Feedback on audit and action planning for dental caries control : a qualitative study to investigate the acceptability among interdisciplinary pediatric dental care teams

Introduction: American Indian and Alaska Native children suffer from the poorest oral health of all populational groups in the United States. Evidence-based practices (EBP) for caries control are well established, but systematically implementing such practices have proven difficult. Audit and feedback with goal setting, and action planning to implement these EBPs have not been tested or adapted for Alaska Native healthcare settings. The aim of this study was to investigate acceptability and perceived feasibility of an audit and feedback intervention for pediatric dental caries control among dental providers and patient stakeholders. Methods: The pilot program was implemented in two dental clinics from a tribal healthcare consortium in Alaska. Key-informant interviews were conducted to investigate the contextual, organizational, and behavioral facilitators and barriers to the implementation and expansion of the program. Interview transcripts were analyzed by two researchers using thematic analysis. Results: Eight key informants were interviewed twice (during and after the intervention period), and one once, for a total of 17 interviews. Patient stakeholders were not interviewed due to COVID-19 pandemic clinic closures and social isolation mandates. Three principal themes emerged: a positive organizational climate and culture fostered the acceptability of the program, the positive impacts of the program observed in the pediatric dental teams and the organization, and the challenges to implement the program including understanding the data reports, trusting the accuracy of the data, and competing priorities. Conclusions: The intervention of audit and feedback with goal setting and action planning was well accepted and perceived as feasible by the study participants given the financial and human resources provided by the research project. This qualitative study can inform the design and evaluation of process-oriented implementation strategies geared towards decreasing health inequities and improving health outcomes, such as dental caries in American Indian and Alaska Native children and adolescents

A holomorphic representation of the Jacobi algebra

A representation of the Jacobi algebra $\mathfrak{h}_1\rtimes \mathfrak{su}(1,1)$ by first order differential operators with polynomial coefficients on the manifold $\mathbb{C}\times \mathcal{D}_1$ is presented. The Hilbert space of holomorphic functions on which the holomorphic first order differential operators with polynomials coefficients act is constructed.Comment: 34 pages, corrected typos in accord with the printed version and the Errata in Rev. Math. Phys. Vol. 24, No. 10 (2012) 1292001 (2 pages) DOI: 10.1142/S0129055X12920018, references update

Simple Space-Time Symmetries: Generalizing Conformal Field Theory

We study simple space-time symmetry groups G which act on a space-time manifold M=G/H which admits a G-invariant global causal structure. We classify pairs (G,M) which share the following additional properties of conformal field theory: 1) The stability subgroup H of a point in M is the identity component of a parabolic subgroup of G, implying factorization H=MAN, where M generalizes Lorentz transformations, A dilatations, and N special conformal transformations. 2) special conformal transformations in N act trivially on tangent vectors to the space-time manifold M. The allowed simple Lie groups G are the universal coverings of SU(m,m), SO(2,D), Sp(l,R), SO*(4n) and E_7(-25) and H are particular maximal parabolic subgroups. They coincide with the groups of fractional linear transformations of Euklidean Jordan algebras whose use as generalizations of Minkowski space time was advocated by Gunaydin. All these groups G admit positive energy representations. It will also be shown that the classical conformal groups SO(2,D) are the only allowed groups which possess a time reflection automorphism; in all other cases space-time has an intrinsic chiral structure.Comment: 37 pages, 4 Table

Realizations of Causal Manifolds by Quantum Fields

Quantum mechanical operators and quantum fields are interpreted as realizations of timespace manifolds. Such causal manifolds are parametrized by the classes of the positive unitary operations in all complex operations, i.e. by the homogenous spaces \D(n)=\GL(\C^n_\R)/\U(n) with $n=1$ for mechanics and $n=2$ for relativistic fields. The rank $n$ gives the number of both the discrete and continuous invariants used in the harmonic analysis, i.e. two characteristic masses in the relativistic case. 'Canonical' field theories with the familiar divergencies are inappropriate realizations of the real 4-dimensional causal manifold \D(2). Faithful timespace realizations do not lead to divergencies. In general they are reducible, but nondecomposable - in addition to representations with eigenvectors (states, particle) they incorporate principal vectors without a particle (eigenvector) basis as exemplified by the Coulomb field.Comment: 36 pages, latex, macros include

Reproductive medicine in northwest Argentina: traditional and institutional systems

<p>Abstract</p> <p>Background</p> <p>The state of conservation of the traditional cultures of Northwest Argentina is variable and somewhat problematic but to a lesser or a greater extent all the peoples are related to an hegemonic culture. We present a case study carried out in the rural communities of the Yungas biome (Salta) where the extent of isolation varies as does the type of access to public health services. The use of medicinal plants in the area is ordinary and widely spread.</p> <p>Methods</p> <p>The data can be organized in two categories, as medical systems public records (for the regional hospital at Los Toldos), and as ethnobotanical sets. A total of 59 surveys to 40 interviewees were undertaken using a semi structured questionnaire. We present an analysis of the relative importance of the medicinal herbs used in reproductive medicine considering the plants used in the traditional medical system and the factors that can affect the relationship between formal medicine and patients. We further analized how the degree of accessibility to the local hospital influences the diversity of use of plant species used to assist deliveries and to decrease infant mortality in children minor than one year of age.</p> <p>Results</p> <p>In reproductive medicine, 13 ailments and/or different physiological states are locally identified and treated. Local population uses 108 ethnospecies for this kind of illnesses. According to the local conception the hot/cold imbalance could be the principal cause for reproductive illnesses; pregnancy may have natural or supernatural origin, post partum and menstruation involve similar sanitary risks, and neonatal care has a strong magic connotation. In relation with the formal medicine, the more accessible is the health center the more women assist to it. We have not found a relation between accessibility and infant mortality.</p> <p>Conclusion</p> <p>In the local reproductive medicine, most of the practices are concerned with the hot/cold balance. According to their importance the factors involved are: the family medicine, the midwife, and the formal doctors. Plants have an important role; however there is a lack of total agreement among the families who use them. Reluctance to institutional deliveries may be due to the weak relationship between patients and doctors, and the lack of logistic assistance to delivering mothers coming from far away locations.</p

Causal structures and causal boundaries

We give an up-to-date perspective with a general overview of the theory of causal properties, the derived causal structures, their classification and applications, and the definition and construction of causal boundaries and of causal symmetries, mostly for Lorentzian manifolds but also in more abstract settings.Comment: Final version. To appear in Classical and Quantum Gravit

Adaptive Evolution of the Myo6 Gene in Old World Fruit Bats (Family: Pteropodidae)

PMCID: PMC3631194This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Allele-Specific Impairment of GJB2 Expression by GJB6 Deletion del(GJB6-D13S1854)

Mutations in the GJB2 gene, which encodes connexin 26, are a frequent cause of congenital non-syndromic sensorineural hearing loss. Two large deletions, del(GJB6-D13S1830) and del(GJB6-D13S1854), which truncate GJB6 (connexin 30), cause hearing loss in individuals homozygous, or compound heterozygous for these deletions or one such deletion and a mutation in GJB2. Recently, we have demonstrated that the del(GJB6-D13S1830) deletion contributes to hearing loss due to an allele-specific lack of GJB2 mRNA expression and not as a result of digenic inheritance, as was postulated earlier. In the current study we investigated the smaller del(GJB6-D13S1854) deletion, which disrupts the expression of GJB2 at the transcriptional level in a manner similar to the more common del(GJB6-D13S1830) deletion. Interestingly, in the presence of this deletion, GJB2 expression remains minimally but reproducibly present. The relative allele-specific expression of GJB2 was assessed by reverse-transcriptase PCR and restriction digestions in three probands who were compound heterozygous for a GJB2 mutation and del(GJB6-D13S1854). Each individual carried a different sequence variant in GJB2. All three individuals expressed the mutated GJB2 allele in trans with del(GJB6-D13S1854), but expression of the GJB2 allele in cis with the deletion was almost absent. Our study clearly corroborates the hypothesis that the del(GJB6-D13S1854), similar to the larger and more common del(GJB6-D13S1830), removes (a) putative cis-regulatory element(s) upstream of GJB6 and narrows down the region of location