127 research outputs found
The indirect approach
No full textAid and conditionalities are the"carrots and sticks"of the conventional, direct approach to fostering economic development. The economic theory of agency is the most sophisticated treatment of the direct carrots-and-sticks approach to influencing human behavior. Considering the outcomes of the conventional approach, it might be worthwhile to explore alternative indirect approaches that focus on enabling clients to act more autonomously, rather than try for fuller control of clients'actions (or"agents"behaviors) with improved carrots and sticks. Are there inherent limitations in the direct approach that will not be addressed with better crafted"agency contracts"or closer monitoring of the agents? The author traces the intellectual history of indirect approaches from Socrates to modern thinkers, such as Wittgenstein, Gandhi, and McGregor. One theme of his survey is that constructivist and active-learning pedagogies constitute an indirect approach in which the teacher does not directly transmit knowledge to the learner, through training, and instruction. These pedagogies - translated into social and economic development as learning writ large - from the basis for an alternative indirect approach to fostering development. Actions have motives, just as beliefs have grounds, concludes the author. In the wide spectrum of human endeavor, there is only a fairly small"bandwidth"in which motives can be supplied by the carrots, and sticks of the direct approach (including agency theory, and market-driven activities as special cases of the direct approach to affecting behavior). Outside that spectrum, trying to use direct methods in a controlling manner, contradicts the motives for actions (and the grounds for beliefs) - like trying to"buy love."For higher activities, motives must come from within. Helpers can at best use an indirect approach to bring doers to the threshold; the doers have to do the rest, which makes the results their own.Public Health Promotion,Teaching and Learning,Curriculum&Instruction,Health Monitoring&Evaluation,Educational Sciences,Educational Sciences,Teaching and Learning,Health Monitoring&Evaluation,General Technology,Curriculum&Instruction
Children with Special Health Care Need’s Association of Passive Tobacco Smoke Exposure and Dental Caries: 2007 National Survey of Children’s Health
No full textPurpose: The purpose of this study was to determine a relationship between passive tobacco smoke exposure (secondhand and third hand tobacco smoke exposure) and dental caries in Children with Special Health Care Needs (CSHCN) ages 0-17 years.
Method: This study used data from the 2007 National Survey of Children’s Health involving 17,901 CSHCN. Telephone survey data were used to determine recent caries experience and passive tobacco smoke exposure (secondhand and third hand tobacco smoke exposure). Recent caries was defined as a positive response to if CSHCN had “decayed teeth or cavities within the past 6 months.” Passive smoke was defined as a positive response to if someone in the household used cigarettes, cigars, or pipe tobacco.
Results: A statistically significant relationship was determined between passive tobacco smoke exposure and recent caries in CSHCN (adjusted odds ratio: 1.23 (95% CI: 1.02, 1.50; p-value= 0.0352).
Conclusion: A positive independent association of passive tobacco smoke exposure and dental caries was determined in Children with Special Health Care Needs (CSHCN)
Relationship of Edentulism, Sleep Disordered Breathing and Cardiovascular Disease: NHANES, 2007-2008
No full textBackground Edentulism, though declining in younger adults, remains prevalent in the U.S. older adult population. Poorer health outcomes, including cardiovascular outcomes have been associated with edentulism. Sleep disorders are also common in older adults and have been associated with cardiovascular disease. The purpose of this study is to determine if edentulism is associated with cardiovascular disease when sleep disorders are included in the analyses. Methods Data from the National Health and Nutrition Examination Survey, 2007-2008 were used in this study. Adjusted logistic regression analyses were performed with cardiovascular disease as the dependent variable and dental status (edentulism, dentate) as the key independent variable and sleep variables introduced as potential confounders. Results In multivariable analyses, edentulism was independently associated with cardiovascular disease with an adjusted odds ratio of 2.15 (95% CI: 1.54, 3.00). The model included a sleep summary variable, race, sex, education, smoking status, and drinking status, physical activity, body mass index, conditions or disease count, family poverty index, and insurance status. Conclusions Edentulism was associated with cardiovascular disease independent of sleep disordered breathing
Association between Serum Uric Acid Levels and Sleep Variables: Results from the National Health and Nutrition Survey 2005–2008
No full textSleep disordered breathing as well as high serum uric acid levels are independent risk factors for cardiovascular disease. However, studies evaluating the relationship between sleep-disordered breathing and hyperuricemia are limited. We examined the 2005–2008 National Health and Nutrition Examination survey's sleep variables and high serum uric acid among 6491 participants aged ≥20 years. The sleep variables included sleep duration, snoring, snorting, and daytime sleepiness. The main outcome was high serum uric acid level, defined as levels of serum uric acid >6.8 mg/dL in males and >6.0 mg/dL in females. We found that snoring more than 5 nights per week, daytime sleepiness, and an additive composite score of sleep variables were associated with high serum uric acid in the age- , sex-adjusted model and in a multivariable model adjusting for demographic and lifestyle/behavioral risk factors. The association was attenuated with the addition of variables related to clinical outcomes such as depression, diabetes, hypertension, and high-cholesterol levels. Our results indicate a positive relationship between sleep variables, including the presence of snoring, snorting, and daytime sleepiness, and high serum uric acid levels
Personal Oral Infection Control, Low Birthweight, and Preterm Births in Appalachia West Virginia: A Cross-Sectional Study
No full textAppalachia West Virginia has a higher prevalence of preterm and low birthweight babies than the US national prevalence. Many factors have been studied which are known to influence preterm births and low birthweight babies. There are limited interventions that are available to decrease the likelihood of preterm and low birthweight babies; however oral health and personal oral infection control may be helpful. The purpose of this study was to evaluate the association of limited personal oral infection control among pregnant West Virginia Appalachian women and poor birth outcomes (preterm and low birthweight babies). Methods. A secondary data analysis of data from the West Virginia Healthy Start Helping Appalachian Parents and Infants (HAPI) Project from 2005 to 2016 was conducted. The researchers determined the odds ratio of personal oral infection control with a powered toothbrush (use of the brush fewer than 13 times per week versus use of the brush 13 or more times per week) on poor birth outcomes. Results. There were 845 women who completed the oral health program within the HAPI project. In unadjusted logistic regression, women who used the powered toothbrush and brushed less frequently had greater odds of poor birth outcomes than women who brushed more frequently (odds ratio of 2.07 [1.18, 3.62] P = 0.011 for low birthweight babies; and an odds ratio of 1.78 [1.04, 3.02] P = 0.034 for preterm birth). The results remained positive but were no longer significant in adjusted analysis. Conclusion. There is a need to identify interventions that will benefit pregnant women so that their pregnancies result in healthy pregnancy outcomes
Adolescent Light Cigarette Smoking Patterns and Adult Cigarette Smoking
No full textPurpose. Light cigarette smoking has had limited research. The purpose of this study was to examine the relationship between light smoking in adolescence with smoking in adulthood. Methods. National Longitudinal Study of Adolescent Health data, Waves I and IV, were analyzed. Previous month adolescent smoking of 1–5 cigarettes/day (cpd) (light smoking); 6–16 cpd (average smoking); 17 or more cpd (heavy smoking); and nonsmoking were compared with the outcome of adult smoking. Results. At baseline, 15.9% of adolescents were light smokers, 6.8% were average smokers, and 3.6% were heavy smokers. The smoking patterns were significantly related to adult smoking. In logistic regression analyses, adolescent light smokers had an adjusted odds ratio (AOR) of 2.45 (95% CI: 2.00, 3.00) of adult smoking; adolescent average or heavy smokers had AOR of 5.57 (95% CI: 4.17, 7.43) and 5.23 (95% CI: 3.29, 8.31), respectively. Conclusion. Individuals who initiate light cigarette smoking during adolescence are more likely to smoke as young adults. Practical Implications. When screening for tobacco use by adolescents, there is a need to verify that the adolescents understand that light smoking constitutes smoking. There is a need for healthcare providers to initiate interventions for adolescent light smoking
Epipathogenesis of caries: Analyses of family structure, fear, and fatalism upon World Health Organization decayed, missing, and filled teeth severity in Appalachia West Virginia and Pennsylvania
No full textAppalachian has many social, economic, and biologic factors impacting dental health over the life-course.;Purpose: This study examined dental caries experience and family structure, dental fear, and fatalism in West Virginia and Pennsylvania.;Method: Using a cross-sectional study design, 2002-2009 Center for Oral Health Research in Appalachia data were analyzed utilizing the World Health Organization definitions for caries experience, dichotomized into low and high. Three groups were studied: 1) children, 11-13 years (N=237); 2) adolescents, 14-17 years (N=191); and 3) adults, 18 years and above (N=1125). For multivariable model development, generalized estimating equations with exchangeable working structures accounted for family clusters.;Results. For children, family (second biological child vs. first biological child and niece/nephew/step-/grandchild/other vs. first biological child) Fatalism Scale, Dental Fear Survey, and Short Form Fear of Pain Questionnaire failed to reach a significant difference with caries experience. There were 38.0% reporting fear on the Dental Fear Survey, and 80.2% on the Short Form Fear of Pain Survey. There were 62.0% reporting fatalism. There were 44.7% first biological children, 32.1% second biological children, and 23.2% with other family relationships.;Overall, for adolescents, family (single parent vs. both parents, same home; and second biological child vs. first biological child and niece/nephew/step-/grandchild/other vs. first biological child) failed to reach a significant difference with caries experience. However, in gender sub-group analysis, living with a single parent was protective for males, with an adjusted odds ratio (AOR) of 0.08 (95% Confidence Interval [CI]: 0.01, 0.42; p = 0.0249). The Fatalism Scale failed to reach a significant difference with caries experience in the overall model. For females, there was an AOR of 6.60 (95% CI: 1.89, 9.64; p = 0.0076). Although the Short Form Fear of Pain Questionnaire failed to reach a significant difference with caries experience in the overall model, for males, the AOR was 12.86 (95% CI: 1.71, 96.59; p = 0.0130) and for females, the AOR was 0.08 (95% CI: 0.01, 0.55; p = 0.100). There were 36.1% reporting fear on the Dental Fear Survey; 63.9% on the Short Form Fear of Pain Survey; and 43.5% reporting fatalism on the Fatalism Scale. There were 54.6% first biological children; 20.6% second biological children, and 24.8% with other family relationships; 53.5% lived in single parent homes.;For adults, a high Dental Fear Survey score was associated with a high caries experience. The AOR was 1.76 (95% CI: 1.29, 2.40; p = .0003). It remained significant for females (AOR= 2.11[95% CI: 1.41, 3.14; p = 0.0003]). For males, those never married, divorced, widowed, separated, or had other living arrangements vs. married/domestic partnering had an AOR of 0.12 (95% CI: 0.04, 0.36; p = .0002).;Conclusion: Caries is a complex disease with many influences. Gender differences exist in age categories in terms of family relationships, fear, and fatalism. Further exploration of these factors is needed to aid in the development of successful interventions to decrease caries severity
Children, Sealants, and Guardians Who Smoke: Trends in NHANES 2001-2002 to 2010-2012
No full textObjective: There are many factors influencing dental behavior. The relationship of smokers who smoked inside the home toward preventive care (measured as dental sealant placement) of the children living in their homes is examined in this study. Methods: Data from the National Health and Nutrition Examination Surveys in 2001-2002 and in 2011-2012 were analyzed. Data included the variables of someone smoking inside the home, dental sealant placement in children ages 6-less than 20 years, and sociodemographic data. The data were obtained from a dental examination and a home interview. Results: There were 3,352 eligible participants in 2001-2002 and 2,374 in 2011-2012. The unadjusted odds ratio for not having dental sealants when there was someone who smoked inside the home as compared with not having dental sealants when there was no one who smoked inside the home was 1.57 (95%CI: 1.17, 2.10) in 2001-2002. The unadjusted odds ratio was 1.56 (95% CI: 1.20, 2.03) in 2011-2012. When the data were adjusted for age, sex, race/ethnicity, insurance, and income to poverty ratio, the 2001-2002 adjusted odds ratio was 1.31 (95%CI: 0.97, 1.78). The adjusted odds ratio in 2011-2012 was 1.41 (95% CI:1.01, 1.95). Conclusions: Children who lived in homes in which someone smoked inside the home were more likely to not have dental sealants compared with children who lived in homes in which no one smoked inside the home. These results are important for understanding the factors related to access to dental care issues for children
Oral Health Knowledge and Dental Visits in Community Living Older Adults in Rural Appalachia-West Virginia: A Cross-Sectional Analysis
No full textIntroduction: The purpose of this study was to investigate the relationship between oral health knowledge and dental visits of older adults in an Appalachian county. Methods: A cross-sectional study design was used. Surveys were returned from 205 older adults (50 years and above) from an Appalachian county. Questions were asked about oral health, last dental visit and sociodemographics. Results: The variable of interest, oral health knowledge, was associated with dental visit. Having low oral health knowledge increased odds of having delayed a dental visit beyond a year (unadjusted odds ratio: 2.99; 95% Confidence interval: 1.70, 5.28). Even after considering the number of existing teeth, and controlling for age, sex, education and smoking, the association remained positive and independently significant (adjusted odds ratio: 2.25; 95% Confidence interval: 1.05, 4.82). Education was the only sociodemographic variable associated with last dental visit Conclusion: The surveyed older adults have a need for increasing dental visits within the previous year. Increasing dental knowledge was associated with odds of increased dental visits. Improving dental knowledge may be a strategy to improve the number of older adults having a dental visit within the year
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