Zirconia Inlay on Vital Teeth with Profunda Caries

Background: Dental caries has historically been considered the most critical component of the global burden of oral disease. Health facilities and dental health education counselling have been conducted, but public knowledge about dental caries is still low. The increasing number of dental caries is currently influenced by one of the factors of community behaviour. Most people do not realize the importance of taking care of oral and dental health. The ignorance of the community results in a decrease in productivity due to the influence of the perceived illness. Advances in dentistry since the last decade has allowed the use of conservative dental care. Modern restorative dentistry offers many methods for restoring teeth, both direct and indirect. The need for restoration of posterior teeth is related to aesthetic purposes and functional, biocompatibility and biomechanical aspects of the remaining tooth structure. Some materials that are widely used as tooth-coloured indirect restorations in posterior teeth are zirconia. Zirconia has its characteristics, especially in terms of functionality, such as mechanical strength, physical strength and aesthetics. Purpose: This study aims to determine the management of indirect restoration treatment using zirconia inlay on upper premolar. Case(s): A 46-yearold male patient complained that the filling of his upper left tooth was often loose and uncomfortable when used for eating because the food was stuck in it. The patient wants his teeth treated. The history of treatment on the tooth in question has been patched two times, but it often comes off partially. Case Management: From the examination that has been carried out, a clinical diagnosis of reversible pulpitis was established. The treatment plan that will be carried out is indirect pulpcapping using MTA and resin-modified glass ionomer cement as the base material. The planned restoration treatment is a fixed inlay restoration made of monolithic zirconia. Conclusion: Recently, zirconia has also been developed staining with improved translucency so that it becomes more aesthetic. Zirconia has a higher level of material resistance than otherrestorative materials such as composites. This is what makes zirconia the choice, especially for use as a framework for all-ceramic and partially-fixed crowns dental prosthesis.

Sociodemographic and clinical factors, visit expectations and driving factors for emergency department attendance for uncomplicated upper respiratory tract infection

BackgroundUpper respiratory tract infections (URTIs) account for substantial non-urgent ED attendances. Hence, we explored the reasons for such attendances using a mixed-methods approach.MethodsWe interviewed adult patients with URTI who visited the second busiest adult ED in Singapore from June 2016 to November 2018 on their expectations and reasons for attendance. A structured questionnaire, with one open-ended question was used. Using the Andersen’s Behavioural Model for Healthcare Utilisation, the topmost reasons for ED attendances were categorised into (1) contextual predisposing factors (referral by primary care physician, family, friends or coworkers), (2) contextual enabling factors (convenience, accessibility, employment requirements), (3) individual enablers (personal preference and trust in hospital-perceived care quality and efficiency) and (4) individual needs (perceived illness severity and non-improvement). Multivariable multinomial logistic regression was used to assess associations between sociodemographic and clinical factors, patient expectations for ED visits and the drivers for ED attendance.ResultsThere were 717 patients in the cohort. The mean age of participants was 40.5 (SD 14.7) years, 61.2% were males, 66.5% without comorbidities and 40.7% were tertiary educated. Half had sought prior medical consultation (52.4%) and expected laboratory tests (55.7%) and radiological investigations (46.9%). Individual needs (32.8%) and enablers (25.1%) were the main drivers for ED attendance. Compared with ED attendances due to contextual enabling factors, attendances due to other drivers were more likely to be aged ≥45 years, had prior medical consultation and expected radiological investigations. Having a pre-existing medical condition (adjusted OR (aOR) 1.78, 95% CI 1.05 to 3.04) and an expectation for laboratory tests (aOR 1.64, 95% CI 1.01 to 2.64) were associated with individual needs while being non-tertiary educated (aOR 2.04, 95% CI 1.22 to 3.45) and having pre-existing comorbidities (aOR 1.79, 95% CI 1.04 to 3.10) were associated with individual enablers.ConclusionsMeeting individual needs of perceived illness severity or non-improvement was the topmost driver of ED visits for URTI, while contextual enabling factors such as convenience was the lowest. Patients’ sociodemographic and clinical factors and visit expectations influence their motivations for ED attendances. Addressing these factors and expectations can alleviate the overutilisation of ED services.

Health status as a personal resource: Analyzing associations between perceived illness severity, burnout, and work engagement amongst employees with autoimmune diseases

Epidemiological data suggest that the prevalence of autoimmune diseases is increasing. Although evidence implies that people with chronic illnesses experience higher levels of burnout, there are few available insights for developing preventative interventions. This paper builds on the job-demands resources model (JD-R) to investigate the association between impaired health, burnout, and work engagement. In two longitudinal studies, we test the effects of job demands and resources among employed people with autoimmune diseases and identify individual health status as a personal resource within the JD-R model to investigate the incremental effects of autoimmune illness severity on burnout. Study 1 investigated the effects of illness severity amongst 87 employees with inflammatory bowel diseases. Controlling for job characteristics, perceived illness severity was the strongest predictor of e burnout and predicted the vigor subdimension of work engagement. In study 2, we analyzed the effects of illness severity amongst 129 employees with multiple sclerosis and found similar effects of illness severity on both outcomes. Our studies provide important insights for employees with chronic illnesses and the organizations in which they work and give indications for theory development, future research, and the development of interventions.

The Association between Neighborhood Disorder and Health: Exploring the Moderating Role of Genotype and Marriage

The present study extends prior research on the link between neighborhood disorder and health by testing an integrated model that combines various social and biological factors. Hypotheses were tested using a sample of 325 African American women from the Family and Community Health Study (FACHS). As expected, inflammatory burden was the biophysiological mechanism that mediated much of the association between neighborhood physical disorder and perceived physical health. This finding provided additional support for the view that global self-ratings of health are powerful predictors of morbidity because, in large measure, they are indicators of chronic, systemic inflammation. Further, both genetic variation and marital status served to moderate the association between neighborhood disorder and health. Finally, being married largely eliminated the probability that neighborhood disorder would combine with genetic vulnerability to increase inflammatory burden and perceived illness. Overall, the findings demonstrate the value of constructing integrated models that specify various biophysiological mechanisms that link social conditions to physical health.

Exposure to a severe illness prototype, perceptions of severity, and coping responses

The aim of this experimental study was to examine the relationship of exposure to a lung cancer illness prototype to perceptions of illness severity, illness recognition, and coping responses. Two hundred and ten students were presented with Scenarios of a person suffering from lung cancer-related symptoms. Participants were randomly assigned in two groups: half were asked to think of themselves as the patient, and half of “someone else they know”. After each Scenario, participants were asked to respond to a set of questions regarding the perceived severity of symptoms, potential coping actions, and illness recognition. Repeated Measures MANOVAs, moderation analyses, correlations, and chi-square tests were used to analyse the data. According to the results, gradual exposure to more severe symptoms was related to increased perceived illness severity, increased possibility of using an active coping plan (e.g., care seeking), and more accurate illness recognition. Perceived illness severity was related to more active coping. Still, most participants inaccurately recognized an acute disorder in the majority of Scenarios. Participants in the other-person-group reported greater possibility of using active coping. The findings provide support to several of the Common Sense Model suggestions regarding the role of illness prototypes. They also indicate that illness prototypes are flexible, dynamic constructs that vary according to the specific aspects of the condition.

Stigma by association: Parent stigma and youth adjustment in inflammatory bowel disease

Objective Examine the indirect association between parents’ experience of stigma (i.e., associative stigma) and youth depressive symptoms through the serial effects of associative stigma on parent and youth illness intrusiveness in pediatric inflammatory bowel disease (IBD). Methods During routine clinic visits, 150 youth with well-controlled IBD (ages 10–18 years) completed measures of perceived illness intrusiveness and depressive symptoms. Parents completed measures of associative stigma and illness intrusiveness. Pediatric gastroenterologists provided ratings of IBD disease severity. Results Structural equation modeling revealed significant direct associations for associative stigma → parent illness intrusiveness, parent illness intrusiveness → youth illness intrusiveness, and youth illness intrusiveness → youth depressive symptoms. Results also revealed a significant associative stigma → parent illness intrusiveness → youth illness intrusiveness→ youth depressive symptoms serial mediation path, indicating that parents’ experience of associative stigma indirectly influenced youth depressive symptoms through its sequential effects on parent and youth perceived illness intrusiveness. Conclusions Parents who face stigma related to their child’s IBD (i.e., associative stigma) are more likely to experience IBD-induced lifestyle intrusions (i.e., illness intrusiveness), which in turn is associated with youths’ illness intrusiveness and ultimately youth depressive symptoms. These findings provide further evidence for the important role of illness-related stigma in pediatric IBD, particularly the transactional relation between parents’ associative stigma and youths’ illness appraisals and emotional functioning. The clinical implications of our results for addressing adjustment difficulties in youth with IBD are also discussed.

4226 Poor provider-patient communication, lack of readiness for discharge, and perceived illness threat are associated with quality of life after survival from cardiac arrest

OBJECTIVES/GOALS: Studies have shown that cardiac arrest survivors have poor quality of life (QoL) secondary to neurologic injury. We hypothesized that poor provider-patient communication, lack of readiness for discharge, and perceived illness threat would be associated with QoL in cardiac arrest survivors. METHODS/STUDY POPULATION: We distributed an online survey to the Sudden Cardiac Arrest Foundation listserv. Survivors completed the Questionnaire for the Quality of Provider-Patient Interactions (QQPPI), Readiness for Hospital Discharge Scale (RHDS), and the Brief Illness Perception Questionnaire (B-IPQ). When completing the QQPPI and RHDS, survivors were asked to think back to their hospitalization and discharge. QoL domains (physical, psychological, social) were measured via the WHO-QOL BREF. Three multiple regression models examined associations between QQPPI, RHDS, and B-IPQ scores with QoL domains, adjusted for age, sex, months since arrest, and understanding of arrest and post-arrest symptoms at discharge. RESULTS/ANTICIPATED RESULTS: A total of 163 survivors (mean age 50.1 years, 50.3% women) provided complete survey data. Greater perceived illness threat (β: −.45, p < .001) and lower readiness for discharge (β: .22, p = .01) were associated with worse physical QoL; greater perceived illness threat (β: −.45, p < .001) was associated with worse psychological QoL; and greater perceived illness threat (β: −.3, p < .001) and poor provider-patient communication (β: .35, p < .001) were associated with worse social QoL. Our models explained 48%, 43%, and 30% of the variance in physical, psychological, and social QoL, respectively (p < .001). DISCUSSION/SIGNIFICANCE OF IMPACT: In-hospital interactions and perceived illness threat have important ramifications for cardiac arrest survivors attempting to return to daily life. Discussions regarding cardiac arrest sequelae, expectations, and specific treatment options during hospitalization could impact future QoL.