Oral Assessment and Preventive Actions within the Swedish Quality Register Senior Alert: Impact on Frail Older Adults’ Oral Health in a Longitudinal Perspective

Poor oral health is common among older people in nursing homes. To identify and prevent oral health problems among the residents, ROAG-J (Revised Oral Assessment Guide–Jönköping), a risk-assessment instrument, is used by nursing staff routinely, and the outcome is registered in the web-based Swedish quality register Senior Alert. This study aims to investigate the preventive actions registered when oral health problems are identified and the effect of these actions longitudinally. ROAG-J data registered at nursing homes in Sweden during 2011–2016 were obtained from the Senior Alert database. Out of 52,740 residents (≥65 years), 41% had oral health problems, of whom 62% had preventive actions registered. The most common action was “Assistance with cleaning teeth”. Longitudinally, during the five-year observation period, a slight increase in oral health problems assessed with ROAG-J was found. Registered preventive actions, however, led to significant improvement in the subsequent assessment for the ROAG items lips, tongue, and dentures. Standardised risk assessments like ROAG-J provide an opportunity to detect problems early and establish preventive actions. The study, however, indicates a further need for structured education and a continuous follow-up in ROAG-J. Moreover, increased collaboration between nursing and dental care to improve oral health for older residents at nursing homes is needed.

Clinical Implications of Oral Assessment In Elderly Patients With Acute Heart Failure: A Single-Center, Retrospective Study

Background: Oral health problems are common and are associated with various geriatric conditions in older adults. The importance of oral health has not been fully highlighted in the assessment and management of patients with heart failure. Here, we investigated the clinical implications of oral assessment in elderly patients with acute heart failure.Methods: We evaluated oral health using the revised oral assessment guide in 77 patients aged 65 years or older who were admitted to hospital for acute heart failure. Poor oral health was defined as a revised oral assessment guide score ≥ 9.Results: Poor oral health was identified in 66.2% of the patients. Patients with poor oral health had high prevalence of decreased physical function, undernutrition, and cognitive impairment. A reduction in the Barthel Index, as an indicator of activities of daily living during hospitalization, was significant in the enrolled patients. The Barthel Index decreased more in patients with poor oral health than those with normal oral health. Furthermore, the revised oral assessment guide score on admission was found to be the only independent predictor of changes in the Barthel Index during hospitalization in the multivariate regression analyses. Conclusions: Oral assessment using the revised oral assessment guide during hospitalization could provide useful information for the management of elderly heart failure patients.Trail registration: Patients were retrospectively registered.

Clinical Implications of Oral Assessment in Elderly Patients with Acute Heart Failure: A Single-center, Retrospective Study

Oral health problems are common and are associated with various geriatric conditions in older adults. The importance of oral health has not been fully highlighted in the assessment and management of patients with heart failure. Here, we investigated the clinical implications of oral assessment in elderly patients with acute heart failure. We evaluated oral health using the revised oral assessment guide in 77 patients aged 65 years or older who were admitted to hospital for acute heart failure. Poor oral health (defined as a revised oral assessment guide score ≥ 9) was identified in 66.2% of the patients. Patients with poor oral health had high prevalence of decreased physical function, undernutrition, and cognitive impairment. A reduction in the Barthel Index, as an indicator of activities of daily living during hospitalization, was significant in the enrolled patients. The Barthel Index decreased more in patients with poor oral health than those with normal oral health. Furthermore, the revised oral assessment guide score on admission was found to be the only independent predictor of changes in the Barthel Index during hospitalization in the multivariate regression analyses. In conclusion, oral assessment using the revised oral assessment guide during hospitalization could provide useful information for the management of elderly heart failure patients.

A Theoretical Review on the Need to Use Standardized Oral Assessment Rubrics for ESL Learners in Saudi Arabia

There is a growing need for standardized oral assessment rubrics in learning institutions. This is linked to the growing number of ESL learners not only in Saudi Arabia but other parts of the world. To assess the need to use standardized oral assessment rubrics, this particular study explores various peer reviewed articles that support the use of standardized rubrics while assessing oral skills among ESL learners in Saudi Arabia. Standardized rubrics give students a reference point in regards to what is expected while learning oral skills. As a result, students are able to work towards improving their skills to meet the standards of the rubric. Various scholars have given different definitions for the term rubric. In all the definitions, grading criteria is a common feature. Some experts have stated that, modern rubrics should go beyond grading to guiding students in understanding their expectations in oral tests. When developing standardized rubrics, teachers should ensure that the rubrics meet the required validity and reliability to assist ESL learners in meeting their goals. Literature shows that there is a gap in the current oral assessment rubrics in Saudi Arabia, and it requires a prompt review. Therefore, developing a standardized rubric should take a multidisciplinary approach. Scholars and experts teaching ESL students must be consulted to ensure all important factors are considered and incorporated in the standardized rubric. 

Classroom Assessment for EFL Learning to Speak at Junior high School

The present study investigated the current practice of EFL Classroom assessment focusing on speaking skills in Junior High School. Speaking Assessment is a tool used to evaluate students’ oral skills in the formal system by the English teachers. The investigation of classroom speaking assessment in this school was based on its effectiveness in light of alternative assessment tool and pedagogical values. By using ADDIE model, we constructed an oral assessment in accordance with the needs and levels of students as well as components on the oral assessment. There were five commons models such as Oral Interview, Role Play, Guessing Games, Story Telling and Oral Report that are communicative, relevant, continues, simple and various forms. These models can be used to assess students’ speaking skills regardless of time and place as its validity and practicality tests appeared to be high (93.75 and 87.5). It can be concluded that these assessment models are applicable for teachers to assess students’ speaking skill. The paper further elaborates discussion on the utilizing of students’ ability, progress, and their learning process. In short, it is a high time for the teachers to apply these models in the classroom.