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Additional file 1: Supplemental File A. Table of Measures for MHL Course Survey. Supplemental File B. Modified Mental Health Literacy Scale (O’Connor et al., 2015) [36]. Supplemental File C. Course Uptake and Acceptability.

We propose a simple statistical-physics-inspired model for the effect of intrinsic fluctuations on supply and demand in markets. The model consists of agents that trade in two types of goods of which the total number is separately conserved. The relative preference of an individual agent for the two types of goods is determined by a utility that is identical for all agents. Market supply and demand curves are computed and compared for various motivated choices of the distribution of goods over the agents. In particular, we compare the "mean-field" case, in which all agents have the same number of goods and that is akin to the economics textbook case, to the case of Boltzmann-Gibbs distributed goods, in which agents have a fluctuating number of goods. We find that the resulting equilibrium prices are not equal for these two approaches, especially when a large fraction of the agents can neither buy nor sell.

Purpose of review Although cities present opportunities for infectious pathogens such as HIV to spread, public health infrastructure within these cities also provides opportunities to design effective approaches to eliminate transmission of these pathogens. The HIV Transmission Elimination AMsterdam (H-TEAM) Initiative, a consortium of relevant stakeholders involved in HIV prevention and care, designed an integrated approach to curb the HIV epidemic in Amsterdam, including providing preexposure prophylaxis (PrEP), increasing awareness of acute HIV infection, offering same-day test and treat, and improving indicator disease-driven HIV testing. Recent findings In 2013, approximately 230 people in Amsterdam were newly diagnosed with HIV, largely belonging to one of two key affected populations, namely MSM and people with a migration background. Since the start of H-TEAM in 2014, a decrease in new diagnoses was observed (130 in 2017), with an increasing proportion of MSM who had been diagnosed with a recent infection. Summary The H-TEAM shows that a city-based concerted effort is feasible. However, major challenges remain, such as reducing the number of late HIV diagnoses, and identifying and providing appropriate services to a diminishing group of individuals who are likely the source of transmission.

Gaussian graphical models (GGM) allow for learning conditional independence structures that are encoded by partial correlations. Whereas there are several \proglang{R} packages for classical (i.e., frequentist) methods, there are only two that implement a Bayesian approach. These are exclusively focused on identifying the graphical structure; that is, detecting non-zero effects. The \proglang{R} package \pkg{BGGM} not only fills this gap, but it also includes novel Bayesian methodology for extending inference beyond identifying non-zero relations. \pkg{BGGM} is built around two Bayesian approaches for inference--estimation and hypothesis testing. The former focuses on the posterior distribution and includes extensions to assess predictability, as well as methodology to compare partial correlations. The latter includes methods for Bayesian hypothesis testing, in both exploratory and confirmatory contexts, with the novel matrix-$F$ prior distribution. This allows for testing order and equality constrained hypotheses, as well as a combination of both with the Bayes factor. Further, there are two approaches for comparing any number of GGMs with either the posterior predictive distribution or Bayesian hypothesis testing. This work describes the software implementation of these methods. We end by discussing future directions for \pkg{BGGM}.

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Contains fulltext : 215207.pdf (Publisher’s version ) (Open Access) BACKGROUND: Profound neuromuscular blockade (NMB) during anaesthesia has been shown to reduce postoperative pain scores, when compared with a moderate block. We hypothesised that profound NMB during laparoscopic donor nephrectomy (LDN) could also improve the early quality of recovery after surgery. OBJECTIVES: To compare the effectiveness of profound versus moderate NMB during LDN in enhancing postoperative recovery. DESIGN: A phase IV, double-blinded, randomised controlled trial. SETTING: Multicentre trial, from November 2016 to December 2017. PATIENTS: A total of 101 living kidney donors scheduled for LDN were enrolled, and 96 patients were included in the analyses. INTERVENTIONS: Patients were randomised to receive profound (posttetanic count 1 to 3) or moderate (train-of-four count 1 to 3) neuromuscular block. MAIN OUTCOME MEASURES: The primary outcome was the early quality of recovery at postoperative day 1, measured by the Quality of Recovery-40 Questionnaire. Secondary outcomes were adverse events, postoperative pain, analgesic consumption and length-of-stay. RESULTS: The intention-to-treat analysis did not show a difference with regard to the quality of recovery, pain scores, analgesic consumption and length-of-stay. Less intra-operative adverse events occurred in patients allocated to profound NMB (1/48 versus 6/48). Five patients allocated to a profound NMB received a moderate block and in two patients neuromuscular monitoring failed. The as-treated analysis revealed that pain scores were significantly lower at 6, 24 and 48 h after surgery. Moreover, the quality of recovery was significantly better at postoperative day 2 in patients receiving a profound versus moderate block (179.5 +/- 13.6 versus 172.3 +/- 19.2). CONCLUSION: Secondary analysis indicates that an adequately maintained profound neuromuscular block improves postoperative pain scores and quality of recovery. As the intention-to-treat analysis did not reveal a difference regarding the primary endpoint, future studies should pursue whether a thoroughly maintained profound NMB during laparoscopy improves relevant patient outcomes. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02838134.

The multivariate normal linear model is one of the most widely employed models for statistical inference in applied research. Special cases include (multivariate) t testing, (M)AN(C)OVA, (multivariate) multiple regression, and repeated measures analysis. Statistical procedures for model selection where the models may have equality and order constraints on the model parameters of interest are limited however. This paper presents a default Bayes factor for this model selection problem. The default Bayes factor is based on generalized fractional Bayes methodology where different fractions are used for different observations and where the default prior is centered on the boundary of the constrained space under investigation. First, the method is fully automatic and therefore can be applied when prior information is weak or completely unavailable. Second, using group specific fractions, the same amount of information is used from each group resulting in a minimally informative default prior having a matrix Cauchy distribution, resulting in a consistent default Bayes factor. Third, numerical computation can be done using parallelization which makes it computationally cheap. Fourth, the evidence can be updated in a relatively simple manner when observing new data. Fifth, the selection criterion can be applied relatively straightforwardly in the presence of missing data that are missing at random. Applications for the social and behavioral sciences are used for illustration., Comment: 31 pages, 0 figures

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Item does not contain fulltext PURPOSE: To compare the level of agreement between carious lesion assessments according to the visual clinical examination and the colour photograph methods. MATERIALS AND METHODS: Data on the presence of enamel/dentin carious lesions in previously sealed occlusal surfaces in first molars were obtained by two trained and calibrated examiners through visual clinical examination and from colour photographs 4 years after sealing. Kappa statistics were applied to calculate agreement between assessment methods. Data analysis was performed using sign, Bowker symmetry and McNemar's tests. RESULTS: The prevalence of dentin carious lesions was very low. The kappa coefficients for detecting enamel/dentin carious lesions using the two assessment methods were 0.65 (CI: 0.56-0.74) for examiner 1 and 0.70 (CI: 0.62-0.78) for examiner 2. Examiner 2 observed more enamel/dentin carious lesions on colour photographs than did examiner 1 (p = 0.008). Sensitivity analyses did not confirm this outcome. CONCLUSIONS: There was no difference in the detection of enamel/dentin carious lesions in previously sealed occlusal surfaces using colour photographs vs visual clinical examination. The colour photograph method is therefore equivalent to the visual clinical examination in detecting enamel/dentin carious lesions. More studies are required.

Item does not contain fulltext PURPOSE: To test the hypotheses: 1) cumulative survival rates of fully and partially retained high-viscosity glass-ionomer (HVGIC) ART sealants with heat application and glass-carbomer sealants on occlusal and free-smooth surfaces are both higher than that of resin sealants; 2) cumulative survival rate of fully and partially retained high-viscosity glass-ionomer ART sealant with heat application on occlusal and free-smooth surfaces is higher than that of comparable ART sealants without heat application. MATERIALS AND METHODS: The block-randomised clinical trial covered 405 eight-year-old children. The HVGIC was Ketac Molar Easymix, the glass carbomer was GlassCarbomer and the resin sealant was Clinpro. Retention rates of sealants on occlusal and free-smooth surfaces using conventional and modified categorisation (fully and partially retained sealants vs those completely lost [at least one-third of surface re-exposed]) were the dependent variables. The Kaplan-Meier survival method was used. RESULTS: The cumulative survival rate of completely and partially retained resin sealants on occlusal (81.2%) and free-smooth (81%) surfaces after 4 years was statistically significantly higher, and that of glass-carbomer sealants (10.8% and 21.1%, respectively) was statistically significantly lower than those of the other sealant groups. There was no statistically significant difference in survival rates of completely and partially retained high-viscosity glass-ionomer ART sealants with (56% for both surfaces) or without heat application (56%) on occlusal and free-smooth surfaces (55.7% and 59.1%, respectively). CONCLUSIONS: Resin sealants had the highest and glass-carbomer sealants the lowest retention rate after 4 years. Application of heat to high-viscosity glass-ionomer ART sealants did not result in a significantly higher sealant retention rate. Use of the modified categorisation for determining sealant retention is advocated.

Contains fulltext : 97208.pdf (Publisher’s version ) (Closed access) AIM: To determine whether gradually exposing Brazilian children to the dental environment would decrease their levels of dental anxiety over a 14.5-month period. STUDY DESIGN AND METHODS: The study was carried out on 302 children of both genders, aged 6-7 years old. Dental anxiety was assessed using the Facial Image Scale (FIS) at five time points: 1) before an epidemiological examination; 2) before the first treatment session; 3) before the second treatment session; 4) before the first evaluation session 5) before the second evaluation session. STATISTICS: ANOVA, Student-t tests and ANCOVA were used to analyse the data. RESULTS: There was a statistically significant decrease in levels of dental anxiety between time points 1 and 5. Eighty-nine percent of the children with FIS score 1 or 2 at baseline had the same scores at the last time point, whereas 82% of children with FIS score 4 or 5 at baseline had a FIS score of 1 or 2 at the last time point. CONCLUSION: A gradual exposure of children to the dental environment in sequential dental visits of different natures in a school premise decreased their levels of dental anxiety over a 14.5-month period. 01 december 2011

Contains fulltext : 87333.pdf (Publisher’s version ) (Open Access) In order to gain insight into the development of caries prevalence and caries experience among Dutch youth, a meta-analysis was carried out on epidemiological caries data collected in 5 and 6 and 11 and 12 year-olds between 1980 and 2009. From the present analysis it appears that after the mid-1980's a halt occurred in the decline of caries experience in the primary dentition among 5 and 6 year-olds. At the same time, the percentage of children with a caries-free primary dentition who were covered by public health insurance or participated in institutions for youth dental care decreased. Among 11 to 12 year-olds there is no indication that the prevalence of caries in the permanent dentition has changed. Considering the high percentage of 12 year-olds with a caries-free permanent dentition, an additional improvement in oral health for this age-group will be difficult to achieve. The average restorative index of the primary dentition in 5-6 year-old children covered by public health insurance and children in The Hague appears not to have changed dramatically in the last 15 years. 01 maart 2010

When analyzing repeated measurements data, researchers often have expectations about the relations between the measurement means. The expectations can often be formalized using equality and inequality constraints between (i) the measurement means over time, (ii) the measurement means between groups, (iii) the means adjusted for time-invariant covariates, and (iv) the means adjusted for time-varying covariates. The result is a set of informative hypotheses. In this paper, the Bayes factor is used to determine which hypothesis receives most support from the data. A pivotal element in the Bayesian framework is the specification of the prior. To avoid subjective prior specification, training data in combination with restrictions on the measurement means are used to obtain so-called constrained posterior priors. A simulation study and an empirical example from developmental psychology show that this prior results in Bayes factors with desirable properties.

Item does not contain fulltext Reproducibility of the centric relation position for patients with temporomandibular disorders (TMD) is not documented in the current literature. It was the objective of this study to assess clinical variability of the centric relation position for TMD patients with a muscle-determined technique by means of an anterior deprogramming device, the leaf gauge. A sample of 60 patients with signs of TMD was selected, 8 men (Mean age 28,6, SD 5,2) and 52 women (Mean age 30,5, SD 10,1). All patients were examined with the Research Diagnostic Criteria, including pain on movement and/or function, mouth opening, joint sounds and palpation of masticatory muscles. All 60 patients were allocated to one of the following diagnostic subgroups: myofascial pain, disk displacement with reduction, disk displacement without reduction, osteoarthritis, trauma. Twelve control subjects were taken from a previous study. Three sequential centric relation records were taken; the first one was used to mount a set of casts to an articulator. Criteria of precision were formulated beforehand: 2 out of 3 centric relation records had to be identical in a split-cast procedure. Variables XL and XR represented mandibular displacement in the sagittal plane, variables YL and YR in the transversal plane, and ZL and ZR in the vertical plane, on the left and right condylar level respectively. Variables XMIN, YMIN and ZMIN represented the minimal sagittal, transversal and vertical displacement left or right respectively. Likewise, variables XMAX, YMAX and ZMAX represented the maximal sagittal, transversal and vertical displacement left or right. XDIFF, YDIFF and ZDIFF represented the difference between the minimal and maximal values of X, Y and Z. The diagnostic subgroup trauma was excluded, because there was only one patient. The null-hypothesis of no between-group differences in within-subject and total variability was tested with an analysis of variance (ANOVA). The level of significance was set at 0.05. To minimize type I errors caused by multiple testing Scheffe's test was used to maintain an overall significance of 0.05. No significant difference between patients and control subjects could be found for variables XL, XR, YL, YR, ZR and ZL. Variables XMIN, YMIN, ZMIN, XMAX, YMAX, ZMAX, XDIFF, YDIFF and ZDIFF showed no significant differences. Scheffe's testing for the variables XL, XR, YL, YR, ZL and ZR, as well as the variables XMIN, YMIN, ZMIN, XMAX, YMAX, ZMAX, XDIFF YDIFF and ZDIFF showed no significant differences. The results of this study suggest no variability in centric relation position between TMD-patients and control subjects by means of the leaf gauge.

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Item does not contain fulltext Although reproducibility of centric relation position, determined with an anterior deprogramming device, a leaf gauge, is widely accepted among clinicians, data confirming statistical evidence are lacking in the current literature. The objective of this study was to prove clinical reliability of a measuring-procedure to locate the centric relation position, determined with the leaf gauge. A sample of 15 subjects (6 men, 9 women, age 22 to 46), assessed with the Research Diagnostic Criteria to rule out any TMD-signs, was selected. Three observers each took three sequential interocclusal records with the leaf gauge, to mount a set of casts into the centric relation position in an articulator. Out of 15 subjects, 12 (5 men, 7 women) fitted criteria of precision--three out of three interocclusal records for each of the three observers--in a split-cast procedure. The applied statistical method is an analysis of variance model (ANOVA) with two factors for 3 observers and 12 subjects. The variance components estimation procedure is MIVQUE (0). The a was set at 0.05. No significant difference between observers for the measured variables sagittally (XL, XR), transversally (YL, YR), and vertically (ZL, ZR) could be found. MIVQUE variance components estimates for observers is < 0, varies for subjects from 0.04 to 0.20 and varies for error from 0.12 to 0.25 mm. Reliability of a measuring-procedure to locate a muscle-determined centric relation position could be established satisfactory.

Item does not contain fulltext The prevention of dental erosion with fluoride is still largely unknown territory. It was the aim of this study to determine the erosion-inhibiting effect of topical neutral 1% sodium fluoride (NaF) application and an application of a 4% titanium tetrafluoride (TiF4) solution compared with no treatment. Ten bovine incisors were selected and three enamel samples prepared from each tooth. One sample from each tooth was assigned to one of three experimental groups. The experimental treatments were: no fluoride application (control); 4 min application of neutral 1% NaF gel; and 4 min application of 4% TiF4 solution. All of the specimens were repeatedly exposed to 50 mm citric acid solution containing 0.4 mm CaCl2, and 2.2 mm KH2PO4 at pH 3.0 over four consecutive days. The acid exposure was performed in intervals and the intensity was increased over the days of the experiment. Enamel dissolution was determined by calcium content measurement of the acid solution after exposure, using atomic absorption spectroscopy. A statistically significant erosion-inhibiting effect was found for both NaF and TiF4 treatments compared with the control group from an erosion exposure time of 3 min. The reduction of calcium loss, however, was higher for the TiF4-treated specimens than the NaF-treated. From 16 min of erosion exposure, the erosion-inhibiting effect was significantly stronger in the TiF4 than the NaF group. The relative reduction of calcium loss compared with the control group remained stable for the TiF4 group, whereas for the NaF group the relative reduction decreased with cumulative erosion time. It is concluded that topical TiF4 application provides a potential treatment option in erosion prevention.

Contains fulltext : 77549.pdf (Publisher’s version ) (Closed access) Large auditory-visual (AV) speech corpora are the grist of modern research in speech science, but no such corpus exists for Australian English. This is unfortunate, for speech science is the brains behind speech technology and applications such as text-to-speech (TTS) synthesis, automatic speech recognition (ASR), speaker recognition and forensic identification, talking heads, and hearing prostheses. Advances in these research areas in Australia require a large corpus of Australian English. Here the authors describe a blueprint for building the Big Australian Speech Corpus (the Big ASC), a corpus of over 1,100 speakers from urban and rural Australia, including speakers of non-indigenous, indigenous, ethnocultural, and disordered forms of Australian English, each of whom would be sampled on three occasions in a range of speech tasks designed by the researchers who would be using the corpus.

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Background Nintedanib (formerly known as BIBF 1120) is an intracellular inhibitor that targets multiple tyrosine kinases. A phase 2 trial suggested that treatment with 150 mg of nintedanib twice daily reduced lung-function decline and acute exacerbations in patients with idiopathic pulmonary fibrosis. Methods We conducted two replicate 52-week, randomized, double-blind, phase 3 trials (INPULSIS-1 and INPULSIS-2) to evaluate the efficacy and safety of 150 mg of nintedanib twice daily as compared with placebo in patients with idiopathic pulmonary fibrosis. The primary end point was the annual rate of decline in forced vital capacity (FVC). Key secondary end points were the time to the first acute exacerbation and the change from baseline in the total score on the St. George’s Respiratory Questionnaire, both assessed over a 52-week period. Results A total of 1066 patients were randomly assigned in a 3:2 ratio to receive nintedanib or placebo. The adjusted annual rate of change in FVC was −114.7 ml with nintedanib versus −239.9 ml with placebo (difference, 125.3 ml; 95% confidence interval [CI], 77.7 to 172.8; P

Item does not contain fulltext OBJECTIVES: To assess and compare the cumulative survival rate of amalgam and atraumatic restorative treatment (ART) restorations in primary molars over 3 years. METHODS: 280 children aged 6-7 years old were enrolled in a cluster randomized controlled clinical trial using a parallel group design covering two treatment groups: conventional restorative treatment with amalgam (CRT) and atraumatic restorative treatment (ART) using a high-viscosity glass-ionomer (HVGIC) Ketac Molar Easymix. Three pedodontists placed 750 restorations (364 amalgam and 386 ART in 126 and 154 children, respectively) which were evaluated at 0.5, 1, 2 and 3 years. The proportional hazard rate regression model with frailty correction, ANOVA and Wald tests, and the Jackknife procedure were applied in analysing the data. RESULTS: The cumulative survival rates over 3 years for all, single- and multiple-surface CRT/amalgam restorations (72.6%, 93.4%, 64.7%, respectively) were no different from those of comparable ART/HVGIC restorations (66.8%; 90.1% and 56.4%, respectively) (p=0.10). Single-surface restorations had higher survival rates than multiple-surface restorations for the both treatment procedures (p

Item does not contain fulltext AIM: The study objective was to collect diagnostic data, to explore correlations between diagnostic variables, to provide an accurate initial diagnosis, and to provide appropriate management in consecutive subjects consulting with a multidisciplinary halitosis team because of a halitosis complaint. METHOD: Nine hundred and fifty-four subjects with halitosis complaints applied for consultation. Subjects' history data were collected and organoleptic measurements and a physical examination were performed. Finally, genuine halitosis or pseudo-halitosis/halitophobia was diagnosed initially and management was provided. RESULT: Genuine oral halitosis was diagnosed initially in 93% of cases. Using oral cleaning materials, performing mechanical tongue cleaning, and periodical dentist consultation were over-represented in women, whereas men were more likely to have observable biofilm and carious lesions than women. Female gender was associated with tongue coating. Positive associations were found between age and performing mechanical tongue cleaning, organoleptic measurement scores as well as poor oral health. Educational level was positively associated with oral self care behaviours. Performing mechanical tongue cleaning was not associated with periodical dentist consultation. CONCLUSION: In nearly all subjects complaining of halitosis, an oral cause could be detected.

Aplasia cutis is one of the features of the Adams-Oliver syndrome, beside limb anomalies. Aplasia cutis, congenital absence of skin, is a lesion that usually presents over the vertex of the skull. Management of aplasia cutis depends on the size of the skin defect and the child's physical condition. Scalp defects larger than approximately 1 cm should be treated surgically. In patients with aplasia cutis, surgery should preferably be performed using rotation scalp flaps, and additional split skin grafts. The history of two babies with the Adams-Oliver syndrome is presented. In the Adams-Oliver syndrome, large rotation scalp flaps are not reliable due to the abnormal vascularity of the skin. Skin grafting is the safest way, preventing hemorrhage and infection, in the operative treatment of aplasia cutis in these babies.

Item does not contain fulltext AIMS: To study the effect of fluconazole on the steady-state pharmacokinetics of the protease inhibitors ritonavir and saquinavir in HIV-1-infected patients. METHODS: Five subjects treated with saquinavir and three with ritonavir received the protease inhibitor alone (saquinavir 1200 mg three times daily, ritonavir 600 mg twice daily) on day 1, and the same protease inhibitor in combination with fluconazole (400 mg on day 2 and 200 mg on days 3 to 8). Pharmacokinetic parameters were determined on days 1 and 8. RESULTS: In the saquinavir group, the median increase in the area under the plasma concentration vs time curve was 50% from 1800 microg l(-1) h to 2700 microg l(-1) h (P = 0.04, median increase: 900 microg l(-1) h; 2.5 and 97.5 percentile: 500-1300), and 56% for the peak concentration in plasma (from 550 to 870 microg l(-1), P = 0.04; median increase: 320 microg l(-1) h, 2.5 and 97.5 percentile: 60-450 microg l(-1)). In the ritonavir group, there were no detectable changes in the pharmacokinetic parameters on addition of fluconazole. CONCLUSIONS: Because of the favourable safety profile of saquinavir, dose adjustments are probably not necessary with concomitant use of fluconazole, as is the case for ritonavir.

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Item does not contain fulltext Background Chronic kidney disease (CKD) is highly prevalent in patients with diabetes or hypertension in primary care. A shared care model could improve quality of care in these patients Aim To assess the effect of a shared care model in managing patients with CKD who also have diabetes or hypertension. Design and setting A cluster randomised controlled trial in nine general practices in The Netherlands. Method Five practices were allocated to the shared care model and four practices to usual care for 1 year. Primary outcome was the achievement of blood pressure targets (130/80 mmHg) and lowering of blood pressure in patients with diabetes mellitus or hypertension and an estimated glomerular filtration rate (eGFR)

Item does not contain fulltext Controversy exists as to whether centric slide is an etiological factor for temporomandibular disorders. In this cross-sectional study the magnitude of centric slides, obtained with 2 different articulations and one with a millimetre ruler was compared. The study enrolled a group of 27 healthy individuals and 83 TMD patients, the latter divided in 3 groups of 26, 28 and 29 subjects with the RDC/TMD diagnoses of myofascial pain, osteoarthritis and disc displacement without reduction, respectively. Measurement reliability of a chinpoint guided articulation was compared with a musculoskeletally stable articulation, obtained using a leaf gauge. Next, centric slide was measured, if any, intraorally with a millimetre ruler and in both articulations measuring the difference between centric relation and the maximal intercuspal position. A mandibular full-arch Tanner type stabilisation splint was fabricated for each of the TMD patients. After splint treatment, new casts were obtained and mounted using both methods to locate centric relation. The magnitude of centric slide intraorally and in both articulations was reassessed. For the analysis of the variables a mixed-model procedure was applied (alpha = 0.05). At baseline and upon conclusion of splint treatment all groups exhibited centric slides with large standard deviations (ranging from 1.03 +/- 0.83 to 1.97 +/- 1.3 millimetre). In the mixed-model procedure a significant difference in magnitude existed between the millimetre ruler and both the chinpoint guidance as well as the leaf gauge articulation (P < 0.001). No correlation between centric slide and TMD could be demonstrated.

Item does not contain fulltext Objectives: To assess attitudes, subjective norms, and intentions of primary health-care (PHC) providers in performing routine oral examination for oropharyngeal candidiasis (OPC) during outpatient consultations. Methods: A 47-item Theory of Planned Behaviour-based questionnaire was developed and administered, in a cross-sectional survey, to 216 PHC providers (clinical officers and nurses) working in 54 clinics, dispensaries, and health centers in Nairobi Province in January 2010. The constructs - attitudes, subjective norms, and perceived behavioral control (dependent variables) - and their individual indirect (direct) items were analyzed for scores, internal validity, independent variables (district, gender, years of service, profession, and age), and contribution to intentions. Perceived behavioral control had low construct validity and was therefore removed from subsequent analyses. Results: The questionnaire was completed by 195 participants (90 percent response rate). PHC provider's attitudes, subjective norms, and intentions to perform an oral examination during outpatient consultations were highly positive, with mean scores of 6.30 (0.82), 6.06 (1.07), and 5.6 (1.33), respectively, regardless of sociodemographic characteristics. Indirect attitude and subjective norms were strongly correlated to their individual items (r = 0.63-0.79, P < 0.05 and r = 0.78-0.87, P < 0.05) and moderately to their direct items (r = 0.44, P < 0.0001 and r = 0.52, P < 0.0001). Attitudes (P = 0.0026) and subjective norms (P < 0.0001) were both predictive of intentions. Conclusions: PHC providers were willing to integrate patients' oral health care into their routine medical consultations. Emphasizing the importance of detecting other oral problems and of the fact that routine oral examination for OPC is likely to give patients' fulfillment will enhance PHC providers' morale in performing routine oral examinations. Winning support from policy makers, their supervisors, specialists, and colleagues is important for motivating PHC providers to perform routine oral examinations for OPC at their workplaces.

Small fixed-wing unmanned aerial vehicles (UAVs) limits the use of heavy, computational and power consuming sensors. To further increase the use of UAVs, their navigation filters must be robust and reliable. This paper focuses on dynamic attitude, heading reference systems (AHRS) that can be applied to small fixed-wing UAVs. Two options of observers are explored, both using a low-cost single inertial measuring unit (IMU) and Global Positioning System (GPS) receiver. The first option utilizes the kinematics of fixedwing aircraft together with individual IMU and GPS properties. This leads to a set of three angle correction equations that can correct the attitude and heading angles prediction by the onboard IMU. The second set of observers use the GPS velocity measurements which are differentiated to obtain the vehicles acceleration, which can be used to estimate the attitude angles. The attitude and heading angles are obtained using two types of navigation filters. Besides the conventional extended Kalman filter (EKF) a different type of algorithm is explored that uses a coordinate transformation matrix as a basis. The algorithm is a particular nonlinear complementary filter that uses the coordinate transformation matrix between a North-East-Down (NED) and body-fixed frame of reference. This transformation matrix is a special type of Lie group called special orthogonal group or SO(3). In this paper four different AHRS options are explored, two sets of possible observers and two integration algorithms. The performance of all four is explored using a simulation of a small fixed-wing UAV together with detailed IMU and GPS receiver modeling. Besides performance, AHRS time synchronization for coupled IMU/GPS configurations applied to highly dynamic platforms is analyzed. The AHRS identification simulations show that all four options can be applied to real-time AHRS, with little difference between the two sets of observers. During the simulations, the passive complementary filter (PCF) based on the SO(3) group shows a significant improvement over conventional EKF with lower computational requirements.

A detailed experimental and simulation study of the extraction of a 24 keV He-ion beam from an ECR ion source and the subsequent beam transport through an analyzing magnet is presented. We find that such a slow ion beam is very sensitive to space-charge forces, but also that the neutralization of the beam's space charge by secondary electrons is virtually complete for beam currents up to at least 0.5 mA. The beam emittance directly behind the extraction system is 65 pi mm mrad and is determined by the fact that the ion beam is extracted in the strong magnetic fringe field of the ion source. The relatively large emittance of the beam and its non-paraxiality lead, in combination with a relatively small magnet gap, to significant beam losses and a five-fold increase of the effective beam emittance during its transport through the analyzing magnet. The calculated beam profile and phase-space distributions in the image plane of the analyzing magnet agree well with measurements. The kinematic and magnet aberrations have been studied using the calculated second-order transfer map of the analyzing magnet, with which we can reproduce the phase-space distributions of the ion beam behind the analyzing magnet. Using the transfer map and trajectory calculations we have worked out an aberration compensation scheme based on the addition of compensating hexapole components to the main dipole field by modifying the shape of the poles. The simulations predict that by compensating the kinematic and geometric aberrations in this way and enlarging the pole gap the overall beam transport efficiency can be increased from 16 to 45%.

Item does not contain fulltext The hypothesis was tested that the level of pain experienced by children during conventional restorative treatment is higher than during atraumatic restorative treatment (ART) or an ultraconservative treatment. The sample consisted of 244 children, 6- to 7 yr of age, who had at least two teeth with dentine carious lesions. Before the first treatment session (Tx-1), in which one of the carious teeth was treated using one of the treatments, the level of dental anxiety was assessed using the Facial Image Scale (FIS). The child reported the intensity of pain experienced during the procedure using the Wong-Baker FACES Pain Rating Scale. When conventional restorative treatment was used, more children needed local anaesthesia. Analyses excluding the data of children who had received local anaesthesia showed no treatment group effect on the Wong-Baker score, a FIS Tx-1 effect on the Wong-Baker score, and a statistically significant correlation between FIS Tx-1 and Wong-Baker scores. There was no significant difference in the pain levels of children treated using conventional restorative treatment, atraumatic restorative treatment or ultraconservative treatment. Local anaesthesia had to be administered more frequently to children in the conventional restorative group than to those in the other two treatment groups.

Item does not contain fulltext OBJECTIVE: To identify barriers to restorative care, as perceived by dental practitioners. METHODS: Of the total of 147 dental practitioners employed in regional and district government hospitals and municipal health centres, 138 completed a pre-tested questionnaire: a response rate of 94%. Factor analysis was performed to extract barrier factors. Chi-square test was used to test the influences of independent variables on discrete dependent variables, and ANOVA was used to test the influences of independent variables on continuous dependent variables. RESULTS: Knowledge of patients and beliefs of patients were perceived as the most important barriers. Others were financial, motivation of practitioners, dentistry looked down upon by administration and patients' fear of noise from drill. Practitioners who worked in high and medium economic zones perceived patients' fear of noise from drill as a barrier to restorative care more than their counterparts in low economic zones. Practitioners who worked in low economic zones perceived dentistry looked down upon by administration as a barrier to restorative care more than colleagues in high and medium economic zones. CONCLUSIONS: Knowledge and beliefs of patients about restorative care were the two main factors that hindered restorative care, as perceived by dental practitioners in Tanzania. Organized information provision to the population and regular continuing education meetings for practitioners on restorative and preventive care, plus adoption of Atraumatic Restorative Treatment in daily clinical work are considered appropriate in addressing these barriers. 01 maart 2010

Item does not contain fulltext OBJECTIVE: To assess the relation between cost and effectiveness of implantable middle ear hearing devices in patients with pure sensorineural hearing loss. DESIGN: Literature review. RESULTS: Four studies were identified that described the effect of middle ear implantation on quality of life in groups of at least 20 patients. Several different quality of life questionnaires were used. CONCLUSIONS: Our review demonstrated that middle ear implantation is a cost-effective health care intervention in patients with sensorineural hearing loss who suffered an additional therapy-resistant chronic external otitis.

This paper aims to link the use of sound amplification technology to the Acousmatic theory as conceived by Pierre Schaeffer. The argument pursued here is part of my multi-disciplinary PhD thesis that researches the influence of the use amplification technology on music from Semiotic, Sociology of Music and Aesthetic perspectives.

Contains fulltext : 79011.pdf (Publisher’s version ) (Open Access)

“Music corrupts the minds of our young”. This allegation has generated numerous studies investigating the ‘music taste’ and psychosocial functioning of popular music audiences. Youth are considered to be susceptible to messages promoting sexual promiscuity, substance use, violence and sometimes suicide. The most notorious music genres in this regard are rap/hip hop, and harder forms of rock such as heavy metal and punk. This thesis focused on the role of ‘music taste’ by; analyzing the consistency of music preferences over time investigating the behavioural correlates of different music tastes among adolescents and young adults (twelve to twenty-nine year olds); and exploring the positive effects of music on listeners. The first study showed that, at the intra-individual level, taste consistency varied substantially. Overall, however, musical taste in terms of genre and style ratings is surprisingly consistent for the age-group twelve to seventeen, and is even more consistent among older youth and young adults. Music preferences were found to be consistently associated with problem behaviours. Especially relevant was music that can be described as non-mainstream. Non-mainstream refers to both music that tends towards the deviant and subversive (e.g., punk/hardcore, techno/hardhouse), as well as music that can be qualified as elitist and adult-oriented (e.g. jazz, classical music). Preference for ‘harder’ types of music was associated with substance use and externalising problems, while preference for ‘adult-oriented’ music was positively associated with internalising problems. In addition, young people that displayed low or no involvement with predominant youth cultures appeared to belong to a non-mainstream sub-group and displayed higher rates of social problems. Youth that liked popular, accessible music types, such as the music found in the charts, reported an absence of problem behaviours. In these studies other factors associated with the problem behaviours under study, such as school functioning and relationship with parent were controlled for. Nevertheless, music preferences remained uniquely associated with problem behaviours. In the studies on the relationship between music preferences and substance use one important factor was the substance use behaviour of peers. Both music preference and reported substance use by peers showed partial and sometimes complete overlap in explaining self-reported substance use. Although it was not possible to test with cross-sectional data, it is likely that simultaneous processes of selection and influence of both music and friends were at work. Finally, these studies indicated a unique association between music taste on the one hand, and externalising and internalising problem behaviours on the other. Regardless of specific music preferences, music appeared to have a positive effect on most of its listeners. Even those that indicated the frequent use of music to act out negative emotions showed no evidence of sustaining negative states, as had been suggested previously in the literature. Instead, music listening appeared to help resolve those negative states. Music may be associated with psychosocial problems, but “without music, life would be a mistake” (F. Nietzsche, 1886).

“Music corrupts the minds of our young”. This allegation has generated numerous studies investigating the ‘music taste’ and psychosocial functioning of popular music audiences. Youth are considered to be susceptible to messages promoting sexual promiscuity, substance use, violence and sometimes suicide. The most notorious music genres in this regard are rap/hip hop, and harder forms of rock such as heavy metal and punk. This thesis focused on the role of ‘music taste’ by; analyzing the consistency of music preferences over time investigating the behavioural correlates of different music tastes among adolescents and young adults (twelve to twenty-nine year olds); and exploring the positive effects of music on listeners. The first study showed that, at the intra-individual level, taste consistency varied substantially. Overall, however, musical taste in terms of genre and style ratings is surprisingly consistent for the age-group twelve to seventeen, and is even more consistent among older youth and young adults. Music preferences were found to be consistently associated with problem behaviours. Especially relevant was music that can be described as non-mainstream. Non-mainstream refers to both music that tends towards the deviant and subversive (e.g., punk/hardcore, techno/hardhouse), as well as music that can be qualified as elitist and adult-oriented (e.g. jazz, classical music). Preference for ‘harder’ types of music was associated with substance use and externalising problems, while preference for ‘adult-oriented’ music was positively associated with internalising problems. In addition, young people that displayed low or no involvement with predominant youth cultures appeared to belong to a non-mainstream sub-group and displayed higher rates of social problems. Youth that liked popular, accessible music types, such as the music found in the charts, reported an absence of problem behaviours. In these studies other factors associated with the problem behaviours under study, such as school functioning and relationship with parent were controlled for. Nevertheless, music preferences remained uniquely associated with problem behaviours. In the studies on the relationship between music preferences and substance use one important factor was the substance use behaviour of peers. Both music preference and reported substance use by peers showed partial and sometimes complete overlap in explaining self-reported substance use. Although it was not possible to test with cross-sectional data, it is likely that simultaneous processes of selection and influence of both music and friends were at work. Finally, these studies indicated a unique association between music taste on the one hand, and externalising and internalising problem behaviours on the other. Regardless of specific music preferences, music appeared to have a positive effect on most of its listeners. Even those that indicated the frequent use of music to act out negative emotions showed no evidence of sustaining negative states, as had been suggested previously in the literature. Instead, music listening appeared to help resolve those negative states. Music may be associated with psychosocial problems, but “without music, life would be a mistake” (F. Nietzsche, 1886).

Estimation of the parameters of multimodal pilot models can give useful insight in pilots use of visual and simulator motion cues in manual vehicle control tasks. Depending on control task design, current multimodal pilot model identification techniques are in some instances unable to provide reliable parameter estimates. Application of a maximum likelihood estimation algorithm was found to yield good parameter estimates for data from a manual target-following task for which previously used identification techniques fell short, allowing for stronger conclusions on the effect of simulator motion cues on manual control for this task.

Item does not contain fulltext PURPOSE: To assess esthetic perceptions among Tanzanian adults regarding missing teeth using a cross-sectional clinical study of a convenience sample of 5,532 subjects in the Northern coastal zone of Tanzania. MATERIALS AND METHODS: The dental status of urban and rural Tanzanian adults (5,532 subjects, ages between 20 and 80 years) was recorded. A structured interview was used to assess esthetic perception (yes/no complaint) considering the location and number of missing teeth. Logistic regression analysis was applied to determine the effects of the variables age (2 groups: < or = 45 years vs > 45 years), gender, socioeconomic status (high/middle vs low), and residence (urban vs rural) on the number of complaints. RESULTS: Of the subjects with 1 or more missing maxillary anterior teeth, 54% reported a complaint. Dissatisfaction was reported by significantly more subjects < or = 45 years of age and subjects with high/middle socioeconomic status. Gender and residence had no significant influence. Of the subjects with missing maxillary premolar(s) (no missing anterior teeth), 25% reported esthetic complaints (missing first premolar: 24%; missing second premolar: 11%; missing first and second premolar on the same side: 44%). Dissatisfaction was significantly greater in women, subjects < or = 45 years of age, and subjects with high/middle socioeconomic status. Residence had no significant influence. Fewer than 1% of the subjects were dissatisfied with missing maxillary molars. CONCLUSION: Among this group of Tanzanian adults, absence of teeth played a considerable role in the esthetic appreciation of their dentition. Complaints were associated with both number and location of missing teeth.

Contains fulltext : 69290.pdf (Publisher’s version ) (Closed access) OBJECTIVE: To determine whether there are differences in prevalence of and health care consumption for asthma and COPD between Dutch people of Turkish, Moroccan and Surinamese origin and indigenous Dutch people. DESIGN: Retrospective. METHOD: Based on data from the 'Second Dutch national study into morbidity and interventions in general practice', we compared the prevalence of asthma and COPD in the different ethnic groups. In addition, we compared the use of various airway medications and the number of general practice contacts between these ethnic groups. RESULTS: We analysed data of 240,067 indigenous Dutch, 2,942 Turkish, 2,416 Moroccan and 3,320 Surinamese subjects. Asthma is more prevalent among Surinamese and seems less prevalent among Moroccans. COPD seems less prevalent among immigrants than among the indigenous Dutch population. Immigrants tend to have less prescriptions of prophylactic maintenance airway medication and they also tend to have less airway-related general practice contacts than indigenous Dutch patients. CONCLUSION: Differences exist in the prevalence of and health care consumption for asthma and COPD between the different ethnic groups in the Netherlands. There seems to be underdiagnosis of COPD in immigrants. Moreover, immigrant asthma and COPD patients are probably undertreated.

Contains fulltext : 70707.pdf (Publisher’s version ) (Closed access) BACKGROUND: Blood pressure does not reach guideline targets in the majority of hypertensive patients. Longitudinal data from general practice records on trends in hypertension management and the influence of guideline changes are lacking. OBJECTIVE: To describe the longitudinal impact of guideline revisions on the process and outcome of hypertension management in a primary care based database. METHODS: We extracted data from the Nijmegen Monitoring Project (NMP), an academic practice-based research network with 50,000 patients listed. Based on the years of publication of the first Dutch guideline on hypertension (1991) and two revisions (1997 and 2003), we formed three cohorts of patients newly diagnosed with hypertension. We compared data such as patient characteristics, 2-year blood pressure course, type of first-choice antihypertensive drugs, and number of medications after 2 years of treatment. RESULTS: Both the mean age at time of diagnosis of hypertension and pulse pressure rose between cohorts. In agreement with revisions in the guidelines, the use of diuretics as first-choice drugs increased significantly from the first to the last cohort. The percentage of patients with three or more antihypertensive drugs remained equal. The relative 2-year systolic blood pressure decline did not differ with clinical relevance between the cohorts. CONCLUSION: Our study has demonstrated that general practitioners achieve substantial and prolonged blood pressure reduction. However, guideline revisions do not seem to influence the amount of reduction, despite clear formulation of stricter treatment goals. In addition to qualitative research to identify the causes of this phenomenon, research to evaluate the effect of expert support systems on risk awareness and risk gain by additional treatment is necessary.

Background: The extent to which the prognosis for AIDS and death of patients initiating highly active antiretroviral therapy (HAART) continues to be affected by their characteristics at the time of initiation (baseline) is unclear. Methods: We analyzed data on 20,379 treatment-naive HIV-1- infected adults who started HAART in 1 of 12 cohort studies in Europe and North America (61,798 person-years of follow-up, 1844 AIDS events, and 1005 deaths). Results: Although baseline CD4 cell count became less prognostic with time, individuals with a baseline CD4 count 350 cells/μL (hazard ratio for AIDS = 2.3, 95% confidence interval [CI]: 1.0 to 2.3; mortality hazard ratio = 2.5, 95% CI: 1.2 to 5.5, 4 to 6 years after starting HAART). Rates of AIDS were persistently higher in individuals who had experienced an AIDS event before starting HAART. Individuals with presumed transmission by means of injection drug use experienced substantially higher rates of AIDS and death than other individuals throughout follow-up (AIDS hazard ratio = 1.6, 95% CI: 0.8 to 3.0; mortality hazard ratio = 3.5, 95% CI: 2.2 to 5.5, 4 to 6 years after starting HAART). Conclusions: Compared with other patient groups, injection drug users and patients with advanced immunodeficiency at baseline experience substantially increased rates of AIDS and death up to 6 years after starting HAART.

Een tolk is een professional die een boodschap sprekend overbrengt van de ene in de andere taal. De zichtbaarheid van tolken is misschien niet heel groot voor het bredere publiek, maar tolken bieden een dienst die een essentiële input vormt voor vele uiteenlopende activiteiten. Zo worden tolken ingezet bij de uitvoering van taken van publiek belang. Het gaat om publieke belangen zoals effectieve rechtsbescherming, veiligheid en gezondheidszorg. Omdat de justitiële keten of de gezondheidszorg net zo sterk is als de zwakste schakel in de keten, kan een gebrek aan kwalitatief goede tolken belangrijke publieke taken in gevaar brengen. De minister van Justitie is verantwoordelijk voor een effectieve rechtsgang en in dat kader ook voor de inzet van tolken in de justitiële sfeer. Deze verantwoordelijkheid heeft in de loop der jaren geleid tot een stelsel waarbij het ministerie van Justitie verantwoordelijkheid kreeg over tolkdiensten in de (semi) publieke sfeer - dus ook buiten het justitiële domein. In de praktijk betekende dit dat het ministerie van Justitie zowel de bemiddeling van tolken als de financiering van tolkdiensten op zich nam voor publieke afnemers. De organisatie van de inzet van tolken door publieke afnemers heeft vanaf de jaren ‘90 veel kritiek geoogst. Er is een groot aantal inhoudelijke en financiële onvolkomenheden geconstateerd en een betere positionering van de verantwoordelijkheden voor financiering, organisatie en certificering van tolken (en vertalers) was gewenst. De volgende concrete maatregelen zijn genomen om de inzet van tolken op het publieke domein beter en efficiënter te laten verlopen: Publieke afnemers buiten het justitiële domein die in het verleden gebruik maakten van de gesubsidieerde dienstverlening van het Tolk- en Vertaalcentrum Nederland (TVCN) hebben op 1 januari 2005 hun eigen budget overgeheveld gekregen; De bemiddelingsactiviteiten van het Tolk- en Vertaalcentrum Nederland zijn Europees aanbesteed; Er komt een nieuwe wet: de Wet beëdigde tolken en vertalers met een prominente rol voor het register Tolken en Vertalers. Naast aandacht voor deze concrete maatregelen, moet er ook aandacht besteed worden aan de transitie. Dit rapport is een tussentijdse evaluatie om te kunnen bepalen of men nog op de goede weg zit