Parity & untreated dental caries in US women.

While parity (number of children) reportedly is related to tooth loss, the relationship between parity and dental caries has not been extensively investigated. We used path analysis to test a theoretical model that specified that parity influences dental caries levels through dental care, psycho- social factors, and dental health damaging behaviors in 2635 women selected from the NHANES III dataset. We found that while increased parity was not associated with a greater level of total caries (DFS), parity was related to untreated dental caries (DS). The mechanisms by which parity is related to caries, however, remain undefined. Further investigation is warranted to determine if disparities in dental caries among women are due to differences in parity and the likely changes that parallel these reproductive choices.

Recommendations for research and public policy in gambling studies.

The purpose of this article is to respond to and expand on the ideas presented by Father McGowan in The Ethics of Gambling Research: An Agenda for Mature Analysis. We provide specific recommendations for future research and public policy in the field of gambling studies. We suggest that key conceptual definitions--such as, problem, compulsive, and pathological gambling--should be clarified, established, and distinguished from one another before gambling research is conducted. Proper methodological procedures are recommended, where power analyses, pilot studies, and representative samples are appropriately conducted and analyzed. Retrospective and Prospective studies are considered and differentiated while Discrete Time Event History Analysis--namely, Life Tables Analysis and Discrete Time Logistic Regression--are proposed.

The neglected half of Alzheimer disease: cognitive and functional concomitants of severe dementia.

OBJECTIVE: Traditional mental status and psychometric assessments bottom out in the late stages of Alzheimer disease (AD). A method adapted from cognitive testing in infants, the Ordinal Scales of Psychological Development was modified (M-OSPD) and applied to a severely demented population. The concurrent validity of this method was tested in comparison with Functional Assessment Staging (FAST). Internal consistency as a measure for reliability was also determined. DESIGN: Cross sectional study. SETTING: Subjects were generally evaluated in their residence, usually a nursing home or a private home. PATIENTS: Severely cognitively impaired subjects who fulfilled criteria for probable AD were studied. MEASUREMENTS: Evaluation consisted of clinical global, mental status, functional, and cognitive assessments including the Global Deterioration Scale (GDS) and the Mini-Mental State Examination (MMSE). RESULTS: Seventy patients were evaluated. Traditional mental status assessments (eg, the MMSE) manifested virtually uniform bottom scores in all GDS stage 7 subjects (n = 46), and GDS stage 6 subjects had MMSE scores within one standard deviation unit of zero. In contrast, the M-OSPD scale continued to show results in the last stages of the disease. The Spearman correlation coefficient between the M-OSPD total score and the 11 FAST substages represented in this sample was -0.77 (P < 0.001). CONCLUSIONS: The results indicate that patients who are functionally more impaired also show continuing increments in cognitive loss. These cognitive and functional assessments for measuring the magnitude of deterioration in AD can be applied to the estimated half-million nursing home residents presently labeled "untestable" with the goal of optimization of care and residual capacities.