The next generation of patient education: multilingual Dental Explorer 3D.

The A3 Imperative (Anything, Anywhere, Anytime) that has left its mark on our information and knowledge society also characterizes the healthcare sector: we see "informed patients" who always consult the Web prior to their visit to the physician or dentist. The problem is that the knowledge concerning their suspected disease is often superficial. It is the task of the treatment provider to make factual information available and to discuss diagnostic aspects and therapeutic concepts with the patient, competently and based on the merits of the individual case. Dentistry is particularly affected by the online information trend, because the available restorative options cover a broad therapeutic spectrum with many conceivable alternatives that present a highly complex picture. Against this background, a dedicated three-dimensional multimedia software program was developed that visualizes all relevant individual dental treatment options in 3D as appropriate to the patient's oral status, actively supporting chairside communication. A 2D and 3D database containing more than 20,000 image and video files was created that visualizes--in several languages--the status of the individual patient and the planned restorative treatment. With this far-ranging concept, the process of patient-shared or participatory decision-making has been raised to new qualitative levels.

Mortality from diseases associated wtih smoking: United States, 1960-77.

Extensive studies using epidemiological, experimental, and clinical methods have been made on the effects of tobacco on health. In 1962, the Advisory Committee on Smoking and Health appointed by the Surgeon General of the Public Health Service reviewed and evaluated the studies available at that time and presented the results in the report Smoking and Health, issued in 1964. In their report the Advisory Committee weighed the evidence of the relationship of smoking, particularly of cigarettes, to Malignant neoplasm of trachea, bronchus, and lung and to a number of other diseases. As a result of various activities that were undertaken following the publication of Smoking and Health and the interest in measuring the long-range effects of programs to stop the rise in mortality during the productive years of life from Malignant neoplasm of trachea, bronchus, and lung and from other diseases linked with cigarette smoking, it was considered desirable to pay special attention to current and future mortality trends from these diseases. In 1966, the National Center for Health Statistics published a reports on mortality associated with smoking, which was designed to lay the foundation for the long-range observation of these trends. This report was divided into two major sections: (1) the trends of mortality from diseases that the Surgeon General's Advisory Committee considered to be causally related to smoking, and (2) the trends of mortality from diseases that the Advisory Committee considered to be associated with but not clearly causally related to smoking. It covered the 1950-64 period.

Mortality trends: age,color, and sex United States - 1950-69.

The crude death rate for the United States experience d a clear downward trend throughout the first half of this century. It reached a low in 1954 (919.0 deaths per 100,000 population) and then began to level off (figure 1). The rate was relatively stable during 1954-69 with the exception of fluctuations associated for the most part with epidemics of influenza. For the severe influenza epidemic year of 196 8-with peaks of mortality at both the beginning and end of the year-a high point of 965.7 deaths per 100,000 population was reached. The rate then dropped back for 1969 (951.9 deaths per 100,000) to about the same level recorded for 1966.

Leading components of upturn in mortality for men, United States - 1952-67.

Excluding the sharp peaks in the mortali~ curve reflecting the pandemic of influenza in 1918-19 and subsequent severe epidemics of influenza and pneumonia in a number of other years, the trend of the death rate for the United States was clearly downward during 1900-1950. Then the death rate leveled off and remained almost stationary during 1950-60. Moriyama 1 began to ask if the stationary level was transitory or whether it marked the beginning of a new uptrend in mortality. An analysis of age-color-sex specific death rates for the period 1948-68 answers the question at least for male persons. For both white men and those of other races, for most age groups beginning with 15-19 years, the course of mortality was indeed upward in the 1960's (tables 1 and 2).