Since the beginning of the era of space travel, there have been mentions of related health effects. Various studies have described the effect of space travel and microgravity on health. Some of these studies involved short and extended follow-ups of the effect of microgravity on the head and neck of astronauts. Therefore, we aimed to analyse the oral and maxillofacial health effects associated with this sophisticated mission. It is essential to identify relevant problems and address microgravity complications. Humans have long dreamed of flying and in recent years, the dream has evolved to exploring space and creating new habitats on other planets such as Mars. This led to an increase in the need for dental treatment of the flight crew members, which led to the creation of aviation dentistry for the screening and treatment of the oral cavity of the flight crew. We are moving towards a more conservative approach than before, such as removing pulpless teeth in aircrew patients or extracting roots that had a fracture or incomplete extraction. With all the advancements in aerospace knowledge, the aviation dentistry has rarely or briefly been discussed in dental textbooks. Dentists must screen each flight crew member thoroughly and impose flight restrictions and ground them if necessary; the reasons will be discussed later within this paper. It is the duty of dentists and surgeons to notify their patients (aircrew members) about the postoperative flight consequences and restrictions.

This article argues that Luke influences the Gospel of Thomas, on the basis of an examination of those places where redactional material in Luke not in Mark is found in Thomas. This has been argued already by various scholars, but the present study aims (a) to refine further the method used to argue this position and (b) to expand the catalogue of those Thomas sayings which can be shown to indicate Lukan influence. Furthermore, it proposes (c) to respond to recent scholarship arguing that Thomas influences Luke, as well as to scholars maintaining the independence of Thomas and the Synoptics.

With the considerable cost of disease-related malnutrition to individuals and to society (estimated to be >£13×109 for the UK, 2007 prices), there is a need for effective and evidence-based ways of preventing and treating this condition. The wide range of oral nutritional supplements that may be prescribed for the dietary management of malnutrition and other conditions account for only about 1% (about £99×106, 2007 data) of the prescribing budget in England. Systematic reviews and meta-analyses consistently suggest that ready-made, multi-nutrient liquids which may be prescribed can improve energy and nutritional intake, body weight and have a variety of clinical and functional benefits in a number of patient groups. Meta-analyses have repeatedly shown that oral nutritional supplements produce significant reductions in complications (e.g. infections) and mortality, and a recent meta-analysis shows a reduction in hospital admissions (OR 0·56 (95% CI 0·41, 0·77), six randomised controlled trials). Such benefits suggest that the appropriate use of oral nutritional supplements should form an integral part of the management of malnutrition, particularly as there is currently a lack of evidence for alternative oral nutrition strategies (e.g. food fortification and counselling). As with all therapies, compliance to oral nutritional supplements needs to be maximised and the use monitored. To make sure that those at risk of malnutrition are identified and treated appropriately, there is a need to embed national and local policies into routine clinical practice. In doing so, the economic burden of this costly condition can be curtailed. As recently suggested by the National Institute for Health and Clinical Excellence, substantial cost savings could be made if screening and treatment of malnourished patients was undertaken.

Background: Mental illness and cognitive impairment are risk factors for poor dental health.

Methods: We conducted a cross-sectional study to compare the dental health of older patients attending out-patient clinics and day hospitals of old age psychiatry services (the psychiatry group, n = 103) with those attending general/geriatric medical services (the medical group; n = 99). Those living in care homes, and those with diagnosed mental illness (in the medical group) were excluded. A registered mental health nurse assessed mental and general health using validated and previously published instruments. A registered dentist made an independent assessment of dental health (examination to assess oral pathology, status of remaining teeth, and dentures) and made an overall judgment about whether the patient needed any dental treatment (a “normative” need).

Results: The normative need for dental treatment was significantly higher among the psychiatry group compared to the medical group (85% vs 52%; p<0.001); even after taking account of the effect of age, gender, teeth status, physical comorbidity, cognition, depressive symptoms, and overall mental and social health [adjusted odds ratio, OR (95% confidence interval): 4.32 (2.09, 8.91)]. The presence of any natural remaining teeth [OR: 4.44 (2.10, 9.42)] and Barthel Index [OR: 0.96 (0.93, 0.99)] were the two other independent predictors of the need for treatment.

Conclusion: Dental problems are common in community-living older people, especially those with some natural remaining teeth and those with mental illness. There is a need to develop integrated mental health and dental care services for older people with emphasis on prevention of dental problems.

Morphine is recommended as the strong opioid of choice by the World Health Organization (WHO) for cancer pain management. It is associated with delay in gastro-intestinal transit; as a result, patients may experience marked constipation. We describe a case of intestinal pseudo-obstruction associated with the use of oral morphine in a terminally ill cancer patient.