Features of home and neighbourhood and the liveability of older South Africans

While older people live in developing countries, little is known about the relative importance of features of their communities in influencing their liveability. We examine components of home and neighbourhood among older South Africans. Linear regression analyses revealed that features of home (basic amenities, household composition, financial status and safety) and neighbourhood (ability to shop for groceries, participate in organizations and feel safe from crime) are significantly associated with life satisfaction. Approaches to liveability that are person-centred and also set within contexts beyond home and neighbourhood are needed to address boundaries between home and neighbourhood; incorporate personal resources into liveability models and import broader environmental contexts such as health and social policy.     

A prospective multicentre observational study of adverse iatrogenic events and substandard care preceding intensive care unit admission (PREVENT)

We examined the current incidence, type, severity and preventability of iatrogenic events associated with intensive care unit admission in five hospitals in England. All unplanned adult admissions to intensive care units were prospectively reviewed over a continuous six‐week period. In the week before admission, 76/280 patients (27%) experienced 104 iatrogenic events. The majority of iatrogenic events were categorised as medical (37%), drug (17%) or nursing events (17%). Seventy‐seven per cent of the events were considered preventable and 80% caused or contributed to admission. Eleven events were thought to have contributed to a patient's death. The mean (SD) age of patients who had an event was greater (63 (21) years) than those who had not (57 (19) years, p = 0.023), and they had a longer median (IQR [range]) intensive care stay, 4 (1–8 [0–29]) days vs 3 (1–5 [0–20]) days, respectively, p = 0.043.     

Safeguarding the health of dental professionals

BACKGROUND: A healthy dentist is one of the most important ingredients in a successful dental practice, an ingredient not to be taken for granted. Professionals, dentists included, can and do experience illnesses and problems that can disrupt or impair a practice. CONCLUSIONS: In addition to the vulnerabilities of the human condition--addictive disorders, psychiatric illnesses, infectious disease, family and relationship problems, or the many varieties of human misery--dentists have undergone a powerful process of socialization into their professional role that makes it difficult to seek help for themselves. Stigma about addictive and psychiatric illnesses continues to be a problem despite significant advances in scientific understanding of these disorders. Many people, especially those in positions of community visibility as dentists are, still struggle with shame when they associate problems with personal failure. Dental societies are in an ideal position to provide resources and support, should they choose to take this opportunity, and the ADA has the information and expertise to help them do this. PRACTICE IMPLICATIONS: Dentists can become more aware of their own vulnerabilities and enhance their personal and professional effectiveness, as well as evaluate ways they may support their staff and colleagues.     

Management of the primary dentition in vitamin D-resistant rickets

Vitamin D-resistant rickets (familial hypophosphatemia) is a systemic disease secondary to defective renal-tubular reabsorption of phosphate. The major oral manifestations are spontaneous abscesses in a caries-free dentition. Pulpotomies or extractions were frequently described in the dental literature as the therapies of choice. This article presents a new prophylactic approach utilizing zinc oxide--eugenol pulpectomies and full crown coverage in an attempt to retain the primary dentition and prevent abscess formation.     

The small liver: A radiographic feature of fatal neonatal cirrhosis

Newborns with neonatal cirrhosis may have confusing clinical pictures. The demonstration of a small liver on abdominal radiographs may be helpful in suggesting the diagnosis of intrauterine hepatic damage.