World Hepatitis Day: More must be done to stop this silent killer

15 July 2013 -- Viral hepatitis – a group of infectious diseases known as Hepatitis A, B, C, D, and E – affects hundreds of millions of people worldwide, causing acute and chronic disease and killing close to 1.4 million people every year. On World Hepatitis Day, 28 July 2013, WHO and partners focus on the fact that although the burden of disease caused by viral hepatitis is growing, it remains largely ignored or unknown to many policymakers, health workers and the public.

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WHO to launch global policy report

Hepatitis is a silent epidemic that kills two people per minute throughout the world

PAHO/WHO urges everyone to become better informed about hepatitis, to get screened for the disease and to seek treatment, if needed

Washington, D.C., 23 July 2013 (PAHO/WHO) - Viral hepatitis affects some 424 million people throughout the world, killing 1.4 million per year as a result of complications such as acute liver failure, cirrhosis, or liver cancer. The disease is sometimes called a "silent epidemic" because most people who are infected are unaware of their status.

The theme of this year's World Hepatitis Day, July 28, is "This is the hepatitis. Know It. Confront it." This year the Pan American Health Organization/World Health Organization (PAHO/WHO) is marking the day by calling on everyone to become better informed about hepatitis, to get screened for the disease and to seek treatment, if needed.

"People know very little about hepatitis, its potential severity, and its serious consequences for health and quality of life," said PAHO Director Carissa F. Etienne. "We therefore need to intensify our information, education and communication initiatives around this disease and take action to promote prevention and early detection so people can get the treatment they need."

Hepatitis is an inflammation of the liver generally caused by a viral infection. Five principal types of hepatitis virus are known: A, B, C, D and E, which can be transmitted through a variety of routes including unprotected sexual intercourse, unsafe injecting and piercing practices and through contaminated water or food. These cause infection and severe and chronic inflammation of the liver, which in turn can lead to cirrhosis and liver cancer. In the Americas, between 8 million and 11 million people suffer from chronic hepatitis B infection, and 7 million have chronic hepatitis C.

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Variation in Health Care Spending: Target Decision Making, Not Geography

For over three decades, researchers have documented large, systematic variation in Medicare fee-for-service spending and service use across geographic regions, seemingly unrelated to health outcomes. This variation has been interpreted by many to imply that high spending areas are overusing or misusing medical care. Policymakers, seeking strategies to reduce Medicare costs, naturally wonder if cutting payment rates to high cost areas would save money without adversely affecting Medicare beneficiary health care quality and outcomes. Yet, many have cautioned that geographically-based payment policies may have adverse effects if higher costs are caused by other variables like beneficiary burden of illness, or area policies that affect health outcomes.

In 2009, a group of U.S. House of Representatives members asked the HHS to sponsor two IOM studies focused on geographic payments under Medicare, independent of final health reform legislation. The first study evaluated the accuracy of geographic adjustment factors used for Medicare payment. This second study investigates geographic variation in health care spending and quality and to analyze Medicare payment polices that might encourage high-value care that would modify provider payments based on composite measures of cost and quality of geographic-area performance.

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Coexistence of Headache Attributed to Airplane Travel and Diving Headache

On-Site Conference Reporting

BREAKING NEWS From the 2013 International Headache Congress—Coexistence of Headache Attributed to Airplane Travel and Diving Headache

BOSTON—The term “airplane headache,” a newly acknowledged clinical entity in the ICHD-3, refers to a recently described headache form whose attacks are strictly related to airplane travel, mostly to the landing phase. According to a report presented at the International Headache Congress 2013 meeting, airplane headache can coexist with a similar headache form associated with diving.

Using a detailed questionnaire, Giorgio Zanchin, MD, Director of the Headache Center, Department of Neurology at Padua University, Italy, and colleagues identified among 85 patients with airplane headache, nine patients with headache attacks also occurring during free or scuba diving. These patients (five females, four males, mean age 37), who complained of airplane headache attacks during landing in more than 50% of their flights, referred to the occasional onset of jabbing, severe, unilateral headaches in the frontotemporal region during free or scuba diving. They described this headache as presenting with the same features as that experienced during airplane landing. No accompanying symptoms were reported. Three patients free dove, attaining the maximum depth of five to eight meters, and six patients scuba dove, reaching an average depth of approximately 20 meters. According to the patient reports, the pain started shortly after the ascent, reaching its peak in a few minutes. No concomitant airway disturbance was reported during diving. In eight of the nine cases, the pain occurred in more than 30% of their dives; one patient complained of the headache occasionally.

Dr. Zanchin and colleagues reported that brain MRI, angio-MRI, and cranial CT-scan for sinuses were normal in these patients.

The coexistence of headache with peculiar, overlapping features triggered by these different situations—airplane landing and ascending after diving—supports the hypothesis of a shared pathophysiologic mechanism: the rapid change of external pressure, which occurs in both conditions, not accompanied by an adequate compensation inside the cranial sinuses.

The FDI African Strategy for Oral Health: addressing the specific needs of the continent

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ORIGINAL ARTICLE

International Dental Journal 2013; 63: 113–120 doi: 10.1111/idj.12044

The FDI African Strategy for Oral Health: addressing the specific needs of the continent
Patrick Hescot1, Emile China2, Denis Bourgeois3, Susan Maina4, Orlando Monteiro da Silva1, Jean Luc Eisele1, Christopher Simpson1 and Virginie Horn1
1FDI World Dental Federation, Geneve, Switzerland; 2Association des Chirurgiens-Dentistes du Benin, Cadjeˆhoun,Cotonou, Benin; 3Faculte d’Odontologie, Universite Claude Bernard Lyon I, Lyon Cedex, France; 4Kenya Dental Association, Nairobi, Kenya.
The FDI World Dental Federation has defined a strategy for the development of oral health in Africa during the “African Summit” held in Cape Town, South Africa. The summit gathered presidents from 16 African National Dental Associa- tions, FDI stakeholders, the World Health Organisation and government delegates. The outcomes of this summit were stated in a Declaration, defining the functional principles of the African strategy as three priorities:
1. To establish and reinforce the credibility of NDAs
2. To acquire and develop leadership and management skills 3. Effective peer-to-peer exchange of information.
Key words: Oral health, Africa, strategy, leadership, declaration, national dental associations

FDI World Dental Federation is the global voice of the dental profession and diverse by nature; it reflects a wide range of needs and circumstances specific to individual regions and nations. Founded in 1900, its initial membership comprised a small group of mainly Western countries, Argentina, Australia, Austria, Bel- gium, Brazil, Canada, Chile, Colombia, Cuba, Den- mark, France, Germany, Hungary, Italy, Japan, Mexico, the Netherlands, Portugal, Russia, Sweden, Switzerland, the United Kingdom and the United States of America. It was not until later that countries of the African continent became members.
Oral health and dentistry in Africa have been afflicted by the problems characterising the world’s developing regions, such as poverty, malnutrition, high incidence of infectious diseases and child mortal- ity, lack of oral health policy and inadequate national budget for oral health. Nevertheless, there are future opportunities for development and strong economic growth. A number of areas have registered significant progress in their transition towards sustainable eco- nomic development. In some large cities, high quality dentistry is being offered through private practices. Dental schools are being built in various countries

and there is an expansion of public awareness pro- grammes on oral health such as the Live.Learn.Laugh (LLL) partnership between FDI and Unilever, now implemented in six African countries.
Of an estimated 80,000 health professionals involved totally or partially in oral health care, some 40,000 are dentists1, with an average ratio across the continent of 0.4 dentist to 10,000 inhabitants2; never- theless there are wide discrepancies: in Egypt, the ratio is 1:2,904; in Kenya it is 1:40,631 in Ethiopia, it is 1:1,278,446. There are also huge disparities in research, as illustrated by the number of publications on oral health from African institutions3.
FDI African members have, through the General Assembly and representatives at the Council, repeat- edly expressed the need for a special effort towards oral health in Africa. In 2004 (Nairobi) and in 2010 (Durban), FDI organised workshops to discuss global activities and supporting principles for an action plan in Africa4.
Within its overall commitment of ‘leading the world to optimal oral health’, FDI’s Vision 2020 has now set very clear goals both for the dental profession and for access to oral health care; these are as applicable 

Suboptimal Treatment of Episodic Migraine Increases Risk of Progression to Chronic Migraine

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On-Site Conference Reporting

BREAKING NEWS From the 2013 International Headache Congress—Suboptimal Treatment of Episodic Migraine Increases Risk of Progression to Chronic Migraine

BOSTON—Individuals with episodic migraine may progress to chronic migraine at higher rates without optimal treatment, according to researchers at the International Headache Congress 2013 meeting.

Using data from the American Migraine Prevalence and Prevention (AMPP) Study, Richard B. Lipton, MD, and colleagues at Montefiore Medical Center and Albert Einstein College of Medicine in New York City and Vedanta Research in Chapel Hill, North Carolina, found that patients receiving maximally optimized treatment were more than three times less likely to progress to chronic migraine than were those with poorly optimized treatment.

Study participants with episodic migraine in 2006 who completed the Migraine Treatment Optimization Questionnaire (mTOQ-4) and provided outcome data in 2007 were eligible for the analyses. The mTOQ-4 assesses the frequency of four acute response outcomes: pain free at two hours, sustained pain free at 24 hours, perceived ability to plan daily activities, and perceived control of migraine. Response options include never (0), rarely (0), less than half the time (1), and half the time or more (2). Sum scores ranged from 0 to 8 and were divided into four categories: very poor optimization (0), poor optimization (1 to 5), moderate optimization (6 or 7), and maximal optimization (8). Episodic migraine was defined according to ICHD-2 criteria as 15 or fewer headache days per month on average; chronic migraine was defined as more than 15 headache days per month.

“Of 4,625 eligible subjects with episodic migraine, 48% had very poor or poor treatment optimization,” said Dr. Lipton, lead author of the study. “We found that people in those groups had three times the risk of progression to chronic migraine.”

RATES OF OPTIMIZATION AND PROBABILITY OF TRANSITION FROM EPISODIC MIGRAINE TO CHRONIC MIGRAINE, BASED ON TREATMENT OPTIMIZATION

Level of Acute Treatment Optimization for Migraine	N	Rate of CM Onset in Following Year
Very Poor	308	8.1%
Poor	1,919	4.4%
Moderate	1,132	2.9%
Maximal	1,266	2.5%

“We have seen in the AMPP Study that those with episodic migraine have certain risk factors, such as headache frequency, medication use, and depression, that are associated with increased risk of chronic migraine,” Dr. Lipton said. “This observational study chart shows that as treatment is increasingly optimized, the risk of progression from one year to the next declines.”

Study coauthor, Dawn C. Buse, PhD, noted, “These findings are exciting, as they provide clinical targets for intervention. When we discover factors that increase the risk of progression, health care providers can focus their efforts in those areas to improve care and outcomes. In this case, we have found several factors in acute migraine treatment that may likely improve outcomes, including using medications that work quickly and maintain pain-free results, which allows and empowers people who live with migraine the freedom and confidence to make plans and fully engage in their lives.”

Aged care resources in collaboration with the University of Adelaide

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Aged Care Package

The Dental Hygienists Association of South Australia (Inc) has produced with the support of the National body and in collaboration with the School of Dentistry at the University of Adelaide, a self-contained portfolio of various documents designed to assist oral health professionals in the preparation and provision of training to staff and residents in acute care and long term care facilities.

Contained within the Oral Health for Those Who Care package is a video on how to deliver education sessions together with support documents such as useful references, suggested discussion questions and evaluation forms.

This package is available on a USB with the ability to produce two DVD’s, and an accompanying handbook, to assist health professionals and carers in the provision of oral health care to residents in supportive care facilities. These can be made available to the facilities for in-house training.

The Oral Health for Those Who Care package is relevant to a range of health professionals in various settings and can be used in part, to comply with continuing professional development requirements.

Portfolios offer a unique opportunity to mix and match resources for a variety of audiences- we believe you will find this package a useful adjunct for your presentations and education sessions.

Margie Steffens DDH

Lecturer and Community Outreach Dental Manager

School of Dentistry

University of Adelaide

                                                                                                  Member Price    AU$108.00                                                                                                                          Non-Member Price    AU$126.00                                                                 

AU$108.00

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price does not include tax; shipping costs apply

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