Investigating social inequalities in older adults’ dentition and the role of dental service use in 14 European countries

Background

Oral disease, despite being largely preventable, remains the most common chronic disease worldwide and has a significant negative impact on quality of life, particularly among older adults.

Objective

This study is the first to comprehensively and at a large scale (14 European countries) measure the social inequalities in the number of natural teeth (an informative oral health marker) in the over 50-year-old population and to investigate the extent to which such inequalities are attributable to dental service use.

Methods

Using Wave 5 of the Survey of Health, Ageing and Retirement in Europe, which included internationally harmonized information on over 50,000 individuals across 14 European countries, we calculated Gini and Concentration indices (CI) as well as the decompositions of CIs by socioeconomic factors.

Results

Sweden consistently performed the best with the lowest inequalities as measured by Gini (0.1078), CI by income (0.0392), CI by education (0.0407), and CI by wealth (0.0296). No country performed the worst in all inequality measures. However, unexpectedly, some wealthier countries (e.g., the Netherlands and Denmark) had higher degrees of inequalities than less-wealthy countries (e.g., Estonia and Slovenia). Decomposition analysis showed that income, education, and wealth contributed substantially to the inequalities, and dental service use was an important contributor even after controlling for income and wealth.

Conclusions

The study highlighted the importance of comprehensively investigating oral health inequalities. The results are informative to policymakers to derive country-specific health policy recommendations to reduce oral health inequalities in the older population and also have implications for oral health improvement of the future generations.

     

Beyond QALYs: Multi-criteria based estimation of maximum willingness to pay for health technologies

The QALY is a useful outcome measure in cost-effectiveness analysis. But in determining the overall value of and societal willingness to pay for health technologies, gains in quality of life and length of life are prima facie separate criteria that need not be put together in a single concept. A focus on costs per QALY can also be counterproductive. One reason is that the QALY does not capture well the value of interventions in patients with reduced potentials for health and thus different reference points. Another reason is a need to separate losses of length of life and losses of quality of life when it comes to judging the strength of moral claims on resources in patients of different ages. An alternative to the cost-per-QALY approach is outlined, consisting in the development of two bivariate value tables that may be used in combination to estimate maximum cost acceptance for given units of treatment—for instance a surgical procedure, or 1 year of medication—rather than for ‘obtaining one QALY.’ The approach is a follow-up of earlier work on ‘cost value analysis.’ It draws on work in the QALY field insofar as it uses health state values established in that field. But it does not use these values to weight life years and thus avoids devaluing gained life years in people with chronic illness or disability. Real tables of the kind proposed could be developed in deliberative processes among policy makers and serve as guidance for decision makers involved in health technology assessment and appraisal.     

Lifestyle factors and social ties associated with the frequency of laughter after the Great East Japan Earthquake: Fukushima Health Management Survey

Purpose

Although mental health problems such as depression after disasters have been reported, positive psychological factors after disasters have not been examined. Recently, the importance of positive affect to our health has been recognised. We therefore investigated the frequency of laughter and its related factors among residents of evacuation zones after the Great East Japan Earthquake of 2011.

Methods

In a cross-sectional study on 52,320 participants aged 20 years and older who were included in the Fukushima Health Management Survey in Japan’s fiscal year 2012, associations of the frequency of laughter with changes in lifestyle after the disaster, such as a changed work situation, the number of family members, and the number of address changes, and other sociodemographic, psychological, and lifestyle factors were examined using logistic regression analysis. The frequency of laughter was assessed using a single-item question: “How often do you laugh out loud?”

Results

The proportion of those who laugh almost every day was 27.1%. Multivariable models adjusted for sociodemographic, psychological, and lifestyle factors demonstrated that an increase in the number of family members and fewer changes of address were significantly associated with a high frequency of laughter. Mental health, regular exercise, and participation in recreational activities were also associated with a high frequency of laughter.

Conclusion

Changes in lifestyle factors after the disaster were associated with the frequency of laughter in the evacuation zone. Future longitudinal studies are needed to examine what factors can increase the frequency of laughter.

     

Parent–child separation: the relationship between separation and psychological adjustment among Chinese rural children

Purpose

The current study aimed to explore the characteristics of psychological adjustment among Chinese left-behind children (LBC) in rural areas, and to examine the association between separation duration from parent/parents (SDP) and children’s psychological adjustment and the extent to which personality mediates this hypothesized link.

Methods

We surveyed 534 rural children and adolescents aged 10–17 years at school (440 LBC and 94 non-LBC) in 2013, who were selected for participation using stratified cluster sampling from two counties in Chongqing, China. Measures used included socio-demographic variables, age at the commencement and end of the separation from parents, the revised Chinese Juvenile Eysenck Personality Questionnaire, and the Adolescent Psychological Adaptability Scale.

Results

Most children (82.4%) had experienced separation from parents. t test results showed a marginally significant difference (p?=?.08) in psychological adjustment between LBC (mean?=?64.44, SD?=?8.62) and non-LBC (mean?=?66.16, SD?=?9.26). LBC’s mean SDP was 5.64 years (SD?=?3.90). Correlation analysis showed that children’s SDP was negatively associated with psychological adjustment. Structural equation modeling showed that neuroticism, but not extraversion or psychoticism, fully mediated the link between children’s SDP and psychological adjustment.

Conclusion

Personality (neuroticism) is one of the mediating pathways through which long-term SDP may predict poor psychological adjustment among children. Given the detrimental impact of long-term SDP, interventions should target the mediating pathway to buffer against the negative impact of parental separation on the affected rural children and to improve their mental health.

     

How Mentor Support Interacts With Mother and Teacher Support in Predicting Youth Academic Adjustment: An Investigation Among Youth Exposed to Big Brothers Big Sisters of Canada Programs

This study examines three potential contributions (i.e., additive only, hierarchical compensatory, and hierarchical conditional) of mentor support to youth academic adjustment, taking into account interactions with support from mothers and teachers. We derived data from a larger study of the Big Brothers Big Sisters (BBBS) of Canada community mentoring program. The sample included 427 youth (average age 9.8 years; 64% girls, 56% White) who received one-to-one community-based mentoring for at least three months. We assessed perceptions of support from mothers and teachers before the match and assessed perceptions of support from mentors five times throughout the mentoring experience. Hierarchical linear regression analyses showed that mentor support predicted positive changes in youth academic adjustment (i.e., school attitude, academic self-efficacy, assistance seeking, and problem solving) mainly when mentees already reported high support from their mother. This finding clearly supports the conditional model and invites researchers to question the assumption that mentoring constitutes a corrective experience for young people (i.e., the compensatory model). BBBS agencies are strongly encouraged to involve parents in the mentoring process and to view them as experts, assets, and allies in their effort to meet the youth’s needs.     

Histological and Genotoxic Biomarkers in <Emphasis Type="Italic">Prochilodus lacustris</Emphasis> (Pisces,Prochilodontidae) for Environmental Assessment in a Protected Area in the Northeast of Brazil

The quality of aquatic environments all around the world is being altered by different human activities that represent direct threat to the ecological system and the aquatic biota. This study aimed to evaluate the occurrence of histological and genotoxic alterations in Prochilodus lacustris as indicators of anthropic impacts in a lacustrine environment in northeast Brazil. The histological alterations were evaluated using the histological alteration index, and the genotoxic alterations were detected using the micronuclei test, at three sampling stations (S1, S2 and S3). The gills presented lesions with three stages of severity, with mild lesions more frequent in the specimens collected at station S1. Mild hepatic tissue lesions were the most frequent type in both areas. Micronucleus analysis showed that station S3 was the most affected. The biological responses observed indicated that the fish are under influence of environmental changes. It is important to highlight that the organisms collected at station S3 had a more compromised health status.     

Kinetic Modeling of Cr(VI) Reduction by nZVI in Soil: The Influence of Organic Matter and Manganese Oxide

The effect of soil composition on the reduction of hexavalent chromium (Cr(VI)) by zero valent iron nanoparticles was studied. A model was proposed, to investigate both the effect of manganese oxide and the simultaneous effect of manganese dioxide and soil organic matter on the kinetic of Cr(VI) reduction. Fe(0) nanoparticles consumption by the reaction with dissolved oxygen, water and soluble Cr(VI) was taken into account. The model was validated through experimental tests performed on soil samples collected at an industrial polluted site, and on artificially contaminated samples from the same site, in the presence of selected amount of leonardite.     

Assessment of the Remediation Effect of Nano-hydroxyapatite in Exogenous Pb-contaminated Soil Using Toxicity Characteristic Leaching Procedure and Soil Enzyme Activities

This study assessed the level of Pb in soil and five wild plant species (Calotropis procera, Datura alba, Parthenium hysterophorus, Cenchrus ciliaris and Ricinus communis) during all the four seasons. Two busy roads varying in age and traffic volume were selected i.e., Faisalabad–Sargodha road (FSR) and Pindi Bhattian to Lillah (M-2) in the Punjab, Pakistan. Results showed raised levels of Pb in both plants and soil samples along both roads. The range of Pb concentration in plants was 0.08–3.98 and 1.95–4.74 mg kg^??1 for soil. Higher Pb contamination was recorded along FSR road as compared to M-2. Among seasons, the higher Pb concentration was found during summer, probably due to very high temperature. Among all the plants studied, Calotropis procera accumulated the highest level (3.98 mg kg^??1 dry wt.) of Pb; Thus, it can be used as good biomonitor/phytoremediator at Pb contaminated areas.     

Geochemical Assessment of Fluoride Pollution in Groundwater of Tribal Region in India

This study assessed the fluoride (F^?) pollution in groundwater samples (n?=?170) of tribal regions around Bailadila Iron Ore Mines [BIOM] Complex of Dantewada District, India. Weathering of carbonate and silicate clays were important geogenic sources of dissolved ions. A Piper diagram showed a Ca–HCO₃ water type, with positive chloro-alkaline indices illustrating the occurrence of direct base-exchange reactions. The F^? concentrations varied from 0.08 to 1.95 mg L^?1 with a mean value of 0.9?±?0.3 mg L^?1. Only two groundwater samples showed F^? concentrations?>?1.5 mg L^?1, the drinking water guideline established by the World Health Organization (WHO) and Bureau of Indian Standards (BIS). Factor analysis showed high loadings of HCO₃^? and F^?, indicating alkaline conditions, favoring the dissolution of F^? in the groundwater. The K _fluor value is less than 10^?10.6, indicating that the dissociation of fluorite is very slow. As a result, groundwater locations were under-saturated with respect to fluorite.     

Effect of Dibutyl Phthalate on the Tolerance and Lipid Accumulation in the Green Microalgae <Emphasis Type="Italic">Chlorella vulgaris</Emphasis>

Offshore oil exploration creates threats to coastal ecosystems, including increasing urbanization and associated effluent releases. Genotoxicity biomarkers in mussels were determined across a gradient of coastal zone influences of offshore petroleum exploration in southeastern Brazil. Coastal ecosystems such as estuaries, beaches and islands were seasonally monitored for genotoxicity evaluation using the brown mussel Perna perna. The greatest DNA damage (5.2%?±?1.9% tail DNA and 1.5‰? ±?0.8‰ MN) were observed in urban estuaries, while Santana Archipelago showed levels of genotoxicity near zero and is considered a reference site. Mussels from urban and pristine beaches showed intermediate damage levels, but were also influenced by urbanization. Thus, mussel genotoxicity biomarkers greatly indicated the proposed oil exploration and urbanization scenarios that consequently are genetically affecting coastal organisms.