Attitudes to dental hygienists: evaluation of the Dental Hygienist Beliefs Survey in a Swedish population of patients and students

Abstract:  Objectives: The aim was to evaluate and test the psychometric properties of the Dental Hygienist Beliefs Survey (DHBS) in a Swedish sample of different patient groups and students. It was hypothesized that negative dental hygienist beliefs would discriminate between fearful and non-fearful study groups. The DHBS was distributed together with the revised Dental Beliefs Survey (DBS-R) and the Dental Anxiety Scale (DAS). The study sample included 394 subjects (130 students, 144 general dental patients, 90 periodontal patients and 30 patients on a waiting list for dental fear treatment). The results verified that the DHBS discriminates well between dentally fearful and non-fearful study groups. The DHBS had high internal consistency (Cronbach's α  = 0.96−0.98) in all the groups. The correlation between the DHBS and the DBS-R was high ( ρ  = 0.82, P  < 0.001). Furthermore, the DHBS correlated significantly with the DAS, as well as with a low but significant correlation to age (more negative attitudes in younger age groups) and gender (more negative attitudes amongst women). Regression analysis showed that gender and the DHBS items: 23, 16 and 28, i.e. items related to feeling helpless, worries/fears not being taken seriously and fear about 'bad news' possibly preventing treatment, were the most important predictors of dental fear. The results suggest that the DHBS may be a valid and reliable scale to use in order to assess patient's specific attitudes to dental hygienists. However, the psychometric properties including test–retest analysis and the underlying factor structure of the DHBS need to be further explored.     

Oral status of 35 subjects with eating disorders--a 1-year study

The aim was to record changes over time in the oral status of subjects with diagnosed eating disorders. The outpatient psychiatrist had referred to the hospital dental clinic 35 women (19–47 yr, median 27 yr) with eating disorders, diagnosed according to DSM III‐R criteria. At the baseline examination, dental, medical and dietary histories were taken, and intra‐oral clinical and radiographic examinations were supplemented by intra‐oral photographs, study casts and salivary analysis. The subjects were re‐examined 1 yr later. Together, the investigators assessed progression of tooth wear blindly by comparing coded study casts from the baseline and 12‐month examinations. Progression of erosive tooth wear was recorded in almost half of the subjects. Several subjects had low unstimulated salivary flow rates (<0.1 ml/min) and very high counts of mutans streptococci and lactobacilli, both at baseline and 1 yr later. The flow rates for paraffin‐stimulated saliva at baseline were significantly lower for subjects with progression of erosive tooth wear than for those without. Because of the increased susceptibility to both caries and erosion, patients with eating disorders should be encouraged to have regular dental check‐ups. Test of salivary flow may serve as an indicator of patients' risk of progression of erosive tooth wear.     

Experiences of oral care in patients with haematological malignancies or head and neck cancer

The aim of the present study was to investigate cancer patients' experiences of oral hygiene information, oral care and self-care, information on oral complications, examination of the oral cavity, and ability to eat and drink during cancer treatment, and to explore patient attitudes to oral examination and oral hygiene. The sample consisted of 41 consecutive patients treated with radiotherapy for head and neck cancer ( n  = 18) or with chemotherapy for haematological malignancies ( n  = 23). Patients were interviewed at the end of radiotherapy or the second/third chemotherapy cycle. Compared with patients receiving chemotherapy, those who received radiotherapy had significantly more often visited hospital dentistry, been informed about oral complications and oral hygiene, received instructions in oral hygiene procedures, and been examined by hospital staff. More of the radiotherapy patients experienced oral symptoms and difficulties to eat and drink during treatment. There were no significant differences between the groups with regard to patient experiences of the oral hygiene procedures. Only one patient objected to having hospital staff discuss oral hygiene procedures, and three did not want hospital staff to examine their oral cavity. Patients undergoing radiotherapy or chemotherapy need to be monitored during treatment with regard to their oral status and oral symptoms and complications. There are no acceptable reasons for allowing patients to suffer from oral symptoms that can be reduced.     

Rough sets: a knowledge discovery technique for multifactorial medical outcomes

Rough sets is a fairly new and promising technique for data mining and knowledge discovery from databases. This tutorial article presents the fundamentals of rough set theory in a nontechnical manner and outlines how the technique can be used to extract minimal if-then rules from tables of empirical data that either fully or approximately describe given example classifications. An example application for prediction of ambulation for patients with spinal cord injury is given. Because such rules are readily interpretable, they can be inspected to yield possible new insight into how various contributing factors interact and, thus, serve as hypothesis generators for further research. Additionally, the set of mined rules may function as a classifier of new, unseen cases.     

Duration of carbon dioxide absorption by soda lime at low rates of fresh gas flow

STUDY OBJECTIVE: To determine the impact of a low fresh gas flow rate on the duration of carbon dioxide (CO2) absorption by soda lime. DESIGN: Nonclinical, experimental. SETTING: Experimental laboratory. METHODS: In vitro test with Sodasorb and a semiclosed breathing circle ventilating a test lung with a CO2 inflow of 250 ml per minute. Fresh gas flow rates of 0.25, 0.5, 1, 2, and 4 L/min were studied. MEASUREMENTS AND MAIN RESULTS: CO2 was measured at the breathing circuit test lung interface with a mainstream capnometer. Duration of CO2 absorption was determined as the time for the inspired CO2 tension (PICO2) to increase from 0 mm to 7 mm of mercury. The times of this interval were recorded four times for each fresh gas flow rate and compared by analysis of variance; p less than 0.05 was considered significant. Time to soda lime failure was significantly longer at 2 L/min than at 1 L/min fresh gas flow and at 1 L/min than at 0.25 L/min fresh gas flow. CONCLUSION: Because soda lime color indicators are unreliable, when a semiclosed breathing circle is used at a low rate of fresh gas flow without CO2 monitoring, the CO2 absorbent must be replaced more frequently.     

Using Boolean reasoning to anonymize databases

This paper investigates how Boolean reasoning can be used to make the records in a database anonymous. In a medical setting, this is of particular interest due to privacy issues and to prevent the possible misuse of confidential information. As electronic medical records and medical data repositories get more common and widespread, the issue of making sensitive data anonymous becomes increasingly important. A theoretically well-founded algorithm is proposed that via cell suppression can be used to make a database anonymous before releasing or sharing it to the outside world. The degree of anonymity can be tailored according to the specific needs of the recipient, and according to the amount of trust we place in the recipient. Furthermore, the required measure of anonymity can be specified as far down as to the individual objects in the database. The algorithm can also be used for anonymization relative to a particular piece of information, effectively blocking deterministic inferences about sensitive database fields.     

A systematic review of dysgeusia induced by cancer therapies

Purpose  

The purpose was to review relevant scientific papers written since 1989 which focused on the prevalence and management of dysgeusia as an oral side effect of cancer treatment.