Feasibility and costs of water fluoridation in remote Australian Aboriginal communities

Background: Fluoridation of public water supplies remains the key potential strategy for prevention of dental caries. The water supplies of many remote Indigenous communities do not contain adequate levels of natural fluoride. The small and dispersed nature of communities presents challenges for the provision of fluoridation infrastructure and until recently smaller settlements were considered unfavourable for cost-effective water fluoridation. Technological advances in water treatment and fluoridation are resulting in new and more cost-effective water fluoridation options and recent cost analyses support water fluoridation for communities of less than 1,000 people.Methods: Small scale fluoridation plants were installed in two remote Northern Territory communities in early 2004. Fluoride levels in community water supplies were expected to be monitored by local staff and by a remote electronic system. Site visits were undertaken by project investigators at commissioning and approximately two years later. Interviews were conducted with key informants and documentation pertaining to costs of the plants and operational reports were reviewed.Results: The fluoridation plants were operational for about 80% of the trial period. A number of technical features that interfered with plant operation were identified and addressed though redesign. Management systems and the attitudes and capacity of operational staff also impacted on the effective functioning of the plants. Capital costs for the wider implementation of these plants in remote communities is estimated at about $US94,000 with recurrent annual costs of$US11,800 per unit.Conclusion: Operational issues during the trial indicate the need for effective management systems, including policy and funding responsibility. Reliable manufacturers and suppliers of equipment should be identified and contractual agreements should provide for ongoing technical assistance. Water fluoridation units should be considered as a potential priority component of health related infrastructure in at least the larger remote Indigenous communities which have inadequate levels of natural fluoride and high levels of dental caries

Comparison evaluation of Curcumin(Curcuma longa extract)with the application of expressed breast milk in the treatment of nipple cracks in lactating primiparous women: A randomized clinical trial

زمینه و هدف: شقاق پستان مشکل شایعی در زنان شیرده می باشد که می تواند باعث قطع زودهنگام شیردهی گردد. زردچوبه یکی از قدیمی ترین گیاهان دارویی است که به دلیل دارا بودن کورکومین، اثر ترمیم کننده روی زخم ها دارد. این مطالعه با هدف تعیین تأثیر عصاره آبی الکلی کورکومین و مقایسه آن با باقی گذاردن قطره شیر مادر در درمان شقاق پستان انجام گردید. روش بررسی: پژوهش حاضر به صورت کارآزمایی بالینی تصادفی در سال 1392 بر روی زنان نخست زای مراجعه کننده به مراکز بهداشتی غرب اهواز انجام گردید. 88 مادر شیرده مبتلا به شقاق پستان، به شکل تصادفی به دو گروه مساوی درمان با کورکومین و گروه باقی گذاردن قطره شیر مادر تقسیم شدند. به منظور بررسی روند بهبود زخم و عوارض جانبی کورکومین، قبل ازدرمان، روز سوم و روز هفتم پس از شروع درمان، مقیاس استور توسط پژوهشگر تکمیل گردید. یافته ها: قبل از مطالعه و همچنین در روز هفتم تفاوت معنی دار بین میانگین نمره شقاق پستان در دو گروه مشاهده نشد؛ اما در روز سوم میانگین نمره شقاق در گروه کورکومین (267/0±761/)0 در مقایسه با گروه باقی گذاردن قطره شیر مادر (426/0±23/1) به طور معنی داری کمتر بود. همچنین اختلاف میانگین نمره شقاق قبل از درمان با روز سوم و همچنین با روز هفتم پس از شروع درمان، در هر دو گروه، معنی دار بود. نتیجه گیری: کورکومین و شیر مادر هر دو در درمان شقاق پستان موثر هستند؛ ولی باتوجه به عوارض جانبی محدود، فعالیت ضد میکروبی و اثر بیشتر کورکومین در کوتاه مدت، پیشنهاد می گردد از این دارو برای درمان شقاق پستان استفاده شود

Greedy Selfish Network Creation

We introduce and analyze greedy equilibria (GE) for the well-known model of selfish network creation by Fabrikant et al.[PODC'03]. GE are interesting for two reasons: (1) they model outcomes found by agents which prefer smooth adaptations over radical strategy-changes, (2) GE are outcomes found by agents which do not have enough computational resources to play optimally. In the model of Fabrikant et al. agents correspond to Internet Service Providers which buy network links to improve their quality of network usage. It is known that computing a best response in this model is NP-hard. Hence, poly-time agents are likely not to play optimally. But how good are networks created by such agents? We answer this question for very simple agents. Quite surprisingly, naive greedy play suffices to create remarkably stable networks. Specifically, we show that in the SUM version, where agents attempt to minimize their average distance to all other agents, GE capture Nash equilibria (NE) on trees and that any GE is in 3-approximate NE on general networks. For the latter we also provide a lower bound of 3/2 on the approximation ratio. For the MAX version, where agents attempt to minimize their maximum distance, we show that any GE-star is in 2-approximate NE and any GE-tree having larger diameter is in 6/5-approximate NE. Both bounds are tight. We contrast these positive results by providing a linear lower bound on the approximation ratio for the MAX version on general networks in GE. This result implies a locality gap of $\Omega(n)$ for the metric min-max facility location problem, where n is the number of clients.Comment: 28 pages, 8 figures. An extended abstract of this work was accepted at WINE'1

The Effect of Graduated Driver Licensing on Teen Driver Crash Involvement.

Purpose: The purpose of this dissertation was to answer the following questions: 1. What is the effect of each component of Graduated Driver Licensing (learner license duration, required hours of supervised driving, passenger restrictions and nighttime driving restrictions) on 16- and 17-year-old drivers’ fatal crash rates? 2. What is the effect of GDL on 18-year-old drivers’ crash rates, and what mechanisms might be responsible for any increase in rates? Method: To answer question 1, states that introduced a single GDL component, independent of other components were identified. The effect of the single GDL component on 16- and 17-year-old drivers fatal crashes was estimated using single-state time series analysis, adjusting for adult crashes and gas prices. To answer question 2, single-state time series analysis was used to estimate the effect of GDL on 16-, 17-, and 18-year-old drivers’ crashes in Florida and Michigan, where GDL applies to 15- to 17-year-old drivers, and in Maryland, where GDL applies to novice drivers of all ages, adjusting for adult crashes and gas prices. Results: A learner license period that guaranteed six-months delay in licensure to drive independently was associated with a significant decline in 16- and 17-year-old drivers’ fatal crash rates. In one state, novice drivers’ fatal crash rates increased 34.5% following the introduction of 30 hours of required supervised driving. A passenger restriction for the first 12 months of intermediate licensure was followed by a 46% reduction in fatal passenger crash rates that approached significance (p= .06). Nighttime driving restrictions, implemented alongside supervised driving hours, did not reduce fatal nighttime crashes. The introduction of GDL was followed by a significant increase in possible-injury/property-damage-only crashes among 18-year-old drivers in Michigan and by a significant decrease in possible-injury/property-damage-only crashes among 18-year-old drivers’ rates in Maryland. Conclusion: Some GDL components confer a safety benefit. However, the entire program is responsible for a greater reduction in crashes than the additive contribution of individual components. GDL programs applied exclusively to 16- and 17-year-old drivers may result in some teens not being licensed until age 18. Requiring all novice drivers to complete a GDL program is recommended.PHDHealth Behavior & Health EducationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/93997/1/jpehsani_1.pd

The Effect of Printed Educational Material from the Coroner in Victoria, Australia, on Changing Aged Care Health Professional Practice: A Subscriber Survey

There are substantial knowledge and research gaps about the effects of printed educational material on professional practice. This study has examined whether the Residential Aged Care Coronial (RACC) Communiqué, an electronic newsletter of narrative case reports about lessons learned from deaths in residential aged care settings reported to the coroner in Victoria, Australia, prompted subscribers to initiate change in professional practice to improve care. An anonymous electronic survey was distributed to all registered subscribers of the RACC Communiqué to collect information about self-reported changes in professional practice, respondent characteristics, reading behavior, and an assessment of effect and content of the publication. Researchers from the Victoria Institute of Forensic Medicine, Victoria, Australia, conducted the study in 2008. Of 778 subscribers invited to participate in the study, 426 (54.8%) provided valid responses. The majority of respondents were aged 45 and older, female, and working at a residential aged care facility in a management role. Half of the survey respondents reported making a change to their professional practice as a result of reading the RACC Communiqué, with one-fifth of these respondents agreeing that they would not have made the self-reported change if they had not read this publication. These findings are greater than the previously reported small effects of education through printed education material and make an important contribution to understanding the use of printed education material for initiating professional practice change.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79369/1/j.1532-5415.2010.02742.x.pd

Signal Transmission in the Auditory System

Contains table of contents for Section 3, an introduction, and reports on seven research projects.National Institutes of Health Grant 5 R01 DC00194National Institutes of Health Grant P01 DC00119National Institutes of Health Grant F32 DC00073National Institutes of Health Grant 5 R01 DC00473National Institutes of Health Grant 2 R01 DC00238National Institutes of Health Grant 2 R01 DC00235National Institutes of Health Grant 5 P01 DC00361National Institutes of Health Grant T32 DC00006Whitaker Health Sciences Fun

Genome-Scale Networks Link Neurodegenerative Disease Genes to α-Synuclein through Specific Molecular Pathways

Numerous genes and molecular pathways are implicated in neurodegenerative proteinopathies, but their inter-relationships are poorly understood. We systematically mapped molecular pathways underlying the toxicity of alpha-synuclein (α-syn), a protein central to Parkinson's disease. Genome-wide screens in yeast identified 332 genes that impact α-syn toxicity. To “humanize” this molecular network, we developed a computational method, TransposeNet. This integrates a Steiner prize-collecting approach with homology assignment through sequence, structure, and interaction topology. TransposeNet linked α-syn to multiple parkinsonism genes and druggable targets through perturbed protein trafficking and ER quality control as well as mRNA metabolism and translation. A calcium signaling hub linked these processes to perturbed mitochondrial quality control and function, metal ion transport, transcriptional regulation, and signal transduction. Parkinsonism gene interaction profiles spatially opposed in the network (ATP13A2/PARK9 and VPS35/PARK17) were highly distinct, and network relationships for specific genes (LRRK2/PARK8, ATXN2, and EIF4G1/PARK18) were confirmed in patient induced pluripotent stem cell (iPSC)-derived neurons. This cross-species platform connected diverse neurodegenerative genes to proteinopathy through specific mechanisms and may facilitate patient stratification for targeted therapy. Keywords: alpha-synuclein; iPS cell; Parkinson’s disease; stem cell; mRNA translation; RNA-binding protein; LRRK2; VPS35; vesicle trafficking; yeas