KDA Today

KDA Today

For Immediate Release

Date: Sep 12th, 2016
Contact: W. Michael Mansfield, D.M.D.
Phone: 800-292-1855
Email: info@kyda.org

Aging and Frailty Basics

Seeing a friend, relative, patient or acquaintance age through the years and/or who is at the end of life is an experience most everyone has faced. As the percentage of the population over the age of 65 continues to increase in the United States, an increasing percentage of the patients many dentists see will be over 65. According to the Pew Research Center (http://www.pewresearch.org/daily-number/baby-boomers-retire/ Accessed 7-19-16), 10,000 people turn 65 every day. In the “State of Aging Report 2013” by the Center for Disease Control and Prevention (http://www.cdc.gov/aging/pdf/state-aging-health-in-america-2013.pdf Accessed 7-19-16), it is estimated that approximately 20% of the U.S. population will be over 65 by the year 2030. Having a working knowledge of key components of Aging and Frailty will allow all of us to better understand, help and communicate with those people over 65, their caregivers and other healthcare professionals.

At this point in time (2016), who are these people who make up the over 65 demographic? The over 65 demographic (often called older adults or senior adults) consists of three generations. Those three generations are the GI or Greatest Generation, the Traditional or Silent Generation, and the Baby Boom or Boomer Generation. People who are members of a particular generation often have similarities and shared values due in part to shared experiences/events which help define them.

The Greatest Generation
We are seeing the members of the Greatest or GI Generation rapidly leave us. According to many experts, this generation consists of people born roughly between the years of 1900 and 1925. There are events which are shared by members of a particular generation which help define them. For the Greatest Generation, three of those events would be: WWI, the Great Depression and WWII. Dr. Jill Novak writes in a post titled, “The Six Living Generations in America”, (http://www.marketingteacher.com/the-six-living-generations-in-america/ Accessed 7-16-16)
the characteristics members of the GI Generation often share include:
• Assertive and energetic doers.
• Excellent team players, community-minded, and strongly loyal to jobs, groups, schools, etc.
• Strongly interested in personal morality and near-absolute standards of right and wrong.
• Believing that you work until your die or can’t work anymore.
• Avoiding debt, saving and buying with cash.
• Able to remember life without airplanes, radio/TV, refrigerators, electricity and air conditioning.

The Traditional Generation
People born between 1925 and 1946 make up the Traditional or Silent Generation. Shared events for this generation include: the Great Depression, WWII, the Post-WW II Economic Boom, the Korean War, Assassinations of John Kennedy, Bobby Kennedy and Martin Luther King, the Vietnam War, the Civil Rights Movement and Watergate.
Common characteristics/beliefs of members of the Traditional Generation according to Dr. Novak include;
(http://www.marketingteacher.com/the-six-living-generations-in-america/ Accessed 7-16-16)
• Have a strong sense of trans-generational common values and near-absolute truths.
• Are disciplined, self-sacrificing, cautious.
• Most women have stayed home, generally to raise children and if they have worked, it is/was only at certain jobs like teacher, nurse or secretary.
• Men are loyal to the corporation and generally believe that once you get a job, you keep it for life.
• The richest, most free-spending retirees in history.
• Believe that marriage is for life and that divorce and having children out of wedlock are not acceptable.
• Are avid readers.
Note: Like most members of the Greatest Generation, they are punctual.

Baby Boom Generation
People born between 1946 and 1964 comprise the Baby Boom Generation (Boomers). Defining events for the Baby Boom Generation include: Assassinations of John Kennedy, Bobby Kennedy and Martin Luther King, the Vietnam War, Man Stepping on the Moon, Woodstock, Watergate and the Internet.
Common characteristics/beliefs of members of the Baby Boom Generation according to Dr. Novak include;
(http://www.marketingteacher.com/the-six-living-generations-in-america/ Accessed 7-16-16)
• Optimistic, driven, team-oriented.
• Envision technology and innovation as requiring a learning process.
• Tend to be positive about authority, hierarchal structure and tradition.
• Sometimes called the “me” generation and are often considered self-righteous and self-centered.
• Have strong desires to reset or change the common values for the good of all.
• Women of this generation began working outside the home in record numbers.
• The first generation to have their own children raised in a two-income household where mom was not omnipresent.
• The first TV generation and divorce generation, where divorce is/was beginning to be accepted as a tolerable reality.
• The first generation to use the word “retirement” to mean being able to enjoy life after the children have left home. Instead of sitting in a rocking chair, they go skydiving, exercise and take up hobbies, which increases their longevity.

Activities of Daily Living
Understanding characteristics common to each of these generations can lead to better communications and an understanding of factors which may be associated with specific behaviors by members of a particular generation. Good communications with other healthcare professionals can also be facilitated by members of the dental profession having an understanding of common measures/assessments of aging. For example, the Activities of Daily Living (ADL) are a list of activities which may be assessed to help determine a person’s functional status. These activities include 17 Functions which are evaluated as being able to be done independently, with help, dependent on/requiring someone else to do or does not do. Note that oral care is one of the items on the list of Daily Living Functions commonly assessed that is provided below. A checklist of the Activities of Daily Living (ADL) may be found at:
(http://www-tc.pbs.org/wgbh/caringforyourparents/caregiver/pdf/cfyp_adl_checklist.pdf Accessed 7-15-16)
-Bathing
-Managing Medications
-Dressing
-Using the Phone
-Grooming
-Managing Money
-Oral Care
-Housework
-Toileting
-Doing Laundry
-Transferring
-Driving
-Walking
-Shopping
-Climbing Stairs
-Cooking
-Eating

Instrumental Activities of Daily Living
Instrumental Activities of Daily Living (IADL) are activities which are more complex than the Activities of Daily Living (ADL). According to the American Psychological Association, (http://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/daily-activities.aspx Accessed 7-16-16) an IADL Scale was developed to assess people living and functioning in community settings and not long term care facilities, such as nursing homes. The IADL scale consists of 22 activities such as shopping, cooking and managing finances. The capacity to handle these complex functions normally is lost before the more basic activities of daily living (e.g., eating and oral care/tooth brushing), which are measured by ADL scales. Dental care professionals may be one of the first healthcare professionals to notice people who are starting to experience a decline in their ability to take care of themselves by observing a decline in oral health status.

What is Successful Aging?
Models which contain various elements key to a person being able to age successfully have been proposed. One popular model recognizes the importance of spirituality to a person’s ability to optimally age. In 2002, Crowther, Parker and others proposed adding the additional component of “Maximizing Positive Spirituality” to the widely recognized Rowe and Kahn Model of Successful Aging. The article titled, “Rowe and Kahn’s Model of Successful Aging: Revisited: Positive Spirituality-The Forgotten Factor” appears in Volume 42, No.5 of The Gerontologist. Rowe and Kahn’s Model had originally consisted of three components, however, the Revised Rowe and Kahn Model of Successful Aging consists of the following four components:
· Minimizing Risk and Disability/Disease
· Engaging in Life Actively (Social Engagement)
· Maximizing Physical and Mental Activities (Cognitive Function)
· Maximizing Positive Spirituality

According to the World Health Organization, (http://www.who.int/mediacentre/factsheets/fs404/en/ Accessed 7-16-16), at the biological level, aging results from the impact of the accumulation of a wide variety of molecular/cellular damage over time, which leads to a gradual decrease in physical and mental capacity, a growing risk of disease, and ultimately death. These changes are only loosely associated with a person’s age in years. While some older adults at a particular age may have extremely good health and functioning, other older adults at that same age are frail and require significant help from others. Although some of the variations in older people’s health are genetic, much is due to people’s physical and social environments – including their homes, neighborhoods, and communities, as well as their personal characteristics – such as their sex, ethnicity, or socioeconomic status.

There appears to be a range from Excellent/Good to Poor/Failing in describing the health status of adults as they age, which illustrates the diversity in the physical and mental status of older adults. As we age, people may acquire more chronic conditions and a decreased ability to handle acute conditions. According to the U.S. Center for Disease Control, (http://www.cdc.gov/nchs/health_policy/adult_chronic_conditions.htm Accessed 7-18-16) in 2008, 85% of people over 65 have one or more chronic condition; 56% have two or more chronic conditions; and 23% have three or more chronic conditions. The Appalachian Region has a high frequency of multiple chronic conditions and because Kentucky is in the heart of the Appalachian Region, dental professionals will likely see patients with numerous chronic conditions.

What is Frailty?
The term Frail is often used to describe older adults who are at the Poor/Failing end of the Health Status Continuum. What is Frailty? According to an article titled, “Frailty in elderly people” by Clegg, A Young, J Iliffe, S and others that appeared in the Journal The Lancet (March 2, 2013, Volume 381 pp 752-762), Frailty is a state of vulnerability to poor resolution of homoeostasis after a stressor event and is strongly associated with adverse outcomes. It is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homoeostatic reserves until minor stressor events trigger disproportionate changes in health status. Failure to detect frailty potentially exposes patients to interventions from which they might not benefit and indeed could be harmed.

Fried LP., Tangen CM, Walston J, and others in a 2001 article which appeared in The Journal of Gerontology: Medical Sciences Vol. 56A, No.3 M146-M156 titled, “Frailty in Older Adults: Evidence for a Phenotype” attempted to provide a standard definition for Frailty. Figure I of the article provides a diagram which summarizes many key components (clinical signs and symptoms) which contribute to the “Cycle of Frailty”. Key components include:
· Chronic Under-nutrition
· Sarcopenia (Loss of Muscle Mass) Note: This also results in decreased strength and power, decreased walking speed and decreased Activity
· Decreased Metabolic Rate
· Decreased Total Energy Expenditure

On a personal note, my father experienced Frailty and more specifically, a minor event that triggered other significant events. The photo of my father, below, was taken approximately one year before he died in 2012. Characteristic of many in the Greatest Generation, Dad believed one should work until they had to quit or died. He worked until he was almost 84-years -old. The stressor event that led to his having to retire, becoming frail and ultimately his death, just before he was 87-years-old, was breaking his ankle. Dad had incurred a decline in numerous physiological systems during his lifetime, however, this event initiated a series of other serious health events, which ultimately led to his being hospitalized and then placed in a long term care facility where he died a few months later. After his retirement and broken ankle he became more inactive, physically. This inactivity led to increased muscle weakness (Sarcopenia), which led to numerous falls and instability.

The results of my father’s inactivity as he approached the end of his life, show the importance of older adults staying active and how important it is to “keep moving”. Many people think that as one ages there should be a decrease in physical activity, however, this is not true in most cases. According to the Department of Health and Human Services’ Office of Disease Prevention and Health Promotion Physical Guidelines for Older Adults, for adults aged 65 and older who are fit and have no limiting chronic conditions, the guidelines are the same as for all adults. However, the HPDP office does have some specific Guidelines Just for Older Adults which contain some provisions. (http://health.gov/paguidelines/guidelines/older-adults.aspx Accessed 7-18-16). These include recommending that when older adults are limited because of chronic conditions, they should be as physically active as their abilities and conditions allow and they should do exercises to maintain and improve balance to decrease the risk of falling.

A person’s walking speed is a great indicator of their overall health status. A study of 35,000 people by S. Studenski and others at the University of Pittsburg which appeared in the January, 2011 issue of the Journal of the American Medical Association, JAMA. (2011; 305(1):50-58.) showed that in every segment of the population studied (regardless of sex and age), there was a strong correlation between walking speed and longevity. Specifically, the greater the walking speed in our older years, the greater the longevity, generally speaking. This is probably not exactly news that everyone would like to know. However, it is a great way to get a glimpse of a person’s (i.e. patients) overall health. The bottom line for all of us could be to “keep moving”, even as we age. An interesting Interview with Dr. Studenski may be found online at (https://www.youtube.com/watch?v=ziLSckxVprc Accessed July 15, 2016).

In Conclusion, understanding basic aspects of aging and frailty will help members of the dental profession effectively communicate with older adult patients, caregivers and other healthcare professionals when treating older adult patients.

Press Releases

Click on any title below to read the press release. The release will open up in a new browser window with no menus or images, so that you may print or copy the press release without extraneous graphics.

Oct 16th, 2017Prepare for New Patients: 3 Ways to Get the Most from the ADAs New Find-a-Dentist Campaign
Oct 16th, 2017The Opioid Epidemic in Kentucky
Oct 16th, 2017On the Road (Again)
Oct 16th, 2017August Eclipse
Oct 16th, 2017We have a Place for you at the KDA!
Oct 13th, 201710 Ways the ADA Made a Difference in 2017
Aug 18th, 2017Did You Know You Are Already Practicing Teledentistry?
Aug 18th, 2017Our Associations Future depends on the Engagement of Every Member
Aug 18th, 2017What a Long, Strange Trip Its Been!
Aug 18th, 2017Will the Future of Health Care Be More Closely Related to the Fertility Rate than the Actions of Congress?
Aug 18th, 2017New Regulations on Amalgam Waste Removal
Aug 11th, 2017Check Out our FREE Friday 2-fer Special!!!
Jun 26th, 2017The Road to French Lick
Jun 26th, 2017We Need a New Sheriff in Town
Jun 26th, 2017An Amazing Year at the KDA!
Jun 1st, 2017KDA Board Selects Bowman Insurance Agency to Service Association Health Insurance Plan
Jun 1st, 2017Are you interested in serving as a KDA Delegate or Alternate Delegate?
Apr 24th, 2017Reflections on our 2017 KDA Legislative Day
Apr 24th, 2017And The Winner Is
Apr 24th, 2017The Daunting Task of Changing Someone Elses Bad Habits
Apr 24th, 2017A Memorable Legislative Day
Apr 3rd, 2017Take advantage of great Q2 price reductions!
Feb 16th, 2017Still Much to Do and Many Changes on the Horizon
Feb 16th, 2017Celebrate the Best in Everyone!
Feb 16th, 2017KDA Editor Wins Prestigious William J Gies Award Editorial Award
Feb 16th, 2017Trends in Dentistrythe More Things Change, the More they Stay the Same
Feb 16th, 2017A Look Ahead
Feb 2nd, 2017Association Glove Program: 2017 First Quarter Specials
Dec 20th, 2016I Used To Be a Libra
Dec 20th, 2016Whats in Your Water?!
Dec 20th, 2016Political Slogans and Other Words to Live By
Dec 20th, 2016Membership is the Key to Our Future and the Responsibility of All: Our Own Members are Our Best Recruitment Tool
Oct 24th, 2016Our KDA Foundation is Small, but We CAN Make a Difference
Oct 24th, 2016You Cant Always Get What You Want
Oct 24th, 2016Kentucky Dental Foundation Board Members Work to Establish Goals and Priorities to Ensure a Bright Future
Oct 24th, 2016Happy Trails from the Mountains of Eastern Kentucky
Oct 10th, 2016October is Breast Cancer Awareness Month: Simple Steps Women Can Take to Reduce the Odds of Developing Breast Cancer
Sep 12th, 2016Does Frankfort Need a Better Understanding of our Medicaid Population?
Sep 12th, 2016Lets Move!
Sep 12th, 2016Bonus Points May Not Be Enough
Sep 12th, 2016Understanding the Aging Phenomenon/The Aging Tsunami: Demographic Imperative
Sep 12th, 2016Polypharmacy: A Geriatric Syndrome with Serious Implications for Oral Health
Sep 12th, 2016Aging and Frailty Basics
Jun 14th, 2016Women Rising: The Unseen Barriers
Jun 14th, 2016Pigs in Space
Jun 14th, 2016What Can I Tell You?
Jun 14th, 2016Half Way through 2016 and Still a year to Go...
Apr 15th, 2016A Grateful Heart
Apr 15th, 2016Love Never Fails
Apr 15th, 2016Survivor Stories: How to Endure the Rank of New Dentist and Live to tell about it
Apr 15th, 2016Dentistry is Our Life's Work - Be passionate!
Feb 12th, 2016Be PROACTIVE and Rededicate Yourself to Membership in our Tripartite Organization
Feb 12th, 2016My New Years Resolution
Feb 12th, 2016# the future is not what it used to be
Feb 12th, 2016NOW is the time to belong to the KDA!
Dec 28th, 2015You Can Keep Our Momentum Moving Forward
Dec 28th, 2015Meet the Bevins
Dec 28th, 2015Measuring the Burdon of Ethics
Dec 28th, 2015Downtown Fun. If You Dont Believe Us, Come See!
Dec 28th, 2015Highlights of the 2015 ADA House of Delegates
Nov 23rd, 2015Delta Dental of Kentucky Hints at a Large Statewide Project in the Works for 2016 at the Kentucky Oral Health Summit
Oct 27th, 2015Scary Good Web Design Tips From Officite
Oct 15th, 2015Medicaid Work Group Update
Oct 15th, 2015Just the Facts: Kentucky Meeting Changes Create Confusion
Oct 15th, 2015Our New Mission will require the Efforts of All
Oct 15th, 2015Oral Health Literacy as a Primary Goal and Not an Afterthought
Oct 15th, 2015Still Crazy after Just One Year
Oct 15th, 2015Womens Forum Enjoys Perfect Weather, Perfect Setting and Engaging Dialogue!
Aug 14th, 2015A Plan for Our Future, and a New Mission StatementHelping Member Dentists Succeed and Serve
Aug 14th, 2015First, Do No Harm?
Aug 14th, 2015Can You Hear Me, Now?
Aug 14th, 2015Calling ALL Members and Non-Members: We Need Organized Dentistry!
Jun 23rd, 2015Our new KDA Mission: Helping Member Dentists Succeed and Serve
Jun 23rd, 2015Weve got a Plan!
Jun 23rd, 2015Irrelevance
Jun 23rd, 2015My Introduction: A Smidge of Trepidation, Overwhelmingly Full of Pride and Anticipation
Jun 23rd, 2015Part II: The KDAs Dental Access Summit A Report
Jun 18th, 2015Medicare Part D: Q&A - American Dental Association - May 29, 2015
Apr 28th, 2015Thank You for the Opportunity
Apr 28th, 2015Ask not What Your KDA Can Do for you
Apr 28th, 2015The View from No Mans Land
Apr 28th, 2015KDAS Dental Access Summit Saturday, January 31, 2015 Report to KDA Part I
Feb 20th, 2015Into the Belly of the Beast
Feb 20th, 2015For the Record
Feb 20th, 2015Its all about the membership in 2015!
Feb 20th, 2015Think Big!
Dec 29th, 2014Things are Moving Faster than Fast!
Dec 29th, 2014Who Wouldnt Want to Be a Part of This?
Dec 29th, 2014When Is the Right Time?
Oct 24th, 2014Dental Insurance Direct Deposit Through A Virtual Credit Card; What Does It Cost Me?
Oct 21st, 2014Who Can I Hire for $100 a Month?
Oct 21st, 2014Last Call
Oct 21st, 2014Im here to Help
Oct 21st, 2014Get passionate! This is Our Profession!
Oct 21st, 2014Postscript for an Editors Passing
Oct 21st, 2014and he did what?!: Giving a Professional Second Opinion
Aug 21st, 2014Your KDA is Working Hard for You!
Aug 21st, 2014Nobody Goes Into Dentistry Because They Love Molars!
Aug 21st, 2014Synergy
Aug 21st, 2014KENTUCKY HEALTH NOW: The GOALS of our GOVERNOR
Jun 16th, 2014New Friendships and Lasting Connections Creating a Stronger Interest in Organized Dentistry
Jun 16th, 2014New Friendships and Lasting Connections Creating a Stronger Interest in Organized Dentistry
Jun 16th, 2014YOU HAD TO BE THERE!
Jun 16th, 2014Denigration
Jun 16th, 2014Think Big. Think Positively. Think Proactively.
Apr 24th, 2014The Dentists Guide to Social Media Marketing
Apr 24th, 2014I am the KDA! You are the KDA! WE are the KDA!
Apr 24th, 2014Dare to Dream!
Apr 24th, 2014I Only Have A Loose Screw!
Feb 20th, 2014Where Do We Go From Here?
Feb 20th, 2014Medicaid: An Example of Missing the Goals for Oral Health in Kentucky
Feb 20th, 2014UKCDs First Regional Dental Program: The First Ten Years
Feb 20th, 2014UofL Brightening the Smiles of Children
Feb 20th, 2014Go Tell It on the Mountains
Dec 23rd, 2013Letting the Secret Out
Dec 23rd, 2013It Is What They Left Behind
Dec 23rd, 2013Dr. John Thompson Awarded Distinguished Editor Award
Dec 23rd, 2013Teamwork Creates Champions: the Kentucky Meeting: March 13-16, 2014
Dec 23rd, 2013Listen to Interviews with our Speakers!
Dec 23rd, 2013Welcome Dental Students and New Dentists!
Dec 23rd, 20132014 Kentucky Meeting Details
Oct 17th, 2013I Still Like Maps!
Oct 17th, 2013Ground Game
Oct 17th, 2013Kentucky Department of Insurance, HB 497 and Non-covered Services
Oct 17th, 2013Dr. Janet Faraci Lees Legacy
Oct 17th, 2013Dr. Janet Faraci Lee Leadership Development Award
Aug 12th, 2013The Affordable Care Act: What does it mean for Our Members?
Aug 12th, 2013All Membership Is Local
Aug 12th, 2013White Crosses
Aug 12th, 2013KDA MembershipWhere Do We Go from Here?
Aug 12th, 2013Thoughts from a New Dentist: the Top Three Reasons that I am Involved with Organized Dentistry
Aug 12th, 2013How can KDAIS Benefit You, as a KDA member?
Aug 12th, 2013Beyond the Website: Marketing on the Modern Web
Aug 12th, 2013Delinquent Accounts.Collections..YUCK!
Aug 12th, 2013Every Patient Matters. So Does Every Transaction.
Jun 13th, 2013Preaching to the Choir
Jun 13th, 2013Something I Wish I Didn't Know!
Jun 13th, 2013The Foundation of the Kentucky Dental Association: Positioned to Make a Powerful Statement
Apr 15th, 2013United We Stand, Divided We Fall
Apr 15th, 2013So Long, Farewell, Auf Wiedersehen, Adieu
Apr 15th, 2013Exchange What?
Apr 15th, 2013The Pediatric Dental Benefit: Must Offer, May Purchase
Apr 15th, 2013Participate in Your KDPAC! Contribute and Deliver
Feb 12th, 2013Its a Dentist Thing
Feb 12th, 2013A Profession in Flux
Feb 12th, 2013Living Is What You Do When Life Gets In the Way
Feb 12th, 2013The Tip of the Iceberg: Actions by the Kentucky Department for Medicaid Services Which May Sink KMAP
Oct 19th, 2012Self-Regulation
Oct 19th, 2012House Bill 1 and What It Means to You
Oct 19th, 2012Membership Matters
Aug 21st, 2012Sarrell Dental: Beyond the Operatory
Aug 21st, 2012The Perception of Dentistry
Jun 18th, 2012Leadership or Politics?
Jun 18th, 2012What Part of the “Affordable Care Act” Has Been Affordable?
Jun 18th, 2012I Had an Uncle…
Apr 6th, 2012The "New Old" Still have Teeth
Apr 6th, 2012What a Year, so far!
Apr 6th, 2012Many Thanks for a Great and Memorable Year
Feb 21st, 2012All for One and One for All!
Feb 21st, 2012Happy New Normal
Dec 19th, 2011Access to Care?
Dec 19th, 2011The Wide World of Sports
Oct 28th, 2011To the KDA Executive Board and the entire KDA
Oct 28th, 2011Report of the Sixth District Trustee
Oct 18th, 2011Managed Care and Dentistry in Kentucky: a Dentist’s Dilemma
Oct 18th, 2011Word-of-Mouth on Steroids!
Oct 18th, 2011Why We Shouldn't Lose Sight of Our Purpose...
Aug 4th, 2011Mentor a Young Dentist and Change a Life
Aug 4th, 2011OMG, what is EBD?
Aug 4th, 2011CAPWIZ: Legislative Advocacy Made Easy
Jun 13th, 2011Outside Our Line
Jun 13th, 2011I Might Soon Be Coming to a Town Near You...
Apr 18th, 2011Let Me Ask For a Minute of Your Time
Apr 18th, 2011I Pledge to Be your Humble Servant…
Apr 18th, 2011Blindsided
Apr 18th, 2011On Your Side, Not Your List
Feb 17th, 2011Dr. Andy Elliott for President-elect of the American Dental Association
Feb 4th, 2011A Little Planning Really Helps
Feb 4th, 2011Adjusting Attitudes
Jan 4th, 2011Dental Management of Patients Taking Antiplatelet Medications
Nov 30th, 2010Delegates Report from the 2010 American Dental Association House of Delegates, Orlando, Florida
Nov 30th, 2010Dental Education Found Worthy
Nov 30th, 2010Holiday Greetings to All
Oct 25th, 2010Delegates Report from the 2010 American Dental Association House of Delegates, Orlando, Florida
Oct 7th, 2010What Happens in Alaska, doesn’t Stay in Alaska
Oct 7th, 2010What If …?
Oct 7th, 2010I’m in a Hurry!
Oct 7th, 2010Who Will Speak for Me?
Oct 7th, 2010We Need To Do a Better Job of Communicating
Aug 6th, 2010Kentucky's Dental Practice Act: The Passing of an Old Friend
Aug 6th, 2010The Times They Are Changing
Jun 10th, 2010How a Star was Born
Jun 10th, 2010I Need Your Help…
Apr 20th, 2010KDA and Louisville Water Company Share 150th Birthday and Public Health Vision
Apr 20th, 2010President's Message MA 2010
Apr 20th, 2010Getting It Right!
Feb 25th, 2010Please Join Us for an Exciting, Event-Filled Year Ahead!
Feb 25th, 2010What is a Legacy?
Dec 14th, 2009There is Hope: Suicide Awareness and Prevention in Kentucky
Dec 14th, 2009Challenging the Myth of the Suicide-Prone Dentist
Dec 14th, 2009Holiday Reflections…
Nov 6th, 2009Don’t Balance Health Care Books by Shortchanging Physicians
Nov 6th, 2009Break your Right Arm and Suddenly You have Time to Study Economics.
Jun 26th, 2009Making the World a Better Place, One Village at a Time!
Apr 13th, 2009Breaking Glass
Feb 20th, 2009At the Heart of any Worthy Project is a Committed Volunteer