SACM - United Kingdom
Permanent URI for this collectionhttps://drepo.sdl.edu.sa/handle/20.500.14154/9667
Browse
5 results
Search Results
Item Restricted Mixed Method Study to Assess Behcet’s Syndrome Impacts on Quality of Life of Children(Saudi Digital Library, 2025-06-30) AlQahtani, Eman; Prof S. Albadri; Associate Prof. C. Pain; Dr L. Roper; Dr L. El SharkasiIntroduction: Behcet’s Syndrome (BS) is a rare, chronic inflammatory condition that can significantly affect the daily lives of children and young people (CYP). While BS is well-documented in adults, there is limited research on how it impacts CYP, particularly in terms of their quality of life (QoL) and access to appropriate healthcare, including dental care. Oral ulcers, a hallmark symptom, can cause considerable pain and difficulties with eating, speaking, and maintaining oral hygiene. This thesis explores the challenges faced by CYP with BS, the gaps in healthcare services, and the need for including a paediatric dentist within the multidisciplinary care. Method: This research is based on three interconnected studies: Literature Review – A comprehensive review of existing research on BS in CYP, highlighting the condition’s clinical manifestations, diagnostic challenges, and its impact on QoL, with a focus on oral health. A retrospective service evaluation was conducted using medical records of 34 CYP diagnosed with BS who attended the Multidisciplinary Clinic (MDT) at Alder Hey Hospital (AHH) between January 1, 2012, and December 31, 2021. The primary aim was to assess the oral health needs of these children. To achieve this, data were collected on their symptoms, clinical characteristics, referral pathways, and management approaches. As this was a service evaluation, ethical approval was not required, and the project was formally registered with the local governance team. Qualitative Study: Semi-structured interviews were conducted remotely via Zoom with CYP aged 8-18 years diagnosed with BS. Recruitment was facilitated by Behcet’s UK charity and AHH. Thematic analysis was conducted using an inductive approach to identify key themes. Ethical approval was granted by the Health Research Authority (REC; IRAS: 318222). Results: Service evaluation: Thirty-four children diagnosed with BS attended the MDT at AHH between 2012 and 2021, with an average age of 12.8 years (range: 5-17). A family history of BS was present in 26.5% (n=9) of cases. Oral ulceration was the most common initial symptom, affecting 97.1% (n=33), with frequent recurrences every 2-3 weeks. Other common findings included joint pain (79.4%), genital ulceration (44.1%), gastrointestinal symptoms (82.4%), and ocular involvement (41.1%). Only 14.7% (n=5) had a confirmed BS diagnosis, while 85.3% (n=29) remained probable cases. General paediatrics (47%) and rheumatology (17.6%) were the primary referral sources, with ophthalmology (35.3%) and physiotherapy (29.4%) receiving the highest number of onward referrals. Paediatric dental assessments were documented in only 52.2% (n=18), highlighting potential gaps in oral health management. Qualitative interviews: revealed Five key themes: (1) Living with BS Symptoms: CYP experienced disruptions to daily functions, including eating, sleeping, and maintaining hygiene, driven by symptoms such as oral and genital ulcers, fatigue, and joint pain. These challenges hindered their ability to socialise and participate in routine activities. (2) Living with Uncertainty: The unpredictable nature of BS fostered anxiety, making it difficult to plan routines or attend school consistently. (3) Fear of Disbelief and Misjudgement: Participants reported being dismissed by teachers, peers, and healthcare professionals due to the invisibility of symptoms, exacerbating feelings of isolation. (4) Support Systems: Mixed experiences with school accommodations and healthcare highlighted systemic gaps, including inconsistent support and delayed diagnoses. (5) Walking the Tightrope of Treatment and Relief: CYP expressed frustration over limited relief despite ongoing treatment, coupled with the burden of medication side effects. Conclusion: The findings from this thesis sheds light on the challenges faced by CYP with BS, particularly in relation to their daily lives, healthcare experiences, and oral health needs. The service evaluation revealed that while oral ulcers were the most common symptom, paediatric dental assessments were not consistently recorded, suggesting gaps in oral healthcare within the MDT. The qualitative study highlighted how BS disrupts essential daily activities, causing physical discomfort, emotional distress, and social isolation. Many CYP struggled with the unpredictability of their symptoms, difficulties accessing appropriate care, and a lack of understanding from professionals. These findings underscore the need for a more integrated approach to care, with paediatric dentists playing a key role in the MDT. Addressing oral health early could help prevent long term dental complications and improve overall well-being. Greater awareness, better referral pathways, and improved support systems are essential to ensuring CYP with BS receive the care they need. Future research should explore ways to enhance early diagnosis, personalised treatment, and coordinated multidisciplinary management.12 0Item Restricted The association between loneliness and Oral health among older adults In England. Secondary data analysis of the English Longitudinal Study of Ageing (2018-2019)(University Collage London, 2024-08) Bedaiwi, Alia; Venturelli, Renato; Heilmann, AnjaBackground: Population aging is a global phenomenon, accompanied by increasing rates of oral diseases and loneliness among older adults. These two issues have significant impacts on individuals' quality of life. While the relationship between loneliness and various health outcomes is well-established, the connection between loneliness and oral health has been less explored. Aim: The aim of this research was to investigate the association between loneliness and subjective measures of oral health, including OHRQoL and SROH, among older people living in England using cross-sectional data from ELSA. Methods: Secondary analysis was conducted using data from ELSA Wave 9. The study population consisted of adults aged 50 and above, with oral health outcomes measured through OIDP and SROH, and loneliness assessed using a three-item UCLA scale. After controlling for socioeconomic, behavioral, and health-related variables, the relationship between oral health outcomes and loneliness was examined using logistic regression models. Results: The study found a significant association between loneliness and poorer oral health outcomes. Those who reported feeling lonely were more likely to experience at least one impact on daily performance due to oral health problems and were more likely to rate their oral health as fair or poor. These associations remained significant after adjusting for factors such as gender, age, cohabitation ,status, wealth, and smoking. Conclusion: Loneliness is associated with poorer oral health among older adults. Addressing loneliness could improve oral health and overall well-being, suggesting a need for integrated public health interventions that target both social and health-related factors in aging populations.10 0Item Restricted The Role of Education on The Association Between Ethnicity and Tooth Loss(King's College London, 2024-08) Alfraih, Jood; Delgado Angulo, ElsaAbstract Aim: The study aimed to explore the association between tooth loss and ethnicity and to assess the mediating role of education in this relationship. Methods: A secondary analysis was conducted on cross-sectional data from adults aged 16 and over who participated in the Health Survey for England in 1999, 2000, 2001, 2002, and 2005. Logistic regression models were employed to examine the association between ethnicity and tooth loss, with the adjustment for sociodemographic variables. The role of education as a mediator in this relationship was also assessed. Results: The findings revealed significant ethnic differences in the prevalence of edentulism. Black Caribbean and White British participants exhibited the highest prevalence rates of edentulism, whereas Bangladeshi individuals had significantly lower odds of experiencing tooth loss. Education emerged as a critical determinant, with higher educational attainment associated with lower odds of edentulism. The mediation analysis highlighted that Black Caribbean individuals with no education had significantly higher odds of edentulism. Conclusion: The study underscores the complex interplay between ethnicity, education, and tooth loss. It highlights the need for public health interventions that target oral health education and improve access to care, particularly for ethnic minorities and lower socioeconomic groups.24 0Item Restricted DENTAL VISIT PATTERNS IN CHILDHOOD AND THEIR ASSOCIATION WITH DENTAL ISSUES IN ADULTHOOD(King's College London, 2024-08) Alaskar, Bayan; Angulo, Elsa DelgadoAim: To examine the frequency of childhood dental visits, identify the factors influencing these patterns, and assess their correlation with adult oral health status. Methods: This study used data from the NCDS and the BCS70. Data on dental visits was obtained during home interviews, where parents answered questions about their children's dental visits in the past year. Information on adult oral health was collected, when cohort members answered two questions about mouth and/or gum problems they had experienced. Parental social class at the time of the cohort member's birth was reported by the mother, while the cohort member's own social class was self-reported. Logistic regression models were used to test the association between childhood dental visits and oral health in adulthood. Results: The data shows significant differences in mouth and gum problems based on sex, social class, and education level, with higher prevalence among females, individuals in routine social classes, those with no education, and those without childhood dental visits. Logistic regression analysis reveals that individuals with one, two, or three childhood dental visits have lower odds of persistent mouth trouble compared to those with no visits. Specifically, those with three visits show the most significant reduction in odds. The same trend is observed for mouth/gum problems in the last 12 months, with frequent childhood dental visits linked to lower odds of these issues. Conclusion: There is a link between childhood dental visit patterns and adult oral health, with regular childhood dental visits significantly reducing the likelihood of persistent and recent mouth and gum problems31 0Item Restricted A service evaluation of children and caregivers who are referred to dental specialists at St Thomas and King’s Hospital Paediatric Dental Institution in London.(Saudi Digital Library, 2021-10-01) Almegren, Nora; Hosey, Marie ThereseBackground: Dental caries is the most prevalent disease affecting children worldwide. It does not only affect oral health, but also a child’s health and wellbeing. This service evaluation reports on the preventive care received by children prior to referral at the specialist paediatric dental hospital at St Thomas’ Hospital, London. Method: Data were collected retrospectively from computerized referral records for children referred to specialist paediatric dental service at St Thomas’ Hospital London between December 2019 to July 2020. Data were manually processed into an electronic database. Patient demographics, reason for referral, dental history and prevention advice were recorded. Data was analysed using descriptive statistics. Results: One hundred and twelve referral forms were reviewed. There were 46 girls and 66 boys. Majority of children were healthy, pre-cooperative, with urgent referrals. Fifty-eight children (52%) were referred due to dental caries, of these 34 were between the age of 0-to-7 years. Out of 112, 62 children (55%) were regular attendees and 50 (47%) were occasional attendees or had never attended previously. Eleven families already have had another child undergone extraction for dental caries. All referred children received verbal dental advice (oral hygiene and dietary) from the referrer. Conclusion: The majority of children were referred for dental treatment under specialist in a hospital dental service at St Thomas Hospital were high-caries-risk- children. As ECC can be preventable, prevention measures are essential to ensure families the effectiveness of home care liaising with the local dentist’s preventive care to reduce future incidence of caries as the vast majority were referred due to dental caries. The importance of shared care between practitioners and specialist in hospital providing multidisciplinary care for the child’s quality of life. Further investigation to explore the health care at home and promote local community oral health service at home and nursery schools.12 0