Need of Assistance with Daily Oral Hygiene Measures Among Nursing Home Resident Elderly Versus the Actual Assistance Received from the Staff

The aim was to evaluate the need of assistance with daily oral hygiene measures among nursing home resident elderly versus the actual assistance received from the staff. The need of daily oral hygiene assistance was assessed descriptively for nursing home resident elderly who participated in an annual oral health screening in three geographical regions in Sweden, in the year 2008. All individuals of age ≥ 65 years were included (n = 22,453; 6,327 men; 16,126 women). The proportion of individuals in need of assistance with daily oral hygiene measures was 77.5 % (n=22,453), whereas the proportion of individuals receiving assistance with daily oral hygiene measures was 6.9 % in total (n=22,453). The proportions were largely similar in all geographical regions. There seems to be a large discrepancy between the need of assistance with daily oral hygiene measures, and the oral hygiene assistance received, among nursing home resident elderly

Pallogeometria

Tämä pro gradu -tutkielma käsittelee pallogeometriaa. Pallogeometria on yksi epäeuklidisista geometrioista, sillä se ei noudata jokaista viittä Eukleideen postulaattia, joihin tasogeometria tuloksineen perustuu. Työn alkupuolella käsitellään tarkemmin paralleelipostulaattia, joka on erottava tekijä euklidisen ja epäeuklidisen geometrian välillä. Pallogeometrian osuus aloitetaan pallon määritelmällä, josta siirrytään isoympyrän määritelmään. Isoympyrän käsite on hyvin oleellinen tässä tutkielmassa esitettyjen lauseiden ja tulosten kannalta. Tutkielmassa esitellään lisäksi pallokolmion, napakolmion ja pallokulman määritelmät. Pallokolmion sivut muodostuvat isoympyrän kaarista ja pallokulmankin käsite liittyy hyvin läheisesti isoympyrään. Pallokulman suuruus voidaan nimittäin laskea isoympyrän kaaren pituutena. Tutkielmassa esitellään myös kolmioepäyhtälö pallokolmioille sekä hieman yllättäväkin tulos siitä, että pallokolmion kulmien summa ei ole vakio. Se on suurempi kuin tasokolmion kulmien summa, mutta pienempi kuin 540 asetta. Tämän tutkielman lopussa käsitellään pallokolmioiden yhdenmuotoisuuslauseita. Tasokolmion yhdenmuotoisuuslauseet ovat yleistettävissä pallokolmioille, mutta pallokolmioille on olemassa myös yhdenmuotoisuuslause, joka ei päde tasogeometrian kolmioille. Kyseinen lause esitellään ja todistetaan tässä tutkielmassa. Lisäksi tutkitaan peilauksen aiheuttamaa eroavaisuutta tasogeometrian ja pallogeometrian yhdenmuotoisuudessa. Tutkielman viimeisenä aiheena esitellään pallokolmion pinta-alan määritelmä sekä tarkastellaan isoympyröiden ja pallon halkaisijan rajoittamaa pallokappaletta – lunea

A Systematic Review of the Preventive Effect of Oral Hygiene on Pneumonia and Respiratory Tract Infection in Elderly People in Hospitals and Nursing Homes: Effect Estimates and Methodological Quality of Randomized Controlled Trials

The objective of this study was to investigate the preventive effect of oral hygiene on pneumonia and respiratory tract infection, focusing on elderly people in hospitals and nursing homes, by systematically reviewing effect estimates and methodological quality of randomized controlled trials (RCTs) and to provide an overview of additional clinical studies in this area. Literature searches were conducted in the Medline database, the Cochrane library databases, and by hand-searching reference lists. Included publications were analyzed for intervention (or topic) studied, main conclusions, strength of evidence, and study design. RCTs were further analyzed for effect magnitudes and methodological details. Absolute risk reductions (ARRs) and numbers needed to treat (NNTs) were calculated. Fifteen publications fulfilled the inclusion criteria. There was a wide variation in the design and quality of the studies included. The RCTs revealed positive preventive effects of oral hygiene on pneumonia and respiratory tract infection in hospitalized elderly people and elderly nursing home residents, with ARRs from 6.6% to 11.7% and NNTs from 8.6 to 15.3 individuals. The non-RCT studies contributed to inconclusive evidence on the association and correlation between oral hygiene and pneumonia or respiratory tract infection in elderly people. Mechanical oral hygiene has a preventive effect on mortality from pneumonia, and nonfatal pneumonia in hospitalized elderly people and elderly nursing home residents. Approximately one in 10 cases of death from pneumonia in elderly nursing home residents may be prevented by improving oral hygiene. Future research in this area should be focused on high-quality RCTs with appropriate sample size calculations

Hierarchical Clustering and Trajectory Analyses Reveal Viremia-Independent B-Cell Perturbations in HIV-2 Infection

Time to AIDS in HIV-2 infection is approximately twice as long compared to in HIV-1 infection. Despite reduced viremia, HIV-2-infected individuals display signs of chronic immune activation. In HIV-1-infected individuals, B-cell hyperactivation is driven by continuous antigen exposure. However, the contribution of viremia to B-cell perturbations in HIV-2-infected individuals remains largely unexplored. Here, we used polychromatic flow cytometry, consensus hierarchical clustering and pseudotime trajectory inference to characterize B-cells in HIV-1- or HIV-2-infected and in HIV seronegative individuals. We observed increased frequencies of clusters containing hyperactivated T-bethighCD95highCD27int and proliferating T-bet+CD95highCD27+CD71+ memory B-cells in viremic HIV-1 (p < 0.001 and p < 0.001, respectively), viremic HIV-2 (p < 0.001 and p = 0.014, respectively) and in treatment-naïve aviremic HIV-2 (p = 0.004 and p = 0.020, respectively)-infected individuals, compared to seronegative individuals. In contrast, these expansions were not observed in successfully treated HIV-1-infected individuals. Finally, pseudotime trajectory inference showed that T-bet-expressing hyperactivated and proliferating memory B-cell populations were located at the terminal end of two trajectories, in both HIV-1 and HIV-2 infections. As the treatment-naïve aviremic HIV-2-infected individuals, but not the successfully ART-treated HIV-1-infected individuals, showed B-cell perturbations, our data suggest that aviremic HIV-2-infected individuals would also benefit from antiretroviral treatment