The Value of Evidence-Based Computer Simulation of Oral Health Outcomes for Management Analysis of the Alaska Dental Health Aide Program

Objectives: To create an evidence‐based research tool to inform and guide policy and program managers as they develop and deploy new service delivery models for oral disease prevention and intervention. Methods: A village‐level discrete event simulation was developed to project outcomes associated with different service delivery patterns. Evidence‐ based outcomes were associated with dental health aide activities, and projected indicators (DMFT, F+ST, T‐health, SiC, CPI, ECC) were proxy for oral health outcomes. Model runs representing the planned program implementation, a more intensive staffing scenario, and a more robust prevention scenario, generated 20‐year projections of clinical indicators; graphs and tallies were analyzed for trends and differences. Results: Outcomes associated with alternative patterns of service delivery indicate there is potential for substantial improvement in clinical outcomes with modest program changes. Not all segments of the population derive equal benefit when program variables are altered. Children benefit more from increased prevention, while adults benefit more from intensive staffing. Conclusions: Evidence‐ based simulation is a useful tool to analyze the impact of changing program variables on program outcome measures. This simulation informs dental managers of the clinical outcomes associated with policy and service delivery variables. Simulation tools can assist public health managers in analyzing and understanding the relationship between their policy decisions and long‐term clinical outcomes.The Ford Foundation

IUPHAR-DB: An Expert-Curated, Peer-Reviewed Database of Receptors and Ion Channels

The International Union of Basic and Clinical Pharmacology database (IUPHAR-DB) integrates peer-reviewed pharmacological, chemical, genetic, functional and anatomical information on the 354 non-sensory G protein-coupled receptors (GPCRs), 71 ligand-gated ion channel subunits and 141 voltage-gated ion channel subunits encoded by the human, rat and mouse genomes. These genes represent the targets of about a third of currently approved drugs and are a major focus of drug discovery and development programs in the pharmaceutical industry. Individual gene pages provide a comprehensive description of the genes and their functions, with information on protein structure, ligands, expression patterns, signaling mechanisms, functional assays and biologically important receptor variants (e.g. single nucleotide polymorphisms and splice variants). The phenotypes resulting from altered gene expression (e.g. in genetically altered animals) and genetic mutations are described. Links are provided to bioinformatics resources such as NCBI RefSeq, OMIM, PubChem, human, rat and mouse genome databases. Recent developments include the addition of ligand-centered pages summarising information about unique ligand molecules in IUPHAR-DB. IUPHAR-DB represents a novel approach to biocuration because most data are provided through manual curation of published literature by a network of over 60 expert subcommittees coordinated by NC-IUPHAR. Data are referenced to the primary literature and linked to PubMed. The data are checked to ensure accuracy and consistency by the curators, added to the production server using custom-built submission tools and peer-reviewed by NC-IUPHAR, before being transferred to the public database. Data are reviewed and updated regularly (at least biennially). Other website features include comprehensive database search tools, online and downloadable gene lists and links to recent publications of interest to the field, such as reports on receptor-ligand pairings. The database is freely available at "http://www.iuphar-db.org":http://www.iuphar-db.org. Curators can be reached at curators [at] iuphar-db.org. We thank British Pharmacological Society, UNESCO (through the ICSU Grants Programme), Incyte, GlaxoSmithKline, Novartis, Servier and Wyeth for their support

Associations between recalled use of legal UK youth gambling products and adult disordered gambling

Background and aims: The UK allows a number of gambling products to be legally used by people under the age of 18. The aim of this study was to explore associations between recalled legal usage of five youth gambling products and adult disordered gambling. Methods: A retrospective cross-sectional study of 1,057 adult UK gamblers, aged 18–40. Recalled legal use of five youth gambling products (category D fruit machines, coin push machines, crane grab machines, the National Lottery, and National Lottery scratchcards) was correlated with adult disordered gambling symptoms as measured by the Problem Gambling Severity Index (PGSI). Results: Recalled rates of legal engagement with each product ranged from 50.9% for Category D fruit machines to 96.6% for coin push machines. For category D fruit machines, the National Lottery, and National Lottery scratchcards, merely having legally engaged with these products as a child was associated with adult disordered gambling. Furthermore, higher levels of recalled legal youth usage with each of the five products was also associated with adult disordered gambling. Discussion and conclusions: These results relate to recent government proposals to increase the National Lottery scratchcard legal age to 18, and add to a wider literature on youth gambling and subsequent gambling-related harm

Community awareness of green roofs in Sydney

There are environmental, economic and social benefits of installing green roofs and walls on city buildings. The environmental benefits are lower building related operational carbon emissions, reductions in the urban heat island, increases in bio-diversity and reductions in storm-water run-off. Economically, the benefits are reduced roof maintenance costs, lower running costs, higher capital and rental values for commercial buildings. Finally the social or community gains are the creation of aesthetically pleasing spaces, landmarksand cultural capital as well as provision of recreational spaces. Furthermore social, psychological and therapeutic gains accrue when the roof or wall is visible to people andis used for social interaction and leisure activities. The perceived drawbacks are perceived greater risk of building leaks, high costs of installation and maintenance, and access and security issues. Whilst the technology to design and install green roofs and walls has existed for hundreds of years the uptake and the demand for green roofs and walls has not been high. Overall, the environmental social and economic gains are not perceived sufficient to create significant demand to set up green roofs and walls. In Sydney Australia, the existing number of green roofs and walls are testimony to this observation. With the aim of addressing the barriers to the uptake of green roofs and walls; it is essential to understand the way in which the key stakeholders; here the community, perceive the technology. With this knowledge it is then feasible to develop an agenda to mitigate any erroneous perceptions that exists. This research reports on a survey with the Sydney community to determine their perceptions of green roofs and walls

Simple atmospheric perturbation models for sonic-boom-signature distortion studies

Sonic-boom propagation from flight level to ground is influenced by wind and speed-of-sound variations resulting from temperature changes in both the mean atmospheric structure and small-scale perturbations. Meteorological behavior generally produces complex combinations of atmospheric perturbations in the form of turbulence, wind shears, up- and down-drafts and various wave behaviors. Differences between the speed of sound at the ground and at flight level will influence the threshold flight Mach number for which the sonic boom first reaches the ground as well as the width of the resulting sonic-boom carpet. Mean atmospheric temperature and wind structure as a function of altitude vary with location and time of year. These average properties of the atmosphere are well-documented and have been used in many sonic-boom propagation assessments. In contrast, smaller scale atmospheric perturbations are also known to modulate the shape and amplitude of sonic-boom signatures reaching the ground, but specific perturbation models have not been established for evaluating their effects on sonic-boom propagation. The purpose of this paper is to present simple examples of atmospheric vertical temperature gradients, wind shears, and wave motions that can guide preliminary assessments of nonturbulent atmospheric perturbation effects on sonic-boom propagation to the ground. The use of simple discrete atmospheric perturbation structures can facilitate the interpretation of the resulting sonic-boom propagation anomalies as well as intercomparisons among varied flight conditions and propagation models

Heterogeneity in Disordered Gambling: Decision-Making and Impulsivity in Gamblers Grouped by Preferred Form.

Background: Previous research has indicated that disordered gamblers display deficits in impulsivity and risky decision-making, compared to healthy control groups. However, disordered gamblers are not a homogenous group, and differences in performance on neurocognitive tasks may be related to the form of gambling in which an individual chooses to engage. The present study used neurocognitive tasks and questionnaire measures to ascertain group differences in gamblers grouped by preferred form of gambling. Method: Treatment-seeking pathological gamblers from the National Problem Gambling Clinic, London (n = 101), completed a neurocognitive assessment comprising the Cambridge gamble task (CGT), the stop-signal task (SST), a probabilistic reversal learning task (PRL), and the Kirby Monetary Choice Questionnaire, as well as questionnaire measures of gambling severity, impulsivity, depression, and anxiety. Analyses compared gamblers who favored fixed-odds betting terminals (FOBTs) (the modal form) to gamblers who preferred other forms of gambling (non-FOBT). Results: The FOBT group showed impaired decision-making under risk on the CGT compared to the non-FOBT group, choosing the likely option less on more uncertain decisions. The FOBT group made fewer perseverative errors on the PRL task, had lower depression and anxiety scores, and were less likely to have a family history of problem gambling than the non-FOBT group. Discussion: Decision-making and cognitive flexibility differences between gamblers grouped by gambling type supports preferred form as an important source of heterogeneity in gambling disorder. Decision-making strategies and risk attitudes should be considered when approaching cognition-focused treatment strategies, allowing interventions to be targeted at specific cognitive deficits

Mountain wave turbulence in the presence of directional wind shear over the Rocky Mountains

Mountain wave turbulence in the presence of directional wind shear over the Rocky Mountains in Colorado is investigated. Pilot Reports (PIREPs) are used to select cases in which moderate or severe turbulence encounters were reported in combination with significant directional wind shear in the upstream sounding from Grand Junction, CO (GJT). For a selected case, semi-idealized numerical simulations are carried out using the WRF-ARW atmospheric model, initialized with the GJT atmospheric sounding and a realistic but truncated orography profile. In order to isolate the role of directional wind shear in causing wave breaking, sensitivity tests are performed to exclude the variation of the atmospheric stability with height, the speed shear, and the mountain amplitude as dominant wave breaking mechanisms. Significant downwind transport of instabilities is detected in horizontal flow cross-sections, resulting in mountain-wave-induced turbulence occurring at large horizontal distances from the first wave breaking point (and from the orography that generates the waves). The existence of an asymptotic wake, as predicted by Shutts for directional shear flows, is hypothesized to be responsible for this downwind transport. Critical levels induced by directional wind shear are further studied by taking 2D power spectra of the magnitude of the horizontal velocity perturbation field. In these spectra, a rotation of the most energetic wave modes with the background wind, as well as perpendicularity between the background wind vector and the wave-number vector of those modes at critical levels, can be found, which is consistent with the mechanism expected to lead to wave breaking in directional shear flows

A comparison of diet quality in a sample of rural and urban Australian adults

The diet quality of rural Australians is under researched. Characterising disparities in diet quality between rural and urban populations may inform targeted interventions in at- risk groups. A cross-sectional study aimed to determine the relationship between diet quality, rurality and socio-demographic characteristics in a sample of Australian adults. Participants were recruited at rural and regional events between 2017 and 2020, in New South Wales, Australia. Diet quality was measured using the Healthy Eating Quiz or Australian Eating Survey to generate an Australian Recommended Food Score (ARFS). ARFS was compared by rurality and sociodemographic characteristics using multivariate regression. Participants (n = 247; 53% female) had a mean ± SD ARFS of 34.5 ± 9.0. There was no significant effect of rurality on ARFS (β-coefficient = −0.4; 95%CI −3.0, 2.3). Compared to participants aged 18–30 years, higher ARFS was evident for those aged 31–50 (β = 5.4; 95%CI 0.3, 10.4), 51–70 (β = 4.4; 95%CI 0.3, 8.5) and >71 years (β = 6.5; 95% CI 1.6–11.4). Compared to those living alone, participants living with a partner (β = 5.2; 95%CI 2.0, 8.4) and families with children (β = 5.6; 95%CI 1.4, 9.8) had significantly higher ARFS. ARFS was significantly lower with each additional self-reported chronic health condition (β = −1.4; 95%CI −2.3, −0.4). Our results indicate that diet quality as defined by the ARFS was classified as ‘getting there’ and that age, living arrangements and chronic health conditions, but not rurality, influenced diet quality in a sample of Australian adults