The aim of this case-control study of 617 children was to investigate early childhood caries (ECC) risk indicators in a non-fluoridated region in Australia. ECC cases were recruited from childcare facilities, public hospitals and private specialist clinics to source children from different socioeconomic backgrounds. Non-ECC controls were recruited from the same childcare facilities. A multinomial logistic modelling approach was used for statistical analysis. The results showed that a large percentage of children tested positive for Streptococcus mutans if their mothers also tested positive. A common risk indicator found in ECC children from childcare facilities and public hospitals was visible plaque (OR 4.1, 95% CI 1.0–15.9, and OR 8.7, 95% CI 2.3–32.9, respectively). Compared to ECC-free controls, the risk indicators specific to childcare cases were enamel hypoplasia (OR 4.2, 95% CI 1.0–18.3), difficulty in cleaning child’s teeth (OR 6.6, 95% CI 2.2–19.8), presence of S. mutans (OR 4.8, 95% CI 0.7–32.6), sweetened drinks (OR 4.0, 95% CI 1.2–13.6) and maternal anxiety (OR 5.1, 95% CI 1.1–25.0). Risk indicators specific to public hospital cases were S. mutans presence in child (OR 7.7, 95% CI 1.3–44.6) or mother (OR 8.1, 95% CI 0.9–72.4), ethnicity (OR 5.6, 95% CI 1.4–22.1), and access of mother to pension or health care card (OR 20.5, 95% CI 3.5–119.9). By contrast, a history of chronic ear infections was found to be protective for ECC in childcare children (OR 0.28, 95% CI 0.09–0.82). The biological, socioeconomic and maternal risk indicators demonstrated in the present study can be employed in models of ECC that can be usefully applied for future longitudinal studies.
This study examined the psychometric characteristics of the Parent and Family Adjustment Scales (PAFAS). The PAFAS was designed as a brief outcome measure for assessing changes in parenting practices and parental adjustment in the evaluation of both public health and individual or group parenting interventions. The inventory consists of the Parenting scale measuring parenting practices and quality of parent-child relationship and of the Family Adjustment scale measuring parental emotional adjustment and partner and family support in parenting. Two studies were conducted to validate the inventory. A sample of 370 parents participated in Study 1 and a sample of 771 parents participated in Study 2. Children's ages ranged from 2 to 12 years old. In Study 1 confirmatory factor analysis supported an 18-item, four factor model of PAFAS Parenting, and a 12-item, three factor model of PAFAS Family Adjustment. Psychometric evaluation of the PAFAS revealed that the scales had good internal consistency, as well as satisfactory construct and predictive validity. In Study 2 confirmatory factor analysis supported stability of the factor structures of PAFAS Parenting and PAFAS Family Adjustment revealed in Study 1. Potential uses of the measure and implications for future validation studies are discussed.
Adherence with preventive medication, even within the context of a research study, was generally low and highly variable. Subjective measures of adherence were found to overestimate adherence in young asthmatics.
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