Caries and costs: an evaluation of a school-based fluoride varnish programme for adolescents in a Swedish region.

UNLABELLED: In 2003, 19 public dental clinics in Västra Götaland Region implemented a population-based programme with fluoride varnish applications at school every six months, for all 12 to 15 year olds. In 2008, the programme was extended to include all 112 clinics in the region. OBJECTIVE: To evaluate caries increment and to perform a cost analysis of the programme. BASIC RESEARCH DESIGN: A retrospective design with caries data for two birth cohorts extracted from dental records. Three groups of adolescents were compared. For Group 1 (n = 3,132), born in 1993, the fluoride varnish programme started in 2003 and Group 2 (n = 13,490), also born in 1993, had no fluoride varnish programme at school. These groups were compared with Group 3 (n = 11,321), born in 1998, when the programme was implemented for all individuals. The total cost of the four-year programme was estimated at 400SEK (≈ 44€) per adolescent. RESULTS: Caries prevalence and caries increment in 15 year olds were significantly lower after the implementation of the programme. Group 2, without a programme, had the highest caries increment. The cost analysis showed that it was a break-even between costs and gains due to prevented fillings at the age of 15. CONCLUSIONS: This school-based fluoride varnish programme, implemented on a broad scale for all 12 to 15 year olds, contributed to a low caries increment at a low cost for the adolescents in the Västra Götaland Region in Sweden.

Assessment of body perception among Swedish adolescents and young adults.

PURPOSE: To assess body perception in adolescents and young adults without anorexia nervosa. METHOD: Using a visual size estimation technique, perceived body size was estimated in four groups of Swedish adolescents and young adults without anorexia nervosa (86 males and 95 females). Perceived body size was estimated at nine different body sites comparing these estimations to real body size. RESULTS: The results show that 95% of males and 96% of females overestimated their body size (mean overestimation: males +22%, females +33%). The overestimations were greatest in females. The greatest overestimations were made of the waist (males +31%, females +46%), buttocks (males +22%, females +42%), and thighs (males +27%, females +41%). CONCLUSIONS: The results indicate that overestimation of body size may be a general phenomenon in adolescents and young adults in a country such as Sweden, implying a similar, but less pronounced distortion of body image as in individuals with anorexia nervosa.

Cardiovascular risk indicators cluster in girls from families of low socio-economic status.

We evaluated tobacco use, physical activity, dietary intake and cardiovascular risk indicators (s-lipids, s-insulin, s-ferritin, anthropometric measurements, blood pressure, physical fitness) in healthy 14- and 17-year-old Swedish adolescents in relation to socio-economic status (SES) of their parents. Girls reported more smoking than boys (14-year-olds 10 and 3%, 17-year-olds 27 and 18%, girls and boys, respectively). Daily smoking was associated to low SES of the family, but was most strongly associated to smoking in peers (OR = 58.7). Tobacco use was considerably higher among adolescents attending vocational programs at secondary high school as compared with theoretical programs. Daily smokers had a more unfavourable serum lipid profile compared with non-smokers. Adolescents from families with a low educational level of the mother had a higher relative dietary fat intake. Boys and girls from families of low SES had higher body mass index (BMI), and girls, but not boys, also had lower physical fitness. Clustering of high BMI, low physical fitness and daily smoking was more pronounced in girls from families of low SES. In conclusion, our study shows that in both boys and girls low SES and educational level of the parents are related to an unfavourable cardiovascular risk profile in Swedish adolescents. Furthermore, smoking in adolescents is more related to smoking in peers than to smoking in parents, implying that preventive efforts should focus on peer groups.

The inter rater reliability of the original and of the modified Ashworth scale for the assessment of spasticity in patients with spinal cord injury.

Thirty patients with spinal cord injury (SCI) were randomly selected to participate in this study which evaluated the inter rater reliability of the original and of the modified Ashworth scale for the assessment of spasticity in the lower limbs. A doctor and a physiotherapist rated the muscle tone of hip adductors, hip extensors, hip flexors and ankle plantarflexors according to the original and to the modified Ashworth scale. The results were analyzed using a Cohen's Kappa statistical test and showed varying levels of reliability for different muscle groups and limbs. Kappa values ranged between 0.21 and 0.61 (mean 0.37). The original scale was slightly more reliable than was the modified scale. However, this difference was not significant (P > 0.05), and was not consistent between the two limbs and between different muscle groups. It was concluded that the Ashworth scale is of limited use in the assessment of spasticity in the lower limb of patients with SCI. Further work is required to establish a standardised speed of muscle stretching during the test, or to find more appropriate grades and descriptions of spasticity for this patient group. The effects of training of the raters in the use of the scales also warrants further investigation.