Innovations that Address Socioeconomic, Cultural, and Geographic Barriers to Preventive Oral Health Care

This report focuses on nine oral health innovations that integrate service delivery and workforce models in order to reduce or eliminate socioeconomic, geographic, and cultural barriers to care. Two additional reports in this series describe the remaining programs that provide care in non-dental settings and care to young children. Although the programs are diverse in their approaches as well as in the specific characteristics of the communities they serve, a common factor among them is the implementation of multiple strategies to increase the number of children from low-income families who access preventive care, and also to engage families and communities in investing in and prioritizing oral health. For low-income children and their families, the barriers that must be addressed to increase access to preventive oral health care are numerous. For example, even children covered by public insurance programs face a shortage of dentists that accept Medicaid and who specialize in pediatric dentistry.(Guay, 2004).The effects of poverty intersect with other barriers such as living in remote geographic areas and community-wide history of poor access to dental care in populations such as recent immigrants . Overcoming these barriers requires creative strategies that address transportation barriers; establish welcoming environments for oral health care; and are linguistically and culturally relevant. Each of these nine programs is based on such strategies, including:-Expanding the dental workforce through training new types of providers or adding new providers to their workforce to increase reach and community presence;-Implementing new strategies to increase the cost-effectiveness of care so that more oral health care services are available and accessible;-Providing training and technical assistance that increase opportunities for and competence in delivering oral health education and care to children;-Developing creative service delivery models that address transportation and cultural barriers as well as the fear and stigma associated with dental care that may arise in communities with historically poor access.The findings from the EAs of these programs are synthesized to highlight diverse and innovative strategies for overcoming barriers to access that have potential for rigorous evaluation that could emerge as best practices. If proven effective, these innovative program elements could then be disseminated and replicated to increase access for populations in need of preventive oral health care

Dental Professionals in Non-Dental Settings

This report focuses on nine oral health innovations seeking to increase access to preventive oral health care in nondental settings. Two additional reports in this series describe the remaining programs that provide care in dental settings and care to young children. The nine innovations described here integrate service delivery and workforce models in order to reduce or eliminate socioeconomic, geographic, and cultural barriers to care. Although the programs are diverse in their approaches as well as in the specific characteristics of the communities they serve, a common factor among them is the implementation of multiple strategies to increase the number of children from low-income families who access preventive care, and also to engage families and communities in investing in and prioritizing oral health. For low-income children and their families, the barriers that must be addressed to increase access to preventive oral health care are numerous. For example, even children covered by public insurance programs face a shortage of dentists that accept Medicaid and who specialize in pediatric dentistry. The effects of poverty intersect with other barriers such as living in remote geographic areas and having a community-wide history of poor access to dental care in populations such as recent immigrants. Overcoming these barriers requires creative strategies that address transportation barriers, establish welcoming environments for oral health care, and are linguistically and culturally relevant. Each of these nine programs is based on such strategies, including:-Expanding the dental workforce through training new types of providers or adding new providers to the workforce toincrease reach and community presence;-Implementing new strategies to increase the cost-effectiveness of care so that more oral health care services are available and accessible;-Providing training and technical assistance that increase opportunities for and competence in delivering oral health education and care to children;-Offering oral health care services in existing, familiar community venues such as schools, Head Start programs and senior centers;-Developing creative service delivery models that address transportation and cultural barriers as well as the fear and stigma associated with dental care that may arise in communities with historically poor access.The findings from the EAs of these programs are synthesized to highlight diverse and innovative strategies for overcoming barriers to access. These strategies have potential for rigorous evaluation and could emerge as best practices. If proven effective, these innovative program elements could then be disseminated and replicated to increase access for populations in need of preventive oral health care

Accountants’ perceptions of communication in not-for-profit organisations: inhibitors, enablers and strategies

Purpose: The not-for-profit (NFP) context displays unique characteristics that include stakeholder diversity, multiple stakeholder agendas, and the pervasiveness of philanthropic values and related organisational mission. This study investigated accountants’ perceptions of NFPs’ characteristics that enable and inhibit their communication along with the strategies they adopt to overcome their communication challenges. Design/methodology/approach: This qualitative interview-based study is informed by Giddens’ structuration theory. Thirty NFP accountants, from three Australian states, were interviewed. Thematic analysis was used to identify the relationships between NFP organisational characteristics and accountants’ communication strategies, and their interactions with organisational structures. Findings: The study reveals important relationships between many stakeholders with limited financial acumen, organisational resource constraints, the currency of NFP information technologies, the dominance of operational mission over financial imperatives, and the supply of organisational accountants. Accountants’ structural adaptations emerge in their adopting multiple forms of communications reframing. Research limitations/implications: The NFP environment exhibits a mix of characteristics, some of which pose challenges for accountants’ communication while others facilitate their communication. Social implications: Increasingly, governments are relying on NFPs for the provision of services once provided by the state. Enhancing NFP accountants’ communication has the potential to improve outcomes for NFPs. Originality/value: The study broadens prior research on accountants’ communication beyond formal written reporting to recognise and articulate their informal communication strategies

Accountants’ perceptions of communication in not-for-profit organisations: inhibitors, enablers and strategies

Purpose The not-for-profit (NFP) context displays unique characteristics that include stakeholder diversity, multiple stakeholder agendas, and the pervasiveness of philanthropic values and related organisational mission. This study investigated accountants’ perceptions of NFP’s characteristics that enable and inhibit their communication along with the strategies they adopt to overcome their communication challenges. Design/methodology/approach This qualitative interview-based study is informed by Giddens’ structuration theory. Thirty NFP accountants, from three Australian states, were interviewed. Thematic analysis was used to identify the relationships between NFP organisational characteristics and accountants’ communication strategies, and their interactions with organisational structures. Findings The study reveals important relationships between many stakeholders with limited financial acumen, organisational resource constraints, the currency of NFP information technologies, the dominance of operational mission over financial imperatives, and the supply of organisational accountants. Accountants’ structural adaptations emerge in their adopting multiple forms of communications reframing. Research limitations/implications The NFP environment exhibits a mix of characteristics, some of which pose challenges for accountants’ communication while others facilitate their communication. Social implications Increasingly governments are relying on NFPs for the provision of services once provided by the state. Enhancing NFP accountants’ communication has the potential to improve outcomes for NFPs. Originality/value The study broadens prior research on accountants’ communication beyond formal written reporting to recognise and articulate their informal communication strategies

Phylogeny and evolution of anomalous roots in Daviesia (Fabaceae : Mirbelieae)

The phylogeny of the Australian legume genus Daviesia was estimated using sequences of the internal transcribed spacers of nuclear ribosomal DNA. Partial congruence was found with previous analyses using morphology, including strong support for monophyly of the genus and for a sister group relationship between the clade D. pachyloma and the rest of the genus. A previously unplaced bird-pollinated species, anceps + D. D. epiphyllum, was well supported as sister to the only other bird-pollinated species in the genus, D. speciosa, indicating a single origin of bird pollination in their common ancestor. Other morphological groups within Daviesia were not supported and require reassessment. A strong and previously unreported sister clade of Daviesia consists of the two monotypic genera Erichsenia and Viminaria. These share phyllode-like leaves and indehiscent fruits. The evolutionary history of cord roots, which have anomalous secondary thickening, was explored using parsimony. Cord roots are limited to three separate clades but have a complex history involving a small number of gains (most likely 0-3) and losses (0-5). The anomalous structure of cord roots ( adventitious vascular strands embedded in a parenchymatous matrix) may facilitate nutrient storage, and the roots may be contractile. Both functions may be related to a postfire resprouting adaptation. Alternatively, cord roots may be an adaptation to the low-nutrient lateritic soils of Western Australia. However, tests for association between root type, soil type, and growth habit were equivocal, depending on whether the variables were treated as phylogenetically dependent (insignificant) or independent ( significant)

Angiography and embolisation for solid abdominal organ injury in adults - a current perspective

Over the past twenty years there has been a shift towards non-operative management (NOM) for haemodynamically stable patients with abdominal trauma. Embolisation can achieve haemostasis and salvage organs without the morbidity of surgery, and the development and refinement of embolisation techniques has widened the indications for NOM in the management of solid organ injury. Advances in computed tomography (CT) technology allow faster scanning times with improved image quality. These improvements mean that whilst surgery is still usually recommended for patients with penetrating injuries, multiple bleeding sites or haemodynamic instability, the indications for NOM are expanding

Stronger Constraints on the Evolution of the MBH−σ∗M_{\rm{BH}}-\sigma_* Relation up to z∼0.6z\sim0.6

We revisit the possibility of redshift evolution in the $M_{\rm{BH}}-\sigma_*$ relation with a sample of 22 Seyfert 1 galaxies with black holes (BHs) in the mass range $10^{6.3}-10^{8.3}~M_\odot$ and redshift range $0.03<z<0.57$ with spectra obtained from spatially resolved Keck/Low-Resolution Imaging Spectrometer observations. Stellar velocity dispersions were measured directly from the Mg Ib region, taking into consideration the effect of Fe II contamination, active galactic nucleus (AGN) dilution, and host-galaxy morphology on our measurements. BH masses are estimated using the H$\beta$ line width, and the luminosity at 5100 \overset{\lower.5em\circ}{\mathrm{A}} is estimated from surface brightness decomposition of the AGN from the host galaxy using high-resolution imaging from the Hubble Space Telescope. Additionally, we investigate the use of the [O III]$\lambda5007$ emission line width as a surrogate for stellar velocity dispersion, finding better correlation once corrected for Fe II contamination and any possible blueshifted wing components. Our selection criteria allowed us to probe lower-luminosity AGNs and lower-mass BHs in the non-local universe than those measured in previous single-epoch studies. We find that any offset in the $M_{\rm{BH}}-\sigma_*$ relation up to $z\sim0.6$ is consistent with the scatter of local BH masses, and address the sources of biases and uncertainties that contribute to this scatter.Comment: Accepted 14 May 2019 for publication in ApJ. 42 pages, 12 figures, 4 tables. Corrected for typographical error

Evolutionary consequences of shifts to bird-pollination in the Australian pea-flowered legumes (Mirbelieae and Bossiaeeae)

BACKGROUND Interactions with pollinators are proposed to be one of the major drivers of diversity in angiosperms. Specialised interactions with pollinators can lead to specialised floral traits, which collectively are known as a pollination syndrome. While it is thought that specialisation to a pollinator can lead to either an increase in diversity or in some cases a dead end, it is not well understood how transitions among specialised pollinators contribute to changes in diversity. Here, we use evolutionary trait reconstruction of bee-pollination and bird-pollination syndromes in Australian egg-and-bacon peas (Mirbelieae and Bossiaeeae) to test whether transitions between pollination syndromes is correlated with changes in species diversity. We also test for directionality in transitions that might be caused by selection by pollinators or by an evolutionary ratchet in which reversals to the original pollination syndrome are not possible. RESULTS Trait reconstructions of Australian egg-and-bacon peas suggest that bee-pollination syndrome is the ancestral form and that there has been replicated evolution of bird-pollination syndromes. Reconstructions indicate potential reversals from bird- to bee-pollination syndromes but this is not consistent with morphology. Species diversity of bird-pollination syndrome clades is lower than that of their bee-pollination syndrome sisters.We estimated the earliest transitions from bee- to bird-pollination syndrome occurred between 30.8 Ma and 10.4 Ma. Geographical structuring of pollination syndromes was found; there were fewer bird-pollination species in the Australian southeast temperate region compared to other regions of Australia. CONCLUSIONS A consistent decrease in diversification rate coincident with switches to bird pollination might be explained if greater dispersal by bird pollinators results in higher levels of connectivity among populations and reduced chances of allopatric speciation.The earliest transitions overlap with the early diversification of Australian honeyeaters - the major lineage of pollinating birds in Australia. Our findings are consistent with the idea that environment and availability of pollinators are important in the evolution of pollination syndromes. Changes in flower traits as a result of transitions to bird-pollination syndrome might also limit reversals to a bee-pollination syndrome.Funding was provided by the Australian Research Council (grant number: DP0985473)

Apes communicate about absent and displaced objects: methodology matters

Displaced reference is the ability to refer to an item that has been moved (displaced) in space and/or time, and has been called one of the true hallmarks of referential communication. Several studies suggest that nonhuman primates have this capability, but a recent experiment concluded that in a specific situation (absent entities) human infants display displaced reference but chimpanzees do not. Here we show that chimpanzees and bonobos of diverse rearing histories are capable of displaced reference to absent and displaced objects. It is likely that some of the conflicting findings from animal cognition studies are due to relatively minor methodological differences, but are compounded by interpretation errors. Comparative studies are of great importance in elucidating the evolution of human cognition, however, greater care must be taken with methodology and interpretation for these studies to accurately reflect species differences