Oral health, academic performance, and school absenteeism in children and adolescents: A systematic review and meta-analysis.

BACKGROUND: The authors conducted a systematic review and meta-analysis to provide a summary estimate of the association between oral health and academic performance. TYPES OF STUDIES REVIEWED: The authors conducted a systematic search of PubMed, Embase, and Google Scholar for studies on oral health, school absence, and academic achievement published in English from January 1945 through December 2017. Exposures included subjectively or objectively measured caries, oral pain, and periodontitis. Outcomes included school absence and school achievement. RESULTS: The authors screened a total of 2,041 studies, from which they extracted data from 14 studies of 139,989 children (12 cross-sectional studies, 1 case-control study, and 1 longitudinal study). Five studies had school absence as the primary outcome, and 7 studies had student achievement as the primary outcome. Three studies included both outcomes. The authors found no studies for periodontitis. The average modified Newcastle-Ottawa Scale score was 3.93. The authors rated 10 studies as having a low risk of bias and 4 as having a high risk of bias. Qualitative synthesis suggested that poor oral health may have negative effects on student absenteeism and achievement, but study quality was highly variable. Results from meta-analyses indicated that poor oral health was significantly associated with increased odds of poor academic performance (pooled odds ratio, 1.52; 95% confidence interval, 1.20 to 1.83) and absenteeism (pooled odds ratio, 1.43; 95% confidence interval, 1.24 to 1.63). CONCLUSIONS AND PRACTICAL IMPLICATIONS: Increased focus on the broader implications of improvements in oral health for children, such as educational or socioemotional development, is of further interest to practicing dentists owing to the greater connection between oral health and general health. The authors of this study found that caries or tooth pain had a negative association with academic achievement and school absenteeism. However, study quality was limited by inconsistent exposure and outcome definitions and a predominance of cross-sectional designs. Thus, causal conclusions are not supported.

Spatial Distribution of Parkinson's Disease Prevalence in Québec by Hydrographic Region.

The association between environmental exposures and Parkinson's disease continues to garner interest. In the late 1980s, Barbeau et al. reported in the Canadian Journal of Neurological Sciences a heterogeneous distribution of Parkinson's disease cases across the province of Québec by hydrographic region. Here we report the findings of a validation study based on data obtained from the Québec medication insurance program-information which was unavailable to the previous group. Similar to Barbeau et al., our analysis showed a heterogeneous distribution of cases across the province with higher prevalence in the same region of interest, in addition to other areas.

Suicide following an infestation of bed bugs.

PATIENT: Male, 62. FINAL DIAGNOSIS: Bipolar disorder. SYMPTOMS: Bordeline personality disorder. MEDICATION: - CLINICAL PROCEDURE: Bed bug infestation. SPECIALTY: Psychiatry. OBJECTIVE: Unusual clinical course. BACKGROUND: In the past decade, bed bug infestations have been increasingly common in high income countries. Psychological consequences of these infestations are rarely examined in the scientific literature. CASE REPORT: We present a case, based on a coroner's investigation report, of a woman with previous psychiatric morbidity who jumped to her death following repeated bed bug infestations in her apartment. Our case report shows that the bed bug infestations were the likely trigger for the onset a negative psychological state that ultimately led to suicide. CONCLUSIONS: Given the recent surge in infestations, rapid action needs to be taken not only in an attempt to control and eradicate the bed bugs but also to adequately care for those infested by bed bugs.

Mental health effects from urban bed bug infestation (Cimex lectularius L.): a cross-sectional study.

OBJECTIVE: To assess whether bed bug infestation was linked to sleep disturbances and symptoms of anxiety and depression. DESIGN: Exploratory cross-sectional study. SETTING: Convenience sample of tenants recruited in apartment complexes from Montreal, Canada. PARTICIPANTS: 39 bed bug-exposed tenants were compared with 52 unexposed tenants. MAIN OUTCOME MEASURES: The effect of bed bug-exposed tenants on sleep disturbances, anxiety and depression symptoms measured using the Pittsburgh Sleep Quality Index, 5th subscale, Generalised Anxiety Disorder 7-item scale and Patient Health Questionnaire, 9-item, respectively. RESULTS: In adjusted models, bed bug infestation was strongly associated with measured anxiety symptoms (OR (95% CI)=4.8 (1.5 to 14.7)) and sleep disturbance (OR (95% CI)=5.0 (1.3-18.8)). There was a trend to report more symptoms of depression in the bed bug-infested group, although this finding was not statistically significant ((OR (95% CI)=2.5(0.8 to 7.3)). CONCLUSIONS: These results suggest that individuals exposed to bed bug infestations are at risk of experiencing sleep disturbance and of developing symptoms of anxiety and possibly depression. Greater clinical awareness of this problem is needed in order for patients to receive appropriate mental healthcare. These findings highlight the need for undertaking of deeper inquiry, as well as greater collaboration between medical professionals, public health and community stakeholders.

Comorbidity information in older patients at an emergency visit: self-report vs. administrative data had poor agreement but similar predictive validity.

OBJECTIVES: The objectives of this study were (1) to ascertain the level of agreement between the Charlson Comorbidity Index (CCI) based on self-report vs. administrative records, and factors affecting agreement and (2) to compare the predictive validity of the two indices in a sample of older emergency department (ED) patients. STUDY DESIGN AND SETTING: The study was a secondary analysis of data from a randomized trial of an ED-based intervention. The self-report and administrative CCI were compared using the intraclass correlation coefficient (ICC). Factors examined for effect on agreement included health service utilization, age, and sex. The predictive validity of the indices was compared using subsequent health services utilization and functional decline as outcomes. Participants (n=520) were recruited at four university-affiliated Montreal hospitals. Eligibility criteria included 65 years of age or older, able to speak English or French, and discharged to the community. RESULTS: Agreement between the two sources was poor to fair (overall weighted ICC 0.43 [95% confidence interval [CI]: 0.40, 0.47]). The predictive validity was similar for the two indices (area under the receiver-operating characteristic curve 0.51-0.66, depending on the outcomes). CONCLUSION: Agreement between self-report and administrative comorbidity data is only poor to fair but both have comparable predictive validity.