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A Sheiham

Publications and source records attributed to A Sheiham.

At least 37 records · Page 2Linked to original sources

Fluoride gels for preventing dental caries in children and adolescents.

BACKGROUND: Topically applied fluoride gels have been widely used as a caries-preventive intervention in dental surgeries and school-based programs for over two decades. OBJECTIVES: To determine the effectiveness and safety of fluoride gels in the prevention of dental caries in children and to examine factors potentially modifying their effect. SEARCH STRATEGY: Multiple electronic database searches, reference lists of articles, journal handsearch, selected authors and manufacturers. SELECTION CRITERIA: Randomized or quasi-randomized controlled trials with blind outcome assessment, comparing fluoride gel with placebo or no treatment in children up to 16 years during at least one year. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces (D(M)FS). DATA COLLECTION AND ANALYSIS: Inclusion decisions, quality assessment and data extraction were duplicated in a random sample of one third of studies, and consensus achieved by discussion or a third party. Study authors were contacted for missing data. The primary outcome measure was the prevented fraction (PF), that is the caries increment in the treatment group expressed as a percentage of the control group. Random effects meta-analyses were performed where data could be pooled. Potential sources of heterogeneity were examined in random effects meta-regression analyses. MAIN RESULTS: Twenty-five studies were included, involving 7747 children. For the 23 that contributed data for meta-analysis, the D(M)FS pooled prevented fraction estimate was 28% (95% CI, 19% to 37%; p<0.0001). There was clear heterogeneity, confirmed statistically (p<0.0001). The effect of fluoride gel varied according to type of control group used, with D(M)FS PF on average being 19% (95% CI, 5% to 33%; p<0.009) higher in non-placebo controlled trials. A funnel plot of the 23 studies indicated a relationship between prevented fraction and study precision. Only two trials reported on adverse events. REVIEWER'S CONCLUSIONS: There is clear evidence of a caries-inhibiting effect of fluoride gel. The best estimate of the magnitude of this effect, based on the 14 placebo-controlled trials, is a 21% reduction (95% CI, 14 to 28%) in D(M)FS. This corresponds to an NNT of 2 (95% CI, 1 to 3) to avoid 1 D(M)FS in a population with a caries increment of 2.2 D(M)FS/year, or an NNT of 24 (95% CI, 18 to 36) based on an increment of 0.2 D(M)FS/year. There is little information concerning deciduous dentition, on adverse effects or on acceptability of treatment. Future trials should include assessment of potential adverse effects.

Adolescent↗

Caries reductions between 1995, 1997 and 1999 in preschool children in Diadema, Brazil.

AIMS: This study aimed to assess changes in caries prevalence and severity in preschool children in Diadema, Brazil. METHODS: Three cross-sectional surveys were conducted, using the same protocol, in 1995, 1997 and 1999. The first survey included children aged 5-35 months, and the second and third, children aged 5-59 months. Participants were selected from all children attending a National Day of Children's Vaccination; 548, 992 and 690 in 1995, 1997 and 1999, respectively. This approach was sound as uptake rates for all years studied were above 90% for children aged between 1 and 59 months in all three surveys. Caries experience was measured using the World Health Organization (WHO) def index. Time-lag and quasi-longitudinal analysis were carried out. RESULTS: Time-lag analysis showed a marked and statistically significant decline in the prevalence and severity of coronal and rampant caries between 1995 and 1999. There were reductions of 36.5% in the prevalence of caries in 2-year-olds between 1995 and 1997 (P < 0.002) and 36.0% between 1997 and 1999 (P = 0.041). The mean def-s at the same age decreased from 2.0 in 1995 to 1.1 in 1997 (P < 0.001) and to 1.0 in 1999 (P > 0.05). The quasi-longitudinal analysis showed a statistically significantly increase in the percentage of children with caries between 1995 and 1997 and 1997 and 1999 (P < 0.001), but not for 2-year-old children between 1995 and 1997 (P > 0.05). The same pattern was observed for severity of dental caries. CONCLUSION: Oral health in preschool children in Diadema improved markedly during 1995-99.

Age Factors↗

Number of teeth and nutritional status in Thai older people.

OBJECTIVE: To assess the association between the number of natural teeth and nutritional status in older Thai people aged 60-74 years. RESEARCH DESIGN: A cross-sectional study. METHOD: Stratified purposive sampling from senior citizen centres, households in sub-districts and municipal communities in Chiang Mai metropolitan area. MAIN OUTCOME MEASURES: The number of natural teeth and underweight status. RESULTS: Mean Body Mass Index was 22.1 (+/- 4.0) kg/m2 in the whole sample; 29.4% of the total sample were underweight. After controlling for confounders (personal income and age), there was a significant association between BMI and number of teeth. The crude odds ratio of underweight were 2.42 for 19 or less natural teeth and 2.84 for no natural teeth compared to 20 teeth or above (P < 0.001). A significant association was also found between number of natural teeth and being underweight (< 20 kg/m2) in the older age group (68-74 years) after controlling for personal income, gender, education and current smoking (odds ratio = 2.27, 95% CI = 1.25, 4.13). CONCLUSIONS: The results support the association between the number of natural teeth and being underweight.

Age Factors↗

Evidence-based dentistry: an overview of the challenges in changing professional practice.

A great deal of effort and resources are currently being directed at developing an evidence-based approach to healthcare delivery. The success of the evidence-based movement will depend upon the provision of necessary support to help GDPs achieve change. This paper aims to give an overview of current knowledge on what types of interventions are most effective at changing health professionals' clinical practices. Barriers to change are highlighted and the implications for the development of evidence-based dentistry are considered. Further research on organisational, social and personal influences affecting the application of evidence-based practice is necessary.

Attitude of Health Personnel↗

The relationship between sweetness preference and dental caries in mother/child pairs from Maringá-Pr, Brazil.

AIM: Children's patterns of sugar consumption and dental health status have been associated to their mothers' patterns. As a liking for sweetness has been related to caries levels, this study was carried out to analyse the relationship between sweetness preference and caries experience in mother/child pairs. PARTICIPANTS AND METHODS: A cross-sectional survey was conducted on a sample of low socio-economic mothers and their 4-5-year-olds from Maringá-Pr, Brazil. Mothers' and children's preference for sugar was measured using the Sweet Preference Inventory. Their caries experience was assessed according to World Health Organization (WHO) guidelines. RESULTS: High levels of sweetness preference and caries experience were found in the sample studied. Although not strong, a significant correlation in patterns of sweetness preference (r=0.12, P<0.05) and caries experience (r=0.14, P<0.05) between mother/child pairs was identified. Among the social-demographic variables, only family income was statistically associated with the children's preference for sweetness (P<0.05). No significant association between sweetness preference and caries experience could be established. CONCLUSION: The findings of this study suggest that mothers may play an important role on the establishment of their children dietary preferences and patterns of dental health. Also, that the socio-economic status may influence children's preference for sugar.

Adult↗

Social deprivation, income inequality, social cohesion and dental caries in Brazilian school children.

This ecological study investigated the associations between social deprivation, income inequality and social cohesion and dental caries levels in school children of the Distrito Federal, Brazil. Three sources of data were used: (1) area-based data from a 1997 social survey carried out on 13,000 families, (2) 1995 census data collected for the Government of the Distrito Federal (GDF), and (3) dental caries data from a 1997 oral health survey on 7296 6-12-year-old school children. Results of simple linear regression showed that percent with less than eight years of education (P = 0.03) and percent who did not have a maid (P = 0.009), were negatively statistically significantly associated with the percent of children free of caries. None of the deprivation measures were statistically significantly associated with mean DMF-T scores (P > 0.05). GINI coefficient, an indicator of social inequalities, was negatively statistically significantly associated with both measures of dental caries experience, percent of caries free (P = 0.003) and mean DMF-T scores (P = 0.01). Per thousand number of homicides or attempted homicides, an indicator of social cohesion was of marginal statistical significance associated with caries experience. Results of multiple linear regression analyses showed that only the Gini coefficient remained statistically significantly associated with both dental clinical measures used, after adjusting for potential confounding. In conclusion, relative rather than absolute levels of income were stronger determinants of the onset of caries in this study.

Brazil↗

Prevalence of impacts of dental and oral disorders and their effects on eating among older people; a national survey in Great Britain.

OBJECTIVE: The objective was to assess the prevalence, in a British population aged 65 years and older, of oral health related impacts and the effects they had on the quality of daily life and in particular on eating. METHODS: 753 free living and 202 institutionalised subjects aged 65 years and over, participating in the oral health survey of the British National Diet and Nutrition Survey (NDNS), had a dental examination and interview. Data on the impact of dental and oral disorders on the activities of daily living based upon the modified Oral Impacts on Daily Performance (OIDP) indicator were collected. RESULTS: 17% of the free living edentate participants reported that their mouth affected their pattern of daily living on a regular basis. Oral impacts levels were lowest in dentate subjects with the greatest number of teeth. For the dentate, the most common oral impacts were on eating and speaking. Impacts relating to emotional stability, sleeping, relaxing, carrying out physical activity and social contact were very infrequent, but were severe when they did occur. Among those with an impact on eating, 25% said it was severe and 42% had the impact nearly every day or in a spell of 3 or more months. Oral impacts were more prevalent among the institution sample, particularly the dentate. The impacts were associated with the inability or difficulty to eat a range of 16 common foods. CONCLUSION: This survey has shown that the oral status of older people fairly frequently affects the quality of life of older people, and in particular, the ability to eat several common types of foods.

Aged↗

Adolescents' sense of coherence, oral health status, and oral health-related behaviours.

OBJECTIVE: To investigate the relationship between sense of coherence (SOC) and oral health. It was hypothesised that subjects with better oral health status and better oral health-related behaviours have higher levels of SOC. METHODS: A cross-sectional study was conducted in Goiânia-GO, Middle-West Brazil, on a sample of 664 15-year-olds randomly selected from schools. Data were collected through questionnaires, the short version of Antonovsky's SOC Scale (13-item) and clinical dental examinations. Multiple logistic regression and polytomous ordered regression were used in the data analysis. Two sets of outcome variables were selected for the analyses: oral health status (dental caries, oral cleanliness, and periodontal disease), and oral health-related behaviours (frequency of sugar intake, toothbrushing frequency, and pattern of dental attendance). RESULTS: Adolescents' SOC was associated with their caries experience in anterior teeth (OR=0.81 for 10 units increase in SOC scale; 95% CI=0.66-0.98), but the relationship did not remain significant after controlling for other factors. Adolescents with higher SOC were less likely to visit the dentist mainly when in trouble, compared with those with lower SOC (OR=0.83, 95% CI=0.71-0.98), or equivalently more likely to visit for mainly check-ups. Other measures of oral health status and behaviours were not significantly associated with SOC. CONCLUSION: SOC was identified as a psychosocial determinant of adolescents' oral health-related behaviour, particularly affecting their pattern of dental attendance.

Adolescent↗

Prevalence and correlates of traumatic injuries to the permanent teeth of schoolchildren aged 9-14 years in Belo Horizonte, Brazil.

A cross-sectional survey was carried out on 3702 boys and girls aged 9-14 years, attending public and private primary schools in Belo Horizonte, Brazil. A multi-stage sampling technique using an equal probability scheme was adopted to select the children. The response rate for the total sample was 97%. Dental examinations were carried out by one dentist (MISC). Intra-examiner agreement was very good. The prevalence of dental injuries increased from 8% at the age of 9 years to 13.6% at 12 and 16.1% at 14 years. Adjusted results showed that children from high socio-economic backgrounds were 1.4 (95% CI = 1.15-1.79) times more likely to present with a dental injury than children with low SES. Boys were 1.7 times (95% CI = 1.41-2.16) more likely to have dental injuries than girls. Children with an overjet size greater than 5.0 mm were 1.37 times (95% CI = 1.06-1.80) more likely to have a dental injury than children with an overjet size equal or lower than 5.0 mm. Finally, children with an adequate lip coverage were 0.56 times (95% CI = 0.44-0.72) less likely to have a traumatic dental injury than those with inadequate lip coverage.

Adolescent↗

Prevalence, causes and correlates of traumatic dental injuries among 13-year-olds in Brazil.

A cross-sectional survey was carried out. This involved 652 out of a total of 764 (85%) 13-year-old adolescents enrolled in private and public schools located in urban areas in Cianorte, Brazil. They were interviewed and examined for traumatic dental injuries by one trained examiner (B.N.) using validated criteria. Sociodemographic data included sex, family structure (nuclear families, single parents and step-parents) and socio-economic indicators. Anthropometric measures included height and weight. The body mass index (BMI) was calculated (mean=20.1; SD=3.7). Those who had BMI scores equal or above the 85% percentile were considered overweight (BMI >23). The prevalence of traumatic injuries to the permanent incisors was 20.4%. The most common reported cause of injuries to the permanent incisors was falls (24.1%) followed by collisions with people or inanimate objects (15%), traffic accidents (10.5%), misuse of the teeth (6%), sports (2.3%) and violence (1.5%). Unknown causes accounted for 40.6%. Children from non-nuclear families, overweight children and boys were 2.18, 1.93 and 2.19 times respectively more likely to have dental injuries than children from nuclear families, non-overweight children and girls (P<0.01) after adjusting for family structure, BMI, sex, family income and level of education of the parents. The relationship between dental injuries and socioeconomic indicators was not statistically significant. In conclusion, being from a non-nuclear family, overweight and a boy increased the risk of having traumatic dental injury, but the relationship with socio-economic indicators was not statistically significant.

Accidental Falls↗

The relationship between sweetness preference, levels of salivary mutans streptococci and caries experience in Brazilian pre-school children.

AIM: To analyse the relationship between preference for sweetness, levels of salivary mutans streptococci and levels of caries in low socio-economic 4-5-year-old Brazilian children. DESIGN: A cross-sectional survey. SUBJECTS AND METHODS: 298 children of both sexes, who, in 1998, were regularly attending public nurseries were randomly selected. Caries experience was assessed according to WHO guidelines. Saliva samples were analysed for mutans streptococci using the spatula method. Children's preference for sugar was measured using the 'Sweet Preference Inventory'. Personal interviews with the mothers were conducted. RESULTS: 255 children completed all aspects of the research, a response rate of 85.6%. 34.9% of them were caries-free. The mean dmf-s was 4.25 (SD 6.16), the decayed component being 3.56 (SD 5.82) and the filled surfaces, 0.69 (SD 1.85). For these pre-school children; male sex (P < 0.01), single parent (P < 0.01), habit of eating or drinking items that contained non-milk extrinsic sugar between meal times (P < 0.05) and high levels of salivary mutans streptococci (P < 0.001) were significantly associated with higher dmfs scores. There was no statistical relationship between sweetness preference and dental caries and with mutans streptococci levels. CONCLUSION: Levels of salivary mutans streptococci but not sweetness preference were potential good predictors of caries experience among 4-5 year-old-children living in urban area of Brazil.

Brazil↗

Does the condition of the mouth and teeth affect the ability to eat certain foods, nutrient and dietary intake and nutritional status amongst older people?

OBJECTIVES: To assess how the dental status of older people affected their stated ability to eat common foods, their nutrient intake and some nutrition-related blood analytes. DESIGN: Cross-sectional survey part of nation-wide British National Diet and Nutrition Survey: people aged 65 years and older. Data from a questionnaire were linked to clinical data and data from four-day weighed dietary records. Two separate representative samples: a free-living and an institutional sample. Seven-hundred-and-fifty-three free-living and 196 institution subjects had a dental exam and interview. RESULTS: About one in five dentate (with natural teeth) free-living people had difficulty eating raw carrots, apples, well-done steak or nuts. Foods such as nuts, apples and raw carrots could not be eaten easily by over half edentate (without natural teeth but with dentures) people in institutions. In free-living, intakes of most nutrients and fruit and vegetables were significantly lower in edentate than dentate. Perceived chewing ability increased with increasing number of teeth. Daily intake of non-starch polysaccharides, protein, calcium, non-haem iron, niacin, vitamin C and intrinsic and milk sugars were significantly lower in edentate. Plasma ascorbate and retinol were significantly lower in the edentate than dentate. Plasma ascorbate was significantly related to the number of teeth and posterior contacting pairs of teeth. CONCLUSIONS: The presence, number and distribution of natural teeth are related to the ability to eat certain foods, affecting nutrient intakes and two biochemical measures of nutritional status.

Aged↗

Dietary effects on dental diseases.

Dental caries is a highly prevalent chronic disease and its consequences cause a lot of pain and suffering. Sugars, particularly sucrose, are the most important dietary aetiological cause of caries. Both the frequency of consumption and total amount of sugars is important in the aetiology of caries. The evidence establishing sugars as an aetiological factor in dental caries is overwhelming. The foundation of this lies in the multiplicity of studies rather than the power of any one. That statement by the British Nutrition Foundation's Task Force on Oral Health, Diet and Other Factors, sums up the relationship between sugars and caries in Europe. There is no evidence that sugars naturally incorporated in the cellular structure of foods (intrinsic sugars) or lactose in milk or milk products (milk sugars) have adverse effects on health. Foods rich in starch, without the addition of sugars, play a small role in coronal dental caries. The intake of extrinsic sugars beyond four times a day leads to an increase risk of dental caries. The current dose-response relationship between caries and extrinsic sugars suggests that the sugars levels above 60 g/person/day for teenagers and adults increases the rate of caries. For pre-school and young children the intakes should be proportional to those for teenagers; about 30 g/person/day for pre-school children. Fluoride, particularly in toothpastes, is a very important preventive agent against dental caries. Toothbrushing without fluorides has little effect on caries. As additional fluoride to that currently available in toothpaste does not appear to be benefiting the teeth of the majority of people, the main strategy to further reduce the levels of caries, is reducing the frequency of sugars intakes in the diet. Dental erosion rates are considered to be increasing. The aetiology is acids in foods and drinks and to a much lesser extent from regurgitation.

Acids↗

Socio-economic determinants of selected dietary indicators in British pre-school children.

OBJECTIVES: To assess the proportion of pre-school children meeting reference nutrient intakes (RNIs) and recommendations for daily intakes of iron, zinc, vitamins C and A, and energy from non-milk extrinsic sugars. To assess whether meeting these five dietary requirements was related to a series of socio-economic variables. DESIGN: Secondary analysis of data on daily consumption of foods and drinks from the National Diet and Nutrition Survey (NDNS) of children aged 1.5-4.5 years based on 4-day weighed intakes. SUBJECTS: One thousand six hundred and seventy-five British pre-school children aged 1.5-4.5 years in 1993. RESULTS: Only 1% of children met all five RNIs/recommendations examined; 76% met only two or fewer. Very few children met the recommendations for intakes of zinc (aged over four years) and non-milk extrinsic sugars (all ages). The number of RNIs/recommendations met was related to measures of socio-economic class. Children from families in Scotland and the North of England, who had a manual head of household and whose mothers had fewest qualifications, met the least number of RNIs/recommendations. CONCLUSIONS: Very few pre-school children have diets that meet all the RNIs and recommendations for iron, zinc, vitamins C and A, and energy from non-milk extrinsic sugars. Dietary adequacy with respect to these five parameters is related to socio-economic factors. The findings emphasise the need for a range of public health policies that focus upon the social and economic determinants of food choice within families.

Ascorbic Acid↗

Assessing the difference between sociodental and normative approaches to assessing prosthetic dental treatment needs in dentate older people.

OBJECTIVE: To illustrate differences in assessed need using normative and sociodental approaches to assess prosthetic treatment needs of dentate older people. DESIGN: A cross-sectional study using non-random sample. SETTING: Metropolitan area of Chiang Mai, Thailand. SUBJECTS: 707 older individuals, 549 of the total sample were dentate, living independently, aged 60 to 74 years. RESULTS: The dentate population examined consisted of 289 classified as 'normal health' and 44 with a nutritional problem. Of the total population, 60% (333) had a normative need for partial dentures. Excluding the 44 with a nutritional problem, 50% (146) of the NTM group had 'impact-related treatment need' and of the latter 146, 69% (102) had a high propensity for health behaviour. 41% of the 102 who had 'impact-related' and 'propensity related treatment need' had 'accessible treatment need'. That is 14.5 per 100 of those with normative need. The gap between normative and 'accessible need' was greater among those with 'general health related treatment need' due to underweight. Of the 44 with a NTM and had a health problem, 45% (20) had a 'propensity related treatment need'. 40% of the group with a 'propensity related treatment need' had 'accessible treatment need'. Overall of the 44 older people with a normative need for a prosthesis and who had a health problem, only 2.4% had 'accessible treatment need' mainly due to lack of finance. If the treatment were subsidised then 45% of those with 'propensity related treatment need' would be eligible for treatment. CONCLUSION: Large differences of estimated treatment need were found between a sociodental and a normative approach to assess prosthetic dental treatment needs of older Thai people.

Activities of Daily Living↗

Clinical and behavioural risk indicators for root caries in older people.

OBJECTIVE: To investigate the clinical and behavioural factors indicating root caries risk among older people. DESIGN: Cross-sectional clinical and interview data from the National Diet and Nutrition Survey (aged 65 years and over) in Great Britain. Logistic regression models of the prevalence of root caries and linear regression models of the extent of root caries were constructed to quantify the role of a range of clinical and behavioural risk indicators, including sugars intake. SETTING: A national sample of older British adults, free-living and institutionalised. PARTICIPANTS: 462 dentate adults aged 65 years or over. RESULTS: Nine or more intakes of sugars per day more than doubled the odds of root caries being present (OR 2.2-2.4). Other clinical and behavioural factors affecting root caries included wearing a partial denture in the presence of heavy plaque deposits (OR 2.1-2.6) and infrequent tooth brushing (OR 2.8-4.1). Linear regression models showed that, amongst those that had root caries, sucking sweets in the presence of a dry mouth, poor hygiene, partial dentures and living in an institution contributed to the extent of root caries, as measured by the RCI(d). CONCLUSIONS: Of the factors open to possible clinical or behavioural intervention, frequent sugars intake, poor hygiene and partial dentures were all associated with large increases in risk.

Aged↗

The prevalence of dental impacts on daily performances in older people in Northern Thailand.

OBJECTIVE: To assess the prevalence of oral related impacts on the quality of daily life in older Thais. DESIGN: A cross-sectional study on a non-random sample. SETTING: Metropolitan area of Chiang Mai, Thailand Subjects: 707 older individuals living independently, aged 60 to 74 years, 549 were dentate, 158 were edentate. METHODS: Clinical examination and questionnaire for the Oral Impacts on Daily Performances (OIDP) index and on dental behaviours. RESULTS: About one half of the older people interviewed (52.8%) had at least one OIDP oral impact. The most common performance affected was eating (47.2%). The two main symptoms that caused oral impacts in the total sample were functional limitation and pain. The majority of older people had low OIDP scores below 8.0 (76.4%). Almost one in 10 had OIDP scores above 16.0. Individuals with a high income were more likely to have lower OIDP score (p<0.001). Subjects who had attended a dentist were more likely to have no oral impacts (p=0.02). There was a significant difference between OIDP scores related to some clinical variables; dental status (p=0.002), having mobile teeth (p=0.005), periodontal attachment loss (p<0.001), missing anterior and posterior teeth (p<0.001). CONCLUSIONS: Oral impacts that affected quality of life of older people were relatively common but not severe. The impacts were related to some social and clinical variables.

Aged↗

Evaluation of a modified version of the index of Oral Impacts On Daily Performances (OIDP) in elderly populations in two European countries.

OBJECTIVE: To examine the psychometric properties of a modified version of the index of Oral Impacts on Daily Performance (OIDP) in elderly populations in two European countries, namely Great Britain and Greece. The psychometric properties examined in this study refer to internal consistency and face, content, criterion and construct validity. DESIGN AND SETTING: Cross-sectional epidemiologic surveys of independently living people aged 65 years or older. Data were collected by interviewers through structured questionnaires. The British sample consisted of the randomly selected independently living persons that participated in the dental component of the National Diet and Nutrition Survey (NDNS) of adults aged 65 years or over. The Greek sample is an opportunity sample drawn from eligible people living in two municipalities of the Athens region. SUBJECTS: 753 people participated in the British and 681 in the Greek sample. RESULTS: Through pilot work in both countries, the OIDP index was modified and both Greek and British modified versions demonstrated satisfactory face and content validity. In the main studies, Cronbach's alpha of the modified OIDP was 0.77 for the Greek and 0.69 for the British sample. In both samples, the index showed very significant associations with perceived dental treatment need (p<0.001), perceived general health (p<0.001 in Greek, p=0.002 in British) and intermediate oral impacts (p<0.001), as well as with satisfaction with oral health in the Greek sample (p<0.001). CONCLUSIONS: Overall, this study has demonstrated that the modified OIDP is a valid and reliable measure of oral health related quality of life in elderly people in Great Britain and Greece.

Aged↗