How to label bruxism that is a sign of a disorder? That's the question! Response to letter by Meira e Cruz & Ettlin (2018)

Non peer reviewe

A qualitative exploratory study of informal carers’ experiences of identifying and managing oral pain and discomfort in community-dwelling older people living with dementia

Increased prevalence of dementia and poor oral health in older people is associated with more people living with dementia who experience oral pain and discomfort. However, little is known about how informal carers manage oral pain for people living with dementia in the community. This study aimed to explore informal carers’ experiences of identifying and managing oral pain and discomfort in people living with dementia, and barriers and enablers they encountered. Focus groups with informal carers of people living with dementia were conducted, transcribed verbatim, and analysed using thematic analysis. Carers’ accounts suggested that day-to-day contact was required to identify oral pain and discomfort, and a symptomology of the signs and symptoms was developed. Carers’ accounts also highlighted issues in maintaining oral health, difficulties in accessing the mouth, managing dentures, competing demands, and difficulties in accessing treatment due to health service-, behavioural- and treatment- related barriers. Enablers included informal carers’ pivotal role in the identifying and managing oral pain and discomfort in people living with dementia. The study concludes that carers want more partnership work with dental professionals, and clearer care pathways are required to meet the oral health needs of people living with dementia who experience oral pain

Why using 'harmless behaviour', 'risk factor' and 'protective factor' as terms describing the various possible consequences of bruxism is still the best option

Non peer reviewe

"She said..." "He said...": Cross applications in NSW apprehended domestic violence order proceedings

This thesis examines the use of cross applications in civil protection order proceedings in New South Wales (NSW) (known as Apprehended Domestic Violence Orders, ADVOs). A cross application takes place when one person in an existing or former intimate relationship, usually the woman, applies for an ADVO and sometime afterwards the defendant in that originating application, usually the man, seeks an ADVO against the first person. The focus on cross applications provides a means to investigate the nature of men’s and women’s competing allegations about domestic violence, and to explore the way in which professionals working within the ADVO system approach, and seek to unravel, these competing claims. This thesis draws on the extensive debate within the sociological literature about ‘what is domestic violence’ and whether domestic violence is gendered in its perpetration. This debate has been paid scant attention in the legal literature. This thesis examines the assumptions underpinning the legal definitions and understandings of domestic violence in the civil protection order system, with reference to these theoretical debates about ‘what is domestic violence’ and ‘what counts as domestic violence’. To do so it draws on empirical work: semi-structured in-depth interviews with women involved in cross applications and key professionals working in the field, documentary analysis of court files, and observations of court proceedings. The key contribution of this thesis to this literature is threefold: (1) it explores the question of gender perpetration through the investigation of official data (a data source little explored in debates about gender and domestic violence), (2) it combines qualitative and quantitative methods in a single study, and (3) it extends questions about the gendered perpetration of domestic violence to the legal arena (in particular the prime legal arena that responds to domestic violence in NSW, the ADVO system, a system ostensibly designed to better respond to domestic violence). This thesis found that, like other studies in this field, the analysis of quantitative data alone reveals few differences between the types of violence men and women are alleged to use against their intimate partners. However when supplemented by qualitative data differences started to emerge particularly for men who lodged their application second in time. This qualitative analysis reveals not only that male second applicants appeared to make claims of a different nature, but that some men appeared to use the ADVO process to undermine women’s claims for legal protection. The differences that emerged between men and women’s alleged experiences of domestic violence resonated with feminist understandings of domestic violence that highlight its function of control and the repetitive, cumulative environment in which violence is perpetrated by men against women. While the study focussed on cross applications, its findings reveal a number of issues of concern for the ADVO system more broadly: its focus on incidents, the poor quality of complaint narratives, the brevity of court proceedings and the emphasis on settlement. These features undermine the progressive potential of the ADVO legislation to capture more than single incidents of largely physical violence. This was further compounded by the fact that while the professionals interviewed articulated broad definitions of domestic violence, this tended to be lost when responding to practice-orientated questions (here professionals returned to incident-based definitions). Perhaps more significantly the defining feature of domestic violence as a mechanism of control is not articulated in the NSW legislation, and hence (not unsurprisingly) was generally not articulated in the complaint narratives examined in this thesis. Yet control was the dominant way in which the women interviewed described their relationship with their former partner. The failure of complaint narratives to reflect the dimension of control, combined with the failure of key professionals to give sufficient emphasis to control in their practice under the ADVO legislation, an absence highlighted through the focus on cross applications, is an issue of concern for the ADVO system generally. This is important given the growing recognition in the research literature of the fundamental nature of control to the experience of domestic violence, particularly women’s experiences of domestic violence

Wanneer de arts de patiënt is: Een zorgethisch onderzoek naar de ervaring van artsen die patiënt zijn geweest en de invloed van die ervaring op het verlenen van zorg

In de relatie tussen artsen en patiënten is er vaak sprake van detached concern (Martinsen, 2011). Dit is een houding waarbij emotionele betrokkenheid tussen artsen en patiënten vermeden wordt en waarbij lichaam en ziekte als objectief worden beschouwd. Het lichaam wordt uitgesloten in het denken over moraliteit in de medische praktijk. Uit onderzoek blijkt echter dat een focus op het objectieve lichaam niet voldoende is in het contact tussen artsen en patiënten (Adler, 2002; Stewart, 2005; Gasparik, Abram, Ceana, Sebesi, Farcas & Gasparik, 2014). De mate waarin een arts zich kan inleven in de patiënt en dat gevoel kan overbrengen, is van invloed op de gezondheid van de patiënt (Adler, 2002). Artsen die zelf patiënt zijn geweest beschrijven dat hun ervaring als patiënt hun manier van zorgverlenen positief heeft beïnvloed (Ten Haaft, 2010). Er lijkt echter nog geen onderzoek te zijn gedaan naar de inhoud van deze invloed op het zorgverlenen. In de beschrijvingen van ervaringen van artsen die zelf patiënt zijn geweest, ligt de focus op het emotionele en sociale aspect en blijft het lichamelijke aspect onderbelicht. Dit onderzoek verdiept zich in de invloed van de patiënt-ervaring op het verlenen van zorg en op de verbinding met lichamelijkheid in het contact tussen artsen en patiënten. In het theoretische onderzoek is de huidige denkwijze met betrekking tot ethiek in de medische praktijk verkend. Vervolgens is het begrip lichamelijkheid uitgediept aan de hand van de theorie embodied care van Hamington (2004, 2012). Hierin is omschreven hoe de inclusie van lichamelijkheid in het denken over moraliteit in de medische praktijk een bijdrage kan leveren aan goede zorg. Vervolgens is empirisch onderzoek gedaan naar de ervaringen van artsen die zelf patiënt zijn geweest en de invloed van deze ervaringen op het verlenen van zorg. Er zijn twee artsen geïnterviewd over hun ervaringen. Tevens is bij deze artsen in de spreekkamer geobserveerd. De verbinding van de empirische data met de zorgethische theorie heeft geleid tot inzicht in de ervaringen van artsen die zelf patiënt zijn geweest en de veranderingen in het verlenen van zorg. In het verlenen van zorg aan patiënten is het voor artsen van belang om patiënten om uitleg te vragen, te zorgen dat één arts het ziekteproces overziet, duidelijk en concreet te zijn en zichtbaar en bereikbaar te zijn

Delayed-onset muscle soreness does not influence occlusal sensitivity and position sense of the mandible

Masticatory muscle-pain patients often complain about sensorimotor changes, but the effects of pain on the psychophysical properties remain unclear. This study aimed to investigate the effects of delayed-onset muscle soreness (DOMS) on the jaw's position sense (PS) and occlusal sensitivity (OS). In all, 12 participants underwent intense concentric–eccentric jaw exercises. Self-reported muscle fatigue and pain, pain-free maximum mouth opening (MMO), pain pressure thresholds (PPTs) at right and left masseter and right and left anterior temporalis, maximum voluntary bite force (MVBF), PS and OS were recorded before, immediately after, 24 h, 48 h and 1 week after the exercises. Data were analysed with repeated measures anova. Pain and fatigue increased significantly after the exercises, while fatigue also increased 24 h afterwards. Time and site had a significant effect for PPTs, not for MVBF. MMO decreased significantly 24 h after the exercises. OS and PS did not change significantly. Experimentally induced DOMS does not influence the psychophysical properties of the masticatory system