1) The study surveyed 187 dentists in Pelotas, Brazil to assess their attitudes and perceptions regarding child abuse and their ability to identify suspected cases.
2) While most dentists believed they could detect child abuse, only 14.3% reported ever suspecting a case and the majority of those who did suspect did not report it to authorities.
3) Dentists working at a university were more likely to have suspected child abuse compared to those in private practice, possibly because they see more patients and receive more training on the issue.
This document summarizes a study on systems-level barriers that contribute to secondary conditions in individuals with fetal alcohol spectrum disorders (FASD). The study involved interviews and focus groups with parents of children with FASD and service providers.
The key findings were:
1) A pervasive lack of knowledge about FASD exists throughout multiple systems, including healthcare, education, and social services. This lack of knowledge contributes to barriers across different systems.
2) Systems-level barriers that interfere with preventing secondary conditions include delayed diagnosis of FASD, difficulty qualifying for and accessing services, poor implementation of services, and challenges maintaining services long-term.
3) Broad system changes are needed using a public
The document summarizes a study that investigated the prevalence of dental caries among children aged 7-14 in Tirana, Albania. 372 children were examined from three schools in different socioeconomic areas of the city. Results found that 87% of children consumed sweets daily and only 67% reported brushing their teeth once per day. Dental caries experience was found to be high, with a mean of 2.06 decayed teeth per child. This poses a challenge for improving access to dental care and preventive programs in Albania.
Awareness of Dental Health and Treatment among the High School Childrenpaperpublications3
Abstract: The study aims to know the current status of dental health awareness about the dental treatment options among high school children for whom the oral health awareness is essential in order to seek early attention and treatment , there exceeds different level of understanding knowledge regarding the awareness about the treatment in spite of available studies with valuable information .but unfortunately a group of population fail to initiate to indulge them with the information’s also end up with mis conceptions regarding the treatments, finally the study would help to emphasize and to shift the focus areas which have been unnecessarily stressed upon . No matter what age one knows the key for mataining good health. Knowing what particular dental problems each have and their capability to decide their most appropriate means to prevent dental problems and reduces the occurrence and marinating a healthy oral cavity from the teen age that helps to maintain for their whole life time.
Can Integrated Parental and Teacher Support Meet the Challenges of the Autist...Anna Fisher
This document proposes an intervention to improve care and outcomes for autistic adolescents in classrooms. It involves setting individualized goals for students through collaboration between parents and teachers, and tracking progress toward goals through monthly meetings. The program aims to address challenges like inadequate support, bullying, and lack of involvement from parents and teachers. It is expected to improve students' social, academic, and life skills by holding all parties accountable for the child's progress. Evaluating paperwork documenting goal progress each year will assess whether the intervention is effective at improving outcomes for students.
Clearing the Error: Patient Participation in Reducing Diagnostic ErrorJefferson Center
To generate new, patient-centered insights into diagnostic error, we convened diverse groups in public deliberation to recommend and evaluate actions that patients and/or their advocates would be willing and able to perform to improve diagnostic quality.
This document summarizes a presentation about communication experiences of children with cerebral palsy in health care settings and the potential for technologies to improve engagement. It discusses parent feedback wanting involvement in decision making and consideration of broader impacts. Using technologies like PCEHR and decision aids may help provide better evidence and access to information. Clinical implications discussed include involving parents and children in goal setting and information sharing. Future research directions explored uptake of PCEHR, health impacts of technologies, and communicative environments in health settings.
This document summarizes a research project on child protection conducted at Birmingham Children's Hospital. It involved a literature review on child protection guidelines, interviews with clinical staff, and a survey distributed to hospital staff. The survey presented a hypothetical child abuse case study and assessed staff understanding of clinical guidelines. The majority (96.4%) of hospital staff demonstrated a clear understanding of guidelines for identifying potential child abuse cases. While adherence to clinical documents was encouraging, the research concluded more should be done to prevent abuse through longer-term measures rather than just identifying evidence of abuse. Overall, the research found hospital staff generally understood how to appropriately handle potential child abuse cases according to clinical guidelines.
This document summarizes a study on systems-level barriers that contribute to secondary conditions in individuals with fetal alcohol spectrum disorders (FASD). The study involved interviews and focus groups with parents of children with FASD and service providers.
The key findings were:
1) A pervasive lack of knowledge about FASD exists throughout multiple systems, including healthcare, education, and social services. This lack of knowledge contributes to barriers across different systems.
2) Systems-level barriers that interfere with preventing secondary conditions include delayed diagnosis of FASD, difficulty qualifying for and accessing services, poor implementation of services, and challenges maintaining services long-term.
3) Broad system changes are needed using a public
The document summarizes a study that investigated the prevalence of dental caries among children aged 7-14 in Tirana, Albania. 372 children were examined from three schools in different socioeconomic areas of the city. Results found that 87% of children consumed sweets daily and only 67% reported brushing their teeth once per day. Dental caries experience was found to be high, with a mean of 2.06 decayed teeth per child. This poses a challenge for improving access to dental care and preventive programs in Albania.
Awareness of Dental Health and Treatment among the High School Childrenpaperpublications3
Abstract: The study aims to know the current status of dental health awareness about the dental treatment options among high school children for whom the oral health awareness is essential in order to seek early attention and treatment , there exceeds different level of understanding knowledge regarding the awareness about the treatment in spite of available studies with valuable information .but unfortunately a group of population fail to initiate to indulge them with the information’s also end up with mis conceptions regarding the treatments, finally the study would help to emphasize and to shift the focus areas which have been unnecessarily stressed upon . No matter what age one knows the key for mataining good health. Knowing what particular dental problems each have and their capability to decide their most appropriate means to prevent dental problems and reduces the occurrence and marinating a healthy oral cavity from the teen age that helps to maintain for their whole life time.
Can Integrated Parental and Teacher Support Meet the Challenges of the Autist...Anna Fisher
This document proposes an intervention to improve care and outcomes for autistic adolescents in classrooms. It involves setting individualized goals for students through collaboration between parents and teachers, and tracking progress toward goals through monthly meetings. The program aims to address challenges like inadequate support, bullying, and lack of involvement from parents and teachers. It is expected to improve students' social, academic, and life skills by holding all parties accountable for the child's progress. Evaluating paperwork documenting goal progress each year will assess whether the intervention is effective at improving outcomes for students.
Clearing the Error: Patient Participation in Reducing Diagnostic ErrorJefferson Center
To generate new, patient-centered insights into diagnostic error, we convened diverse groups in public deliberation to recommend and evaluate actions that patients and/or their advocates would be willing and able to perform to improve diagnostic quality.
This document summarizes a presentation about communication experiences of children with cerebral palsy in health care settings and the potential for technologies to improve engagement. It discusses parent feedback wanting involvement in decision making and consideration of broader impacts. Using technologies like PCEHR and decision aids may help provide better evidence and access to information. Clinical implications discussed include involving parents and children in goal setting and information sharing. Future research directions explored uptake of PCEHR, health impacts of technologies, and communicative environments in health settings.
This document summarizes a research project on child protection conducted at Birmingham Children's Hospital. It involved a literature review on child protection guidelines, interviews with clinical staff, and a survey distributed to hospital staff. The survey presented a hypothetical child abuse case study and assessed staff understanding of clinical guidelines. The majority (96.4%) of hospital staff demonstrated a clear understanding of guidelines for identifying potential child abuse cases. While adherence to clinical documents was encouraging, the research concluded more should be done to prevent abuse through longer-term measures rather than just identifying evidence of abuse. Overall, the research found hospital staff generally understood how to appropriately handle potential child abuse cases according to clinical guidelines.
This study characterized the risk factors, characteristics, and comorbidities of 173 Brazilian patients with cleft lip and/or cleft palate (CL/P). Most patients were male with cleft lip and palate. Common neonatal issues included jaundice and respiratory distress. Associated comorbidities included anemia, respiratory diseases, and cardiovascular diseases. Many patients had delayed neuropsychomotor development or speech delays. A high proportion of patients had not received recommended lip or palate surgery by the standard ages. The study found high frequencies of parental consanguinity, familial recurrence of CL/P, and maternal exposures like alcohol and smoking during pregnancy that could increase CL/P risk. Characterizing this patient population is important
Joint primer by the National Association of Healthcare Purchaser Coalitions and the Washington Health Alliance in promoting adoption of Choosing Wisely in the state of Washington
This document summarizes issues related to pediatric adherence for HIV treatment in children and adolescents. It provides data on pediatric enrollment and adherence from ICAP programs in multiple countries. Key challenges to pediatric adherence are forgetting doses, staying away from home, and sleeping through doses. Developmental factors like age and disclosure status can also impact adherence. The document discusses strategies to support pediatric adherence, including education, reminders, involvement of caregivers, clinics that are child-friendly, and multidisciplinary teams. Country examples from South Africa, Kenya, and Ethiopia demonstrate approaches like appointment diaries, integration of services, and collaboration between medical and psychosocial teams to address children's developmental needs.
A Qualitative Assessment of Program Characteristics for individuals with FASDNaira Tahir
This document summarizes a qualitative study that aimed to identify characteristics of effective intervention programs for preventing secondary conditions in individuals with fetal alcohol spectrum disorders (FASD). Researchers conducted focus groups and interviews with 25 parents of children with FASD and 18 service providers. Five primary characteristics of effective programs were identified: 1) being available across the lifespan, 2) having a prevention focus, 3) being individualized, 4) being comprehensive, and 5) being well-coordinated across systems and developmental stages. The study findings can help guide the development and evaluation of new intervention programs for this population.
Millions of children losing out on preventive careYael Waknine
A CDC report found that millions of children and teenagers are not receiving recommended preventive health services. Data collected before the ACA showed low rates of immunizations, dental care, developmental screenings, and counseling for issues like tobacco use and reproductive health. Only 21.1% of young children received comprehensive developmental screening, and many children lacked basic services like vision and hearing tests. The report indicates certain groups face even lower access, and calls for increased preventive care to promote long-term health.
This presentation summarizes research on the determinants of access to quality health care for children in Georgia. The study used a merged dataset containing information on over 1,300 Georgia children ages 4-17. Access was defined based on utilization of preventive care and quality of received care. Results from descriptive analyses and multivariable logistic regressions found that over 30% of children had access to higher quality care. Factors like having insurance, higher income levels, and being in better health were associated with higher odds of access, while being a racial/ethnic minority was associated with lower odds. The findings can help inform efforts to improve insurance coverage and reduce disparities in access to quality care for children in Georgia.
This document discusses using text messaging to improve communication with adolescent patients. It reviews past research showing mixed results on using texting to change health behaviors or outcomes for chronic conditions. However, studies focusing on softer endpoints like engagement and education show more promising results. The experience of one pediatrician, Dr. Natasha Burgert, who pioneered texting with patients, provides real-world evidence it can be successful. The paper aims to propose best practices for texting initiatives with adolescents based on past research and clinical experiences.
Nonverbal Communication and Autism April PriestApril Priest
This study aims to examine how nonverbal communication in the form of comforting touches by therapists affects stress levels in nonverbal autistic children, as measured by cortisol levels. The hypothesis is that nonverbal behaviors will be more effective at calming upset autistic children than verbal communication alone, due to their limited verbal abilities. The study will involve autistic children and their ABA therapists. Saliva samples will be collected when children are upset to measure cortisol levels after verbal-only versus touch-based comforting. It is predicted touch will be superior in lowering cortisol.
Genetic counseling: Introduction, definition, purposes of genetic counseling, indications of genetic counseling, beneficiaries of genetic counseling, phases of genetic counseling, role of nurse in genetic counseling, application of genetic counseling.
This document discusses trauma and its impacts on children in foster care. It provides an overview of PTSD and high rates of PTSD among children in foster care due to abuse, neglect, and family dysfunction. It also discusses the overuse of psychotropic medications in foster care and the need for trauma-informed treatment. Non-pharmacological interventions like TF-CBT are effective for treating trauma in children. Trauma-informed approaches are also needed within the criminal justice system given high rates of trauma among justice-involved individuals.
The impact of traumatic childhood experiences on cognitive and behavioural fu...BARRY STANLEY 2 fasd
This thesis examines the impact of traumatic childhood experiences on cognitive and behavioural functioning in children with fetal alcohol spectrum disorders (FASD). A systematic literature review found few studies have investigated dual exposure to prenatal alcohol exposure (PAE) and trauma. The author conducted four original studies: 1) a caregiver survey of adversity, empathy and behaviour; 2) a cognitive study of intelligence and executive function; 3) a neuroimaging study of prefrontal cortex activity; and 4) qualitative interviews with caregivers. The main finding was traumatic experiences may subtly impact children with FASD, especially cognitively, as they were similar to children with only FASD. Clinicians should view children with both exposures primarily as having F
Web only rx16 pharma wed_200_1_hagemeier_2fleming_3vernachioOPUNITE
Community pharmacists are well positioned to help address the growing problem of opioid and benzodiazepine addiction but face challenges. Early identification of at-risk patients, supportive benefit structures, and intervention training could empower pharmacists. While many recognize their responsibility, behavioral engagement in prevention is often lacking due to practice barriers, lack of patient information, and fear of responses. Standardizing communication expectations and screening tools could help pharmacists better fulfill their role on the treatment team.
The study assessed the reproductive education needs of infertile clients undergoing assisted reproduction treatment in Iran. A questionnaire was used to evaluate the knowledge and attitudes of 154 clients regarding fertility, infertility, and infertility treatment. Results showed the highest knowledge scores related to factors affecting pregnancy, while the lowest scores related to the natural reproductive cycle and genital anatomy. Males had higher knowledge than females for some topics. Education level also impacted knowledge, with those having less than a diploma scoring lower. Most clients believed education programs should address treatment types and procedures. The study concluded it is important to educate infertile clients on infertility causes and treatments to enable informed decision making.
Ethical and Legal Issues Related to Medical Genetics Rayhan Shahrear
Define ethics and bioethics.
State the major ethical issues related to medical genetics.
Outline the uniqueness of medical genetics.
Outline the relevant ethical principles in medicine.
Discuss some ethical dilemmas that arise in the genetic clinic.
Explain the ethical dilemmas and public interest.
Dr. Najnin Akhter
Phase-A, Year-2, Block-6
Guided by Prof. K M Shamim
This document describes a study that conducted focus groups with pregnant and postpartum women employed in an urban corporate setting in North Carolina. The purpose was to examine their knowledge gaps and recommend topics for maternal education programs sponsored by health insurance companies. Two focus groups were held with a total of 8 participants. Responses were analyzed using NVivo software. Results indicated several topics that should be considered for educational materials, including visual content, interactivity, father involvement, breastfeeding/bottle feeding, booklet length, and mental health/postpartum depression. However, the small sample size limits generalizability, so more in-depth focus groups are needed to inform future studies.
Austin Public Health is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Public Health.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances & happenings in all areas of Public Health. Austin Public Health accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of public health.
Austin Public Health strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Web only rx16 treat-wed_1115_1_hudson_2badaOPUNITE
The document discusses treatment and outcomes of neonatal abstinence syndrome (NAS). It summarizes a presentation by two doctors on NAS treatment. It then describes a study examining outcomes of a palliative early treatment model for NAS at Greenville Memorial Hospital. The model involved early low-dose methadone treatment for opioid exposed newborns in a low-acuity nursery setting. Results showed lower length of stay, less weight loss and medical complications compared to national averages, with total hospital costs averaging $5,909 per case.
This document summarizes a study on why patients in KwaZulu-Natal, South Africa stop taking their antiretroviral (ART) medications. The study interviewed 180 current ART patients, 60 former patients who stopped treatment, and 30 healthcare providers across 5 public health sites. It found that former patients generally came from more vulnerable social and financial situations than current patients. Many stopped due to medication side effects or lack of money for food or transportation. Overall, the circumstances around patients stopping ART involved vulnerable social situations with little support, marginal economic conditions with few reliable income sources, and struggles with side effects.
New York State Drug Court Program: The
participant will be able to: Demonstrate the efficacy of
patient navigation in order to improve maternal/child
health outcomes and parenting skills for the court
involved population.
This study characterized the risk factors, characteristics, and comorbidities of 173 Brazilian patients with cleft lip and/or cleft palate (CL/P). Most patients were male with cleft lip and palate. Common neonatal issues included jaundice and respiratory distress. Associated comorbidities included anemia, respiratory diseases, and cardiovascular diseases. Many patients had delayed neuropsychomotor development or speech delays. A high proportion of patients had not received recommended lip or palate surgery by the standard ages. The study found high frequencies of parental consanguinity, familial recurrence of CL/P, and maternal exposures like alcohol and smoking during pregnancy that could increase CL/P risk. Characterizing this patient population is important
Joint primer by the National Association of Healthcare Purchaser Coalitions and the Washington Health Alliance in promoting adoption of Choosing Wisely in the state of Washington
This document summarizes issues related to pediatric adherence for HIV treatment in children and adolescents. It provides data on pediatric enrollment and adherence from ICAP programs in multiple countries. Key challenges to pediatric adherence are forgetting doses, staying away from home, and sleeping through doses. Developmental factors like age and disclosure status can also impact adherence. The document discusses strategies to support pediatric adherence, including education, reminders, involvement of caregivers, clinics that are child-friendly, and multidisciplinary teams. Country examples from South Africa, Kenya, and Ethiopia demonstrate approaches like appointment diaries, integration of services, and collaboration between medical and psychosocial teams to address children's developmental needs.
A Qualitative Assessment of Program Characteristics for individuals with FASDNaira Tahir
This document summarizes a qualitative study that aimed to identify characteristics of effective intervention programs for preventing secondary conditions in individuals with fetal alcohol spectrum disorders (FASD). Researchers conducted focus groups and interviews with 25 parents of children with FASD and 18 service providers. Five primary characteristics of effective programs were identified: 1) being available across the lifespan, 2) having a prevention focus, 3) being individualized, 4) being comprehensive, and 5) being well-coordinated across systems and developmental stages. The study findings can help guide the development and evaluation of new intervention programs for this population.
Millions of children losing out on preventive careYael Waknine
A CDC report found that millions of children and teenagers are not receiving recommended preventive health services. Data collected before the ACA showed low rates of immunizations, dental care, developmental screenings, and counseling for issues like tobacco use and reproductive health. Only 21.1% of young children received comprehensive developmental screening, and many children lacked basic services like vision and hearing tests. The report indicates certain groups face even lower access, and calls for increased preventive care to promote long-term health.
This presentation summarizes research on the determinants of access to quality health care for children in Georgia. The study used a merged dataset containing information on over 1,300 Georgia children ages 4-17. Access was defined based on utilization of preventive care and quality of received care. Results from descriptive analyses and multivariable logistic regressions found that over 30% of children had access to higher quality care. Factors like having insurance, higher income levels, and being in better health were associated with higher odds of access, while being a racial/ethnic minority was associated with lower odds. The findings can help inform efforts to improve insurance coverage and reduce disparities in access to quality care for children in Georgia.
This document discusses using text messaging to improve communication with adolescent patients. It reviews past research showing mixed results on using texting to change health behaviors or outcomes for chronic conditions. However, studies focusing on softer endpoints like engagement and education show more promising results. The experience of one pediatrician, Dr. Natasha Burgert, who pioneered texting with patients, provides real-world evidence it can be successful. The paper aims to propose best practices for texting initiatives with adolescents based on past research and clinical experiences.
Nonverbal Communication and Autism April PriestApril Priest
This study aims to examine how nonverbal communication in the form of comforting touches by therapists affects stress levels in nonverbal autistic children, as measured by cortisol levels. The hypothesis is that nonverbal behaviors will be more effective at calming upset autistic children than verbal communication alone, due to their limited verbal abilities. The study will involve autistic children and their ABA therapists. Saliva samples will be collected when children are upset to measure cortisol levels after verbal-only versus touch-based comforting. It is predicted touch will be superior in lowering cortisol.
Genetic counseling: Introduction, definition, purposes of genetic counseling, indications of genetic counseling, beneficiaries of genetic counseling, phases of genetic counseling, role of nurse in genetic counseling, application of genetic counseling.
This document discusses trauma and its impacts on children in foster care. It provides an overview of PTSD and high rates of PTSD among children in foster care due to abuse, neglect, and family dysfunction. It also discusses the overuse of psychotropic medications in foster care and the need for trauma-informed treatment. Non-pharmacological interventions like TF-CBT are effective for treating trauma in children. Trauma-informed approaches are also needed within the criminal justice system given high rates of trauma among justice-involved individuals.
The impact of traumatic childhood experiences on cognitive and behavioural fu...BARRY STANLEY 2 fasd
This thesis examines the impact of traumatic childhood experiences on cognitive and behavioural functioning in children with fetal alcohol spectrum disorders (FASD). A systematic literature review found few studies have investigated dual exposure to prenatal alcohol exposure (PAE) and trauma. The author conducted four original studies: 1) a caregiver survey of adversity, empathy and behaviour; 2) a cognitive study of intelligence and executive function; 3) a neuroimaging study of prefrontal cortex activity; and 4) qualitative interviews with caregivers. The main finding was traumatic experiences may subtly impact children with FASD, especially cognitively, as they were similar to children with only FASD. Clinicians should view children with both exposures primarily as having F
Web only rx16 pharma wed_200_1_hagemeier_2fleming_3vernachioOPUNITE
Community pharmacists are well positioned to help address the growing problem of opioid and benzodiazepine addiction but face challenges. Early identification of at-risk patients, supportive benefit structures, and intervention training could empower pharmacists. While many recognize their responsibility, behavioral engagement in prevention is often lacking due to practice barriers, lack of patient information, and fear of responses. Standardizing communication expectations and screening tools could help pharmacists better fulfill their role on the treatment team.
The study assessed the reproductive education needs of infertile clients undergoing assisted reproduction treatment in Iran. A questionnaire was used to evaluate the knowledge and attitudes of 154 clients regarding fertility, infertility, and infertility treatment. Results showed the highest knowledge scores related to factors affecting pregnancy, while the lowest scores related to the natural reproductive cycle and genital anatomy. Males had higher knowledge than females for some topics. Education level also impacted knowledge, with those having less than a diploma scoring lower. Most clients believed education programs should address treatment types and procedures. The study concluded it is important to educate infertile clients on infertility causes and treatments to enable informed decision making.
Ethical and Legal Issues Related to Medical Genetics Rayhan Shahrear
Define ethics and bioethics.
State the major ethical issues related to medical genetics.
Outline the uniqueness of medical genetics.
Outline the relevant ethical principles in medicine.
Discuss some ethical dilemmas that arise in the genetic clinic.
Explain the ethical dilemmas and public interest.
Dr. Najnin Akhter
Phase-A, Year-2, Block-6
Guided by Prof. K M Shamim
This document describes a study that conducted focus groups with pregnant and postpartum women employed in an urban corporate setting in North Carolina. The purpose was to examine their knowledge gaps and recommend topics for maternal education programs sponsored by health insurance companies. Two focus groups were held with a total of 8 participants. Responses were analyzed using NVivo software. Results indicated several topics that should be considered for educational materials, including visual content, interactivity, father involvement, breastfeeding/bottle feeding, booklet length, and mental health/postpartum depression. However, the small sample size limits generalizability, so more in-depth focus groups are needed to inform future studies.
Austin Public Health is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Public Health.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances & happenings in all areas of Public Health. Austin Public Health accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of public health.
Austin Public Health strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Web only rx16 treat-wed_1115_1_hudson_2badaOPUNITE
The document discusses treatment and outcomes of neonatal abstinence syndrome (NAS). It summarizes a presentation by two doctors on NAS treatment. It then describes a study examining outcomes of a palliative early treatment model for NAS at Greenville Memorial Hospital. The model involved early low-dose methadone treatment for opioid exposed newborns in a low-acuity nursery setting. Results showed lower length of stay, less weight loss and medical complications compared to national averages, with total hospital costs averaging $5,909 per case.
This document summarizes a study on why patients in KwaZulu-Natal, South Africa stop taking their antiretroviral (ART) medications. The study interviewed 180 current ART patients, 60 former patients who stopped treatment, and 30 healthcare providers across 5 public health sites. It found that former patients generally came from more vulnerable social and financial situations than current patients. Many stopped due to medication side effects or lack of money for food or transportation. Overall, the circumstances around patients stopping ART involved vulnerable social situations with little support, marginal economic conditions with few reliable income sources, and struggles with side effects.
New York State Drug Court Program: The
participant will be able to: Demonstrate the efficacy of
patient navigation in order to improve maternal/child
health outcomes and parenting skills for the court
involved population.
The document analyzes the performance of optical wireless communication using Alamouti space-time block coding (STBC) with coherent detection under different channel conditions. It implements two new Alamouti STBC architectures - one using a single carrier frequency and the other using multiple carrier frequencies. The performance is analyzed by simulating the bit error rate for various modulation schemes over gamma-gamma, Rayleigh, and log-normal turbulence channels while varying parameters like the number of transmitters and receivers. The analysis shows that Alamouti STBC can effectively mitigate the impact of turbulence-induced fading in optical wireless channels.
Welcome to Burger Street the best Fast Food Restaurants in various locations of United State. We offer you the delicious food with various Combo Meals. Visit today and enjoy delectable meals.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
06 Days 05 Nights Sri Lanka Holiday, 06 Days 05 Nights vacation package, Tour...dilratours
This 6-day tour package from Dilra Tours in Sri Lanka includes sightseeing in major cities and areas of cultural and natural significance. The itinerary covers destinations like Sigiriya, Dambulla, Kandy, Kitulgala, Nuwara Eliya, Bentota, Colombo, and Negombo. Tourists will visit important landmarks like Sigiriya Rock Fortress, Temple of the Tooth, spice gardens, waterfalls, beaches and more. They will also experience activities like white water rafting in Kitulgala and a boat safari in Bentota. Accommodation, transportation, meals and tour guides are included in the package.
basic info to understand forward head posture...if any objection then plz leave a comment and for more details you can send message to harisubedi12@yahoo.com
Preventing dental caries in children ,5 yearsNina Shevchenko
This systematic review aimed to update recommendations on preventing dental caries in children under 5. The review found:
1) No studies directly evaluated the effectiveness of screening by primary care providers on caries outcomes.
2) One good-quality study found primary care examination had reasonable accuracy for identifying cavities.
3) No studies evaluated the accuracy of primary care risk assessment for future caries.
4) Two nonrandomized trials found multifactorial interventions including education were associated with reduced caries, but did not isolate the effectiveness of education alone.
Research Presentation on the Influence of Irrational Health Beliefs on Dental...Munir Gomaa
This research is conducted by Munir Gomaa in his third and fourth years of dental school and is titled "Influence of Irrational Health Beliefs in Adults on Dental-Related Perceptions, Practices, and Diseases in Adult and Pediatric Patients." The research examines how, as an example, irrational fears related to going to a dentist might contribute to that patient's overall oral health.
School Children Dental Health, Dental Fear and Anxiety in relation to their P...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
The document discusses factors affecting dental hygiene among Latino children. It finds that low socioeconomic status is associated with poor dental hygiene, as Latino children experience higher rates of dental problems than non-Latino children. Barriers like low income, lack of insurance, low education, and poor nutrition impact dental hygiene. However, increasing dental education and access to care can help reduce disparities. Improving education on proper hygiene can help lower dental problems, even for families who cannot regularly visit dentists due to financial hardship.
EFFECTIVENESS OF SCHOOL DENTAL SCREENING, PARENTAL KNOWLEDGE AND HEALTH EDUC...DrRipika Sharma
Introduction: The objective of the study is to evaluate the effectiveness of school screening, parental knowledge and health education in
stimulating dental attendance among 6 to 10 years old children.
Material and Methods: A randomized controlled trial was carried out, with a sample size of 155 in each group. The study was conducted over a
period of 3 months, baseline clinical findings were assessed using dentition status and plaque index and knowledge of parents was evaluated using a
questionnaire in both the groups. The study group participants received oral health education and educational leaflets were distributed to the
parents. Further after 3 months, the post-intervention improvement was assessed as before. Statistical analyses were performed using SPSS version
22. Descriptive statistics, Chi-square test, paired t-test, Wilcoxon signed rank test was used to analyze the data.
Results: The overtime changes in oral health knowledge of parents were significantly different in the study group (p-value <0.001). Highly
significant reduction in Plaque scores was reported in the study group compared to control group (p-value <0.001). Overall there were no
significant differences in DMFT and dmft increments between the groups. The intervention was not effective at reducing the level of active caries
and increasing attendance in the population under study.
Conclusion: Even though the intervention had positive effects on plaque score and and on oral health knowledge of parents, but the rate of
utilization was low. We need additional efforts addressing another individual, family, and community level factors to make such programs more
fruitful
Background- Oral health is a multi-factorial concept, determined by knowledge, behavior, and attitude of a person. Like any behavior carried out daily like a habit, oral health behaviors are also repeated like a habit. The multidimensionality of behavioral change makes studying it, and factors associated with it, a challenge, since there are so many aspects to consider. Objectives- To find an association between the oral health status and socio-behavioral factors among 12-15 years old school children of Belagavi city, India. Methods- A descriptive cross-sectional study was conducted to find an association between the oral health status and the knowledge, attitude and behavior of adolescents. One thousand participants were selected using two-stage random sampling. Dental caries, bleeding on probing, dental trauma, enamel fluorosis, intervention urgency was recorded according to the WHO 2013 proforma and the parameters regarding knowledge, attitudes as well as behavior using a closed ended self-designed questionnaire. Mann-Whitney U test, Kruskal Wallis, and linear correlation tests were done. Results- Among 1000 subjects, 767 (76.7%) participants were found to have dental caries and 512 (51.2%) showed the presence of gingival bleeding. Out of a total score of 41, the mean knowledge score was 34.47 (±3.84) for boys and 34.76 (±4.13) for girls. Linear correlation showed that attitude was weakly correlated (r=0.18 and 0.20 respectively) but with a strong statistical significance to knowledge as well as behavior respectively. Conclusion- Attitude when compared separately either with knowledge or behavior showed a weak correlation that was highly significant. Comparison of behavior with caries experience showed a weak negative correlation which was statistically insignificant. Key-words- Oral health, Adolescents, Socio-behavioral, Knowledge, Attitude, Behavior
This document discusses the importance of early diagnosis and intervention for autism spectrum disorder (ASD). While signs of ASD can be detected as early as age 2, the median age of diagnosis is around 4 years old. Minority and low-income children tend to be diagnosed even later, facing greater barriers to healthcare access. Relying solely on pediatricians for screening and diagnosis likely results in missed cases. Early childcare providers see children's development in a social context and may be well-positioned to recognize atypical development. However, little research has examined using early childcare providers as screeners for ASD. This study aims to investigate the feasibility of early childcare providers screening young children for ASD in underserved
Oral health Knowledge, attitudes and behaviour among a sample of Kurdish peop...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This document summarizes a study that examined the effectiveness of different motivational interventions to promote oral hygiene autonomy in individuals with special needs. The study involved 21 adults with disabilities who received four motivational activities over four months. Oral hygiene was evaluated before and after each activity using the Simplified Oral Hygiene Index. The results showed that supervised tooth brushing and discussions with parents/guardians were the most effective at improving oral hygiene scores, suggesting motivational activities can enhance quality of life for those with special needs.
Dental Myth, Fallacies and Misconceptions and its Association with Socio-Dent...DrRipika Sharma
Introduction: It is important to know about the myths and misconceptions, especially in India, where general and oral health is
embroiled in various myths and ritualistic practices.
Objectives: The purpose of this study is aimed at assessing the prevalence of dental myth and utilizes socio-dental impact
locus of control scale (SILOC) health model, as the theoretical framework to understand the dental myth and belief and possible
reasons for noncompliance with recommended health action.
Materials and Methods: A cross-sectional study was conducted by the out-patients attending dental institute, in Bengaluru
city. A total of 150 individuals were included, data were collected using a pretested and validated three-part questionnaire
including demographic data, questions regarding dental myth, and seven items SILOC. Data obtained were statistically analyzed
using descriptive statistics, t-test, and spearman’s rank correlation.
Results: Almost all the participant believed in one or more dental myth. About 71.3% of the participant had high (≥11) SILOC
scores. Statistically significant difference (P < 0.001) was found between mean SILOC scores and gender with males having
a lower mean score (14.94) as compared to females (18.62). When SILOC scores and myth scores were compared against
socioeconomic status, it showed statistically significant difference (P < 0.001), between them. The SILOC scores highly correlated
with myth scores.
Conclusion: Various dental myth and false perception still lurk in the minds of the population, to discourage the unhealthy
practices; we the health professionals have to provide intensive health education and promote the adoption of healthy practices.
It would be prudent to familiarize professionals to understand these myths and beliefs as they act as barriers toward seeking
treatment.
Key words: Culture, Gender, Internal-external control, Oral health, Social class
The document discusses barriers to interpersonal communication, including language barriers, cultural medical mistrust, psychological barriers, and differing cultural beliefs that can affect communication. It also describes the procedures used in a physical exam, such as inspection, percussion, palpation, auscultation, and manipulation. Finally, it explains the SOAP method for documenting patient data, where subjective data comes from the patient, objective data from observations and exams, assessment is the provider's analysis, and planning is the treatment plan.
This study evaluated the socio-demographic determinants of dental service utilization among 741 secondary school students in Nigeria. The results showed that only 27.9% of students had visited a dentist before, mainly when experiencing pain. There was a statistically significant association between student type (boarding vs day) and class (junior vs senior secondary) with utilization. However, logistic regression found no socio-demographic factors predictive of utilization. In conclusion, while knowledge of dentists was high, actual utilization of dental services remained poor with no socio-demographic predictors of that utilization.
This randomized controlled trial tested the effectiveness of postcard mailings on increasing dental utilization among low-income children in Yakima County, Washington. Over 5,800 children were randomly assigned to receive different postcards or no postcards. The postcards provided information about enrolling in the county's dental program or highlighted specific benefits like fluoride varnish. Analysis of Medicaid claims data found no significant differences in dental utilization rates between the groups, indicating the postcard mailings did not increase utilization of preventive dental services. Baseline utilization was already relatively high, potentially limiting the impact of the mailings.
abscess advanced trauma life support anterio advanced trauma life support antibiotics apically repositioned flap dental diseases dr dr shabeel drshabeel’s face eye trauma lidocaine anodontia management medical medicine misuse and abuse orthodontics teeth braces pharmacy pn preparation dental students for community based ed presentations s abscess abscess tooth active orthodonti shabeel shabeel"s shabeel’s shabeelpn trends of antimicrobial usage in dental practice View all
’s abscess abscess advanced trauma life support anterio abscess tooth active orthodontics adolescent advanced trauma life support aesthetic dentistry airway management alignment of teeth amalgam anesthesia in dentistry anesthetics in dentistry anterior open bite antibiotic resistanace antibiotics antibiotics and leukopenia aphthous ulcers apically repositioned flap apicoectomy appliances arch dental arch form orthodontics braces arch length orthodontics braces arch wire orthodontist braces ayurvedha baby teeth bloger boil books braces braces teeth cancer canker sore pain cavity preparation children community based learning congenitally missing teeth cosmetic dentistry csf leaks dental dental anesthetics dental restorations dental teeth dento alveolar fractures disease
This study evaluated parental acceptance of 8 behavior management techniques (BMTs) used in pediatric dental practice among 200 Thai parents. The techniques included tell-show-do, voice control, passive restraint, active restraint, parental presence/absence, oral sedation, nitrous oxide/oxygen, and general anesthesia. Parents rated the techniques on a 100mm visual analog scale after watching video demonstrations. Tell-show-do received the highest rating while parental presence/absence received the lowest. Parental dental anxiety was associated with lower acceptance of parental presence/absence. Children's previous experience with certain techniques increased parental acceptance of those techniques. The study provides insights into Thai parental perspectives on commonly used BMTs to help dent
1. The document outlines a proposed study by Bosco Jose to assess the knowledge and practice of mothers of lower primary school children regarding prevention of dental caries in Mangalore.
2. The study will utilize a descriptive survey design and purposive sampling to collect data from 60 mothers using structured questionnaires on knowledge and practice.
3. The objectives are to determine mothers' level of knowledge and practice regarding dental caries prevention, and to analyze the correlation between knowledge and practice and their association with demographic variables.
The document discusses a research study assessing the oral health status of basic education students at Our Lady of Fatima University. It aims to determine the students' demographic profiles, most common oral conditions, and current oral health status in terms of caries formation, calculus deposits, and number of extractions. The study also compares oral health factors between elementary and high school students. Overall results found that over half of students experienced dental caries, with the condition being more prevalent in females. Most students also had supragingival plaque and calculus deposits. The Philippines generally has poor oral health among children according to national survey data.
Assessing Children At Risk Organizational And Professional Conditions Within...Katie Robinson
This document summarizes a study that assessed organizational and professional conditions related to identifying and reporting children at risk of harm within four Swedish children's hospitals. The study found that hospitals differed in the level of organizational support provided to staff. It also found that different professional groups, such as nurses and nurse assistants, had lower levels of awareness about reporting obligations and support structures compared to physicians and social workers. The study argues that all professional groups need equal access to education and the opportunity to be more involved in assessments and reporting to strengthen multidisciplinary collaboration and properly identify children at risk.
This document provides an overview of child abuse and neglect. It defines different types of child abuse like physical abuse, sexual abuse, emotional abuse, and neglect. It also discusses factors contributing to child abuse, statistics on abuse, clinical assessment of abuse, signs of abuse, and legal requirements for reporting suspected abuse. The goal is to educate dental professionals on properly identifying, documenting, treating, and reporting suspected cases of child abuse.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
Special TechSoup offer for a free 180 days membership, and up to $150 in discounts on eligible orders.
Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
What is Digital Literacy? A guest blog from Andy McLaughlin, University of Ab...
Art trauma
1. Community Dentistry
Braz Oral Res. 2012 Jan-Feb;26(1):5-11 5
Marina Sousa Azevedo(a)
Marília Leão Goettems(a)
Adão Brito(a)
Anna Paula Possebon(a)
Juliana Domingues(a)
Flávio Fernando Demarco(b)
Dione Dias Torriani(c)
(a)
Graduate Program in Dentistry, School
of Dentistry, Federal University of Pelotas,
Pelotas, RS, Brazil.
(b)
Department of Operative Dentistry, School
of Dentistry, Federal University of Pelotas,
Pelotas, RS, Brazil.
(c)
Department of Social and Preventive
Dentistry, School of Dentistry, Federal
University of Pelotas, Pelotas, RS, Brazil.
Community Dentistry
Corresponding author:
Dione Dias Torriani
E-mail: dionedt@gmail.com
Received for publication on Aug 23, 2011
Accepted for publication on Nov 16, 2011
Child maltreatment: a survey of dentists
in southern Brazil
Abstract: Child abuse is a serious public health problem and affects the
victims’ physical and mental health and development. The aims of this
study were two-fold: to assess the attitudes and perceptions of dentists
regarding child abuse, and to investigate professional characteristics as-
sociated with the identification of suspected child abuse. A questionnaire
was sent to the 276 dentists of Pelotas, RS, Brazil, and 187 (68.0%) were
returned. Demographic characteristics and profiles of the dentists, and
information about their knowledge and attitudes regarding child abuse
were collected. Descriptive analysis was performed, and associations
were tested by chi-square and Fisher’s exact tests. From all dentists sur-
veyed, 123 (71.9%) reported providing treatment for children. Most den-
tists believed they could detect cases of child abuse (78.7%), but 85.7%
had never suspected it. Among those who did suspect, 76.0% did not
report the cases to authorities. No differences were observed between
sexes, years of graduation, types of licenses, and the frequency at which
children were treated. A higher proportion of dentists working at univer-
sity had suspected child abuse. Even though dentists considered them-
selves able to identify suspicious cases, only a small percentage reported
those suspicions, indicating a lack of awareness by these professionals in
the adoption of protective measures for victims of aggression. It is nec-
essary that dental professionals receive interdisciplinary training to en-
hance their ability to care for and protect children.
Descriptors: Child Abuse; Violence; Child; Dentistry.
Introduction
Child maltreatment, sometimes referred to as child abuse and neglect,
includes all forms of physical and emotional ill-treatment, sexual abuse,
neglect, and exploitation that result in actual or potential harm to a
child’s health, development, or dignity. Within this broad definition, five
subtypes can be distinguished:
• physical abuse,
• sexual abuse,
• neglect and negligent treatment,
• emotional abuse, and
• exploitation.1
Abuse is an act of commission, whereas child neglect is an act of
omission.
Declaration of Interests: The authors
certify that they have no commercial or
associative interest that represents a conflict
of interest in connection with the manuscript.
2. Child maltreatment: a survey of dentists in southern Brazil
6 Braz Oral Res. 2012 Jan-Feb;26(1):5-11
Every child has the right to health and a life free
from violence. Each year, however, millions of chil-
dren around the world are the victims of and wit-
nesses to physical, sexual, and emotional violence.
Child maltreatment is a huge global problem, with
a serious impact not only on the victims’ physical
and mental health, well-being, and development
throughout their lives, but also, by extension, on so-
ciety in general.1
In Brazil, the maltreatment of children and ad-
olescents has been recognized as a serious public
health problem. In a recent review addressing child
neglect and abuse by parents, the authors verified
that the number of incidents of psychological and
physical violence is still high. The prevalence of
physical abuse in the studies published in the last 15
years was 15.7%.2
Dentists are in an ideal position to help detect
signs of child abuse and should be able to recognize
those signs. Statistics have shown that as many as
50% to 75% of all cases of child abuse include trau-
ma to the mouth, face, and head.3,4
Despite the ob-
ligation to report suspected cases, however, dental
health professionals continue to under-report child
abuse, although awareness of their potential role in
detecting this crime is growing.5-8
Therefore, the aims of this study were to assess
the attitudes and perceptions of dentists regarding
child abuse, and to investigate professional char-
acteristics associated with the identification of sus-
pected child abuse.
Methodology
Population and settings
This cross-sectional study was approved by the
Human Research Ethics Committee of the Federal
University of Pelotas (116/2009). Pelotas is a south-
ern Brazilian city and has nearly 327.000 inhabit-
ants.9
A list of all dentists practicing in the city in
2009 was obtained from the local Board of Den-
tistry. Those whose data were complete (address
and telephone number) were eligible to be included
(n = 276).
Dental students distributed the questionnaires at
the addresses listed, between March and July. All
practitioners received an explanation of the study
and were given the opportunity to ask questions. If
the professional agreed to participate in the study,
the survey was completed, and the student returned
after a week to collect the questionnaire and the
signed informed consent.
Questionnaire
A previously tested self-administered question-
naire consisting of 48 close-ended items with re-
sponse options organized vertically was used for
data collection.
In the present study, variables regarding demo-
graphic characteristics (sex, age), professional data
(workplace, number of years of professional activ-
ity, and specialization level), and attitudes toward
treatment of children with primary dentition (if the
dentist provided treatment for children) were used.
Information about knowledge and attitudes regard-
ing child abuse was collected. Dentists were asked if
they had suspected child abuse and neglect. In the
case of a positive answer, they were asked if they
had reported the case; in the case of a negative an-
swer, they were asked if they believed they could
recognize child abuse. “Workplace” was defined as
public, private, both, or Dental School. “Years of
dental practice” was categorized into four groups:
• fewer than 10 years,
• 10 to 20 years,
• 21 to 30 years, and
• 30 or more years.
The type of license was classified as:
• general practitioner,
• pediatric dentistry, or
• other specialty.
Data analysis
Questionnaire responses were tabulated, and
percent frequency distributions for responses to
each item were computed. Chi-square test and Fish-
er’s exact test were used to analyze two categorical
or nominal variables. Data were analyzed with Stata
10.0 (Stata Corporation, College Station, USA). The
level of significance was set at α = 0.05.
3. Azevedo MS, Goettems ML, Brito A, Possebon AP, Domingues J, Demarco FF, Torriani DD
7Braz Oral Res. 2012 Jan-Feb;26(1):5-11
Results
Of the 276 surveys delivered, 187 surveys were
returned, for a response rate of 68%. The ma-
jority of dentists surveyed were female (52.4%),
and 96.0% considered themselves as being white.
Around 66% of the dentists worked in private
practice. Nearly 46% had up to 10 years of dental
practice. Almost 2/3 of the dentists were special-
ists (63.7%), eight of whom were pediatric dentists.
Generally, 123 (71.9%) provided dental treatment
for children (Table 1).
Most dentists believed they could detect cases of
child abuse (78.7%). When asked if they had already
suspected child abuse, 85.7% reported that this
had never occurred. Among those who did suspect,
76.0% did not report the case to legal authorities
(Table 2).
No differences were observed between sexes,
years of graduation, types of licenses, and the fre-
quency at which children were treated in the office.
A statistically higher proportion of dentists work-
ing at university had suspected cases of child abuse
(Table 3).
Discussion
This study used a self-report questionnaire to ob-
tain information from dentists about their attitudes
and perceptions regarding child maltreatment. The
representative sample and the high response rate
achieved allow for a valid assessment. This method
is widely used in cross-sectional study designs where
all data can be collected at one point in time, thus
avoiding any possible interviewer interference. Also,
our study ensured the confidentiality of the ques-
tionnaires, which allowed for more confidence in
the replies and may have contributed to the high re-
sponse rate. Other surveys with similar methodol-
ogy had a lower response rate.10,11
Abuse or neglect may present to the dental team
in many ways:
• (a) through a direct allegation made by the child,
a parent, or some other person;
• (b) through signs and symptoms which are sug-
gestive of physical abuse or neglect; and/or
• (c) through observations of child behavior or
parent-child interaction.12
Dentists who treat children regularly are more
likely to attend a victim of abuse, since half of all
victims are under 7 years of age.13
Of the Pelotas
dentists surveyed, 123 reported seeing children in
their offices. Among the dentists included, those
Table 1 - Demographic characteristics and profiles of den-
tal practices in Pelotas, Brazil, 2009 (n = 187).
Variables n (%)
Sex
• Male 89 (47.6)
• Female 98 (52.4)
Years of dental practice
• Up to 10 84 (45.4)
• 11-20 43 (23.2)
• 21-30 28 (15.1)
• More than 30 30 (16.2)
Type of license
• General practitioner 66 (36.3)
• Specialist 116 (63.7)
Practice location
• Private 121 (66.1)
• Public 17 (9.3)
• Both (Private/Public) 22 (12.0)
• Dental School 23 (12.6)
Dental attendance of children
• No, parents do not seek 8 (4.7)
• No, prefer to refer to others 40 (23.3)
• Yes, less than once a month 30 (17.5)
• Yes, at least once a month 31 (18.1)
• Yes, at least once a week 38 (22.2)
• Yes, at least once a day 24 (14.0)
Table 2 - Dentists’ attitudes and perceptions about child
abuse. Pelotas, Brazil, 2009 (n = 175).
Questionnaire items
Number of dentists (%)
Yes No
Have you ever recognized a
suspicious case of child abuse or
neglect in your dental office?
25 (14.3) 150 (85.7)
If yes, did you report it? 6 (24.0) 19 (76.0)
If no, do you believe you are able to
recognize a suspicious case?
118 (78.7) 32 (21.3)
4. Child maltreatment: a survey of dentists in southern Brazil
8 Braz Oral Res. 2012 Jan-Feb;26(1):5-11
who attended children more than once a month,
pediatric dentists, males, dentists with 21-30 years
of practice, and those working at dental school sus-
pected child maltreatment more frequently. How-
ever, there was a statistically significant difference
only for the practice location. It is possible that this
difference is due to the fact that dentists in a univer-
sity see a higher number of patients and are trained
to deal properly with this issue.
The majority of the dentists believed they could
detect cases of child maltreatment (78.7%). Similar
results were found in a northeastern Brazilian city,
where 65% of the dentists considered themselves
capable of such a diagnosis.14
This is an encourag-
ing finding which indicates that they have probably
been adequately prepared for this professional task.
However, it is widely believed that abuse is be-
ing under-reported by health care professionals, in-
cluding the dental community. It is worrisome that
while dentists are in a position to report suspected
child abuse cases, only 24% of those who suspected
child maltreatment had reported it to authorities.15,16
A northern Ireland study showed that fewer den-
tists had recognized and reported suspicious cases
of child physical abuse throughout their profes-
sional life compared with other health profession-
als.17
Although parents or guardians avoid returning
to the same physician or emergency room to obtain
treatment for an abused child, they do not seem to
avoid repeat visits to the same dental care provid-
ers. Therefore, it is surprising that dental profession-
als account for only a small percentage of reports of
child abuse and neglect.16
Under-reporting of child abuse is a significant
problem in the dental profession. In a survey of
2,005 California dentists, 16% had suspected a case
of child abuse or neglect in the preceding 5 years,
with only 6% of the respondents actually reporting
a case to authorities.16
In a study conducted in two
Brazilian cities, 52.9% of the pediatric dentists had
seen a suspicious child physical abuse case; however,
only 14.3% had reported to the authorities.18
Only
one study found that most suspected cases were re-
ported (89.0).14
There are different reasons for dentists’ hesitancy
to report suspected cases. In the Bsoul et al.6
study,
the respondents indicated that their major reason for
hesitating to report was the lack of adequate patient
history. According to the authors, perhaps dentists
need to be better informed about how to recognize
and gather information to explain children’s physi-
cal wounds or emotional behaviors. Other reasons
cited were the lack of adequate knowledge about
abuse, and about the dentists’ role in reporting the
case. These findings highlight the need for mandato-
ry training in the recognition and reporting of child
abuse.
Jordanian dental professionals reported that the
main factors influencing their decision to report cas-
es of suspected child abuse were:
• lack of history (76%),
• uncertainty about diagnosis (73%), and
• possible consequences to the child (66%).
Table 3 - Factors associated with previous suspicions of
child abuse, Pelotas, 2009 (n = 175).
Variable
Recognized a
suspicious case
p
Yes No
n (%) n (%)
Sex
• Male 16 (19.5) 66 (80.5)
0.06*
• Female 9 (9.7) 84 (90.3)
Years of practice
• Up to 10 10 (12.0) 73 (88.0)
0.58#
• 11-20 7 (16.2) 36 (83.7)
• 21-30 5 (21.7) 18 (78.3)
• More than 30 3 (12.5) 21 (87.5)
Practice location
• Private 10 (8.9) 102 (91.1)
0.008#
• Public 3 (17.7) 14 (82.4)
• Both (Private/Public) 4 (19.1) 17 (80.9)
• Dental School 8 (36.4) 14 (63.6)
Type of license
• Pediatric Dentistry 3 (33.3) 6 (66.7)
0.12#
• General practitioner/others 22 (13.7) 139 (86.3)
Frequency of dental attendance of children
• Once a month or less 5 (8.3) 55 (91.7)
0.07*
• More than once a month 12 (19.7) 49 (80.3)
* chi-square test; # Fisher’s exact test.
5. Azevedo MS, Goettems ML, Brito A, Possebon AP, Domingues J, Demarco FF, Torriani DD
9Braz Oral Res. 2012 Jan-Feb;26(1):5-11
Other influencing factors cited by almost half of
the dentists included:
• effects on the child’s family,
• concerns about confidentiality,
• hostility of Jordanian families, and
• the uncertainty about the consequences of re-
porting.
Effect on work and fear of litigation were re-
ported by less than one-third of the dentists. The
least-reported factor was the belief that “it is not
the dentist’s responsibility” (22%).19
In the study by
Kilpatrick et al., the main reason given by the den-
tal practitioners was concern about confidentiality.15
This apparent reluctance to act on their suspicions
suggests the existence of social and psychological
barriers to the reporting of child abuse or neglect.16
In 1990, an important milestone was the approv-
al of “The child and the adolescent statute”, when
the notification of suspicious cases of domestic vio-
lence became mandatory in Brazil. Health profes-
sionals have become responsible for reporting and
preventing these cases, while the health system must
offer medical and psychosocial assistance for con-
firmed cases.2
Thus, while dentists have a legal and
ethical obligation to identify child abuse and neglect
and make the appropriate referrals, few know that
the law grants professionals immunity from civil
or criminal liability when they make a good-faith
report. Despite the legal requirements for report-
ing child abuse or neglect in Brazil, few reports had
been made by the dentists included in this survey.
Child abuse has been included in the curriculum
framework of Brazilian dental schools, as already
occurs in the United Sates, to qualify dentists (and
future pediatric dentists) in the diagnosis, treat-
ment, and official reporting of these cases. In the
local dental school, this theme is addressed in the
discipline of Pediatric Dentistry. In addition to a fo-
cus on essential competencies, an interdisciplinary
approach to tackling this issue is also important,20
since training professionals in the field of child
abuse and neglect requires an understanding of the
various disciplines involved. Cooperation with spe-
cialists from related disciplines21
is also important
and should be stimulated, because an interdisciplin-
ary approach may help in eliminating the confusion,
delays, and poor decision-making caused by profes-
sionals unprepared to interact with one another.
The low number of suspicious cases may also
be attributed to a lack of dentists’ awareness about
dental neglect, the most frequent type of abuse that
may be seen in a dental office.22
Dental neglect is
defined by the American Academy of Pediatric Den-
tistry as the “willful failure of parent or guardian
to seek and follow through with treatment neces-
sary to ensure a level of oral health essential for ad-
equate function and freedom from pain and infec-
tion.” Dental caries, periodontal diseases, and other
oral conditions, if left untreated, can lead to pain,
infection, and loss of function. It is worth mention-
ing that since many families face challenges in their
attempts to access dental care or acquire insurance
for their children, the clinician should determine
whether dental services are readily available and
accessible to the child when considering whether
negligence has occurred.23
Lack of access to dental
treatment for children has been well-documented
in Brazil; thus, this factor must be taken into ac-
count.24
Even though public access to dental treat-
ment has expanded to larger segments of the Bra-
zilian population, this young population (0-5 years)
is underserved in terms of public dental services.25
Thus, the dentist must consider his patients’ finan-
cial, intellectual, and social situation before making
a final diagnosis.7
In spite of its importance, it is recognized that
few dentists know that a parent or guardian could
be charged with child neglect for failure to follow
through with dental treatment after being informed
that a child had rampant caries.16
In the study by
John et al., only 20% of all dentists interviewed
identified neglect as a form of abuse.26
Consider-
ing the importance of a healthy dentition in diges-
tion, knowing the role of primary dentition in tooth
exchange, and being aware of the consequences of
infections and toothaches in the child’s social life,
dentists have a clear duty to detect and treat cases
of neglect.22
Adequate qualification of dental profes-
sionals is required for the clinical treatment of the
victim, as well as for the early detection of the ag-
6. Child maltreatment: a survey of dentists in southern Brazil
10 Braz Oral Res. 2012 Jan-Feb;26(1):5-11
gression and notification of legal authorities.27
Conclusion
Even though dentists considered themselves able
to identify cases of children maltreatment, among
those who were suspicious, only a small percentage
referred cases to legal authorities. This indicates a
lack of awareness by these professionals about the
adoption of protective measures for victims of ag-
gression. It is necessary that professionals receive
more information on the need to be alert to the de-
tection of suspected cases of maltreatment of chil-
dren and adolescents, and on their legal duty to re-
port such cases to authorities.
References
1. World Health Organization and International Society for Pre-
vention of Child Abuse and Neglect. Preventing child maltreat-
ment: a guide to taking action and generating evidence. 2006.
[citado em 10 mai. 2011]. Disponível em: http://whqlibdoc.
who.int/publications/2006/9241594365_eng.pdf.
2. Reichenheim ME, de Souza ER, Moraes CL, de Mello Jorge
MH, da Silva CM, de Souza Minayo MC. Violence and inju-
ries in Brazil: the effect, progress made, and challenges ahead.
Lancet. 2011 Jun 4;377(9781):1962-75. Epub 2011 May 9.
3. Cairns AM, Mok JY, Welbury RR. The dental practitioner and
child protection in Scotland. Br Dent J. 2005 Oct;199(8):517-
20.
4. Cavalcanti AL. Prevalence and characteristics of injuries to the
head and orofacial region in physically abused children and
adolescents--a retrospective study in a city of the Northeast
of Brazil. Dent Traumatol. 2010 Apr;26(2):149-53.
5. Becker DB, Needleman HL, Kotelchuck M. Child abuse and
dentistry: orofacial trauma and its recognition by dentists. J
Am Dent Assoc. 1978 Jul;97(1):24-8.
6. Bsoul SA, Flint DJ, Dove SB, Senn DR, Alder ME. Reporting
of child abuse: a follow-up survey of Texas dentists. Pediatr
Dent. 2003 Nov-Dec;25(6):541-5.
7. Jessee SA. Risk factors as determinants of dental neglect in
children. ASDC J Dent Child. 1998 Jan-Feb;65(1):17-20.
8. Needleman HL. Orofacial trauma in child abuse: types, preva-
lence, management, and the dental profession’s involvement.
Pediatr Dent. 1986 May;8(1 Spec No):71-80.
9. Instituto Brasileiro de Geografia e Estatística. Estimativas de
População. 2009. [citado em 14 Ago 2009]. Disponível em:
http://www.ibge.gov.br/home/estatistica/populacao/estima-
tiva2009/POP2009_DOU.pdf.
10. Brickhouse TH, Unkel JH, Kancitis I, Best AM, Davis RD.
Infant oral health care: a survey of general dentists, pediatric
dentists, and pediatricians in Virginia. Pediatr Dent. 2008
Mar-Apr;30(2):147-53.
11. Splieth CH, Bunger B, Pine C. Barriers for dental treatment of
primary teeth in East and West Germany. Int J Paediatr Dent.
2009 Mar;19(2):84-90.
12. Sidebotham PD, Harris JC. Protecting children. Br Dent J.
2007 Apr;202(7):422-3.
13. Persaud DI, Squires J. Abuse detection in the dental environ-
ment. Quintessence Int. 1998 Jul;29(7):459-68.
14. Granville-Garcia AF, de Menezes VA, Silva PFRM. Maus-
tratos infantis: Percepção e responsabilidade do cirurgião-
dentista. Rev Odonto Cien. 2008 Jan-Mar;23(1):35-9.
15. Kilpatrick NM, Scott J, Robinson S. Child protection: a survey
of experience and knowledge within the dental profession
of New South Wales, Australia. Int J Paediatr Dent. 1999
Sep;9(3):153-9.
16. Ramos-Gomez F, Rothman D, Blain S. Knowledge and atti-
tudes among California dental care providers regarding child
abuse and neglect. J Am Dent Assoc. 1998 Mar;129(3):340-8.
17. Lazenbatt A, Freeman R. Recognizing and reporting child
physical abuse: a survey of primary healthcare professionals.
J Adv Nurs. 2006 Nov;56(3):227-36.
18. Santos JF, Nunes KS, Cavalcanti AL, Silva EC. Maus-tratos
infantis: conhecimento e atitudes de Odontopediatras em
Uberlândia e Araguari, Minas gerais. Pesqui Bras Odonto-
pediatria Clin Integr. 2006 Set-Dez;6(3):273-9.
19. Owais AI, Qudeimat MA, Qodceih S. Dentists’ involvement
in identification and reporting of child physical abuse: Jordan
as a case study. Int J Paediatr Dent. 2009 Jul;19(4):291-6.
20. Champion KM, Shipman K, Bonner BL, Hensley L, Howe
AC. Child maltreatment training in doctoral programs in
clinical, counseling, and school psychology: where do we go
from here? Child Maltreat. 2003 Aug;8(3):211-7.
21. Pabis´ M, Wron´ska I, Slusarska B, Cuber T. Paediatric nurses’
identification of violence against children. J Adv Nurs. 2011
Feb;67(2):384-93.
22. Kiran K, Kamala BK. Child abuse and the role of a dental
professional-The Indian scenario. Child Abuse Negl. 2011
Mar;35(3):157-8.
23. American Academy of Pediatrics Committee on Early Child-
hood, Adoption, and Dependent Care: Oral and dental aspects
of child abuse and neglect. Pediatrics. 1986 Sep;78(3):537-9.
24. Camargo MB, Dumith SC, Barros AJ. [Regular use of dental
care services by adults: patterns of utilization and types of
services]. Cad Saude Publica. 2009 Sep;25(9):1894-906. Por-
tuguese.
25. Pucca GA, Costa JF, Chagas L e D, Sivestre RM. Oral health
policies in Brazil. Braz Oral Res. 2009 Jun;23 Suppl 1:9-16.
7. Azevedo MS, Goettems ML, Brito A, Possebon AP, Domingues J, Demarco FF, Torriani DD
11Braz Oral Res. 2012 Jan-Feb;26(1):5-11
26. John V, Messer LB, Arora R, Fung S, Hatzis E, Nguyen T,
et al. Child abuse and dentistry: a study of knowledge and
attitudes among dentists in Victoria, Australia. Aust Dent J.
1999 Dec;44(4):259-67.
27. Cavalcanti AL, Granville-Garcia AF, Costa EMM de B, Fontes
L de BC, Sá LOPD de, Lemos AD. Dentist’s role in recogniz-
ing child abuse: a case report. Rev Odonto Cien. 2009 Out-
Dez;24(4):432-4.