Are dentists interested in the oral-systemic disease connection? A qualitative study of an online community of 450 practitioners

Background: Dentists in the US see an increasing number of patients with systemic conditions. These patients are challenging to care for when the relationship between oral and systemic disease is not well understood. The prevalence of professional isolation exacerbates the problem due to the difficulty in finding expert advice or peer support. This study aims to identify whether dentists discuss the oral-systemic connection and what aspects they discuss; to understand their perceptions of and attitudes toward the connection; and to determine what information they need to treat patients with systemic conditions.Methods: We retrieved 14,576 messages posted to the Internet Dental Forum from April 2008 to May 2009. Using natural language processing and human classification, we identified substantive phrases and keywords and used them to retrieve 141messages on the oral-systemic connection. We then conducted coding and thematic analysis to identify recurring themes on the topic.Results: Dentists discuss a variety of topics on oral diseases and systemic health, with the association between periodontal and systemic diseases, the effect of dental materials or procedures on general health, and the impact of oral-systemic connection on practice behaviors as the leading topics. They also disseminate and share research findings on oral and systemic health with colleagues online. However, dentists are very cautious about the nature of the oral-systemic linkage that may not be causal. Nonetheless, they embrace the positive association as a motivating point for patients in practice. When treating patients with systemic conditions, dentists enquire about the cause of less common dental diseases potentially in relation to medical conditions in one-third of the cases and in half of the cases seek clinical guidelines and evidence-based interventions on treating dental diseases with established association with systemic conditions.Conclusions: Dentists' unmet information needs call for more research into the association between less studied dental conditions and systemic diseases, and more actionable clinical guidelines for well-researched disease connections. To improve dissemination and foster behavioral change, it is imperative to understand what information clinicians need and in which situations. Leveraging peer influence via social media could be a useful strategy to achieve the goal. © 2013 Song et al.; licensee BioMed Central Ltd

From information technology to informatics: The information revolution in dental education

The capabilities of information technology (IT) have advanced precipitously in the last fifty years. Many of these advances have enabled new and beneficial applications of IT in dental education. However, conceptually, IT use in dental schools is only in its infancy. Challenges and opportunities abound for improving how we support clinical care, education, and research with IT. In clinical care, we need to move electronic dental records beyond replicating paper, connect information on oral health to that on systemic health, facilitate collaborative care through teledentistry, and help clinicians apply evidence-based dentistry and preventive management strategies. With respect to education, we should adopt an evidence-based approach to IT use for teaching and learning, share effective educational content and methods, leverage technology-mediated changes in the balance of power between faculty and students, improve technology support for clinical teaching, and build an information infrastructure centered on learners and organizations. In research, opportunities include reusing clinical care data for research studies, helping advance computational methods for research, applying generalizable research tools in dentistry, and reusing research data and scientific workflows. In the process, we transition from a focus on IT-the mere technical aspects of applying computer technology-to one on informatics: the what, how, and why of managing information

An eHealth capabilities framework for graduates and health professionals: Mixed-methods study

© Melissa Brunner, Deborah McGregor, Melanie Keep, Anna Janssen, Heiko Spallek, Deleana Quinn, Aaron Jones, Emma Tseris, Wilson Yeung, Leanne Togher, Annette Solman, Tim Shaw. Background: The demand for an eHealth-ready and adaptable workforce is placing increasing pressure on universities to deliver eHealth education. At present, eHealth education is largely focused on components of eHealth rather than considering a curriculum-wide approach. Objective: This study aimed to develop a framework that could be used to guide health curriculum design based on current evidence, and stakeholder perceptions of eHealth capabilities expected of tertiary health graduates. Methods: A 3-phase, mixed-methods approach incorporated the results of a literature review, focus groups, and a Delphi process to develop a framework of eHealth capability statements. Results: Participants (N=39) with expertise or experience in eHealth education, practice, or policy provided feedback on the proposed framework, and following the fourth iteration of this process, consensus was achieved. The final framework consisted of 4 higher-level capability statements that describe the learning outcomes expected of university graduates across the domains of (1) digital health technologies, systems, and policies; (2) clinical practice; (3) data analysis and knowledge creation; and (4) technology implementation and codesign. Across the capability statements are 40 performance cues that provide examples of how these capabilities might be demonstrated. Conclusions: The results of this study inform a cross-faculty eHealth curriculum that aligns with workforce expectations. There is a need for educational curriculum to reinforce existing eHealth capabilities, adapt existing capabilities to make them transferable to novel eHealth contexts, and introduce new learning opportunities for interactions with technologies within education and practice encounters. As such, the capability framework developed may assist in the application of eHealth by emerging and existing health care professionals. Future research needs to explore the potential for integration of findings into workforce development programs

Premelting of ice adsorbed on a rock surface

Considering ice-premelting on a quartz rock surface (i.e. silica) we calculate the Lifshitz excess pressures in a four layer system with rock–ice–water–air. Our calculations give excess pressures across (1) ice layer, (2) water layer, and (3) ice–water interface for different ice and water layer thicknesses. We analyse equilibrium conditions where the different excess pressures take zero value, stabilized in part by repulsive Lifshitz interactions. In contrast to previous investigations which considered varying thickness of only one layer (ice or water), here we present theory allowing for simultaneous variation of both layer thicknesses. For a given total thickness of ice and water, this allows multiple alternative equilibrium solutions. Consequently the final state of a system will depend on initial conditions and may explain variation in experimental measurements of the thicknesses of water and ice layers

Social and health epidemiology of immigrants in Germany: past, present and future

Razum O, Wenner J. Social and health epidemiology of immigrants in Germany: past, present and future. Public Health Reviews. 2016;37(1): 4.Germany has experienced different forms of immigration for many decades. At the end of and after the Second World War, refugees, displaced persons and German resettlers constituted the largest immigrant group. In the 1950s, labor migration started, followed by family reunification. There has been a constant migration of refugees and asylum seekers reaching peaks in the early 1990s as well as today. Epidemiological research has increasingly considered the health, and the access to health care, of immigrants and people with migration background. In this narrative review we discuss the current knowledge on health of immigrants in Germany. The paper is based on a selective literature research with a focus on studies using representative data from the health reporting system. Our review shows that immigrants in Germany do not suffer from different diseases than non-immigrants, but they differ in their risk for certain diseases, in the resources to cope with theses risk and regarding access to treatment. We also identified the need for differentiation within the immigrant population, considering among others social and legal status, country of origin and duration of stay. Though most of the studies acknowledge the need for differentiation, the lack of data currently rules out analyses accounting for the existing diversity and thus a full understanding of health inequalities related to migration to Germany

Ethnicity and incidence of Hodgkin lymphoma in Canadian population

<p>Abstract</p> <p>Background</p> <p>Research has shown that ethnicity is a significant predictor of Hodgkin lymphoma (HL). Variations in cancer incidence among ethnic groups in the same country can lead to important information in the search for etiological factors. Other risk factors important in the etiology of HL are medical history and exposure to pesticides. In this report we investigated the association between ethnicity and HL in the presence of medical history, and exposure to pesticides.</p> <p>Methods</p> <p>The data resulting from a matched population-based case-control study conducted in six provinces of Canada (Ontario, Quebec, Manitoba, Saskatchewan, Alberta, and British Columbia) was analyzed to determine whether or not there was any association between ethnicity and incidence of HL when adjusted for personal medical history and pesticide exposure. Information on ethnicity, personal medical history, and pesticide exposure was collected by questionnaires via mail on 316 men diagnosed with HL; and on 1506 controls. A conditional logistic regression was utilized and results were presented as odds ratios and 95% confidence intervals.</p> <p>Results</p> <p>In our study population, the distribution of ethnic groups was: 38.5% North American, 15% British, 8.4% Western European, 8.2% Eastern European, 1.7% Asian, 1.4% Scandinavian and 27% of other ethnic origin. Compared to North Americans (i) the risk of HL was greater among the Eastern European descendents (Odds Ratio (OR_adj): 1.82; 95% confidence interval (CI): 1.02, 3.25) and Western European (OR_adj: 1.62; 95% CI: 0.95–2.76) descent population (borderline significance at 5% level); and (ii) the risk of HL was lower in Asian descents. Diagnosis with measles (OR_adj: 0.72, 95% C.I.: 0.53–0.98) and/or positive history of allergy desensitization shots (OR_adj: 0.55, 95% C.I.: 0.30–0.99) were negatively associated with the incidence of HL, while diagnosis with acne (OR_adj: 2.12, 95% C.I.: 1.19–3.78), shingles (OR_adj: 2.41, 95% C.I.: 1.38–4.22) and positive family history of cancer (OR_adj: 1.93, 95% C.I.: 1.40–2.65) increased the risk of HL. Exposure to individual herbicide dichlorprop showed an increased risk of HL (OR_adj: 6.35, 95% C.I.: 1.56–25.92).</p> <p>Conclusion</p> <p>In Canada, compared to North Americans descendents, the risk of HL was significantly greater among the Eastern European and Western European descent population. Our results related to association between ethnicity and HL support the findings reported by other researchers. Our data showed that subjects who were diagnosed with measles or had allergy desensitization shots negatively associated with the incidence of HL; and other medical conditions, ever diagnosed with acne, and positive family history of cancer were positively associated with the incidence of HL.</p