The oral medicine of tooth wear

This review illustrates, through a series of case histories, how oral medicine insights aid the diagnosis and management of patients with excessive tooth wear. The cases reviewed are drawn from the records of 500 southeast Queensland patients referred to the author over a 12 year period. Patients most at risk of dental erosion have work and sports dehydration, caffeine addiction, gastro-oesophageal reflux, asthma, diabetes mellitus, hypertension or other systemic diseases or syndromes that predispose to xerostomia. Saliva protects the teeth from the extrinsic and intrinsic acids which cause dental erosion. Erosion, exacerbated by attrition and abrasion, is the main cause of tooth wear. These cases illustrate that teeth, oral mucosa, salivary glands, skin and eyes should be examined for evidence of salivary hypofunction and attendant medical conditions. Based on comprehensive oral medicine, dietary analyses and advice, it would seem patients need self-management plans to deal with incipient chronic tooth wear. The alternative is the expensive treatment of pain, occlusal damage and pulp death required to repair the effects of acute severe tooth wear.

Assessment and management of dysphagia following pharyngolaryngectomy with free jejunal interposition: A series of eight case studies

The physiological and structural deficits contributing to swallowing complications in the pharyngolaryngectomy patient population are not homogeneous. Consequently, a team approach, involving medical investigations as well as clinical and radiological assessments of swallowing, is necessary to facilitate diagnosis of the underlying impairment and assist the medical/surgical and speech pathology team members in the process of individualizing the management plan for each patient. In the present study, the clinical assessment and management of eight pharyngolaryngectomy patients who presented with a decline in swallowing function unrelated to immediate postsurgical effects or direct effects of radiotherapy are reported. Clinical and radiological investigations revealed a heterogeneous group of factors contributing to their swallowing impairments and disability levels, including difficulty with graft and anastomotic patency and graft motility, impaired lingual coordination, increased bolus transit time, nasal and oral regurgitation, patient distress, and recurrence. Variation between the cases supported the need for differential intervention and management plans for all eight patients. Ratings of perceived swallowing disability, handicap, and well-being/distress levels at initial assessment and again six months following dysphagia intervention revealed a pattern of reduced levels of impairment, functional disability, and overall patient distress levels following informed intervention. The present case study data highlights the key role thorough clinical and radiological investigations play in the process of diagnosing the factors contributing to dysphagia and guiding the management of the resultant swallowing disability in the pharyngolaryngectomy population.

Asian perceptions of BMD: Defence or disequilibrium?

As geopolitical competition between the United States and China intensifies, East Asian policy-makers are apprehensive about the Bush Administration's plans to develop ballistic missle defence (BMD). Missile defence threatens to undermine other fundamental assumptions aout nuclear weapons politics and arms control.

Expert review of an approach to functional capacity evaluation

Functional capacity evaluation (FCE) is a widely used tool in work rehabilitation, despite the limited examination of the soundness of its measurement properties. This paper outlines the development of a new approach to FCE, the GAPP FCE, and reports on the findings of an expert review of aspects of its content validity and technical adequacy and how it meets established test criteria. Five expert occupational therapists reviewed the materials of the GAPP FCE then completed a questionnaire related to the content validity, technical adequacy and safety, reliability, validity, practicality and utility of the GAPP FCE. The experts gave support to most aspects of these criteria. The main issue identified by the review was related to interpretation and extrapolation of the FCE results for return to work. This and other issues are discussed in relation to recent developments in FCE and plans for future development of the GAPP FCE.

City profile - Colombo

Rooted in a history that dates back 1500 years, the concentration of economic activity and infrastructure in Colombo represents an extreme case of urban primacy within the national context of Sri Lanka. Located on the West Coast of the country, the Colombo metropolitan area accommodates a quarter of the country's 18.6 million population, and is the economic and political core of the country. However, Colombo is a city of extremes. Its modem and well-serviced core stands in stark contrast to the circumstances of more than half of its population, who live in poorly serviced shack and shanty settlements. The proportion of the population living in these areas continues to expand, notwithstanding a history of innovative and participatory approaches to development planning and management. Complicating these development challenges, the potential of the city is undermined by a civil war that has been under way since the early 1980s, taking an immense toll in loss of life, political polarization, and economic opportunity costs. This paper traces Colombo's historical development, provides a description of contemporary characteristics and challenges faced by the city, and examines the evolution of plans and programmes designed to improve the conditions of low-income settlements in the city. (C) 2002 Elsevier Science Ltd. All rights reserved.

Longitudinal study of veterinarians from entry to the veterinary course to ten years after graduation: career paths

Objective To map out the career paths of veterinarians during their first 10 years after graduation, and to determine if this could have been predicted at entry to the veterinary course. Design Longitudinal study of students who started their course at The University of Queensland in 1985 and 1986, and who completed questionnaires in their first and fifth year as students, and in their second, sixth and eleventh year as veterinarians. Methods Data from 129 (96%) questionnaires completed during the eleventh year after graduation were coded numerically then analysed, together with data from previous questionnaires, with SAS System 7 for Windows 95. Results Ten years after they graduated, 80% were doing veterinary work, 60% were in private practice, 40% in small animal practice and 18% in mixed practice. The equivalent of 25% of the working time of all females was taken up by family duties. When part-time work was taken into account, veterinary work constituted the equivalent of 66% of the group working full-time. That 66% consisted of 52% on small animals, 7% on horses, 6% on cattle/sheep and 1% on pigs/poultry. Those who had grown up on farms with animals were twice as likely to be working with farm animals as were those from other backgrounds. Forecasts made on entry to the veterinary course were of no value in predicting who would remain in mixed practice. Conclusions Fewer than one-fifth of graduates were in mixed practice after 10 years, but the number was higher for those who grew up on farms with animals. Forecasts that may be made at interview before entry to the course were of little value in predicting the likelihood of remaining in mixed veterinary practice.

Longitudinal study of veterinarians from entry to the veterinary course to 10 years after graduation: attitudes to work, career and profession

Objective To describe the attitudes of veterinarians to their work, career and profession during the 10 years after graduation. Design Longitudinal study of students who started their course at The University of Queensland in 1985 and 1986, and who completed questionnaires in their first and fifth year as students, and after one, five and 10 years as veterinarians. Methods Data from 129 (96%) questionnaires completed after 10 years as a veterinarian were coded numerically then analysed, together with data from previous questionnaires, with SAS System 7 for Windows 95. Results After 10 years, almost all respondents were either very glad they had done the veterinary course (57%) or generally glad, though with some misgivings (37%). Despite this, only 55% would definitely become a veterinarian if they 'had to do it over again'. The responses for about one-third were different from those given five years earlier. The views of many were related to the level of support and encouragement received in their first job after graduation. There were 42% who were working less than half-time as veterinarians, and their main reasons were, in order, raising children, long hours of work, attitudes of bosses and clients, and poor pay. A majority was concerned about the ethics and competence of some colleagues, and almost all believed that consideration of costs must influence the type of treatment animals receive. Conclusions Most veterinarians were glad to have done the veterinary course, but for about one-quarter their career had not lived up to expectations and almost half would not do it again in another incarnation. Stress, hours of work, difficulties in balancing personal life with career and low income were important concerns for many. Low income may contribute to the low number of males entering the veterinary profession.

A methodology for building energy modelling and calibration in warm climates

In the last 7 years, a method has been developed to analyse building energy performance using computer simulation, in Brazil. The method combines analysis of building design plans and documentation, walk-through visits, electric and thermal measurements and the use of an energy simulation tool (DOE-2.1E code), The method was used to model more than 15 office buildings (more than 200 000 m(2)), located between 12.5degrees and 27.5degrees South latitude. The paper describes the basic methodology, with data for one building and presents additional results for other six cases. (C) 2002 Elsevier Science Ltd. All rights reserved.

The Relative Frequency of the Synthetic End Composite Futures in the Newspaper Quest-France and some Observations on Distribution

Figures on the relative frequency of synthetic and composite future forms in Ouest-France are presented and compared with those of earlier studies on the passé simple and passé composé. The synthetic future is found to be dominant. Possible formal explanations for distribution are found to be inconclusive. Distribution across different text-types is found to be more promising, since contrastive functions of the two forms can be identified in texts where they co-occur. The composite future typically reports new proposals or plans as current news, while the synthetic future outlines details that will be realised at the time of implementation. Both functions are important in dailies, but current news is more often expressed in the present tense at the expense of the composite future.

Segmenting the market of West Australian senior tourists using an artificial neural network

Measuring perceptions of customers can be a major problem for marketers of tourism and travel services. Much of the problem is to determine which attributes carry most weight in the purchasing decision. Older travellers weigh many travel features before making their travel decisions. This paper presents a descriptive analysis of neural network methodology and provides a research technique that assesses the weighting of different attributes and uses an unsupervised neural network model to describe a consumer-product relationship. The development of this rich class of models was inspired by the neural architecture of the human brain. These models mathematically emulate the neurophysical structure and decision making of the human brain, and, from a statistical perspective, are closely related to generalised linear models. Artificial neural networks or neural networks are, however, nonlinear and do not require the same restrictive assumptions about the relationship between the independent variables and dependent variables. Using neural networks is one way to determine what trade-offs older travellers make as they decide their travel plans. The sample of this study is from a syndicated data source of 200 valid cases from Western Australia. From senior groups, active learner, relaxed family body, careful participants and elementary vacation were identified and discussed. (C) 2003 Published by Elsevier Science Ltd.

Climate change and biotic invasions: a case history of a tropical woody vine

The impacts of climate change in the potential distribution and relative abundance of a C3 shrubby vine, Cryptostegia grandiflora, were investigated using the CLIMEX modelling package. Based upon its current naturalised distribution, C. grandiflora appears to occupy only a small fraction of its potential distribution in Australia under current climatic conditions; mostly in apparently sub-optimal habitat. The potential distribution of C. grandiflora is sensitive towards changes in climate and atmospheric chemistry in the expected range of this century, particularly those that result in increased temperature and water use efficiency. Climate change is likely to increase the potential distribution and abundance of the plant, further increasing the area at risk of invasion, and threatening the viability of current control strategies markedly. By identifying areas at risk of invasion, and vulnerabilities of control strategies, this analysis demonstrates the utility of climate models for providing information suitable to help formulate large-scale, long-term strategic plans for controlling biotic invasions. The effects of climate change upon the potential distribution of C. grandiflora are sufficiently great that strategic control plans for biotic invasions should routinely include their consideration. Whilst the effect of climate change upon the efficacy of introduced biological control agents remain unknown, their possible effect in the potential distribution of C. grandiflora will likely depend not only upon their effects on the population dynamics of C. grandiflora, but also on the gradient of climatic suitability adjacent to each segment of the range boundary.

Matriz de capacita????o modelada por compet??ncias para atuar em programas de educa????o a dist??ncia: uma proposta para as escolas de governo

This study discusses distance learning (DL) as a corporate education strategy in the scope of National Policy on Staff Development. The purpose was to identify, along with managers and specialists of National Network of Schools of Government in Brazil (RNEG), demanded competencies for DL professionals acting in continued education to service public. Part of the research is based in official documents and in related capacity-building initiatives of Schools of Government in the last three years. Through questionnaire sent to managers of institutions of RNEG, we identified existing infrastructure, teams profile, actions developed in DL and training needs. The research allowed to map the critical competencies to work in DL programs and to create a proposal from a Competency-Based Training Matrix for school teams in order to leverage continuing education programs to public servants in three spheres of government. The results revealed the key technological, pedagogical, management and communication skills, as well as the critical activities and content to be included in the training plans. It was found that 88% of institutions have already implemented or are in the process of implementing DL, and the other 12% are deficient in qualified staff to make regulations on hiring personnel or in technology fluency. This corroborates the importance and the contribution of Competency-Based Training Matrix for RNEG

Balanced scorecard (BSC): uma vis??o metodol??gica para o acompanhamento de sua implementa????o

A Embrapa, na inten????o de operacionalizar a gest??o dos seus planos estrat??gicos (Plano Diretor da Embrapa ??? PDE e Planos Diretores das Unidades ??? PDUs) desenvolveu a metodologia Mogest para a implementa????o do seu Modelo de Gest??o Estrat??gica (MGE), no ??mbito corporativo e de suas 40 unidades de neg??cio, com base na modifica????o do m??todo Balanced Scorecard ??? BSC, de Kaplan. Posteriormente, ap??s a implementa????o dos MGEs, no per??odo de 1999 at?? os dias atuais, inicia-se e desenvolve-se a fase de acompanhamento por meio da elabora????o do m??todo MGE/Acompanha. Este trabalho aborda, de forma modificada, o uso do diagrama elaborado por Norton, apud Coutinho (2002), para acompanhar/avaliar a implementa????o do BSC para uma organiza????o orientada ?? estrat??gia, inserido no m??todo MGE/Acompanha (2000), elaborado pela Equipe MGE e aplicado em uma das unidades de neg??cio da Embrapa. Os resultados mostraram a efici??ncia do m??todo e proporcionaram a internaliza????o do conceito ???painel de bordo???, desenvolvido no software Oracle BSC (OBSC).

Transpar??ncia, monitoramento e avalia????o de programas no Brasil: em busca de opacidades que podem restringir o exerc??cio do controle social

A nova lei brasileira de acesso ?? informa????o estabeleceu um conjunto de defini????es, princ??pios e diretrizes voltado ?? promo????o da transpar??ncia e ?? viabiliza????o do exerc??cio do controle social sobre a a????o governamental. Segundo esta lei, os resultados dos programas do Plano Plurianual (PPA) fazem parte do conjunto de informa????es que precisam ser franqueadas aos cidad??os. Tais resultados s??o gerados a partir das regras da sistem??tica de monitoramento e avalia????o de programas que deve ser estabelecida no pr??prio PPA. Este trabalho objetiva analisar a ader??ncia desta sistem??tica ?? lei de acesso ?? informa????o, com a finalidade de suscitar o debate sobre a exist??ncia de certas opacidades que podem restringir o acompanhamento e a avalia????o da a????o governamental pela sociedade

Pr??-equidade de g??nero: incorporando pol??ticas de a????o afirmativa no mundo do trabalho

A institui????o do Programa Pr??-equidade de G??nero ?? o reconhecimento p??blico da desigualdade de tratamento e de oportunidades, que ainda permanece entre mulheres e homens. A implementa????o ?? consolidada com a coloca????o em pr??tica dos planos de a????es firmados entre a Secretaria Especial de Pol??ticas para as Mulheres (SPM) e as organiza????es aderentes. A pesquisa explorat??ria teve como objetivo apresentar o programa e discuti-lo com base no modelo "policy cycle como aprendizado", de Silva e Melo (2000). Os resultados subsidiar??o pesquisa futura sobre a avalia????o do programa. Dentro da estrat??gia adotada, a coleta de dados ocorreu em documentos institucionais e dados bibliogr??ficos em mar??o de 2009, com o seguinte resultado: a avalia????o n??o trata de forma clara da efetividade e da sustentabilidade do programa. Este trabalho est?? dividido em seis partes: descri????o do m??todo utilizado; apresenta????o do Programa Pro-equidade de G??nero; avalia????o de suas duas primeiras edi????es; breve contextualiza????o das pol??ticas p??blicas no Brasil e o modelo "policy cicle como aprendizado"; rela????es entre o programa e o modelo; e considera????es finais.