Dental insurance,service use and health outcomes in Australia: a systematic review

Private health insurance plays a key role in financing dental care in Australia. Having private dental insurance has been associated with higher levels of access to dental care, visiting for a check‐up and receiving a favourable pattern of services. Associations with better oral health have also been reported. In the absence of any existing review, this paper aims to systematically review the relationship between dental insurance and dental service use and/or oral health outcomes in Australia. A systematic search of online databases and subsequent sifting resulted in 36 publications, 33 of which were cross sectional and three cohort analyses. Dental service outcomes were more commonly reported than oral health outcomes. There was considerable heterogeneity in the outcome measures reported, for both service use and health outcomes. Overall, the majority of the evidence was from cross sectional studies and few studies reported analyses adjusted for confounding factors. The consolidated evidence points towards a positive association between dental insurance and dental visiting. Dentally insured adults are likely to have more regular access to dental care and have a more favourable pattern of service use than the uninsured. However, evidence of associations between dental insurance and oral health are mixed.     

A monoclonal antibody-defined membrane antigen complex is required for neutrophil-neutrophil aggregation

We examined the aggregation responses of normal neutrophils treated with the murine monoclonal antibody (MoAb) 60.3. Addition of MoAb 60.3 to normal neutrophils produced dose-dependent inhibition of neutrophil aggregation in response to phorbol myristate acetate, zymosan-activated plasma, and N-formyl-methionylleucylphenylalanine. We conclude that the membrane glycoprotein complex recognized by MoAb 60.3--designated CDw18- -is required for neutrophil-neutrophil aggregation in vitro.     

Analysis of T-cell receptor beta chain (T beta) gene rearrangements demonstrates the monoclonal nature of T-cell chronic lymphoproliferative disorders

We investigated the rearrangement patterns of the gene coding for the beta chain of the T cell receptor (T beta) in 11 patients with T-cell derived chronic lymphoproliferative disorders, including T-cell prolymphocytic leukemia (T-PLL) and T-cell chronic lymphocytic leukemia (T-CLL). We found that all five cases of T-PLL, and five of six cases of T-CLL, displayed T beta-gene rearrangements, clearly establishing their monoclonal nature. Clonality could not be determined in one case of T-CLL where the T beta gene was found unrearranged. Our results demonstrate that the majority of cases of both clinically aggressive T- PLL and clinically indolent T-CLL are monoclonal. These results suggest that the analysis of T beta gene rearrangements represents a valid tool for the differential diagnosis and clinical monitoring of T-cell derived chronic lymphoproliferative diseases.     

Hereditary nonspherocytic hemolytic anemia and hexokinase deficiency

An 11-yr-old child with mild chronic hemolytic anemia was found to have decreased red cell hexokinase activity in spite of the reduced mean age of her red cell population. Similar decreases in red cell hexokinase activity were documented in the patient's parents and in one sib. The red cells were morphologically normal. Red cell 2,3-DPG levels were normal and ATP and glucose-6-phosphate levels were diminished. The kinetic properties, electrophoretic mobility, and thermal stability of the residual red cell hexokinase were normal or nearly so. Glucose consumption of the hexokinase-deficient cells was not appreciably decreased, probably because less of the potent inhibitor glucose-6- phosphate was present in the erythrocytes. It is likely, although not certain, that in this patient nonspherocytic hemolytic anemia resulted from hexokinase deficiency.     

Inhibition of sympathetic preganglionic discharges by epinephrine and α-methylepinephrine

The present study was undertaken to determine the effect of iontophoretic applications of epinephrine (E) and its derivative α-methylepinephrine (mE) on the discharges of sympathetic preganglionic neurons (SPNs).Spontaneously active SPNs located in thoracic segment T2 were antidromically identified in White Carneaux pigeons anesthetized with urethane and immobilized with purified α-cobratoxin.All SPNs tested were inhibited by E, mE, several other catecholamines, clonidine, GABA, glycine and morphine.The inhibitory effects of E and mE but not those of GABA were antagonized by iontophoretic applications of the preferential α₂-antagonists piperoxane and yohimbine, but not by the α₁-antogonist praxosin or the β-antagonist sotalol when similarly applied.The inhibitory effects of GABA, glycine and morphine were respectively antagonized by bicuculline methiodide, strychnine and naloxone, but these antagonists failed to alter the action of E.It is concluded that (1) epinephrine and its α-methyl derivative inhibit the discharges of SPNs via the activation of α₂-receptors and(2) the epinephrine-induced inhibition does not result from the secondary release of GABA, glycine or opioid peptides from afferent terminals or interneurons.     

Leadership in the nursing unit: relationships with nurses' well-being

The head nurse occupies an important position in the nursing unit Concerning leadership style, a distinction is traditionally made between consideration and initiating structure Sometimes a third style is distinguished as well, namely 'production-orientated' leadership In a study of 561 nurses from 16 general hospitals in The Netherlands, the influence of two leadership styles upon the reactions of nurses (job satisfaction, experienced meaningfulness, health complaints and absenteeism) to their work situations was examined, namely the styles of social (i e consideration) and instrumental leadership (a combination of the styles initiating structure and production-onentated) The separate effects of the two styles were studied, as well as the connection between combinations of leadership styles and reactions The results indicate that social leadership contributes positively to nurses' reactions to their job Instrumental leadership, on the other hand, leads to health complaints From the analyses of combinations of leadership styles it appears that nurses are most satisfied if the head nurse pays much attention to both dimensions of leadership For health complaints, a tendency in this directions is also found Finally, it becomes clear that nurses with a great need for autonomy prefer a different type of leadership from nurses with little need for autonomy