Current stress and poor oral health.

BACKGROUND: Psychological stress appears to contribute to poor oral health systemically in combination with other chronic diseases. Few studies directly examine this relationship. METHODS: Data from a cross-sectional study of 2,412 participants between the ages of 25-64 years old living in the City of Toronto between 2009 and 2012 were used to examine the relationship between current stress and two self-rated oral health outcomes (general oral health and oral pain). Dental care utilization and access to dental insurance were examined as effect modifiers. RESULTS: A positive relationship between current stress and poor oral health was observed for both outcomes (oral pain coefficient 0.32, 95 % CI 0.26-0.38; general oral health coefficient 0.28, 95 % CI 0.19-0.36). Effects on oral pain were stronger for the uninsured, while effects on general oral health were stronger with decreasing socioeconomic position. CONCLUSIONS: Our findings suggest that individuals with greater perceived stress also report poorer oral health, and that this relationship is modified by dental insurance and socioeconomic position. These findings warrant a greater focus on the role of psychological stress in the development of oral disease, including how perceived stress contributes to health inequities in self-reported oral health status. Patients experiencing stressful lives may differentially require closer monitoring and more vigilant maintenance of their oral health, above and beyond that which is needed to achieve a state of health in the oral environment of less stressed individuals. There may be health promoting effects of addressing psychosocial concerns related to dental care - particularly for the poor and uninsured.

The demographic and contextual correlates of work-related repetitive strain injuries among Canadian men and women.

BACKGROUND: The study sought to identify gender differences in work-related repetitive strain injuries (RSI), as well as examine the degree to which non-work factors such as family roles interact with gender to modify RSI risk. Another aim is to examine whether there are potential provincial differences in work-related RSI risk. METHODS: The 2003/2005 Canadian Community Health Survey included over 89,000 respondents who reported working in the past 12 months. Separate multi-level models for men and women were used to identify the correlates of work-related RSIs. RESULTS: Women reported sustaining more work-related RSIs than men. Also, having one or more children in the household was associated with lower work-related RSI risk for females. Both men and women in British Columbia reported higher work-related RSI rates than in Ontario. CONCLUSIONS: Gender contributes to RSI risk in multiple and diverse ways based on labor market segregation, non-work exposures, and possibly biological vulnerability, which suggests more tailored interventions. Also, the provincial differences indicate that monitoring and surveillance of work injury across jurisdictions can assist in province-wide prevention and occupational health and safety evaluation.

Retrenched Welfare Regimes Still Lessen Social Class Inequalities in Health: A Longitudinal Analysis of the 2003-2010 EU-SILC in 23 European Countries.

This article builds on recent work that has explored how welfare regimes moderate social class inequalities in health. It extends research to date by using longitudinal data from the EU-SILC (2003-2010) and examines how the relationship between social class and self-reported health and chronic conditions varies across 23 countries, which are split into five welfare regimes (Nordic, Anglo-Saxon, Eastern, Southern, and Continental). Our analysis finds that health across all classes was only worse in Eastern Europe (compared with the Nordic countries). In contrast, we find evidence that the social class gradient in both measures of health was significantly wider in the Anglo-Saxon and Southern regimes. We suggest that this evidence supports the notion that welfare regimes continue to explain differences in health according to social class location. We therefore argue that although downward pressures from globalization and neoliberalism have blurred welfare regime typologies, the Nordic model may continue to have an important mediating effect on class-based inequalities in health.

Spatial analysis of exposure to traffic-related air pollution at birth and childhood atopic asthma in Toronto, Ontario.

Findings from the Toronto Child Health Evaluation Questionnaire (TCHEQ) study indicate that early childhood exposure to traffic-related air pollution (TRAP) is related to the onset of atopic childhood asthma. To test this hypothesis further, we investigated whether spatial patterns in the birth neighbourhood of TCHEQ subjects with atopic asthma (136 of 909 schoolchildren in grades 1-2) could be explained by TRAP and other risk factors. If a causal relationship exists between early childhood residential exposure to TRAP and the development of atopic asthma, we hypothesise that (1) clusters of current asthma should exist around the place of residence at birth, and (2) accounting for residential concentrations of TRAP at birth should explain some of the autocorrelation. Several high asthma clusters were observed. Adjusting for TRAP completely explained one cluster; elsewhere, clusters were only partially explained by TRAP. Findings suggest that exposure during early childhood to TRAP in Toronto is an important contributor to the development of the atopic asthma phenotype and reveal the likely importance of other risk factors not measured in the fixed effects of the model.

Bowel function of long-term tube-fed patients consuming formulae with and without dietary fiber.

Diarrhea, constipation and subsequent laxative use are chronic problems in long-term enterally fed patients. We have conducted a double-blind randomized crossover study to evaluate the effects of two enteral formulae (Enrich, 12.8 g of dietary fiber per 1000 kcal and Ensure, fiber-free) on stool frequency, fecal weight, laxative use, gastrointestinal tolerance and bowel function in chronic care tube-fed patients. Twenty-eight subjects (24 male, 4 female) completed the study. Mean daily number of stools and mean daily fecal wet weight in Enrich-fed patients were not significantly different from those of patients receiving Ensure. Ensure-fed patients required significantly more laxatives (p = 0.02) than those receiving Enrich. There were 26 reports of diarrhea in the Ensure-fed group as compared to 6 in the Enrich-fed group, and this difference was significant (p = 0.006). Reporting rates for constipation were not significantly different in the two groups. At the end of the study, the bowel function of 57.1% of patients receiving Enrich was improved when compared with that of 14.3% of Ensure-fed patients, and this difference was significant (p = 0.005). These results suggest that the addition of dietary fiber to enteral formulae improves gastrointestinal tolerance and bowel function, and reduces laxative use in long-term enterally fed patients.

Parental stress increases body mass index trajectory in pre-adolescents.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: Rates of childhood obesity have increased since the mid-1970s. Research into behavioural determinants has focused on physical inactivity and unhealthy diets. Cross-sectional studies indicate an association between psychological stress experienced by parents and obesity in pre-adolescents. WHAT THIS STUDY ADDS: We provide evidence of a prospective association between parental psychological stress and increased weight gain in pre-adolescents. Family-level support for those experiencing chronic stress might help promote healthy diet and exercise behaviours in children. OBJECTIVE: We examined the impact of parental psychological stress on body mass index (BMI) in pre-adolescent children over 4 years of follow-up. METHODS: We included 4078 children aged 5-10 years (90% were between 5.5 and 7.5 years) at study entry (2002-2003) in the Children's Health Study, a prospective cohort study in southern California. A multi-level linear model simultaneously examined the effect of parental stress at study entry on the attained BMI at age 10 and the slope of change across annual measures of BMI during follow-up, controlled for the child's age and sex. BMI was calculated based on objective measurements of height and weight by trained technicians following a standardized procedure. RESULTS: A two standard deviation increase in parental stress at study entry was associated with an increase in predicted BMI attained by age 10 of 0.287 kg m(-2) (95% confidence interval 0.016-0.558; a 2% increase at this age for a participant of average attained BMI). The same increase in parental stress was also associated with an increased trajectory of weight gain over follow-up, with the slope of change in BMI increased by 0.054 kg m(-2) (95% confidence interval 0.007-0.100; a 7% increase in the slope of change for a participant of average BMI trajectory). CONCLUSIONS: We prospectively demonstrated a small effect of parental stress on BMI at age 10 and weight gain earlier in life than reported previously. Interventions to address the burden of childhood obesity should address the role of parental stress in children.

Ketazolam once daily for spasticity: double-blind cross-over study.

This double-blind cross-over study of 14 severely spastic inpatients with chronic multiple sclerosis reveals that once-daily doses of ketazolam, a new drug, are effective in reducing spasticity in a significant proportion of patients without significant side-effects. Added to the similar findings of an earlier double-blind controlled study of divided doses, the results suggest that this special feature of ketazolam provides a unique flexibility that may be exploited in individual cases.

Ketazolam treatment for spasticity: double-blind study of a new drug.

A minor tranquilizer, ketazolam, was tested in a double-blind, randomized, crossover study of 50 patients for its effects in neurologic spasticity. The drug was compared with diazepam (widely accepted as an effective antispasticity agent) and a placebo. The patients with spasticity were almost all cases of multiple sclerosis (24) or stroke (24). Thirty-nine patients completed the study. There was not statistically significant superiority of either diazepam or ketazolam, but both relieved symptoms significantly better than the placebo, as measured clinically and by electromyographic recording of deep tendon reflexes. Ketazolam is a relatively safe and clinically effective antispasticity agent (especially for patients with multiple sclerosis). The well-known "big 3"--dantrolene sodium, baclofen, and diazepam--produce large and small problems in many individual cases; hence, ketazolam now offers a safe and clinically useful alternative.

Calcaneal bone density reduction in patients with restricted mobility.

This cross-sectional study revealed a prevalence of reduced calcaneal bone density in a population of 49 chronic continuing care patients with restricted mobility. Calcaneal bone density was measured using the Compton gamma ray scattering technique, which permits examination of trabecular bone. Predicted densities were determined from the ages and weights of the subjects. Descriptive factors such as gender, diagnosis, duration of the condition, and muscle tone were correlated with bone density. Twenty-eight patients (57%) had indications of reduced calcaneal bone density. None of the descriptive factors was associated with the variability in bone density ratio (forward stepwise regression analysis, p = NS). The reduced calcaneal density found in these patients with restricted mobility is probably a result of their not bearing weight and the inevitable severe reduction in their physical activity.