bluuebunny/crossref_metadata_2025 huggingface dataset:
The Rise and Fall of High Definition Television: The Impact of European Technology Policy
Authors: Dai Xiudian , Cawson Alan , Holmes Peter
Published: March 2008

This article discusses the European attempt to revive the European consumer electronics industry by mobilizing resources in favour of High Definition Television (HDTV) technology. The policy was ultimately doomed, as digital technology and commercial broadcasters' actions undermined its viability and the public authorities, especially the European Commission, continued beyond the point at which failure was unavoidable. Nevertheless, the policy was not inherently unviable from the outset and not all the results and lessons from the programme are entirely negative. The Commission appears to be profiting from some of the lessons in its approach to digital broadcasting, and EU firms' activity in the US is benefiting from the IBA MAC research and development.
The Second Death (or the Second Coming?) of the WEU
Authors: Duke Simon
Published: March 2008

The Western European Union (WEU) has received much attention since its rejuvenation in the mid‐1980s, in large part due to its integral role as part of the European Union's Common Foreign and Securiy Policy (CFSP). This article argues that the lack of a clearly defined CFSP, contradictions within the Treaty on European Union, the lack of a clearly defined institutional identity vis‐à‐vis other security related organizations, and the lack of military capacity, will make the task of avoiding the ‘second death’ of the WEU an uphill struggle.
Secular Trends in the Lifetime Prevalence of Alcohol Dependence in the United States: A Re‐evaluation
Authors: Grucza Richard A. , Bucholz Kathleen K. , Rice John P. , Bierut Laura J.
Published: March 2008

Background:  U.S. epidemiologic surveys have consistently found higher lifetime prevalence of alcohol dependence among younger subjects than among older groups. Because lifetime prevalence is cumulative, such patterns are suggestive of strong secular trends; i.e., more‐recently born subjects have developed more disease in a shorter period of time than their elders. However, it remains unclear whether such patterns truly reflect secular trends or are confounded by age‐dependent factors such as differential recall, differential mortality, and other effects.

Methods:  Using data from 2 large, national epidemiological surveys, a repeated cross‐sectional analysis was conducted to compare lifetime prevalence of alcohol dependence across temporally adjacent birth cohorts surveyed at the same age, thus enabling estimates of cross‐cohort differences while controlling for age‐related factors.

Results:  In contrast with results from single cross‐sectional analyses, there were few significant cross‐cohort differences among groups of men compared at similar ages. On the other hand, women born between 1954 and 1963 were at 1.2‐fold higher odds for lifetime drinking, and those who drank were at 1.5‐fold higher odds for lifetime alcohol dependence, compared with the immediately preceding birth cohort (1944 to 1953). The 1944 to 1953 cohort was also at elevated odds for lifetime drinking compared with their predecessors (1934 to 1943). These results were largely due to changes among White and Hispanic women.

Conclusions:  These results suggest that there have been substantial secular increases in drinking and alcohol dependence among women, but not men. Analyses of single cross‐sectional studies may tend to over‐estimate secular trends by failing to account for age‐dependent effects. Nonetheless, secular increases in drinking and alcohol dependence among women are evident after taking age‐related factors into account.
Effects of Developmental Exposure to Ethanol on Caenorhabditis elegans
Authors: Davis Justin R. , Li Yun , Rankin Catharine H.
Published: March 2008

Background:  We investigated the effects of chronic ethanol exposure on physical development, reproduction, and life expectancy of Caenorhabditis elegans, a microscopic nematode worm. It has a small nervous system of 302 neurons and a short lifespan of 2 to 3 weeks.

Methods:  In this study, the worms were chronically exposed to varying concentrations of ethanol for different periods of their life: for their entire lifespan, during larval development only, and during adulthood only. In addition, the worms were exposed to ethanol acutely during different stages of embryonic development.

Results:  Chronic exposure to ethanol during larval development temporarily delayed physical growth, slowed development, delayed the onset of reproductive maturity, and decreased both reproductive fecundity and longevity. Chronic exposure to ethanol beginning when worms completed development and reached reproductive maturity resulted in reduced C. elegans body length, decreased reproductive fecundity, and life expectancy. Finally, acute embryonic exposure of C. elegans eggs to high concentrations of ethanol at different stages of development resulted in a lower probability of exposed eggs hatching into larval worms depending on when eggs were exposed during development. Furthermore, some of the worms that did hatch displayed distinct physical dysmorphologies as a consequence of acute ethanol exposure during embryonic development.

Conclusions:  These data suggest that exposing C. elegans to ethanol during critical development periods results in characteristic phenotypic outcomes. Thus, C. elegans offers a novel model for exploring the mechanisms by which ethanol exposure affects development.
Tau‐Induced Traffic Jams Reflect Organelles Accumulation at Points of Microtubule Polar Mismatching
Authors: Shemesh Or A. , Erez Hadas , Ginzburg Irith , Spira Micha E.
Published: March 2008

It is currently accepted that tau overexpression leads to impaired organelle transport and thus to neuronal degeneration. Nevertheless, the underlying mechanisms that lead to impaired organelle transport are not entirely clear. Using cultured Aplysia neurons and online confocal imaging of human tau, microtubules (MTs), the plus‐end tracking protein – end‐binding protein 3, retrogradely and anterogradely transported organelles, we found that overexpression of tau generates the hallmarks of human tau pathogenesis. Nevertheless, in contrast to earlier reports, we found that the tau‐induced impairment of organelle transport is because of polar reorientation of the MTs along the axon or their displacement to submembrane domains. ‘Traffic jams’ reflect the accumulation of organelles at points of MT polar discontinuations or polar mismatching rather than because of MT depolymerization. Our findings offer a new mechanistic explanation for earlier observations, which established that tau overexpression leads to impaired retrograde and anterograde organelle transport, while the MT skeleton appeared intact.
No difference indicated in electroencephalographic power spectral analysis in 3‐ and 6‐month‐old infants fed soy‐ or milk‐based formula
Authors: Jing Hongkui , Pivik R.T. , Gilchrist Janet M. , Badger Thomas M.
Published: March 2008

Increasing concern has been recently raised on the possible effects of soy‐derived phyto‐oestrogens on the development of cognitive functions in infants. However, limited studies have been conducted to date, and no data have been made available for determining whether infant soy formula can affect normal development of the human brain. We compared electroencephalographic (EEG) spectral power derived from high‐density recordings of infants fed milk‐based or soy formula (46 fed milk‐based formula and 39 fed soy formula) at 3 and 6 months of age. The spectral parameters included absolute power, relative power and spectral edge frequency (SEF) at 85%, 90% and 95% levels. The frequency domain contained four bands (0.1–3, 3–6, 6–9 and 9–12 Hz). EEG signals were collected from eight brain areas in each hemisphere. The results showed that the highest spectral power was mainly distributed in the low‐frequency bands and was predominant in the frontal and anterior temporal areas. None of the spectral variables significantly differed between the soy‐ and milk‐fed infants (anova, all P > 0.2). However, significant effects were indicated on the SEFs for factors of sex, age and brain area (all P < 0.01). Hemispheric differences in the absolute and relative power were also indicated. Our results suggest that the EEG power spectral development of soy‐fed infants does not differ from that of infants fed milk‐based formula. In addition, EEG spectral development appears more advanced in female than in male infants at 6 months.
Variation in breastfeeding behaviours, perceptions, and experiences by race/ethnicity among a low‐income statewide sample of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants in the United States
Authors: Hurley Kristen M. , Black Maureen M. , Papas Mia A. , Quigg Anna M.
Published: March 2008

The objective of this study was to examine how breastfeeding behaviours, perceptions and experiences vary by race/ethnicity among a low‐income sample in the USA. Bilingual interviewers conducted a cross‐sectional telephone survey of 767 white, African American or Hispanic mothers who received the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Rates of breastfeeding initiation and duration varied by race/ethnicity. Hispanic mothers were more likely to initiate breastfeeding than African American (91% vs. 65%) or white (61%) mothers. Hispanic mothers breastfed longer (mean 5 months) than either African American (mean 3.5 months) or white (mean 3 months) mothers. The most common reason for not breastfeeding was fear of difficulty or pain during breastfeeding (35.6%). Among mothers who did not initiate breastfeeding, African American and white mothers were more likely than Hispanic mothers to report perceptions of breastfeeding difficulty or pain, and Hispanic mothers were more likely than African American and white mothers to report perceptions of infant breast rejection. The most common reason reported for breastfeeding cessation was not having enough milk (23.4%). Hispanic mothers were more likely than African American and white mothers to cite perceptions of milk insufficiency and infant breast refusal than concerns regarding breast discomfort or pain. African American mothers were more likely than white mothers to report cessation to return to work. In conclusion, while breastfeeding initiation rates approach Healthy People 2010 goals, breastfeeding duration remains far below these goals. Race/ethnicity differences in experiences related to breastfeeding cessation suggest that culturally sensitive breastfeeding interventions are necessary.
Intakes from non‐breastmilk foods for stunted toddlers living in poor urban villages of Phnom Penh, Cambodia, are inadequate
Authors: Anderson Victoria P. , Cornwall Janet , Jack Susan , Gibson Rosalind S.
Published: March 2008

In Cambodia, the energy and nutrient densities of the traditional rice‐based complementary diets used for infant feeding are very low. Whether the adequacy improves after the first year of life is uncertain. Therefore, we examined the feeding practices and the energy and nutrient intakes from non‐breastmilk foods (NBMFs) of two groups: partially breastfed (PBF) (n = 41) and non‐breastfed (NBF) (n = 210) stunted toddlers aged 12–42 months from poor villages in Phnom Penh, Cambodia. Intakes of NBMFs were estimated from 24‐h recalls and a specially constructed Cambodian food composition table. All the toddlers were breastfed initially, but more than 50% received complementary foods before 6 months of age (mainly rice porridge). Many PBF toddlers received mixed feeding and were often bottle‐fed diluted sweetened condensed milk. Unresponsive feeding was widespread. Inappropriate snacks, such as crisps, were the major source of energy, calcium, iron, zinc and vitamin A from NBMFs for the PBF group, and energy and iron for the NBF group. The snacks were often purchased and consumed without any adult supervision. For both groups, intakes of energy, calcium, iron and zinc were consistently below recommendations, as a result of the low micronutrient density of NBMFs and the small amounts fed per feeding. Increasing intakes of animal‐source foods and dark‐green and yellow fruits and vegetables would enhance micronutrient densities, although this may be neither feasible nor sufficient to overcome the existing deficits. Instead, the feasibility of micronutrient fortification of the rice‐based diets of Cambodian toddlers should be explored.
Biscuits, Sausage, Gravy, Milk, and Orange Juice: School Breakfast Environment in 4 Rural Appalachian Schools
Authors: Graves Andrea , Haughton Betsy , Jahns Lisa , Fitzhugh Eugene , Jones Sonya J.
Published: March 2008

Background:  The purpose of this study was to assess the school breakfast environment in rural Appalachian schools to inform school environment intervention and policy change.

Methods:  A total of 4 rural schools with fourth‐ and fifth‐grade students in East Tennessee were assessed. A cross‐sectional descriptive examination of the school food environment where food service managers submitted school menus, production sheets, and vendor bid sheets as part of the dietary data collection protocol for a school‐based nutrition intervention study. The school breakfast environment was characterized in terms of calories, fat, saturated fat, and fiber from foods served on a per person basis using menus entered into Nutrient Data Systems for Research and production sheets for amounts of each food item served. Food items were grouped by the meal components of the School Breakfast Program (SBP) and ranked according to the items served most frequently.

Results:  Total fat provided slightly less than half the calories (43%); 15% of calories were from saturated fat. The top‐ranked foods for each meal component were biscuits, sausage, 2% milk, orange juice, and gravy.

Conclusions:  Results suggest that clearer policies or regulations for the SBP are warranted to support policy efforts to promote childhood health. These should include technical assistance and provision of resources for school food service managers to provide low‐fat meal options. Further research is needed to determine whether what is offered at school breakfast is actually consumed and how that might affect children’s weight because of the high fat content.
Diet Quality and Academic Performance*
Authors: Florence Michelle D. , Asbridge Mark , Veugelers Paul J.
Published: March 2008

Background:  Although the effects of nutrition on health and school performance are often cited, few research studies have examined the effect of diet quality on the academic performance of children. This study examines the association between overall diet quality and academic performance.

Methods:  In 2003, 5200 grade 5 students in Nova Scotia, Canada, and their parents were surveyed as part of the Children’s Lifestyle and School‐performance Study. Information on dietary intake, height, and weight and sociodemographic variables were linked to results of a provincial standardized literacy assessment. Diet Quality Index—International was used to summarize overall diet quality. Multilevel regression methods were used to examine the association between indicators of diet quality and academic performance while adjusting for gender and socioeconomic characteristics of parents and residential neighborhoods.

Results:  Across various indicators of diet quality, an association with academic performance was observed. Students with decreased overall diet quality were significantly more likely to perform poorly on the assessment. Girls performed better than boys as did children from socioeconomically advantaged families. Children attending better schools and living in wealthy neighborhoods also performed better.

Conclusions:  These findings demonstrate an association between diet quality and academic performance and identify specific dietary factors that contribute to this association. Additionally, this research supports the broader implementation and investment in effective school nutrition programs that have the potential to improve student access to healthy food choices, diet quality, academic performance, and, over the long term, health.
Subcutaneous abscess caused byClostridium perfringensand osteomyelitis in a dog
Authors: Cattin I. , Liehmann L. , Ammon P. , Dupre G.
Published: March 2008

A case of a subcutaneous abscess caused byClostridium perfringensinfection in a five‐month‐old dog is reported in this study. Clinical examination, radiological findings and cytological analysis of abscess fluid were consistent withClostridiuminduced disease. Treatment including drainage of the abscess and antibiotic therapy led to rapid clinical improvement. However, despite aggressive medical therapy and proper wound care, the deep soft tissue infection led to osteomyelitis with premature closure of the growth plates of the tibia and secondary bone shortening. Prolonged treatment with metronidazole and amoxicillin‐clavulanic acid resulted in an excellent outcome with normal weight bearing.
Virus Diseases of The Respiratory Tract of Cats
Authors: Studdert M. J. , Martin Margaret C.
Published: March 2008

Feline rhinotracheitis (FR) virus antigenically similar to the only known antigenic type of FR virus was isolated from nasal and pharyngeal swabs obtained from four cats with respiratory disease. The incidence of FR virus neutralising antibody in 45 cat serums obtained in the environs of Melbourne was approximately 50%. Data is presented that shows that the incidence of neutralising antibody to 2 antigenically distinct feline picornaviruses was 96% and 87% respectively. Complement fixing antibody to the Chlamydia (Psittacosis) group antigen was not found in any of 35 serums tested; it is suggested that the significance of Chlamydia sp as a cause of feline pneumonitis may require reappraisal.
A SURVEY CONCERNING CATTLE TICK CONTROL IN QUEENSLAND#
Authors: Elder J. K. , Waters K. S. , Dunwell G. H. , Emmerson F. R. , Kearnan J. F. , Morris R. S. , Knott S. G.
Published: March 2008

This paper reports those findings concerning property management from the 1977–78 survey of tick control in Queensland, which could effect efficient tick control and also presents a profile of the cattle industry in the tick infested areas at the time of the survey.

The average property size was 400 hectares and the average number of cattle on the properties was 726.4. Larger properties tended to have crossbred Zebu cattle. The average number of paddocks per property was 7.2.

The most popular stabilised crossbred Zebu breed was Santa Gertrudis but the most common type of cattle was crossbred Zebu, which was on 30% of properties. There were negligible numbers of crossbred Zebu cattle on dairy properties. Control of other external parasites may result in additional dippings in areas where they occur.

Although fence maintenance appears to be carried out regularly it is clear that the effectiveness of tick control measures, such as pasture spelling and dipping which depend on clean musters, could be affected by the occurrence of fire, floods and other natural disasters on half the properties in the tick infested areas.

There is no evidence from results in the survey that attention to other farming activities (mainly cropping) prevents producers from paying sufficient attention to tick control. In fact cropping often provides the opportunity for producers to rotate cattle around pastures.

Producers appear to consider the cost of tick control is a burden and they expect assistance from the Government to reduce these costs. They do not appear to have considered how they can reduce the costs themselves.
A SURVEY CONCERNING CATTLE TICK CONTROL IN QUEENSLAND
Authors: Elder J. K. , Kearnan J. F. , Waters K. S. , Dunwell G. H. , Emmerson F. R. , Knott S. G. , Morris R. S.
Published: March 2008

The results of a survey on tick control carried out in 1977–78 indicate that tick resistant cattle have been introduced for their heat and drought tolerance and their ability to grow more rapidly than European cattle, especially in the extensive grazing country of Northern and Central Queensland. In South‐eastern Queensland acceptance of tick resistant cattle has been slower because producers believe they are more difficult to manage than European cattle. A need for more publicity to be given to the different handling methods required by these animals was shown. Some producers cull their less resistant crossbred Zebu cattle and others could be encouraged to do so.

Pasture spelling appears to be quite common especially in the Coastal North; it is being carried out for pasture management rather than as a tick control measure. Producers in Central and South‐eastern Queensland, who do not spell pastures, feel that it reduces the carrying capacity.
Evaluation of an enzyme‐linked immunosorbent assay for the detection of Corynebacterium pseudotuberculosis infection in sheep
Authors: SUTHERLAND S S , ELLIS T M , MERCY A R , PATON M , MIDDLETON H
Published: March 2008

SUMMARY: :Two enzyme‐linked immunosorbent assays to measure antibody to the cell wall antigen (C‐ELISA) and toxin antigen (T‐ELISA) of C. pseudotuberculosis were evaluated on serum from 6 separate groups of sheep. For sheep naturally infected with C. pseudotuberculosis the sensitivity and specificity of the C‐ELISA was 76% and 73% respectively and for the T‐ELISA 67% and 77% respectively. For sheep slaughtered one year after artificial infection the sensitivity of both tests was 83% and the specificity 72%. For sheep slaughtered 4 months after artificial infection the specificity of both tests was < 30% while the mean sensitivity was 85%. The C‐ELISA in conjunction with the T‐ELISA detected 92% of sheep with lung lesions. Aust Vet J 64: 263–266
Holoprosencephaly in Border Leicester lambs
Authors: ROTH I J , MORROW C J , WILKINSJ J F , HARPER P A W
Published: March 2008

SUMMARY: : Holoprosencephaly in Border Leicester lambs is described. This defect is characterised by lack of the longitudinal cerebral fissure, fusion of the cerebral hemispheres and a single lateral ventricle. Facial defects are also associated with this condition. Results of a breeding experiment suggest that it is inherited in an autosomal recessive manner. Results from a survey indicate that the condition is widespread in Border Leicester sheep. Aust Vet J 64: 271–273
ACCESS TO CARE: THE HANDICAPPED
Authors: Busch Linda
Published: March 2008

Three times a week, twice a week in summer months, the Easter Seals dental team stops at shelter homes, day care centers, or nursing homes for special children and adults in the Cook County (Chicago) area.

The team members—two dentists and one dental hygienist—have undergone a four‐month training program designed to acquaint them with techniques needed in treating some special care patients.
Behavioral approaches to toothbrushing programs for handicapped adults
Authors: Entwistle Beverly Morse , Rudrud Eric H.
Published: March 2008

Various behavioral management programs and principles have been used in teaching independent living skills such as toothbrushing to developmentally disabled individuals.1–5 Dental professionals are not generally familiar with these programs, as some have been conducted in educational or residential settings by professionals such as special educators, psychologists, activity coordinators, and direct care staff. Many programs using these techniques have viewed the act of toothbrushing as a single process that everyone must accomplish in a similar manner. Few programs have taken into account the varying needs and handicapping conditions of individuals with developmental disabilities. This paper will review various behavioral approaches and their application to toothbrushing programs for persons with disabilities.
Perception of dental needs by the well elderly
Authors: Marinelll Rosalie D. , Sreebny Leo M. , Kamen Saul
Published: March 2008

The elderly currently represent approximately 12% of the US total population. Although there is considerable variation within the population older than 60, there is evidence that the general health and socioeconomic status of this age group is different enough from the young and middle‐aged population to warrant special consideration in the health‐care delivery system (Dr. Saul Ka‐men, unpublished data, 1979). Oral health care is also affected by changes in physical or economic factors that often accompany aging. The institutionalized elderly are those severely hampered by both physical and economic disabilities, and represent 5% of those older than 65. The unmet dental needs of these individuals have been estimated at from 50% to 80% and are well documented.1–3
OPINION
Authors: Nowak Arthur J.
Published: March 2008

It is not my intent to provide all the solutions to the problems. My intent is to identify the special population, their needs, and their unique characteristics. Each of us can help to increase the availability of dental care for this population. Although it may be impossible to be 100% successful, a tremendous step can be taken if we all join in this effort. This commitment, toourselves, our colleagues, and our patients, will increase the accessibility of special patients to good dental health and, at the same time, increase our busyness.
Gerontological nursing
Authors: BROCK ANNA MARIE
Published: March 2008

Editor's note: The nurse is the most important person in a geriatric facility. The dentist working in a hospital or long‐term care facility is well advised to establish a close relationship with nurses who are perceptive and knowledgeable about the patient's dental problems and ability to accept treatment. Treatment success and patient cooperation often depend on the knowledge, concern and special efforts of the geriatric nurse.

Dr. Brock provides an understanding of who the geriatric nurse is, the role, and responsibilities based on broad knowledge and understanding of the realities of supervising and providing care for the elderly.
Advanced education in general dentistry
Authors: BRADLEY RICHARD E.
Published: March 2008

Editor's note: This paper was presented at the Southeast Regional Conference of the American Association of Hospital Dentists on April 21, 1979. Even though the newer form of advanced general dentistry programming was approved by the Council on Dental Education, the editor believes that the detailed argumentation in this paper should be published to provide future readers with the documentation and logic behind this newer form of advanced general dentistry education.
Nutrition and aging
Authors: DREIZEN SAMUEL
Published: March 2008

The following papers were presented at the First Annual Interdisciplinary Conference on Gerontology in Houston on May 21–22, 1982.
A denture identification program for nursing home residents
Authors: WILLIAMS J.EARL , ZWEMER JACK D. , HARDIN JEFFERSON F. , DELLA‐GIUSTINA VICTOR E. , CHANDLER KAY M.
Published: March 2008

Editor's note: This brief paper describes a simple, yet important procedure that brings students into meaningful contact with elderly patients in a nursing home environment. It is most important that students be afforded opportunity for exposure to living conditions and care facilities for the elderly. Readers are invited to express their thoughts (not necessarily about denture identification techniques).
The expanding role of the dental consultant in the hospital
Authors: GREENBERG MARTIN S.
Published: March 2008

In summary, oneofthe major tasks of a hospital dentist is dental treatment for patients with severe life‐threatening medical disorders. There are huge gaps in our knowledge of this field which can be corrected only by controlled testing of treatment protocols. The hospital dental department is the best site to carry out these studies.
Mobile oral treatment and examination chair
Authors: BAYCAR ROBERT , AKER FRANK , SEROWSKI ANDREW , BAILEY GORDON
Published: March 2008

A lightweight portable cardboard chair has been developed for use in portable dental care delivery programs. The design will accommodate an adult patient, is sturdy, and includes a reclining and upright position. A stool has been added to the design for sitdown dentistry, and, when disassembled, the stool component parts are used as supports for the upright backrest.
Adrenal insufficiency: report of case
Authors: SCHEITLER LAWRENCE E. , TUCKER W. MARK , CHRISTIAN DAVID C.
Published: March 2008

The medical consultation from the patient's primary physician, although an invaluable aid in the treatment of the medically compromised patient, is no panacea. The competent management demonstrated by the case report and the potentially life‐threatening situation that followed, can occur with the simple forceps extraction of two periodontally involved teeth.
Efficacy of tissue brushing as measured by the prosthodontic tissue index
Authors: BLOEM THOMAS J. , RAZZOOG MICHAEL E. , CHAMBERLAIN BARBARA B. , LANG BRIEN
Published: March 2008

This study was conducted to determine the efficacy of brushing the oral mucosa supporting complete dentures with a soft brush to see if this treatment would reduce inflammation.

The oral mucosa health status of 60 patients was monitored for 120 days using the PTI to measure inflammation. For comparison the patients were divided into two groups, and every effort was made to balance the groups for those variables that may effect inflammation. The patients were also compared with themselves. The experiment consisted of three phases; Phase 1 established baseline data, and Phases 2 and 3 were information‐gathering sessions. Each patient received brushing instructions at the start of the brushing test period and additional brushing instruction during a reinforcement session after 30 days. Tissue brushing did reduce the inflammation index of the oral mucosa examined.
The evolution of hospital dental department to health care provider
Authors: RANDELL STEVEN
Published: March 2008

Clinical hospital dentistry and postgraduate hospital‐based dental education unquestionably represem the cutting edge of the modern dental profession. If specialized and underserved populations are to receive care, and if new graduates are to be adequately prepared to work in a restructured health system, the changing order must be acknowledged. Meeting the challenge of diversification and prudent business management requires the same intensity and excellence that hospital dentists have tradi‐tionally devoted to patient care and resident education.
A dental care system for patients with developmental disabilities: Hospital Dentistry
Authors: BRODY HARVEY A.
Published: March 2008

The organization and functioning of a dental care program for the developmentally disabled in San Francisco have been described. The program has both direct service and educational components. It uses the services of a specially trained dental social worker and a network of private dentists, and is organized as part of a hospital‐based dental department.
Special considerations in drug therapy for elderly dental patients
Authors: PATTON LAUREN L.
Published: March 2008

This paper won first place in the third annual Arthur Elfenbaum Essay Contest, sponsored by the American Society for Geriatric Dentistry.
Improving communication with the older patient: overcoming the physical barrier of a hearing loss
Authors: WARNER RICHARD W.
Published: March 2008

This paper won first place in the fourth annual Arthur Elfenbaum Essay Contest, sponsored by the American Society for Geriatric Dentistry.
Relaxing effects of music in dentistry for mentally handicapped patients
Authors: DAVILA JORGE M. , MENENDEZ JORGE
Published: March 2008

People have long found the dental situation stressful. This is doubly true for mentally handicapped patients who may not understand the necessity of dental procedures. Attempts to develop means of reducing excessive anxiety and stress in these patients will benefit not only the patients but also make the dentist's task easier to accomplish. This study evaluates music as a distraction and relaxation technique in 24 mentally handicapped adults.
A simplified splint for decreasing or preventing stenostomia in patients with burns
Authors: SHEHAN MARK T. , MEDFORD HOUCK M.
Published: March 2008

Modified orthodontic cheek retractors are used to prevent stenostomia in a patient with second degree facial bums and in a patient with severe allergic dermatitis. This appliance is designed to be rapidly fabricated, accommodate any mouth size. be adjustable, and easy for patient and staff members to manage. It is inexpensive, and fabrication requires little oral manipulation.
Toward understanding the use of dental services by the elderly
Authors: BRANCH LAURENCE G. , ANTCZAK ALEXIA A. , STASON WILLIAM B.
Published: March 2008

Predictors of dental service use were examined among a statewide sample of 776 noninstitutionalized Massachusetts residents who were older than 70 years of age. Dependent variables were use of any dental services (41% had used at least one service within 12 months) and use of those for preventive care (25%). Use of dental services by older adults was negatively influenced by older age and lower level of education, and positively affected by greater perceived need for dental treatment. Medi‐caid coverage was associated with lower use of dental services. Because Medicaid reimburses for dental services in Massachusetts, ability to pay did not seem to be a critical determinant in this population.
A physician's view of responsibility in reporting child abuse
Authors: Fontana Vincent J.
Published: March 2008

Child abuse and neglect can be prevented and children's lives can be salvaged by prompt recognition and reporting by child care professionals. There are effective multidisciplinary treatment programs that can break the cycle of violence breeding violence from generation to generation.
The effect of clinical experience on the attitudes and confidence of senior dental students toward treating children with handicapping conditions
Authors: UDIN RICHARD D. , KUSTER CURTIS G.
Published: March 2008

Forty‐two senior dental students participated in a 3‐day clinical rotation in which they treated children with handicapping conditions. A questionnaire was given before and after the experience to determine whether the clinical rotation was effective in altering the students' perceived confidence and attitudes toward treating these children. After the rotation, there was a statistically significant increase in confidence, but no change in perceived attitudes.
Necrotizing sialometaplasia: report of two cases
Authors: LAMBERT PAUL M.
Published: March 2008

Necrotizing sialometaplasia is a benign, self‐limiting disease that requires no treatment. It is often confused with malignancy, resulting in unnecessary, extensive surgery. Clinicians need to be aware of this lesion and include it in a differential diagnosis of ulcerated lesions. Correct diagnosis depends on histopathological diagnosis by a pathologist who is familiar with the characteristics of this disease.
The pregnant patient: considerations in dental care
Authors: ROTHWELL BRUCE R. , GREGORY CRYSTAL E. B. , SHELLER BARBARA
Published: March 2008

Although definitely not a disease, pregnancy poses a unique set of circumstances and necessary precautions for the dentist. The hormonal and anatomic changes produce effects that must be accounted for in providing dental care. As pregnancy is a transitory state, many elective dental procedures can be scheduled for completion after the baby is born. Pregnancy, however, does present the potential for dental problems that will require preventive strategies or actual treatment during pregnancy. Many medications commonly used in dentistry are acceptable for use by pregnant patients, particularly in the last two trimesters, but care must be exercised in their selection.
Interpretation of the psychiatric diagnostic scheme: an aid to dental treatment planning
Authors: FRIEDLANDER ARTHUR H. , FREDERICK CALVIN J.
Published: March 2008

Familiarity of the dentist with the currently used scheme for diagnosing the patient who has a mentally handicapping condition provides vital information. This scheme will assist in the preparation and interpretation of a properly worded consultation to the mental health professional caring for the patient. It will allow for the formulation of a comprehensive dental treatment plan consistent with the patient's emotional and cognitive status as well as alert the dentist to the patient's potential perceptions and misconceptions of care.
Laser excision of type III phenytoin‐induced gingival hyperplasia
Authors: MARSHALL WILLIAM R. , LATTANZI DAVID A. , WEAVER G. SCOTT , SCHMITT LARRY J.
Published: March 2008

This article describes the advantages of using laser therapy as an alternative method of treatment of gingival hyperplasia for a patient who is mentally compromised and has epilepsy. Advantages and disadvantages of the C02 laser are discussed. When excising tissue with the C02 laser, postoperative bleeding and discomfort are minimized, eliminating the need for a postoperative dressing. A case report describes a patient who was treated effectively with this technique.
The role of a social worker in a hospital dental department
Authors: CLASSMAN PAUL , BRODY HARVEY , OLVARADO JANIS , HAIKALIS SUSAN
Published: March 2008

The interactions of a social worker in the hospital dental department include community outreach programs, outpatient and inpatient care coordination, counseling and education. The social worker is available to work with patients who may require extra time, such as patients with handicapping conditions, patients who have a dental phobia, or patients with medically compromising conditions. The position is cost‐effective to the department.
Need for dental hygiene and dental care in Veterans Administration patients
Authors: MASEMAN DENISE C. , HUNTLEY DIANE E. , WHETSTONE SHEILA D.
Published: March 2008

The Periodontol Treatment Needs System (PTNS) was used to classify needs of 102 patients, 97 males and five females, at the VAMC Dental Service. The PTNS is based on the presence or absence of plaque, calculus or overhangs, inflammation, and pocket depth. In addition, need for restorative and prosthetic care was added to the PTNS based on dentists' diagnosis. All classification was done by quadrant.

All subjects required dental hygiene or periodontal care; 45% of the subjects need restorative treatment, prosthetic treatment, or both. Differences in numbers of patients requiring each type of treatment were highly significant. Multiple regression showed that age was positively related to type of treatment needed, with a significant difference in dental hygiene or periodontal needs by quadrant.

The results of this study show greater need for dental hygiene and periodontal treatment than for dental treatment in these patients.
The central indwelling venous catheter in the pediatric patient—dental treatment considerations
Authors: SPULLER RICHARD L.
Published: March 2008

Dentists need to understand and recognize the special needs of this unique patient population before dental therapy is instituted. The primary objective of this paper is to familiarize the dental practitioner with the central venous catheter and its indications in pediatric medicine. In addition, recommendations concerning the appropriate management of these patients are provided.
Retrospective study of emergency room dental patier retained in a hospital dental practice
Authors: DANE JOHN N. , HAYDEN WILLIAM J. , SOLDANELS A. P.
Published: March 2008

To maintain viability, hospital dental services must evaluate patient pools to help improve referrals and retention. Because the emergency room has traditionally been a source of new patients for the dental department, a retrospective study was done to determine any factors that might relate to the retention of emergency room dental patients. A total of 198 dental patient records were surveyed. Results indicated that certain similarities exist in those patients retained in the hospital dental practice.
Dental health of homeless adults
Authors: CELBERG LILLIAN , LINN LAWRENCE S. , ROSENBERG DARA J.
Published: March 2008

As part of a community‐based study, we were able to assess the number of grossly decayed and missing teeth, as well as recent use of dental services, among 529 homeless adults. We found that 27% reported having had a toothache during the previous month (only one‐tenth of these individuals had sought help from a dentist for their toothache). Homeless adults, as compared with a general population, were half as likely to have made a dental visit within the preceding year (26.7% versus 55.0%) and had more grossly decayed teeth (x̄= 2.3 versus = 1.4). Individuals with more tooth decay and missing teeth were more likely to be older, have physical health problems, smoke more cigarettes, use more alcohol, and have worse personal hygiene. Age, not length of homelessness, was the most important predictor variable of missing teeth. Thus, homeless adults have a higher degree of dental pathosis as well as a lower use of dental services than the general population. On the basis of these findings, more accessible dental services need to be designed for the homeless population.
Predictors of the use of dental services by older veterans
Authors: STRAYER MICHAEL S. , BRANCH LAURENCE G. , JONES JUDITH A. , ADELSON RICHARD
Published: March 2008

By the year 2000, it is likely that more than 66% of all US males will be veterans as a result of the large World War II cohort. This growing population of older veterans will have a major influence on the use of dental services at Veterans Administration facilities. The objectives of the project reported here were to identify and examine factors that explain use of dental services by noninstitutionalized veterans older than 55 years; this was a secondary analysis of a VA commissioned survey of 3,013 community‐based veterans older than 55 years.

A behavioral model developed by Anderson and Aday that identified predisposing, enabling, and need factors that determined use of health care services was adopted to analyze the data. A linear regression analysis showed that need factors accounted for the greatest degree of explained variance in use of dental services (R2= .15), whereas enabling factors accounted for the least degree of variance (R2= .02). Perception of dental problems, positive perception of physical health, perception of ability to meet expenses, and levels of education and income were significant predictors of use of dental services.

The findings of this study show the use of dental services by noninstitutionalized veterans and other noninstitutionalized older populations is influenced by similar factors. The findings can be useful in discussing and formulating dental health care policy for older veterans.
Initial results of the use of a drug‐interaction system
Authors: Logan Henrietta , Baker Karen , Cowen Howard
Published: March 2008

Dentists' knowledge about drug interactions, particularly in medically compromised older patients, may not be adequate. An on‐line drug interaction system was tested for 4 months in a dental clinic to ascertain its usefulness in training students. Characteristics of high‐risk patients are described, as well as opinions of users about the applicability of information presented and its relation to patient care. Approximately 3% of the patients seen were at risk of trauma from drug interactions, half of which were considered likely to occur. Implications of drug interaction data are also discussed in relation to treatment planning.
Training for the future: issues in geriatric dentistry
Authors: Sinkford Jeanne C.
Published: March 2008

The following report was presented during the October regional meeting of the American Society for Geriatric Dentistry in Washington, DC. The needs for dentists who specialize in geriatric dentistry and dental curriculum in geriatrics are discussed, together with issues that face dental educators in geriatric dentistry.

Aging of the population presents a special challenge to dentists, considering that 75 % of the patients that current students will treat at the height of their dental careers will be 65 or older. Students must be taught the difference between oral health care for older persons and such care for younger persons. They must understand the physical, social, and behavioral changes that are often combined with debilitating effects of acute and chronic diseases in older persons.

The needs to increase the number of advanced training programs in geriatric dentistry, upgrade undergraduate geriatric curriculum, and stimulate research to enhance the quality of life of older persons have been the focal points here.
Pouching of medications in the mouth: a case report
Authors: Wakham M. Dean , McNeal Donald R. , Burtner A. Paul
Published: March 2008

Foods or medicines can be pouched or held in the mouth to prolong taste, enjoyment, or effect. This article describes a patient who pouches medications. The oral injury that occurred from this behavior is reported.

In this report, an institutionalized 44‐year‐old female who was developmentally disabled with sloughing of oral tissue and ulcer formation in the mandibular buccal vestibules visited the dental clinic. Toothbrush trauma to the oral tissues was suspected initially and was ruled out. On the empirical recommendations of an oral pathologist who examined the patient, ketoconazole was prescribed by the patient's physician. This treatment was not effective. After medication pouching was suspected, simethicone was changed from chewable tablets to a liquid. The patient's caretakers and nurses observed the patient after medications were administered to be sure that the patient was not holding medication in her mouth.

Although tissue sloughing was resolved, ulcerations of the tissue persisted in the mandibular mucobuccal fold. A biopsy of these ulcerated areas was not diagnostic for any suspected pathosis. Five months after her initial visit, the patient showed no signs of ulceration or desquamation of her oral tissues. Thus, changing simethicone chew‐able tablets to a liquid, the increased efforts of the direct care staff members and nurses to prevent the patient from holding medications in her mouth, and the gradual improvement of the patient's oral condition confirmed the provisional diagnosis of pouching medications.

Medication pouching may not be a unique habit limited to patients in institutions for the mentally handicapped. It is a problem observed in some geriatric patients in long‐term facilities or nursing homes, as well (J. Thomas, director of geriatric dentistry, Veterans Administration Medical Center, personal communication, 1990). Several recommendations should be followed to prevent this habit and the injury that may occur:

1. Patients who have difficulty swallowing tablets or capsules may be given liquid medications.

2. Medications that can be crushed without adversely affecting the drug's absorption in the gastrointestinal tract can be administered in applesauce or another pleasant tasting food. Mitchell22 has reported on several medications that should not be crushed.

3. Fluids should be given to facilitate swallowing.

4. After medications are given, inspect the mouth for any remaining portions.

One problem dental professionals may encounter when treating patients with mental retardation or impairment is the difficulty in determining the causes that would be helpful in correctly diagnosing certain oral problems. This difficulty results from the reduced capability for communication between the doctor and patient and from the doctor's lack of awareness of unique habits found among these patients. When examining patients of this type, medication pouching should be included as a possible causative factor in the differential diagnosis of oral ulcerative lesions.