Feasibility and costs of water fluoridation in remote Australian Aboriginal communities

Background: Fluoridation of public water supplies remains the key potential strategy for prevention of dental caries. The water supplies of many remote Indigenous communities do not contain adequate levels of natural fluoride. The small and dispersed nature of communities presents challenges for the provision of fluoridation infrastructure and until recently smaller settlements were considered unfavourable for cost-effective water fluoridation. Technological advances in water treatment and fluoridation are resulting in new and more cost-effective water fluoridation options and recent cost analyses support water fluoridation for communities of less than 1,000 people.Methods: Small scale fluoridation plants were installed in two remote Northern Territory communities in early 2004. Fluoride levels in community water supplies were expected to be monitored by local staff and by a remote electronic system. Site visits were undertaken by project investigators at commissioning and approximately two years later. Interviews were conducted with key informants and documentation pertaining to costs of the plants and operational reports were reviewed.Results: The fluoridation plants were operational for about 80% of the trial period. A number of technical features that interfered with plant operation were identified and addressed though redesign. Management systems and the attitudes and capacity of operational staff also impacted on the effective functioning of the plants. Capital costs for the wider implementation of these plants in remote communities is estimated at about $US94,000 with recurrent annual costs of$US11,800 per unit.Conclusion: Operational issues during the trial indicate the need for effective management systems, including policy and funding responsibility. Reliable manufacturers and suppliers of equipment should be identified and contractual agreements should provide for ongoing technical assistance. Water fluoridation units should be considered as a potential priority component of health related infrastructure in at least the larger remote Indigenous communities which have inadequate levels of natural fluoride and high levels of dental caries

Pregnancy without ovarian function A case report

A 38-year-old nulliparous woman suffering from premature menopause was stimulated with oestradiol valerate in order to create an artificial endometrial cycle. Three oocytes were donated by a woman on an in vitro fertilisation cycle and were inseminated with the patient's husband's sperm. These were then transferred into the patient's uterus after the endometrium had been primed with progesterone to change it to the secretory phase. Pregnancy resulted and proceeded well. Gestation was terminated at the 34th week by caesarean section and 2 healthy boys and 1 girl were delivered

Development of the Lunar and Solar Perturbations in the Motion of an Artificial Satellite

Problems relating to the influence of lunar and solar perturbations on the motion of artificial satellites are analyzed by an extension of Cayley's development of the perturbative function in the lunar theory. In addition, the results are modified for incorporation into the Hansen-type theory used by the NASA Space Computing Center. The theory is applied to the orbits of the Vanguard I and Explorer VI satellites, and the results of detailed computations for these satellites are given together with a physical description of the perturbations in terms of resonance effects

Development of next generation sequencing panel for UMOD and association with kidney disease

Chronic kidney disease (CKD) has a prevalence of approximately 10% in adult populations. CKD can progress to end-stage renal disease (ESRD) and this is usually fatal unless some form of renal replacement therapy (chronic dialysis or renal transplantation) is provided. There is an inherited predisposition to CKD with several genetic risk markers now identified. The UMOD gene has been associated with CKD of varying aetiologies. An AmpliSeq next generation sequencing panel was developed to facilitate comprehensive sequencing of the UMOD gene, covering exonic and regulatory regions. SNPs and CpG sites in the genomic region encompassing UMOD were evaluated for association with CKD in two studies; the UK Wellcome Trust Case-Control 3 Renal Transplant Dysfunction Study (n = 1088) and UK-ROI GENIE GWAS (n = 1726). A technological comparison of two Ion Torrent machines revealed 100% allele call concordance between S5 XL™ and PGM™ machines. One SNP (rs183962941), located in a non-coding region of UMOD, was nominally associated with ESRD (p = 0.008). No association was identified between UMOD variants and estimated glomerular filtration rate. Analysis of methylation data for over 480,000 CpG sites revealed differential methylation patterns within UMOD, the most significant of these was cg03140788 p = 3.7 x 10-10

Preventative medical care in remote Aboriginal communities in the Northern Territory: a follow-up study of the impact of clinical guidelines, computerised recall and reminder systems, and audit and feedback

MIDDLESEX HOUSE,34-42 CLEVELAND ST, LONDON, ENGLAND, W1T 4L

Conceptualizing the adventure-sports coach

As a comparatively recent development, the adventure-sports coach struggles for a clear and distinct identity. The generic term ‘instructor’ no longer characterizes the role and function of this subgroup of outdoor professionals. Indeed, although the fields of adventure/outdoor education and leadership are comparatively well researched, the arrival of this ‘new kid on the block’ appears to challenge both the adventure-sports old guard and traditional views of sports coaching. In an attempt to offer clarity and stimulate debate, this paper attempts to conceptualize the adventure-sports coach in the context of the existing roles in the field and current motivations for activity in the outdoors. We identify issues that are specific to the adventure-sports coach while also recognizing those skills and competencies shared with other professionals, both in the adventure sports profession and traditional sports coaching fields. Based on this review, we offer a conceptual model which may be used to focus debate, stimulate research and, at a possible later stage, to underpin accreditation, training and professional development

Design and performance of ropes for climbing and sailing

Ropes are an important part of the equipment used by climbers, mountaineers, and sailors. On first inspection, most modern polymer ropes appear similar, and it might be assumed that their designs, construction, and properties are governed by the same requirements. In reality, the properties required of climbing ropes are dominated by the requirement that they effectively absorb and dissipate the energy of the falling climber, in a manner that it does not transmit more than a critical amount of force to his body. This requirement is met by the use of ropes with relatively low longitudinal stiffness. In contrast, most sailing ropes require high stiffness values to maximize their effectiveness and enable sailors to control sails and equipment precisely. These conflicting requirements led to the use of different classes of materials and different construction methods for the two sports. This paper reviews in detail the use of ropes, the properties required, manufacturing techniques and materials utilized, and the effect of service conditions on the performance of ropes. A survey of research that has been carried out in the field reveals what progress has been made in the development of these essential components and identifies where further work may yield benefits in the future

Daily monthly and seasonal variation in PSA levels and the association with weather parameters

International audienceProstate-specific antigen (PSA) levels have shown daily and seasonal variation, although data are conflicting regarding the season with higher PSA levels and the clinical relevance of this. We assessed the correlation of total PSA levels with meteorological data on a daily, weekly, monthly and seasonal basis. Data from 53 224 men aged 45-74 years, with an initial PSA <10.0ng/ml were correlated with temperature (oC), duration of bright sunshine (hours) and rainfall (mm). There was seasonal variation in PSA levels, with median PSA being higher in spring compared to other seasons (1.18 vs. 1.10ng/ml, p=0.004). Seasonal variation was not apparent when PSA levels were age-adjusted (p=0.112). Total PSA was not correlated with daily, weekly or monthly hours of sunshine, rainfall nor mean temperature. In contrast, age-adjusted PSA varied with weekday, with higher PSA levels on Thursday and Friday compared to other days (1.16 vs. 1.10ng/ml respectively). On multivariate analysis, only age predicted for PSA levels >3.0ng/ml. In conclusion, PSA levels did show seasonal variation although there was no direct correlation between PSA and any meteorological parameter. The degree of seasonal variation is small and the decision to proceed to prostate biopsy should be independent of season or weather parameters