Attitudes towards Oral Health in Patients with Rheumatoid Arthritis: A Qualitative Study Nested within a Randomized Controlled Trial

Introduction: Patients with rheumatoid arthritis (RA) present a higher incidence and severity of periodontitis than the general population. Our study, Outcomes of Periodontal Treatment in Patients with Rheumatoid Arthritis (OPERA), was a randomized waiting-list controlled trial using mixed methods. Patients randomized to the intervention arm received intensive periodontal treatment, and those in the control arm received the same treatment with a 6-mo delay. Aim: The nested qualitative component aimed to explore patients’ experiences and priorities concerning oral health and barriers and facilitators for trial participation. Methods: Using purposive sampling until thematic saturation was reached, we conducted 21 one-to-one semistructured interviews with randomized patients in either of the 2 treatment arms as well as with patients who did not consent for trial participation. Results: The patients described their experiences about RA, oral health, and study participation. Previous experiences with dental care professionals shaped patients’ current perceptions about oral health and the place of oral health on their list of priorities compared with other conditions. Patients also highlighted some of the barriers and facilitators for study participation and for compliance with oral health maintenance. The patients, in the control arm, presented their views regarding the acceptable length of waiting time for the intervention. Conclusion: The associations between periodontal and systemic health are increasingly recognized by the literature. Our study provided an insight into RA patients’ experiences and perceptions about oral health. It also highlighted some of the barriers and facilitators for participating in a periodontal interventional study for this group. We hope that our findings will support the design of larger interventional periodontal studies in patients with RA. The complex challenges faced by the burden of RA and the associated multimorbidities in this patient group might highlight opportunities to improve access to oral health services in this patient population. Knowledge Transfer Statement: This article provided insights into the experiences and perceptions of rheumatoid arthritis patients about their oral health to improve patient participation in a definitive clinical trial

Perioperative supplementation with a fruit and vegetable juice powder concentrate and postsurgical morbidity: a double-blind, randomised, placebo controlled clinical trial

Aims Surgical trauma leads to an inflammatory response that causes surgical morbidity. Reduced antioxidant micronutrient (AM)a levels and/or excessive levels of Reactive Oxygen Species (ROS)b have previously been linked to delayed wound healing and presence of chronic wounds. We aimed to evaluate the effect of pre-operative supplementation with encapsulated fruit and vegetable juice powder concentrate (JuicePlus+®) on postoperative morbidity and Quality of Life (QoL)c. Methods We conducted a randomised, double-blind, placebo-controlled two-arm parallel clinical trial evaluating postoperative morbidity following lower third molar surgery. Patients aged between 18 and 65 years were randomised to take verum or placebo for 10 weeks prior to surgery and during the first postoperative week. The primary endpoint was the between-group difference in QoL over the first postoperative week, with secondary endpoints being related to other measures of postoperative morbidity (pain and trismus). Results One-hundred and eighty-three out of 238 randomised patients received surgery (Intention-To-Treat population). Postoperative QoL tended to be higher in the active compared to the placebo group (p=0.059). Furthermore, reduction in mouth opening 2 days after surgery was 3.1 mm smaller (p=0.042), the mean pain score over the postoperative week was 9.4 mm lower (p=0.007) and patients were less likely to experience moderate to severe pain on postoperative day 2 (RR 0.58, p=0.030), comparing verum to placebo groups. Conclusion Pre-operative supplementation with a fruit and vegetable supplement rich in AM may improve postoperative QoL and reduce surgical morbidity and post-operative complications after surgery

Measurement of SUSY masses via cascade decays for SPS 1a

If R-parity conserving supersymmetry exists below the TeV-scale, new particles will be produced and decay in cascades at the LHC. The lightest supersymmetric particle will escape the detectors, thereby complicating the full reconstruction of the decay chains. In this paper we expand on existing methods for determining the masses of the particles in the cascade from endpoints of kinematical distributions. We perform scans in the mSUGRA parameter space to delimit the region where this method is applicable. From the examination of theoretical distributions for a wide selection of mass scenarios it is found that caution must be exerted when equating the theoretical endpoints with the experimentally obtainable ones. We provide analytic formulae for the masses in terms of the endpoints most readily available. Complications due to the composite nature of the endpoint expressions are discussed in relation to the detailed analysis of two points on the SPS 1a line. Finally we demonstrate how a Linear Collider measurement can improve dramatically on the precision of the masses obtained

Sulforaphane restores cellular glutathione levels and reduces chronic periodontitis neutrophil hyperactivity in vitro

The production of high levels of reactive oxygen species by neutrophils is associated with the local and systemic destructive phenotype found in the chronic inflammatory disease periodontitis. In the present study, we investigated the ability of sulforaphane (SFN) to restore cellular glutathione levels and reduce the hyperactivity of circulating neutrophils associated with chronic periodontitis. Using differentiated HL60 cells as a neutrophil model, here we show that generation of extracellular O2 . - by the nicotinamide adenine dinucleotide (NADPH) oxidase complex is increased by intracellular glutathione depletion. This may be attributed to the upregulation of thiol regulated acid sphingomyelinase driven lipid raft formation. Intracellular glutathione was also lower in primary neutrophils from periodontitis patients and, consistent with our previous findings, patients neutrophils were hyper-reactive to stimuli. The activity of nuclear factor erythroid-2-related factor 2 (Nrf2), a master regulator of the antioxidant response, is impaired in circulating neutrophils from chronic periodontitis patients. Although patients' neutrophils exhibit a low reduced glutathione (GSH)/oxidised glutathione (GSSG) ratio and a higher total Nrf2 level, the DNA-binding activity of nuclear Nrf2 remained unchanged relative to healthy controls and had reduced expression of glutamate cysteine ligase catalytic (GCLC), and modifier (GCLM) subunit mRNAs, compared to periodontally healthy subjects neutrophils. Pre-treatment with SFN increased expression of GCLC and GCM, improved intracellular GSH/GSSG ratios and reduced agonist-activated extracellular O2 . - production in both dHL60 and primary neutrophils from patients with periodontitis and controls. These findings suggest that a deficiency in Nrf2-dependent pathways may underpin susceptibility to hyper-reactivity in circulating primary neutrophils during chronic periodontitis. © 2013 Dias et al

Dark matter searches at LHC

Besides Standard Model measurements and other Beyond Standard Model studies, the ATLAS and CMS experiments at the LHC will search for Supersymmetry, one of the most attractive explanation for dark matter. The SUSY discovery potential with early data is presented here together with some first results obtained with 2010 collision data at 7 TeV. Emphasis is placed on measurements and parameter determination that can be performed to disentangle the possible SUSY models and SUSY look-alike and the interpretation of a possible positive supersymmetric signal as an explanation of dark matter.Comment: 15 pages, 14 figures, Invited plenary talk given at DISCRETE 2010: Symposium On Prospects In The Physics Of Discrete Symmetries, 6-11 Dec 2010, Rome, Ital

Collider Physics and Cosmology

In the coming year, the Large Hadron Collider will begin colliding protons at energies nearly an order of magnitude beyond the current frontier. The LHC will, of course, provide unprecedented opportunities to discover new particle physics. Less well-known, however, is that the LHC may also provide insights about gravity and the early universe. I review some of these connections, focusing on the topics of dark matter and dark energy, and highlight outstanding prospects for breakthroughs at the interface of particle physics and cosmology.Comment: 14 pages, plenary talk presented at the 18th International Conference on General Relativity and Gravitation (GRG18) and the 7th Edoardo Amaldi Conference on Gravitational Waves (Amaldi7), Sydney, Australia, 8-14 July 2007; published versio

Going Solo: findings from a survey of women ageing without a partner and who do not have children

Greater longevity in the UK population has led to the increasing diversity of women experiencing ageing in a multitude of ways. Internationally gender inequalities within ageing are still relatively invisible within both government policy and everyday life for particular groups of women. This paper explores the concept of women growing older ‘solo’ by which we mean women who find themselves non partnered and ageing without children as they move into later life. We report on the findings from a mixed-methods survey of 76 solo women in the UK aged 50 years and over, used to provide a broader overview of the issues and challenges they face as they move into later life. Qualitative data from the survey captured respondents’ perspectives about the links between their relationships status and wellbeing in later life and highlighted specific cumulative disadvantages emerging for some women as a result of their solo lifestyles. We discuss two key themes were identified; ‘solo-loneliness’ and ‘meaningful futures’ in conjunction with the relevant literature and make suggestions for future research within gender and ageing studies that could enhance more positive approaches to solo lifestyles

Oxygen Tension Regulates Pancreatic β-Cell Differentiation Through Hypoxia-Inducible Factor 1α

International audienceThese data demonstrate that beta-cell differentiation is controlled by pO2 through HIF1alpha. Modifying pO2 should now be tested in protocols aiming to differentiate beta-cells from embryonic stem cells

Active ageing, pensions and retirement in the UK

The ageing population has led to increasing concerns about pensions and their future sustainability. Much of the dominant policy discourse around ageing and pension provision over the last decade has focussed on postponing retirement and prolonging employment. These measures are central to productive notions of ‘active ageing’. Initially the paper briefly sets out the pension developments in the UK. Then it introduces active ageing and active ageing policy, exploring its implications for UK pension provision. It demonstrates that a more comprehensive active ageing framework, which incorporates a life-course perspective, has the potential to assist the UK to respond to the challenges of an ageing population. In doing so it needs to highlight older people as an economic and social resource, and reduce barriers to older people’s participation in society