Predictors of Unmet Dental Health Needs in US Adults in 2018: A Cross-Sectional Analysis

OBJECTIVE

To identify predictors of unmet dental needs for adults 18 y of age or older in the United States.

METHOD

Using the Aday and Andersen framework and data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we ran logistic regression to estimate predictors for adults of not having a dental visit within 5 y and having lost any teeth using a national sample of 155,060 survey respondents.

RESULTS

Results showed that predisposing factors (age, race/ethnicity, gender, and educational attainment) and enabling factors (income and health insurance status) are important predictors for losing teeth due to decay or gum disease. Men, the elderly, and less educated and low-income residents were less likely to have seen a dentist within the past 5 y and more likely to have lost their permanent teeth. Compared to non-Hispanic White adults, Hispanics adults were more likely to have had a dental visit within the past 5 y. Unmet dental needs varied across states. People living in states with extensive Medicaid dental care benefit coverage were less likely to lose their teeth and more likely to have had a dental visit within the past 5 y.

CONCLUSION

Efforts to improve oral health should address unmet dental needs of men and adults with low socioeconomic status. Studying the variation between state oral health care programs could further our understanding of how public policy can improve population oral health.

KNOWLEDGE TRANSFER STATEMENT

Men, non-Hispanic Blacks, mixed and other race minorities, and low socioeconomic status adults are most at risk of unmet dental needs. States can address these needs by expanding Medicaid coverage for adults.

Effect of continuous positive airway pressure therapy in patients with paroxysmal atrial fibrillation and obstructive sleep apnea: a randomized controlled trial

Background

There is strong evidence for an association between atrial fibrillation (AF) and sleep apnea (SA).

Purpose

We aimed to examine the effect of treatment with continuous positive airway pressure (CPAP) on the burden of AF.

Methods

After a run-in period for CPAP-tolerance, we randomly assigned 108 eligible patients between 18–75 years, who had paroxysmal AF and moderate-to-severe obstructive SA (apnea-hypopnea index (AHI)≥15), to receive either CPAP treatment (n=54) plus usual care or usual care alone (n=54) for five months. An implanted loop recorder measured time in AF continuously. The primary endpoint was the difference in change of AF burden (% of time in AF) between CPAP treatment and usual care from baseline (one month prior to randomization) to the last three months of the intervention period. Secondary endpoints were changes in quality of life assessed by the Short Form-36 (SF-36), Epworth Sleepiness Scale (ESS), and the Functional Outcomes of Sleep Questionnaire (FOSQ).

Results

Mean (SD) age was 62.4 (7.7) years, BMI 29.4 (4.2) kg/m2, ESS 7.9 (3.2), and 76.1% were men. In the intervention group, the mean duration of adherence to CPAP therapy was 4.3 hours/night. During treatment mean AHI decreased from 27.6 events/hour at baseline to 2.3 events/hour during follow-up. Mean time in AF decreased from 5.0%-4.3% in the control group and from 5.6%-4.1% in the CPAP group, but the difference in change was not significant (p=0.52). Sub-analysis of those using CPAP><4 hours/night also showed no difference, neither did the quality of life questionnaires.

Conclusion

This is the first randomized controlled trial to assess the effect of treatment of SA on the burden of AF, and did not detect a difference between those treated with CPAP compared to usual care alone.

Funding Acknowledgement

Type of funding source: Public hospital(s). Main funding source(s): Oslo University Hospital is the main funding Source. ResMed Science Center provided an unrestricted grant.

Musculoskeletal disorders and correctional measures on fig gardeners in Estahban, 2017

Introduction: Agriculture is one of the high-risk occupations, and musculoskeletal disorders are an integral part of this occupation and major farmers suffer from these disorders. The purpose of this study is correctional measures in Estahban. Method: This descriptive-analytical, cross-sectional and observational study was performed on workers in the fig orchard. The Nordic, demographic and body map questionnaires were used to evaluate the prevalence of musculoskeletal symptoms. The study population was 170 randomly selected by simple random sampling. Subsequently, individuals who were exclusively working in the fig orchard (n = 95) were assessed for risk assessment. The methods for evaluating were PATH and QEC. Data were analyzed by SPSS software using McNemar and Wilcoxon tests before and after the intervention. Results: Workers number 95 (55.9%) were only fig orchard workers and the other persons 75 (44.1%) had other jobs. workers 16 (9.4%) were single and 154 (90.6%) were married, mean age were 47.5 ± 14.4 years and work experience was 26.4 ±14.4 years. Frequency of musculoskeletal disorders in organs using body map was significantly different from before intervention (P <0.001). PATH risk level before and after the intervention was less than 0.05, in QEC method the mean total score before and after intervention was 94.36 ±16.09 and 52.63 ±12.18, respectively (P <0.001). Conclusion: Ergonomic interventions can be used as a corrective action.

Evaluation of different gridded rainfall datasets for rainfed wheat yield prediction in an arid environment

The accuracy of daily output of satellite and reanalysis data is quite crucial for crop yield prediction. This study has evaluated the performance of APHRODITE (Asian Precipitation-Highly-Resolved Observational Data Integration Towards Evaluation), PERSIANN (Rainfall Estimation from Remotely Sensed Information using Artificial Neural Networks), TRMM (Tropical Rainfall Measuring Mission), and AgMERRA (The Modern-Era Retrospective Analysis for Research and Applications) precipitation products to apply as input data for CSM-CERES-Wheat crop growth simulation model to predict rainfed wheat yield. Daily precipitation output from various sources for 7 years (2000-2007) was obtained and compared with corresponding ground-observed precipitation data for 16 ground stations across the northeast of Iran. Comparisons of ground-observed daily precipitation with corresponding data recorded by different sources of datasets showed a root mean square error (RMSE) of less than 3.5 for all data. AgMERRA and APHRODITE showed the highest correlation (0.68 and 0.87) and index of agreement (d) values (0.79 and 0.89) with ground-observed data. When daily precipitation data were aggregated over periods of 10 days, the RMSE values, r, and d values increased (30, 0.8, and 0.7) for AgMERRA, APHRODITE, PERSIANN, and TRMM precipitation data sources. The simulations of rainfed wheat leaf area index (LAI) and dry matter using various precipitation data, coupled with solar radiation and temperature data from observed ones, illustrated typical LAI and dry matter shape across all stations. The average values of LAI_max were 0.78, 0.77, 0.74, 0.70, and 0.69 using PERSIANN, AgMERRA, ground-observed precipitation data, APHRODITE, and TRMM. Rainfed wheat grain yield simulated by using AgMERRA and APHRODITE daily precipitation data was highly correlated (r² ≥ 70) with those simulated using observed precipitation data. Therefore, gridded data have high potential to be used to supply lack of data and gaps in ground-observed precipitation data.

Autolysis control and structural changes of purified ficin from Iranian fig latex with synthetic inhibitors

The fig's ficin is a cysteine endoproteolytic enzyme, which plays fundamental roles in many plant physiological processes, and has many applications in different industries such as pharmaceutical and food. In this work, we report the inhibition and activation of autolysis and structural changes associated with reaction of ficin with iodoacetamide and tetrathionate using high-performance liquid chromatography (HPLC), ultra filtration membrane, and dynamic light scattering (DLS) methods. The ficin structural changes were also determined using UV-absorption, circular dichroism (CD), fluorescence spectroscopy, and differential scanning calorimetry (DSC) techniques. These techniques demonstrated that iodoacetamide completely inhibited ficin autolysis, which was irreversible. However, tetrathionate partially and reversibility inhibited its autolysis. The ficin structural changes with two synthetic inhibitors were associated with secondary structural changes related to decreased alpha-helix and increased beta sheet and random coil conformations, contributing to its aggregation.

Towards proposition of a diagnostic reference level for mammographic examination in the greater Khorasan Province, Iran

Although, over the past few years, the application of mammography has risen up sharply in Iran, very little, if any, has been reported of the extent of patient's dose from this type of imaging. The purpose of this study was to establish local diagnostic reference level (DRL) arising from mammography in the great Khorasan province of Iran. It is generally assumed that the glandular tissue is the most vulnerable type of breast tissue. Therefore, the mean glandular dose (MGD) has been widely accepted as the most appropriate dosimetric quantity to predict the risk of radiation-induced cancer. Literary, DRL for mammography is defined as the 75th percentile of MGD distribution. In Khorasan province, 7 out of 40 centres were randomly selected. In this work, 100 patients were studied. Thermoluminescence dosimeters have been used to measure entrance surface doses (ESDs). Since, it is difficult to directly measure MGD, Monte Carlo model-based conversion factors were utilised to conclude MGD from ESD. The results have revealed that patients dose is varied widely. The measured ESDs ranged from 0.74 to 19.81 mGy for the craniocaudal (CC) view and 1.20 to 25.79 mGy for the mediolateral oblique (MLO) view. The average MGDs per image were 0.88 and 1.11 mGy for CC and MLO views, respectively. Based on the internationally adopted definition, DRL arising from mammography tests for Khorasan is 1.33 mGy. Implementation of a dose reduction programme is suggested because of the large variations observed in patient MGD values. In this study, the DRL value is significantly lower than the corresponding values suggested by other researchers elsewhere.

The intermediary role of self-efficacy in relation with stress, glycosylated haemoglobin and health-related quality of life in patients with type2 diabetes

BACKGROUND

Stress is not always a direct result of stressful conditions, but rather the way they are perceived. Thus individual variables that may be associated with perceived stress should be examined in stress studies. This study investigates the intermediary role of self-efficacy in relation with stress, glycosylated haemoglobin and health-related quality of life in patients with type2 diabetes.

METHODS

All women with diabetes in Yazd Diabetes Research Centre, in 2012, were considered and 80 women were selected by random sampling. They completed Shirer's self-efficacy scale questionnaire, depression, anxiety and stress scale (DASS), and ADDQ0L19 questionnaire. Then they were introduced to the lab for blood test. Data were analysed by SPSS software and stepwise regression method.

RESULTS

Pearson correlation test results showed that the hemoglobin A1c (r = 0.35) and Quality of Life (r = -0.22) are associated with stress (P <0.05). As so hemoglobin A1c (r = 0.83) and Quality of Life (r = 0.37) with variable of self efficacy are associated positively and significantly (P <0.05). Results of stepwise regression also showed that self efficacy and stress scales 0.697 of variance hemoglobin A1c and 0.140 of variance of Quality of life explaining to do.

CONCLUSION

The impact of stress on blood sugar and patients' health-related quality of life can be influenced by their self-efficacy; therefore it is suggested that an educational intervention is done to increase patients' self-efficacy to better cope with stress in their life.

Inverted impacted primary maxillary incisors: a case report

Tooth impaction rarely occurs in primary dentition. Most of the primary teeth impactions are seen in second molars. The purpose of this article is to present a 4-year-old girl with bilateral impaction of inverted primary maxillary central incisors which trauma had displaced their tooth germ before erupting.

DXRaySMCS: a user-friendly interface developed for prediction of diagnostic radiology X-ray spectra produced by Monte Carlo (MCNP-4C) simulation

In this work, the general purpose Monte Carlo N-particle radiation transport computer code (MCNP-4C) was used for the simulation of X-ray spectra in diagnostic radiology. The electron's path in the target was followed until its energy was reduced to 10 keV. A user-friendly interface named 'diagnostic X-ray spectra by Monte Carlo simulation (DXRaySMCS)' was developed to facilitate the application of MCNP-4C code for diagnostic radiology spectrum prediction. The program provides a user-friendly interface for: (i) modifying the MCNP input file, (ii) launching the MCNP program to simulate electron and photon transport and (iii) processing the MCNP output file to yield a summary of the results (relative photon number per energy bin). In this article, the development and characteristics of DXRaySMCS are outlined. As part of the validation process, output spectra for 46 diagnostic radiology system settings produced by DXRaySMCS were compared with the corresponding IPEM78. Generally, there is a good agreement between the two sets of spectra. No statistically significant differences have been observed between IPEM78 reported spectra and the simulated spectra generated in this study.

Organ and effective doses of patients arising from coronary angiography and percutaneous transluminal coronary angioplasty at two hospitals in Mashhad-Iran

A detailed study of radiation doses received by 83 patients who underwent coronary angiography (CA) and 26 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) by the femoral route in two hospitals in Mashhad-Iran is presented. All procedures were undertaken with Siemens angioscope X-ray equipment. Thermoluminescent dosimeters (TLD-100), suitably calibrated, were used to measure the dose received at five locations on the patient's skin (on the thyroid, gonads and lens of eyes). A dose area product (DAP) meter was also used. DAP values and fluoroscopy times were recorded for each patient. The mean values for DAP were 32.47+/-4.03 and 44.49+/-5.64 Gy cm2 for CA and PTCA, respectively. The patient dosimetry results revealed the thyroid receives the highest dose in CA and PTCA examinations. Also, in this study, DAP to effective dose conversion factors were estimated by means of a Rando phantom and the effective dose received by the patients was estimated for CA and PTCA examinations. The estimated mean values of effective dose were 6.75+/-0.85 and 9.61+/-1.24 mSv, respectively.