Access to dental care is affected by financial and structural barriers as well as other predisposing and enabling factors among older adults. Thus, increase in user services will require efforts to reduce financial barriers and make dental care culturally and linguistically competent.

No abstract

Findings indicate that there were some misconceptions in oral health among this group of older adults. These are important influences on the success/failure of an oral health programme. Oral health education is needed to increase older adults' oral health knowledge, in particular of oral cancer, and to some extent periodontal disease, and improves attitudes and oral health self-efficacy. Oral health knowledge, attitudes and self-efficacy were minimally explained by socio-demographic and clinical variables.

upon Tyne, Newcastle upon Tyne, UKIn 1974 a purpose built establishment was set up on Tyneside in the United Kingdom to train Merchant Navy personnel in fire fighting. It is staffed by six instructors and an assistant divisional officer seconded from the Tyne and Wear Metropolitan Fire Brigade. Courses are run with emphasis on the practicalities of search and rescue techniques as well as fire fighting in realistic heat and smoke conditions. As part of an investigation into the possible long term effects on health of the working environment effects on the skin were studied. Working conditionsBefore each exercise men were instructed in the use of compressed air breathing apparatus. They were issued with standard fire fighters' uniform including protective gloves. The face was partially covered by the breathing mask but the ears were uncovered to facilitate hearing.Men were instructed in the layout of a large steel "tank," referred to by the nickname of M V Superheat, simulating part of a ship. It measured roughly 9 x 4 m and was 8 m in height. The building was divided into four main compartments with subcompartments and communication was effected by steel ladders.Within this system of compartments were two fires, fuelled by wood from crates and pallets, emitting dense smoke and heat throughout the tank. The heat was intense with visibility nil except near the fires, and communication was by sound and touch. The tank could be entered by various routes according to the design of the exercise but exit was at ground level.After the exercise the trainees showered to remove the yellow staining of their skin caused by deposits of a tarry substance from the burning wood. The smell of this on the scalp persisted despite showering.The instructors trained men in the tank in batches InvestigationOn site the conditions were investigated at first hand and later the six men were examined in detail, especially from the dermatological point of view, having completed a questionnaire concerning their health and especially their reaction to hot conditions and to sunshine in the past. Results of a full blood count and urine analysis were normal. The health record of the six men was excellent. One man, however, had psoriasis which he said had improved since he had worked as a fire fighting instructor. Another man, aged 31, had, before joining the fire service, worked in Africa, where he developed an epithelioma of the lip, presumably due to sun exposure. He noted that the reddening of his skin after working in the tank lasted for up to a week. FindingsAll six men had noted discoloration of the skin by smoke and said that they developed redness and swelling of the ears or neck or both, sometimes with blistering. These changes were followed if pronounced by peeling of the skin resembling the effect of sunburn. These skin changes lasted about 48 hours. Periodically men would notice a singed feeling in the ears when working in the tanks.Examination confirmed the presence of redness and swelling of the exposed skin on emerging from a perio...