A review of a child population dental preventive programme in Halton and St Helens.

INTRODUCTION: An evaluation was undertaken to measure the dental health of five cohorts of 5-year-old children living in Halton and St Helens, each cohort having had a different length of time they were exposed to a population dental prevention programme before their fifth birthday. METHOD: The dental health of each of five consecutive cohorts of 5-year-old children was measured epidemiologically using standardised methods. RESULTS: The mean level of active decay (dt) in the cohort that had the greatest exposure to the preventive intervention (cohort 5, 2011/12) was 0.83, whereas the mean level of active decay in the cohort with no exposure to the preventive programme (cohort 1, 2007/8) was 1.07. This represents a reduction of 22% in the mean level of active decay in 5-year-olds. There was also a 5.9% absolute increase in the number of 5-year-old children free from decay experience between cohorts 5 and 1. Children living in Halton and St Helens with postcodes in the more socially deprived index of multiple deprivation (IMD) tertiles gained the most from the programme. Comparing cohort 5 and cohort 1, the increase in the proportion of children free from decay was greatest in IMD tertiles 1 and 2 and least in IMD tertile 3 (least socially disadvantaged). CONCLUSION: Following a four-year population dental preventive programme the dental health of 5-year-old children living in Halton and St Helens has improved and dental health inequalities have reduced. As there was no control group, the effects seen are associative and cannot be assumed to be causative.

Cognitive and motor assessment in autopsy-proven corticobasal degeneration.

OBJECTIVE: To investigate the clinical features of autopsy-proven corticobasal degeneration (CBD). METHODS: We evaluated symptoms, signs, and neuropsychological deficits longitudinally in 15 patients with autopsy-proven CBD and related these observations directly to the neuroanatomic distribution of disease. RESULTS: At presentation, a specific pattern of cognitive impairment was evident, whereas an extrapyramidal motor abnormality was present in less than half of the patients. Follow-up examination revealed persistent impairment of apraxia and executive functioning, worsening language performance, and preserved memory. The motor disorder emerged and worsened as the condition progressed. Statistical analysis associated cognitive deficits with tau-immunoreactive pathology that is significantly more prominent in frontal and parietal cortices and the basal ganglia than temporal neocortex and the hippocampus. CONCLUSION: The clinical diagnosis of corticobasal degeneration should depend on a specific pattern of impaired cognition as well as an extrapyramidal motor disorder, reflecting the neuroanatomic distribution of disease in frontal and parietal cortices and the basal ganglia.

Oncology health care professionals' attitudes to cancer: a professional concern.

BACKGROUND: Despite the known benefits of screening, early detection and advances in treatment modalities, negative attitudes to cancer persist among health care professionals, and cancer remains the most feared disease in modern society. Attitudes to cancer may create a barrier to communication between patients and health care professionals, hinder early detection, treatment and rehabilitation, and may influence decision making about referral to specialist services and the selection of appropriate treatments. DESIGN: A descriptive survey was conducted, within a Regional Cancer Centre, to evaluate oncology health care professionals' attitudes towards cancer. Attitudes were measured using the Burns' Cancer Belief Scales. RESULTS: Regardless of gender, profession and clinical experience, all health care professionals displayed persistently negative attitudes towards cancer. No statistically significant difference was detected between gender, profession, clinical experience or specialist education, and although small in number, no major differences were found between group means. CONCLUSIONS: Oncology health care professionals hold negative attitudes towards cancer and changing these attitudes presents a significant challenge. Educational programmes and supportive strategies may alleviate fears and promote a more positive image of cancer. However, such strategies must be based on an understanding of current attitudes towards this phenomenon.

Creating an effective marketing team. Six leading healthcare marketers offer their perspectives. Interview by Richard D. Stier.

Richard D. Stier, senior vice president and chief marketing officer, Adventist Health System, Shawnee Mission, Kansas, asked six top healthcare marketers to assume they had just been appointed vice president and chief marketing officer for a medium-sized, 300-bed, not-for-profit community hospital. Their mission: Create the most effective, powerhouse marketing team in the country.