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

Optimising cognitive load and usability to improve the impact of e-learning in medical education

CITATION: Davids, M. R., Halperin, M. L. & Chikte, U. M. E. 2015. Optimising cognitive load and usability to improve the impact of e-learning in medical education. African Journal of Health Professions Education, 7(2):147-152, doi:10.7196/AJHPE.569The original publication is available at http://www.ajhpe.org.zaE-learning has the potential to support the development of expertise in clinical reasoning by being able to provide students with interactive learning experiences, exposure to multiple cases, and opportunities for deliberate practice with tailored feedback. This review focuses on two important but underappreciated factors necessary for successful e-learning, i.e. the management of the learner’s cognitive load and the usability of the technology interface. Cognitive load theory views learning as involving active processing of information by working memory via separate visual and auditory channels. This system is of very limited capacity and any cognitive load that does not directly contribute to learning is considered extraneous and likely to impede learning. Researchers in cognitive load theory have provided evidence-based instructional design principles to reduce extraneous cognitive load and better manage the cognitive processing necessary for learning. Usability is a concept from the field of human-computer interaction which describes how easy technology interfaces are to use, and is routinely evaluated and optimised in the software development industry. This is seldom the case when e-learning resources are developed, especially in the area of medical education. Poor usability limits the potential benefit of educational resources, as learners experience difficulties with the technology interface while simultaneously dealing with the challenges of the content presented. Practitioners in the field of human-computer interaction have provided guidelines and methods for evaluating and optimising the usability of e-learning materials. The fields of cognitive load theory and human-computer interaction share a common goal in striving to reduce extraneous cognitive load. The load induced by poor usability of e-learning materials can be viewed as a specific component of extraneous cognitive load, adding to any load resulting from poor instructional design. The guidelines from these two fields are complementary and, if correctly implemented, may substantially improve the impact of our e-learning resources on the development of the clinical reasoning skills of students.AFRIKAANSE OPSOMMING: Geen opsomming beskikbaarhttp://www.ajhpe.org.za/index.php/ajhpe/article/view/569sPublisher's versio

Association between dental and periodontal conditions with chronic kidney disease: A cross-sectional analysis of urban South Africans

Oral diseases are preventable causes of poor health outcomes in people with chronic kidney disease (CKD). Investigate the association between dental and periodontal conditions with kidney function and determine whether inflammation mediate the association between periodontitis and CKD. Cross-sectional analysis of 1551 South African adults of mixed ancestry. CKD was classified as estimated glomerular filtration rate (eGFR) <60mL/min/1.73m2. Oral profile was captured by decayed, missing, filled teeth index (DMFTi), bleeding on probing (BOP), pocket depth (PD), clinical attachment loss (CAL), and periodontitis classified as PD ≥4 mm.Overall, 6% had CKD, with 93% and 66% of participants with and without CKD, respectively having a high DMFTi (p<0.0001). Further, 84% (CKD) and 43% (without CKD) were edentulous (p<0.0001). A great proportion of the dentate sub-sample (n=846) had periodontitis, however, BOP, PD ≥4mm and CAL ≥4mm were similar between the groups. DMFTi was associated with eGFR and prevalent CKD (p<0.023), with this association driven by the Missing component. Periodontitis was not associated with eGFR nor CKD (p>0.282). In routine care of people with CKD, attention should be given to oral health

Water fluoridation is the right thing to do

EditorialThe original publication is available at http://www.samj.org.za[No abstract available]Publisher’s versio

Guest editorial

EditorialThe original publication is available at http://www.samj.org.za[No abstract available]Publisher’s versio

HIV/AIDS - the evolving pandemic and its impact on oral health in sub-Saharan Africa.

This review provides an update on HIV/AIDS based on a literature search (1989-1999) in respect of its epidemiology and oral manifestations in sub-Saharan Africa. The African epidemic is unique in its heterosexual spread, high prevalence in men, women and children, rapid rise in young women and risk of vertical transmission. Viral subtypes A and D predominate in Africa, subtype C in South Africa and subtype E in Central Africa. The pandemic is fueled by endemic poverty, malnutrition, gender inequality and sexual and cultural practices. Oral lesions may frequently be the initial presenting signs of HIV infection, early clinical features, predictors of progression of disease and may be useful in staging and classification. Health care workers require training to understand, diagnose, manage and research these manifestations.Revie

Attitudes to water fluoridation in South Africa 1998. Part I. Analysis by age, sex, population and province.

The successful implementation of water fluoridation (WF) depends upon support from the public. A survey was conducted in 1998 by the Human Sciences Research Council to assess attitudes of the South African population towards WF. A representative sample of 2,220 persons over the age of 18 years was interviewed. Questions relating to current knowledge, sources of information, the purpose of water fluoridation and its desirability as a public health measure were put to respondents. Only 25% of the population had heard or read of WF. The major sources of information were the electronic and printed media (40% and 27% respectively), while 2.5% heard about it from dentists. Just over a third of the sample (35.5%) identified the purpose of WF as protecting teeth from decay; 28% said it was to purify water and 28.5% were uncertain of, or did not know its purpose. Nearly two-thirds (61.9%) indicated that fluoride should be added to drinking water if it can reduce tooth decay, while 9% were not in favour and 29% were uncertain. The results suggest that most people do not know what WF is or does, though most were in agreement that it should be implemented to reduce tooth decay.Articl

Community dental service--the first year.

In July 2000, the first group of graduates entered compulsory community dental service. The aim of this study was to document the experiences of the community dentists in their first year of placement. A cross-sectional, descriptive study was carried out among 171 community dentists. A structured questionnaire divided into nine sections: demography, the allocation process, accommodation and living conditions, dental clinic facilities--equipment and materials, work environment, income, sense of achievement, intellectual fulfillment. Thirty five per cent of the sample responded. Of the respondents 54% could speak the local language; almost half (45%) felt that the allocation process was not handled efficiently and 40% said that they needed more information; 60% were placed within 20 km of the nearest town; 26% did not have access to telephone or fax and only 52% were provided with accommodation. Twenty six per cent described the condition of the clinics as poor. Almost a quarter of the respondents indicated that they did not have full sets of instruments. Ten per cent did not have an autoclave nor a high-speed handpiece. Fifty seven per cent did not have oxygen and half the clinics did not have any emergency equipment. Fifty per cent reported that equipment broke down often and an equal number that it was not fixed promptly. More than 90% indicated that they needed a short course to help with repairs. Almost two-thirds said that they enjoyed their work environment. Fifty three per cent had supervision, but 30% felt that they did not need supervision. Although 75% felt that their professional competence had been enhanced, more than three-quarters indicated that they had lost some of their clinical competence in one or other area. While 58% felt that there were many opportunities to improve clinical skills, almost two thirds felt that they were over-skilled for the job. Three-quarters of the respondents indicated that the year had been fulfilling and worthwhile. Problem areas centred around the adequacy of the information provided, accommodation and breakdown of equipment. With the next community service placement, it would be useful if the experiences and lessons of the first year could be taken into account.Articl

Community dental service--the first year.

In July 2000, the first group of graduates entered compulsory community dental service. The aim of this study was to document the experiences of the community dentists in their first year of placement. A cross-sectional, descriptive study was carried out among 171 community dentists. A structured questionnaire divided into nine sections: demography, the allocation process, accommodation and living conditions, dental clinic facilities--equipment and materials, work environment, income, sense of achievement, intellectual fulfillment. Thirty five per cent of the sample responded. Of the respondents 54% could speak the local language; almost half (45%) felt that the allocation process was not handled efficiently and 40% said that they needed more information; 60% were placed within 20 km of the nearest town; 26% did not have access to telephone or fax and only 52% were provided with accommodation. Twenty six per cent described the condition of the clinics as poor. Almost a quarter of the respondents indicated that they did not have full sets of instruments. Ten per cent did not have an autoclave nor a high-speed handpiece. Fifty seven per cent did not have oxygen and half the clinics did not have any emergency equipment. Fifty per cent reported that equipment broke down often and an equal number that it was not fixed promptly. More than 90% indicated that they needed a short course to help with repairs. Almost two-thirds said that they enjoyed their work environment. Fifty three per cent had supervision, but 30% felt that they did not need supervision. Although 75% felt that their professional competence had been enhanced, more than three-quarters indicated that they had lost some of their clinical competence in one or other area. While 58% felt that there were many opportunities to improve clinical skills, almost two thirds felt that they were over-skilled for the job. Three-quarters of the respondents indicated that the year had been fulfilling and worthwhile. Problem areas centred around the adequacy of the information provided, accommodation and breakdown of equipment. With the next community service placement, it would be useful if the experiences and lessons of the first year could be taken into account.Articl