37 results on '"Paisi, Martha"'
Search Results
2. Developing oral health services for people experiencing severe and multiple disadvantage: a case study from Southwest England
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Paisi, Martha, primary, Withers, Lyndsey, additional, Anderson, Rebecca, additional, Doughty, Janine, additional, Griffiths, Lisa, additional, Jameson, Ben, additional, Murphy, Elizabeth, additional, Musa, Afsha, additional, Nelder, Abigail, additional, Rogers, Shona, additional, and Witton, Robert, additional
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- 2024
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3. A Scoping Review of the Oral Health Status, Oral Health Behaviours and Interventions to Improve the Oral Health of Children and Young People in Care and Care Leavers
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Booth, Joelle, primary, Erwin, Jo, additional, Burns, Lorna, additional, Axford, Nick, additional, Horrell, Jane, additional, Wheat, Hannah, additional, Witton, Robert, additional, Shawe, Jill, additional, Doughty, Janine, additional, Kaddour, Sarah, additional, Boswell, Skye, additional, Devalia, Urshla, additional, Nelder, Abigail, additional, and Paisi, Martha, additional
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- 2024
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4. Access to Dental Care for Children and Young People in Care and Care Leavers: A Global Scoping Review
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Erwin, Jo, primary, Horrell, Jane, additional, Wheat, Hannah, additional, Axford, Nick, additional, Burns, Lorna, additional, Booth, Joelle, additional, Witton, Robert, additional, Shawe, Jill, additional, Doughty, Janine, additional, Kaddour, Sarah, additional, Boswell, Skye, additional, Devalia, Urshla, additional, Nelder, Abigail, additional, and Paisi, Martha, additional
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- 2024
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5. Obesity and dental caries in children in Plymouth
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Paisi, Martha
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618.92 ,Obesity ,Caries ,Children ,Inequalities ,Spatial - Abstract
Background: Obesity and dental caries are two of the most common conditions affecting children and both have significant implications on children’s wellbeing and future health. Even though research into the relationship between the two conditions has been conducted for many years, results to date remain equivocal. Furthermore, the majority of the studies only examined individual-level determinants of the two conditions. Aim: The current work aimed to examine the nature, direction and effect size of the relationship between obesity and caries in children in Plymouth, United Kingdom. It also aimed to better understand the individual and the broader environmental determinants of the two conditions. Methods: The study was divided into three parts: a systematic review examining the relationship between the two conditions in children and adolescents using a validated and study design specific tool; an analysis of extant data concerning Plymouth children’s weight status and dental caries using a spatial approach; and lastly a school survey of local children aged four to six years, where different types of obesity were examined in relation to dental caries. In the latter survey, several neighbourhood-level and individual characteristics were also examined in relation to the two conditions. Results: The systematic review indicated that there was no consistent association between high Body Mass Index and caries in individuals less than 18 years old. The ecological study identified spatial clusters of obesity and caries in Plymouth children and the results supported the importance of developing geographically focused prevention and intervention strategies which take into account the presence of spatial heterogeneity. The school survey did not find evidence of a relationship between any type of obesity and caries in Plymouth children but identified several indicators that affect the distribution of the two conditions. Conclusions: This work has given insight into the nature, direction and size of the relationship between obesity and caries in Plymouth children and has highlighted several indicators which need to be considered when developing local public health interventions.
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- 2017
6. Improving oral health and related health behaviours (substance use, smoking, diet) in people with severe and multiple disadvantage: A systematic review of effectiveness and cost-effectiveness of interventions.
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McGowan, Laura J., John, Deepti A., Kenny, Ryan P. W., Joyes, Emma C., Adams, Emma A., Shabaninejad, Hosein, Richmond, Catherine, Beyer, Fiona R., Landes, David, Watt, Richard G., Sniehotta, Falko F., Paisi, Martha, Bambra, Claire, Craig, Dawn, Kaner, Eileen, and Ramsay, Sheena E.
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BIBLIOGRAPHIC databases ,HEALTH behavior ,SUBSTANCE abuse ,SMOKING cessation ,NICOTINE replacement therapy ,ORAL health ,CONTINGENT employment ,EVIDENCE gaps - Abstract
Background: People experiencing homelessness co-occurring with substance use or offending ('severe and multiple disadvantage' SMD) often have high levels of poor oral health and related health behaviours (particularly, substance use, smoking, poor diet). This systematic review aimed to assess the effectiveness and cost-effectiveness of interventions in adults experiencing SMD to improve oral health and related health behaviours. Methods and findings: From inception to February 2023, five bibliographic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus) and grey literature were searched. Two researchers independently screened the search results. Randomized controlled trials (RCTs), comparative studies and economic evaluations were included that reported outcomes on oral health and the related health behaviours. Risk of bias was assessed and results narratively synthesized. Meta-analyses were performed where appropriate. This review was registered with PROSPERO (reg. no: CRD42020202416). Thirty-eight studies were included (published between 1991 and 2023) with 34 studies reporting about effectiveness. Most studies reported on substance use (n = 30). Interventions with a combination of housing support with substance use and mental health support such as contingent work therapy appeared to show some reduction in substance use in SMD groups. However, meta-analyses showed no statistically significant results. Most studies had short periods of follow-up and high attrition rates. Only one study reported on oral health; none reported on diet. Three RCTs reported on smoking, of which one comprising nicotine replacement with contingency management showed improved smoking abstinence at 4 weeks compared to control. Five studies with economic evaluations provided some evidence that interventions such as Housing First and enhanced support could be cost-effective in reducing substance use. Conclusion: This review found that services such as housing combined with other healthcare services could be effective in improving health behaviours, particularly substance use, among SMD groups. Gaps in evidence also remain on oral health improvement, smoking, and diet. High quality studies on effectiveness with adequate power and retention are needed to address these significant health challenges in SMD populations. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Co‐production of health and social science research with vulnerable children and young people: A rapid review.
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Erwin, Jo, Burns, Lorna, Devalia, Urshla, Witton, Robert, Shawe, Jill, Wheat, Hannah, Axford, Nick, Doughty, Janine, Kaddour, Sarah, Nelder, Abigail, Brocklehurst, Paul, Boswell, Skye, and Paisi, Martha
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SOCIAL sciences ,MEDICAL information storage & retrieval systems ,HEALTH status indicators ,RESEARCH funding ,AT-risk people ,CINAHL database ,SYSTEMATIC reviews ,MEDLINE ,MEDICAL research ,PSYCHOLOGY information storage & retrieval systems ,PEOPLE with disabilities ,MEDICAL care costs ,ADOLESCENCE ,CHILDREN - Abstract
Background: The term 'care‐experienced' refers to anyone who is currently in care or has been in care at any stage in their life. A complex interplay of factors leads to care‐experienced children and young people (CECYP) experiencing poorer oral health and access to dental care than their peers. A rapid review of the co‐production of health and social care research with vulnerable children and young people (CYP) was carried out to inform the development of a co‐produced research project exploring the oral health behaviours and access to dental services of CECYP. Here, 'co‐production' refers to the involvement of CYP in the planning or conduct of research with explicit roles in which they generate ideas, evidence and research outputs. Aim: To learn how to meaningfully involve vulnerable CYP in the co‐production of health and social science research. Objectives: To identify: Different approaches to facilitating the engagement of vulnerable CYP in co‐production of health and social science research; different activities carried out in such approaches, challenges to engaging vulnerable CYP in co‐production of health and social science research and ways to overcome them and areas of best practice in relation to research co‐production with vulnerable CYP. Search Strategy: A rapid review of peer‐reviewed articles was conducted in six databases (MEDLINE, Embase, SocINDEX, CINAHL, PsycINFO and Web of Science) and grey literature to identify studies that engaged vulnerable CYP in co‐approaches to health and social research. Main Results: Of 1394 documents identified in the search, 40 were included and analysed. A number of different approaches to co‐production were used in the studies. The CYP was involved in a range of activities, chiefly the development of data collection tools, data collection and dissemination. Individual challenges for CYP and researchers, practical and institutional factors and ethical considerations impacted the success of co‐production. Discussion and Conclusion: Co‐production of health and social science with vulnerable CYP presents challenges to researchers and CYP calling for all to demonstrate reflexivity and awareness of biases, strengths and limitations. Used appropriately and well, co‐production offers benefits to researchers and CYP and can contribute to research that reflects the needs of vulnerable CYP. Adherence to the key principles of inclusion, safeguarding, respect and well‐being facilitates this approach. Patient and Public Contribution: Members of our patient and public involvement and stakeholder groups contributed to the interpretation of the review findings. This manuscript was written together with a young care leaver, Skye Boswell, who is one of the authors. She contributed to the preparation of the manuscript, reviewing the findings and their interpretation. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Barriers and facilitators to dental care access among asylum seekers and refugees in highly developed countries: a systematic review
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Paisi, Martha, Baines, Rebecca, Burns, Lorna, Plessas, Anastasios, Radford, Philip, Shawe, Jill, and Witton, Robert
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- 2020
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9. Body mass index and dental caries in young people: a systematic review
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Paisi, Martha, Kay, Elizabeth, Bennett, Cathy, Kaimi, Irene, Witton, Robert, Nelder, Robert, and Lapthorne, Debra
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- 2019
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10. New Home, New You: A retrospective mixed‐methods evaluation of a health‐related behavioural intervention programme supporting social housing tenants
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Paisi, Martha, primary, Allen, Zoe, additional, and Shawe, Jill, additional
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- 2023
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11. Mental health and wellbeing interventions in the dental sector: a systematic review
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Plessas, Anastasios, Paisi, Martha, Bryce, Marie, Burns, Lorna, O’brien, Timothy, Hanoch, Yaniv, and Witton, Robert
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Introduction UK dentists experience high levels of stress, anxiety and burnout. Poor mental health can lead practitioners to exit the profession, contributing to workforce and service loss. Therefore, there is a need to focus on interventions to protect the mental health and wellbeing of dental teams. Three levels of intervention can be deployed in the workplace to support mental health and wellbeing: primary prevention, secondary prevention, and tertiary prevention. Aim The aim of this systematic review was to identify evidence on interventions used to prevent, improve or tackle mental health issues among dental team members and dental profession students in countries of very high development. Methods This systematic review was conducted according to a predefined protocol and reported according to PRISMA guidelines. The MEDLINE, Embase CINAHL, DOSS, Scopus, and PsycINFO databases were searched. Prospective empirical studies were considered for inclusion. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) was used to assess the methodological quality of the included studies. The identified interventions were categorised according to level of prevention. Results The search yielded 12,919 results. Eight studies met the inclusion criteria. All of the studies concerned dentists or dental students. There were no studies for other groups of dental professionals. No primary prevention-level studies were identified. Secondary prevention-level studies (n = 4) included various psychoeducational interventions aiming to raise awareness and improve coping skills and led to significant improvements in stress levels and burnout of dentists and dental students. Tertiary prevention-level studies (n = 4) mainly employed counselling which was shown to be beneficial for dentists and students experiencing psychological ill-health. Conclusions Mental wellbeing awareness should be put at the centre of dental education and the workplace. Leadership and innovation are required to design primary-level interventions which can be implemented in the UK dental sector, with its distinct organisational and service characteristics.
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- 2022
12. Obesity and caries in four-to-six year old English children: a cross-sectional study
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Paisi, Martha, Kay, Elizabeth, Kaimi, Irene, Witton, Robert, Nelder, Robert, Potterton, Ruth, and Lapthorne, Debra
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- 2018
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13. Factors influencing oral health behaviours, access and delivery of dental care for autistic children and adolescents: A mixed‐methods systematic review
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Erwin, Jo, primary, Paisi, Martha, additional, Neill, Sarah, additional, Burns, Lorna, additional, Vassallo, Isaac, additional, Nelder, Abigail, additional, Facenfield, Jemma, additional, Devalia, Urshla, additional, Vassallo, Tara, additional, and Witton, Robert, additional
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- 2022
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14. Scoping review: Scope of practice of nurse-led services and access to care for people experiencing homelessness
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McWilliams, Lucy, Paisi, Martha, Middleton, Sandy, Shawe, Jill, Thornton, Anna, Larkin, Matthew, Taylor, Joanne, Currie, Jane, McWilliams, Lucy, Paisi, Martha, Middleton, Sandy, Shawe, Jill, Thornton, Anna, Larkin, Matthew, Taylor, Joanne, and Currie, Jane
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Aims To investigate the scope of practice of nurse-led services for people experiencing homelessness, and the impact on access to healthcare. Design A scoping review. Data Sources On 20th November, 2020, the following databases were searched: CINAHL, Embase, MEDLINE, PubMed and Scopus. Review Methods Included studies focused on people experiencing homelessness aged 18 years and over, nurse-led services in any setting, and described the nursing scope of practice. Studies were peer-reviewed primary research, published in English from the year 2000. Three authors performed quality appraisal using the Mixed Methods Assessment Tool. Results were synthesised and discussed narratively, and reported according to the PRISMA-ScR 2020 Statement. Results Seventeen studies were included from the United States (n=9), Australia (n=3), United Kingdom (n=3), and Canada (n=2). Total participant sample size was n=6,248. Studies focused on registered nurses (n=5), nurse practitioners (n=5), or both (n=4), in outpatient or community settings. The nursing scope of practice was broad and covered a range of skills, knowledge and attributes. Key skills identified include assessment and procedural skills, client support, and health education. Key attributes were a trauma informed approach and building trust through communication. Important knowledge included understanding the impact of homelessness, knowledge of available services, and the capacity to undertake holistic assessments. Findings suggest that nurse-led care facilitated access to healthcare through building trust and supporting clients to access services. Conclusion An optimised nursing scope of practice can facilitate access to healthcare for people experiencing homelessness. Key factors in enabling this include autonomy in nursing practice, organisational support, and education. Impact The broad range of skills, knowledge and attributes reported
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- 2022
15. Barriers and facilitators to hepatitis C screening and treatment for people with lived experience of homelessness: A mixed‐methods systematic review
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Paisi, Martha, primary, Crombag, Neeltje, additional, Burns, Lorna, additional, Bogaerts, Annick, additional, Withers, Lyndsey, additional, Bates, Laura, additional, Crowley, Daniel, additional, Witton, Robert, additional, and Shawe, Jill, additional
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- 2021
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16. Factors Influencing Oral Health Behaviours, Access and Provision of Dental Care for Autistic Children and Adolescents in Countries with a Very High Human Development Index: Protocol for a Mixed Methods Systematic Review
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Erwin, Jo, primary, Paisi, Martha, additional, Witton, Robert, additional, Neill, Sarah, additional, Burns, Lorna, additional, Vassallo, Isaac, additional, Nelder, Abigail, additional, Facenfield, Jemma, additional, Devalia, Urshla, additional, and Vassallo, Tara, additional
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- 2021
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17. Exploring Interventions to Improve the Oral Health and Related Health Behaviours of Adults Experiencing Severe and Multiple Disadvantage: Protocol for a Qualitative Study with Stakeholders
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Joyes, Emma C., primary, McGowan, Laura J., additional, Adams, Emma A., additional, Paisi, Martha, additional, Burrows, Martin, additional, Shabaninejad, Hosein, additional, Beyer, Fiona, additional, Haddow, Kate, additional, Coyte, Aishah, additional, Landes, David, additional, Moffatt, Suzanne, additional, Watt, Richard G., additional, Sniehotta, Falko F., additional, Bambra, Clare, additional, Craig, Dawn, additional, Kaner, Eileen, additional, and Ramsay, Sheena E., additional
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- 2021
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18. Investigating the Effectiveness and Acceptability of Oral Health and Related Health Behaviour Interventions in Adults with Severe and Multiple Disadvantage: Protocol for a Mixed-Methods Systematic Review
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McGowan, Laura J., primary, Joyes, Emma C., additional, Adams, Emma A., additional, Coyte, Aishah, additional, Gavin, Richard, additional, Richmond, Catherine, additional, Shabaninejad, Hosein, additional, Beyer, Fiona, additional, Broadbridge, Angela, additional, Dobson, Kevin, additional, Landes, David, additional, Moffatt, Suzanne, additional, Watt, Richard G., additional, Sniehotta, Falko F., additional, Freeman, Ruth, additional, Paisi, Martha, additional, Bambra, Clare, additional, Craig, Dawn, additional, Kaner, Eileen, additional, and Ramsay, Sheena E., additional
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- 2021
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19. Dental care for homeless persons: Time for National Health Service reform
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Witton, Robert, primary and Paisi, Martha, additional
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- 2021
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20. Effect of treating carious teeth on children’s and adolescents’ anthropometric outcomes: A systematic review of randomised controlled trials
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Paisi, Martha, Plessas, Anastasios, Pampaka, Despina, Burns, Lorna, and Witton, Robert V.
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Dental caries ,Systematic review ,Clinical Medicine ,Child development ,Medical and Health Sciences ,Dental care for children - Abstract
Objective: To examine the impact of treating carious teeth on children’s and adolescents’ anthropometric outcomes. Basic research design: Four electronic databases and four electronic clinical trials registries were searched. Two reviewers independently conducted the screening, data extraction and critical appraisal. The Cochrane Risk of Bias Tool for Randomised Controlled Trials was used to assess the risk of bias in the included studies. Results: The searches yielded 399 potential studies. Following deduplication and screening of the papers, four were considered eligible for inclusion of which two referred to the same study. None of the included studies was found to have a high risk of bias in any of the domains. However, performance bias was deemed of unclear risk in all studies. One of the studies found that following extraction of pulpally involved teeth, underweight children exhibited a statistically significant improvement in their weight-for-age (change in mean=0.26; p
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- 2020
21. Additional file 5 of Barriers and facilitators to dental care access among asylum seekers and refugees in highly developed countries: a systematic review
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Paisi, Martha, Baines, Rebecca, Burns, Lorna, Plessas, Anastasios, Radford, Philip, Shawe, Jill, and Witton, Robert
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Additional file 5. Illustrative quotations for each domain. Illustrative quotations for each of the six domains.
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- 2020
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22. Additional file 2 of Barriers and facilitators to dental care access among asylum seekers and refugees in highly developed countries: a systematic review
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Paisi, Martha, Baines, Rebecca, Burns, Lorna, Plessas, Anastasios, Radford, Philip, Shawe, Jill, and Witton, Robert
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Additional file 2. Search strategy that was used in Ovid Embase (and adapted for use in other databases). The search strategy used in Ovid EMBASE.
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- 2020
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23. Barriers and facilitators to hepatitis C screening and treatment for people with lived experience of homelessness: A mixed‐methods systematic review.
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Paisi, Martha, Crombag, Neeltje, Burns, Lorna, Bogaerts, Annick, Withers, Lyndsey, Bates, Laura, Crowley, Daniel, Witton, Robert, and Shawe, Jill
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HEPATITIS C treatment , *HEPATITIS C diagnosis , *CINAHL database , *MEDICAL information storage & retrieval systems , *SYSTEMATIC reviews , *MEDICAL screening , *EXPERIENCE , *HOMELESSNESS , *MEDLINE , *THEMATIC analysis - Abstract
Background: People experiencing homelessness have an increased risk of hepatitis C virus (HCV) infection, with rates higher than the general population. However, their access to HCV diagnosis is limited and treatment uptake is low. Objectives: To identify and describe the barriers and facilitators for HCV screening and treatment for adults with lived experience of homelessness in highly developed countries. Methods: Bibliographic databases (Embase, MEDLINE, CINAHL and SocINDEX) and grey literature (Google, EThOS, the Health Foundation, Social Care Online, the World Health Organisation, Shelter, Crisis and Pathway) were searched. Two reviewers independently screened and appraised all studies. The Critical Appraisal Skills Programme tool and the Joanna Briggs Institute checklist were used. The analysis involved a three‐stage process: coding, theme generation and theme mapping under Penchansky and Thomas's modified access model. Results: Twelve papers/reports were included in the review. Several interacting factors influence access of people with lived experience of homelessness to HCV testing and treatment. Some mirror those identified for the general population. The precarious conditions associated with the lived experience of homelessness along with the rigidity of hospital settings and lack of awareness emerged as dominant barriers. Flexibility, outreach, effective communication, tailoring and integration of services were found to be important facilitators. Evidence from Black, Asian and minority ethnic groups is limited. Conclusions: People experiencing homelessness face multiple barriers in accessing and completing HCV treatment, relating to both their lived experience and characteristics of health systems. Although some barriers are readily amenable to change, others are more difficult to modify. The facilitators identified could inform future targeted measures to improve HCV diagnosis and treatment for people experiencing homelessness. Research is warranted into successful models to promote screening, diagnosis and treatment. Patient or Public Contribution: Our team includes a peer advocate, a hepatology nurse and a community volunteer, all with significant experience in promoting and engaging in HCV care and outreach for people experiencing homelessness. They contributed to the protocol, interpretation and reporting of the review findings. [ABSTRACT FROM AUTHOR]
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- 2022
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24. Evaluation of a community dental clinic providing care to people experiencing homelessness: A mixed methods approach
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Paisi, Martha, primary, Baines, Rebecca, additional, Worle, Christina, additional, Withers, Lyndsey, additional, and Witton, Robert, additional
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- 2020
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25. A Dental Student Perspective on the Impacts of an Inter-professional Engagement Module
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Ahmed, Ahmed, primary, Bannerman, Naa-Lamiley, additional, Paisi, Martha, additional, Witton, Robert, additional, and Potterton, Ruth, additional
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- 2020
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26. Additional file 2: of Body mass index and dental caries in young people: a systematic review
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Paisi, Martha, Kay, Elizabeth, Bennett, Cathy, Kaimi, Irene, Witton, Robert, Nelder, Robert, and Lapthorne, Debra
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Characteristics of studies included in the systematic review. This table presents details of all the studies that were included in the review and their citations (end of the table). The studies are grouped according to the type of relationship they identified, with some studies finding more than one pattern of relationship. (DOCX 150 kb)
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- 2019
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27. Additional file 1: of Body mass index and dental caries in young people: a systematic review
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Paisi, Martha, Kay, Elizabeth, Bennett, Cathy, Kaimi, Irene, Witton, Robert, Nelder, Robert, and Lapthorne, Debra
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Reasons for exclusion of full text articles from the review. This file lists all the full text articles that were excluded from the present review along with the reason for their exclusion. (DOCX 36 kb)
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- 2019
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28. Additional file 3: of Body mass index and dental caries in young people: a systematic review
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Paisi, Martha, Kay, Elizabeth, Bennett, Cathy, Kaimi, Irene, Witton, Robert, Nelder, Robert, and Lapthorne, Debra
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health services administration ,technology, industry, and agriculture ,health care economics and organizations ,humanities - Abstract
Risk of flaws in each individual study and across studies. The table contains the risk of flaws between and within studies against all major and minor domains that were evaluated. The meanings of abbreviations are as follow: L = Low risk of flaw; H = High risk flaw; U = Unclear risk flaw; NA = not applicable. (DOCX 71 kb)
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- 2019
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29. The impact of the Cyprus comprehensive smoking ban on air quality and economic business of hospitality venues
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Christophi Costas A, Paisi Martha, Pampaka Despina, Kehagias Martha, Vardavas Constantine, and Connolly Gregory N
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Environmental pollution ,Tobacco smoke ,Secondhand smoking ,Smoking ban ,Economic viability ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Several countries, including Cyprus, have passed smoke-free legislations in recent years. The goal of this study was to assess the indoor levels of particulate matter in hospitality venues in Cyprus before and after the implementation of the law on 1/1/2010, evaluate the role of enforcement, and examine the legislation’s effect on revenue and employment. Methods Several hospitality venues (n = 35) were sampled between April 2007 and January 2008, and 21 of those were re-sampled after the introduction of the smoking ban, between March and May 2010. Data on enforcement was provided by the Cyprus Police whereas data on revenue and employment within the hospitality industry of Cyprus were obtained from the Cyprus Statistical Service; comparisons were made between the corresponding figures before and after the implementation of the law. Results The median level of PM2.5 associated with secondhand smoking was 161 μg/m3 pre-ban and dropped to 3 μg/m3 post-ban (98% decrease, p Conclusion Smoke free legislations, when enforced, are highly effective in improving the air quality and reducing the levels of indoor PM2.5. Strict enforcement plays a key role in the successful implementation of smoking bans. Even in nations with high smoking prevalence comprehensive smoking laws can be effectively implemented and have no negative effect on accommodation, food, and beverage services.
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- 2013
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30. A preliminary assessment of low level arsenic exposure and diabetes mellitus in Cyprus
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Makris Konstantinos C, Christophi Costas A, Paisi Martha, and Ettinger Adrienne S
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Arsenic ,Diabetes ,Exposure ,Drinking water ,Environmental health ,Endocrine ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background A preliminary study was undertaken in a community of Cyprus where low-level arsenic (As) concentrations were recently detected in the groundwater that was chronically used to satisfy potable needs of the community. The main objective of the study was to assess the degree of association between orally-ingested As and self-reported type-2 diabetes mellitus (DM) in 317 adult (≥18 years old) volunteers. Methods Cumulative lifetime As exposure (CLAEX) (mg As) was calculated using the median As concentrations in water, individual reported daily water consumption rates, and lifetime exposure duration. Logistic regression models were used to model the probability of self-reported DM and calculate odds ratios (OR) in univariate and multivariate models. Results Significantly higher (p < 0.02) CLAEX values were reported for the diabetics (median = 999 mg As) versus non-diabetics (median = 573 mg As), suggesting that As exposure could perhaps be related to the prevalence of DM in the study area, which was 6.6%. The OR for DM, comparing participants in the 80th versus the 20th percentiles of low-level As CLAEX index values, was 5.0 (1.03, 24.17), but after adjusting for age, sex, smoking, education, and fish consumption, the As exposure effect on DM was not significant. Conclusions Further research is needed to improve As exposure assessment for the entire Cypriot population while assessing the exact relationship between low-level As exposure and DM.
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- 2012
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31. Obesity and dental caries in young children in Plymouth, United Kingdom: A Spatial Analysis
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Paisi, Martha, Kay, Elizabeth, Kaimi, Irene, Witton, Robert, Nelder, Robert, Christophi, Costas A., and Lapthorne, Debra
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Geographic location ,Caries ,Obesity ,Inequalities ,Socioeconomic factors ,Clinical Medicine ,Children ,Medical and Health Sciences - Abstract
Objective: To examine the spatial clustering of obesity and dental caries in young children in Plymouth, United Kingdom, to evaluate the association between these conditions and deprivation, and explore the impact of neighbourhood-level characteristics on their distribution. Basic research design: Cross-sectional study analysing data from the National Child Measurement Programme (N=2427) and the Local Dental Health Survey (N=1425). The association of deprivation with weight status and caries was determined at individual and area level, using ANOVA and Poisson models. The overall spatial clustering was assessed using a modified version of the Global Moran's I, while clusters were located through Local Indicators of Spatial Association. Spatial autocorrelation was assessed using the variograms of the raw values. Log-linear Poisson models were fitted to assess the significance of neighbourhood characteristics on overweight/obesity and caries distribution. Results: At an individual level, deprivation was not associated with BMI z-scores but was a significant predictor of caries (p
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- 2018
32. A Dental Student Perspective on the Impacts of an Interprofessional Engagement Module.
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Ahmed, Ahmed, Bannerman, Naa-Lamiley, Paisi, Martha, Witton, Robert, and Potterton, Ruth
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- 2020
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33. Low-level Arsenic Exposure in Drinking Water and Diabetes Mellitus in Cyprus: Preliminary Findings
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Makris, Konstantinos C., primary, Christophi, Costas, additional, and Paisi, Martha, additional
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- 2011
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34. Barriers and Facilitators to Dental Care Services Utilization Among Children With Disabilities: A Systematic Review and Thematic Synthesis.
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Al-Mashhadani S, Nasser M, Alsalami A, Burns L, and Paisi M
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- Humans, Child, Oral Health, Dental Care for Disabled, Adolescent, Dental Care for Children, Dental Care, Disabled Children, Health Services Accessibility
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Background: This systematic review investigates barriers and enablers to dental care utilization by disabled children. Given the high global prevalence of disabilities in children, coupled with poor oral hygiene and a 45% rate of dental caries in this group, developing inclusive oral health strategies is critical. The review aims to synthesize literature on factors affecting oral healthcare improvement for disabled children, identifying barriers, facilitators and knowledge gaps., Methods: The review was conducted following the Joanna Briggs Institute's methods and reported according to PRISMA guidelines. A comprehensive search spanned multiple databases, considering perspectives from carers, parents, dentists and health professionals. The focus was on studies involving children up to age 17 with disabilities, as defined by WHO, using dental care services. Exclusions included non-qualitative studies, populations over 18 and nondisabled children. There were no restrictions on publication date or language. Thematic synthesis of the studies extracted themes related to barriers and enablers in oral healthcare for disabled children., Results: Thematic synthesis identified five overarching themes: stigma, communication issues, professional development, oral health education and medical-dental collaboration. Facilitators included enhancing accessibility and availability of dental care through a holistic approach, improving dental care facility environments and ensuring skilled dental care providers., Discussion: The review underscores the importance of interprofessional collaboration, improved parent/caregiver education and specialized dental facilities to support children with disabilities. It identifies key barriers and facilitators in dental care, including challenging stereotypes, improving communication between providers and parents, enhancing holistic training and addressing gaps in oral health education and integrated healthcare systems., Conclusion: Addressing the complex dynamics of dental care for disabled children is essential for developing inclusive and effective preventive and therapeutic strategies. This review highlights the need for tailored approaches and enhanced support systems to improve oral health outcomes in this vulnerable population., Patient and Public Contribution: The members of the family support department, Middle East and North Africa (MENA) Organization for Rare Disease and Disability who provided the disability voice and contributed to providing input to the review protocol., (© 2024 The Author(s). Health Expectations published by John Wiley & Sons Ltd.)
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- 2024
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35. Factors influencing implementation and sustainability of interventions to improve oral health and related health behaviours in adults experiencing severe and multiple disadvantage: a mixed-methods systematic review.
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John DA, Adams EA, McGowan LJ, Joyes EC, Richmond C, Beyer FR, Landes D, Watt RG, Sniehotta FF, Paisi M, Bambra C, Craig D, Kaner E, and Ramsay SE
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- Adult, Humans, Diet, Health Promotion methods, Health Behavior, Oral Health, Substance-Related Disorders prevention & control
- Abstract
Objectives: Among people experiencing severe and multiple disadvantage (SMD), poor oral health is common and linked to smoking, substance use and high sugar intake. Studies have explored interventions addressing oral health and related behaviours; however, factors related to the implementation of these interventions remain unclear. This mixed-methods systematic review aimed to synthesise evidence on the implementation and sustainability of interventions to improve oral health and related health behaviours among adults experiencing SMD., Methods: Bibliographic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, EBSCO, Scopus) and grey literature were searched from inception to February 2023. Studies meeting the inclusion criteria were screened and extracted independently by two researchers. Quality appraisal was undertaken, and results were synthesised using narrative and thematic analyses., Results: Seventeen papers were included (published between 1995 and 2022). Studies were mostly of moderate quality and included views from SMD groups and service providers. From the qualitative synthesis, most findings were related to aspects such as trust, resources and motivation levels of SMD groups and service providers. None of the studies reported on diet and none included repeated offending (one of the aspects of SMD). From the quantitative synthesis, no difference was observed in programme attendance between the interventions and usual care, although there was some indication of sustained improvements in participation in the intervention group., Conclusion: This review provides some evidence that trust, adequate resources and motivation levels are potentially important in implementing interventions to improve oral health and substance use among SMD groups. Further research is needed from high quality studies and focusing on diet in this population., Prospero Registration Number: CRD42020202416., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
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- 2024
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36. Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental healthcare providers.
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Kumbargere Nagraj S, Eachempati P, Paisi M, Nasser M, Sivaramakrishnan G, Francis T, and Verbeek JH
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- Chlorhexidine therapeutic use, Health Personnel, Humans, Mouthwashes therapeutic use, Respiratory Aerosols and Droplets, Water, Communicable Diseases drug therapy, Oils, Volatile, Severe Acute Respiratory Syndrome
- Abstract
Background: Aerosols and spatter are generated in a dental clinic during aerosol-generating procedures (AGPs) that use high-speed hand pieces. Dental healthcare providers can be at increased risk of transmission of diseases such as tuberculosis, measles and severe acute respiratory syndrome (SARS) through droplets on mucosae, inhalation of aerosols or through fomites on mucosae, which harbour micro-organisms. There are ways to mitigate and contain spatter and aerosols that may, in turn, reduce any risk of disease transmission. In addition to personal protective equipment (PPE) and aerosol-reducing devices such as high-volume suction, it has been hypothesised that the use of mouth rinse by patients before dental procedures could reduce the microbial load of aerosols that are generated during dental AGPs., Objectives: To assess the effects of preprocedural mouth rinses used in dental clinics to minimise incidence of infection in dental healthcare providers and reduce or neutralise contamination in aerosols., Search Methods: We used standard, extensive Cochrane search methods. The latest search date was 4 February 2022., Selection Criteria: We included randomised controlled trials and excluded laboratory-based studies. Study participants were dental patients undergoing AGPs. Studies compared any preprocedural mouth rinse used to reduce contaminated aerosols versus placebo, no mouth rinse or another mouth rinse. Our primary outcome was incidence of infection of dental healthcare providers and secondary outcomes were reduction in the level of contamination of the dental operatory environment, cost, change in mouth microbiota, adverse events, and acceptability and feasibility of the intervention., Data Collection and Analysis: Two review authors screened search results, extracted data from included studies, assessed the risk of bias in the studies and judged the certainty of the available evidence. We used mean differences (MDs) and 95% confidence intervals (CIs) as the effect estimate for continuous outcomes, and random-effects meta-analysis to combine data MAIN RESULTS: We included 17 studies with 830 participants aged 18 to 70 years. We judged three trials at high risk of bias, two at low risk and 12 at unclear risk of bias. None of the studies measured our primary outcome of the incidence of infection in dental healthcare providers. The primary outcome in the studies was reduction in the level of bacterial contamination measured in colony-forming units (CFUs) at distances of less than 2 m (intended to capture larger droplets) and 2 m or more (to capture droplet nuclei from aerosols arising from the participant's oral cavity). It is unclear what size of CFU reduction represents a clinically significant amount. There is low- to very low-certainty evidence that chlorhexidine (CHX) may reduce bacterial contamination, as measured by CFUs, compared with no rinsing or rinsing with water. There were similar results when comparing cetylpyridinium chloride (CPC) with no rinsing and when comparing CPC, essential oils/herbal mouthwashes or boric acid with water. There is very low-certainty evidence that tempered mouth rinses may provide a greater reduction in CFUs than cold mouth rinses. There is low-certainty evidence that CHX may reduce CFUs more than essential oils/herbal mouthwashes. The evidence for other head-to-head comparisons was limited and inconsistent. The studies did not provide any information on costs, change in micro-organisms in the patient's mouth or adverse events such as temporary discolouration, altered taste, allergic reaction or hypersensitivity. The studies did not assess acceptability of the intervention to patients or feasibility of implementation for dentists. AUTHORS' CONCLUSIONS: None of the included studies measured the incidence of infection among dental healthcare providers. The studies measured only reduction in level of bacterial contamination in aerosols. None of the studies evaluated viral or fungal contamination. We have only low to very low certainty for all findings. We are unable to draw conclusions regarding whether there is a role for preprocedural mouth rinses in reducing infection risk or the possible superiority of one preprocedural rinse over another. Studies are needed that measure the effect of rinses on infectious disease risk among dental healthcare providers and on contaminated aerosols at larger distances with standardised outcome measurement., (Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)
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- 2022
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37. Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases.
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Kumbargere Nagraj S, Eachempati P, Paisi M, Nasser M, Sivaramakrishnan G, and Verbeek JH
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- Adolescent, Adult, Aerosols, Aged, Air Filters, Child, Child, Preschool, Colony Count, Microbial methods, Dentistry, Disinfectants, Humans, Infection Control, Dental economics, Infection Control, Dental instrumentation, Middle Aged, Randomized Controlled Trials as Topic statistics & numerical data, Rubber Dams, Suction, Young Adult, Air Microbiology, Bacterial Infections prevention & control, Infection Control, Dental methods, Occupational Diseases prevention & control, Virus Diseases prevention & control
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Background: Many dental procedures produce aerosols (droplets, droplet nuclei and splatter) that harbour various pathogenic micro-organisms and may pose a risk for the spread of infections between dentist and patient. The COVID-19 pandemic has led to greater concern about this risk., Objectives: To assess the effectiveness of methods used during dental treatment procedures to minimize aerosol production and reduce or neutralize contamination in aerosols., Search Methods: Cochrane Oral Health's Information Specialist searched the following databases on 17 September 2020: Cochrane Oral Health's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (in the Cochrane Library, 2020, Issue 8), MEDLINE Ovid (from 1946); Embase Ovid (from 1980); the WHO COVID-19 Global literature on coronavirus disease; the US National Institutes of Health Trials Registry (ClinicalTrials.gov); and the Cochrane COVID-19 Study Register. We placed no restrictions on the language or date of publication., Selection Criteria: We included randomized controlled trials (RCTs) and controlled clinical trials (CCTs) on aerosol-generating procedures (AGPs) performed by dental healthcare providers that evaluated methods to reduce contaminated aerosols in dental clinics (excluding preprocedural mouthrinses). The primary outcomes were incidence of infection in dental staff or patients, and reduction in volume and level of contaminated aerosols in the operative environment. The secondary outcomes were cost, accessibility and feasibility., Data Collection and Analysis: Two review authors screened search results, extracted data from the included studies, assessed the risk of bias in the studies, and judged the certainty of the available evidence. We used mean differences (MDs) and 95% confidence intervals (CIs) as the effect estimate for continuous outcomes, and random-effects meta-analysis to combine data. We assessed heterogeneity., Main Results: We included 16 studies with 425 participants aged 5 to 69 years. Eight studies had high risk of bias; eight had unclear risk of bias. No studies measured infection. All studies measured bacterial contamination using the surrogate outcome of colony-forming units (CFU). Two studies measured contamination per volume of air sampled at different distances from the patient's mouth, and 14 studies sampled particles on agar plates at specific distances from the patient's mouth. The results presented below should be interpreted with caution as the evidence is very low certainty due to heterogeneity, risk of bias, small sample sizes and wide confidence intervals. Moreover, we do not know the 'minimal clinically important difference' in CFU. High-volume evacuator Use of a high-volume evacuator (HVE) may reduce bacterial contamination in aerosols less than one foot (~ 30 cm) from a patient's mouth (MD -47.41, 95% CI -92.76 to -2.06; 3 RCTs, 122 participants (two studies had split-mouth design); very high heterogeneity I² = 95%), but not at longer distances (MD -1.00, -2.56 to 0.56; 1 RCT, 80 participants). One split-mouth RCT (six participants) found that HVE may not be more effective than conventional dental suction (saliva ejector or low-volume evacuator) at 40 cm (MD CFU -2.30, 95% CI -5.32 to 0.72) or 150 cm (MD -2.20, 95% CI -14.01 to 9.61). Dental isolation combination system One RCT (50 participants) found that there may be no difference in CFU between a combination system (Isolite) and a saliva ejector (low-volume evacuator) during AGPs (MD -0.31, 95% CI -0.82 to 0.20) or after AGPs (MD -0.35, -0.99 to 0.29). However, an 'n of 1' design study showed that the combination system may reduce CFU compared with rubber dam plus HVE (MD -125.20, 95% CI -174.02 to -76.38) or HVE (MD -109.30, 95% CI -153.01 to -65.59). Rubber dam One split-mouth RCT (10 participants) receiving dental treatment, found that there may be a reduction in CFU with rubber dam at one-metre (MD -16.20, 95% CI -19.36 to -13.04) and two-metre distance (MD -11.70, 95% CI -15.82 to -7.58). One RCT of 47 dental students found use of rubber dam may make no difference in CFU at the forehead (MD 0.98, 95% CI -0.73 to 2.70) and occipital region of the operator (MD 0.77, 95% CI -0.46 to 2.00). One split-mouth RCT (21 participants) found that rubber dam plus HVE may reduce CFU more than cotton roll plus HVE on the patient's chest (MD -251.00, 95% CI -267.95 to -234.05) and dental unit light (MD -12.70, 95% CI -12.85 to -12.55). Air cleaning systems One split-mouth CCT (two participants) used a local stand-alone air cleaning system (ACS), which may reduce aerosol contamination during cavity preparation (MD -66.70 CFU, 95% CI -120.15 to -13.25 per cubic metre) or ultrasonic scaling (MD -32.40, 95% CI - 51.55 to -13.25). Another CCT (50 participants) found that laminar flow in the dental clinic combined with a HEPA filter may reduce contamination approximately 76 cm from the floor (MD -483.56 CFU, 95% CI -550.02 to -417.10 per cubic feet per minute per patient) and 20 cm to 30 cm from the patient's mouth (MD -319.14 CFU, 95% CI - 385.60 to -252.68). Disinfectants ‒ antimicrobial coolants Two RCTs evaluated use of antimicrobial coolants during ultrasonic scaling. Compared with distilled water, coolant containing chlorhexidine (CHX), cinnamon extract coolant or povidone iodine may reduce CFU: CHX (MD -124.00, 95% CI -135.78 to -112.22; 20 participants), povidone iodine (MD -656.45, 95% CI -672.74 to -640.16; 40 participants), cinnamon (MD -644.55, 95% CI -668.70 to -620.40; 40 participants). CHX coolant may reduce CFU more than povidone iodine (MD -59.30, 95% CI -64.16 to -54.44; 20 participants), but not more than cinnamon extract (MD -11.90, 95% CI -35.88 to 12.08; 40 participants)., Authors' Conclusions: We found no studies that evaluated disease transmission via aerosols in a dental setting; and no evidence about viral contamination in aerosols. All of the included studies measured bacterial contamination using colony-forming units. There appeared to be some benefit from the interventions evaluated but the available evidence is very low certainty so we are unable to draw reliable conclusions. We did not find any studies on methods such as ventilation, ionization, ozonisation, UV light and fogging. Studies are needed that measure contamination in aerosols, size distribution of aerosols and infection transmission risk for respiratory diseases such as COVID-19 in dental patients and staff., (Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)
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- 2020
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