Socio-demographic disparity in oral health among the poor: a cross sectional study of early adolescents in Kilwa district, Tanzania

There is a lack of studies considering social disparity in oral health emanating from adolescents in low-income countries. This study aimed to assess socio-demographic disparities in clinical- and self reported oral health status and a number of oral health behaviors. The extent to which oral health related behaviors might account for socio-demographic disparities in oral health status was also examined. A cross-sectional study was conducted in Kilwa district in 2008. One thousand seven hundred and forty five schoolchildren completed an interview and a full mouth clinical examination. Caries experience was recorded using WHO criteria, whilst type of treatment need was categorized using the ART approach. The majority of students were caries free (79.8%) and presented with a low need for dental treatment (89.3%). Compared to their counterparts in opposite groups, rural residents and those from less poor households presented more frequently with caries experience (DMT>0), high need for dental treatment and poor oral hygiene behavior, but were less likely to report poor oral health status. Stepwise logistic regressions revealed that social and behavioral variables varied systematically with caries experience, high need for dental treatment and poor self reported oral health. Socio-demographic disparities in oral health outcomes persisted after adjusting for oral health behaviors. Socio-demographic disparities in oral health outcomes and oral health behaviors do exist. Socio-demographic disparities in oral health outcomes were marginally accounted for by oral health behaviors. Developing policies and programs targeting both social and individual determinants of oral health should be an urgent public health strategy in Tanzania

Reduced Complexity Model Intercomparison Project Phase 1: introduction and evaluation of global-mean temperature response

Reduced-complexity climate models (RCMs) are critical in the policy and decision making space, and are directly used within multiple Intergovernmental Panel on Climate Change (IPCC) reports to complement the results of more comprehensive Earth system models. To date, evaluation of RCMs has been limited to a few independent studies. Here we introduce a systematic evaluation of RCMs in the form of the Reduced Complexity Model Intercomparison Project (RCMIP). We expect RCMIP will extend over multiple phases, with Phase 1 being the first. In Phase 1, we focus on the RCMs' global-mean temperature responses, comparing them to observations, exploring the extent to which they emulate more complex models and considering how the relationship between temperature and cumulative emissions of CO2 varies across the RCMs. Our work uses experiments which mirror those found in the Coupled Model Intercomparison Project (CMIP), which focuses on complex Earth system and atmosphere–ocean general circulation models. Using both scenario-based and idealised experiments, we examine RCMs' global-mean temperature response under a range of forcings. We find that the RCMs can all reproduce the approximately 1 ∘C of warming since pre-industrial times, with varying representations of natural variability, volcanic eruptions and aerosols. We also find that RCMs can emulate the global-mean temperature response of CMIP models to within a root-mean-square error of 0.2 ∘C over a range of experiments. Furthermore, we find that, for the Representative Concentration Pathway (RCP) and Shared Socioeconomic Pathway (SSP)-based scenario pairs that share the same IPCC Fifth Assessment Report (AR5)-consistent stratospheric-adjusted radiative forcing, the RCMs indicate higher effective radiative forcings for the SSP-based scenarios and correspondingly higher temperatures when run with the same climate settings. In our idealised setup of RCMs with a climate sensitivity of 3 ∘C, the difference for the ssp585–rcp85 pair by 2100 is around 0.23∘C(±0.12 ∘C) due to a difference in effective radiative forcings between the two scenarios. Phase 1 demonstrates the utility of RCMIP's open-source infrastructure, paving the way for further phases of RCMIP to build on the research presented here and deepen our understanding of RCMs

The IPCC Sixth Assessment Report WGIII climate assessment of mitigation pathways: from emissions to global temperatures

While the Intergovernmental Panel on Climate Change (IPCC) physical science reports usually assess a handful of future scenarios, the Working Group III contribution on climate mitigation to the IPCC's Sixth Assessment Report (AR6 WGIII) assesses hundreds to thousands of future emissions scenarios. A key task in WGIII is to assess the global mean temperature outcomes of these scenarios in a consistent manner, given the challenge that the emissions scenarios from different integrated assessment models (IAMs) come with different sectoral and gas-to-gas coverage and cannot all be assessed consistently by complex Earth system models. In this work, we describe the "climate-assessment"workflow and its methods, including infilling of missing emissions and emissions harmonisation as applied to 1202 mitigation scenarios in AR6 WGIII. We evaluate the global mean temperature projections and effective radiative forcing (ERF) characteristics of climate emulators FaIRv1.6.2 and MAGICCv7.5.3 and use the CICERO simple climate model (CICERO-SCM) for sensitivity analysis. We discuss the implied overshoot severity of the mitigation pathways using overshoot degree years and look at emissions and temperature characteristics of scenarios compatible with one possible interpretation of the Paris Agreement. We find that the lowest class of emissions scenarios that limit global warming to "1.5 ° C (with a probability of greater than 50 %) with no or limited overshoot"includes 97 scenarios for MAGICCv7.5.3 and 203 for FaIRv1.6.2. For the MAGICCv7.5.3 results, "limited overshoot"typically implies exceedance of median temperature projections of up to about 0.1 ° C for up to a few decades before returning to below 1.5 ° C by or before the year 2100. For more than half of the scenarios in this category that comply with three criteria for being "Paris-compatible", including net-zero or net-negative greenhouse gas (GHG) emissions, median temperatures decline by about 0.3-0.4 ° C after peaking at 1.5-1.6 ° C in 2035-2055. We compare the methods applied in AR6 with the methods used for SR1.5 and discuss their implications. This article also introduces a "climate-assessment"Python package which allows for fully reproducing the IPCC AR6 WGIII temperature assessment. This work provides a community tool for assessing the temperature outcomes of emissions pathways and provides a basis for further work such as extending the workflow to include downscaling of climate characteristics to a regional level and calculating impacts

The IPCC Sixth Assessment Report WGIII climate assessment of mitigation pathways: from emissions to global temperatures

While the Intergovernmental Panel on Climate Change (IPCC) physical science reports usually assess a handful of future scenarios, the Working Group III contribution on climate mitigation to the IPCC's Sixth Assessment Report (AR6 WGIII) assesses hundreds to thousands of future emissions scenarios. A key task in WGIII is to assess the global mean temperature outcomes of these scenarios in a consistent manner, given the challenge that the emissions scenarios from different integrated assessment models (IAMs) come with different sectoral and gas-to-gas coverage and cannot all be assessed consistently by complex Earth system models. In this work, we describe the “climate-assessment” workflow and its methods, including infilling of missing emissions and emissions harmonisation as applied to 1202 mitigation scenarios in AR6 WGIII. We evaluate the global mean temperature projections and effective radiative forcing (ERF) characteristics of climate emulators FaIRv1.6.2 and MAGICCv7.5.3 and use the CICERO simple climate model (CICERO-SCM) for sensitivity analysis. We discuss the implied overshoot severity of the mitigation pathways using overshoot degree years and look at emissions and temperature characteristics of scenarios compatible with one possible interpretation of the Paris Agreement. We find that the lowest class of emissions scenarios that limit global warming to “1.5 ∘C (with a probability of greater than 50 %) with no or limited overshoot” includes 97 scenarios for MAGICCv7.5.3 and 203 for FaIRv1.6.2. For the MAGICCv7.5.3 results, “limited overshoot” typically implies exceedance of median temperature projections of up to about 0.1 ∘C for up to a few decades before returning to below 1.5 ∘C by or before the year 2100. For more than half of the scenarios in this category that comply with three criteria for being “Paris-compatible”, including net-zero or net-negative greenhouse gas (GHG) emissions, median temperatures decline by about 0.3–0.4 ∘C after peaking at 1.5–1.6 ∘C in 2035–2055. We compare the methods applied in AR6 with the methods used for SR1.5 and discuss their implications. This article also introduces a “climate-assessment” Python package which allows for fully reproducing the IPCC AR6 WGIII temperature assessment. This work provides a community tool for assessing the temperature outcomes of emissions pathways and provides a basis for further work such as extending the workflow to include downscaling of climate characteristics to a regional level and calculating impacts

The IPCC Sixth Assessment Report WGIII climate assessment of mitigation pathways: from emissions to global temperatures

While the Intergovernmental Panel on Climate Change (IPCC) physical science reports usually assess a handful of future scenarios, the Working Group III contribution on climate mitigation to the IPCC's Sixth Assessment Report (AR6 WGIII) assesses hundreds to thousands of future emissions scenarios. A key task in WGIII is to assess the global mean temperature outcomes of these scenarios in a consistent manner, given the challenge that the emissions scenarios from different integrated assessment models (IAMs) come with different sectoral and gas-to-gas coverage and cannot all be assessed consistently by complex Earth system models. In this work, we describe the “climate-assessment” workflow and its methods, including infilling of missing emissions and emissions harmonisation as applied to 1202 mitigation scenarios in AR6 WGIII. We evaluate the global mean temperature projections and effective radiative forcing (ERF) characteristics of climate emulators FaIRv1.6.2 and MAGICCv7.5.3 and use the CICERO simple climate model (CICERO-SCM) for sensitivity analysis. We discuss the implied overshoot severity of the mitigation pathways using overshoot degree years and look at emissions and temperature characteristics of scenarios compatible with one possible interpretation of the Paris Agreement. We find that the lowest class of emissions scenarios that limit global warming to “1.5 ∘C (with a probability of greater than 50 %) with no or limited overshoot” includes 97 scenarios for MAGICCv7.5.3 and 203 for FaIRv1.6.2. For the MAGICCv7.5.3 results, “limited overshoot” typically implies exceedance of median temperature projections of up to about 0.1 ∘C for up to a few decades before returning to below 1.5 ∘C by or before the year 2100. For more than half of the scenarios in this category that comply with three criteria for being “Paris-compatible”, including net-zero or net-negative greenhouse gas (GHG) emissions, median temperatures decline by about 0.3–0.4 ∘C after peaking at 1.5–1.6 ∘C in 2035–2055. We compare the methods applied in AR6 with the methods used for SR1.5 and discuss their implications. This article also introduces a “climate-assessment” Python package which allows for fully reproducing the IPCC AR6 WGIII temperature assessment. This work provides a community tool for assessing the temperature outcomes of emissions pathways and provides a basis for further work such as extending the workflow to include downscaling of climate characteristics to a regional level and calculating impacts

Do public health nurses in Norway promote information on oral health?

Background (i) to describe oral health counselling in Norway to parents with infants and toddlers, ii) to assess existing collaboration and routines in oral health matters between nurses and personnel in the PDS, iii) to evaluate to what extent oral health was integrated in the basic educational curriculum of public health nurses. Methods This study was based on two separate surveys: the sample of Study I was 98 randomly selected child health clinics. A questionnaire covering oral health promotion counselling of parents with young children was returned by 259 nurses. Study II was a telephone survey addressing teachers of public health nurses at the eight educational institutions in Norway. Results The response rate in Study I was 45%. Nutrition (breast feeding, diet) was the health subject most often prioritized in the counselling targeting parents of young children (by 60% of the nurses). Oral health was not among the first priority counselling subjects. The subject was seldom spontaneously mentioned by parents. Seventy percent of respondents reported (agreed or totally agreed) that they managed to provide information parents needed and 72% believed that the information they gave influenced parents' health behaviours. Seven nurses (5.2%) responded that they agreed with the statement that the information they gave only slightly influenced parents' health behaviour. Lack of time was mentioned as being a problem. Approximately half of the nurses (48%) had regular contact with the PDS for the 0-3 year-old children, but only a quarter of the nurses claimed that children's teeth were routinely examined at the child clinics. Some forms of previously established contact with the PDS enhanced the likelihood of nurses' referrals. Oral health was a minor part of the educational curriculum for public health nurses; at three institutions, the subject was totally absent. Conclusion Collaboration between nurses and the PDS in Norway could be improved. Oral health should have a bigger place in the basic educational curriculum

Dental caries prevention strategies among children and adolescents with immigrant - or low socioeconomic backgrounds- do they work? A systematic review

Abstract Background This systematic review was designed to uncover the most reliable evidence about the effects of caries preventive strategies in children and adolescents of immigrant or low socioeconomic backgrounds. Methods According to pre-determined inclusion and exclusion criteria, relevant articles focusing on underprivileged groups were electronically selected between January1995 and October 2015. The literature search was conducted in five databases; PubMed, Embase, CINAHL, SweMed+ and Cochrane Library. Accepted languages for included articles were English, German and Scandinavian languages. Abstracts and selected articles in full text were read and assessed independently by two review authors. Systematic reviews and meta-analyses were not included. Also articles with topics of water fluoridation and fluoride toothpaste were excluded, this due to all existing evidence of anti-caries effect for disadvantaged groups. The key data about the main characteristics of the study were compiled in tables and a quality grading was performed. Results Thirty-seven articles were selected for further evaluation. Supervised toothbrushing for 5-year-old school children was found to be an effective prevention technique for use in underprivileged groups. Also a child/mother approach, targeting nutrition and broad oral health education of mothers showed effectiveness. For older children, a slow-release fluoride device and application of acidulated phosphate fluoride (APF) gel showed to be effective. Conclusion On the basis of this review, we maintain that in addition to studies of water fluoridation and fluoride toothpaste, there are other preventive intervention studies providing scientific evidence for caries reduction among children and adolescents with immigrant or low socioeconomic backgrounds

Do public health nurses in Norway promote information on oral health?

Abstract Background (i) to describe oral health counselling in Norway to parents with infants and toddlers, ii) to assess existing collaboration and routines in oral health matters between nurses and personnel in the PDS, iii) to evaluate to what extent oral health was integrated in the basic educational curriculum of public health nurses. Methods This study was based on two separate surveys: the sample of Study I was 98 randomly selected child health clinics. A questionnaire covering oral health promotion counselling of parents with young children was returned by 259 nurses. Study II was a telephone survey addressing teachers of public health nurses at the eight educational institutions in Norway. Results The response rate in Study I was 45%. Nutrition (breast feeding, diet) was the health subject most often prioritized in the counselling targeting parents of young children (by 60% of the nurses). Oral health was not among the first priority counselling subjects. The subject was seldom spontaneously mentioned by parents. Seventy percent of respondents reported (agreed or totally agreed) that they managed to provide information parents needed and 72% believed that the information they gave influenced parents' health behaviours. Seven nurses (5.2%) responded that they agreed with the statement that the information they gave only slightly influenced parents' health behaviour. Lack of time was mentioned as being a problem. Approximately half of the nurses (48%) had regular contact with the PDS for the 0-3 year-old children, but only a quarter of the nurses claimed that children's teeth were routinely examined at the child clinics. Some forms of previously established contact with the PDS enhanced the likelihood of nurses' referrals. Oral health was a minor part of the educational curriculum for public health nurses; at three institutions, the subject was totally absent. Conclusion Collaboration between nurses and the PDS in Norway could be improved. Oral health should have a bigger place in the basic educational curriculum.</p

Dental caries at enamel and dentine level among European adolescents – a systematic review and meta-analysis

Background: In contrast with the last century, caries epidemiology has begun integrating enamel caries into determinations of caries prevalence and experience. The objective of the present systematic review and meta-analysis was to assess the caries status including estimations of enamel caries, of European adolescents. Method: Four databases (Medline Ovid, Embase, CINAHL, and SweMed+) were systematically searched from 1 January 2000 through 20 September 2021 for peer-reviewed publications on caries prevalence and caries experience in 12–19-year-olds; that also included evaluations of enamel lesions. Summary estimates were calculated using random effect model. Results: Overall, 30 publications were selected for the systematic review covering 25 observational studies. Not all studies could be used in the meta-analyses. Caries prevalence was 77% (n = 22 studies). Highest prevalence was reported in the age groups 16–19 years, and in studies where caries examinations were done before 2010. The overall mean DMFT score was 5.93 (n = 14 studies) and it was significantly lower among Scandinavian adolescents than among other European adolescents (4.43 vs. 8.89). The proportion of enamel caries (n = 7 studies) was 50%, and highest in the lowest age group (12–15 years). Results from the present systematic review reflected the caries distribution to be skewed at individual-, tooth- and surface levels; at tooth and surface level, also changed according to age. Conclusions: Although studies in which the caries examinations had been done in 2010 or later documented a reduction in caries prevalence, caries during adolescence still constitutes a burden. Thus, the potential for preventing development of more severe caries lesions, as seen in the substantial volume of enamel caries during early adolescence, should be fully exploited. For this to happen, enamel caries should be a part of epidemiological reporting in national registers.publishedVersio