ABSTRACT
OBJECTIVES: To evaluate the acceptability of different intra-oral and extra-oral orthodontic appliances, to rank orthodontic appliances from the most to the least attractive and to investigate the factors that may affect the acceptance of orthodontic treatment. SUBJECTS: A random sample of 800 students (schoolchildren and university students) were invited to participate in this study and a total of 688 students were included (86%). METHODS: A self-administrated structured questionnaire was constructed for the purpose of this study. RESULTS: More than one-half in each age group (53%) claimed that they would accept to have orthodontic treatment. Acceptance of the different orthodontic appliances was affected by gender, age and type of school. Removable appliance was reported as the most acceptable and facemask was reported as the least acceptable orthodontic appliances. Majority of subjects ranked ceramic and facemask appliances as the most and the least attractive orthodontic appliances, respectively. The predictor variables for the acceptance of orthodontic treatment were perceived demand for orthodontic treatment, perceived positive effect of orthodontic treatment and expected benefits from orthodontic treatment. CONCLUSIONS: Removable appliance was the most acceptable orthodontic appliance whereas ceramic appliance was ranked as the most attractive one. Facemask was the least acceptable and the least attractive option.
Subject(s)
Esthetics , Orthodontic Appliances/classification , Patient Acceptance of Health Care , Adolescent , Age Factors , Attitude to Health , Ceramics/chemistry , Dental Materials/chemistry , Extraoral Traction Appliances , Female , Health Knowledge, Attitudes, Practice , Humans , Jordan , Male , Malocclusion/psychology , Malocclusion/therapy , Needs Assessment , Orthodontic Appliance Design , Orthodontic Appliances, Functional , Orthodontic Appliances, Removable , Schools/classification , Self Report , Sex Factors , Young AdultABSTRACT
BACKGROUND AND STUDY AIMS: Optical colonoscopy is considered the gold standard for colorectal examination and has the advantage of allowing biopsies and polypectomy. However, the data on its safety and effectiveness in the elderly population are limited and somewhat conflicting. We prospectively assessed whether there are differences in completion rates, diagnostic yield, complication rates and 30-day mortality between patients aged > or = 65 years and patients aged < 65 undergoing colonoscopy at our centre. PATIENTS AND METHODS: Data were collected prospectively on 2000 colonoscopies performed over a 2-year period (January 2002 to January 2004). We compared 1000 consecutive colonoscopies in patients aged > or = 65 with 1000 consecutive colonoscopies in patients aged < 65 (control group). Data were collected on sedation; on completion rates, both crude and adjusted to discount failures due to obstructive disease; on diagnostic yield; complications, and on 30-day mortality. RESULTS: The median age was 75 years (51 % women) for the elderly group and 54 years (59 % women) for controls. The proportion of patients who received sedation was similar for both groups (59 % vs. 62 %, P = 0.97) but the mean dose of midazolam was lower in the elderly group (3.8 mg vs. 4.5 mg, P < 0.0001). The crude completion rate was lower for the elderly group (81.8 % vs. 86.5 %, P = 0.004), but the adjusted rate was similar for both groups (88.1 % elderly vs. 87.6 % control, P = 0.18). The overall diagnostic yield was higher in the elderly group (65 % vs. 45 %, P < 0.0001) with higher rates of carcinoma detected (7.1 % vs. 1.3 %, P < 0.0001). The complication rate was low (0.2 % per group). CONCLUSIONS: Colonoscopy in the elderly is safe and effective with a high diagnostic yield. Colonoscopy may now be the imaging modality of choice in the elderly population.
Subject(s)
Colonic Diseases/diagnosis , Colonoscopy , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Colonoscopy/adverse effects , Female , Humans , Male , Middle AgedSubject(s)
Celiac Disease/diet therapy , Cooking/methods , Health Knowledge, Attitudes, Practice , Restaurants/standards , Adult , Dietetics/standards , Empathy , Female , Humans , Male , Middle Aged , Politics , Quality of Life , Self EfficacyABSTRACT
Colorectal cancer (CRC) is the third most common cancer after lung and prostate cancers, and is the second most common cancer in women in the United Kingdom (UK) after breast cancer. The disease is well suited for prevention with screening programs. CRC is invariably fatal when diagnosed at an advanced stage but curable when diagnosed early, since it passes through a detectable asymptomatic stage. Screening tests with varying degrees of sensitivity and specificity are available. Prior to implementation of a nationwide national programme in the UK, trials are underway to identify the most sensitive and specific screening modality, and to address patient acceptability and resource implications. Screening for CRC using faecal occult blood (FOB) tests may be feasible. There is evidence to show that this modality saves lives at a cost similar to the breast screening programme currently underway in the UK. One-off flexible sigmoidoscopy is an alternative to FOB screening, and pilot data suggest that the technique is logistically feasible in the UK; a multicentre randomised trial is currently underway. Total colonoscopy is the gold standard test, but at present no large randomised controlled trials support this strategy. Colonoscopy is expensive and labour-intensive, and training issues need to be addressed. At the present time, tailored screening (in which intensity is adjusted for individual risk) appears reasonable. FOB and flexible sigmoidoscopy are cost effective but vary in sensitivity and specificity. Public education programmes are essential for any screening strategy to be effective.
