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1.
Article in English | MEDLINE | ID: mdl-36767250

ABSTRACT

(1) Background: The aim of this study is to review the benefits of the 8020 Campaign since its inception. (2) Methods: We followed the PRISMA guideline and collected information regarding the 8020 Campaign through online database searches. (3) Results: Twenty-five studies met the inclusion criteria and were eligible for analysis. The main outcomes of the 25 included studies were reviewed. The quality evaluation demonstrated a range of studies showing a credible relationship between masticatory function, number of teeth, salivary secretion, frequent dental check-ups, and general health concerns. Due to the risk of bias, publication bias, and indirectness, 22 studies were considered that only had "fair" quality. (4) Conclusions: The 8020 Foundation funded several of the studies, and other research papers noted the 8020 Campaign in their papers, however there were no clear explanations for any direct relationship between their findings and the 8020 Campaign. As a result, evidence for the direct effectiveness and benefits assessment of the 8020 Campaign positive outcomes were compromised by confounding social and economic variables over the 30-year period. To fully elucidate how improvement in Japan's oral health was directly related to the 8020 Campaign, a more informed and systematic explanation of the campaign's structure and activities is required.


Subject(s)
Health Promotion , Oral Health , Japan
3.
Int Dent J ; 71(3): 224-232, 2021 Jun.
Article in English | MEDLINE | ID: mdl-34024332

ABSTRACT

BACKGROUND: Assessing perceived needs for dental treatment is important in understanding and predicting people's health behaviours. The purpose of this study is to examine older men's perceptions regarding dental treatment needs, and to investigate the disparity between perceived needs and the actual oral health of a population of community-dwelling older Australians. METHODS: Using cross-sectional data from the 4th wave of the Concord Health and Ageing in Men Project, logistic regression analysis of perceived needs for dental treatment was conducted for 596 men aged 78 and over, with functional tooth units (FTUs), number of decayed tooth surfaces, and periodontitis as independent variables. RESULTS: Thirty-six percent (n = 216) of the participants believed they required some form of dental treatment. The remaining participants did not perceive a need for treatment, yet 65.3% objectively required prosthodontic or restorative care. The regression model showed men with lower FTUs were significantly more likely to report a perceived need for dental treatment than those with 12 FTUs [0-6 FTUs: adjusted odds ratio (OR) 2.58, 95% CI 1.28-5.20; 7-11 FTUs: adjusted OR 2.43, 95% CI 1.16-5.10]. However, neither the number of decayed tooth surfaces nor the existence of periodontitis was associated with perceived dental treatment needs. CONCLUSIONS: Most older men viewed their oral health positively, and the majority of those with objectively assessed needs, did not perceive themselves as requiring dental treatment. Loss of FTUs appears to alert participants to seek treatment, but not the presence of dental caries or periodontitis.


Subject(s)
Dental Caries , Oral Health , Aged , Aging , Australia/epidemiology , Cross-Sectional Studies , Dental Care , Humans , Independent Living , Male
4.
BMC Geriatr ; 21(1): 255, 2021 04 16.
Article in English | MEDLINE | ID: mdl-33863274

ABSTRACT

BACKGROUND: Unintended weight loss and the reduction in appetite are common phenomenon among older people. Reduced appetite has been linked to medication related reductions in saliva production, reduced taste ability and poor oral health. Poor appetite can result in reduced nutrient intake ensuing weight loss. It is possible that poor appetite is a mediating step on the causal pathway between oral health and weight loss. This study investigates whether poor oral health and loss of appetite are related to weight loss. METHODS: This is an observational study where data were obtained from the Concord Health and Ageing in Men Project (CHAMP). Information on socio-demographics, appetite and health related behavior was collected by self-completed questionnaire. Intraoral assessment was conducted by calibrated oral health therapists. Height and weight were measured by trained staff. Regression analysis investigated associations between oral health and appetite as risk factors for weight loss. RESULTS: Participants included 542 community dwelling older males. 99 older men (18.3%) experienced 5% or more weight loss over 3 years. Men who lost weight from baseline had lower BMI and lower body weight, had higher prevalence of frailty and depression, reported poorer appetite, and had fewer teeth (13.8 ± 9.5) than those who did not lose weight (16.3 ± 9.3). Before adjustment, the prevalence ratio (PR) for weight loss was 1.76 (95% Confidence Interval (CI), 1.19-2.59) for participants with 0-19 natural teeth present compared to those with 20 or more teeth. When adding appetite and other variables to the model, the PR for number of teeth and weight loss was unchanged: 1.78 (95% CI, 1.06-3.00). The mediation analysis showed that the indirect effect of appetite on the association between number of natural teeth on weight loss was not found to be significant. CONCLUSION: This study found that number of natural teeth present and appetite are independently related to weight change among elderly men in Australia. Tooth loss can increase the risk of swallowing difficulty leading to change in food preference, avoidance of foods and a decrease in energy intake. Our study showed the importance of oral health interventions to encourage maintenance of 20 or more natural teeth in older people.


Subject(s)
Independent Living , Oral Health , Aged , Aged, 80 and over , Aging , Appetite , Australia , Cross-Sectional Studies , Humans , Male , Weight Loss
5.
Gerodontology ; 37(3): 222-232, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32478960

ABSTRACT

BACKGROUND: In Australia and globally, there is an increasing problem of unmet oral health needs of older people above 65 residing in aged care facilities. Various workforce models have been trialled to implement oral health care programmes in aged care facilities, but the evidence behind these programmes and their underlying workforce models is not known. OBJECTIVE: To systematically review the literature on the effectiveness, and economic feasibility of the current workforce models addressing oral care in aged care facilities. METHODS: CINAHL, Cochrane CENTRAL, MEDLINE, EMBASE, EMB Reviews, NHS Economic Evaluation Database and grey literature were searched. Studies were included if they described an oral health workforce model with a clinical intervention and defined oral health outcome measures. Analysis was conducted using the NHMRC guidelines for scientific and economic evaluations. RESULTS: Twenty-eight studies were included. Four distinct workforce models of care were identified. 60% of the studies demonstrated short-term effectiveness in clinical measures. Workforce models were similar in their effectiveness, with varying levels of quality within each model. Although three studies considered individual components of economic feasibility, only one provided a comprehensive economic analysis of both the costs and health outcomes. CONCLUSIONS IMPLICATIONS OF FINDINGS: All workforce models of care had some positive impact on oral health for residents of aged care. Oral health should be included as a health focus in age care facilities. Future studies should include longer-term health outcomes with rigorous economic analysis to ensure sustainably delivered workforce models of care for oral health management within aged care.


Subject(s)
Assisted Living Facilities , Health Workforce , Oral Health , Australia , Cost-Benefit Analysis , Humans
6.
JDR Clin Trans Res ; 3(3): 272-278, 2018 07.
Article in English | MEDLINE | ID: mdl-30938599

ABSTRACT

An increasing number of Australians are being admitted to hospitals and day procedure centers to have dental treatment under a dental general anesthetic (DGA). Children younger than 2 y are having DGAs. These operations are costly and, although there have been improvements in safety, are not without risk. Most DGAs in children are to treat dental caries and have been defined as potentially preventable dental hospitalizations (PPDHs). This article reports on an analysis of the impact of access to community water fluoridation (CWF), availability of oral health professionals (OHPs), and socioeconomic status (SES) on PPDHs of 0- to 4-y-olds in 2012-2013 in Victoria, Australia. Data on these variables were obtained at the community (postcode) level. From the negative binomial multivariate analysis, each of the 3 independent variables was independently significantly associated with PPDHs at the postcode level. Children residing in postcodes without CWF on average had 59% higher rates than those with access (incident rate ratio [IRR], 1.59; P < 0.0001), children in postcodes with the lowest level of availability of OHPs had 65% higher rates than those with the highest access (IRR, 1.65; P < 0.0001), and children living in the most disadvantaged SES quintiles had 57% higher rates than children in the most advantaged quintiles (IRR, 1.57; P < 0.0001). There was a stepwise social gradient by SES quintile. In analysis of access to CWF and SES status, children without access to CWF had 86% higher PPDH rates than children with access (IRR, 1.86; P < 0.0001). In summary, no access to CWF, poor availability of OHPs, and lower SES status were independently associated with higher PPDH rates among 0- to 4-y-olds in Victoria at the postcode level. The study highlights the importance of considering 3 interacting factors-access to CWF, access to OHPs, and SES-in efforts to reduce PPDH rates in young children. Knowledge Transfer Statement: Extending access to water fluoridation, increasing the availability of dental services, and raising disadvantaged families' socioeconomic status are each likely to decrease the rate of dental general anesthetics in young children.


Subject(s)
Dental Caries , Child , Child, Preschool , Fluoridation , Hospitalization , Humans , Oral Health , Victoria
7.
Gerodontology ; 34(4): 420-426, 2017 Dec.
Article in English | MEDLINE | ID: mdl-28722250

ABSTRACT

OBJECTIVE: To describe an oral health care programme for older people in Residential Aged Care Facilities (RACFs) to improve access to care and support facilities. INTRODUCTION: Different models of residential care have been proposed, but few have been comprehensive (providing on-site health promotion and service delivery) or sustainable. METHODS: A partnership model of oral health care, with dental services plus oral health education, was integrated into the community outreach services of a metropolitan hospital department of aged care. The programme provided annual oral health education and training to staff, and on-site dental care to 10 (RACFs). RESULTS: None of the RACFs had received organised education or on-site dental service care prior to the programme. At the completion of the third year of the programme, 607 residents (75% of the total bed capacity for the 10 RACFs) had received an annual oral health assessment, and 271 (46.5%) had received on-site dental care. More than 120 nursing and allied health staff had received education and training in oral health support to residents. Oral cleanliness, the proportion not experiencing dental pain and referral for additional care decreased significantly over the period, but dental caries experience and periodontal conditions remained a concern. CONCLUSIONS: Sustainable domiciliary oral health services and oral health education are feasible and practical using a partnership model within the Australian health system. Adaptability, continuity and the use of oral health therapists/dental hygienists in the coordination and management of the programme further contribute to viability.


Subject(s)
Dental Care for Aged , Home Care Services , Oral Health , Residential Facilities , Urban Health Services , Aged , Aged, 80 and over , Dental Care for Aged/organization & administration , Female , Health Services Accessibility/organization & administration , Home Care Services/organization & administration , Humans , Male , Models, Organizational , New South Wales , Quality Improvement , Residential Facilities/organization & administration , Urban Health Services/organization & administration
8.
Prog Mol Biol Transl Sci ; 141: 141-59, 2016.
Article in English | MEDLINE | ID: mdl-27378757

ABSTRACT

Inositol 1,4,5-trisphosphate receptors (IP3Rs) are large (∼300kDa) proteins that associate into tetrameric ion channels in the endoplasmic reticulum (ER) membrane. Activation and opening of the channel upon binding of IP3 and Ca(2+) allows the flow of Ca(2+) ions from stores within the ER lumen to the cytosol, thereby promoting a number of Ca(2+)-dependent cellular events, such as secretion, neurotransmitter release, and cell division. Intriguingly, it appears that the same conformational change that IP3Rs undergo during activation makes them a target for degradation by the ubiquitin-proteasome pathway and that this mode of processing allows the cell to tune its internal Ca(2+) response to extracellular signals. Here, we review recent studies showing that activated IP3Rs interact with an array of proteins that mediate their degradation, that IP3Rs are modified by a complex array of ubiquitin conjugates, that this ubiquitination and degradation functions to regulate IP3-mediated Ca(2+) responses in the cell, and that mutations to different proteins involved in IP3R degradation result in a set of similar diseases.


Subject(s)
Inositol 1,4,5-Trisphosphate Receptors/metabolism , Ubiquitination , Animals , Disease , Endoplasmic Reticulum-Associated Degradation , Humans , Proteasome Endopeptidase Complex/metabolism , Proteolysis
10.
Mol Psychiatry ; 21(3): 339-47, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26008736

ABSTRACT

The search for genetic variants underlying major depressive disorder (MDD) has not yet provided firm leads to its underlying molecular biology. A complementary approach is to study gene expression in relation to MDD. We measured gene expression in peripheral blood from 1848 subjects from The Netherlands Study of Depression and Anxiety. Subjects were divided into current MDD (N=882), remitted MDD (N=635) and control (N=331) groups. MDD status and gene expression were measured again 2 years later in 414 subjects. The strongest gene expression differences were between the current MDD and control groups (129 genes at false-discovery rate, FDR<0.1). Gene expression differences across MDD status were largely unrelated to antidepressant use, inflammatory status and blood cell counts. Genes associated with MDD were enriched for interleukin-6 (IL-6)-signaling and natural killer (NK) cell pathways. We identified 13 gene expression clusters with specific clusters enriched for genes involved in NK cell activation (downregulated in current MDD, FDR=5.8 × 10(-5)) and IL-6 pathways (upregulated in current MDD, FDR=3.2 × 10(-3)). Longitudinal analyses largely confirmed results observed in the cross-sectional data. Comparisons of gene expression results to the Psychiatric Genomics Consortium (PGC) MDD genome-wide association study results revealed overlap with DVL3. In conclusion, multiple gene expression associations with MDD were identified and suggest a measurable impact of current MDD state on gene expression. Identified genes and gene clusters are enriched with immune pathways previously associated with the etiology of MDD, in line with the immune suppression and immune activation hypothesis of MDD.


Subject(s)
Anxiety Disorders/genetics , Depressive Disorder, Major/genetics , Gene Expression/genetics , Genetic Predisposition to Disease/genetics , Interleukin-6/genetics , Polymorphism, Single Nucleotide/genetics , Adult , Cross-Sectional Studies , Depressive Disorder, Major/diagnosis , Female , Gene Expression Regulation/genetics , Genome-Wide Association Study , Humans , Interleukin-6/metabolism , Killer Cells, Natural/metabolism , Longitudinal Studies , Male , Middle Aged , Signal Transduction/genetics
11.
Biometrika ; 102(4): 783-796, 2015 Dec.
Article in English | MEDLINE | ID: mdl-30799871

ABSTRACT

We consider the detection and identification of recurrent departures from stationary behaviour in genomic or similarly arranged data containing measurements at an ordered set of variables. Our primary focus is on departures that occur only at a single variable, or within a small window of contiguous variables, but involve more than one sample. This encompasses the identification of aberrant markers in genome-wide measurements of DNA copy number and DNA methylation, as well as meta-analyses of genome-wide association studies. We propose and analyse a cyclic shift-based procedure for testing recurrent departures from stationarity. Our analysis establishes the consistency of cyclic shift [Formula: see text]-values for datasets with a fixed set of samples as the number of observed variables tends to infinity, under the assumption that each sample is an independent realization of a stationary Markov chain. Our results apply to any test statistic satisfying a simple invariance condition.

12.
Community Dent Oral Epidemiol ; 40 Suppl 2: 102-9, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22998313

ABSTRACT

Australia has a complex history of providing public dental services to its communities. From the early days of Colonial settlement, the provision of dental care to the Australian public has largely been driven and influenced by organized groups and associations of dentists. The Constitution of Australia, under Section 51 xxiii A, allows for the Commonwealth to provide for medical and dental services. Unlike the United Kingdom, however, dental services have not been embedded into a universal national health service agenda. In 1974, that the Australian Government through the Australian School Dental Program provided the first funding and national direction for public dental services - and that, limited to children. The Commonwealth Dental Health Program 1993-1997 was the second national endeavor to provide public dental services, this time to financially disadvantaged adults. Since that time, public dental service responsibility has been shuttled between States/Territories and the Commonwealth. A new paradigm for public dental services in Australia requires strong Commonwealth leadership, as well as the commitment of State and Territories and the organized dental profession. The National Health and Hospitals Reform Commission provided the most recent scenario for a radical change in mission. This paper canvases the competing roles of strategic, functional, and structural issues in relationship to social network and policy issues, which must be recognized if Australians truly seek to reform public dental services.


Subject(s)
Dental Care/organization & administration , Health Care Reform , Australia , Dental Care/economics , Health Care Reform/organization & administration , Health Services Accessibility/organization & administration , Humans , National Health Programs/organization & administration , Stomatognathic Diseases/therapy
13.
Community Dent Health ; 29(1): 117-23, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22482262

ABSTRACT

OBJECTIVES: This study was to analyze the association of hyposalivation with oral function, nutritional status and oral health in community-dwelling elderly Thai. METHOD: The subjects were 612 elderly people (mean age = 68.8, SD 5.9 years). Oral function (tasting, speaking, swallowing and chewing) and Mini Nutritional Assessment (MNA) were evaluated. Oral examination investigated teeth and periodontal status. Both unstimulated and stimulated whole saliva were collected for 5 minutes. RESULTS: Among all subjects, 14.4 % were classified within the hyposalivation. Hyposalivation was associated with gender, systemic disease, medication, and smoking. Subjects within the hyposalivation group had a higher number of decayed teeth and a higher prevalence of periodontitis than the normal salivation group (p < 0.05). The hyposalivation group also had a lower number of teeth present and a lower mean MNA score than the normal salivation group (p < 0.05). Logistic regression analysis showed that hyposalivation in both dentate and edentulous subjects was significantly associated with tasting, speaking, swallowing and chewing. CONCLUSION: This study suggested that hyposalivation is a risk factor not only for dental caries and periodontal disease but also for taste disturbances, speaking problems, swallowing problems, poor chewing ability and malnutrition. Monitoring salivary flow is an important measure in the care of older people.


Subject(s)
Deglutition Disorders/epidemiology , Independent Living , Mastication/physiology , Nutritional Status/physiology , Oral Health , Speech Disorders/epidemiology , Xerostomia/epidemiology , Aged , Alcohol Drinking/epidemiology , Chronic Disease , Dental Caries/epidemiology , Drug Therapy/statistics & numerical data , Female , Humans , Male , Malnutrition/epidemiology , Middle Aged , Mouth, Edentulous/epidemiology , Periodontitis/epidemiology , Risk Factors , Saliva/metabolism , Secretory Rate/physiology , Sex Factors , Smoking/epidemiology , Taste Disorders/epidemiology , Thailand/epidemiology , Tooth Loss/epidemiology
14.
Gerodontology ; 29(2): e220-8, 2012 Jun.
Article in English | MEDLINE | ID: mdl-21083744

ABSTRACT

OBJECTIVE: To investigate oral hygiene and periodontal disease in residents of Victoria nursing homes. BACKGROUND: The Australian population is ageing with a growing proportion of elderly Australians living in nursing homes. With declining edentulism rates, periodontal disease is becoming more prevalent in this population. MATERIALS AND METHODS: A total of 275 dentate residents from 31 Victorian nursing homes had a questionnaire and clinical examination using the Visual Plaque Index and a modified Community Periodontal Index. RESULTS: Self-reported oral hygiene habits of residents were poor, with less than one-third of residents cleaning their teeth twice daily or more. Periodontal health was found to be extremely poor, and the prevalence of 4 mm+ periodontal pockets was 35.6%, with 10.2% having 6 mm+ pockets. Logistic regression found that age, gender, number of teeth present and oral hygiene were all strongly associated with the prevalence of 4 mm+ periodontal pockets. CONCLUSION: Poor oral hygiene and the presence of significant plaque and calculus were common findings in this study. Periodontal diseases are a significant problem for residents in nursing homes. Addressing this health issue will require improved training for carers and better access to appropriate dental services.


Subject(s)
Homes for the Aged/statistics & numerical data , Nursing Homes/statistics & numerical data , Oral Hygiene/statistics & numerical data , Periodontal Diseases/epidemiology , Age Factors , Aged , Aged, 80 and over , Chronic Disease , Dementia/epidemiology , Dental Calculus/epidemiology , Dental Plaque Index , Drug Therapy/statistics & numerical data , Female , Gingival Recession/epidemiology , Gingivitis/epidemiology , Humans , Male , Periodontal Index , Periodontal Pocket/epidemiology , Periodontitis/epidemiology , Self Report , Sex Factors , Tooth Loss/epidemiology , Toothbrushing/statistics & numerical data , Victoria/epidemiology
15.
Gerodontology ; 29(2): e512-9, 2012 Jun.
Article in English | MEDLINE | ID: mdl-21707743

ABSTRACT

OBJECTIVES: The aim of this project was to investigate edentulism and dental caries in nursing home residents in Victoria, Australia. BACKGROUND: The Australian population is ageing with a growing number of people living in nursing homes. These residents are at increased risk for dental caries, have more teeth present now than at any time in the past 50 years and often have difficulty maintaining adequate oral hygiene. MATERIALS AND METHODS: Clinical dental examinations were conducted at 31 nursing homes in Melbourne and regional Victoria between May 2005 and June 2006. A total of 510 residents were examined out of 1345 eligible participants. Socio-demographic and medical history was collected via questionnaire. RESULTS: Just over half of the residents were dentate (53.9%), and dentate residents had a mean of 14.4 teeth present and 2.66 untreated decayed teeth. Residents who required total assistance with oral hygiene had more decayed teeth and fewer filled teeth than residents who did not require assistance. CONCLUSIONS: Nursing home residents in Victoria are retaining an increasing number of natural teeth and have more tooth surfaces at risk for dental caries. Untreated dental caries was a significant problem for residents, particularly for those who are dependent on others for their daily oral hygiene care.


Subject(s)
Dental Caries/epidemiology , Mouth, Edentulous/epidemiology , Nursing Homes/statistics & numerical data , Activities of Daily Living , Age Factors , Aged , Aged, 80 and over , Chronic Disease , DMF Index , Dementia/epidemiology , Dental Restoration, Permanent/statistics & numerical data , Dentition , Dentures/statistics & numerical data , Diabetes Mellitus/epidemiology , Drug Therapy/statistics & numerical data , Female , Humans , Jaw, Edentulous, Partially/epidemiology , Length of Stay/statistics & numerical data , Male , Middle Aged , Oral Hygiene/statistics & numerical data , Rural Health/statistics & numerical data , Sex Factors , Stroke/epidemiology , Tooth Loss/epidemiology , Urban Health/statistics & numerical data , Victoria/epidemiology
16.
Community Dent Oral Epidemiol ; 39(4): 378-84, 2011 Aug.
Article in English | MEDLINE | ID: mdl-21756266

ABSTRACT

OBJECTIVE: The Australian population is ageing, and a growing proportion of elderly Australians are now living in residential aged care facilities (RACFs). These residents are commonly dependent on others for their daily oral hygiene care and often display high levels of plaque and calculus. With declining edentulism rates, periodontal disease is becoming more prevalent in this population. The aim of this study was to investigate the ability of a dental hygienist to undertake a dental examination for residents of aged care facilities, devise a periodontal and preventive treatment plan and refer patients appropriately to a dentist. METHODS: A total of 510 residents from 31 Victorian RACFs were examined, with 275 dentate residents included in this study. Between May 2005 and June 2006, residents were examined by a single experienced dental epidemiologist and one of four dental hygienists using a plane mouth mirror and periodontal probe. RESULTS: A total of 510 residents from 31 RACFs had a dental examination from a dentist and one of four dental hygienists. The treatment needs of residents examined were high, with nearly all of the 275 dentate residents requiring preventive and periodontal treatment, and three-quarters requiring referral to a dentist for treatment. There was excellent agreement between the dentist and hygienists regarding the decision to refer residents to a dentist for treatment, with high sensitivity (99.6%) and specificity (82.9%). Only 8.0% of residents were referred by a hygienist to a dentist when the dentist considered that no referral was required. CONCLUSIONS: Dental hygienists have the skills and knowledge necessary for undertaking a dental examination for residents, correctly identifying the majority of residents who require a referral to a dentist. They are capable of formulating appropriate dental hygiene treatment plans for residents of aged care facilities. It is recommended that there should be greater utilization of hygienists in the provision of dental care to residents of aged care facilities, as a safe, efficient and effective use of health resources.


Subject(s)
Dental Care for Aged , Dental Hygienists , Homes for the Aged , Aged , Aged, 80 and over , Australia , Dental Care for Aged/methods , Humans , Male , Periodontal Diseases/diagnosis , Referral and Consultation , Tooth Diseases/diagnosis , Workforce
17.
Community Dent Health ; 28(4): 297-300, 2011 Dec.
Article in English | MEDLINE | ID: mdl-22320069

ABSTRACT

OBJECTIVE: The objective of this study was to investigate clinical oral health status relationships that affect quality of life (using the 12-item General Oral Health Assessment Index (GOHAI)) and self-rated oral health in a community of Japanese residents. METHODS: 459 residents of Yokote City, Japan aged 40-55 years had oral health examinations and completed self-administered questionnaires collecting data on age, gender, GOHAI items and self-rated oral health. Linear regression analysis was performed with GOHAI or self-rated oral health as a dependent variable and gender, age and indicators of oral health status as independent variables. RESULTS: The GOHAI indicated 42.7% of subjects were concerned about the appearance of their teeth, 30.1% were worried about teeth problems and 27.5% concerned about sensitive teeth. Analyses showed that gender, decayed teeth, oral dryness and missing teeth were significantly associated with variation in GOHAI scores, and that gender, decayed teeth, oral dryness and oral hygiene were significantly associated with variation in self-rated oral health. CONCLUSION: This study revealed that in this sample of Japanese adults aged 40-55 years, decayed teeth and oral dryness affected both GOHAI and self-rated oral health, whereas missing teeth affected GOHAI and oral hygiene affected self-rated oral health. Subjects did not recognise periodontal disease as a quality of life impacting condition or as a health problem.


Subject(s)
Health Status , Oral Health/classification , Quality of Life , Self Concept , Adult , DMF Index , Dental Calculus/psychology , Dental Caries/psychology , Dentin Sensitivity/psychology , Esthetics, Dental , Female , Gingival Hemorrhage/psychology , Humans , Japan , Male , Middle Aged , Oral Hygiene/psychology , Periodontal Pocket/psychology , Self Report , Sex Factors , Surveys and Questionnaires , Tooth Diseases/psychology , Tooth Loss/psychology , Xerostomia/psychology
18.
Clin Genet ; 79(2): 136-46, 2011 Feb.
Article in English | MEDLINE | ID: mdl-20681990

ABSTRACT

It is generally presumed that the cystic fibrosis (CF) population is relatively homogeneous, and predominantly of European origin. The complex ethnic make-up observed in the CF patients collected by the North American CF Modifier Gene Consortium has brought this assumption into question, and suggested the potential for population substructure in the three CF study samples collected from North America. It is well appreciated that population substructure can result in spurious genetic associations. To understand the ethnic composition of the North American CF population, and to assess the need for population structure adjustment in genetic association studies with North American CF patients, genome-wide single-nucleotide polymorphisms on 3076 unrelated North American CF patients were used to perform population structure analyses. We compared self-reported ethnicity to genotype-inferred ancestry, and also examined whether geographic distribution and cystic fibrosis transmembrane regulator (CFTR) mutation type could explain the population structure observed. Although largely Caucasian, our analyses identified a considerable number of CF patients with admixed African-Caucasian, Mexican-Caucasian and Indian-Caucasian ancestries. Population substructure was present and comparable across the three studies of the consortium. Neither geographic distribution nor CFTR mutation type explained the population structure. Given the ethnic diversity of the North American CF population, it is essential to carefully detect, estimate and adjust for population substructure to guard against potential spurious findings in CF genetic association studies. Other Mendelian diseases that are presumed to predominantly affect single ethnic groups may also benefit from careful analysis of population structure.


Subject(s)
Cystic Fibrosis/ethnology , Cystic Fibrosis/epidemiology , Demography , Genome-Wide Association Study , Ethnicity/statistics & numerical data , Genotype , Humans , North America , Principal Component Analysis
19.
Aust Dent J ; 55(1): 37-44, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20415910

ABSTRACT

BACKGROUND: Although community water fluoridation has been one of the cornerstone strategies for the prevention and control of dental caries, questions are still raised regarding its cost-effectiveness. This study assessed the impact of changing dental needs on the cost savings from community water fluoridation in Australia. METHODS: Net costs were estimated as Costs((programme)) minus Costs((averted caries).) Averted costs were estimated as the product of caries increment in non-fluoridated community, effectiveness of fluoridation and the cost of a carious surface. Modelling considered four age-cohorts: 6-20, 21-45, 46-65 and 66+ years and three time points 1970s, 1980s, and 1990s. Cost of a carious surface was estimated by conventional and complex methods. Real discount rates (4, 7 (base) and 10%) were utilized. RESULTS: With base-case assumptions, the average annual cost savings/person, using Australian dollars at the 2005 level, ranged from $56.41 (1970s) to $17.75 (1990s) (conventional method) and from $249.45 (1970s) to $69.86 (1990s) (complex method). Under worst-case assumptions fluoridation remained cost-effective with cost savings ranging from $24.15 (1970s) to $3.87 (1990s) (conventional method) and $107.85 (1970s) and $24.53 (1990s) (complex method). For 66+ years cohort (1990s) fluoridation did not show a cost saving, but costs/person were marginal. CONCLUSIONS: Community water fluoridation remains a cost-effective preventive measure in Australia.


Subject(s)
Dental Care/economics , Fluoridation/economics , Health Services Needs and Demand/economics , Adolescent , Adult , Age Factors , Aged , Child , Cohort Studies , Cost Savings , Cost-Benefit Analysis , Crowns/economics , DMF Index , Dental Caries/economics , Dental Caries/prevention & control , Dental Restoration, Permanent/economics , Health Care Costs , Humans , Middle Aged , Models, Economic , Oral Health , Time Factors , Victoria , Young Adult
20.
Clin Pharmacol Ther ; 88(1): 45-51, 2010 Jul.
Article in English | MEDLINE | ID: mdl-20182423

ABSTRACT

Achieving the ability to identify individuals who are susceptible to drug-induced liver injury (DILI) would represent a major advance in personalized medicine. Clayton et al. demonstrated that the pattern of endogenous metabolites in urine could predict susceptibility to acetaminophen-induced liver injury in rats. We designed a clinical study to test this approach in healthy adults who received 4 g of acetaminophen per day for 7 days. Urine metabolite profiles obtained before the start of treatment were not sufficient to distinguish which of the subjects would develop mild liver injury, as indicated by a rise in alanine aminotransferase (ALT) to a level more than twice the baseline value (responders). However, profiles obtained shortly after the start of treatment, but prior to ALT elevation, could distinguish responders from nonresponders. Statistical analyses revealed that predictive metabolites included those derived from the toxic metabolite N-acetyl paraquinone imine (NAPQI), but that the inclusion of endogenous metabolites was required for significant prediction. This "early-intervention pharmaco-metabonomics" approach should now be tested in clinical trials of other potentially hepatotoxic drugs.


Subject(s)
Acetaminophen/adverse effects , Analgesics, Non-Narcotic/adverse effects , Chemical and Drug Induced Liver Injury/diagnosis , Acetaminophen/metabolism , Acetaminophen/pharmacology , Adolescent , Adult , Alanine Transaminase/blood , Analgesics, Non-Narcotic/metabolism , Analgesics, Non-Narcotic/pharmacology , Biotransformation , Chemical and Drug Induced Liver Injury/genetics , Chemical and Drug Induced Liver Injury/urine , Cohort Studies , Data Interpretation, Statistical , Female , Humans , Least-Squares Analysis , Liver Function Tests , Magnetic Resonance Spectroscopy , Male , Middle Aged , Multivariate Analysis , Predictive Value of Tests , Young Adult
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