Oral Hygiene and Handwashing Practices among Middle School Students in 15 Latin American and Caribbean Countries.

OBJECTIVE: To examine the relationship between infrequent toothbrushing and infrequent handwashing among middle school students from 15 Latin American and Caribbean countries (Antigua and Barbuda, Argentina, British Virgin Islands, Cayman Islands, Costa Rica, Grenada, Guatemala, Guyana, Peru, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and Grenadines, Suriname, Trinidad and Tobago, and Uruguay). METHODS: A secondary analysis was done of nationally-representative data from 33 174 middle school students who participated in the Global School-based Student Health Survey (GSHS) between 2006 and 2011. RESULTS: In all 15 countries, the association between rarely brushing or cleaning teeth and rarely handwashing after using the toilet was significant for both boys and girls. The pooled odds ratio for this association was 6.7 (5.8, 7.7). CONCLUSION: Healthcare providers who notice signs of poor dental hygiene or infrequent bathing in adolescents should consider providing comprehensive hygiene education to their patients, since infrequent oral and body hygiene behaviours tend to co-exist and both are threats to health.

Parental involvement and bullying among middle-school students in North Africa.

Bullying, especially in developing countries, has not been much examined, especially the influence of parents on the risk of being bullied. The aim of this study was to determine whether active parenting is associated with reduced peer victimization among middle-school students in North Africa. A secondary analysis of data from more than 13,000 middle-school students who participated in the Global School-based Student Health Survey (GSHS) in Egypt, Libya, Morocco and Tunisia between 2006 and 2008, was conducted using multiple logistic regression models. About 60% of students in Egypt and one-third of students in Libya, Morocco and Tunisia reported having been bullied in the past month. In all 4 countries, boys reported more peer victimization than girls. In Egypt, Morocco and Tunisia, students who reported that their parents checked their homework, were understanding, and knew how the student spent free time had a reduced likelihood of peer victimization but this association was not significant in Libya. Interventions for reducing bullying should consider the positive impact of involved parents.

Parental involvement and bullying among middle school students in North Africa

Bullying, especially in developing countries, has not been much examined, especially the influence of parents on the risk of being bullied. The aim of this study was to determine whether active parenting is associated with reduced peer victimization among middle-school students in North Africa. A secondary analysis of data from more than 13 000 middle-school students who participated in the Global School-based Student Health Survey [GSHS] in Egypt, Libya, Morocco and Tunisia between 2006 and 2008, was conducted using multiple logistic regression models. About 60% of students in Egypt and one-third of students in Libya, Morocco and Tunisia reported having been bullied in the past month. In all 4 countries, boys reported more peer victimization than girls. In Egypt, Morocco and Tunisia, students who reported that their parents checked their homework, were understanding, and knew how the student spent free time had a reduced likelihood of peer victimization but this association was not significant in Libya. Interventions for reducing bullying should consider the positive impact of involved parents

Bullying, mental health, and parental involvement among adolescents in the Caribbean.

OBJECTIVE: To examine the relationships between peer victimization, mental health, and parental involvement among middle school students in the Caribbean. METHODS: Data from the Global School-based Student Health Survey (GSHS) conducted in the Cayman Islands, St Lucia, St Vincent and the Grenadines, and Trinidad and Tobago in 2007 were analysed using age- and gender-adjusted logistic regression models. RESULTS: About one-quarter of the 6780 participants reported having been bullied in the past month. Rates of bullying were similar for boys and girls, and younger children reported higher rates of peer victimization. Nearly 25% of students reported sadness and hopelessness, more than 10% reported loneliness and anxiety and more than 15% reported having seriously considered suicide in the past year. Bullied students were much more likely than non-bullied students to report mental health issues (p < 0.01). Students who felt that their parents were understanding and monitored their free time activities reported fewer mental health issues and were somewhat less likely to report being a victim of a bully. CONCLUSION: The strong association between bullying and poor mental health in the Caribbean emphasizes the need to develop and implement strategies for reducing bullying among children and adolescents.

Patterns of co-authorship in international epidemiology.

BACKGROUND: The objective of this study was to identify current patterns of international collaboration based on authorship of epidemiological articles. METHODS: All articles published in nine high-impact public health journals in 2006 were read, and information about the study country and the authors' countries of affiliation was extracted. All countries were assigned to an income level using World Bank classifications. This paper presents results for the 1686 articles that focused on a single study country. RESULTS: International collaboration is common, but the dominant partnerships vary by the income level of the study country. 74.2% of articles reporting on research conducted in low- and middle-income study countries involved co-authors from two or more countries, and nearly all of these international collaborations included co-authors from both low/middle-income and high-income countries. Only 13.0% of studies based in high-income countries involved co-authors from two or more countries, and the majority of these studies involved co-authors with affiliations solely from high-income countries. More than 90% of articles from both low/middle- and high-income study countries included at least one co-author from the study country. CONCLUSION: There is a high rate of local co-authorship in both low/middle- and high-income study countries. Most articles that focus on high-income countries include only authors from high-income countries. Most articles that focus on low- and middle-income study countries are "north-to-south" international collaborations that include co-authors from both low/middle- and high-income countries. "South-south" partnerships are rare.

Reporting of ethics-related methods in epidemiological research.

OBJECTIVE: This paper describes the variety of ways that information about ethics-related methods are included or not included in public health research articles. METHODS: Information about the ethics-related content of all articles published in nine highly-respected public health journals in 2006 was extracted. RESULTS: Of 989 primary analyses, 73% of the articles commented on ethics committee approval or exemption, 63% mentioned participant consent and 9% indicated whether or not inducement or compensation was given. 84% of articles mentioned a funding source, but fewer than 4% identified any potential conflict of interest. Reporting rates for committee review and consent were higher for experimental than for observational studies and were comparatively higher in studies conducted among potentially vulnerable populations like children and residents of low income countries. CONCLUSIONS: More complete reporting would facilitate the design, evaluation and comparison of future research studies.

The effects of socioeconomic development on worldwide hepatitis A virus seroprevalence patterns.

BACKGROUND: Hepatitis A virus (HAV) infection confers long-term immunity, so mathematical analysis of age-specific seroprevalence in populations can reveal changes in the infection rate over time. HAV transmission is related to access to clean drinking water, personal hygiene and public sanitation. METHODS: We used an SIR (susceptible-infectious-recovered) compartmental model with age structure to fit a time-dependent logistic function for HAV force of infection for 157 published age-seroprevalence data sets. We then fit linear regression models for socioeconomic variables and infection rate. RESULTS: The proportion of the population with access to clean drinking water, the value of the human development index (HDI), and per capita gross domestic product (GDP) are all inverse predictors of HAV infection rates. Declining infection rates were observed in 65.6% of the surveys. Discussion This work demonstrates the utility of HAV seroprevalence studies to reveal patterns of change in force of infection and to assess the association between socioeconomic risk factors and transmission rates.

Declining hepatitis A seroprevalence: a global review and analysis.

Hepatitis A virus (HAV) is spread by faecal-oral contact or ingestion of contaminated food or water. Lifelong immunity is conferred by infection or vaccination, so anti-HAV seroprevalence studies can be used to indicate which populations are susceptible to infection. Seroprevalence rates are highly correlated with socioeconomic status and access to clean water and sanitation. Increasing household income, education, water quality and quantity, sanitation, and hygiene leads to decreases in HAV prevalence. Japan, Australia, New Zealand, Canada, the United States, and most European nations have low anti-HAV rates. Although anti-HAV rates remain high in most Latin American, Asian, and Middle Eastern nations, average seroprevalence rates are declining. Surveys from Africa generally indicate no significant decline in anti-HAV rates. Because the severity of illness increases with age, populations with a high proportion of susceptible adults should consider targeted vaccination programmes.

Vision, cognition and developmental characteristics of girls and women with Rett syndrome.

Forty-two females with Rett syndrome, aged 2.5 to 47 years, were assessed with the Teller Acuity Cards and a new version of the Fagan test for age 2 years and above, and their parents were interviewed about the children's communication skills. The visual function of the subjects indicated arrested development, and they scored significantly lower on the Fagan test than a normal comparison group. Their visual processing and memory deteriorated somewhat with age, while those of the comparison group showed a slight increase. Both age at onset of Rett syndrome symptomatology and speech measures were inversely correlated with visual processing and memory, indicating that age at recession may have differential consequences for different functions. Among the subjects, persistent looking was associated with low cognitive function. The results have implications for intervention, and demonstrate that the paradigm of preferential looking may be useful in cognitive assessment of females with Rett syndrome.