A Case-Control Study on Risk Predictors Associated with Periodontitis in Systemically Healthy Patients; a Regression Analysis

Aim: This case-control study was conducted to analyze the association of periodontitis with risk predictors i.e. age, gender, education status, brushing habits and past dental visits in systemically healthy patients. Materials and Methods: The study included total of 1097 systemically healthy, non-tobacco using patients with age ≥ 18 years that reported to periodontology department from year 2018. The demographic details and dental care pattern of the patients were extracted from the records of periodontology department, and their frequencies were formulated. The association of five study variables i.e. age, gender, education status, brushing habits and past dental visits was assessed using forward step-wise logistic regression analysis. Results: Total of 471(42.9%) patients were diagnosed with periodontitis. Higher frequency of periodontitis was observed in patients who were male and ≥ 50 years of age. Regression analysis showed that the subjects with < 50 years of age, ≥ 12 years of education, regular brushing habits and regular past dental visits had greater odds of being safe from periodontitis. Conclusion: Since the population chosen for this research was systemically healthy, non-tobacco using individuals, a high prevalence (42.9%) of periodontitis was observed indicating the need to analyze the factors other than systemic conditions contributing in prevalence of periodontitis. Furthermore, a positive association between study variables and periodontitis was observed in this research, which will help the clinicians in prediction of periodontitis in systemically healthy, non-tobacco using individuals.

CORRELATION OF PARENTING STYLE AND INFECTIOUS DESEASE TOWARDS TODDLERS NUTRITIONAL STATUS IN SCAVENGER FAMILIES

ABSTRACT The period of toodler (below five years old children) is very important; it is also a critical period which determines their future. Today, there are many children who have no adequate nutrients in their growth and development. The data in 2013 revealed that 17% or 98 million children in the developing countries underwent nutrition deficiency. The objective of the research was to find out the correlation of care pattern and infectious diseases with nutrition status of scavengers’ children at the Terjun Landfill, Medan Marelan Sub-district. The research used a survey method with cross sectional design. The samples were 84 toodlers at Lingkungan I, Kelurahan Paya Pasir. The variables were care pattern and infectious diseases. The data were analyzed by using chi square test. The result of the research showed that 45 children had good nutritional status, based on BB/U (Weight/Age), TB/U (Height/Age), and BB/TB (Weight/Height). Care pattern was assessed from three sub-variables: feeding pattern, health practice, and sanitation practice. All in all, the majority of the women had care pattern well, and there were two infectious diseases: diarrhea and ISPA (Acute Respiratory Tract Infection). The result of chi square test showed that there was no correlation between care pattern and toodler’s nutritional status, but there was the correlation between infectious diseases and their nutritional status (p=0.002). It is recommended that women not take their children to a landfill since children are vulnerable to infection. Hygiene and environmental sanitation should be promoted so that the respondent will be prevented from infectious diseases.Keywords: Balita, Care Pattern, Infectious Disease, Nutritional Status, Scavengers

A case-control study on risk predictors associated with periodontitis in systemically healthy patients; a Regression Analysis

OBJECTIVE: This case-control study was conducted to analyze the association of periodontitis with risk indicators i.e. age, gender, education status, brushing habits and past dental visits in systemically healthy patients. METHODS: The study included total of 1097 systemically healthy, non-tobacco using patients with age ≥ 18 years that reported to periodontology department from year 2018. The demographic details and dental care pattern of the patients were extracted from the records of periodontology department, and their frequencies were formulated. The association of five study variables i.e. age, gender, education status, brushing habits and past dental visits was assessed using forward step-wise logistic regression analysis. RESULTS: Total of 471(42.9%) patients were diagnosed with periodontitis. Higher frequency of periodontitis was observed in patients who were male and ≥ 50 years of age. Regression analysis showed that the subjects with < 50 years of age, ≥ 12 years of education, regular brushing habits and regular past dental visits had greater odds of being safe from periodontitis. CONCLUSION: Since the population chosen for this research was systemically healthy, non-tobacco using individuals, a high prevalence (42.9%) of periodontitis was observed indicating the need to analyze the factors other than systemic conditions contributing in prevalence of periodontitis. Furthermore, a positive association between study variables and periodontitis was observed in this research, which will help the clinicians in prediction of periodontitis in systemically healthy, non-tobacco using individuals.

Thoughts on the Future Medical Care Pattern of Pediatrics in China Based on the Outbreak of COVID-19

ABSTRACT The outbreak of pneumonia known as coronavirus disease (COVID-19) has occurred in China since December 2019 and spread rapidly across the world. Pediatric medical workers have a serious imbalance doctor–patient ratio in China; they have accumulated experience during the fight against COVID-19; however, some flaws were revealed in their current medical system. Meanwhile, these problems were also reported in other countries. Thus far, the outbreak of COVID-19 is still rampant across the world. The experience from anti-COVID-19 could be useful and teach us to provide better medical services for Chinese children and prepare for similar public emergencies in the future. Furthermore, it also provides guidance for pediatric medical staff in managing COVID-19 in other developing countries.

Individual variation in parental care drives divergence of sex roles

In many animal species, parents provide care for their offspring, but the parental roles of the two sexes differ considerably between and within species. Here, we use an individual-based simulation approach to investigate the evolutionary emergence and stability of parental roles. Our conclusions are in striking contrast to the results of analytical models. In the absence of initial differences between the sexes, our simulations do not predict the evolution of egalitarian care, but either female-biased or male-biased care. When the sexes differ in their pre-mating investment, the sex with the highest investment tends to evolve a higher level of parental care; this outcome does not depend on non-random mating or uncertainty of paternity. If parental investment evolves jointly with sexual selection strategies, evolution results in either the combination of female-biased care and female choosiness or in male-biased care and the absence of female preferences. The simulations suggest that the parental care pattern drives sexual selection, and not vice versa. Finally, our model reveals that a population can rapidly switch from one type of equilibrium to another one, suggesting that parental sex roles are evolutionarily labile. By combining simulation results with fitness calculations, we argue that all these results are caused by the emergence of individual variation in parental care strategies, a factor that was hitherto largely neglected in sex-role evolution theory.

Hubungan Pola Asuh Ibu Dengan Keberhasilan Toilet Training Pada Anak Usia Prasekolah (4-6 Tahun) Di Raudhatul Athfal Al-Mu’minin Kabupaten Ciamis

Toilet training in children is an attempt to train children so that the children were able to control in the conduct of urination and defecation. Do urinate and defecate, children need good preparation physically, psychologically or intellectually, through the preparation of the expected child able to control bowel movements and urination with independently. Factors that can affect the success of toilet training is parenting the mother or parents. A survey in the United Kingdom, was a half million children aged 6-16 years still love bed wetting, about 17% of children aged five years, 14% of children aged seven years, 9% of children aged nine years old, and 1-2% of the children aged 15 years still bedwetting. As for the cases of bedwetting in children 6 years of age in Indonesia is around 12%. This study aims to determine the relationship between mother's parenting with successful toilet training in preschoolers (4-6 years) in Raudhatul Athfal Al-Mu'minin District Ciamis. This type of research is quantitative with cross sectional study design. Total population 82 people and sampling by way of purposive sampling. Bivariate analysis using Chi Square test. The results showed that as many as 63 respondents (100%) that implementing democratic parenting all succeed in toilet training, as much as 2 respondents (100%) that implements the authoritarian parenting all haven't managed to do the toilet training and as many as 3 of the respondents (100%) that implements the permissive parenting all have not succeeded in toilet training. The result of statistical test, p value = 0.000 <(? = 0,05) means that there is a significant correlation between mother care pattern with successful toilet training in preschool age children (4-6 years). Conclusion of this study is that there is a significant relationship between mother care pattern with successful toilet training in preschool children (4-6 years) in Raudhatul Athfal Al-Mu'minin District Ciamis. It is expected that mothers can apply democratic parenting so that successful toilet training can be achieved.

Breast Cancer in West Java: Where Do We Stand and Go?

Background: Breast cancer is the most common cancer in Indonesia, a low-middle income country in Southeast Asia. We provide a regional hospital-based cancer registry of the central hospital in West Java, Indonesia. This study aims to characterize the presentation, diagnosis, evaluation, and management of breast cancer; to develop a regional breast cancer registry in West Java to monitor cancer care patterns; to evaluate cancer treatment outcomes.Methods: The data were collected from the medical records deposited in the Hasan Sadikin General Hospital Information System. The team has been contracted to operate the registry & organize an advisory board to standardize definitions of coding terminology of the registry’s reporting system and to monitor the cancer care pattern. Data validation was conducted by a team in the cancer registry, consisting of health officers, pathologists, and registrars. Data management and analysis were conducted by the cancer registry team.Results: A total of 913 women diagnosed with breast cancer, from January 2014 until December 2018, were studied. The median age was 49.5 years old. The initial diagnosis was at the age of 42.4 years old on average. About 64.5% were diagnosed with stage-3 and -4 cancers, and 75.1% had undergone a mastectomy, of which 47.3% of the intent was palliative. Of those who have hormonal receptors, only 26.9% were positive, and 36.5% were not assessed for immunohistochemistry evaluation. Inappropriate surgical management of breast cancer was common at the community level, which included indiscriminate diagnostic lumpectomy (21.9%), incomplete mastectomy and omission, or suboptimal lymph node axillary clearance (47.4%). Only 3.0% of patients received breast-conserving surgery and were treated with mastectomy and reconstruction. Conclusions: Breast cancer in West Java is often recognized at the late stage. Treatment was suboptimal, leading to poor survival. A more aggressive approach to early detection and treatment needs to be developed to improve the outcomes of this potentially curable disease.

Patterns of Mental Health Care in Remote Areas: Kimberley (Australia), Nunavik (Canada), and Lapland (Finland): Modèles de soins de santé mentale dans les régions éloignées: Kimberley (Australie), Nunavik (Canada) et Laponie (Finlande)

Objective: Mental health (MH) care in remote areas is frequently scarce and fragmented and difficult to compare objectively with other areas even in the same country. This study aimed to analyze the adult MH service provision in 3 remote areas of Organization for Economic Cooperation and Development countries in the world. Methods: We used an internationally agreed set of systems indicators, terminology, and classification of services (Description and Evaluation of Services and DirectoriEs for Long Term Care). This instrument provided a standard description of MH care provision in the Kimberley region (Australia), Nunavik (Canada), and Lapland (Finland), areas characterized by an extremely low population density and high relative rates of Indigenous peoples. Results: All areas showed high rates of deprivation within their national contexts. MH services were mostly provided by the public sector supplemented by nonprofit organizations. This study found a higher provision per inhabitant of community residential care in Nunavik in relation to the other areas; higher provision of community outreach services in the Kimberley; and a lack of day services except in Lapland. Specific cultural-based services for the Indigenous population were identified only in the Kimberley. MH care in Lapland was self-sufficient, and its care pattern was similar to other Finnish areas, while the Kimberley and Nunavik differed from the standard pattern of care in their respective countries and relied partly on services located outside their boundaries for treating severe cases. Conclusion: We found common challenges in these remote areas but a huge diversity in the patterns of MH care. The implementation of care interventions should be locally tailored considering both the environmental characteristics and the existing pattern of service provision.

Single-institutional analysis of clinicopathologic features and overall survival (OS) in melanoma patients (pts).

e14023 Background: Melanoma is ranked 5th commonest malignancy in United States and SEER has projected 3,290 new skin melanoma cases in Michigan in 2020. Diagnosis of recurrent & metastatic melanoma has associated with poor prognosis and survival. Henry Ford Cancer Institute (HFCI) is a tertiary cancer care facility serves cancer patients from communities throughout metropolitan Detroit tri-county areas where a higher melanoma presentation (1.56%) in black pts than this group at national database (0.6%). A subgroup of white Michiganders travel to Southern sunshine states in winter months known as “snowbirds” have contributed to melanoma incidences in Michigan. We aim to review our institute tumor registry data to analyze the clinicopathological features, care pattern and correlated survival outcomes. Methods: We have identified adult melanoma pts through institute tumor registry between 2007 – 2017, who had demographics, initial diagnosis, recurrence, then death or last follow-up for overall survival (OS) outcome. Data were analyzed using IBM SPSS, R-statistical and log-rank test. Results: Of 1327 eligible pts, median age was 63, and 874 (65.86%) pts were invasive at onset diagnosis. 1298 (97.81%) pts were white, 23 (1.73%) pts were black. Slightly more females (55.54%) over males and overall 301 deaths (22.68%) were observed. 1277 pts with cutaneous melanoma had better 5- and 10-year (yr) OS at 78.14%, and 68.32% compared to 50 (3.77%) non-cutaneous pts at 13.31% and 8.87%, respectively. Black pts carried a poor 5-yr OS at 34.68% vs white at 76.4%. 116 (17.9%) pts presented with recurrences, had 5-yr OS at 34.58%. Of 121 (9.1%) pts who never had been disease-free, showed worse 5-yr OS at 15.87%, with trend of improvement since FDA-approval of immune checkpoint inhibitor therapies. Conclusions: We have analyzed our melanoma care pattern, experience and survival outcomes at 5-yr and/or 10-yr from a tertiary community cancer care facility. We have assessed our current practice benchmarks with plan to improve our care delivery by having built a multidisciplinary team, and launched Melanoma & Skin Cancer Clinical Care Pathway through Tumor Board to improve care access, to decrease care disparity, then to standardize quality of care including encouraging clinical trial enrollments which will enhance quality of melanoma care and survival outcomes of advanced and metastatic cases.