http://hdl.handle.net/10468/87 2017-09-01T04:35:39Z http://hdl.handle.net/10468/3766 Knowledge of caries risk factors/indicators among Japanese and Irish adult patients with different socio-economic profiles: a cross-sectional study Nishi, Makiko; Harding, Máiréad; Kelleher, Virginia; Whelton, Helen; Allen, Finbarr Background: A previous study has shown deficient knowledge of caries risk factors/indicators in a Japanese adult population regarded to have a high interest in preventive dentistry. No prior research has investigated caries risk knowledge in an Irish adult population. We hypothesise there may be unexpected differences or similarities in knowledge across countries with similar levels of economic development when comparing groups with different socio-economic and cultural profiles. Understanding what influences knowledge is important for the development of effective and efficient caries prevention strategies. The current paper aims to describe the knowledge of caries risk factors/indicators in two groups with different socio-economic profiles from two culturally distinct countries. Methods: Cross-sectional surveys of adult dental patients were carried out in Japan and in the Republic of Ireland (RoI) using similar self-administered paper questionnaires. Patients were asked to identify caries risk factors/indicators from eight (Japan) or ten (RoI) listed items. The Japanese study involved 482 patients (aged ≥20 years) from 52 dental members of a nationwide web-based initiative Promoting Scientific Assessment in Prevention of Tooth Decay and Gum Disease (PSAP). The Irish study involved 159 patients (aged 20–69 years) accessing state-provided (‘medical card’) dental services from eight dental practices in County Cork. The two samples were compared. Results: A higher proportion of Irish respondents identified ‘Not visiting the dentist for check-up and cleaning’ (OR 2.655; 99% CI 1.550, 4.547) and ‘Not using fluoride’ (OR 1.714; 99% CI 1.049, 2.802) than did Japanese respondents. A lower proportion of Irish respondents identified ‘A reduced amount of saliva’ (OR 0.262; 99% CI 0.159, 0.433) than Japanese respondents. Similarly shown in both studies were a persistent belief that ‘Not brushing teeth properly’ is a caries risk factor and a lack of knowledge on saliva buffering capacity as a caries risk factor. Conclusions: Deficiencies in knowledge which should be addressed: among the Japanese group, of dental check-up/cleaning visits and of fluoride use for caries prevention; among the Irish group, of saliva quantity as a caries risk factor. In addition, in both groups, we need to inform patients of the defensive role of saliva. 2017-02-16T00:00:00Z http://hdl.handle.net/10468/2376 The effect of copayments for prescriptions on adherence to prescription medicines in publicly insured populations; A systematic review and meta-analysis Sinnott, Sarah-Jo; Buckley, Claire M.; O'Riordan, David; Bradley, Colin P.; Whelton, Helen Introduction: Copayments are intended to decrease third party expenditure on pharmaceuticals, particularly those regarded as less essential. However, copayments are associated with decreased use of all medicines. Publicly insured populations encompass some vulnerable patient groups such as older individuals and low income groups, who may be especially susceptible to medication non-adherence when required to pay. Non-adherence has potential consequences of increased morbidity and costs elsewhere in the system. Objective: To quantify the risk of non-adherence to prescribed medicines in publicly insured populations exposed to copayments. Methods: The population of interest consisted of cohorts who received public health insurance. The intervention was the introduction of, or an increase, in copayment. The outcome was non-adherence to medications, evaluated using objective measures. Eight electronic databases and the grey literature were systematically searched for relevant articles, along with hand searches of references in review articles and the included studies. Studies were quality appraised using modified EPOC and EHPPH checklists. A random effects model was used to generate the meta-analysis in RevMan v5.1. Statistical heterogeneity was assessed using the I-2 test; p>0.1 indicated a lack of heterogeneity. Results: Seven out of 41 studies met the inclusion criteria. Five studies contributed more than 1 result to the meta-analysis. The meta-analysis included 199, 996 people overall; 74, 236 people in the copayment group and 125,760 people in the non-copayment group. Average age was 71.75years. In the copayment group, (verses the non-copayment group), the odds ratio for non-adherence was 1.11 (95% CI 1.09-1.14; P = <0.00001). An acceptable level of heterogeneity at I-2 = 7%, (p = 0.37) was observed. Conclusion: This meta-analysis showed an 11% increased odds of non-adherence to medicines in publicly insured populations where copayments for medicines are necessary. Policy-makers should be wary of potential negative clinical outcomes resulting from non-adherence, and also possible knock-on economic repercussions. 2013-01-01T00:00:00Z http://hdl.handle.net/10468/115 The heights and weights of Irish children from the post-war era to the Celtic tiger Perry, Ivan J.; Whelton, Helen; Harrington, Janas M.; Cousins, Bernard BACKGROUND: Childhood obesity is a significant global health issue. National level data on long-term secular trends are relatively sparse. METHODS: Data were obtained from three large-scale surveys of school-aged children in Ireland involving measurements of height and weight in 1948, the 1970s and 2002. RESULTS: Significant increases in height and weight were observed in both boys and girls and in all age groups across the decades. The increases in weight were disproportionate to the trends in height. While boys aged 14 years were 23 cm taller 2002 than in 1948, their average weight was 61 kg, compared with 37 kg in 1948, an increase of 24 kg. A substantial proportion of the increase in weight is seen between the 1970s and 2002. CONCLUSIONS: The data provide stark and compelling evidence on the evolution of the obesity epidemic in Irish children in tandem with the increase in economic prosperity. 2009-03-01T00:00:00Z http://hdl.handle.net/10468/85 Prevalence of overweight and obesity on the island of Ireland: results from the North South Survey of Children's Height, Weight and Body Mass Index, 2002 Whelton, Helen; Harrington, Janas M.; Crowley, Evelyn; Kelleher, Virginia; Cronin, Michael; Perry, Ivan J. Background: Childhood obesity is emerging as a major public health problem in developed and developing countries worldwide. The aim of this survey was to establish baseline data on the prevalence and correlates of overweight and obesity among children and adolescents in the Republic of Ireland (RoI) and Northern Ireland (NI). Methods: The heights and weights of 19,617 school-going children and adolescents aged between 4 and 16 years in NI and RoI were measured using standardised and calibrated scales and measures. The participants were a representative cross-sectional sample of children randomly selected on the basis of age, gender and geographical location of the school attended. Overweight and obesity were classified according to standard IOTF criteria. Results: Males were taller than females, children in RoI were taller than those in NI and the more affluent were taller than the less well off. The overall prevalence of overweight and obesity was higher among females than males in both jurisdictions. Overall, almost one in four boys (23% RoI and NI) and over one in four girls (28% RoI, 25% NI) were either overweight or obese. In RoI, the highest prevalence of overweight was among 13 year old girls (32%) and obesity among 7 year old girls (11%). In NI the highest prevalence of overweight and obesity were found among 11 and 8 year old girls respectively (33% and 13%). Conclusion: These figures confirm the emergence of the obesity epidemic among children in Ireland, a wealthy country with the European Union. The results serve to underpin the urgency of implementing broad intersectoral measures to reduce calorie intake and increase levels of physical activity, particularly among children. 2007-07-31T00:00:00Z