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In contrast, indicators that point to particularly disadvantaged segments of the population (unemployment rate, welfare benefits) are better predictors of life expectancy.

We do not find a consistent urban-rural gap in life expectancy. Our results suggest that policies that improve living standards for poorer segment of the population are the most likely to reduce the existing differences in life expectancy.

We do not find a consistent urban-rural gap in life expectancy. Our results suggest that policies that improve living standards for poorer segment of the population are the most likely to reduce the existing differences in life expectancy.Objectives General practitioner (GP) follow-up after a hospital admission is an important indicator of integrated care. We examined the characteristics of patients who saw a GP within 2 weeks of hospital discharge in the Central and Eastern Sydney (CES) region, Australia, and the relationship between GP follow-up and subsequent hospitalisation. Methods This data linkage study used a cohort of 10240 people from the 45 and Up Study who resided in CES and experienced an overnight hospitalisation in the 5 years following recruitment (2007-14). Characteristics of participants who saw a GP within 2 weeks of discharge were compared with those who did not using generalised linear models. Time to subsequent hospitalisation was compared for the two groups using Cox proportional hazards regression models stratified by prior frequency of GP use. Results Within 2 weeks of discharge, 64.3% participants saw a GP. Seeing a GP within 2 weeks of discharge was associated with lower rates of rehospitalisation for infrequent GP users (i.e. less then 8 visits in year before the index hospitalisation; hazard ratio (HR) 0.83; 95% confidence interval (CI) 0.70-0.97) but not frequent GP users (i.e. ≥8 plus visits; HR 1.02; 95% CI 0.90-1.17). Conclusion The effect of seeing a GP on subsequent hospitalisation was protective but differed depending on patient care needs. What is known about the topic? There is general consensus among healthcare providers that primary care is a significant source of ongoing health care provision. What does this paper add? This study explored the relationship between GP follow-up after an uncomplicated hospitalisation and its effect on rehospitalisation. What are the implications for practitioners? Discharge planning and the transfer of care from hospital to GP through discharge arrangements have substantial benefits for both patients and the health system.Purpose he purpose of this study was to evaluate in vitro the effect of 5.25 percent sodium hypochlorite (NaOCl) on the bond strength of resin sealant to hypomineralized enamel. Methods Sound (S) and hypomineralized (H) enamel specimens were subjected to three different treatments (1) etch only (E); (2) 5.25 percent NaOCl treatment (60 seconds) after (Post) etching; and (3) 5.25 percent NaOCl treatment (60 seconds) before (Pre) etching. PS-1145 research buy A sealant rod was bonded for microshear bond strength (μSBS) testing. DIAGNOdent™ and spectrophotometry were used to detect changes in surface organic content and verify the amount of organic material removed. Results Ninety S and 90 H specimens were randomly grouped into SE, SPost, SPre, HE, HPost, HPre groups. The average μSBS of hypomineralized enamel in etch only (HE) and NaOCl pre-etch (HPre) were significantly lower (9.2 MPa). NaOCl after etching significantly increased the μSBS of hypominineralized enamel (HPost) to 14.5 MPa, similar to sound enamel. DIAGNOdent™ readings were significantly lower in NaOCl Post versus E and NaOCl Pre, suggesting lower surface organic content. Spectrophotometry confirmed that NaOCI significantly removed more organic material in hypomineralized enamel. Conclusion Applying 5.25 percent sodium hypochlorite for 60 seconds after etching (32 percent phosphoric acid) increased the bond strength of resin sealant to hypomineralized enamel comparable to that of sound enamel, as a result of surface organic content removal.Purpose The purpose of this study was to determine differences in dental services received between rural and urban residents in a national sample of children with private insurance. Methods This was a retrospective study of deidentified claims data from a major national private insurer. Children younger than 18 years of age enrolled throughout 2018 and who had at least one visit to the dentist that year were included. Differences in the frequency of dental procedures received were determined by chi-square tests. Multilevel logistic regression was used to evaluate the effect of individual-level and ZIP Code-level covariates, including rurality, on the odds of receiving a preventive dental service or having a tooth extracted. Results A total of 603,064 children, with an average age of 10.2±4.4 (standard deviation) years, visited a dentist, and 6.52 percent lived in a rural area. In a multilevel logistic regression correcting for patient age, patient gender, ZIP Code average income, and dental provider density, rurality was positively associated with receiving a tooth extraction (odds ratio [OR] equals 1.06; P less then 0.001) and negatively associated with receiving a preventive service (OR equals 0.85; P less then 0.001). Female gender was a negative predictor of preventive services and a predictor of having a tooth extracted. Conclusion Children living in rural areas had reduced rates of preventive dental care and higher rates of tooth extraction than their nonrural counterparts.Purpose To evaluate dentists' perspectives on the Medicaid program and explore hypothetical changes that could lead to increased participation. Methods A 26-item questionnaire assessing demographics, practice profile, attitudes towards the Medicaid program and hypothetical scenarios to increase participation was administered to general and pediatric dentists. Results A total of 165 surveys were completed; 50.6 percent of respondents indicated they were not Medicaid participating providers. Pediatric dentists were more likely than general dentists to be participating in Medicaid and willing to participate in the future, 35.5 percent vs. 23.2 percent respectively. A 68 percent increase in fees would yield the highest level of participation with 58.4 percent of participants responding they would treat at least 16 additional children per week. Pediatric versus general dentists would be more likely to participate in Medicaid with more modest raises, i.e. 30-44 percent range. Low compensation by Medicaid (weighted average of 4.77) was the greatest barrier indicated by all participants. Hispanic dentists had greater odds of participating in Medicaid than non-Hispanic dentists. Dentists who were 'employees' had a greater odds of participating in Medicaid than a 'solo owner of a practice'. Conclusion Increased participation in Medicaid would require a combination of meaningful increases in reimbursement rates, loan forgiveness programs and tax credits.Purpose The purpose of this study was to evaluate the oral health-related quality of life (OHRQoL) of preschoolers before (T1), 15 days (T2), and three months (T3) after carious lesion treatments using 30 percent silver diamine fluoride (SDF, 0.05). Total B-ECOHIS decreased for both treatments (P less then 0.05). The ES was moderate for children in T2 and T3, considering all treatments, while for families the ES was moderate at T2 and small/moderate at T3 after treatment with SDF and ART, respectively. Conclusion Treatments with 30 percent silver diamine fluoride or atraumatic restorative treatment improved the oral health-related quality of life of preschoolers, with no variation among those treated.Purpose The purpose of this study was to compare the 12-month clinical outcomes of primary maxillary incisors restored with composite strip crowns (CSCs), NuSmile preveneered stainless steel crowns (PVSSCs), and NuSmile zirconia crowns (ZCs). Methods A total of 135 teeth in 49 two- to four-year-olds with early childhood caries were randomly assigned to crown groups. Demographic and tooth-related variables at baseline and 12 months were assessed by calibrated examiners. Fisher's exact or chi-square tests were used to test associations (P less then 0.05). Parental satisfaction of crown esthetics was evaluated by questionnaire. Results Children were, on average, 3.4 years old, female (55 percent), and had a mean decayed, missing, and filled primary teeth (dmft) index score of 10.6. At 12 months, crown retention was significantly lower for CSCs versus PVSSCs or ZCs (79 percent, 100 percent, and 95 percent, respectively; P=0.002). Partial and complete loss of material was significantly higher in CSCs than PVSSCs or ZCs (29 percent, 11 percent, and zero percent, respectively; P less then 0.001). CSCs presented with increased marginal discrepancies and color change (P less then 0.001). Most parents were very satisfied (87 percent); those dissatisfied were concerned with the color of CSCs and PVSSCs (63 percent versus 37 percent; P=0.005). Conclusions Composite strip crowns showed significantly reduced clinical success in retention, durability, marginal adaptation, and color compared to preveneered stainless steel crowns or zirconia crowns. Parental esthetic satisfaction was highest for NuSmile ZCs.Purpose The purpose of this study was to assess and compare the clinical and radiographic success rates of low-level laser therapy (LLLT) and formocresol (FC) for pulpotomy in primary teeth. Methods Utilizing a split-mouth technique, 106 primary molars of 36 five- to eight-year-olds were included. The teeth were selected according to specific clinical and radiographic inclusion criteria and randomly assigned to the LLLT group and FC group. A pulpotomy was performed on each molar; 53 teeth were treated with LLLT, and 53 teeth were treated using FC. Children were followed at six and 12 months for clinical and radiographic evaluation. Results At six months, the clinical success rate was 98 percent for each group. Radiographic success was 100 percent for the LLLT group and 98 percent for the FC group. At 12 months, both groups showed a clinical success of 96.1 percent. Radiographic success at 12 months was 100 percent and 98 percent for LLLT and FC, respectively. Conclusions Both low-level laser therapy and formocresol pulpotomy techniques showed favorable clinical and radiographic outcomes in human primary molar teeth over 12 months. Further longitudinal studies with longer follow-up periods and larger sample sizes are encouraged.Purpose The purpose of this study was to assess the trends and evidence typology published in the journal Pediatric Dentistry over the last two decades (1999 to 2018). Methods All articles from Pediatric Dentistry published between 1999 to 2018 were reviewed manually. Articles were assessed by topic, study design, level of evidence, source of funding, and country of origin. Letters to the editor, editorials, abstracts, short communications, practice guidelines, technical papers, and organization-related communications were excluded from the analysis. Results A total of 1,311 papers from Pediatric Dentistry were included for the final analysis. Across the 20 years, cariology (12.7 percent) was the most published topic, followed by restorative dentistry (10.6 percent) and systemic diseases (9.4 percent). The quality of evidence varied from level Ia (1.0 percent), level Ib (9.7 percent), level IIa (1.1 percent), level IIb (15.0 percent), level IIc (5.0 percent), and level III (50.1 percent). Forty-three different countries contributed to this publication history, with the USA, UK, and Brazil accounting for over half of the articles.

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