Influence of first-time mothers' early employment on severe early childhood caries in their child

Aim. To examine whether mothers' early employment status is related to the development of severe early childhood caries in their child. Methods. Questionnaire survey of 429 first-time mothers in metropolitan Adelaide, South Australia, and dental examinations of their child at 20 months of age. Results. At 20 ± 2.5 months of age, 5.6% of children exhibited caries defined as one or more demineralized or cavitated lesions on the upper incisors. Of the mothers, 52.2% had no paid employment, 39.6% were part-time and 8.2% full-time employed. Overall, mothers' participation in the workforce had no influence on the frequency of severe early childhood caries in their child, but there was a significant interaction with family structure. For mothers without employment there was no difference between single, and two-parent families, but children with an employed single mother more frequently had caries than those with a working mother in a two-parent family (P < 0.04). However, there were no significant differences in children's reported general health. Conclusions. The data indicate a need to explore strategies that may assist single mothers and especially those in the workforce to prevent severe early childhood caries in their child.Kamila Plutzer and Marc J. N. C. Keirs

Influence of an intervention to prevent early childhood caries initiated before birth on children's use of dental services up to 7 years of age

BACKGROUND: In a previously reported randomised controlled trial, advising first time mothers on the prevention of early childhood caries from before their child was born, decreased the prevalence of early childhood caries at 20 months of age 5-fold. OBJECTIVE: We examined the effect of the intervention on the frequency and nature of dental visits up to 7 years of age. METHODS: Of 649 expectant mothers who participated in the trial, 277 completed a "Child Oral Health Survey" 7 years later. Their answers were compared with those of a comparison group of 277 mothers selected at random among those living in the same area with a first child born in the same year enrolled with the South Australian School Dental Services (SA SDS). RESULTS: Only 1.5% of children had a dental visit before 12 months of age and only 4% before 2 years of age unless a dental problem had arisen. The age at the first visit did not differ among groups, but the reasons for the visit did as did the number of visits and the need for treatment under sedation or anaesthesia. In the trial group, 34% of first visits were for pain, 29% for injury, and 29% for concern with appearance. In the comparison group, pain was the main concern in 49%, injury in 9.5%, and appearance in 25% (p=0.019). Over time, children in the trial had an average of 2.2 visits compared with 3.1 in the comparison group. In the intervention group of the trial, no child had required treatment under sedation or general anaesthesia compared with 2.9% in the control group, and 6.5% in the comparison group. Only 15% of mothers reported that they had received any information on caries prevention from health care professionals other than dental care practitioners. CONCLUSION: Providing first-time mothers with guidance on the prevention of childhood caries decreased the use of dental services to deal with problems in preschool children.Kamila Plutzer, Marc J.N.C Keirs

Paclitaxel-Coated Balloon for the Treatment of Infrainguinal Disease: 12-Month Outcomes in the All-Comers Cohort of BIOLUX P-III Global Registry

Purpose: To further investigate the safety and performance of the Passeo-18 Lux drug-coated balloon (DCB) for the treatment of atherosclerotic infrainguinal disease under real-world conditions. Materials and Methods: BIOLUX P-III is an international, prospective, observational registry (ClinicalTrials.gov identifier NCT02276313) conducted at 41 centers in Europe, Asia, and Australia with follow-up visits at 6, 12, and 24 months. Of 700 patients (mean age 70.0\ub110.2 years; 439 men) with 863 lesions in the all-comers cohort, 330 (47.1%) patients had diabetes and 234 (37.7%) had chronic limb-threatening ischemia. The majority (79.3%) of lesions were in the femoropopliteal segment; of all lesions, 645 (74.9%) were calcified and 99 (11.5%) had in-stent restenosis (ISR). The mean lesion length was 84.7\ub173.3 mm. The primary clinical endpoint was major adverse events (MAEs) within 6 months, a composite of device- and procedure-related mortality through 30 days, major target limb amputation, and clinically-driven target lesion revascularization (TLR). The primary performance endpoint was clinically-driven TLR within 12 months. Results: At 6 and 12 months, freedom from MAEs was 94.0% and 89.5% in the all-comers cohort: 95.0% and 91.2% in the femoropopliteal group and 95.3% and 88.0% in the ISR subgroup, respectively. Freedom from clinically-driven TLR at 12 months was 93.1% in the all-comers cohort, 93.9% in the femoropopliteal lesions, and 89.4% for ISR lesions. All-cause mortality was 6.1% in the all-comers cohort: 5.9% in both the femoropopliteal and ISR subgroups. There were no device- or procedure-related deaths at up to 12 months. The Rutherford category improved in &gt;80% of all subgroups at 12 months. Conclusion: In a real-world patient population, the safety and performance of the Passeo-18 Lux DCB for the treatment of atherosclerotic infrainguinal lesions are maintained, with good performance outcomes and low complication rates at 12 months

Dealing with Missing Outcomes: Lessons from a Randomized Trial of a Prenatal Intervention to Prevent Early Childhood Caries

Severe early childhood caries (S-ECC) affects 17% of 2-3 year old children in South Australia impacting on their general health and well-being. S-ECC is largely preventable by providing mothers with anticipatory guidance. Randomised controlled trials (RCTs) are the most decisive way to test this, but that approach suffers from near inevitable loss to follow-up that occurs with preventative strategies and distant outcome assessment

Cyclic AMP signalling pathways in the regulation of uterine relaxation

Studying the mechanism(s) of uterine relaxation is important and will be helpful in the prevention of obstetric difficulties such as preterm labour, which remains a major cause of perinatal mortality and morbidity. Multiple signalling pathways regulate the balance between maintaining relative uterine quiescence during gestation, and the transition to the contractile state at the onset of parturition. Elevation of intracellular cyclic AMP promotes myometrial relaxation, and thus quiescence, via effects on multiple intracellular targets including calcium channels, potassium channels and myosin light chain kinase. A complete understanding of cAMP regulatory pathways (synthesis and hydrolysis) would assist in the development of better tocolytics to delay or inhibit preterm labour. Here we review the enzymes involved in cAMP homoeostasis (adenylyl cyclases and phosphodiesterases) and possible myometrial substrates for the cAMP dependent protein kinase. We must emphasise the need to identify novel pharmacological targets in human pregnant myometrium to achieve safe and selective uterine relaxation when this is indicated in preterm labour or other obstetric complications

Diseño de un modelo de referenciación a personas en emergencia social víctimas del conflicto armado residentes en Bogotá

Tesis de GradoEl propósito de la investigación fue diseñar la estructura conceptual de un modelo de referenciación para víctimas del conflicto armado atendidas en el servicio Enlace Social de la Secretaria Distrital de Integración Social residentes Bogotá. Así como, realizar la caracterización de 361 registros de la ficha del sistema de registro de beneficiarios SIRBE aplicada a VCA participantes en el servicio ES de la SDIS desde el año 2013 hasta Septiembre del 2017 y caracterización 18 instituciones y 29 programas o servicios dirigidos a VCA con el fin de identificar la oferta de servicios sociales disponibles para este grupo poblacional.1. Resumen 2. Antecedentes conceptuales y empíricos 3. Justificación 4. Objetivos 5. Método 6. Resultados 7. Discusión y conclusiones 8. Referencias 9. ApéndicesMaestríaMagister en Psicologí

Teething: a problem for children, parents and their doctors

Teething symptoms can be due to more serious health problems and parental administration of analgesics can mask these problems in young children. Unfortunately, once more serious problems have been excluded, there is no evidence-based information on what is effective in alleviating the discomfort of a teething child.Kamila Plutzer and Marc J.N.C. Keirsehttp://www.medicinetoday.com.au/home/article/view/109

Reassessment at 6-7 years of age of a randomized controlled trial initiated before birth to prevent early childhood caries

OBJECTIVE: To assess whether the effect of providing mothers with guidance during pregnancy and when the child was 6 and 12 months old, which had drastically reduced the prevalence of early childhood caries at 20 months of age, would be sustained at 6–7 years of age. METHODS: Children, whose mothers had been enrolled in a randomized controlled trial during pregnancy and a comparison group of similar school children, were examined for the presence of caries by the South Australian School Dental Services (SA SDS) at 6–7 years of age. RESULTS: Of 625 eligible trial participants, 277 (44%) participated in the follow-up and dental records were available for 187 of them (30%). Loss to follow-up and reasons for it were similar in the intervention and control groups. At 6–7 years of age, 33% of children in the trial had caries compared with 42% in the SA SDS comparison group (n = 263). All measures of caries severity (d3mft, d3mfs and SiC30) were lower, but not significantly so, in the intervention than in the control group. Children in the comparison group of school children had more severe caries than those in the trial (P < 0.01) and in the intervention group especially(P < 0.005). Children in both randomized groups suffered significantly less toothache than those in the comparison group (P < 0.001). CONCLUSION: Providing new mothers with guidance on caries prevention helps to reduce early childhood caries and has a sustainable effect up to school age.K. Plutzer, A.J. Spencer and M.J.N.C. Keirs

How first mothers perceive and deal with teething symtoms: a randomized controlled trial

Article first published online: 6 MAR 2011Background: Teething, especially in their first child, continues to be a daunting problem for parents. Objective: The objective of this paper was to assess the effects of providing first-time mothers with information about symptoms commonly associated with teething and ways to manage these. Methods: In a randomized controlled trial to decrease the incidence of early childhood caries, we included information on teething as another issue in a child's oral health. Mothers in the intervention group received three rounds of printed information: at enrolment during pregnancy and when the child was 6 and 12 months old. Information on teething arrived when a child reached 6 months of age. Outcome assessment was at 20 ± 2.5 months of age. Data were complemented with a systematic search for evidence on teething symptoms and how to alleviate them in other populations. Results: Of 649 expectant mothers enrolled in the study, 441 completed the ‘Child's oral health’ questionnaire. There were no significant differences in teething symptoms reported by mothers in the intervention (n= 232) and control (n= 209) groups. However, mothers in the intervention group were less likely to use topical and oral medications to manage teething problems (P < 0.03) and relied more on rubbing the gums to ease discomfort (P < 0.005) than mothers in the control group. Conclusions: Providing mothers with information on how to address teething symptoms markedly reduced the use of medications for symptom relief. There is still need for better evidence, first, on what symptoms can or cannot be attributed to teething and, second, on what is effective in alleviating them.K. Plutzer, A. J. Spencer and M. J. N. C. Keirs