Biomedical subjects
M Kinirons
Publications and source records attributed to M Kinirons.
Effectiveness of the school dental screening programme in stimulating dental attendance for children in need of treatment in Northern Ireland.
UNLABELLED: The school dental screening programme has been in existence from the beginning of the 20th century yet its value in encouraging attendance among children with a dental health need is not fully established. OBJECTIVE: To evaluate the effectiveness of school dental screening in promoting dental attendance among children with a treatment need and to examine the relative importance of screening, social class and other factors in dental attendance. METHODS: Sixty-four participating schools were assigned to study and control groups using a stratified, blocked randomisation technique. The study group children received the standard school dental screening and the dental attendance of those with a positive screening result was assessed after 2 months by means of a questionnaire issued to the children's parents. The control group children were not, at this stage, screened, yet their parents received the same questionnaire assessing dental attendance over the 2-month period. However, only questionnaires from control group children who had a positive result at a subsequent screening were retained for analysis. RESULTS: A total of 2,321 children were screened, with 980 having a positive result. The mean dmft of those screening positive was 4.85. In all, 664 completed questionnaires were returned, giving a response rate of 67.8%. Dental attendance was reported among 45.5% of the study group (n=352) in the 2 months following screening. In the same period, 27.6% of the control group (n=312) claimed attendance. The effect was found to be significant among the high employed group (P<0.01) and the unemployed group (P<0.05). CONCLUSION: School dental screening was capable of stimulating dental attendance. The strong effect among the lowest socio-economic group shows that school dental screening may be used to decrease dental health inequalities.
Recent dental attendance and levels of untreated caries in a sample of 11-12 year old children in Northern Ireland.
The object of the present study was to determine the relationship between dental attendance and the levels of untreated caries in a sample of 11-12 year old pupils attending first form of second level schools in the South Belfast area of Northern Ireland. A sample of 199 first form pupils attending second level schools in the area was obtained. The diagnosis of caries depended mainly on visual evidence following removal of debris and moisture. Blunted probes were used to confirm or reject doubtful lesions and no radiographs were taken. Details of parental employment status were obtained by a questionnaire to the parents. The data were entered on to an N.C.S.S. data analysis system for stepwise regression and analysis of variance. Overall there was a significant difference in the untreated caries status of those with different attendance patterns, the major difference being that a much higher proportion of those who had not attended within the previous 12 months had active caries. Almost half of the children had attended in the previous six months and only 16 (8 per cent) had not attended in the previous 12 months. Independent analysis indicated that parental employment status was significantly related to the level of untreated caries (p > or = 0.05). Independent variables entered in the stepwise regression were attendance, employment status and DMFT. The strongest predictors of untreated caries were previous caries experience and period since dental attendance, while employment status was a significant but weaker factor in the analysis. These findings may be relevant when planning the frequency of school dental screenings and managing the frequency of dental recalls and examinations.
Community-acquired Staphylococcus epidermidis endocarditis complicated by splenic disease 9 years after aortic valve replacement.
We describe here a case of Staphylococcus epidermidis prosthetic aortic valve endocarditis 9 y after valve replacement. Surprisingly, the microorganism was community-acquired, highly virulent and associated with splenic disease. The patient recovered following emergency valve replacement and prolonged antibiotic therapy. Splenectomy was not required.
A preliminary study of patient comfort associated with customised mouthguards.
OBJECTIVE: To compare patient perception of custom made mouthguards of ideal and less than ideal designs in terms of their comfort and "wearability". METHOD: A mouthguard of ideal design (A) and one incorporating common design faults of underextension and unadjusted occlusion (B) were provided for 22 active sportsmen and women. They were not informed of the details of the design or the status of the protector. Half the participants were asked to wear mouthguard A first and the other half wore B first, each worn for one hour on two consecutive nights. Questionnaires were used to evaluate and rate the comfort and wearability of each mouthguard. RESULTS: Eighteen people completed the study. The ideal appliance was rated as significantly more retentive and comfortable overall and specifically was more comfortable to lips, gums, and tongue. It was also recognised as being less bulky, less likely to keep the teeth apart, or to cause pain in the jaw muscles. CONCLUSIONS: Comfort is likely to be increased if mouthguards are extended labially to within 2 mm of the vestibular reflection, adjusted to allow even occlusal contact, rounded at the buccal peripheries, and tapered at the palatal edges.
Characteristics of children referred to a general anaesthetic service in Northern Ireland.
General anaesthetics are still frequently given to children for dental extractions and this method of treatment is most prevalent in regions such as Northern Ireland where high levels of dental disease persist in children. The aim of this study was to establish the social and dental characteristics of the children receiving general anaesthetics for dental extractions. Parents of children referred to the community dental extraction service in the Craigavon and Banbridge area of Northern Ireland completed a closed-ended questionnaire. In the sample there was a significantly lower level of maternal education than seen in the general population. There was a significantly higher level (p < 0.01) of dental anxiety seen in the sample group of children compared to the general population. For the primary dentition the corrected dmft values were higher than in the general population as was the untreated decay component while lower numbers of filled and of extracted teeth were seen. In the permanent dentition the caries experience and levels of extractions were similar to those seen in the general population while the level of untreated decay was higher and the mean number of fillings was lower. There was a similar pattern of attendance as that seen in the general child population.
Dental caries experience of children with haemophilia in Northern Ireland.
It is generally agreed that persons suffering from haemophilia from a priority group for dental care. The present study compares the prevalence of dental caries in haemophilic children in Northern Ireland with the reported values for similarly aged children in the population. The prevalence of caries experience and of untreated caries were low in the haemophiliacs in both the primary and permanent dentitions. No teeth had been extracted due to caries and a high level of fluoride usage was claimed. The dental care of these patients is carried out at the regional treatment centre and forms an integral part of their medical care.
Laparoscopy does have a role in tuberculous peritonitis.
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A survey of factors influencing the prescribing of sugar-free medicines for children by a group of general medical practitioners in Northern Ireland.
Factors which influence the prescribing of sugar-free medicines by 47 general medical practitioners were examined by means of questionnaire. The doctors all practise in the Newry and Mourne district of the Southern Health and Social Services Board, Northern Ireland. Twenty-six (55%) of the doctors stated that they support the principle of prescribing sugar-free medicines for children; the same number stated that they oblige parental requests and 14 (30%) stated that they frequently prescribe a common group of sugar-free medicines. However, only 14 (30%) of the doctors considered that their knowledge of sugar-free medicines was up-to-date. The main sources of information about sugar-free preparations were drug company travelling representatives and professional journals, but a few doctors learned of this issue from other professionals, including dental practitioners. The majority of doctors (especially those with a practice policy of prescribing sugar-free medicines) felt it was important to prescribe sugar-free preparations for all children, not only for those requiring long-term medication. The results show that there is a reasonable level of interest in this issue among the doctors in the area, but that there is an on-going need for further encouragement and provision of information for them, in order to increase as far as possible the use of sugar-free preparations for children.
Ethics and economics of health care. British medicine has lessons for North American medicine.
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Improving the documentation and appropriateness of cardiopulmonary resuscitation decisions.
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Familial and maternal factors affecting the dental health and dental attendance of preschool children.
Factors affecting the dental health and dental registration of preschool children were examined. Questionnaires were completed for 340 randomly selected children and the dental caries status of 294 of these children was examined. There was a statistically significant relationship between the dental caries experience of the child and its position in the family, the lowest caries experience occurring in the second and third born. The peak age of new dental registration appeared to occur during children's third year. The person responsible for bringing the child for dental appointments was the mother in 290 instances out of 340. Maternal education level was significantly associated with child dental health. The caries prevalence in children whose mothers were educated to 3rd level was 10.6 per cent as compared to 38.1 per cent for 2nd level and 46.8 per cent for below '0' level mothers. Mothers who were relaxed about their own dental care were the most likely to have preschool children who were registered for dental care. Similarly those mothers whose last dental visit occurred in the previous six months were the most likely to have children who were registered.
Prognosis and cardiopulmonary resuscitation in elderly patients.
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Elderly patients and resuscitation. Some patients can benefit.
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Occupational stress factors in hospital dentists.
This investigation examined perceived stress levels, personality characteristics and stress outcomes in a group of hospital dentists working in Belfast. Mean scores for this group were also compared with normative values. The occupational stress indicator was distributed to 45 hospital dentists; 40 returned the completed questionnaire. The mean score for each stress-related factor was analysed and compared with normative values. In addition the ranked scores for sources of stress were examined, and no significant differences could be demonstrated between the two groups. However, for external locus of control this group of hospital dentists demonstrated a significantly higher mean score of 42.3 than the mean normative value of 38.6. The dentists' score for their perception of their state of physical ill health was 23.9 and was significantly lower than the normative value of 27.8 but no differences could be demonstrated between the groups for mental health, Type A personality or mean stress levels.
When to withhold resuscitation. Consultants agree with their juniors.
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Post whiplash dystonia well controlled by transcutaneous electrical nervous stimulation (TENS): case report.
It has been established that peripheral trauma can cause focal and generalized dystonias, which may be difficult to treat. The case presented of a 28-year-old with post whiplash focal dystonia shows that transcutaneous electrical nerve stimulation (TENS) may be a useful treatment in the early management of focal dystonias which fail to respond to conventional therapy.