Tackling socially determined dental inequalities: ethical aspects of Childsmile, the national child oral health demonstration programme in Scotland

Many ethical issues are posed by public health interventions, including whether they ought to be aimed at improving health across society or reducing specific health inequalities, whether they should be targeted or universal and the issue of which targeting criteria ought to be used. Although abstract theorising about these issues can be useful, it is the application of ethical theory to real cases which will ultimately be of benefit in decision-making. To this end, this paper will analyse the ethical issues involved in Childsmile, a national oral health demonstration programme in Scotland that aims to improve the oral health of the nation’s children and reduce dental inequalities through a combination of targeted and universal interventions. With Scotland’s level of dental caries among the worst in the Western world, Childsmile represents perhaps the largest programme of work aimed at combating oral health inequalities in the UK. The areas of ethical interest include several contrasting themes: reducing health inequalities and improving health; universal and targeted interventions; political values and evidence base; prevention and treatment; and underlying all of these, justice and utility

Wages, racial composition, and quality sorting in labor markets

This paper examines the relationship between wage rates and the racial composition of jobs, using large cross-sectional and longitudinal samples constructed from monthly Current Population Surveys for 1983-92. Support is found for a "quality sorting" model that posits an equilibrium in which the racial composition of jobs serves as a skill index of unmeasured labor quality. Estimation of standard wage-level equations shows that wages of both black and white workers are substantially lower in occupations with a high density of blacks. Consistent with the quality sorting hypothesis, the magnitude of the relationship is reduced sharply after accounting for occupational skill measures. Longitudinal wage-change estimates controlling for person-specific quality indicate little if any causal effect of racial composition on wages. Estimates of racial discrimination are reduced only moderately after accounting for racial composition; unexplained differentials occur within occupations or reflect inter-occupational differences uncorrelated with racial composition and occupational skill measures.

Metaphors and social science

The social sciences have a considerable history of attempts to apply models and theories from the physical sciences. All such attempts have failed, primarily because social scientists have commonly not distinguished between applications and possibly useful metaphors

Using Deep Neural Networks to Classify Astronomical Images

As the quantity of astronomical data available continues to exceed the resources available for analysis, recent advances in artificial intelligence encourage the development of automated classification tools. This paper lays out a framework for constructing a deep neural network capable of classifying individual astronomical images by describing techniques to extract and label these objects from large images

A comparison of surface sensible and latent heat fluxes from aircraft and surface measurements in FIFE 1987

Surface fluxes of sensible and latent heat over a tall-grass prairie in central Kansas, as measured by 22 surface stations during FIFE 1987, are compared with values gained indirectly by linear extrapolation of aircraft-measured flux profiles to the surface. The results of 33 such comparisons covering the period 26 June to 13 October 1987 indicate that the sensible heat flux profiles were generally more linear with less scatter in the measurements at each level than were the latent heat flux profiles, the profile extrapolations of sensible heat flux in general underestimate the surface averages by about 30 percent, with slightly better agreement during periods of small flux, and the profile extrapolations of latent heat flux in general underestimate the surface averages by about 15 percent, with overestimates during periods of small fluxes (dry conditions) and overestimates during periods of large fluxes (moist conditions). Possible origins of the differences between the two sets of measurements are discussed, as directions for further research

Evaluation of dental therapists undertaking dental examinations in a school setting in Scotland

Objective: To measure agreement between dental therapists and the Scottish gold-standard dentist undertaking National Dental Inspection Programme (NDIP) examinations. Methods: A study of interexaminer agreement between 19 dental therapists and the national gold-standard dentist was carried out. Pre-calibration training used the caries diagnostic criteria and examination techniques agreed by the British Association for the Study of Community Dentistry (BASCD). Twenty-three 5-year-old children (Primary 1) and 17 11-year-old children (Primary 7) children were examined. Agreement was assessed using kappa statistics on d 3 mft and D 3 MFT for P1 and P7 children, sensitivity and specificity values, and kappa statistics on d 3 t/D 3 T and ft/FT. Calibration data on P1 and P7 children from 2009–2012 involving dentists as examiners were used for comparison. Economic evaluation was undertaken using a cost minimization analysis approach. Results: The mean kappa score was 0.84 (SD 0.07) ranging from 0.69 to 0.94. All dental therapists scored good or very good agreement with the gold-standard dentist. This compares with historic NDIP calibration data with dentists, against the same gold-standard dentist, where the mean kappa value was 0.68 (SD 0.22) with a range of 0.35-1.00. The mean sensitivity score was 0.98 (SD 0.04) (range 0.88-1.0) and mean specificity score was 0.90 (SD 0.06) (range 0.78-0.96). Health economic analysis estimated that salary costs would be 33.6% lower if dental therapists were substituted for dentists in the year 2013, with an estimated saving of approximately £103 646 per annum on the national budget. Conclusion: We conclude that dental therapists show a high level of interexaminer agreement, and with the appropriate annual training and calibration, they could undertake dental examinations as part of the NDIP programme