Anticipatory guidance and children's oral health: A scoping review.

BACKGROUND: Anticipatory guidance (AG) involves providing parents with information about developmental milestones and promoting optimal development. Oral AG was first introduced as a comprehensive approach to provide age-appropriate oral health information and preventive interventions. The literature regarding this important topic has not yet been reviewed and summarised. AIM: To describe the literature on AG provided to parents about their children's oral health and identify gaps in the current research. METHOD: The scoping review mapped the existing peer-reviewed and guideline documents about AG and children's oral health using the framework established by Arksey and O'Malley (2005) and modified by Levac et al. (2010). Firstly, we defined our research questions and searched the literature using Medline, Web of Science and Scopus. Secondly, we selected all types of literature and then applied the inclusion and exclusion criteria, and finally, we analysed and summarised the information using thematic analysis. RESULTS: Forty-three peer-reviewed articles and six guidelines were included. There was variation in how AG was described and defined. While some studies have evaluated the effectiveness of AG, most have investigated its short-term effectiveness only, with few interventional studies assessing this approach in the long-term. CONCLUSION: While the concept of AG shows promise, there is no consensus within the current literature on a defined definition and there is a lack of long-term evaluation.

A systematic review of the quality and scope of economic evaluations in child oral health research.

BACKGROUND: Economic evaluations provide policy makers with information to facilitate efficient resource allocation. To date, the quality and scope of economic evaluations in the field of child oral health has not been evaluated. Furthermore, whilst the involvement of children in research has been actively encouraged in recent years, the success of this movement in dental health economics has not yet been explored. This review aimed to determine the quality and scope of published economic evaluations applied to children's oral health and to consider the extent of children's involvement. METHODS: The following databases were searched: CINAHL, Cochrane Library, Econlit, EThOS, MEDLINE, NHS EED, OpenGrey, Scopus, Web of Science. Full economic evaluations, relating to any aspect of child oral health, published after 1997 were included and appraised against the Drummond checklist and the Consolidated Health Economic Evaluation Reporting Standards by a team of four calibrated reviewers. Data were also extracted regarding children's involvement and the outcome measures used. RESULTS: Two thousand seven hundred fifteen studies were identified, of which 46 met the inclusion criteria. The majority (n = 38, 82%) were cost-effectiveness studies, with most focusing on the prevention or management of dental caries (n = 42, 91%). One study quantified outcomes in Quality Adjusted Life Years (QALYs), and one study utilised a child-reported outcome measure. The mean percentage of applicable Drummond checklist criteria met by the studies in this review was 48% (median = 50%, range = 0-100%) with key methodological weaknesses noted in relation to discounting of costs and outcomes. The mean percentage of applicable CHEERS criteria met by each study was 77% (median = 83%, range = 33-100%), with limited reporting of conflicts of interest. Children's engagement was largely overlooked. CONCLUSIONS: There is a paucity of high-quality economic evaluations in the field of child oral health. This deficiency could be addressed through the endorsement of standardised economic evaluation guidelines by dental journals. The development of a child-centred utility measure for use in paediatric oral health would enable researchers to quantify outcomes in terms of quality adjusted life years (QALYs) whilst promoting child-centred research.

Deaths from necrotizing fasciitis in the United States, 2003-2013.

Necrotizing fasciitis (NF) is a life-threatening infection requiring urgent surgical and medical therapy. Our objective was to estimate the mortality burden of NF in the United States, and to identify time trends in the incidence rate of NF-related mortality. We obtained data from the National Center for Health Statistics, which receives information from death certificates from all states, including demographic information and cause of death. The U.S. Multiple Cause of Death Files were searched from 2003 to 2013 for a listing of NF (ICD-10 code M72.6) as either the underlying or contributing cause of death. We identified a total of 9871 NF-related deaths in the United States between 2003 and 2013, corresponding to a crude mortality rate of 4·8 deaths/1,000,000 person-years, without a significant time trend. Compared to white individuals, the incidence rate of NF-associated death was greater in black, Hispanic, and American Indian individuals, and lower in Asian individuals. Streptococcal infection was most commonly identified in cases where a pathogen was reported. Diabetes mellitus and obesity were more commonly observed in NF-related deaths compared to deaths due to other causes. Racial differences in the incidence of NF-related deaths merits further investigation.

Tailoring the photovoltaic effect in (1 1 1) oriented BiFeO3/LaFeO3 superlattices.

Ferroelectric and photovoltaic properties of (BiFeO3)(1-x)Λ/(LaFeO3) xΛ superlattices grown by pulsed laser deposition have been investigated (Λ being the bilayer thickness). For a high concentration of BiFeO3 a ferroelectric state is observed simultaneously with a switchable photovoltaic response. In contrast for certain concentration of LaFeO3 a non-switchable photovoltaic effect is evidenced. Such modulation of the PV response in the superlattices is attributed to the ferroelectric to paraelectric phase transition which is controlled with the increase of x. Remarkably, concomitant to this change of PV mechanism, a change of the conduction mechanism also seems to take place from a bulk-limited to an interface-limited transport as x increases.

Conduction mechanism and switchable photovoltaic effect in (1 1 1) oriented BiFe0.95Mn0.05O3 thin film.

Epitaxial 200 nm BiFe0.95Mn0.05O3 (BFO) film was grown by pulsed laser deposition (PLD) on (1 1 1) oriented SrTiO3 substrate buffered with a 50 nm thick SrRuO3 electrode. The BFO thin film shows a rhombohedral structure and a large remnant polarization of Pr = 104 µC cm-2. By comparing I(V) characteristics with different conduction models we reveal the presence of both bulk limited Poole-Frenkel and Schottky interface mechanisms and each one dominates in a specific range of temperature. At room temperature (RT) and under 10 mW laser illumination, the as grown BFO film presents short-circuit current density (J sc) and open circuit voltage (V oc) of 2.25 mA cm-2 and -0.55 V respectively. This PV effect can be switched by applying positive voltage pulses higher than the coercive field. For low temperatures a large V oc value of about -4.5 V (-225 kV cm-1) is observed which suggests a bulk non-centrosymmetric origin of the PV response.

Down-regulation of CD28, TCR-zeta (zeta) and up-regulation of FAS in peripheral cytotoxic T-cells of primary breast cancer patients.

BACKGROUND: Several studies have supported the hypothesis that the concept of immuno-surveillance would not be effective in cancer patients. One reason for suppression of antitumor immunity may be attributed to immune impairment of T-lymphocytes, which extends beyond the tumor-microenvironment and might effect the peripheral blood. Therefore the aim of this study was to investigate the expression of immunoregulatory antigens in peripheral blood lymphocytes of primary breast cancer patients in comparison with healthy donors. MATERIALS AND METHODS: The peripheral blood immune status of 61 patients with primary breast cancer was analysed by FACS-analysis. The different lymphocytic subpopulations were identified by intracellular/extracellular monoclonal antibodies in three-color flow cytometry. The distribution was compared to age-matched healthy female donors (n = 29). RESULTS: The expression of TCR zeta-chain, an important signal complex for T-cell activation and functional integrity of specific immune response, was significantly reduced in the cytotoxic specific T-cell population. Cytotoxic T-cells (CD3+/CD8+) also showed a down-regulation of CD28, the important ligand to the co-stimulatory molecule CD80 (B7.1) on antigen-presenting cells. Moreover, breast cancer patients had significantly more CD95 (FAS) expressing cytotoxic T-cells than their healthy counterparts (p < 0.05). CONCLUSION: The significant up-regulation of CD95 and down-regulation of TCR zeta and CD28 in peripheral cytotoxic T-cells of breast cancer patients leads to the hypothesis of systemic immunosuppression, which could open the door for tumor cell dissemination via the blood stream and which is the subject of ongoing studies.

Personality and disease: correlations of multiple trait scores with various illnesses.

Correlations between personality measures and self-reported data on health status were examined in a sample of 5133 men and women, aged between 40 and 65. A wider range of diseases was studied than is typical. Small but theoretically meaningful correlations with personality were found for some diseases. Personality syndromes of Emotional Lability, Type A Behaviour, Behavioural Control, Locus of Control over Diseases and Psychoticism were distinguished factorially. Emotional Lability appeared to be the most robust predictor of general disease vulnerability. Some small but significant associations between specific illnesses and Type A and Behavioural Control were also found.

Morphometric study of the equine navicular bone: comparisons between fore and rear limbs.

Navicular bones collected from the four limbs of 95 sound horses were studied. The anatomic bases have been laid down about morphometry of the navicular bones and their variations according to limbs, after corrections have been made for morphologic type, gender, weight, size and age. All the dimensions of the navicular bone (except for the thickness) were larger in the fore limb. This phenomenon probably reflects an attempt to compensate for the greater forces exerted upon the fore limbs during exercise and at rest. Navicular bones collected from the four limbs of 61 sound horses were studied and the anatomic bases were described for histomorphometry of the fore and rear navicular bones. Fore navicular bones possess less cortical bone at the level of the articular surface, as well as at the level of the flexor surface and proximal border, but larger amounts of cancellous bone. Articular and flexor surface cortical bone show a larger porosity in the fore navicular bones and a larger amount of mineralized cartilage. The mineralized portion for distal impar- and collateral sesamoidean ligaments are also larger for the fore navicular bones. Two distinct zones are observed for the flexor surface cortex that have never been reported in the literature before: an external zone, which is mainly composed of poorly remodelled lamellar bone, arranged in a disto-proximal oblique direction, and an internal zone, which is mainly composed of secondary bone, with a latero-medial direction of Haversian canals. Bone architecture is discussed with regard to the mechanic load, encountered by the bone during locomotion.