From classroom teaching to clinical practice: experiences of senior dental students regarding the shortened dental arch concept

This study explored the barriers to a meaningful translation of didactic classroom instruction to clinical practice, using the shortened dental arch (SDA) concept as a case study. A combination of survey and individual and group interviews (a mixed- methods approach) was used to collect data related to the SDA. The cohort consisted of senior dental students and their clinical teachers at the University of the Western Cape, South Africa. The response rates were 100 percent for the students (n=73) and 78 percent for the clinical teachers (n=16). Triangulation was employed to eliminate bias and strengthen the reliability of the re- search. In the quantitative analysis, most students (81 percent) reported having heard about the SDA concept at the university, but their responses revealed an absence of clinical implementation. The students agreed that patients can function adequately with an SDA and agreed with presenting it as a treatment option to patients. In the qualitative analysis, a “change in the clinical require- ments,” “being empowered by exposing them to SDA literature,” and “change in health policies” were recommended measures to increase implementation of the SDA approach clinically. The students were positive about the SDA as a treatment option, but the lack of adequate knowledge and encouragement in clinical implementation was a hindrance to its use.Web of Scienc

How oral infections can influence chronic kidney disease – a review of the literature

A healthy mouth is necessary for optimal health and quality of life. However, oral health is often compromised in adults with chronic kidney disease (CKD). The aim of this review was to present the scientific foundations behind the connection between oral diseases and chronic kidney disease (CKD) in adults, discuss common oral conditions and their systemic effects, investigate biological pathways through which oral infections affect the body and provide guidelines for physicians/nephrologists. Prevalence of oral disease is increased in CKD, including periodontal disease, oral mucosal lesions, edentulousness, xerostomia, gingival overgrowth in immunosuppressed patients and potentially caries. There is moderate to strong evidence to support a negative impact of oral infections in CKD, particularly periodontal disease, with systemic inflammation, bacteraemia of oral origin, endothelial function and gut dysbiosis being potential pathways for this interaction. Poor oral health can be a hidden source of infection and has been associated with increased mortality in CKD patients. Elimination of potential foci for oral infections is crucial before renal transplantation. Frequent dental monitoring is crucial for these patients and should be part of a multidisciplinary approach to manage CKD, with special attention to end-stage kidney disease

The pH Levels of Different Methamphetamine Drug Samples on the Street Market in Cape Town

The purpose of this study was to determine the pH levels of 29 different samples of methamphetamine on the street market in Cape Town. The sample was dissolved in water and the pH of each sample determined. The pH levels varied from 3.02 to 7.03 with an average of 5.0. Seventy-two percent (21) of the samples had a pH level below the saliva “critical pH point of 5.6” and therefore should cause significant damage to enamel, especially in hyposalivation subjects without a saliva flow. However, about 26% of the samples had a pH level close to the neutral point and should cause minor damage to enamel. To lessen enamel damage, subjects should exercise good oral hygiene practice, rinse with a fluoride-containing mouth rinse, drink artificially sweetened drinks, and eat cheese. It is concluded that most of the methamphetamine samples have a low enough pH to cause direct damage to enamel especially in hyposalivation subjects

Sustainable workforce: South African Audiologists and Speech Therapists.

(c) The Author/s 2020Background Audiologists and Speech Therapists play a vital role in addressing sustainable development goals by supporting people who are marginalised due to communication challenges. The global burden of disease and poor social living conditions impact negatively on the development of healthy communication, therefore requiring the services of Audiologist and Speech therapists. Against this background, we examined the demographic profile and the supply, need and shortfall of Audiologists and Speech Therapists in South Africa. Methods The data set was drawn from the Health Professions Council of South Africa (HPCSA) registers (for 2002–2017) for the speech, language and hearing professions. This demographic profile of the professions was created based on the category of health personnel; category of practice, geographical location, population group (race) and sex. The annual supply was estimated from the HPCSA database while the service–target approach was used to estimate need. Additional need based on National Health Insurance Bill was also included. Supply–need gaps were forecast according to three scenarios, which varied according to the future intensity of policy intervention to increase occupancy of training places: ‘best guess’ (no intervention), ‘optimistic’ (feasible intervention), and ‘aspirational’ (significant intervention) scenarios up to 2030. Results Most (i.e. 1548, 47.4%) of the professionals are registered as Audiologists and Speech Therapists, followed by 33.5% registered as Speech Therapists and 19.1% registered as Audiologists. Around 88.5% professionals registered as Audiologists and Speech Therapists are practising independently, and 42.6% are practising in the Gauteng province. The profession is comprised majorly of women (94.6%), and in terms of the population groups (race), they are mainly classified as white (59.7%). In 2017, in best guess scenario, there is a supply–need gap of around 2800 professionals. In the absence of any intervention to increase supply capacity, this shortfall will remain same by the year 2030. By contrast, in aspirational scenario, i.e. supply is increased by 300%, the forecasted shortfall for 2030 reduces to 2300 from 2800 professionals. Conclusions It is clear that without significant interventions, South Africa is likely to have a critical shortfall of Audiologists and Speech Therapists in 2030. Policy-makers will have to carefully examine issues surrounding the current framework regulating training of these and associated professionals, in order to respond adequately to future requirements

Knowledge of medical specialists on the emergency management of hyperkalaemia with a focus on insulin-based therapy

Introduction: Hyperkalaemia is a common electrolyte disorder in hospitalised patients and may cause life-threatening cardiac arrythmias and death. There is a lack of consensus regarding its optimal management, which may result in wide variations in practice and the guidance provided to junior staff. Methods: We conducted a survey on a Research Electronic Data Capture (REDCap) platform to evaluate the knowledge of medical specialists regarding the diagnosis and management of hyperkalaemia, with a focus on insulinbased therapy. A convenience sample of 70 specialists in nephrology, internal medicine, emergency medicine and critical-care medicine were invited to participate. Comparisons were also made between nephrologists and nonnephrologists. Results: A total of 51 medical specialists responded, of whom 47% were nephrologists. They were more likely to initiate therapy at a potassium concentration ([K]) of 6 mmol/L, whereas non-nephrologists tended to start at a lower concentration (P < 0.01). Half the respondents regarded blood gas machine measurements as providing an accurate measure of [K]. Non-nephrologists were more likely to perform an ECG before starting treatment (P = 0.02). All respondents regarded insulin and dextrose as the most effective and reliable means for shifting K. Only 22% monitored the serum glucose concentration beyond 2 hours following insulin-based therapy, and 22% thought that hypoglycaemia was an uncommon complication if dextrose also was administered. Conclusions: This is the first comprehensive survey to report on the knowledge of specialists regarding the emergency management of hyperkalaemia. There is a need to address knowledge gaps, particularly around the optimal and safe use of insulin-based therapies. Our findings and recommendations should be useful in informing the development of consensus guidelines and educational resources on hyperkalaemia. &nbsp

Essays on regional economic growth in India

In the first chapter I study regional growth and sub-national income convergence in India in the context of economic reforms that were undertaken since 1991. I also examine convergence in development inputs such as population growth, literacy and investment at the sub-national level. My results show that there is a strong evidence of divergence in per capita income of the 15 states studied in the sample. The standard deviation of net state domestic product has increased over time indicating no evidence of convergence in the pre- or post-reforms period. Population, state capital expenditure and commercial bank credit have also diverged over time across these 15 Indian states. However, literacy shows evidence of convergence across states.In the second chapter I study sectoral output patterns and growth across states in India during pre- and post economic reforms period (1970-1990 and 1991-2005). I also study the relationship between per capita income and the shares of primary, secondary, and tertiary sectors in the total output. The data shows that the growth of secondary sector has stagnated in India. Thus there was an increase of just 1.45 percent in the secondary sector mean share in total output during post-reform period. The primary sector's share in the total output has declined with increasing per capita income conforming the theoretical prediction. As far as the tertiary sector is concerned, it has experienced rapid growth over the sample period. However, employment growth in the tertiary sector has been very slow. I have also investigated for the effect of increasing per capita income and other development inputs like investment, population and literacy rate on the changes in sectoral shares. I find literacy rates and state capital expenditure to be positively and significantly linked to the increase in tertiary sector output.In the third chapter I study the relationship between socio-political violence and economic growth across 16 states in India. I find that in India at large riots do not have a significant effect on NSDP growth. In spite of the various socio-political disturbances in terms of caste, language and ethnic issues, India has continued to develop economically. The episodes of socio-political problems and related violence do not seem to have put a drag on India's fast pace of economic growth. However, I find that in case of seven states that are affected with Maoist/Naxalite violence, riots have a significant growth-inhibiting effect

Assessment of periodontal status and treatment needs of a disabled population using the CPITN

KIMThe Community Periodontal Index of Treatment Needs (CPITN) was used to assess the periodontal status of 213 handicapped persons attending seven institutions in Johannesburg. Fewer than 2% had healthy mouths, 8% had bleeding only, followed by calculus (46%), shallow pockets (40%) and deep pockets (4%). The mean number of sextants with bleeding or higher score was 5.9. Oral hygiene instruction was indicated for 98% and prophylaxis for 90% of the participants. The CPITN was easily used in the disabled population but may overestimate treatment need in view of the current understanding that periodontal disease does not automatically progress from a low CPITN level to the next. A more appropriate measure of treatment need in handicapped persons is require

GENE MAPPING: BASICS, TECHNIQUES AND SIGNIFICANCE

Watson says, "Like the system of interstate highways spanning our country, the map of the human genome will be completed stretch by stretch". It may be possible to use genetic information to diagnose the disease accurately and to predict a patient\u27s likely response to a particular medicine or treatment. For whole genome mapping development and application of mapping, sequencing and computational tools are very essential and also linkage, physical and sequence maps are required to put the information together. For most genome mapping projects involve markers consisting of a unique site in the genome and should be independent of any particular experimental resource. For mapping purpose the DNA and RNA identification is essential. These genes are identified by hybridizing DNA clones against Northern blot, cDNA libraries, Zoo blot, Western blot and Southern blot of genomic DNA digested with rare cutter restriction endonuclease. The various experimental studies of gene mapping have extended our understanding of the genetics. This has allowed the investigators to detect a particular gene, which is responsible for the disease. Recent studies have shown the various effective and scientific gene mapping techniques and gene identification methods, which are helpful to diagnose a particular disease. It is easy for the doctor to give right medicine to the right patient to cure the disease when he can identify the defective gene responsible for disease. This article reviews the details of identification techniques of genes, gene mapping with broad applications. KEY WORDS: Gene mapping; Restriction mapping; Fluorescent in situ hybridization (FISH); Sequenced tagged site (STS) mapping; Somatic cell hybridization