PubMed Health⌕ Search

Biomedical subjects

D Locker

Publications and source records attributed to D Locker.

At least 145 records · Page 8Linked to original sources
PubMed1990

Rehabilitation ideology and respiratory support technology.

This paper examines the impact changing ventilation technology and the ideologies of rehabilitation medicine on the long term adaptations of people with post-polio respiratory disability. Multiple in-depth interviews with 10 respirator-dependent people indicates that cultural ideologies learned during rehabilitation continue to effect the adoption of technology and daily management of respiratory insufficiency. Adaptive strategies through which benefits of technology are maximized and the social costs minimized, have transformed rehabilitation ideologies and moderated the late, aging-related effects of poliomyelitis.

Adult↗
PubMed1990

Differences in oral health status between institutionalized and non-institutionalized older adults.

Differences in oral health status between independent and institutionalized adults have been difficult to interpret because the latter population is typically older and has a higher proportion of women, confounding any association between institutionalization and disease levels. We undertook an analysis of oral disease amongst institutionalized (n = 149) and non-institutionalized (n = 246) samples of older adults randomly selected from the population in East York, Ontario. When the confounding effects of age and gender were controlled by constructing 67 matched pairs, institutionalized people were more than twice as likely to be edentulous (OR = 2.17, 95% CI = 1.09-4.29). This association was confirmed using data from all subjects in a logistic regression model. Analysis of covariance of data from dentate subjects revealed that the institutionalized seniors had fewer filled teeth (P less than 0.05, controlling for age and sex), but there were no statistically significant differences in the number of teeth which were missing, decayed, or requiring extraction. These findings suggest that antecedent, sociodemographic factors prior to institutionalization are responsible for the higher probability of oral disease in this group of older adults.

Age Factors↗
PubMed1990

What dental phobics say about their dental experiences.

Previous surveys have indicated that there is a substantial proportion of dentally anxious individuals in the general population. Many of these individuals avoid contact with dentistry as much as possible, while fearful individuals who present themselves for treatment are probably too uncomfortable or too afraid to make their views known. Consequently, a study of the feelings and attitudes of a group of dental phobics was carried out as part of a larger study of the efficacy of psychological treatments for excessive dental anxiety. The subjects were recruited by means of a newspaper advertisement and asked to complete a questionnaire designed to obtain information regarding their dental experiences and attitudes. Twenty-three individuals provided enough data for analysis. They were distributed widely in terms of age, education, income levels, and general fearfulness. They reported less satisfaction with the level of understanding or acceptance found in the last dentist they had seen than with the dentist's level of technical competence and the diagnostic information they received. Dental phobics who had been to a dentist in the past year were generally more satisfied with their dentist than those who had not. It is suggested that a good dentist-patient relationship based on understanding and acceptance is an important factor in overcoming the avoidance of fearful patients.

Adult↗
PubMed1990

Ontario dental assistants' job satisfaction: relationship to work stress and intention to change jobs.

Low job satisfaction has been linked to rapid turnover of dental assistants with resultant loss of productivity and reduced quality of patient care. Work dissatisfaction has also been linked to stress related diseases. The aim of this mailed survey of 1,000 Ontario certified dental assistants was to test a survey instrument developed in the United States and to relate satisfaction to work stress and to the intent to change jobs. Eighty-one per cent of eligible subjects responded. The satisfaction sub-scales of the survey instrument were found generally to have acceptable construct validity and to be reliable when applied to an Ontario population. However, some minor modifications were necessary. Although over 36 per cent said they were generally very satisfied with their work, the intent to change jobs was significantly related to areas of dissatisfaction concerning recognition for work done and opportunities for personal and professional growth. Stress was related to dissatisfaction with work-related fatigue, time pressure and nonpatient tasks. These findings have implications for dental practice management.

Adult↗
PubMed1989

Association of symptoms and signs of TM disorders in an adult population.

Most population-based studies of TM disorders report a discrepancy between the frequency of symptoms and the frequency of signs of functional disturbances of the temporomandibular joint. In addition, studies have reported varying relationships between subjectively perceived symptoms and signs found on clinical examination. This study examines this relationship in 148 Canadian adults who were part of a larger sample of 677 subjects who completed a telephone administered symptom questionnaire. Symptoms were reported by 63.5% and signs were found in 88.1%. While a degree of discordance was observed, there was a close and statistically significant association between symptoms and signs. This was the case whether summary variables or individual symptoms and signs were used as the dependent variable and whether proportions with or absolute numbers of symptoms and signs were examined. The validity of the symptom questionnaire was examined in order to assess its ability to identify "cases" of TMD. Validity tests showed a sensitivity of 81.4% and a specificity of 48.3%. When "false" positives and "true" positives were compared, the former were found to be significantly less likely to report pain.

Adolescent↗
PubMed1989

Work-related stress and its predictors among Canadian dental assistants.

This paper reports the results of a survey of 1000 certified dental assistants in Ontario, Canada. The aim was to obtain data on work-related stress, its sources and predictors. Of those responding to the survey, 38.8% said that their work was moderately stressful and 14.5% said it was very or extremely stressful. Approximately one-third had been bothered by stress at work on three or more days in the previous week. The main sources of stress were working under constant time pressures, running behind schedule and feeling undervalued by the dentist. Stepwise regression analysis revealed that the main predictors of work stress were not having a clear job description, working long hours, life stress while not at work and age. However, these variables explained less than 10% of the variance in job stress scores. Overall, 22.8% said it was very likely that they would seek work in another practice or seek work outside dentistry in the coming year. There was a significant association between work stress and job intentions; 43.0% of those reporting high levels of stress intended to change jobs compared to 8.9% of those who said that their job was not at all stressful (P less than 0.0001). These findings have implications for the way in which dental practice is organised and managed.

Adult↗
PubMed1989

Prevalence of and factors associated with root decay in older adults in Canada.

We collected data on the oral health status and treatment needs of a random sample of persons aged 50 years and over. Data on root decay were obtained from the 183 subjects who were dentate. All remaining teeth were examined for root decay and restorations, whether root surfaces were affected by recession or not. Analysis was undertaken by case and root surface, with separate analyses of decayed (DS), and decayed and filled (DFS) root surfaces. One or more root surfaces with untreated decay were found in 37.2% of subjects, while one or more decayed or filled root surfaces were found in 56.8%. The mean number of decayed surfaces was 1.3 per person, and the mean number of decayed and filled root surfaces was 2.6. Multiple and logistic regression analyses showed that oral health variables were more important predictors of the presence and severity of root decay than demographic, general health, or dental care factors.

Age Factors↗
PubMed1989

Dental insurance and its effects among the elderly in Ontario.

This paper examines the association between dental insurance, dental utilization and oral health outcomes among elderly people living independently in two communities in Ontario. Dental insurance had no independent effect on use of dental services, dissatisfaction with oral health status or clinically defined treatment needs. However, dentate attenders were less likely to be dissatisfied with their oral health and less likely to need dental treatment than those defined as non-attenders. One unexpected finding was that the dentate elderly had higher levels of utilization than is often reported in the literature but still had high levels of treatment need.

Aged↗
PubMed1988

Studies of a novel repetitive sequence family in the genome of mice.

A new middle repetitive sequence is described in the mouse genome. It has been revealed with a recombinant clone isolated from a Mus musculus BamHI gene library constructed in pBR322 and containing an insertion of 1.73 kb. When digests of genomic DNA were subjected to Southern blot hybridization, using the 1.73-kb insert as probe, we obtained a light smear and discrete bands, indicating a dispersion in the mouse genome of this sequence. This 1.73-kb sequence seems to be a part of a greater repetitive sequence at least 6 kb in length. The sizes of the bands hybridizing with the 1.73-kb insert are similar when compared between different laboratory strains but differ remarkably between the two species M. musculus and Mus caroli. We have shown also a great variation in the copy number of the sequence studied between these two species. When rat DNA is probed with the 1.73-kb insert, no hybridization is observed. Subcloning of the 1.73-kb sequence in three fragments has pointed out that the reiteration was not homogeneous along the 1.73-kb sequence. The 1.73-kb clone was sequenced and compared with other interspersed repetitive sequences, previously described in the rodent genome, and no homology was found.

Animals↗
PubMed1988

Prevalence of symptoms associated with temporomandibular disorders in a Canadian population.

Few epidemiologic studies of TM disorders have used random samples drawn from the general population. The aim of this study was to estimate the prevalence and distribution of symptoms commonly associated with such disorders among a sample of adults in Toronto, Canada. A random digit dialing technique was used to identify 1002 individuals aged 18 and over. A symptom questionnaire was completed by 67.7%. Overall, 48.8% responded positively to one or more of the nine questions concerning symptoms. Joint sounds, tiredness or stiffness of jaw muscles, and an uncomfortable bite were the symptoms most frequently reported. Functional pain or pain while at rest was reported by 12.9%. Sex and age differences were small although statistically significant, with women and the younger age groups more likely than men or the older age groups to report one or more symptoms. Significant associations were observed between the reporting of symptoms and potential risk factors such as parafunctional behaviours and reports of frequent stress. The proportion in need of treatment varied from 3.5% to 9.7% according to the case definition used.

Adolescent↗
PubMed1988

Response trends and nonresponse bias in a mail survey of oral and facial pain.

While mail surveys offer a low-cost method for collecting health data, they have been unpopular because of concerns about low response rates and nonresponse bias. This paper examines the response to a mail survey concerning oral and facial pain and uses regression techniques to assess the degree and direction of nonresponse bias on estimated prevalence rates. The analysis shows that early and late responders to the survey differed in terms of sociodemographic variables and responses to items concerning pain. The regression analysis suggests that the rather high prevalence rates revealed by the survey are not a product of bias induced by nonresponse and deserve further investigation.

Adolescent↗
PubMed1988

Risk factors for dental fluorosis in a fluoridated community.

We conducted a case-control study to determine the sources of fluoride which are particular risk factors to dental fluorosis. Cases and non-cases were identified by the screening of 8-, 9-, and 10-year-old schoolchildren in the fluoridated community of East York, Ontario. Parents were interviewed about the child's first five years of residence and about diet and preventive caries practices. The Mantel-Haenszel odds ratio and associated chi-square tests were used to assess the association of fluorosis with several potential sources, controlling for other sources of fluoride and mother's education. The prevalence of mild fluorosis [1-4 on the Thylstrup and Fejerskov (1978) Index] was 13%. Those who brushed their teeth before the age of 25 months had 11 times the odds of fluorosis compared with those beginning toothbrushing later; prolonged use of infant formula (greater than or equal to 13 months) was associated with 3.5 times the risk of fluorosis, compared with no, or shorter duration of, formula use. We estimate that these factors were responsible for 72% and 22%, respectively, of the cases in our population. Dental fluorosis is not a public health problem in East York, but parents should be advised to supervise toothbrushing by children under 2 years of age.

Child↗
PubMed1987

Prevalence of oral and facial pain and discomfort: preliminary results of a mail survey.

A mail survey was undertaken to estimate the prevalence of oral and facial pain and discomfort in the City of Toronto. Self-complete questionnaires were sent to a random sample of 1014 persons drawn from the voter's list. Replies were received from 72% of those eligible. Overall, 53% of respondents had experienced some pain or discomfort in the 4 wk prior to the completion of the questionnaire. The most common kinds of pain and discomfort reported were pain in the teeth with hot or cold fluids (28.8%), sore and bleeding gums (26.3%) and toothache (14.1%). Pain in jaws, face and oral mucosa was reported by less than 10% of the subjects. While much of the pain experienced by the respondents was classified as mild, half (50.1%) said that it was moderately severe or severe. Only 40% of those reporting pain had sought the advice of a dentist or doctor. Sex differences in the reporting of pain were small and statistically non-significant, although age differences were marked and significant. The younger age groups were more likely to report both pain and discomfort than the older age groups. The survey has revealed a substantial amount of oral and facial pain in the community, much of which is not subject to professional attention.

Adolescent↗
PubMed1987

The impact of dental and facial pain.

This paper presents data from a mail survey on dental and facial pain. The survey was conducted in the City of Toronto in 1986. The aim of the study was to obtain estimates of the prevalence of such pain and its impact on daily life. A random sample of 1014 names was drawn from the voters' list, and, as a result of four mailings, information was obtained on 71.6% of the eligible sample. Of those returning questionnaires, 39.7% reported dental or facial pain in the previous four weeks. A psychological impact in the form of worry or concern was reported by 70.3% of those experiencing pain, while 58.0% reported one or more behavioral impacts. The most common behavioral impacts were consulting a dentist or doctor, avoiding certain foods, taking medication, and disturbance of sleep. Severe behavioral impacts such as work disability, need for bed rest, and reduced social contacts were also reported by some of those having pain. The results suggest that dental and facial pain imposes a significant burden on the community. Further research is indicated, with more sensitive impact measures being used.

Adolescent↗