A Model for the Analysis of Caries Occurrence in Primary Molar Tooth Surfaces

Recently methods of caries quantification in the primary dentition have moved away from summary ‘whole mouth’ measures at the individual level to methods based on generalised linear modelling (GLM) approaches or survival analysis approaches. However, GLM approaches based on logistic transformation fail to take into account the time-dependent process of tooth/surface survival to caries. There may also be practical difficulties associated with casting parametric survival-based approaches in a complex multilevel hierarchy and the selection of an optimal survival distribution, while non-parametric survival methods are not generally suitable for the assessment of supplementary information recorded on study participants. In the current investigation, a hybrid semi-parametric approach comprising elements of survival-based and GLM methodologies suitable for modelling of caries occurrence within fixed time periods is assessed, using an illustrative multilevel data set of caries occurrence in primary molars from a cohort study, with clustering of data assumed to occur at surface and tooth levels. Inferences of parameter significance were found to be consistent with previous parametric survival-based analyses of the same data set, with gender, socio-economic status, fluoridation status, tooth location, surface type and fluoridation status-surface type interaction significantly associated with caries occurrence. The appropriateness of the hierarchical structure facilitated by the hybrid approach was also confirmed. Hence the hybrid approach is proposed as a more appropriate alternative to primary caries modelling than non-parametric survival methods or other GLM-based models, and as a practical alternative to more rigorous survival-based methods unlikely to be fully accessible to most researchers

Magnetic properties of Ni2.18Mn0.82Ga Heusler alloys with a coupled magnetostructural transition

Polycrystalline Ni2.18Mn0.82Ga Heusler alloys with a coupled magnetostructural transition are studied by differential scanning calorimetry, magnetic and resistivity measurements. Coupling of the magnetic and structural subsystems results in unusual magnetic features of the alloy. These uncommon magnetic properties of Ni2.18Mn0.82Ga are attributed to the first-order structural transition from a tetragonal ferromagnetic to a cubic paramagnetic phase.Comment: 4 pages, 4 figures, revtex

Assessing the perceived impact of post Minamata amalgam phase down on oral health inequalities: a mixed-methods investigation

Background: Data from countries that have implemented a complete phase out of dental amalgam following the Minamata agreement suggest increased costs and time related to the placement of alternatives with consumers absorbing the additional costs. This aim of this study was to investigate the impact of a complete phase out of dental amalgam on oral health inequalities in particular for countries dependent on state run oral health services. Methods: A mixed methods component design quantitative and qualitative study in the United Kingdom. The quantitative study involved acquisition and analysis of datasets from NHS Scotland to compare trends in placement of dental amalgam and a survey of GDPs in Yorkshire, UK. The qualitative study involved analysis of the free text of the survey and a supplementary secondary analysis of semi-structured interviews and focus groups with GDPs (private and NHS), dental school teaching leads and NHS dental commissioners to understand the impact of amalgam phase down on oral health inequalities. Results: Time-trends for amalgam placement showed that there was a significant (p < 0.05) reduction in amalgam use compared with composites and glass ionomers. However dental amalgam still represented a large proportion (42%) of the restorations (circa 1.8 million) placed in the 2016–2017 financial year. Survey respondents suggest that direct impacts of a phase down were related to increased costs and time to place alternative restorations and reduced quality of care. This in turn would lead to increased tooth extractions, reduced access to care and privatisation of dental services with the greatest impact on deprived populations. Conclusion: Amalgam is still a widely placed material in state run oral health services. The complete phase down of dental amalgam poses a threat to such services and threatens to widen oral health inequalities. Our data suggest that a complete phase out is not currently feasible unless appropriate measures are in place to ensure cheaper, long-lasting and easy to use alternatives are available and can be readily adopted by primary care oral health providers

Protocol for a Randomised controlled trial to Evaluate the effectiveness and cost benefit of prescribing high dose FLuoride toothpaste in preventing and treating dEntal Caries in high-risk older adulTs (reflect trial)

Background Dental caries in the expanding elderly, predominantly-dentate population is an emerging public health concern. Elderly individuals with heavily restored dentitions represent a clinical challenge and significant financial burden for healthcare systems, especially when their physical and cognitive abilities are in decline. Prescription of higher concentration fluoride toothpaste to prevent caries in older populations is expanding in the UK, significantly increasing costs for the National Health Services (NHS) but the effectiveness and cost benefit of this intervention are uncertain. The Reflect trial will evaluate the effectiveness and cost benefit of General Dental Practitioner (GDP) prescribing of 5000ppm fluoride toothpaste and usual care compared to usual care alone in individuals 50years and over with high-risk of caries.Methods/designA pragmatic, open-label, randomised controlled trial involving adults aged 50years and above attending NHS dental practices identified by their dentist as having high risk of dental caries. Participants will be randomised to prescription of 5000ppm fluoride toothpaste (frequency, amount and duration decided by GDP) and usual care only. 1200 participants will be recruited from approximately 60 dental practices in England, Scotland and Northern Ireland and followed up for 3years. The primary outcome will be the proportion of participants receiving any dental treatment due to caries. Secondary outcomes will include coronal and root caries increments measured by independent, blinded examiners, patient reported quality of life measures, and economic outcomes; NHS and patient perspective costs, willingness to pay, net benefit (analysed over the trial follow-up period and modelled lifetime horizon). A parallel qualitative study will investigate GDPs' practises of and beliefs about prescribing the toothpaste and patients' beliefs and experiences of the toothpaste and perceived impacts on their oral health-related behaviours.DiscussionThe Reflect trial will provide valuable information to patients, policy makers and clinicians on the costs and benefits of an expensive, but evidence-deficient caries prevention intervention delivered to older adults in general dental practice.Trial registrationISRCTN: 2017-002402-13 registered 02/06/2017, first participant recruited 03/05/2018.Ethics Reference No: 17/NE/0329/233335.Funding Body: Health Technology Assessment funding stream of National Institute for Health Research.Funder number: HTA project 16/23/01.Trial Sponsor: Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL.The Trial was prospectively registered

'Support our networking and help us belong!': listening to beginning secondary school science teachers

This study, drawing on the voice of beginning teachers, seeks to illuminate their experiences of building professional relationships as they become part of the teaching profession. A networking perspective was taken to expose and explore the use of others during the first three years of a teacher’s workplace experience. Three case studies, set within a wider sample of 11 secondary school science teachers leaving one UK university’s PostGraduate Certificate in Education, were studied. The project set out to determine the nature of the networks used by teachers in terms of both how they were being used for their own professional development and perceptions of how they were being used by others in school. Affordances and barriers to networking were explored using notions of identity formation through social participation. The focus of the paper is on how the teachers used others to help shape their sense of belonging to this, their new workplace. The paper develops ideas from network theories to argue that membership of the communities are a subset of the professional inter‐relationships teachers utilise for their professional development. During their first year of teaching, eight teachers were interviewed, completing 13 semi‐structured interviews. This was supplemented in Year 2 by a questionnaire survey of their experiences. In the third year of the programme, 11 teachers (including the original sample of eight) were surveyed using a network mapping tool in which they represented their communications with people, groups and resources. Finally, three of the teachers (common to both samples) were then interviewed specifically about their networking practices and experiences using the generation of their network map as a stimulated recall focus. The implications of the analysis of these accounts are that these beginning teachers did not perceive of themselves wholly as novices and that their personal aspirations to increase participation in practical science, develop a career or work for pupils holistically did not always sit comfortably with the school communities into which they were being accommodated. While highlighting the importance of trust and respect in establishing relationships, these teachers’ accounts highlight the importance of finding ‘peers’ from whom they can find support and with whom they can reflect and potentially collaborate towards developing practice. They also raise questions about who these ‘peers’ might be and where they might be found

Constructing a new understanding of the environment under postsocialism

This paper introduces a special grouping of papers on the theme of the environment and postsocialism. After the collapse of state socialism in Europe between 1989 and 1991, many immediate approaches to environmental reconstruction assumed that economic liberalisation and democratisation would alleviate problems. Since then, critics have argued that these proposed solutions were themselves problematic, and too closely reflected Western European and North American conceptions of environmental quality and democracy. The result has been a counterreaction focusing on detail and specificity at national levels and below. In this paper, we summarise debates about the environment and postsocialism since the period 1989 - 91. In particular, we examine whether an essentialistic link can be made between state socialism and environmental problems, and how far civil society -- or environmentalism -- may result in an improvement in perceived environmental quality. Finally, we consider the possibility for developing an approach to the environment and postsocialism that lies between crude generalisation and microscale studies

Interaction between Plate Make and Protein in Protein Crystallisation Screening

Background: Protein crystallisation screening involves the parallel testing of large numbers of candidate conditions with the aim of identifying conditions suitable as a starting point for the production of diffraction quality crystals. Generally, condition screening is performed in 96-well plates. While previous studies have examined the effects of protein construct, protein purity, or crystallisation condition ingredients on protein crystallisation, few have examined the effect of the crystallisation plate