Potentially Pathogenic Bacteria in Nesting Olive Ridley Turtles in Northwestern Mexico.

Olive ridleys (Lepidochelys olivacea) are the most common sea turtle found in the Gulf of California. Unfortunately, the bacterial flora of nesting olive ridley turtles is still unknown. We conducted a study to identify, characterize, serotype, and determine the antibiotic resistance of potentially pathogenic bacteria isolated from olive ridley turtles nesting in northwestern Mexico. Bacteria were isolated and identified from the oral cavity and cloaca of 47 postnesting turtles. Escherichia coli and Vibrio parahaemolyticus were characterized, and antibiotic resistance testing was performed. One hundred bacteria belonging to 21 species were isolated, 53 from the oral cavity and 47 from the cloaca, the most prevalent being Pseudomonas aeruginosa, followed by Aeromonas hydrophila, Vibrio alginolyticus, Vibrio parahaemolyticus, Klebsiella pneumoniae, and E. coli, among others. Moreover, two to three different bacterial species were found co-colonizing both anatomical sites in some turtles. E. coli phylogroups B1, A, F, and unknown were identified as diarrheagenic E. coli (enteroaggregative and enteropathogenic E. coli). O1, O4, K8, K12, OUT, and KUT of V. parahaemolyticus serogroups were identified, also comprising pathogenic and nonpathogenic strains. Finally, 100% of the bacterial species tested were antibiotic resistant, and both MDR and XDR strains were found. In conclusion, olive ridley turtles are colonized by a diversity of bacterial species with a high rate of antibiotic resistance, some with pathogenic potential to turtles, representing a health risk factor for the species.

Caracterización sociodemográfica, clínica y ecográfica de la enfermedad de nódulos tiroideos y su relación con la malignidad en un centro de alta complejidad colombiano / Sociodemographic, clinical and ultrasound characterization of thyroid nodule pathology and its association with malignancy in a Colombian high-complexity center

Antecedentes y objetivo Los nódulos tiroideos se encuentran entre las dolencias más frecuentes, con un 10% de riesgo de malignidad. El objetivo es describir la frecuencia de las características demográficas, clínicas y ecográficas de la enfermedad de nódulos tiroideos en adultos y explorar la relación con la malignidad del tumor. Métodos Estudio transversal analítico, retrospectivo, en adultos con nódulos tiroideos y aspiración con aguja fina nodular realizada en pacientes adultos de un centro de referencia colombiano entre 2009-2019. Los datos se obtuvieron de la historia clínica y se estimaron medidas descriptivas de las variables demográficas, clínicas y ecográficas de los pacientes y se exploró su relación con la malignidad del tumor. Resultados Se incluyeron 445 pacientes y 515 nódulos. La mediana de edad fue de 55 años (RIQ 44-64), 86,8% mujeres, 54,8% tenía lesión única. El 80,2 y el 19,8% eran nódulos benignos y malignos, con una mediana de 15,7mm (RIQ 11-25) y 12,7mm (RIQ 8,5-18,3), respectivamente (p<0,001). El hipotiroidismo y el consumo de levotiroxina fueron mayores en quienes tenían nódulos malignos, (p<0,001). Las características ecográficas fueron diferentes estadísticamente entre los nódulos: en los malignos hubo mayor frecuencia de composición sólida, hipoecogenicidad y margen irregular, mientras que en los benignos se destacó la ausencia de foco ecogénico (p<0,001). Conclusión Las características ecográficas son fundamentales para definir el riesgo de malignidad de un nódulo tiroideo, por lo cual, considerar las más frecuentes puede ayudar en el abordaje más adecuado desde la atención primaria (AU)

Background and objective Thyroid nodules are among the most frequent conditions, with a 10% risk of malignancy. The objective is to describe the frequency of demographic, clinical, and ultrasonographic characteristics of thyroid nodule pathology in adults and to explore the relationship with tumor malignancy. Methods An analytical, retrospective cross-sectional study in adults with thyroid nodules and nodular fine-needle aspiration performed in adult patients from a Colombian reference center between 2009-2019. Data were obtained from the clinical history, descriptive measures of the patient's demographic, clinical, and ultrasound variables were estimated, and their relationship with the malignancy of the tumor was explored. Results A total of 445 patients and 515 nodules were included. The median age was 55 years (IQR 44-64), 86.8% of women, and 54.8% had a single lesion. Percentages of 80.2 and 19.8 were benign and malignant nodules, with a median of 15.7mm (IQR 11-25) and 12.7mm (IQR 8.5-18.3), respectively (p<0.001). Hypothyroidism and levothyroxine consumption were higher in those with malignant nodules (p<0.001). The echographic characteristics were statistically different between the nodules. In the malignant ones, there was a higher frequency of solid composition, hypoechogenicity, and irregular margins. In contrast, in the benign ones, the absence of echogenic focus stood out (p<0.001). Conclusion The ultrasound characteristics are essential to define the risk of malignancy of a thyroid nodule. Therefore, considering the most frequent ones can help in the most appropriate approach to primary care (AU)

Salivary Cortisol and Anxiety in Canadian Dentists over 1 Year of COVID-19.

The dental profession has endured unprecedented disruption amid COVID-19. Novel stressors have included a high risk of occupational exposure to COVID-19, financial losses, and stricter infection prevention and control requirements. The present study investigated the longitudinal impact of COVID-19 on the stress and anxiety levels of a cohort of Canadian dentists (N = 222) between September 2020 and October 2021. Salivary cortisol was selected as a biomarker of mental stress, and 10 sets of monthly saliva samples (2,131 in total) were self-collected, sent to our laboratory in prepaid courier envelopes, and analyzed by enzyme-linked immunosorbent assay. To assess COVID-19 anxiety, 9 monthly online questionnaires were administered, comprising a general COVID-19 anxiety instrument and 3 items regarding the impact of dentistry-related factors. Bayesian log-normal mixed effect models were fitted to estimate the longitudinal trajectory of salivary cortisol levels and their association with the disease burden of COVID-19 in Canada. After accounting for age, sex, vaccination status, and the diurnal rhythm of cortisol secretion, a modest positive association was found between dentists' salivary cortisol levels and the count of COVID-19 cases in Canada (96% posterior probability). Similarly, the self-reported impact of dentistry-related factors, such as fear of getting COVID-19 from a patient or coworker, was greatest during peaks of COVID-19 waves in Canada; however, general COVID-19 anxiety decreased consistently throughout the study period. Interestingly, at all collection points, the majority of participants were not concerned about personal protective equipment. Overall, participants reported relatively low rates of psychological distress symptoms in relation to COVID-19, a result that should be reassuring for the dental community. Our findings strongly suggest a link between self-reported and biochemical measurements of stress and anxiety in Canadian dentists during the COVID-19 pandemic.

[Sociodemographic, clinical and ultrasound characterization of thyroid nodule pathology and its association with malignancy in a Colombian high-complexity center]. / Caracterización sociodemográfica, clínica y ecográfica de la enfermedad de nódulos tiroideos y su relación con la malignidad en un centro de alta complejidad colombiano.

BACKGROUND AND OBJECTIVE: Thyroid nodules are among the most frequent conditions, with a 10% risk of malignancy. The objective is to describe the frequency of demographic, clinical, and ultrasonographic characteristics of thyroid nodule pathology in adults and to explore the relationship with tumor malignancy. METHODS: An analytical, retrospective cross-sectional study in adults with thyroid nodules and nodular fine-needle aspiration performed in adult patients from a Colombian reference center between 2009-2019. Data were obtained from the clinical history, descriptive measures of the patient's demographic, clinical, and ultrasound variables were estimated, and their relationship with the malignancy of the tumor was explored. RESULTS: A total of 445 patients and 515 nodules were included. The median age was 55 years (IQR 44-64), 86.8% of women, and 54.8% had a single lesion. Percentages of 80.2 and 19.8 were benign and malignant nodules, with a median of 15.7mm (IQR 11-25) and 12.7mm (IQR 8.5-18.3), respectively (p<0.001). Hypothyroidism and levothyroxine consumption were higher in those with malignant nodules (p<0.001). The echographic characteristics were statistically different between the nodules. In the malignant ones, there was a higher frequency of solid composition, hypoechogenicity, and irregular margins. In contrast, in the benign ones, the absence of echogenic focus stood out (p<0.001). CONCLUSION: The ultrasound characteristics are essential to define the risk of malignancy of a thyroid nodule. Therefore, considering the most frequent ones can help in the most appropriate approach to primary care.

Healthy and Respectful Workplaces: The Experiences of Dental Hygienists in Canada.

INTRODUCTION: Like any health care practitioner, dental hygienists can experience mistreatment in the workplace. They can be subjected to harassment, bullying, abuse, and violence. These negative experiences can have adverse consequences on psychological and physical well-being and can lead to job dissatisfaction, depression, and burnout. The aim of this study was to describe dental hygienists' experiences related to healthy and respectful workplaces. METHODS: This was an online self-administered survey sent to all members of the Canadian Dental Hygienists Association. Respondents were asked to report the occurrence, frequency, and impact of different types of mistreatment as experienced over their career. RESULTS: In total, 3,780 dental hygienists responded to the survey (response rate = 22%). More than 70% of respondents experienced some form of mistreatment over their career from dentists, office managers, coworkers, and/or patients. Of those who experienced mistreatment, 67% reported losing the respect they felt for the offending person, 55% reported experiencing symptoms of depression, and 30% quit their job. CONCLUSIONS: Mistreatment toward dental hygienists can be prevalent in Canadian dental care settings, resulting in negative consequences to dental hygienists' well-being. KNOWLEDGE TRANSFER STATEMENT: The findings of this article suggest that measures are needed to support healthy and respectful workplaces in Canadian dental care settings. This includes but is not limited to 1) training and education for all members of the dental care team concerning mistreatment, 2) enacting policies in dental care settings to discourage these types of behaviors, and 3) providing help and support to individuals who experience these incidents.

Trends in repeat general anaesthesia for treatment of dental caries at a children's hospital in Toronto, Canada: a 10-year retrospective investigation.

BACKGROUND: Treatment of early childhood caries (ECC) under general anaesthesia (GA) was the most common day surgical procedure performed for preschool children in Canada. Evidence with regard to the rate of repeat GA for dental care for Canadian Children is limited. AIM: To determine the rate of repeat dental caries treatment performed under GA over a 10-year period and to assess the relationship between the frequency of repeat dental treatment under GA and medical comorbidities. DESIGN: This was a retrospective assessment of the dental records of 973 children who required repeat dental treatment under GA over a 10-year period. The rate of repeat dental treatment under GA was calculated. A Chi-square analysis was performed to determine associations between medical comorbidities and the frequency of repeat dental treatment under GA. RESULTS: The rate of repeat dental treatment under GA over a 10-year period was 10.8%. The yearly repeat rate and simple moving 5-year rate of repeat dental treatment under GA increased. Having a medical comorbidity was not associated with repeat dental treatment under GA. CONCLUSIONS: The rate of repeat dental treatment under GA was consistent with the rates reported in the dental literature and increased over the 10-year period.

Oral Health and Cardiovascular Disease: Mapping Clinical Heterogeneity and Methodological Gaps.

BACKGROUND: Numerous studies have examined the associations between poor oral health and the incidence of cardiovascular disease (CVD) over the past 25 y. This long history of research has resulted in a broad and heterogenous epidemiological field whose implications are difficult to understand and whose methodological gaps are hard to track. OBJECTIVES: This systematic mapping review aims to systematically map clinical heterogeneity and methodological gaps in assessing the relationship between poor oral health and CVD outcomes. METHODS: Medline, Embase, and Cochrane Library were searched to identify longitudinal studies that examined the relationship between any oral health indicator and CVD outcomes. Each database was searched from its inception date and June 27, 2018. Extracted data assess the clinical heterogeneity (participants' characteristics, exposure and outcome measures, length of follow-up) and methodological gaps (availability of randomized controlled trials, utilization of time-varying exposures, propensity methods, mediation analysis, and competing risks analysis). RESULTS: Eighty-five studies met the inclusion criteria. Clinical heterogeneity is evident in participants' characteristics (age, clinical status, and occupation) and in the definitions of oral health indicators and CVD outcomes. More important, a significant proportion of studies reported unclear definitions for CVD outcomes. The search strategy did not reveal any randomized controlled trials. Time-varying exposures, propensity methods, mediation analysis, and competing risks analysis are used infrequently in the identified studies. CONCLUSION: There is a need for a universally accepted conceptual framework on the association between oral health and CVD to derive more consistent definitions for oral health and CVD outcomes that are aligned with the investigated research questions. There is also a need to use emerging research methods to maximize the impact of research in this area. KNOWLEDGE TRANSFER STATEMENT: Clinical heterogeneity is evident in the definitions of oral health indicators and cardiovascular disease outcomes. Propensity methods, mediation analysis, and competing risks analysis are used infrequently in the identified studies. The identified clinical heterogeneity and methodological gaps interfere with summarizing existing evidence and understanding their practical implications. Advancing the current understanding of the associations between oral health and cardiovascular disease goes hand in hand with minimizing clinical heterogeneity and closing the identified methodological gaps.

COVID-19 Has Clarified 2 Foundational Policy Questions in Dentistry.

KNOWLEDGE TRANSFER STATEMENT: This commentary can be used by governments, regulators, professional groups, and other stakeholders in their considerations of what constitutes essential or medically necessary dental care and how to best allocate dental care resources.

The Biology of Social Adversity Applied to Oral Health.

Biological embodiment is a concept derived from Engel's biopsychosocial model to health, theorized as the process by which adverse social exposures trigger neuroendocrine and immune responses, leading to disease and/or increased disease susceptibility. This critical review discusses the biopsychosocial model as applied to oral health and its relevance to oral health policy while deciphering some of the pathobiological processes underlying social adversity. In periodontal disease, for example, such processes can occur via the activation of the hypothalamic-pituitary-adrenal axis and the consequent release of the chronic stress hormone cortisol. The latter contributes to a proinflammatory immune state that increases the risk for periodontal inflammation. Recent research shows that cortisol relates to an elevated oral inflammatory load, demonstrated as hyperactive neutrophils that are pivotal to periodontal tissue damage. Consistent with the biopsychosocial model, this relationship is amplified in those of lower income and higher financial stress. Similarly, among children from lower socioeconomic backgrounds, cortisol is linked to a higher cariogenic bacterial load. Such findings implicate the stress pathway as key in the oral pathogenic process, particularly under social/socioeconomic adversity. Collectively, this work emphasizes the importance of addressing social factors in alleviating oral disease burden and reducing the social gaps therein.

Visits for Nontraumatic Dental Conditions in Ontario's Health Care System.

BACKGROUND: Physicians' offices and emergency departments (EDs) are not suited for addressing nontraumatic dental conditions (NTDCs); however, significant numbers of people in Canada, including Ontario, visit such settings for their dental complaints. Also, people sometimes visit hospitals for day surgery to get their complicated dental conditions treated. This reflects the inefficient usage of the health care system and gaps in accessing timely dental care. METHODS: We assessed trends in the burden of NTDCs in Ontario by estimating the visits made for such conditions to physicians, EDs, and hospitals for day surgery. Aggregate data for years 2001 to 2015 were retrieved from Intellihealth Ontario. Descriptive analysis was conducted to calculate rates of visits as stratified by sex, age groups (0 to 6, 7 to 18, 19 to 64, and ≥65 y), and jurisdictions (public health unit level). RESULTS: On average, 70,274 visits to physicians, 51,861 to EDs, and 13,889 to hospital day surgery are made each year in Ontario for NTDCs, which costs approximately CAN$29 million. Children aged 0 to 6 y visit more than their counterparts. Statistically significant increasing trends for physician and ED visits were observed over the years. Analyses show large variations in rates of visits across public health units, with higher rates in rural communities. CONCLUSION: A large number of visits for NTDCs, with jurisdictional variations, were consistently made to nondental health care settings in Ontario over the last 15 y. Central- and local-level policy options for optimizing resources and health care system use are required. KNOWLEDGE TRANSFER STATEMENT: The findings of this study will provide oral and general health professionals a comprehensive understanding about the ineffective usage of a health care system for nontraumatic dental conditions. Quantifying the burden and associated dollars spent will promote crucial policy discussions to explore the possible options for providing emergency and essential dental services for all Canadians and possible equitable options to enhance access to dental care for vulnerable populations in Canadian society.

Blood biochemistry of olive ridley (Lepidochelys olivacea) sea turtles foraging in northern Sinaloa, Mexico.

Blood parameters provide an excellent tool to evaluate the health status of wildlife. However, there are few studies about health parameters of sea turtles in Mexico. For olive ridley turtles (Lepidochelys olivacea), no information was available to establish the health baseline for the species. The objective of this study was to establish reference blood biochemistry values for olive ridley turtles in the northern Sinaloa foraging area. Between 2013 and 2015, 82 olive ridley turtles were captured. Body condition index (BCI) presented a mean of 1.46 ± 0.14 (1.17-2.02) that categorized the population with excellent body condition; in addition, 99% of the turtles captured had a good physical appearance. Blood was collected for biochemistry analysis from 60 turtles. Significantly higher values of total protein, albumin, A/G ratio (albumin/globulin) and PCV (packed cell volume or hematocrit) were observed in adult when compared to subadult turtles. On the other hand, no significant differences were found when females and males were compared. Based on the BCI, physical assessment, and blood parameters, and compared to other sea turtle species, olive ridley turtles in northern Sinaloa were considered in excellent health. To the best of our knowledge, this is the first study to establish normal blood biochemistry values of foraging olive ridley turtles in northern Sinaloa.

Comparing self-reported and clinically diagnosed unmet dental treatment needs using a nationally representative survey.

OBJECTIVES: To describe the validity and diagnostic accuracy of self-reported data compared with clinically assessed data for the ascertainment of clinical dental treatment needs in the Canadian population. METHODS: A secondary analysis of data from the Canadian Health Measures Survey (2007-2009) was undertaken. Clinical treatment needs were classified into preventive and diagnostic, restorative, endodontic, periodontic, surgical, and orthodontic categories. Sensitivity, specificity, positive and negative predictive values (NPVs), kappa statistics and likelihood ratios (LR) were calculated to compare self-reported and clinically determined needs. Survey weights were applied to generate nationally representative findings of the Canadian population. RESULTS: Generally across most dental need categories, agreement between self-reported and clinically-determined dental need was found to be moderate to poor (kappa <0.6). For most needs, self-reported data was found to be highly specific (>90 percent) but not very sensitive. Low positive (<60 percent) and high NPVs (>80 percent) revealed that self-reported information was found to be more precise in reassuring when most dental needs were not present, opposed to confirming needs that were required. High positive LRs were obtained for endodontic (+LR = 12.15) and orthodontic needs (+LR = 14.82), indicating good diagnostic accuracy of positive self-report for these outcomes. CONCLUSIONS: Our findings suggest that in general, self-reports are poor estimates for normative dental treatment needs but do have some merit in confirming non-needs. Exceptionally, self-reports do have suitable diagnostic accuracy for predicting orthodontic and endodontic needs.

Current stress and poor oral health.

BACKGROUND: Psychological stress appears to contribute to poor oral health systemically in combination with other chronic diseases. Few studies directly examine this relationship. METHODS: Data from a cross-sectional study of 2,412 participants between the ages of 25-64 years old living in the City of Toronto between 2009 and 2012 were used to examine the relationship between current stress and two self-rated oral health outcomes (general oral health and oral pain). Dental care utilization and access to dental insurance were examined as effect modifiers. RESULTS: A positive relationship between current stress and poor oral health was observed for both outcomes (oral pain coefficient 0.32, 95 % CI 0.26-0.38; general oral health coefficient 0.28, 95 % CI 0.19-0.36). Effects on oral pain were stronger for the uninsured, while effects on general oral health were stronger with decreasing socioeconomic position. CONCLUSIONS: Our findings suggest that individuals with greater perceived stress also report poorer oral health, and that this relationship is modified by dental insurance and socioeconomic position. These findings warrant a greater focus on the role of psychological stress in the development of oral disease, including how perceived stress contributes to health inequities in self-reported oral health status. Patients experiencing stressful lives may differentially require closer monitoring and more vigilant maintenance of their oral health, above and beyond that which is needed to achieve a state of health in the oral environment of less stressed individuals. There may be health promoting effects of addressing psychosocial concerns related to dental care - particularly for the poor and uninsured.

Isolation, characterization, and antibiotic resistance of Vibrio spp. in sea turtles from Northwestern Mexico.

The aerobic oral and cloacal bacterial microbiota and their antimicrobial resistance were characterized for 64 apparently healthy sea turtles captured at their foraging grounds in Ojo de Liebre Lagoon (OLL), Baja California Sur (BCS), Mexico (Pacific Ocean) and the lagoon system of Navachiste (LSN) and Marine Area of Influence (MAI), Guasave, Sinaloa (Gulf of California). A total of 34 black turtles (Chelonia mydas agassizii) were sampled in OLL and eight black turtles and 22 olive ridley turtles (Lepidochelys olivacea) were sampled in LSN and MAI, respectively from January to December 2012. We isolated 13 different species of Gram-negative bacteria. The most frequently isolated bacteria were Vibrio alginolyticus in 39/64 (60%), V. parahaemolyticus in 17/64 (26%), and V. cholerae in 6/64 (9%). However, V. cholerae was isolated only from turtles captured from the Gulf of California (MAI). Among V. parahaemolyticus strains, six O serogroups and eight serovars were identified from which 5/17 (29.4%) belonged to the pathogenic strains (tdh (+) gene) and 2/17 (11.7%) had the pandemic clone (tdh (+) and toxRS/new (+)). Among V. cholerae strains, all were identified as non-O1/non-O139, and in 4/6 (66%) the accessory cholera enterotoxin gene (ace) was identified but without virulence gene zot, ctxA, and ctxB. Of the isolated V. parahaemolyticus, V. cholerae, and V. alginolyticus strains, 94.1, 33.4, and 100% demonstrated resistance to at least one commonly prescribed antibiotic (primarily to ampicillin), respectively. In conclusion, the presence of several potential (toxigenic) human pathogens in sea turtles may represent transmission of environmental microbes and a high-risk of food-borne disease. Therefore, based on the fact that it is illegal and unhealthy, we discourage the consumption of sea turtle meat or eggs in northwestern Mexico.

Trace elements in blood of sea turtles Lepidochelys olivacea in the Gulf of California, Mexico.

This study determined the concentrations of heavy metals in blood collected from Pacific Ridley sea turtles (Lepidochelys olivacea) inhabiting the coast of Guasave, Mexico, in the Gulf of California. The highest reported metal concentration in blood was Zn, followed by Se. Of nonessential toxic metals, As was reported in higher percentage compared to Cd. The concentrations of metals detected were present as follows: Zn > Se > Mn > As > Ni > Cd > Cu. Cd concentration in blood is higher in our population in comparison with other populations of L. olivacea, and even higher in other species of sea turtles. Our study reinforces the usefulness of blood for the monitoring of the levels of contaminating elements, and is easily accessible and nonlethal for sea turtles.

Selected heavy metals and selenium in the blood of black sea turtle (Chelonia mydas agasiizzi) from Sonora, Mexico.

The concentration of heavy metals (Zn, Cd, Ni, Cu, Mn) and selenium (Se) was analyzed in blood collected from 12 black turtles (Chelonia mydas agasiizzi) captured in Canal del Infiernillo, Punta Chueca, Mexico. The most abundant metals were Zn (63.58 µg g(-1)) and Se (7.66 µg g(-1)), and Cd was the lower (0.99 µg g(-1)). The sequential concentrations of trace metals were Zn > Se > Cu > Mn > Ni > Cd. In conclusion, this information is important as a baseline when using blood as tissue analysis of heavy metals; however, these levels could represent recent exposure in foraging grounds of black turtles in the Sea of Cortez.

Self-reported cost-prohibitive dental care needs among Canadians.

OBJECTIVES: To explore self-reported cost-prohibitive dental treatment needs among Canadians. METHODS: Data were collected through a national telephone interview survey of 1006 randomly selected Canadian adults. Descriptive analyses based on socio-demographic characteristics and dental-related behaviours were undertaken. Logistic regression was used to determine the predictors of experiencing a cost-prohibitive dental care need. Chi-square tests were used to determine significant differences in the treatments reported as unaffordable by socio-demographic characteristics and dental-related behaviours. RESULTS: Those of low income, no insurance coverage and poor self-rated oral health were more likely to report having a cost-prohibitive dental care need. The top needs reported as unaffordable were fillings, cleanings and check-ups. Comparatively, preventive services were selected as cost-prohibitive more often by the insured, dentures by the oldest group and extractions by those with a high school education or less. CONCLUSIONS: This study confirms that there are significant relationships between socio-demographic factors, dental-related behaviours and the types of dental services that are selected as unaffordable. Indirectly, this shows us how socio-demographic factors may influence the types of dental services that are reported as 'needed' by certain groups. Difficulties in distinguishing between the services that are 'needed' from and those that are 'wanted' demonstrate some of the policy complexity associated with publicly financed dental care.

Baseline heavy metals and metalloid values in blood of loggerhead turtles (Caretta caretta) from Baja California Sur, Mexico.

Environmental pollution due to heavy metals is having an increased impact on marine wildlife accentuated by anthropogenic changes in the planet including overfishing, agricultural runoff and marine emerging infectious diseases. Sea turtles are considered sentinels of ecological health in marine ecosystems. The objective of this study was to determine baseline concentrations of zinc, cadmium, copper, nickel, selenium, manganese, mercury and lead in blood of 22 clinically healthy, loggerhead turtles (Caretta caretta), captured for several reasons in Puerto López Mateos, Baja California Sur, Mexico. Zinc was the most prevalent metal in blood (41.89 µg g⁻¹), followed by Selenium (10.92 µg g⁻¹). The mean concentration of toxic metal Cadmium was 6.12 µg g⁻¹ and 1.01µg g⁻¹ respectively. Mean concentrations of metals followed this pattern: Zn>Se>Ni>Cu>Mn>Cd>Pb and Hg. We can conclude that blood is an excellent tissue to measure in relatively non-invasive way baseline values of heavy metals in Caretta caretta.

Disability days in Canada associated with dental problems: a pilot study.

OBJECTIVE: The aim of this study was to explore disability days, or bed days and cut-down days, associated with dental problems in Canada. METHODS: Data were collected through a national telephone interview survey of 1005 Canadians aged 18 years and over using random digit dialling. Participants were asked to enumerate the number of disability days associated with dental problems in the previous 2-week period. Descriptive and bivariate logistic regression analyses were undertaken. RESULTS: In the previous 2-week period, 33 people, or 3.3% of the sample, reported spending a day in bed because of a dental problem. Of these, 22 people also reported having to cut down on their normal activity because of the dental problem. It appears that younger age groups, those with the lowest incomes, college educations, no dental insurance, oral pain and a history of visiting a hospital emergency room for a dental problem, were all more likely to report a dental disability day. CONCLUSIONS: These data demonstrate the potential economic impacts of dental problems in Canada, yet they must be interpreted with caution because of the very low prevalence of the main outcome measure, the potential for selection bias and the relative inconsistency with existing historical estimates.