DYNAMICS OF INDICATORS OF DECIDUOUS TEETH CARIES IN CHILDREN 3-5 YEARS OLD

Children's dental health has always been and remains an extremely important issue in modern society. According to the WHO, the incidence of dental caries in different countries and among different contingents ranges from 80% to 98%. In recent decades, there has been a growing trend among children. Of particular concern is the significant incidence of early dental caries in children, which is up to two years 62%, and at three years 70.3%. Effective prevention programs and early treatment of caries can improve the quality of children's dental health, and consequently the quality of their general physical health. The aim of our study was to study the dynamics of caries of deciduous teeth (prevalence, intensity, treatment necessity of deciduous teeth, the level of dental aid) in 3-5 years old aged children (observation during the year). All children were examined for the prevalence (%) and intensity of caries of deciduous teeth by the DEF-index and their increase was found in all age groups. The increase in caries for each age group is from 0.2 to 0.3 teeth. The prevalence of caries was studied at each age. 3-year-old children had a caries prevalence of 36.0 ± 6.85%. One year after the first examination, the prevalence of caries in 4-year-old children was now 42.0 ± 7.05%, which is 6% more than a year ago. The same trend is observed in children in the period from 4 to 5 years. The increase in the prevalence of caries in this group for the year is 6.7%. And in the group 5-year-old children the increase in the prevalence of caries per year was 3.1%. Comparison of children 4-year-old, but different groups did not reveal a significant difference. And at the age of 5 a probable difference in the prevalence of caries was revealed. Children with preventive work had a prevalence of 44.0 ± 5.77% against a group of children who were not provided with recommendations for maintaining dental health (65.3 ± 4.91%). In general, in children 3-5-years-old during first examination, the prevalence of caries was 49.1 ± 7.21%. During the year, the increase in the prevalence of caries in the same group of children, but 4-6-years-old, is only 4.9%. The intensity of caries indicates a slight increase in the number of teeth with caries in each group of children. But a comparison of this indicator in children of the same age of different periods of the survey revealed a probable difference at the age of 5 years (1.9 ± 0.35 teeth) (children who were recommended) against 2.7 ± 0.33 teeth (examined 1 year ago).The treatment necessity of deciduous teeth is 54% and the level of dental aid is 13%. Carrying out preventive work with children and their parents on selection of subjects and means of hygiene, regular care of an oral cavity, observance of a healthy food, necessity of sanitation of an oral cavity gave the chance to increase quantity of fillings at children of 4-6 years in comparison with 3-5 years and reducing the number of removed teeth due to complicated caries. Effective prevention programs and early treatment of caries can improve the quality of children's dental health, and consequently the quality of their general physical health. Timely and planned oral hygiene is a common and effective method of prevention of caries and periodontal disease in young patients. That is why a significant place in the prevention of caries in children is occupied by hygienic education and upbringing of children and their parents.

Resilience and pain catastrophizing among patients with total knee arthroplasty: a cohort study to examine psychological constructs as predictors of post-operative outcomes

Background Patients’ psychological health may influence recovery and functional outcomes after total knee arthroplasty (TKA). Pain catastrophizing, known to be associated with poor function following TKA, encompasses rumination, magnification, and helplessness that patients feel toward their pain. Resilience, however, is an individual's ability to adapt to adversity and may be an important psychological construct that supersedes the relationship between pain catastrophizing and recovery. In this study we sought to identify whether pre-operative resilience is predictive of 3-month postoperative outcomes after adjusting for pain catastrophizing and other covariates. Methods Patients undergoing TKA between January 2019 and November 2019 were included in this longitudinal cohort study. Demographics and questionnaires [Brief Resilience Scale (BRS), Pain Catastrophizing Scale (PCS), Knee injury and Osteoarthritis Outcome Score, Junior (KOOS, JR.) and Patient-Reported Outcomes Measurement Information System Physical and Mental Health (PROMIS PH and MH, respectively)] were collected preoperatively and 3 months postoperatively. Multivariable regression was used to test associations of preoperative BRS with postoperative outcomes, adjusting for PCS and other patient-level sociodemographic and clinical characteristics. Results The study cohort included 117 patients with a median age of 67.0 years (Q1–Q3: 59.0–72.0). Fifty-three percent of patients were women and 70.1% were white. Unadjusted analyses identified an association between resilience and post-operative outcomes and the relationship persisted for physical function after adjusting for PCS and other covariates; in multivariable linear regression analyses, higher baseline resilience was positively associated with better postoperative knee function (β = 0.24, p = 0.019) and better general physical health (β = 0.24, p = 0.013) but not general mental health (β = 0.04, p = 0.738). Conclusions Our prospective cohort study suggests that resilience predicts postoperative knee function and general physical health in patients undergoing TKA. Exploring interventions that address preoperative mental health and resilience more specifically may improve self-reported physical function outcomes of patients undergoing TKA.

The Role of Community Health Workers in Oral Health Promotion and the Impact of their services in Sub-Saharan Africa: A Systematic Review.

Oral ailments are largely preventable but remain a significant public health concern afflicting nearly half the global population. These conditions account for 220 years of life lost per 100,000 people and about US$500 billion in health-related expenditures. Sub-Saharan Africa bears a significant burden of oral health problems thus exerting additional pressure on the scarce human resources for health. Community healthcare workers (CHWs) could be potentially utilised to bridge the shortage of oral health professionals in sub-Saharan Africa, hence, this systematic review that seeks to explore their current roles in oral health and potential impact on general physical health. This review follows the PRISMA guidelines and databases searched include PubMed, Web of Science, Medline, and CINAHL published between January 2010 and December 2019. Nine studies met the study eligibility criteria. This review established that CHWs perform variable roles cutting across primary, secondary, and tertiary prevention including providing oral hygiene education, recognising common pathologies, and treating oral lesions, administration of tooth extractions, dental pain management, and referral for advanced care. Although this could potentially improve oral health, our review did not establish the extent of the specific impact on general physical health of patients and the burden of oral condition.

Course of activities of daily living in nursing home residents with dementia from admission to 36-month follow-up

Background Dementia is affecting both the person with the disease and the family members. It is associated with nursing home admission, and a reduced ability to perform personal activities of daily living (P-ADL). The aim of this study was to examine the association between the severity of dementia and P-ADL function, and to study if additional factors such as neuropsychiatric symptoms, type of nursing home unit, and use of medication were associated with P-ADL function. Methods A total of 582 nursing home residents with dementia, included at admission to the nursing home, were followed with biannual assessments for 36 months. P-ADL was assessed using the Physical Self-Maintenance scale, and severity of dementia was measured with the Clinical Dementia Rating scale. In addition, neuropsychiatric symptoms, general physical health, and use of medications were assessed at the same time points. Demographic information was collected at baseline. Linear mixed models were estimated. Results There was a significant (p < 0.05) non-linear decline in P-ADL function over time in analysis not adjusting for any characteristics. More severe dementia at baseline and at the follow-up assessments was associated with lower P-ADL function (p < 0.001), with the association being stable over time. A higher level of neuropsychiatric symptoms, not using anti-dementia medication, being in a regular care unit as compared to a special care unit and having poor/fair general physical health as compared to good/excellent, were associated with a lower P-ADL function. Conclusion The association between more severe dementia and lower P-ADL function was stable over a 36-month follow-up period of nursing home residents with dementia. Health care planners and clinicians should be aware of this when planning for and treating nursing home residents.

‘They deserve a treat’: the nature and antecedents of parental licensing surrounding children’s physical activity

Objective: Little is known about parents’ compensatory health beliefs (CHB) surrounding their children’s engagement in physical activity (PA). Our aim was to provide evidence regarding the nature of, and factors underpinning, parents’ PA-related compensatory beliefs for their children. Design: A qualitative descriptive approach and thematic content analysis were employed. Setting: Parents were recruited from community sport and PA programmes. Participants: Eighteen parents aged 32–52 years (mean age = 40·8 (sd 5·4) years; six males; twelve females). Results: Analyses indicated that parents compensate through ‘passive’ or ‘active’ means. Among parents who compensated, most described their provision of ‘treat’ foods/drinks and a minority described allowing extended sedentary time to their children. Parents’ reasons underpinning these beliefs related to their child’s general physical/health status and psychological characteristics, and their own motivation and mood state. Conclusions: These findings provide the first evidence of unhealthy dietary and sedentary behaviour CHB that parents may hold regarding their children’s involvement in PA.

Pre- and Post-operative Pain Catastrophizing and Resilience of Patients With Total Knee Arthroplasty: A Cohort Study

BackgroundPatients undergoing total knee arthroplasty (TKA) have psychological comorbidities that influence recovery and functional outcomes. Resilience is a psychological construct defined as an individual's ability to adapt to adversity. Pain catastrophizing encompasses rumination, magnification, and helplessness that patients feel toward their pain. Pain catastrophizing is associated with poor function following surgery. Studies assessing the influence of resilience on postoperative outcomes have shown inconsistent findings and have not accounted for the influence of pain catastrophizing. We sought to identify (1) whether baseline pain catastrophizing and resilience are predictive of postoperative knee function, general physical health, and general mental health three months after TKA and (2) whether baseline pain catastrophizing and resilience are associated with preoperative knee function, general physical health, and general mental health.MethodsPatients undergoing TKA between January 2019 and November 2019 were included in this longitudinal cohort study. Demographics and questionnaires [Brief Resilience Scale (BRS), Pain Catastrophizing Scale (PCS), Knee injury and Osteoarthritis Outcome Score, Junior (KOOS, JR.) and Patient-Reported Outcomes Measurement Information System Physical and Mental Health (PROMIS PH and MH, respectively)] were collected preoperatively and 3 months postoperatively. Multivariable regression was used to test associations of preoperative BRS and PCS with postoperative outcomes.ResultsThe study cohort included 117 patients with a median age of 67.0 years (Q1-Q3: 59.0-72.0). Fifty-three percent of patients were women and 70.1% were white. In multivariable linear regression analyses, baseline pain catastrophizing did not demonstrate a significant association with postoperative 3-month knee function, (β = -0.08, p = 0.543), general physical health (β = -0.11, p = 0.313), or general mental health (β = 0.01, p = 0.919). Baseline resilience positively associated with postoperative knee function (β = 0.24, p = 0.019) and general physical health (β = 0.24, p = 0.013).ConclusionsOur prospective analysis suggests that resilience predicts postoperative knee function and general physical health in patients undergoing TKA. Given the inconsistent findings in this area of research, future studies should continue to delineate preoperative constructs that impact patients following surgery. Exploring interventions targeting the preoperative mental health of patients undergoing TKA may improve outcomes in this cohort.

Phenotypes of neuropathic pain

Невропатическая боль (НБ) возникает вследствие прямого повреждения или болезни соматосенсорной нервной системы. Целью настоящего исследования было проведение анализа базы данных пациентов с НБ для поиска групп пациентов имеющих сходные профили сенсорных симптомов, а также определение взаимосвязи между наличием и выраженностью этих симптомов с интенсивностью боли, тяжестью нарушений сна, степенью ограничений повседневной активности и тяжестью нарушений общего соматического здоровья. Материал и методы. Проведен кластерный и сравнительный анализ базы данных больных с НБ (n = 6506), полученной в скрининговом когортном двухэтапном исследовании пациентов, обратившихся за амбулаторной помощью к врачу неврологу. Результаты и обсуждение. Анализ методом К-средних выявил 3 кластера сенсорных симптомов, не связанных с этиологическими причинами НБ. Фенотипы (кластеры) НБ отличались по интенсивности боли, степени тяжести нарушений сна, степени снижения повседневной активности и тяжести нарушений общего соматического здоровья. Выводы. В реальной клинической практике фенотипическая стратификация НБ важна не только с позиций механизм-обоснованого подхода к её терапии, но и для прогнозирования интенсивности боли и степени ухудшения качества жизни у конкретного больного. Neuropathic pain (NeP) is caused by a direct damage or disease of the somatosensory nervous system. The aim of this study was to conduct an additional analysis of the database of patients with NeP to identify groups of patients with similar profiles of the sensory symptom and to determine the relationship between the presence and severity of these symptoms and the intensity of pain, severity of sleep disorders, degree of limitations in daily activity, and severity of disorders in general physical health. Material and methods. Cluster and comparative analyses were performed of the database of patients with NeP (n = 6506). The database was obtained in a two-stage screening cohort study of patients who had sought outpatient care of a neurologist. Results and discussion. The analysis using the K-means method provided 3 clusters of sensory symptoms not related with etiological causes of NeP. The phenotypes (clusters) differed in pain intensity, severity of sleep disorders, degree of decline in daily activity, and severity of disorders in general somatic health. Conclusions. In real clinical practice, the phenotypic stratification of NeP is important not only from the standpoint of the mechanism-based approach to its treatment but also for predicting the intensity of pain and the degree of deterioration of the quality of life in a particular patient.

Associations Between Forced and “Persuaded” First Intercourse and Later Health Outcomes in Women

The effects of nonconsensual first experiences of sexual intercourse in women are understudied. This was investigated in 3,875 adult women of whom 6.7% reported “persuaded” first-sex and 0.8% reported forced first-sex. Compared with willing first-sex, both forced and “persuaded” first-sex occurred earlier, involved a greater age difference between partners, and were associated with more lifetime sexual partners and some measures of worse psychological well-being. In addition, “persuaded” first-sex was associated with worse general physical health. “Persuaded” first-sex and its relation to health need to be better understood, along with how culture influences women’s experiences of first-sex.

Anxiety, Anxiety Symptoms, and Their Correlates in Persons with Dementia in Norwegian Nursing Homes: A Cause for Concern

Background/Aims: Little is known about anxiety and its associations among persons with dementia in nursing homes. This study aims to examine anxiety, anxiety symptoms, and their correlates in persons with dementia in Norwegian nursing homes. Methods: In all, 298 participants with dementia ≥65 years old from 17 nursing homes were assessed with a validated Norwegian version of the Rating Anxiety in Dementia scale (RAID-N). Associations between anxiety (RAID-N score) and demographic and clinical characteristics were analyzed with linear regression models. Results: Anxiety, according to a cutoff of ≥12 on the RAID-N, was found in 34.2% (n = 102) of the participants. Irritability (59.7%) and restlessness (53.0%) were the most frequent anxiety symptoms. The participants' general physical health, a wide range of neuropsychiatric symptoms, and anxiolytic use were significant correlates of higher RAID-N scores. Conclusion: Knowledge about anxiety, anxiety symptoms, and their correlates may enhance early detection of anxiety and planning of necessary treatment and proactive measures among this population residing in nursing homes.