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Ramos TMC, da Silva Alves ÁA, Apolinário TA, de Toledo FF, Gomes VE, Barbosa KGN, Sampaio AA, Ferreira RC. Challenges to conducting research on oral health with older adults living in long-term care facilities. BMC Oral Health 2024; 24:422. [PMID: 38580950 PMCID: PMC10998329 DOI: 10.1186/s12903-024-04204-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/29/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The challenges to conducting oral health studies involving older people in long-term care facilities (LTCFs) must be debated. OBJECTIVE This study aimed to investigate researchers' perceptions and experiences while conducting an epidemiological survey on oral health among older individuals residing in LTCFs. METHODS A qualitative study was conducted involving six researchers who utilized field diaries to record their impressions during data collection through interviews (older individuals (or their proxies), caregivers, and LTCF coordinators) and oral examinations of the older people participants. Additionally, researchers responded to open-ended questions about their experiences. The collected material was subjected to content analysis by two researchers. RESULTS The themes that emerged from the analysis were institutional context, aspects affecting the operationalization of the study, and data collection oriented by the clinical-functional profile of the older people. According to the researchers' perceptions, LTCF coordinators demonstrated concern for the study's benefits for older adults and the preservation of institutional routines during the research process. Caregivers emerged as vital sources of information, guiding researchers in navigating the challenges posed by the physical and mental complexities of the older people participants, necessitating empathy, sensitivity, and attentive listening from the researchers. The organization of materials and a streamlined data collection process proved essential for optimizing time efficiency and reducing stress for participants and researchers. CONCLUSION The researchers recognized the important role played by LTCF coordinators and formal caregivers, underscoring the significance of empathetic methodologies and streamlined data collection processes in mitigating the challenges inherent to research conducted within LTCFs.
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Affiliation(s)
- Thayse Mayra Chaves Ramos
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | - Álvaro Augusto da Silva Alves
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thais Andrade Apolinário
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Flávia Fonseca de Toledo
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Viviane Elisângela Gomes
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kevan Guilherme Nóbrega Barbosa
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline Araújo Sampaio
- Department of Clinical, Pathology and Surgical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Raquel Conceição Ferreira
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Parisius KGH, Verhoeff MC, Lobbezoo F, Avivi-Arber L, Duyck J, Hirano H, Iijima K, Janssens B, Kossioni A, Lin CS, McKenna G, Müller F, Schimmel M, Visser A, Watanabe Y, Gobbens RJJ. Towards an operational definition of oral frailty: A e-Delphi study. Arch Gerontol Geriatr 2024; 117:105181. [PMID: 37713933 DOI: 10.1016/j.archger.2023.105181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVES Building upon our recently developed conceptual definition of oral frailty (the age-related functional decline of orofacial structures), this e-Delphi study aims to develop an operational definition of oral frailty by identifying its components. METHODS We used a modified e-Delphi study to reach a consensus among international experts on the components of oral frailty. Twelve out of fifteen invited experts in the field of gerodontology participated. Experts responded to three rounds of an online 5-point scale questionnaire of components to be included or excluded from the operational definition of oral frailty. After each round, scores and rationales were shared with all experts, after which they could revise their position. A consensus was reached when at least 70% of the experts agreed on whether or not a component should be included in the operational definition of oral frailty. RESULTS The experts achieved a high level of agreement (80 - 100%) on including eight components of oral frailty and excluding nineteen. The operational definition of oral frailty should include the following components: 1) difficulty eating hard or tough foods, 2) inability to chew all types of foods, 3) decreased ability to swallow solid foods, 4) decreased ability to swallow liquids, 5) overall poor swallowing function, 6) impaired tongue movement, 7) speech or phonatory disorders, and 8) hyposalivation or xerostomia. CONCLUSION This e-Delphi study provided eight components that make up the operational definition of oral frailty. These components are the foundation for the next stage, which involves developing an oral frailty assessment tool.
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Affiliation(s)
- Karl G H Parisius
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam, The Netherlands; Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, The Netherlands.
| | - Merel C Verhoeff
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam, The Netherlands
| | | | - Joke Duyck
- Department of Oral Health Sciences, KU Leuven, Belgium
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute for Geriatrics and Gerontology, Japan
| | - Katsuya Iijima
- Institute for Future Initiatives, Institute of Gerontology, The University of Tokyo, Japan
| | - Barbara Janssens
- Department of Oral Health Sciences, Gerodontology, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University, Belgium
| | - Anastassia Kossioni
- Division of Gerodontology, Department of Prosthodontics, Dental School, National and Kapodistrian University of Athens, Greece
| | - Chia-Shu Lin
- Department of Dentistry, National Yang Ming Chiao Tung University, Taiwan
| | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, Northern Ireland United Kingdom
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthdontics, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthdontics, University Clinics of Dental Medicine, University of Geneva, Switzerland; Department of Reconstructive Dentistry and Gerodontology, school of Dental Medicine, University of Bern, Switzerland
| | - Anita Visser
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University of Groningen, The Netherlands; University Medical Center Groningen, The Netherlands; Department for Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Centre, The Netherlands
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan
| | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, The Netherlands; Zonnehuisgroep Amstelland, The Netherlands; Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium; Department of Tranzo Academic Centre for Transformation in Care and Welfare, Faculty of Behavioural and Social Sciences, Tilburg University, The Netherlands
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Kengne Talla P, Rodrigues A, Hachey S, Affoo R, Basiren Q, Bouferguene S, Syed M, Emami E. Oral health care and living environment for older people: a scoping review protocol. JBI Evid Synth 2024; 22:314-324. [PMID: 37799097 DOI: 10.11124/jbies-22-00415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
OBJECTIVE This scoping review will map the literature on the extent of knowledge on living environment oral health care (LIVEOR) by examining its different terminologies, its description, the stakeholders involved, the implementation characteristics, and the outcomes reported by the authors. INTRODUCTION Older people want to receive oral health care in their current living environment. Although several authors have explored some aspects of LIVEOR for older people, there are still inconsistent findings regarding the extent of this model of care. INCLUSION CRITERIA This scoping review will include quantitative, qualitative, and mixed method studies, as well as any type of knowledge synthesis on LIVEOR involving people aged 60 years and over. The search will not be limited by language, time frame, geographic location, or publication date. METHODS We will use the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). The search will include MEDLINE, CINAHL, Embase, Web of Science, and the Cochrane Library. A hand-search of the references of the included studies, and a gray literature search will also be conducted. Two independent reviewers will screen titles, abstracts, and full texts of selected studies, and perform data extraction. Findings are expected to explore what is known of LIVEOR targeting older people and to identify any knowledge gaps for future studies. We will disseminate our findings mostly through peer-reviewed publications. REVIEW REGISTRATION Open Science Framework https://osf.io/e7fm2.
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Affiliation(s)
- Pascaline Kengne Talla
- Faculty of Dental Medicine and Oral Health Sciences, Université McGill University, Montreal, QC, Canada
| | - Anisha Rodrigues
- Faculty of Dental Medicine and Oral Health Sciences, Université McGill University, Montreal, QC, Canada
| | - Shauna Hachey
- School of Dental Hygiene, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
| | - Rebecca Affoo
- School of Communication Sciences and Disorders, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Quentin Basiren
- Faculty of Dental Medicine and Oral Health Sciences, Université McGill University, Montreal, QC, Canada
| | - Sabrina Bouferguene
- Faculty of Dental Medicine and Oral Health Sciences, Université McGill University, Montreal, QC, Canada
| | - Mahidul Syed
- Faculty of Dental Medicine and Oral Health Sciences, Université McGill University, Montreal, QC, Canada
| | - Elham Emami
- Faculty of Dental Medicine and Oral Health Sciences, Université McGill University, Montreal, QC, Canada
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Tepox-Puga SM, Rocha-Ortiz JA, Medina-Solís CE, Castrejón-Pérez RC, Sánchez-García S, Borges-Yáñez SA. Prevalence, and Risk Indicators of Coronal and Root Caries in Mexican Older Adults in Nursing Homes. Clin Cosmet Investig Dent 2023; 15:333-347. [PMID: 38107875 PMCID: PMC10723588 DOI: 10.2147/ccide.s439342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023] Open
Abstract
Background Several factors are associated with coronal and root caries in older persons. The purpose of this study was to determine the experience, prevalence, and risk indicators (socioeconomic, sociodemographic, and dental variables) of coronal and root caries in older persons residing in nursing homes in Mexico. Methods A cross-sectional study was carried out in 227 dentate participants with natural teeth. Convenience sample, where all dentate residents were invited to participate. The dependent variables were coronal caries and root caries, which were determined through an oral clinical examination. The independent variables were sociodemographic factors, location, type of center, surfaces free of dental biofilm and calculus, surfaces with recession, retainers in contact with surfaces with recession, xerostomia, smoking, and the previous use of dental services. The binary logistic regression model was used in the analysis. Results The mean age of the participants in this study was 77.7±8.8 years, and 69.2% were women. Moreover, 71.8% live in long-term care facilities, and 48.0% live in Mexico City. The prevalence of coronal and root caries was found to be 67.8% and 50.7%, respectively. Being male and living in Mexico City were risk indicators for coronal caries, and with a 1% increase in surfaces with no biofilm, the risk decreased by 2%. Being widowed, having government or no social security, denture retainers, and coronal caries were risk indicators for root caries, while the utilization of dental services indicated lower risk. Conclusion Several variables that differ in nature were found to be risk indicators for coronal and root caries. Coronal caries increases the risk of root caries. Prevention should be aimed at identifying persons at higher risk, and dental care should be improved for persons living in long-term care institutions.
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Affiliation(s)
| | | | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry, Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca, Mexico
| | - Roberto Carlos Castrejón-Pérez
- Department of Geriatric Clinical and Epidemiological Research, National Institute of Geriatrics, National Institutes of Health, México City, México
| | - Sergio Sánchez-García
- Epidemiological and Health Services Research Unit, Aging Area, National Medical Center “Siglo XXI”, Mexican Institute of Social Security, Ciudad de Mexico, Mexico
| | - Socorro Aída Borges-Yáñez
- Department of Dental Public Health, Graduate and Research Division, Dental School, National Autonomous University of Mexico, University City, México City, Mexico
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Karkada D, D'Costa VG, Acharya S. Do residential care and low social capital negatively influence oral health-related quality of life (OHRQoL) among older adults? A cross-sectional study. Gerodontology 2023; 40:39-46. [PMID: 34927278 DOI: 10.1111/ger.12614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To compare oral health status, OHRQoL and social capital between dependent older adults living in a residential care setting (RC) and community dwellers living independently (CD) and to assess the possible role of social capital and residential status as independent predictors of OHRQoL in a sample of older adults in the Udupi region of Karnataka, South India. BACKGROUND As the global population ages, a greater number of older adults are now living in residential care settings than ever before. This study provides insights into the role of residential care and social capital in influencing the oral health-related quality of life (OHRQoL) among older adults. MATERIALS AND METHODS A total of 296 older adults, comprising 148 dependent older adults living in residential care (RC) and 148 community dwelling older adults living independently (CD), completed the General Oral Health Assessment Index (GOHAI) and a Social Capital Scale after undergoing clinical oral examination for dentition and periodontal status. RESULTS The caries experience in both the residential care group (RC) and the community dwelling group (CD) was high with mean DMF scores of 21.6 (SD = 9.6) and 20.1 (SD = 10.7) respectively. The Mean Social Capital score was significantly higher (P = .01) among the RC group (33.2, SD = 5.1) than the CD group (31.5, SD = 5.7), whereas the mean GOHAI score was significantly higher (P = .02) among the CD (61.5, SD = 6.8) than the RC group (59.5, SD = 7.9). Linear regression showed lower DMFT scores (β: -0.26, P ˂ .001), being a community dweller (β: 0.14, P = .01) and having higher social capital (β: 0.11, P = .04) were associated with better OHRQoL (higher GOHAI scores) after adjusting for possible confounders. CONCLUSION Dependent older adults living in residential care had higher social capital but poorer OHRQoL. Caries experience, residential status and social capital were independently associated with OHRQoL.
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Affiliation(s)
- Deeksha Karkada
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Valerie Gloria D'Costa
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Shashidhar Acharya
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
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Rocha-Ortiz JA, Tepox-Puga SM, Borges-Yañez SA, Mendoza-Rodríguez M, Escoffié-Ramirez M, Minaya-Sánchez M, Casanova-Rosado JF, Casanova-Rosado AJ, Pontigo-Loyola AP, Medina-Solis CE. Tooth Loss and Associated Factors in Mexican Older Adults in Nursing Homes: A Multicenter Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2023; 2023:4169097. [PMID: 37096226 PMCID: PMC10122601 DOI: 10.1155/2023/4169097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/07/2023] [Accepted: 02/18/2023] [Indexed: 04/26/2023]
Abstract
The objective of this study was to determine the experience of tooth loss and associated factors in older adults and elderly residing in nursing homes. A cross-sectional study was conducted in Mexican older adults and elderly aged ≥60 years living in four nursing homes (two in Mexico City, Mexico: one in Cuernavaca, Morelos, and one in Oaxaca, Oaxaca). The data were collected at the facility (home nursing) by two dentists in 2019. To determine the number of tooth loss and DMFT, a clinical oral examination was performed. In addition, a questionnaire was applied to determine diverse independent variables (demographic, socioeconomic, and behavioral). The analysis was performed using nonparametric tests and negative binomial regression (p < 0.05). 257 subjects were included. The mean age was 81.25 ± 9.02 years, and 60.7% were women. The mean number of lost teeth was 18.78 ± 9.05 (women = 19.43 ± 8.59 and men = 17.77 ± 9.68; p > 0.05). In the multivariate negative binomial regression model, it was found that, for each one-year increase in age, the mean tooth loss increased 0.92% (p < 0.05). In current smokers (p < 0.01) and in those who brush their teeth < 2 times a day (p < 0.01), the average of tooth loss increased 22.04% and 61.46%, respectively. The experience of tooth loss in Mexican older adults and elderly was high. Demographic (age) and habit of behavior (tobacco use and less frequent tooth brushing) were associated with increased tooth loss. It is important to promote oral health programs for institutionalized older adults.
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Affiliation(s)
- Jesús Alberto Rocha-Ortiz
- Master and Doctoral Program in Medical, Dental and Health Sciences at the School of Dentistry, National Autonomous University of México, 04510 Mexico City, Mexico
| | - Sandra Manuela Tepox-Puga
- Master and Doctoral Program in Medical, Dental and Health Sciences at the School of Dentistry, National Autonomous University of México, 04510 Mexico City, Mexico
| | - S. Aída Borges-Yañez
- Dental Public Health Department, Graduate and Research Division at the School of Dentistry, National Autonomous University of México, 04510 Mexico City, Mexico
| | - Martha Mendoza-Rodríguez
- Academic Area of Dentistry of Institute of Health Sciences at Autonomous University of Hidalgo State, 42160 Pachuca, Mexico
| | | | | | | | | | | | - Carlo Eduardo Medina-Solis
- Academic Area of Dentistry of Institute of Health Sciences at Autonomous University of Hidalgo State, 42160 Pachuca, Mexico
- Advanced Studies and Research Center in Dentistry “Dr. Keisaburo Miyata” of School of Dentistry at Autonomous University State of Mexico, Toluca, Mexico
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Lopes S, Tavares V, Mascarenhas P, Lopes M, Cardote C, Godinho C, Oliveira C, Santos CA, Oom M, Grillo-Evangelista J, Fonseca J. Oral Health Status of Adult Dysphagic Patients That Undergo Endoscopic Gastrostomy for Long Term Enteral Feeding. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084827. [PMID: 35457695 PMCID: PMC9028949 DOI: 10.3390/ijerph19084827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/09/2022] [Accepted: 04/13/2022] [Indexed: 12/03/2022]
Abstract
Background: Endoscopic Gastrostomy (PEG) is required to maintain a feeding route when neurological or cancer dysphagia impact oral intake. This study aimed to evaluate the oral health and oral changes of PEG-patients without oral feeding for three months. Methods: Prospective observational study, with a PEG-patients convenience sample. Data were obtained before PEG (T0) and 3 months after gastrostomy (T1). Initial oral hygiene habits were collected through a questionnaire. Intra-oral evaluation was performed using: Plaque Index (IP), Gingival Index (IG), Decayed, Missing and Filled Teeth Index (DMF), Community Periodontal Index (CPI), and Attachment Loss (AL). T0 and T1 were compared to evaluate oral health evolution. Results: Thirty-nine patients aged 65.3 ± 17.4 years were included. Initial (T0) oral health was worse than expectable. Between assessments period, oral indexes suffered a general deterioration with statistical relevance to the DMF. The frequency of deep periodontal pockets and attachment loss remained stable. Conclusions: PEG-patients presented poor oral health and insufficient oral hygiene habits, even before gastrostomy. After three months of PEG feeding, oral health suffered a general deterioration. This outcome was probably associated with the absence of oral feeding activity, which is beneficial to oral homeostasis, and further reduced oral hygiene. Improved oral daily care and dental appointments should become part of the PEG-patients follow-up.
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Affiliation(s)
- Sara Lopes
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (V.T.); (M.L.); (C.C.); (M.O.); (J.G.-E.)
| | - Vitor Tavares
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (V.T.); (M.L.); (C.C.); (M.O.); (J.G.-E.)
| | - Paulo Mascarenhas
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal; (P.M.); (C.G.)
| | - Marta Lopes
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (V.T.); (M.L.); (C.C.); (M.O.); (J.G.-E.)
| | - Carolina Cardote
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (V.T.); (M.L.); (C.C.); (M.O.); (J.G.-E.)
| | - Catarina Godinho
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal; (P.M.); (C.G.)
| | - Cátia Oliveira
- Artificial Feeding Team (GENE), Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal; (C.O.); (C.A.S.)
| | - Carla Adriana Santos
- Artificial Feeding Team (GENE), Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal; (C.O.); (C.A.S.)
| | - Madalena Oom
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (V.T.); (M.L.); (C.C.); (M.O.); (J.G.-E.)
| | - José Grillo-Evangelista
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz (IUEM), 2829-511 Almada, Portugal; (S.L.); (V.T.); (M.L.); (C.C.); (M.O.); (J.G.-E.)
| | - Jorge Fonseca
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), 2829-511 Almada, Portugal; (P.M.); (C.G.)
- Artificial Feeding Team (GENE), Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal; (C.O.); (C.A.S.)
- Correspondence:
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Impact of an Oral Hygiene Intervention in People with and without Dementia on Oral Health Parameters-Results from the Oral Health, Bite Force, and Dementia (OrBiD) Pilot Study. J Clin Med 2022; 11:jcm11051356. [PMID: 35268447 PMCID: PMC8911423 DOI: 10.3390/jcm11051356] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 12/20/2022] Open
Abstract
This study aimed to assess the influence of an oral hygiene intervention on oral health, depending on the degree of dementia. A clinical evaluation of oral health parameters (index of decayed, missing, and filled teeth (DMFT-index), periodontal screening index (PSI), oral hygiene index (OHI), and bleeding on probing (BOP)) was performed in 120 subjects assigned to five groups, based on the mini mental state examination (MMSE) at baseline and after 12 months. Each MMSE group (no dementia (noDem, MMSE 28–30), mild cognitive impairment (mCI, MMSE 25–27), mild dementia (mDem, MMSE 18–24), moderate dementia (modDem, MMSE 10–17), and severe dementia (sDem, MMSE ≤ 9)) was split into control (no intervention) and experimental groups (intervention on oral hygiene: increased frequency, daily usage of high-fluoride toothpaste). In total, 99 out of 120 subjects were included in the analysis. The dropout rate was high in subjects with modDem and sDem due to death. In subjects with noDem, mCI, and mDem, no changes in the DMFT were found, but improvements in the OHI, BOP, and PSI were observed. Subjects with modDem or sDem demonstrated a deterioration in DMFT; however, in these patients, OHI improved in all control and experimental groups, BOP improved in the experimental group only, and PSI did not improve at all. The scope of improving oral health parameters by increasing the recall frequency and by continuously using high fluoride toothpaste is at its limits in people with severe dementia. Multidimensional approaches should be sought to improve the oral health of vulnerable older patients.
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Parisius KG, Wartewig E, Schoonmade LJ, Aarab G, Gobbens R, Lobbezoo F. Oral frailty dissected and conceptualized: A scoping review. Arch Gerontol Geriatr 2022; 100:104653. [DOI: 10.1016/j.archger.2022.104653] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/26/2022] [Accepted: 02/04/2022] [Indexed: 01/28/2023]
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SILVA LG, THOMAZ J, MELLO ALSF, FANTUZZI B, MARGREITER S, FIGUEIREDO DDR. Intra- and interobserver reliability of nurses and dentists in the assessment and screening of oral conditions of institutionalized older adults. REVISTA DE ODONTOLOGIA DA UNESP 2022. [DOI: 10.1590/1807-2577.01922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract Introduction older persons in Long-Term Care (LTC) facilities have functional impairments and a higher disease prevalence. Nurses’ comprehensive assessment of older persons’ health is highlighted, including using tools for screening dental treatment needs. Objective to report the intra- and inter-observer reliability of older adults’ oral health assessment in LTC facilities by video. Material and method descriptive study, in three LTC facilities, in the Florianópolis region, Southern Brazil. Data were collected according to Oral Health Assessment Tool (OHAT), which presents 8 categories (“lips, tongue, gums/tissues, saliva, natural teeth, dentures, dental hygiene, and toothache”), and the scores 0=healthy, 1=presence of changes (could be a need for care), 2=unhealthy (need for dental service); final score from 0 to 16. In each LTC facility, a Nurse assessed oral conditions and made a video of each older adult using a smartphone. The dentist performed the oral health assessment through the videos. Estimated Kappa test, p<0.05. Result the sample was 34 older adults, 71% were female. Interobserver reliability between Nurses 1 and 2 and Dentist for “lips” and “natural teeth” was classified as poor and excellent/very good for toothache and denture conditions. The nurse’s intraobserver reliability was classified as weak for the “natural teeth” assessment. Conclusion the OHAT showed reliability for assessing denture conditions and pain. However, nurses’ training for recognizing oral conditions that require dental care is suggested, as well as the management of this action by the dentist and LTC facilities.
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Vieira BLDC, Morais LPD, Vargas-Ferreira F, Guimarães MRC, Mattos FF, Vargas AMD. Use and need of removable dental prostheses in an institutionalized Brazilian elderly population: a cross-sectional study. Braz Oral Res 2021; 35:e134. [PMID: 34932663 DOI: 10.1590/1807-3107bor-2021.vol35.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 07/05/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to assess the use and need of conventional removable prostheses (total and partial) and their associated factors among institutionalized elders. A cross-sectional study was conducted with 1003 elderly people living in non-profit private long-term care institutions in Belo Horizonte, Brazil. Inclusion criteria required a minimum Mini Mental State of Examination (MMSE) score of 21. After the test, 191 individuals were included. Oral examination and interviews were conducted to identify participants' use (throughout the day/every day) and need (do not have/have but do not use) of removable dental prostheses. Socioeconomic health indicators and behaviours were collected from institutional records and via interviews. Bivariate analysis was performed using chi-square test (p<0.05). Poisson regression with robust variance was used in multivariate analysis. Most elders were female (76.4%) and independent in their daily activities (56.5%). Elderly men (PR 1.26) and those whose dental visit was more than one year ago (PR 1.38) showed higher need of dental prostheses. Elderly women (PR 1.68) and individuals with morbidities (PR 1.33) had higher prostheses use. This study demonstrates how socio-demographic characteristics, health indicators, and oral health services impact the use and need of dental prostheses among elders and how these can contribute to public oral health policy development.
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Affiliation(s)
- Bruno Luís de Carvalho Vieira
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Social and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Larissa Pereira de Morais
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Social and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Fabiana Vargas-Ferreira
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Social and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Mirna Rodrigues Costa Guimarães
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Social and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Flávio Freitas Mattos
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Social and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Andréa Maria Duarte Vargas
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Social and Preventive Dentistry, Belo Horizonte, MG, Brazil
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Medeiros MMDD, Figueredo OMCD, Pinheiro MA, Oliveira LFSD, Wanderley RL, Araújo ECFD, Cavalcanti YW, Rodrigues Garcia RCM. Prosthetic rehabilitation status, dental prosthesis functionality and masticatory function in nursing home residents. Gerodontology 2021; 39:310-319. [PMID: 34476837 DOI: 10.1111/ger.12587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/13/2021] [Accepted: 08/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the association of masticatory function with prosthetic rehabilitation status and dental prosthesis functionality in nursing home residents. BACKGROUND Prosthetic rehabilitation status and dental prosthesis functionality may adversely affect mastication of older people, and this relationship is underestimated in nursing home residents. MATERIALS AND METHODS This cross-sectional study included 179 nursing home residents who used dental prostheses [mean (SD) age: 78.9 (9.0) years]. Masticatory function data were determined by assessing (a) masticatory performance using two-colour chewing gum, and (b) swallowing thresholds by counting the number of peanut chewing cycles. Older adults were categorised as: (1) using dental prostheses in both jaws (n = 100) and (2) partially dentate using removable partial dental prostheses (RPDPs) or complete dentures (CDs) in only one jaw (n = 41), or (3) edentulous using CD in only one jaw (n = 38). Stability, retention, occlusion, vertical dimension and defects were considered in assessing dental prosthesis functionality. RESULTS Greater variance of hue (VOH) of the chewing gum and lower swallowing thresholds (worse masticatory function) was associated with edentulous using CD in only one jaw. Older adults wearing dental prostheses with poor occlusion and vertical dimensions presented worse masticatory function. Dental prosthesis stability was associated with lower VOH values. Higher number of chewing cycles while eating peanuts was associated with non-broken dental prosthesis use. CONCLUSION Edentulous participants using CD in only one jaw and non-functional dental prosthesis use negatively affect the masticatory function of nursing home residents.
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Affiliation(s)
| | | | - Mayara Abreu Pinheiro
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
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Rodrigues LG, Vettore MV, Figueiredo IL, Sampaio AA, Ferreira RC. Oral health assessment of older adults living in long-term care facilities by non-dental professionals: a systematic review protocol of instruments. BMJ Open 2021; 11:e050289. [PMID: 34426468 PMCID: PMC8383852 DOI: 10.1136/bmjopen-2021-050289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Regular oral health assessment among older adults living in long-term care facilities (LTCF) can improve their oral health. Different instruments have been developed and used to evaluate the oral health of institutionalised older people by non-dental professionals. These instruments must demonstrate adequate measurement properties. This systematic review aims to examine the studies describing the instruments employed to assess the oral health of older adults living in LTCF by non-dental professionals. The study will also evaluate the measurement properties of such instruments using the checklist proposed by the Consensus-based Standards to select health Measurement Instruments (COSMIN). METHODS AND ANALYSIS Studies describing the development of instruments for assessing oral health of institutionalised older adults by non-dental professionals will be included. Studies assessing at least one measurement property (validity, reliability or responsiveness) will be also considered. Electronic searches will be conducted on MEDLINE (PubMed, Ovid), Embase, Web of Science, Scopus and LILACS databases. Two independent reviewers will select the studies and will extract data concerning the characteristics of the research and the instrument. The measurement properties will be evaluated using the COSMIN checklist. The Grading of Recommendations, Assessment, Development and Evaluation approach will be used to grade the quality (or certainty) of evidence and strength of recommendations. ETHICS AND DISSEMINATION No ethical approval is required. The results will be submitted for publication to a peer-review journal and presented at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42020191479.
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Affiliation(s)
- Lorrany Gabriela Rodrigues
- Department of Social and Preventive Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Mario Vianna Vettore
- Department of Social and Preventive Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Isadora Lemos Figueiredo
- Department of Social and Preventive Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Aline Araújo Sampaio
- Department of Dental Clinical, Pathology and Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Raquel Conceição Ferreira
- Department of Social and Preventive Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Silva E Farias IP, Montenegro LDAS, de Araújo EGO, Raymundo MLB, Brito ACM, de Lucena EHG, de Sousa SA, de Almeida LDFD, Cavalcanti YW. Impact of oral health on nutritional status, self-perception of oral health and quality of life of institutionalized elderly. J Clin Exp Dent 2021; 13:e172-e178. [PMID: 33575002 PMCID: PMC7864356 DOI: 10.4317/jced.57340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/23/2020] [Indexed: 12/27/2022] Open
Abstract
Background This study aimed to investigate the influence of oral health on nutritional status, self-perception of oral health and health related quality of life of institutionalized elders. Material and Methods A cross-sectional study was conducted with 193 institutionalized elders living in the metropolitan region of João Pessoa (Brazil). The independent variables included were: 1) caries experience (DMFT index and its components); 2) use and need of dental prostheses; and 3) type of edentulism. The dependent variables included were related to nutritional status, self-perception of oral health and health-related quality of life. Data were submitted to a descriptive and comparative analysis, through correlation, association and difference tests, considering a significance level of 5% (p<0.05). Results No statistical significant correlations or associations between the oral health status and nutritional status and quality of life were found (p>0.05). Individuals who did not need prosthesis had higher scores for nutritional status. Self-perception of oral health and health-related quality of life did not vary significantly according to the studied variables. Conclusions The oral health status has a limited impact on the nutritional status, and does not impact the self-perception of oral health and quality of life of the institutionalized elders. Key words:Nursing homes, oral health, quality of life.
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Affiliation(s)
- Ilky-Pollansky Silva E Farias
- Graduate Program in Dentistry. Master Student, School of Dentistry. Federal University of Paraíba, João Pessoa, PB, Brazil
| | | | | | | | - Arella-Cristina-Muniz Brito
- Graduate Program in Dentistry. Master Student, School of Dentistry. Federal University of Paraíba, João Pessoa, PB, Brazil
| | - Edson-Hilan-Gomes de Lucena
- Adjunct Professor, Department of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, PB, Brazil
| | - Simone-Alves de Sousa
- Adjunct Professor, Department of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, PB, Brazil
| | | | - Yuri-Wanderley Cavalcanti
- Adjunct Professor, Department of Clinical and Social Dentistry, Federal University of Paraíba, João Pessoa, PB, Brazil
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Wanderley RL, Gomes Filho FN, Bonifácio MFR, Freire AR, Oliveira LFSD, Medeiros MMDD, Garcia RMCR, Cavalcanti YW. Masticatory Function and Nutritional Status in Brazilian Institutionalized Elders: Influence of Denture Use. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Oliveira LFSD, Wanderley RL, AraÚjo ECFD, Medeiros MMDD, Figueredo OMCD, Pinheiro MA, Rodrigues Garcia RCM, Cavalcanti YW. Factors associated with oral health-related quality of life of institutionalized elders. Braz Oral Res 2020; 35:e015. [PMID: 33331407 DOI: 10.1590/1807-3107bor-2021.vol35.0015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 07/27/2020] [Indexed: 12/30/2022] Open
Abstract
This study aimed to evaluate the correlation between two Oral Health-Related Quality of Life (OHRQoL) questionnaires (the Oral Health Impact Profile (OHIP-14) and the Geriatric Oral Health Assessment Index (GOHAI)) and to investigate the factors associated with the OHRQoL of institutionalized elderly individuals. A cross-sectional multicenter study was performed with 344 institutionalized elderly individuals residing in two Brazilian cities. Six trained researchers interviewed the elderly individuals. Sociodemographic data were collected from medical records. Dental caries experience and the use of and need for dentures were recorded through oral examination performed by two trained examiners. A Likert scale (1-5 points) was used to assess general health and self-perceived oral health. The number of chewing cycles needed to chew a portion of peanuts was used to assess the swallowing threshold. The OHIP-14 and GOHAI were used to evaluate OHRQoL, and statistically significant correlations were assessed using Spearman's correlation test (p < 0.05). Poisson regression (p < 0.05) was used to investigate the association of OHRQoL with independent variables. Scores on the OHIP-14 (7.57 ± 8.63) and GOHAI (32.46 ± 3.85) were strongly and inversely correlated (r2 = -0.671, p < 0.001), although these measures were associated with different factors. A higher OHIP-14 total score (worse OHRQoL) was associated with female gender, a greater number of healthy teeth, worse self-perceived general health and oral health, and a lower swallowing threshold (p < 0.05). A higher GOHAI total score (better OHRQoL) was associated with a greater number of filled teeth, better self-perceived oral health and a greater swallowing threshold (p < 0.05). In conclusion, worse OHRQoL among institutionalized elderly individuals is associated with worse self-perceived oral health and a greater swallowing threshold.
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Affiliation(s)
- Luiz Fabrício Santos de Oliveira
- Universidade Federal da Paraíba - UFPB, Graduate Program in Dentistry, Clinical and Social Dentistry Department. Federal University of Paraiba. João Pessoa, PB, Brazil
| | - Rayssa Lucena Wanderley
- Universidade Federal da Paraíba - UFPB, Graduate Program in Dentistry, Clinical and Social Dentistry Department. Federal University of Paraiba. João Pessoa, PB, Brazil
| | - Elza Cristina Farias de AraÚjo
- Universidade Federal da Paraíba - UFPB, Graduate Program in Dentistry, Clinical and Social Dentistry Department. Federal University of Paraiba. João Pessoa, PB, Brazil
| | - Mariana Marinho Davino de Medeiros
- Universidade Estadual de Campinas - Unicamp, Piracicaba School of Dentistry, Prosthodontics and Periodontology Department, Piraciaba, SP, Brazil
| | - Olívia Maria Costa de Figueredo
- Universidade Estadual de Campinas - Unicamp, Piracicaba School of Dentistry, Prosthodontics and Periodontology Department, Piraciaba, SP, Brazil
| | - Mayara Abreu Pinheiro
- Universidade Estadual de Campinas - Unicamp, Piracicaba School of Dentistry, Prosthodontics and Periodontology Department, Piraciaba, SP, Brazil
| | | | - Yuri Wanderley Cavalcanti
- Universidade Federal da Paraíba - UFPB, Graduate Program in Dentistry, Clinical and Social Dentistry Department. Federal University of Paraiba. João Pessoa, PB, Brazil
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Medeiros MMD, Pinheiro MA, Figueredo OMC, Oliveira LFS, Wanderley RL, Cavalcanti YW, Rodrigues Garcia RCM. Masticatory function in nursing home residents: Correlation with the nutritional status and oral health–related quality of life. J Oral Rehabil 2020; 47:1511-1520. [DOI: 10.1111/joor.13096] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/25/2020] [Accepted: 09/10/2020] [Indexed: 12/13/2022]
Affiliation(s)
| | - Mayara Abreu Pinheiro
- Department of Prosthodontics and Periodontology Piracicaba Dental School University of Campinas São Paulo Brazil
| | - Olívia Maria Costa Figueredo
- Department of Prosthodontics and Periodontology Piracicaba Dental School University of Campinas São Paulo Brazil
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Medeiros MMDD, Figueredo OMCD, Pinheiro MA, Oliveira LFSD, Wanderley RL, Cavalcanti YW, Rodrigues Garcia RCM. Factors associated with the overlap of frailty and nutrition in institutionalized older adults: A multicenter study. Arch Gerontol Geriatr 2020; 90:104150. [DOI: 10.1016/j.archger.2020.104150] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 06/05/2020] [Accepted: 06/06/2020] [Indexed: 12/29/2022]
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