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This article presents findings from an experiential learning exercise in which 34 care practitioners enrolled on a part-time BSc programme in Dementia Studies were asked to identify their own favourite music, and then to investigate the musical preferences of one of their clients with dementia. For both groups, practitioners and clients, three dominant themes influencing choice of music emerged: loving relationships; significant life events and places, and a sense of physical enjoyment. This exercise enabled the group of practitioners involved to identify commonalities between their own musical memories and those of their clients with dementia. They also uncovered considerable amount of new information about their client¿s life histories. On this basis they were able to make a number of new recommendations for improving care practice.

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This qualitative study describes the experience of eight men with fibromyalgia (FM). Data from repeated semi-structured interviews was analysed using the constant comparative method, in order to generate a grounded theory. The specific aims were to explore how individuals perceived and made sense of their condition, and to discover the impact of FM upon their sense of identity and intimate relationships. Two core categories emerged from data analysis - loss and limited understanding. Losses pertained to the men's capabilities and activities; role and identity; work; and relationships. Limited understanding was described in relation to three levels of experience: limited understanding by the individual sufferer; by other people; and by health care professionals. Various intervening and contextual variables were identified for each phenomenon. Analysis suggested that loss is more likely to be pronounced where pain is severe and constant; the degree of incapacity is high; and there is a complete cessation of work. Intervening conditions likely to reduce the sense of loss included role expectations consistent with capabilities; absence of young dependants; a flexible work environment; living with a partner; favourable social comparisons; high self-efficacy and accepting attitude towards illness. Limited understanding was likely to be more pronounced where the individual perceived no rational link between the triggering event and symptoms of FM, and where new difficulties were encountered. The individual was more likely to perceive that others misunderstood their situation if they were not using a mobility aid themselves. Individuals were more likely to perceive limited understanding by the medical profession where the GP had not been especially supportive, and where contact with the specialist was unsatisfactory. Limited understanding was exacerbated by intervening variables including lack of contact with other FM sufferers and a treatment history focusing on 'fixing' the problem. Men with FM struggled to find meaning in their experience. Some individuals were able to locate possible causes, but all the men were unable to fully understand their condition. The analysis suggested that the experience of FM varies for different men. The study reveals that FM is a complex experience characterised by loss, which sufferers and health care professionals struggle to understand. Implications for health care practice and further research are discussed. This study will help FM sufferers understand their condition more fully. Moreover, it should enrich the understanding of health care professionals - thereby facilitating encounters characterised by greater support and empathy for men with FM.

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Healthspan describes the length of time an individual lives without disability or chronic disease. Characteristic to aging is the risk for the onset of both through a progressive accumulation of deficits in normal physiologic function. In the past, the declines associated with aging were simply accepted as inevitable. Today, longevity research has undergone a meteoric rise in popularity. This is due to several landmark studies demonstrating that what was once thought of as inevitable has potential to be delayed. This thesis aims to consolidate current theories of biochemical processes believed to underlie aging, and explore their interconnections. Furthermore, current pharmaceutical and lifestyle interventions being studied to promote longevity and target these specific pathways will be analyzed for safety and practicality for use in a primary care setting. Through a shift from symptom-based care to personalized preventative care, the goal is to maximize function into older age and empower individuals to live life to the fullest well beyond what was previously imagined.

Child overweight has reached an epidemic level throughout the United States. A total of 65 primary care providers in southern Appalachia were surveyed to understand current issues in addressing child overweight in rural primary care practice. The study shows that while providers realized the importance of child overweight intervention, many were not ready and did little to address child overweight in their practices. The providers' skill levels in addressing child overweight were generally less than sufficient. Common barriers to child overweight treatment included lack of parental motivation and involvement, lack of supportive services, and lack of clinician time. In conclusion, rural primary care is facing many challenges in addressing child overweight. However, with more training in behavioral intervention skills and through establishing a family-based intervention and a group visit approach, primary care providers could play a more active role in the fight against the epidemic of child overweight.

BACKGROUND: Periodontitis is prevalent among adults 30 years and older and its prevalence increases with age. By 2040, there is an expected 50% increase in adults over the age of 65 years old in the US population. Therefore, it is essential to maintain good oral health and prevent tooth loss, pain, discomfort, and poor nutrition from improper chewing of food. Adults directly influence their periodontitis risk factors through at home oral care practices and smoking habits. Thus, the importance of home oral care practices and better choices in smoking habits may prevent the progression of periodontitis. The purpose of this study is to assess the association of at home oral care practices and smoking to periodontitis. The findings may be useful in future oral health education to emphasize the importance of oral hygiene care at home and smoking cessation. It may help dentists identify patients that will benefit from oral care instructions and smoking cessation and possibly aid in the development of prevention programs to combat the high prevalence of periodontitis in the foreseen growing population of the elders over the age of 65 in the U.S. OBJECTIVES: To assess the association of at home oral care practices to periodontitis and compare smokers and nonsmokers with respect to their oral care practices. We expect that people who regularly brush their teeth, floss, and use mouthwash twice or more per day, and who are nonsmokers will have less periodontitis. METHODS: Three categories of brushing: two to six times/week, once a day, or two or more/day in the past week were used. Additionally, three categories of flossing and rinsing: never, once to six times/week, or one or more times/day in the past week were also used. Odds ratio was calculated controlling for age, bone loss, gender, socioeconomic status, and smoking. Additionally, odds ratio was calculated for the oral care practices comparing smokers versus non-smokers. RESULTS: A total of 141 adults participated in the survey, 18% never flossed, 23% never rinsed, 6% brushed less than daily, and 35% had periodontitis. After controlling for variables, the lack of flossing was associated to periodontitis (odds ratio=1,88, 95% 1.00, p<0.0492) while rinsing and brushing were not associated with periodontitis. There were five times higher odds of periodontitis for a participant who never flossed compared to counterparts (95% CI 2.10-13.56). A dose response was not observed. After calculating for the odds ratio of the association of oral care practices to periodontitis among smokers versus non-smokers, the lack of flossing was positively associated with periodontitis such that smokers who never flossed had twice the higher odds of periodontitis compared to counterparts (odds ratio=4.20, CI 1.30-13.50, p<0.012). Participants who were smokers, with bone loss, and from low socioeconomic status had higher odds of having periodontitis. DISCUSSION: The lack of flossing was associated with higher prevalence of periodontitis. Smokers and especially daily smokers were more likely to engage in poor oral hygiene behaviors. Participants with bone loss, low socioeconomic status, and smokers were also associated with higher prevalence of periodontitis. Flossing at least once a week had a protective association to periodontitis. However, this was a cross-sectional study so a causal relation between the oral care practices and periodontitis cannot be established.