Exploring Mothers’ Perspectives About Why Grandparents in Appalachia Give Their Grandchildren Cariogenic Foods and Beverages: A Qualitative Study

BackgroundDental caries is the most common chronic childhood disease. Past studies revealed that grandparents provide their grandchildren with cariogenic foods and beverages (eg, those with free sugars and/or modified starches). Qualitative research can help identify what drives this phenomenon.ObjectiveOur aim was to examine mothers’ explanations for why grandparents in north central and central Appalachia give their grandchildren cariogenic foods and beverages.DesignA qualitative study on children’s oral health in Pennsylvania and West Virginia from 2018 through 2020 was performed. In-person, semi-structured interviews were conducted. Qualitative data from interviews were recorded, transcribed, and then coded using NVivo. Data analysis for this study was performed using thematic analysis with iterative theme development.Participants/settingThe participants were 126 mothers of children aged 3-5 years from West Virginia (n = 66) and Pittsburgh, PA (n = 60).Main outcome measuresMothers’ perspectives about why grandparents give their grandchildren cariogenic foods and beverages were analyzed.ResultsIn the study sample, 85% of mothers (n = 107/126) named at least 1 of their children’s grandparents as a member of their social network responsible for their children’s oral health. From these interviews, 85% of mothers (n = 91/107) discussed that grandparents gave their grandchildren cariogenic foods and beverages. The mothers described the following 4 themes to explain why grandparents gave their grandchildren cariogenic foods and beverages: privilege of the grandparent role; responsibilities of the grandparent role; symbol of care and affection; and limited consideration or understanding of the detrimental impact.ConclusionsGrandparents play a role in giving their grandchildren cariogenic foods and beverages, which could potentially contribute to childhood caries. Research is needed to develop effective social interventions to help some grandparents understand the implications of a cariogenic diet on their grandchildren’s oral health and/or decrease their provision of cariogenic foods and beverages.     

Trifluridine/Tipiracil in Combination with Bevacizumab in First-Line for Metastatic Colorectal Cancer: A Way Forward. A Point of View Based on Cost-Effectiveness

Introduction: The aim of this analysis is to assess the pharmacological costs of trifluridine/tipiracil as first-line treatment in metastatic colorectal cancer (mCRC) patients who were not candidates for combination with cytotoxic chemotherapies.Discussion: TASCO1 Trial was considered (153 patients). Differences in costs between the 2 arms (trifluridine/tipiracil plus bevacizumab vs. capecitabine plus bevacizumab) was 9113 € (10 264 USD), with a cost savings of 1982 € (2232 USD) per month of overall survival (OS)-gain.Conclusion: Trifluridine/tipiracil could be consider a cost-effective treatment also in first-line for mCRC patients who were not candidates for combination with cytotoxic chemotherapies.     

Silver Diamine Fluoride Protocol for Reducing Preventable Dental Hospitalisations in Victorian Children

IntroductionThis study was designed to assess whether a dental caries management protocol combining a single application of 38% silver diamine fluoride (SDF) with comprehensive oral health education will successfully divert high-risk children from dental treatment under dental general anaesthesia (DGA), arrest active caries in primary teeth, and improve parent-reported child oral health–related quality of life (OHRQoL).MethodsChildren aged 2 to 10 years, who attended two public dental agencies in Victoria, Australia, and were unable to tolerate restorative treatments in the clinic setting, elected to participate in either a 38% SDF intervention protocol or, alternatively, referral for DGA. Follow-up examinations were completed at 6 months to assess caries progression, decayed missing filled tooth index, PUFA index (pulpal involvement, ulceration, fistula, abscess), DGA referral rates, and OHRQoL (Early Childhood Oral Health Impact Scale [ECOHIS]).ResultsOf the total sample, 89.5% of children (n = 102) [mean (SD) age, 4.1 (1.0) years] with 401 active carious lesions elected to participate in the 38% SDF protocol; 10.5% (n = 12) of parents opted for referral for treatment under DGA. The proportion of active caries subsequently arrested at follow-up (number of arrested lesions/number of lesions treated) was 0.78 (95% CI, 0.69 to 0.87). There was an 88% reduction in referrals for DGA in eligible children over the 6-month period. The 38% SDF intervention group showed a significant improvement in ECOHIS scores at follow-up (P < .001).DiscussionAdoption of the 38% SDF intervention protocol resulted in a significant reduction in the rate of preventable dental hospitalisations. Most parents opted against referral for DGA. Parent-reported OHRQoL for children improved significantly.