Background: In frail older people with natural teeth factors like polypharmacy, reduced salivary flow, a decrease of oral self-care, general healthcare issues, and a decrease in dental care utilization contribute to an increased risk for oral complications. On the other hand, oral morbidity may have a negative impact on frailty. Objective: This study explored associations between oral health and two frailty measures in community-dwelling older people. Design: A cross-sectional study. Setting: The study was carried out in a Primary Healthcare Center (PHC) in The Netherlands. Participants: Of the 5,816 persons registered in the PHC, 1,814 persons were eligible for participation at the start of the study. Measurements: Two frailty measures were used: 1. Being at risk for frailty, using Electronical Medical Record (EMR) data, and: 2. Survey-based frailty using ‘The Groningen Frailty Indicator’ (GFI). For oral health measures, dental-record data (dental care utilization, dental status, and oral health information) and self-reported oral problems were recorded. Univariate regression analyses were applied to determine the association between oral health and frailty, followed by age- and sex-adjusted multivariate logistic regressions. Results: In total 1,202 community-dwelling older people were included in the study, 45% were male and the mean age was 73 years (SD=8). Of all participants, 53% was at risk for frailty (638/1,202), and 19% was frail based on the GFI (222/1,202). A dental emergency visit (Odds Ratio (OR)= 2.0, 95% Confidence Interval (CI)=1.33;3.02 and OR=1.58, 95% CI=1.00;2.49), experiencing oral problems (OR=2.07, 95% CI=1.52;2.81 and OR=2.87, 95% CI= 2.07;3.99), and making dietary adaptations (OR=2.66, 95% CI=1.31;5.41 and OR=5.49, 95% CI= 3.01;10.01) were associated with being at risk for frailty and surveybased frailty respectively. Conclusions: A dental emergency visit and self-reported oral health problems are associated with frailty irrespective of the approach to its measurement. Healthcare professionals should be aware of the associations of oral health and frailty in daily practice.
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Background: Early childhood caries is considered one of the most prevalent diseases in childhood, affecting almost half of preschool-age children globally. In the Netherlands, approximately one-third of children aged 5 years already have dental caries, and dental care providers experience problems reaching out to these children. Objective: Within the proposed trial, we aim to test the hypothesis that, compared to children who receive usual care, children who receive the Toddler Oral Health Intervention as add-on care will have a reduced cumulative caries incidence and caries incidence density at the age of 48 months. Methods: This pragmatic, 2-arm, individually randomized controlled trial is being conducted in the Netherlands and has been approved by the Medical Ethics Research Board of University Medical Center Utrecht. Parents with children aged 6 to 12 months attending 1 of the 9 selected well-baby clinics are invited to participate. Only healthy children (ie, not requiring any form of specialized health care) with parents that have sufficient command of the Dutch language and have no plans to move outside the well-baby clinic region are eligible. Both groups receive conventional oral health education in well-baby clinics during regular well-baby clinic visits between the ages of 6 to 48 months. After concealed random allocation of interventions, the intervention group also receives the Toddler Oral Health Intervention from an oral health coach. The Toddler Oral Health Intervention combines behavioral interventions of proven effectiveness in caries prevention. Data are collected at baseline, at 24 months, and at 48 months. The primary study endpoint is cumulative caries incidence for children aged 48 months, and will be analyzed according to the intention-to-treat principle. For children aged 48 months, the balance between costs and effects of the Toddler Oral Health Intervention will be evaluated, and for children aged 24 months, the effects of the Toddler Oral Health Intervention on behavioral determinants, alongside cumulative caries incidence, will be compared. Results: The first parent-child dyads were enrolled in June 2017, and recruitment was finished in June 2019. We enrolled 402 parent-child dyads. Conclusions: All follow-up interventions and data collection will be completed by the end of 2022, and the trial results are expected soon thereafter. Results will be shared at international conferences and via peer-reviewed publication.
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The aim of this study was to evaluate the impact of the implementation of an Oral Care Program on home care nurses' attitudes and knowledge about oral health (care) and the impact on older people's oral health. A pre-post study, without a control group, was conducted. A preventive Oral Care Program (OCP) was designed, focusing on home care nurses and older people, in collaboration with dental hygienists. Implementation was measured with questionnaires at baseline and after 6 months for home care nurses; for older people, implementation was measured at baseline and after 3 months with the Oral Health Assessment Tool and a questionnaire about oral (self) care between January 2018 and September 2019. Although the study design has limitations, the oral health of older people improved significantly after 3 months and the OCP was most beneficial for people with full dentures. The OCP improved knowledge and attitude of home care nurses. The program fitted well with the daily work routines of home care nurses. Individual-centered care plans for older people, education of home care nurses and the expertise of the dental hygienists have added value in home care nursing. Future implementations should focus on older people with natural teeth.
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Worldwide over- and misuse of antibiotics has contributed to the development of antibiotic-resistance. The occurrence and increase of antibiotic-resistance is one of the most pressing global health care issues of the 21st century. Recently it has been recognized that fruit and flower anthocyanins have antimicrobial activity and thereby the potential to function as novel antibiotics. At the Hanze University of Applied Science, we were able to confirm the antimicrobial efficacy of purified Rosa and Tulipa anthocyanin extracts against an array of microbial species. Using our optimized extraction methods, anthocyanins can easily be extracted and purified from floral residual streams. Once marketed as novel antimicrobials, this valorization of residual streams to high-value compounds contributes to the transition towards a circular economy. However, for future application in different antimicrobial products, it is necessary to identify and characterize single antimicrobial anthocyanin molecules. Moreover, analysis of pilot-scale extraction- and fractionation-yields and antimicrobial bench-mark doses will provide information on their market and application potential. In the current project we propose to develop a strategy composed of fractionation and state-of-the-art characterization methods to identify anthocyanin-molecules with potent antimicrobial effects. To our knowledge this is the first strategy that combines in-depth chemical characterization of anthocyanins in relation to their antimicrobial efficacy. Once developed, this strategy will allow us to single out anthocyanin molecules with antimicrobial properties. The development of the proposed fractionation and characterization strategy is the first step towards the development of single anthocyanin molecules as novel plant-based antibiotics.
In line with the ‘Natuur- en milieubeleidsplan Caribisch Nederland 2020-2030 (NMBP)’ the consortium intends with this research proposal to contribute to a prosperous society with a resilient population and healthy natural environment. The Caribbean Netherlands are dealing with a situation where imported vegetables and fruits are mostly imported and hardly affordable. This leads to consuming unhealthy food and high obesities rates as a consequence. A lack of good agricultural practices with regard to water-smart and nature inclusive agriculture, as well as limited coping capacities to deal with hazards and climate change, results in very limited local production and interest. Initiatives that focused only on agrotechnological solutions for food resilient futures turned out to be ineffective due to a lack of local ownership, which jeopardizes sustainability. Moreover, the ‘green’ and ‘blue’ domains are not seen as attractive career perspectives among youth, hampering a bright future for those domains. The aim of this research is to contribute to water-smart and nature inclusive food resilience embedded in a local participatory perspective in the Caribbean Netherlands. To address the above challenges, a living lab approach is adopted, where youth will be trained as (co)-facilitators (WP1) who will contribute to a participatory envisioning process and an articulation of food resilient futures (WP2). Finally, based on the envisioning process local stakeholders will select and implement experiments for food resilient futures followed by dissemination of results among key stakeholders as well as children and youth at the BES islands (WP3). This project strategy will lead to a network of a living lab where professionals and youth work together on food resilient futures. Training manuals and the results of experiments with regard to water and food system alternatives will be used actively to encourage youth to be involved in sustainable agriculture and consumption.
Inside Out is an innovative research project that translates cutting-edge microbiome science into immersive, multisensory experiences aimed at long-term behavioral and mental health transformation. Combining extended reality (XR), speculative gastronomy, and narrative therapy, the project enables participants to explore their inner microbiome landscape through taste, smell, touch, and interactive storytelling. This pioneering methodology connects gut-brain science with emotional and sensory engagement. Participants experience their bodies from the inside out, cultivating a visceral understanding of the symbiotic microbial worlds within us. The project includes AI-generated "drinkable memories," microbiome-inspired food designs, haptic-olfactory VR environments, and robotic interactions that choreograph the body as terrain. Developed in collaboration with designers from Polymorf, producer Studio Biarritz, psychiatrist-researcher Anja Lok, and microbiome scientists from Amsterdam UMC and the Amsterdam Microbiome Expertise Center, Inside Out bridges scientific rigor with artistic expression. The project seeks to: • Increase embodied understanding of the microbiome’s role in health and well-being • Shift public perception from hygiene-based fear to ecological thinking • Inspire behavioral change related to food, gut health, and mental resilience The outcomes are designed to reach a large audience and implementation in science museums, art-science festivals, and educational programs, with a view toward future clinical applications in preventive healthcare and mental well-being. By making the invisible microbiome tangible, Inside Out aims not only to inform, but to transform—redefining how we relate to the ecosystems within us.
