bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward a New Conceptualization of Settlements for Demography
Authors: Hugo Graeme , Champion Anthony , Lattes Alfredo
Published: January 2004

It has long been recognized that where people live and work can be a relevant factor in helping to explain demographic behavior, yet the treatment of location in censuses and surveys remains surprisingly crude. Emphasis is still being given to the urban–rural dichotomy based on definitions that most countries around the world introduced 40 to 50 years ago and have modified little since. Given the increase in the complexity of settlement systems in recent decades in less developed as well as in more developed contexts, this simple classification is no longer adequate for examining the role of settlement in demographic processes. The time has come to rethink how settlement should be differentiated in population data collection and analysis. Contemporary technologies and methodologies make it possible to analyze spatially referenced data in ways that are more rapid and sophisticated than could have been imagined when the conventional approach was devised.
Two‐and‐a‐Half Cheers: A Review Essay on the International Migration Report 2002*
Authors: Coleman David A.
Published: January 2004

Amy Chua, World on Fire: How Exporting Free Market Democracy Breeds Ethnic Hatred and Global Instability

Surjit S. Bhalla, Imagine There's No Country: Poverty, Inequality, and Growth in the Era of Globalization

John Firor and Judith Jacobsen, The Crowded Greenhouse: Population, Climate Change, and Creating a Sustainable World

Joel Perlmann and Mary C. Waters (eds.), The New Race Question: How the Census Counts Multiracial Individuals
SHORT REVIEWS
Authors: Bongaarts John , Diers Judith A. , Hewett Paul C. , McNicoll Geoffrey
Published: January 2004

Books reviewed in this article:

Paul Demeny and Geoffrey Mcnicoll (eds.), Encyclopedia of Population

Barbara Ehrenreich and Arlie Russell Hochschild (eds.), Global Woman: Nannies, Maids, and Sex Workers in the New Economy

Food and Agriculture Organization of the United Nations, World Agriculture: Towards 2015/2030: An FAO Perspective and Summary Report

Jeanne X. Kasperson and Roger E. Kasperson, Global Environmental Risk

Richard Lynn, Eugenics: A Reassessment

Douglas W. Maynard, Hanneke Houtkoop‐Steenstra, Nora Gate Schaeffer, and Johannes van der Zouwen (eds.), Standardization and Tacit Knowledge: Interaction and Practice in the Survey

Anthony M. Messina (ed.), West European Immigration and Immigrant Policy in the New Century
Explanations of Unmet Need for Contraception in Chitwan, Nepal
Authors: Stash Sharon
Published: January 2004

This article explores reasons why women's fertility preferences and their contraceptive behaviors often appear to be contradictory. Ninety‐eight separate interviews with women and their husbands conducted in rural Chitwan District, Nepal, over a 12‐month period in 1993–94 revealed that people continually and self‐consciously weigh the perceived benefits and risks of practicing family planning relative to their situations. Temporary and, especially, hormonal methods are perceived to carry unacceptable health risks. Contraceptive technologies are evaluated in relation to competing priorities and interests. Household poverty heightened the perceived risk of family planning use; poor people fear they can ill afford negative effects to their health that might result. People assess their health status and physical workload, factors that they believe condition their ability to use family planning methods without experiencing damaging health effects. Strategies employed to lower contraceptive risk include altering the method of choice, manipulating relationships with spouses, timing the adoption of contraceptives, managing the context of service provision, and acting in light of the experiences of others. Qualitative findings from the fieldwork are complemented by analysis of data from a standardized fertility survey.
Understanding the Prevalence of Female Sterilization in Rural South India
Authors: Säävälä Minna
Published: January 2004

By analyzing the practice of female sterilization in rural Andhra Pradesh, in southern India, this article examines the role culture plays in demographic research. The popularity of female sterilization in rural Andhra Pradesh is shown to be intelligible if the symbolic value of a young mother's reproductive capacity is understood in terms of familial power relations. Through sterilization, young mothers can symbolically push their influential mothers‐in‐law toward old age, thus increasing their own relative prestige, and they can strive to control the ambiguity surrounding their reproductive functions. This study is based on 14 months of participant observation in three rural villages, a survey of 396 households, and unstructured interviews with 42 women and two men. It shows how demography and anthropology can be mutually supportive in their efforts to clarify population phenomena.
Contraceptive Switching in Bangladesh
Authors: Steele Fiona , Diamond Ian
Published: January 2004

Bangladesh has experienced a substantial decline in fertility that has been achieved by means of a large increase in the use of modern methods of contraception. As contraceptive prevalence increases, aspects of contraceptive‐use dynamics, including reasons for discontinuation and behavior after discontinuation, become important influences on fertility. This report uses calendar data from the 1993–94 Bangladesh Demographic and Health Survey to examine contraceptive behavior following discontinuation of modern‐method use. The individual‐level characteristics found to influence switching behavior include the method used, method‐related difficulties with previous contraceptive use, and education. A large amount of unexplained variation in switching rates remains, however, largely at the individual level, but also at the community level for certain types of transition.
Maternal Mortality in Vietnam in 1994–95
Authors: Hieu Do Trong , Hanenberg Robert , Vach Trinh Huu , Vinh Dao Quang , Sokal David
Published: January 2004

This report presents the first population‐based estimates of maternal morality in Vietnam. All the deaths of women aged 15–49 in 1994–95 in three provinces of Vietnam were identified and classified by cause. Maternal mortality was the fifth most frequent cause of death. The maternal mortality ratio was 155 deaths per 100,000 live births. This ratio compares with the World Health Organization's estimates of 430 such deaths globally and 390 for Asia. The maternal mortality ratio in the delta regions of these provinces was half that of the mountainous and semimountainous regions. Because a larger proportion of the Vietnamese population live in delta regions than elsewhere, the maternal mortality ratio for Vietnam as a whole may be lower than that of the three provinces studied. Maternal mortality is low in Vietnam primarily because a relatively high proportion of deliveries take place in clinics and hospitals, where few women die in childbirth. Also, few women die of the consequences of induced abortion in Vietnam because the procedure is legal and easily available.
Assessing Recall and Understanding of Informed Consent in a Contraceptive Clinical Trial
Authors: Fortney Judith A.
Published: January 2004

Recall and understanding of information provided to contraceptive study participants in four sites were assessed. Analysis was completed of data for 70 women who were asked about their recollection of information and understanding of participation. Most women understood the purpose of the study. Their reasons for agreeing to participate varied by site and included wanting to try a new method, wanting to help others, and wishing to avoid pregnancy. Most women recalled correctly the burden of participation—number and frequency of visits, tests, and examinations. Most understood that they could withdraw from the study without jeopardizing their care. The women were also asked to recall the risks and benefits of the contraceptive they were testing. Only 23 percent recalled the pregnancy risk correctly; 40 percent underestimated and 19 percent overestimated it. Few women interpreted rates of risk correctly; some perceived high rates as low ones and the rates of the spermicide being studied as better than those of other contraceptives. This study confirms that risk is better recalled than understood. The participants surveyed remembered the information they were questioned about better than did participants in some other studies, a finding that supports earlier research results showing that younger, healthier patients (such as contraceptive users) recall better than older, less healthy ones.
Selection of useful probiotic lactic acid bacteria from the Lactobacillus acidophilus group and their applications to functional foods
Authors: SAITO Tadao
Published: January 2004

In the present review, a new mass screening system for selecting probiotic strains from Lactobacillus (L) acidophilus group lactic acid bacteria (LAB) with strong adhesion to the human intestinal tract is described. Characteristics of antimicrobial peptides (bacteriocin), lactose‐hydrolyzing enzymes and immunostimulative oligo DNA motifs in L. gasseri strains are also described. Finally, the use of L. acidophilus LAB, selected by our screening method, that have strong adhesion to the human colonic mucosa in functional yogurt products is described. Adhesiveness to the human intestine is one of the most important characteristics of probiotic LAB. A new screening system that involves a combination of three methods is proposed: rat colonic mucin (RCM)‐micro plate assay, Carnoy's histochemical staining method and carbohydrate probe binding assay. By using an RCM‐coated poly‐vinylidene‐diflouride membrane that mimics the human colonic mucous layer, a new lectin was isolated and its structure was clarified by gene cloning. Furthermore, the structures and functions of a new cyclic bacteriocin (gassericin A), new lactose‐hydrolyzing enzymes, and new immunostimulating oligo DNA motifs from Lactobacillus gasseri (B1 subgroup) were clarified. A new functional yogurt ‘Fit down’ is proposed, that is fermented by an adhesive strain of L. acidophilus LA67 selected by our screening and contains antihypertensive peptides derived from whey proteins by protease digestion. In the future, superior functional foods containing more effective probiotic LAB are expected to be developed by the use of the proposed mass screening system.
Effect of cyclodextrin diallyl maleate on methane production, ruminal fermentation and microbes in vitro and in vivo
Authors: LILA Zeenat Ara , MOHAMMED Nazimuddin , TATSUOKA (AJISAKA) Noriko , KANDA Shuhei , KUROKAWA Yuzo , ITABASHI Hisao
Published: January 2004

Effects of β‐cyclodextrin diallyl maleate (CD‐M) on methane production, ruminal fermentation and digestibility were studied both in vitro and in vivo. In in vitro study, diluted ruminal fluid (30 mL) was incubated anaerobically at 38°C for 6 and 24 h with or without CD‐M using hay plus concentrate (1.5:1) as a substrate. The CD‐M was added at different concentrations (0, 1.25, 2.5, 5.0 and 7.5 g/L). The pH of the medium and numbers of protozoa were not affected by the addition of CD‐M. Total volatile fatty acids were increased and ammonia‐N was decreased, molar proportion of acetate was decreased and propionate was increased (P < 0.05) by CD‐M. Methane was inhibited (P < 0.05) by 14–76%. The effect of CD‐M on methane production and ruminal fermentation was further investigated in vivo using four Holstein steers in a cross‐over design. The steers were fed Sudangrass hay and concentrate mixture (1.5:1) with or without CD‐M (2% of feed dry matter) as a supplement. Ruminal proportion of acetate tended to decrease and that of propionate was increased (P < 0.05) 2 h after CD‐M dosing. Total viable counts, cellulolytic, sulfate reducing, acetogenic bacteria and protozoa were unaffected while methanogenic bacteria were decreased (P < 0.05) by CD‐M. The plasma concentration of glucose was increased, whereas that of urea‐N was decreased (P < 0.05). Methane was inhibited (P < 0.05) from 36.4 to 30.1 L/kg dry matter intake by the addition of CD‐M. Apparent digestibilities of dry matter and neutral detergent fiber were not affected while that of crude protein was increased (P < 0.05) in the medicated steers. These data suggested that dietary supplementation of CD‐M decreased methane production and improved nutrient use.
Effects of ruminal dosing of mechanical stimulating brush on digestibility and rumen fermentation status in Holstein steers fed low rice straw at different lengths
Authors: HORIGUCHI Ken‐ichi , TAKAHASHI ToshiyoshI
Published: January 2004

The objectives of the present study were to determine the effect of ruminal dosing of mechanical stimulating brush (Rumen faibu; RF) on digestibility and on rumen fermentation status in Holstein steers fed high concentrate and low rice straw. Eight steers (461 kg in average bodyweight) were used. Four steers were orally dosed three RF per head (RF‐dosing) and the other four were not dosed (non‐RF). All steers were fed enough concentrate and rice straw to gain 1.4 kg/day in bodyweight. Rice straw was cut 2 cm and 30 cm. The organic cell wall content of feeding diets was 17% in dry matter basis. Digestibility and nutritive value were not affected by RF dosing and length of rice straw. Ruminal pH was significantly lower in RF‐dosing group than in non‐RF group after feeding, and tended to be higher in long rice straw than in short rice straw throughout the day. There were no clear difference on total volatile fatty acid concentration and molar proportion of volatile fatty acid by RF dosing and length of rice straw throughout examined period. These present results suggest that digestibility and rumen fermentation status are not affected by RF dosing when organic cell wall content of feeding diets is approximately 17% in dry matter with rice straw over 2 cm.
The effects of grazing and supplemental protein concentrations during the grazing period on subsequent finishing performance and carcass quality in Japanese Black cattle steers
Authors: SUGIMOTO Masahito , KUZUOKA Syuji , YAYOTA Chizuru , SATO Yukinobu
Published: January 2004

The effects of grazing and supplemental protein concentrations, provided during the grazing period, on subsequent finishing performance and carcass quality were investigated. This experiment was carried out using 15 Japanese Black cattle (Wagyu) steers. The steers were fed as follows: (i) grazing supplemented with moderate protein concentrate (GMP) (18% crude protein (CP); dry matter (DM) basis) before finishing, followed by feeding in a barn until slaughter; (ii) grazing supplemented with low protein concentrate (GLP) (14% CP; DM basis) before finishing, followed by feeding in the barn until slaughter; and (iii) no grazing before finishing (NG). From the end of the grazing season to the end of the growing period, the GMP and GLP steers were managed in the same way as the NG steers. All of the animals were fed the same diet in the finishing period (9 months to 28 months). None of the three treatments affected the average daily gains. For all treatments, chilled carcass weights were more than 450 kg and did not differ significantly among the groups. The longissimus muscle areas in the grazed steers were numerically larger than in those receiving the NG treatment. Fat thickness was significantly greater (P < 0.05) in the NG steers than in the grazed steers. The intramuscular fat and marbling scores were not affected in the grazed steers. In conclusion, the carcass quality of grazed steers was similar to that of the NG steers at a similar final age, and the quantity of meat in the NG steers would be less than that of the GMP and GLP steers. Therefore, spring‐born Wagyu steers should be grazed using the GLP supplement before fattening.
Effects of probiotic Bacillus cereus toyoi on abdominal fat accumulation in the Japanese quail (Coturnix japonica)
Authors: HOMMA Hideya , SHINOHARA Taku
Published: January 2004

Effects of a commercial probiotic, Bacillus cereus toyoi on abdominal fat accumulation in the Japanese quail fed either a commercial control diet (crude protein (CP), 23.5%; metabolizable energy (ME), 11.7MJ/kg) or a high‐energy diet (CP, 23.0%; ME, 13.8MJ/kg) were investigated. Four‐week‐old male birds (n = 108) were divided into four diet groups: control diet, control with probiotic, high‐energy diet and high‐energy diet with probiotic. At 8 weeks and 12 weeks of age (4 and 8 weeks of probiotic supplementation period, respectively), abdominal fat, muscles and the liver were weighed. The weight of total fat and protein in the muscles and liver were also determined. A rectal temperature was recorded weekly. Bodyweight and feed intake in both diets were not affected by probiotic supplementation. At 8 weeks of age, birds fed the control diet with probiotic had significantly less abdominal fat than those fed without the probiotic, and a similar tendency was seen for both diet groups at 12 weeks of age. The decrease in abdominal fat coincided with an increase in rectal temperature. These results suggest that greater metabolizable energy was consumed through elevation of heat production by supplementation of B. cereus toyoi, with hardly any energy stored as body fat. Probiotic supplementation appears to induce greater muscle weight, higher protein and lower lipid content in muscles by 8 weeks of age, and lower lipid content in muscles and greater liver weight by 12 weeks of age, in the Japanese quail.
Change of fatty acid composition of white adipose tissue with increasing age in Syrian hamster fed alfalfa or cereal based diet
Authors: SUDA Yoshihito , SHINOHARA Hisashi , YAMAGUCHI Toshiyasu , MATSUDA Toshiaki , NAKAGAWA Kazuki , OHTOMO Yukiko , NISHIDA Akira , YAMAGISHI Toshihiro
Published: January 2004

The present study's aim was to investigate change of fatty acid composition of white adipose tissue with increasing age in Syrian hamster fed continuously alfalfa (LU) or cereal based diet (F2). A total of 43 Syrian hamsters with male and female, 22 head maintained with mating between sibling in a close herd fed F2 (GN) and 21 head selected for long‐term for large number of weaning pups per a mater using GN fed LU (ALF), were used. Fatty acid composition in adipose tissues taken from the back leg subcutaneous depot, periphery of kidney and reproductive organs at 3, 8 and 13 weeks of age were determined by using a gas chromatograph. Carbon (C)18:0 in GN tended to decrease and C18:1 increased significantly with increasing age, suggesting that Δ9‐desaturase had related adaptively. C18:3 in ALF increased significantly with increasing age. The present results indicate that, although the composition in unsaturated fatty acid (USFA) in both herds was different, the ratio of USFA to saturated fatty acid increased with increasing age suggesting that USFA in GN fed F2 was at a high level compared with in ALF fed LU.
Expression of agouti gene in bovine adipocytes
Authors: SUMIDA Takeshi , HINO Naoko , KAWACHI Hiroyuki , MATSUI Tohru , YANO Hideo
Published: January 2004

Agouti expressed in human adipocytes enhances lipogenesis and inhibits lipolysis through increasing intracellular Ca2+. This factor stimulates fat accumulation through a paracrine/autocrine manner. However, agouti gene expression has not been clarified in bovine adipocytes. In the present study, it is found that agouti mRNA was expressed in adipocytes prepared from bovine adipose tissue using reverse transcription polymerase chain reaction. This is thought to be the first report where agouti gene is expressed in adipocyte of wild‐type animal except for humans. This result suggests the possibility that agouti regulates adipocyte function in cattle.
Influence of estrogen on acetylcholinesterase activity in primary cultures of cerebral cells from neonatal rats
Authors: TSUCHIYA Kyoko , YAMAMURO Yutaka , SENSUI Naoto
Published: January 2004

To estimate the influence of estrogen on the functional development of the central nervous system during the neonatal period, several doses of estradiol‐17β (E2) were treated to cultured cells from the cerebral cortex of neonatal rats and the acetylcholinesterase (AChE) activity was examined. E2 was added to give the following final concentrations: 0, 10−10, 10−9, and 10−8 M. After 72 h of incubation, all cells were obtained from dishes to determine the AChE activity. Although apparent morphological changes were not observed among treatments cultured for 72 h, E2 suppressed dose‐dependently the spontaneous increase of AChE activity in cerebral cells. Furthermore, a single dose of tamoxifen, an E2 receptor binding molecule with agonist and antagonist properties, also acted in a similar manner as E2. These findings suggest that the functional development of the cerebral cortex, at least the cholinergic system, during the neonatal period is regulated by E2.
Physicochemical properties of water‐soluble myofibrillar proteins prepared from chicken breast muscle
Authors: ITO Yukiko , TOKI Shinji , OMORI Takashi , IDE Hiroshi , TATSUMI Ryuichi , WAKAMATSU Jun‐ichi , NISHIMURA Takanori , HATTORI Akihito
Published: January 2004

The solubility of skeletal muscle myofibrillar proteins in water was examined. The solubility of the proteins was found to be sensitive to ionic strength and pH of the solution. At the ionic strength of less than 12 mM and neutral pH, more than 80% of myofibrillar proteins were solubilized. Heating at a temperature of more than 70°C was required for the proteins to retain their solubility. The solubility of freeze‐dried protein powder prepared from water‐soluble myofibrillar proteins was also examined, and it was found that addition of trehalose and heating were essential for re‐solubilization in water. Amino acid composition of water‐soluble myofibrillar proteins was found to be almost the same as that of myofibrillar proteins.
Factors affecting agonistic interactions of weanling pigs after grouping in pens with a tire
Authors: ISHIWATA Toshie , UETAKE Katsuji , TANAKA Toshio
Published: January 2004

The effects on agonistic interactions of installing a tire in a pen with 24 weanling pigs allocated to six pens, with four animals in each, were determined. At the first grouping, two pigs were transferred from each pen to another pen where non‐littermates existed. Then half of the pens were equipped with a tire (Grouping 1). After one week, the pigs transferred at Grouping 1 were again transferred to other pens were non‐littermates existed (Grouping 2). At Grouping 2, any pen was not newly equipped with a tire and no pig was exposed to a tire for the first time. After another week, the pigs transferred at the previous groupings were once more transferred to other pens where non‐littermates existed (Grouping 3). At Grouping 3, the pigs in the pens with a tire were transferred to pens without a tire, and the pigs in the pens without a tire were transferred to pens with a tire. Then all pens were equipped with a tire. In Grouping 1, the effects on agonistic interactions of installing a tire were not significant. However, the injury score (less the score, less the number and damage of injury) was higher in the pens without a tire than in the pens with a tire (P < 0.05). In Grouping 2, pigs in the pens with a tire were attacked more than pigs in the pens without a tire (P < 0.05). The number of agonistic behaviors positively correlated with access to the tire (rs = 0.31; P < 0.01). In Grouping 3, the number of attacks received by pigs with no experience in using a tire was larger on the first day after grouping than on the 4th day (P < 0.05). The injury score was higher for pigs being transferred than for pigs not being transferred (P < 0.05). In conclusion: (i) installing a tire in a pen did not reduce the agonistic interactions of pigs, but it could change the style of their attacks, and (ii) initially having pigs experienced in using a tire can be useful for reducing the damage caused by agonistic interactions.
Ammonia‐assimilating microbes in microbial community in a lagoon for wastewater from paddock of dairy cattle
Authors: SASAKI Hiraku , KITAZUME Osamu , SASAKI Takako , NAKAI Yutaka
Published: January 2004

In the present article the distribution and abundance of ammonia‐assimilating microbes among the natural habitants in a lagoon were investigated. In the medium containing lagoon‐extract, about 20% of total 82 isolates showed ammonia‐assimilating ability. By sequencing of 16S ribosomal DNA (rDNA), the highest ammonia‐assimilating isolates at 10°C and 37°C were identified as Janthinobacterium lividum and Bacillus sp., respectively. The structure of the microbial community was analyzed by polymerase chain reaction‐denaturing gradient gel electrophoresis (PCR‐DGGE). Almost of the dominant species that were detected by PCR‐DGGE did not coincide with isolates, which showed the high ammonia‐assimilating ability, but one specie by PCR‐DGGE coincided with ammonia‐assimilating isolate. These results suggested that ammonia‐assimilating microbes existed as non‐dominant species in the microbial community in a lagoon.
Fluoride profiles in the cementum and root dentine of human permanent anterior teeth extracted from adult residents in a naturally fluoridated and a non‐fluoridated area
Authors: Kato S. , Nakagaki H. , Toyama Y. , Kanayama T. , Arai M. , Togari A. , Matsumoto S. , Strong M. , Robinson C.
Published: January 2004

Objectives:To determine the effect of water fluoride concentration on the fluoride profile across the entire thickness of the cementum and root dentine of human permanent anterior teeth in adults. Subjects:Twenty‐eight human permanent anterior teeth from individuals aged from 30 to over 60 years were studied. Setting:Teeth were obtained from a natural high‐fluoride area (West Hartlepool, UK; 1.0–1.3 ppm F in drinking water, WHP) and the other from a non‐fluoridated naturally low fluoride area (Leeds, UK; 0.1 ppm F in drinking water, LDS). Design:Cementum and root dentine were sampled using an abrasive micro‐sampling technique from the cementum surface to the pulpal surface of root dentine. Results:Fluoride concentration was higher in tooth roots (the cementum and dentine) taken from the naturally fluoridated area (WHP) than from the non‐fluoridated area (LDS). Age and average fluoride concentration showed a positive correlation in WHP dentine, middle region of the root (r = 0.78, P < 0.001) and in the apical region of the root (r = 0.67, P < 0.05). WHP cementum had the strongest fluoride concentration correlation with age in the cervical region of the root (r = 0.67, P < 0.01). An analysis of variance (ANOVA) showed that the area (water fluoride content), age and number of years lived in the area combined with total age were significant. Conclusions: The fluoride content of cementum and root dentine in adult residents is related to fluoride content in drinking water.
Oral health and history of respiratory tract infection in frail institutionalised elders
Authors: Mojon P. , Budtz‐Jørgensen E. , Miche J.‐P. , Limeback H.
Published: January 2004

Objectives:The purpose of this study was to look for a relationship between history of respiratory tract infection (RTI) and oral health in very old subjects. Setting and Subjects:302 frail elders (mean age: 85 years) living in a medical care facility were examined by one dentist. Outcome Measures:The incidence of RTI over 1 year had been recorded along with markers of nutritional status and degree of dependency. The oral examination comprised an evaluation of hygiene, quality of prostheses and the prevalence of caries, periodontal disease and mucosal disorders. Results:One third (33%) of the subjects had experienced at least one episode of RTI and a fifth (19%) had visited the dentist in emergency. The incidence of RTI had been greater among dentate subjects and those who came to the dentist in emergency. The dentate subjects with a history of RTI had higher plaque score (P=0.02). Half (49%) of the subjects had oral disorders that could develop in a dental emergency and these subjects had had a higher risk of RTI (relative risk: 1.9, 95% confidence interval: 1.1–3.9). The presence of selected oral disorders associated with low serum albumin increased the relative risk of having had RTI to 3.2 (1.5–6.7). The association between presence of actual oral health problems and previous experience of RTI was more noticeable in those who had poor general health or were more debilitated. Conclusions:The present study suggests that poor oral hygiene and the presence of potential emergency could be major risk factors for RTI among the frail elderly.
Staff attitudes to oral health care. A comparative study of registered nurses, nursing assistants and home care aides
Authors: Wårdh Inger , Andersson Lars , Sörensen Stefan
Published: January 2004

This study compares differences in attitude, of oral health care of nursing personnel working with dependent elderly and severely disabled patients. A questionnaire was administered to 398 personnel covering (1) personal oral health care habits. (2) experiences and attitudes in assisting oral care and (3) willingness to assist patients/residents with their daily oral hygiene. Three hundred and sixty ‐ four persons answered the questionnaire, including 70 registered nurses, 148 nursing assistants and 146 home care aides. The study revealed that oral care assistance is viewed as more disagreeable than other nursing activities. Although registered nurses were found to have more positive attitudes toward oral care assistance than the other nursing groups, they were seldom invoked in the daily practice of oral hygiene care. The results indicate a gap between knowledge and practice in nursing personnel's attitudes toward oral health care of dependent elderly and severely disabled patients.
A reference guide to drugs and dry mouth – 2nd edition
Authors: Sreebny Leo M. , Schwartz Steven S.
Published: January 2004

Xerostomia (dry mouth) is an uncomfortable and potentially harmful oral symptom which is usually caused by a decrease in the secretion rate of saliva (salivary gland hypofunction, or SGH). It is more prevalent in the elderly population, primarily due to their increased use of drugs and their susceptibility to disease. Many drugs and drug classes have been linked to xerostomia; the xerogenic effect increases when many drugs are taken concurrently. This Reference Guide to Drugs and Dry Mouth is designed to allow the reader to rapidly identify those pharmacologic agents which have the capacity to induce xerostomia and SGH. Xerogenic drugs can be found in 42 drug categories and 56 sub‐categories. A guide to the management of drug‐induced SGH and xerostomia is also provided.
The development of patient information leaflets. Care of the mouth after radiotherapy
Authors: Zakrzewska J. M. , Leeson R. M. A. , Mcluskey M. , Vickers M.
Published: January 2004

Objectives:Describe the methodology used to produce a patient leaflet on care of the mouth after radiotherapy. Design:Prospective study to design a patient information leaflet. Setting and Subjects: Patients undergoing radiotherapy for oral cancer. Intervention:After a review of the relevant literature, a patient questionnaire was produced. This was then completed by patients undergoing radiotherapy treatment and gave an indication of the problems being encountered. Healthcare professionals were surveyed for their views. A leaflet was then produced according to published guidelines. It was taken back to another group of patients and a further version produced after input from a health promotion group. Results:A leaflet was produced after wide consultation and survey. Conclusion:Considerable effort must to be put into the production of patient information leaflet. It must be discussed with patients in the target group if it is to be sensitive, understood and find acceptance among its users
A preliminary assessment of intra‐oral lubricating systems for dry mouth patients
Authors: Frost P. M. , Gardner R. M. , Price A. R. , Sinclair G. F.
Published: January 2004

Objective:To provide extended intra‐oral delivery of a saliva substitute. Intervention:Three different types of prostheses containing saliva substitute were designed and assessed: a two‐part device resembling a mandibular complete denture sealed by cobalt‐samerium magnets, a one‐part clear resin device for the edentate patients and a flexible mouth guard type of appliance containing a lubricant releasing bubble for the dentate patients. Setting:A teaching hospital Oral Medicine and Rheumatology Clinic. Subjects:8 edentate and 3 dentate Sjogren Syndrome sufferers. Outcome measures:Subjective dryness after a week of wearing the lubricating appliance. Results:The majority of the subjects wore the appliances for 6–12 hours during each 24 hours. The initial dryness severity diminished after wearing the lubricating prosthesis. The patients preferred to wear the appliance at night. Conclusion:All criteria were fulfilled on designing a saliva substitute lubricating appliance and some of the subjects have worn this prosthesis successfully for up to 3 years. Particular benefit was obtained by night‐time wear.
Geroprosthodontics: The Nijmegen and Manchester Dental Schools approach
Authors: de Baat C. , McCord J.F. , Hoad‐Reddick G. , Witter D.J.
Published: January 2004

If quality of care for elderly patients is to be achieved, thorough and realistic geroprosthodontic treatment planning is essential. This requires mature consideration, incorporating comprehensive patient assessment and selection of the most appropriate treatment option for each patient. The latter should be based on criteria which meet the demands of a healthy dentition and which enable a patient to achieve satisfactory oral function. The Nijmegen and Manchester Dental Schools have evolved simple patient‐related treatment guidelines. These start with a problem‐oriented approach which leads to a provisional treatment. The provisional treatment is intended to result in a healthy dentition that is monitored over an appropriate period. Evaluation of the provisional treatment leads to three options: extension of the monitoring time, preservation of the natural occlusion or loss of the natural occlusion. Definitive prosthodontic treatment plans are based on the second or third option. In the maintenance of good oral health after prosthodontic treatments, plaque and diet control are essential elements. Recall or maintenance programmes must be carried out if successful treatment is to be achieved and maintained.
Partial dentures as an independent indicator of root caries risk in a group of older adults.
Authors: Steele J.G. , Walls A.W.G. , Murray J.J.
Published: January 2004

Objectives:To estimate the independent association between the wearing of removable partial dentures (RPD) and the presence of root caries in a population of older adults. Design:Multivariate logistic regression modeling of root caries prevalence using different measures of root caries as dependent variables. The model included measures of disease history as indicators of historical risk. Setting:Data collected in the field from three areas of England. Subjects:Random sample of adults aged 60 years and over, drawn from lists of patients registered with general medical practitioners. Intervension:Field measurements of a range of oral health variables including oral disease, disease history, oral status and various social and demographic measures. Main outcome measures:The presence of root caries, unsound and sound root restorations. Results:Of the five different models of root caries prevalence which were used, RPDs featured as an independent risk indicator for root surface cades in the three which were related to the presence of untreated disease. The odds ratios for the contribution made by RPDs were all over 1.6, and when considered alone was in excess of 2 in one model. These models were generally well fitting. RPDs did not feature as a risk indicator in the two models which related only to the presence of root surface restorations. Conclusions:In this study, where RPDs were present, the odds of untreated disease being present increased substantially
The normative need for tooth extractions in older adults in Ontario, Canada
Authors: Hawkins R.J. , Main P.A. , Locker D.
Published: January 2004

Objective: To determine the reasons for clinically defined need for tooth extractions were examined. Design:Descriptive survey; interview and clinical data. Setting:The City of North York, Canada. Subjects:1,531 dentate adults aged 65 and over, 69% being nursing home residents. Measurements: Age, sex, type of residence and dental attendance pattern. Outcome measure: Normative need for tooth extraction. Results:One or more extractions were required by 38% of nursing home residents and 21% of independently‐living subjects. The mean number of teeth indicated for extraction were 1.4 and 0.6, respectively. Among nursing home residents, caries was more often the reason for extraction for almost all tooth types, but for independently‐living subjects periodontal reasons were more common. Overall, a significantly higher proportion of nursing home residents needed extractions due to both caries and periodontal reasons (25% and 16%) compared to subjects who lived independently (10% and 11%). For nursing home residents in all age groups, more subjects required caries‐related extractions, but for independently‐living subjects about equal proportions required extractions due to caries and periodontal diseases. Although the percentage of subjects requiring extraction due to caries varied significantly by age and residence type, the percentage needing extractions due to periodontal diseases showed slight variation and remained under 20%. Conclusion:This study indicates that among high risk groups of older adults caries continues to be the major reason for tooth extraction. However, problems with sampling limit the external validity of these results.
Cephalometric evaluation of the changes in mandibular symphysis after 7 years of denture wearing
Authors: Karkazis H.C. , Lambadakis J. , Tsichlakis K.
Published: January 2004

Objective: To evaluate changes in mandibular symphysis during 7 years of complete denture wearing following extraction of natural anterior teeth. Design:Comparison among measurements taken at four different occasions in a prospective cephalometric study. Setting:The study was conducted at the Dental School of Athens University. Subjects:10 complete denture wearers (5 women, 5 men) with average age of 53.2 years, at the beginning of the study. Measures:Linear and area measurements of the mandibular symphysis. Results:The overall reduction in the anterior mandibular height was 7.87 mm and in the mandibular symphysis area 54.8 mm2 (p<0.05). Females presented higher total average reduction in both variables tested, and more rapid bone loss during the first two years of denture wear, compared to men. Superimposition of the tracings revealed considerable individual variation in mandibular symphysis changes. Conclusion:Results are in line with the findings of other authors indicating continuous reduction and dramatic inter‐subject variation in the mandibular alveolar bone, following extraction of natural teeth and wearing of complete dentures.
Oral health knowledge, beliefs and practices of a sample of Chinese elders in Inner London, UK, aged 54 years and over: a pilot investigation.
Authors: Pau Allan K H. , Croucher Ray
Published: January 2004

Objectives:To explore the self‐reported oral health and health behaviours of a sample of Inner London Chinese elders and the impact of their sell‐reported oral health on their social functioning and eating ability. Design:Cross sectional. Setting:Luncheon clubs in Central and East London, UK. Subjects:54 Chinese elders aged 54–81 years. Intervention:A structured questionnaire, administered by two interviewers in Cantonese. Main outcome measures:Knowledge and beliefs about the causes and prevention of tooth decay and gum disease, the oral conditions experienced in the previous twelve months and the impact of these conditions. Results:Overall health was rated more positively than oral health, although those who reported below average oral health were more likely to report below average overall health. Whilst over half thought that sugar and sweet food could cause tooth decay, only 19% thought that poor oral hygiene could cause gum disease. Over half thought that “hot air” caused gum disease. Three quarters brushed their teeth at least twice a day. Two thirds had experienced at least one oral condition in the previous twelve months, with the more elderly being more likely to report this. Social impacts affected 41% of the sample whilst 44% of suffered at least one dietary impact. Conclusions:The burden of oral conditions is substantial, especially on the more elderly members, impacting on the performance of social functions. These burdens indicate a need for oral health services. Beliefs in the traditional Chinese explanation of “hot air” as a cause of gum disease were common. Health promotion effort should consider these when developing health messages.
The teaching of prosthodontic care for older people: a non‐rote philosophy
Authors: Heath M R , Wright PS
Published: January 2004

This essay complements that de Baat et al1 in the last issue with emphasis on the importance of the variability between individual older people. The consequent need for an open minded approach towards planning Prosthodontics is discussed, based on each patient's motivation for aesthetics, function, comfort and self esteem. Both functional expectations and motivation to learn effective health behaviour vary widely, and evaluation of both is essential for realistic planning because further tooth loss and the need for partial dentures occur so frequently. The consequent variation in plans raises the question – which are the strategic teeth to maintain a stable dental occlusion or a future tooth stabilised denture? For undergraduates this demands a non‐rote approach to learning.
Ageing changes in human muscle and bone in relation to oral function and general health
Authors: Heath Robin , Goldspink Geoffrey
Published: January 2004

The Symposium was held on the 26 June 1998 at the Annual meeting of the IADR in Nice. It was “sponsored” by the Geriatric Oral Research Group, the Prosthodontics, Neuroscience, Nutrition & Implantology Research Groups of the IADR and notably it was generously supported by Unilever Dental Research
Oro‐facial muscles: internal structure, function and ageing
Authors: McComas Alan J
Published: January 2004

Structure and function are reviewed in the masticatory muscles and in the muscles of the lower face and tongue. The enormous strength of jaw closure is in large part due to the pinnated arrangement of the muscle fibres in the masseter. This muscle, like other masticatory muscles, is unusual in that the cell bodies of the muscle spindle afferents lie in the brain stem rather than in an external ganglion; spindles are absent in the lower facial muscles. Although few data are available, the numbers of motor units in the masticatory muscles, and probably in the lower facial muscles also, appear to he much greater than in limb muscles. The motor units in the facial and tongue muscles are largely composed of histochemical type II (‘fast‐twitch’) fibres, but in the masticatory muscles there are substantial numbers of fibres intermediate between type I (‘slow twitch’) and type II, and fibre type grouping is present. In comparison with limb muscles, there is little information on ageing changes in oro‐facial muscles. The masticatory muscles do, however, show some atrophy and loss of X‐ray density, while motor unit twitches are prolonged. Strength is reduced in the tongue and masticatory muscles. It is known that limb muscle properties are largely governed by their innervation, both through the pattern and amount of impulse activity, and the delivery of trophic messengers; the situation for oro‐facial muscles is unclear. The structural and functional differences between the two types of muscle indicate the need for conducting ageing studies on the oro‐facial muscles, rather than relying on extrapolations from limb muscles.
Exercise and nutritional needs of elderly people: effects on muscle and bone
Authors: Evans William J.
Published: January 2004

Advancing age is associated with a remarkable number of changes in body composition. Reductions in lean body mass have been well characterized. This decreased lean body mass occurs primarily as a result of losses in skeletal muscle mass1, 2. This age‐related loss in muscle mass has been termed sarcopenial3. Loss in muscle mass accounts for the age‐associated decreases in basal metabolic rate, muscle strength, and activity levels, which, in turn is the cause of the decreased energy requirements of the elderly. In sedentary individuals, the main determinant of energy expenditure is fat‐free mass, which declines by about 15% between the third and eighth decade of life. It also appears that declining caloric needs are not matched by an appropriate decline in caloric intake, with the ultimate result an increased body fat content with advancing age. Increased body fatness along with increased abdominal obesity are thought to be directly linked to the greatly increased incidence of Type II diabetes among the elderly. This review will discuss the extent to which regularly performed exercise can effect nutritional needs and functional capacity in the elderly. In addition, some basic guidelines for beginning an exercise program for older men and women, and establishing community‐based programs are provided.
Age changes in bone
Authors: Boyde A. , Kingsmill V.J.
Published: January 2004

Changes in bone structure as a function of age have been studied by simple inspection, x‐ray imaging, stereo‐photography, deep field optical microscopy, circularly polarised light microscopy, and scanning electron microscopy (SEM), including both topographic and compositional backscattered electron (BSE) imaging modes. The study of bone as a three‐dimensional object, rather than in thin sections, enables us to envisage modelling and remodelling processes in context. The study of ultra‐flat block surfaces permits the acquisition of data from an effectively very thin layer in the block face, and to examine bone as a spectrum of tissue types varying in the degree of mineralisation. Particular attention has been paid in our earlier studies to the iliac crest, lumbar vertebral bodies, femoral mid‐shaft, neck and head and parietal and frontal skull bones. Recently, we have compared findings from these sites with observations on the mandible. We conclude, from our new imaging data, that common generalisations about the changes in bone in ageing and osteoporosis are too simplified, and that the mandible differs sufficiently from post‐cranial skeletal sites that it would be unwise to extrapolate from findings in the jaw to the circumstances elsewhere.