Associations Between Oral Health Fatalism and Demographic Factors, Dental Practices, Fatalism, and Oral Health Self-Efficacy.

Purpose: To evaluate the relationship between demographics, dental beliefs and practices, fatalism, oral health self-efficacy, and oral health fatalism (OHF) among parent (guardian, caregivers). Methods: English-speaking parents of children presenting for dental care at a hospital dental clinic, a dental surgery center, and two private practices answered a 33-item questionnaire regarding demographics, general fatalistic views, and dental beliefs, practices, and history. Participants rated their agreement with the OHF statement: "Most children eventually develop dental cavities." Results: More than half (58.4 percent) of parent respondents (n equals 332) were Caucasian, and 44.6 percent had education beyond high school. Most were female (81.3 percent), with public (Medicaid) insurance (67.5 percent), and were raising three (average) children. Less than 30 percent endorsed the OHF statement, and 42.5 percent were neutral. Higher OHF was found in parents of children with Medicaid insurance (P=0.02), fair (P=0.01) or poor (P=0.03) dental health, previous caries history (P=0.02), and those attending their first dental visit (P=0.03). Higher OHF was found in parents whose children do not brush their teeth when asked (P=0.02) or who do not behave when a parent helps (P=0.02), as well as those who subscribe to general fatalism beliefs (P=0.002). Conclusions: Higher oral health fatalism was associated with general fatalism, low oral health self-efficacy, parents of children with Medicaid insurance, suboptimal dental health, and first dental visits. Future studies investigating whether OHF can change over time and the role providers play in OHF can help dental professionals understand parent health behaviors and plan for health promotion interventions.

The Optimal State Scoring Tool: guidance for interdisciplinary care of infants with severe bronchopulmonary dysplasia and its relation to linear growth.

OBJECTIVE: Infants with severe bronchopulmonary dysplasia (sBPD) have complex medical courses. We developed the clinician-rated Optimal State Scoring Tool (OSST) that measures factors relevant to clinical improvement of sBPD and investigated preliminary validity using linear growth outcome and OSST scores in sBPD patients. METHODS: Tool development process and pilot findings are provided for 13 patients evaluated longitudinally. OSST scores, length measurements, and steroid dependency values were obtained. Changes in OSST scores and lengths were examined using linear mixed-effect models. RESULTS: OSST scores were significantly correlated with linear growth (95% CI 0.36, 0.57). The steroid-dependent group showed significantly slower rate of linear growth (95% CI 0.74, 1.05) and slower rate of increase in OSST scores (95% CI 0.99, 2.13) compared to the non-steroid-dependent group, with the OSST showing the largest effect size. CONCLUSION: Pilot data reflect promising evidence for OSST construct validity in monitoring clinical outcomes in sBPD patients.

Screening for Anxiety in Pediatric Primary Care: A Systematic Review.

CONTEXT: Anxiety is common, screening tools are available, and treatment can be effective. Recently, anxiety screening has been recommended for adolescent girls beginning at 13 years of age. OBJECTIVE: To evaluate the evidence regarding anxiety screening test accuracy in primary care for children and adolescents and assess the effectiveness of treatment of individuals identified through screening. DATA SOURCES: We searched PubMed, the Cochrane library, and references to potentially eligible studies cited in other articles. STUDY SELECTION: Screening studies were included if they were conducted in primary care or a similar population and employed a reference standard based on DSM criteria. Treatment studies were included if subjects were identified through screening and there was at least 1 comparator intervention or a placebo arm. DATA EXTRACTION: At least 2 reviewers evaluated each identified reference. RESULTS: Two screening studies (1 with low risk of bias and 1 with high risk of bias) and 1 treatment study with a low risk of bias were included. The screening study with a low risk of bias reported a sensitivity of 56% and specificity of 80%. The treatment study found individual cognitive behavioral therapy to be effective for screen-detected adolescents with social phobia. LIMITATIONS: This review only included screening or treatment studies with clear evidence that the study populations were derived from an unselected population reflective of typical primary care. Relevant studies not indexed in PubMed or the Cochrane library could have been missed. CONCLUSIONS: There are significant gaps in evidence related to anxiety screening in the primary care setting.