An immunohistochemical study of the distribution of p 16 protein in oral mucosa in smokers, non-smokers and in frictional keratosis

Objective: Our study aimed to characterize alteration in the immunohistochemical p16 expression in normal oral mucosa and non-neoplastic hyperproliferative disorders (i.e. frictional keratosis and mucosa from smokers). Study design: 43 specimen of oral mucosa were examined using immunohistochemistry. Results: In normal mucosa, there was strong positive nuclear staining in a proportion of fibroblasts and endothelial cells in the lamina propria, with variable expression in nuclei of the epithelial layer. However, when the patient?s tobacco smoking was examined, p16 nuclear staining in oral epithelium was seen in 4/20 (20%) of smokers and 0/23 (0%) of non-smokers. In every case of frictional keratosis (n=11), there was strong nuclear staining of some basal and supra-basal cells. In addition, there was strong nuclear staining of parakeratinizing squamous in a band above the spinous layer. In clinically normal oral epithelium of smokers and in frictional keratosis, basal and supra-basal cells expressed strong p16 nuclear staining which was absent in the control tissue examined. Conclusion: Our data suggest that p16 expression may be involved in the long-term loss of proliferation in cell senescence of oral mucosa

Screening programmes for the early detection and prevention of oral cancer

Background Oral cancer is an important global healthcare problem, its incidence is increasing and late-stage presentation is common. Screening programmes have been introduced for a number of major cancers and have proved effective in their early detection. Given the high morbidity and mortality rates associated with oral cancer, there is a need to determine the effectiveness of a screening programme for this disease, either as a targeted, opportunistic or population based measure. Evidence exists from modelled data that a visual oral examination of high-risk individuals may be a cost-effective screening strategy and the development and use of adjunctive aids and biomarkers is becoming increasingly common. Objectives To assess the effectiveness of current screening methods in decreasing oral cancer mortality. Search strategy The following electronic databases were searched: the Cochrane Oral Health Group Trials Register (to 20 May 2010), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, Issue 2), MEDLINE via OVID (1950 to 20 May 2010), EMBASE viaOVID(1980 to 20 May 2010) and CANCERLIT via PubMed (1950 to 20 May 2010). There were no restrictions regarding language or date of publication. Selection criteria Randomised controlled trials (RCTs) of screening for oral cancer or potentially malignant disorders using visual examination, toluidine blue, fluorescence imaging or brush biopsy. Data collection and analysis The original review identified 1389 citations and this update identified an additional 330 studies, highlighting 1719 studies for consideration. Only one study met the inclusion criteria and validity assessment, data extraction and statistics evaluation were undertaken by six independent review authors. Main results One 9-year RCT has been included (n = 13 clusters: 191,873 participants). There was no statistically significant difference in the age-standardised oral cancer mortality rates for the screened group (16.4/100,000 person-years) and the control group (20.7/100,000 person-years). A 43% reduction in mortality was reported between the intervention cohort (29.9/100,000 person-years) and the control arm (45.4/100,000) for high-risk individuals who used tobacco or alcohol or both, which was statistically significant. However, this study had a number of methodological weaknesses and the associated risk of bias was high. Authors' conclusion Although there is evidence that a visual examination as part of a population based screening programme reduced the mortality rate of oral cancer in high-risk individuals, whilst producing a stage shift and improvement in survival rates across the population as a whole, the evidence is limited to one study and is associated with a high risk of bias. This was compounded by the fact that the effect of cluster randomisation was not accounted for in the analysis. Furthermore, no robust evidence was identified to support the use of other adjunctive technologies like toluidine blue, brush biopsy or fluorescence imaging within a primary care environment. Further randomised controlled trials are recommended to assess the efficacy, effectiveness and cost-effectiveness of a visual examination as part of a population based screening programme. This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2010, Issue 11. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.</p

Wybrane umiejętności uczestników postępowania mediacyjnego w sprawach rodzinnych

The article presents the results of pilot studies. It refers to the opinions of participants of mediation and mediators regarding the parties’ skills (with particular focus on communication skills). The study was conducted using questionnaires devised for this occasion (for both the participants in mediation and the mediators). What is worth noting are the convictions of the parties regarding their own communication skills, the diversity of the respondents’ opinions, inter alia, in terms of their interpersonal skills and the ability to communicate their own needs, the high degree of emotion and the ways of dealing with clients’ emotions indicated by mediators. In the opinion of the mediators, the parties have high self-presentation skills but at the same time are not able to accept either criticism or praise. Differences in communication styles and decision-making methods for women and men participating in mediation were indicated. Moreover, the major areas of communication and taboo in the process were identified. The research leads to the conclusion that family mediators should take into account the possibility and preparation of the parties, so that they can be more effective

Suicidal Behavior and Psychological Distress in University Students: A 12-Nation Study. Archives of Suicide Research

This study investigated the prevalence of suicidal behavior and psychological distress in university students across 12 nations. A total of 5572 university students from 12 countries were surveyed about suicide ideation, suicide attempts and psychological distress by means of a self-administered questionnaire. Almost 29% of the samples reported having contemplated suicide and 7% reported attempting suicide. Of the total sample, 51.1% scored above the General Health Questionnaire-12 ≥ 3 cut-off point, 41.6% above the GHQ-12 ≥ 4 cut-off point, and 33.8% scored above the GHQ-12 ≥ 5 cut-off point. While odds of suicide ideation were elevated in Austria and the UK, reduced ORs were detected for China, Italy, Saudi Arabia, Tunisia, and Turkey. Similarly, while odds of suicide attempt were high in Jordan, Palestine, Saudi Arabia, and to some extent in Turkey, reduced ORs were observed for Austria, China, Italy, Japan and the USA. Elevated ORs for psychological distress were seen in Japan, Jordan, Palestine, Saudi Arabia, Tunisia and Turkey but reduced ORs were noted in Austria, China, Iran, Italy and the USA. Psychological distress was strongly associated with reports of suicide ideation and attempts. Suicide ideation, suicide attempt and psychological distress are common in university students but their rates vary depending on the sociocultural context. Due attention should be devoted to the mental health needs of young adults enrolled in higher educational institutions and more cross-cultural research is warranted to better understand the etiology of the observed intersocietal variations in suicidal behavior and psychological distress

Cross - national comparisons of attitudes towards suicide and suicidal persons in university students from 12 countries

This paper reports the results of a comparative investigation of attitudes to suicide and suicidal persons in 5,572 university students from 12 countries. Participants filled out two scales measuring attitudes towards suicide and suicidal persons, a measure of psychological distress together with the questions about suicidal behavior. Results showed that the highest suicide acceptance scores were observed in Austrian, UK, Japanese and Saudi Arabian samples and the lowest scores were noted in Tunisian, Turkish, Iranian and Palestinian samples. While the highest social acceptance scores for a suicidal friend were noted in Turkish, US, Italian and Tunisian samples, the lowest scores were seen in Japanese, Saudi Arabian, Palestinian and Jordanian samples. Compared to participants with a suicidal past, those who were never suicidal displayed more internal barriers against suicidal behavior. Men were more accepting of suicide than women but women were more willing to help an imagined suicidal peer. Participants with accepting attitudes towards suicide but rejecting attitudes towards suicidal persons reported more suicidal behavior and psychological distress, and were more often from high suicide rate countries and samples than their counterparts. They are considered to be caught in a fatal trap in which most predominant feelings of suicidality such as hopelessness or helplessness are likely to occur. We conclude that in some societies such as Japan and Saudi Arabia it might be difficult for suicidal individuals to activate and make use of social support systems

Screening programmes for the early detection and prevention of oral cancer

Oral cancer is an important global healthcare problem, its incidence is increasing and late-stage presentation is common. Screening programmes have been introduced for a number of major cancers and have proved effective in their early detection. Given the high morbidity and mortality rates associated with oral cancer, there is a need to determine the effectiveness of a screening programme for this disease, either as a targeted, opportunistic or population-based measure. Evidence exists from modelled data that a visual oral examination of high-risk individuals may be a cost-effective screening strategy and the development and use of adjunctive aids and biomarkers is becoming increasingly common

Economics methods in Cochrane systematic reviews of health promotion and public health related interventions.

Peer reviewedPublisher PD

Assessing the association between unstimulated whole salivary flow rate (UWSFR) and oral health status among healthy adult subjects : a cross-sectional study

This study aimed to test the association between the unstimulated whole salivary flow rate (UWSFR) and the oral health status represented by dental and gingival status among healthy adult subjects. This work was a cross-sectional study of patients attending the undergraduate dental clinics at AlFarabi College for Dentistry and Nursing, Riyadh, Saudi Arabia. The study population consisted of 502 systemically healthy adults aged 18?35 years. UWSFR was collected for all study participants and expressed as ml/min. Oral health status was estimated using the Community Periodontal Index (CPI) and the Oral Hygiene Index-Simplified (OHI-S). The number of decayed teeth and the number of available teeth were also calculated to evaluate dental status. The mean UWSFR was 0.42 (±0.3) ml/min, and the male participants significantly had more UWSFR than the females. UWSFR was significantly affected by CPI, OHI-S, body mass index (BMI) and gender as indicated in the univariate analysis. However, multiple regression analysis revealed that only gender was a significant predictor of UWSFR. The male subjects were shown to have a higher average of 0.133 ml/min than the females. High BMI scores, moderate-to-severe gingivitis and low level of oral hygiene increased UWSFR. However, further longitudinal studies are recommended to test the role of salivary cytokine levels to validate the exact association between the UWSFR and the oral health status

Immunohistochemical Expression of p53 in Pleomorphic Adenoma and Carcinoma Ex Pleomorphic Adenoma

Context. Immunohistochemical stains for p53 are used as a diagnostic marker associated with malignancy in several histologic types of salivary gland tumors. This marker may be useful in differentiating pleomorphic adenoma (PA) from carcinoma ex pleomorphic adenoma (CPA), as these tumors are often difficult to distinguish on the basis of morphology alone. Objective. to evaluate whatever inactivation of tumor suppressor gene (p53) increases with the tumor progression from normal salivary tissue to PA and eventually CPA. Design. Paraffin blocks of 29 cases of PA, which were surrounded by normal parotid gland, and 27 cases of carcinoma ex pleomorphic adenoma were retrieved and validated. In all cases of carcinoma ex pleomorphic adenoma, a PA “ghost” was identified, and the malignant element was either undifferentiated carcinoma or adenocarcinoma. Results. The results showed negative nuclear expression of P53 in normal parotid gland. Nuclear P53 was expressed strongly in 6/29 (20.7%) pleomorphic salivary adenoma and 10/27 (37%) carcinoma ex pleomorphic adenoma. Conclusion. Our data suggest that inactivation of p53 may play an important role in the evolution of pleomorphic salivary adenoma and carcinoma ex pleomorphic adenoma

Percepcja siebie w opiniach badanych wychowanków zakładu poprawczego, uczniów oraz seniorów – badania pilotażowe

Self-esteem is thinking about oneself. It is an attitude that builds mood, shapes behavior or relations with others. The basis of self-esteem are judgments and opinions about oneself. Elements that construct self-esteem are primar-ily acceptance and repulsion. The article contains the analysis of the answers of three groups (the pupils of a correctional institution, the pupils of a sports school and the people over 60 years old) referring to appearance, perception of oneself (others), position in a group (perception of leader’s features), gaining respect. The article focuses on indicating the basic information, considering the differences that are important for each group. Self-image and self-evaluation through the prism of physicality is an issue that accompanies people of all ages and life situations. As a rule, however, there are differences in the perception of certain – important – features that influence the image. Every person, in their own way, processes information about reality and at the same time assumes its appropriate image.Samoocena to myślenie o sobie, które wpływa na nastrój, sposób zachowania czy relacje z innymi. Podstawą samooceny są sądy i opinie odnoszące się własnej osoby. Elementy konstruujące samoocenę to przede wszystkim akceptacja i odtrącenie. W artykule zawarto analizę odpowiedzi trzech grup (wychowanków zakładu poprawczego, uczniów szkoły sportowej i osób powyżej 60 roku życia) na pytania odnoszące się do wyglądu, postrzegania siebie (innych), pozycji w grupie (postrzeganie cech lidera) oraz zdobywania szacunku. Badania mają charakter wstępny. W artykule skupiono się na wskazaniu podstawowych informacji z uwzględnieniem różnic istotnych dla poszczególnych grup. Wyobrażenie i ocenianie siebie przez pryzmat fizyczności jest zagadnieniem towarzyszącym ludziom w każdym wieku i sytuacji życiowej. Zasadą jest jednak zróżnicowanie w postrzeganiu poszczególnych – istotnych – cech wypływających na wizerunek. Każdy człowiek we właściwy dla siebie sposób przetwarza informacje o rzeczywistości i jednocześnie zakłada odpowiedni jej obraz