Validity of 5-year-old children's oral hygiene pattern referred by mothers = Validacion del patron de higiene bucal de ninos de cinco anos de edad relatado por las madres

Published in English and Portuguese.OBJECTIVE: To determine the validity of oral hygiene questions for children, as commonly used in epidemiological studies, and assess their validity by family income and mother's education. METHODS: A subsample of 1122 children from the 2004 Pelotas Birth Cohort, Southern Brazil (who had participated in a 2009 oral health study) was analyzed. The children received dental examinations, and their mothers were interviewed at home. The gold standard for oral hygiene was the Simplified Oral Hygiene Index; from its total score, the outcome was dichotomized into the absence (total score = 0) or presence (total score > 1) of dental plaque. The mothers answered questions related to their child's oral hygiene, including daily toothbrushing, toothbrushing before sleeping and the combination of the two (oral hygiene). These responses were dichotomized into regular and irregular. The validity was determined by calculating the percentages and respective 95% confidence intervals for sensitivity, specificity, positive predictive value and negative predictive value. RESULTS: The overall prevalence of dental plaque was 37.0%. The following sensitivities, specificities, positive predictive values and negative predictive values were observed: 29.6%, 82.5%, 49.8% and 66.6%, respectively, for irregular daily toothbrushing; 41.8%, 64.6%, 40.9% and 65.5%, respectively, for irregular toothbrushing before sleeping; and 48.8%, 60.8%, 42.2% and 67.0%, respectively, for irregular oral hygiene. The validity of the oral hygiene reporting varied across different levels of family income and mother's education. The sensitivity and positive predictive values were higher among children with lower incomes and less educated mothers, while opposite associations were observed for specificity and negative predictive value. CONCLUSIONS: Oral hygiene questions answered by mothers of five year-old children are not an appropriate substitute for direct oral hygiene assessment by the clinical examination of dental plaque. = OBJETIVO: Determinar la validación de preguntas frecuentemente utilizadas en estudios epidemiológicos sobre higiene bucal de niños y compararla según renta familiar y escolaridad de la madre. MÉTODOS: Se analizaron 1.122 niños participantes del sub-estudio de salud bucal de 2009 de la Cohorte de Nacimientos de Pelotas, Sur de Brasil, 2004. Los niños fueron examinados y sus madres entrevistadas en el domicilio. El patrón-oro de la condición de higiene bucal fue evaluado por medio del Índice de Higiene Oral Simplificado y a partir del escore total el resultado fue dicotomizado en: placa dental ausente (escore total=0) y presente (escore total ≥1). Las preguntas testadas sobre el patrón de higiene bucal de los niños fueron formuladas a las madres e incluyeron: frecuencia diaria de cepillado, cepillado antes de dormir y la combinación de esas dos (higiene bucal), con sus opciones de respuesta dicotomizadas en regular e irregular. La validez fue determinada por medio del cálculo de los valores porcentuales y respectivos intervalos de 95% de confianza de sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo. RESULTADOS: La prevalencia de placa dental fue 37,0%. Los valores de sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo fueron, respectivamente: 29,6%, 82,5%, 49,8% y 66,6%, para frecuencia de cepillado diaria irregular; 41,8%, 64,6%, 40,9% y 65,5%, para cepillado antes de dormir irregular; 48,8%, 60,8%, 42,2% y 67,0%, para higiene bucal irregular. La validez del patrón de higiene bucal varió conforme el nivel de renta familiar y la escolaridad de la madre, y la sensibilidad y el valor predictivo positivo fueron mayores entre los individuos con menor renta familiar y con madres menos escolarizadas y el opuesto, para la especificidad y el valor predictivo negativo. CONCLUSIONES: Preguntas sobre higiene bucal respondidas por las madres de niños no son buenas sustitutas del patrón real de higiene bucal medido por medio de examen clínico bucal de placa dental.Andreia Morales Cascaes, Karen Glazer Peres, Marco Aurélio Peres, Flávio Fernando Demarco, Iná Santos, Alicia Matijasevich, Aluísio J D Barro

Mental health problems and smoking among adolescents from Southern Brazil

OBJECTIVE: To analyze the association between mental health problems and smoking in adolescents. METHODS: A total of 4,325 adolescents aged 15 from the 1993 birth cohort of the city of Pelotas, Southern Brazil, was studied. Smoking was defined as having smoked one or more cigarettes in the previous 30 days. Mental health was assessed according to the total score of the Strengths and Difficulties Questionnaire. Score >; 20 points was considered positive. Data were analyzed using Poisson regression with adjustment for robust variance. RESULTS: Smoking prevalence was 6.0% and about 30% of the adolescents presented some mental health problem. In the crude analysis, the prevalence ratio for smoking was 3.3 (95%CI 2.5; 4.2). After the adjusted analysis (for sex, age, skin color, family income, mother's level of schooling, group of friends who smoke, employment in the previous year, school failure, physical activity during leisure time and experimental use of alcohol), it decreased to 1.7 (95%CI 1.2; 2.3) among those with mental health problem. CONCLUSIONS: Mental health problems in adolescence may be related to tobacco consumption.OBJETIVO: Analisar a associação entre problemas de saúde mental e uso de tabaco em adolescentes. MÉTODOS: Foram analisados 4.325 adolescentes de 15 anos da coorte de nascimentos de 1993 da cidade de Pelotas, RS. Tabagismo foi definido como fumar um ou mais cigarros nos últimos 30 dias. Saúde mental foi avaliada de acordo com o escore total do questionário Strengths and Difficulties Questionnaire e escore maior ou igual a 20 pontos foi considerado como positivo. Os dados foram analisados por regressão de Poisson, com ajuste robusto para variância. RESULTADOS: A prevalência de tabagismo foi 6,0% e cerca de 30% dos adolescentes apresentaram algum tipo de problema de saúde mental. Na análise bruta, a razão de prevalências para tabagismo foi de 3,3 (IC95% 2,5; 4,2). Após ajuste (para sexo, idade, cor da pele, renda familiar, escolaridade da mãe, grupo de amigos fumantes, trabalho no último ano, repetência escolar, atividade física de lazer e uso experimental de bebida alcoólica), diminuiu para 1,7 (IC95% 1,2; 2,3) entre aqueles com problemas de saúde mental. CONCLUSÕES: Problemas de saúde mental na adolescência podem ter relação com o consumo de tabaco.OBJETIVO: Analizar la asociación entre problemas de salud mental y uso de cigarro en adolescentes. MÉTODOS: Se analizaron 4.325 adolescentes de 15 años de la cohorte de nacimientos de 1993 de la ciudad de Pelotas, Sur de Brasil. Tabaquismo fue definido como fumar uno o más cigarros en los últimos 30 días. Salud mental fue evaluada de acuerdo con el escore total del cuestionario Strengths and Difficulties Questionnaire y escore mayor o igual a 20 puntos fue considerado como positivo. Los datos fueron analizados por regresión de Poisson, con ajuste robusto para varianza. RESULTADOS: La prevalencia de tabaquismo fue 6,0% y cerca de 30% de los adolescentes presentaron algún tipo de problema de salud mental. En el análisis bruto, la tasa de prevalencias de problema de tabaquismo de 3,3 (IC95% 2,5;4,2). Posterior al ajuste para sexo, edad, color de la piel, renta familiar, escolaridad de la madre, grupo de amigos fumadores, trabajo en el último año, repitencia escolar, actividad física de ocio y uso experimental de bebida alcohólica, disminuyó a 1,7 (IC95% 1,2;2,3) entre aquellos con problemas de salud mental. CONCLUSIONES: Problemas de salud mental en la adolescencia pueden tener relación con el consumo de tabaco

Seasonality of Leaf and Fig Production in Ficus squamosa, a Fig Tree with Seeds Dispersed by Water

The phenology of plants reflects selection generated by seasonal climatic factors and interactions with other plants and animals, within constraints imposed by their phylogenetic history. Fig trees (Ficus) need to produce figs year-round to support their short-lived fig wasp pollinators, but this requirement is partially de-coupled in dioecious species, where female trees only develop seeds, not pollinator offspring. This allows female trees to concentrate seed production at more favorable times of the year. Ficus squamosa is a riparian species whose dispersal is mainly by water, rather than animals. Seeds can float and travel in long distances. We recorded the leaf and reproductive phenology of 174 individuals for three years in Chiang Mai, Northern Thailand. New leaves were produced throughout the year. Fig production occurred year-round, but with large seasonal variations that correlated with temperature and rainfall. Female and male trees initiated maximal fig crops at different times, with production in female trees confined mainly to the rainy season and male figs concentrating fig production in the preceding months, but also often bearing figs continually. Ficus squamosa concentrates seed production by female plants at times when water levels are high, favouring dispersal by water, and asynchronous flowering within male trees allow fig wasps to cycle there, providing them with potential benefits by maintaining pollinators for times when female figs become available to pollinate

Education as a Predictor of Chronic Periodontitis: A Systematic Review with Meta-Analysis Population-Based Studies

The impact of socioeconomic inequalities on health is well-documented. Despite the links of periodontal disease with cardiovascular diseases, adverse pregnancy outcomes and diabetes, no meta-analysis of socioeconomic variations in periodontal disease exists. This meta-analytic review was conducted to determine the extent to which education attainment influences risk of periodontitis in adults aged 35+ years in the general population.The authors searched studies published until November 2010 using EMBASE and MEDLINE databases. References listed were then scrutinised, our own files were checked, and, finally, we contacted experts in the field. The authors included only general population-based studies conducted in adults aged 35 years and more. All articles were blind reviewed by two investigators. In the case of disagreement, a third investigator arbitrated. Using PRISMA statement, two reviewers independently extracted papers of interest.Relative to the higher education group, people with low education attainment experience a greater risk of periodontitis (OR: 1.86 [1.66–2.10]; p<0.00001). The association was partially attenuated after adjustment for covariates (OR: 1.55 [1.30–1.86]; p<0.00001). Sensitivity analyses showed that methods used to assess periodontitis, definition of cases, study country and categorization of education are largely responsible for the heterogeneity between studies. No significant bias of publication was shown using both the Egger (p = 0.16) and rank correlation tests (p = 0.35).In the studies reviewed, low educational attainment was associated with an increased risk of periodontitis. Although this evidence should be cautiously interpreted due to methodological problems in selected studies, efforts to eliminate educational inequalities in periodontitis should focus on early life interventions