Oral Health Among Vietnamese Using a Community Health Centre in Richmond, Victoria

BACKGROUND: The purpose of this study was to assess the prevalence of specific oral diseases in a Vietnamese background population living in Melbourne, Australia, and to compare these findings to existing oral health data. METHODS: One hundred and fifty-eight subjects of Vietnamese background, 18 and older, participated in the study. RESULTS: Subjects were clinically examined, in a cross-sectional study, using standard World Health Organization criteria. The mean decayed, missing and filled surfaces scores were 27.8 (26.1). With the exception of one person, all subjects displayed clinical signs of gingivitis and 39 per cent had shallow pockets. Complex periodontal therapy was required by about 5 per cent of the sample. Comparing these findings to existing data on oral health in Melbourne, subjects in the study had lower DMFS scores, a higher number of untreated decayed surfaces and higher prevalence of gingivitis but less need for advanced periodontal treatment. CONCLUSIONS: These findings, in terms of dental caries and periodontal disease, represent a more encouraging oral health situation than that previously described in this immigrant population. Inequalities within the present sample were not reflected in the overall caries experience but were reflected in the proportion of unmet restorative needs. Further research is needed to get a clearer picture of the factors that shape the oral health of migrant Vietnamese populations and expansion of this research into other migrant groups is also necessary.     

Guidelines for rating Global Assessment of Functioning (GAF)

Background  

Global Assessment of Functioning (GAF) is a scoring system for the severity of illness in psychiatry. It is used clinically in many countries, as well as in research, but studies have shown several problems with GAF, for example concerning its validity and reliability. Guidelines for rating are important. The present study aimed to identify the current status of guidelines for rating GAF, and relevant factors and gaps in knowledge for the development of improved guidelines.     

Anorexia Nervosa as a Compulsive Behaviour Disease

A number of anorexic young women develop bulimia, a conditionin which binge eating is driven so intensely they cannot resistit. Although this drive has the character of a compulsion thepatients do not as a rule suffer from obsessional-compulsiveneurosis. A questionnaire was developed and used to determinewhether similar compulsive drives manifest themselves in restrictinganorexics and whether there are compulsive features resemblingpatients with compulsive personality disorder (as describedin DSM-IIl) in eating disorders. A total of 162 patients werestudied, comprising 42 controls, 30 depressed patients, 34 non-bingeinganorexics, 28 bingeing anorexics and 28 compulsive patients.The questionnaire was shown to be a stable instrument and, onthe compulsion scale, the anorexics, bulimics and compulsivepatients all scored very highly (mean±S.E.; 32.1±1.9,35.8±1.9, 28.0±2.2, respectively) compared tothe controls (13.1±1.1, p<0.005). The compulsive patientsdid not have anorexia-type eating disorders. It was concludedthat many of the factors which underlie compulsive personalitydisorder are present in primary eating disorders and the compulsivenature of anorexia could not be ignored when treatment was considered.The difference between compulsive behaviour and addiction isdiscussed in the light of the failure of long-term naloxoneinfusion to cure severe anorexia, even though some patientshad dramatic weight gains associated with the anti-lipolyticaction of naloxone.     

Molecular characterization of rat NKR-P2, a lectin-like receptor expressed by NK cells and resting T cells

The gene for a rat NK lectin-like receptor (NKLLR), named NKR-P2, has been cloned and characterized. Sequence analysis shows that it represents the orthologue of human NKG2D and that the two molecules form a distinct NKLLR family, no more related to NKG2A/B, -C or -E than to other NKLLR families. Nkrp2 is a single-copy gene containing seven introns, mapping to the rat NK gene complex. Rat NKR-P2 differs from the human orthologue in that its cytoplasmic tail contains 13 additional amino acids, encoded by a separate exon. Splice variants lacking this exon were not detected in T cells or NK cells. NKR-P2 is strongly expressed by NK cells. In contrast to other NKLLR, it is also strongly expressed by resting thoracic duct CD4+ and CD8+ T cells, but not by thymocytes or other hemopoietic cells.      

Cognitive apprenticeship in clinical practice: can it stimulate learning in the opinion of students?

Learning in clinical practice can be characterised as situated learning because students learn by performing tasks and solving problems in an environment that reflects the multiple ways in which their knowledge will be put to use in their future professional practice. Collins et al. introduced cognitive apprenticeship as an instructional model for situated learning comprising six teaching methods to support learning: modelling, coaching, scaffolding, articulation, reflection and exploration. Another factor that is looked upon as conducive to learning in clinical practice is a positive learning climate. We explored students’ experiences regarding the learning climate and whether the cognitive apprenticeship model fits students’ experiences during clinical training. In focus group interviews, three groups of 6th-year medical students (N = 21) discussed vignettes representing the six teaching methods and the learning climate to explore the perceived occurrence of the teaching methods, related problems and possibilities for improvement. The students had experienced all six teaching methods during their clerkships. Modelling, coaching, and articulation were predominant, while scaffolding, reflection, and exploration were mainly experienced during longer clerkships and with one clinical teacher. The main problem was variability in usage of the methods, which was attributed to teachers’ lack of time and formal training. The students proposed several ways to improve the application of the teaching methods. The results suggest that the cognitive apprenticeship model is a useful model for teaching strategies in undergraduate clinical training and a valuable basis for evaluation, feedback, self-assessment and faculty development of clinical teachers.     

Diuresis cystometry versus filling cystometry: The diagnostic value of diuresis cystometry in patients with frequency,urgency, and/or urge incontinence complaints

Filling cystometry was performed in 16 asymptomatic patients. Cystometry under high diuretic conditions (diuresis cystometry) was also performed in 37 asymptomatic patients. It appeared that diuresis cystometry is not more complicated than filling cystometry. The prevalence of detrusor instability in the asymptomatic groups is independent of the type of cystometry. Diuresis cystometry was performed in 36 patients with frequency, urgency, and/or urge incontinence, in whom the prevalence of instability during filling cystometry was comparable with that found in the asymptomatic patients. It appeared that the prevalence of instability in the symptomatic group is significantly higher than in the asymptomatic group during diuresis cystometry. This difference is even much higher with respect to the prevalence of detrusor instability with pressure rises of more than 15 cm H₂O.     

Trends in research on the tutor in problem-based learning: conclusions and implications for educational practice and research

The tutor role in problem-based learning (PBL) has attracted the interest of many researchers and has led to an abundance of studies. This article reports on major trends in studies investigating the tutor during the past 10 years. Three major trends were observed by the authors while analysing the studies conducted: studies on the differential influence of content expert and non-content expert tutors on student achievement, studies on process variables, and studies on the relationship between tutor characteristics and differential contextual circumstances. The aim of this article is to summarize the main findings of the studies conducted so far within the three trends observed, to provide directions for educational practitioners and policy makers, and to suggest directions for future research questions. The studies included were selected by conducting a literature search in medical journals, which was complemented with the personal archives of the authors. The results of the studies conducted within the three trends of research have led to advanced insights in tutoring. The outcomes revealed that content expert tutors tend to use their subject-matter expertise more to direct the discussion in the tutorial group, whereas non-content expert tutors tend to use their process-facilitation expertise more to direct the tutorial group. Furthermore, a tutor's performance is not a stable characteristic but is partly situation specific. It is concluded that a tutor should both know how to deal with the subject matter expertise and should know how to facilitate the learning process. Faculty and policy makers should put substantial efforts into designing curricula and cases and developing tutors' skills by faculty development strategies that stimulate reflection. The research agenda should be driven more by modern educational theories of learning in which tutoring is a process aimed at stimulating constructive, self-directed, situated and collaborative learning by students. Furthermore, more qualitative studies should be conducted to gain better insights in teachers' conceptions about the tutor role and student learning to better understand their behaviours.