Performance and cross-cultural comparison of the short-form version of the CPQ11-14 in New Zealand, Brunei and Brazil

<p>Abstract</p> <p>Background</p> <p>The Child Perception Questionnaire (CPQ_11-14) is a self-report instrument developed to measure oral-health-related quality of life (OHRQoL) in 11-14-year-olds. Earlier reports confirm that the 16-item short-form version performs adequately, but there is a need to determine the measure's validity and properties in larger and more diverse samples and settings.</p> <p>Aim</p> <p>The objective of this study was to examine the performance of the 16-item short-form impact version of the CPQ_11-14in different communities and cultures with diverse caries experience.</p> <p>Method</p> <p>Cross-sectional epidemiological surveys of child oral health were conducted in two regions of New Zealand, one region in Brunei, and one in Brazil. Children were examined for dental caries (following WHO guidelines), and OHRQoL was measured using the 16-item short-form item-impact version of the CPQ_11-14, along with two global questions on OHRQoL. Children in the 20% with the greatest caries experience (DMF score) were categorised as the highest caries quintile. Construct validity was evaluated by comparing the mean scale scores across the categories of caries experience; correlational construct validity was assessed by comparing mean scores and children's global ratings of oral health and well-being.</p> <p>Results</p> <p>There were substantial variations in caries experience among the different communities (from 1.8 in Otago to 4.9 in Northland) and in mean CPQ_11-14scores (from 11.5 in Northland to 16.8 in Brunei). In all samples, those in the most severe caries experience quintile had higher mean CPQ_11-14scores than those who were caries-free (P < 0.05). There were also greater CPQ scores in those with worse self-rated oral health, with the Otago sample presenting the most marked gradient across the response categories for self-rated oral health, from 'Excellent' to 'Fair/Poor' (9.6 to 19.7 respectively).</p> <p>Conclusion</p> <p>The findings suggest that the 16-item short-form item impact version of the CPQ_11-14performs well across diverse cultures and levels of caries experience. Reasons for the differences in mean CPQ scores among the communities are unclear and may reflect subtle socio-cultural differences in subjective oral health among these populations, but elucidating these requires further exploration of the face and content validity of the measure in different populations.</p

Avaliação da capacidade preditiva da circunferência da cintura para obesidade global e hipertensão arterial em mulheres residentes na Região Metropolitana de Belo Horizonte, Brasil

Avaliou-se a capacidade que a Circunferência da Cintura (CC) tem em identificar valores de IMC ≥25 (sobrepeso) e ≥30 (obesidade) a partir de níveis de ação recomendados internacionalmente. Setecentas e noventa e uma mulheres entre 15-59 anos foram recrutadas. Foram calculadas a sensibilidade e a especificidade no diagnóstico de sobrepeso e obesidade e a sensibilidade e especificidade na predição da hipertensão, a partir de valores de CC. As associações foram testadas por análise de regressão linear e regressão logística controlando para o efeito de fatores de confusão. A CC ≥80 e ≥88cm discriminou corretamente 89,8% de mulheres com IMC ≥25 e 88,5% com IMC ≥30. A obesidade abdominal (CC ≥88cm) esteve associada significativamente com a hipertensão na análise multivariada (OR = 2,88, IC 95%: 1,77-4,67). A hipertensão foi identificada com sensibilidade de 63,8 e 42,8% e especificidade de 68,0 e 83,3% para CC ≥80 e ≥88, respectivamente. A obesidade abdominal nos pontos de corte propostos pode discriminar adequadamente indivíduos em risco de se tornarem obesos, no entanto, apresenta um poder apenas moderado para discriminar indivíduos com níveis pressóricos altos. _______________________________________________________________________________ ABSTRACTThis study examined the capacity of waist circumference (WC) to identify subjects with overweight (BMI ≥25) and obesity (BMI ≥30), in agreement with internationally recommended levels of action. Data were obtained from 791 women, 15-59 years old. After identifying overweight and obesity according to WC values, sensitivity and specificity were calculated to verify whether WC could be a good risk predictor for hypertension. Associations were tested by linear regression and logistic regression, controlling for confounding.WC cut-off points of 80cm and 88cm correctly identified 89.8% and 88.5% of women with overweight and obesity, respectively. Abdominal obesity (WC ≥88cm) was statistically associated with hypertension in the multivariate analysis (OR = 2.88; 95% CI: 1.77-4.67). Hypertension was identified with a sensitivity of 63.8% and 42.8%, and with a specificity of 68.0% and 83.3%, for WC ≥80 and ≥88, respectively. The proposed cut-off points for abdominal obesity can potentially distinguish individuals at risk for future obesity, but has only moderate power to predict individuals with high blood pressure

EUV spectra of highly-charged ions W54+^{54+}-W63+^{63+} relevant to ITER diagnostics

We report the first measurements and detailed analysis of extreme ultraviolet (EUV) spectra (4 nm to 20 nm) of highly-charged tungsten ions W$^{54+}$ to W$^{63+}$ obtained with an electron beam ion trap (EBIT). Collisional-radiative modelling is used to identify strong electric-dipole and magnetic-dipole transitions in all ionization stages. These lines can be used for impurity transport studies and temperature diagnostics in fusion reactors, such as ITER. Identifications of prominent lines from several W ions were confirmed by measurement of isoelectronic EUV spectra of Hf, Ta, and Au. We also discuss the importance of charge exchange recombination for correct description of ionization balance in the EBIT plasma.Comment: 11 pages, 4 figure

Structural Determinants and Children's Oral Health: A Cross-National Study

Much research on children's oral health has focused on proximal determinants at the expense of distal (upstream) factors. Yet, such upstream factors-the so-called structural determinants of health-play a crucial role. Children's lives, and in turn their health, are shaped by politics, economic forces, and social and public policies. The aim of this study was to examine the relationship between children's clinical (number of decayed, missing, and filled teeth) and self-reported oral health (oral health-related quality of life) and 4 key structural determinants (governance, macroeconomic policy, public policy, and social policy) as outlined in the World Health Organization's Commission for Social Determinants of Health framework. Secondary data analyses were carried out using subnational epidemiological samples of 8- to 15-y-olds in 11 countries ( N = 6,648): Australia (372), New Zealand (three samples; 352, 202, 429), Brunei (423), Cambodia (423), Hong Kong (542), Malaysia (439), Thailand (261, 506), United Kingdom (88, 374), Germany (1498), Mexico (335), and Brazil (404). The results indicated that the type of political regime, amount of governance (e.g., rule of law, accountability), gross domestic product per capita, employment ratio, income inequality, type of welfare regime, human development index, government expenditure on health, and out-of-pocket (private) health expenditure by citizens were all associated with children's oral health. The structural determinants accounted for between 5% and 21% of the variance in children's oral health quality-of-life scores. These findings bring attention to the upstream or structural determinants as an understudied area but one that could reap huge rewards for public health dentistry research and the oral health inequalities policy agenda

A Potent and Selective S1P1 Antagonist with Efficacy in Experimental Autoimmune Encephalomyelitis

SummaryLymphocyte trafficking is critically regulated by the Sphingosine 1-phosphate receptor-1 (S1P1), a G protein-coupled receptor that has been highlighted as a promising therapeutic target in autoimmunity. Fingolimod (FTY720, Gilenya) is a S1P1 receptor agonist that has recently been approved for the treatment of multiple sclerosis (MS). Here, we report the discovery of NIBR-0213, a potent and selective S1P1 antagonist that induces long-lasting reduction of peripheral blood lymphocyte counts after oral dosing. NIBR-0213 showed comparable therapeutic efficacy to fingolimod in experimental autoimmune encephalomyelitis (EAE), a model of human MS. These data provide convincing evidence that S1P1 antagonists are effective in EAE. In addition, the profile of NIBR-0213 makes it an attractive candidate to further study the consequences of S1P1 receptor antagonism and to differentiate the effects from those of S1P1 agonists

Malocclusion, psycho-social impacts and treatment need: A cross-sectional study of Tanzanian primary school-children

<p>Abstract</p> <p>Background</p> <p>studies on the relationship between children's malocclusion and its psycho-social impacts are so far largely unexplored in low-income countries. This study aimed to assess the prevalence of malocclusion, reported dental problems and dissatisfaction with dental appearance among primary school children in Tanzania. The relationship of dissatisfaction with socio-demographic characteristics, clinically defined malocclusion and psychosocial impacts of dental anomalies was investigated. Orthodontic treatment need was estimated using an integrated socio-dental approach.</p> <p>Method</p> <p>One thousand six hundred and one children (mean age 13 yr) attending primary schools in the districts of Kinondoni and Temeke completed face to face interviews and a full mouth clinical examination. The survey instrument was designed to measure a Kiswahili translated and culturally adapted Child Oral Impact on Daily Performance (Child-OIDP) frequency score, reported dental problems, dissatisfaction with dental appearance/function and socio-demographic characteristics.</p> <p>Results</p> <p>The prevalence of malocclusion varied from 0.9% (deep bite) to 22.5% (midline shift) with a total of 63.8% having at least one type of anomaly. Moderate proportions of children admitted dental problems; ranging from 7% (space position) to 20% (pain). The odds ratio of having problems with teeth position, spaces, pain and swallowing if having any malocclusion were, respectively 6.7, 3.9, 1.4 and 6.8. A total of 23.3% children were dissatisfied with dental appearance/function. Children dissatisfied with their dental appearance were less likely to be Temeke residents (OR = 0.5) and having parents of higher education (OR = 0.6) and more likely to reporting problem with teeth position (OR = 4.3) and having oral impacts (OR = 2.7). The socio-dental treatment need of 12% was five times lower than the normative need assessment of 63.8%.</p> <p>Conclusion</p> <p>Compared to the high prevalence of malocclusion, psycho social impacts and dissatisfaction with appearance/function was not frequent among Tanzanian schoolchildren. Subjects with malocclusion reported problems most frequently and malocclusion together with other psycho-social impact scores determined children's satisfaction with teeth appearance- and function.</p

A geographical population analysis of dental trauma in school-children aged 12 and 15 in the city of Curitiba-Brazil

<p>Abstract</p> <p>Background</p> <p>The study presents a geographical analysis of dental trauma in a population of 12 and 15 year-old school-children, in the city of Curitiba, Brazil (n = 1581), using a database obtained in the period 2005-2006. The main focus is to analyze dental trauma using a geographic information system as a tool for integrating social, environmental and epidemiological data.</p> <p>Methods</p> <p>Geostatistical analysis of the database and thematic maps were generated showing the distribution of dental trauma cases according to Curitiba's Health Districts and other variables of interest. Dental trauma spatial variation was assessed using a generalized additive model in order to identify and control the individual risk-factors and thus determine whether spatial variation is constant or not throughout the Health Districts and the place of residence of individuals. In addition, an analysis was made of the coverage of dental trauma cases taking the spatial distribution of Curitiba's primary healthcare centres.</p> <p>Results</p> <p>The overall prevalence of dental trauma was 37.1%, with 53.1% in males and 46.7% in females. The spatial analysis confirms the hypothesis that there is significant variation in the occurrence of dental trauma, considering the place of residence in the population studied (Monte Carlo test, p = 0,006). Furthermore, 28.7% of cases had no coverage by the primary healthcare centres.</p> <p>Conclusions</p> <p>The effect of the place of residence was highly significant in relation to the response variable. The delimitation of areas, as a basis for case density, enables the qualification of geographical territories where actions can be planned based on priority criteria. Promotion, control and rehabilitation actions, applied in regions of higher prevalence of dental trauma, can be more effective and efficient, thus providing healthcare refinement.</p