The aim of this investigation was to evaluate orthodontic treatment need and patient satisfaction among young adults living in a city where free-of-charge orthodontic treatment was provided. A total of 281 18- to 19-year-old subjects randomly selected from the population register of the city of Vantaa took part in the study. The drop-out rate was 30%. Treatment need was clinically assessed according to the Index of Orthodontic Treatment Need (IOTN), consisting of a Dental Health Component (DHC) and an Aesthetic Component (AC). Information on previous orthodontic treatment was based on the patient records. Satisfaction of the subjects with their dental appearance and with the orthodontic treatment received was obtained using a questionnaire. The rate of orthodontic treatment among the subjects was 46% (54% for the females and 37% for the males, p < 0.05). 4% had discontinued treatment. A definite need for treatment (DHC 4 to 5/AC 8 to 10) was assessed in 15% of the subjects, and borderline/moderate need (DHC 3/AC 5 to 7) in 36%. No difference in IOTN scores between the treated and untreated subjects was found. Females had significantly more often no treatment need (DHC 1 to 2/AC 1 to 4) compared with males (p < 0.05). The majority of subjects (89%) reported that they were very or quite satisfied with their dental appearance. The odds of being satisfied were significantly higher for the treated subjects (OR = 2.71, p < 0.05) and lower for those at the non-attractive end of the AC scale (OR = 0.14, p < 0.01). Neither gender nor DHC grade significantly affected the odds of being satisfied among the subjects. The results indicate that the majority of young adults in this study were satisfied with their dental appearance regardless of objective treatment need of various degrees. The high treatment rate in relation to unnoticed treatment need calls for reevaluation of priorities in patient selection.

The Coronavirus pandemic and associated measures for the protection of the public have impacted differently on different parts of the population and across different nations. In many areas, COVID-19 has also either exacerbated already existing or created new inequalities in relation to specific parts of the population. Older individuals are one group in society that has been widely impacted, while social isolation/shielding measures have placed them in higher risk of loneliness, isolation, financial deprivation and mental health challenges, to name a few. This commentary reflects on such inequalities across four European nations (the United Kingdom (UK), Republic of Ireland, Finland, Spain) and draws attention to the critical role of Gerontological Social Work (GSW), while emphasizing the ways in which social work can intervene. First, we identify common concerns for the rights of older people that span across all four nations and second, we identify significant roles for GSW practitioners at the individual, community and policy levels and conclude with a call for GSW in these four nations to be reimagined in a time of global crisis.

Extracellular matrix (ECM) molecules, such as laminin, tenascin, chondroitin sulphate proteoglycans and heparan sulphate proteoglycans have been suggested to have 'signpost' and directing roles in the formation of axonal projections in cortical development. We show here that the expression of the neurite outgrowth-promoting protein heparin-binding growth-associated molecule (HB-GAM) and N-syndecan, a transmembrane heparan sulphate proteoglycan previously isolated as a receptor for HB-GAM, is spatiotemporally associated with the developing thalamocortical pathway in the rat brain. Using in situ hybridization, thalamic neurons were shown to express mRNA for N-syndecan, and in vitro, thalamic neurons grew more neurites on HB-GAM than on laminin. The HB-GAM-induced neurite outgrowth in thalamic neurons was inhibited by heparitinase, heparin, soluble N-syndecan and by an excess of soluble HB-GAM in the culture medium. In a pathway assay, thalamic neurons selectively preferred attaching and growing neurites on matrices containing HB-GAM than on those containing fibronectin or laminin alone, suggesting that HB-GAM may modulate the effect of other ECM proteins. On an unfixed brain slice preparation, thalamic neurons repeatedly showed a typical neurite outgrowth and attachment pattern resembling the expression pattern of HB-GAM. On the brain slices, the neurite outgrowth was significantly inhibited by heparitinase, heparin and soluble HB-GAM, thus displaying features of neurite outgrowth on matrix-bound HB-GAM. Our results suggest that HB-GAM is important for the neurite outgrowth of thalamic neurons and it may function as an ECM-bound guidance cue for thalamic neurons that possess HB-GAM-binding heparan sulphates on their cell membrane.

This chapter brings together three dimensions of negative social relations as they impinge on and are experienced by older people, which have not been addressed together in previous studies. Each dimension, conflictual relationships, abuse and discrimination, is characterised by demeaning social interactions that are important to address when considering social exclusion in ageing societies. Five national studies were carried out in Norway, Finland, Israel, Italy and New Zealand. The studies in each dimension confirmed many of the findings of earlier research that have identified the negative health and social relations associations with each dimension. The three dimensions that are usually studied within their own boundaries are brought together to demonstrate the similar way each reduces the quality of life and social inclusion of older people. They function as exclusionary mechanisms in comparable ways within the social relations domain and have an important place in a conceptual framework of old-age social exclusion. While previous research has focussed on each dimension separately, this lens on the similarities and interrelationships of the three dimensions has enabled a broader understanding of exclusionary mechanisms. It also enables more comprehensive and effective policy formation, than a focus on one dimension at a time.