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PubMed2003

Socioeconomic status, C-reactive protein, immune factors, and responses to acute mental stress.

Low socioeconomic status (SES) is associated with increased risk of coronary heart disease and immune-related disorders. We hypothesised that SES would be inversely associated with the acute phase reactant C-reactive protein (CRP) and with circulating lymphocyte levels, and that lymphocyte responses to acute psychological stress would also vary with SES. CRP was obtained from 226, and lymphocyte counts from 127 healthy volunteers from the Whitehall II cohort, and SES was defined primarily by grade of employment. CRP concentration was greater in lower compared with higher SES participants (1.18+/-0.75 vs. 0.75+/-0.8 mg/l,p=.002) independently of sex, age, body mass, waist/hip ratio, smoking, alcohol, and season of the year. Similar differences were evident when SES was defined by income and educational attainment. Higher SES was also associated with lower total lymphocyte (p=.023), T-lymphocyte (p=.024) and natural killer (NK) cell counts (p=.006). Total, T- and B-lymphocyte, and NK cell counts increased with stress, but immune stress reactivity did not vary with SES. Post-stress recovery was delayed in women compared with men. The results suggest that moderate inflammation and immune activation may be processes through which lower SES increases disease risk.

Adult↗
PubMed1998

Equity and orthodontic treatment: a study among adolescents in Northern Ireland.

This epidemiological study investigated the reasons why children in Northern Ireland who need orthodontic treatment do not receive treatment even when it is provided free by the state. A total of 1584 15- and 16-year-olds were examined in 23 high schools with the Index of Orthodontic Treatment Need. The characteristics of the adolescents who had received orthodontic treatment were compared with those who had a definite need for treatment and yet did not receive treatment or advice. One in 10 of the adolescents examined had an unmet need for orthodontic treatment. Logistic regression analysis was used to assess the influence of 11 variables including socioeconomic status, religion, and standard of dental health on the uptake of orthodontic care. This analysis revealed that the only significant predictors of whether an adolescent received orthodontic treatment was the dental attendance pattern of the adolescent, the adolescent's dental health, and the dental attendance pattern of the adolescent's mother. Those adolescents who had good dental health, who regularly attended a dentist, and whose mother regularly attended a dentist were more likely to receive orthodontic treatment.

Adolescent↗
PubMedDate not supplied

Cognitive development in preschool children prenatally exposed to PCBs and MeHg.

A number of epidemiological studies have shown predictive relationships between prenatal exposure to polychlorinated biphenyls (PCBs) and subtle deficits in cognitive development in infancy through the preschool years [Child Dev. 56 (1985) 853; J. Pediatr. 116 (1990) 38; J. Pediatr. 134 (1999) 33; Toxicol. Lett. 102-103 (1998) 423; Neurotox. 21 (6) (2000) 1029-1038]. However, since not all studies have demonstrated these relationships (J. Pediatr. 119 (1991) 58-63), debate regarding the role of prenatal PCB exposure in cognitive development continues. The current study was designed to provide additional data to assist in resolving this question. Two hundred twelve children enrolled in the Oswego Newborn and Infant Development Project were assessed using the McCarthy Scales of Children's Abilities at 38 months of age, followed by a reassessment at 54 months of age. The relationship between prenatal exposure to PCBs (cord blood PCBs) and McCarthy performance was assessed at both ages after first controlling for a wide range of important predictors of cognitive development, including socioeconomic status (SES), maternal IQ, maternal education, home environment, cigarette smoking, and many others. Cord blood PCBs were statistically significant predictors of small but measurable deficits in McCarthy performance at 38 months of age. Moreover, a significant interaction between cord blood PCBs and maternal hair mercury (MeHg) was found, such that negative associations between prenatal MeHg exposure and McCarthy performance were found in subjects with higher levels of prenatal PCB exposure. No relationship between PCBs and/or MeHg and McCarthy performance was observed when the children were reassessed almost 1.5 years later (54 months of age). Inspection of the age-related trajectory of McCarthy performance revealed that the more highly exposed children caught up with the least exposed children by 54 months. Although the current data partially replicate the findings of Jacobson et al., Patandin et al., and Walkowiak et al. [J. Pediatr. 116 (1990) 38; J. Pediatr. 134 (1999) 33; Lancet 358 (2001) 1602], results reported here suggest that functional recovery may occur. Moreover, the interaction between PCB and MeHg cannot be considered conclusive until it has been replicated in subsequent investigations.

Age Factors↗
PubMed1997

[Is it possible to improve sleep in children? A research on health education in nursery schools].

An educational project in nursery schools was carried out with the aim to improve children's sleep. Its effectiveness was tested in terms of awareness of families and length of sleep of children. The method was a prevention trial based on the random division of classes of 3-year old into two groups (intervention group and control group) comprising children enrolled in nursery schools in the Rhône region (France) in 1992. The project, lasting 2 years, relied on physicians from the community (Maternal, Child Health Service and School Health Service), their role being to mobilise the teaching teams, distribute specific teaching tools and raise awareness of families to respect the sleep patterns of children, during routine medical examinations. The study was carried out in 140 nursery schools with 1,500 children in each group. The evaluation was based on the application of a logistical regression model taking potentially confounding factors into account, and an analysis in sub-groups in order to demonstrate the effectiveness of intervention on particularly exposed groups. The results show: 1) the feasibility of such an intervention among nursery school children on a large scale, 2) the effectiveness of the action, with a reduction of the risk of "poor knowledge" among parents (OR = 0.76), particularly in urban areas, and a reduction in the risk "short nights" in the sub-group of children who had " little sleep at 3 years" in low social class families (OR = 0.50).

Child, Preschool↗
PubMed1998

The position of the monozygotic twins among their school class-mates in the light of results of Janusz Korczak's "Plebiscite on likes and dislikes".

Within the "Wrocław Longitudinal Twin Study" in a part of the material the liking level of singletons (SIN) to identical twins (TMZ) and of TMZ to SIN was analysed cross-sectionally, in the period of 11th to 18th year of life. In each of the 76 classes of elementary and high schools in Wrocław (Poland), including the investigated in 1976-7 TMZ (64 pairs), were evaluated the relations between school-mates, using the Korczak's five-degree scale of liking. The declared by TMZ and SIN liking decreased with age between pupils of the same sex, and increased between pupils of opposite sex, however, in TMZ with some delay. The liking declared by TMZ of both sexes to SIN was on average lower than that declared by SIN to TMZ. The degree of liking declared by SIN to TMZ of the same sex was average higher than in relation of SIN to SIN particularly among girls. Thus, there occurred the so-called "prima donna effect". The liking declared to pupils of opposite sex in relation of SIN to TMZ was on average lower than the analogous one in relation of SIN to SIN and in relation TMZ to SIN even worse. The higher contrast in treating pupils of the same and opposite sex in TMZ than in SIN indicates a lower social maturity in TMZ. A diverse influence of socio-economic conditions on the declared toward then liking by boys and girls was found. The low number of separated twins did not allow to make a generalisation on specificity of their position in class. The sending of TMZ to different classes appeared to be in Wrocław elementary schools sporadic (1 repeater), and in high schools observed in 38%, from that 28% of twins went to equivalent classes, usually in different school, and in 10% of pairs one of the twins repeated the class.

Adolescent↗
PubMed1975

Congenital malformations, twinning and associated variables in a Brazilian population.

A sample of 6052 newborn children (4968 whites, 1084 Blacks) issued from parents with a generally low socioeconomic level, was studied in relation to congenital anomalies and twinning rates. The observed frequency of major malformations was 1.3% and of minor defects 2.0%. The twinning rate was 1.4%. Race differences were generally nonsignificant in these variables. These results are in agreement with those obtained in some other Brazilian series, but discrepancies were also observed. A total of 13% of the malformations observed proved to be familial, polydactyly being the most common anomaly encountered in this class. The frequency of malformations different from those present in the propositi is higher in their sibships than the general prevalence of defective children found among the sibs of normal babies (13% and 4% respectively). Age, gestation length and exposure of the mothers to noxious agents during pregnancy were not significantly different when the parents of normal and malformed children were compared. On the other hand, as expected, the parents of twins are significantly older than those of single-born, and the gestation length was much reduced in pregnancies resulting in multiple births.

Black People↗
PubMed1999

Complaints of fatigue: related to too much as well as too little external stimulation?

Fatigue has been acknowledged as a widespread problem associated with a variety of factors. In the present paper, we attempt to explain fatigue complaints on the basis of Pennebaker's (1982) "competition of cues" notion. Competition of cues suggests that both extremely low and extremely high levels of external stimulation in daily life may be related to relatively higher frequencies of complaint. The dimensional structure of external stimulation is first explored and then the shape of the relation between external stimulation (i.e., stimuli perceived in daily life) and fatigue was studied in a sample of 777 general-practice patients. Other risk factors for fatigue and moderating factors are also taken into consideration. Results show that quantity and quality of external stimulation can be distinguished. Both high quantity (high "experienced overload") and low quality (low "attractiveness of external stimulation") are related to higher fatigue frequencies. "Experienced overload" is a particularly strong predictor, in addition to "perceived health" of fatigue complaints. It is concluded that the "quality-quantity model for understanding fatigue" proposed here highlights psychological factors important for any theoretical framework of fatigue.

Adolescent↗
PubMed2002

A cross-sectional study of dentine hypersensitivity.

AIM: The aim of this study was to establish the prevalence of dentine hypersensitivity in a cross-sectional study of patients visiting general dental practitioners in the United Kingdom over a period of one calendar month. METHODS: Nineteen dental practioners examined 4841 patients over a period of one calendar month and patients that had dentine hypersensitivity diagnosed were questioned further about their occupation and smoking habits. The amount of buccal gingival recession associated with the sensitive teeth was also recorded using a study form. RESULTS: 201 patients were diagnosed as having dentine hypersensitivity, giving a prevalence figure of 4.1%. The commonest teeth affected were the upper premolar teeth and the commonest initiating factor was cold drinks. A tendency for a greater number of sensitive teeth was also found for patients with periodontal disease who also smoked. There was also a tendency for the patients with sensitive teeth to come from higher social groups.

Adolescent↗
PubMed2001

Dietary habits and dental health over the first 18 months of life.

OBJECTIVES: The main objective of this study was to describe the dental health of infants and toddlers with special reference to their dietary habits and oral hygiene behaviour over the first 18 months of life. METHODS: The longitudinal dietary data were obtained at 6, 12 and 18 months of age by using a 3-day weighed diet diary. Dental examinations were carried out at 12, and again at 18 months of age. The information on demographic factors and oral hygiene behaviours over the first 18 months of life was gathered by using a structured questionnaire at 12 and 18 months. RESULTS: 163 children were studied. Visible dental plaque was present in 18% and 25% of children at 12 and 18 months of age, respectively. No child had dental caries at either 12 or 18 months of age. There was a statistically significant correlation between visible plaque measured as plaque index at 12 months and the mean daily eating/drinking episodes at 6 months (r=0.25, P=0.001) and 12 months (r=0.15, P=0.05). The correlations between plaque index at 18 months and the mean eating/drinking episodes at both 12 months (r=0.2, P=0.04) and 18 months (r=0.2, P=0.02) were low but statistically significant. Nevertheless, there was no significant correlation between accumulation of plaque at either 12 or 18 months and the mean daily frequency consumption of food and drink containing non-milk extrinsic sugars (NMES) at any age. Children who brushed their teeth themselves were more likely to have visible plaque compared with children whose teeth were cleaned by their parents. The partial correlation showed that positive relation between mean daily eating/drinking episodes and plaque was not influenced by tooth brushing.

Analysis of Variance↗
PubMed2002

Plaque minerals in the prediction of caries activity.

BACKGROUND/AIMS: Attempts to identify subjects who will develop caries lesions in future years have been only moderately successful, suggesting that one or more important risk factors are being overlooked. The aim of this study was to validate the use of plaque calcium, phosphate and fluoride concentrations as significant risk factors in caries. METHODS: DMFS and DMFT rates were measured three times over 2 years in a group of rural Chinese schoolchildren initially aged 12 years and not living in a high-fluoride area. At the baseline and year 1 examinations, dental plaque was accumulated for 3 days and, after collection, was analysed for Ca, P and F. Plaque scores, dental health behaviour and parents' occupation data were also recorded. RESULTS: The mean DMFS increment over 2 years was 1.14 with a range of -2 to +9. Regression analysis taking all factors into account identified only plaque Ca concentration, baseline DMFS score and toothbrushing frequency as significant factors in identifying high-risk individuals. Plaque Ca also showed predictive ability on its own. For example, when high caries was defined as 3+ new DMFS and a Ca cut-off value of 200 nmol/mg dry wt was selected, sensitivity was 0.84 and specificity 0.38. However, with this cut-off value the percentage predicted to have high caries risk was unrealistically high at 66%. As in several other studies, baseline caries score was a useful predictor of future caries. CONCLUSION: Low plaque Ca concentration showed a modest ability to predict future caries, and since it is implicated directly in the chain of events leading to caries, its use in caries prediction should be considered further. Plaque P and F showed no predictive ability in this study.

Calcium↗
PubMed2003

Caries incidence in permanent first molars after discontinuation of a school-based chlorhexidine-thymol varnish program.

OBJECTIVES: To determine whether the cessation for 3 years of a 24-month program of chlorhexidine-thymol varnish applications would affect caries incidence in the first permanent molars of a population of schoolchildren of middle and lower-middle socioeconomic level. METHODS: Two groups of 6-7-year-old schoolchildren, randomized by school-class, were followed up in a clinical trial. One group received applications of chlorhexidine-thymol varnish every 3 months and the other group acted as controls. The program ended after 24 months and its effects were evaluated. Three years later, 55.5% of the schoolchildren were re-examined and the caries increments were documented. RESULTS: At the end of the 24-month program, the treated children had significantly fewer decayed and filled surfaces in permanent molars (lower DFS index) versus the controls. At 3 years after the discontinuation of the program, this difference had disappeared; there were no differences in the incidence of decayed, missing and filled surfaces (DMFS) index in permanent molars between the treated children and the controls. CONCLUSION: The cessation for 3 years of a 3-month program of chlorhexidine-thymol varnish applications resulted in a nonsignificant increase in the prevalence of dental caries in the permanent first molar.

Anti-Infective Agents, Local↗
PubMed2001

High risk human papillomavirus in oral squamous carcinoma: evidence of risk factors in a Venezuelan rural population. Preliminary report.

In a search for the presence of human papillomavirus (HPV) and some etiologic cofactors in oral squamous cell carcinoma (OSCC), 50 women diagnosed as OSCC were analyzed by a multiplex polymerase chain reaction (PCR) assay specific for HPV types 6, 11, 16, and 18. This study revealed that 60% (30/50) of the OSCC patients were positive for HPV-DNA sequences. This group was analyzed according to smoking, alcohol consumption, number of pregnancies, poor oral health and low social economic status. The current results indicate an increased incidence of HPV malignant types in the oral cavity in women with OSCC. Also, they support a multifactorial model of oral cancer causation.

Adult↗
PubMed2001

Oral status indicators DMFT and FS-T: reflections on index selection.

Oral status in a population has traditionally been described by the DMFT index (decayed, filled, and missing teeth). There seems to be contradicting and confusing evidence in the literature with regard to the usefulness of different indices. Limitations of the DMFT are recognised, and attempts have been made to develop other indices. Two indices, DMFT and FS-T (filled and sound teeth) have been selected for analysis in the present paper. The purpose of this paper is to examine the relationship between DMFT and FS-T in different populations, and to show consequences of choice of index exemplified in analytical analysis. Data stem from the Trondelag-83 and -94 studies that were follow-up studies of the Norwegian portion of the 1973 International Collaborative Study. Sunflower scatter plots and regression analyses were used to describe the variation in DMFT and FS-T in different populations. DMFT was more suitable for describing variation in populations with low levels of disease than FS-T, while FS-T was more suitable for describing variation in populations with high levels of disease. It may be concluded that both DMFT and FS-T should be presented when describing oral status in a population. However, choice of index depends first of all on the purpose of the investigation. If there are theoretical reasons to prefer one index instead of the other, the superiority of the alternative index in terms of variation must be disregarded.

Adult↗