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Background: Inflammatory periodontal diseases are initiated by microbial biofilms. The reduction of the biofilm is important in the management of the disease. This study compares periodontopathogen levels following the treatment of chronic periodontitis using Er:YAG laser (ERL) debridement and mechanical scaling and root planing (SRP).Methods: Using a split-mouth design, two quadrants were randomly allocated for treatment. Two hundred and fifty-two subgingival plaque samples were collected from 21 patients, before treatment (baseline) and at 6 and 12 weeks post-therapy. Multiplex qPCR was used to determine relative levels of Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythensis (Tf), and Aggregatibacter actinomycetemcomitans (Aa).Results: Tf and Pg were significantly reduced post-treatment for both ERL and SRP. ERL treatment resulted in a reduction of Td at 12 weeks. Following SRP treatment Aa was significantly reduced at 12 weeks. No statistically significant difference was seen when treatments were compared at 6 and 12 weeks.Conclusions: A comparable reduction in the level of the four periodontal pathogens assayed was achieved with Er:YAG laser debridement and mechanical scaling and root planing. [ABSTRACT FROM AUTHOR]

Background: In a 2-y intervention targeting increased physical activity and healthy eating in primary school children, the adjusted body mass index (BMI) z score was 0.26 units (95% CI: 0.21, 0.32) lower in intervention than in control children. Few obesity prevention initiatives in children have undertaken follow-up analyses.Objective: The objective was to determine whether differences in BMI persisted ~2 y after the cessation of the intervention.Design:All children who had at least one measurement of height and weight at any time during the study (baseline and years 1 or 2) were invited to participate in follow-up measurements (height and weight).Results: Five hundred fifty-four of 727 eligible children (76%) participated. Children who refused to participate (n = 14) or had moved from the study area (n = 159) did not differ from the remaining participants in baseline age, sex, or BMI. The mean BMI z score (and 95% CI) remained significantly lower in intervention children at follow-up in the whole group (n = 554; -0.17; -0.25, -0.08) and in the group who underwent at least 1 (n = 389; -0.19; -0.24, -0.13) or 2 (n = 256; -0.21; -0.29, -0.14) full years of intervention. Intervention children were less likely to be overweight, but only in those who were present for the full intervention (n = 256; RR: 0.81; 95% CI: 0.69, 0.94).Conclusion: Despite the main intervention initiative (school-based activity coordinators charged with the responsibility of enhancing physical activity and promoting healthy eating) being discontinued at the end of the intervention, continued benefits to BMI remained apparent in intervention children ~2 y later. © American Society for Nutrition [ABSTRACT FROM AUTHOR]

BACKGROUND: Developing effective strategies for obesity prevention in children is urgently required. OBJECTIVE: We determined the effectiveness of a 2-y controlled community-based intervention to prevent excessive weight gain in 5-12-y-old children by enhancing opportunities for healthy eating and noncurricular physical activity. DESIGN: Children (n = 730) from 4 intervention and 3 control schools underwent measurements of height, weight, waist circumference, blood pressure, diet, and physical activity at baseline and at 1 and 2 y. Intervention components included nutrition education that targeted reductions in sweetened drinks and increased fruit and vegetable intake and activity coordinators who managed an activity program that focused on noncurricular lifestyle-based activities (eg, community walks). RESULTS: Body mass index (BMI; in kg/m(2)) z score was significantly lower in intervention children than in control children by a mean of 0.09 (95% CI: 0.01, 0.18) after 1 y and 0.26 (95% CI: 0.21, 0.32) at 2 y, but the prevalence of overweight did not differ. Waist circumference was significantly lower at 2 y (-1 cm), and systolic blood pressure was reduced at 1 y (-2.9 mm Hg). An interaction existed between intervention group and overweight status (P = 0.029), such that mean BMI z score was reduced in normal-weight (-0.29; 95% CI: -0.38, -0.21) but not overweight (-0.02; 95% CI: -0.16, 0.12) intervention children relative to controls. Intervention children consumed fewer carbonated beverages (67% of control intake; P = 0.04) and fruit juice or drinks (70%; P = 0.03) and more fruit (0.8 servings/3 d; P < 0.01). CONCLUSION: A relatively simple approach, providing activity coordinators and basic nutrition education in schools, significantly reduces the rate of excessive weight gain in children, although this may be limited to those not initially overweight. This trial was registered at Australian Clinical Trials Registry as #12605000578606. Copyright © 2007 American Society for Nutrition [ABSTRACT FROM AUTHOR]

BACKGROUND: Dental caries and restorations in proximal tooth surfaces often impinge upon the periodontal biological width. AIM: This study examines whether these factors may contribute to risk for periodontal attachment loss at these sites. METHODS: The study is based upon data from the Dunedin Multidisciplinary Health and Development Study, a long-standing cohort study. Approximal tooth surfaces of 884 study members were evaluated for restorations and caries at age 26 and again at 32 years, and probing depth and gingival recession were recorded in millimetres at age 32. Attachment loss was computed as the sum of pocket depth and gingival recession. Data were analysed using generalized estimating equations. RESULTS: Where a caries/restorative event had occurred on an inter-proximal tooth surface before age 26, the age-32 attachment loss at the corresponding periodontal site was approximately twice more likely to be >or=3 mm than if the adjacent tooth surface had remained sound to age 32. This was also true where a caries/restorative event had occurred subsequent to age 26. The association remained after controlling for potential confounders, including smoking. CONCLUSIONS: Site-specific periodontal attachment loss due to dental caries or restorative events occurs in adults in their third and fourth decades of life. [ABSTRACT FROM AUTHOR]

Objective: To assess the financial impact of childhood cancer on families.Methods: This was a cross-sectional survey of parents caring for children who were diagnosed with cancer during the period 1990-1993. Self-administered questionnaires were completed by the parents of 237 children from throughout New Zealand with different types of cancer. Dollar amounts were adjusted to the equivalent of December 2000.Results: Eighty-six per cent of the 192 living children were well or in remission. A further 45 children had died. The average extra amount spent, because of the child's illness, by the family of a living child in the 30 days prior to participation in the study was NZ$220 (SD NZ$330). On average, this was 13% of the family income after tax. After reported entitlement to compensation from various sources was allowed for, families were left with a mean deficit of NZ$157 (SD NZ$278) for the 30 days. Twelve families had a shortfall of more than NZ$500, including three families that had a shortfall of more than NZ$1000. Expenditure was greater for those whose children spent more time in hospital (P = 0.003). There was no significant association between the total cost and the distance travelled to the treatment centre (P = 0.96). For 24 families, after-tax income in the month prior to participation in the study was at least NZ$500 lower than it had been in the month before the child's diagnosis. Thirty-seven per cent of families reported that they needed to borrow money because of the financial effects of the child's illness. Bereaved parents spent an average of NZ$3065 (SD NZ$2168) on funeral expenses.Conclusion: There is a large financial burden on families who have a child with cancer. [ABSTRACT FROM AUTHOR]

Objective: The extent to which lifestyle must be altered to improve insulin sensitivity has not been established. This study compares the effect on insulin sensitivity of current dietary and exercise recommendations with a more intensive intervention in normoglycemic insulin-resistant individuals.Research Design and Methods: Seventy-nine normoglycemic insulin-resistant (determined by the euglycemic insulin clamp) men and women were randomized to either a control group or one of two combined dietary and exercise programs. One group (modest level) was based on current recommendations and the other on a more intensive dietary and exercise program. Insulin sensitivity was measured using a euglycemic insulin clamp, body composition was measured using dual-energy X-ray absorptiometry, and anthropometry and aerobic fitness were assessed before and after a 4-month intervention period. Four-day dietary intakes were recorded, and fasting glucose, insulin, and lipids were measured.Results: Only the intensive group showed a significant improvement in insulin sensitivity (23% increase, P=0.006 vs. 9% in the modest group, P=0.23). This was associated with a significant improvement in aerobic fitness (11% increase in the intensive group, P=0.02 vs. 1% in the modest group, P=0.94) and a greater fiber intake, but no difference in reported total or saturated dietary fat.Conclusions: Current clinical dietary and exercise recommendations, even when vigorously implemented, did not significantly improve insulin sensitivity; however, a more intensive program did. Improved aerobic fitness appeared to be the major difference between the two intervention groups, although weight loss and diet composition may have also played an important role in determining insulin sensitivity. [ABSTRACT FROM AUTHOR]

Aims: To compare the effects of prone and supine sleep position on the main physiological responses to mild asphyxia: increase in ventilation and arousal.Methods: Ventilatory and arousal responses to mild asphyxia (hypercapnia/hypoxia) were measured in 53 healthy infants at newborn and 3 months of age, during quiet sleep (QS) and active sleep (AS), and in supine and prone sleep positions. The asphyxial test mimicked face down rebreathing by slowly altering the inspired air: CO(2), maximum 5% and O(2), minimum 13.5%. The change in ventilation with inspired CO(2) was measured over 5-6 minutes of the test. The slope of a linear curve fit relating inspired CO(2) to the logarithm of ventilation was taken as a quantitative measure of ventilatory asphyxial sensitivity (VAS). Sleep state and arousal were determined by behavioural criteria.Results: At 3 months of age, prone positioning in AS lowered VAS (0.184 prone v 0.269 supine, p = 0.050). At newborn age, sleep position had no effect on VAS. Infants aged 3 months were twice as likely to arouse to the test than newborns (p = 0.013). Placing infants prone as opposed to supine increased the chances of arousal 1.57-fold (p = 0.035).Conclusion: Our findings show 3 month old babies sleeping prone compared to supine have poorer ventilatory responses to mild asphyxia, particularly in AS, but the increased prevalence of arousal is a protective factor. [ABSTRACT FROM AUTHOR]

BACKGROUND: A central fat pattern has adverse health implications in both children and adults. Because adiposity tracks from childhood into adulthood, the ability of simple anthropometric techniques to correctly measure truncal adiposity in childhood needs to be assessed. OBJECTIVES: We sought to assess the validity of waist circumference, waist-to-hip ratio (WHR), and the conicity index as indicators of trunk fat mass in children and adolescents. DESIGN: Trunk fat mass (kg) was measured with dual-energy X-ray absorptiometry in 278 girls and 302 boys aged 3-19 y. Receiver operating characteristic (ROC) curves and areas under the curves (AUCs) for the ROCs were calculated to compare the relative abilities of the anthropometric measures to correctly identify children with high trunk fat mass (z score for our study population of > or =1). RESULTS: The 80th percentile for waist circumference correctly identified 89% of girls and 87% of boys with high trunk fat mass (sensitivity) and 94% of girls and 92% of boys with low trunk fat mass (specificity). Waist circumference performed significantly better as an index of trunk fat mass than did WHR or the conicity index, as shown by the AUCs in girls and boys, respectively: waist circumference AUCs = 0.97 and 0.97, conicity index AUCs = 0.80 and 0.81, and WHR AUCs = 0.73 and 0.71. Our cutoffs for high trunk fat mass and high waist circumference are provided for both sexes for each year of age. CONCLUSION: Waist circumference provides a simple yet effective measure of truncal adiposity in children and adolescents. Copyright © 2000 American Society for Clinical Nutrition [ABSTRACT FROM AUTHOR]

The aim of this study was to explore whether the risk of sudden infant death syndrome (SIDS) associated with prone sleeping position and other risk factors varies with season. The study was a large nation-wide case-control study, which compared 485 cases with 1800 controls. Parents of 393 (81.0%) cases and 1591 (88.4%) controls were interviewed. Obstetric records were also examined. Infants dying in winter were older and had lower birthweights than those dying in summer. The increased risk of SIDS associated with prone sleeping position was greater in winter than in summer. In contrast, the increased risk of SIDS associated with excess thermal insulation and bed sharing was less in winter than in summer. Prone sleeping position accounts for about half of the difference between the mortality rate in summer and that in winter. This suggests that some factor related to season modifies the effect of prone sleeping position. [ABSTRACT FROM AUTHOR]

Presents information on a study which identified the effects of advancing age on lactose malabsorption in women and determined whether lactose malabsorbers have lower bone mineral density or display faster bone loss than lactose absorbers. Background to the study; Methods; Results; Conclusions.

Focuses on the impact of the distribution and organization of frontal cortex-projecting dopamine (DA) neurons in non-human primates. Exhibition of the mesencephalic distribution of neurons; Compartmentalization of the mesofrontal DA system; Heterogeneity of cognitive and affective symptoms.

Receiver operating characteristic (ROC) curves were constructed to assess the value of body mass index (BMI) as a screening measure for total adiposity and to examine waist-to-hip ratio (WHR) and waist circumference as measures of central fat distribution. Body fat reference measurements were determined by dual-energy X-ray absorptiometry (DXA). The study population comprised 96 healthy white women aged 16-80 y. A positive reference test was defined as a result at or above the 75th percentile for our study population for all DXA measurements. Sensitivity and specificity were calculated at several percentile cutoffs for BMI, WHR, and waist girth. The areas under the ROC curves were calculated to compare the relative ability of each anthropometric technique to correctly classify subjects according to the reference measurement for that technique. BMI (our 75th percentile = 27.3) performed well as a screening measure of total adiposity, correctly identifying 83% of subjects with a high body fat mass while misclassifying only eight subjects [four false-negatives (subjects with high fat mass who were in the low BMI category) and four false-positives (subjects with a low fat mass who were in the high BMI category)]. The screening performance of WHR (our 75th percentile = 0.81) was lower, accurately categorizing 58% of subjects while misclassifying 28 subjects. By contrast, waist circumference (our 75th percentile = 86.9 cm) was significantly better than WHR at screening for regional fat distribution, accurately classifying 83% of subjects and misclassifying eight subjects (P < 0.05). We conclude that BMI and waist circumference provide simple yet sensitive methods for the estimation of total and central adiposity in groups of adult women. Copyright (c) 1998 American Society for Clinical Nutrition [ABSTRACT FROM AUTHOR]

Background: The teaching of anatomy to medical undergraduates continues to develop. Medical imaging can accurately demonstrate anatomy. 'disect' is a computer program which manipulates and reconstructs real CT images in 3-D. Aim: To implement and assess a novel computer-based imaging resource. Methods: Third-year undergraduate medical students at the University of East Anglia were randomised to different methods of delivering the program - either self-directed use or guided use with worksheets. Knowledge of gastro-intestinal anatomy was assessed using a 20-item test. Attitudes to using 'disect' were evaluated using Likert scales. Results: Most students reported the program was easy to use and a valuable resource for learning anatomy. There was no difference in scores between guided use and self-directed use (10.7 marks versus 10.6 marks, p¼0.52). Students who undertook the anatomy special study module, which involved dissection of the digestive system, performed best (12.8 marks versus 9.9 marks, p¼0.005). Conclusion: Students can adequately use a computer program to see major anatomical structures derived from CT scans. Students reported that learning anatomy can be aided by the imaging-based resource. Learning anatomy is a multi-modal activity and packages like 'disect' can enhance learning by supplementing current teaching methods. [ABSTRACT FROM AUTHOR]