[A Phd completed. Older people in the dentist practice: oral health and oral health care]. / Serie: Hora est. Ouderen in de tandartspraktijk: mondgezondheid en mondzorgverlening.

This thesis describes the oral health of community-dwelling older people who visit a dental practice as seen from the perspective of both the older person and the dentist. In addition, the oral health care provided by dentists and the barriers they may perceive are described. The older people who still visit the dentist are relatively healthy, well-educated, and dentate. As they grow older, they face increasing health problems, increased medication use and oral health issues. The age of 75 seems to be a tipping point. Dentists are mainly providing curative care, focusing on preserving the dentition. In the assessment of oral health, older people appeared to assess their own oral health more positively than the dentist. The barriers in the provision of oral health care were mainly related to health problems, misunderstood behaviour, and poor daily oral hygiene by the older people. Earlier identified barriers appeared to be related to knowledge, practice conditions and financial reimbursement for the work.

[A view on collective oral care for frail older people: united we stand]. / Visie op de collectieve mondzorg voor kwetsbare ouderen: eendracht maakt macht.

Oral health in frail older people is often poor. There are a number of reasons for this, such as increased morbity and decreased motivation for (self) care. Good oral health is, however, very important. Studies have revealed poor oral health to cause or aggravate several medical and psychological problems. Illness and medication can, in turn, damage oral health. Oral health among the elderly should therefore be carefully monitored and maintained. This requires multidisciplinary and interprofessional collaboration on the part of healthcare professionals and others involved. Such collaboration is now still very limited; hardly anything has been written about how such collaboration in the area of oral care for frail older people should or could be organised. This article provides an overview of the possibilities and the relevant factors in the area of oral care for the elderly in promoting collaboration among healthcare professionals and others involved. All of this is under the banner of 'united we stand'.

Vesicle deformation by draining: geometrical and topological shape changes.

A variety of factors, including changes in temperature or osmotic pressure, can trigger morphological transitions of vesicles. Upon osmotic upshift, water diffuses across the membrane in response to the osmotic difference, resulting in a decreased vesicle volume to membrane area ratio and, consequently, a different shape. In this paper, we study the vesicle deformations on osmotic deflation using coarse grained molecular dynamics simulations. Simple deflation of a spontaneously formed spherical vesicle results in oblate ellipsoid and discous vesicles. However, when the hydration of the lipids in the outer membrane leaflet is increased, which can be the result of a changed pH or ion concentration, prolate ellipsoid, pear-shaped and budded vesicles are formed. Under certain conditions the deflation even results in vesicle fission. The simulations also show that vesicles formed by a bilayer to vesicle transition are, although spontaneously formed, not immediately stress-free. Instead, the membrane is stretched during the final stage of the transition and only reaches equilibrium once the excess interior water has diffused across the membrane. This suggests the presence of residual membrane stress immediately after vesicle closure in experimental vesicle formation and is especially important for MD simulations of vesicles where the time scale to reach equilibrium is out of reach.

[Specialties in dentistry. Salivary flow and swallowing in Parkinson's disease]. / Beroepsdifferentiatie in de tandheelkunde. 5. Speekselvloed en slikvermogen bij de ziekte van Parkinson.

Parkinson's disease is a slowly progressive and irreversible disorder of the nervous system. Drooling is listed as a secondary symptom of Parkinson's disease. Its cause is insufficiently clear. In the literature 2 possible causes are described: hypersalivation and swallowing abnormalities. These parameters have not been measured in a single study before. This article presents a review of the literature on the subject and describes the design for a future clinical study. The aim of this clinical study is to gain an insight into the cause and the prevalence of drooling in Parkinson's patients. A group of 50 Parkinson's patients will be compared to a group of 50 controls. The objectives of this comparative study comprise the assessment of salivary flow volumes, swallowing capacity, subjective experiences with drooling and an objective observation of drooling, the drooling quotient. Finally, the possibilities for treatment will be described.

[Active oral health care for frail elderly people. An increasing responsibility]. / Proactieve mondzorg voor onzelfredzame ouderen. Een toenemende verantwoordelijkheid.

The number of elderly people in the Dutch society is increasing. As a result their number will grow in any dental practice. More elderly people keep (at least part of) their own dentition which requires pro-active oral health care. Ageing is associated with a greater prevalence of chronic diseases and disability. General self-care might decrease when frailty comes. As a consequence, problems with oral self-care will occur. Dental general practitioners have a responsibility to provide adequate oral care for their elderly patients. Information on their general medical conditions and the effects these might have on their oral health should be collected for individual oral health care programmes. Preventive and individual oral care programmes are recommended.

The interface of SrTiO3 and H2O from density functional theory molecular dynamics.

We use dispersion-corrected density functional theory molecular dynamics simulations to predict the ionic, electronic and vibrational properties of the SrTiO3/H2O solid-liquid interface. Approximately 50% of surface oxygens on the planar SrO termination are hydroxylated at all studied levels of water coverage, the corresponding number being 15% for the planar TiO2 termination and 5% on the stepped TiO2-terminated surface. The lateral ordering of the hydration structure is largely controlled by covalent-like surface cation to H2O bonding and surface corrugation. We find a featureless electronic density of states in and around the band gap energy region at the solid-liquid interface. The vibrational spectrum indicates redshifting of the O-H stretching band due to surface-to-liquid hydrogen bonding and blueshifting due to high-frequency stretching vibrations of OH fragments within the liquid, as well as strong suppression of the OH stretching band on the stepped surface. We find highly varying rates of proton transfer above different SrTiO3 surfaces, owing to differences in hydrogen bond strength and the degree of dissociation of incident water. Trends in proton dynamics and the mode of H2O adsorption among studied surfaces can be explained by the differential ionicity of the Ti-O and Sr-O bonds in the SrTiO3 crystal.

The bilayer-vesicle transition is entropy driven.

Self-assembled bilayer membranes have a remarkable inclination to form closed shells or vesicles. This bilayer-vesicle transition has been shown experimentally and by various kinds of computer simulation techniques. Here we study this transition using coarse-grained molecular dynamics. The advantage of this simulation technique is that it allows for a detailed analysis of the transition, such as changes of the internal energy. Generally it is assumed that the bilayer-vesicle transition is driven by minimization of the edge energy. However, our simulations, which include solvent particles, show an increase in the potential energy of the system during the transition, implicating that the transition is not energy but entropy driven.

Gas-surface interactions using accommodation coefficients for a dilute and a dense gas in a micro- or nanochannel: heat flux predictions using combined molecular dynamics and Monte Carlo techniques.

The influence of gas-surface interactions of a dilute gas confined between two parallel walls on the heat flux predictions is investigated using a combined Monte Carlo (MC) and molecular dynamics (MD) approach. The accommodation coefficients are computed from the temperature of incident and reflected molecules in molecular dynamics and used as effective coefficients in Maxwell-like boundary conditions in Monte Carlo simulations. Hydrophobic and hydrophilic wall interactions are studied, and the effect of the gas-surface interaction potential on the heat flux and other characteristic parameters like density and temperature is shown. The heat flux dependence on the accommodation coefficient is shown for different fluid-wall mass ratios. We find that the accommodation coefficient is increasing considerably when the mass ratio is decreased. An effective map of the heat flux depending on the accommodation coefficient is given and we show that MC heat flux predictions using Maxwell boundary conditions based on the accommodation coefficient give good results when compared to pure molecular dynamics heat predictions. The accommodation coefficients computed for a dilute gas for different gas-wall interaction parameters and mass ratios are transferred to compute the heat flux predictions for a dense gas. Comparison of the heat fluxes derived using explicit MD, MC with Maxwell-like boundary conditions based on the accommodation coefficients, and pure Maxwell boundary conditions are discussed. A map of the heat flux dependence on the accommodation coefficients for a dense gas, and the effective accommodation coefficients for different gas-wall interactions are given. In the end, this approach is applied to study the gas-surface interactions of argon and xenon molecules on a platinum surface. The derived accommodation coefficients are compared with values of experimental results.