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Objective: Examine the literature on the experiences of living with removable dentures (complete or partial) to identify any gaps and provide a map for future research. Background: Increasing proportions of society are living partially dentate with some form of restoration, including removable dentures. Previous studies have reported on the location, materials and usage of these prostheses, along with effects on oral‐health‐related quality of life (OHRQoL). However, less is known about experiences with removable dentures from a patient‐centred perspective. Methods: A scoping review of the qualitative literature was undertaken using the framework of Arksey and O'Malley, updated by Levac et al. Literature searches were carried out using Medline and Web of Science. Papers were screened by title and abstract using inclusion and exclusion criteria. Remaining papers were read in full and excluded if they did not meet the required criteria. Nine papers were included in the final review. Findings: Key themes from these papers were: impact of tooth loss and living without teeth, and its impacts in relation to social position, appearance, confidence and function (chewing and speaking); social norms and tooth loss, including attitudes to tooth retention and treatment costs, and changes in intergenerational norms towards dentures; expectations of treatment, including patients being more involved in decision making, viewing the denture as a "gift" and dentures helping to achieve "an ideal"; living with a removable denture (complete or partial), including patient preparedness for a denture, adaptation and impacts on activities and participation; and the dentist‐patient relationship, including issues with information and communication, and differing priorities between patients and dentists. Conclusion: Little qualitative research exists on experiences of living with a removable denture. Existing literature demonstrates the importance of dispersed activities in differing social, spatial and temporal contexts when wearing removable dentures. Focusing on processes of positive adaptation to dentures and OHRQoL, rather than deficits, is also required to fully understand patients' experiences. Additionally, more complex technological advances may not always be in the best interest of every patient. [ABSTRACT FROM AUTHOR]

These nurses care for patients before and after surgery. [ABSTRACT FROM AUTHOR]

Aim: To develop and validate a condition specific measure of oral health-related quality of life for dentine hypersensitivity (Dentine Hypersensitivity Experience Questionnaire, DHEQ). Materials and Methods: Questionnaire construction used a multi-staged impact approach and an explicit theoretical model. Qualitative and quantitative development and validation included in-depth interviews, focus groups and cross-sectional questionnaire studies in a general population (n=160) and a clinical sample (n=108). Results: An optimized DHEQ questionnaire containing 48 items has been developed to describe the pain, a scale to capture subjective impacts of dentine hypersensitivity, a global oral health rating and a scale to record effects on life overall. The impact scale had high values for internal reliability (nearly all item-total correlations >0.4 and Cronbach's α=0.86). Intra-class correlation coefficient for test-retest reliability was 0.92. The impact scale was strongly correlated to global oral health ratings and effects on life overall. These results were similar when DHEQ was validated in a clinical sample. Conclusions: DHEQ shows good psychometric properties in both a general population and clinical sample. Its use can further our understanding of the subjective impacts of dentine sensitivity. [ABSTRACT FROM AUTHOR]

Few studies have examined, comprehensively and prospectively, determinants of oral-health-related quality of life. The aim of this study was to examine the relationships between psychosocial factors and oral health status, health perceptions, and quality of life. Measures of symptom and functional status, health perceptions, quality of life, oral health beliefs, and psychological (sense of coherence, self-esteem, health locus of control) and social factors (parents' income and education) were collected from 439 12- and 13-year-olds at baseline and six-month follow-up, together with a clinical examination at baseline. Structural equation modeling indicated that increased levels of caries and more symptoms predicted more functional limitations, and, cross-sectionally, greater functional impact was associated with worse health perceptions, which were linked to lower quality of life. Sense of coherence was the most important psychosocial predictor. These factors are important in understanding how oral health affects young people's daily lives. [ABSTRACT FROM AUTHOR]

Objectives: Andersen's revised behavioural model provides a framework for understanding the factors which influence utilization of health services and key health outcomes. To date, there have been few studies that have explicitly tested the model in relation to oral health. The aim of this study was to test the model and to examine the direct and mediated pathways between social, attitudinal and behavioural factors and perceived oral health outcomes. Methods: The model was tested in a general population sample with data from the UK adult dental health survey ( N = 3815) using the two-stage process of structural equation modelling. Results: Structural equation modelling indicated support in line with the hypotheses within the model; enabling resources (oral health education advice, type of dental service, finding NHS treatment expensive, dental anxiety) predicted need (number of decayed or unsound teeth and perceived treatment need); enabling resources and need predicted personal health practices and use of services (frequency of toothbrushing, recent dental attendance, attendance orientation) which, in turn, predicted perceived oral health outcomes (oral health quality of life). Both enabling resources and need also predicted perceived oral health outcomes. The impact of predisposing factors (social class, qualifications, income) on need, personal health practices and use of services, and oral health outcomes was indirect; that is, mediated by intervening factors. In the final model, 26%, 37%, 49% and 21% of the variance was accounted for in enabling resources, treatment need, personal health practices and use of services and perceived oral health outcomes respectively. Conclusion: The results provide support for Andersen's behavioural model as applied to perceived oral health. Further conceptual development of the model is discussed. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to provide an empirical test of the construct validity of the Oral Health Impact Profile as a measure of Locker's conceptual model of oral health. Methods: A secondary analysis of data from the Ontario Study of Older Adults was carried out using structural equation modelling to assess the degree to which scale items measured the construct they were supposed to measure ( within-construct validity) and whether relations between constructs were as hypothesized by Locker's model ( between-construct validity). Results: The findings indicated that the Oral Health Impact Profile as currently conceived does not have adequate within-construct validity. Scale items did not always measure the construct they were supposed to measure, some items within a construct were redundant, many measured more than one construct, and the scale did not represent seven separate constructs of oral health as originally devised. Following reconceptualization of the scale, the revised six-factor 22 item version was a better fit to the data. However, the scale did not have adequate between-construct validity. Conclusion: The present findings do not provide support for the conceptual basis of the Oral Health Impact Profile as a measure of Locker's model of oral health. The need for further conceptual development of the scale, and Locker's model, are discussed. [ABSTRACT FROM AUTHOR]

Locker's (1988) multidimensional model of oral health provides a scientific model for the understanding of oral disease and its consequences. To date, there have been no studies that have explicitly tested the model with empirical evidence. This study aimed to: first, test the model in a general population sample using data from the UK adult dental health survey (N = 5268); and, second, to cross-validate these results in two different and diverse samples--edentulous elders (N = 133) and a clinical sample of xerostomia patients (N = 85). Structural equation modeling indicated support for the model as applied to each of the samples. All of the direct pathways hypothesized by the model were significant, in addition to several indirect or mediated pathways between key variables. Further conceptual development of the model is discussed, particularly the role of individual difference factors, and theoretical and methodological issues in oral-health-related quality-of-life research are highlighted. [ABSTRACT FROM AUTHOR]

It has been widely recognized, both in the UK and internationally, that there is a need for a multidimensional or holistic approach to maternity care, which incorporates psychological as well as physical aspects, in order to optimize women's experiences both in the intra- and postpartum period. Central to such an approach is the relationship between women and maternity care staff. The aim of this study was to explore the impact of maternity care staff on women's experiences, and feelings associated with the childbirth process. Semi-structured interviews were conducted with 24 primiparous and multiparous women, and transcripts analysed using open and axial coding with triangulation. Three main themes emerged from women's accounts: perceptions of control, staff attitudes and behaviours, and resource issues. Each of these themes was evident throughout the various stages of the childbirth process, in the delivery suite, on the maternity ward, and specifically in relation to breastfeeding. In the women's accounts, feelings of little control were related to inadequate information provision, poor communication, and no opportunity to influence decision making. These, together with the negative attitudes and behaviours of maternity staff, and issues of under-resourcing, were often linked to negative feelings such as fear, anger, disappointment, distress, guilt, and inadequacy. These findings illustrate the importance of maternity care staff recognizing women's psychological and emotional needs during the childbirth process, and the impact that they themselves may have on women's experiences. These issues are discussed with reference to the wider debate on authority and power within the medical relationship, from a feminist viewpoint. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about the role of wireless local area networks in the healthcare industry.

This study examined spirituality in the cultural context of African Americans and how it relates to their health care-seeking behaviors. Focus group methodology was utilized for data collection. Three focus (3) groups were conducted in the Hampton Roads area. The sample consisted of African American men (n= 12, 35%) and women (n= 22, 65%). Between 11 and 12 participants were in each group for a total of 34 participants, ranging in age between 10 and 80 years. A semi-structured interview guide facilitated the focus groups. This guide was designed to facilitate the subjects' overall perceptions of spirituality, health and health care-seeking behaviors. Focus group data were transcribed and analyzed by selecting phrases exemplifying common themes. Result: The findings indicated that spirituality had an influence on health and health-care seeking behaviors' in African Americans. It was concluded that spirituality should be a focus for health care professionals in providing holistic care for African Americans. [ABSTRACT FROM AUTHOR]

Background: Children with disabilities experience poorer oral health and frequently have complex needs. The accessibility of oral health care services for children with disabilities is crucial for promoting oral health and overall well-being. This study aimed to systematically review the literature to identify the barriers and facilitators to oral health care services for children with disabilities, and to propose priority research areas for the planning and provision of dental services to meet their needs., Methods: This was a mixed methods systematic review. Multiple databases searched included MEDLINE, Scopus, PsycINFO, EMBASE, and CINAHL. The search strategy included Medical Subject Heading (MeSH) terms related to children, disabilities, and access to oral health. Eligibility criteria focused on studies about children with disabilities, discussing the accessibility of oral health care., Results: Using Levesque's framework for access identified barriers such as professional unwillingness, fear of the dentist, cost of treatment, and inadequate dental facilities. Facilitators of access offered insight into strategies for improving access to oral health care for children with disabilities., Conclusion: There is a positive benefit to using Levesque's framework of access or other established frameworks to carry out research on oral healthcare access, or implementations of dental public health interventions in order to identify gaps, enhance awareness and promote better oral health practices. The evidence suggests that including people with disabilities in co-developing service provision improves accessibility, alongside using tailored approaches and interventions which promote understanding of the importance of dental care and increases awareness for professionals, caregivers and children with disabilities., Trial Registration: Protocol has been registered online on the PROSPERO database with an ID CRD42023433172 on June 9, 2023., (© 2024. The Author(s).)

Objectives: This study comprises a synthesis of published qualitative studies from developed countries on the perspectives of carers regarding the oral hygiene toothbrushing practices of preschool children, through the lens of social practice theory., Methods: A search of the following electronic databases was conducted for all available years: MEDLINE, EMBASE and Global Health using the Ovid platform; Dentistry & Oral Sciences Source (DOSS), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus. Included qualitative studies reported primary caregivers' perceptions of oral hygiene practices (focusing on toothbrushing) in preschool children (0-5 years old) in developed countries. A thematic synthesis of the qualitative findings was undertaken for the results of each study., Results: Eleven articles were included in this meta-synthesis. The focus of this paper was toothbrushing practices. A conceptual map of toothbrushing as a social practice was developed. Key findings included practice elements (meanings, competences, and materials), spatial and temporal aspects, and barriers and facilitators to performance., Conclusions: The application of a social practice lens to published qualitative research on the oral hygiene of preschool children provided insights into the meanings and competences related to toothbrushing, as perceived by primary caregivers. However, it also revealed limited information on material, spatial and temporal aspects of toothbrushing practices, indicating the importance of considering social practice theory as a framework in future research to address this gap. Furthermore, exploring toothbrushing in connection with related social practices has the potential to increase understanding of factors influencing oral health in preschool children., (© 2024 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

Objective: To describe the association between dental caries and school readiness in 5-year-old children taking part in the Born in Bradford (BiB) birth cohort, UK., Methods: The Early Years Foundation Stage Profile (EYFSP) assesses the school readiness of young children and is strongly predictive of future academic attainment. Children are recorded as 'emerging' (below expected), 'expected', or 'exceeding' in five key learning areas. The Oral Health Survey of 5-year-olds (OHS5) is undertaken biennially in England, assessing caries experience at a dentine threshold (d 3 mft). EYFSP and OHS5 were available for a proportion of children participating in BiB. Odds ratios and confidence intervals for caries experience were established, and odds ratios adjusted for significant sociodemographic variables., Results: EYFSP and OHS5 data were available for 2.5% (n = 346) BiB participants. Nearly half (45.2%) had caries. A measure of socio-economic status, receiving free school meals, was the only demographic variable strongly related to caries experience (OR: 2.8, 95% CI: 1.6-4.9). After adjustment, children 'emerging' in EYFSP learning areas had 1.6- to 2.2-fold (95% CI: 1.0-3.8) higher odds of experiencing caries. Children 'exceeding' EYFSP learning areas had 2.3- to 4-fold (95% CI: 0.1-0.9) lower odds of caries experience., Conclusion: This is the first study to explore the association between caries experience and school readiness using a holistic assessment tool. The association was found across different learning areas and was comparable to and independent of socio-economic status. The findings indicate oral health-related absenteeism is not a causative factor. EYFSP shows potential to enhance the targeting of preventive interventions at a child, class or school level., (© 2024 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

Introduction: Despite substantial research and provision of dental care, significant morbidity remains for children's oral health. Guided by social practice theory (SPT), this research moves away from the often-ineffective focus on changing individual behavior to rethinking the centrality of the social world in promoting or undermining oral health outcomes. We define social practice as a routinized relational activity linking and integrating certain elements (competence, materials, and meanings) into the performance of a practice that is reproduced across time and space., Objective: To investigate oral health in preschool children in Perth, Western Australia, using social practice theory., Methods: With no definitive methodology for investigating SPT, we chose focused ethnography as a problem-focused, context-specific approach using mainly interviews to investigate participants' experience caring for their children's oral health. The focus of analysis was the practice of oral health care, not individual behavior, where themes identified from participants' transcripts were organized into categories of elements and performance., Results: Eleven parents, all of whom were married or partnered, were interviewed in 2021. Findings identified social practices relevant to oral health within parenting and family relations linked to routine daily activities, including shopping, consumption of food and beverages, and toothbrushing. Oral health literacy was reflected in integrating competence, materials, and meanings into performing oral health care, notably preferences for children to drink water over sugary beverages and information often being sourced from social media and mothers' groups rather than health providers., Conclusion: Focusing on social practices as the unit of analysis offers a more layered understanding of elements in young children's oral health care that can indicate where the problem may lie. Findings provide an opportunity to consider future research and policy directions in children's oral health., Knowledge Transfer Statement: Examining social practices related to young children's oral health care identifies parents/carers' knowledge about, for example, toothbrushing, the resources required, and why toothbrushing is important. Analyzing these separate elements can reveal both enablers and barriers to oral health care. This provides researchers, clinicians and policymakers an opportunity to focus on not changing individual behavior but understanding how social context impacts parents/carers' capacity to make optimum decisions around young children's oral health., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Oral diseases affect a significant proportion of the world's population, yet international comparisons involving oral health outcomes have often been limited due to differences in the way country-level primary data are collected. In response to this, the World Dental Federation (FDI) Oral Health Observatory project was launched with the goal of collecting and producing standardised international data on oral health across countries. The aim of this descriptive cross-sectional study was to examine associations between self-reported general health and a range of factors (sociodemographics, oral health-related behaviours, oral impacts, clinical variables) using these standardised international datasets., Methods: Dentists within FDI member National Dental Associations who chose to take part in the project were selected using a multistage sampling method. The number of dentists in each cluster was set according to the proportion of the national population living in the area, and 50 patients per dentist were systematically approached to take part. Patients and dentists completed 2 separate questionnaires on a mobile app. Ordinal logistic regression (conducted in December 2022) was used to analyse the linked patient and dentist data from 6 countries: China (n = 2242); Colombia (n = 1029); India (n = 999); Italy (n = 711); Japan (n = 1271); and Lebanon (n = 798). Self-reported general health was the dependent variable, with age, sex, education, self-reported oral health-related behaviours, self-reported oral impacts, and clinical variables acting as the independent variables., Results: The results demonstrated a different pattern of associations in the different countries. Better self-reported general health was associated with degree-level education in all 6 countries and with reporting no oral impact and no sensitive teeth in 4 countries. Several country-specific patterns were also found, including the importance of tooth brushing in Colombia, periodontal health in Italy, and differing associations with sugary drinks consumption in India and Japan., Conclusions: These descriptive findings provide a basis for further research and, importantly, for advocacy in identifying patient oral health care needs according to both person-reported and clinical aspects. This can facilitate optimisation of service provision and potentially influence policy and investments., Competing Interests: Conflict of interest None disclosed., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: The aim of this study was to conceptualise the key stages of the patient journey in the provision of a new denture and examine the factors leading to successful patient-related outcomes., Methods: Two partially dentate patient samples were included: (i) Denture wearers - patients who had a denture fitted within the previous five years and (ii) New dentures - patients receiving treatment for a new or replacement denture. The methods involved direct targeted participant observations of the denture fitting process, debriefing interviews and a follow-up focus group exploring the patient journey. Data were analysed through the use of phenomenology and grounded theory., Results: Interviews were completed with twenty participants of the denture-wearing sample (11 males and nine females, age range 22 to 86 years). Thirteen participants were included in the treatment journey sample in two primary care settings (six males and seven females, age range 55 to 101 years). Tooth loss and recovery was described as being in an 'emotional tunnel' resulting from 'bodyphonic processes' associated with tooth loss. 'Bodyphonia' subsequently became the context for 'taking control' and 'managing disclosure' when living with a removable denture. Different courses through this process can be readily observed, moderated by different variables (i.e., previous experience, working knowledge, a good fit, the treatment alliance, negotiated compromises and bounded responsibility)., Conclusions: An'integrating framework' that seeks to describe the patient journey from the experience of tooth loss to recovery with a denture is proposed. This framework could be used to aid development of a clinical pathway to guide treatment options., Clinical Significance: This paper conceptualises the patient journey. It stresses the importance of understanding the stages patients go through and highlights that for the dental team, the try-in stage is perhaps the best stage to give information about the denture and plans for continued care., Competing Interests: Declaration of competing interest Funding: This study is collaborative study funded by Haleon (Surrey, UK). Haleon have not influenced the results or the findings of this work but have collaborated in the development of the methodology, aims and objectives., (Copyright © 2024. Published by Elsevier Ltd.)

Objectives: Adults who have learning disabilities are a vulnerable group, little is known about their oral health and how this affects their quality of life. The aims of this secondary analysis of data from the 2009 Adult Dental Health Survey (ADHS) were to describe the oral health status of adults with learning disabilities, determine if severity of learning disability is associated with oral health and identify some of the methodological complexities of working with this population. The survey yields the most recent representative data on the oral health of adults with learning disabilities in England and importantly, contains information about oral health related quality of life (OHRQoL)., Basic Research Design: Secondary analysis of data from a supplemental survey of adults with learning disabilities collected alongside the 2009 ADHS., Participants: 607 participants with a diagnosed learning disability aged 18 years and over., Results: Adults with learning disabilities had similar levels of active dental caries, fewer natural teeth, and fewer fillings than comparable participants from the general population. Self-reported oral and general health were worse for adults with learning disabilities than the general population. Possible associations between the severity of learning disability and the numbers of decayed, missing or filled teeth were identified. However, large amounts of missing data limited the analysis., Conclusions: There are important questions relating to the accessibility of existing self-reported oral health questionnaires and the reliability of proxy-reported questions about OHRQoL that should be addressed to give a fuller picture of the oral health of adults with learning disabilities., (Copyright© 2024 Dennis Barber Ltd.)

Background: Children with disabilities generally face poorer oral health outcomes compared with their non-disabled peers due to a range of factors including inadequate oral hygiene, infrequent dental visits and systemic barriers in accessing care., Aim: This ethnographic study explored the perspectives of caregivers and professionals to identify the ways that children with disabilities are included in oral health., Design: A purposive sample of 10 caregivers, all mothers with disabled children aged 9-15 years, five healthcare providers and five educators in Saudi Arabia, participated. Data collection used participant observation and semi-structured in-depth interviews. Data were analysed using reflexive thematic analysis., Results: The findings suggest that mothers lacked a supportive environment to develop their skills and knowledge about oral health care, preventing them from including their children in oral health. Inaccessible services added to the exclusion of both mothers and children. Some dental professionals exhibited poor communication skills and discriminatory attitudes towards the children and problematising mothers. Educators tended to discuss disabled children in terms of inability, displaying a deficit approach to impairment., Conclusions: The evidence suggests the exclusion of mothers from oral health. This has an impact on how they enable their children. Recommendations include adopting a social model of disability in dental education and policies in Saudi Arabia to address inequalities. Provision of support, education and focusing on societal barriers moves towards inclusion rather than conceptualising disability as an individual problem., (© 2024 BSPD, IAPD and John Wiley & Sons Ltd.)

Objectives: In celebration of the journal's 50th anniversary, the aim of the study was to review the whole collection of Community Dentistry and Oral Epidemiology (CDOE) publications from 1973 to 2022 and provide a complete overview of the main publication characteristics., Methods: The study used bibliometric techniques such as performance and science mapping analysis of 3428 articles extracted from the Scopus database. The data were analysed using the 'Bibliometrix' package in R. The journal's scientific production was examined, along with the yearly citation count, the distribution of publications based on authors, the corresponding author's country and affiliation and citation count, citing source and keywords. Bibliometric network maps were constructed to determine the conceptual, intellectual and social collaborative structure over the past 50 years. The trending research topics and themes were identified., Results: The total number of articles and average citations has increased over the years. D Locker, AJ Spencer, A Sheiham and WM Thomson were the most frequently published authors, and PE Petersen, GD Slade and AI Ismail published papers with the highest citations. The most published countries were the United States, United Kingdom, Brazil and Canada, frequently engaging in collaborative efforts. The most common keywords used were 'dental caries', 'oral epidemiology' and 'oral health'. The trending topics were healthcare and health disparities, social determinants of health, systematic review and health inequalities. Epidemiology, oral health and disparities were highly researched areas., Conclusion: This bibliometric study reviews CDOE's significant contribution to dental public health by identifying key research trends, themes, influential authors and collaborations. The findings provide insights into the need to increase publications from developing countries, improve gender diversity in authorship and broaden the scope of research themes., (© 2023 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

Objectives: SENIOR (uSing rolE-substitutioN In care homes to improve oRal health) is a randomised controlled trial designed to determine whether role substitution could improve oral health for this population. A parallel process evaluation was undertaken to understand context. This paper reports on the first phase of the process evaluation., Background: The oral health and quality-of-life of older adults residing in care homes is poorer than those in the community. Oral health care provision is often unavailable and a concern and challenge for managers. The use of Dental Therapists and Dental Nurses rather than dentists could potentially meet these needs., Materials and Methods: Semi-structured interviews were conducted with 21 key stakeholders who either worked or had experience of dependent care settings. Questions were theoretically informed by the: Promoting Action on Research Implementation in Health Services (PAHRIS) framework. The focus was on contextual factors that could influence adoption in practice and the pathway-to-impact. Interviews were fully transcribed and analysed thematically., Results: Three themes (receptive context, culture, and leadership) and 11 codes were generated. Data show the complexity of the setting and contextual factors that may work as barriers and facilitators to intervention delivery. Managers are aware of the issues regarding oral health and seek to provide best care, but face many challenges including staff turnover, time pressures, competing needs, access to services, and financial constraints. Dental professionals recognise the need for improvement and view role substitution as a viable alternative to current practice., Conclusion: Although role substitution could potentially meet the needs of this population, an in-depth understanding of contextual factors appeared important in understanding intervention delivery and implementation., (© 2024 Gerodontology Association and John Wiley & Sons Ltd.)

Background: Poor oral health is common among older adults residing in care homes impacting their diet, quality of life, self-esteem, general health and well-being. The care home setting is complex and many factors may affect the successful implementation of oral care interventions. Exploring these factors and their embedded context is key to understanding how and why interventions may or may not be successfully implemented within their intended setting., Objectives: This methodology paper describes the approach to a theoretically informed process evaluation alongside a pragmatic randomised controlled trial, so as to understand contextual factors, how the intervention was implemented and important elements that may influence the pathways to impact., Materials and Methods: SENIOR is a pragmatic randomised controlled trial designed to improve the oral health of care home residents in the United Kingdom. The trial uses a complex intervention to promote and provide oral care for residents, including education and training for staff., Results: An embedded, theoretically informed process evaluation, drawing on the PAHRIS framework and utilising a qualitative approach, will help to understand the important contextual factors within the care home that influence both the trial processes and the implementation of the intervention., Conclusion: Utilising an implementation framework as the basis for a theoretically informed process evaluation provides an approach that specifically focuses on the contextual factors that may influence and shape the pathways to impact a given complex intervention a priori, while also providing an understanding of how and why an intervention may be effective. This contrasts with the more common post hoc approach that only focuses on implementation after the empirical results have emerged., (© 2023 The Authors. Gerodontology published by Gerodontology Association and John Wiley & Sons Ltd.)

Objectives: To examine the association between dental clinical status and school performance and school attendance in the Kingdom of Bahrain (KoB) using a life-course framework., Methods: This time-ordered cross-sectional study included 466 school children in Grade 2 (aged 7-8 years) and their parents in the KoB. Data were collected through parents' self-administered questionnaires, children's face-to-face interviews and dental clinical examinations. Data on children's school performance and school attendance were gathered from parents and school records. Structural equation modelling (SEM) examined the direct and indirect pathways between variables., Results: Children born in families with high socio-economic status (SES) were less likely to have dental caries and more likely to have better school performance at 7-8 years of age. Dentine caries was directly linked with poor school performance. Treated teeth directly predicted high school performance. The presence of dentine caries mediated the relationship of SES with school performance., Conclusions: Birth and current socio-economic factors were significant predictors of dental clinical conditions and school performance. Dental caries and fewer treated teeth directly predicted poor school performance., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Abstract: Elevated circulating fibrinogen levels correlate with increased risk for both cardiovascular and venous thromboembolic diseases. In vitro studies show that formation of a highly dense fibrin matrix is a major determinant of clot structure and stability. Here, we analyzed the impact of nonpolymerizable fibrinogen on arterial and venous thrombosis as well as hemostasis in vivo using FgaEK mice that express normal levels of a fibrinogen that cannot be cleaved by thrombin. In a model of carotid artery thrombosis, FgaWT/EK and FgaEK/EK mice were protected from occlusion with 4% ferric chloride (FeCl3) challenges compared with wild-type (FgaWT/WT) mice, but this protection was lost, with injuries driven by higher concentrations of FeCl3. In contrast, fibrinogen-deficient (Fga-/-) mice showed no evidence of occlusion, even with high-concentration FeCl3 challenge. Fibrinogen-dependent platelet aggregation and intraplatelet fibrinogen content were similar in FgaWT/WT, FgaWT/EK, and FgaEK/EK mice, consistent with preserved fibrinogen-platelet interactions that support arterial thrombosis with severe challenge. In an inferior vena cava stasis model of venous thrombosis, FgaEK/EK mice had near complete protection from thrombus formation. FgaWT/EK mice also displayed reduced thrombus incidence and a significant reduction in thrombus mass relative to FgaWT/WT mice after inferior vena cava stasis, suggesting that partial expression of nonpolymerizable fibrinogen was sufficient for conferring protection. Notably, FgaWT/EK and FgaEK/EK mice had preserved hemostasis in multiple models as well as normal wound healing times after skin incision, unlike Fga-/- mice that displayed significant bleeding and delayed healing. These findings indicate that a nonpolymerizable fibrinogen variant can significantly suppress occlusive thrombosis while preserving hemostatic potential in vivo., (© 2024 American Society of Hematology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)