Fluoride removal and its impact on oral health in Sri Lanka's dry zone: Discussion and recommendation

Fifty percent of the dry zone areas in Sri Lanka have fluoride levels above 1 ppm. This paper discusses the ground conditions and recommends an appropriate range of fluoride in drinking water which can support preventive practices for improving the oral health of children 8-years old and younger. In efforts to address the Chronic Kidney Disease of Unknown etiology (CKDU), water treatment to reduce contaminant level in potable water has been implemented. Such treatment would also remove fluoride and has resulted in potable water with various fluoride levels, depending on concentrations in the raw water. While it is important to reduce fluoride levels, it is important to have appropriate residual levels for prevention of dental caries. It needs, however, to be noted fluoride in excess can cause dental fluorosis. In Sri Lanka's dry zone areas increasing prevalence of dental fluorosis with decreasing prevalence of dental caries has been noted. Consumption of tea and powdered milk could increase total intake of fluoride. Fluoridated toothpaste, when used properly, may, however, result in negligible intake of fluoride. Sri Lanka's hot tropical climate which results in substantial intake of fluids reinforces the need to consider reduction in water fluoride. Consideration of local studies and international standards indicate fluoride levels should be in the range of 0.225–0.500 ppm. In the range of 0.225–0.500 ppm, the prevalence of dental fluorosis and caries was only 14% and 8%, respectively, in an endemic district. When fluoride levels are above 0.500 ppm, the issue of dental fluorosis shall need to be addressed. When levels are below 0.225 ppm, oral health care services shall need to be directed at preventing dental caries.     

Emergency department visits by pediatric patients sustained as a passenger on a motorcycle

Objective: Currently only 5 out of the 50 states in the United States have laws restricting the age of passengers permitted to ride on a motorcycle. This study sought to characterize the visits by patients under the age of 16 to U.S. emergency departments (EDs) for injuries sustained as a passenger on a motorcycle.

Methods: In this retrospective cohort study, data were obtained from the Nationwide Emergency Department Sample (NEDS) for the years 2006 to 2011. Pediatric patients who were passengers on a motorcycle that was involved in a crash were identified using International Classification of Diseases, Ninth Revision (ICD-9) External Cause of Injury codes. We also examined gender, age, disposition, regional differences, common injuries, and charges.

Results: Between 2006 and 2011 there were an estimated 9,689 visits to U.S. EDs by patients under the age of 16 who were passengers on a motorcycle involved in a crash. The overall average patient age was 9.4 years, and they were predominately male (54.5%). The majority (85%) of these patients were treated and released. The average charges for discharged patients were $2,116.50 and amounted to roughly $17,500,000 during the 6 years. The average cost for admission was $51,446 per patient and totaled over $54 million. The most common primary injuries included superficial contusions; sprains and strains; upper limb fractures; open wounds of head, neck, and trunk; and intracranial injuries.

Conclusion: Although there were only about 9,700 visits to U.S. EDs for motorcycle crashes involving passengers less than 16 years old for 2006 to 2011, the total cost of visits that resulted in either ED discharge or hospital admission amounted to over $71 million.     

Beyond ‘just’ flood risk management: the potential for—and limits to—alleviating flood disadvantage

Regional Environmental Change - The threat of flooding poses a considerable challenge for justice. Not only are more citizens becoming exposed to risk, but they are expected to play increasingly...     

A Critique of Estimating Future Costs Using Most Likely Value

ASTM E2137 (Standard Guide for Estimating Monetary Costs and Liability for Environmental Matters, or E2137) is the guidance for developing estimates of future environmental costs. E2137 provides a hierarchy of cost estimation approaches, and expresses an explicit preference for the use of probabilistic cost analysis to develop expected values for environmental costs. Dr. Ram and his colleagues have published an article (Remediation Journal, Autumn 2013) which rejects the use of EV analysis, arguing that while “good in principle” it has little practical value because it is nearly impossible to develop supportable probabilities. The E2137 principles and processes have been used for more than a decade in the context of addressing future environmental costs, yet their view of E2137 renders the standard meaningless. We conclude that the deficiency is not in the ASTM standard, and that when properly constructed, probabilistic analyses can be used to develop expected values with supportable probabilities. ©2015 Wiley Periodicals, Inc.     

Downscaling and visioning of mountain snow packs and other climate change implications in North Vancouver, British Columbia

This paper provides an overview of a collaborative study on visualizing climate change at the local scale. A conceptual framework has been developed, in which local scenarios and visualizations of climate change impacts and response were created to facilitate local dialogue on incorporating climate change into long-term planning and implementation of community development decisions. As part of a larger effort to generate a new integrated participatory visioning process, this paper describes a case study of the District of North Vancouver which created visualizations of changing mountain snow and landscape conditions, and provides new insights on issues and dilemmas in using realistic landscape visualizations to depict scientific modelling projections, local responses to climate change, and uncertainty. Results from this study suggest that the visualizations, and subsequent dialogue sessions, did influence emotional response to climate change as well as self-assessed understanding of adaptation and mitigation response options. However, there is a need to test this visioning process with larger heterogeneous groups of participants in order to better assess its effectiveness in enabling dialogue on local responses to climate change.     

Neanderthal medics? Evidence for food, cooking, and medicinal plants entrapped in dental calculus

Neanderthals disappeared sometime between 30,000 and 24,000?years ago. Until recently, Neanderthals were understood to have been predominantly meat-eaters; however, a growing body of evidence suggests their diet also included plants. We present the results of a study, in which sequential thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS) and pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS) were combined with morphological analysis of plant microfossils, to identify material entrapped in dental calculus from five Neanderthal individuals from the north Spanish site of El Sidrón. Our results provide the first molecular evidence for inhalation of wood-fire smoke and bitumen or oil shale and ingestion of a range of cooked plant foods. We also offer the first evidence for the use of medicinal plants by a Neanderthal individual. The varied use of plants that we have identified suggests that the Neanderthal occupants of El Sidrón had a sophisticated knowledge of their natural surroundings which included the ability to select and use certain plants.     

Organic agriculture and ecosystem services

Ecosystem services (ES), such as biological control, pollination, soil formation, nutrient cycling in agriculture are vital for the sustainable supply of food and fibre. The current trends of decline in the ability of agricultural ecosystems to provide ES pose great threat to food security worldwide. This paper discusses the concept of ES and identifies ES associated with agriculture. It discusses the economic and ecological benefits of these ES on farmland in general and its linkages with organic agriculture. The provision of ES on farmland may help to motivate the redesign of small-scale farms using new eco-technologies based on novel and sound ecological knowledge. This has potential to meet the food demand of growing population without damaging human health and the environment.     

Does hedgerow management on organic farms benefit small mammal populations?

Organic farming is a whole-farm management approach believed to encourage biodiversity by excluding the input of agrochemicals and introducing specific management regimes for non-crop habitats. We examined the impact of the hedgerow management regime encouraged for organic farms on small mammal populations, since small mammal numbers influence a range of species at higher trophic levels and, in particular, are key to the conservation of a range of mammalian and avian predators. We compared differences in management and structure of non-crop habitats at the farm-scale between organic and conventional farms, and used within-farm variations in hedgerow size to predict the effect of hedgerow size on small mammals on both farm types. There were no significant differences in the proportion of non-crop habitats between organic and conventional farms, although management differences produced larger hedgerows on organic farms and greater diversity of hedgerow growth stages. However, a difference in hedgerow size between the farm types did not have a significant effect on small mammal abundance or diversity. We conclude that increased hedgerow size is not benefiting small mammal populations on organic farms: significant gains in small mammal numbers may be more effectively achieved by increasing the area of non-crop habitats rather than by improving management regimes.