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Biomedical subjects

N Nuttall

Publications and source records attributed to N Nuttall.

16 recordsLinked to original sources
PubMed2005

Impacts of oral disorders in the United Kingdom and Australia.

BACKGROUND: Surveys of oral health have not previously compared national adult populations using measures of subjective oral health. AIMS: To compare subjective oral health of adults in the UK and Australian populations. METHODS: Cross sectional studies were conducted of people aged 18+ years in the 1998 UK Adult Dental Health Survey and the 1999 Australian National Dental Telephone Interview Survey. Subjective oral health was measured using the 14-item Oral Health Impact Profile questionnaire (OHIP-14). RESULTS: Among dentate people, the percentage reporting impacts 'fairly often' or 'very often' was marginally greater in Australia (18.2%, 95% confidence interval (CI) = 16.2-20.2) than the UK (15.9%, 95%CI = 14.4-17.4). There were larger regional variations in prevalence within populations, ranging from 14.8% to 22.3% among Australian states/ territories, and from 13.6% to 19.8% among countries within the UK. However, the mean number of impacts and rated severity of impacts was significantly greater in Australia than the UK. CONCLUSIONS: While the percentage of adults reporting adverse impacts of oral health was similar, Australians reported a larger number of impacts and more severe impacts than dentate people in the UK. Differences in the number and severity of impacts between the two populations may be an artifact of different data collection methods or may reflect relatively subtle socio-cultural differences in subjective oral health between these populations.

Adolescent↗
PubMed1999

Case of Staphylococcus schleiferi endocarditis and a simple scheme to identify clumping factor-positive staphylococci.

Staphylococcus schleiferi is a coagulase-negative staphylococcus infrequently reported as a human pathogen. We report a case of prosthetic valve endocarditis attributed to this organism, contrast it to another Staphylococcus species that gives similar clumping factor results (S. lugdunensis), and propose a simple, effective identification scheme for identification of clumping factor-positive staphylococci.

Aged↗
PubMed1998

Seroepidemiology of invasive pneumococcal disease in Queensland, 1990 to 1997.

Serotypes responsible for 842 cases of invasive pneumococcal disease in Queensland between February 1990 and October 1997 were identified. Type 14 caused 37.5% of episodes in children aged 0-4 years and 19.2% of adult cases. Types 6A, 6B, 14, 18C, and 19F were significantly more frequent in young children while types 3, 4, 7F, 9V and 23F predominated in adults. The regional incidence of type 14 and 7F disease differed significantly in Southeast and Far North Queensland. Coverage for 87% of children aged less than 5 years in this study would be provided by a recently advocated polysaccharide-protein conjugate vaccine containing capsular antigens of types 4, 6B, 9V, 14, 18C, 19F and 23F. Similarly, more than 90% of adults would be covered by the currently available 23- valent polysaccaride vaccine.

Adolescent↗
PubMed1998

Colony variation in Staphylococcus lugdunensis.

Staphylococcus lugdunensis is being increasingly reported as a pathogen with an outcome resembling that of S. aureus rather than coagulase-negative staphylococci. Recent local isolates exhibited colonial variation that delayed identification and interpretation of clinical significance. Until now previous descriptions have not emphasized colonial variation as an important identifying characteristic of S. lugdunensis.

Down Syndrome↗
PubMed1997

Review of attendance behaviour.

Frequent dental check-ups correlate with good dental health. However, many non-attenders see no need to attend a dentist until they have a problem that needs attention. Dental attendance may be stimulated by highlighting to the patient the reasons for future dental checks, persisting with recall messages and tailoring the recall method to individual patients.

Adult↗
PubMed1995

Clinical decision making--an art or a science? Part V: Patient preferences and their influence on decision making.

Part IV of this series introduced the idea that the value a patient places on an outcome has an important influence on the decision making process. This article considers this concept further. It argues that dentists should assess a patient's preferences and consider these before deciding on a treatment option. The article explains that by enumerating all the treatment options and possible outcomes, it is possible to assess the value placed on each result. Similarly an assessment is crucial if the dentist aims to achieve the optimum treatment result--one which is regarded as the most favourable outcome by the patient.

Attitude to Health↗
PubMed1995

Clinical decision making--an art or a science? Part IV: Assessing risks and probabilities.

Deciding whether a patient requires any dental treatment will depend on an assessment of the risks involved. How likely is it that the condition will get worse if it is left untreated? How likely is it that a particular treatment will be successful? This article looks at risk assessment and examines how the relative risks of a particular course of action might be communicated. It argues that dentists should be able to explain clearly and concisely what is likely to happen to the patient.

Decision Support Techniques↗
PubMed1995

Clinical decision making--an art or a science? Part III: To treat or not to treat?

Part II of this series examined the two principle sources of variation: variation stemming from perceptual differences such as diagnostic errors, and variation stemming from judgmental differences such as different treatment strategies. This paper looks at judgmental variation in more detail, considers the nature of practice variation, and asks whether such variations are a sign of good or bad clinical practice.

Decision Making↗
PubMed1995

Clinical decision making--an art or a science? Part II: Making sense of treatment decisions.

Clinical decisions made by dentists can vary considerably. Although there has been a tendency in the media to attribute these differences between practitioners to deliberate unethical practice, as Part I concluded, variations in decision making are a result of the complexity of assessing the risks of different treatment options and evaluating the outcomes of treatment. This article looks at why dentists can make different decisions when faced with identical cases (variation), why sometimes the 'correct' decision is not made (error), and also looks at what other issues affect treatment decision making once disease has been perceived.

Clinical Competence↗
PubMed1995

Clinical decision making--an art or a science? Part I: An introduction.

In order to make the most appropriate decision in a given set of circumstances, an understanding is needed of how people formulate decisions on the basis of their surroundings. Using a case history, this article introduces the factors involved in clinical decision making and highlights the relevance of those factors in the decision making process. These will be discussed in depth in later sections of this series.

Adult↗
PubMed1995

Decision processes in the management of dental disease. Part 2: Rationalizing dental treatment decisions in clinical practice.

Continuing from a previous paper, the authors outline methods that dental practitioners should use in making decisions in clinical practice. Using the analysis techniques described in both articles the dentist will be able to focus on key issues in the decision-making process and, perhaps as importantly, ignore issues that are peripheral. This article demonstrates a method (decision analysis) in which the practitioner can incorporate this information into the process of deciding which dental treatment to offer.

Decision Support Techniques↗
PubMed1993

Investigation of milk-borne Streptococcus zooepidemicus infection associated with glomerulonephritis in Australia.

An outbreak of infection due to Streptococcus zooepidermicus is reported. The index case was a patient who suffered an episode of septicaemia complicated by glomerulonephritis. Two other persons in his family were found to be asymptomatic throat carriers. The source of the outbreak was unpasteurised milk from a house cow on the farm where the family lived. Molecular studies confirmed that the strains isolated from the index case, the other family members and the cow's milk were identical. Although a renal biopsy was not performed, the diagnostic criteria for poststreptococcal glomerulonephritis were satisfied. The organism is an uncommon human pathogen that sometimes causes outbreaks of severe infection which may be associated with glomerulonephritis.

Animals↗
PubMed1992

Group A streptococcal infection in an aboriginal community.

OBJECTIVE: To determine whether group A streptococcal infection and poststreptococcal sequelae are still a significant health issue for Aboriginal communities. DESIGN: A cross-sectional survey of streptococcal carriage, infection and antibody levels. SETTING: A north Queensland Aboriginal community. PARTICIPANTS: One hundred and twenty preschool and school-aged children (2 to 12 years of age) living in the Lockhart River Community on Cape York Peninsula. RESULTS: Pyoderma was present in 43% of the children and in 76% of these culture of skin lesions grew group A streptococci. Group A streptococci also grew from 13% of throat swabs, making a total of 36% of children culture positive. Anti-streptolysin O and anti-DNAase B levels were remarkably high and increased with age. CONCLUSIONS: The evidence presented confirms a high level of group A streptococcal carriage and infection in children of the Lockhart River Community. Further investigation of this problem is warranted in other Aboriginal communities with a view to instituting appropriate control programs.

Antistreptolysin↗