A scoping review of the implications of adult obesity in the delivery and acceptance of dental care.

Background Due to the increasing prevalence of obesity within the general population it is presumed that the prevalence of overweight and obese adults accessing dental services will also increase. For this reason dentists need to be aware of implications of managing such patients.Methods A scoping review was carried out. Both Medline via OVID and Scopus databases were searched along with grey literature databases and the websites of key organizations. Inclusion and exclusion criteria were established. The data were collected on a purpose-made data collection form and analysed descriptively.Results The review identified 28 relevant published articles and two relevant items of grey literature. Following review of this literature three themes relating to adult obesity in the delivery and acceptance of dental care emerged; clinical, service delivery and patient implications. The majority of the papers focused on the clinical implications.Conclusion On the topic of adult obesity and dental care, the majority of published and grey literature focuses on the clinical implications. Further research is needed on both the patients' perspectives of being overweight or obese and the delivery and acceptance of dental care and the service delivery implications

Abdominal obesity and metabolic syndrome: exercise as medicine?

Background: Metabolic syndrome is defined as a cluster of at least three out of five clinical risk factors: abdominal (visceral) obesity, hypertension, elevated serum triglycerides, low serum high-density lipoprotein (HDL) and insulin resistance. It is estimated to affect over 20% of the global adult population. Abdominal (visceral) obesity is thought to be the predominant risk factor for metabolic syndrome and as predictions estimate that 50% of adults will be classified as obese by 2030 it is likely that metabolic syndrome will be a significant problem for health services and a drain on health economies.Evidence shows that regular and consistent exercise reduces abdominal obesity and results in favourable changes in body composition. It has therefore been suggested that exercise is a medicine in its own right and should be prescribed as such. Purpose of this review: This review provides a summary of the current evidence on the pathophysiology of dysfunctional adipose tissue (adiposopathy). It describes the relationship of adiposopathy to metabolic syndrome and how exercise may mediate these processes, and evaluates current evidence on the clinical efficacy of exercise in the management of abdominal obesity. The review also discusses the type and dose of exercise needed for optimal improvements in health status in relation to the available evidence and considers the difficulty in achieving adherence to exercise programmes. Conclusion: There is moderate evidence supporting the use of programmes of exercise to reverse metabolic syndrome although at present the optimal dose and type of exercise is unknown. The main challenge for health care professionals is how to motivate individuals to participate and adherence to programmes of exercise used prophylactically and as a treatment for metabolic syndrome

Crowdsourcing: A new tool for policy-making?

Crowdsourcing is rapidly evolving and applied in situations where ideas, labour, opinion or expertise of large groups of people are used. Crowdsourcing is now used in various policy-making initiatives; however, this use has usually focused on open collaboration platforms and specific stages of the policy process, such as agenda-setting and policy evaluations. Other forms of crowdsourcing have been neglected in policy-making, with a few exceptions. This article examines crowdsourcing as a tool for policy-making, and explores the nuances of the technology and its use and implications for different stages of the policy process. The article addresses questions surrounding the role of crowdsourcing and whether it can be considered as a policy tool or as a technological enabler and investigates the current trends and future directions of crowdsourcing. Keywords: Crowdsourcing, Public Policy, Policy Instrument, Policy Tool, Policy Process, Policy Cycle, Open Collaboration, Virtual Labour Markets, Tournaments, Competition

Utjecaj toksičnosti metala na reprodukcijsku funkciju u muškaraca

A combination of genetic, environmental and lifestyle factors contributes to adverse effects on the reproductive health in men. Metals are pervasive in food, water, air, tobacco smoke, and alcoholic beverages. Experimental studies suggest that many metals have adverse effects on the male reproductive function. However, information about reproductive effects of human exposure to metals is scarce and/or inconsistent. This review summarises the information from epidemiological studies of the effects of metal exposure on reproductive function in men. Factors capable of affecting these relationships were identifi ed and discussed. A particular attention is given to the studies considering influence of concomitant exposure to various metals. These studies have generally confirmed that even moderate- to low-level exposure to lead affects certain reproductive parameters, and that exposure to cadmium affects the prostate function and serum testosterone levels. Adverse effects of mercury, manganese, chromium and arsenic on semen quality and altered serum hormone are less well documented. There is no clear evidence that boron exposure may impair reproductive health in men. Only a few studies have investigated reproductive effects of concomitant exposure to several metals and controlled for potential confounders. Future studies should consider the contribution of combined exposure to various metals and/or other factors that may influence individual susceptibility to reproductive health impairment in men.Postoje indikacije da kombinacija genetskih, okolišnih i čimbenika načina života pridonosi uočenom poremećaju reprodukcijskog zdravlja u muškaraca. Metali su široko rasprostranjeni u čovjekovu okolišu te u hrani, vodi, zraku, cigaretnom dimu i alkoholnim pićima. Rezultati eksperimentalnih istraživanja sugeriraju štetne učinke većine ispitivanih metala na mušku reprodukcijsku funkciju. Međutim, odgovarajuća su istraživanja u ljudi oskudna. Ovaj rad sažima rezultate dosadašnjih epidemioloških istraživanja o učincima izloženosti metalima na mušku reprodukcijsku funkciju. Poseban naglasak dan je istraživanjima koja su razmatrala utjecaj istodobne izloženosti različitim metalima uz čimbenike čovjekova načina života i njihovo međudjelovanje na reprodukcijske učinke. Objavljeni rezultati daju dovoljno dokaza o štetnom djelovanju olova i žive na neke reprodukcijske parametre te kadmija na poremećaj prostate i razinu testosterona u serumu, čak u uvjetima umjerene do niske razine izloženosti. Manje je dokaza o štetnom djelovanju na kvalitetu sjemena i razinu spolnih hormona nađeno za mangan. Podaci koji upućuju na moguće štetno djelovanje arsena ili kroma nisu dosljedni, dok o štetnom djelovanju bora na mušku reprodukcijsku funkciju nema jasnih podataka. Utjecaj potencijalno uzročnih varijabli uzet je u obzir samo u nekoliko radova. Stoga buduća istraživanja poremećaja reprodukcijskog zdravlja u muškaraca trebaju razmatrati doprinos istovremene izloženosti različitim metalima koji u kombinaciji s ostalim čimbenicima mogu utjecati na osobnu (pre)osjetljivost

Anatomical characteristics and hydrologic signals in tree-rings of oaks (Quercus robur L.)

Q. robur decline in European floodplain forests in recent years seems to be strongly associated with the deteriorating hydrological regime. We investigated the influence of the Krka River flow on tree-ring patterns of Q. robur from the Krakovo floodplain forests (Slovenia) to assess the effect of micro-location conditions on hydrological signals in wood-anatomical characteristics. We selected two groups of Q. robur trees growing at nearby locations with different hydrological conditions, resulting in frequent autumn and spring flooding at the wetter site (=W oaks) but no flooding at the other, drier site (=D oaks). We found differences between the two groups in the anatomical structure of tree-rings; however, ring width proved to be the main variable determining the anatomical structure of oak wood. D and W oaks responded differently to the Krka River flow in the studied period. Radial growth of D oaks was negatively influenced by spring flow, but positively influenced by minimum summer flow. In W oaks, ring width was positively correlated with mean summer flow. Thus, environmental information stored in wood-anatomical features may vary, even within the same forest stand, and largely depends on the micro-environment. Reduced wood increments of D oaks suggest that growth conditions are less favourable, implying a link between the health state of oaks from lowland forest and hydrological conditions. Trees intended for hydrological reconstruction must therefore be carefully selected to avoid the possibility of error and potential loss of information. Anatomical characteristics and hydrological signals in tree-rings of oaks from areas with regular flooding may vary, even within the same forest stand, and largely depends on the micro-environmental conditions

On boundaries and difference : communities of practice and power relations in creative work

Tensions and struggles are a usual occurrence when knowledge ‘to get the job done’ needs to be produced at the boundaries of different disciplines and skills. Yet, power struggles have been often overlooked, and a deeper understanding of power dynamics in, and between, communities of practice is needed. An ethnographic study of the work practices of a digital media agency is utilised as a basis for the conceptual work of addressing tensions and struggles evident in creative design work. The approach developed here reactivates the critical and relational perspectives of communities of practice theory rearticulating it with the insights of Laclau and Mouffe’s site ontology. This study offers a transformative redefinition of communities of practice’s existing theoretical kit. It also shows how creative abrasions are situated in the broader politics of management and organisation of creative design work