Child maltreatment in Dubai and the Northern United Arab Emirates: dental hygienists and assistants’ knowledge

Purpose Dental assistants (DAs) and hygienists (DHs) should play an active role in the detection and reporting of child abuse and neglect (CAN). We aimed to investigate CAN knowledge of DAs and DHs in the United Arab Emirates (UAE) and some of the inhibiting factors to the process of CAN reporting. Methods A cross-sectional study design was utilized. We surveyed 186 DAs and DHs using a previously validated self-administered anonymous CAN knowledge questionnaire. Statistical analysis was performed using χ2-square, Fisher’s exact test, t test/Mann–Whitney, and a ROC curve (p < 0.05). Results Among 186 DAs and DHs surveyed, satisfactory knowledge of CAN was demonstrated by 50.5%. DAs scored a significantly higher score of knowledge compared to DHs (p = 0.03). The most reported CAN referral inhibiting factor was “being afraid to get in trouble with parents”. The recognition of a child with special needs and parents missing multiple appointments as risk factors for CAN was significantly higher in the DAs compared to DHs (p = 0.04, p = 0.024, respectively). Awareness of local laws was related to CAN knowledge in DAs (p = 0.012) and DHs (p = 0.008). Conclusion The lack of appropriate knowledge regarding CAN necessitates a clear reporting process and better education for DAs and DHs in the UAE

The Impact of Alveolar Bone Grafting on Cleft Lip and Palate: a Literature Review

Introduction: Alveolar bone grafting between the ages of nine years to eleven years is a routine procedure for children with a cleft involving the alveolus. It is believed to encourage dental development and subsequent treatment within the region of the cleft and to improve nasolabial aesthetics. The aims of this article are to review the literature as to its impact on dental development and subsequent treatment, nasolabial aesthetics and the nasal airway. Methods: An electronic search was conducted using Medline and Embase, with no restriction as to date of publication, study design or language. Results: The results suggest that secondary alveolar bone grafting when carried out at the appropriate time has significant benefits and for subsequent dental treatment, often allows space closure of adjacent teeth and eliminating the need for a prosthesis. Although it has an effect of nasolabial aesthetics it is equivocal as to whether this improves nasolabial aesthetics or merely improves the likelihood of aesthetic improvement of subsequent nasal surgery. Nasal obstruction is a significant issue in patients with cleft lip and palate with smaller nasal volume and mean cross-sectional area. It would appear that there is a reduction in the growth of the airway after an age that approximates to the timing for secondary alveolar grafting, although there are no studies that can refute or con"rm its actual impact. Conclusions: Alveolar bone grafting between the ages of 9 - 11 years appears to produce clear benefits in terms of dental development and subsequent dental treatment. Its impact on nasolabial aesthetics appear equivocal as although there are changes in some landmarks post-surgery it is unclear as to whether these changes produce a benefit in terms of aesthetics for the patient

The health of nine Royal Naval Arctic crews, 1848 to 1854: implications for the lost Franklin Expedition

Medical factors including tuberculosis, scurvy, lead poisoning and botulism have been proposed to explain the high death rate prior to desertion of the ships on Sir John Franklin's expedition of 1845?1848 but their role remains unclear because the surgeons? Sick books which recorded illness on board have eluded discovery. In their absence, this study examines the Sick books of Royal Naval search squadrons sent in search of Franklin, and which encountered similar conditions to his ships, to consider whether their morbidity and mortality might reflect that of the missing expedition. The Sick books of HMS Assistance, Enterprise, Intrepid, Investigator, Pioneer and Resolute yielded 1,480 cases that were coded for statistical analysis. On the basis of the squadrons? patterns of illness it was concluded that Franklin's crews would have suffered common respiratory and gastro-intestinal disorders, injuries and exposure and that deaths might have occurred from respiratory, cardiovascular and tubercular conditions. Scurvy occurred commonly and it was shown that the method of preparing ?antiscorbutic? lemon juice for the search squadrons and Franklin's ships would have reduced its capacity to prevent the disease but there were no grounds to conclude that scurvy was significant at the time of deserting the ships. There was no clear evidence of lead poisoning despite the relatively high level of lead exposure that was inevitable on ships at that time. There was no significant difference between the deaths of non-officer ranks on Franklin's ships and several of the search ships. The greater number of deaths of Franklin's officers was proposed to be more probably a result of non-medical factors such as accidents and injuries sustained while hunting and during exploration