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Influence of the smoking habit in the surgery of inflammatory bowel disease.

UNLABELLED: The smoking habit is a key factor in the development of inflammatory bowel disease (IBD), but little information exists as to the relationship between smoking habit, the need of surgery and its complications. OBJECTIVES: To investigate the relationship between smoking habit, the need of surgery, their complications and clinical recurrence after surgery in Crohn's disease (CD) and ulcerative colitis (UC). METHODS: We studied a group of 62 patients (22 with UC and 40 with CD) with previous surgery. We analyzed the clinical and surgical characteristics of the disease. Smoking habit was established by a personal interview. This group of patients was compared with another control group of 202 patients (133 with UC and 69 with CD) with IBD without previous surgery. RESULTS: Smoking habit was similar between operated and non-operated patients for both UC (73% and 80% non-smokers) and CD (67% and 63% smokers) The number and type of complications after surgery were not related with smoking habit. In CD patients, although the recurrences did not depend on the smoking habit, they did occur earlier in smokers than in non smokers (83.6 +/- 21 vs 155 +/- 50 weeks, p = ns). CONCLUSIONS: The smoking habit does not seem to influence significantly the need of surgery and post surgical development of IBD, although in CD the smokers seems to present recurrence before non smokers.

Adult↗

Khmer dental and medical students' knowledge about the betel quid chewing habit in Cambodia.

95 of 144 questionnaires submitted by volunteer Khmer medical and dental students on the betel quid chewing habit in Cambodia were evaluated (58 medical, 37 dental). Questions related to the composition of the betel quid, the physiological and oral effects as well as traditional and sociological aspects. Statistical tests showed that there were differences between dental and medical students, particularly relating to the knowledge about oral effects. While 81.1% of dental students knew that betel quid chewing causes oral cancer, only 31.0% of the medical students were adequately informed. Similarly, 51.4% of the dental students knew about the relation between betel quid chewing and submucous fibrosis compared to 8.6% of the medical students (P < 0.001). In contrast, only 18.9% of the dental students thought that betel quid chewing strengthens the gum, while 56.9% of the medical students believed that betel quid chewing would have this effect (P < 0.001). The answers also showed that students do not indulge in the betel quid habit. The decline of the betel quid chewing habit was also indicated by the fact that while 5.3% of students had parents chewing betel quid, in contrast 40% of students reported grandparents with this habit. There are deficiencies of knowledge about the most important effects of betel quid chewing, particularly in medical students. Since both medical and dental students will in their future professional life have an enormous impact on health and health education, it seems justified that the dental and medical curricula should focus on these traditional habits. Proper health education starting in the dental and medical school is warranted in Cambodia and probably also in other South and Southeast Asian countries where the betel quid chewing habit is prevalent so as ultimately to improve public knowledge on the oral and other effects of this habit.

Areca↗

Habit versus planned behaviour: a field experiment.

A field experiment investigated the prediction and change in repeated behaviour in the domain of travel mode choices. Car use during seven days was predicted from habit strength (measured by self-reported frequency of past behaviour, as well as by a more covert measure based on personal scripts incorporating the behaviour), and antecedents of behaviour as conceptualized in the theory of planned behaviour (attitude, subjective norm, perceived behavioural control and behavioural intention). Both habit measures predicted behaviour in addition to intention and perceived control. Significant habit x intention interactions indicated that intentions were only significantly related to behaviour when habit was weak, whereas no intention-behaviour relation existed when habit was strong. During the seven-day registration of behaviour, half of the respondents were asked to think about the circumstances under which the behaviour was executed. Compared to control participants, the behaviour of experimental participants was more strongly related to their previously expressed intentions. However, the habit-behaviour relation was unaffected. The results demonstrate that, although external incentives may increase the enactment of intentions, habits set boundary conditions for the applicability of the theory of planned behaviour.

Adult↗

Oral habits among 7-10 year-old school children in Ibadan, Nigeria.

OBJECTIVE: To assess the prevalence of oral habits among 7-10 year-old children in Ibadan, Nigeria. DESIGN: An epidemiological survey of randomly selected school children. Criteria for social class was based on registrar general's social class. SETTING: Primary schools from different parts of Ibadan city, Nigeria. SUBJECTS: 493 school children aged 7-10 years consisting of 237(48.1%) boys and 256(51.9%) girls. MAIN OUTCOME MEASURES: Only children still actively involved in oral habits were coded positive. RESULTS: In all, 49(9.9%) of the children were involved in one type of oral habit or the other with digit sucking being most prevalent 40(8.1%). Lip sucking was observed in 6(1.2%) while 1(0.2%) had an unusual sucking habit--sucking of left forearm with resultant severe anterior open bite (10 mm). The relationship between the oral habits anterior open-bite and increased overjets were very significant statistically (p<0.01). No significant associations were noted between the habits and social class as well as Angle's classification of molar relations. None of the children examined had gone for routine dental check-ups before except for the 62(12.6%) who had previous dental consultations due to toothaches. CONCLUSION: Oral habits especially digit sucking needing management was revealed by this study and none of them had been to a dentist for help. This suggests that there is need to intensify oral health education in our environment, targeted at both parents and school children to enable them benefit from interceptive orthodontic care which has numerous advantages.

Age Distribution↗

Oral habits in school going children of Delhi: a prevalence study.

This study was conducted on 5554 children aged 5-13 years old with the objectives of recording the prevalence of oral habits among North Indian children according to sex. These children were selected from the schools of Delhi. The sample represented the entire school-going population of Delhi in the age group of 5-13 years. Statistical analysis was carried out using BMDP software and sex differences were calculated by using Fisher's exact test. The results showed that the prevalence of oral habits in Delhi school going children was 25.5%. Tongue thrust was the commonest habit (18.1%) followed by mouth breathing (6.6%). Thumb sucking was relatively less common habit and seen in only 0.7% of children. There were no significant differences between boys and girls for the prevalence of oral habits. However, for the specific habit types there was a sex difference. Thumb sucking was more common in girls (1.0%) when compared with boys (0.4%) and this difference was statistically significant (P < 0.001). There was a reverse trend for the mouth breathing, which was more common (P < 0.001) in boys (7.8%) than girls (5.3%). There were no differences for tongue thrust habit between boys (17.5%) and girls (18.6%).

Adolescent↗

Habitable zones around main sequence stars.

A one-dimensional climate model is used to estimate the width of the habitable zone (HZ) around our Sun and around other main sequence stars. Our basic premise is that we are dealing with Earth-like planets with CO2/H2O/N2 atmospheres and that habitability requires the presence of liquid water on the planet's surface. The inner edge of the HZ is determined in our model by loss of water via photolysis and hydrogen escape. The outer edge of the HZ is determined by the formation of CO2 clouds, which cool a planet's surface by increasing its albedo and by lowering the convective lapse rate. Conservative estimates for these distances in our own Solar System are 0.95 and 1.37 AU, respectively; the actual width of the present HZ could be much greater. Between these two limits, climate stability is ensured by a feedback mechanism in which atmospheric CO2 concentrations vary inversely with planetary surface temperature. The width of the HZ is slightly greater for planets that are larger than Earth and for planets which have higher N2 partial pressures. The HZ evolves outward in time because the Sun increases in luminosity as it ages. A conservative estimate for the width of the 4.6-Gyr continuously habitable zone (CHZ) is 0.95 to 1.15 AU. Stars later than F0 have main sequence lifetimes exceeding 2 Gyr and, so, are also potential candidates for harboring habitable planets. The HZ around an F star is larger and occurs farther out than for our Sun; the HZ around K and M stars is smaller and occurs farther in. Nevertheless, the widths of all of these HZs are approximately the same if distance is expressed on a logarithmic scale. A log distance scale is probably the appropriate scale for this problem because the planets in our own Solar System are spaced logarithmically and because the distance at which another star would be expected to form planets should be related to the star's mass. The width of the CHZ around other stars depends on the time that a planet is required to remain habitable and on whether a planet that is initially frozen can be thawed by modest increases in stellar luminosity. For a specified period of habitability, CHZs around K and M stars are wider (in log distance) than for our Sun because these stars evolve more slowly. Planets orbiting late K stars and M stars may not be habitable, however, b ecause they can become trapped in synchronous rotation as a consequence of tidal damping. F stars have narrower (log distance) CHZ's than our Sun because they evolve more rapidly. Our results suggest that mid-to-early K stars should be considered along with G stars as optimal candidates in the search for extraterrestrial life.

Atmosphere↗

Psychosocial factors and dietary habits associated with vegetable consumption.

OBJECTIVE: We assessed scales of psychosocial factors and dietary habits related to vegetable consumption and examined associations of these scales with vegetable intake. METHODS: Data are from 838 adults who participated in a 1997 to 1998 Washington State random digital-dial survey designed to monitor attitudes and behavior related to cancer risk and prevention. Information was collected on psychosocial factors related to vegetable consumption, vegetable-related dietary habits, demographic (participant) characteristics, and vegetable intake. Factor analyses were used to identify the underlying dimensions in the psychosocial and dietary habits scales. Analyses of variance, linear regression, and Pearson's correlations examined associations among participant characteristics, psychosocial factors, dietary habits, and vegetable consumption. RESULTS: Factor analyses of the psychosocial scale suggested four coherent dimensions or subscales--importance of eating vegetables, health benefits, convenience and taste of raw vegetables, and taste of cooked vegetables--with good internal consistency reliability (Cronbach's alpha = 0.67-0.77). There were four subscales within the dietary habits scale--add vegetables to mixed dishes, include vegetables at lunch and dinner, eat raw vegetables, and eat salads--with fair internal consistency reliability (Cronbach's alpha = 0.37-0.61). The psychosocial factors and dietary habits were strongly correlated (summary scales Pearson's r = 0.55), and after adjustment for participant characteristics, both scales were significantly and positively associated with vegetable intake (Pearson's r = 0.45 and 0.54, respectively, for summary scales; all Ps < 0.001). Further, the scales explained between 14% and 23% of the variance in vegetable intake. CONCLUSIONS: These scales of psychosocial factors and dietary habits related to vegetable consumption could be used to target intervention messages and evaluate intervention effects.

Adolescent↗

Healthy dietary habits in relation to social determinants and lifestyle factors.

The aim of the present study was to evaluate the importance of social status and lifestyle for dietary habits, since these factors may influence life expectancy. We studied the association of four indicators for healthy dietary habits (fruits and vegetables, fibre, fat and Hegsted score) with sex, age, socio-economic status, education, physical leisure exercise, smoking and personal attention paid to keeping a healthy diet. Data were gathered with a self-administered quantitative food-frequency questionnaire distributed to a representative sample of Norwegian men and women aged 16-79 years in a national dietary survey, of whom 3144 subjects (63%) responded. Age and female sex were positively associated with indicators for healthy dietary habits. By separate evaluation length of education, regular physical leisure exercise and degree of attention paid to keeping a healthy diet were positively associated with all four indicators for healthy dietary habits in both sexes. Socio-economic status, location of residence and smoking habits were associated with from one to three indicators for healthy dietary habits. In a multiple regression model, age, education and location of residence together explained from 1 to 9% of the variation (R2) in the four dietary indicators. Length of education was significantly associated with three of four dietary indicators both among men and women. By including the variable 'attention paid to keeping a healthy diet' in the model, R2 increased to between 4 and 15% for the four dietary indicators. Length of education remained correlated to three dietary indicators among women, and one indicator among men, after adjusting for attention to healthy diet, age and location of residence. Residence in cities remained correlated to two indicators among men, but none among women, after adjusting for age, education and attention to healthy diet. In conclusion, education was associated with indicators of a healthy diet. Attention to healthy diet showed the strongest and most consistent association with all four indicators for healthy dietary habits in both sexes. This suggests that personal preferences may be just as important for having a healthy diet as social status determinants.

Adolescent↗

Age and sex differences in health habits and beliefs of schoolchildren.

All children in Grades 3 through 12 of one school system completed a survey about health habits and beliefs including smoking and eating habits, perceptions of exercise, weight, and parental involvement in health. The surveys were factor-analyzed within grade and sex, and the overall factors that emerged were Smoking Habits, Family Discussion of Health, Family Thinking About Health, Nutritional Habits, and Health Locus of Control. Analysis of variance of each factor revealed that girls generally reported healthier food habits than did boys. However, girls reported more smoking and less exercise. There are also changes in habits and belief with age; junior high school is a particularly important time for the development of several habits. The findings are discussed in relation to theories of child development and the implications for the content and timing of future health education intervention programs with children.

Adolescent↗

Prevalence, age of onset and demographic relationships of different areca nut habits amongst children in Tower Hamlets, London.

OBJECTIVE: To examine prevalence and demographic relationships of different areca nut habits amongst children. DESIGN: Self-administered questionnaire. SUBJECTS: Children aged between 11 and 15. Of 800 questionnaires distributed, 704 were fully completed (88%). SETTING: Two secondary schools in the London district of Tower Hamlets. MEASURES: Demographic, areca nut habits used, age first used, still using, frequency of use. RESULTS: Users of any areca nut habit were exclusively from the South Asian population. Of this population, 77% had engaged in a habit, and dependent upon habit between 54 and 92% of these still remained current users. The highest prevalence of current use for boys and girls respectively was for areca nut alone (36%, 43%), followed by mistee pan (35%, 29%), betel-quid (27%, 26%) and pan masala (14%, 16%). Of the current users, 44% engaged in one habit only, 24% two, 20% three and 13% all four. The highest period of risk for starting to use areca nut alone, betel-quid and mistee pan was between ages 5 and 12, whilst for pan masala it was after 10. Boys had a significantly higher risk of beginning use before 10 (P < .001) and a higher frequency of use for pan masala (P< .01), areca nut alone (P< .05) and betel-quid (P = .06) than girls. The frequency of using each habit was between 3 and 5 episodes per week, however boys use pan masala approximately 10 times per week. CONCLUSION: South Asian children may already be experienced users of areca nut. Greater attention should be directed towards identifying signs of oral submucous fibrosis, oral cancer and other potentially malignant lesions within the South Asian population.

Adolescent↗

Multiple socio-economic circumstances and healthy food habits.

OBJECTIVE: To examine associations between seven indicators of socio-economic circumstances and healthy food habits, while taking into account assumed temporal order between these socio-economic indicators. DESIGN AND SETTING: Data were derived from cross-sectional postal questionnaires in 2000-2002. Socio-economic circumstances were assessed by parental education, childhood economic difficulties, own education, occupational class, household income, home ownership and current economic difficulties. Healthy food habits were measured by an index consisting of consumption of fresh vegetables, fruit or berries, rye bread, fish and choosing vegetable fats on bread and oil in cooking. Sequential logistic regression models were used, adjusting for age and marital status. PARTICIPANTS: Employees of the City of Helsinki, Finland (n=8960, aged 40-60 years). RESULTS: Healthy food habits were reported by 28% of women and by 17% of men. Own education, occupational class, household income, home ownership and current economic difficulties were associated with healthy food habits. These associations were attenuated but mainly remained after mutual adjustments for the socio-economic indicators. Among women, a pathway was found suggesting that part of the effects of education on food habits were mediated through occupational class. CONCLUSIONS: Employees in higher and lower socio-economic positions differ in their food habits, and those in lower positions and economically disadvantaged are less likely to report healthy food habits. Health promotion programmes and food policies should encourage healthier food choices among those in lower socio-economic positions and among those with economic difficulties in particular.

Adult↗

Past food habit change is related to obesity, lifestyle and socio-economic factors in the Malmo Diet and Cancer Cohort.

OBJECTIVES: To examine if obesity status and socio-economic and lifestyle factors are associated with self-reported past food habit change, and also whether the level of obesity depends on the reason for change. DESIGN: Cross-sectional analysis within the Malmo Diet and Cancer (MDC) study using data from the baseline examination and the extensive socio-economic and lifestyle questionnaire including questions of past food habit change. The risk of having changed food habits in the past was examined using logistic regression. Mean differences in obesity status across categories of reasons for past food habit change were examined using analysis of variance. SETTING: Malmö, the third largest city in Sweden. SUBJECTS: A sub-sample (15 282 women and 9867 men) from the MDC cohort recruited from 1992 to 1996. RESULTS: Individuals with body mass index (BMI) >30 kg m(-2) had an increased risk of having reported past food habit change compared with individuals with BMI <25 kg m(-2) (odds ratio (OR) = 1.63, 95% confidence interval (CI) = 1.48-1.83 for women; OR = 1.53, 95% CI = 1.32-1.76 for men). The highest level of obesity was observed among individuals who had changed their diet due to reasons related to the metabolic syndrome. Changers were more likely to be highly educated and to live alone, be retired, ex-smokers and non-drinkers at baseline. CONCLUSIONS: Because past food habit change is related to obesity and other lifestyle and socio-economic factors, a complex confounding situation may exist that could seriously influence observed relationships between diet and disease. Studies need to collect information on past food habit change and take this information into account in the analysis and when interpreting study outcomes.

Aged↗

Associations between obesity, breakfast-time food habits and intake of energy and nutrients in a group of elderly Madrid residents.

OBJECTIVE: The objective of this study was to gain more knowledge about the breakfast habits of different groups of elderly people and to investigate the differences in breakfast habits between overweight and normal weight elderly subjects. METHODS: A study was made of the food preferences, dietary habits and the intake of energy and nutrients at breakfast in a group of 122 elderly Spanish people (65 men and 57 women) aged 75.7+/-8.7 years. Study participants were divided into two groups: overweight and obese subjects (O) with a body mass index (BMI)>or=25 kg/m2 (58% of the population), and normal weight subjects (NW) with a BMI<25 kg/m2 (42% of the population). The members of each group were further divided into subgroups according to age (>or=80 years of age (Y) and<or=79 (Z)), to determine if this factor gave rise to any differences in breakfast habits or modified existing differences between NW and O subjects. RESULTS: NW subjects more frequently indicated a preference for fruit (Y), juices (Y) and bread (Y and Z) as breakfast foods, and showed less preference for churros (Y) (a traditional Spanish breakfast fritter) than did O subjects. NW subjects consumed more varied breakfasts, taking both a greater number of foods and more groups of foods. They also spent a longer time eating their breakfasts and consumed greater quantities of food than did O subjects. The breakfasts of NW subjects covered a higher percentage of their theoretical energy expenditure and provided greater contributions of fiber, vitamin E and iron to meet recommended intakes than did those of O subjects. Age did not produce any statistically significant differences in subjects' breakfast habits. CONCLUSION: The shorter length of time spent eating breakfast, the consumption of smaller quantities and less varied diets and the different composition of NW and O breakfasts, could indicate the existence of less healthy breakfast habits among overweight and obese subjects. It is also possible that less adequate breakfast habits contribute to the appearance and further development of obesity.

Aged↗

Disturbed bowel habits in patients with non-ulcer dyspepsia.

UNLABELLED: BACKGROUND; Emerging medications for non-ulcer-dyspepsia, such as the serotonin-receptor modulators, also affect bowel habits by altering colonic transit. If drugs that alter colonic function were to prove useful in non-ulcer dyspepsia, knowledge of baseline bowel habit disturbances would be potentially critical. AIM: To estimate the rate of non-ulcer dyspepsia patients with clinically relevant constipation or diarrhoea potentially precluding use of motility agents. METHODS: Consecutive patients with non-ulcer dyspepsia (n = 79), gastro-oesophageal reflux disease (n = 135) and organic upper gastrointestinal disease (upper gastrointestinal disease; n = 36) completed a validated symptom questionnaire evaluating predominant bowel habits in the last year. RESULTS: Prevalence of constipation was higher in non-ulcer dyspepsia (34%) than in gastro-oesophageal reflux disease (P = 0.01) and organic upper gastrointestinal disease (P = 0.01), prevalence of alternating diarrhoea/constipation (24%) and diarrhoea (22%) was similar, while prevalence of normal bowel habits was significantly less in non-ulcer dyspepsia (20%; P = 0.01 vs. gastro-oesophageal reflux disease and P < 0.01 vs. organic upper gastrointestinal disease). Constipation was particularly frequent in ulcer-like and dysmotility-like non-ulcer dyspepsia, while prevalence of diarrhoea was lowest in dysmotility-like non-ulcer dyspepsia. A normal bowel habit was equally uncommon in male (21%) and female non-ulcer dyspepsia patients (20%). CONCLUSIONS: Only one of five non-ulcer dyspepsia patients had normal bowel habits based on clinical symptoms; constipation is particularly prevalent. Patients with functional dyspepsia who are prescribed motility altering drugs should be evaluated by taking a thorough bowel habit history.

Adult↗

Attitudes of Saudi Arabian mothers towards the digit-sucking habit in children.

OBJECTIVE: The purpose of this study was to report on the attitudes of Saudi mothers towards the digit-sucking habit in their children and their attempts to stop this fixation. DESIGN: The research took the form of a cross-sectional study. METHODS: Data was collected from a sample of 50 Saudi mothers whose children currently had a digit-sucking habit. One investigator used a specially designed questionnaire to interview all the mothers. RESULTS: The results showed that 48% of mothers did not like to see the habit at any age, and no mother accepted the habit after the age of 4 years. Most mothers (86%) tried to stop their children digit-sucking. Sixty-six per cent of the present sample had noticed the adverse effect of this fixation on their child's occlusion, and this was given as the main reason for their attempts to stop the habit. The most common method used by Saudi mothers to stop their children sucking their digits was the application of a bitter tasting lotion to the fingers (66%). Although 48% of mothers had sought advice about digit-sucking from dentists and paediatricians (30% and 18%, respectively), 60% of the dentists and all of paediatricians had made no suggestions about any solutions. CONCLUSION: No mother accepted the habit in their children after the age of 4 years. The majority of mothers had noticed the adverse effect of the digit-sucking fixation. Non-invasive procedures were most commonly used by Saudi mothers attempting to stop this habit in their children.

Adult↗

Attempts at changing dietary and exercise habits to reduce risk of cardiovascular disease: who's doing what in the community?

The objective of this study was to characterize adults in Olmsted County, MN who were attempting to change both their dietary and physical activity habits. A random digit-dial telephone survey was taken of 1232 adults, with questions about lifestyle, medical conditions, demographics, and receipt of previous lifestyle advice from a health care professional. Respondents were grouped in four categories: 1) changing neither diet nor exercise habits (22%); 2) changing diet habits only (20%); 3) changing exercise habits only (9%); and 4) changing both diet and exercise habits (49%). Along with several demographic and behavioral factors, receipt of physician advice to change exercise and dietary habits was a strong predictor of attempts to change both lifestyle habits. Only a minority of the population (23%), however, reported having received such advice. These results support the positive impact of health professional advice on dietary and exercise change in the population. Public health campaigns should be aimed at increasing the provision of such advice.

Adult↗

Characterization of the alternating bowel habit subtype in patients with irritable bowel syndrome.

BACKGROUND: Due to a wide range of symptom patterns, patients with irritable bowel syndrome (IBS) are often subgrouped by bowel habit. However, the IBS subgroup with alternating bowel habits (IBS-A) has been poorly characterized. OBJECTIVES: (i) To determine a set of bowel habit symptom criteria, which most specifically identifies IBS patients with an alternating bowel habit, (ii) to describe IBS-A bowel symptom patterns, and (iii) to compare clinical characteristics among IBS-A, constipation-predominant (IBS-C), and diarrhea-predominant IBS (IBS-D). METHODS: One thousand one hundred and two Rome I positive IBS patients were analyzed. Three sets of potential criteria for IBS-A were developed and compared by multirater Kappa test. Gastrointestinal, psychological, extraintestinal symptoms, and health-related quality of life were compared in IBS-A, IBS-C, and IBS-D using chi(2) test and analysis of variance (ANOVA). RESULTS: Stool consistency was determined to be the most specific criteria for alternating bowel habits. IBS-A patients reported rapid fluctuations in bowel habits with short symptom flares and remissions. There was a greater prevalence of psychological and extraintestinal symptoms in the IBS-A subgroup compared to IBS-C and IBS-D. No differences were seen between bowel habit subtypes in health-related quality of life. CONCLUSIONS: IBS-A patients have rapidly fluctuating symptoms and increased psychological comorbidity, which should be taken into account for clinical practice and clinical trials.

Adolescent↗

Dietary habits and oral hygiene as predictors of caries in 3-year-old children.

The value of defined levels of oral hygiene and dietary habits for predicting caries was investigated. The material comprised 143 3-yr-olds. Three levels of oral hygiene and dietary habits, respectively, were used. Oral hygiene was registered as gingival status. Dietary habits were recorded by interview. Two groups were then formed by pooling stepwise the caries data for the nine possible combinations of oral hygiene and dietary habits and setting the most discriminating border, screening level, where the properties sensitivity and specificity simultaneously reached their highest value. Children with clean teeth, irrespective of dietary habits, and children with suitable dietary habits, provided they did not have general gingivitis with bleeding, might be regarded as no caries risks, while children with other combinations of oral hygiene and dietary habits were caries risks. The difference in decayed surfaces between the two groups was statistically significant (p less than 0.001). The sensitivity was 0.89 and the specificity 0.70. The predictive value of a negative test (0.91) was higher than that of a positive test (0.64).

Child, Preschool↗