Dental anxiety and dental attendance among 25-year-olds in Norway: time trends from 1997 to 2007

<p>Abstract</p> <p>Background</p> <p>So far, there are few studies considering the development of dental anxiety and dental attendance patterns across time in the general population of Norwegian adults. This study aimed to 1) determine the frequency of dental anxiety and regular dental attendance among 25-year-olds in Norway in 1997 and 2007, 2) to study the development (time trend) of dental anxiety and the socio-behavioral distribution of dental anxiety from 1997 to 2007.</p> <p>Method</p> <p>Random samples of 1,190 and 8,000 25-yr-olds were drawn from the populations of three counties in Western Norway in 1997 and 2007, respectively. The eligible participants received questionnaires by mail including questions on socio-demographics, dental anxiety (DAS) and dental attendance.</p> <p>Results</p> <p>In 1997, 11.5% males versus 23% females reported high dental anxiety (DAS ≥ 13). Corresponding figures in 2007 were 11.3% and 19.8%. The proportions who had attended yearly for a dental check-up during the past 5 years fell from 62% in 1997 (men 56.9% and women 66.4%) to 44.6% (men 38.1% and women 48.6%) in 2007. After controlling for potential confounding factors, the 25-year-olds were 1.4 times more likely to report dental anxiety in 1997 compared to 2007. The decrease was largely attributable to a lower mean DAS score among higher educated females in 2007 than in 1997. The discrepancy in dental anxiety between regular and non-regular dental attendees had decreased, largely attributable to a decline in dental anxiety among irregular dental attendees.</p> <p>Conclusion</p> <p>The study showed reduced dental anxiety and dental attendance among 25 year-olds in Norway from 1997 to 2007. This study points to the importance of controlling for possible changes in socio-demographic distributions when different cohorts are compared.</p

Evaluation of the effect of patient education on rates of falls in older hospital patients: Description of a randomised controlled trial

Background. Accidental falls by older patients in hospital are one of the most commonly reported adverse events. Falls after discharge are also common. These falls have enormous physical, psychological and social consequences for older patients, including serious physical injury and reduced quality of life, and are also a source of substantial cost to health systems worldwide. There have been a limited number of randomised controlled trials, mainly using multifactorial interventions, aiming to prevent older people falling whilst inpatients. Trials to date have produced conflicting results and recent meta-analyses highlight that there is still insufficient evidence to clearly identify which interventions may reduce the rate of falls, and falls related injuries, in this population. Methods and design. A prospective randomised controlled trial (n = 1206) is being conducted at two hospitals in Australia. Patients are eligible to be included in the trial if they are over 60 years of age and they, or their family or guardian, give written consent. Participants are randomised into three groups. The control group continues to receive usual care. Both intervention groups receive a specifically designed patient education intervention on minimising falls in addition to usual care. The education is delivered by Digital Video Disc (DVD) and written workbook and aims to promote falls prevention activities by participants. One of the intervention groups also receives follow up education training visits by a health professional. Blinded assessors conduct baseline and discharge assessments and follow up participants for 6 months after discharge. The primary outcome measure is falls by participants in hospital. Secondary outcome measures include falls at home after discharge, knowledge of falls prevention strategies and motivation to engage in falls prevention activities after discharge. All analyses will be based on intention to treat principle. Discussion. This trial will examine the effect of a single intervention (specifically designed patient education) on rates of falls in older patients in hospital and after discharge. The results will provide robust recommendations for clinicians and researchers about the role of patient education in this population. The study has the potential to identify a new intervention that may reduce rates of falls in older hospital patients and could be readily duplicated and applied in a wide range of clinical settings. Trial Registration. ACTRN12608000015347

Consensus-based care recommendations for adults with myotonic dystrophy type 1

Purpose of review Myotonic dystrophy type 1 (DM1) is a severe, progressive genetic disease that affects between 1 in 3,000 and 8,000 individuals globally. No evidence-based guideline exists to inform the care of these patients, and most do not have access to multidisciplinary care centers staffed by experienced professionals, creating a clinical care deficit. Recent findings The Myotonic Dystrophy Foundation (MDF) recruited 66 international clinicians experienced in DM1 patient care to develop consensus-based care recommendations. MDF created a 2-step methodology for the project using elements of the Single Text Procedure and the Nominal Group Technique. The process generated a 4-page Quick Reference Guide and a comprehensive, 55-page document that provides clinical care recommendations for 19 discrete body systems and/or care considerations. Summary The resulting recommendations are intended to help standardize and elevate care for this patient population and reduce variability in clinical trial and study environments. Described as “one of the more variable diseases found in medicine,” myotonic dystrophy type 1 (DM1) is an autosomal dominant, triplet-repeat expansion disorder that affects somewhere between 1:3,000 and 1:8,000 individuals worldwide.1 There is a modest association between increased repeat expansion and disease severity, as evidenced by the average age of onset and overall morbidity of the condition. An expansion of over 35 repeats typically indicates an unstable and expanding mutation. An expansion of 50 repeats or higher is consistent with a diagnosis of DM1. DM1 is a multisystem and heterogeneous disease characterized by distal weakness, atrophy, and myotonia, as well as symptoms in the heart, brain, gastrointestinal tract, endocrine, and respiratory systems. Symptoms may occur at any age. The severity of the condition varies widely among affected individuals, even among members of the same family. Comprehensive evidence-based guidelines do not currently exist to guide the treatment of DM1 patients. As a result, the international patient community reports varied levels of care and care quality, and difficulty accessing care adequate to manage their symptoms, unless they have access to multidisciplinary neuromuscular clinics. Consensus-based care recommendations can help standardize and improve the quality of care received by DM1 patients and assist clinicians who may not be familiar with the significant variability, range of symptoms, and severity of the disease. Care recommendations can also improve the landscape for clinical trial success by eliminating some of the inconsistencies in patient care to allow more accurate understanding of the benefit of potential therapies

Nouseled in books: Women's stories of reading.

This study of women who are passionate readers of novels is based on my own experiences and on interviews with nine women. In addition to the ethnographic study of real readers, I look at past constructions of the woman reader that influence our stories. Women and fiction have a long history together. As soon as fiction began to take its present form, women became, by some accounts, its principal readers and authors. They continued reading despite early critics' fears that, on the one hand, a woman might become so nouseled in amorous bookes, vaines stories and fonde trifeling fancies, that shee smelleth of naughtiness even all hir lyfe after (Edward Hake, 1574) or, on the other hand, Literature, until then a male province, would be destroyed by readers who have no design in reading but for pleasure (Richard Steele, 1713). The women I interviewed told stories of their earliest memories of books, their school experiences, what they read, how they used reading as children, why and what they read as adults, and when their reading intersected with life. One speaks of having a sense of self and identity ... like a permeable membrance, so that I spill over into the book and the book spills over into me. Another, a psychotherapist, believes she learned skills for her job through reading. A third realized, as a result of this study, that Reading has really organized my life, and I just thought of it as something that I did. I never saw it as a driving force. Since these white, middle-class, highly educated women did not see school reading as particularly relevant to their reading lives, I raise questions about the continuing male-centeredness of fiction in the curriculum, the use of literature to teach writing or to teach about literature, and the privileging of academic approaches to reading novels that ignore women's practices. I also show how these particular women have been able through reading novels both to strengthen their identification as female and resist cultural restraints with which women must contend.Ph.D.Cultural anthropologyEducationReading instructionSocial SciencesWomen's studiesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/131386/2/9909851.pd

Cutting out the middleman

In vivo, hydrogenases require maturases for active site incorporation. However, in vitro, an active site model with limited catalytic activity could be incorporated into the apo form of [FeFe]-hydrogenase without the aid of maturases, generating enzyme with native activity

Magnetostratigraphy and biostratigraphy of ODP Leg 105 sites and DSDP Hole 12-112

During Ocean Drilling Program (ODP) Leg 105, three sites (Sites 645 through 647) were drilled in Baffin Bay and the Labrador Sea to examine the tectonic evolution and the climatic and oceanic histories of this region. Biostratigraphic and magnetostratigraphic results vary at each site, while stratigraphic resolution depends on the limited abundance of marker species and the completeness of the paleomagnetic record. Because of the paucity of planktonic microfossils and the poor paleomagnetic record signatures, stratigraphic determinations at Site 645 often rely on defining minimum temporal constraints on specific samples or stratigraphic intervals. The completed stratigraphy indicates that the sedimentary sequence recovered at Site 645 is early Miocene to Holocene in age. The magnetostratigraphy and biostratigraphies are better defined at Sites 646 and 647 in the Labrador Sea. Site 646 generally contains a well-developed magnetostratigraphy and calcareous microfossil biostratigraphy. This biostratigraphy is based on calcareous nannofossils and planktonic foraminifers typical of the North Atlantic Ocean. Siliceous microfossils are also present at Site 646, but they are restricted to upper Pliocene through Holocene sediments. The stratigraphic sequence recovered at Site 646 is late Miocene to Holocene in age. Based primarily on the calcareous nannofossil stratigraphy, the sequence recovered at Site 647 consists of lower Eocene to lower Oligocene, lower Miocene, upper Miocene, and upper Pliocene through Holocene sediments. Three hiatuses are present in this sequence: the older hiatus separates lower Oligocene sediments from lower Miocene sediments, another hiatus separates lower Miocene sediments from upper Miocene sediments, and the youngest one separates upper Miocene from upper Pliocene sediments. A magnetostratigraphy is defined for the interval from the Gauss/Matuyama boundary through the Brunhes (Clement et al., this volume). Both planktonic foraminifers and siliceous microfossils have restricted occurrences. Planktonic foraminifers occur in Pliocene and younger sediments, and siliceous microfossils are present in lower Miocene and lower Oligocene sediments. The near-continuous Eocene through lower Oligocene sequence recovered at Site 647 allows the calcareous nannofossils and diatom stratigraphies at this site to act as a Paleogene stratigraphic framework. This framework can be compared with the stratigraphy previously completed for DSDP Site 112