Validity and reliability of the Oral Impacts on Daily Performance (OIDP) frequency scale: a cross-sectional study of adolescents in Uganda

Background: Assessing oral health related quality of life impact of mouth in adolescents is a relatively ignored area in dental research. This study aimed to examine reliability and validity of an abbreviated version of the oral impact of daily performance (OIDP) questionnaire and to analyse the interrelationship among OIDP scores, socio-demographic characteristics and oral health status in Uganda. Method: 1146 adolescents (mean age 15.8, response rate 87%) attending secondary schools in Kampala (urban) and Lira (rural) completed a survey instrument designed to measure subjective oral health indicators including the eight-item OIDP frequency scores. A clinical examination was conducted among 372 students (mean age 16.3, response rate 72%) and caries was assessed following the World Health Organisation criteria (1997). Results: 62% of the students experienced at least one oral impact during the 6 months preceding the survey. Cronbach's alpha for the OIDP frequency items was 0.91 and the corrected item-total correlation ranged from 0.62 to 0.75. Discriminant and construct validity were demonstrated in that the OIDP scores varied systematically in the expected direction with missing teeth and self-report indicators of oral health status, respectively. Socio-demographics and dental attendance did not predict OIDP through interaction with clinical indicators but varied systematically and independently with OIDP frequency scores in the multivariate analysis. Conclusion: the OIDP frequency score have acceptable psychometric properties in the context of an oral health survey among Ugandan adolescents. Some evidence of the importance of social and personal characteristics in shaping adolescents' responses to oral disorders was provided.publishedVersio

Influences of behaviour and attitude on education related inequality in tooth loss: findings from Norway and Sweden over 5 years of follow-up

Objectives Following community dwelling cohorts in Norway and Sweden from 65 to 70 years, this study aimed to answer the following questions; Is there cross country variation in educational inequality in tooth loss between the Norwegian and Swedish cohorts? Does oral health behaviours and attitudinal beliefs play a role in explaining educational inequality in tooth loss across time and cohorts? Material and Methods In 2007 and 2012 Statistics Norway administered mailed questionnaires to all individuals born in 1942 in three counties. The response rate was 58% (n = 4211) in 2007 and 54.5% (n = 3733) in 2012. In Sweden the same questionnaires were sent to the 1942 cohort in two counties. The final response rate in 2007 and 2012 were respectively, 73.1% (n = 6078) and 72.2% (n = 5697). Results In Norway, tooth loss prevalence was 21.8% in 2007 and 23.2% in 2012. Corresponding figures in Sweden were 25.9% and 27.3%. The prevalence of tooth loss was higher among lower than higher educated participants and the gradient was significantly weaker in Sweden than in Norway. Multiple variable analyses adjusting for oral behavioural and attitudinal variables attenuated education related gradients in both cohorts. Conclusion Education related inequality in tooth loss was stronger in the Norwegian than in the Swedish cohort across the survey years. Oral behaviours and attitudinal beliefs played a role in explaining the gradients across time. This illustrates a necessity to promote oral health enhancing behaviours and attitudinal beliefs, particularly so in lower educational groups.publishedVersio

Oral health related quality of life and reasons for non-dental attendance among patients with substance use disorders in withdrawal rehabilitation

No study has assessed the socio-behavioral distribution of oral health related quality of life (OHRQoL) among patients with substance use disorders receiving medically assisted rehabilitation therapy (MAR) in Norway. Objectives To examine the prevalence of oral impacts on daily performances (OIDP) and its distribution among MAR patients in western Norway. We also examined whether oral impacts discriminate with different reasons for non-dental attendance. Material and Methods A cross-sectional study focusing OHRQoL was nested to the INTRO-HCV study and implemented in six rehabilitation clinics for people with substance use disorders. A total of 167 MAR patients completed personal interviews and oral clinical examination upon entering the clinic for their MAR medication. Results The prevalence of oral impacts (OIDP > 0) was 61%. Logistic regression, adjusted for sex and age presented with odds ratios (OR) with 95% confidence intervals (CI) revealed that less than 20 remaining teeth (OR = 5.3 95% CI: 1.6–23.3) and dissatisfaction with dental care (OR = 5.1 95% CI: 1.3–19.0) increased the odds of having OIDP > 0. OIDP > 0 was also associated with insufficient dental follow-up due to dental anxiety and poor experiences with perceived attitudes of dental workers. Means OIDP among people with negative experiences with attitudes of dental care workers were 3.1 (SD 0.8) compared to 1.4 (SD 0.7) among those without negative experiences, and 2.8 (SD) for those with dental anxiety compared to 1.8 (SD) among those without. Conclusion OHRQoL among MAR patients was generally poor. To reach those with a need for dental care, modification of the existing rehabilitation approach toward closer collaboration between dental health care workers and others in contact with drug users might be necessary.publishedVersio

Dental health personnel’s experience with receiving inquiries from child welfare services: a national cross-sectional study

Objectives To assess if and to what extent public dental health personnel (PDHP) receive inquiries from child welfare services (CWS), and to assess whether PDHP’s experience of receiving inquiries is associated with PDHP’s characteristics and whether the associations are influenced by PDHP’s experience of reporting to CWS. Material and methods Questionnaires were distributed to 1542 PDHP in Norway. Descriptive statistics were used for analysis. Negative-binominal-regression analyses with incidence rate ratios (IRRs) and confidence intervals (CIs) were used to estimate the association between received inquiries from CWS and PDHP characteristics. Results From a total of 1074 respondents, 52.4% had received inquiries from CWS (2012–2014) with a mean number of 3.9 (SD = 4.5). PDHP’s likelihood of receiving inquiries was significantly associated with having many patients, working in small municipalities, working in eastern Norway, having good knowledge of the Health Personnel Act, and having experience reporting to CWS. Regional differences were the only association that varied according to PDHP reporting activity. Conclusions PDHP receive inquiries from the CWS. The likelihood of receiving inquiries is associated with several characteristics of PDHP. To increase PDHP’s likelihood of receiving inquiries, it is important to establish contact between the CWS and PDHS and ensure that the PDHP has good knowledge of the Health Personnel Act.publishedVersio

HIV and AIDS related knowledge, sources of information, and reported need for further education among dental students in Sudan- a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Information on the HIV and AIDS-related knowledge among dental students provides a crucial foundation for efforts aimed at developing an appropriate dental curriculum on HIV and AIDS, and for attracting the attention of dental school educators towards the subject.</p> <p>Purposes</p> <p>Focusing on a census of dental students attending their 3^rd, 4^thand 5^thstudy year at publicly – and privately funded dental faculties in Khartoum, this study aimed to assess the prevalence and socio-economic correlates of dental students' knowledge, sources of information and reported need for further education related to HIV and AIDS.</p> <p>Methods</p> <p>At the time of the survey (March–May 2007), the total number of dental students registered was 782 of which 642 (response rate 82%, mean age 21.7 year, 72% girls) completed anonymous self-administered questionnaires in supervised class room settings.</p> <p>Results</p> <p>A total of 49% and 86% had correct sum scores with respect to knowledge of transmission through contamination and through shaking hands and eating, respectively. About half the dental students recognized a need for further education across HIV related issues, varying from 75% (basic HIV/AIDS related issues) to 84% (patient management). Only 38% of the students had correct sum scores regarding various occupational groups at risk for contacting HIV and AIDS. Multiple logistic regression analysis revealed that compared to privately funded dental school students, publicly funded dental school students were less likely to have correct knowledge about modes of HIV transmission (OR = 0.6) and occupational risk groups (OR = 0.6) and to have received information from lectures/health care workers (OR = 0.5).</p> <p>Conclusion</p> <p>Students attending privately funded schools were more knowledgeable about various HIV related issues than students from publicly funded schools. About half of the students investigated had received HIV/AIDS information from various sources and reported need for further education. This suggests that students are not adequately prepared for treating patients with HIV infection and AIDS and that the dental school curriculum needs improvements. Differences between public and private dental schools should be considered when planning such improvements.</p

HIV and AIDS related knowledge, source of information, and reported need for further education among dental students in Sudan- a cross sectional study

Background: Information on the HIV and AIDS-related knowledge among dental students provides a crucial foundation for efforts aimed at developing an appropriate dental curriculum on HIV and AIDS, and for attracting the attention of dental school educators towards the subject. Purposes: Focusing on a census of dental students attending their 3rd, 4th and 5th study year at publicly – and privately funded dental faculties in Khartoum, this study aimed to assess the prevalence and socioeconomic correlates of dental students' knowledge, sources of information and reported need for further education related to HIV and AIDS. Methods: At the time of the survey (March–May 2007), the total number of dental students registered was 782 of which 642 (response rate 82%, mean age 21.7 year, 72% girls) completed anonymous selfadministered questionnaires in supervised class room settings. Results: A total of 49% and 86% had correct sum scores with respect to knowledge of transmission through contamination and through shaking hands and eating, respectively. About half the dental students recognized a need for further education across HIV related issues, varying from 75% (basic HIV/AIDS related issues) to 84% (patient management). Only 38% of the students had correct sum scores regarding various occupational groups at risk for contacting HIV and AIDS. Multiple logistic regression analysis revealed that compared to privately funded dental school students, publicly funded dental school students were less likely to have correct knowledge about modes of HIV transmission (OR = 0.6) and occupational risk groups (OR = 0.6) and to have received information from lectures/health care workers (OR = 0.5). Conclusion: Students attending privately funded schools were more knowledgeable about various HIV related issues than students from publicly funded schools. About half of the students investigated had received HIV/AIDS information from various sources and reported need for further education. This suggests that students are not adequately prepared for treating patients with HIV infection and AIDS and that the dental school curriculum needs improvements. Differences between public and private dental schools should be considered when planning such improvements

Explaining the intention of dental health personnel to report suspected child maltreatment using a reasoned action approach

Background: This study provides an empirical test of the reasoned action approach (RAA) socio-cognitive theory with the aim of 1) predicting the intention of public dental health personnel (PDHP) to report suspected child-maltreatment to child welfare services (CWS); 2) estimating the effects of the theoretical constructs of RAA, including experiential and instrumental attitudes, injunctive and descriptive norms, and perceived capacity and autonomy regarding PDHP’s behavioural intentions; and 3) exploring whether the RAA operates equivalently (i.e., is invariant) in male and female providers. Methods: This national cross-sectional study was conducted in Norway. An electronic survey was distributed to 1542 dentists and dental hygienists working in the public dental health service. The survey included RAA items constructed in accordance with the recommendations for the RAA model. Structural equation modelling (SEM) was used to identify factors derived from the theory of RAA to predict PDHP reporting intentions. Results: A total of 77.8% (1200) of those surveyed responded to the survey. The present study provided support for the utility of the RAA across both male and female providers in predicting their intention to report suspected child-maltreatment to the CWS. The final modified SEM model revealed that instrumental attitudes and perceived behavioural control (based on merged capacity and autonomy parameters) were the strongest predictors of intention to report, followed by the reporting of descriptive norms, injunctive norms and experiential attitudes. These factors explained 63.6% of the observed variance in the reporting intention. Conclusions: The large amount of explained variance suggests that RAA is a well-functioning theory that predicts PDHP’s reporting intentions to CWS across gender, and gives an understanding of the socio-cognitive factors involved. To strengthen reporting intention among dental personnel, this study suggests educators should focus on the value and positive consequences of reporting, the resources available and how to overcome obstacles; attention to normative expectations and individuals’ feelings about reporting may also be helpful.publishedVersio

HIV and AIDS related knowledge, source of information, and reported need for further education among dental students in Sudan- a cross sectional study

Background: Information on the HIV and AIDS-related knowledge among dental students provides a crucial foundation for efforts aimed at developing an appropriate dental curriculum on HIV and AIDS, and for attracting the attention of dental school educators towards the subject. Purposes: Focusing on a census of dental students attending their 3rd, 4th and 5th study year at publicly – and privately funded dental faculties in Khartoum, this study aimed to assess the prevalence and socioeconomic correlates of dental students' knowledge, sources of information and reported need for further education related to HIV and AIDS. Methods: At the time of the survey (March–May 2007), the total number of dental students registered was 782 of which 642 (response rate 82%, mean age 21.7 year, 72% girls) completed anonymous selfadministered questionnaires in supervised class room settings. Results: A total of 49% and 86% had correct sum scores with respect to knowledge of transmission through contamination and through shaking hands and eating, respectively. About half the dental students recognized a need for further education across HIV related issues, varying from 75% (basic HIV/AIDS related issues) to 84% (patient management). Only 38% of the students had correct sum scores regarding various occupational groups at risk for contacting HIV and AIDS. Multiple logistic regression analysis revealed that compared to privately funded dental school students, publicly funded dental school students were less likely to have correct knowledge about modes of HIV transmission (OR = 0.6) and occupational risk groups (OR = 0.6) and to have received information from lectures/health care workers (OR = 0.5). Conclusion: Students attending privately funded schools were more knowledgeable about various HIV related issues than students from publicly funded schools. About half of the students investigated had received HIV/AIDS information from various sources and reported need for further education. This suggests that students are not adequately prepared for treating patients with HIV infection and AIDS and that the dental school curriculum needs improvements. Differences between public and private dental schools should be considered when planning such improvements.publishedVersio

Utilization of dental health care services in context of the HIV epidemic- a cross-sectional study of dental patients in the Sudan

Background: HIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersen's model in terms of predisposing (sociodemographics), enabling (knowledge, attitudes and perceived risk related to HIV) and need related factors (oral health status) predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors. Methods: Dental patients were recruited from Khartoum Dental Teaching Hospital (KDTH) and University of Science and Technology (UST) during March-July 2008. A total of 1262 patients (mean age 30.7, 56.5% females and 61% from KDTH) were examined clinically (DMFT) and participated in an interview. Results: A total of 53.9% confirmed having attended a dental clinic for treatment at least once in the past 2 years. Logistic regression analysis revealed that predisposing factors; travelling inside Sudan (OR = 0.5) were associated with lower odds and females were associated with higher odds (OR = 2.0) for dental service utilization. Enabling factors; higher knowledge of HIV transmission (OR = 0.6) and higher HIV related experience (OR = 0.7) were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR = 1.3) were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR = 4.8). Conclusion: Disparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV infection control and confidence on the competence of dentists should be improved to minimize avoidance behaviour and help establish dental health care patterns in Sudan.publishedVersio

Mothers' education but not fathers' education, household assets or land ownership is the best predictor of child health inequalities in rural Uganda

Background: Health and nutrition inequality is a result of a complex web of factors that include socio-economic inequalities. Various socio-economic indicators exist however some do not accurately predict inequalities in children. Others are not intervention feasible. Objective: To examine the association of four socio-economic indicators namely: mothers' education, fathers' education, household asset index, and land ownership with growth stunting, which is used as a proxy for health and nutrition inequalities among infants and young children. Methods: This was a cross-sectional survey conducted in the rural district of Hoima, Uganda. Two-stage cluster sampling design was used to obtain 720 child/mother pairs. Information on indicators of household socio-economic status and child anthropometry was gathered by administering a structured questionnaire to mothers in their home settings. Regression modelling was used to determine the association of socio-economic indicators with stunting. Results: One hundred seventy two (25%) of the studied children were stunted, of which 105 (61%) were boys (p < 0.001). Bivariate analysis indicated a higher prevalence of stunting among children of: non-educated mothers compared to mothers educated above primary school (odds ratio (OR) 2.5, 95% confidence interval (CI) 1.4–4.4); non-educated fathers compared to fathers educated above secondary school (OR 1.7, 95% CI 0.8–3.5); households belonging in the "poorest" quintile for the asset index compared to the "least poor" quintile (OR 2.1, 95% CI 1.2–3.7); Land ownership exhibited no differentials with stunting. Simultaneously adjusting all socio-economic indicators in conditional regression analysis left mothers' education as the only independent predictor of stunting with children of non-educated mothers significantly more likely to be stunted compared to those of mothers educated above primary school (OR 2.1, 95% CI 1.1–3.9). More boys than girls were significantly stunted in poorer than wealthier socio-economic strata. Conclusions: Of four socio-economic indicators, mothers' education is the best predictor for health and nutrition inequalities among infants and young children in rural Uganda. This suggests a need for appropriate formal education of the girl child aimed at promoting child health and nutrition. The finding that boys are adversely affected by poverty more than their female counterparts corroborates evidence from previous studies.publishedVersio