RAAMATU TUTVUSTUS: Abiks keskkonnatervishoiu paremal mõistmisel

Eesti Arst 2016; 95(1):6

Fluor joogivees, selle võimalikud tervisemõjud

Fluori bioloogilisest rollist inimorganismis on veel vähe teada. Inimese põhiliseks fluori allikaks on joogivesi. Fluoritud vee kaariesevastase toime kõrval on saadud mitmeid eba soodsaid tervisemõjusid, mistõttu diskuteeritakse joogivee fluorimise tõhususe, otstarbekuse, ohutuse ja eetilisuse üle. Paljudes maades on joogivee fluorimine lõpe tatud. Fluori terviseriski hindamisel tuleb tänapäeval arvestada peale joogivee ka teisi fluori saamise allikaid. Eesti Arst 2006; 85 (1): 26–3

Exposure to High Fluoride Drinking Water and Risk of Dental Fluorosis in Estonia

The purpose of this study was to assess exposure to drinking water fluoride and evaluate the risk of dental fluorosis among the Estonian population. The study covered all 15 counties in Estonia and 93.7% of population that has access to public water supplies. In Estonia groundwater is the main source for public water supply systems in most towns and rural settlements. The content of natural fluoride in water ranges from 0.01 to 7.20 mg/L. The exposure to different fluoride levels was assessed by linking data from previous studies on drinking water quality with databases of the Health Protection Inspectorate on water suppliers and the number of water consumers in water supply systems. Exposure assessment showed that 4% of the study population had excessive exposure to fluoride, mainly in small public water supplies in western and central Estonia, where the Silurian-Ordovician aquifer system is the only source of drinking water. There is a strong correlation between natural fluoride levels and the prevalence of dental fluorosis. Risk of dental fluorosis was calculated to different fluoride exposure levels over 1.5 mg/L

Eesti elanike fluoriekspositsioon joogivee kaudu

Joogivee fluorisisaldus mõjutab eelkõige hammaste tervist, kuid fluoril on ka mitmeid kahjulikke toimeid. Käesolevas uuringus määrati inimeste joogivee fluorisisaldus üle Eesti. See kõikus suurtes piirides, olenedes veeallikast ja piirkonnast. Esimest korda hinnati elanike joogiveekaudset fluoriekspositsiooni. See on optimaalne vaid 38,1%-l uuringurahvastikust. Fluoriekspositsioon on mittepiisav Narva, enamikul Tallinna ja kolmandikul Tartu linna elanikel, neile lisandub veel 242 000 inimest maakondadest. Neid ohustab hambakaaries. Üle normatiivi fluoriekspositsioon on 42 600 (4,1%) elanikul peamiselt Pärnu-, Lääne-, Rapla- ja Tartumaal. Nad on ohustatud fluori toksilisest toimest. Artiklis on lühidalt käsitletud erineva fluoriekspositsiooni ebasoodsa toime ennetamise võimalusi. Eesti Arst 2007; 86 (1): 13–1

Management of potential drug interactions in community pharmacies: a questionnaire-based survey in Switzerland

Objective: To analyze the current drug-interaction management in Swiss community pharmacies, with a particular focus on electronic systems, and to compare the results with those expressed by German general practitioners in a recent survey. Methods: Data were collected with a postal questionnaire which was randomly sent to 500 out of 833 community pharmacies in the German part of Switzerland. Results: The response rate was 57.4%, and only 24.7% pharmacists reported that they were confronted less than daily with potential drug interactions. Use of computer software to identify potential drug interactions was widespread in community pharmacies (90.2%), and the software was the primary source of information (81.2 ± 29.6%). The quality of the interaction software was judged sensitive (identifying all dangerous interactions) by 80.5 ± 21.5%, but specific (identifying only relevant interactions) by only 38.3 ± 32%. Pharmacists declared a low override rate (14%) of drug interaction alerts, although unjustified alerts were reported by 60.6 ± 33.1%. In contrast to general practitioners, pharmacists opted less often for information on the mechanism of the interaction, and more frequently for details for dose adjustment. Both groups complained about deficient information on non-interacting alternatives. Conclusion: The information needs of community pharmacists differed considerably from general practitioners, and pharmacists were overwhelmed by inappropriate alerts because of a lack of specificity of their drug-interaction systems. Substantial improvement of drug-interaction software systems is thus required at least in two important aspects, the suppression of inappropriate alerts and the tailoring to the needs of the use

Segmenting Visitors to Battlefield Sites: International Visitors to the Former DMZ in Vietnam

Vietnam is an emerging tourist destination with rapid development in the tourism industry over the last decade. Well-known for the Vietnam War, it is expected that battlefield sites are among the country's main attractions for international tourists. However, to date, there has been no research examining visitors to battlefield sites in Vietnam. This study aims to contribute to filling this perceived gap by examining the visitors to the former Vietnamese De-militarised Zone (DMZ). Its objectives are: (1) to identify tourist motivations for visiting the DMZ, (2) to segment the DMZ visitors based on motivations, and (3) to determine the importance of battlefield sites in tourists' decision to travel to Vietnam. International visitors to the Vinh Moc Tunnels, a site often included in the DMZ tour, were chosen as a study sample. Data in this study was collected in an intercept self-completed questionnaire survey, which resulted in a sample of 481 respondents. Statistical analysis of the data was supplemented by content analysis of qualitative findings where appropriate. The findings show that respondents visited the DMZ for a variety of motivations. Five motivations were generated from the factor analysis of 22 quantitative motivational items namely: Personal involvement, Interest in war related sites and exhibitions, Education and exploration, Location and convenience, and Novelty seeking. These delineated motivations were supported and extended by respondents' self-expressed motivations. Based on these motivations, three groups of visitors to the DMZ were identified using cluster analysis: the Battlefield Tourism Enthusiast, the Opportunist, and the Passive Tourist. These three visitors segments differed significantly in terms of socio-demographic characteristics, trip related characteristics, and especially travel decision-making. The Enthusiasts had the highest interest in visiting battlefield sites in Vietnam. The Opportunists tended to visit sites based on location and convenience, and the Passive Tourists indicated relatively low rankings for all reasons for visiting battlefield sites. This study also found that battlefield sites only played a small role in tourists' decision to visit Vietnam and that most tourists visited Vietnam for its culture, landscape and history. Several implications and recommendations arise from this study, including the need for continuing research on motivations for battlefield tourism in other countries. In addition, it is suggested that the educative function should be emphasised in developing battlefield sites as tourist attractions

Voronoi diagrams on piecewise flat surfaces and an application to biological growth

This paper introduces the notion of Voronoi diagrams and Delaunay triangulations generated by the vertices of a piecewise flat, triangulated surface. Based on properties of such structures, a generalized flip algorithm to construct the Delaunay triangulation and Voronoi diagram is presented. An application to biological membrane growth modeling is then given. A Voronoi partition of the membrane into cells is maintained during the growth process, which is driven by the creation of new cells and by restitutive forces of the elastic membrane

A discrete Laplace-Beltrami operator for simplicial surfaces

We define a discrete Laplace-Beltrami operator for simplicial surfaces. It depends only on the intrinsic geometry of the surface and its edge weights are positive. Our Laplace operator is similar to the well known finite-elements Laplacian (the so called ``cotan formula'') except that it is based on the intrinsic Delaunay triangulation of the simplicial surface. This leads to new definitions of discrete harmonic functions, discrete mean curvature, and discrete minimal surfaces. The definition of the discrete Laplace-Beltrami operator depends on the existence and uniqueness of Delaunay tessellations in piecewise flat surfaces. While the existence is known, we prove the uniqueness. Using Rippa's Theorem we show that, as claimed, Musin's harmonic index provides an optimality criterion for Delaunay triangulations, and this can be used to prove that the edge flipping algorithm terminates also in the setting of piecewise flat surfaces.Comment: 18 pages, 6 vector graphics figures. v2: Section 2 on Delaunay triangulations of piecewise flat surfaces revised and expanded. References added. Some minor changes, typos corrected. v3: fixed inaccuracies in discussion of flip algorithm, corrected attributions, added references, some minor revision to improve expositio