SCIENTIFIC RESOURCES
Oral Health and Children and Adolescents
The National Maternal and Child Oral Health Resource Center (OHRC) (www.mchoralhealth.org) and the MCH Library (http://mchlibrary.info) have released a revised and expanded knowledge path about oral health and children and adolescents. Released for the February 2003 National Children's Dental Health Month, this electronic resource guide offers a selection of current, high-quality resources about oral health, including publications and databases from OHRC. Health professionals, policymakers, program administrators, and researchers can access the guide to identify timely information on this topic. Current knowledge paths on other maternal and child health topics are available at http://mchlibrary.info/KnowledgePaths/index.html.
Oral Health U.S., 2002 Report
The Data Resource Center of NIDCR/CDC has released the first edition of its annual report titled, "Oral Health U.S., 2002," which summarizes the oral health status of the U.S. population. It is a compendium of data relating to oral, dental, and craniofacial status; to effects of conditions originating in the craniofacial complex or originating elsewhere but affecting this area; and to other data categories, including demographic, health services, health economics, and environmental, that impact oral health. Future issues of the report will communicate basic data while also capturing trends, changing priorities, and emerging issues. The report is available as a PDF file at http://drc.nidcr.nih.gov/report.htm. You can also order a CD-ROM from this site at no charge.
NIH Establishes 11 Research Centers Focused on Women's Health Factors
The National Institutes of Health has designated 11 new Specialized Centers of Research at the following schools, focusing on how sex and gender factors affect women's health: Emory University; Medical University of South Carolina; Northwestern University; University of California, Los Angeles; University of California, San Francisco; University of Maryland; University of Michigan, Ann Arbor; University of Pittsburgh; University of Washington; Washington University; and Yale University.
Journal of the Canadian Dental Association Now Online
The electronic version of the April 2003 edition of the Journal of the Canadian Dental Association is now available online. For the table of contents of the English version, visit http://www.cda-adc.ca/jcda/vol-69/issue-4/index.html. You will have free access to the full text of peer-reviewed articles and editorials.
- Dr. Connie Drisko has been named dean of the Medical College of Georgia School of Dentistry. She is currently professor of periodontics, associate dean for academic planning/faculty development and director of clinical research at the University of Louisville School of Dentistry.
- To the Gates Foundation, who recently gave $60 million for microbicide research to the International Partnership for Microbicide Development. Microbicides are topical products that women can use vaginally or rectally as a foam or gel to prevent transmission of sexually transmitted diseases. Dr. Zeda Rosenberg, chief executive of the partnership, said that she has raised a total of $100 million, stating that this represents a "meaningful down payment" toward development of an affordable microbicide. In addition to the Gates Foundation, she also received funds from the Rockefeller Foundation and from the countries of Britain, Denmark, Ireland, the Netherlands, and Norway.
KUDOS!
Microbicide research has focused on more than 60 compounds which are either in preclinical or Phase I and Phase II safety trials; however, one Phase III trial costs millions of dollars, and funds are needed for additional Phase III efficacy trials. Currently, only two Phase III trials are underway.
Worldwide, every day, 5,000 women are infected with HIV, the virus that causes AIDS. Millions of women are infected with sexually transmitted diseases, many of whom have a husband or partner as their only risk factor. Dr. Helene Gayle, head of the HIV, TB, and reproductive health program at the Gates Foundation, said that it would be 2010 before Phase III clinical trials were completed and microbicides were available.
SCIENCE
Women Heart Patients Face Obstacles to Diagnosis, Recovery
More than one-half of women with heart disease are dissatisfied with their health care and face significant obstacles to their recovery, according to the first-ever national survey of female heart patients. The results of the survey are published in the January/February edition of Women's Health Issues. Of those who were dissatisfied with some aspect of their health care, 58 percent pointed directly to physician attitudes and communication styles as the culprits. Specifically, they cited physician insensitivity, rudeness, abruptness and ignorance about heart disease in women.
The survey involved telephone interviews with 204 women heart patients and was funded by WomenHeart: The National Coalition for Women with Heart Disease (www.womenheart.org), the nation's only patient-advocacy organization founded by and for women with heart disease.
To obtain a free brochure on "How Do I Know I Have Heart Disease? A Woman's Guide to Diagnosis and Testing," send an email to [email protected] or write to WomenHeart at: 818 18th Street NW, Suite 730, Washington, DC 20006.
Study Finds Girls More Easily Addicted
Girls and young women are more easily addicted to drugs and alcohol, have different reasons than boys for abusing substances, and may need single-sex treatment programs to beat back their addictions, according to a three-year study of the National Center on Addiction and Substance Abuse at Columbia University. The nationwide survey of females ages 8 to 22 found the gender gap is narrowing between boys and girls who smoke, drink, and use drugs. Based on the results, the primary investigator for this landmark study called for a gender-specific approach to substance-based addiction, publicly seconded by Mrs. Jeb Bush, Senator Hillary Rodham Clinton (D-N.Y.), and Rep. Nancy Johnson, (R-Conn.). For more information, visit the National Center on Addiction and Substance Abuse Web site: www.casacolumbia.org.
UPCOMING CONFERENCES
ADEA (American Dental Education Association) Second International Women's Leadership Conference — June 20-23, 2003; Scandic Hotel Crown Göteborg; Göteborg, Sweden; www.adea.org; (202) 667-9433, Ext. 157; [email protected]
AAWD (American Association of Women Dentists) 2003 Annual Meeting (in conjunction with the AGD Conference) — July 17-20, 2003; Grand Ole Opry; Nashville, Tenn.; www.aawd.org; [email protected]
AGD (Academy of General Dentistry) 2003 Annual Meeting — July 17-20, 2003; Gaylord Opryland Hotel and Convention Center; Nashville, Tenn.; www.agd.org; [email protected]; (312) 440-4300
NDA (National Dental Association) 2003 Annual Meeting — Aug. 1-6, 2003; New Orleans, La..; www.ndaonline.org; (202) 588-1697
AAWD Cruise and Learn to Bermuda — Aug. 31-Sept. 7, 2003; www.briles.com/cruise.html; [email protected]
HDA (Hispanic Dental Association) 11th Annual Meeting, Washington, D.C. — Oct. 10-11, 2003; Crystal Gateway Marriott; Arlington, Va..; www.hdassoc.org; [email protected]; (800) 852-7921
ADA (American Dental Association) 2003 Annual Session — Oct. 23-26, 2003; The Moscone Center; San Francisco, Calif.; www.ada.org; [email protected]; (312) 440-2388 or (800) 232-1432
Call for papers!
See the January/February 2003 issue of Woman Dentist Journal for instructions on submitting editorial material for publication. You can also visit www.aawd.org to view an online version of WDJ's Call for Papers.
SCIENCE NEWS & TECHNOLOGY
Evaluate Innovations Based on Science
How do you evaluate innovations and whether you will use them? Do you see an innovation as traditional or too radical to use? The Structure of Scientific Revolution, Thomas Kuhn's seminal work, discusses the behavior of scientists when confronted with new and changing paradigms.
When new evidence clearly demonstrated the need for a change, scientists were observed trying to make that new evidence conform to the old view. Sometimes, they were found to be discarding or reinterpreting data. As you consider using innovations, focus on the science and make your decisions for your practice. Think about scientific rigor as a measuring tool for your practice.
Remember that statistics and sufficient power for a study do matter (even if statistics had to be the most poorly taught course in dental school). If you don't remember what a p value is, dust off that textbook and check it out. This may help you to keep up with jargon of bench scientists dropping words like RCT (randomized controlled trial), Cochane Collaboration (see Mar/April WDJ), and p values.
Below are some tidbits related to science.
ORAL HEALTH MATTERS & WOMEN'S HEALTH
In March 2003, Health and Human Services Secretary Tommy G. Thompson introduced a national plan to address the growing health epidemic of diabetes in women. Diabetes is the sixth leading cause of death in the United States and is a major contributor to heart disease, the number one killer of women. With the increasing lifespan of women, the rapid growth of minority, racial, and ethnic populations in the United States — who are hardest hit by the diabetes burden — and the apparent increase in new cases of diabetes among younger women in their adolescent years, the number of women at high risk for diabetes and its complications continues to increase.
The National Agenda for Public Health Action: The National Public Health Initiative on Diabetes and Women's Health is designed to mobilize the nation to address diabetes as a growing health concern. It calls for expanding community-based health education programs, promoting risk assessment, supporting quality care and self-management for diabetes and its complications, and encouraging research into the factors that influence diabetes and women's health. More than 9 million American women have diabetes.
The impact of periodontal disease on maintaining glycemic control for diabetics has been incompletely evaluated in sufficiently representative samples among all populations, including among women. No large-scale randomized controlled trials (RCTs), the gold standard of scientific method, have been conducted evaluating the relationships between periodontal disease and glycemic control. No RCT is planned at this time.
The National Agenda is available at http://www.cdc.gov/diabetes/pubs/english.htm.
Smallpox vaccination policy is being revised for 500,000 military personnel who were planning to be vaccinated against smallpox, announced the Pentagon in early April. Following a few cases of sudden cardiac deaths after vaccination, the military program will screen for hypertension, cholesterolemia, diabetes, and family history of heart disease. Despite efforts to avoid exposing pregnant women to smallpox vaccine, 103 have received it in the national vaccination program as of May 2. Six were health workers and 85 were in the military, with the other 12 in vaccine studies. Two of the women had early miscarriages, but it cannot be determined if this was related to the vaccine. Please advise pregnant women NOT to receive the vaccine. Fetal vaccinia, though rare, can kill the fetus or newborn or cause premature birth. On Dec. 13, 2002, President Bush announced a plan to vaccinate key military personnel and called for voluntary vaccination of health personnel.
BIODEFENSE TODAY
As our nation moves toward a biodefense position, being prepared is most important. With recent orange alerts being issued by the Department of Homeland Security, it is important to have a plan of action to evacuate both your home and your office. Make sure that your whole team knows the routine, with intact and nonintact communication systems. You may wish to schedule an exercise to evacuate.
In the event of a crisis, as a professional remember some basic risk communication —
Be First. Be Right. Be Credible.
Build trust and credibility by expressing these traits:
- Empathy and caring
- Competence and expertise
- Honesty and openness
- Commitment and dedication
Top tips include the following:
- Don't over reassure
- Acknowledge uncertainty
- Express wishes (I wish I had answers)
- Explain the process that's in place to find answers
- Acknowledge people's fear
- Give people things to do
- Ask more of people (share risk)
Remember that communicating with children may be important. For resources on children, go to http://www.aap.org/advocacy/releases/disastercomm.htm.
SARS UPDATE
Rapid tests are becoming commonplace in the diagnosis of many diseases. Earlier this year, rapid test sites for HIV testing were expanded (OraQuick Rapid HIV-1 Antibody Test™). Instead of traditional HIV voluntary counseling and testing using ELISA and Western Blot technology with a client returning the next week, patients have the option to receive voluntary counseling and testing with a 20-minute laboratory test. Other diseases are being diagnosed with rapid tests.
At this writing, Severe Acute Respiratory Disease (SARS) has spread to at least 32 U.S. states, and the pandemic continues to spread globally. In general, SARS begins with a fever greater than 100.4°F (>38.0°C). Other symptoms may include headache, an overall feeling of discomfort, and body aches. Some people also experience mild respiratory symptoms. After two to seven days, SARS patients may develop a dry cough and have trouble breathing.
Genomic sequencing of the virus that causes SARS linked the new virus to the coronavirus virus. Coronaviruses are responsible for severe disease in animals and about 20 to 30 percent of common colds among people. With the viral sequence on the Internet, researchers are on the road to the development of a rapid test. Check out the latest news for the development of a rapid test for SARS, which could require only a saliva sample.
In general, enveloped viruses such as coronaviruses do not last a long time in the environment. In earlier studies, a different coronavirus was shown to survive for up to three hours on surfaces. At this time, it is uncertain how long the newly discovered coronavirus associated with SARS can survive in the environment. In one preliminary study, researchers in Hong Kong found that both dried and liquid samples of the new coronavirus survived as long as 24 hours. Additional studies are underway.
High filtration masks (95 percent efficiency with double straps) will provide protection to staff, along with basic infection-control standards. Remember that basic handwashing along with basic decontamination procedures (shoes can be a source) is important. For the latest on SARS and guidance for clinicians, go to http://www.cdc.gov/ncidod/sars/clinicians.htm. As of April 4, 2003, an executive order for quarantinable communicable diseases was issued. Go to http://www.cdc.gov/ncidod/sars/executiveorder040403.htm.
