factors and this may impact the oral microbiota toward pregnancy gingivitis. However, it is still not clear how the oral microbial dysbiosis can modulate oral diseases as oral microbiome during pregnancy is very poorly characterized. In addition, the recent revelation that placental microbiome is akin to oral microbiome further potentiates the importance of oral dysbiosis in adverse pregnancy outcomes. Hence, leveraging on the 16S rRNA gene sequencing technology, we present a snapshot of the variations in the oral microbial composition with the progression of pregnancy and in the postpartum period and its association with pregnancy gingivitis. Despite the stability of oral microbial diversity during pregnancy and postpartum period, we observed that the microbiome makes a pathogenic shift during pregnancy and reverts back to a healthy microbiome during the postpartum period. Co-occurrence network analysis provided a mechanistic explanation of the pathogenicity of the microbiome during pregnancy and predicted taxa at hubs of interaction. Targeting the taxa which form the ecological guilds in the underlying microbiome would help to modulate the microbial pathogenicity during pregnancy, thereby alleviating risk for oral diseases and adverse pregnancy outcomes. Our study has also uncovered the possibility of novel species in subgingival plaque and saliva as the key players in the causation of pregnancy gingivitis. The keystone species hold the potential to open up avenues for designing microbiome modulation strategies to improve host health during pregnancy.

This study explores how children's perceptions of stress factors and coping strategies are constructed over time. Children were interviewed before and after they made the transition from preschool to primary school. This study also explores teachers' and parental strategies in helping children to cope with stress at school. The sample included 53 six-year-old children, their parents and teachers. The findings show that children generally could make accurate predictions of unhappy things that might happen during the transition to primary school. Children reported being incompetent in fulfilling teachers' expectations regarding learning, self-help skills and conforming to rules. Children also reported peer conflicts and being nervous about authority. Children learned direct problem-solving skills, seeking social support and emotional regulation at preschool, but had only used the first two coping strategies at school. A majority of parents thought that transition problems affected children's emotions, whereas most teachers thought that transition problems affected children's learning.

A total of 267 five-, seven-, and ten-year-olds (M = 7.62), 147 in Hong Kong and 120 in the United States, evaluated hypothetical personal (and moral) events described as either essential or peripheral to actors' identity. Except for young Chinese in the peripheral condition, straightforward personal events were overwhelmingly evaluated as acceptable based on personal justifications. Children primarily endorsed compliance, but attributed negative emotions to actors when mothers forbade personal choices, especially when described as essential to identity. Conventional justifications declined among Chinese children and pragmatic justifications for these judgments increased with age for all children, as did judgments that personal events were up to the child. Rules were seen as more legitimate and events were seen as more up to mothers to decide for moral than personal events.