Changes in dental health investment across the adolescent years.

BACKGROUND: Studies investigating investment in health across the life course are lacking. The aim of this study was to examine investment in dental health across adolescence. METHODS: Changes in dental health investment, as measured by dental registration (months) between when adolescents were aged 11/12 years compared to when they were 15/16-years-old, were investigated using ordinary least squares (OLS) regressions. Adolescents aged 11 or 12 years in April 2003 in the Northern Ireland Longitudinal Study were included (n = 13,564). The overall change in registration and changes according to socio-economic status, highest educational attainment of household reference person, parental marital status, as well as the individuals' gender and number of siblings were examined. Within variable disparities at both age groups were also investigated. RESULTS: Average number of months registered with a dentist fell from 8.14 months (11/12 years old) to 7.38 months (15/16 years old) (p <0.001). No gender disparities existed when adolescents were aged 11/12 years but when adolescents were 15/16 years old, females had significantly higher registration than males (8.72 months:8.20 months; p <0.001). CONCLUSIONS: During the transition from childhood to adulthood, an individual's dental health may suffer as a result of a decline in registration rates with a dentist. This risk is likely to be greater among males than females. The role of children's services within dentistry should be reviewed.

Experience Sampling Methodology studies of depression: the state of the art.

BACKGROUND: Experience Sampling Methodology (ESM) is ideally suited to test the predictions, and inform the development of contemporary cognitive models of depression. Yet there has been no systematic examination of ESM in depression research. METHOD: A search of databases (PsychARTICLES, PsycINFO, AMED, Ovid Medline and CINAHL) was conducted to identify studies published within the last 25 years investigating major depressive disorder (MDD) using ESM. RESULTS: Altogether, 19 studies using ESM, or comparable methodologies, with clinically depressed individuals were identified and critically reviewed. The identified studies examined six aspects of MDD: methodological issues; positive and negative affect; cortisol secretion; antidepressant treatment; work performance; genetic risk factors. CONCLUSIONS: Despite some methodological limitations of existing studies, ESM has made a significant contribution to our current understanding of depression by consolidating existing theories, uncovering new and clinically relevant findings and identifying questions for future research. This review concludes by introducing the possibility of using ESM as an intervention tool in clinical practice and proposing that ESM could be useful for furthering knowledge of the causes of MDD.

The use of multiple sclerosis condition-specific measures to inform health policy decision-making: mapping from the MSWS-12 to the EQ-5D.

BACKGROUND: Walking impairment has a major influence on the quality of life of people with multiple sclerosis (MS). The Multiple Sclerosis Walking Scale (MSWS-12) assesses the impact of MS on walking ability from the patient's perspective, but in its current form, is not amenable for use in many policy decision-making settings. OBJECTIVES: Statistical 'mapping' methods were used to convert MSWS-12 scores to EQ-5D health state values. METHODS: The relationship between the measures was estimated using cohort data from people with MS in South West England. Regression analyses were conducted, estimation errors assessed, and predictive performance of the best models tested using longitudinal data. RESULTS: Model performance was in line with that of other mapping studies, with the best-performing models being an ordinary least squares (OLS) model using MSWS-12 item scores, and an OLS model using the total MSWS-12 score and its squared term. CONCLUSIONS: A process has been described whereby data from a patient-reported outcome measure (MSWS-12) can be converted to (EQ-5D) health state values. These values may be used to consider the health-related quality of life of people with MS, to estimate quality adjusted life-years for use in effectiveness and cost-effectiveness analyses, and to inform health policy decisions.