The life course approach: explaining the association between height and dental caries in Brazilian adolescents

AIM: To investigate the relationship between height and dental caries in Brazilian adolescents. METHODS: A cross-sectional survey design was used to collect retrospective data. Of 764 eligible 13-year-old adolescents enrolled in urban private or public schools in a Brazilian town, 652 were clinically examined and interviewed. Data were collected on socioeconomic circumstances, family related variables, oral health behaviour and anthropometric measures (height and weight). Dental caries was measured by decayed, missing and filled teeth (DMFT) index. The DMFT was categorized according to two levels of severity (low DMFT 6) using the 75th percentile of the distribution as the cut-off point. Data analysis involved multiple logistic regression. RESULTS: Adolescents who were the second or later child were 1.90 times more likely to have a high DMFT, whilst being a taller adolescent had a protective effect on caries experience (OR = 0.04; 95% CI = 0.00-0.79). In addition, adolescents from rural areas (OR = 2.74; 95% CI = 1.56-4.82), those whose mothers had less than 8 years of education (OR = 2.10; 95% CI = 1.03-4.27) and those who reported high levels of paternal punishment (OR = 1.60; 95% CI = 1.02-2.52) had an increased risk of having a high DMFT. CONCLUSION: There is a relationship between height and dental caries experience in this sample of Brazilian adolescents.     

The relationship between traumatic dental injuries and adolescents' development along the life course

Few models have been proposed to explain the aetiology of traumatic dental injuries. Those that have, focus on risk factors at present stage of life. The contribution of risk factors for dental injuries at different stages of life needs to be investigated. OBJECTIVES: To test the relationship between life course experiences and the occurrence of traumatic dental injuries in adolescents. METHODS: A cross-sectional survey was used to collect data retrospectively. Out of a total number of 764 eligible 13-year-old-adolescents enrolled in private and public schools located in urban areas in the town of Cianorte, Brazil, 652 (85%) agreed to participate in the study. They were interviewed and examined for traumatic dental injuries by two trained dental epidemiologists using validated criteria. The interviews collected information on socioeconomic circumstances, family related variables, school grade and anthropometric measures (height and weight). RESULTS: Adolescent boys, those from non-nuclear families, those reporting high levels of paternal punishment and those who were at lower grades at school for their age were more likely to experience dental injuries than girls, adolescents from nuclear families, those reporting low levels of paternal punishment and those who were at higher grades at school. CONCLUSION: It was concluded that adolescents who experienced adverse psychosocial environments along the life course had more traumatic dental injuries than their counterparts who experienced more favourable environments.     

Play-based procedural preparation and support intervention for cranial radiation

Purpose

The primary objective of this study was to examine the relationship between play-based procedural preparation and support intervention and use of sedation in children with central nervous system (CNS) tumors during radiation therapy. The secondary objective was to analyze the cost-effectiveness of the intervention compared to costs associated with daily sedation.

Methods

A retrospective chart review was conducted, and 116 children aged 5–12 years met criteria for inclusion. Outcome measures included the total number of radiation treatments received, the number of treatments received with and without sedation, and the type and duration of interventions, which consisted of developmentally appropriate play, education, preparation, and distraction provided by a certified child life specialist.

Results

The results of univariate analyses showed that age, tumor location, and total number and duration of interventions were significantly associated with sedation use during radiation therapy. Multivariate analyses showed that, after adjustment for age, tumor location, and craniospinal radiation, a significant relationship was found between the total number and duration of the interventions and sedation use. The implementation of a play-based procedural preparation and support intervention provided by a certified child life specialist significantly reduced health-care costs by decreasing the necessity of daily sedation.

Conclusions

Support interventions provided by child life specialists significantly decreased both sedation use and the cost associated with daily sedation during cranial radiation therapy in children with CNS tumors. This study supports the value of the child life professional as a play-based developmental specialist and a crucial component of cost-effective healthcare.

     

Profiling postprandial thermogenesis in muscle and fat of sheep and the central effect of leptin administration

Brown adipose tissue thermogenesis is an important component of energy expenditure as exemplified in rodents. Other tissues such as white adipose tissue and muscle are also capable of thermogenesis, but regulation of heat production in these tissues is poorly understood. We used a relatively large animal model, the ovariectomized sheep, in which site-specific temperature measurements were made as an index of thermogenic output. Dataloggers were implanted into the retroperitoneal (visceral) fat, gluteal (sc) fat, and skeletal muscle of the hind limb, and were programmed to record temperature every 15 min. Animals (n = 4) were then placed on a feeding schedule (fed between 1100 and 1600 h) to entrain a postprandial response in thermogenesis. Baseline thermogenesis (0800-1100 h) was higher (P < 0.05) in visceral fat and muscle than in gluteal fat, whereas the amplitude of the postprandial increase was similar at all three sites. Intracerebroventricular infusion into the lateral ventricle of either vehicle (artificial cerebrospinal fluid) or leptin (10 microg/h at 100 microl/h) for 24 h (0900-0900) was performed in a cross-over design with a 1-wk recovery period between treatments. Central leptin infusion did not alter the basal thermogenic rate but markedly enhanced the postprandial response in both fat and muscle tissues. This was manifest by increased (P < 0.05) amplitude and duration of the postprandial thermogenic response, and the effect was greater in muscle and visceral fat than in gluteal fat. These data demonstrate that leptin is able to regulate thermogenesis in muscle, providing a novel target for the manipulation of energy balance.