Probing problems and priorities in oral health (care) among community dwelling elderly in the Netherlands: a mixed method study

Background: Complex dentitions and decline in adequate oral hygiene in elderly may lead to poor oral health. This may have impact on their general health, wellbeing and quality of life. With increased longevity, the problems and needs in oral health of community dwelling elderly lead to changes in oral health care needs. We identified and prioritized problems and needs in oral health of community dwelling elderly. Methods: The problems and needs in oral health of community dwelling elderly were elicited during focus groups and interviews. The list of problems and needs derived thereof was presented to 97 elderly who prioritized these. Results: Overall, older people appeared to be satisfied with their current oral health, and the maintenance and care for their oral health. Cost of care was identified as a major problem in general. There are differences in current perceived problems and needs and problems and needs anticipated for the future. Perceived current problems and needs concern dental care provision and knowledge on oral health of professionals and patients. For anticipated future problems and needs the importance of daily oral care by caregivers was prioritised, while emphasis was placed on fear of losing autonomy. Conclusion: It is important to take the perspectives and expectations of elderly into account in policy and planning of future oral health care practice, because these differ from the perspectives of dental professionals

Samenstelling van blad, stengel en rhizomen in relatie tot optimaal oogst-tijdstip van Miscanthus x giganteus

A plurality of components (such as sugars, lignin, pectin) of Miscanthus x giganteus has been studied in stem, leaf, and rhizomes for the harvest times July and January in view of the optimal harvest time. Additional literature search shows that the end of October is the optimum time for harvesting on the basis of the maximum above-ground dry matter yield and sugar yield, and dry matter yield in the next year. It will have to be investigated whether the optimal harvest time also applies to long-term research

Dutch Oncology COVID-19 consortium:Outcome of COVID-19 in patients with cancer in a nationwide cohort study

Aim of the study: Patients with cancer might have an increased risk for severe outcome of coronavirus disease 2019 (COVID-19). To identify risk factors associated with a worse outcome of COVID-19, a nationwide registry was developed for patients with cancer and COVID-19. Methods: This observational cohort study has been designed as a quality of care registry and is executed by the Dutch Oncology COVID-19 Consortium (DOCC), a nationwide collaboration of oncology physicians in the Netherlands. A questionnaire has been developed to collect pseudonymised patient data on patients' characteristics, cancer diagnosis and treatment. All patients with COVID-19 and a cancer diagnosis or treatment in the past 5 years are eligible. Results: Between March 27th and May 4th, 442 patients were registered. For this first analysis, 351 patients were included of whom 114 patients died. In multivariable analyses, age ≥65 years (p < 0.001), male gender (p = 0.035), prior or other malignancy (p = 0.045) and active diagnosis of haematological malignancy (p = 0.046) or lung cancer (p = 0.003) were independent risk factors for a fatal outcome of COVID-19. In a subgroup analysis of patients with active malignancy, the risk for a fatal outcome was mainly determined by tumour type (haematological malignancy or lung cancer) and age (≥65 years). Conclusion: The findings in this registry indicate that patients with a haematological malignancy or lung cancer have an increased risk of a worse outcome of COVID-19. During the ongoing COVID-19 pandemic, these vulnerable patients should avoid exposure to severe acute respiratory syndrome coronavirus 2, whereas treatment adjustments and prioritising vaccination, when available, should also be considered

Poor oral health, a potential new geriatric giant. Significant oral health (care) issues in frail older people

Contains fulltext : 91389.pdf (publisher's version ) (Open Access)Radboud Universiteit Nijmegen, 1 december 2011Promotores : Baat, C. de, Schols, J.M.G.A., Vanobbergen, J.N.O

The effect of a daily application of a 0.05% chlorhexidine oral rinse solution on the incidence of aspiration pneumonia in nursing home residents: a multicenter study.

Contains fulltext : 174842.pdf (publisher's version ) (Open Access)BACKGROUND: Dysphagia and potential respiratory pathogens in the oral biofilm are risk factors for aspiration pneumonia in nursing home residents. The aim of the study was to examine if the daily application of 0.05% chlorhexidine oral rinse solution is effective in reducing the incidence of aspiration pneumonia in nursing home residents with dysphagia. Associations between background variables (age, gender, dysphagia severity, care dependency, medication use, number of medical diagnoses, teeth and dental implants, and wearing removable dentures) and the incidence of aspiration pneumonia were also examined. METHODS: This study is a multicenter study in which for 1 year participants with dysphagia in the intervention group received the usual oral hygiene care with the addition of a 0.05% chlorhexidine oral rinse solution, whereas participants in the control group received only oral hygiene care. RESULTS: Data of 103 participants in 17 nursing homes were analyzed. Survival analysis showed no significant difference in the incidence of pneumonia between both groups (Cox regression, HR = 0.800; 95% CI [0.368-1.737], p = 0.572). Cox regression analysis for Functional Oral Intake Scale (FOIS)-level showed a significant risk of the incidence of pneumonia (HR = 0.804; 95% CI [0.656-0.986], p = 0.036). After adjustment for Group and FOIS-level, Cox multivariate proportional hazard regression analysis showed that the variables age, gender, Care-dependency Scale-score (CDS) number of diseases, medication use, number of teeth, and the presence of dental implants or removable dentures were not significantly associated with the incidence of pneumonia. CONCLUSIONS: Chlorhexidine oral rinse solution 0.05% as an adjunctive intervention in daily oral hygiene care was not found to reduce incidence of aspiration pneumonia. The requested number of participants to achieve sufficient power was not established and high drop-out rate and non-structural compliance was present. The power was considered to be sufficient to analyze the associations between the background variables and the incidence of pneumonia in the included nursing home residents with dysphagia. Dysphagia was found to be a risk factor for aspiration pneumonia. TRIAL REGISTRATION: Registration in The Netherlands National Trial Register: TC = 3515. Approval for the study was obtained from the Medical Ethical Committee of the Radboud University Medical Center (NL. nr:41,990.091.12)

[Oral health care guidelines for elderly people in long-term care facilities. Effectiveness and implementation in The Netherlands and Flanders],[Oral health care guidelines for elderly people in long-term care facilities. Effectiveness and implementation in The Netherlands and Flanders]

Contains fulltext : 79768.pdf (publisher's version ) (Open Access)Oral health care includes self-care, volunteer care, and professional care for maintaining or advancing appropriate oral health. It has been demonstrated that the oral health care in long-term care facilities for elderly people in The Netherlands and Flanders (Belgium) is not adequate. Daily oral hygiene care, carers' knowledge and skills providing adequate oral health care, (co)morbidity, and drug usage are points of special interest in realizing an improvement of oral health care and oral health. The Dutch Association of Nursing Home Physicians has formulated oral health care guidelines for elderly people in long-term care facilities. A research project on the effectiveness and implementation will be carried out, determining the guidelines'quality. The aim of the project is improving the quality of oral health care for and the quality of oral health and life of elderly people in long-term care facilities in The Netherlands and Flanders

Prioritering en aanbevelingen in de mondzorg voor ouderen

De mondgezondheid van ouderen, vooral kwetsbare zorgafhankelijke ouderen is suboptimaal. In een Priority Setting Partnershiponderzoek hebben ouderen en andere belanghebbenden geparticipeerd om ervaren belemmeringen in de mondzorg te inventariseren en hieruit agendapunten voor onderzoek te destilleren. Hiertoe zijn in 5 focusgroepen discussies gehouden met respectievelijk een groep ouderen, verzorgers, externe partijen en behandelaars. In een vijfde zogenoemde consensusgroep werd de definitieve lijst van prioriterende agendapunten geformuleerd. De belangrijkste prioriteiten betreffen beleid en organisatie, bewustwording, samenwerking tussen verschillende zorgverleners, financiering en organisatie van mondzorg voor thuiswonende ouderen, en onderwijs over mondzorg aan alle zorgverleners. Bewustwording over het belang van de mondgezondheid van ouderen bij zorgverleners is de eerste stap naar betere mondgezondheid van ouderen in Nederland