Law as a Tool in “the War on Obesity”: Useful Interventions, Maybe, But, First, What’s the Problem?

Law as a Tool in “The War on Obesity”: Useful Interventions, Maybe, But, First, What’s the Problem?

J Law Med Ethics. 2013 Mar; 41(1): 28-41
Bogart WA

This article explores the effectiveness of legal interventions to promote healthier eating/drinking and exercise in responding to obesity. Undue emphasis on weight loss and prevention of excess gain have largely been failures and have fueled prejudice against fat people. A major challenge lies in shifting norms: away from stigmatization of the obese and towards more nutritious eating/drinking and increased activity with acceptance of bodies in all shapes and sizes. Part of the enormity of this challenge lies in the complex effects of law and its relationship with norms, including unintended consequences of regulation. To illustrate such complications, the paper examines two interventions and the actual effects that they have produced (or could under differing conditions): junk food taxes, particularly on SSBs (sugar sweetened beverages), and restriction of advertising to children, especially the ban in Quebec. HubMed – eating


Adapting and testing the oral impacts on daily performances among adults and elderly in Brazil.

Gerodontology. 2013 Apr 14;
Abegg C, Fontanive VN, Tsakos G, Davoglio RS, de Oliveira MM

OBJECTIVES: To cross-culturally adapt and evaluate the psychometric properties of the oral impact on daily performance (OIDP) in Brazilians aged 50-74 years; to test the impact of oral health on ‘work’ and ‘vigorous physical activity’. BACKGROUND: Clinical oral health indicators do not assess the perceived impact of oral health on people’s lives. METHODS: The study was performed through small group interviews, pilot studies and a main study with 200 people aged 50 and over. Data were collected through interviews in health centres. RESULTS: For content validity, ‘eating’ (1.00, p < 0.001) and 'speaking' (0.96, p < 0.001) obtained the highest level of agreement among experts. For criterion and construct validity, there was an inverse correlation between self-rated oral health, perceived oral treatment needs and satisfaction with oral health and OIDP score. Cronbach's alpha coefficient varied from 0.69 to 0.67 when 'work' and 'vigorous physical activities' were deleted. Test-retest reliability was 0.69 (ICC). CONCLUSION: The validation process showed that the Brazilian OIDP has the necessary basic psychometric properties to be used in the 50-74 years age group in Brazil. 'Work' and 'vigorous physical activities' had low impact on oral health. The activity 'vigorous physical activities' was not maintained in the instrument because of its low impact, while 'work' was maintained due of the increase in the 50-59 years age group in the Brazilian population. HubMed – eating


Comparison of adverse effects between lingual and labial orthodontic treatment.

Angle Orthod. 2013 Apr 12;
Long H, Zhou Y, Pyakurel U, Liao L, Jian F, Xue J, Ye N, Yang X, Wang Y, Lai W

Abstract Objective: To compare adverse effects between labial and lingual orthodontic treatments through a systematic review of the literature. Materials and Methods: The protocol of this systematic review (CRD42012002455) was registered in the International Prospective Register of Systematic Reviews (PROSPERO). An electronic search was conducted in PubMed, Embase, Web of Science, CENTRAL, SIGLE, ProQuest Dissertations & Theses, and for articles published between January 1980 and December 2012. Primary outcomes included pain and caries; secondary outcomes were eating difficulty, speech difficulty, oral hygiene, and treatment duration. Meta-analyses were conducted in Comprehensive Meta-Analysis version 2.2.064. Results: Six studies were included, two randomized controlled trials and four clinical controlled trials; of these, four were medium quality and two were low quality in terms of the risk of bias. Five of the six outcomes were evaluated in the included studies, and treatment duration was not; pain, eating difficulty, speech difficulty were statistically pooled. Meta-analysis revealed that the pooled odds ratios were 1.20 (95% confidence interval [CI] ?=? 0.30-4.87) for overall pain, 32.24 (95% CI ?=? 14.13-73.55) for pain in tongue, 0.08 (95% CI ?=? 0.04-0.18) for pain in cheek, 0.11 (95% CI ?=? 0.03-0.42) for pain in lip, 3.59 (95% CI ?=? 1.85-6.99) for eating difficulty, and 8.61 (95% CI ?=? 3.55-20.89) for speech difficulty. Sensitivity analysis showed consistent results except for eating difficulty. No publication bias was detected. Conclusions: The likelihood of overall pain was similar between the two modalities. Patients who underwent lingual orthodontic treatment were more likely to suffer from pain in the tongue and less likely to suffer from pain in the cheek and lip. Lingual orthodontic treatment increased the likelihood of speech difficulty. Eating difficulty, oral hygiene, caries, and treatment duration could not be compared in this systematic review. HubMed – eating


Management of swallowing difficulties in people with advanced dementia.

Nurs Older People. 2013 Mar; 25(2): 26-31
Parker M, Power D

Problems with eating and swallowing are recognised as features of advancing dementia and may be a sign that the person is entering the terminal phase of illness. Such problems cause considerable concern and anxiety among family members, carers and health professionals. They also raise moral and ethical issues about artificial nutrition and the emotional and practical aspects of end of life care. This article discusses the eating and swallowing difficulties that may present in people with advanced dementia and multidisciplinary best practice in their management. It also explores how families, carers and care home staff can be supported in making best interest decisions about artificial nutrition and end of life care for people with advanced dementia. HubMed – eating