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

Exploring spontaneous interactions between people with profound intellectual and multiple disabilities and their peers

Background Peers living in the same group form important interaction partners for people with profound intellectual and multiple disabilities (PIMD). Given the severity of their disabilities, direct support persons (DSPs) play a significant role in facilitating interactions between these peers. This study explores the spontaneous interactions between persons with PIMD and the possibilities provided by DSPs related to physical positioning. Method Observational data were obtained from 14 people with PIMD for three consecutive hours in a non-controlled situation. Results Of all 213 observed interactions, 5.1% were with peers, 73.4% with DSPs, 14.9% with the observer, and 6.5% with others. In 61.3% of the observed timeframes, the participants with PIMD were positioned in a way that made it impossible to touch or/and to look at a peer. Conclusion Generally, the observed positioning of the participants made contacts between peers nearly impossible. DSPs should create optimal conditions for interaction between peers

Overcoming the low reactivity of biobased, secondary diols in polyester synthesis

Shifting away from fossil- to biobased feedstocks is an important step towards a more sustainable materials sector. Isosorbide is a rigid, glucose-derived secondary diol, which has been shown to impart favourable material properties, but its low reactivity has hampered its use in polyester synthesis. Here we report a simple, yet innovative, synthesis strategy to overcome the inherently low reactivity of secondary diols in polyester synthesis. It enables the synthesis of fully biobased polyesters from secondary diols, such as poly(isosorbide succinate), with very high molecular weights (M(n) up to 42.8 kg/mol). The addition of an aryl alcohol to diol and diacid monomers was found to lead to the in-situ formation of reactive aryl esters during esterification, which facilitated chain growth during polycondensation to obtain high molecular weight polyesters. This synthesis method is broadly applicable for aliphatic polyesters based on isosorbide and isomannide and could be an important step towards the more general commercial adaption of fully biobased, rigid polyesters

PISOX Copolyesters─Bio- and CO₂-Based Marine-Degradable High-Performance Polyesters

Oxalate esters and isosorbide serve as intriguing polymer building blocks, as they can be sourced from renewable resources, such as CO2 and glucose, and the resulting polyesters offer outstanding material properties. However, the low reactivity of the secondary hydroxyl groups makes it difficult to generate high-molecular-weight polymers from isosorbide. Combining diaryl oxalates with isosorbide appears to be a promising approach to produce high-molecular-weight isosorbide-based polyoxalates (PISOX). This strategy seems to be scalable, has a short polymerization time (<5 h), and uniquely, there is no need for a catalyst. PISOX demonstrates outstanding thermal, mechanical, and barrier properties; its barrier to oxygen is 35 times better than PLA, it possesses mechanical properties comparable to high-performance thermoplastics, and the glass transition temperature of 167 °C can be modified by comonomer incorporation. What makes this high-performance material truly exceptional is that it decomposes into CO2 and biomass in just a few months in soil under home-composting conditions and it hydrolyzes without enzymes present in less than a year in 20 °C water. This unique combination of properties has the potential to be utilized in a range of applications, such as biomedical uses, water-resistant coatings, compostable plastic bags for gardening and agriculture, and packaging plastics with diminished environmental impact

The use of a real-time computer-aided detection system for visible lesions in the Barrett's esophagus during live endoscopic procedures:a pilot study (with video)

Background and aims: This pilot study evaluated the performance of a recently developed computer-aided detection (CADe) system for Barrett's neoplasia during live endoscopic procedures. Methods: Fifteen patients with a visible lesion and 15 without were included in this study. A CAD-assisted workflow was used that included a slow pullback video recording of the entire Barrett's segment with live CADe assistance, followed by CADe-assisted level-based video recordings every 2 cm of the Barrett's segment. Outcomes were per-patient and per-level diagnostic accuracy of the CAD-assisted workflow, in which the primary outcome was per-patient in vivo CADe sensitivity. Results: In the per-patient analyses, the CADe system detected all visible lesions (sensitivity 100%). Per-patient CADe specificity was 53%. Per-level sensitivity and specificity of the CADe assisted workflow were 100% and 73%, respectively. Conclusions: In this pilot study, detection by the CADe system of all potentially neoplastic lesions in Barrett's esophagus was comparable to that of an expert endoscopist. Continued refinement of the system may improve specificity. External validation in larger multicenter studies is planned. (Clinical trial registration number: NCT05628441.)</p

The course of neuropathy after cessation of cisplatin treatment, combined with Org 2766 or placebo

Peripheral neuropathy is an important and disabling side-effect of cisplatin treatment. A new drug, Org 2766, has been found to prevent this neuropathy up to 1 month after treatment. A group of 18 patients with ovarian cancer, who participated in an earlier randomized study with placebo or Org 2766, together with cisplatin and cyclophophamide, were thereafter prospectively followed up to 2 years after discontinuation of treatment to monitor the development of neurological signs and symptoms and vibration perception threshold (VPT). Exploratory, descriptive data analysis shows that between 1 and 4 months after the last cycle the average sum score for neurological signs and symptoms and VPT had deteriorated compared with 1 month after treatment. Thereafter a gradual but incomplete improvement was seen between 4-12 and 12-24 months after treatment. These changes were seen in all patients regardless of previous treatment with Org 2766 or placebo, but deterioration was less pronounced in patients previously treated with Org 2766. These results suggests that treatment with Org 2766 to prevent a cisplatin-induced neuropathy should possibly be continued up to 4 months after the last cycle of cisplatin

Neural substrates for the distinct effects of presynaptic group III metabotropic glutamate receptors on extinction of contextual fear conditioning in mice

The group III metabotropic glutamate (mGlu) receptors mGlu7 and mGlu8 are receiving increased attention as potential novel therapeutic targets for anxiety disorders. The effects mediated by these receptors appear to result from a complex interplay of facilitatory and inhibitory actions at different brain sites in the anxiety/fear circuits. To better understand the effect of mGlu7 and mGlu8 receptors on extinction of contextual fear and their critical sites of action in the fear networks, we focused on the amygdala. Direct injection into the basolateral complex of the amygdala of the mGlu7 receptor agonist AMN082 facilitated extinction, whereas the mGlu8 receptor agonist (S)-3,4-DCPG sustained freezing during the extinction acquisition trial. We also determined at the ultrastructural level the synaptic distribution of these receptors in the basal nucleus (BA) and intercalated cell clusters (ITCs) of the amygdala. Both areas are thought to exert key roles in fear extinction. We demonstrate that mGlu7 and mGlu8 receptors are located in different presynaptic terminals forming both asymmetric and symmetric synapses, and that they preferentially target neurons expressing mGlu1α receptors mostly located around ITCs. In addition we show that mGlu7 and mGlu8 receptors were segregated to different inputs to a significant extent. In particular, mGlu7a receptors were primarily onto glutamatergic afferents arising from the BA or midline thalamic nuclei, but not the medial prefrontal cortex (mPFC), as revealed by combined anterograde tracing and pre-embedding electron microscopy. On the other hand, mGlu8a showed a more restricted distribution in the BA and appeared absent from thalamic, mPFC and intrinsic inputs. This segregation of mGlu7 and mGlu8 receptors in different neuronal pathways of the fear circuit might explain the distinct effects on fear extinction training observed with mGlu7 and mGlu8 receptor agonists. This article is part of a Special Issue entitled 'Metabotropic Glutamate Receptors'. © 2012 Elsevier Ltd. All rights reserved