Erosive tooth wear in children.

Erosive tooth wear in children is a common condition. Besides the anatomical differences between deciduous and permanent teeth, additional histological differences may influence their susceptibility to dissolution. Considering laboratory studies alone, it is not clear whether deciduous teeth are more liable to erosive wear than permanent teeth. However, results from epidemiological studies imply that the primary dentition is less wear resistant than permanent teeth, possibly due to the overlapping of erosion with mechanical forces (like attrition or abrasion). Although low severity of tooth wear in children does not cause a significant impact on their quality of life, early erosive damage to their permanent teeth may compromise their dentition for their entire lifetime and require extensive restorative procedures. Therefore, early diagnosis of erosive wear and adequate preventive measures are important. Knowledge on the aetiological factors of erosive wear is a prerequisite for preventive strategies. Like in adults, extrinsic and intrinsic factors, or a combination of them, are possible reasons for erosive tooth wear in children and adolescents. Several factors directly related to erosive tooth wear in children are presently discussed, such as socio-economic aspects, gastroesophageal reflux or vomiting, and intake of some medicaments, as well as behavioural factors such as unusual eating and drinking habits. Additionally, frequent and excessive consumption of erosive foodstuffs and drinks are of importance.

After Bali: WTO Rules Applying to Public Food Reserves

Once more, agriculture threatened to prevent all progress in multilateral trade rule-making at the Ninth WTO Ministerial Conference in December 2013. But this time, the “magic of Bali” worked. After the clock had been stopped mainly because of the food security file, the ministers adopted a comprehensive package of decisions and declarations mainly in respect of development issues. Five are about agriculture. Decision 38 on Public Stockholding for Food Security Purposes contains a “peace clause” which will now be shielding certain stockpile programmes from subsidy complaints in formal litigation. This article provides contextual background and analyses this decision from a legal perspective. It finds that, at best, Decision 38 provides a starting point for a WTO Work Programme for food security, for review at the Eleventh Ministerial Conference which will probably take place in 2017. At worst, it may unduly widen the limited window for government-financed competition existing under present rules in the WTO Agreement on Agriculture – yet without increasing global food security or even guaranteeing that no subsidy claims will be launched, or entertained, under the WTO dispute settlement mechanism. Hence, the Work Programme should find more coherence between farm support and socio-economic and trade objectives when it comes to stockpiles. This also encompasses a review of the present WTO rules applying to other forms of food reserves and to regional or “virtual” stockpiles. Another “low hanging fruit” would be a decision to exempt food aid purchases from export restrictions.

Sectio caesarea: actual controversy

Caesarean section is one of the most frequently performed operations in human medicine. It has become a routine procedure with a very low morbidity and mortality. Over the centuries, it has emerged an essential achievement in obstetric medicine. In the presence of cephalo-pelvic-disproportion, cervical dystocia, malpresentation, preterm birth, macrosomia, placental insufficiency, placenta praevia or fetal distress it is crucial to improve the perinatal morbiditiy and mortality of mother and child. The procedure has become much more frequent over the past 20 years for multiple reasons. There is variety in incidence between countries but also regional differences. It's occurrence is being influenced by level of education and socio-economic status of the pregnant woman. In the meantime, also the longterm consequences of cesarean section are well known. The potential hazards for future pregnancies and deliveries are well described. Actual controversy addresses cesarean section on demand without any medical indication, which in fact is only seldom performed in Switzerland. The ethical justification of this procedure needs to be discussed in view of the current tendency towards autonomy and self-determination of the pregnant woman.

Resilient Adaptation to Climate Change in African Agriculture

Africa’s agriculture faces varying climate change impacts which mainly worsen production conditions and adversely affect its economies. Adaptations thus need to build the resilience of farming systems. Using “resilient adaptation” as a concept, this study analyses how adaptations at farm and policy/institutional-levels contribute to the resilience of Sub-Saharan African agriculture. The developed tool, “the Resilience Check”, provides socio-economic data which complements existing adaptation tools. The underlying development gaps such as insecure property rights, poverty, low self-organisation, inadequate climate data and infrastructure limit resilient adaptations. If farmers could implement recommended practices, existing measures and improved crops can address most impacts expected in the medium-term. However, resource use efficiency remains critical for all farm management types. Development-oriented adaptation measures are needed to provide the robust foundations for building resilience. Reaching the very poor remains a challenge and the externally driven nature of many interventions raises concern about their sustainability. The study recommends practical measures such as decentralising various services and integrating the action plans of the multilateral environmental agreements into one national action plan.

Irrigation development in Eritrea: potentials and constraints: Proceedings of the workshop of AEAS and SLM Programme Eritrea

Development of irrigation, which is of crucial importance in Eritrea, is perceived by many as the main technique for improving the precarious food security situation in this Sahelian country in the Horn of Africa. The present publication presents the outcome of a nationwide workshop held in 2003, which brought together administrators, scientists, and members of public development agencies and NGOs. These workshop participants presented experiences, lessons learnt, and ideas about how to move forward in relation to development of irrigation in Eritrea. Specifically, the publication deals with the following broad themes, lessons learnt, and experiences in Eritrea: · spate irrigation systems and measurement of performance, as well as experience with modernisation of spate irrigation systems in Eritrea · small-scale irrigation systems and their potentials and pitfalls, including development of low-cost micro irrigation · climate and irrigation, including rainfall forecasts · socio-economic aspects of irrigation, including gender questions, institutional requirements, and irrigation and livelihoods The publication contains an extensive summary in the Tigrinya language, in order to facilitate access to the key findings by local non-English-speaking stakeholders in irrigation development.

How the Euro divides the union: the effect of economic adjustment on support for democracy in Europe

As often pointed out in the literature on the European debt crisis, the policy programme of austerity and internal devaluation imposed on countries in the Eurozone's periphery exhibits a lack of democratic legitimacy. This article analyses the consequences these developments have for democratic support at both the European and national levels. We show that through the policies of economic adjustment, a majority of citizens in crisis countries has become ‘detached’ from their democratic political system. By cutting loose the Eurozone's periphery from the rest of Europe in terms of democratic legitimacy, the Euro has divided the union, instead of uniting it as foreseen by its architects. Our results are based on aggregated Eurobarometer surveys conducted in 28 European Union (EU) member states between 2002 and 2014. We employ quantitative time-series cross-sectional regression analyses. Moreover, we estimate the causal effect of economic adjustment in a comparative case study of four cases using the synthetic control method.

Impact of a communication strategy on family satisfaction in the intensive care unit.

BACKGROUND Family satisfaction of critically ill patients has gained increased interest as important indicator to evaluate the quality of care in the intensive care unit (ICU). The family satisfaction in the ICU questionnaire (FS-ICU 24) is a well-established tool to assess satisfaction in such settings. We tested the hypothesis that an intervention, aiming at improved communication between health professionals and patients' next of kin in the ICU improves family satisfaction, as assessed by FS-ICU 24. METHODS Using a multicenter before-and-after study design, we evaluated medium-term effectiveness of VALUE, a recently proposed strategy aiming at improved communication. Satisfaction was assessed using the FS-ICU 24 questionnaire. Performance-importance plots were generated in order to identify items highly correlated with overall satisfaction but with low individual score. RESULTS A total of 163 completed family questionnaires in the pre-intervention and 118 in the post-intervention period were analyzed. Following the intervention, we observed: (1) a non-significant increase in family satisfaction summary score and sub-scores; (2) no decline in any individual family satisfaction item, and (3) improvement in items with high overall impact on satisfaction but quoted with low degree of satisfaction. CONCLUSION No significant improvement in family satisfaction of critically ill adult patients could be found after implementing the VALUE strategy. Whether these results are due to insufficient training of the new strategy or a missing effect of the strategy in our socio-economic environment remains to be shown.

Public School Choice and Integration: Evidence from Durham, North Carolina

Using evidence from Durham, North Carolina, we examine the impact of school choice programs on racial and class-based segregation across schools. Theoretical considerations suggest that how choice programs affect segregation will depend not only on the family preferences emphasized in the sociology literature but also on the linkages between student composition, school quality and student achievement emphasized in the economics literature, and on the availability of schools of different types. Reasonable assumptions about how these factors differ for students of different races and socio-economic status suggest that the segregating choices of students from advantaged backgrounds are likely to outweigh any integrating choices by disadvantaged students. The results of our empirical analysis are consistent with these theoretical considerations. Using information on the actual schools students attend and on the schools in their assigned attendance zones, we find that schools in Durham are more segregated by race and class as a result of school choice programs than they would be if all students attended their geographically assigned schools. In addition, we find that the effects of choice on segregation by class are larger than the effects on segregation by race.

Findings of the University of Texas Health Science Center at San Antonio's Dental School pilot mobile van program in Laredo, Texas

Lack of access to oral health care frequently affects those of lower socio-economic level; individuals in this group experience more dental decay, and the caries experience is more likely to be untreated. Inadequate dental care access may be attributed to exclusion that is due to income, geography, age, race or ethnicity. Objective: The present study aims were to: (1) determine how oral disease prevalence and access to dental services in four US-Mexico Border unincorporated low socioeconomic settlements identified as colonias compare to each other and Laredo, Texas, and (2) determine if insurance status affects dental care access and/or disease prevalence. Methods: A secondary analysis of data from a retrospective chart review of 672 patients attending a Mobile Dental Van Program in the Webb County colonias. Demographic information, (ethnicity, age, gender, insurance coverage and colonia site), dental visits within past year, insurance status, presence of dental sealants, prevalence of untreated dental decay (caries), and presence of gum disease (gingivitis and periodontitis) were extracted. Pearson's chi-square tests (χ2) were computed to compare the prevalence of these outcomes between colonias and Laredo and their potential association with insurance status. Results: For 6 - 11 year olds, dental visits in the past year were lower for colonias (39%), than Laredo (58.5%) (p<0.002). Caries prevalence was higher for colonias (56.6%), than Laredo (37.1%) (p<0.001). Gum disease prevalence was higher in colonias (73%), than in Laredo (21.4%) (p<0.001). No significant differences were noted for caries (χ2=1.73; p<0.188) and gum disease (χ2=0.0098; p<0.921) by patient's insurance status. For adults 36 - 64 years of age, dental visits in the past year were lower in colonias (22.4%), than Laredo (36.3%) (p<0.001). Caries prevalence was higher for colonias (78.3%), than Laredo (54.0%) (p<0.001). Gum disease prevalence was also higher among colonias (91.3%) than Laredo (61.3%) (p<0.001). No significant differences were noted for caries (χ2=0.0010; p<0.975) and gum disease (χ2=0.0607; p<0.805) by patient's insurance status. Conclusion: Colonia residents seeking dental care at a Mobile Dental Van Program in Webb County have significantly higher prevalence of oral disease regardless of insurance status.^

A systematic review of literature on socioeconomic disparities in the prevalence of dental caries

Dental caries, also known as tooth decay, are a disease of the oral cavity that affects the tooth structure and leads to the occurrence of cavities in teeth. Dental caries are one of the leading chronic diseases in the population and are very common in childhood. If not treated appropriately, dental caries have debilitating effect on the oral and general health of individuals. ^ Objectives. The aims of this review are to (1) analyze and elucidate the relationship between the social and economic determinants of health like income, education and race/ethnicity and the prevalence of dental caries and (2) identify and understand the pathways/underlying causes through which these factors affect the occurrence of dental caries. This review will provide a foundation for formulation of better oral health policies in future by identifying the key socio-economic factors and pathways affecting the prevalence of dental caries. Knowledge about these socioeconomic factors could be incorporated in the design of future policies and interventions to achieve greater benefits.^ Methods. This review includes information from all pertinent articles, reviews, surveys, reports, peer reviewed literature and web sources that were published after 2000. The selection criterion includes literature focusing on individuals between the ages of 1 to 65 years, and individuals from different subgroups of community based on income, education and race/ethnicity. The analyses of literature include identifying if a relationship between income/education/race and the prevalence of dental caries exists by comparing the prevalence of dental caries in different socio-economic groups. Also included in this review are articles that are relevant to the mechanisms/pathways through which income/education/race affect the prevalence of dental caries.^ Results. Analyses of available literature suggests that disparities in the prevalence of dental caries may be attributed to differences in income, education and race/ethnicity. Higher prevalence of dental caries was observed in African-American and Mexican-American individuals, and in people with low income and low education. The leading pathways through which the socioeconomic factors affect the prevalence of dental caries are the lack of access to dental care, lack of awareness about good oral hygiene beliefs and habits, oral health, inability to afford dental care, lack of social support to maintain oral health and lack of dental insurance.^ Conclusion. Disparities in the prevalence of dental caries exist in various socio-economic groups. The relationship between socio-economic factors and dental caries prevalence should be considered in the development of future policies and interventions that are aimed at reducing the prevalence of dental caries and enhancing oral health status.^

Formative evaluation of a parental involvement program for obesity prevention with low-income elementary school children

This study addresses the responses to a postcard campaign with health messages targeting the parents of children in a sample of low-income elementary schools and assesses the feasibility and areas of possible improvements in such a project. The campaign was implemented in Spring 2009 with 4 th grade students (n=1070) in fifteen economically disadvantaged elementary schools in Travis County, Texas. Postcards were sent home with children, and parents filled out a feedback card that the children returned to school. Response data, in the form of self-administered feedback cards (n=2665) and one-on-one teacher interviews (n=8), were qualitatively analyzed using NVivo 8 software. Postcard reception and points of improvement were then identified from the significant themes that emerged including health, cessation or reduction of unhealthy behaviors, motivation, family, and the comprehension of abstract health concepts. ^ Responses to the postcard campaign were almost completely positive, with less than 1% of responses reporting some sort of dislike, and many parents reported a modification of their behavior. However, possible improvements that could be made to the campaign are: increased focus of the postcards on the parents as the target population, increased information about serving size, greater emphasis on the link between obesity and health, alteration of certain skin tones used in the graphical depiction of people on the cards, and smaller but more frequent incentives to return the feedback cards for the students. The program appears to be an effective method of communicating health messages to the parents of 4th grade children.^

ASSOCIATIONS AND INTERRELATIONSHIPS OF SOCIOECONOMIC STATUS, BEHAVIORAL FACTORS AND BIOLOGICAL FACTORS WITH BIRTH WEIGHT

Although the influences of socioeconomic, behavioral and biological factors on birth weight have been extensively studied, most studies have been limited to clinical populations. This study examines such relationships in a national probability sample, the National Health and Nutrition Examination Survey of 1971-1974. The study sample consisted of 2161 white children and 812 black children, aged 1 to 5 years. Analyses were performed on a subsample consisting of 753 white and 138 black children whose mothers were also selected into the survey. Detailed analyses examined interrelationships among socio-economic, behavioral and biological factors by means of multiple regression and partial correlation procedures in the white population. These analyses were not carried out among blacks because of an observed clustering bias introduced in the black subsample that hampered generalization to the US population.^ The results among the whites indicated that the biological factors of maternal height, maternal weight, maternal size (weight/height('2)), maternal age and sex of child were independently related to birth weight and were also interrelated with socioeconomic factors such as family income, education of the mother and education of the head of the household. The joint effect was significantly associated with birth weight.^ Mothers' dietary practices represented the behavioral factors. Selected nutrients from the mothers' 24-hour dietary recall were used to develop indices of dietary quality. Dietary quality was significantly interrelated with socioeconomic status, biological factors and birth weight.^ The findings of this study suggest that smaller, younger mothers of lower socioeconomic status and female children were significantly associated with lower birth weight. The findings also suggest that dietary quality is a mediating factor among socioeconomic status and biological factors in that mothers with more financial and educational resources have better dietary practices. Such mothers may also practice other health behaviors that would prevent having a low birthweight baby. This dissertation contributes primarily to the further conceptualization and empirical testing of the interrelationships among socioeconomic, behavioral and biological factors with respect to birth weight. ^

Variabilidad en poblaciones de maíz nativo de la Mixteca Baja Oaxaqueña, México

La diversidad genética poblacional de maíz en México es muy dinámica y depende de factores biológicos, agroecológicos y socio-económicos, y necesidades familiares. En este trabajo se describió y clasificó la variabilidad morfológica de una colección de 60 muestras poblacionales de maíz, colectadas en 44 municipios de la Mixteca Baja Oaxaqueña (846 msnm a 1842 msnm). Las muestras se sembraron y cultivaron durante el ciclo primavera-verano de 2010, en Santo Domingo Tonala, Oaxaca, bajo un diseño de bloques completos al azar con cuatro repeticiones. Se evaluaron 19 caracteres morfológicos de planta, mazorca, grano y espiga (panoja), y se determinaron diferencias significativas entre poblacionales en estos caracteres. Los caracteres altura de planta y mazorca, días a floración masculina y femenina, y número de granos por hilera en la mazorca fueron determinantes para describir la variabilidad morfológica total. La variación morfológica y fenológica de las poblaciones de maíz se asocia con los patrones altitudinales y geográficos de donde proceden. Se determinaron seis grupos fenotípicos significativamente diferentes con características de mazorca, grano y planta semejantes a las descritas para las razas Celaya, Bolita, Pepitilla, Ancho, y ciertos complejos raciales entre Ancho, Mixteco, Celaya y Bolita.

Impacto de un programa de alfabetización temprana en niños de sectores urbano marginales

Este trabajo tiene como objetivos contribuir al conocimiento del proceso de alfabetización temprana en español en niños de sectores sociales desfavorecidos, y analizar los resultados de la implementación de un programa destinado al desarrollo de habilidades y conocimientos relativos a la lectura y la escritura inicial. El tipo de intervención propuesta, surge del programa ECOS , ya probado en español, pero no replicado suficientemente en niños de edades preescolares. Se ha estudiado el impacto de la aplicación de dicho programa, destinado a niños de 4, 5 y 6 años de edad, pertenecientes a sectores en desventaja socio económica, que concurrían a jardines de infantes de la Provincia de Buenos Aires (Argentina). Esta tesis se enmarca en los modelos de investigación proporcionados desde la Psicología Cognitiva y la corriente sociocultural, y sustenta la hipótesis de que el presente programa incrementa, en mayor medida que la curricula escolar las habilidades de conciencia fonológica, el reconocimiento y escritura de palabras y textos, así como también las habilidades de comprensión y producción oral de textos narrativos, en el corto y mediano plazo. Su originalidad reside en la especificidad del programa seleccionado y en haber considerado de manera conjunta la evaluación de su impacto, a través de un seguimiento longitudinal, que permitió no sólo verificar la persistencia de sus efectos a mediano plazo, sino también las relaciones que guardan entre sí las variables evaluadas, el poder predictivo de unas sobre otras, el momento en el que se produce el impacto y sobre cuáles de las variables y el tamaño de ese impacto. La investigación se realizó comparando el desempeño de dos grupos de niños uno experimental en el cual se aplicó dicho programa y uno control. Al inicio de la investigación los niños fueron homologados en cuanto al estrato social de procedencia (identificado por el nivel educacional y ocupacional de los padres), a las características de los establecimientos educativos a los que concurrían y a la de los contextos alfabetizadores hogareños así como respecto de sus conocimientos y habilidades iniciales. Las variables a ser consideradas en la evaluación de los desempeños fueron las siguientes: habilidades de conciencia fonológica, conocimientos sobre material impreso y sobre el sistema de escritura, lectura y escritura de palabras de diferente longitud y complejidad, lectura de pseudopalabras, lectura y escritura de textos y comprensión y renarración oral de textos narrativos. Los niños fueron evaluados en cuatro oportunidades diferentes, comparándose los desempeños de ambos grupos en el transcurso de dos años y medio: Se aplicó un modelo de medidas repetidas y se calculó el estadístico Effect Size para todas las variables al finalizar la intervención y mediano plazo. Las conclusiones extraídas de esta investigación ponen en evidencia el impacto positivo del programa de intervención. A mediano plazo se verifica una diferencia promedio de alrededor del 30 entre los niños de ambos grupos, en los porcentajes de aciertos en las pruebas que evalúan las habilidades de conciencia fonológica, lectura y escritura de palabras y comprensión de textos

Índices de sensibilidad ambiental en el espacio periurbano de Mar del Plata

La evaluación de la Sensibilidad Ambiental (SA) constituye un instrumento que permite establecer la capacidad del medio para asimilar, contener o atenuar determinados eventos degradantes para el mismo; dicha sensibilidad es función de las condiciones intrínsecas de los factores ambientales. El objetivo del presente trabajo es evaluar la SA de unidades de paisaje del periurbano de Mar del Plata para sostener las principales actividades desarrolladas en él. Estas unidades de paisaje fueron definidas mediante la integración de factores del medio natural y socioeconómico; éstos se ponderaron con un valor de sensibilidad que es función de las actividades. La integración de los resultados permitió obtener un índice final para cada una de las unidades, el cual es: Bajo (menor o igual a 5), Moderado (entre 6 y 9), Alto (entre 10 y 13) o Muy Alto (mayor o igual a 14).