- 作者列表："Ming Y","Hsu SW","Yen YY","Lan SJ
STATEMENT OF PROBLEM:Oral health-related quality of life (OHRQoL) is a subjective measure that assesses a person's perception of oral health. Patients with Alzheimer disease (AD) suffer from impaired cognitive function and a compromised ability to perform activities of daily living. Further exploration is needed to clarify whether OHRQoL is negatively impacted by cognitive degeneration and oral health conditions among patients with AD. PURPOSE:The purpose of this systematic review was to increase understanding of OHRQoL among patients with AD and explore factors that may affect OHRQoL. MATERIAL AND METHODS:Searches were conducted in PubMed, the Cochrane Library database, Medline, EBSCO, ProQuest, and EMBASE until August 30, 2018, with no date restrictions. The initial search targeted quantitative observational studies published in English that included the keywords AD, oral, prosthesis, and OHRQoL. Data extraction was independently conducted by 2 reviewers. OHRQoL was investigated as the outcome. Cognitive status and oral health conditions were treated as exposures. Tools used to measure OHRQoL included the Geriatric Oral Health Assessment Index (GOHAI) and the Oral Health Impact Profile. The research adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS:Six studies were included. The sample sizes ranged from 30 to 226 participants, 5 studies used cross-sectional designs, and 1 was a nonrandomized controlled trial. Three studies reported higher OHRQoL scores among participants with AD than those among controls, but only 1 study showed a statistically significant difference. A statistical analysis was conducted with 4 studies that reported GOHAI scores, and no significant differences were found in GOHAI scores between participants with AD and controls (standard mean difference: 0.09; 95% confidence interval: -0.66 to 0.85). All studies that explored factors affecting OHRQoL showed different associations between cognitive impairment, oral health conditions, and OHRQoL. One study showed that cognitive impairment was negatively associated with OHRQoL. Three studies found oral health conditions (including periodontitis, gingival bleeding, probing depth >4 mm, and number of natural teeth) impaired the OHRQoL of participants with AD. Three studies reported that prosthetic type and quality positively affected OHRQoL among participants with AD. CONCLUSIONS:OHRQoL may not fully represent actual oral health problems of patients with AD. Clinical dentists should evaluate oral problems in this population, preferably by using both subjective and objective examinations, including oral and dental conditions. This will ensure oral problems among patients with AD can be detected early and timely treatment provided.
问题陈述: 口腔健康相关生活质量 (OHRQoL) 是评估一个人对口腔健康的感知的主观测量。患有阿尔茨海默病 (AD) 的患者患有受损的认知功能和执行日常生活活动的能力受损。需要进一步探索以明确OHRQoL是否受到AD患者的认知退化和口腔健康状况的负面影响。 目的: 本系统评价的目的是增加对AD患者OHRQoL的了解，并探讨可能影响OHRQoL的因素。 材料和方法: 在PubMed，Cochrane图书馆数据库，Medline，EBSCO，ProQuest和EMBASE中进行搜索，直到2018年8月30日，没有日期限制。最初的搜索目标是用英语发表的定量观察性研究，包括关键词AD，口腔，假体和OHRQoL。数据提取由2名评价者独立进行。将OHRQoL作为结果进行调查。认知状态和口腔健康状况被视为暴露。用于测量OHRQoL的工具包括老年口腔健康评估指数 (GOHAI) 和口腔健康影响概况。该研究遵循系统评价和荟萃分析指南的首选报告项目。 结果: 共纳入6个研究。样本量为30-226名参与者，5项研究采用横断面设计，1项为非随机对照试验。3项研究报告AD参与者的OHRQoL评分高于对照组，但只有1项研究显示统计学显著差异。用4项报告GOHAI评分的研究进行统计分析，并且在患有AD的参与者和对照之间未发现GOHAI评分的显著差异 (标准平均差: 0.09; 95% 置信区间: -0.66至0.85)。所有探索影响OHRQoL的因素的研究都显示了认知障碍，口腔健康状况和OHRQoL之间的不同关联。一项研究表明，认知障碍与OHRQoL呈负相关。三项研究发现口腔健康状况 (包括牙周炎，牙龈出血，探测深度> 4毫米和天然牙齿数量) 损害了AD参与者的OHRQoL。三项研究报告说，假体类型和质量对AD参与者的OHRQoL有积极影响。 结论: OHRQoL可能不能完全代表AD患者的实际口腔健康问题。临床牙医应评估该人群中的口腔问题，优选使用主观和客观检查，包括口腔和牙齿状况。这将确保AD患者的口腔问题能够被早期发现并及时提供治疗。
METHODS::Emotion regulation (ER) strategies are often categorized as universally adaptive or maladaptive. However, it has recently been proposed that this view is overly simplistic: instead, adaptive ER involves applying strategies variably to meet contextual demands. Using data from four experience-sampling studies (Ns = 70, 95, 200, and 179), we tested the relationship between ER variability and negative affect (NA) in everyday life. The constantly changing demands of daily life provide a more ecologically valid context in which to test the role of variability. We calculated 2 global indicators of variability: within-strategy variability (of particular strategies across time) and between-strategy variability (across strategies at one time-point). Associations between within-strategy variability and NA were inconsistent. In contrast, when controlling for mean strategy endorsement, between-strategy variability was associated with reduced NA across both individuals and measurement occasions. This is the first evidence that variably choosing between different strategies within a situation may be adaptive in daily life. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
METHODS::Purpose: Patient self-care tools can improve patient outcomes in chronic disease. In uveitis, there is an unmet need for the innovative Uveitis Patient Passport (UPP). This study aims to evaluate the success of the passport's introduction into a tertiary uveitis service through patient experience.Methods: The UPP, created in consultation with patients and the multidisciplinary team, was evaluated using a patient questionnaire and mixed quantitative and qualitative methodology.Results: Key themes emerged, with the passport used by participants as a self-care resource and an aid for cross-specialty communication. Patient involvement in evaluation identified key areas for passport development in line with patient needs. These included improving clinician engagement and future transference into a smartphone application.Conclusion: The introduction of the first UPP was a success, especially as a self-care tool for supporting patients in managing their uveitis with the potential to improve patient outcomes.
METHODS::A body of research documented that the study of mental health of the oldest individuals may contribute to understand the psychological characteristics of longevity. This study had two related aims. First, to fully characterize the psychological health of Sardinian elders in the very late adult span. Second, to determine the psychological health of long-lived individuals (i.e., centenarians) from this population. Three gender-matched age groups (octogenarian, nonagenarian, centenarian) of cognitively healthy, community dwelling adults were recruited in Sardinia, an Italian island characterized by higher levels of longevity. Comparisons of total and sub-scale levels of psychological well-being and depressive symptomatology were made while controlling for social desirability. There were few differences in any index of psychological health between the groups; only a decrease in the coping strategies sub-scale of psychological well-being was observed between the centenarians and the octogenarians. Social desirability was differentially associated with specific dimensions of depressive symptoms and psychological well-being. These findings highlight that there is minimal age-related decline in the psychological health of a longevous population, even among its very oldest members. The present outcomes suggest that older Sardinians represent an advantageous population for the investigation of the psychological markers of longevity, since they demonstrate positive adaptation to the challenges (e.g., changes related to their social network) of very late adulthood.