Do economic incentives influence the provision of dental services in a third-party funded dental scheme?

Objectives:To investigate whether the provision of dental services is influenced by economic incentives in a third-party funded dental service in the Republic of Ireland. Methods:Four treatment items were identified as outcome variables. These items were characterised by variation in regulation among administrative regions or variation in regulation over time. The items were Extra Oral Radiographs, Endodontics, Prolonged Periodontal Treatment, and Surgical Extractions. Claims data were obtained from the Primary Care Reimbursement Service (PCRS), formerly known as the General Medical Services Payments Board (GMSPB). Population data were obtained from the Central Statistics Office. Data were obtained from the Principal Dental Surgeons in Ireland who apply local regulatory or price controls for certain items of treatment. The data were analysed to determine the impact of the variation in regulatory approach on claims data among the eight regional health administrative areas whilst controlling for known clinical or population structural factors. Results There was a substantially lower than average provision of Extra-Oral Radiographs in regions where regulation was stringently applied.The provision of Prolonged Periodontal Treatment was positively correlated with price. The dentist-to-population ratio is positively correlated with claims for Surgical Extractions. ConclusionsThere is evidence from within the funding system that economic incentives, arising from either the contract itself or due to the geographical structure of the dentist workforce in Ireland, leads to variations in certain items of service provision which are potentially inefficient and independent of known treatment need

Predictors of utilisation of dental care services in a nationally representative sample of adults.

OBJECTIVE: The objective of this study was to identify the predictors of utilisation of dental care services in Ireland. PARTICIPANTS: The 2007 Irish Survey of Lifestyle, Attitudes and Nutrition is a cross-sectional study, conducted in 2006/2007 (n = 10,364), by interviews at home to a representative sample of adults aged 18 years or over. MAIN OUTCOME MEASURES: Multivariate logistic regression was used to investigate the influence of socioeconomic, predisposing and enabling factors on the odds of males and females having a dental visit in the past year. RESULTS: The significant predictors of visiting the dentist in the past year were for males: having 3rd level education, employment status, earning 50,000 euros or more, location of residence, use of a car, brushing frequently, and dentition status. For females, the predictors were being between 25-34 or 55-64 years-old, education level, earning 50,000 euros or more, location of residence, use of a car, brushing frequently and dentition status. CONCLUSIONS: Predictors of the use of dental services vary by gender. Predictors common to both genders were education level, higher income, location of residence, use of a car, brushing frequently and dentition status. Many of the predictors of dental visiting in the past year are also related to social inequalities in health. These predictors may be useful markers of impact for policies designed to address inequalities in access to oral health services

Studies on the evaluation of quality in the Granny Smith apple

Quality is a complex property and cannot be measured directly. As present grading systems for apples are not entirely satisfactory, there is a need to establish simple quantitative methods for estimating apple condition that are relevant to consumer perception of quality

Knowledge production and disciplinary practices in a British University: A qualitative cross-disciplinary case study

Knowledge is a controversial matter in UK Higher Education (HE). The increasing regulation of universities’ research focus and outputs, and the balance of applied and pure research are highly contested. Funders and government call increasingly for research that is co-produced with non-academic partners, and that demonstrates impact beyond HE. Many academics also support these calls. Yet at grass-roots level, there are epistemological tensions such as researchers’ rights to academic freedom. Moreover, there is a lack of literature exploring current research practices from a cross-disciplinary perspective. This cross-sectional, qualitative case study aimed to explore researchers’ experiences to understand if, why and how, these pressures have changed disciplinary working practices and knowledge types, and what researchers think of these changes. The study took place in one research-intensive UK University using group interviews in four disciplinary areas. Data was analysed at a semantic level, using thematic analysis. The theoretical lens of “social realism” provided a philosophical basis to the research and aided understanding of the data. Researchers reported changes to working practices because of emphasis on research relevance, technological advances and pressures to work across disciplines. There was a broadening of knowledge types and a simultaneous narrowing of research topics in some disciplinary areas. Depending on the types of knowledge they worked with, researchers had different perspectives on peer-review, the right to absolute academic freedom and newer forms of research evaluation. There were differences in the data relating to discipline and academic rank. The conclusions advocate a social realist position, with four recommendations: maintenance of impact in the REF and the introduction and monitoring of the effect of “responsible metrics” to protect disciplinary research; the tailoring of professional learning opportunities regarding research practice to disciplinary contexts; future research in relation to Basil Bernstein’s work on the trajectory of singular and regional knowledge forms

Histochemistry and ultrastructure of oogenesis in Ibla quadrivalvis and Tetraclita rosea, and the biochemical composition of developing embryos of Ibla quadrivalvis (Crustacea, Cirripedia).

1. Oogenesis in I. quadrivalvis and T. rosea was divided by light microscopy into 7 stages. The stages were examined histologically and histochemically for nucleic acids, proteins, carbohydrates and lipids

Predicting the subsurface

Britain is blessed with a magnificent variety of landscapes, much of it the result of the diverse range of rock types that form our small island, and the different ways in which they respond to weathering and erosion. Nowhere is this clearer than when enjoying a walk along many of the paths that snake around our coastline; dramatic colour changes in the cliffs, steep climbs and descents between headlands and bays all reflect changes in the underlying geology. Sometimes the connection is obvious, such as the contrast between the low, sandy and muddy cliffs that tumble into the sea along the coast of Essex, and the rugged white cliffs on the south coast of England. These natural features, which we take for granted, have a significant impact on how we live and move about our island

Residential care, stigma and relational alienation: exploring the lived experience of children’s homes with young people and carers - an ethnographic study

This thesis questions both social meaning and lived experience of residential care for children, by drawing on data gathered during an ethnographic study of two local authority children’s homes. Theories of ‘social death’ are utilised to understand the social relationships of children and young people. Children’s homes continue to be a site of research and intervention in the UK and elsewhere. The established view of residential care in the UK is that it is the ‘last resort’ option for children in the care system, due to the preference for family-based accommodation. Recently, while there has been greater acknowledgement that residential care can be a positive choice for children, the sector continues to be a site of controversy. This is due to factors such as abuse scandals, poor outcome measures, placement breakdowns and cost effectiveness. A number of studies reveal that young people cite placement instability as a key factor which negatively affects their experience. Those in residential care are likely to experience the greatest upheaval in the care system. Drawing on the work of Ennew (2002), this thesis proposes that such factors combine to affect the personhood of children in residential settings due to the children’s home contrasting to normative ideals of what children ought to experience in the context of childhood. Data reveals that the absence of enduring relationships within children’s home is deeply problematic in terms of the social, psychological and symbolic status of children and young people. Findings also promote a critical stance to the individualising of children in care and the ability of the rights framework to compensate for wider losses. Building on Orlando Patterson’s (1982) work on social death the concept of ‘relational alienation’ is developed as an original theoretical contribution to knowledge, to comprehend the loss of relational life and personhood which children and young people experience in residential care. The thesis concludes with recommendations aimed at reducing the risk of social death for children in care and residential care

The student teaching experience : a qualitative examination

This study examined the experience of three secondary science student teachers from Western Oregon State College in Monmouth, Oregon during the Spring quarter of 1990. The question was: What is student teaching like from the point of view of the student teacher? The research methodology was qualitative, more specifically participant observation, prolonged engagement, and using the Constant Comparative Model. Data sources included audio taped journals from the student teachers, transcribed audio tapes from seminars, video tapes of teaching, rich descriptions from field notes made by the researcher, a journal from one cooperating teacher, and a journal kept by the researcher. Analysis of the data set produced 81 coding categories. A data set was marked, cut and filed under these coding categories. Patterns and generalizations were drawn from the categorized data set. The three student teachers had widely varied experiences. The analysis of data resulted in the generation of seven hypotheses concerning student teaching. They were as follows: 1. Student teachers react to the student teaching experience differently. 2. The student teaching experience may be so complex that a total, Gestalt, understanding of it is not possible. 3. For some student teachers, there is a critical point, called The Wall. 4. The nature of the critical point and the outcomes of the experience vary greatly among the student teachers. 5. Student teachers need a support group or support individual available during the student teaching experience. 6. The cooperating teacher(s) is/are a stronger influence on the student teacher than is the college supervisor. 7. The predictors for success in student teaching that were used in this study are likely unreliable