RESUMEN
The experience of a pilot service involving practitioners with a special interest in periodontics is described. The service functioned as a clinical network between the primary and secondary sector and featured consultant outreach. Between June 2006 and May 2007 it experienced 441 referrals. It improved patient access to periodontal care and was successful in targeting specific disease categories and in meeting key performance indicators. The service was non-surgical and emphasised patient self-efficacy. It produced highly effective clinical outcomes. It was well accepted by both patients and referring practitioners. It did not replace the need for a consultant-led service in the eyes of the referring practitioners. The BPE was used to identify suitable patients; audit indicated that there was a tendency for practitioners to underscore the level of periodontal disease.
Asunto(s)
Redes Comunitarias , Atención Odontológica , Odontólogos , Enfermedades Periodontales/terapia , Atención Primaria de Salud , Adulto , Anciano , Actitud del Personal de Salud , Actitud Frente a la Salud , Auditoría Odontológica , Atención Odontológica/organización & administración , Relaciones Dentista-Paciente , Inglaterra , Retroalimentación , Femenino , Odontología General/educación , Accesibilidad a los Servicios de Salud , Humanos , Relaciones Interprofesionales , Masculino , Persona de Mediana Edad , Higiene Bucal , Educación del Paciente como Asunto , Índice Periodontal , Periodoncia/educación , Proyectos Piloto , Atención Primaria de Salud/organización & administración , Derivación y Consulta , Autoeficacia , Adulto JovenRESUMEN
Insurance effects of biodiversity can stabilize the functioning of multispecies ecosystems against environmental variability when differential species' responses lead to asynchronous population dynamics. When responses are not perfectly positively correlated, declines in some populations are compensated by increases in others, smoothing variability in ecosystem productivity. This variance reduction effect of biodiversity is analogous to the risk-spreading benefits of diverse investment portfolios in financial markets. We use data from the BIODEPTH network of grassland biodiversity experiments to perform a general test for stabilizing effects of plant diversity on the temporal variability of individual species, functional groups, and aggregate communities. We tested three potential mechanisms: reduction of temporal variability through population asynchrony; enhancement of long-term average performance through positive selection effects; and increases in the temporal mean due to overyielding. Our results support a stabilizing effect of diversity on the temporal variability of grassland aboveground annual net primary production through two mechanisms. Two-species communities with greater population asynchrony were more stable in their average production over time due to compensatory fluctuations. Overyielding also stabilized productivity by increasing levels of average biomass production relative to temporal variability. However, there was no evidence for a performance-enhancing effect on the temporal mean through positive selection effects. In combination with previous work, our results suggest that stabilizing effects of diversity on community productivity through population asynchrony and overyielding appear to be general in grassland ecosystems.
Asunto(s)
Biodiversidad , Poaceae , Dinámica Poblacional , Factores de TiempoRESUMEN
The range of payments by health insurance companies in case of accident and illness is presented and possible deficits of reimbursement are explained. The discussion of benefits and possible negative effects of physical activity leads--with a side-glance to professional sport--to the claim for a more reasonable use of our physical structure. Finally, abuses of our social network and financial consequences from our behavior are quoted as examples.