Ef Corbet

Epidemiology of periodontitis in the Asia and Oceania regions

The prevalence and features of periodontal diseases in Asia and Oceania were reviewed comprehensively in 2002 (39), with subsequent corrections (38). Periodontal conditions in Asians were further considered in 2006 (35). This review provides an update of what is known about the epidemiology of periodontal disease in the Asia and Oceania region (Table 1). Due to space limitations, the region covered by this review is somewhat less extensive than the region covered in the 2002 review. Also, periodontal epidemiology has itself advanced since 2002, and these advances have an influence on the current update. The issues raised in recent years that impact upon periodontal epidemiology, and must thus be considered in any review of the epidemiology of periodontal diseases and conditions, are discussed with respect to periodontal disease in this region. Fifty-five sovereign states and dependencies, home to approximately four billion people, or 60% of the world s population, are located in this region, which covers 29.9% of the Earth s land area. A large number of languages are spoken by the numerous ethnic groups who live in various landscapes from sea level up to the heights afforded by the Himalayas. The populations have to endure various local climates, including tundra; humid, subtropical; alpine desert and equatorial. All major global religious beliefs are found within the region. The differences in geography, natural resources, climate, ethnicity, history and beliefs have led to different levels of political and socio-economic development, behaviors and healthcare systems, and hence great diversities in the levels of general and oral health in the various populations. The availability of oral healthcare providers differs widely across the region, as is evident from Table 2. Some countries in this region are considered to be developed, and are among the top 30 highest ranked countries in terms of life quality and standards of living. Figure 1 shows the countries of the region according to the income per person, divided into low income, low–middle income, upper middle income and high income according to the scales used by the World Bank (http://go.worldbank.org/7EIAD6CKO0). In low-income countries of the region, the life expectancy at birth barely exceeds 60 years, whereas in high-income countries, such as Japan and Hong Kong, life expectancy at birth comfortably exceeds 80 years, a difference of more than two decades. Lowincome countries of the region still experience a relatively high infant mortality, while in high-income countries of the region, infant mortality is among the lowest in the world. Japanese and Hong Kong Chinese females have the first and second longest life expectancies in the world, and Hong Kong Chinese and Japanese men have the second and fourth longest life expectancies worldwide. However, five countries or sovereign states of the region are within the lowest 50 in the world in terms of life expectancy. Figure 2 shows the countries of the region according to the purchasing power parity of their gross domestic products. In theory, in an ideal world with optimally efficient markets, goods should have only one price. The purchasing power parity of the gross domestic product of countries is used by the World Bank to represent the value of the gross domestic product, and Fig. 2 is based on the purchasing power parity given in the World Bank s World Development Indicators for 2005 (http://data.worldbank.org/indicator). Purchasing power parity implies a notional exchange rate that would make the cost of identical goods and services the same in different countries. However, within this region, what is a necessity in some countries is an unimaginable luxury in other countries. Hence there is no real value of goods, and cultural influences and economic circumstances are not taken into account in the purchasing power parity calculations. Almost 70% of the world s illiterate adults live in this region, the majority being female.

Blended learning, knowledge co-construction and undergraduate group work

(designated ‘Learning from Lives’ [LFL]), and the other with medical and interprofessional students (‘Interprofessional Learning Pathway’ [IPLP]). Learning from Lives aims to provide a practical, in-depth understanding of the nature and effect of impairment on people’s lives and societal reactions towards disability and is situated at the beginning of clinical rotation. In IPLP medical students work with 13 other student health and social care professionals as they follow an authentic patient journey (Callum) aimed at developing their understanding of the roles, cultures and beliefs of their colleagues. In LFL, the students, working in clinical partnerships, meet with patients face-to-face in their homes or clinical settings. They are also able to access a pilot online patient journey. The same patient journey was used in the virtual IPLP. Ethical permission was not required. Why the idea was necessary The idea in LFL arose because service problems in accessing patients made it difficult for us to ensure that students were able to meet their learning outcomes. We chose to provide online patient and professional cases. Student evaluation suggested that e-learning cases enriched the module, but did not replace face-to-face learning. The patient journey was scripted from the original scenario, with each health professional talking about Callum and his or her role in his care. This was in contrast to the IPLP, where Callum was text-based and his story was told objectively. Student evaluation commented that it would be beneficial to have video and audio clips intertwined with the text-based scenario. What was done Video and audio clips were professionally created using an actress and scripts derived from the original text-based version. In LFL medical students were able to watch four introductory clips depicting Callum’s journey from his mother’s and his paediatrician’s perspectives. They then had a restricted choice of viewing further clips of the mother discussing particular issues with other professionals involved in his care. Students had to identity their reasons for their choice of clips. Once they had given this information, they were able to view the clips, which added to the story. In IPLP the video clips were divided across four episodes. The clips were chosen to supplement and enhance the storyline at each point. Evaluation of results and impact Students’ evaluation of LFL supported the idea of using of e-cases, but the comparison of e-cases and the experience of face-to-face contact showed clearly that e-cases could not replace such contact. Students considered that e-learning precluded their ability to utilise the body language and verbal cues that are available in face-to-face contact. By contrast, students’ participating in IPLP valued the multimedia input, stating that it had enhanced their learning by providing them with insights into other perspectives. Evidence of the students’ connection with the mother’s anxiety and concerns was apparent only in discussions with the multimedia student group. Evaluations suggest that multimedia clips serve to enrich each module, but cannot replace face-to-face or text-based cases.

Tooth loss in treated periodontitis patients responsible for their supportive care arrangements

assured best evidence that is relevant to the NHS, its staff and patients. • Develop methods to package research knowledge for effective dissemination and implementation. • Inform NHS dental policy, service and education interests on evidence-based dentistry issues. It was concluded that the vC-IOH represented a good model of cooperation as its constituent bodies covered different aspects of evidence provision and dissemination. As such it should play an integral part in the development of evidence-based dentistry and could become a voice for dental professionals and the public, providing the latest information in a variety of formats.