Correlation between dental care utilization and oral cavity cancer in a large sample of community-based United States residents

Cancer of the oral cavity and pharynx remains one of the ten leading causes of cancer death in the United States (US). Besides smoking and alcohol consumption, there are no well established risk factors. While poor dental care had been implicated, it is unknown if the lack of dental care, implying poor dental hygiene predisposes to oral cavity cancer. This study aimed to assess the relationship between dental care utilization during the past twelve months and the prevalence of oral cavity cancer. A cross-sectional design of the National Health Interview Survey of adult, non-institutionalized US residents (n=30,475) was used to assess the association between dental care utilization and self reported diagnosis of oral cavity cancer. Chi square statistic was used to examine the crude association between the predictor variable, dental care utilization and other covariates, while unconditional logistic regression was used to assess the relationship between oral cavity cancer and dental care utilization. There were statistically significant differences between those who utilized dental care during the past twelve months and those who did not with respect to education, income, age, marital status, and gender (p < 0.05), but not health insurance coverage (p = 0.53). Also, those who utilized dental care relative to those who did not were 65% less likely to present with oral cavity cancer, prevalence odds ratio (POR), 0.35, 95% Confidence Interval (CI), 0.12–0.98. Further, higher income advanced age, people of African heritage, and unmarried status were statistically significantly associated with oral cavity cancer, (p < 0.05), but health insurance coverage, alcohol use and smoking were not, p > 0.05. However, after simultaneously controlling for the relevant covariates, the association between dental care and oral cavity cancer did not attenuate nor persist. Thus, compared with those who did not use dental care, those who did wee 62% less likely to present with oral cavity cancer adjusted POR, 0.38, 95% CI, 0.13-1.10. Among US adults residing in community settings, use of dental care during the past twelve months did not significantly reduce the predisposition to oral cavity cancer. However, due to the nature of the data used in this study, which restricts temporal sequence, a large sample prospective study that may identify modifiable factors associated with oral cancer development namely poor dental care, is needed. ^

Obesity and risk of multiple myeloma: A case-control study

Introduction. Several studies have reported a positive association of body mass index (BMI) with multiple myeloma; however, the period of adulthood where BMI is most important remains unclear. In addition, it is well known that body fat is associated with both sex-steroid hormone storage and with increasing insulin levels; therefore, it was hypothesized that the association between obesity and multiple myeloma may be attributed to increased aromatization of androgen in adipose tissue. Objective. The overall objective of this case-control study was to determine whether multiple myeloma cases had higher BMI and greater adult weight gain relative to healthy controls. In addition, we tested the hypothesis that hormone replacement therapy use among women will further increase the association between BMI and risk of multiple myeloma. This study used data from a pilot case-control study at M.D. Anderson Cancer Center (MDACC), entitled Etiology of multiple myeloma, directed by Dr. Sara Strom and Dr. Sergio Giralt. Methods. The pilot study recruited a total of 122 cases of histopathologically confirmed multiple myeloma from MDACC. Controls (n=183) were selected from a database of random digit dialing controls accrued in the Department of Epidemiology at MDACC and were frequency matched to the cases on age (±5 years), gender, and race/ethnicity. Demographic and risk factor information were obtained from all participants who completed a self-administered questionnaire. Items included in the questionnaire include demographic information, height and weight at age 25, 40 and current/diagnosis, medical history, family history of cancer, smoking and alcohol use. Statistical analysis. Initial descriptive analysis included Student's t-test and Pearson's chi-squared tests. Odds ratios and 95% confidence intervals were calculated to quantify the association between the variables of interest and multiple myeloma. A multivariable model will be developed using unconditional logistic regression. Results. MM cases were 1.79 times (95% CI=0.99-3.32) more likely to have been overweight or obese (BMI > 25 kg/m2) at age 25 relative to healthy controls after controlling for age, gender, race/ethnicty, education and family history of cancer. Being overweight or obese at age 40 was not significantly associated with mutliple myeloma risk (OR=1.42, 95% CI=0.86-2.34) nor was being overweight or obses at diagnosis (OR=1.43, 95% CI=0.78, 2.63). We observed a statistically significant 2-fold increased odds of multiple myeloma in individuals who gained more than 4.7 kg during between 25 and 40 years (OR=1.97, 95% CI=1.15-3.39). When assessing HRT as a modifier of the BMI and multiple myeloma association among women (N=123), no association between obesity and MM status was observed among women who have never used HRT (OR=0.60, 95% CI=0.23-1.61; n=73). Yet among women who have ever used HRT (n=50), being overweight or obese was associated with an increase in MM risk (OR=2. 93, 95% CI=0.81-10.6) after adjusting for age; however, the association was not statistically significant. Significance. This study provides further evidence that increased BMI increases the risk of multiple myeloma. Furthermore, among women, HRT use may modify risk of disease. ^

If we call them, will they change? Feasibility of a telephone adaptation of motivational interviewing aimed at parents to reduce television time among 2nd and 4th grade children

Television viewing is a sedentary behavior that is modifiable. Reducing media-related behaviors via parent-focused interventions may hold promise for decreasing childhood obesity. This feasibility study examines a novel parent-centered brief telephone-delivered Motivational Enhancement Interview (MEI) to encourage parents of 2nd and 4th graders to set a rules limiting TV time or remove the TV from the child's bedroom. This quasi-experimental sub-study was part of the larger CATCH: En Vivo pilot study conducted in a Hispanic population in the Texas Rio Grande Valley. Parents in the MEI condition were contacted via telephone and encouraged to meet the American Academy of Pediatrics (AAP) recommended 2 hours per day or less of TV. Unconditional logistic regression was used to analyze the data. At post-test, 85% of parents of 4th graders in the MEI group (compared to 71% at pre-test) reported having a rule limiting TV time. The adjusted odds ratio for the MEI group compared to the control group was 3.88, 95% CI (0.72-20.99). At pre-test, 63.16% of 2nd graders had a television in their bedrooms. The 2nd grade MEI intervention reduced that number to 41.03% (OR=0.25, 95%CI (0.08-0.82)). This first look at using MEI to target parents of children to modify TV behavior presents evidence on a promising strategy for modifying children's home media environment and warrants further investigation. ^

Dietary patterns and risk of pancreatic cancer in a hospital-based case-control study

Background. It is important to understand the association between diet and risk of pancreatic cancer in order to better understand the etiology of pancreatic cancer.^ Objectives. Describe the dietary patterns of cases of adenocarcinoma of the pancreas and non-cancer controls and evaluate the odds of having a healthy eating pattern among cases and non-cancer controls.^ Design and Methods. An ongoing hospital-based case-control study was conducted in Houston, Texas from 2000-2008 with 678 pancreatic adenocarcinoma cases and 724 controls. Participants completed a food frequency questionnaire and a risk factor questionnaire. Dietary patterns were derived by principal component analysis and associations between dietary patterns and pancreatic cancer risk were assessed using unconditional logistic regression.^ Results. Two dietary patterns were derived: fruit-vegetable and high fat-meat. There were no statistically significant associations between the fruit-vegetable pattern and pancreatic cancer. An inverse association was seen between the high fat-meat pattern and pancreatic cancer risk when comparing those in the upper intake quintile to those scoring in the lowest quintile after adjusting for demographic and risk factor variables (OR=0.67, p=0.03). In sex-stratified analysis adjusted for demographic and risk factor variables, females scoring in the upper intake quintile of the fruit-vegetable pattern had a 49% lower risk of pancreatic cancer compared to females scoring in the lowest quintile (OR=0.51, p=0.03). An inverse relationship was also seen for the high fat-meat pattern when comparing females in the upper intake quintile to females in the lowest quintile (OR=0.50, p=0.03). In males, neither dietary pattern was significantly associated with pancreatic cancer.^ Conclusions. The current findings for the fruit-vegetable pattern are similar to those of previous studies and support the hypothesis that there is an inverse association between a “healthy” diet (comprised of fruits, vegetables, and whole grains) and risk of having pancreatic cancer (in females only). However, the inverse relationship with the high fat-meat pattern and risk of pancreatic cancer is contrary to other results. Further research on dietary patters and pancreatic cancer risk may lead to better understanding of the etiologic cause of pancreatic cancer.^

The theory of runs with application to drought predictions

The primary interest was in predicting the distribution runs in a sequence of Bernoulli trials. Difference equation techniques were used to express the number of runs of a given length k in n trials under three assumptions (1) no runs of length greater than k, (2) no runs of length less than k, (3) no other assumptions about the length of runs. Generating functions were utilized to obtain the distributions of the future number of runs, future number of minimum run lengths and future number of the maximum run lengths unconditional on the number of successes and failures in the Bernoulli sequence. When applying the model to Texas hydrology data, the model provided an adequate fit for the data in eight of the ten regions. Suggested health applications of this approach to run theory are provided. ^

Effects of informative censoring on the hazard function: Application to the proportional hazards regression model

The standard analyses of survival data involve the assumption that survival and censoring are independent. When censoring and survival are related, the phenomenon is known as informative censoring. This paper examines the effects of an informative censoring assumption on the hazard function and the estimated hazard ratio provided by the Cox model.^ The limiting factor in all analyses of informative censoring is the problem of non-identifiability. Non-identifiability implies that it is impossible to distinguish a situation in which censoring and death are independent from one in which there is dependence. However, it is possible that informative censoring occurs. Examination of the literature indicates how others have approached the problem and covers the relevant theoretical background.^ Three models are examined in detail. The first model uses conditionally independent marginal hazards to obtain the unconditional survival function and hazards. The second model is based on the Gumbel Type A method for combining independent marginal distributions into bivariate distributions using a dependency parameter. Finally, a formulation based on a compartmental model is presented and its results described. For the latter two approaches, the resulting hazard is used in the Cox model in a simulation study.^ The unconditional survival distribution formed from the first model involves dependency, but the crude hazard resulting from this unconditional distribution is identical to the marginal hazard, and inferences based on the hazard are valid. The hazard ratios formed from two distributions following the Gumbel Type A model are biased by a factor dependent on the amount of censoring in the two populations and the strength of the dependency of death and censoring in the two populations. The Cox model estimates this biased hazard ratio. In general, the hazard resulting from the compartmental model is not constant, even if the individual marginal hazards are constant, unless censoring is non-informative. The hazard ratio tends to a specific limit.^ Methods of evaluating situations in which informative censoring is present are described, and the relative utility of the three models examined is discussed. ^

Association of processed red meat and prostate cancer stage in Mexican-Americans: A population based case-control study

Objective: The objective of this study is to investigate the association between processed and unprocessed red meat consumption and prostate cancer (PCa) stage in a homogenous Mexican-American population. Methods: This population-based case-control study had a total of 582 participants (287 cases with histologically confirmed adenocarcinoma of the prostate gland and 295 age and ethnicity-matched controls) that were all residing in the Southeast region of Texas from 1998 to 2006. All questionnaire information was collected using a validated data collection instrument. Statistical Analysis: Descriptive analyses included Student's t-test and Pearson's Chi-square tests. Odds ratios and 95% confidence intervals were calculated to quantify the association between nutritional factors and PCa stage. A multivariable model was used for unconditional logistic regression. Results: After adjusting for relevant covariates, those who consume high amounts of processed red meat have a non-significant increased odds of being diagnosed with localized PCa (OR = 1.60 95% CI: 0.85 - 3.03) and total PCa (OR = 1.43 95% CI: 0.81 - 2.52) but not for advanced PCa (OR = 0.91 95% CI: 1.37 - 2.23). Interestingly, high consumption of carbohydrates shows a significant reduction in the odds of being diagnosed with total PCa and advanced PCa (OR = 0.43 95% CI: 0.24 - 0.77; OR = 0.27 95% CI: 0.10 - 0.71, respectively). However, consuming high amounts of energy from protein and fat was shown to increase the odds of being diagnosed with advanced PCa (OR = 4.62 95% CI: 1.69 - 12.59; OR = 2.61 95% CI: 1.04 - 6.58, respectively). Conclusion: Mexican-Americans who consume high amounts of energy from protein and fat had increased odds of being diagnosed with advanced PCa, while high amounts of carbohydrates reduced the odds of being diagnosed with total and advanced PCa.^

Maternal exposure to hazardous air pollutants and oral clefts among offspring: Texas, 1999-2008

Birth defects are a leading cause of infant mortality in the United States. About one in 33 births in the United States is diagnosed with birth defects. Common birth defects include neural tube defects, Down syndrome and oral clefts. The present study focused on oral clefts. ^ Oral clefts refer to the malformation of lip, mouth or both. Birth prevalence of oral clefts in Texas is about 11 per 10,000 births. Etiologically, oral clefts have been classified into two groups, cleft lip with or without cleft palate (CL±P) and isolated cleft palate (CP). In spite of their high prevalence and clinical significance, the etiology of oral clefts in humans has not been well understood. Though a number of risk factors have been identified in epidemiological studies, most of them do not explain the majority of the cases. The need to identify novel risk factors associated with oral clefts provided the motivation for this study. The present study focused on maternal exposure to several hazardous air pollutants. A common subgroup of hazardous air pollutants is the volatile organic compounds found in petroleum derivatives. Four important hydrocarbons in this group are benzene, toluene, ethyl benzene and xylenes (BTEX). ^ The specific aim of this study was to evaluate the association between maternal exposure to environmental levels of BTEX and oral clefts among offspring in Texas for the period 1999-2008. ^ A case-control study design was used to assess if maternal exposure to BTEX increased the risk of oral clefts. The Texas Birth Defects Registry provided data on cases of non-syndromic oral clefts delivered in Texas during the period 1999-2008. Census tract level maternal exposure to BTEX concentrations were obtained from the Hazardous Air Pollutant Exposure Model (HAPEM) developed by the U.S. Environmental Protection Agency. Unconditional logistic regression was used to assess the relationship between maternal exposure to BTEX levels and risk of oral clefts in offspring. ^ In the selected population, mothers who had high estimated exposure to any of the BTEX compounds were not more likely to deliver an offspring with oral clefts. Future research efforts will focus on additional birth defects and thorough assessment of additional potential confounders.^

Entrevista a Angela McRobbie : los estudios culturales y el imperativo de entender y explicar los cambios sociales

Angela McRobbie es socióloga y dirige el Departamento de Comunicación en Goldsmiths College, Universidad de Londres. En la actualidad, se encuentra entre las referentes más destacadas de los Estudios Culturales británicos. Ha publicado numerosos ensayos en revistas internacionales sobre problemáticas vinculadas con la juventud, los estilos musicales y los consumos culturales, así como ha indagado en los cambios sociales y políticos ocurridos desde los tiempos del thatcherismo. Entre sus libros, sobresalen: Postmodernism and Popular Culture (Routledge, 1994); Feminism and Youth Culture (Macmillan, 1994); Back to Reality? Social Experience and Cultural Studies (Manchester University Press, 1997); British Fashion Design (1998), In the Culture Society. Art, Fashion and Popular Music (Routledge, 1999) y compiló junto a Paul Gilroy y Lawrence Grossberg, Without Guarantees. In Honour of Stuart Hall (Verso, 2000), con motivo del retiro de éste de la Open University en 1997.

Una aproximación paisajística de Potrerillos

Se está creando un nuevo espacio. La construcción de la presa de Potrerillos implica muchos cambios en la localidad. Potrerillos le debe su identidad a la importancia que tiene su esencia, su origen, y su historia en la conformación de su estructura y sus propiedades formales particulares, elementos que deben considerarse a la hora de analizar la definición de su paisaje. Es importante que el ordenamiento territorial y un análisis apropiado del paisaje guarden relación. Que formen parte de la misma estrategia de desarrollo, en función de la valoración de los sitios no sólo a partir de su funcionalidad sino a través de su configuración paisajística. Se garantiza de esta forma un tipo de intervención que no solo contemple el óptimo funcionamiento de la localidad sino que mantenga y potencie sus características diferenciadoras, que son en definitiva el motivo por el cual se plantea el desarrollo y transformación del sitio.

Estrategias para la reinserción social de jóvenes en conflicto con la ley

La justicia penal adolescente es un sistema de administración judicial que extiende los derechos y garantías del debido proceso a los adolescentes a quienes se acuse de haber participado en la comisión de una infracción a la ley penal. Se podría decir que las finalidades de la justicia penal juvenil, por orden de importancia son: Administrar justicia de forma democrática. Fomentando la responsabilización del adolescente que ha cometido una infracción penal; promoviendo su integración social y favoreciendo la participación de la comunidad en el proceso de reinserción social, mediante la oferta de servicios y programas para el cumplimiento de medidas socio-educativas. Cabe preguntarse ¿Las instituciones correccionales son coadyuvantes en la reinserción de los jóvenes en conflicto con la ley de tal modo que no vuelvan a confrontar con el orden jurídico vigente cuando egresen? La respuesta es muy compleja porque si bien desde la situación de las instituciones el aislamiento que sufre el joven no les da defensas para poder cambiar sus circunstancias de vida a la hora de reingresar a la sociedad y esto lleva a una alta probabilidad de volver a delinquir. Sin embargo las Ciencias Sociales plantean otras alternativa para logran la inserción de los jóvenes, una de ellas, se inclina a la estimulación de la resiliencia. Esta implica: sobreponerse a las dificultades y tener éxito a pesar de estar expuestos a situaciones de alto riesgo; mantener la competencia bajo presión, esto significa adaptarse con éxito y recuperarse de un trauma ajustándose de forma exitosa a los acontecimientos negativos de la vida.

Liberdade - ponto de chegada de uma criação contínua : os portuguez (1814-1826)

Razão de uma escolha: a importância do periódico O Portuguez e do seu redactor João Bernardo da Rocha Loureiro no desencadear da Revolução Liberal portuguesa de 1820, que deu início ao processo que colocou fim à monarquia absoluta e desencadeou a desconstrução do Antigo Regime em Portugal. Nesta panorâmica, e tendo como horizonte de chegada a fruição da liberdade, pode dizer-se que, enquanto sistema de significações colectivas, o imaginário do redactor Rocha Loureiro parece actuar como reacção ao poder dissolvedor da inteligência, como regulador que satisfaz a busca apaixonada de um grupo ou sociedade que persegue a sua identidade da qual a liberdade é elemento constituinte, fundamental e fundamentador. A liberdade define-se pela ausência de limitação às garantias necessárias para o harmonioso desenvolvimento do indivíduo. Antes de mais a liberdade é, na sua essência, uma ausência de limitação, sendo simultaneamente uma determinação positiva e espontânea da vontade de liberdade em que cada um procura atingir o fim racional de que está possuído. O indivíduo deseja a liberdade com vista a alcançar o melhor possível do seu ser. Na essência, a vontade de liberdade de cada um confunde-se com a vontade colectiva que encontra a sua expressão no poder político.

Procedimientos servianos de lectura acerca de los certámenes fúnebres en Eneida V : La naumaquia (vv. 104-285)

La figura de Servio y su comentario a la obra virgiliana constituye la summa opera de la tradición escolar tardoantigua; su importancia reside porque es el resultado de numerosas estratificaciones que recogen diversos abordajes exegéticos. Al tratarse de un comentario ?continuo?, los Commentarii servianos comprenden un conjunto de saberes que examinan la obra literaria desde la perspectiva histórica y de todo aquello que se relacionaba con esta. A partir de esta mirada lectora, la comunicación se centrará en el análisis que Servio realiza sobre la naumaquia del libro V de la Eneida (vv. 104-285), donde el texto base expone una secuencia narrativa caracterizada por epicismos homéricos y pos-homéricos que el gramático desarticula, privilegiando aspectos como el lingüístico, retórico, fabuloso y histórico-arqueológico. Asimismo, se comprobará que el certamen virgiliano constituye un pretexto para instalar un nuevo contexto que garantice la continuidad del sistema burocrático imperial

La formación del mercado de tierras durante la expansión de la frontera bonaerense. Chascomús y Junín, 1860-1890

En este trabajo nos proponemos analizar la formación del mercado de tierras durante la expansión de la frontera de la provincia de Buenos Aires entre 1860 y 1890, a partir de un enfoque local comparado, enfocando la investigación en dos partidos: Chascomús y Junín. Postulamos que la constitución del mercado de tierras en la campaña bonaerense fue un proceso gradual, que se inició apenas comenzaron a poblarse las tierras defendidas por los fuertes de la frontera interior y se establecían ciertas garantías de seguridad para la propiedad privada

La periferia de "la gran transformación" : El mercado de tierras en la provincia de Buenos Aires. Los casos de Chascomús y Junín en perspectiva comparada, 1780-1912

En este trabajo nos proponemos analizar la formación del mercado de tierras durante la expansión de la frontera de la provincia de Buenos Aires a partir de un enfoque local comparado, estudiando los partidos de Chascomús y Junín. Postulamos que la constitución del mercado de tierras en la campaña bonaerense fue un proceso gradual, que se inició apenas comenzaron a poblarse las tierras defendidas por los fuertes de la frontera interior y se establecieron ciertas garantías de seguridad para la propiedad privada.