UNDERSTANDING THE PHENOMENON OF EARLY CHILDHOOD CARIES IN RURAL AND REMOTE CHILDREN IN NORTHERN SASKATCHEWAN: A REALIST SYNTHESIS
Bibliographic record
Abstract
Early childhood caries in preschool children is a growing public health concern in Canada. Children in Northern Saskatchewan experience poor oral health outcomes compared to those in the southern regions of the province (Inam, 2021; Saskatchewan Health Authority Oral Health Program, n.d.). Despite various efforts by the government and non-governmental organizations to address this problem, the situation is still a major public health concern. This study aims to understand the phenomenon of early childhood caries in rural and remote children in Northern Saskatchewan. While initially appearing as a straightforward phenomenon, it is, in fact, a complex systemic phenomenon. Therefore, this study employs a systems approach to realism to understand its complexity. Based on realist philosophy, I used realist synthesis, a theory-driven process that synthesizes evidence and aims to create a generative explanation for causation ‐ that is, an outcome (O) of interest was generated by relevant mechanism(s) (M) being triggered in various contexts (C). This study followed six iterative steps, including 1. initial program theory, 2. search strategy, 3. the selection and appraisal of documents, 4. data extraction, 5. analysis and synthesis of data, and 6. the dissemination of results. Through the iterative process of searching and data analysis, this realist synthesis developed an initial program theory, identified some potential mechanisms (parents' perceived values, prioritization and beliefs, self-efficacy, stress, depression, trust, anxiety, fear of being judged, and losing their child to social service, perceived food value, effects of colonialism in their beliefs, confidence, and empowerment) at the individual and community levels, and designed a multilayer conceptual map showing a hierarchy of different level mechanisms, and their interactions with each other in influencing the existence of early childhood caries in rural and remote children in Northern Saskatchewan based on available data. The mechanisms identified and hypothesized in this realist synthesis are based on secondary data that will need to be tested with the community in future research aimed to refine or refute this initial program theory.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.024 | 0.024 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.012 | 0.012 |
| Science and technology studies | 0.004 | 0.007 |
| Scholarly communication | 0.009 | 0.004 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".