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PubMedDate not supplied

Non-nutritive sucking behaviors in preschool children: a longitudinal study.

PURPOSE: Prolonged duration of non-nutritive sucking behaviors may have consequences in regard to the developing orofacial structures and occlusion. Little is known as to why some children have prolonged sucking habits beyond the first 2 to 3 years of life. This paper reports on non-nutritive sucking patterns among a large cohort of healthy children from birth to 36 months of age and older, and identifies factors predictive of prolonged non-nutritive sucking habits. METHODS: Over 600 children were followed from birth to at least 36 months of age using mailed questionnaires sent when children reached the ages of 6 weeks, and 3, 6, 9, 12, 16, and 24 months, and then yearly thereafter. Parents answered questions concerning non-nutritive sucking behaviors including use of pacifier and digit sucking. The study categorized children who maintained habits to 36 months of age or older as having prolonged habits, and using multivariate analyses, compared them to children without prolonged habits on various sociodemographic variables. RESULTS: The study found that for over 20% of the children, a non-nutritive sucking habit was prolonged to 36 months of age or older. Factors associated with prolonged sucking habits included older maternal age, higher maternal education level, and having no older siblings. CONCLUSIONS: Identifying factors related to prolonged non-nutritive sucking habits may be important in developing and targeting recommendations regarding such behaviors in an effort to prevent malocclusions that result from prolonged sucking habits.

Chi-Square Distribution↗
PubMed2002

An evaluation of clinical mock boards and their influence on the success rate on qualifying boards.

An important responsibility of each dental school to its graduating dental students is exposure to and evaluation on a mock board that simulates one or more of the examinations given by its respective regional testing agencies. An introduction to the procedures and environment that will be encountered on a qualifying examination will hopefully increase a student's chance for success on such a test. The purpose of this study was to test the relationship of the various attributes or variables of mock boards given by dental schools in the United States and Puerto Rico with results obtained on the regional or state qualifying board(s) related to timing, structure, method of evaluation, graduation, and remediation. A twenty-item questionnaire was mailed to key clinical or curricular deans at fifty-four accredited dental schools. Ninety-three percent of schools completed and returned the questionnaire. In the sample of respondents, the percentages of schools participating in the various qualifying exams were: CRDTS = 22 percent; NERB = 42 percent; SRTA = 20 percent; WREB = 28 percent; Independents = 24 percent, with a reported overall passing rate (greater than or equal to 70) of 58 percent. The median time between the mock board and the qualifying board was 7.5 weeks. Results indicated that no single aspect of a mock board had a statistically significant effect on the outcome of qualifying examinations, resulting in a failure to reject the null hypothesis. Such findings may indicate that schools should focus their efforts on reassessing the restrictions and requirements imposed upon their students related to their mock board. A future study could include surveying recent graduates for their opinions of the value of their mock board experiences.

Certification↗
PubMed1994

Familial occurrence of Hirschsprung's disease.

We assessed the familial occurrence of Hirschsprung's disease from 224 probands born in Denmark after 1959. Probands who were still alive received a mailed questionnaire, and medical reports for the probands and their relatives with suspected Hirschsprung's disease were examined. The diagnosis of Hirschsprung's disease required a histologically verified biopsy or surgical colonic specimens, and exclusion of a secondary causes for Hirschsprung's disease. Familial occurrence was seen in 11 families. Ten first-degree, two third-degree and one fifth-degree relatives had Hirschsprung's disease. Both short segment agangliosis (the sigmoid colon or below) and long segment agangliosis (above the sigmoid colon) occurred in five of the 11 families, implying that the etiology of Hirschsprung's disease with short and long segment agangliosis is the same. Compared with the general population, the first-degree relatives of the 224 probands had a minimum of a 93-fold increased risk of Hirschsprung's disease. This strongly suggests that genetic factors play a role in Hirschsprung's disease.

Denmark↗
PubMedDate not supplied

Patients' and cohabitants' reports on snoring and daytime sleepiness, 1-8 years after surgical treatment of snoring.

A follow-up study was performed with the aim to evaluate all individuals surgically treated by the uvulopalatopharyngoplasty (UPPP) or laser uvulopalatoplasty (LUPP) method from a whole county in Sweden, 1-8 years after surgery, by assessing snoring occurrence and daytime sleepiness, as experienced by the patients and their cohabitants. Questionnaires were mailed to all operated people (n = 457) and were returned by 91% (346 men, 69 women) preoperatively diagnosed as habitual snorers (n = 255), cases of obstructive sleep apnea syndrome (n = 110) and unspecified snorers (n = 48). In addition 345 bedpartners participated. For outcome of surgery, no significant differences in diagnoses or sex were found. Improvement in snoring occurrence was reported by 89.6% of the patients, confirmed by 92% of the cohabitants (r = 0.84, p < 0.01). The remaining snoring occurrence was significantly dependent on the surgical method and the time after operation. Excessive daytime sleepiness (EDS) was experienced by 73.3% of the patients compared to 67% reported by the cohabitants. Of 415 patients operated on, 18% were free from snoring and 25% were free from EDS. Individuals with a shorter time since surgery reported less snoring. The UPPP method gave a significantly better result than LUPP for the symptom 'snoring'.

Adult↗
PubMed2001

A survey of Hong Kong dentists' attitudes towards advertising.

OBJECTIVE: To determine the attitudes of dental practitioners in the Hong Kong Special Administrative Region (SAR) of the Peoples' Republic of China towards advertising of dental services by members of the profession, a practice that is currently not permitted by legislation. DESIGN: Self-completion questionnaires were mailed to 400 members of the Hong Kong Dental Association. In addition to being presented with a number of closed questions, respondents were invited to expand on their answers in a more qualitative, open-ended manner. RESULTS: 271 replies were received, representing a response rate of 68%. Respondents were largely against a move towards any deregulation which would result in dentists being allowed to advertise their services in the SAR (57.9% against, 28.0% for), this despite a high proportion of respondents reporting that, in their opinion, the Hong Kong public do not know enough about the services provided by dentists in the SAR (69.7%). CONCLUSIONS: Opinions amongst Hong Kong dentists are divided with a majority feeling that a move to allow advertising would not benefit either the public or the profession. There is, however, a significant proportion of dentists who feel that there is a need for such deregulation.

Adult↗
PubMed1997

Diet and alcohol consumption and lung cancer risk in the New York State Cohort (United States)

The relationship between diet and alcohol and lung cancer was evaluated among participants of the New York State Cohort (United States), comprising 27,544 men (395 cases) and 20,456 women (130 cases) who completed a brief mailed questionnaire in 1980. Participants were followed up through 1987 with the assistance of the New York State Department of Health's Vital Statistics Section and Cancer Registry. Among men, inverse relationships with vitamin C, folate, and carotenoids, and positive associations with total fat, monounsaturated and saturated fat were observed after adjusting for age, education, cigarettes/day, years smoking, and total energy intake. The relationships observed with folate and saturated fat were stronger for heavy smokers. Also, the effect of folate, total fat, and monounsaturated fat seemed to be limited to squamous cell carcinomas. We found no indication that cholesterol or polyunsaturated fat was associated with lung cancer. Diet did not appear to exert a major role on lung cancer risk among women. Although diet modification should never be considered a substitute for smoking cessation, its role as an additional strategy in lung cancer prevention deserves attention.

Adult↗
PubMed2000

Chronicity of sexual harassment and generalized work-place abuse: effects on drinking outcomes.

AIMS: This study examined the impact of two forms of interpersonal conflict in the work-place, sexual harassment (SH) and generalized work-place abuse (GWA), on drinking outcomes. We hypothesized that SH and GWA would be associated more strongly with negative outcomes than task-related work stressors, especially when SH and GWA were chronic problems. DESIGN: This was a two-wave panel study. SETTING: The study was conducted at an urban university in the United States. PARTICIPANTS: Participants were 2038 university employees in four occupational groups (faculty, student, clerical and service workers) who responded to both waves of the survey. MEASUREMENTS: Data on SH, GWA, task-related stressors and drinking outcomes were gathered from self-report mail questionnaires. Data from 1880 non-abstaining respondents were included in the analyses. FINDINGS: SH and GWA experiences were widespread, typically chronic, and tended to co-occur. In regression analyses controlling for demographics, occupational group, prior drinking and task-related stress, GWA chronicity was linked to increased odds of reporting one or more indicators of problem drinking at time 2, in contrast to onset and remission. SH chronicity coupled with no GWA experiences was also significantly related to increased drinking variability. Task-related stressors generally did not explain significant variance in drinking outcomes. CONCLUSIONS: SH and GWA may be better predictors of drinking behavior compared to task-related stressors, particularly when harassment is chronic. Increased attention to conflictual relationships in the work-place, the relationship between SH and GWA and the dynamic nature of stressors in general is necessary in future research on drinking behavior.

Alcohol Drinking↗
PubMed2000

Adequacy of dental records in clinical practice: a survey of dentists.

PURPOSE: The purposes of the study were to determine Minnesota dentists' perception of the adequacy of their dental record documentation, assess the general format and contents of dental records they used, and compare the self-reported contents of dental records with guidelines established by the American Dental Association (ADA). METHOD: Using ADA's published recommendations for structure and guidelines of the dental record from 1987, a 20-item questionnaire was developed, pretested, and used to survey a random sample of 750 Minnesota dentists. Reminder postcards were sent two weeks after the initial survey mailing. A third mailing to nonrespondents, including cover letter and duplicate questionnaire, was conducted three weeks later. Of the surveys returned, 63% (N = 475) were analyzed. Data analyses, including frequencies and tests of chi-square, were conducted using Statview and SPSS. RESULTS: While 15% (N = 69) of respondents used a single-page record format, 44% (N = 209) used multiple forms filed in a specific location within the record. Of the dentists responding, 403 (85%) felt their record documentation was adequate without comparison to any specified criteria. However, statistically significant differences occurred between dentists' perception of record adequacy and the actual presence or absence of ADA criteria for all record components. Data analysis revealed that information was absent 9.4% to 87.1% of the time. CONCLUSION: A discrepancy exists between dentists' perception of dental record adequacy and the ADA recommendations for structure and guidelines. Inadequate dental record components should be targeted for improvement.

American Dental Association↗
PubMed2001

Smokers who do not want to quit--is consonant smoking related to lifestyle and socioeconomic factors?

AIMS: To examine whether consonant smokers (who say they would not like to quit) differ from dissonant smokers (who would like to quit) in other forms of health-related behaviour and socioeconomic background. METHODS: The participants included 2,709 male and 1,774 female smokers (aged 25-64 years old) from six annual population-based samples, examined between 1989 and 1994 via a mailed questionnaire. RESULTS: Consonant male smokers were more likely to be heavy drinkers, use mostly butter on bread, and to not eat vegetables. Particularly in the middle educational and income groups, consonant male smokers were more likely to be heavy drinkers. Consonant female smokers were more often heavy drinkers and more sedentary than dissonant female smokers. If a male smoker belonged to the lower income group he was more likely to be a consonant smoker. CONCLUSIONS: Consonant male smokers had more adverse health behaviours compared to dissonant smokers, but nearly half of them did not have any other adverse health behaviours. However, a negative attitude towards smoking cessation was associated with other adverse health behaviours. There were no socioeconomic differences in willingness to quit smoking among female smokers and those differences between male smoker groups were small. Factors other than motivation to quit should be targeted to diminish socioeconomic differences in smoking cessation.

Adult↗
PubMed2004

Alcohol use by healthcare professionals.

BACKGROUND: This study investigated alcohol use, misuse and abuse in a sample of dentists, nurses, pharmacists and physicians. Previous studies have lacked cross healthcare group comparisons and have rarely included dentists. METHODS: As part of a larger mail survey, 479 healthcare professionals (68.7% response) completed self-report items on patterns of alcohol use, monthly drinking, heavy episodic drinking, alcohol-related dysfunction and social or professional influences. RESULTS: Dentists consumed more alcohol than other groups of healthcare professionals; however, use of alcohol by nurses may have a wider impact. The data also suggest alcohol use by healthcare professionals may be related to age, but not gender or income. Physicians received significantly more offers to drink alcohol from pharmaceutical companies and dentists received significantly more offers to drink alcohol in social situations than other healthcare professionals. CONCLUSIONS: When compared to the general population, healthcare professionals appear to drink less, however, these findings also suggest that dentists use significantly more alcohol than most other groups of healthcare professionals. Together these findings address significant knowledge gaps that exist surrounding the prevalence of and pathways promoting alcohol use and misuse by healthcare professionals.

Adult↗
PubMed1995

Relation between infant feeding and infections during the first six months of life.

We assessed the effect of the method of feeding on respiratory and gastrointestinal illnesses during the first 6 months of life among 776 infants born in New Brunswick, Canada. During a 1-year period, these infants were drawn from the offspring of a population of primiparous women in the province who, after at least 36 weeks of pregnancy, gave birth to one normal infant weighing 2500 gm or more. Data were collected by means of a self-administered standardized questionnaire mailed to every mother a week before her infant reached 6 months of age. The crude incidence density ratio (IDR) revealed a protective effect of breast-feeding on respiratory illnesses (IDR = 0.66; 95% confidence interval (CI), 0.52 to 0.83), on gastrointestinal illnesses (IDR = 0.53; 95% CI, 0.27 to 1.04) and on all illnesses (IDR = 0.67; 95% CI, 0.54 to 0.82). The protective effect of breast-feeding on respiratory illnesses persisted even after adjustment for age of the infant, socioeconomic class, maternal age, and cigarette consumption (adjusted IDR = 0.78; 95% CI, 0.61 to 1.00). Moreover, if we distinguished ear infection from other respiratory illnesses, we observed a separate protective effect for these two types of events. The results of this retrospective cohort study suggest a protective effect of breast-feeding in our population during the first 6 months of life.

Bottle Feeding↗
PubMed2002

Trends in reproductive, smoking, and other chronic disease risk factors by birth cohort and race in a large occupational study population.

PURPOSE: To illustrate the value of cohort studies to assess trends in chronic disease risk factors. METHODS: In collaboration with the American Registry of Radiologic Technologists and the University of Minnesota, the National Cancer Institute initiated a cohort study of cancer among radiologic technologists. More than 90,000 technologists who responded to a mailed questionnaire were grouped into ten birth cohorts from before 1920 through 1960 and later, and stratified by self-reported racial/ethnic groups. Trends in height, smoking, and reproductive factors were analyzed. RESULTS: Among the trends observed were that the proportion of young men (< 18 years) smoking generally fell in each birth cohort after 1925, whereas the proportion of young women smoking rose for those born after 1950. Among women born since 1940, the mean age at menarche for white women has remained at 12.5 years, but has declined among black and Asian/Pacific Islander women. Recent birth cohorts (since 1955) show among the highest mean ages at birth of first child (> 26 years), highest rates of nulliparity at age 25 (>/= 63 %), and lowest mean parity levels (< or = 1.7) compared with earlier cohorts. CONCLUSION: Analyses of large cohorts can clarify birth cohort trends in chronic disease risk factors.

Adult↗
PubMed1997

Interviewing techniques with adolescents in primary care.

PURPOSE: Privacy is of utmost concern to adolescents seeking advice regarding life-style and behavior choices. Lack of privacy and confidential health services are barriers to adolescents' access to health care. This study describes primary care physicians' practices with regard to inviting parent(s) to leave the room in order to interview the teen alone, and the factors associated with use of this technique. METHOD: A cross-sectional random survey of 1,630 pediatricians, internists, and family practitioners in a large metropolitan area was performed using a confidential mailed questionnaire. RESULTS: The majority of the physicians were in private practice, male, board certified, Caucasian, and did not have a subspecialty. Forty-nine percent of the respondents "almost always" or "always" invite parent(s) to leave the room in order to interview the teen alone. Physicians who were female, board certified, and completed residency from 1974-94 were most likely to use this technique. Among physicians who frequently employ this strategy, the decision to interview the teen alone varied according to the clinical scenario. Using logistic regression analysis, only gender and board certification were significantly related to use of this interviewing method. CONCLUSION: A large proportion of physicians do not interview their adolescent patients alone, therefore, not affording them privacy to discuss confidential health concerns. Future research should focus on developing and validating methods to teach physicians skills to interview adolescents privately.

Adolescent↗
PubMed2000

Factors affecting the diagnosis of peripheral vascular disease before vascular surgery referral.

OBJECTIVE: Many new patients evaluated by vascular surgeons are referred by internal medicine physicians (IMPs). Objectives shared by vascular surgeons and IMPs include early identification of peripheral arterial disease (PAD), improved referral relationships, and reduction of health care costs. The approach to PAD by IMPs and identification of deficiencies that might contribute to suboptimal care form the basis for this report. METHODS: An anonymous survey was mailed to all IMPs (n = 843) in the central and southern parts of Illinois. Questions concerned IMP demographics, approach to diagnostic testing, referral patterns, perception of adequacy of education of PAD, and how often parts of the history and physical examination for PAD would be performed on the initial office visit of a hypothetical 65-year-old male with hypertension (each answer measured as 0%-25%, 25%-50%, 50%-75%, and 75%-100% of the time completed). RESULTS: There was a response from 360 IMPs: 230 IMPs (27.3%) returned the questionnaire, and 130 IMPs (15.4%) declined to participate. Practice locations for IMPs returning the questionnaire included rural (36%), suburban (22%), and urban (40%). Practice types included academic (7%), solo private (29%), group private (53%), and other (14%). A history of cardiac disease was obtained most of the time by 92% of IMPs (75%-100% answer category). Histories for pulmonary disease, diabetes mellitus, stroke, and smoking were obtained most of the time with similar frequencies (85%, 86%, 73%, and 96%, respectively). In contrast, only 37% obtained a history for claudication, and 26% obtained a history for foot ulceration 75% to 100% of the time (P <.05, all comparisons). Examination of the heart (95%) and lungs (96%) occurred most of the time (75%-100% answer category) compared with each part of the pulse examination (range, 34%-60%; P <.05, all comparisons) and aortic aneurysm palpation (39%; P <.05). If pedal pulses were absent, examination by IMPs with Doppler scan and ankle-arm indices were mostly distributed in the 0% to 25% answer category (79% and 79%, respectively). After suspecting PAD, most IMPs obtained diagnostic tests first compared with specialist referral: carotid disease (91% vs 9%), aortic aneurysm (91% vs 9%), and lower extremity PAD (86% vs 14%). Initial referral patterns were made to vascular surgeons (49%), general surgeons (33%), cardiothoracic surgeons (13%), cardiologists (4%), and radiologists (1%). Most IMPs believed medical school (70%) and residency (73%) provided adequate training for PAD diagnosis. CONCLUSIONS: Deficiencies may exist in the identification of PAD by IMPs that could adversely affect diagnosis, time to referral, health care costs, and ultimately, patient outcome. Improvements in medical school education and IMP training in the diagnosis of PAD are needed.

Female↗
PubMed2004

Obesity is associated with increased risk of gastrointestinal symptoms: a population-based study.

OBJECTIVES: Perception of sensations arising from the gastrointestinal tract may be diminished in obese subjects and thus facilitate overeating. Alternatively, excess food intake may cause gastrointestinal (GI) symptoms in obese patients. We evaluated the relationship between body mass index (BMI) and specific GI symptoms in the community. METHODS: Residents of Olmsted County, MN were selected at random to receive by mail one of two validated questionnaires. The association of reported GI symptoms with BMI (kg/m(2)) was assessed using a logistic regression analysis adjusting for age, gender, psychosomatic symptom score, and alcohol and tobacco use. RESULTS: Response rate was 74% (1,963 of 2,660). The prevalence of obesity (BMI > or = 30 kg/m(2)) was 23%. There was a positive relationship between BMI and frequent vomiting (p= 0.02), upper abdominal pain (p= 0.03), bloating (p= 0.002), and diarrhea (p= 0.01). The prevalence of frequent lower abdominal pain, nausea, and constipation was increased among obese (BMI > or = 30 kg/m(2)) compared to normal weight participants, however, no significant association was found between BMI and these symptoms. CONCLUSIONS: In the community, increasing BMI is associated with increased upper GI symptoms, bloating, and diarrhea. Clarification of the cause-and-effect relationships and the mechanisms of these associations require further investigation.

Adult↗
PubMed1989

Children with juvenile rheumatoid arthritis at school. Functional problems, participation in physical education. The implementation of Public Law 94-142.

Parents of 135 children with juvenile rheumatoid arthritis (JRA) completed a mailed questionnaire about problems at school. Writing was the most frequently reported difficulty, with hand involvement causing more problems than decreased mobility. Compared to children with pauciarticular JRA, those with polyarticular or systemic JRA were significantly more likely to miss school, experience problems, participate less in physical education, have an Individualized Educational Plan (IEP) developed, and receive related services. Only 39 parents had heard of PL 94-142, and only 21 of those could define the federal law. Twenty children had an IEP within the previous two years. Possible deficiencies in the implementation of PL 94-142 were discovered. This study demonstrates that the treatment of children with JRA should include efforts to: 1) identify and remediate potential performance limitations before they become problematic at school; 2) communicate this information to parents and school personnel; 3) and improve parents' awareness and understanding of PL 94-142.

Activities of Daily Living↗
PubMed2003

Orthodontic training in pediatric dental residencies.

The purpose of this study was to determine the amount and types of orthodontic training in pediatric dental residencies. A twenty-one-item survey was mailed to sixty directors of pediatric dental residencies. Follow-up surveys were sent to those who had not responded. Fifty-two surveys were returned for a response rate of 87 percent. Most programs provided forty-eight formal orthodontic course hours, one-half to one day of clinical orthodontic experience per week, and six to ten case starts for each resident. Most program directors anticipated this amount of experience would increase or stay the same in the future. Though most programs had an affiliated graduate orthodontic program, fewer than half of the programs had an orthodontist on faculty from the affiliated program (43 percent). As expected, orthodontic training varies with different program characteristics. The faculty members teaching orthodontics in pediatric dental residencies are often not from affiliated graduate orthodontic programs. Most program directors do not anticipate a decrease in the didactic or clinical components in the next five years.

Analysis of Variance↗
PubMed2000

[The prevalence of diabetes mellitus and its association with other cardiovascular risk factors in the province of Albacete. The Vascular Disease Group of Albacete (GEVA)].

OBJECTIVE: To find the prevalence of DM in the population of Albacete, and their relationship with other risk factors. DESIGN: A descriptive cross-sectional population study. SETTING: Community setting in the province of Albacete. PARTICIPANTS: A sample of 2121 people+ over 18 (843 from the capital and 1278 from the rest of the province) was selected through stratified random sampling. MEASUREMENTS AND MAIN RESULTS: Appointments were made by mail. All those attending underwent anamnesis, a physical examination, EKG and basic analytic test. 1263 people older than 18 years were studied. The prevalence of DM observed with WHO criteria was 6.7% (95% CI, 5.9%-7.4%), of which 6.5% corresponded to known DM and only 0.2% to unknown. If ADA criteria were used, the prevalence was 9.8%. We found association between DM and age, obesity, hypertension, hyperlipaemia, low HDL-c, high levels of fibrinogen, left ventricular hypertrophy, arrhythmias and personal history of ischemic cardiopathy and peripheric arteriopathy. CONCLUSIONS: DM is a highly prevalent pathology in Albacete. We consider necessary to standard epidemiological methods that allow us to know the real situation of DM in our country. Other cardiovascular risk factors are more prevalent in diabetic patients, increasing their coronary risk. The control of modifiable factors is fundamental to avoid as possible the chronic complications of the disease.

Adult↗