Investigation of oral health assessment measures for the care planning of dependent adults

Ph. D. Thesis.Dependent adults (i.e. eighteen-year-old or older who need or receives assistance due to a reduction in mental capacity or physical capability) can experience oral health problems. Whilst the reasons behind these problems are complex, evidence suggests that caregivers’ limited knowledge about oral health and care may play a role. Oral health measurement instruments could provide one means by which to help caregivers establishing appropriate oral care plans for dependent adults and, thus, preventing or managing these problems. This project aimed to investigate oral health assessment measures for oral care planning of dependent adults through three separate studies. A qualitative evidence synthesis was undertaken to establish an empirical conceptual model of oral health in dependent adults. It showed that oral health in dependent adults is a dynamic and multidimensional construct that consists of four domains: the intactness and cleanliness of oral structures; oral pain and discomfort; oral functions; and noticeable oral health aspects. A systematic review was undertaken to critically appraise published oral health measurement instruments for dependent adults. It revealed many instruments have been proposed, but none of these instruments has been adequately and comprehensively tested to establish strong evidence in relation to their measurement properties, feasibility and interpretability. Finally, a qualitative interview study was undertaken to explore healthcare service providers’ perspectives on barriers and implementation issues in relation to measuring oral health in dependent adults. The consistent theme was that the implementation of oral health measurement instruments may not be easy due to multiple potential barriers. These barriers therefore need to be considered during implementation, including those related to instruments, service providers, dependent adults and implementation environment. The findings in this thesis support a recommendation that multiple perspectives need to be considered when designing and evaluating oral health measurement instruments used to guide oral care planning for dependent adults. By doing this, these instruments are more likely to meet different stakeholders’ needs and, thus, can be successfully implemented.King Saud bin Abdulaziz University for Health Science

Measurement properties, interpretability and feasibility of instruments measuring oral health and orofacial pain in dependent adults:a systematic review

Background: Dependent adults have been shown to have a greater experience of oral health deterioration and orofacial pain. This is partly because their non-dental caregivers may not easily identify oral health problems and orofacial pain experienced by them. Thus, this systematic review aimed to investigate measurement properties, interpretability and feasibility of instruments assessing oral health and orofacial pain in dependent adults, which can be used by the non-dental caregivers to establish oral care plans for those who are dependent upon them. Methods: Seven bibliographic databases were searched: MEDLINE, Embase, CINAHL, CENTRAL, HTA, OATD and OpenGrey. Citations and reference lists of the included studies were also manually searched. Two authors independently screened titles and abstracts, and then full texts. A quality assessment of included studies was conducted independently by two authors using the COSMIN Risk of Bias checklist. The best evidence synthesis method was used to synthesise results from different studies for each measurement property per measurement instrument by integrating the overall rating for each measurement property per measurement instrument with its quality level of evidence. Results: Nineteen eligible studies were included, which reported the development, measurement properties’ evaluation, interpretability and feasibility of nine oral health and three orofacial pain measurement instruments. Methodological quality of the included studies ranged from very good to inadequate. None of the identified measurement instruments has been adequately and comprehensively tested. Conclusions: While several measurement instruments were identified in this systematic review, more evidence is needed to be able to more comprehensively evaluate these instruments. Among those identified, the OPS-NVI demonstrated sufficient construct validity, while the OHAT and the THROAT demonstrated sufficient reliability. These instruments therefore have potential for future use with more confidence once other measurement properties, interpretability and feasibility have been sufficiently tested and evaluated.</p

Establishing an empirical conceptual model of oral health in dependent adults:Systematic review

Aim: This qualitative evidence synthesis was performed to establish a conceptual model of oral health in dependent adults that defines the construct of oral health and describes its interrelationships based on dependent adults’ and their caregivers’ experiences and views. Methods: Six bibliographic databases were searched: MEDLINE, Embase, PsycINFO, CINAHL, OATD, and OpenGrey. Citations and reference lists were manually searched. A quality assessment of included studies was conducted independently by two reviewers using the Critical Appraisal Skills Programme (CASP) checklist. The ‘best fit’ framework synthesis method was applied. Data were coded against an a priori framework and data not captured by this framework were thematically analyzed. To assess the confidence of the findings from this review, the Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) approach was used. Results: Twenty-seven eligible studies were included from 6126 retrieved studies. Four themes were generated to further understand oral health in dependent adults: oral health status, oral health impact, oral care, and oral health value. Conclusion: This synthesis and conceptual model offer a better understanding of oral health in dependent adults and subsequently provide a starting point to guide establishment of person-centred oral care interventions.</p

Examination of sleep in relation to dietary and lifestyle behaviors during Ramadan: A multi-national study using structural equation modeling among 24,500 adults amid COVID-19

Background Of around 2 billion Muslims worldwide, approximately 1.5 billion observe Ramadan fasting (RF) month. Those that observe RF have diverse cultural, ethnic, social, and economic backgrounds and are distributed over a wide geographical area. Sleep is known to be significantly altered during the month of Ramadan, which has a profound impact on human health. Moreover, sleep is closely connected to dietary and lifestyle behaviors. Methods This cross-sectional study collected data using a structured, self-administered electronic questionnaire that was translated into 13 languages and disseminated to Muslim populations across 27 countries. The questionnaire assessed dietary and lifestyle factors as independent variables, and three sleep parameters (quality, duration, and disturbance) as dependent variables. We performed structural equation modeling (SEM) to examine how dietary and lifestyle factors affected these sleep parameters. Results In total, 24,541 adults were enrolled in this study. SEM analysis revealed that during RF, optimum sleep duration (7–9 h) was significantly associated with sufficient physical activity (PA) and consuming plant-based proteins. In addition, smoking was significantly associated with greater sleep disturbance and lower sleep quality. Participants that consumed vegetables, fruits, dates, and plant-based proteins reported better sleep quality. Infrequent consumption of delivered food and infrequent screen time were also associated with better sleep quality. Conflicting results were found regarding the impact of dining at home versus dining out on the three sleep parameters. Conclusion Increasing the intake of fruits, vegetables, and plant-based proteins are important factors that could help improve healthy sleep for those observing RF. In addition, regular PA and avoiding smoking may contribute to improving sleep during RF

Fikih modern praktis : 101 panduan hidup muslim sehari-hari

Tidak ada manusia yang lepas dari persoalan dan tantangan. Bersama itu pula, Allah Yang Maha Pengasih memberikan kemudahan. Islam, melalui tuntunan Al-Qur�an dan Sunah, dianugerahkan kepada umat manusia sebagai sumber solusi bagi banyak problematika. Namun sebelum dapat menerapkan segala tuntunan Allah dan Rasul-Nya tersebut, kita tentu harus terlebih dulu memahaminya dengan baik. Fikih Modern Praktis menjawab kebutuhan itu dengan menyajikan berbagai penjelasan tentang hukum Islam yang perlu diketahui setiap Muslim. Disusun secara sistematis, mudah dipahami, mengikuti perkembangan zaman, dan menampilkan poin-poin pembahasan dalam bentuk diagram serta acuan-acuan singkat, buku ini memudahkan Anda menemukan jawaban paling tepat untuk berbagai persoalan. Dibagi menjadi 3 tema besar�Tuntunan Ibadah, Penghidupan, dan Membangun Hubungan Sosial�buku ini membahas, antara lain: - tata cara ibadah dan hubungan dengan Allah (hablum minallah)�wudhu, shalat, zakat, puasa, haji; - amal yang bersifat wajib dan yang sunah; - hubungan dengan sesama manusia (hablum minan-naas)�makanan, pakaian, jual-beli; serta - interaksi kita dengan lawan jenis maupun nonmuslim. Kelebihan buku ini adalah Anda tidak harus membacanya dari awal, melainkan dapat merujuk langsung ke Daftar Isi untuk mencari topik yang diinginkan. Dengan berorientasi pada asas kejelasan, kepraktisan, dan kemudahan, buku ini sangat layak Anda jadikan referensi tepercaya

Oral health decline in patients after stroke:a qualitative study

Introduction To develop and implement effective oral care interventions for patients after stroke, there is a need to understand the causes behind the decline in their oral health. This qualitative study was, therefore, undertaken to explore experiences and views of health service providers about the causes of oral health decline in this group of patients. Methods A purposively selected sample of healthcare service providers who work in two NHS Trusts in the North of England were interviewed utilising a semi-structured interview technique. Interviews were conducted with the assistance of a topic guide and continued until data saturation (n = 30) was reached. The constant comparative approach was used to analyse the data. Results Two major factors, perceived by the participants, were thought to cause oral health decline in patients after stroke. Post-stroke neurological deficits resulting in oral-related functional disturbances was the first. The second was the barriers leading to difficulties in performing or receiving daily oral care. These barriers were related to the patients, their service providers, or the environment in which care is being delivered. Conclusions This study described the major factors affecting the oral health of patients after stroke, which can offer a starting point for developing effective oral care interventions for them.</p

Implementation issues and barriers for assessing oral health in dependent patients after stroke:A qualitative study

Objectives: To explore implementation issues and potential barriers for assessing oral health in dependent post-stroke patients. Methods: Semi-structured interviews were conducted with a purposively identified sample of healthcare service providers who work in two National Health Service (NHS) Trusts in the north of England. Interviews were conducted until data saturation was achieved (n = 30). Data were analysed using the constant comparative method. Results: Six themes were drawn out in this study, which described potential barriers to assessing oral health in post-stroke patients, aspects of oral health that need assessment, streamlining the oral health assessment, input methods for oral health assessment, characteristics of assessors, and how oral care should be planned. Conclusions: Assessment of oral health for post-stroke patients has been viewed as a complex task because of several identified barriers. Several suggestions have been proposed to overcome these barriers, aiming to enable more feasible and effective oral health assessments for post-stroke patients. Clinical Significance: The findings from this study have the potential to contribute to developing oral health measurement instruments that might be more successfully implemented and guide oral care planning for dependent patients after stroke.</p

Oral health decline in patients after stroke:a qualitative study

Introduction To develop and implement effective oral care interventions for patients after stroke, there is a need to understand the causes behind the decline in their oral health. This qualitative study was, therefore, undertaken to explore experiences and views of health service providers about the causes of oral health decline in this group of patients. Methods A purposively selected sample of healthcare service providers who work in two NHS Trusts in the North of England were interviewed utilising a semi-structured interview technique. Interviews were conducted with the assistance of a topic guide and continued until data saturation (n = 30) was reached. The constant comparative approach was used to analyse the data. Results Two major factors, perceived by the participants, were thought to cause oral health decline in patients after stroke. Post-stroke neurological deficits resulting in oral-related functional disturbances was the first. The second was the barriers leading to difficulties in performing or receiving daily oral care. These barriers were related to the patients, their service providers, or the environment in which care is being delivered. Conclusions This study described the major factors affecting the oral health of patients after stroke, which can offer a starting point for developing effective oral care interventions for them.</p