An assessment of attitudes to, and extent of, the practice of denture marking in South Australia

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.Denture marking or labelling is not a new concept in either prosthetic or forensic dentistry and its routine practice has been urged by forensic odontologists internationally for many years. In the general community it is often recommended for institutionalized persons to prevent confusion of ownership of dentures. In Australia, the Nursing Home Standards require that dentures of residents be 'discreetly labelled' and marking of all dentures is recommended by the Australian Dental Association. In some countries the marking of dentures is regulated by legislation, but elsewhere there seems to be a reluctance to effect this practice. Various methods which have been proposed include the insertion of an identifying label during the fabrication of the dentures with the utilization of a number of materials and coding systems. This study reports the results of a survey undertaken to determine the extent of the practice of denture marking in South Australia, the methods in use, and the attitudes of dentists, dental technicians and institutions to it. The results indicated that 24.5 per cent of all practitioners providing removable prostheses to their patients include an identifying label as part of the service on some occasions. This included 19.9 per cent of general dental practitioners, 25 per cent of specialist prosthodontists, 57.1 per cent of practitioners with training in forensic odontology, and 43.5 per cent of clinical dental technicians. No practitioner labelled dentures routinely. Reasons cited for not labelling dentures included cost, lack of awareness of standards and recommendations and a belief that it was of little importance.P. M. V. Alexander, J.A Taylor, F.S.P Szuster, K.A. Brow

Predictors of breastfeeding duration among women in Kuwait: results of a prospective cohort study

The purposes of this paper are to report the prevalence of breastfeeding to six months among women in Kuwait and to determine the factors that are associated with the duration of breastfeeding. A cohort of 373 women recruited from maternity wards in four hospitals in Kuwait city were followed from birth to 26 weeks postpartum. The association of any and full breastfeeding duration and predictor variables were explored using multivariate Cox’s proportional hazards models. At six months, 39% of all infants were receiving some breast milk and only 2% of infants had been fully breastfed to 26 weeks. Women born in other Arab countries were less likely to discontinue breastfeeding than women born in Kuwait. Other factors positively associated with breastfeeding duration were level of maternal education, higher parity, infant being demand fed in hospital and a preference for breastfeeding on the part of the infant’s father and maternal grandmother. The introduction of a pacifier before four weeks of age and the mother intending to return to work by six months were negatively associated with duration. These findings present a number of opportunities for prolonging breastfeeding duration in Kuwait

Inducing safer oblique trees without costs

Decision tree induction has been widely studied and applied. In safety applications, such as determining whether a chemical process is safe or whether a person has a medical condition, the cost of misclassification in one of the classes is significantly higher than in the other class. Several authors have tackled this problem by developing cost-sensitive decision tree learning algorithms or have suggested ways of changing the distribution of training examples to bias the decision tree learning process so as to take account of costs. A prerequisite for applying such algorithms is the availability of costs of misclassification. Although this may be possible for some applications, obtaining reasonable estimates of costs of misclassification is not easy in the area of safety. This paper presents a new algorithm for applications where the cost of misclassifications cannot be quantified, although the cost of misclassification in one class is known to be significantly higher than in another class. The algorithm utilizes linear discriminant analysis to identify oblique relationships between continuous attributes and then carries out an appropriate modification to ensure that the resulting tree errs on the side of safety. The algorithm is evaluated with respect to one of the best known cost-sensitive algorithms (ICET), a well-known oblique decision tree algorithm (OC1) and an algorithm that utilizes robust linear programming

Dental Microwear From Natufian Hunter-Gatherers and Early Neolithic Farmers: Comparisons Within and Between Samples

Microwear patterns from Natufian hunter-gatherers (12,500–10,250 bp) and early Neolithic (10,250–7,500 bp) farmers from northern Israel are correlated with location on facet nine and related to an archaeologically suggested change in food preparation. Casts of permanent second mandibular molars are examined with a scanning electron microscope at a magnification of 500×. Digitized micrographs are taken from the upper and lower part of facet nine. Microwear patterns are recorded with an image-analysis computer program and compared within and between samples, using univariate and multivariate analyses. Comparisons within samples reveal a greater frequency of pits on the lower part of the facet among the farmers, compared to the upper part. Microwear does not vary over the facet among the hunter-gatherers. Comparisons between samples reveal larger dental pits (length and width) and wider scratches among the farmers at the bottom of the facet, compared to the hunter-gatherers. Microwear does not vary between samples at the top of the facet. The microwear patterns suggest that the Natufian to early Neolithic development led to a harder diet, and this is related to an archaeologically suggested change in food processing. The harder diet of the early farmers may have required higher bite forces that were exerted at the bottom of facet nine, in the basin of the tooth

An intervention modelling experiment to change GP's intentions to implement evidence-based practice : using theory-based interventions to promote GP management of upper respiratory tract infection without prescribing antibiotics #2

Background: Psychological theories of behaviour may provide a framework to guide the design of interventions to change professional behaviour. Behaviour change interventions, designed using psychological theory and targeting important motivational beliefs, were experimentally evaluated for effects on the behavioural intention and simulated behaviour of GPs in the management of uncomplicated upper respiratory tract infection (URTI). Methods: The design was a 2 × 2 factorial randomised controlled trial. A postal questionnaire was developed based on three theories of human behaviour: Theory of Planned Behaviour; Social Cognitive Theory and Operant Learning Theory. The beliefs and attitudes of GPs regarding the management of URTI without antibiotics and rates of prescribing on eight patient scenarios were measured at baseline and post-intervention. Two theory-based interventions, a "graded task" with "action planning" and a "persuasive communication", were incorporated into the post-intervention questionnaire. Trial groups were compared using co-variate analyses. Results: Post-intervention questionnaires were returned for 340/397 (86%) GPs who responded to the baseline survey. Each intervention had a significant effect on its targeted behavioural belief: compared to those not receiving the intervention GPs completing Intervention 1 reported stronger self-efficacy scores (Beta = 1.41, 95% CI: 0.64 to 2.25) and GPs completing Intervention 2 had more positive anticipated consequences scores (Beta = 0.98, 95% CI = 0.46 to 1.98). Intervention 2 had a significant effect on intention (Beta = 0.90, 95% CI = 0.41 to 1.38) and simulated behaviour (Beta = 0.47, 95% CI = 0.19 to 0.74). Conclusion: GPs' intended management of URTI was significantly influenced by their confidence in their ability to manage URTI without antibiotics and the consequences they anticipated as a result of doing so. Two targeted behaviour change interventions differentially affected these beliefs. One intervention also significantly enhanced GPs' intentions not to prescribe antibiotics for URTI and resulted in lower rates of prescribing on patient scenarios compared to a control group. The theoretical frameworks utilised provide a scientific rationale for understanding how and why the interventions had these effects, improving the reproducibility and generalisability of these findings and offering a sound basis for an intervention in a "real world" trial. Trial registration: Clinicaltrials.gov NCT00376142This study is funded by the European Commission Research Directorate as part of a multi-partner program: Research Based Education and Quality Improvement (ReBEQI): A Framework and tools to develop effective quality improvement programs in European healthcare. (Proposal No: QLRT-2001-00657)

The factor validity of the Western Ontario Rotator Cuff Index

BACKGROUND: The Western Ontario Rotator Cuff Index (WORC) is a self-report questionnaire developed specifically to evaluate disability in persons with pathology of the rotator cuff of the shoulder. The authors created items in 5 categories based on a model of quality of life, but never validated this structure. The purpose of this study was to examine the validity of the original 5-domain model of the WORC by performing factor analysis. METHODS: Three hundred twenty nine subjects (age, mean: 52, SD: 12) were tested prior to undergoing surgery for rotator cuff pathologies. They completed the WORC, a self-report questionnaire, which has 21 items on the effect of the rotator cuff problem on symptoms, activities and emotions. Statistical calculations included correlations between items, Cronbach's alpha of the total scale and subscales, and principal component factor analysis with oblique rotation. RESULTS: Correlations ranged from .09 to .70 between all the items, from .29 to .70 between items within a subscale, and from .53 to .72 between subscale scores. Cronbach's alpha was .93 for the total scale, and .72 to .82 for the subscales. The factor analysis produced 3 factors that explained 57% of the variance. The first factor included symptoms and emotional items, the second included strength items and the third included daily activities. CONCLUSION: The results of this study did not support the 5-domain model of the WORC