Preliminary phonological analysis of the Limi dialect of Humla Bhotia

The purpose of this research was to analyse the phonological system of the Limi dialect of Humla Bhotia. Humla Bhotia is a Tibeto-Burman language that is spoken by approximately 4000 5000 people in the far northwestern Humla province of the Kingdom of Nepal. The language has not previously been the subject of analysis. The data base for this thesis was collected on two different dialects of Humla Bhotia in Kathmandu, the capital of Nepal, from February to May 2000. I had three language informants who speak Humla Bhotia as their mother tongue. One of the informants speaks the Upper Humla dialect and the other two informants speak the Limi dialect. In this thesis I have concentrated on the phonology of the dialect of Limi but occasionally I also make reference to the Upper Humla dialect. The Limi data base consists of 600 words elicited in isolation, sentences where words have been checked for consonantal and pitch variation, and five texts comprising 117 sentences. Firstly, I have studied the geographical location, population and dialects of Humla Bhotia. Five dialects were identified: Limi, Upper Humla, La Yakba, Nyinba and Humli Khyampa. Information on the dialect areas is based on the accounts of seven mother tongue speakers of the language and on Nancy Levine s (1988) anthropological research of the ethnic group Nyinba. Secondly, I have analysed the phonological system of Limi from the viewpoint of American stucturalism much along the lines followed by Pike 1966 [1947] ja 1967 [1948]. In defining the prosodic elements I have also used acoustic analysis. In the Limi dialect there are 7 vowel phonemes. No vowel clusters occur within the same syllable. In this preliminary analysis 29 contrastive plosives, 8 affricates and 5 6 fricatives were found. The data also revealed 4 nasal phonemes, two rhotic phonemes, one lateral phoneme and two central approximants. Further research is however called for to check the phonemic status of these segments. Four contrastive prosodic elements were encountered: nasalisation, length, phonation type and pitch movement. There are two contrastive types of phonation: tense and lax. Many words were found with a third type of phonation, modal phonation. How modal phonation relates to the prosodic system is unclear at this stage and is therefore left for further research to determine. There are two contrastive pitch movement tonemes: a rising toneme and falling toneme. The falling toneme occurs in free variation with a level pitch contour. Rising appears to be linked with lax phonation and falling with tense phonation.

Impact of dental insurance on adults’ oral health care in Tehran, Iran.

The aim of the present study was to determine relationships between insurance status and utilization of oral health care and its characteristics and to identify factors related to insured patients’ selection of dental clinic or dentist. The study was based on cross-sectional data obtained through phone interviews. The target population included adults in the city of Tehran. Using a two-stage stratified random technique, 3,200 seven-digit numbers resembling real phone numbers were drawn; when calling, 1,669 numbers were unavailable (busy, no answer, fax, line blocked). Of the 1,531 subjects who answered the phone call, 224 were outside the target age (under 18), and 221 refused to respond, leaving 1,086 subjects in the final sample. The interviews were carried out using a structured questionnaire and covered characteristics of dental visits, the respondent’s reason for selecting a particular dentist or clinic and demographic and socio-economic background (gender, age, level of education, income, and insurance status). Data analysis included the Chi-square test, ANOVA, and logistic regression and the corresponding odds ratios (OR). Of all the 1,086 respondents, 57% were women, 62% were under age 35, 46% had a medium and 34% a high level of education, 13% were under the poverty line, and 70% had insurance coverage; 64% with the public, and 6% with a commercial insurance. Having insurance coverage was more likely for women (OR=1.5), for those in the oldest age group (OR=2.0), and for those with a high level of education (OR=2.5). Of those with dental insurance, 54% reported having had a dental visit within the past 12 months ; more often by those with commercial insurance in comparison with public (65% vs. 53% p<0.001). Check-up as the reason for the most recent visit occurred most frequently among those with commercial insurance (28%) compared with those having public insurance (16%) or being non-insured (13%) (p<0.001). Having had two or more dental visits within the past 12 months was most common among insured respondents, when compared with the non-insured (31% vs. 22% p=0.01). The non-insured respondents reported tooth extractions almost twice as frequently as did the insured ones (p<0.001). Of the 726 insured subjects, 60% selected fully out-of-pocket-paid services (FOP), and 53% were unaware of their insurance benefits. Of those who selected FOP, good interpersonal aspects (OR=4.6), being unaware of dental insurance benefits (OR=4.6), and good technical aspects (OR=2.3) as a reason had greater odds of selecting FOP. The present study revealed that dental insurance was positively related to demand for oral health care as well as to utilization of services, but to the latter with a minor extent. Among insured respondents, despite their opportunity to use fully or highly subsidized oral health care services, good interpersonal relationship and high quality of services were the most important factors when an insured patient selected a dentist or a clinic. The present findings indicate a clear need to modify dental insurance systems in Iran to facilitate optimal use of oral health care services to maximize the oral health of the population. A special emphasis in the insurance schemes should be focused on preventive care.