[A strategy for therapy of depressive disorders and anxiety disorders by a health education intervention in medical consultations: the results of the APRAND program]. / Prévention des troubles anxieux et dépressifs par une action d'éducation pour la santé en consultation: résultats du programme APRAND.

BACKGROUND: Studies devoted to the detection and treatment of anxiety and depression in adult populations show that at least 10% meet ICD10 criteria for an anxiety or a depressive disorder, but only half are diagnosed as such and only one third of those receive appropriate treatment. The goal of the APRAND program was to explore the possibility of improving management strategies via health education during doctors' visits. METHODS: In 2001, EDF-GDF conducted an experimental program in which 21 physicians from its in-house health insurance program used the MINI mental state examination to screen for ICD10 criteria for anxiety and depressive disorders in 9743 employees on sick leave. A "here-elsewhere" epidemiologic study evaluated the program, recording the initial diagnoses and studying a year later the outcome of the persons identified with these disorders in 8 active centers (with prevention activities) and in 13 control centers (without prevention activities). The activities consisted of explanations of the disorders identified, delivery of the test results, delivery of leaflets based on the WHO guidelines, and strong recommendations to see a general practitioner, or a psychiatrist, or the occupational physician, if necessary. Logistic regressions compared the two groups, taking into account sex, age, geographic region, comorbidity, and medical care at screening. RESULTS: Preventive activities were significantly associated with the disappearance at 1 year of depressive episodes (OR=1.93; CI 95%; 1.3-2.84) and of phobic or panic disorders (OR=1.98; CI 95%; 1.14-3.44). The only other variables affecting prognosis were age and sex. The probability of recovery or remission increased by 10 to 20% at active centers, according to age, sex and disorder. Moreover, the physicians reported that they learned a great deal from the program, which thus also improved their practices. CONCLUSION: Diagnosis and prognosis of depressive episodes and phobic and panic disorders in adult populations can be improved by a preventive diagnostic and educational approach of the type used by APRAND during doctor's visits.

The index of ADOH: concept of measuring oral self-care functioning in the elderly.

Measures of ability, or function, are used in the health field to determine the level of performance of a specific task, assess the loss of function, and to measure the return to function as a result of rehabilitation or interventions. While these measures are important to all age groups, it is the elderly and chronically ill who are at most risk for adverse changes in their health and functional status. The Index of the Activities of Daily Oral Hygiene (ADOH) is an instrument to assess and monitor functional dependency in manipulating aids used in oral self-care. It is part of the overall concept of oral self-care which subsumes function, education and training, and compliance in achieving and maintaining oral health. The purpose of the Index of ADOH is two-fold: to assess a subject for the progressive loss of the physical ability to manipulate the aids used in oral self-care, and to measure the return to function in response to care intervention and rehabilitative services. These manipulative tasks are associated with flossing, brushing, topical fluoride application, and the use of oral rinses. Aside from changes in function, the Index of ADOH can be used by health care providers and administrators to project the need for services or support for home care.

A clinical comparison between xeroradiography and film radiography for the detection of recurrent caries.

Xeroradiographs and conventional film radiographs (D- and E-speed) were compared in a clinical study with the use of one-half complete-mouth radiographs for the detection of recurrent dental caries in 200 teeth. The results indicated that film was the most useful in identification of noncarious restored teeth (91% correct versus 79% correct for xeroradiography); however, xeroradiography was better than film for detection of recurrent caries (67% versus 53%). With ROC analysis, both film and xeroradiography were equally useful, having the same ROC value of 0.78. At rates of 67% and 53% for detection of the presence of recurrent caries, neither imaging system can overcome basic geometric limitations of superimposition of metallic restorations. Thus, there is the continued need for careful clinical assessesment of existing restorations for the presence of recurrent caries.

A clinical comparison of xeroradiography and film radiography for the detection of proximal caries.

Xeroradiographs and conventional film radiographs (D- and E-speed) were compared in a clinical study with the use of 1 complete-mouth radiographs for (1) the presence of interproximal caries and (2) the determination of the depth of interproximal caries with the use of 200 tooth surfaces. In addition, an analysis of correct classification rates making a comparison of the same techniques was conducted. The results with the use of ROC analysis indicated that when a comparison was made of xeroradiography and D- and E-speed film, all techniques were equally useful. A broad range of observer ROC area values was found, indicating that diagnostic performance varies greatly with observer. The results of the diagnostic decisions made on carious surfaces versus noncarious surfaces indicated that all techniques tested were similar: 90% correct for noncarious surfaces and 77% correct for carious surfaces.

Contour of class V composite restorations.

For class V composite restorations, reproducing the natural contour of the tooth may best be attained with the use of a matrix. The matrix techniques that produced the best contours were the compound index with the plastic sheath or Mylar strip, and those among the worst used the composite instrument with and without alcohol.

Silver-plated dies. Part I: Platability of impression materials.

The purpose of this study were to determine the acceptability of silver-plated dies made from representative brands of impression material from each of the four groups of elastomers and to determine the time required for initial plating of dies. Permlastic and Impregum , each previously shown to produce consistent silver-plated dies, were used for comparison. Representatives from the condensation-reaction and addition-reaction ( polyvinylsiloxanes ) silicones groups were tested until satisfactory materials were selected. Citricon and Xantopren - Optosil were tested in the former group and President and Reprosil in the latter. Conclusions include the following: All materials were flash-plated in 10 minutes or less. Acceptable silver-plated dies were obtained from Permlastic and Impregum . Acceptable silver-plated dies were obtained from condensation-reaction silicones with Xantopren - Optosil . From the polyvinylsiloxane group, Reprosil plated more consistently than President. Both produce acceptable dies. The technique modification studied was not effective for Citricon and President. The surface quality of silver-plated dies and the consistency of plating varies with materials. Individual impression materials should be tested prior to their routine clinical use with silver-plating procedures.

Simplified Class V matrix for resin restorations.

A matrix technique and its modifications to assist in the restoration of Class V lesions occurring in the gingival third of the teeth are described. This technique is applicable for filled and unfilled restorative resins.