Geriatric oral health care content and barriers to its incorporation in undergraduate nursing curricula: New Zealand survey

Introduction: An increasingly older population demands major remodeling of our health care system. Older adults are most likely to be affected by the oral-systemic connection due to their impairment in functional capacity and reduced ability to undertake routine oral care. An economic way to improve oral health outcomes in older populations is by involving nurses and caregivers in ensuring the maintenance of oral health for older adults. This study aimed to investigate the present educational content relevant to the oral health of older adults, the oral-systemic connection, and assessment methods in New Zealand nursing education. Methods: A cross-sectional survey was conducted among nursing educators to understand the extent of oral health care education. Quantitative descriptive data were analyzed using SPSS software and qualitative data were analyzed descriptively and presented as themes. Results: The results indicated that the majority of oral health topics were already incorporated into nursing education, however most important topics such as risk factors associated with dental caries, periodontal health, and risk factors are not taught in almost 40% of the schools. The four themes identified in qualitative analyses are “no barrier”, “lack of expertise”, “no space for more content” and oral health content “already included”. Conclusion: Educators reported that oral health topics are already incorporated into New Zealand undergraduate nursing curricula. However, the quantity and quality of oral health content relevant to older adults need to be improved and updated to suit the current oral health care needs of the growing older population

Knowledge of nursing graduates on oral health care for older people in the long-term care

Objectives: Oral health self-care deteriorates in older adults due to a decreasing level of cognition increasing disability and/or a reduction in manual dexterity. Older adults in hospital care or residential care therefore increasingly need assistance for oral health care. There is an increase in dentate patients entering residential care due to advances in dentistry. It is suggested therefore that nurses in aged care increasingly need advanced knowledge to care for their older dentate patients to prevent and minimize progression of oral diseases, given the impact of poor oral health on general health. The current study was conducted to investigate the oral health care knowledge of nursing graduates across Aotearoa New Zealand. Methods: A cross-sectional study was conducted among third year nursing graduates in 18 nursing institutes in New Zealand. Oral health care knowledge and oral–systemic connection knowledge, and predictors of oral health care knowledge were investigated. Results: Total 148 students participated in the student's survey, making it 15% of 2020 graduates. The students’ survey results suggested that nursing graduates have good basic oral health knowledge, however, their knowledge of the oral–systemic disease connection and the value of an examination of the oral cavity were poor. Conclusion: The oral health care knowledge of nursing students and their ability to care for older adults relies on oral health care education in their nursing programs. A revision of curricula to improve oral health education in nursing programs is strongly recommended

The "business" of dentistry: Consumers' (patients') criteria in the selection and evaluation of dental services

The dimensions of patient-centred care include not only clinical effectiveness and patient safety, but, importantly, the preferences of patients as consumers of healthcare services. A total of 249 participants were included in the study, with a balanced population proportional representation by age, gender, ethnicity and geographic region of New Zealand. An online questionnaire was used to identify participants' decision-making process, and what factors and barriers for participants to seek dental treatment. Cross-tabulations, Spearman correlation analysis and Pearson Chi-Square analysis were used for the statistical analyses. Three most common reasons for visit were check-up (77%), clean (57%) and relief of pain 36%). A desire to treat a perceived problem was the most common encouraging factor to seek dental care. Cost was the most common barrier to seeking dental services. The majority of participants attended a private practice (84%), with convenience of location and referral from professionals the most likely to influence their choice. Participants felt the most important trait a dental practitioner could demonstrate was to discuss treatment options with them before any treatment. Dental check-up, teeth cleaning and relief of pain were the most common reasons for patients to choose dental services. Cost and ethnicity of the consumers had a significant impact on how dental services were perceived and sought. Dental practitioners may need to reorientate how they express value of oral health practice, not just in regard to communication with patients, but also with government funding agencies

The effect of organic acid and sodium chloride dips on the shelf-life of refrigerated Irish brown crab (Cancer pagurus) meat

peer-reviewedCrab (Cancer pagurus) meat (white and brown) has a short shelf-life. Chemical treatments may inhibit microbial spoilage and extend shelf-life. The effect of 5% organic acids (lactic acid (LA), acetic acid (AA) and citric acid (CA)) and 5% sodium chloride (NaCl) on TVC (mesophiles and psychrophiles), Enterobacteriaceae, Pseudomonas spp. and lactic acid bacteria (LAB) were investigated during storage (2 °C for 12 days). AA was the most effective treatment for white meat, reducing the initial TVCm and TVCp by 1.6 and 1.8 log10 cfu/g, respectively, and extended the shelf life to 8–11.5 days, compared to 5 days for untreated control samples. LA treatment also significantly (P  0.05). A similar pattern was observed for brown meat samples, although the shelf life was increased by a maximum of 1–3 days. The growth of Enterobacteriaceae, Pseudomonas spp. and LAB was significantly (P < 0.05) reduced on AA treated samples only. It was concluded that the shelf-life of crab meat may be extended by up to 3 days using lactic acid and more than doubled using acetic acid.Funding for this project was provided by the Food Institutional Research Measure (FIRM), project number 13F529, administered by the Department of Agriculture, Food and the Marine (DAFM), Ireland

A randomized clinical trial investigating the effect of three vital tooth bleaching protocols on oral health-related quality of life

Objectives: This study aimed to compare changes in oral health-related quality of life (OHRQoL) resulting from three vital tooth bleaching protocols. Methods: The participants (n = 105) were randomly assigned to one of three vital bleaching treatment groups: home bleaching (HB), in-office bleaching (IOB), or combined bleaching (CB). HB involved the use of custom-made trays and 10% carbamide peroxide for a 14-day treatment period. IOB utilized 37.5% hydrogen peroxide applied in three cycles. CB treatment involved the use of IOB followed by HB. Tooth colour change was evaluated using a shade guide (ΔVS) and a digital spectrophotometry device (ΔES). The Oral Health Impact Profile-14 (OHIP-14) and Oral Impact on Daily Performance-22 (OIDP-22) instruments were used to assess changes in OHRQoL at baseline, 15-days and 6-month recalls. Linear mixed models were used to estimate between- and within-group differences. Results: All bleaching protocols led to significant improvements in overall OHIP-14 scores at the 6-month recall (p ≤ 0.037). CB and IOB treatments were associated with more substantial positive impacts on overall scores, psychological discomfort, physical disability (CB only), and psychological disability (CB only) compared to HB (p ≤ 0.011). Significant enhancements in OIDP-22 scores were observed in the CB and HB groups at the 6-month recall compared to baseline (p ≤ 0.006), with evidence indicating that these improvements were greater in the CB group compared to the IOB group (p = 0.007). Conclusion: All bleaching treatments demonstrated a positive impact on OHRQoL. However, the positive impact was most consistent across domains and age groups in the CB group. The positive impact was less pronounced in older age groups

The meaning of place in supporting sociality

While social isolation in an ageing population is a concern in many locations, it is greater in towns where divisive local geography and declining investment conspire against meeting places and mutual awareness. This research into the design of location-based tools to support sociality asks whether embedded digital tools that make neighbourhood activities and/or people’s movements more visible have the potential to increase serendipitous encounters and deepen a sense of community cohesion. Taking to the streets of a small town to explore if digital tools might improve the situation, we used participatory and provocation methods to inspire engagement with the theme and compare design concepts for sociality. Participants showed great passion for the town and its people, but also caution about publicly revealing even basic information, because of anticipated local consequences. They preferred an indirect approach. We use these insights to analyze “place” and discuss the specifics of designing for sociality in challenging contexts

Trajectories of Pain and Function after Primary Hip and Knee Arthroplasty:The ADAPT Cohort Study

BACKGROUND AND PURPOSE:Pain and function improve dramatically in the first three months after hip and knee arthroplasty but the trajectory after three months is less well described. It is also unclear how pre-operative pain and function influence short- and long-term recovery. We explored the trajectory of change in function and pain until and beyond 3-months post-operatively and the influence of pre-operative self-reported symptoms. METHODS:The study was a prospective cohort study of 164 patients undergoing primary hip (n = 80) or knee (n = 84) arthroplasty in the United Kingdom. Self-reported measures of pain and function using the Western Ontario and McMaster Universities Osteoarthritis index were collected pre-operatively and at 3 and 12 months post-operatively. Hip and knee arthroplasties were analysed separately, and patients were split into two groups: those with high or low symptoms pre-operatively. Multilevel regression models were used for each outcome (pain and function), and the trajectories of change were charted (0-3 months and 3-12 months). RESULTS:Hip: Most improvement occurred within the first 3 months following hip surgery and patients with worse pre-operative scores had greater changes. The mean changes observed between 3 and twelve months were statistically insignificant. One year after surgery, patients with worse pre-operative scores had post-operative outcomes similar to those observed among patients with less severe pre-operative symptoms. Knee: Most improvement occurred in the first 3 months following knee surgery with no significant change thereafter. Despite greater mean change during the first three months, patients with worse pre-operative scores had not 'caught-up' with those with less severe pre-operative symptoms 12 months after their surgery. CONCLUSION:Most symptomatic improvement occurred within the first 3 months after surgery with no significant change between 3-12 months. Further investigations are now required to determine if patients with severe symptoms at the time of their knee arthroplasty have a different pre-surgical history than those with less severe symptoms and if they could benefit from earlier surgical intervention and tailored rehabilitation to achieve better post-operative patient-reported outcomes

Angiotensin II Enhances Adenylyl Cyclase Signaling via Ca2+/Calmodulin. Gq-Gs Cross-Talk Regulates Collagen Production in Cardiac Fibroblasts

Cardiac fibroblasts regulate formation of extracellular matrix in the heart, playing key roles in cardiac remodeling and hypertrophy. In this study, we sought to characterize cross-talk between Gq and Gs signaling pathways and its impact on modulating collagen synthesis by cardiac fibroblasts. Angiotensin II (ANG II) activates cell proliferation and collagen synthesis but also potentiates cyclic AMP (cAMP) production stimulated by β-adrenergic receptors (β-AR). The potentiation of β-AR-stimulated cAMP production by ANG II is reduced by phospholipase C inhibition and enhanced by overexpression of Gq. Ionomycin and thapsigargin increased intracellular Ca2+ levels and potentiated isoproterenol- and forskolin-stimulated cAMP production, whereas chelation of Ca2+ with 1,2-bis(2-aminophenoxy)ethane-N,N,N′, N′-tetraacetic acid/AM inhibited such potentiation. Inhibitors of tyrosine kinases, protein kinase C, or Gβγ did not alter this cross-talk. Immunoblot analyses showed prominent expression of adenylyl cyclase 3 (AC3), a Ca2+-activated isoform, along with AC2, AC4, AC5, AC6, and AC7. Of those isoforms, only AC3 and AC5/6 proteins were detected in caveolin-rich fractions. Overexpression of AC6 increased βAR-stimulated cAMP accumulation but did not alter the size of the ANG II potentiation, suggesting that the cross-talk is AC isoform-specific. Isoproterenol-mediated inhibition of serum-stimulated collagen synthesis increased from 31 to 48% in the presence of ANG II, indicating that βAR-regulated collagen synthesis increased in the presence of ANG II. These data indicate that ANG II potentiates cAMP formation via Ca2+-dependent activation of AC activity, which in turn attenuates collagen synthesis and demonstrates one functional consequence of cross-talk between Gq and Gs signaling pathways in cardiac fibroblasts

Effects of castration and slaughter age on the fatty acid composition of ovine muscle and adipose tissue from two breeds

peer-reviewedFatty acids (g/100 g total fatty acids) in M. longissimus thoracis et lumborum (LTL) and total branched chain fatty acids (μg/g fat) in subcutaneous adipose tissue (SAT) of rams and castrates from Scottish Blackface (SB) or Texel × Scottish Blackface (T × SB) lambs, slaughtered at mean ages of 196, 242, 293, 344 or 385 days were determined. Lambs were fed pasture prior to a 36-day finishing period on a barley/maize-based concentrate ration. The intramuscular fat content (IMF; %) was higher (P < 0.001) in castrates than in rams and in SB compared to T × SB lambs (P < 0.001). The proportions of c9-C18:1 and total monounsaturated fatty acids (MUFA) were higher (P < 0.001) in LTL of castrates than rams. The proportions of C18:2n-6 and total n-6 polyunsaturated fatty acids (PUFA) were lower (P = 0.001) in LTL of castrates compared to rams related to differences in IMF content. The proportions of C14:0, C16:0, c9-C18:1 and total MUFA were higher (P < 0.05), while the proportions of C18:2n-6, C20:4n-6, C20:5n-3, total PUFA, n-6 and n-3 PUFA were lower (P < 0.05), in SB than in T × SB lambs, which was related to differences in IMF content. There was a higher (P < 0.001) proportion of conjugated linoleic acid (CLA) c9,t11-C18:2 in LTL from SB compared to T × SB. The effects of slaughter age on the proportions of fatty acids in LTL did not show a clear trend. The concentration of 4-methylnonanoic acid was higher (P = 0.002) in SAT of rams than castrates, particularly in older lambs. Despite the differences in the muscle fatty acid composition due to gender, slaughter age or breed of lambs, the ratio of n-6/n-3 PUFA (≤3.11) was within the dietary recommendation of <4.0 for human health

Effect of castration and age at slaughter on sensory perception of lamb meat

peer-reviewedThis study assessed the effect of castration and slaughter age (196–385 days old) on sensory quality of lamb meat from two sheep breeds (Scottish Blackface, SB; Texel x Scottish Blackface, TxSB). Results obtained using a trained sensory panel showed small but statistically significant differences due to castration, with rams having higher scores for Intensity of Lamb Aroma, Animal Smell/Farm Smell, Woolly Aroma, Rancid Aroma, Manure/Faecal Aroma, Sweaty Aroma and Off-flavours. SB lamb had higher scores for Intensity of Lamb Aroma, Lamb Flavour, Lamb Aftertaste, Tenderness and Juiciness. Age effects on sensory attributes were not linear and significant age × gender interactions were observed. The number of samples considered “extreme” in undesirable flavour attributes was higher among rams and T × SB animals. The impact of the sensory differences on consumer acceptability of lamb remains to be established