Browsing by Author "Mohamed, Nadia"
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- ItemEarly childhood caries and dental treatment need in low socio-economic communities in Cape Town, South Africa(AOSIS, 2018-05-12) Mohamed, Nadia; Barnes, Jo M.Background: Early childhood caries (ECC) is a particularly severe problem in low socio-economic communities which impacts the overall health and well-being of children. The extensive waiting lists for general anaesthesia and sedation services at the only tertiary dental care centre in the study area for the treatment of children with ECC were an indication of the extent of the problem. The true extent of the problem in this area was, however, not known. This information is crucial in order to plan and execute remedial measures. Aim: To assess the prevalence of oral and dental problems, especially ECC, in children under six years of age in the study population, and ascertain their need for dental treatment. Methods: A cross-sectional survey of 659 children from selected schools and clinics in the study area was carried out between 2010 and 2013. Results: A caries prevalence of 71.6% (472/659) was recorded. Of these, 67.5% (445/659) of children were in need of dental treatment. Conclusion: Over the last decade, there has been no improvement in the caries status of children in the study population, and no organised measures have been put in place to address this problem. Awareness needs to be raised so that governments, especially in developing countries, can take appropriate measures to alleviate this public health problem. Time and resources have to be invested in the education of all health professionals dealing with children, by raising their awareness of the early stages of the disease so that timeous referrals can be made.
- ItemAn investigation of early childhood caries in the lower socio-economic areas surrounding Tygerberg Oral Health Centre in order to plan a community appropriate intervention strategy(Stellenbosch : Stellenbosch University, 2014-12) Mohamed, Nadia; Barnes, J. M.; Nel, E. D. L. R.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept.of Interdisciplinary Health Sciences. Division of Community Health.ENGLISH ABSTRACT: The long waiting lists for general anaesthesia and sedation services for children with Early Childhood Caries (ECC) at the Tygerberg Oral Health Centre highlighted the problem of ECC in this area. This was confirmed by a retrospective study of patient records at the Centre. ECC is largely caused by a combination of lifestyle factors, especially feeding and oral hygiene practices. Socio-economic status and parental factors such as education and employment have also been shown to play a role in the development of ECC. In order to address this problem, a study was designed to determine the prevalence of ECC in children from the lower socio-economic communities which drain to the Tygerberg Oral Health Centre and assess the knowledge of the caregivers of these children. A total of 659 children were examined at crèches and schools as well as community health clinics. The children examined at the clinics accompanied others and did not have any health reason for the visit themselves. As the aetiology is largely behaviour-driven and children are dependent on their caregivers to meet their basic needs, 366 caregivers attending the community health clinics with their children, were interviewed to determine their practices and knowledge of oral health. A total of 83 health care workers at these clinics were also interviewed to assess their knowledge of oral health matters and determine the role that they can play in the prevention of this disease. A cross-sectional community survey was carried out by means of clinical assessments and structured interviews with the aid of questionnaires. The survey was divided into 3 parts: 1. Prevalence of ECC amongst the children 2. Knowledge of the caregivers about oral health care 3. Knowledge of health care workers at the clinics in these communities about ECC The prevalence study revealed that 71.6% of children in the study population presented with caries. This is extremely high and highlights the need for serious interventions. Parents/ caregivers were shown to be ill-informed regarding their children’s oral health care needs which include dietary and oral hygiene practices as well as how this disease can be prevented. It is clear that caregivers need to be educated regarding feeding practices, weaning time, dietary content and the importance of basic oral health. The importance of preserving the primary dentition and regular dental attendance also needs to be emphasized in this community where dental health does not seem to be a priority. Health care workers such as nurses who come into contact with children from an early age would be the ideal vehicle to impart this information. However, as revealed from the results of this study, there is a serious lack of knowledge amongst these professionals regarding oral health matters. Time and resources therefore have to be invested to improve their knowledge and lessen their load so that more emphasis can be placed on prevention. Small changes can make a big difference towards addressing the burden of this disease on the health care system.
- ItemWorkplace-based assessment of final year students in Paediatric Dentistry at the University of the Western Cape : is it an indication of clinical competence?(Stellenbosch : Stellenbosch University, 2018-12) Mohamed, Nadia; Smit, E. J.; Van Schalkwyk, Susan; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY : Clinical competence is multifaceted and requires the integration of knowledge, skills and attitudes. The clinical environment where patients are treated, provides an opportunity for student assessment of clinical competence in an authentic workplace setting at the ‘does’ level of behaviour. Final year dental students in the Department of Paediatric Dentistry at the University of the Western Cape are assessed in the clinical environment on a daily basis through multiple clinical evaluations over the course of a year. An additional end-of-module clinical assessment in the form of a single blinded patient case (BPC) is required to decide if students have reached the expected level of clinical competence. Both the reliability and feasibility of this single end-of-module clinical case have been questioned in this setting. The utility of continuous formative WPBA during a course in determining progression gained at the end of a programme is however still being debated in the literature. This study aimed to determine if the current continuous WPBA results in the Department of Paediatric Dentistry could be used as an indication of clinical competence of final year students at the end of the module. A retrospective, quantitative, cross-sectional study was conducted of all complete assessment records of final year students (2016- 2017) from the Paediatric Dentistry Department at UWC. The characteristics of, and correlation between, the continuous WPBA components were analysed together with an evaluation of the reliability and validity of the assessment results. On average, students achieved the highest score for the single BPC at the end of the module. Mini-CEX scores changed significantly over time in the 2016 class, but not in the 2017 class. This may be due to changes in departmental assessment practices rather than a true improvement in scores over time. Correlations between the individual WPBA components (average mini-CEX, logbook quota, case presentations) and the final combined paediatric mark were high. The average mini-CEX and case presentation scores were moderately correlated with the single BPC scores. Correlation between the percentage of logbook quota completed and clinical scores were however weak. Due to the low failure rate in this cohort, predictive values for struggling students could not be determined. The continuous formative WPBA practices were found to be both valid and reliable when using Kane’s (2013) and Royal’s (2017) frameworks for analysis. The continuous formative WPBA practices in the Department of Paediatric Dentistry at the University of the Western Cape have proven to be feasible as it is integrated in the daily routine patient care provided in the paediatric dental clinics. The findings of this study suggests that the continuous formative WPBA scores are an indication of clinical competence of final year dental students at UWC and could be used to decide if students have reached the expected level of clinical competence in this module. The addition of the single BPC could be reconsidered due to its feasibility and reliability concerns. Further prospective research is however necessary to determine the reliability and validity of the continuous formative WPBA practices. To our knowledge, this is the first study to evaluate the utility of continuous formative WPBA in making pass/fail decisions in the South African context.