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.

Leading Sheep III

Leading Sheep is a framework for supporting decision-making about technologies and practices to increase the profitability and productivity of the Queensland Sheep Businesses. Leading Sheep aims to achieve a high level of engagement with sheep businesses in Queensland to support their ongoing decision making processes about productivity and profitability.

Physical activity, fitness, abdominal obesity, and cardiovascular risk factors in Finnish men and women : The National FINRISK 2002 Study

Physical inactivity, low cardiorespiratory fitness, and abdominal obesity are direct and mediating risk factors for cardiovascular disease (CVD). The results of recent studies suggest that individuals with higher levels of physical activity or cardiorespiratory fitness have lower CVD and all-cause mortality than those with lower activity or fitness levels regardless of their level of obesity. The interrelationships of physical activity, fitness, and abdominal obesity with cardiovascular risk factors have not been studied in detail. The aim of this study was to investigate the associations of different types of leisure time physical activity and aerobic fitness with cardiovascular risk factors in a large population of Finnish adults. In addition, a novel aerobic fitness test was implemented and the distribution of aerobic fitness was explored in men and women across age groups. The interrelationships of physical activity, aerobic fitness and abdominal obesity were examined in relation to cardiovascular risk factors. This study was part of the National FINRISK Study 2002, which monitors cardiovascular risk factors in a Finnish adult population. The sample comprised 13 437 men and women aged 25 to 74 years and was drawn from the Population Register as a stratified random sample according to 10-year age groups, gender and area. A separate physical activity study included 9179 subjects, of whom 5 980 participated (65%) in the study. At the study site, weight, height, waist and hip circumferences, and blood pressure were measured, a blood sample was drawn, and an aerobic fitness test was performed. The fitness test estimated maximal oxygen uptake (VO2max) and was based on a non-exercise method by using a heart rate monitor at rest. Waist-to-hip ratio (WHR) was calculated by dividing waist circumference with hip circumference and was used as a measure of abdominal obesity. Participants filled in a questionnaire on health behavior, a history of diseases, and current health status, and a detailed 12-month leisure time physical activity recall. Based on the recall data, relative energy expenditure was calculated using metabolic equivalents, and physical activity was divided into conditioning, non-conditioning, and commuting physical activity. Participants aged 45 to 74 years were later invited to take part in a 2-hour oral glucose tolerance test with fasting insulin and glucose measurements. Based on the oral glucose tolerance test, undiagnosed impaired glucose tolerance and type 2 diabetes were defined. The estimated aerobic fitness was lower among women and decreased with age. A higher estimated aerobic fitness and a lower WHR were independently associated with lower systolic and diastolic blood pressure, lower total cholesterol and triglyceride levels, and with higher high-density lipoprotein (HDL) cholesterol and HDL to total cholesterol ratio. The associations of the estimated aerobic fitness with diastolic blood pressure, triglycerides, and HDL to total cholesterol ratio were stronger in men with a higher WHR. High levels of conditioning and non-conditioning physical activity were associated with lower high-sensitivity C-reactive protein (CRP) levels. High levels of conditioning and overall physical activities were associated with lower insulin and glucose levels. The associations were stronger among women than men. A better self-rated physical fitness was associated with a higher estimated aerobic fitness, lower CRP levels, and lower insulin and glucose levels in men and women. In each WHR third, the risk of impaired glucose tolerance and type 2 diabetes was higher among physically inactive individuals who did not undertake at least 30 minutes of moderate-intensity physical activity on five days per week. These cross-sectional data show that higher levels of estimated aerobic fitness and regular leisure time physical activity are associated with a favorable cardiovascular risk factor profile and that these associations are present at all levels of abdominal obesity. Most of the associations followed a dose-response manner, suggesting that already low levels of physical activity or fitness are beneficial to health and that larger improvements in risk factor levels may be gained from higher activity and fitness levels. The present findings support the recommendation to engage regularly in leisure time physical activity, to pursue a high level of aerobic fitness, and to prevent abdominal obesity.

Preparing pharmacists to vaccinate in Australia’s first Pharmacist Immunisation Pilot

Background: In November 2013, the Queensland Department of Health announced its intention to pilot pharmacist vaccination for influenza in the 2014 flu season. The Pharmaceutical Society of Australia Queensland Branch was tasked with developing a training program for the pilot. Aim: The aim was to develop, implement and evaluate a training program for pharmacist vaccination relevant to the needs of Australian pharmacists. Method: Background content was delivered via two online modules, while training for practical injection skills and anaphylaxis management were provided in a face-to-face workshop. Participants were required to complete the Australasian Society of Clinical Immunology and Allergy (ASCIA) anaphylaxis e-training for pharmacists, and hold a current First-Aid and CPR certificate. On completion of the course, pharmacists were asked to evaluate the training program. Results: Overall, 157 pharmacists across Queensland completed the training. Participants rated the training highly on a 5-point Likert scale (>4.4 for all fields) for relevance to practice, comfort with the skill, confidence to do the task and relevance of the learning objectives to the training. Qualitative feedback indicated that a key component of the training was the ability to practice injections on each other. Conclusion: The findings demonstrate participants felt prepared for vaccination following completion of the training program, as reflected in the high level of confidence reported. A follow-up post-pilot will explore if this confidence was translated into practice during the implementation phase.

Implementation of CSP-S for description of distributed algorithms

The implementation of CSP-S (a subset of CSP)—a high level language for distributed programming—is presented in this paper. The language CSP-S features a parallel command, communication by message passing and the use of guarded command. The implementation consists of a compiler translating the CSP-S constructs into intermediate language. The execution is carried out by a scheduler which creates an illusion of concurrency. Using the CSP-S language constructs, distributed algorithms are written, executed and tested with the compiler designed.

Delivering superior forage oat varieties for sub-tropical Australia

This full application seeks ongoing funding for the Agri-Science Queensland's forage oat breeding program through the Meat and Livestock Australia Partners in Innovation program with Heritage Seeds as the Donor Company and the commercial collaborator. The focus of the breeding program will shift to the use of minor genes that confer partial resistance or adult plant resistance to leaf rust. Accumulation of several minor genes in a single variety should produce a high level of effective field resistance, and better durability of resistance, with less likelihood of a mutational change in the pathogen.

Flat grain beetle fumigation protocol

Flat grain beetle (FGB) is a major emergency plant pest (EPP) of stored grain in Australia. Populations of FGB have recently developed high level resistance to phosphine (the only viable fumigant available for non-quarantine use) resulting in control failures with current dosage regimes. As there is no practical alternative to phosphine, failure to control FGB with phosphine places at risk market access for Australian grain worth up to $7 billion in annual trade. Therefore there is an urgent need to develop appropriate phosphine fumigation protocols to eradicate outbreaks of strongly resistant FGB. Research outcomes: - Characterisation of high resistance to phosphine in flat grain beetles (FGB) for the first time internationally. - Establishment of fumigation protocols and an eradication strategy that will enable industry to eradicate infestations of phosphine-resistant flat grain beetle and prevent or delay further selection for resistance to phosphine. - Development of a rapid test to detect highly resistant FGB. -Facilitate continued market access of Australian grain.

Methodology for developing competency standards for dietitians in Australia

Competency standards document the knowledge, skills, and attitudes required for competent performance. This study develops competency standards for dietitians in order to substantiate an approach to competency standard development. Focus groups explored the current and emerging purpose, role, and function of the profession, which were used to draft competency standards. Consensus was then sought using two rounds of a Delphi survey. Seven focus groups were conducted with 28 participants (15 employers/practitioners, 5 academics, 8 new graduates). Eighty-two of 110 invited experts participated in round one and 67 experts completed round two. Four major functions of dietitians were identified: being a professional, influencing the health of individuals, groups, communities, and populations through evidence-based nutrition practice, and working collaboratively in teams. Overall there was a high level of consensus on the standards: 93% achieved agreement by participants in round one and all revised standards achieved consensus on round 2. The methodology provides a framework for other professions wishing to embark on competency standard review or development.

DFL: A Data Flow Language

Many novel computer architectures like array and multiprocessors which achieve high performance through the use of concurrency exploit variations of the von Neumann model of computation. The effective utilization of the machines makes special demands on programmers and their programming languages, such as the structuring of data into vectors or the partitioning of programs into concurrent processes. In comparison, the data flow model of computation demands only that the principle of structured programming be followed. A data flow program, often represented as a data flow graph, is a program that expresses a computation by indicating the data dependencies among operators. A data flow computer is a machine designed to take advantage of concurrency in data flow graphs by executing data independent operations in parallel. In this paper, we discuss the design of a high level language (DFL: Data Flow Language) suitable for data flow computers. Some sample procedures in DFL are presented. The implementation aspects have not been discussed in detail since there are no new problems encountered. The language DFL embodies the concepts of functional programming, but in appearance closely resembles Pascal. The language is a better vehicle than the data flow graph for expressing a parallel algorithm. The compiler has been implemented on a DEC 1090 system in Pascal.

A market assessment and evaluation of structural roundwood products from hardwood pulp plantations.

Roundwood structures have always been used for temporary and low cost shelters and other fleeting structures. Novel concepts for the use of plantation hardwoods in roundwood form in construction were developed and circulated along with an electronic questionnaire to stakeholders representing growers, designers and users of hardwood. Responses indicate that there is a high level of interest in developing products from the emerging small roundwood resource and a detailed program of research was supported and recommended by the majority of participants in the survey. These results indicate a high level of support for further investigation into the use of plantation hardwood for roundwood components. Respondents representing a wide range of stakeholders have indicated that to gain benefit from a detailed project they would require solutions for connection systems and protection from pests and weathering, indications of cost and assurance of ongoing supply for niche applications, data for strength, acoustic dampening and thermal insulation properties, acceptance by regulatory authorities and training for on-site construction.

Molecular classification of familial colorectal and endometrial carcinoma

Hereditary nonpolyposis colorectal cancer (HNPCC) is the most common known clearly hereditary cause of colorectal and endometrial cancer (CRC and EC). Dominantly inherited mutations in one of the known mismatch repair (MMR) genes predispose to HNPCC. Defective MMR leads to an accumulation of mutations especially in repeat tracts, presenting microsatellite instability. HNPCC is clinically a very heterogeneous disease. The age at onset varies and the target tissue may vary. In addition, families that fulfill the diagnostic criteria for HNPCC but fail to show any predisposing mutation in MMR genes exist. Our aim was to evaluate the genetic background of familial CRC and EC. We performed comprehensive molecular and DNA copy number analyses of CRCs fulfilling the diagnostic criteria for HNPCC. We studied the role of five pathways (MMR, Wnt, p53, CIN, PI3K/AKT) and divided the tumors into two groups, one with MMR gene germline mutations and the other without. We observed that MMR proficient familial CRC consist of two molecularly distinct groups that differ from MMR deficient tumors. Group A shows paucity of common molecular and chromosomal alterations characteristic of colorectal carcinogenesis. Group B shows molecular features similar to classical microsatellite stable tumors with gross chromosomal alterations. Our finding of a unique tumor profile in group A suggests the involvement of novel predisposing genes and pathways in colorectal cancer cohorts not linked to MMR gene defects. We investigated the genetic background of familial ECs. Among 22 families with clustering of EC, two (9%) were due to MMR gene germline mutations. The remaining familial site-specific ECs are largely comparable with HNPCC associated ECs, the main difference between these groups being MMR proficiency vs. deficiency. We studied the role of PI3K/AKT pathway in familial ECs as well and observed that PIK3CA amplifications are characteristic of familial site-specific EC without MMR gene germline mutations. Most of the high-level amplifications occurred in tumors with stable microsatellites, suggesting that these tumors are more likely associated with chromosomal rather than microsatellite instability and MMR defect. The existence of site-specific endometrial carcinoma as a separate entity remains equivocal until predisposing genes are identified. It is possible that no single highly penetrant gene for this proposed syndrome exists, it may, for example be due to a combination of multiple low penetrance genes. Despite advances in deciphering the molecular genetic background of HNPCC, it is poorly understood why certain organs are more susceptible than others to cancer development. We found that important determinants of the HNPCC tumor spectrum are, in addition to different predisposing germline mutations, organ specific target genes and different instability profiles, loss of heterozygosity at MLH1 locus, and MLH1 promoter methylation. This study provided more precise molecular classification of families with CRC and EC. Our observations on familial CRC and EC are likely to have broader significance that extends to sporadic CRC and EC as well.

Internet marketing capabilities and international market growth

The Internet has been shown to facilitate elements of internationalisation such as information accumulation and network opportunities. However, there is limited understanding of how the Internet combined with marketing capabilities drives international market growth. This study, based on a sample of 224 Australian firms, develops and tests, using structural equation modelling (SEM), a conceptual model of Internet marketing capabilities and international market growth. Results indicate that firms deploying Internet marketing capabilities will benefit due to the reduction of information uncertainty and increased capacity to develop international network capabilities. Moreover, Internet marketing capabilities indirectly lead to international market growth when the firm has a high level of international strategic orientation and international network capabilities. Overall, Internet marketing capabilities enhance the firm's ability to generate other internal capabilities within the firm, which in turn have a positive impact on the international market growth of the firm.

Relaxation Labeling with Learning Automata

Relaxation labeling processes are a class of mechanisms that solve the problem of assigning labels to objects in a manner that is consistent with respect to some domain-specific constraints. We reformulate this using the model of a team of learning automata interacting with an environment or a high-level critic that gives noisy responses as to the consistency of a tentative labeling selected by the automata. This results in an iterative linear algorithm that is itself probabilistic. Using an explicit definition of consistency we give a complete analysis of this probabilistic relaxation process using weak convergence results for stochastic algorithms. Our model can accommodate a range of uncertainties in the compatibility functions. We prove a local convergence result and show that the point of convergence depends both on the initial labeling and the constraints. The algorithm is implementable in a highly parallel fashion.

Inheritance and relative dominance, expressed as toxicity response and delayed development, of phosphine resistance in immature stages of Rhyzopertha dominica (F.) (Coleoptera: Bostrichidae)

Fumigation of stored grain with phosphine (PH 3) is used widely to control the lesser grain borer Rhyzopertha dominica. However, development of high level resistance to phosphine in this species threatens control. Effective resistance management relies on knowledge of the expression of resistance in relation to dosage at all life stages. Therefore, we determined the mode of inheritance of phosphine resistance and strength of the resistance phenotype at each developmental stage. We achieved this by comparing mortality and developmental delay between a strongly resistant strain (R-strain), a susceptible strain (S-strain) and their F 1 progenies. Resistance was a maternally inherited, semi-dominant trait in the egg stage but was inherited as an autosomal, incompletely recessive trait in larvae and pupae. The rank order of developmental tolerance in both the sensitive and resistant strains was eggs > pupae > larvae. Comparison of published values for the response of adult R. dominica relative to our results from immature stages reveals that the adult stage of the S-strain is more sensitive to phosphine than are larvae. This situation is reversed in the R-strain as the adult stage is much more resistant to phosphine than even the most tolerant immature stage. Phosphine resistance factors at LC 50 were eggs 400×, larvae 87× and pupae 181× with respect to reference susceptible strain (S-strain) adults indicating that tolerance conferred by a particular immature stage neither strongly nor reliably interacts with the genetic resistance element. Developmental delay relative to unfumigated control insects was observed in 93% of resistant pupae, 86% of resistant larvae and 41% of resistant eggs. Increased delay in development and the toxicity response to phosphine exposure were both incompletely recessive. We show that resistance to phosphine has pleiotropic effects and that the expression of these effects varies with genotype and throughout the life history of the insect. © 2012.

Experimental investigation of the effects of oxygenated fuels on exhaust emissions in a heavy duty diesel engine

Physical and chemical properties of biofuels vary among various feedstocks and their subsequent conversions to fuels. The biofuels contain various amounts of oxygen, and this has a significant influence on exhaust emission. This oxygen content has been considered in order to investigate its effect on diesel engine exhaust emissions. The experiments have been conducted with a heavy duty diesel engine and various oxygenated fuels. It is found that the amount of oxygen in the fuel has a high level of influence on its exhaust emissions, and this provides agreement with diesel emissions results such as PN reduction. By increasing the amount of oxygen in the blend (by adding more biofuel), the particulate number (PN) is reduced and NOx increases gradually. However, the variation of PN and NOx are not similar for waste cooking biodiesel (WCBD) and butanol blend, even though their oxygen content are the same in the blends. This is due to the source of the biofuel and their internal chemistry.