Diabetes and Periodontal Disease: The Need for Interprofessional Patient Care.

PosterObjective: The objective of this clinical case presentation is to emphasize the importance of an interprofessional approach to health care. Specifically, this case will emphasize the importance of managing diabetes in a periodontal patient. Background: A 69 year old patient presented with the chief complaint of, “I want my teeth cleaned.” The medical history revealed several medications and conditions that could potentially impact the oral cavity. The patient presented with type II diabetes mellitus, which became uncontrolled during the treatment; was taking a calcium channel blocker to control his high blood pressure, and was using a bi-pap machine for his sleep apnea. The patient also was obese and gave a history of bariatric surgery, GERD, and recent back pain. Assessment: The initial clinical examination of this patient revealed generalized mild bone loss as evidenced by 3-4mm from the CEJ radiographically (generalized moderate plaque induced gingivitis with dark pink spongy tissue with bulbous papilla that did not adhere tightly to the tooth with bleeding) and generalized mild chronic periodontitis as evidenced by 4-5mm CAL and 6mm CAL associated with swollen gingiva. Localized severe periodontitis of 8mm CAL on tooth number 19 was present. Dental Hygiene Treatment Plan: Scaling and root planing was performed for selective areas along with a periodontal tissue re-evaluation. Treatment: The treatment was performed throughout three separate appointments. At the beginning of treatment the patient’s A1C was 8.5% and his blood glucose was 195 mg/dl. Results: The re-evaluation appointment revealed slight improvement in the health of the gingiva, but minimal to no improvement in probing depths. Conclusion: This case highlights the need for an interprofessional approach to patient care. Problems with diabetes management, as well as other contributing factors, have been known to impact periodontal therapy outcomes

Australian Strawberry Good Practice Guide

The Australian Strawberry Good Practice Guide has been developed as part of the Australian Strawberry Industry Development Program. This program is funded by Hort Innovation, using the strawberry research and development levy and contributions from the Australian Government. Hort Innovation is the grower owned, not-for-profit research and development corporation for Australian horticulture

Understanding social and clinical associations with unemployment for people with schizophrenia and bipolar disorders: large-scale health records study

Purpose People with severe mental illness (SMI) experience high levels of unemployment. We aimed to better understand the associations between clinical, social, and demographic inequality indicators and unemployment. Methods Data were extracted from de-identified health records of people with SMI in contact with secondary mental health services in south London, UK. A Natural Language Processing text-mining application was applied to extract information on unemployment in the health records. Multivariable logistic regression was used to assess associations with unemployment, in people with SMI. Results Records from 19,768 service users were used for analysis, 84.9% (n = 16,778) had experienced unemployment. In fully adjusted models, Black Caribbean and Black African service users were more likely to experience unemployment compared with White British service users (Black Caribbean: aOR 1.62, 95% CI 1.45–1.80; Black African: 1.32, 1.15–1.51). Although men were more likely to have experienced unemployment relative to women in unadjusted models (OR 1.36, 95% CI 1.26–1.47), differences were no longer apparent in the fully adjusted models (aOR 1.05, 95% CI 0.97–1.15). The presence of a non-affective (compared to affective) diagnosis (1.24, 1.13–1.35), comorbid substance use (2.02, 1.76–2.33), previous inpatient admissions (4.18, 3.71–4.70), longer inpatient stays (78 + days: 7.78, 6.34–9.54), and compulsory admissions (3.45, 3.04–3.92) were associated with unemployment, in fully adjusted models. Conclusion People with SMI experience high levels of unemployment, and we found that unemployment was associated with several clinical and social factors. Interventions to address low employment may need to also address these broader inequalities

The 'causes' of teenage pregnancy: review of South African research - Part 2

This article forms the second of a two-part series in which South African research on teenage pregnancy is reviewed. Part 1 of the series dealt with the consequences of teenage pregnancy; this paper reviews the 'causes' thereof. International literature is incorporated in the discussion by way of comparison. Contributory factors which have been investigated by South African researchers include: reproductive ignorance; the earlier occurrence of menarche; risktaking behaviour; psychological problems; peer influence; co-ercive sexual relations; dysfunctional family patterns; poor health services; socio-economic status; the breakdown of cultural traditions; and the cultural value placed on children. Preston-Whyte and colleagues present a revisionist argument, stating that early pregnancy may represent a rational life choice for certain adolescent women. The article is concluded with comments on methodological problems encountered in the South African research, and a discussion on the implications in terms of policy formulation