Dental Attendances to General Medical Practitioners in Wales: a 44 Year Analysis

One-third of the UK population is composed of problem-oriented dental attenders, seeking dental care only when they have acute dental pain or problems. Patients seek urgent dental care from a range of health care professionals, including general medical practitioners. This study aimed to identify trends in dental attendance at Welsh medical practices over a 44-y period, specifically in relation to dental policy change and factors associated with repeat attendance. A retrospective observational study was completed via the nationwide Secure Anonymised Information Linkage (SAIL) Databank of visits to general medical practice in Wales. Read codes associated with dental diagnoses were extracted for patients attending their general medical practitioner between 1974 and 2017. Data were analyzed with descriptive statistics and univariate and multivariable logistic regression. Over the 44-y period, there were 439,361 dental Read codes, accounting for 288,147 patient attendances. The overall attendance rate was 2.60 attendances per 1,000 patient-years (95% CI, 2.59 to 2.61). The attendance rate was negligible through 1987 but increased sharply to 5.0 per 1,000 patient-years in 2006 (95% CI, 4.94 to 5.09) before almost halving to 2.6 per 1,000 in 2017 (95% CI, 2.53 to 2.63) to a pattern that coincided with changes to National Health Service policies. Overall 26,312 patients were repeat attenders and were associated with living in an area classified as urban and deprived (odds ratio [OR], 1.22; 95% CI, 1.19 to 1.25; P < 0.0001) or rural (OR, 0.84; 95% CI, 0.83 to 0.85; P < 0.0001). Repeat attendance was associated with greater odds of having received an antibiotic prescription (OR, 2.53; 95% CI, 2.50 to 2.56; P < 0.0001) but lower odds of having been referred to another service (OR, 0.75; 95% CI, 0.70 to 0.81; P < 0.0001). Welsh patients’ reliance on medical care for dental problems was influenced by social deprivation and health policy. This indicates that future interventions to discourage dental attendance at medical practitioners should be targeted at those in the most deprived urban areas or rural areas. In addition, health policy may influence attendance rates positively and negatively and should be considered in the future when decisions related to policy change are made

Preoperative Kidney Function linked to mortality and readmission outcomes at Day 90 and 30 in Older Emergency Surgical Patients

Grants were received from British Geriatric Society and The Renal Association to support Louis EvansPeer reviewedPublisher PD

The Effect of Hybrid Photovoltaic Thermal Device Operating Conditions on Intrinsic Layer Thickness Optimization of Hydrogenated Amorphous Silicon Solar Cells

Historically, the design of hybrid solar photovoltaic thermal (PVT) systems has focused on cooling crystalline silicon (c-Si)-based photovoltaic (PV) devices to avoid temperature-related losses. This approach neglects the associated performance losses in the thermal system and leads to a decrease in the overall exergy of the system. Consequently, this paper explores the use of hydrogenated amorphous silicon (a-Si:H) as an absorber material for PVT in an effort to maintain higher and more favourable operating temperatures for the thermal system. Amorphous silicon not only has a smaller temperature coefficient than c-Si, but also can display improved PV performance over extended periods of higher temperatures by annealing out defect states from the Staebler-Wronski effect. In order to determine the potential improvements in a-Si:H PV performance associated with increased thicknesses of the i-layers made possible by higher operating temperatures, a-Si:H PV cells were tested under 1 sun illumination (AM1.5) at temperatures of 25oC (STC), 50oC (representative PV operating conditions), and 90 oC (representative PVT operating conditions). PV cells with an i-layer thicknesses of 420, 630 and 840 nm were evaluated at each temperature. Results show that operating a-Si:H-based PV at 90 oC, with thicker i-layers than the cells currently used in commercial production, provided a greater power output compared to the thinner cells operating at either PV or PVT operating temperatures. These results indicate that incorporating a-Si:H as the absorber material in a PVT system can improve the thermal performance, while simultaneously improving the electrical performance of a-Si:H-based PV

Parallelization, Special Hardware and Post-Newtonian Dynamics in Direct N - Body Simulations

The formation and evolution of supermassive black hole (SMBH) binaries during and after galaxy mergers is an important ingredient for our understanding of galaxy formation and evolution in a cosmological context, e.g. for predictions of cosmic star formation histories or of SMBH demographics (to predict events that emit gravitational waves). If galaxies merge in the course of their evolution, there should be either many binary or even multiple black holes, or we have to find out what happens to black hole multiples in galactic nuclei, e.g. whether they come sufficiently close to merge resulting from emission of gravitational waves, or whether they eject each other in gravitational slingshot interactions

Dental Attendances to General Medical Practitioners in Wales: A 44 Year-Analysis

One-third of the UK population is composed of problem-oriented dental attenders, seeking dental care only when they have acute dental pain or problems. Patients seek urgent dental care from a range of health care professionals, including general medical practitioners. This study aimed to identify trends in dental attendance at Welsh medical practices over a 44-y period, specifically in relation to dental policy change and factors associated with repeat attendance. A retrospective observational study was completed via the nationwide Secure Anonymised Information Linkage (SAIL) Databank of visits to general medical practice in Wales. Read codes associated with dental diagnoses were extracted for patients attending their general medical practitioner between 1974 and 2017. Data were analyzed with descriptive statistics and univariate and multivariable logistic regression. Over the 44-y period, there were 439,361 dental Read codes, accounting for 288,147 patient attendances. The overall attendance rate was 2.60 attendances per 1,000 patient-years (95% CI, 2.59 to 2.61). The attendance rate was negligible through 1987 but increased sharply to 5.0 per 1,000 patient-years in 2006 (95% CI, 4.94 to 5.09) before almost halving to 2.6 per 1,000 in 2017 (95% CI, 2.53 to 2.63) to a pattern that coincided with changes to National Health Service policies. Overall 26,312 patients were repeat attenders and were associated with living in an area classified as urban and deprived (odds ratio [OR], 1.22; 95% CI, 1.19 to 1.25; P < 0.0001) or rural (OR, 0.84; 95% CI, 0.83 to 0.85; P < 0.0001). Repeat attendance was associated with greater odds of having received an antibiotic prescription (OR, 2.53; 95% CI, 2.50 to 2.56; P < 0.0001) but lower odds of having been referred to another service (OR, 0.75; 95% CI, 0.70 to 0.81; P < 0.0001). Welsh patients’ reliance on medical care for dental problems was influenced by social deprivation and health policy. This indicates that future interventions to discourage dental attendance at medical practitioners should be targeted at those in the most deprived urban areas or rural areas. In addition, health policy may influence attendance rates positively and negatively and should be considered in the future when decisions related to policy change are made

On Birthing Dancing Stars: The Need for Bounded Chaos in Information Interaction

While computers causing chaos is acommon social trope, nearly the entirety of the history of computing is dedicated to generating order. Typical interactive information retrieval tasks ask computers to support the traversal and exploration of large, complex information spaces. The implicit assumption is that they are to support users in simplifying the complexity (i.e. in creating order from chaos). But for some types of task, particularly those that involve the creative application or synthesis of knowledge or the creation of new knowledge, this assumption may be incorrect. It is increasingly evident that perfect order—and the systems we create with it—support highly-structured information tasks well, but provide poor support for less-structured tasks.We need digital information environments that help create a little more chaos from order to spark creative thinking and knowledge creation. This paper argues for the need for information systems that offerwhat we term ‘bounded chaos’, and offers research directions that may support the creation of such interface

Unitarity and the Bethe-Salpeter Equation

We investigate the relation between different three-dimensional reductions of the Bethe-Salpeter equation and the analytic structure of the resultant amplitudes in the energy plane. This correlation is studied for both the $\phi^2\sigma$ interaction Lagrangian and the $\pi N$ system with $s$-, $u$-, and $t$-channel pole diagrams as driving terms. We observe that the equal-time equation, which includes some of the three-body unitarity cuts, gives the best agreement with the Bethe-Salpeter result. This is followed by other 3-D approximations that have less of the analytic structure.Comment: 17 pages, 8 figures; RevTeX. Version accepted for publication in Phys. Rev.

BICCO-Net II. Final report to the Biological Impacts of Climate Change Observation Network (BICCO-Net) Steering Group

• BICCO-Net Phase II presents the most comprehensive single assessment of climate change impacts on UK biodiversity to date. • The results provide a valuable resource for the CCRA 2018, future LWEC report cards, the National Adaptation Programme and other policy-relevant initiatives linked to climate change impacts on biodiversity

Leadership in Improving Schools: A Qualitative Perspective

This article reports early case-study data gathered from 20 schools involved in the ‘Impact of School Leadership on Pupil Outcomes’ project. We present and discuss the perceptions of headteachers and other school leaders regarding leadership factors that directly and indirectly affect pupil outcomes in these improving schools. Included are issues relating to the pivotal role played by the headteacher in setting and communicating a strategic vision for the school; models of distributed leadership; and the building of leadership capacity so as to build a collective responsibility for the improvement of pupil outcomes