Can A Funny Story about Tooth Brushing Decrease Plaque Scores in Children? A Longitudinal Field Experiment.

Dental caries is the most common chronic condition among children, it is thus a necessity to develop health communication tools to increase children's dental hygiene. Prior research among adults indicates that entertaining narrative communication can promote health behaviors, but knowledge on narrative effects on children's health outcomes is limited. In a repeated measures field experiment (N = 94, 4-10 years) we examined the long-term effects of repeated exposure to a humorous tooth brushing narrative about an orange monkey, versus an expository text on dental care, on children's self-reported and biomedical dental hygiene (plaque scores). We also explored narrative, affective and cognitive processes. Findings showed that the humorous narrative increased character engagement, enjoyment, and moral judgment compared with the expository condition. Enjoyment and moral judgment, in turn, predicted increases and decreases in plaque scores, respectively. We conclude that effectiveness of humorous narrative approach crucially depends on whether the child understands it when a story character is violating the rule.

Low incidence of deep vein thrombosis after knee arthroscopy without thromboprophylaxis: a prospective cohort study of 335 patients.

BACKGROUND: There is little data on the risk of deep vein thrombosis after knee arthroscopy. PATIENTS AND METHODS: We performed a prospective cohort study to establish the incidence of venous thrombo-embolic (VTE) complications after knee arthroscopy in daycare, as detected by bilateral complete compression ultrasonography (CCUS) at day 14 (11-17) postoperatively. 335 patients completed bilateral extended ultrasound. No thromboprophylaxis was given. RESULTS: 19 (5.7%; 95% CI: 3.5%-8.7%) showed VTE on CCUS, of whom 2 were symptomatic. 1 patient developed a non-fatal pulmonary embolus during the 8-week follow-up period. There was no difference in immobilization characteristics between the patients who developed postoperative DVT and those who did not; nor could other risk factors be identified. INTERPRETATION: Since the incidence of VTE is low and a specific high-risk group for the development of VTE could not be identified, it seems justified to withhold routine pharmacological thromboprophylaxis after arthroscopy of the knee in a daycare setting.

Compliance of Dutch orthopedic departments with national guidelines on thromboprophylaxis. A survey of Dutch orthopedic thromboprohylaxis.

All 110 Dutch orthopedic departments were sent a survey on perioperative thromboprophylaxis protocols, and 79% responded. After hip and knee replacements, all used pharmacological thromboprophylaxis: a low-molecular weight heparin (LMWH) in 87% of departments, which was most often combined with vitamin K antagonists (VKAs). LMWH was usually started preoperatively (91%). After discharge, VKAs were mostly prescribed (79%) for at least 6 weeks, and often for 3 months. 17% of departments used LMWH for 6 weeks, whereas in only 3% no post-discharge prophylaxis was given. In day-care surgery, including arthroscopies, 58% use LMWH and in short-stay surgery 80% administer LMWH during the hospital stay. Because of lack of conclusive evidence for day-care surgery, the national guidelines cannot support pharmacological prophylaxis in this setting. In general, Dutch orthopedic departments comply poorly with the national guidelines on extended thromboprophylaxis for hip and knee replacement surgery, which recommends postoperative LMWH for 6 weeks. They are divided in the use of pharmacological prophylaxis in day-care surgery.

Preliminary validation of clinical assessment for deep vein thrombosis in orthopaedic outpatients.

The purpose of our study was to determine if a previously published clinical decision rule designed to estimate the probability of proximal deep vein thrombosis in outpatients is valid when applied exclusively to outpatients with musculoskeletal disorders. We also sought to determine whether probability estimates differed for patients with or without trauma, fracture, or recent orthopaedic surgery. Data collected from outpatients with surgical and nonsurgical musculoskeletal disorders (n = 464) were extracted from the datasets of three previously published studies done on heterogeneous groups of patients (n = 3424). Followup for all patients was 3 months. Testing of all patients for thromboembolic disease was done using validated diagnostic procedures. Probability estimates for orthopaedic outpatients were consistent with estimates from published studies. The proportion of patients who had venous thromboembolism was 5.6% (95% confidence interval, 3.5-8.7%) for the low probability group, 14.1% (95% confidence interval, 8.6-22.4%) for the moderate probability group, and 47.4% (95% confidence interval, 35.3-60%) for the high probability group. Validity estimates for patients with and without recent trauma, surgery, or fracture differed, but not dramatically. The validity of the clinical decision rule as applied to outpatients with musculoskeletal disorders was supported.