Quality of orthodontic care-A multicenter cohort study in Germany : Part 1: Evaluation of effectiveness of orthodontic treatments and predictive factors.

AIMS: Orthodontic care and its effectiveness have increasingly become the focus of political and public attention in the recent past. Therefore, this multicenter cohort study aimed to report about the effectiveness of orthodontic treatments in Germany and to identify potential influencing factors. METHODS: A total of 586 patients from seven German study centers were screened for this cohort study, of which 361 patients were recruited at the end of their orthodontic treatment. Of these, 26 patients had missing study models and/or missing treatment information. Thus, 335 participants were included. The severity of malocclusion was rated using the Peer Assessment Rating (PAR) Index at baseline (T0) retrospectively and-prospectively-after the retention period (T1). Practitioner-, treatment- and patient-related information were analyzed in order to detect potential predictive factors for treatment effectiveness. RESULTS: Study participants (202 female and 133 male) were on average 14.8 (standard deviation [SD] ± 6.1) years old at start of active treatment. Average PAR score at T0 was 25.96 (SD ± 10.75) and mean posttreatment PAR score was 3.67 (SD ± 2.98) at T1. An average decrease of total PAR score by 22.30 points (SD ± 10.73) or 83.54% (SD ± 14.58; p < 0.001) was detected. Furthermore, 164 treatments (49.1%) were categorized as 'greatly improved' but only 3 treatments (0.9%) as 'worse or no different'; 81.5% of all cases finished with a high-quality treatment outcome (≤5 PAR points at T1). Logistic regression analyses detected staff experience as a significant predictive factor for high-quality results (odds ratio 1.27, p = 0.001, 95% confidence interval 1.11-1.46). CONCLUSION: The improvement rate among this selected German cohort indicated an overall very good standard of orthodontic treatment. Staff experience proved to be a predictive factor for high-quality results.

Measuring physical aggressiveness in heterosexual, homosexual, and transsexual males.

The purpose of this study was the development of a self-report measure of boyhood aggressiveness for use with adult males. Aggressiveness was defined as a generalized disposition to engage in physically combative or competitive interactions with male peers. This attribute is of sexological interest because of the reported difference in physical aggressiveness between heterosexual and homosexual boys. A physical aggressiveness scale (PAS) was constructed from items regarding boyhood athletic interest and proficiency, as well as fighting with and feelings of unease around male peers. The PAS and Part A of the Feminine Gender Identity Scale for males (FGIS(A), Freund et al., 1977) were administered to 193 adult men. The PAS was shown to be reliable and factorially pure. The PAS scores of homosexuals were significantly lower than those of heterosexuals, and the scores of male-to-female transsexuals were lower yet. No differences were found among three heterosexual groups: prison inmates and nonuniversity- and university-educated males. Precisely symmetrical results were obtained with the FGIS(A), with the male-to-female transsexuals scoring highest and the heterosexuals lowest. Group differences in FGIS(A) scores were greater than those in PAS scores; this was interpreted as possible evidence that physical aggressiveness is more sensitive than gender identity to variables uncorrelated with erotic preference, e.g., perceptual-motor ability, rate of physical maturation, etc. The main results suggest that whatever underlying factor relates homosexuality to feminine gender identity in childhood relates this erotic preference to anomalously low levels of physical aggressiveness in childhood as well.