Do teenagers’ and parents’ alcohol-related views meet? – Analysing focus group data from Finland and Norway

Aims: This study analyses how Finnish and Norwegian teenagers and parents of teenagers perceive the appropriateness, desirability or harmfulness of different drinking situations. The focus is on whether teenagers and parents perceive the situations similarly or differently.

Methods: Our data consist of focus group interviews from Finland and Norway with teenagers aged 14–17 years (n?=?8 groups, n?=?44 participants) and parents (n?=?8 groups, n?=?38). Three pictures portraying different drinking situations were presented to the participants, who were asked to describe (1) what kind of situation the picture depicts, (2) whether the way of drinking in the picture was acceptable or not and (3) whether they identified with the situation or not.

Findings: Our analysis showed that teenagers and parents defined the situations similarly and applied rather similar criteria when assessing the appropriateness of drinking. The most important criteria related to the amount and the way of drinking, and whether or not children were present in the situation. Regarding the identification with the situations, teenagers seemed to have somewhat stricter attitudes towards intoxication than adults, which can be perceived as a sign of an ongoing trend of decreasing youth drinking.

Conclusions: Overall, our analysis suggests that the alcohol worlds of parents and teenagers resembled each other, supporting the notion that the generational gap between parents and teenagers is diminishing.     

Risk factors and etiology of childhood hearing loss: a cohort review of 296 subjects

Abstract

Background: The association between the Joint Committee on Infant Hearing (JCIH) risk factors and etiology of hearing loss (HL) is not studied well in children.

Objectives: To clarify the etiologic causes and evaluate the JCIH risk characteristics of children with HL.

Methods: A retrospective study of 296 children with HL born between 2009.01 and 2013.12 in Stokholm. Demographic data, family and medical histories, audiologic results, imaging findings, and genetic results were ascertained and analyzed.

Results: In 221 with bilateral hearing loss (BHL), family history and neonatal risk indicators were the most common risks (59 each), followed by syndrome related risks. In 75 with unilateral hearing loss (UHL), craniofacial anomaly was the most common risk, followed by family history. Etiology was established in 93 with BHL, in which syndromic HL accounted for 37.2%, chromosomal aberrations for 21.3%, and environmental causes for 19.1%. Etiology was established in 35 with UHL, in which ear malformation accounted for the most (74.3%), followed by environmental causes (14.3%).

Conclusions and significance: Childhood HL can be attributed to a variety of causes with an etiology identifiable in 42.5% of BHL and 46.7% of UHL. BHL and UHL have different patterns of JCIH risk exposure and etiology.     

Outdoor pedestrian fall‐related injuries among Swedish senior citizens – injuries and preventive strategies

Senior citizens get around, to a large extent, as pedestrians, and safe walking is desirable for senior citizens allowing them to stay mobile, independent and healthy in old age. Senior citizens are over‐represented in injury statistics, and fall‐related injuries are common. The aim of this study was to investigate fall‐related injuries including healthcare costs among senior citizen pedestrians injured when walking in public outdoor environments and to describe their self‐reported causes and suggested preventive strategies. The data were based on a combination of information from injury data and a questionnaire. Three hundred senior citizens attended one emergency department after sustaining injuries from pedestrian falls; 60% suffered nonminor injuries, mostly fractures. One‐fifth of the pedestrians were hospitalised for an average of 8 days with an indirect hospital cost of 6.2 million EUR (55 million SEK). Environmental factors such as ice were the most commonly described cause of the injury incident. Forty per cent of the respondents indicated that the municipality was responsible for the cause of the injury incident. Fewer respondents mentioned their own responsibility as a preventive strategy. Thirty per cent described a combination of improvements such as better road maintenance, changes in human behaviour and use of safety products as preventive strategies. It is of great importance to highlight general safety, products and preventive strategies to minimise injury risks, so that pedestrians can safely realise the known health benefits of walking and thereby limit healthcare costs.     

Ceramic-on-ceramic vs ceramic-on-polyethylene,a comparative study with 10-year follow-up

BACKGROUNDIn press-fit total hip arthroplasty (THA) ceramic-on-ceramic (CoC) bearings are a potential for overcoming the wear that is seen in ceramic-on-polyethylene (CoPE) bearings, and can lead to wear-induced osteolysis, resulting in loosening of the implant. However, CoC bearings show disadvantages as well, such as squeaking sounds and being more fragile, which can cause ceramic head or liner fracture. Because comparative long-term studies are limited, the objective of this study was to determine the long-term difference in wear, identify potential predictive factors for wear, investigate radiological findings such as osteolysis, and evaluate clinical functioning and complications between these bearings.AIMTo determine 10-year differences in wear, predictive factors for wear, and investigate radiological findings and clinical functioning between CoC and CoPE.METHODSThis observational prospective single-center cohort study with a 10-year follow-up includes a documented series of elective THAs. Primary outcome was wear measured by anteroposterior (AP) radiographs. Secondary outcomes were potential predictive factors for wear, complications during follow-up, Harris hip score (HHS), and radiological findings such as presence of radiolucency, osteolysis, atrophy, and hypertrophy around the cup. Due to the absence of wear in the CoC group, stratified analysis to identify risk factors for wear was only performed in the CoPE group by use of univariate linear regression analysis. HHS was expressed as a change from baseline and the association with bearing type was assessed by use of multivariate linear regression analysis, adjusted for potential confounders.RESULTSA total of 17 CoPE (63.0%) and 25 CoC (73.5%) cases were available for follow-up and showed a linear wear of respectively 0.130 mm/year (range 0.010; 0.350) and 0.000 mm/year (range 0.000; 0.005), which was significant (P < 0.001) between both groups. Wear always occurred in the cranial direction. Cup inclination was the only predictive factor for polyethylene (PE) wear. No dislocations, ceramic head, or liner fractures were seen. The HHS showed a mean change from baseline of 37.1 points (SD 18.5) in the CoPE group and 43.9 (SD 17.0) in the CoC group. This crude difference of 6.8 (range -5.2; 18.7) in favor of the CoC group was not significant (P = 0.26) and was not significant when adjusted for age, gender, and diagnosis either (P = 0.99). No significant differences in complications and radiological findings were seen between groups. CONCLUSIONCoC bearing shows lower wear rates compared to CoPE at 10-year follow-up with cup inclination as a predictive factor for wear and no differences in complications, HHS, and radiological findings.     

Combined body mass index and abdominal obesity,lifestyle and health in a Norwegian adult population: a cross-sectional study

Aim

This study aimed to determine the prevalence of combined body mass index and waist circumference (BMI-WC) disease risk categories in a Norwegian adult population aged 18–51 years and describe selected health indicators (lifestyle factors, medical conditions, self-perceived health and high sensitive serum C-reactive protein (hs-CRP)) within these categories.

Subjects and methods

A sample of 1318 adults (aged 18–51 years) answered a comprehensive questionnaire covering lifestyle factors, medical conditions, self-perceived health and background variables in the population-based cross-sectional Telemark study, Norway, 2014–2015. BMI, WC and hs-CRP were determined as part of a broader medical examination. Four combined BMI-WC risk categories were constructed, based on recommendations provided by the US National Institutes of Health (NIH), and associations with health indicators examined using multiple logistic regression analyses.

Results

More than half of the participants represented combined BMI-WC categories with elevated disease risk (27% with increased risk, 11% with high risk and 19% with very high risk). Unfavourable health indicators (low physical activity, cardiovascular disease (CVD) history, physician-diagnosed high blood pressure and diabetes, lowered self-perceived health and elevated hs-CRP) increased in line with BMI-WC disease risk. Associations were observed independent of gender, age, education level and residential area.

Conclusion

The findings highlight the importance of using both BMI categories and WC for personalised assessment of obesity-related risk and need for follow-up. The findings are considered relevant to public health intervention programmes targeting adults with overweight and obesity. Follow-up studies are warranted to study morbidity development in the BMI-WC risk categories.

     

Total ankle replacement for posttraumatic arthritis: Similar outcome in postfracture and instability arthritis: a comparison of 90 ankles

Background and purpose

Most studies on total ankle replacement (TAR) have used a case mix of patients. We evaluated the outcome of TAR performed for end-stage arthritis either because of fracture or ligamentous injury.

Patients and methods

We prospectively followed 88 consecutive patients (50 postfracture ankles and 40 ankles with instability arthritis (2 bilateral)) who underwent TAR between 2001 and 2009. Mean follow-up for both groups was 5 years.

Results

Preoperative varus deformity of 10° or more was present in 23 ankles in the instability group. At 6 years, survival with revision or salvage fusion as an endpoint was 87% (95% CI: 74–99) in the postfracture group and 79% (95% CI: 63–94) in the instability group. Progressive periprosthetic osteolysis was seen in 23 ankles, and required salvage fusion in 6. The number of reoperations was similar in both groups. Clinical outcome, as assessed with 2 ankle scores and 2 questionnaires, showed good results and was similar at the latest follow-up.

Interpretation

The outcome was similar in the postfracture and instability groups and also similar to that reported in series including a case mix of patients. In contrast to earlier reports, preoperative frontal plane deformity in this series was not identified as a risk factor for failure.Most published articles on total ankle replacement (TAR) have presented results from mixed cohorts of patients suffering from end-stage ankle arthritis of several different etiologies, such as posttraumatic arthritis, primary arthritis, and rheumatoid arthritis (Buechel et al. 2003, Wood et al. 2008, Bonnin et al. 2011, Rippstein et al. 2011, Barg et al. 2013, Zaidi et al. 2013). To our knowledge, there have been no studies on TAR concentrating exclusively on patients withposttraumatic arthritis, but some studies have focused on TAR in combined cohorts of posttraumatic and primary osteoarthritis (Saltzman et al. 2010, Bai et al. 2010, Flavin et al. 2013).This is surprising, as posttraumatic arthritis is considered to be the most frequent cause of ankle arthritis (Saltzman et al. 2005).2 subgroups of posttraumatic arthritis should be distinguished: (1) postfracture arthritis, secondary to an intra- or juxta-articular fracture; and (2) ligamentous posttraumatic arthritis, secondary to a single severe ankle sprain or as a result of recurrent or chronic instability (Valderrabano et al. 2009). We refer to the latter as instability arthritis. Patients suffering from end-stage instability arthritis frequently present with a varus deformity of the ankle as a result of both lateral ligament laxity and asymmetric cartilage loss medially (Harrington 1979, Doets et al. 2008, Ryssman and Myerson 2011).We evaluated the medium-term outcome of TAR for end-stage posttraumatic ankle arthritis and compared it for postfracture arthritis and for instability arthritis. Our research questions were whether patients treated with TAR for instability arthritis—as they more frequently have a deformity and perhaps also residual instability after TAR—will have worse results with respect to (1) implant survival, (2) the number of reoperations, and (3) ankle-specific and general patient- and physician-based outcomes.     

Abnormal vomer development in human fetuses with isolated cleft palate.

OBJECTIVE: The aim of this study was to elucidate the prenatal human development of the vomer with emphasis on the vomeral footplate and to assess vomeral morphology in fetuses with isolated cleft palate. MATERIAL AND METHODS: Nine human fetuses of which four were normal (menstrual age [MA] 13 to 21 weeks) and five with isolated cleft palate (14 to 19 weeks MA) were studied. Midaxial cranial tissue blocks from the fetuses were cut frontally in 4microm serial sections. Sections were stained with toluidine blue in 30% ethanol. RESULTS: From 16 weeks MA, the vomeral footplate of normal fetuses was formed from bilateral ossifications located below a U-shaped vomeral body. Later in development, an osseous connection was found between the footplate and the vomeral body. Neither bilateral areas of ossification below the vomer nor a vomeral footplate was observed in isolated cleft palate fetuses. CONCLUSIONS: In normal fetuses, the base or footplate of the vomeral bone appears from 16 weeks MA in frontal sections. In fetuses with isolated cleft palates, with no connection between the nasal septum and the maxillary processes, this vomeral footplate does not develop in the period observed (14 to 19 weeks MA).     

Fear of injections and report of negative dentist behavior among Caucasian American and Taiwanese adults from dental school clinics

Abstract Fear of injections and reports of negative dentist behavior and associations with dental anxiety and avoidance of treatment were explored among 951 adults from denial school clinics in Iowa City, Iowa and Taipei. Taiwan. Use and fear of anesthetic injections and negative dentist behavior were assessed by written questionnaire to test associations with demographics, overall dental anxiety (Dental Anxiety Scale or “DAS”) and utilization behaviors. Frequency and logistic regression analyses showed that use of dental anesthetics for routine treatment was much greater overall among Caucasian Americans than Taiwanese, as was fear of injections. Taiwanese and Americans with high dental anxiety (DAS 12) had similar high fear of injections, but inspite of similar fears about dental drilling, high anxiety Taiwanese reported using much less local anesthesia for routine treatments than did high anxiety Americans. Report of condescending remarks to patients (“put downs”) by dentists was mainly an American phenomenon associated with high dental anxiety. Avoidance of appointment making was high for persons afraid of injections and for Americans reporting negative dentist behavior. Avoidance was highest in subjects with high dental anxiety. That predominant characteristics or etiologies of dental anxiety can differ by cultural differences in dental health care systems, dentist beliefs and/or expectations of patients within those systems was discussed in relation to the literature.