Effects of socio-economic and behavioural factors on early childhood caries among children attending a dental clinic in Nairobi, Kenya

Background: Early childhood caries (ECC) is a growing oral health problem in the developing nations and has been associated with a number of socio-economic and behavioural factors.Objective: To determine the effects of some socio-economic and behavioural factors related to ECC in 3-6-year-old children attending an out-patient paediatric dental clinic in Nairobi, Kenya.Design: A descriptive cross-sectional studySetting: The Lady Northey dental clinic during the period of October to November 2014.Subjects: Two hundred and seventy two (272) children whose parents/guardians were initially interviewed to determine the socio-economic status of each of the children.Results: The prevalence of dental caries among the children was 95.5%, most of whom had poor oral hygiene. The high decayed, missing and filled teeth (dmft) was associated with the low socio-economic status of the parents/guardians, poor oral hygiene, increased consumption of cariogenic sugars and low oral health seeking behaviour.Conclusion: The high prevalence of ECC of 95.5% found among the children who participated in the study has a prominent association to their socio-economic and behavioural factors

Diversification into novel habitats in the Africa clade of Dioscorea (Dioscoreaceae): erect habit and elephant's foot tubers

Background: Dioscorea is a widely distributed and highly diversified genus in tropical regions where it is represented by ten main clades, one of which diversified exclusively in Africa. In southern Africa it is characterised by a distinct group of species with a pachycaul or "elephant''s foot" structure that is partially to fully exposed above the substrate. In contrast to African representatives of the genus from other clades, occurring mainly in forest or woodland, the pachycaul taxa and their southern African relatives occur in diverse habitats ranging from woodland to open vegetation. Here we investigate patterns of diversification in the African clade, time of transition from forest to more open habitat, and morphological traits associated with each habitat and evaluate if such transitions have led to modification of reproductive organs and mode of dispersal. Results: The Africa clade originated in the Oligocene and comprises four subclades. The Dioscorea buchananii subclade (southeastern tropical Africa and South Africa) is sister to the East African subclade, which is respectively sister to the recently evolved sister South African (e. g., Cape and Pachycaul) subclades. The Cape and Pachycaul subclades diversified in the east of the Cape Peninsula in the mid Miocene, in an area with complex geomorphology and climate, where the fynbos, thicket, succulent karoo and forest biomes meet. Conclusions: Diversification out of forest is associated with major shifts in morphology of the perennial tuber (specifically an increase in size and orientation which presumably led them to become pachycaul) and rotation of stem (from twining to non-twining). The iconic elephant''s foot morphology, observed in grasslands and thicket biomes, where its corky bark may offer protection against fire and herbivory, evolved since mid Miocene. A shift in pollination trait is observed within the forest, but entry into open habitat does not show association with reproductive morphology, except in the seed wing, which has switched from winged all round the seed margin to just at the base or at the apex of it, or has been even replaced by an elaiosome

A new classification of Cyperaceae (Poales) supported by phylogenomic data

Cyperaceae (sedges) are the third largest monocot family and are of considerable economic and ecological importance. Sedges represent an ideal model family to study evolutionary biology due to their species richness, global distribution, large discrepancies in lineage diversity, broad range of ecological preferences, and adaptations including multiple origins of C4 photosynthesis and holocentric chromosomes. Goetghebeur′s seminal work on Cyperaceae published in 1998 provided the most recent complete classification at tribal and generic level, based on a morphological study of Cyperaceae inflorescence, spikelet, flower, and embryo characters, plus anatomical and other information. Since then, several family-level molecular phylogenetic studies using Sanger sequence data have been published. Here, more than 20 years after the last comprehensive classification of the family, we present the first family-wide phylogenomic study of Cyperaceae based on targeted sequencing using the Angiosperms353 probe kit sampling 311 accessions. In addition, 62 accessions available from GenBank were mined for overlapping reads and included in the phylogenomic analyses. Informed by this backbone phylogeny, a new classification for the family at the tribal, subtribal, and generic levels is proposed. The majority of previously recognized suprageneric groups are supported, and for the first time, we establish support for tribe Cryptangieae as a clade including the genus Koyamaea. We provide a taxonomic treatment including identification keys and diagnoses for the 2 subfamilies, 24 tribes, and 10 subtribes, and basic information on the 95 genera. The classification includes five new subtribes in tribe Schoeneae: Anthelepidinae, Caustiinae, Gymnoschoeninae, Lepidospermatinae, and Oreobolinae

PERBEDAAN TINGKAT PENGETAHUAN DAN SIKAP IBU HAMIL SEBELUM DAN SESUDAH PENYULUHAN MENGENAI IUD PASCAPLASENTA

Background : Post-placental IUD is defined as IUD insertion within 10 minutes after the expulsion of placenta. This method is considered safe and the most potential method to prevent missed opportunity. The use of post-placental IUD currently perceived incompatible with the expectation. One of the factors that cause this thing is the low knowledge level of post-placental IUD in society. Aim : To analyze the difference of knowledge level and attitude towards postplacental IUD on pregnant woman before and after counseling. Methods : This research was conducted using quasi experimental one group pretest-posttest design. Thirty-three samples were taken by consecutive sampling from pregnant woman who lived in the territory of Puskesmas Ngesrep and Puskemas Halmahera, Semarang. Data were analyzed using paired T-Test. Results : The mean value of knowledge level before counseling was 6,09 ± 1,826 whereas after counseling was 8,15 ± 1,661. The mean value of attitude before counseling was 35,79 ± 4,709 with 26 respondents had positive attitude and 7 respondents had negative attitude whereas after counseling the mean value was 39,97 ± 4,261 with all respondents had positive attitude. There was significant difference (p<0,05) on knowledge level (p=0,000) and attitude (p=0,000) before and after counseling. Conclusion : There was significant difference on knowledge level and attitude towards post-placental IUD on pregnant woman before and after counseling. Key words: Post-placental IUD, counseling, knowledge level, attitud

A pilot study on the global practice of informed consent in paediatric dentistry

Background: Conducting oral treatment early in the disease course, is encouraged for better health outcomes. Obtaining informed consent is an essential part of medical practice, protecting the legal rights of patients and guiding the ethical practice of medicine. In practice, consent means different things in different contexts. Silver Diamine Fluoride (SDF) and Silver Fluoride (SF) is becoming popular and cost effective methods to manage carious lesions, however, cause black discolouration of lesions treated. Obtaining informed consent and assent is crucial for any dental treatment—and has specific relevance with SDF/ SF treatments. Methods: The aim of this paper is to describe informed consent regulations for dental care in a selection of countries, focusing on children and patients with special health care needs. An online survey was shared with a convenience sample of dental professionals from 13 countries. The information was explored and the processes of consent were compared. Results: Findings suggest that there are variations in terms of informed consent for medical practice. In Tanzania, South Africa, India, Kenya, Malaysia and Brazil age is the determining factor for competence and the ability to give self-consent. In other countries, other factors are considered alongside age. For example, in Singapore, the United Kingdom, and the United States the principle of Gillick Competence is applied. Many countries' laws and regulations do not specify when a dentist may overrule general consent to act in the “best interest” of the patient. Conclusion: It is recommended that it is clarified globally when a dentist may act in the “best interest” of the patient, and that guidance is produced to indicate what constitutes a dental emergency. The insights gathered provide insights on international practice of obtaining informed consent and to identify areas for change, to more efficient and ethical treatment for children and patients with special needs. A larger follow up study is recommended to include more or all countries

A re-examination of the life and work of A.F.G. Kerr and of his colleagues and friends

Arthur Francis George Kerr’s life is reviewed and related to a previously published account. Kerr’s collecting activity is analysed using an expanded version of the Thai Biogeography Group’s database of collections. 8,666 of the total 48,970 collections are Kerr’s and 3,178 are those of his colleagues and friends. Therefore, the total number of collections made by Kerr and his acquaintances is likely to be larger and more diverse than previously believed. Mapping of these data using GIS show that Kerr’s collecting activities focussed on particular regions of Thailand at particular times. Also large areas of the country remained unexplored by Kerr and his acquaintances: a pattern that, to some extent, persists to this day. The large, but dispersed, archive of Kerr’s photographs, maps, living collections and correspondence indicate that he was a skilled photographer (taking at least 3,000 images), cartographer (producing many hand-drawn maps) and exceptionally acute, accurate and detailed observer (filling numerous notebooks and leaving other records). It is clear that digitising these collections to form an on-line dedicated website is highly desirable to further progress on the flora of Thailand and surrounding countries and would form an unique record of the social history of early 20thC Thailand