Female-male differences in massed drinking: results from a household survey.
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Adult↗
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Results for “Social Class--statistics”
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Effects on later adjustment of living in a stepfamily during childhood and adolescence.
This paper examines the effects of living in a stepfamily during childhood and adolescence on a range of psychosocial outcomes at age 18 years. Data collected during an 18-year longitudinal study were used to examine a sample of 907 children with respect to: exposure to living in a stepfamily during the period from age 6 to 16 years; measures of psychosocial outcomes including mental health, antisocial behaviour, substance use, restricted life opportunities, and sexual risk-taking at age 18 years; and measures of prospectively collected confounding factors. The analyses revealed that children exposed to living in a stepfamily for the first time between ages 6-16 years had elevated risks of a range of psychosocial outcomes at 18 years. These included elevated risks of: (1) juvenile offending; (2) nicotine dependence; (3) abuse or dependence on illicit substances; (4) leaving school without qualifications; (5) early onset of sexual activity; and (6) multiple sexual partners. However, these risks were reduced substantially when psychosocial outcomes were adjusted for the confounding effects of antecedent factors such as: family socioeconomic characteristics: family history of instability, adversity, and conflict; mother's age, religiosity, and smoking; child gender; and preexisting child conduct and attentional problems. After adjustment, the odds ratios between exposure to a stepfamily and adolescent outcomes were nonsignificant. Additional analysis revealed that there were no significant differences in outcomes for boys and girls exposed to stepfamilies. It was concluded that although young people exposed to living in a stepfamily had increased risks of poor psychosocial outcomes, much of this association appeared to be spurious, and arose from confounding social, contextual, and individual factors that were present prior to the formation of the stepfamily.
Adaptation, Psychological↗
Inequalities in health care provision.
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England↗
Discriminating social groups by performance on two lateralized tests.
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Female↗
Health care consumption and consumer social class: a different look at the patient.
Both the need and potential for market segmentation in the health care industry have grown substantially. Social class, a consumer behavior construct applied widely in other marketing contexts, may be useful as a basis for health care segmentation. Using a random sample of 997 households in the Pacific Northwest, the author investigates health care attitudes and behaviors across social class groups. Social class is found to be related positively and significantly to several aspects of health care, including personal health, interest, expenditures, satisfaction, and switching behavior.
Attitude to Health↗
A comparison of methods for measuring socio-economic status by occupation or postal area.
Seven methods of estimating socio-economic status (SES) were compared, including four based on data specific to individuals (Blishen, Pineo-Porter, British Registrar General, Hollingshead) and three based on the average characteristics of the postal code area in which people live (income alone, education alone, income and education combined). Data from the files of 151 patients undergoing in vitro fertilization were used. The four individual scales were highly correlated among themselves (Spearman's correlation coefficient between 0.6 and 0.9) but only moderately correlated with the measures based on postal code (Spearman's correlation coefficient between 0.2 and 0.3).
Educational Status↗
Effect of dental health education on the oral health status of a rural child population by involving target groups.
India, a developing country faces many challenges in rendering oral health needs. The majority of Indian population resides in rural areas, of which more than 40% constitute children. These children cannot avail dental facilities due to inaccessibility, financial constraints and stagnation of public dental healthcare services. This entails the health professional to adopt a more practical approach to achieve primary prevention of oral diseases. The most viable solution seems to be dental health education. Documented evidence shows that teachers and parents can augment dental health behaviour. With this background, it was decided to target children in a rural area for comparing the effect of education on children alone, children coupled with teachers and children with the involvement of their parents. An interventional study of 4 months duration was conducted on 430 children, 7 teachers and 100 parents. The parents were educated at home. Clinical oral health status was assessed prior to the delivery of dental health education and also following the intervention. Results showed that the dental health scores improved best in the group of children involving the teachers. It was concluded that teachers could be targeted in order to enhance the effect of dental health education campaigns on children.
Analysis of Variance↗
Recent dental attendance and levels of untreated caries in a sample of 11-12 year old children in Northern Ireland.
The object of the present study was to determine the relationship between dental attendance and the levels of untreated caries in a sample of 11-12 year old pupils attending first form of second level schools in the South Belfast area of Northern Ireland. A sample of 199 first form pupils attending second level schools in the area was obtained. The diagnosis of caries depended mainly on visual evidence following removal of debris and moisture. Blunted probes were used to confirm or reject doubtful lesions and no radiographs were taken. Details of parental employment status were obtained by a questionnaire to the parents. The data were entered on to an N.C.S.S. data analysis system for stepwise regression and analysis of variance. Overall there was a significant difference in the untreated caries status of those with different attendance patterns, the major difference being that a much higher proportion of those who had not attended within the previous 12 months had active caries. Almost half of the children had attended in the previous six months and only 16 (8 per cent) had not attended in the previous 12 months. Independent analysis indicated that parental employment status was significantly related to the level of untreated caries (p > or = 0.05). Independent variables entered in the stepwise regression were attendance, employment status and DMFT. The strongest predictors of untreated caries were previous caries experience and period since dental attendance, while employment status was a significant but weaker factor in the analysis. These findings may be relevant when planning the frequency of school dental screenings and managing the frequency of dental recalls and examinations.
Analysis of Variance↗
Does dental care improve the oral health of older adults?
OBJECTIVE: To assess the relationship between self-perceived change in oral health status and the provision of dental treatment in an older adult population. DESIGN: A longitudinal study with data collection at baseline and after three years. Information on change in oral health was obtained by interviews with study subjects and information on dental treatment over three years was obtained from subjects' dentists. SUBJECTS: Nine hundred and seven subjects took part at baseline and 611 at follow-up. Of the latter, 495 reported at least one dental visit during the three-year observation period and dental treatment information was available for 408. Outcome measures Global transition judgements and change scores derived from four oral health indexes were used to assess change in oral health status. RESULTS: Over the three-year period, one-tenth of subjects reported that their oral health had improved and one-fifth that it had deteriorated. Those who improved made significantly more dental visits and received significantly more dental services that those who deteriorated or did not change (P<0.0001). They also received a broader range of diagnostic, preventive and therapeutic services. The association between change and dental service provision remained after controlling for other potential determinants of oral health. CONCLUSION: The study suggests that improvements in the oral health of older adults depend upon access to comprehensive dental treatments which can address fully their clinical and self-perceived needs.
Aged↗
Increased acceptance of HRT and improved level of information: a change in Norwegian women's opinion from 1990 to 1997.
AIM: To investigate the development in women's attitude to hormone replacement therapy, and the change in views concerning positive and negative effects. METHODS: National cohort study based on telephone interviews in 1990 and 1997, of women randomly sampled from the Norwegian telephone book (n=1019 and 1003). The same questions were asked in both studies. RESULTS: In 1997, more women stated radio and television, doctors, friends and relatives as sources of information. The general attitude to hormone replacement therapy had become significantly more positive, and the respondents reported a higher level of information than in 1990. However, some misunderstandings about estrogen therapy still remain; the proportion of women who believed that estrogen treatment reduced the risk for breast cancer increased from 4% in 1990 to 15% in 1997. About one third of women aged 60 or more are current or past users. More than 60% of the women in the youngest age group state that they will consider use of estrogen replacement therapy. About four-fifths of the women in 1997 stated their willingness to use long term estrogen therapy if osteoporosis could be prevented. CONCLUSIONS: Estrogen replacement therapy has become a part of the public debate. A high degree of willingness to use estrogen is demonstrated. The self reported level of information is higher and women are generally more correctly informed about positive and negative effects.
Adult↗
Frequency of attendance in general practice and symptoms before development of chronic fatigue syndrome: a case-control study.
BACKGROUND: Chronic fatigue syndrome (CFS) research has concentrated on infective, immunological, and psychological causes. Illness behaviour has received less attention, with most research studying CFS patients after diagnosis. Our previous study on the records of an insurance company showed a highly significant increase in illness reporting before development of CFS. AIM: To investigate the number and type of general practitioner (GP) consultations by patients with CFS for 15 years before they develop their condition. DESIGN OF STUDY: Case-control study in 11 general practices in Devon. SETTING: Forty-nine patients with CFS (satisfying the Centers for Disease Control criteria), 49 age, sex, and general practice matched controls, and 37 patients with multiple sclerosis (MS) were identified from the general practices' computerised databases. METHOD: The number of general practice consultations and symptoms recorded in three five-year periods (quinquennia) were counted before development of the patients' condition. RESULTS: The median number of consultations was significantly higher for CFS patients than that of matched controls in each of the quinquennia: ratios for first quinquennium = 1.88, P = 0.01; second quinquennium = 1.70, P = 0.005; last quinquennium = 2.25, P < 0.001. More CFS patients than controls attended for 13 of the 18 symptoms studied. Significant increases were found for upper respiratory tract infection (P < 0.001), lethargy (P < 0.001), and vertigo (P = 0.02). Similar results were found for CFS patients when compared with MS. CONCLUSIONS: CFS patients consulted their GP more frequently in the 15 years before development of their condition, for a wide variety of complaints. Several possibilities may explain these findings. The results support the hypothesis that behavioural factors have a role in the aetiology of CFS.
Adolescent↗
Psychosocial functioning and dental factors in adolescents with temporomandibular disorders: a case-control study.
AIMS: To examine the influence of psychosocial functioning and dental factors in adolescents with temporomandibular disorders (TMD) versus healthy subjects. METHODS: The TMD sample comprised 63 patients (21 boys and 42 girls, 33% and 67%, respectively, with a mean age of 14.9 years; range 12 to 18 years) and was compared with 64 healthy control subjects (17 boys and 47 girls, 27% and 73%, respectively, with a mean age of 14.8 years). Subjects in the TMD group had to report pain once a week or more and to have a TMD pain diagnosis according to the Research Diagnostic Criteria for TMD. Participants were clinically examined and filled out a questionnaire in which self-reported psychosocial functioning was assessed on standardized measures, including the Youth Self-Report (YSR), somatic complaints, and stress. RESULTS: No significant differences were found in dental factors among adolescents in the TMD group compared with those in the control group. Multiple pains in the body and fatigue were significantly more common in the TMD group compared with the control group. Adolescents with TMD also reported significantly higher levels of stress, somatic complaints, and aggressive behavior than their counterparts in the control group. In particular, young adolescents with TMD reported high levels of psychosocial problems. CONCLUSION: In adolescents with TMD, psychosocial factors such as increased levels of stress, somatic complaints, and emotional problems seem to play a more prominent role than dental factors.
Adolescent↗
A clinical profile to assess the potential risk factors for cleft lip and palate.
Cleft lip and palate is one of the most common malformations in man. Although the subject of a great deal of investigation, etiologic factors contributing to these congenital deformities remain largely unknown. Various factors like race, sex, parental age at the time of conception etc. have been listed as the exogenous factors. This article strives to project any significant relationship of these factors to cleft lip and cleft palate.
Adolescent↗
The relationship between erosion, caries and rampant caries and dietary habits in preschool children in Saudi Arabia.
OBJECTIVES: The aim of this study was to investigate the possible association between dental erosion and caries, and variables including socio-economic status, reported dietary practices and oral hygiene behaviour, in a sample of children in Jeddah, Saudi Arabia. A cross-sectional study including dental examination and questionnaire survey was carried out at a number of kindergartens. SAMPLE AND METHODS: A sample of 987 children (2-5-year-olds) was drawn from 17 kindergartens. Clinical examinations were carried out under standardized conditions by a trained and calibrated examiner (MAM). Information regarding diet and socio-economic factors was drawn from questionnaires distributed to the parents through the schools. These were completed before the dental examination. RESULTS: Of the 987 children, 309 (31%) showed signs of erosion. Caries were diagnosed in 720 (73%) of the children and rampant caries in 336 (34%). Vitamin C supplements, frequent consumption of carbonated drinks and the drinking of fruit syrup from a feeding bottle at bed- or nap-time when the child was a baby, were all related to erosion. Consumption of carbonated drinks and fruit syrups was also related to caries but they were part of a larger number of significant factors including socio-demographic measures and oral hygiene practices. CONCLUSIONS: There was no clear relationship between erosion and social class, or between erosion and oral hygiene practices; the reverse was true for caries. Dietary factors relating to both erosion and caries and/or rampant caries were found in this sample of children.
Age Factors↗
Caries experience and bedtime consumption of sugar-sweetened food and drinks--a survey of 600 children.
OBJECTIVE AND METHOD: To compare the bedtime consumption of sugar-sweetened food and drinks by children with their caries experience. The subjects were 600 children aged 2 to 16 years from two communities in northern England with high overall caries levels, who attended two general dental practices as new patients. The children were predominantly from non-working families and 29% were from ethnic minorities. RESULTS: A positive significant relationship was found between the consumption of either food or drinks containing non-milk extrinsic sugar (NMES) in the hour before bed and both dmft and DMFT in the sample as a whole. The subjects consuming NMES food had a mean dmft of 1.91 and a DMFT of 1.18 compared to 1.13 and 0.42 for subjects who did not. The corresponding mean scores for NMES drinks were 1.76 and 0.94 compared to 1.04 and 0.46. Gender, ethnicity and social-economic status were not significantly related to caries experience. The strongest relationship found was between caries experience and the consumption of both NMES food and drinks before bed, those children having four times the mean DMFT score (1.24) of those who consumed neither (0.31). CONCLUSION: The findings support the introduction of the concept of a sugar-free zone for the hour before bed.
Adolescent↗
Parental occupational status related to dental caries experience in 7-year-old children in Flanders (Belgium).
OBJECTIVES: The study aimed to investigate differences in the oral health of 7-year-old Flemish children by the parents' occupational class and to explore behavioural and demographic factors linked to social inequalities in oral health. PARTICIPANTS: A stratified cluster sample of 1,500 primary school children in Flanders, born in 1989. METHOD: The clinical oral examination was performed in the first year of a longitudinal oral health project in Flanders (1996-2001) by 16 calibrated examiners. Information on occupational level of the parents and on oral health related behaviour was gained, respectively, by the school health care centres and the parents of the children using a structured questionnaire. RESULTS: The mean dmf values between the several SES groups, assessed by occupational status of the parents, were significantly different (P<0.001). The mean dmft and dmfs values were the lowest for the most advantaged children (1.3/2.7) and were threefold higher in the least advantaged children (3.9/9.1). The prevalence of caries-free children was 2.5 times higher among the highest SES families compared with the lowest SES families. In a logistic regression model adjusted for the stratification factors, the excess risk for caries in children increased with decreasing occupational level of the parents. There was a cumulative effect of decreasing occupational level and oral health habits on the caries prevalence. CONCLUSION: The results of the study allow the supposition that social inequalities in oral health among children exist in Flanders. Environmental factors and individual behavioural factors partially explain why social class might influence oral health.
Belgium↗
Profile of orthodontic services provided in private practice by general practitioners and specialist orthodontists for an insured population.
In Australia, the proportion, volume and type of orthodontic care provided by general practitioners and orthodontists are largely unknown. The overall objective of this study was to create a profile of orthodontic services provided by general practitioners and orthodontists for a cohort of insured patients using private practices in New South Wales, Australia, from 1st January 1992 to 31st December 1995. Data were derived from claims records submitted by members of a health insurance fund for rebates for fees paid to private practitioners for orthodontic services they received during the study period. Distribution of the volume and type of service provided by general practitioners and orthodontists was compared using the Chi-squared test. Statistical significance was taken at the 5 per cent level. Orthodontic services were provided predominantly by orthodontists (80%). Fixed orthodontic treatment was provided almost exclusively (91%) by orthodontists. The majority of removable appliance services was provided by general practitioners. Orthodontists provided more orthodontic services in the capital city and other metropolitan areas, whereas general practitioners provided more orthodontic services in rural areas. Orthodontists provided more services to members in the highest socio-economic group, whereas general practitioners provided more services to members in the lowest socio-economic group.
Age Factors↗
Oral motor parafunctions among heavy drug addicts and their effects on signs and symptoms of temporomandibular disorders.
AIMS: To investigate the prevalence of temporomandibular disorders (TMD), bruxism, and other oral habits among drug addicts compared to a normal, non-addicted, matched control population, and to assess the detrimental effect of long-term drug abuse on the parameters studied. METHODS: Subjects included 55 drug-addicted patients (51 males and 4 females) randomly selected from long-term addicts using "hard" narcotics and attending a methadone maintenance center and a control group of 52 normal non-addicted individuals (48 males and 4 females) matched to the addicts for age, gender, and socioeconomic status. A clinical examination and a questionnaire were used. One examiner determined that all questions were correctly understood and answered, and a second examiner performed the clinical examinations and was unaware of the results of the questionnaire. RESULTS: The addicted group had a high prevalence of orofacial motor behavior (bruxing, clenching) as well as signs and symptoms of TMD (morning headache, joint noises, joint and masticatory muscle tenderness to palpation, and tooth wear) compared to the controls. Active (voluntary) jaw opening was significantly smaller, although within an acceptable range when compared to the controls. CONCLUSION: Long-term drug abuse detrimentally affects the stomatognathic system, as expressed in a high prevalence of oral motor behavior and signs and symptoms of TMD.
Adolescent↗