Maternal and Child Health Library

This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.

June 1, 2007

1. MANUAL PROVIDES GUIDANCE IN USING MOBILE VEHICLES AND PORTABLE EQUIPMENT TO DELIVER ORAL HEALTH SERVICES

Mobile-Portable Dental Manual is an online reference tool that focuses on using public health approaches to create health care systems to serve populations that have difficulty accessing the traditional system of oral health service delivery. The manual was launched by the Association of State and Territorial Dental Directors and the National Maternal and Child Oral Health Resource Center with support from the Health Resources and Services Administration's Maternal and Child Health Bureau. Cross-references and links to the companion reference tool, Safety Net Dental Clinic Manual, provide basic principles of designing, staffing, operating, and financing oral health care services, regardless of the type of delivery system used. Chapter content, presented in a question-and-answer format, helps to guide decisions about using mobile vehicles, portable equipment, or a combination system. Links to other Web sites and resources, practical tips, photos and floor plans, lists of equipment and vehicle manufacturers, examples of existing programs, and references are included. The Mobile-Portable Dental Manual is available at http://www.mobile-portabledentalmanual.com. The companion Safety Net Dental Clinic Manual is available at http://www.dentalclinicmanual.com.

• The fluctuation of resources (i.e., receiving money from wages and government benefits at the beginning of the month, and then dealing with dwindling resources later in the month) affects family food purchase and consumption, resulting in unstable eating patterns and unhealthy eating.
• Government benefits -- while providing families with critical economic resources -- also create conditions for economic fluctuations that drive the monthly food cycle. These fluctuations affect families' shopping practices and eating habits.
• Families often rely on neighborhood bodegas, where they have relationships with the owners, who allow families to take credit toward the end of the month, when resources are particularly scarce. This means that families consume the processed and high-fat foods available from bodegas as part of their regular diet when resources diminish.
• In many cases, having children with more than one father in one household introduces opportunities for overeating, poor dietary choices, and strife around food, since interactions with fathers often happen around food, and the foods they bring into households tend to be less healthy.
• Feeding children, often in less-healthy ways, is a strategy by which adults please children. The heavier, gratified bodies of their children, in turn, gratify adults, who see their children as safe, satisfied, and aesthetically pleasing.

• The percentage of very-low-birthweight infants born in hospitals with high-level and high-volume NICUs decreased from 35.6% in 1991 to 21.5% in 2000.
• There was wide variation in unadjusted infant mortality rates among NICU level-of-care and volume groups. Mortality decreased as volume increased within each level of care and with higher levels of care within each volume group.
• The risk of death was significantly higher among very-low-birthweight infants born in hospitals with lower-level and lower-volume NICUs, compared with those born in hospitals with higher-level and higher-volume NICUs. The odds ratios decreased as volume increased within each level of care and as the level of care increased within each volume group.