Temporomandibular dysfunction experience is associated with oral health-related quality of life: an Australian national study

Background There are very few studies of the association between temporomandibular dysfunction (TMD) and oral health-related quality of life (OHRQoL) in a representative sample from the Asia–Pacific region. Accordingly, we aimed to quantify the association of TMD with OHRQoL dimensions and overall measurement scores in a representative sample of Australian adults while accounting for a range of confounders, and statistically estimating whether TMD experience is meaningfully associated with OHRQoL. Method Australia’s National Survey of Adult Oral Health 2004–2006 data were used. The outcome variables were the Oral Health Impact Profile (OHIP-14) domains and overall scores while the main exposure was self-reported Diagnostic Criteria Question for TMD. The analysis accounted for confounders including oral health status obtained from the oral examination, demographics, socioeconomics, health behaviours and health including perceived stress subscales of the PSS-14. We conducted complex samples analysis while using Cohen’s f2 effect size to estimate whether the association is meaningful. Results TMD prevalence was 9.9% (95% CI: 8.4–11.6%) among 4133 Australian adults. TMD experience was associated with impairments to the seven OHIP-14 OHRQoL domains (P < .05) with higher impairments observed in physical pain (B = 0.82, 95% CI: .45–1.20, P < .001), psychological discomfort (B = 0.68, 95% CI: .29–1.06, P = .001) and psychological disability (B = 0.52, 95% CI: .20–.84, P = .001) in adjusted multivariate analyses. The difference in the mean OHIP-14 scores for those reporting TMD (Mean = 13.1, 95% CI: 12.0–14.0) and those who did not (Mean = 6.6, 95% CI: 6.0–6.8) was significant (t = 7.51, P < .001). In an adjusted multivariable model for OHIP-14 scores, TMD experience was associated with higher OHIP-14 scores (B = 3.34, 95% CI: 1.94–4.75, P < .001) where the Cohen’s f2 was .022. Further, perceived stress subscales: perceived distress and perceived control were associated with TMD experience and OHIP-14 scores (P < .05). Conclusion Lower OHRQoL was observed in Australian adults who reported TMD experience but with small clinical importance which might support considering TMD in regular dental care. The higher impairments observed in physical pain, psychological discomfort and psychological disability domains of OHRQL can help clinicians and researchers focus their attention on these domains. The confounding effect exhibited by the perceived stress subscale might support their inclusion in future TMD and OHRQoL research.

Comprehensive Analysis of the Quality of Orthodontic Treatment of Transcarpathian Teenagers

The high prevalence of dental anomalies and deformities requires a careful approach to orthodontic treatment, especially to improve quality of life. The purpose of the study was to determine the effectiveness of orthodontic care by index assessment of the results of correction of dental anomalies and determination of the psychosocial profile in adolescents of the Transcarpathian region. Material and methods. The object of the study were 68 adolescents from the Transcarpathian region. Determination of the correction of dental and maxillary apparatus anomalies was performed by calculating the relevant part of the ICON index, calculating the evaluation of the results. The quality of life of adolescents was assessed using the OHIP-14 quality of life questionnaire. Statistical analysis was performed after consolidation of results using the application package Statistica 10.0 (StatSoft, Inc., USA) and Microsoft Office Excel 2010. Results and discussion. Many studies in the field of psychology have determined that self-esteem is a core characteristic of the individual and together with the level of claims is a regulator of human activity and significantly affects its development. The result of self-esteem depends on how a person evaluates his/her success in joint activities where he/she is a member. This is especially true for teenagers and adolescence. The most important aspect of impaired quality of life in patients of this subgroup were problems of psychological and social nature, issues of external attractiveness, which prevailed even over the physical aspects of the impact, which is quite typical of adolescence. In patients with moderate orthodontic treatment there was a statistically significant improvement on the scales of psychological discomfort (from 6.4±0.6 points to 3.96±0.6 points; p <0.05), psychological disability (from 6.5±0.5 points to 2.18±0.5 points; p <0.05) and social disability (from 5.4±0.5 points to 3.36±0.5 points; p <0.05). Patients in this group after solving problems related to the aesthetics of the smile, as well as discomfort during communication, felt greater psychological comfort, relief in interaction with others and peers. There was a noteworthy shift of accentuation in such patients from problems with appearance to study and active social life. Among patients with severe orthodontic treatment, the most pronounced dynamics was observed on all scales of dental quality of life: on the scale of masticatory dysfunction (from 5.7±1.0 points to 3.12±1.0 points; p <0.05), physical pain (from 7.5±0.7 points to 2.01±0.7 * points; p <0.05), psychological discomfort (from 7.9±0.6 points to 3.48±0.6 points; p <0.05) physical disability (from 7.7±0.5 points to 3.20±0.5 points; p <0.05), psychological disability (from 7.5±0.4 points to 3.41±0.5 points; p <0.05). Conclusion. According to the study results, the success of orthodontic treatment (indicators of severity and effectiveness of orthodontic treatment according to the ISO index) directly correlated with the level of quality of life (r = 0.62; p <0.05)

Sex uden samtykke ̶ udviklingen i islandsk ret

Penal Code chapters on sexual offences have been revised in all the Nordic countries in recent years. The concept of rape has been changed and is now much more extensive than before. In Iceland, the Penal Code´s (GPC) provisions on rape and other violations of people´s sexual freedom were revised and changed with Act no 61/2007. These amendments included a new, broad statutory definition of the concept of rape, which was supposed to cover incidents where the victim did not consent to having intercourse or other sexual interactions with the offender. The concept of consent was not mentioned in the provision, but instead the unlawful act was defined as rape if the perpetrator had intercourse or other sexual interactions with the victim by using violence, any kinds of threats, for example threats on the internet, or other kinds of unlawful coercion, under par. all 1 of Art. 194 GPC. According to par. 2 of Art. 194 GPC, rape also involves the abuse of the situation of a person, who does not have the same capacities as adults generally do to defend themselves against sexual attacks. This can be the abuse of a victim’s permanent condition, i.e. a mental illness or any other type of psychological disability, to have sex with the victim, or the abuse of a victim’s temporary condition which causes the victim to be unable to defend themselves against the offence, e.g. because the victim is drunk, sleeping, or unconscious because of the use of medicines or drugs. In 2018 the definition of rape under par. 1 of Art. 194 was revised again and consent is now included in the provision. It is considered consent if an individual expresses it of his or her own volition. It is not considered consent if violence, threats, or any other type of unlawful coercion is used. Note, however, that this new definition from 2018, where consent is included in the provision on rape does not constitute a substantive change since lack of consent was already an underlying element of the act as previously written and the methods that exclude consent are the same as the ones in the provison from 2007. The article addresses these changes from 2007 and 2018 and the effects they have had on judgments in rape cases, as well as in society.

Assessment of Quality of Life of Free Anterolateral Thigh Flap for Reconstruction of Tissue Defects of Total or Near-Total Glossectomy

Background. The aim of this study was to evaluate quality of life of free anterolateral thigh flap (ALTFF) for reconstruction of tissue defects of total or near-total glossectomy. Methods. Quality of life was assessed by means of the University of Washington Quality of Life (UW-QOL) and the 14-item Oral Health Impact Profile (OHIP-14), after 12 months postoperatively. Results. 65 of 79 questionnaires were returned (82.27%). In the UW-QOL, the best-scoring domain was “shoulder,” whereas the lowest scores were for “chewing” and “pain.” In the OHIP-14, the lowest-scoring domain was “handicap,” followed by “Social disability” and “Psychological disability.” Conclusion. Free anterolateral thigh perforator flaps for reconstruction of total or near-total glossectomy defects after cancer resection would have significantly influenced the patients’ oral functions and quality of life.

(DIS)ABLING BODY AND CONSCIOUSNESS: TECHNOLOGICAL AFTERNESS AND AFTER-HUMANS IN REALIVE AND UPGRADE

ABSTRACT My paper talks about post-human spaces and technological afterness associated with the physiognomy of humans. Mechanical alteration in biological mechanisms is directly experienced in seizing of organic consciousness. The rupture in consciousness splits it into two distinct parts-one belonging to the disappearing human, the other to the emerging cybernetic. The new being is not another human, but (an)other human, an evolved different sameness. In the film Realive (2016) we encounter an extension of the self beyond death by re-placing it into another body. However, this enhancement diffuses all ‘natural’ responses and meaning-making vehicles, primarily the cognizance of death and mortality. In a classic Frankensteinian restoration, Marc is reanimated in 2084 through extensive methods of cryonization under the banner ‘Lazarus project’. The post-human ‘humachines’ dissolve the position of the teleological man and stretch DNA to digitality. Upgrade (2018) shows us the metamorphosis of Grey Trace, a luddite, by an installed biomechanical enhancer chip, Stem. The roach-like implant not only erases Grey’s quadriplegic body, but ironically ‘desires’ to possess and manoeuver the host’s body. Robotic consciousness in these assimilated after-humans is borrowed consciousness activated by infusing the evanescent biological particle - life. Nanotechnology, molecular machines, nerve manipulators, cameras implanted inside the brain, self-generating nanobots, artificial mechanical limbs have emerged as elements of posthuman utopia/dystopia. Paradoxically, in both the films the protagonists, after their reanimation and upgradation, try to return to their original position of death and disability. In their quest to retrieve the lived body they lose their embodied reciprocations with animals, machines and other forms of life. The mysterious, irreducible, unknown and unknowable potentiality of life is levelled and dissipated by surplus information. This paper attempts to discuss the reactions of embodied body as memory post-cryonization, and to understand limits of psychological disability and death of consciousness after technological reconstruction of the disabled body.