Scientific Abstracts Submitted
AIDS Conspiracy Theory, Race/ethnicity and Participation in Biomedical Research
S.L. RUSSELL, NYU College of Dentistry, New York, NY, USA, R.V. KATZ, New York University, USA, R. LEE, New York University College of Dentistry, USA, N. KRESSIN, VA Medical Center, Bedford, MA, USA, C. CLAUDIO, University of Puerto Rico-MSC, San Juan, USA, B.L. GREEN, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA, and M.Q. WANG, University of Maryland at Baltimore School of Public Health, College Park, USA
The need to include racial and ethnic minorities in biomedical research studies requires identification of obstacles that would block the achievement of this goal, and is critical for reducing health disparities in the U.S. Some investigations have reported that racial and ethnic minorities are more likely than Whites to report belief in AIDS/HIV "conspiracy theories." Purpose: 1) To examine whether the "conspiracy theory" that AIDS/HIV "is the result of government plan to intentionally kill a certain group of people " varies by race/ethnicity, and 2) to determine if this belief is related to likelihood of, and fear of, participation in biomedical research studies. Methods: The Tuskegee Legacy Project (TLP) Questionnaire was administered via a telephone interview to 353 adult Blacks, 157 Hispanics and 623 Whites in four areas (Birmingham, AL; Tuskegee, AL; Hartford, CT; San Antonio, TX). Results: Blacks and Hispanics were more likely than Whites to report that it was "very" or "somewhat likely" that AIDS/HIV "was the result of a government plan to intentionally kill a certain group of people" (Blacks 27.8% vs. Hispanics 23.6% vs. Whites 8.0%; Chi-square=71.4, df=2, p 0.001). The racial/ethnic differences persisted when controlling for demographic differences between groups, with Blacks more than three times and Hispanics more than twice as likely as Whites to report such beliefs (ORadj Blacks 3.2, 95%CI 2.3, 4.4 and ORadj Hispanics 2.5, 95%CI 1.6, 3.8). We found that this belief was a weak, although significant, independent predictor of 1) likelihood of participation for Whites only, and 2) fear of participation in Hispanics only. Conclusions: Blacks and Hispanics, compared to Whites, were more likely to report a belief that AIDS/HIV was likely "the result of an intentional government plan to kill a certain group of people," and having such a belief was related to likelihood of participation in Whites only, and to fear of participation in Hispanics only. Supported by NIDCR grants: P50 DE10592, U54 DE014257, T32 DE007255.
‚ Relating Hispanic Cephalometric Facial Profiles to American Blacks and Whites
E.R. RICHARDSON, Center For the Study of Human Growth and Development, Nashville, TN, USA
There are three major cephalometric atlases of facial growth in the United States, i.e. The Bolton Atlas, Riolo et al on whites and Richardson's on Americans of African descent. Hispanics are the fastest growing segment of the American population and largest minority group. Current radiation hygiene standards prevent doing an atlas of facial growth on Hispanics. Objectives: (1) The cephalometric facial profile of Hispanic children is compared to that of both Americans of African and European descent. And (2) to stimulate further study of facial profiles in Hispanics. Methods: Lateral cephalograms of none treated Hispanic children were collected from six orthodontic offices in Nashville. There were 18 girls and 14 boys ages 10-14 years. The measurements taken were SNA, SNB, SNPog. Graphs, tables and statistics (t-test and anova) were used to analyze the data. The data on Hispanics were compared to that on African Americans and European Americans. Results: SNA - Males, no significant difference in Hispanics, Blacks and Cleveland whites, larger than Ann Arbor whites. - Females, no significant difference in Blacks and Cleveland whites, larger than Ann Arbor whites. SNB - Males, closer to Blacks and Cleveland whites...larger than Ann Arbor whites. - Females, closer to Blacks and Ann Arbor whites SNPog - Males, closer to whites - Females, closer to Blacks and Ann Arbor whites. Conclusions: The profile of Hispanic females is closer to that of African Americans while the male SNA is closer to African Americans but the SNB-SNPog relationship is closer to European Americans. The mouth area is fuller than European Americans but not quite as full as in African Americans. The profile of Hispanics reflect the impact of growing up in a warm climate. Further study is needed on this large segment of the U.S. population. Study was supported in part by USPH grant #DE 02862.
ƒ Oral Health Experience of Transitory Horse Racetrack Adults and Children
L.M. KASTE1, K.J. OPACICH2, N. COLOVOS3, R. DHAKE3, A. CLANCY4, and P.J. GOETSCH5, 1University of Illinois at Chicago, USA, 2University of Illinois - Rockford, USA, 3Northwest Community Healthcare, Arlington Heights, IL, USA, 4Illinois Department of Public Health, Chicago, USA, 5Racing Industry Charitable Foundation Clinic, Arlington Park, IL, USA
Objectives: Horse racetrack workers are increasingly Hispanic. Essentially no health status literature exists on them or their families. This paper presents self-reported oral health care utilization information for adults employed at the racetrack and their children. Methods: A June 2006 health assessment on a racetrack backstretch outside Chicago included participation incentives such as access during the workday, prizes, feedback on health, and personal identification only for consenting. Within the oral health assessment, in English or Spanish, were three BRFSS questions on oral health care utilization. Results: 334 individual attended oral health screenings. 88% completed questionnaires in Spanish. 25% were children older than 3 years. 73% of the children visited a dentist <1 year, while 47% of the adults did (p<.001). 18% of children and 14% of adults had never been to the dentist. Permanent teeth were removed due to disease for 7% of children and 43% of adults (p<.001). While 56% of children and 38% of adults reported having their teeth cleaned <1 year, 37% of children and 24% of adults never had their teeth cleaned (p<.001). Conclusion: Although the state mandates schoolchildren have oral health examinations, assurance must be made that this applies to transitory workforce populations, including provision of treatment and prevention services. Contrasts with county BRFSS Hispanic adult data are dramatic: 67% were to a dentist within 1 year (2004) and 67% had teeth cleaned within 1 year (2003). Adult dental care utilization may reflect prioritization, knowledge and barriers conveyed to their children. Issues concerning documentation and confidentiality provided limitations for both investigators and participants. These data will help plan services and develop hypotheses for future research. 5P20MD000524-04, National Center of Minority Health and Health Disparities, NIH.
„ Barriers to Oral Health Care for Chicago Mexican-American Children
A.M. VARGAS, I. PUNWANI, A. KOERBER, and S. FADAVI, University of Illinois - Chicago, USA
Objectives: To identify barriers to oral health care for Chicago Latino children attending a public medical clinic with no dental clinic. Methods: A survey developed to identify medical care barriers among Latinos was modified to address pediatric oral health care barriers, and was administered aloud in Spanish by two Latinas to 101 Latino parents of children under age 12 attending a public clinic. It consisted of 81 multiple-choice and open-ended questions. Results: Parents (91% Mexican-American or Mexican) reported 17% of their children had not been seen by a dentist in over a year. Parents identified as barriers to children's past oral health care: lack of insurance (42%), inability to afford care (39%), inconvenient office hours (36%), long waiting times (25%), difficulty making an appointment (21%), language (21%), distance (19%) and transportation (18%). 15% of parents felt that lack of cultural understanding among dental personnel was a factor. Only 5% noted immigration issues. Those parents who reported difficulties speaking English (66%) also reported adverse consequences to language barriers for their children: 17% felt their child had received poor oral health care and 8% felt their child had received inappropriate treatment as a result of language. None reported a child medicated or hospitalized because of language barrier. These Chicago Latino parents reported more insurance and expense issues, and fewer language and culture issues concerning oral health care than other Latino parents in other areas reported concerning medical care. The difficulty getting appointments may be related to dentists' limiting numbers of Medicaid patients.A sizable minority of parents noted cultural and language difficulties resulting in poor care. Conclusions: Policies to reduce barriers should focus primarily on coverage and dentist acceptance issues for oral health care for Chicago Latino children, but as access improves, cultural and language difficulties may become more prominent.
… Knowledge and Attitudes of Dental Students Towards HIV Infection and AIDS
JUAN F. YEPES, DDS, MD, MPH; MALHAR JHAVERI,, MBBS, MPH; ANDREW HOELLEIN, MD, MS, University of Kentucky Colleges of Dentistry, Medicine and Public Health
Objective: To determine the knowledge and attitude of dental students of University of Kentucky regarding HIV/AIDS. Materials and Methods: Anonymous surveys were distributed to medical students during the spring of 2007. To measure attitudes, students were asked to use a 5-point Likert scale to rate their agreement of statements related to HIV testing, treatment of patients with HIV and healthcare workers with HIV. Multiple choice questions were used to assess student knowledge of HIV. Linear regression and correlation was conducted on individual items to identify possible predictors of attitudes. Results: The overall response rate was 70%. There is no significant difference among gender (p >0.05). 80% of the students agree to do HIV test in a high risk group, while only 35% agree do in all patients in general. Average Knowledge score of all students is 72%. Knowledge about Universal precautions is better as compared to general HIV knowledge (p<0.05). Among general characteristics, significant predictors of attitudes and knowledge are race (p=0.003) and year of curriculum (p=0.0086) respectively. Correlation between knowledge and attitudinal questions is not statistically significant (p>0.05), but those who have a higher knowledge of HIV are less likely to worry about contracting HIV from a patient at some point in his/her career. Conclusions: Some weakness exist in dental students attitudes towards HIV, so evaluation of curriculum content regarding HIV play a crucial role in improving the knowledge of HIV and attitudes of future dental professionals towards HIV persons.
† Relationship of Caries Risk Factors in Hispanic Mothers and Children
C. R. RAMIREZ, E. ESPARZA, L. M. CARDENAS, University of Texas Health Science Center San Antonio, USA
Dental caries continues to be the most prevalent disease of children. According to the Surgeon General, underserved populations are at high risk for caries. Hispanic children are more likely than African-American and Non-Hispanic whites to suffer from this preventable disease. It is estimated that Hispanics will be the largest minority group in the U.S. by 2020. Yet the oral health profile of Hispanics is incomplete due to insufficient sampling of subgroups in national surveys. Purpose: This project surveyed the oral health profile of Hispanic mother's and their children in an underserved community health clinic. Associations between selective cariogenic risk factors in the mother and her child were also explored. Methods: Fifty Hispanic mothers and their young children presenting for the child's initial dental visit participated in this study. Clinical exam including determination of selective risk factors was performed. Streptococcus mutants (SM) and Lactobacilli (LB) growth was determined. Demographics and general oral health data was collected through a survey given to the mothers. Results: Twenty six percent of the mother:child pairs had high counts of both SM & LB. All children that had caries had mothers with high bacterial counts. There was an association between caries risk factors in the mother, measured by SM & LB levels, dmft and DMFT and oral hygiene practices, among others. Conclusion: The results of this study suggest an association between the oral health of Hispanic mothers and their children. Based on the research findings, educating Hispanic mothers on improving their oral health may help lower the caries risk of her child.
‡ Comparative Neural Differentiation of Orofacial and Iliac Marrow Stromal Cells
M. VELASCO, M. DAMEK-POPRAWA, and S.O. AKINTOYE, University of Pennsylvania School of Dental Medicine, Philadelphia, USA
Objectives: Multipotent properties of orofacial (maxilla/mandible) bone marrow stromal cells (OFMSCs) make them ideal donor tissues for craniofacial stem cell-based therapies. Although OFMSCs arise embryologically from neural crest, they display more superior osteogenic properties than iliac crest bone marrow stromal cells (ICMSCs) that arise from mesoderm. Since skeletal site-specific neural differentiation of bone marrow stromal cells is unclear, we hypothesized that neural crest-derived OFMSCs can readily differentiate into neural tissues and are superior donor cells for neural tissue regeneration than ICMSCs. Methods: Using an institutional review board-approved protocol, multicolony human OFMSCs and ICMSCs from 25 year-old female volunteer were expanded in -MEM (Minimum Essential Medium) supplemented with 100 U/ml penicillin, 100 mg/ml streptomycin, 2 mM glutamine and 20% fetal calf serum. Early passage cells sub-cultured in poly-D-lysine coated dishes were pre-induced with10 ng/ml bFGF for 24 hours followed by 12 hour culture in neural induction medium composed of -MEM, 2% DMSO, 10 ng/ml bFGF, 100 M butylated hydroxylanisole, 10 M forskolin, 25 mM KCl, 2 nM valproic acid and 5 g/ml insulin. Parallel control cells were not induced. Markers of neural differentiation were assessed by immunostaining with antibodies to SOX-2, nestin, musashi, 3-tubulin, glial fibrilar acidic protein (GFAP), and oligodendrocyte (O-1). After 24hr neural induction, mRNA was isolated to assess gene transcripts of musashi and 3-tubulin via Real-Time PCR. Results: Relative to control, SOX-2 and GFAP were undetectable in all three cell types after neural induction. Immunostaining of early (nestin, musashi) and late (3- tubulin, O-1) neural markers were comparatively (2-3x) higher in OFMSCs than ICMSCs. OFMSCs gene transcripts of musashi and 3-tubulin were triple and double those of ICMSCs respectively. Conclusions: OFMSCs can differentiate much more readily to neural tissue than ICMSCs. OFMSCs are potentially good donor cells for neural tissue regeneration compared to ICMSCs. (Supported by DHHS/NIH/NCI grant 5K08CA120875-02)
ˆ Conceptualization of Dental Problems and Care Seeking Among Latino Immigrant Caregivers of Young Children
KRISTIN S. HOEFT, University of California- San Francisco, ERIN E. MASTERSON, University of California- San Francisco, JUDITH C. BARKER, University of California- San Francisco.
Objective: This study examined Latino immigrant caregivers' perceptions of and behaviors surrounding early childhood caries in their children aged 1-5 years. Methods: In urban San Jose, CA, a convenience sample of 50 Latino caregivers of young children provided in-depth qualitative interviews in Spanish about their beliefs and experiences surrounding their children's oral health. Transcripts were independently read and thematically analyzed by researchers using NVivo software. Results: The most common reason for a child's first dental visit is a parent-noticed problem (24%), followed closely by pediatrician recommendation (18%), school requirement (18%), having an older sibling already going to the dentist (17%), and parental decision for a checkup or cleaning (17%). The age of first visit averaged 2.6-2.8 years except when prompted by "school requirement" (average age 4.1). Symptoms such as tooth discoloration or disintegration, pain, swelling or trauma alert parents to their child's need for professional dental attention. Parents consider children with 4+ or large carious lesions as having dental "problems." Once caries are completely treated by a dentist, a child with "problems" transitions back to "good teeth." Conclusion: Parents' recognition and conception of dental problems affect care seeking behavior, including initiating about 24% of first dental visits. Other major determinants in timing of first dental exam are pediatricians, schools, older siblings, and parent initiative.
‰ Acceptability and Preferences for Early Childhood Caries Preventive Treatments
S.H. ADAMS, S. HYDE, and S.H. HUSTING, University of California - San Francisco, USA
Determining treatment acceptability (TA) may assist in healthcare planning, resource allocation, implementation, and identifying treatment preferences (TP) among efficacious preventive dental treatments. Objective: Determine parent/caregiver TA and TP of 5 preventive dental treatments for early childhood caries (ECC) in young Hispanic children. Methods: We developed an acceptability interview to evaluate TA of five treatments: three for children- tooth brushing with fluoride toothpaste, fluoride varnish, and xylitol in food; and two for mothers- xylitol gum and chlorhexidine rinse. The assessment included presentation of: illustrated cards describing treatment with a verbal explanation; picture/video clip; and product samples. Parent/caregivers in Head Start (N=211) completed the interview, rated TA of each treatment (1-5 scale) and TP in each of 10 possible pairs. TP were summed to create overall preference (range 0-4). Participants provided open-ended explanations for their choices within each pair. Results: We found that while each treatment was highly acceptable (means ranged 4.6-4.9), the Friedman two-way Rank Test showed that there were significant differences (Chi-Square = 23.4, p. < 001). Chlorhexidine, tooth brushing, and fluoride varnish were most acceptable, not different from each other, but more acceptable than xylitol gum or xylitol in food (p<.01). Summed TP revealed greater variability (means ranged 1.4-2.6; Friedman Rank Test, Chi-Square = 128.2, p. < .001). Fluoride varnish and brushing were preferred 1.8 times more than gum, 1.7 times more than xylitol in food, and 1.2 times more than chlorhexidine (all p < .001). Conclusions: All 5 treatments were highly acceptable, however when choosing among treatments in pairs, overall, fluoride varnish and tooth brushing were favored over other treatments. These results may be useful in planning preventive treatment programs for young children in Hispanic communities.