Dental health and school-based health education among 15-year-olds in Tehran, Iran

The aim of the present study was to assess dental health and its determinants among 15-year-olds in Tehran, Iran and to evaluate the impact of a school-based educational intervention on their oral cleanliness and gingival health. The total sample comprised 506 students. Data collection was performed through a clinical dental examination and a self-administered structured questionnaire. This questionnaire covered the student s background information, socio-economic status, self-perceived dental health, tooth-brushing, and smoking. The clinical dental examination covered caries experience, gingival status, dental plaque status, and orthodontic treatment needs. Participation was voluntary, and all students responded to the questionnaire. Only three students refused the clinical dental examination. The intervention was based on exposing students to dental health education through a leaflet and a videotape designed for the present study. The outcome examinations took place 12 weeks after the baseline among the three groups of the intervention trial (leaflet, videotape, and control). High participation rates at the baseline and scanty drop-outs (7%) in the intervention speak for reliability of the results. Mean value of the DMFT (D=decayed, M=missing, and F=filled teeth) index of the 15-year-olds was 2.1, which comprised DT=0.9, MT=0.2, and FT=1.0 with no gender differences. Dental plaque existed on at least one index tooth of all students, and healthy periodontium (Community Periodontal Index=0) was found in less than 10% of students. Need for caries treatment existed in 40% of students, for scaling in 24%, for oral hygiene instructions in all, and for orthodontic treatment in 26%. Students with the highest level of parents education had fewer dental caries (36% vs. 48%) and less dental plaque (77% vs. 88%). Of all students, 78% assessed their dental health as good or better. Even more of those with their DMFT=0 (73% vs. 27%) and DT=0 (68% vs. 32%) assessed their dental health as good or better. Smokers comprised 5% of the boys and 2% of the girls. Smoking was common among students of less-educated parents (6% vs. 3%). Of all students, 26% reported twice-daily tooth-brushing; girls (38% vs. 15%) and those of higher socio-economic background (33% vs. 17%) did so more frequently. The best predictors for a good level of oral cleanliness were female gender or twice-daily tooth-brushing. The present study demonstrated that a school-based educational intervention can be effective in the short term in improving the oral cleanliness and gingival health of adolescents. At least 50% reduction in numbers of teeth with dental plaque compared to baseline was achieved by 58% of the students in the leaflet group, by 37% in the videotape group, and by 10% of the controls. Corresponding figures for gingival bleeding were 72%, 64%, and 30%. For improving the oral cleanliness and gingival health of adolescents in countries such as Iran with a developing oral health system, school-based educational intervention should be established with focus on oral self-care and oral health education messages. Emphasizing the immediate gains from good oral hygiene, such as fresh breath, clean teeth, and attractive appearance should be key aspects for motivating these adolescents to learn and maintain good dental health, whilst in planning school-based dental health intervention, special attention should be given to boys and those with lower socio-economic status. Author s address: Reza Yazdani, Department of Oral Public Health, Institute of Dentistry, University of Helsinki, P.O. Box 41, FI-00014 Helsinki, Finland. E-mail: reza.yazdani@helsinki.fi

Modelling the manager: Representing rule-based management in farming systems simulation models

We trace the evolution of the representation of management in cropping and grazing systems models, from fixed annual schedules of identical actions in single paddocks toward flexible scripts of rules. Attempts to define higher-level organizing concepts in management policies, and to analyse them to identify optimal plans, have focussed on questions relating to grazing management owing to its inherent complexity. “Rule templates” assist the re-use of complex management scripts by bundling commonly-used collections of rules with an interface through which key parameters can be input by a simulation builder. Standard issues relating to parameter estimation and uncertainty apply to management sub-models and need to be addressed. Techniques for embodying farmers' expectations and plans for the future within modelling analyses need to be further developed, especially better linking planning- and rule-based approaches to farm management and analysing the ways that managers can learn.

Report of the Study Group on “Ecosystem-Based Management Science and its application to the North Pacific”

EXECUTIVE SUMMARY INTRODUCTION OVERVIEW OF INTERNATIONAL EBM HISTORY References CANADA Overview Activities to date Integrated Management implementation in Canada Objectives, indicators and reference points Assessment approaches Research directions for the future Management directions for the future References JAPAN Overview Conservation and sustainable use of marine living resources Harvest control by TAC system Stock Recovery Plan and effort regulation system Stock enhancement by hatchery-produced juvenile release Conservation and sustainable develop-ment on coastal waters The implementation of ecosystem-based management PEOPLE’S REPUBLIC OF CHINA Overview Current actions Output control Input control Summer fishing ban Enhance ecosystem health REPUBLIC OF KOREA Initiatives and actions of ecosystem-based management in Korea Current ecosystem-based management initiatives in Korea Precautionary TAC-based fishery management Closed fishing season/areas Fish size- and sex-controls Fishing gear design restrictions Marine protected areas (MPA) RUSSIA Existing and anticipated ecosystem-based management initiatives Issues related to the implementation of ecosystem-based management UNITED STATES OF AMERICA Definitions and approaches to ecosystem-based fishery management in the United States Present U.S. legislative mandates relating to ecosystem-based fishery management Target species Bycatch species Threatened or endangered species Habitats Food webs Ecosystems Integration of legislative mandates into an ecosystem approach Scientific issues in implementing ecosystem-based approaches References DISCUSSION AND RECOMMENDATIONS APPENDICES Appendix 10.1 Study group membership and participants Appendix 10.2 Terminology definitions Appendix 10.3 Present state of implementing ecosystem-based fishery management in Alaska: Alaska groundfish fisheries Appendix 10.4 Present state of implementing ecosystem-based fishery management off the West Coast of the United States: Pacific Coast groundfish fisheries Appendix 10.5 Descriptions of multi-species and ecosystem models developed or under development in the U.S. North Pacific region that might be used to predict effects of fishing on ecosystems Appendix 10.6 A potential standard reporting format (developed by Australia, and currently being used by the U.S.A in their contribution to this report) (83 page document)

Multiple stable reference points in oyster populations: implications for reference point-based management

In the second of two companion articles, a 54-year time series for the oyster population in the New Jersey waters of Delaware Bay is analyzed to examine how the presence of multiple stable states affects reference-point–based management. Multiple stable states are described by four types of reference points. Type I is the carrying capacity for the stable state: each has associated with it a type-II reference point wherein surplus production reaches a local maximum. Type-II reference points are separated by an intermediate surplus production low (type III). Two stable states establish a type-IV reference point, a point-of-no-return that impedes recovery to the higher stable state. The type-II to type-III differential in surplus production is a measure of the difficulty of rebuilding the population and the sensitivity of the population to collapse at high abundance. Surplus production projections show that the abundances defining the four types of reference points are relatively stable over a wide range of uncertainties in recruitment and mortality rates. The surplus production values associated with type-II and type-III reference points are much more uncertain. Thus, biomass goals are more easily established than fishing mortality rates for oyster population

Ecosystem-based Management for Protected Species in the North Pacific Fisheries

In the North Pacific Ocean, an ecosystem-based fishery management approach has been adopted. A significant objective of this approach is to reduce interactions between fishery-related activities and protected species. We review management measures developed by the North Pacific Fishery Management Council and the National Marine Fisheries Service to reduce effects of the groundfish fisheries off Alaska on marine mammals and seabirds, while continuing to provide economic opportunities for fishery participants. Direct measures have been taken to mitigate known fishery impacts, and precautionary measures have been taken for species with potential (but no documented) interactions with the groundfish fisheries. Area closures limit disturbance to marine mammals at rookeries and haulouts, protect sensitive benthic habitat, and reduce potential competition for prey resources. Temporal and spatial dispersion of catches reduce the localized impact of fishery removals. Seabird avoidance measures have been implemented through collaboration with fishery participants and have been highly successful in reducing seabird bycatch. Finally, a comprehensive observer monitoring program provides data on the location and extent of bycatch of marine mammals and seabirds. These measures provide managers with the flexibility to adapt to changes in the status of protected species and evolving conditions in the fisheries. This review should be useful to fishery managers as an example of an ecosystem-based approach to protected species management that is adaptive and accounts for multiple objectives.

HACCP based management system for improving quality of freshwater giant prawn, Macrobrachium rosenbergii

The study was conducted on the present status of HACCP based quality management system of golda, Macrobrachium rosenbergii farms in Fulpur region of Mymensingh. Information was collected on general condition of farms, culture systems and post-harvest quality management. In almost all farms, there is no or inadequate infrastructure facilities such as, road access, electric supply, telecommunications, ice, feed storage facility, vehicle for golda transportation, washing and toilet facilities. The problems associated with sanitation and hygiene was: widespread use of cow dung, poultry manure and construction of open toilet within the vicinity of prawn culture pond. Different grades of commercially available and locally prepared feeds were used for golda culture in the pond. Golda post-larvae (PL) of 40-50 days old were stocked with carp species. The price of golda PL ranged from Tk. 1.00 to Tk. 1.25/piece. The pond size varied from 50 decimal (0.2 ha) to 2.5 acre (1.0 ha) with an average depth of 2-2.5 m. The culture period of golda varied from April-May to November-December and survival rate ranged between 75 and 80%. Production of golda varied from 250-500 kg/acre (625-1,250 kg/ha). Harvested golda were transported to city market within 4 h. Two size grading were generally followed during pricing, e.g. Tk. 500 to 550/kg for >100 g size and Tk. 300/kg for <100 g size. The cost-benefit ratio was found to remain around 1:1.25 depending on availability of PL. Water quality parameters such as, water temperature, pH, dissolved oxygen, total alkalinity and chlorophyll a in five golda farms in Fulpur region were monitored. Water temperature ranged from 29°C to 33°C, dissolved oxygen from 2.28 to 4.13 mg/l, pH between 6.65 and 7.94, alkalinity from 44 to 70 mg/l and chlorophyll a concentration from 61.88 to 102.34 µg/l in the five investigated ponds. The Aerobic Plate Count (APC) of the water sample was within the range of 2.0x10^6 - 2.96x10^7 CFU/ml and of soil samples within the range of 6.9x10^6 - 7.73x10^6 CFU/g. Streptococcus sp., Bacillus sp., Escherichia coli, Staphylococcus sp., Pseudomonas sp. and Salmonella sp. were isolated from pond water and sediment. Different feed samples used for golda was analyzed for proximate composition. Moisture content ranged around 14.14-21.22%, crude protein 20.55-44.1%, lipid 4.67-12.54% and ash 9.7-27.69%. The TVB-N values and peroxide values of feeds used as starter, grower and fish meal were found within the acceptable ranges and samples were free from pathogenic organisms. A training was organized for the golda farmers on HACCP, water quality and post-harvest quality management of prawn.

Self-management education for cystic fibrosis

Background: Self-management education may help patients with cystic fibrosis and their families to choose, monitor and adjust treatment requirements for their illness, and also to manage the effects of illness on their lives. Although self-management education interventions have been developed for cystic fibrosis, no previous systematic review of the evidence of effectiveness of these interventions has been conducted. Objectives: To assess the effects of self-management education interventions on improving health outcomes for patients with cystic fibrosis and their caregivers. Search methods: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register (date of the last search: 22 August 2013). We also searched databases through EBSCO (CINAHL; Psychological and Behavioural Sciences Collection; PsychInfo; SocINDEX) and Elsevier (Embase) and handsearched relevant journals and conference proceedings (date of the last searches: 01 February 2014 ). Selection criteria: Randomised controlled trials, quasi-randomised controlled trials or controlled clinical trials comparing different types of self-management education for cystic fibrosis or comparing self-management education with standard care or no intervention. Data collection and analysis: Two authors assessed trial eligibility and risk of bias. Three authors extracted data. Main results: Four trials (involving a total of 269 participants) were included. The participants were children with cystic fibrosis and their parents or caregivers in three trials and adults with cystic fibrosis in one trial. The trials compared four different self-management education interventions versus standard treatment: (1) a training programme for managing cystic fibrosis in general; (2) education specific to aerosol and airway clearance treatments; (3) disease-specific nutrition education; and (4) general and disease-specific nutrition education. Training children to manage cystic fibrosis in general had no statistically significant effects on weight after six to eight weeks, mean difference -7.74 lb (i.e. 3.51 kg) (95% confidence interval -35.18 to 19.70). General and disease-specific nutrition education for adults had no statistically significant effects on: pulmonary function (forced expiratory volume at one second), mean difference -5.00 % (95% confidence interval -18.10 to 8.10) at six months and mean difference -5.50 % (95% confidence interval -18.46 to 7.46) at 12 months; or weight, mean difference - 0.70 kg (95% confidence interval -6.58 to 5.18) at six months and mean difference -0.70 kg (95% confidence interval -6.62 to 5.22) at 12 months; or dietary fat intake scores, mean difference 1.60 (85% confidence interval -2.90 to 6.10) at six months and mean difference 0.20 (95% confidence interval -4.08 to 4.48) at 12 months. There is some limited evidence to suggest that self-management education may improve knowledge in patients with cystic fibrosis but not in parents or caregivers. There is also some limited evidence to suggest that self-management education may result in positively changing a small number of behaviours in both patients and caregivers. Authors' conclusions: The available evidence from this review is of insufficient quantity and quality to draw any firm conclusions about the effects of self-management education for cystic fibrosis. Further trials are needed to investigate the effects of self-management education on a range of clinical and behavioural outcomes in children, adolescents and adults with cystic fibrosis and their caregivers.

Comparative analysis European wide marine ecosystem shifts - a large scale approach for developing the basis for ecosystem-based management

Abrupt and rapid ecosystem shifts (where major reorganizations of food-web and community structures occur), commonly termed regime shifts, are changes between contrasting and persisting states of ecosystem structure and function. These shifts have been increasingly reported for exploited marine ecosystems around the world from the North Pacific to the North Atlantic. Understanding the drivers and mechanisms leading to marine ecosystem shifts is crucial in developing adaptive management strategies to achieve sustainable exploitation of marine ecosystems. An international workshop on a comparative approach to analysing these marine ecosystem shifts was held at Hamburg University, Institute for Hydrobiology and Fisheries Science, Germany on 1-3 November 2010. Twenty-seven scientists from 14 countries attended the meeting, representing specialists from seven marine regions, including the Baltic Sea, the North Sea, the Barents Sea, the Black Sea, the Mediterranean Sea, the Bay of Biscay and the Scotian Shelf off the Canadian East coast. The goal of the workshop was to conduct the first large-scale comparison of marine ecosystem regime shifts across multiple regional areas, in order to support the development of ecosystem-based management strategies.

Enhancing the Global Ocean Observing System to meet evidence based needs for the ecosystem-based management of coastal ecosystem services

Ecosystem-based approaches (EBAs) to managing anthropogenic pressures on ecosystems, adapting to changes in ecosystem states (indicators of ecosystem health), and mitigating the impacts of state changes on ecosystem services are needed for sustainable development. EBAs are informed by integrated ecosystem assessments (IEAs) that must be compiled and updated frequently for EBAs to be effective. Frequently updated IEAs depend on the sustained provision of data and information on pressures, state changes, and impacts of state changes on services. Nowhere is this truer than in the coastal zone, where people and ecosystem services are concentrated and where anthropogenic pressures converge. This study identifies the essential indicator variables required for the sustained provision of frequently updated IEAs, and offers an approach to establishing a global network of coastal observations within the framework of the Global Ocean Observing System. The need for and challenges of capacity-building are highlighted, and examples are given of current programmes that could contribute to the implementation of a coastal ocean observing system of systems on a global scale. This illustrates the need for new approaches to ocean governance that can achieve coordinated integration of existing programmes and technologies as a first step towards this goal.