Rodrigo Mariño

Self‐reported and clinically determined oral health status predictors for quality of life in dentate older migrant adults

OBJECTIVE This paper reports the impact of oral health on the quality of life (QOL) of Southern European, dentate older adults, living independently in Melbourne, Australia. Participants were recruited through ethnic social clubs and interviewed about oral health, general health, socio-demographics, and QOL using the Medical Outcomes Study Short-Form 12 (SF-12). The SF-12s physical and mental health component summary scores (PCS and MCS, respectively) were computed. The Oral Health Impact Profile (OHIP-14) assessed the specific impact of oral health on QOL. Participants were also given a clinical oral examination. RESULTS A total of 603 eligible older adults volunteered; 308 were from Greek background and 295 were from Italian background. Mean age was 67.7 years (SD 6.2), with 63.7% being female. The PCS score had a mean value of 45.8 (SD 11.8), and MCS had a mean of 47.8 (SD 5.7). PCS was associated with, periodontal status, chronic health condition, self-perceived oral health needs, self-assessed oral health status, oral health impact score and the interaction between gender and level of education [F(11 552) = 10.57; P < 0.0001]. These independent variables accounted for 16% of the variance in PCS. The multivariate model predicting MCS had only one significant variable (self-reported gingival bleeding), explaining 1.5% of the variance. The OHIP-14 ranged from 0 to 48 with a mean score of 5.6 (SD 9.3). The model predicting OHIP-14 contained four significant variables: perceived oral health treatment needs, number of missing natural teeth, reports of having to sip liquid to help swallow food, and gender [F(4576) = 33.39; P < 0.0001], and explained 18% of the variance. The results demonstrated a negative association between oral health indicators and both the oral health-related QOL and the physical component of the SF-12. CONCLUSION The present findings support a growing recognition of the importance of oral health as a mediator of QOL. However, the self-selected sample and modest predictive power of the multivariate models suggest that further research is needed to expand this explanatory model.

Understanding the New Context of the Male Sex Work Industry

The article reviews past and recent research on male sex work to offer a context to understand violence in the industry. It provides a critical review of research to show, first, the assumptions made about male sex workers and violence and, second, how such discourses have shaped thinking on the topic. The article presents a case study and original findings from two studies conducted by the authors in Australia and Argentina on violence in the male sex industry. Finally, the article reviews examples of legislative reforms to show how the sex industry is being regulated.

Molar-incisor hypomineralisation: prevalence and defect characteristics in Iraqi children.

BACKGROUND.  Little prevalence data relating to molar incisor hypomineralisation (MIH) exist for Middle East populations. AIM.  To evaluate the prevalence and the clinical features of MIH in school-aged children residing in Mosul City, Iraq. DESIGN.  A cluster sample of 823 7- to 9-year-old children had their first permanent molars and incisors (index teeth) evaluated using the European Academy of Paediatric Dentistry (EAPD) criteria for MIH. The examinations were conducted at schools by a calibrated examiner. RESULTS.  Of the children examined, 177 (21.5%) had hypomineralisation defects in at least one index tooth, 153 (18.6%) had at least one affected first molar or first molars and incisors and were considered as having MIH. The most commonly affected teeth were maxillary molars. Demarcated creamy white opacities were the most frequent lesion type. Dental restorations and tooth extraction because of MIH were uncommon. Children with three or more affected teeth were 3.7 times more likely to have enamel breakdown when compared with those children having only one or two affected teeth. CONCLUSIONS.  Molar incisor hypomineralisation was common amongst Iraqi children. Demarcated opacities were more prevalent than breakdown. The severity of the lesions increased with the number of affected teeth. The more severe the defect, the greater the involved tooth surface area.

Male sex workers in three Australian cities: socio-demographic and sex work characteristics.

Abstract This article describes the socio-demographic and sex work characteristics of sex workers in Sydney, Melbourne, and Brisbane. A total of 185 male sex workers completed the questionnaire component of the study. The results of this study serve to debunk many of the myths surrounding the popular view of the male sex worker (MS W). The respondents in this study were on average 27 years old, and the majority had completed secondary education, with 30% having gained some form of tertiary qualification. Interestingly, those MSWs who had not completed secondary education were mostly street workers and were generally aged under 25 years. The majority of sex workers lived in rented accommodation, with only 6% reporting to be homeless. Half of all respondents identified as being “gay,” 31% as “bisexual” and 5.5% as “straight.” More than half of the respondents were in a permanent relationship. Only 7.3% of this group reported using heroin daily, although the majority consumed alcohol, tobacco, marijuana, and ecstasy. The majority of sex workers had been in the profession for less than six months, although some had been working in the industry for more than ten years. Most of the sex workers reported having taken an HIV test and a preference to offer safer sex. The article highlights ways in which the work context of MSW can be better understood and supported by education and public policy programs.

Prevalence of demarcated hypomineralisation defects in second primary molars in Iraqi children

BACKGROUND Demarcated hypomineralization lesions are not uncommon in second primary molars. Data on the prevalence of hypomineralized second primary molars (HSPM) are scarce. AIM To investigate the prevalence of HSPM, assess the relationship between HSPM and first permanent molars previously diagnosed with demarcated lesions and to determine the severity of HSPM in relation to dental caries severity. DESIGN A cluster sample of 809, 7- to 9-year-old children was examined. The scoring criteria proposed by the European Academy of Paediatric Dentistry for hypomineralization in permanent dentition were adapted to score HSPMs. The International Caries Detection and Assessment System was used to assess caries status in the second primary molar of the children diagnosed with demarcated defects. The examination was carried out in schools by a calibrated dentist. RESULTS Of the children examined, 53 (6.6%) had hypomineralization defects in at least one second primary molar. Combinations of affected first permanent and second primary molars were reported in 21 (39.6%) of cases. Severe carious lesions were found mostly in teeth with enamel breakdown. CONCLUSIONS The prevalence of HSPM was 6.6%. Over one-third of affected second primary molars were associated with demarcated lesions in the first permanent molars. The chance of severe caries increased with the increase in the demarcated lesion severity.

Commercial sex between men: A prospective diary‐based study

This paper describes the results of a self‐reporting dairy completed by 186 male sex workers (MSWs) over a 2‐week period in Brisbane, Sydney, and Melbourne, Australia. The diary was completed following each commercial sex encounter by the MSW. The results reveal that MSWs reported 2088 commercial sex encounters during the study period, with an average of 11.2 encounters per MSW. The majority of sex encounters took place in either the clients or the MSWs residence, with significant variations by city. The average sexual encounter lasted 70 minutes, and comprised two sexual acts, masturbation and oral sex. Condom use was reported in 67.4% of all the encounters. Using the AIDS Council safe‐sex classification system, the majority of the commercial sex encounters fell in the “safer sex” category; however, there were significant differences by source of clients and place of the encounter. Use of drugs and alcohol reveal interesting patterns: Clients were more likely to use alcohol, while MSWs had significant differences of usage of the different drugs. This study demonstrates that the majority of MSWs are offering and practicing safe sex behaviours, however, MSWs working in the street setting are still likely to be practising unsafe sex. Male sex work is becoming an organised business and this provides opportunities to implement further public health interventions.

Knowledge, risk perceptions and condom usage in male sex workers from three Australian cities

The study identifies factors associated with knowledge and perception of risk of HIV/AIDS, as well as attitudes to and usage of condoms by a sample of male sex workers (MSW). One hundred and eighty-five male sex workers completed a self-reported questionnaire, including knowledge about HIV transmission, attitudes to condom use and perceptions and personal susceptibility to HIV and sexually transmitted infection (STI) risk, and a two-week diary recording use of condom during commercial sex encounters. The findings reveal that condom use was found in 77.7% of the encounters with clients and the majority of the respondents perceived themselves to be at no risk for HIV because of sex work. Independent sex workers from Melbourne and workers who owned their place of residence used condoms in a significant lower proportion. Generally speaking, knowledge about the risks associated with AIDS was high, with respondents showing lower knowledge about the risks associated with unprotected receptive or active oral sex. Participants held a positive attitude to condom use; most considered the provisions of condoms to be their responsibility rather than clients; and they were more worried about contracting an STI than HIV. Those who scored higher on the knowledge scale had more positive attitudes to condom use and those who had a more positive attitude to condom use recorded a perceived lower risk of contracting STI but not HIV. The study discusses the relevance of these findings for public health risk reduction and sexual health education campaigns.

A profile of the clients of male sex workers in three Australian cities

Objective: This paper describes the profile of clients as reported by 186 male sex workers in three Australian cities.

Male sex workers in Córdoba, Argentina: sociodemographic characteristics and sex work experiences

OBJECTIVE To report on the sociodemographic characteristics and work experiences of 31 male sex workers (MSWs) in the city of Córdoba, Argentina. METHODS Information on each of the MSWs was collected using a questionnaire that covered his personal characteristics and his work background, self-assessed general health status, and use of health and social services. Scales were included in order to assess attitudes towards condom use, knowledge about safe sex, perceptions about the risk of getting HIV, individual self-efficacy, and locus of control. The questionnaire also asked each respondent to rank his level of agreement with interactive strategies for gaining client compliance with safe sex practices. RESULTS In terms of their self-identity, out of the 30 MSWs who answered the question, 10 of them (33.3%) self-identified as heterosexual and 9 (30%) as bisexual. Alcohol and drug consumption and unsafe sexual practices were relatively low among the MSWs. Of the 31 MSWs responding, 21 of them (67.7%) reported that they had been tested for HIV, but only 13 of them (41.9%) said they had been vaccinated for either hepatitis A or hepatitis B. A variety of differences were found between the studys 17 street sex workers (sex workers who offer their services in public places such as streets and parks) and the 14 independent sex workers (sex workers who are self-employed, advertise and manage their own business, and have an exclusive location for their commercial sex work). The street MSWs were younger and had less formal education. Independent MSWs were economically more settled, had been working longer in the sex industry, and were more comfortable about having sex with men. Independent MSWs were also more likely to report a gay sexual orientation and less likely to report using alcohol, marijuana, or other substances. CONCLUSIONS The differences between street MSWs and independent MSWs are important since they could influence the negotiating of safer sex practices with clients. Programs aimed at preventing the spread of HIV and other sexually transmitted infections and promoting responsible self-care among MSWs in Córdoba should be introduced. Such programs could increase the proportion of MSWs who know their HIV serostatus and could make MSWs more aware of the risk of different sex acts performed in commercial sex encounters. Given the differences that we found between street MSWs and independent MSWs, specific strategies and educational materials should be developed for those two subgroups within the MSW population.

A practical method for use in epidemiological studies on enamel hypomineralisation

Abstract With the development of the European Academy of Paediatric Dentistry (EAPD) judgment criteria, there has been increasing interest worldwide in investigation of the prevalence of demarcated opacities in tooth enamel substance, known as molar–incisor hypomineralisation (MIH). However, the lack of a standardised system for the purpose of recording MIH data in epidemiological surveys has contributed greatly to the wide variations in the reported prevalence between studies. The present publication describes the rationale, development, and content of a scoring method for MIH diagnosis in epidemiological studies as well as clinic- and hospital-based studies. The proposed grading method allows separate classification of demarcated hypomineralisation lesions and other enamel defects identical to MIH. It yields an informative description of the severity of MIH-affected teeth in terms of the stage of visible enamel destruction and the area of tooth surface affected (i.e. lesion clinical status and extent, respectively). In order to preserve the maximum amount of information from a clinical examination consistent with the need to permit direct comparisons between prevalence studies, two forms of the charting are proposed, a short form for simple screening surveys and a long form desirable for prospective, longitudinal observational research where aetiological factors in demarcated lesions are to be investigated in tandem with lesions distribution. Validation of the grading method is required, and its reliability and usefulness need to be tested in different age groups and different populations.