Objetivos: o objetivo do presente estudo é avaliar a resposta molares e não molares a dois protocolos de atenção periodontal na fase de manutenção periódica preventiva (MPP). Métodos: Sessenta e dois pacientes com periodontite moderada ou avançada (idade média 50.97 ± 9.26 anos, 40 mulheres, 24 fumantes) foram tratados de acordo com um protocolo não-cirúrgico. Finalizada a fase terapêutica, os pacientes iniciaram a fase de MPP e foram randomicamente alocados para receber controle supragengival isolado (SPG) ou combinado ao subgengival (SPG+SBG). Exames periodontais, instruções de higiene bucal e as respectivas intervenções experimentais foram realizados em consultas trimestrais. Resultados: não foram observadas diferenças significativas nas variáveis demográficas, número médio de dentes e distribuição média de dentes não-molares/molares e de sítios livres/proximais entre os dois grupos experimentais. Quando do baseline, os dentes molares apresentaram um maior número de sítios positivos para IPV, ISG, SS e maiores valores médios de PS e PI quando comparados aos não-molares (p<0.001). Ao longo da fase de MPP, foi demonstrado que independente da terapia aplicada, tanto para molares e não molares, a resposta para ambos os grupos dentários não foi diferente. Da mesma forma, a perda dentária entre molares e não molares não diferiu ao longo de 24 meses. Conclusões: Molares apresentam semelhante resposta durante a fase de MPP quando comparados a dentes não molares, independente do protocolo de intervenção clínica aportado. / Aim: The objective of the present study was to evaluate the response of molar teeth and non-molar teeth to two periodontal care protocols in the periodic preventive maintenance phase (PMP). METHODS: Sixty-two patients with moderate or advanced periodontitis (mean age 50.97 ± 9.26 years, 40 women, 24 smokers) were treated according to a non-surgical protocol. After the therapeutic phase, the patients started the PMP and were randomly assigned to receive supragingival (SPG) or combined subgengival (SPG + SBG) control. Periodontal examinations, oral hygiene instructions and the respective experimental interventions were performed in quarterly consultations. Results: There were no significant differences in demographic variables, mean number of teeth and mean distribution of non-molar / molar teeth and free / proximal sites between the two experimental groups. At the baseline, molar teeth had a higher number of positive sites for VPI, GBI, BOP and higher mean values of PPD and CAL when compared to non-molars (p <0.001). Throughout the MPP phase, it was demonstrated that regardless of the applied therapy, for both molars and non-molars, the response for both dental groups was not different. Likewise, tooth loss between molars and non-molars did not differ over 24 months. Conclusions: Molars presented a similar response during the PMP when compared to non-molar teeth, independent of the protocol of clinical intervention provided.

Florence O. Holmes, for the Masters Of Science Degree in Behavioral Analysis and Therapy, presented on July, 2015, at Southern Illinois University Carbondale. TITLE: ACCEPTABILITY OF INTERVENTIONS OF STAFF IN SHORT TERM CARE SETTING FOR CHILDREN WITH BEHAVIORAL HEALTH ISSUES COMPARING RATING AND HIERARCHICAL SELECTION MAJOR PROFESSOR: Dr. Mark Dixon, Ph.D. The present study asked twenty active treatment team members, in a children’s behavioral health hospital in Springfield, IL to answer a pen and paper survey. This study extended research on treatment acceptability by replicating, Baker and LeBlanc (2011), who compared ratings and hierarchical selections in a long term care facility with older adults. Specifically, participants were given the opportunity to rate treatments using a treatment acceptability survey, and were then given a choice (i.e., asked to select which they would be most comfortable implementing) between various treatment options with using a variety of scenarios and choices. In this study it was interesting to find that though an individual selected a treatment as being a good treatment, when asked what they would feel comfortable using in a pinch did not always match what they related as being acceptable. In comparison the results of Baker and LeBlanc are very similar to the current study. In contrast, the rating for the behavioral intervention was higher in the present study and was also selected much more than in Baker and LeBlanc. Baker and LeBlanc reported statistically significant correlations between selections and ratings. Although this study did not recruit enough participants to allow for a statistical analysis, 50% of the participants in this study had a match for what they rated the highest compared to what they selected the most.

Objetivos: o objetivo do presente estudo é avaliar a resposta molares e não molares a dois protocolos de atenção periodontal na fase de manutenção periódica preventiva (MPP). Métodos: Sessenta e dois pacientes com periodontite moderada ou avançada (idade média 50.97 ± 9.26 anos, 40 mulheres, 24 fumantes) foram tratados de acordo com um protocolo não-cirúrgico. Finalizada a fase terapêutica, os pacientes iniciaram a fase de MPP e foram randomicamente alocados para receber controle supragengival isolado (SPG) ou combinado ao subgengival (SPG+SBG). Exames periodontais, instruções de higiene bucal e as respectivas intervenções experimentais foram realizados em consultas trimestrais. Resultados: não foram observadas diferenças significativas nas variáveis demográficas, número médio de dentes e distribuição média de dentes não-molares/molares e de sítios livres/proximais entre os dois grupos experimentais. Quando do baseline, os dentes molares apresentaram um maior número de sítios positivos para IPV, ISG, SS e maiores valores médios de PS e PI quando comparados aos não-molares (p<0.001). Ao longo da fase de MPP, foi demonstrado que independente da terapia aplicada, tanto para molares e não molares, a resposta para ambos os grupos dentários não foi diferente. Da mesma forma, a perda dentária entre molares e não molares não diferiu ao longo de 24 meses. Conclusões: Molares apresentam semelhante resposta durante a fase de MPP quando comparados a dentes não molares, independente do protocolo de intervenção clínica aportado. / Aim: The objective of the present study was to evaluate the response of molar teeth and non-molar teeth to two periodontal care protocols in the periodic preventive maintenance phase (PMP). METHODS: Sixty-two patients with moderate or advanced periodontitis (mean age 50.97 ± 9.26 years, 40 women, 24 smokers) were treated according to a non-surgical protocol. After the therapeutic phase, the patients started the PMP and were randomly assigned to receive supragingival (SPG) or combined subgengival (SPG + SBG) control. Periodontal examinations, oral hygiene instructions and the respective experimental interventions were performed in quarterly consultations. Results: There were no significant differences in demographic variables, mean number of teeth and mean distribution of non-molar / molar teeth and free / proximal sites between the two experimental groups. At the baseline, molar teeth had a higher number of positive sites for VPI, GBI, BOP and higher mean values of PPD and CAL when compared to non-molars (p <0.001). Throughout the MPP phase, it was demonstrated that regardless of the applied therapy, for both molars and non-molars, the response for both dental groups was not different. Likewise, tooth loss between molars and non-molars did not differ over 24 months. Conclusions: Molars presented a similar response during the PMP when compared to non-molar teeth, independent of the protocol of clinical intervention provided.

Objetivos: Comparar o efeito do controle estrito do biofilme supragengival (SUPRA), em comparação ao controle combinado dos biofilmes supra e subgengival (SUPRA+SUB), na microbiota subgengival de pacientes durante a fase de manutenção periódica preventiva (MPP), ao longo de 1 ano. Materiais e métodos: Sessenta e dois pacientes com periodontite moderada ou avançada (idade média 50.97 ± 9.26 anos, 40 mulheres, 24 fumantes) foram tratados de acordo com um protocolo não-cirúrgico. Finalizada a fase terapêutica, os pacientes iniciaram a fase de MPP e foram randomicamente alocados para receber a intervenção SUPRA ou SUPRA+SUB. Exames periodontais, instruções de higiene bucal, e as respectivas intervenções (SUPRA ou SUPRA+SUB) foram realizados em consultas trimestrais. Biofilme subgengival foi coletado ao baseline, 3, 6 e 12 meses. Técnica de PCR em Tempo Real foi utilizada para quantificar as espécies bacterianas Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf), e o domínio Eubacteria (Bactérias totais). Equações de estimação generalizadas foram usadas para se estimar os efeitos dos tratamentos considerando-se a avaliação longitudinal. Resultados: Não foram observadas diferenças significativas entre os grupos para as contagens de Pg, Td, Tf, e Bactérias totais ao longo de 1 ano. Contudo, a partir dos 3 meses, as contagens de Pg e Tf aumentaram significativamente em ambos os grupos. As contagens de Bactérias totais e Td foram mantidas longitudinalmente. Por outro lado, as contagens médias das espécies bacterianas alvo permaneceram em baixos níveis (≤ 103) durante todo o estudo. Paralelamente, os parâmetros clínicos foram mantidos sem alterações significativas. Conclusões: As intervenções de manutenção investigadas produziram resultados microbiológicos semelhantes ao longo do tempo, o que demonstra o grande e importante impacto do controle do biofilme supragengival durante a fase de MPP. / Aim: Compare the effects of supragingival scaling alone (SPG) against the combined supra and subgingival scaling (SPG+SBG), on subgingival microbiota from patients during periodontal maintenance period (PMP), along 1 year. Material and Methods: Sixty-two patients with moderate or severe periodontitis (mean age 50.97 ± 9.26, 40 females, 24 smokers) were treated according to a non-surgical protocol. Ended the therapy phase, they entered a PMP and were randomly allocated to receive SPG or SPG+SBG interventions. Periodontal exams, oral hygiene instructions, and the respective intervention (SPG or SPG+SBG) were performed at quarterly appointments. Subgingival biofilm was sampled at baseline, 3, 6 and 12 months. Real-time PCR technique was used to quantify the bacteria species Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf), and Eubacteria domain (Total bacteria). Generalized estimating equations were used to estimate treatment effects while accounting for longitudinal evaluation. Results: No significant inter-groups differences were observed to Pg, Td, Tf, and Total bacteria counts over 1 year. However, from 3 months onward, Pg and Tf counts increased significantly in both groups. Total bacteria and Td counts were maintained overtime. Still, the mean counts of target bacteria species remained at low levels (≤ 103) throughout the study. In parallel, the clinical parameters were maintained without significant changes. Conclusions: The PMP interventions yielded similar microbiological results along time, demonstrating the great impact and importance of supragingival biofilm control during PMP.

As the population ages, policymakers struggle to cope with the increasing demands for home care and institutional long-term care. This thesis project focuses on factors associated with the transition from home to institutional care for people with dementia. Using health administrative data at a population level, we construct a multivariable model that estimates the time between home care initiation after dementia diagnosis and placement in a long-term care home. From the model, we identify protective factors that allow people with dementia to remain at home for longer, with a particular emphasis on the health workforce and the contribution of formal and informal caregivers to delaying the transition from home to institutional care. Together, these results inform policymakers in capacity planning and in determining where investments should be targeted to maintain people with dementia at home, along with the associated health workforce implications.

Objetivos: Comparar o efeito do controle estrito do biofilme supragengival (SUPRA), em comparação ao controle combinado dos biofilmes supra e subgengival (SUPRA+SUB), na microbiota subgengival de pacientes durante a fase de manutenção periódica preventiva (MPP), ao longo de 1 ano. Materiais e métodos: Sessenta e dois pacientes com periodontite moderada ou avançada (idade média 50.97 ± 9.26 anos, 40 mulheres, 24 fumantes) foram tratados de acordo com um protocolo não-cirúrgico. Finalizada a fase terapêutica, os pacientes iniciaram a fase de MPP e foram randomicamente alocados para receber a intervenção SUPRA ou SUPRA+SUB. Exames periodontais, instruções de higiene bucal, e as respectivas intervenções (SUPRA ou SUPRA+SUB) foram realizados em consultas trimestrais. Biofilme subgengival foi coletado ao baseline, 3, 6 e 12 meses. Técnica de PCR em Tempo Real foi utilizada para quantificar as espécies bacterianas Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf), e o domínio Eubacteria (Bactérias totais). Equações de estimação generalizadas foram usadas para se estimar os efeitos dos tratamentos considerando-se a avaliação longitudinal. Resultados: Não foram observadas diferenças significativas entre os grupos para as contagens de Pg, Td, Tf, e Bactérias totais ao longo de 1 ano. Contudo, a partir dos 3 meses, as contagens de Pg e Tf aumentaram significativamente em ambos os grupos. As contagens de Bactérias totais e Td foram mantidas longitudinalmente. Por outro lado, as contagens médias das espécies bacterianas alvo permaneceram em baixos níveis (≤ 103) durante todo o estudo. Paralelamente, os parâmetros clínicos foram mantidos sem alterações significativas. Conclusões: As intervenções de manutenção investigadas produziram resultados microbiológicos semelhantes ao longo do tempo, o que demonstra o grande e importante impacto do controle do biofilme supragengival durante a fase de MPP. / Aim: Compare the effects of supragingival scaling alone (SPG) against the combined supra and subgingival scaling (SPG+SBG), on subgingival microbiota from patients during periodontal maintenance period (PMP), along 1 year. Material and Methods: Sixty-two patients with moderate or severe periodontitis (mean age 50.97 ± 9.26, 40 females, 24 smokers) were treated according to a non-surgical protocol. Ended the therapy phase, they entered a PMP and were randomly allocated to receive SPG or SPG+SBG interventions. Periodontal exams, oral hygiene instructions, and the respective intervention (SPG or SPG+SBG) were performed at quarterly appointments. Subgingival biofilm was sampled at baseline, 3, 6 and 12 months. Real-time PCR technique was used to quantify the bacteria species Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf), and Eubacteria domain (Total bacteria). Generalized estimating equations were used to estimate treatment effects while accounting for longitudinal evaluation. Results: No significant inter-groups differences were observed to Pg, Td, Tf, and Total bacteria counts over 1 year. However, from 3 months onward, Pg and Tf counts increased significantly in both groups. Total bacteria and Td counts were maintained overtime. Still, the mean counts of target bacteria species remained at low levels (≤ 103) throughout the study. In parallel, the clinical parameters were maintained without significant changes. Conclusions: The PMP interventions yielded similar microbiological results along time, demonstrating the great impact and importance of supragingival biofilm control during PMP.

In this contribution, we investigate the relationships between paid and unpaid work in the lifeworlds of employed informal carers against the background of the Austrian long-term care regime. We pursue a twofold argument: On the one hand, we emphasize that combining paid and unpaid work currently poses serious difficulties for employed family carers in their everyday lives and impacts their current and future financial and social security. On the other hand, we argue that the relationships between employment and informal care are in fact not well understood by the common concepts of "reconciliation" or "work-life balance". These concepts are not able to explain the complexities of employed carers' lived realities and fail to adequately address the fundamental contradiction in the idea of a "reconciliation" of paid and unpaid work.

Master of Science / Department of Hotel, Restaurant, Institution Management and Dietetics / Carol W. Shanklin / The purposes of this study were to explore factors associated with residents’ dining experience in assisted living facilities and to investigate the influence that these factors had on perceived quality and residents’ satisfaction with their dining experience. Food quality, service quality, mealtime customization, and dining room environment were the four constructs explored. Focus groups were conducted with residents of three assisted living facilities to determine attributes of the constructs that were important to them. A total of 22 residents participated in the three focus groups. A questionnaire developed by Huang was revised to include measurement items identified in the focus groups. The questionnaire was distributed to residents of 16 randomly selected assisted living facilities within a 110 mile radius of the research institution. Of the 492 residents in 16 facilities, 246 completed the questionnaire for a response rate of 50%. Residents evaluated the attributes on a 5-point likert scale (1-strongly disagree; 5-strongly agree). Service quality (4.03) and dining room environment (3.97) attributes were rated significantly higher than food quality (3.64) and customization attributes (3.42). Resident satisfaction also was evaluated on a 5-point scale (1-very dissatisfied; 5-very satisfied). Residents were satisfied with the overall dining experience (3.94) and the overall facility (3.97). Residents were less satisfied with food served (3.67) or the amount of choices they had at meals (3.58). Residents were satisfied with services (3.95) and the dining room atmosphere (3.98). Satisfaction with services and the dining room atmosphere were significantly higher than food served and amount of choices at mealtimes. Residents’ perceptions of food quality, service quality, level of customization, and dining room environment had a positive influence on their satisfaction with the overall dining experience. Residents’ perceptions of food quality had a positive influence on satisfaction with the food served, service quality impacted satisfaction with services, level of customization effected satisfaction with the amount of choices, and dining room environment influenced satisfaction with the dining room atmosphere. Administrators, foodservice directors, and dietitians employed in assisted living facilities can use the results to improve the dining experience for residents and ultimately improve residents’ quality of life.

Objectives: To develop and validate a survey that can be used to measure key infection prevention and control (IP&C) structures and processes in LTC facilities. Methods: This study was designed using a three-phase methodology. In Phase I, six structural and process composite indices were developed based on the 2004 PHAC recommendations for IP&C in LTC and other literature. During the second phase of the study, a group of 7 experts in LTC IP&C used the Delphi methodology to validate and further develop the survey based on group consensus. Five Safety Principles published by the Institute of Medicine were also provided to the experts so they could be used to complement and further develop the concepts covered by the survey. The Delphi phase began in April and ended in October 2007; 114 worksheets were sent to experts to support the consensus-reaching process. Once the validity of a survey draft had been established based on expert-group consensus, it was pilot-tested in Phase III using 20 randomly selected LTC facilities in Fraser Health. Findings: The three-phase methodology used in this study was very useful and innovative way to further develop and validate the literature-based survey developed in Phase I for IP&C in long term care. In addition, by merging two bodies of knowledge and thought into the process, concepts and components that are not explicitly described in IP&C literature yet were felt to be key in program success, were incorporated into the measurement tool. Using Delphi, the experts expressed a need for IP&C professionals working in LTC to increase their knowledge, understanding and use of safety theory and strategies. They also felt that interdisciplinary work, the development of a culture of safety, and the development clear and simple IP&C systems are key ways in which infections can be prevented and outbreaks quickly controlled. In Phase III, the pilot-study analysis demonstrated the utility, validity and reliability of the survey. In addition, the analysis showed that there is a tendency for facilities to have lower levels of components within the Leadership Index and the ICP Index. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

The purpose of this study is to learn about the professional development practices of physiotherapists working in long-term care homes in Ontario. A survey was created based on relevant literature and piloted for this study. The survey included both quantitative and open-ended questions. 44 Physiotherapist responded, which represents approximately 10% of physiotherapists working in long-term care in Ontario. The results indicate that physiotherapists are isolated from their physiotherapist peers and lack access to communities of practice, professional socialisation, professional culture and social regulation. Although physiotherapists’ interactions with interprofessional teams added breadth to their knowledge, these interactions did not enhance their profession-specific skills. Many physiotherapists are seeking professional community and social supports in healthcare settings outside of the long-term care context. The implications of this study are that physiotherapists, their professional associations, and their college must understand the importance of professional socialization in learning, and ensure that physiotherapists working in long-term care have access to and seek such social support. Physiotherapy service providers in long-term care should provide mentoring, support and opportunities for social learning for their clinicians. Finally, long-term care homes and the Ministry of Health and Long-term care need to ensure that policies provide a better definition of the role of physiotherapists in long-term care.