Decline of the edentulism epidemic in Australia

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included. Prepared by LA Crocombe and GD SladeAustralian Research Centre for Population Oral Health, The University of Adelaide, South Australia; prepared by LA Crocombe and GD Slad

Does optimal access to dental care counteract the oral health-related quality of life social gradient?

To determine if an oral health-related quality of life (OHRQoL) social gradient existed when Australian Defence Force (ADF) members have universal and optimal access to dental care.A nominal roll included 4,089 individuals who were deployed to the Solomon Islands (SI) as part of operation ANODE and a comparison group of 4,092 ADF personnel frequency matched to the deployed group on sex, age group, and service type, from which 500 deployed and 500 comparison individuals were randomly selected. The dependent variables were the OHIP-14 summary measures. Rank was used to determine socioeconomic status. The demographic variables selected were: sex and age.Response rate was 44%. Of the individual OHIP-14 items, being self-conscious, painful aching and having discomfort when eating were the most common problems. Mean OHIP-14 severity was 2.8. In bivariate analysis, there was not a significant difference in mean OHIP-14 severity (p=0.52) or frequency of OHIP-14 impacts (p=0.57) by military rank. There was a significant increasing OHIP-14 extent score from commissioned officer to non-commissioned officer to other ranks (0.07, 0.19, 0.40, p=0.03).Even with optimal access to dental care, there was an OHRQoL social gradient between military ranks in the ADF. This article is protected by copyright. All rights reserved.LA Crocombe, and GD Mahone

The Static Failure of Adhesively Bonded Metal Laminate Structures: A Cohesive Zone Approach

Data on distribution, ecology, biomass, recruitment, growth, mortality and productivity of the West African bloody cockle Anadara senilis were collected at the Banc d'Aguuin, Mauritania, in early 1985 and 1986. Ash-free dry weight appeared to be correlated best with shell height. A. senilis was abundant on the tidal flats of landlocked coastal bays, but nearly absent on the tidal flats bordering the open sea. The average biomass for the entire area of tidal flats was estimated at 5.5 g·m−2 ash-free dry weight. The A. senilis population appeared to consist mainly of 10 to 20-year-old individuals, showing a very slow growth and a production: biomass ratio of about 0.02 y−1. Recruitment appeared negligible and mortality was estimated to be about 10% per year. Oystercatchers (Haematopus ostralegus), the gastropod Cymbium cymbium and unknown fish species were responsible for a large share of this. The distinction of annual growth marks permitted the assessment of year-class strength, which appeared to be correlated with the average discharge of the river Senegal. This may be explained by assuming that year-class strength and river discharge both are correlated with rainfall at the Banc d'Arguin.

Investigating potential confounding by indication when considering the association between proton pump inhibitor use, infection, hepatic encephalopathy and mortality in hospitalised decompensated cirrhosis: a post-hoc analysis of the ATTIRE trial

BACKGROUND: Proton pump inhibitors (PPIs) are commonly prescribed to prevent and treat upper gastrointestinal ulceration and bleeding. Studies have identified increased incidence of spontaneous bacterial peritonitis and hepatic encephalopathy (HE) in cirrhosis patients taking PPIs. However, results are conflicting, and as PPIs are prescribed for variceal bleeding, a major risk factor for infection and HE, it is challenging to discern whether these associations are causal. METHODS: In this post-hoc analysis of the ATTIRE trial, we pooled all patient data to investigate the effects of PPI use on clinical outcomes. ATTIRE was a multicentre, open-label, randomised trial of targeted 20% human albumin solution (HAS) daily infusions versus standard care involving 777 adults with decompensated cirrhosis hospitalised with acute complications and albumin <30 g/L. Study recruitment was between Jan 25, 2016, and June 28, 2019, at 35 hospitals across England, Scotland, and Wales. Key exclusion criteria were advanced hepatocellular carcinoma with life expectancy <8 weeks and patients receiving palliative care. In ATTIRE, patients were grouped by PPI use at trial entry. We studied infection and HE at baseline and incidence of hospital acquired infection, new onset HE, renal dysfunction and mortality. We attempted with propensity score matching to account for differences in disease severity. FINDINGS: Overall PPI use at baseline was not associated with increased incidence of infection, renal dysfunction or mortality, but was associated with significantly increased incidence of grade III/IV HE during hospital stay (P = 0.011). This was only significant for those taking intravenous PPIs and these patients had >10 times the incidence of variceal bleeding and near double the 28-day mortality compared to non-PPI patients. However, propensity score matching was not possible as there was such a strong selection of patients for PPI use, that we could not find sufficient non-PPI patients to match to. We found no impact of PPI use on plasma markers of bacterial translocation, infection or systemic inflammation. INTERPRETATIONS: Our real-world data from a completed randomised trial show that PPIs are widely prescribed in the UK and judicious use appears safe in patients hospitalised with decompensated cirrhosis. However, patients prescribed PPIs had fundamentally different phenotypes to those not prescribed PPIs, a form of confounding by indication, which should be strongly considered when interpreting studies and making recommendations about their use. FUNDING: Wellcome Trust and Department of Health and Social Care

Papuan Entrepreneurs

This bulletin includes three brief papers on small-scale entrepreneurial activity among Papuan people.The first presents data on four entrepreneurs among the Orokaiva of the Northern District of Papua.Three of the four were the only entrepreneurs who established enterprises on that scale based on cash-cropping without government help.The fourth was a settler on government land with a government loan.The second paper provides some information on twelve Orokaiva who conceived of themselves mainly as retail traders(even those in the sample whose stores were closed hoped to resume trading and to derive their main income from it). The third paper analyses data collected between April and July 1964 on the system of job contracting in Port Moresby and on all Papuan subcontractors who could be contacted in June and July of that year.Four Orokaiva Cash Croppers / by R. G. Crocombe -- Twelve Orokaiva Traders / by W.J. Oostermeyer and Joanne Gray -- Contractors in Port Moresby by John Langmore