Perceptions of dental fluorosis and evaluation of agreement between parents and children: validation of a questionnaire

This study aimed to validate the Child's and Parent's Questionnaire about Teeth Appearance and to evaluate concerns relative to fluorosis among 213 pairs of parents and 12-year-old children from two regions of Brazil. Reliability was assessed by Cronbach's alpha and intraclass correlation coefficient, and construct and criterion validity by Spearman's correlations. Student t-test was used to compare the two regions and to assess parent/child agreement. Internal consistency was acceptable, and test-retest reliability was moderate to excellent. Perception of moderate to severe fluorosis and clinical data were significantly correlated, as were perception of fluorosis and subjects' concerns. Although parents from Rafael Arruda, Ceará State, showed a higher perception of fluorosis, parental concern was greater in Piracicaba, S?o Paulo State. Parents were more worried and dissatisfied with their children's dental appearance than the children themselves. This version of the questionnaire proved to be valid and reliable for assessing children's and parents' perceptions of dental fluorosis.     

Qualitative research using photo-elicitation to explore the role of food in family relationships among obese adolescents

Obesity in adolescence is a major public health issue. Family relationships have an important role, whether in the onset of the condition, its maintenance, or the way in which the problem is approached. Food and family relationships are two major elements in therapeutic care. The subject of the present study is the investigation of the place of food within family relationships among obese adolescents, so as to tailor care strategies. Twelve semi-structured interviews were conducted among adolescents presenting obesity and their parents. The investigation was qualitative, and used photo-elicitation. A photograph produced by the subject is used as the basis for narrative, and the verbal material obtained is analysed using Interpretative Phenomenological Analysis. The results can be categorised along two axes. The first describes the place of food in the one-to-one parent-child relationship; the second describes the organisation of the family group. This study evidenced two possible lines of approach in understanding the place of food in these families. There are major interrelations between food and relationships within the family, so that implications for therapy can be drawn: taking account of bonding between parent and child, and therapeutic orientation towards family functioning rather than towards individual eating patterns.     

The impact of health literacy on knowledge,Attitude and decision towards hospice care among community‐dwelling seniors

The aim of this study was to investigate the relationships between health literacy and hospice knowledge, attitude and decision in community‐dwelling elderly participants. This cross‐sectional study enrolled 990 community‐dwelling elderly participants in three residential areas, with a mean age of 71.53 ± 7.22 years. Health literacy was assessed using the Mandarin version of the European Health Literacy Survey Questionnaire. Knowledge, attitude and decision towards hospice care were assessed using an interviewer‐administered questionnaire. Partial least squares were used for data analysis. More than half of the respondents had sufficient knowledge of hospice care (60.7%) and a positive attitude (77.3%) and positive decision (85%) towards hospice care. In the structural equation model, general health literacy positively predicted knowledge (β = 0.73, p <0.001), attitude (β = 0.06, p = 0.038) and decision (β = 0.14, p < 0.001) towards hospice care. General health literacy had a greater overall effect on hospice decision (β = 0.57) than hospice knowledge (β = 0.54). In addition, disease prevention health literacy also demonstrated a higher level of influence on hospice decision (β = 0.59) than hospice knowledge (β = 0.53). Health literacy was associated with hospice knowledge, attitude and decision. Incorporating health literacy interventions into hospice promotion strategies is recommended.     

Efficiency and specificity of the KAT-test for rapid diagnosis of falciparum malaria

A new rapid KAT Quick Malaria test for the diagnosis of falciparum malaria, which is based on the detection of a monoclonal antibody-antigen complex of malaria parasites, has been worked out by the KAT Medical CC in South Africa. The efficiency and specificity of the KAT test were compared with those of the microscopic method and with the ICT test for rapid diagnosis of P. falciparum and P. vivax. The polymerase chain reaction was used as a control test. Testing for malaria was performed on 98 blood samples from feverish patients in Vietnam and Tadjikistan and among the persons who had returned to Moscow from endemic regions. The efficiency of the KAT test for falciparum-malaria was found to be 100% versus 90.5% with ICT. The absence of cross-reactions with P. vivax and the presence of pseudopositive results of the KAT test for fever cases of non-malaria origin indicate its high specificity. There was no correlation between the rate of test line colouring and the level of parasitemia. The KAT test yielded positive results only when gametocytes were found in blood specimens.     

原发性高血压患者尿微量白蛋白与冠状动脉病变程度的关系

目的研究原发性高血压患者尿微量白蛋白与冠状动脉病变程度的关系。方法资料完整的原发性高血压患者中,据24h尿白蛋白定量结果分为尿微量白蛋白阳性组82例,从尿微量白蛋白阴性患者中选择与阳性组血压匹配的82例作为阴性对照组,比较两组冠状动脉狭窄程度。结果原发性高血压患者冠心病发病率在尿微量白蛋白阳性组[60/82(74%)]显著高于阴性组[42/82(52%)],且双支病变发病率较高(25%比12%,P<0.05),三支病变发病率也较高(15%比3%,P<0.05)。结论在原发性高血压患者中,尿微量白蛋白阳性者比阴性者有更高的冠心病发病率和更加严重的冠状动脉狭窄性病变。     

Increased dispersion of refractoriness in patients with atrial fibrillation in the early postoperative period after coronary artery bypass grafting

INTRODUCTION: Increased atrial effective refractory period (AERP) dispersion is well correlated with vulnerability to atrial fibrillation (AF). However, the preoperative electrophysiologic characteristics of atrial abnormalities that may play an important role in the development of AF postoperatively in patients with coronary artery bypass grafting (CABG) have not been investigated in detail. METHODS AND RESULTS: Fifty-six consecutive patients who underwent CABG were enrolled in this study. Eighteen patients (14 men and 4 women; mean age 57.7 +/- 5.2 years) with AF in the early postoperative period and 38 patients (28 men and 10 women; mean age 56.3 +/- 6.4 years) without AF were compared with regard to preoperative clinical, echocardiographic, angiographic, and electrophysiologic parameters. Preoperative PA interval and AERP dispersion values were higher (P < 0.05) in patients who developed AF in the early postoperative period. PA interval (P < 0.05, odds ratio = 1.64, 95% confidence interval 1.17-2.30), AERP in the high right atrium (AERP(HRA); P < 0.05, odds ratio = 0.94, 95% confidence interval 0.91-0.97), AERP in the right posterolateral atrium (AERP(RPL); P < 0.05, odds ratio = 0.79, 95% confidence interval 0.63-0.98), AERP in the distal coronary sinus (AERP(DCS); P < 0.05, odds ratio = 0.84, 95% confidence interval 0.74-1.02), and AERP dispersion (P < 0.001, odds ratio = 1.29, 95% confidence interval 1.12-1.47) were independently related to post-CABG AF in univariate analysis. Increases in preoperative PA interval and AERP dispersion were found to be associated with a high risk for development of post-CABG AF. CONCLUSION: AERP dispersion is a suitable electrophysiologic indicator for atrial vulnerability. The presence of increased preoperative AERP dispersion and PA interval may indicate patients at high risk for development of AF in the early postoperative period after coronary artery bypass grafting.     

Cardiac autonomic functions in obese children

Objective: The autonomic nervous system is assumed to have a role in the pathophysiology of obesity. In this study, we evaluated the autonomic system by measuring heart rate variability (HRV) in obese children.Methods: Thirty-two obese and 30 healthy children (mean ages: 11.6±2.0 years and 11.0±2.9 years, respectively) were enrolled in the study. Obesity was defined as a body mass index higher than 97th percentile for age- and gender-specific reference values. All participants were free of any disease and none of them was receiving any medication. Twenty-four-hour ambulatory electrocardiographic recordings were obtained and the time-domain and frequency-domain indices of HRV were analyzed. The study group was evaluated with respect to insulin resistance by HOMA-IR values.Results: A significant decrease in calculated HRV variables was observed in obese children as compared to controls. The HRV alteration was found in both time-domain and frequency-domain parameters. The subgroup analysis of the study group revealed a significant decrease in all investigated HRV parameters in the insulin-resistant obese children compared to the non-insulin-resistant obese ones.Conclusions: Our results indicate that HRV is decreased in obese children, which implies parasympathetic withdrawal and sympathetic predominance. A marked decrease in HRV was observed in insulin-resistant obese children compared to their non-insulin-resistant counterparts. We propose that autonomic imbalance pertaining especially to insulin resistance may be involved in the pathogenesis of obesity in pediatric patientsConflict of interest:None declared.