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Logistic discrimination will be used in order to find the logarithm of the anti-probability of disease Dk conditioned by the vector S: n lno( Dk | S = s ) = w0k + ∑ wik ⋅ sign( σi ) (14) i=1 where: n – the number of symptoms; m – the number of diseases; k = 1 quality hydroxyzine 25 mg anxiety attacks symptoms, … generic 10mg hydroxyzine mastercard anxiety symptoms during exercise, m; wi – are called ‘weights’ and they are calculated with the equations (15) and (16): w0k = lno( Dk ) (15) p( σi | Dk ) wik = ln (16) p( σi | Dk ) For the patient that is diagnosed it is analyzed the list of symptoms and it is calcu- lated for each symptom σi the value of the function signum best hydroxyzine 25mg anxiety 7 year old boy, using the expression (17): ⎧− 1 purchase hydroxyzine 25 mg otc anxiety symptoms muscle tension,if σi = 0 sign( σi ) = ⎨ , i = 1,. B Artificial Neural Networks There are a lot of cases when is not possible to implement human intelligence with expert systems. The initial idea was that in order to reproduce human intelligence, it would be necessary to build systems with a similar architecture [6]. Artificial neural networks are developed based on brain structure, representing a simplified mathematical model of central nervous system. Like the brain, artificial neural networks can recognize patterns, manage data, and, most important, learn [7]. They are made by artificial neurons, which implement the essence of biologi- cal neuron. In this system, artificial neural networks are used in order to make some predic- tions regarding the treatment response for a patient infected with hepatitis C virus. Hepatitis C is a serious and frequent disease and its evolution has to be carefully overseen during the treatment. Even the efficiency of the hepatitis C treatment improves continuously, the burden of this infection will remain a major issue for the next several decades. The system offers for each evaluated biological indicator predictions regarding the next 12 months evolution, indicating its growing tendency, its stabilizing or de- creasing tendency. It was developed using feed-forward neural networks with back-propagation learning algorithm. Each neural network has a layer of 10 hidden neurons, a single output unit and a variable number of inputs. For each of the four biological indicators that have been studied, there are four layers of neural networks. The networks on the first layer receive as inputs: pa- tient’s age, sex, location (rural/urban), treatment scheme, Knodell score, hepatic fibrosis score and value of the parameter for which the prediction is made, at the initial moment (before the treatment starts). Medical Predictions System works have the same structure as the first layer ones, but they have in addition, as inputs, the outputs of the networks on the former layers; therefore, the networks on the last layer will have not 7 inputs (as the networks on the first layer) but 10 (the initial inputs and the values of biological indicators at 3, 6, and 9 months). The advantage of this architecture is that the input data are processed separate for each biological indicator. The disadvantage is that the errors are propagated through the system because the results of the networks from the first level (to- gether with their errors) are used in the following levels. It develops a multifunctional database and imple- ments an expert system used in order to diagnose different types of hepatitis and to realize some predictions regarding the evolution of the patient and the response to the treatment. The system uses two major components (an inference machine and an architecture of neural networks) that operate on the multifunctional data- base (Fig. It has an interdisciplinary character and fulfils the requirements of a system used in medical diagnosis and prediction. Neural Inference networks machine architecture Multifunctional database Figure 4 The configuration of the expert system First of all, the system offers the possibility to diagnose the most frequent hepati- tis types: B, B+D and C. The user has to set the values of the markers that determine which is the hepatitis type. If the human expert needs more predictions regarding the diagnosis, than he can use the other two branches of the application. The user must set the characteristics of the patient: sex, age, living conditions, symp- toms, and the results of laboratory tests. After that, he will choose one of the three implemented algorithms (Bayes’s theorem, Aitken’s formula, or Logistic model) and the plausibility scores for each evolutional type and grade of hepatitis B are calculated (as can be seen in the right part of Fig. These statistical algorithms are using a part of the multifunctional database: 165 patients infected with hepatitis B virus. The data which describe medical status of these patients were collected from Clinical Hospital of Infectious Diseases No. It is also necessary to introduce the values of the biological indicators before the treatment. The system will predict the evolution of the biological indicators depending on the treatment. Looking at the predicted tendency of the biological indicators during the treatment, a physician can estimate if the patient will respond to a treatment or not. Figure 7 Hepatitis C - The prediction of biological indicators evolution – 100 – Acta Polytechnica Hungarica Vol. All these are stored in another part of multifunctional database, which con- tain almost 200 patients infected with hepatitis C virus. These real data were col- lected from Country Clinical Emergency Hospital, Timisoara. Conclusions This paper tried to evidence some important aspects connected to medical deci- sion making. First of all, logical inference is used to decide what type of hepatitis virus is present for a new patient. After that, the sec- ond part of the system will be used to see what will be the type and the grade of hepatitis B (if the patient is infected with hepatitis B virus). The third part of the system is made for the patients infected with hepatitis C virus and it predicts the biological parameters evolution during the treatment using artificial neural net- works. The hepatitis is a serious disease, its treatment is expensive and severe side effects can appear very often. Therefore, it is important to set a correct diagnosis and to identify those patients who most probably can react to the treatment, so that the others can be protected from a treatment with no benefits. Petrică: Structure of Models for Medical Knowledge Processing, in Sci- entific Bulletin of “Politehnica” University Timişoara, Romania, Transac- tions on Automatic Control and Computer Science, 2004, Vol. Zurada: Introduction to Artificial Neural Systems, West Publishing Company, United States of America, 1992 [4] D. Niedermayer: An Introduction to Bayesian Networks and their Contem- porary Applications, www. Pescaru: Expert Systems, Politehnica University Timisoara, 2000 [6] The Statistics Homepage: Neural Networks, www. Marino: Artificial Neural Networks for the Prediction of Response to Interferon plus Ribavirin Treatment in Pa- tients with Chronic Hepatitis C, in Current Pharmaceutical Design, Vol. It not only explains why these fears are there in the first place, but also gives the reader clear and solid solutions to the problem. Antony and Watling have done a tremendous job of synthesizing the best available scientific data and present- ing it in a straightforward, reader-friendly format. They take the reader step-by-step through the process, showing them why they feel the way they do and how to get better by facing their fears gradually. For- tunately here is a book that outlines in a clear, stepwise manner a plan to help people with medical phobias. Draw- ing on the best available scientific knowledge of evidence-based therapies, the authors translate these treatments into a straightforward and potentially life- saving program. In an easy-to-read style, the authors explain where medical fears come from and then what to do about them.
Thus a vata excess might be the result of irregularity of habits buy 10mg hydroxyzine amex anxiety symptoms perimenopause, excess coffee discount 10 mg hydroxyzine fast delivery anxiety symptoms belching, or cold food hydroxyzine 10mg otc anxiety 8 year old son. The yin/yang principle also has enormous descriptive and explanatory utility discount 25mg hydroxyzine amex anxiety 8 weeks postpartum, eloquent testimony to which can be found in its common use in Western culture. It may yet show its usefulness in tracking the dynamic interplay of complex systems. In fact, an example from biochemistry is sup- plied by Dolittle31 in which he describes the step-by-step process of blood clotting in terms of the play of action/reaction, yang and yin. There is certainly a need for explanatory principles as we slowly drown in our current tidal wave of often isolated “facts. At its core, self-regulation is about the individual’s ability and right to determine what is best for him or her and to do so if necessary in the face of authority and authoritative opinion. This is the core of the liberal democratic tradition and should equally be at the heart of medicine. The practice of self-regulation is based on self-observation, which, if prac- ticed conscientiously, leads an individual to understand what his or her needs are and how to satisfy them. However, an important starting point is to make observations, and we physicians must be able to cultivate this sel- dom taught process before we can help our patients to cultivate greater pow- ers of self-observation for themselves. We must begin by admitting that our meager knowledge concerning the human being is vastly outweighed by our ignorance. We may realize in this process that we have completely lost the ability to see anything that we are not expecting to see. Or if we do see something new, we tend to forget about it; a veil is drawn across our minds. There is no better way of acquiring a new behavior or modus operandi than immersing oneself in the company of an expert who is actively engaged in his or her specialty. We are programmed to learn by modeling in such sit- uations—a fact enshrined in the apprentice system of skills acquisition. Such an experience of full participation can provide a jolt to the perceptual processes and allow us to actually see facets of an individual that we would not have thought possible. Having made our observations, we can then function as scientists, form- ing hypotheses and organizing appropriate experiments. The word experi- ment, of course, tends to send shivers down the spine in the helping professions. In this context, however, I am referring to a process of enlight- ened experimentation in which physician and patient participate in a process of trying safe interventions and carefully monitoring the results. Such trial-and-error methods are the norm in medicine anyway, except that physicians are not usually forthcoming about the fact. The critical difference in enlightened experimentation is that the patients are educated about the process and know that they bear some responsibility for active participation, monitoring, and decision making. Perhaps the most fundamental point about observation and experimenta- tion was passed on to me by Dr. Eric Lederman, a physician, psychiatrist, homeopath, and naturopath who introduced me to the subject of nutrition when I was probably too young to appreciate it fully. I remember very clearly his advice that to understand dietary treatment, one had to experi- ment on oneself. Self-observation and self-knowledge derived from trial-and-error experimentation with oneself are absolutely essential to get the feel of the far-reaching effects of dietary change, supplementation, and all the other aspects of lifestyle manipulation. Through such observation, one is easily convinced that the essential aspect of self-regulation is the body’s ability to register what it needs. For example, we know that the body can be quite subtle in its appreciation of nutritional deficiencies. Some women get marked cravings for meat in the face of a falling iron level, and pregnancy seems to be a time when cravings and aversions reflect organismic needs to nurture and protect the fetus. Surprisingly, we pay little attention to this abil- ity, which is often overridden or obscured by habits and expectations. The epidemic of weight problems (overweight and underweight) in our culture Chapter 2 / The Art of Nutritional Medicine: Patient-Centered Care 39 is eloquent testimony to the fact that even the simpler aspects of dietary self- regulation are a challenge to many. It is easy for the physician to take over the body’s authority and impose his or her ideas of what is right for the person. This may be acceptable as a temporary expedient, but it keeps the patient powerless and dependent. The healer’s role is in fact to help patients reestablish their organismic sensitivity and to learn what they in their uniqueness require and when they require it. Actually, people often know what they require, but they may not have the words to express what is needed or believe that they do not have permission to speak. Often psychologic methods, such as Gendlin’s32 focus- ing or guided imagery, can help increase sensitivity to the body’s signals and the interpretation of these signals. The practitioner provides feedback to the client at many levels, and the client receives feed- back at many levels from the process of enlightened experimentation. The keys are client willingness, active participation, and intelligent appreciation of the process. The practitioner must complement these qualities in an equal partnership with the patient and always be willing to admit ignorance. This produces a special sort of relationship in which mutual feedback is food for the treatment process. Self-regulation also ensures that the body is very “for- giving” of treatment mistakes and excesses. Thus the body detoxifies thera- peutic poisons, rids itself of excesses, and may not immediately protest when we are on some new yet unproductive treatment path. Tintera J: The hypoadrenorortical state and its management, New York State Journal of Medicine 35(13), 1955. Svoboda R: Prakruti: your ayurvedic constitution, Twin Lakes, Wis, 1989, Lotus Press. Arraj J: Tracking the elusive human: an advanced guide to the typological worlds of C. Lee R: Protomorphology: the principle of cell autoregulation, 1947, Lee Foundation. Doolittle J: The evolution of vertebrate blood coagulation, Thromb Haemost 70:24-8, 1993. Health is the result of balanced interchange between mutually interacting physiologic processes: a change in one system affects the function of the entire organism. Homeostatic mechanisms interact to maintain bodily functions within viable limits. Negative feedback systems tend to minimize fluctuations and restore the status quo. The nervous system trans- mits messages as electrical impulses along neural pathways, and the endocrine system conveys chemical information in the blood and interstitial fluid.
A prob- lem with immunobiologic reactions is that they take about three weeks to appear and last months or years buy hydroxyzine 25 mg otc anxiety quotes images. This hinders early diagnosis and the ability to distinguish cur- rent infections from long-standing ones buy cheap hydroxyzine 10 mg line anxiety symptoms dry lips. In experimentally infected rats generic hydroxyzine 10 mg with mastercard anxiety and pregnancy, the antigen is found starting on the fourth day of infection and buy 10 mg hydroxyzine with visa anxiety 60mg cymbalta 90 mg prozac, in a third of human patients, at the end of the third week of infection (Dzbenski et al. As with other diseases, two blood samples should be taken two weeks apart to observe the change in the antibody titers, which can indicate an active infection. Unlike the human infection, in which early diagnosis is needed, only a sensitive diagnosis is needed in swine because the larvae do not become infective until after the 16th day of infection. Trichinoscopy is used in the veterinary inspection of pork in slaughter- houses and meat-packing facilities in many countries. It is a rapid process, but it is not very sensitive and does not reveal light infections. In Sweden in 1961 and in Germany in 1967, epidemic outbreaks involving several hundred cases occurred fol- lowing consumption of pork and pork products that had passed trichinoscopic exam- ination. Some experts estimate that trichinoscopy can detect the infection only when there are three or more larvae per gram of muscle; according to others, the figure is 10 or more larvae per gram. The artificial digestion method is much more efficient and cheaper, but it is slow and does not lend itself to the rhythm of hog processing in large slaughterhouses and industrial packing plants. Its sensitivity is primarily attributed to the use of a sample that is 50 to 100 times larger than that used in trichinoscopy. A practical modification of this method has been proposed, which consists of mixing samples of the diaphragmatic pillars of 20 to 25 hogs from the same source. If trichinae are found in the composite sample, a 50–100 g sample of diaphragm muscle tissue from each individual pig is examined. One of the drawbacks of this test was the high proportion of false positives (about 15%). This drawback has been surmounted by the use of purified antigens (Gamble and Graham, 1984). Control: The purpose of a control program should be to reduce and eventually eradicate the infection in swine, whose meat is the main source of human infection. However, compliance with this regulation is very difficult to ensure, and, therefore, the results are not always satisfactory. The trichinosis problem in some Latin American countries centers on the small rural farms raising a few pigs fed with household or restaurant scraps. These farms are very difficult to supervise, and pigs are slaughtered by the farmers without vet- erinary inspection. Continuous education of the population could at least partially remedy the situation. Trichinoscopy, which is practiced in slaughterhouses in Argentina, Chile, and other countries, has been shown to be effective in protecting the population. Although its sensitivity and cost leave much to be desired, when correctly executed, it protects the consumer against massive infections. Hopes are founded on implementing automated immunologic or molecular biology tests. At the individual level, humans can avoid the infection by abstaining from eating pork or pork products of dubious origin, without veterinary inspection. Pork or pork products that have not been inspected can be submitted to several processes to destroy the trichinae. This temperature turns the raw pork, which is pink and semi-translucent, whitish and opaque. Special care should be taken with rib roasts, pork chops, and pork sausages, which are not always sufficiently cooked, particularly close to the bone. The use of microwave ovens is not recommended because they heat unevenly and they may leave live parasites in portions of the meat. Trichinae are also destroyed by freezing the meat at –15°C for 20 days or at –30°C for 6 days, as long as the piece is not thicker than 15 cm. The meat of wild animals should be cooked; this is the only sure method of destroying the larvae in the Arctic. Proceedings of the Fourth International Conference on Trichinellosis, August 26–28, 1976, Poznan, Poland. Epidemiological and clinical studies on an outbreak of trichinosis in central China. Recent news on trichinellosis: Another outbreak due to horsemeat consumption in France in 1993. Detection of a circulating parasitic antigen in acute infections with Trichinella spiralis: Diagnostic significance of findings. Prospective rheumatological study of muscle and joint symptoms during Trichinella nelsoni infection. Prevalence and risk association for Trichinella infection in domestic pigs in the northeastern United States. Outbreak of trichinosis in Ontario sec- ondary to the ingestion of wild boar meat. Immunodiagnosis of human trichinellosis and identification of specific antigen for Trichinella spiralis. Comparison of human trichinellosis caused by Trichinella spiralis and by Trichinella britovi. Distribution of sylvatic species of Trichinella in Estonia according to climate zones. Aspectos serológicos, clínicos y epi- demiológicos de un brote de triquinosis en Azul, Provincia de Buenos Aires. Diagnosis of porcine trichinellosis: Parasitological and immunoserological tests in pigs from endemic areas of Argentina. Brote de triquinosis en la Comuna de Purranque, Región X, Chile, octubre-noviembre, 1992. Etiology: The agents are several species of the genus Trichostrongylus (nema- tode) that inhabit the small intestine and stomach of sheep, goats, and bovines, and sometimes infect other domestic and wild animals or man. The species are difficult to differentiate, and human case histories often indicate only the genus and not the species. Among these are three cases caused by Haemonchus contortus in Australia, one in Brazil, and one in Iran; two cases caused by Ostertagia ostertagi in Iran and one in Azerbaijan; and one case caused by O. Trichostrongylids are short parasites, measuring 1 cm or less in length, and are as slender as an eyelash, and therefore, difficult to see. This is a free-living worm that makes its home in the soil and feeds on organic waste or small organisms; it quickly molts into a sec- ond-stage larva, which is also free-living; then it molts into a third-stage larva, which is infective to the host.
This represents a new challenge for oral health professionals and policy makers oral healthcare hydroxyzine 10 mg with mastercard anxiety symptoms from work, as it raises questions about need to collaborate closely in order to identify access and quality of care discount hydroxyzine 25 mg without a prescription anxiety in children, legal aspects and and implement adequate solutions cheap hydroxyzine 10 mg with mastercard anxiety questions. Dental education is an area where new solu- The challenges for research in oral health are tions are needed so that the educational model diverse and fundamental discount 25 mg hydroxyzine with visa anxiety symptoms dream like state. In the future the fo- responds to new needs, effectively bridges the cus of research will not only be on basic dis- gap between medical and dental education, covery science and the clinical and technical promotes and strengthens collaborative prac- aspects of providing oral care. In addition, tice, and includes public health, disease pre- there will need to be a greater emphasis on im- vention and health promotion as core activities plementation and translational research, taking of every oral health professional. Unless such into account the global health implications of changes are brought about, the long-term goal oral diseases and the different needs of low- of having suffcient numbers of appropriately and middle-income countries. People have al- achieving this will be the increase in people ways moved to another country for work, but who retain a full set of healthy teeth through- the accelerated migration from poorer to out life. Accreditation of professional education are required, together awareness of public health service 2004–11 1950–2014 dental education programmes and licensure with curricular and institutional reforms, in and policy, inter-professional private school cooperation, critical thinking and private colleges requirements vary regionally, and there are no order to create an effective global oral health public school decision making, self-management public colleges globally recognized competency standards. The cross-border movement of oral which lose the educational investment made tion and trade in the wake of globalization. The Main reasons for dental tourism include lower non with both positive and negative effects. Yet the other hand, the economy of some net outside their home country involves complex positive and negative costs of care in the destination country, no very little is known about the extent of the exporting countries may depend on remit- issues related to ethics, quality of care and the waiting times and short time-span of treatment, impacts on sending migration of oral health professionals, because tances from those migrating abroad. Such efforts must be mindful of the human medical tourism has developed into a major country. It factors coexist with broader health-system, codes of practice for international recruitment is essential that international social and political issues. Orthopaedic surgery, specialized dental General surgery (implants), dental plastic surgery. Furthermore, a paradigm determinants of health, adopting upstream rather than downstream strategies. The continuum from discovery to global prevention and the integration of oral health re- cultural sensitivities and socioeconomic constraints for improving oral health literacy. The first step in this element in a concerted effort to fill essential 9 Raise the issue of oral health inequalities, with the need to promote proportionate continuum is the translation from basic science universalism and specific emphasis on underprivileged communities, in wider public knowledge gaps in oral health. The re- systematically to improve the prioritization sulting disconnect between oral health, den- and integration of oral health in international tistry and the mainstream of global health public health agendas. At the versal Health Coverage, which, as discussed in same time, policies need to be translated into this chapter, constitutes an essential element to tangible actions giving everyone equitable foster progress on oral health outcomes, ine- access to effective prevention and appropriate qualities and socioeconomic impact. Oral health professionals good example for the benefts of integrating oral and their representative organizations partici- and general health. Oral diseases are recog- pated actively in the drafting process of the nized as an area of major public health concern convention and the agreement to phase-down and a deeper integration of oral health into amalgam use. The declaration also make important contributions towards health area that we cannot afford to ignore and that is largely preventable. The increasing health, exceed 10 percent of energy intake was based a shared sense of moral duty to social, and financial burden they cause is the on evidence for their effect on tooth decay. These were supported by the development attention on context of global Health, as a precondition and an outcome of agenda communicable public health and a comprehensive monitoring mechanism that sustainable development, has a central role • Focus attention and diseases and omitted development. Health was directly addressed health problems of • Fragmented the Goal 3, to ‘Ensure healthy lives and promote health system by three of the eight goals. Something adopting a improve prioritization and integration of oral for as preventable as tooth decay life-course approach It will therefore be important to relate oral multi-stakeholder health on international public health agendas. Truly ‘universal’ health coverage will only be achieved when promotive, preventive, curative and rehabilitative oral healthcare are fully integrated in the wider health system context. Moreover, appropriate financing mechanisms must cover all population groups, including the most disadvantaged such as the poor, disabled, immigrants and others. Countries across the powerful concept world include dental services with varying public health has levels of coverage, depending on their to offer. Because oral health • ‘Health for All’ – reaching have to pay needs by providing minimum primary care Reduce cost Include people with healthcare services out-of-pocket? At present a global picture of Extend to access to oral healthcare primary care non- the extent of inclusion of oral healthcare covered coverage should be • Reducing cost sharing and fees, services is not available. Oral Health Care models and to guide College of Dentistry, and Lois Cohen, Who is covered? Article 4 Paragraph 3 Measures to be taken by a Party to phase down the use of dental amalgam shall oral health professionals to advocate for take into account the Party’s domestic circumstances and relevant international guidance and shall atmosphere 50–70 The provisions of the Convention effective prevention strategies against tooth include two or more of the measures from the following list: set challenges to: governments decay; and for policy makers to prioritize 1 Setting national objectives aiming at dental 6 Discouraging insurance policies and for effective implementation prevention and control of oral diseases as part caries prevention and health promotion, thereby programmes that favour dental amalgam use through regulation of of primary healthcare, so that the long-term minimizing the need for dental restoration; over mercury-free dental restoration; total supply, import, use need for dental fillings is reduced. It also makes It is now time for governments and policy recommendations for action to address this makers to respond to the global oral health unacceptable burden and reduce the impact of crisis and act to reduce the burden of oral dis- these largely preventable diseases. Despite progress and advances in some of the possible approaches to achieve some areas, the state of the world’s oral health better recognition, integration and prioritiza- is still characterized by neglect, low prioritiza- tion of oral diseases at the community, national, tion and inadequate responses of governments regional and international level. All chapters of The Challenge of Oral Disease Even in high-income countries, large segments – A call for global action provide practical rec- of the population have limited access to oral ommendations and guidance for action. The healthcare, so that much of the oral disease following presents the key points in a summa- burden remains untreated. Moreover, there is a rized style, in order to facilitate advocacy and paucity of good country-level data on the prev- ready access to the most important aspects. Oral diseases have a major adverse impact on general health The global improvement in life expectancy, and the resulting coverage, particularly in countries with high prevalence, in • Primary prevention and essential surgery services for birth and on quality of life. A healthy and well-functioning dentition increase in the population of older people, makes a life-course order to improve patient survival rates and quality of life, as defects such as cleft lip and/or palate must be part of is important during all stages of life to support essential human approach to oral health very important. The involvement of oral health professionals in Improving oral disease surveillance and data collection The burden of oral diseases – a largely neglected reality effective multi-disciplinary care is essential. The persisting gaps in data on the prevalence of oral diseases, • Dentists and oral healthcare professionals have an obligation and their burden and severity in different populations, means Tooth decay – addressing the most common chronic • Implementing population-wide strategies to maintain a to provide ethical, equitable care to all patients, irrespective that awareness of the signifcance of these diseases is poor. This will also require increased inter- and referral to specialist care are essential to prevent rapid • Monitoring of noma, orofacial trauma and congenital maintaining good oral hygiene. The impacts on quality of life Periodontal disease – a common but preventable oral for those who survive the disease can be high. General population-wide 92 93 Social determinants and common risk factors – the main drivers of oral diseases Inequalities in oral health – disease burden, impact and access to care Both the general and oral health of whole populations are Tobacco use Socioeconomic status is a fundamental determinant of • Public health action on the broader determinants of health, largely determined by social factors and their interaction with Tobacco use in all forms is harmful to health, including oral both oral and general health. Action to reduce oral health with particular emphasis on the younger generation, where a set of common risk factors, namely sugar, tobacco, alcohol health. Dentists and their teams can effectively help patients inequalities needs to address the underlying causes of disease. Oral diseases have considerable impact in terms • Working in partnership across relevant sectors, agencies and barriers to healthcare, promoting affordable housing, safe • Raising taxes on tobacco products to reduce consumption. Dental teams and their national professional bodies • Systematically including health and oral health in all Harmful use of alcohol have an important advocacy role in promoting policies to policies can help to reduce negative effects on health Harmful use of alcohol is a major risk factor for more than reduce health inequalities in the populations they serve. Policy equity of policy decisions in other sectors and can 200 diseases, including oral cancer and periodontal disease, measures include, but are not limited to: contribute to increasing synergies for better health status and must be addressed as part of a comprehensive approach to of populations. Dentists and the dental team – key providers of oral care • Including the dental profession in the planning, • Tackling inequalities requires action across the whole social • Implementing and enforcing effective measures that in the wider healthcare system development and implementation of oral healthcare gradient to deliver the greatest population-wide beneft.
