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BenjaminW.Chaffee1 andAshleyCheng2 1 CentertoAddressDisparitiesinChildren’sOralHealth,DepartmentofPreventiveandRestorativeDentalSciences, UniversityofCaliforniaSanFrancisco,Suite495,3333CaliforniaStreet,SanFrancisco,CA94143-1361,USA 2ArthurA.DugoniSchoolofDentistry,UniversityofthePacific,2155WebsterStreet,SanFrancisco,CA94115,USA CorrespondenceshouldbeaddressedtoBenjaminW.Chaffee;benjamin.chaffee@ucsf.edu Received24February2014;Revised29April2014;Accepted3May2014;Published19May2014 AcademicEditor:Lin-P’ingChoo-Smith Copyright©2014B.W.ChaffeeandA.Cheng.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To describe the epidemiologic literature related to early-life feeding practices and early childhood caries (ECC) with regardtopublicationattributesandtrendsintheseattributesovertime.Methods.Systematicliteraturereviewincludingelectronic andmanualsearches(inBIOSIS,CINAHL,CochraneLibrary,LILACS,MEDLINE,WebofScience,andWHOLIS),coveringthe years1990–2013.Attributesofpublicationsmeetingaprioriinclusioncriteriawereabstractedandorganizedbyglobalregionand trendsovertime.Attributesincludedcountryoforiginandstudydesignofincludedpublicationsandageandcariesprevalenceof thepopulationsstudied.Results.244publicationsdrawnfrom196independentstudypopulationswereincluded.Thenumberof publications and the countries represented increased over time, although some world regions remained underrepresented. Most publications were cross-sectional (75%); while this percentage remained fairly constant over time, the percentage of studies to account for confounding factors increased. Publications varied with respect to the caries experience and age range of children included in each study. Conclusions. Publication productivity regarding feeding practices and ECC research has grown, but this growthhasnotbeenevenlydistributedglobally.Individualpublicationattributes(i.e.,methodsandcontext)candiffersignificantly andshouldbeconsideredwheninterpretingandsynthesizingtheliterature.
1. Introduction Early childhood caries (ECC) is a multifactorial disease [1], with early-life feeding practices as an appealing target for caries prevention. The American Academy of Pediatric DentistrydefinesECCasthepresenceofanyprimarytooth surface that is decayed, filled, or missing due to caries in a child under the age of six [ 2]. ECC is a potential source of pain, infection, and reduced quality of life for children and families [3, 4] and heightens the risk of dental caries in the permanent dentition [5, 6]. Untreated caries in the primary dentitionisoneofthemostcommonconditionsglobally[7], and as many as 60–90% of school-aged children worldwide experiencedentalcaries[8]. Feeding habits for infants and young children play a contributoryroleincariesdevelopment[9,10],andbehaviors
that limit added sugar, reduce bottle use, and serve defined meals or snacks have positive implications for oral health. Ofparticularrelevanceinsettingswhereaccesstotraditional dental care may be limited, feeding practices are potentially modifiable even without reliance on dental providers, and dental-healthy feeding practices could offer additional benefits, such as childhood obesity prevention [11]. Feeding practices can be integrated into oral health-general health interventions,aresearchpriorityforreducingoreliminating oralhealthinequalities[12]. Valid, representative evidence is essential for widely applicable guidelines and to bridge the translation gap from clinicalandepidemiologicresearchtopublichealthpractice [12]. Yet, someauthorshave noteda relativelack of longitudinalandinterventionstudies of ECC andearly-lifefeeding habits [13, 14]. Also, given the prevalence of oral diseases in
Hindawi Publishing Corporation Journal of Oral Diseases Volume 2014, Article ID 675658, 7 pages http://dx.doi.org/10.1155/2014/675658
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Table1:SearchtermsusedinelectronicdatabasesearchinMEDLINE.
Searchterminologyandsyntax (“dentalcaries”[MeSHTerms]OR(“dental”[AllFields]AND“caries”[AllFields])OR“dentalcaries”[AllFields])AND((“diet” [MeSHTerms]OR“diet”[AllFields])OR(“feedingbehavior”[AllFields]OR“feedingbehavior”[MeSHTerms]OR(“feeding”[All Fields]AND“behavior”[AllFields])OR“feedingbehavior”[AllFields])AND(“1990/01/01”[PDAT]:“2013/12/31”[PDAT]))AND ((“child”[MeSHTerms]OR“child”[AllFields])OR(“infant”[MeSHTerms]OR“infant”[AllFields])OR(“child”[MeSHTerms] OR“child”[AllFields]OR“children”[AllFields])ORpreschool[AllFields]OR(“pediatrics”[MeSHTerms]OR“pediatrics”[All Fields]OR“pediatric”[AllFields])) Datecompleted:November1,2013
many lower-resource countries [8], oral health promotion strategies would ideally incorporate evidence drawn from such settings. Understanding heterogeneity across studies is vital for determining the appropriateness of pooling results drawn from different contexts. Finally, identifying trends in ECC research over time might inform future investigative prioritiesbyhighlightinganyexistingresearchgaps. The objective of this systematic review is to characterize the epidemiologic literature connecting early-life feeding practices and ECC. Specifically, this review aims to (1) describetherelevantliterature,publishedfrom1990to2013, regarding global representation and study attributes and (2) evaluatetrendsintheliteratureduringthisperiod.
2. Method 2.1. Systematic Literature Search. Electronic searches, concluded in November 2013, were conducted in the BIOSIS, CINAHL, Cochrane Library, LILACS, MEDLINE, Web of Science, and WHOLIS bibliographic databases, limited to publication dates from 1990. The MEDLINE search used Medical Subject Headings (MeSH) terminology (Table1); analogoussearcheswereadaptedforotherdatabases.Search termswereinEnglish,butwithoutexplicitlanguagerestrictions. Inclusion and exclusion criteria were developed before reviewingcitations.Thisreviewfocusedontheepidemiologic literature, broadly defined as all studies based in human populations, whether observational or experimental, but not laboratory or animal-based research. Excluded were abstracts, dissertations, conference proceedings, commentaries, review articles, position statements, and practice guidelines. Inclusion required a clinical caries assessment in a pediatric population (i.e., primary dentition), rather than participant-reported status, oral hygiene, oral bacterial infection, or dental service utilization. Studies must have featured both caries-positive and caries-free individuals. Feeding practices could relate to current or past diet or habits, including measures of eating frequency, bottle use, breastfeeding, intake of specific foods or nutrients, food types(e.g.,sweets),pacifieruse,utensilsharing,ornocturnal feeding.Excludedwereecologicaldietmeasures,nutritional status measures (e.g., anthropometry and enamel defects), medication use, biomarkers, or maternal diet. Intervention studies were eligible if intervention components related to feeding or diet but not in a combined intervention with
other factors, such as oral hygiene, fluoride, or restorative treatment. Inclusion required a reported measure of association(ordatapermittingitscalculation)betweenatleastone feeding practice and caries (e.g., prevalence ratio). Studies reportingonlyresultsofstatisticaltests(e.g., ?? values)without expressing the magnitude of association were excluded. Onlypublicationsforwhichfull-textcopiescouldbeobtained inEnglish,Portuguese,orSpanishwereconsidered. Two reviewers (BC and AC) independently assessed identified citations and, later, full-text copies of citations deemedpotentiallyrelevantbasedontitlesandabstracts.For any citation selected by only one reviewer, both reviewers discussedthearticletoreachconsensusregardinginclusion. Additionally, a manual search applied the same inclusionexclusion criteria to the citation lists of reviewed full-text publications. Relevant characteristics of included studies wereabstractedtostandardizedforms(Table2).Publications were considered drawn from a single independent study if results were derived from the same or overlapping participants(e.g.,anationalsurvey).
2.2. Study Attributes. Country of origin refers to participant recruitment, not necessarily authors’ home country. For this review, cross-sectional design applies to any study in which feeding practice and caries data were collected simultaneously, regardless of whether investigators asked participants to recall past events or if investigators applied differentsamplingfractionstocaries-positiveandcaries-free children. Longitudinal design applies to studies with data fromtwoormoretimepoints,inwhichtheobservedfeeding practices could be related to future caries. In intervention studies,investigatorsassignedafeeding-relatedtreatmentor intervention to a subgroup of participants, along with an appropriatecontrolgroup.Whenpossible,samplesizerefers to those individuals included in results, not necessarily all participantsinitiallyrecruited. A study was considered peer-reviewed if its journal was designated “refereed” at Ulrichsweb directory (http://ulrichsweb.serialssolutions.com/) or if the journal’s website described the peer-review process. A study was deemed to have accounted for confounding variables if it included multivariable statistical adjustment, stratification for nonfeeding variables, or was a randomized controlled trial. To assess trends over time, included publications were groupedintothree8-yearperiods:1990–1997,1998–2005,and 2006–2013.
JournalofOralDiseases 3
Table2:Dataabstractionform. (a) Publicationcharacteristics:search
IDnumber (assignedby reviewers)
Firstauthor Yearofpublication Journal Title Language
Peerreview (yes/no)
Meetsinclusion criteria
Reasonfor exclusion,if applicable
Identification method(electronic orhandsearch)
IDnumberofotherpublications basedonthesamestudy population
(b) Publicationcharacteristics:designandstudypopulation
Studydesign(e.g., cross-sectional,longitudinal, andintervention)
Countryoforigin WHOregion Samplesize(analytic)
Follow-uppercentage,if applicable Childageatbaseline(mean,range) Childageatfollow-up(mean, range),ifapplicable (c) Cariesoutcomes Examination method(e.g., WHOfield manual) Cariesprevalence, including noncavitateddecay Cariesprevalence, cavitateddecay only Meandmfs Meandmft Othermeasures (d) Statisticalmethodsandresults Measureofassociation reported Adjustmentmethodfor confounding Mainfindings Othernotes Informationfromstudiesunderconsiderationforreviewwasenteredintoaspreadsheetwiththecolumnheadingslistedabove. WHO:WorldHealthOrganization. dmfs/t:decayedmissing(duetocaries)filledprimarysurface/toothindex.
3. Results and Discussion 3.1.Results. Theelectronicliteraturesearchyielded2635hits, of which 1852 represented nonduplicate citations (Figure1). Of these, 421 potentially relevant citations were designated for full-text review. Hand searching identified an additional 33 potentially relevant citations. From the combined 454 potentially relevant citations, 244 publications drawn from 196 independent study populations met inclusion criteria (citationsavailableonrequest). The total number of publications and the number of countriesrepresentedbothincreasedovertime(Table3).Of thesixWorldHealthOrganization(WHO)regions,themost independent studies originated from the Americas, Europe, andWesternPacific;fewerstudieswereconductedinAfrica, theEasternMediterranean,orSoutheastAsia(Figure2).The sourcesofpublicationsshiftedovertime.From1990to1997, themostrepresentedcountriesweretheUnitedStates(??= 9), Sweden (??=8), Finland (??=7), and the United Kingdom(??=7),accountingfor57%(31/54)ofpublications during that period. No included publication dated earlier than 1998 was from Brazil. Since 1998, Brazil produced the most publications of any country (?? = 37), followed by the United States (?? = 36), China (?? = 16), and India (?? = 10).RestrictedtoEnglish-languagepublications,Brazil still accounted for 14% (24/177) of all included publications since1998. The most common study design was cross-sectional, accounting for 75% (182/244) of included publications
(Table3).Onlyninepublications,drawnfromsevenindependent studies, were interventional in design. The percentage of cross-sectional studies was similar over time as was the percentage of publications that underwent some form of peer-review,whichwas>94%inalltimeperiods(Table3).In morerecenttimeperiods,agreaterpercentageofpublications presentedresultsadjustedforputativeconfoundingvariables (Table3). Althoughallstudiespertainedtochildrenintheprimary dentition, the study populations differed considerably with respecttocariesstatus(Figure3)andagerange(Figure4)of the children in each study. In all WHO regions, there were studies representing populations of very low caries burden and populations of very high caries burden. Likewise, some studies featured populations of children within a narrow age range (either younger or older), while other studies were more inclusive, featuring children ranging in age from infancy to near school age. It was not possible to make country-orregionwideestimatesofcariesprevalencebecause most study populations were not intended to be nationally representative.
3.2. Discussion. The body of literature relating early-life feedingpracticesandearlychildhoodcariesislarge,heterogeneous,andincreasingovertime.Whilethisincreasecould bepartlyattributabletobroaderelectronicindexingofmore recentpublications,thisgrowthalsoreflectsageneraltrendof risingpublicationproductivityinthehealthsciences[15,16].
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Citations selected for full-text review 421
Citations excluded after full-text review Not relevant
Abstract, thesis, commentary, review, or practice guidelines Mixed or permanent dentition Feeding exposure not reported Dental outcome not reported Dental status by self-report No measure of association Ecological study Beyond scope of review 185 (160 electronic, 25 hand)
Citations found by hand search 33
Nonreviewable citations Not English, Portuguese, or Spanish language (20) Could not obtain full text (5) 25Publications meeting review criteria 244 (196 independent studies)
Citations excluded 1431
Electronic search 7 databases 2635 hits 1852 unique citations
Non-human or in vitro study
Figure1:Flowdiagramofsystematicliteraturesearch.
Table3:Attributesofpublicationsmeetingreviewinclusioncriteria. Overall ?? = 244 1990–1997 ?? = 54 1998–2005 ?? = 79
2006–2013 ?? = 111 Countriesrepresented 47 19 23 34 Samplesize1, 295 245 249 375 Median(range) (30–13,889) (43–3000) (41–4236) (30–13,889) Studydesign2 Cross-sectional 182(75%) 39(72%) 63(80%) 80(72%) Longitudinal 51(21%) 14(26%) 13(16%) 24(22%) Intervention 9(4%) 1(2%) 2(3%) 6(5%) Peerreviewed 232(95%) 53(98%) 74(94%) 105(95%) Adjustedforconfounding 141(58%) 17(31%) 45(57%) 79(71%) 1In the case of nonindependent publications (i.e., publications drawn from the same study population), only counted is the largest (most inclusive) sample analyzedfromeachstudypopulation. 2Publicationsthatpresentedresultsfrombothcross-sectionalandlongitudinalanalyseswerecountedaslongitudinal.Twopublicationsthatusedotherdesigns werenotincluded.
This century, we observed that the number of publications related to feeding practices and caries that originated from some countries expanded, notably from Brazil, China, and India,which,alongwiththeUnitedStates,comprisedthefour most-represented countries in terms of publications since 1998. Other studies of country-level production in the dental sciences spanning 1999–2003 [17] and in orofacial pain researchduring2004-2005[18]bothfoundtheUnitedStates, Japan,andtheUnitedKingdomtobethethreecountriesmost represented in those fields and time periods. Importantly, these prior assessments assigned publications’ countries of origin as the home countries of the study coauthors. By our
methodology, the source of study participants determined the originating country, highlighting the location to which studyresultswouldbemostgeneralizable,evenforresearch conductedasaninternationalpartnership.Furthermore,our findings could indicate an accentuated rise in oral health research in certain countries in the 8–10 years since these earlier assessments or could reflect a special emphasis on population-based early childhood caries research. In Brazil, forexample,theobservedincreaseinpublicationproductivityfollowsarapidexpansionindentaltrainingopportunities, where more than 100 new dental schools opened nationally from 1995 to 2008 [19]. Additionally, recent efforts to integrate behavioral and population-based sciences into dental
JournalofOralDiseases 5
South Africa Tanzania Nigeria
United States Brazil Canada Antigua and Barbuda
Mexico
Jordan Saudi Arabia Iran Kuwait Lebanon Syria United Arab Emirates
Chile
Uganda
3 2 1
8
11
30 29
221111111
Number of study populations
Number of study populations
Number of study populations
Americans (n = 70)
Africa (n = 7) Eastern Mediterranean (n = 9)
United Kingdom Finland Sweden Turkey
Netherlands Belgium Iceland Israel
Denmark Germany Greece Ireland
Norway Switzerland Lithuania
Italy
Croatia Belarus
10 10 9
222
6 4
11111113 11
Europe (n = 57 )
India Thailand Myanmar
Japan Australia Mongolia
New Zealand
Lao, PDR Malaysia
Philippines Republic of Korea
China
Cambodia
Singapore
8
4
1
6
2 1
17
1111
10
11
Western Pacific (n = 42 )
Southeast Asia (n = 13 )
Figure2:IndependentstudypopulationsbycountryandbyWorld Health Organization region. The number of studies sums to 198, rather than 196, because two studies recruited participants from two countries; one study included participants from Finland and Tanzania and another study included participants from Tanzania andUganda.
education programs in China may have contributed to new opportunitiesforcommunity-basedresearch[20]. In contrast, many world regions, specifically Africa, the Eastern Mediterranean, and Southeast Asia, remain largely underrepresented in the literature, despite shouldering a disproportionate caries burden [8]. It is possible that the language restrictions of this review might have excluded some number of otherwise relevant publications from these regions.However,thenumberofidentifiedcitationsthatwere excluded for language reasons was much smaller than the size of the publication gap between global regions. More highqualitystudiesareneededfromunderrepresentedworld regions to inform comprehensive, globally representative policyandpracticerecommendations. Thecross-sectionaldesignwasusedextensively,limiting the ability of many studies to distinguish the temporal
Caries prevalence
dmf index
0.2
0.4
0.6
0.8
1.0
5
10
15
0 0
Prevalence, including noncavitated decay Prevalence, cavitated decay only dmft index, cavitated decay only dmfs index, cavitated decay only WHO region
Africa Americas Eastern Mediterranean Europe SE Asia Western Pacific
Figure 3: Child caries status by study and by World Health Organizationregion.Thecariesprevalence(ifprovided)andmean number of affected teeth or surfaces (if provided) of the children who contributed data to each independent study are shown. The dmft and dmfs indices exclude noncavitated lesions. Within each region,studypopulationsarerankedfromthemostdentallyhealthy (left) to the least. dmfs/t: decayed missing (due to caries) filled primarysurface/toothindex.
12 24 36 48 60 72 84
Mean age Age range
Age at dental evaluation (months)
WHO region
Africa Americas Eastern Mediterranean Europe SE Asia Western Pacific
Figure 4: Age of participants by study and by World Health Organization region. The mean age (if provided) and age range (if provided)ofthechildrenwhocontributeddatatoeachindependent studyareshown.Withineachregion,studypopulationsareranked fromtheyoungest(left)totheoldest.
orderingbetweencurrentfeedingpracticesandcaries.Many studies relied on maternal recall of past feeding practices, the accuracy of which depends on the length of the recall period and the practice being recalled [21]. Despite these disadvantages, cross-sectional studies are generally more expedient and less costly than longitudinal studies and, therefore, could aid hypothesis generation for subsequent longitudinalinvestigations.
6 JournalofOralDiseases
The relationship between food intake and caries is not a novel area of study [22], yet translation of research findings into effective practice is a persistent implementation gap [12]. This review identified few standalone feeding practice interventions,consistingofjustseventrials.Whilenotallof these interventions yielded significant dental health effects, severalexemplifiedacommon-riskfactorapproachtodisease prevention, investigating oral health outcomes downstream of nutritionalor otherwise general health-focused interventions[23–27]. Thepercentageofpublicationsusingmethodstoaccount for confoundingfactors increasedwith time. While this can be considered a positive development, it does necessarily indicatethattheadjustmentmethodsusedwereappropriate or comprehensive. For example, inclusion of variables in statisticalmodelsasconfoundingfactorswithoutreasonable evidence to suggest such variables plays a confounding role whichmayactuallyincreasebias[28].Furthermore,itisnot knowntowhatextentpublicationbias,thegreatertendency forstatisticallysignificantfindingstoentertheliterature[29], affectedthetrendsobservedinthisreview. Heterogeneity across studies can be informative and must be considered in combining study results [30]. In addition to geographic heterogeneity, differences in the age rangeandcariesexperienceofdifferentpopulationshighlight reasons for caution if pooling results. For example, feeding practices such as bottle use and breastfeeding are strongly related to age, as is ECC, and, therefore, age distributions must be considered during analysis and interpretation of epidemiologicaldata.Studiesmightfindinverserelationships betweencertainfeedingpracticesandcariesifthosepractices predominateamongyoungerchildren.Additionally,relative measures of association, such as the prevalence ratio, are a function of the disease level in the comparison group and, thus, might not be equivalent across populations that vary widely in baseline disease levels. For example, a reported relativeriskof1.5thatrelatescariesprevalenceacrossgroups exposedorunexposedtoaparticularfeedingpracticemight have different practical implications if the prevalence levels beingcomparedare8%to12%versus40%to60%. Thescopeofthisreviewwaslimitedtopaperspublished since1990.Itcannotbeassumedthatanytrendsidentifiedcan beextrapolatedtoearlierperiods.Asalimitation,thisreview tracked trends in a number of objective study attributes but did not perform a specific assessment of the risk of bias or the inherent quality of the individual studies and cannot be used as an assessment of study quality over time. While the observedincreaseinthepercentageofstudiestoaccountfor confoundingfactorsisencouragingandlikelytobecorrelated withstudyquality,thisobservationalonedoesnotnecessarily demonstratethattheoverallqualityofstudieshasimproved generally. ThenumberofpublicationsonfeedingpracticesandECC has increased, suggesting growing interest in the topic. In countingresearchproductivityaspublicationcounts,without weightsforqualityorimpact,however,thisreviewcharacterizedtheliteratureinbroadstrokes,identifyinggapsgenerally as they relate to geographic representation and longitudinal evidence. In future analyses, a systematic synthesis of
thefindingscontainedinthisliteratureisneeded.Ultimately, the translation of identified associations between feeding practices and caries into effective oral health promoting practice will necessarily recognize the interlacing of feeding practices with other caries determinants, such as socioeconomic influences [31], parental factors [32], and other political, economic, social, and community contributions to oralhealth[33].
4. Conclusions The number of publications reporting on early-life feeding practices and ECC has expanded, with increasing representation from some countries (e.g., Brazil, China, and India) butremainingunderrepresentationfromothers(e.g.,African region). Most studies to date have been cross-sectional in design; more high quality longitudinal and intervention studies would provide stronger evidence to inform practice and policy. Publication attributes (i.e., methods and context) can differ significantly by individual publication and should be considered in the interpretation and synthesis of the literature. Integration of multidisciplinary knowledge, including future methodologically rigorous studies from less represented world regions, is needed to address the significantworldwideburdenofearlychildhoodcaries.
Conflict of Interests The authors declare that there is no conflict of interests regardingthepublicationofthispaper.
Acknowledgment This research was made possible by NIH/NIDCR Grants F30DE022208andU54DE019285.
References [1] N. Tinanoff and S. Reisine, “Update on early childhood caries sincetheSurgeonGeneral’sreport,”AcademicPediatrics,vol.9, no.6,pp.396–403,2009. [2] AmericanAcademyonPediatricDentistry,AmericanAcademy of Pediatrics, “Policy on Early Childhood Caries (ECC): classifications, consequences, and preventive strategies,” Pediatric Dentistry,vol.30,supplement,no.7,pp.40–43,2008. [3] J. Abanto, T. S. Carvalho, F. M. Mendes, M. T. Wanderley, M. B¨onecker, and D. P. Raggio, “Impact of oral diseases and disorders on oral health-related quality of life of preschool children,”CommunityDentistryandOralEpidemiology,vol.39, no.2,pp.105–114,2011. [4] P. F. Kramer, C. A. Feldens, S. H. Ferreira, J. Bervian, P. H. Rodrigues, and M. A. Peres, “Exploring the impact of oral diseasesanddisordersonqualityoflifeofpreschoolchildren,” Community Dentistry and Oral Epidemiology, vol. 41, pp. 327– 335,2013. [5] A.L.Greenwell,D.Johnsen,T.A.DiSantis,J.Gerstenmaier,and N.Limbert,“Longitudinalevaluationofcariespatternsformthe primarytothemixeddentition,”PediatricDentistry,vol.12,no. 5,pp.278–282,1990.
JournalofOralDiseases 7
[6] Y.LiandW.Wang,“Predictingcariesinpermanentteethfrom caries in primary teeth: an eight-year cohort study,” Journal of DentalResearch,vol.81,no.8,pp.561–566,2002. [7] W.Marcenes,N.J.Kassebaum,E.Bernab´eetal.,“Globalburden oforalconditionsin1990–2010: asystematicanalysis,”Journal ofDentalResearch,vol.92,no.7,pp.592–597,2013. [8] P.E.Petersen,D.Bourgeois,H.Ogawa,S.Estupinan-Day,and C.Ndiaye,“Theglobalburdenoforaldiseasesandriskstooral health,”BulletinoftheWorldHealthOrganization,vol.83,no.9, pp.661–669,2005. [9] R. H. Selwitz, A. I. Ismail, and N. B. Pitts, “Dental caries,”The Lancet,vol.369,no.9555,pp.51–59,2007. [10] C.Mobley,T.A.Marshall,P.Milgrom,andS.E.Coldwell,“The contributionofdietaryfactorstodentalcariesanddisparitiesin caries,”AcademicPediatrics,vol.9,no.6,pp.410–414,2009. [11] K. A. Spiegel and C. A. Palmer, “Childhood dental caries and childhoodobesity.Differentproblemswithoverlappingcauses,” AmericanJournalofDentistry,vol.25,no.1,pp.59–64,2012. [12] N. Pitts, B. Amaechi, R. Niederman et al., “Global oral healthinequalities:dentalcariestaskgroup—researchagenda,” AdvancesinDentalResearch,vol.23,no.2,pp.211–220,2011. [13] R.Harris,A.D.Nicoll,P.M.Adair,andC.M.Pine,“Riskfactors for dental caries in young children: a systematic review of the literature,” Community Dental Health, vol. 21, no. 1, pp. 71–85, 2004. [14] R.Valaitis,R.Hesch,C.Passarelli,D.Sheehan,andJ.Sinton,“A systematicreviewoftherelationshipbetweenbreastfeedingand earlychildhoodcaries,”CanadianJournalofPublicHealth,vol. 91,no.6,pp.411–417,2000. [15] M.J.Boschen,“Publicationtrendsinindividualanxietydisorders:1980–2015,”JournalofAnxietyDisorders,vol.22,no.3,pp. 570–575,2008. [16] J. P. Deshazo, D. L. Lavallie, and F. M. Wolf, “Publication trendsinthemedicalinformaticsliterature:20yearsof“medical informatics”inMeSH,”BMCMedicalInformaticsandDecision Making,vol.9,no.1,article7,2009. [17] J. A. Gil-Montoya, J. Navarrete-Cortes, R. Pulgar, S. Santa, and F. Moya-Aneg´on, “World dental research production: an ISI database approach (1999–2003),” European Journal of Oral Sciences,vol.114,no.2,pp.102–108,2006. [18] C. Robert, N. Caillieux, C. S. Wilson, J. Gaudy, and C. Arreto, “Worldorofacialpainresearchproduction:abibliometricstudy (2004-2005),” Journal of Orofacial Pain, vol. 22, no. 3, pp. 181– 189,2008. [19] N.A.Saliba,S.A.S.Moimaz,C.A.S.Garbin,andD.G.Diniz, “Dentistry in Brazil: its history and current trends,” Journal of DentalEducation,vol.73,no.2,pp.225–231,2009. [20] C. Huang, Z. Bian, B. Tai, M. Fan, and C. Kwan, “Dental education in Wuhan, China: challenges and changes,” Journal ofDentalEducation,vol.71,no.2,pp.304–311,2007. [21] R. Li, K. S. Scanlon, and M. K. Serdula, “The validity and reliabilityofmaternalrecallofbreastfeedingpractice,”Nutrition Reviews,vol.63,no.4,pp.103–110,2005. [22] A.Stewart,“Whydentalcariesissogeneral,andhowtoprevent it,”BritishMedicalJournal,vol.2,no.877,pp.560–562,1877. [23] B. W. Chaffee, C. A. Feldens, and M. R. V ´ itolo, “Clusterrandomizedtrialofinfantnutritiontrainingforcariesprevention,”JournalofDentalResearch,vol.92,supplement,no.7,pp. 29S–36S,2013.
[24] C.A.Feldens,E.R.J.Giugliani, ´A.Vigo,andM.R.V´itolo,“Early feedingpracticesandsevereearlychildhoodcariesinfour-yearoldchildrenfromsouthernBrazil:abirthcohortstudy,”Caries Research,vol.44,no.5,pp.445–452,2010. [25] S. Karjalainen, L. Sew´on, E. S¨oderling, H. Lapinleimu, R. Sepp¨anen, and O. Simell, “Oral health of 3-year-old children and their parents after 29 months of child-focused antiatherosclerotic dietary intervention in a prospective randomizedtrial,”CariesResearch,vol.31,no.3,pp.180–185,1997. [26] M. S. Kramer, I. Vanilovich, L. Matush et al., “The effect of prolongedandexclusivebreast-feedingondentalcariesinrarly school-age children: new evidence from a large randomized trial,”CariesResearch,vol.41,no.6,pp.484–488,2007. [27] A.Scheiwe,R.Hardy,andR.G.Watt,“Four-yearfollow-upofa randomizedcontrolledtrialofasocialsupportinterventionon infant feeding practices,” Maternal and Child Nutrition, vol. 6, no.4,pp.328–337,2010. [28] A. T. Merchant and W. Pitiphat, “Directed acyclic graphs (DAGs): an aid to assess confounding in dental research,” CommunityDentistryandOralEpidemiology,vol.30,no.6,pp. 399–404,2002. [29] R.LightandD.Pillemer,Summingup:TheScienceofReviewing Research, Harvard University Press, Cambridge, Mass, USA, 1984. [30] S.Greenland,“Invitedcommentary:acriticallookatsomepopularmeta-analyticmethods,”AmericanJournalofEpidemiology, vol.140,no.3,pp.290–296,1994. [31] M. A. da Fonseca, “The effects of poverty on children’s development and oral health,”Pediatric Dentistry, vol. 34, no. 1, pp. 32–38,2012. [32] M.Hooley,H.Skouteris,C.Boganin,J.Satur,andN.Kilpatrick, “Parental influence and the development of dental caries in children aged 0–6 years: a systematic review of the literature,” JournalofDentistry,vol.40,no.11,pp.873–885,2012. [33] J. Lee and K. Divaris, “The ethical imperative of addressing oralhealthdisparities:aunifyingframework,”JournalofDental Research,vol.93,no.3,pp.224–230,2014.
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8.
PARA2005 – Written Assignment 2015 Student: Topic: Assessable items Comments Max Grade
Your Grade
CONTENT 70 ? Introduces the assignment with a brief synopsis of the case and outline the writer intent ? Accurately identifies the key diagnostic signs and relates these signs to a set of plausible differential diagnoses ? Provides a plausible rationale for including each differential diagnosis ? Selects no more than three most likely diagnoses and comprehensively describes pathophysiology/pathology involved and underlying mechanisms responsible for each of the differential diagnoses ? Accurately describes current management practices and/or therapies and provides an informed discussion of their benefits and limitations ? Identifies areas of current research and how outcomes are likely to aid the development of new therapies, prevention or management practices, detection methods etc (can be focussed on a specific aspect or generalistic) ? Critically reviews information and correctly identifies knowledge gaps or areas of debate (can be focussed around a specific clinical aspect of the condition) ? Provides a succinct summary section highlighting 2-3 key points as primary conclusions (based on evidence presented) ? Higher marks will be awarded for a comprehensive exploration of the topic, with consistently sound critical evaluation of concepts and personal synthesis of issues. STRUCTURE 10 ? Develops a sound and informative table of contents ? Main points clearly identified, discussed in a logical and sequential manner and directly related to the table of contents ? Paragraphs and sentences are well structured and linked in terms of context and information content. Appropriate sentence length used with clear concept development and supporting detail provided with minimal repetition ? Clear development of themes and/or discussion “arguments” based on critical review of the literature ? Diagrams and figures used effectively to support text PRESENTATION 5 ? Well set out; clear, easy to read style. ? Grammatical and spelling accuracy. ? Within 10% of word limit EVIDENCE OF RESEARCH 15 ? Researched material is well synthesised into content, cited correctly and accurate details provided in a reference list conforming to Author-Date (Harvard or APA 5th) System. ? Limited use of text books, with only peer reviewed sources used (no web sites) ? Extensive use of primary references supporting critical evaluation of concepts and personal synthesis of issues, areas of debate ? Clear distillation of referenced material into own words, NO evidence of plagiarism OVERALL GRADE 100 7 8 8 8 8 8 7 8 8 2 2 2 2 2 2 2 1 5 3 3 4
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