scholarly journals How effective and cost-effective is water fluoridation for adults? Protocol for a 10-year retrospective cohort study

BDJ Open ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Deborah Moore ◽  
Thomas Allen ◽  
Stephen Birch ◽  
Martin Tickle ◽  
Tanya Walsh ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cost Effectiveness ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Dental Treatment ◽  
Age Groups ◽  
Cost Effective ◽  
Tooth Decay ◽  
Service Utilisation ◽  
Water Fluoridation

Abstract Background Tooth decay can cause pain, sleepless nights and loss of productive workdays. Fluoridation of drinking water was identified in the 1940s as a cost-effective method of prevention. In the mid-1970s, fluoride toothpastes became widely available. Since then, in high-income countries the prevalence of tooth decay in children has reduced whilst natural tooth retention in older age groups has increased. Most water fluoridation research was carried out before these dramatic changes in fluoride availability and oral health. Furthermore, there is a paucity of evidence in adults. The aim of this study is to assess the clinical and cost-effectiveness of water fluoridation in preventing invasive dental treatment in adults and adolescents aged over 12. Methods/design Retrospective cohort study using 10 years of routinely available dental treatment data. Individuals exposed to water fluoridation will be identified by sampled water fluoride concentration linked to place of residence. Outcomes will be based on the number of invasive dental treatments received per participant (fillings, extractions, root canal treatments). A generalised linear model with clustering by local authority area will be used for analysis. The model will include area level propensity scores and individual-level covariates. The economic evaluation will focus on (1) cost-effectiveness as assessed by the water fluoridation mean cost per invasive treatment avoided and (2) a return on investment from the public sector perspective, capturing the change in cost of dental service utilisation resulting from investment in water fluoridation. Discussions There is a well-recognised need for contemporary evidence regarding the effectiveness and cost-effectiveness of water fluoridation, particularly for adults. The absence of such evidence for all age groups may lead to an underestimation of the potential benefits of a population-wide, rather than targeted, fluoride delivery programme. This study will utilise a pragmatic design to address the information needs of policy makers in a timely manner.

scholarly journals Tele-expertise for diagnosis of skin lesions is cost-effective in a prison setting: A retrospective cohort study of 450 patients

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0204545 ◽  
Author(s):  
Kevin Zarca ◽  
Nathanael Charrier ◽  
Emmanuel Mahé ◽  
Fabien Guibal ◽  
Béatrice Carton ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Cost Effective ◽  
Skin Lesions ◽  
Prison Setting

scholarly journals Trends in self-poisoning and psychotropic drug use in people aged 5–19 years: a population-based retrospective cohort study in Australia

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e026001 ◽  
Author(s):  
Rose Cairns ◽  
Emily A Karanges ◽  
Anselm Wong ◽  
Jared A Brown ◽  
Jeff Robinson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Age Groups ◽  
Cohort Effect ◽  
Population Based ◽  
Psychotropic Medicine ◽  
Increased Risk ◽  
Self Harm

ObjectivesTo characterise trends in self-poisoning and psychotropic medicine use in young Australians.DesignPopulation-based retrospective cohort study.SettingCalls taken by the New South Wales and Victorian Poisons Information Centres (2006–2016, accounting for 70% of Australian poisoning calls); medicine dispensings in the 10% sample of Australian Pharmaceutical Benefits Scheme data (July 2012 to June 2016).ParticipantsPeople aged 5–19 years.Main outcome measuresYearly trends in intentional poisoning exposure calls, substances taken in intentional poisonings, a prevalence of psychotropic use (dispensing of antidepressants, antipsychotics, benzodiazepines and medicines for attention deficit hyperactivity disorder (ADHD)).ResultsThere were 33 501 intentional poisonings in people aged 5–19 years, with an increase of 8.39% per year (95% CI 6.08% to 10.74%, p<0.0001), with a 98% increase overall, 2006–2016. This effect was driven by increased poisonings in those born after 1997, suggesting a birth cohort effect. Females outnumbered males 3:1. Substances most commonly taken in self-poisonings were paracetamol, ibuprofen, fluoxetine, ethanol, quetiapine, paracetamol/opioid combinations, sertraline and escitalopram. Psychotropic dispensing also increased, with selective serotonin reuptake inhibitors (SSRIs) increasing 40% and 35% July 2012 to June 2016 in those aged 5–14 and 15–19, respectively. Fluoxetine was the most dispensed SSRI. Antipsychotics increased by 13% and 10%, while ADHD medication dispensing increased by 16% and 10%, in those aged 5–14 and 15–19, respectively. Conversely, dispensing of benzodiazepines to these age groups decreased by 4% and 5%, respectively.ConclusionsOur results signal a generation that is increasingly engaging in self-harm and is increasingly prescribed psychotropic medications. These findings indicate growing mental distress in this cohort. Since people who self-harm are at increased risk of suicide later in life, these results may foretell future increases in suicide rates in Australia.

Age- and sex-related differences in the presentation of paediatric migraine: A retrospective cohort study

Cephalalgia ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 1107-1118 ◽  
Author(s):  
Sophie Louise Wilcox ◽  
Allison Marra Ludwick ◽  
Alyssa Lebel ◽  
David Borsook
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Age Groups ◽  
Marked Change ◽  
Neural Basis ◽  
Clinical Exam ◽  
Associated Symptoms ◽  
Headache Clinic ◽  
Age And Sex

Introduction Although migraine is a common headache complaint in children and adolescents there remains a significant gap in understanding the unique aspects of the disease in these age groups and their evolution with development. The aim of this retrospective cohort study was to identify migraine features that are influenced by age and sex. Methods The headache characteristics of 359 paediatric patients with a clinical diagnosis of migraine from a tertiary paediatric headache clinic were assessed. Patients retrospectively reported headache characteristics during a structured intake interview and clinical exam. Headache characteristics, description and associated symptoms were compared between children (age ≤ 12 years) and adolescents (age > 12 years), and between male and female migraineurs. Results Several migraine features differed significantly with age and/or sex, including: (i) a marked change from a 1:1 sex ratio in children to a 2:1 predominance of girls in adolescents; (ii) a higher frequency of headache attacks per month in adolescents and female migraineurs; (iii) a higher proportion of adolescents endorsed a ‘throbbing’ pain quality; (iv) a higher proportion of children reporting nausea and vomiting; and (v) a higher proportion of adolescents, particularly female migraineurs, had a diagnosis of a co-morbid anxiety. Conclusion The presentation of migraine, both in terms of its headache characteristics and associated symptoms, appear to vary as a function of age and sex. Given that migraine symptoms have a neural basis, it is not surprising that during the key period of neurodevelopment from childhood to adolescence this may impact their presentation.

Effect of Advanced Paternal Age on Reproductive Outcomes in IVF Cycles of Nonmale Factor Infertility: a Retrospective Cohort Study

2021 ◽  
Author(s):  
Xinmei Lu ◽  
Yubing Liu ◽  
Xiang Cao ◽  
Doudou Zhang ◽  
Tiancheng Zhang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Multiple Pregnancy ◽  
Age Groups ◽  
Paternal Age ◽  
Semen Parameters ◽  
Miscarriage Rate ◽  
Vitro Fertilization

Abstract Background: Female age over 35 years has been considered a determinant factor and increases the risk of infertility. However, paternal age has been virtually ignored, and its potential role is still poorly investigated. There is no current consensus on the effects of paternal age on assisted reproductive technology（ART）outcomes. Methods: In total, 381 in vitro fertilization (IVF) cycles of nonmale factor infertility (paternal age <35 y in 261 cycles, 35– 39 y in 72 cycles and ≥ 40 y in 48 cycles) were involved in this retrospective cohort study. Maternal age was controlled at under 35 years old. Embryo quality, clinical and neonatal outcomes were compared.Results: Among different paternal age groups, fertilization rate and high-quality embryos were not significantly different (P> 0.05). Compared with the <35 y group, pregnancy rate was not significantly different in the 35–39 y group (P> 0.05), but significantly lower in the ≥ 40 y group(P < 0.05). Additionally, we found a statistically significantly lower implantation rate for men aged ≥40 years (18.8%) compared to the group of men aged <35 years (31.1%) and men aged 35-39 years (30.0%) (P <0.05). A declining trend in the live birth rate (30.6%, 21.7%, and 19.6%) was noted in the subgroups of paternal age (<35 y, 35-39 y, and ≥40 y) (P >0.05). The miscarriage rate was significantly higher in the 35–39 y (44.8%) than that in the <35 y group (21.0%)(P <0.05). While in the oldest group of paternal age ≥ 40 y, although miscarriage rate increased but not significantly different (P >0.05). There were no significant differences in the preterm birth or multiple pregnancy rates among the different paternal age groups (P >0.05). Ectopic pregnancy was only found in the paternal age <35 y group. There was no abnormality in the birth weight of newborns among the different male age groups. Conclusion: Paternal age over 40 years is a key risk factor that influences the ART success rate even with good semen parameters, though has no impact on embryo development.

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