Association between Environmental Tobacco Smoke Exposure and Adaptive Behavior in Individuals with Autism Spectrum Disorder.

The study focuses on current issues of adaptive behavior in individuals with autism spectrum disorder (ASD) and on the possible risk factor of environmental tobacco smoke (ETS). Children examined at the Academic Research Center for Autism (ARCA) in Bratislava were involved in the study. The study sample included 84 children (71 boys) with ASD (average age 5.35 years) and a non-ASD group of 24 children (20 boys; average age 8.10 years). The "ETS Questionnaire" focused on the detection of parental smoking habits and other ETS exposures. The concentrations of cotinine in urine were measured by ELISA kit. A significant delay in adaptive behavior of children with ASD in comparison with the non-ASD group was identified. The significant differences were in adaptive behavior, communication, and everyday skills. Children with ASD were more likely to be exposed to ETS, especially in the household. Good agreement was found between objective and subjective ETS exposure indicators (kappa = 0.613). Self-reported exposure to ETS corresponded significantly with the median levels of urinary cotinine. In addition to evaluation and assessment of the quality of adaptive behavior, an important goal of further research should be to identify, investigate, and eliminate environmental factors that interfere with adaptive behavior.

Factors Associated with Non-Attendance at Dental Preventive Care in Slovak High School Students.

This study aimed to determine the factors associated with the avoidance of dental preventive care in high school students and their parents in the framework of The Youth and Parents Risk Factor Behavior Survey in Slovakia, the ongoing cross-sectional school-based survey of students and their parents or legal representatives. The data were collected using two separate standardized questionnaires: (i) the questionnaire for students (n = 515) and (ii) the questionnaire for parents (n = 681). The study group included 57 high school students (54.4% males) who did not visit the dentist for preventive care in the previous year. The control group included 458 students (35.8% males) who visited a dentist for preventive care at least once in the previous year. A significantly higher number of males (54.4%), older adolescents, and young adults (21.8%; 20.0%) were not visiting dental preventive care regularly. Incomplete family (56.1%), stressful situations at home (17.5%), and feeling unwell were the factors contributing to the avoidance of dental preventive care. More than 34.5% of adolescents and young adults were not visiting either dental preventive care or pediatric preventive care (adjusted odds ratio (AOR) = 5.14; 95% confidence interval (CI) = 2.40, 10.99). Children of divorced mothers and mothers with household income lower than EUR 900 had significantly higher dental care avoidance in bivariate analysis. A significantly higher percentage of fathers from the exposed group were not visiting dental preventive care regularly (47.8%, p < 0.05). The results of the study can be used as an educational intervention step focusing on the parental influence on adolescent and young adults' behavior and as a challenge for the improvement of dental preventive care in older adolescents and young adults.

The Prevalence of Insulin Resistance and the Associated Risk Factors in a Sample of 14-18-Year-Old Slovak Adolescents.

The prevalence of cardiometabolic risk factors has increased in Slovakian adolescents as a result of serious lifestyle changes. This cross-sectional study aimed to assess the prevalence of insulin resistance (IR) and the associations with cardiometabolic and selected lifestyle risk factors in a sample of Slovak adolescents. In total, 2629 adolescents (45.8% males) aged between 14 and 18 years were examined in the study. Anthropometric parameters, blood pressure (BP), and resting heart rate were measured; fasting venous blood samples were analyzed; and homeostasis model assessment (HOMA)-insulin resistance (IR) was calculated. For statistical data processing, the methods of descriptive and analytical statistics for normal and skewed distribution of variables were used. The mean HOMA-IR was 2.45 ± 1.91, without a significant sex differences. IR (cut-off point for HOMA-IR = 3.16) was detected in 18.6% of adolescents (19.8% males, 17.6% females). IR was strongly associated with overweight/obesity (especially central) and with almost all monitored cardiometabolic factors, except for total cholesterol (TC) and systolic BP in females. The multivariate model selected variables such as low level of physical fitness, insufficient physical activity, breakfast skipping, a small number of daily meals, frequent consumption of sweetened beverages, and low educational level of fathers as significant risk factors of IR in adolescents. Recognizing the main lifestyle risk factors and early IR identification is important in terms of the performance of preventive strategies. Weight reduction, regular physical activity, and healthy eating habits can improve insulin sensitivity and decrease the incidence of metabolic syndrome, type 2 diabetes, and cardiovascular disease (CVD).

Social Noise Exposure in a Sample of Slovak University Students.

PURPOSE: Social noise exposure is currently an emerging problem in adolescents and young adults. Various leisure time activities may be responsible for hearing impairment (temporary or permanent hearing threshold shift or hearing loss). The study aimed to quantify environmental noise from various sources-voluntary (social) noise (personal music players (PMPs), high-intensity noise exposure events), and road traffic noise and to detect hearing disorders in relation to individual listening to PMPs in the sample of young adults living and studying in Bratislava, the capital city of Slovakia. METHODS: The study included 1003 university students (306 men and 697 women, average age 23.1 ± 2) living in Bratislava for 4 or more years; 347 lived in the student housing facility exposed to road traffic noise (LAeq = 67.6 dB) and 656 in the control one (LAeq = 53.4 dB). Respondents completed a validated ICBEN 5-grade scale "noise annoyance questionnaire". In the exposed group a significant source of annoyance was road traffic noise (p < 0.001), noise from entertainment facilities (p < 0.001), industrial noise (p < 0.001), and noise from neighboring flats (p = 0.003). The exposure to PMPs was objectified by the conversion of the subjective evaluation of the volume setting and duration. With the cooperation of the Ear, Nose and Throat (ENT)specialist, we arranged audiometric examinations on the pilot sample of 41 volunteers. RESULTS: From the total sample of respondents, 79.2% reported the use of a PMP in the course of the last week, and the average time was 285 minutes. There was a significant difference in PMP use between the road traffic noise-exposed (85.6%) and the control group (75.8%) (p = 0.01). Among PMP users 30.7% exceeded the lower action value (LAV) for industry (LAeq,8h = 80 dB). On a pilot sample of volunteers (n = 41), audiometry testing was performed indicating a hearing threshold shift at higher frequencies in 22% of subjects. CONCLUSIONS: The results of the study on a sample of young healthy individuals showed the importance of exposure to social noise as well as to road traffic noise and the need for prevention and intervention.

Maternal Body Mass Index and Gestational Weight Gain and Their Association with Pregnancy Complications and Perinatal Conditions.

This study aimed to evaluate the impact of selected pregnancy pathologies statistically depending on overweight/obesity and excessive maternal weight gain during pregnancy on women who gave birth in the years 2013-2015 at the Second Department of Gynecology and Obstetrics at the University Hospital in Bratislava, Slovakia. In a retrospective study, we analyzed data gathered from the sample, which consisted of 7122 women. Our results suggest a statistically significant, higher risk for the groups of women with overweight and obesity and gestational hypertension (adjusted odds ratio (AOR) = 15.3; 95% CI 9.0-25.8 for obesity), preeclampsia (AOR = 3.4; 95% CI 1.9-6.0 for overweight and AOR = 13.2; 95% CI 7.7-22.5 for obesity), and gestational diabetes mellitus (AOR = 1.9; 95% CI 1.2-2.9 for overweight and AOR = 2.4; 95% CI 1.4-4.0 for obesity). A higher incidence of pregnancies terminated by cesarean section was observed in the group of obese women. Gestational weight gain above IOM (Institute of Medicine) recommendations was associated with a higher risk of pregnancy terminated by C-section (AOR = 1.2; 95% CI 1.0-1.3), gestational hypertension (AOR = 1.7; 95% CI 1.0-2.7), and infant macrosomia (AOR = 1.7; 95% CI 1.3-2.1). Overweight and obesity during pregnancy significantly contribute to the development of pregnancy pathologies and increased incidence of cesarean section. Systematic efforts to reduce weight before pregnancy through prepregnancy dietary counseling, regular physical activity, and healthy lifestyle should be the primary goal.

Self-Reported Exposure to ETS (Environmental Tobacco Smoke), Urinary Cotinine, and Oxidative Stress Parameters in Pregnant Women-The Pilot Study.

BACKGROUND: Exposure to ETS (environmental tobacco smoke) is one of the most toxic environmental exposures. OBJECTIVE: To investigate the association of ETS with physiological, biochemical, and psychological indicators, as well as with urine antioxidant capacity (AC) and oxidative damage to lipids in a pilot sample of healthy pregnant women. METHODS: Exposure to ETS was investigated via a validated questionnaire, and urine cotinine and the marker of oxidative damage to lipids via 8-isoprostane concentrations using an ELISA kit. Urine AC was determined by the spectrophotometric Trolox-equivalent antioxidant capacity (TEAC) method. From a sample of pregnant women (n = 319, average age 30.84 ± 5.09 years) in 80, the levels of cotinine and oxidative stress markers were analyzed. RESULTS: Among the 80 pregnant women, 5% (7.4% confirmed by cotinine) reported being current smokers and 25% reported passive smoking in the household (18.8% confirmed by cotinine). The Kappa was 0.78 for smokers and 0.22 for ETS-exposed nonsmokers. Pregnant women in the ETS-exposed group had significantly reduced AC compared to both the nonsmoker (ETS-) and the smoker groups (p < 0.05). Nonsmokers had significantly lower levels of 8-isoprostane than smokers (p < 0.01) and ETS-exposed nonsmokers (p < 0.05). Correlations between urine levels of cotinine and AC were positive in ETS-exposed nonsmokers. CONCLUSION: A harmful association of active and passive smoking and oxidative stress parameters among pregnant women has been indicated.

Evaluation of Tooth Brushing in Slovak Patients with Sclerosis Multiplex

Objective: To analyse issue of teeth brushing according to age, gender and length in Slovak patients with multiple sclerosis disease (MS). Material and Methods: In this descriptive study, the questionnaires were collected in neurologists from December 2016 until September 2017. The study sample consisted of 103 MS patients (44.7% of men) in a mean age of 38.4 ± 9.95 years. The study sample of MS patients was divided into two sub-groups. The first sub-group consisted of MS patients who were restricted in teeth brushing (n=56) and the second group of MS patients, which had no restrictions in teeth brushing (n=47). Descriptive statistics were used to calculate the absolute and relative frequencies, mean and standard deviation. A two-sample ttest was used to compare of the proportion between sub-groups with restrictions and sub-group no restrictions in teeth brushing. The statistically significant level was determined at p<0.05. Results: The significant higher mean age (40.4 ± 10.8 years) was found in MS patients who had restrictions in teeth brushing (p=0.043). Females described often no restrictions in teeth brushing than males (59.6% vs. 40.4%; p<0.05). Length in MS disease (≤3 years) has significant impact on patients in who were not found restrictions in teeth brushing (31.9%; p=0.037). Conclusion: We recommend individual doctor approach to MS patients in older age and using of electric toothbrushes in MS patients who have hand functioning restrictions.

Exposure to Environmental Tobacco Smoke in Relation to Behavioral, Emotional, Social and Health Indicators of Slovak School Children.

Environmental tobacco smoke (ETS) exposure has been shown in general as a major environmental risk factor and deserves attention in vulnerable population groups. The aim of the project is to analyze the relationships among the ETS and behavior and health in 6−15-year-old children in Slovakia. The status of physical and mental health of children in relation to exposure to tobacco smoke was examined in a representative group of 1478 school children. The methods used, included anonymous questionnaires filled in by parents, Columbia Impairment Scale (CIS), Behavior Problem Index (BPI) and anthropometry. The prevalence of ETS exposure is the highest in the capital (27%) and southern cities. A significant association was found between ETS and age, socio-economic status, incompleteness of the family, level of mother’s education and a higher prevalence of respiratory diseases (26.7%). The relationships of ETS with emotional (CIS scores ≥ 16) and behavioral functions (BPI score ≥ 14) were significant in children exposed to mother’s or father’s smoking at home. In the multivariate analysis these associations were not significant; the factors such as income and completeness of the family were dominant. The results showed mostly the predominant impact of social factors on the physical and mental health status of Slovak school children.

Association between Sweet Consumption and Oral Health in European Population

Objective: To evaluate the association between frequency sweet consumption of drink (food) and teeth number, prevalence of dental check-ups and teeth pain in European population. Material and Methods: In this descriptive study, the data was evaluated from Eurobarometer database 72.3. It was involved 30.292 of citizens from EU-27 (European Union) countries in Eurobarometer research. The necessary conditions for the including of European countries in our research were complete information about: (i) frequency of sweet consumption (%) in each EU-27 countries, population percentage who has all natural teeth (%) in each EU-27 countries, (iii) prevalence of dental checkups (%) in each EU-27 countries and (iv) frequency teeth pain in each EU-27 countries. Results: The highest proportion of often teeth pain (9.0%) was in Romania. Positive association between often sweet consumption of drink (food) and often teeth pain was found. Negative association between often sweet consumption of drink (food) and inhabitants' percentage who have all natural teeth was found. Negative association between often sweet consumption of drink (food) and prevalence of dental check-ups was observed. Conclusion: Our results about the impact sweet consumption of drink (food) on oral health are applicable in oral health programs. It is necessary to include more world countries (more European citizens) into linear regression model of oral health.

Impact of Orthodontic Treatment on Oral Health-Related Quality of Life in the Slovak Republic: A Cross-Sectional Study

Objective: To determine the level of Oral Health-related Quality of Life satisfaction in orthodontic patients compared with the control group. Material and Methods: In this cross-sectional study, the standardized questionnaire "Oral Health-related Quality of Life" (OHRQoL) was used. The 37 statements in the questionnaire are divided into four subscales; the total satisfaction score has been evaluated as well. 146 orthodontic patients (42.5% men) aged 8-72 years were divided into four subgroups: (i) patients treated by dental crowns and implants (DCI), (ii) subjects with dental prosthesis (DP), (iii) patients treated by dental braces (DB), and (iv) patients treated by dental retainer (DR). The control group consisted of 49 dental patients without any orthodontic treatment (51.0% men in mean age 20.0±8.2 years). Mean scores and levels of satisfaction (%) were evaluated in all subgroups and in all subscales. Results: The lowest rate of patients OHRQoL satisfaction was observed in the DP subgroup; the highest satisfaction level was found in the DCI subgroup. The highest rate of patient OHRQoL satisfaction in the study group was observed in subscales social well-being and functional limitation, and the highest level of dissatisfaction in a subscale emotional well-being. High significant differences between study and control groups were found in terms of a higher satisfaction level in a control group. Conclusion: The most dissatisfied were the oldest patients with dental prosthesis with the highest level of dissatisfaction in the emotional well-being subscale.

The Analysis of Selected Malocclusion Risk Factors: A Pilot Study

Objective: To analyse selected malocclusion risk factors, their exposure time and overall malocclusion risk scores. Material and Methods: The self-prepared questionnaires were collected at dental practitioners' waiting rooms from 6/2014 to 12/2015. The study group consisted of patients treated by dental braces (n=82; 15.5±4.4 years) and the control group consisted of other patients not treated by dental braces (n=45; 17.6±4.7 years). Data were processed by the statistical program SPSS using descriptive statistics. To verify the hypothesis wad used two sample t-test to compare the average exposure scores and the exposure time between the two groups. To determine associations between categorical variables was used Chi-square test. Statistical significance was set at p-value <0.05. Results: Our results confirmed longer exposure times in all studied malocclusion risk factors, in the case of pacifier sucking the difference was significant (p=0.001). The longest exposure time was found in mouth breathing in the study group (12.2±6.5 years). The lip sucking/chewing cannot be confirmed as a malocclusion risk factor. The study group had higher level of an overall mean risk score (19.8±11.5) compared the control group (16.1±12.1), although not significant. It can be concluded that non-nutritive sucking habits and/or mouth breathing could have damaging effect to normal teeth development. Conclusion: Malocclusions could be preventable, thus we recommend setting up educational programs for dentists and paediatricians as well as for parents focusing on the improvement of oral health knowledge.

The impact of selected environmental, behavioral and psychosocial factors on schoolchildren's somatic and mental health.

Children develop rapidly and many exogenous determinants of health significantly affect their somatic and mental development. There is a subjective perception of cognitive load associated with the educational process. The aim of the study is to assess individual environmental, behavioral and psychosocial factors influencing physical health and to investigate the amount of mental load in children. We investigated 87 schoolchildren (47 girls and 40 boys) aged 10-12 years, who were attending primary school in Bratislava. To assess values of selected factors we used a questionnaire form and personality characteristics were estimated by standardized psycho-diagnostic and IQ tests [range of classic fear, social-situation anxiety and jitters [skala Klasickeho strachu a Socialno-situacnej (in Slovak)] (KSAT), Eyesenck Personality Questionnaire for children (EPQ), Raven's IQ test]. Self-reported perception of mental load was assessed by questionnaire of subjective feelings and states (SFS). Children's body parameters were assessed using anthropometric measurements [height, weight, chest, abdominal and hip girth, Rohrer's index (RI), body mass index (BMI)] and a body fat measurement method (skinfold thickness). The results confirmed a significant relationship between higher parameters of overweight and obesity and irregular breakfast eating (p<0.05), absence of family dining (p<0.05), exposure to tobacco smoke in the family environment (p<0.01) and mother's level of education (p<0.05). Almost 60% of children reported high mental effort and cognitive load associated with the educational process. We note a close relationship between the higher mental load and the score of neuroticism (p<0.01). The physical and mental health of schoolchildren is significantly affected by exogenous factors. Therefore, in terms of protection and promotion of children's health, it is important to evaluate and monitor environmental risk factors and to form their healthy habits.