Patient and public involvement in health literacy interventions: a mapping review

Background: Health literacy is a critical mediating factor that impacts on the health of older adults. Patient and public involvement in health and social care research, policy and design of care delivery is one mechanism that can promote production of better health literacy. This mapping review looks for and describes practices, concepts and methods that have been reported involving patients, public and (non-researcher) professionals in the development and design of health literacy interventions for older people. Methods: Studies that aimed to improve health literacy were identified within a previously created compatible inventory of health behaviour studies for older people. Articles were screened for whether they addressed health literacy and featured involvement of stakeholders other than investigators and patients. Two reviewers independently read each study to identify any patient, public and professional involvement in the research process. We also noted some aspects of outcomes. Results: Twenty-two studies included patient, public and/or professional involvement in at least one research domain: design, management or evaluation. Involvement included volunteers, older people, professionals, patients, and community representatives. All studies were driven by an organisational or biomedical agenda. Conclusions: Patient, public and professional involvement wasrarely reported in studies on health literacy interventions for older people. This could help explain why some interventions fail to improve health literacy in older people. Key words – health literacy intervention research, older people, patient and public involvement, mapping revie

Childhood Asthma and Environmental Exposures at Swimming Pools: State of the Science and Research Recommendations

OBJECTIVES: Recent studies have explored the potential for swimming pool disinfection by-products (DBPs), which are respiratory irritants, to cause asthma in young children. Here we describe the state of the science on methods for understanding children's exposure to DBPs and biologics at swimming pools and associations with new-onset childhood asthma and recommend a research agenda to improve our understanding of this issue. DATA SOURCES: A workshop was held in Leuven, Belgium, 21-23 August 2007, to evaluate the literature and to develop a research agenda to better understand children's exposures in the swimming pool environment and their potential associations with new-onset asthma. Participants, including clinicians, epidemiologists, exposure scientists, pool operations experts, and chemists, reviewed the literature, prepared background summaries, and held extensive discussions on the relevant published studies, knowledge of asthma characterization and exposures at swimming pools, and epidemiologic study designs. SYNTHESIS: Childhood swimming and new-onset childhood asthma have clear implications for public health. If attendance at indoor pools increases risk of childhood asthma, then concerns are warranted and action is necessary. If there is no such relationship, these concerns could unnecessarily deter children from indoor swimming and/or compromise water disinfection. CONCLUSIONS: Current evidence of an association between childhood swimming and new-onset asthma is suggestive but not conclusive. Important data gaps need to be filled, particularly in exposure assessment and characterization of asthma in the very young. Participants recommended that additional evaluations using a multidisciplinary approach are needed to determine whether a clear association exists

Differential mortality in Iran

Background: Among the available data provided by health information systems, data on mortality are commonly used not only as health indicators but also as socioeconomic development indices. Recognizing that in Iran accurate data on causes of death were not available, the Deputy of Health in the Ministry of Health and Medical Education (MOH&ME) established a new comprehensive system for death registration which started in one province (Bushehr) as a pilot in 1997, and was subsequently expanded to include all other provinces, except Tehran province. These data can be used to investigate the nature and extent of differences in mortality in Iran. The objective of this paper is to estimate provincial differences in the level of mortality using this death registration system. Methods: Data from the death registration system for 2004 for each province were evaluated for data completeness, and life tables were created for provinces after correction for under-enumeration of death registration. For those provinces where it was not possible to adjust the data on adult deaths by using the Brass Growth Balance method, adult mortality was predicted based on adult literacy using information from provinces with reliable data. Results: Child mortality (risk of a newborn dying before age 5, or q) in 2004 varied between 47 per 1000 live births for both sexes in Sistan and Baluchistan province, and 25 per 1000 live births in Tehran and Gilan provinces. For adults, provincial differences in mortality were much greater for males than females. Adult mortality (risk of dying between ages 15 and 60, or 45q15) for females varied between 0.133 in Kerman province and 0.117 in Tehran province; for males the range was from 0.218 in Kerman to 0.149 in Tehran province. Life expectancy for females was highest in Tehran province (73.8 years) and lowest in Sistan and Baluchistan (70.9 years). For males, life expectancy ranged from 65.7 years in Sistan and Baluchistan province to 70.9 years in Tehran. Conclusion: Substantial differences in survival exist among the provinces of Iran. While the completeness of the death registration system operated by the Iranian MOH&ME appears to be acceptable in the majority of provinces, further efforts are needed to improve the quality of data on mortality in Iran, and to expand death registration to Tehran province

The Role of the Qur'an and Sunnah in Oral Health.

The aim of this study was to explore the ways in which the main texts in Islam, Holy Qur'an and the Sunnah of the Prophet Mohammed (pbuh), contribute to understandings of oral health. The AHadith provide guidance for oral health-related behaviour but were written at a time when their symbolic meanings were perhaps vastly different to those of today. In gaining more insight into the ways Islamic HRB shape oral health-related practices and outcomes, if at all, we may be better placed to develop a more culturally sensitive and diverse dental public health and oral health promotion which takes into account religious dimensions, mediating factors, HRB and salutogenic mechanisms

Comparison of Fluoride Uptake into Enamel from Sodium Fluoride Gel 0.05% Produced in Iran and Stannous Fluoride 0.4% Gel

Abstract: Background & Aims: The present study compared fluoride uptake into enamel from sodium fluoride 0.05% gel and American Dental Association approved fluoride gel (Stannous fluoride 0.4% , Sultan Co.) when used on healthy enamel of the intact teeth. Methods: In an experimental study, 30 intact teeth extracted for orthodontic purposes were randomly assigned into two groups of 15 teeth. The teeth were sectioned in two mesial and distal halves as control and experimental sides. Defined semi-circular areas on the enamel of experimental halves were treated with gel for 4 minutes, the halves were stored in artificial saliva for 24 hours at 37°C, etched for 30 seconds by 0.5 M perchlorid Acid and washed by 0.2 ml KOH after each etching. Biopsy of the samples was obtained by Acid Etch Enamel Biopsy technique and the fluoride and calcium concentration were calculated by potentiometer and spectrophotometer respectively. Paired t test and student t test were used for statistical analyses. Results: The results showed significant increase of enamel fluoride content in the experimental halves after exposure to both stannous fluoride 0.4% (P=0.0001) and sodium fluoride 0.05% (P=0.009). Mean fluoride uptakes in stannous fluoride 0.4% gel and sodium fluoride 0.05% gel groups were respectively 4052.5 ppm and 892.5 ppm that shows statistically significant difference (P=0.0001). Conclusion: Although both sodium fluoride 0.05% and stannous fluoride 0.4% increased fluoride Content of tooth enamel after application, stannous fluoride 0.4% caused more fluoride uptake into the tooth enamel that is due to its higher amount of fluoride ion (1000 ppm) compared to sodium fluoride gel (225 ppm). Keywords: Fluoride, Dental caries, Prevention, Ename

Comparison of Antibacterial Effect of Fluoride and Chlorhexidine on Two Cariogenic Bacteria: An in Vitro Study

Statement of problem: Dental plaque is the main source for dental caries and there is no proper vaccine that can affect dental plaques. Objectives: Daily use of an efficient anti-plaque product can be very beneficial in plaque control and, thus, prevention of caries. This study aims to evaluate the antibacterial effects of four products of Chlorhexidine and Fluoride on two types of cariogenic bacteria. Materials and Methods: In this in vitro study, the antibacterial effect of Chlorhexidine and Fluoride (gel and solution) against Streptococci Sanguis and Sobrinus was evaluated. Chlorhexidine gluconate 1% gel (Corosodyl, France), Chlorhexidine gluconate 2% solution (Consepsis, Ultradent, US), Sodium fluoride 0.2% solution (Oral-B, US) and Acidulated Phosphate Fluoride 1.23% gel ( Denti-Care, Canada) were used. The disc diffusion method was used for testing bacterial sensitivity. The data were analyzed using paired t-test and Chi-square test. Results: In comparison with the negative control, each of the four gels and solutions showed antibacterial effects but the effects were not statistically significant for fluoride solution (P=0.217). For S. Sobrinus, the mean diameter of inhibition zone around the discs coated with fluoride gel (F g), fluoride solution (F s), Chlorhexidine gel (CHX g) and Chlorhexidine solution (CHX s) were 19, 9, 21.5 and 27.5mm, respectively. For S. Sanguis, the mean diameter of inhibition zone around the discs coated with F g, F s, CHX g and CHX s were 17, 11, 17 and 25mm, respectively. CHX s had the most effect on both bacteria and F s had the least. CHX g and F g were less effective than CHX s, respectively. Conclusion: The results demonstrated that 2% CHX s and 1.23% F g can be effective on inhibition of the growth of some of cariogenic bacteria. Therefore, these agents can be used in the prevention of Early Childhood Caries

Changes in the Concentration of Ions in Saliva and Dental Plaque after Application of CPP-ACP with and without Fluoride among 6-9 Year Old Children

Statement of Problem: The casein phospho peptide-amorphous calcium phosphate with or without fluoride (CPP-ACPF and CPP-ACP respectively) are of considerably new materials which are highly recommended for prevention of dental caries. However, there is a shortage in literature on how they affect the ion concentration of saliva or dental plaque. Objectives: The aim of this study was to evaluate the concentration of calcium, phosphate and fluoride in the plaque and saliva of children with Early Childhood Caries (ECC) after applying the CPP-ACP paste in comparison with the use of CPP- ACPF paste. Materials and Methods: One ml of un-stimulated saliva of 25 preschool children was collected and then 1 mg of the plaque sample was collected from the buccal surfaces of the two first primary molars on the upper jaw. CPP-ACP as well as CPP- ACPF pastes were applied on the tooth surfaces in two separate steps. In steps, plaque and saliva sampling was performed after 60 minutes. The amount of calcium ions was measured by Atomic Absorption Device and the amount of phosphate and fluoride ions was measured by Ion Chromatography instrument. Data were analyzed using Repeated Measurements ANOVA at a p < 0.05 level of significance. Results: Application of both CPP-ACPF and CPP-ACP significantly increased the concentration of calcium, phosphate, and fluoride in both saliva and dental plaque. Moreover, significantly higher salivary fluoride concentration was seen after application of CPP-ACPF compared to CPP-ACP. No other significant difference was observed between these two materials. Conclusions: CPP-ACPF can be more useful than CPP-ACP in protecting the primary teeth against caries process, especially when there is poor hygiene

Concentration of Calcium, Phosphate and Fluoride Ions in Microbial Plaque and Saliva after Using CPP-ACP Paste in 6-9 year-old Children

Statement of Problem: Dental caries is one of the most common chronic diseases in children. The balance between demineralization and remineralization of the decayed teeth depends on the calcium and phosphate content of the tooth surface. Therefore, if a product such as casein phospho peptides - amorphous calcium phosphate (CPP- ACP) which can significantly increase the availability of calcium and phosphate in the plaque and saliva should have an anti-caries protective effect. Objectives: The purpose of this study was to evaluate the concentration of calcium, phosphate and fluoride in the plaque and saliva of children before and after applying the CPP-ACP paste. Materials and Methods: A total of 25 children aged between 6-9 years were selected for this clinical trial study. At first, 1 ml of unstimulated saliva was collected and then 1 mg of the plaque sample was collected from the buccal surfaces of the two first primary molars on the upper jaw. In the next step, CPP-ACP paste (GC Corp, Japan) was applied on the tooth surfaces and then the plaque and saliva sampling was performed after 60 minutes. The amount of calcium ions was measured by Ion meter instrument (Metrohm Co, Swiss) and the amounts of phosphate and fluoride ions were measured by Ion Chromatography instrument (Metrohm Co, Swiss). Data were analyzed using paired t-test at a p < 0.05 level of significance. Results: There were statistically significant differences in the calcium and phosphate concentration of the saliva and plaque before and after applying the CPP-ACP paste. There were also statistically significant differences in the fluoride levels of the plaque before and after applying the CPP-ACP paste. However, there were no statistically significant differences in the fluoride levels of the saliva before and after applying the CPP-ACP paste. Conclusions: In this study, the use of the CPP-ACP paste significantly increased the fluoride levels of the plaque and the calcium and phosphate levels of both saliva and plaque. Hence, CPP-ACP paste can facilitate the remineralization of tooth surfaces and is useful for protecting the primary teeth

Evaluation of fluoride uptake in the enamel of primary teeth after using different concentrations of a green tea extract: An in-vitro study

It is believed that extracts of green tea increase fluoride uptake in deciduous enamel and the aim of this in vitro study was to evaluate the fluoride uptake in the enamel of primary teeth after using different concentrations of an extract of green tea. Seventy-five enamel samples were prepared from deciduous canine teeth of children in Kerman, Iran, and randomly divided into five groups of 15: Group 1 (G1): no treatment (negative control); Groups 2 (G2), 3 (G3), 4 (G4), and 5 (G5) were treated with green tea extract in concentrations of 0.2, 1, 2, and 10, respectively. After the surface treatment, all the samples were submitted to an acid challenge consisting of daily immersion for 5 days in a demineralizing (3 hr) and a mineralizing solution (21 hr). The fluoride concentrations were then calculated with a potentiometer. One-way ANOVA was used for statistical analyses (p<0.05). There was a significant difference between the fluoride uptake in the control and all other groups except for the G2 group (0.2 green tea extract) (p<0.05). There was no statistically significant difference between the fluoride uptake in the enamel in the G2 (0.2 green tea extract and the G3 (1 green tea extract) groups. The findings reveal that green tea can increase the amount of fluoride in the enamel of the primary teeth. © 2020, International Society for Fluoride Research. All rights reserved

Prevalence and associated-factors for Entamoeba gingivalis in adolescents in southeastern Iran by culture and PCR, 2017

Background: This study aimed to identify the prevalence and potential factors associated with Entamoeba gingivalis in adolescents in the city of Kerman, southeastern Iran, 2017. Methods: In this descriptive cross-sectional study, 315 adolescents (mean age; 15 yr) consisting of 189 males and 126 females were randomly selected. For each adolescent, two specimens were collected for culturing and examination by polymerase chain reaction (PCR). Univariate and multivariate logistic regression models were performed to explore any association with demographic and clinical variables. Results: The prevalence of E. gingivalis was 11.7. Totally, 30 (15.9) males and 7 (5.6) females were infected with E. gingivalis. The rate of infection in males was 2.8 times higher than that in females (P<0.001). Statistical analysis identified 4 major factors including sex (OR=4.12, P<0.001), gingival index with severe inflammation (OR = 50, P<0.001), Candida spp. infection (OR=4.41, P<0.001) and decay-missing-filled teeth DMFT (OR=3.27, P<0.001). In contrast to the aforementioned factors, adolescents with history of antibiotic consumption were significantly protected from E. gingivalis infection (OR= 3.24, P<0.001). Culture media detected 9.2% (n= 29), whilst PCR identified 11.4% (n= 36) of infection. Conclusion: The present findings clearly demonstrate a positive association between E. gingivalis and distinct demographic and clinical risk determinants. Therefore, dental practitioners and health surveillance personnel should be aware of these confounding factors to rigorously detect and critically manage oral health issues in school-age children in order to prevent or at least minimize the eventual periodontal complications in later life. © 2020, Iranian Journal of Public Health. All rights reserved