Identifying Frailty in Older Adults in Rural Victoria, Australia: A Secondary Analysis of Population Health Data.

Objectives: To determine the prevalence of frailty among community-dwelling older adults in regional Victoria, Australia. Methods: Frailty status of 376 participants from the Crossroads II cross-sectional study was assessed by selected markers of frailty. The selected variables were psychometrically tested. Associations between frailty and socio-demographic, environmental and health factors were analysed using chi-square, ANOVA and binary logistic regression (BLR). Results: Estimated prevalence of frailty was 39.4%. BLR indicated that frailty decreased with higher educational attainment, (OR = .23; 95% CI: .10-.51) increased for divorced/separated participants (OR = 2.68; 95% CI: 1.29-5.56) and when having three (OR = 3.27; 95% CI: 1.07-9.98), four (OR = 7.20; 95% CI: 2.22-23.31) or five or more chronic conditions (OR = 9.18; 95% CI: 2.83-29.72). Discussion: Frailty in this Australian regional community-dwelling sample was higher than other studies conducted in urban areas of Australia. Present results highlight the importance of exploring the multidimensionality of the frailty construct to have a better understanding which factors are associated with the development of this syndrome.

Coping strategies and the Salutogenic Model in future oral health professionals.

BACKGROUND: Attention to the role of context in shaping individuals' coping strategies is necessary. This study used the Salutogenic Model (SM) as a framework to identify the coping strategies of oral health profession students from three countries. METHODS: Students from Australia, New Zealand and Chile were invited to participate in this cross-sectional study, and were given a questionnaire including socio-demographics, the Perceived Stress Scale, The SOC-13 and the Brief COPE. Descriptive analysis, correlation analysis and profile analysis were computed using SPSS v 20.0. RESULTS: Eight-hundred and ninety-seven valid questionnaires were returned, achieving a 44 % response rate. The coping dimension that the participants most commonly reported using was "Active Coping" with a mean value of 5.9 ± 1.5. Chilean respondents reported higher stress levels (19.8 vs. 17.7) and a lower Sense of Coherence (55.6 vs. 58.0) compared to Australian/New Zealand participants (p < 0.001). The SOC was positively correlated with active coping (p < 0.01) and positive reframing (p < 0.01). Profile analysis showed that when the differences in responses by sex were accounted for, there was no significant effect by country on the coping strategies used (p < 0.32). CONCLUSION: This initial investigation provides insights into the students' coping strategies and the validity of the SM. Students reporting high SOC scores where those who demonstrated the use of active coping and positive reframing as strategies to deal with stressful situations, which indicates the accuracy of the theoretical framework of the SM in health education environments. The results also suggest that a distinctive coping strategy pattern may apply to all participants, regardless of their country and sex.

Socio-demographic characteristics and career choices amongst Chilean dental students / Características socio-demográficas y elección de la carrera en estudiantes de odontología en Chile

This cross-sectional study aimed to explore the socio-demographic and career choice characteristics of dental students in two publicly funded universities in Chile. A total of 601 dental students participated in the study with a 53 percent response rate. The written survey covered age, gender, type of school attended, place of residence, parental occupation, level of education, tuition fees payment methods, along with motivations and preferences towards dentistry as a career. The respondents had an average age of 22 years old. Sixty one percent of respondents were female, and the majority had completed secondary education in private and subsidized schools with only 21.5 percent having finished in public schools. Most of the students covered their tuition fees with parental money (37.1 percent), followed by any type of loan (27.9 percent). The majority of students (63.8 percent) had placed dentistry as their first career choice with self-motivation being the most important reason for their decision. This study provides a description of the socio-demographic and economic profile of Chilean dental students and provides insights about career decision issues. It also purposes areas for further research and management by academics for future program development.

El presente estudio descriptivo de corte transversal explora el perfil socio-demográfico y los factores asociados a la elección de la carrera de los estudiantes de odontología pertenecientes a dos universidades estales chilenas. Un total de 601 estudiantes participaron de esta investigación con una tasa de respuesta del 53 por ciento. La encuesta escrita incluyó, edad, género, educación secundaria, lugar de residencia, nivel educacional y ocupación de los padres, método de pago junto con las motivaciones y proyecciones de los estudiantes hacia la carrera. Los participantes reportaron una edad promedio de 22 años. Sesenta y un por ciento de los participantes fueron mujeres, y la mayoría terminó la enseñanza media en escuelas privadas o subvencionadas, con sólo un 21,5 por ciento que se graduó en escuelas públicas. Un gran número de estudiantes paga la universidad con dinero de sus padres (37,1 por ciento), seguido con créditos de diversa índole (27,9 por ciento). La mayoría de los estudiantes seleccionó odontología como primera preferencia (63,8 por ciento), y esa elección fue principalmente mediada por motivación personal. Este estudio entrega una descripción del perfil socio-demográfico y económico de los estudiantes de odontología en Chile y otorga una visión de la problemática que existe con los factores relacionados con la elección de la carrera. Además este estudio recomienda futuras áreas a investigar y el manejo por parte de los académicos para el desarrollo de programas futuros.

Stress and health-promoting attributes in Australian, New Zealand, and Chilean dental students.

This study investigated stress levels and health-promoting attributes (sense of coherence, social support, and coping strategies) in dental students using a Salutogenic approach. All dental students (n=2,049) from two Australian universities, two Chilean universities, and one New Zealand university were invited to participate in this cross-sectional study. The questionnaire covered sociodemographic and career choice questions, Perceived Stress Scale, Orientation to Life Questionnaire, Multidimensional Scale of Perceived Social Support, and Brief COPE scale. A total of 897 students participated, for a 44 percent response rate. Students' mean age was 22.1 (SD=2.7). The majority were females (59.3 percent). Students reported moderate stress, moderate sense of coherence (SOC), and high levels of social support. Significant differences in the SOC scores by country were reported. The linear regression model for stress explained 44 percent of the variance, in which SOC and social support are negatively associated with stress and the use of maladaptive coping strategies positively predicts high stress. These findings confirm that health-promoting attributes were negatively related to stress in these dental students. This is an initial approach to guide academics in the creation of Salutogenic programs that optimize students' chances to successfully cope with stress.

Economic evaluation of preventive dental programs: what can they tell us?

The role of public health program planners is to determine the effectiveness of public health programs, what recommendations should be made, what future initiatives should be taken, and what policies should be developed. At a basic level, to choose between competing alternatives, two characteristics of an intervention must be considered; these are its outcome and its cost. Based on cost and outcome, planners must select the option that offers the most advantages. Economic evaluation is commonly adopted by decision makers in the health sector to investigate the effectiveness of public health programs and to help plan future initiatives. Economic evaluation assists decision makers who must weigh the information it provides in the context of many and often competing options. In this way, an economic evaluation is an aid to decision making rather than the decision itself. Economic evaluation is becoming essential for informed decision making, with potential implications for public health policy and practice and for clinical practice too. While economic evaluations are commonly used in decision-making processes about health programs, few examples exist in the oral health literature. In the case of preventive oral health programs, economic analysis is often difficult, largely because it makes demands on epidemiological and demographic data that are hard to meet. This study will address the concepts and tools required to conduct economic evaluations of prevention programs. The emphasis will be on oral health and preventive dental programs, although the concepts presented could be useful for other public health programs by practitioners and managers with the aim of producing effective and efficient oral health programs.