Planning the oral health workforce: time for innovation

Contains fulltext : 232783.pdf (Publisher’s version ) (Open Access)The levels and types of oral health problems occurring in populations change over time, while advances in technology change the way oral health problems are addressed and the ways care is delivered. These rapid changes have major implications for the size and mix of the oral health workforce, yet the methods used to plan the oral health workforce have remained rigid and isolated from planning of oral healthcare services and healthcare expenditures. In this paper, we argue that the innovation culture that has driven major developments in content and delivery of oral health care must also be applied to planning the oral health workforce if we are to develop 'fit for purpose' healthcare systems that meet the needs of populations in the 21st century. An innovative framework for workforce planning is presented focussed on responding to changes in population needs, service developments for meeting those needs and optimal models of care delivery

Vegetarian diet and its possible influence on dental health: A systematic literature review

OBJECTIVES: People following a vegetarian diet could be more prone to oral health problems than people following a nonvegetarian diet. The aim of this systematic review was to examine the possible impacts of following a vegetarian diet on dental hard tissues, focusing on caries development, dental erosion and number of natural teeth. METHODS: PubMed, EMBASE, Web of Science and CINAHL were searched systematically up until 17 April 2019. Original studies comparing dental health (exclusively focusing on dental hard tissues) in vegetarians and nonvegetarians were selected. Study characteristics and outcome data were extracted, and the quality of the studies was assessed using the Newcastle-Ottawa Scale. When a dental health characteristic was reported in three or more papers in a comparable way, a meta-analysis was performed. RESULTS: Twenty-one papers reporting on 18 studies were included in this review. In meta-analyses, the vegetarian diet was associated with a higher risk for dental erosion (odds ratio: 2.40 [95% confidence interval: 1.24, 4.66]; P = .009) and a lower decayed, missing and filled teeth (DMFT) score (mean difference: -0.15 [95% confidence interval: -0.29, -0.02]; P = .023), although the quality of most included studies was poor and the findings for DMFT score became insignificant when only studies on adults were included in the meta-analysis. A meta-analysis for the other dental characteristics was not possible due to the limited number of eligible studies. There was inconsistent evidence for a link between following a vegetarian diet and dental caries or the number of natural teeth. CONCLUSIONS: Within the limitations of the present study, the findings suggest that following a vegetarian diet may be associated with a greater risk of dental erosion

Six lessons from introducing sweetened beverage taxes in Berkeley, Cook County, and Philadelphia: A case study comparison in agenda setting and decision making

Contains fulltext : 225353.pdf (Publisher’s version ) (Closed access)Sweetened beverage (SB) taxes have recently been introduced to prevent obesity by several governments, but limited information on related policy adoption processes hampers further diffusion. We investigated the agenda-setting and decision-making phases of SB tax reforms in Berkeley and Philadelphia (where it was successfully adopted), and Cook County (where it was repealed). A web-based survey, semi structured stakeholder interviews, and a local media coverage analysis were used to collect information. Findings were structured and analyzed using the health policy triangle of Buse, Mays and Walt. Six general lessons emerged. First, the policy was coupled to existing high-agenda items (e.g., financing pre-kindergarten in Philadelphia). Second, policy framing had to align prevailing political sentiments, as expressed in media (e.g., 'Berkeley vs. Big Soda' echoed skepticism of corporate influence in politics). Third, existing tax policies and political decision-making rules were important (e.g., confusion how the SB tax related to state and federal taxes fueled Cook County opposition). Fourth, the tax structure required technical and political considerations during policy formulation (e.g., artificially-sweetened beverages were included in Philadelphia to counteract arguments that the tax was regressive). Fifth, it was important to build an advocacy coalition upfront (e.g., the Berkeley coalition was constructed prior to announcing the attempt). Sixth, successful advocacy coalitions were locally grounded and influenced local media (e.g., the Cook County opposition engaged local retailers)

The caries-related cost and effects of a tax on sugar-sweetened beverages

Contains fulltext : 202862.pdf (publisher's version ) (Closed access

Effectiveness and Policy Determinants of Sugar-Sweetened Beverage Taxes

Sugar consumption is on the rise globally with detrimental (oral) health effects. There is ample evidence that sugar-sweetened beverage (SSB) taxes can efficiently reduce sugar consumption. However, evidence alone is seldom enough to implement a policy. In this article, we present a narrative synthesis of evidence, based on real-world SSB tax evaluations, and we combine this with lessons from policy development case studies. This article is structured according to the Health Policy Analysis Triangle, which identifies a policy's content and process and important contextual factors. SSB tax policy content needs to be coupled to existing problems and public sentiment, which depend on more aspects than aspects related to (oral) health alone. Whether or not to include artificially sweetened beverages, therefore, is not solely a matter of showing the evidence of their oral health impact but also dependent on the stated aim of a tax and public sentiment toward tax policies in general. SSB taxes also need to be in line with existing tax and decision-making rules. Earmarking revenue for specific (health promotion) purposes may therefore be less straightforward as it might appear. The policy process of creating context-sensitive SSB tax policy content is not easy either. Advocacy coalitions need to be formed early in the process, and stamina, expertise, and flexibility are required to get a SSB tax adopted in a specific community. This requires a meticulously considered SSB tax structure implementation process. Oral health professionals who want to lead the way in advocating for SSB taxes should realize that evidence-based arguments on potential effectiveness alone will not be enough to realize change. The oral health community can learn important lessons from other "doctor-activists" such as pulmonologists, who have successfully advocated for higher tobacco taxes by being visible in the public debate with clear messaging and robust policy proposals

Effectiveness and Policy Determinants of Sugar-Sweetened Beverage Taxes

Sugar consumption is on the rise globally with detrimental (oral) health effects. There is ample evidence that sugar-sweetened beverage (SSB) taxes can efficiently reduce sugar consumption. However, evidence alone is seldom enough to implement a policy. In this article, we present a narrative synthesis of evidence, based on real-world SSB tax evaluations, and we combine this with lessons from policy development case studies. This article is structured according to the Health Policy Analysis Triangle, which identifies a policy’s content and process and important contextual factors. SSB tax policy content needs to be coupled to existing problems and public sentiment, which depend on more aspects than aspects related to (oral) health alone. Whether or not to include artificially sweetened beverages, therefore, is not solely a matter of showing the evidence of their oral health impact but also dependent on the stated aim of a tax and public sentiment toward tax policies in general. SSB taxes also need to be in line with existing tax and decision-making rules. Earmarking revenue for specific (health promotion) purposes may therefore be less straightforward as it might appear. The policy process of creating context-sensitive SSB tax policy content is not easy either. Advocacy coalitions need to be formed early in the process, and stamina, expertise, and flexibility are required to get a SSB tax adopted in a specific community. This requires a meticulously considered SSB tax structure implementation process. Oral health professionals who want to lead the way in advocating for SSB taxes should realize that evidence-based arguments on potential effectiveness alone will not be enough to realize change. The oral health community can learn important lessons from other “doctor-activists” such as pulmonologists, who have successfully advocated for higher tobacco taxes by being visible in the public debate with clear messaging and robust policy proposals

Acute effects of nandrolone decanoate on cardiodynamic parameters in isolated rat heart

Despite worldwide use of anabolic steroids in last decades, there are still contradictory informations about their acute influence on myocardium. The aim of this study was to examine the acute effects of nandrolone decanoate (ND) on cardiodynamics and coronary flow in isolated rat heart. The hearts of male Wistar albino rats (n=48, 12 per group, age 8 weeks, body mass 180–200 g) were excised and perfused according to Langendorff technique at gradually increased coronary perfusion pressures (40–120 cmH2O). After control sets of experiments, the hearts were perfused with ND in dose of 1 μM, 10 μM and 100 μM, successively. Using sensor placed in the left ventricle, we registered: maximum and minimum rate of pressure development in the left ventricle (dp/dt max and dp/dt min), systolic and diastolic left ventricular pressure (SLVP and DLVP) and heart rate (HR). Coronary flow (CF) was measured flowmetrically. The results clearly show the depression in cardiac function caused by higher doses of ND. The highest concentration of ND (100μM) induced most deleterious impact on the myocardial function and perfusion of the heart (coronary circulation), which could be of clinical significance.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author