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Background/Aim: This retrospective study investigated the effect of lockdowns for Covid‐19 on the rates of oro‐facial trauma hospitalisations in children in Australia and the United Kingdom (UK). Materials and Methods: Hospitalisation data for children up to 19 years old for oro‐facial trauma injuries (according to ICD‐10‐AM principal diagnosis codes) over 5 years were collected for Australian and UK children. The age‐standard rate (ASR) for each age group was calculated per 100,000 population. Results: In the younger Australian children, there was no statistically significant change in the ASR of oro‐facial trauma hospitalisations during the 'Covid year', compared to the average rate over the 3 years preceding. However, there was a significant decrease in the ASR of oro‐facial trauma hospitalisations during the 'Covid year' in older Australian children (aged 10–19), and for all UK children, except for infants under one‐year‐old. Conclusions: Reduction of the ASR of hospitalisations due to oro‐facial trauma during the 'Covid year', and the implementation of lockdown measures in the two countries provides further evidence of the impact of physical activities and travel as contributing factors to oro‐facial injuries in children. In addition to its role in reducing the spread of virus infections during the pandemic, the lockdown measures also resulted in a simultaneous decrease in trauma injuries. [ABSTRACT FROM AUTHOR]

Background: The accessibility to affordable primary healthcare services contributes to population health and health equity. A key aspect to accessibility is the geographical distribution of primary healthcare services. Limited studies have assessed the nationwide spatial distribution of bulk billing-only medical practices or 'no-fee' services. The aim of this study was to provide a nationwide approximation of bulk billing-only services and evaluate the socio-demographic status and population characteristics in relation to the distribution of bulk billing-only GP services. Methods: The methodology in this study used Geographic Information System (GIS) technology to map the locations of all bulk bulking-only medical practices collected in mid-2020 and linked this with population data. The population data and practice locations were analysed at the level of Statistical Areas Level 2 (SA2) regions and used the most recent Census data. Results: The study sample included (n = 2095) bulk billing-only medical practice locations. The nationwide average Population-to-Practice (PtP) ratio was 1 practice to 8529 people for regions with access to bulk billing-only practice, and 57.4% of the Australian population lives within an SA2 that has access to at least one bulk billing-only medical practices. No significant associations were identified between practice distribution and area socio-economic status. Conclusion: The study identified areas with low access to affordable GP services, with many SA2 regions having no access to bulk billing-only practices. Findings also indicate that there was no association between area socio-economic status and the distribution of bulk billing-only services. Inadequate subsidisation of the Medicare rebate threatens the survival of bulk billing only GP services. Little is known of the socio-economic status of bulk billing only practice localities and whether they target disadvantaged populations. This research provides a current estimation of the distribution of bulk billing only GP services in Australia in relation to surrounding population socio-economic demographics. [ABSTRACT FROM AUTHOR]

Introduction. Low back pain (LBP) is common and a significant cause of morbidity. Many patients receive inappropriate imaging for LBP in primary care. Aim. To explore the incidence and type of spinal imaging conducted for LBP patients referred from general practice for specialist surgical opinion, and evaluate whether imaging conformed to clinical guidelines. Methods. Audit of a sequential cohort (n = 100) of new LBP patients referred from primary care for specialist opinion at a suburban Australian capital city independent Spinal Centre. Results. In the 6 months before referral, 90% (95% CI 83–95%) of patients underwent spinal imaging. Imaging was performed in 95% of those who did and 79% of those who did not meet guidelines for radiological investigation. 35% of patients were inappropriately imaged and 3% inappropriately not imaged. Spinal computed tomography (CT) imaging was used in 52% of patients, magnetic resonance imaging (MRI) in 42% and image-guided lumbar spinal interventional procedures in 28%. Discussion. Most patients with LBP referred for surgical opinion have diagnostic radiological investigations whether or not it is indicated by clinical guidelines. The more frequent use of spinal CT compared to MRI may be due to idiosyncrasies of the Australian Medicare Benefits Schedule (MBS) rebate system. The findings of this pilot study provide support for the changes recommended by the 2016 MBS Review Taskforce on LBP that permit GP access to subsidised lumbar MRI, while constraining access to lumbar CT, and provide novel data about spinal imaging and practice in this cohort of patients. [ABSTRACT FROM AUTHOR]

Objective: This research was undertaken to explore factors operating at the level of the clinic and the community which influence the development of the oral health role of Indigenous Health Workers. The research is a significant aspect of a wider study of the disconnect between the strong national policy support for the development of the oral health role of Indigenous Health Workers and the limited development of the role. Design: Semi-structured interviews were conducted with Indigenous Health Workers to explore their perceptions of the priority of the development of an oral health role and to identify facilitators and barriers to sustainable role development. Setting: The study was conducted in three remote Indigenous communities and two regional centres of the Cape York region in far north Australia. Method: Interviews were conducted with 21 Indigenous Health Workers through five group interviews and eight individual interviews. Results: The findings highlight the high priority given by Indigenous Health Workers to the development of their oral health role while also identifying significant barriers to the sustainable development of this role. Conclusion: The identification of barriers to role development operating at the level of the clinic and the community helps to explain the disconnect between policy and practice in the development of the oral health role of these community health personnel.

Objective. This study aimed to map the geographic distribution of tertiary hospitals in Australia’s most populous cities. Good access to hospital facilities improves the health and welfare of a community. The use of geographic information system (GIS) technology can assist in understanding spacial accessibility to services. Methods. Using Quantum GIS, a geodatabase was constructed to incorporate hospital locations and demographic distribution data throughout Australia’s 20 most populous cities. Data on the population’s age groups were integrated into the geodatabase to investigate the distribution of age groups and their utilisation of access to emergency departments in tertiary public health care. Overall this study reported the geospatial distribution of 89 tertiary hospitals and the demographics of the population in areas around these hospitals. Results. The majority of hospitals were located in the three most populated cities of New South Wales (NSW), Sydney, Wollongong and Newcastle, which contain a total of 32 hospitals, with 23 (72%) of the hospitals in Sydney. There were 7.8, 24.0, 53.4 and 81.0% of the population in NSW within 1.5, 3, 6 and 50 km of the hospitals, respectively. The second-highest number of hospitals was in Victoria (n = 22), with 18 (82%) hospitals located in Melbourne. This was followed by Queensland (n = 14), with eight (57%) hospitals located in Brisbane. Conclusions. The results indicate that 82.2% of the Australian population lives within a 50 km radius of a tertiary hospital, with NSW having higher age distribution percentages than the other states. The results of this study could be used to locate and improve areas of need with a high burden of disease and low accessibility to healthcare services. [ABSTRACT FROM AUTHOR]

Objective. The Child Dental Benefits Schedule (CDBS) was introduced in 2014, and its aim was to support access to dental care for eligible children in Australia. Dental caries, and pulp and periapical diseases were the major dental reasons for children’s hospitalisations. This study investigated if the availability of the CDBS had any effects on hospitalisation rates in Australian children. Methods. This study was a retrospective analysis of Medicare data from the Australian Government and the hospitalisation data from The Australian Institute of Health and Welfare (AIHW) from 2008 (6 years before the commencement of the CDBS) to 2020 (6 years after the commencement of the CDBS). Results. Although the hospitalisation rate trend was reducing before the CDBS started (2008–14), this reduction was not statistically significant. The reduction of hospitalisation rates was higher after the commencement of the CDBS (2014–20) and was statistically significant, but the regression model analysis showed a positive correlation between the CDBS and hospitalisation rate. The analysis without ‘abnormal’ year data (2019–20, COVID-19 pandemic year) supported no statistically significant decrease in hospitalisation rate after the commencement of the CDBS in 2014 until 2019. Conclusion. Although the CDBS is improving access to dental care for eligible children, any possible effects the CDBS might have on hospitalisations are not yet evident. [ABSTRACT FROM AUTHOR]

Objectives: It is well known that there are associations between overall health, age, socioeconomic status and rural residency. The objective of this study was to determine the distribution of Australia's aged population by socioeconomic status, as well as remoteness. Methods: The study employed the Australian Statistical Geography Standard (Statistical Area Level 1 and Remoteness Areas). The database of the geographic boundaries was integrated into the ageing population and socioeconomic data using the Geographic Information System. The socioeconomic data was analysed through the Index of Relative Socioeconomic Disadvantage. Results: Over a decade, the older population in Australia has increased noticeably. In 2016, there was a high percentage of older people (≥65 years) in Tasmania (Tas), 19%, while the lowest percentage was recorded in the Northern Territory (NT), 7%. Across the country, Tasmania had the highest percentage of older citizens living in the most disadvantaged areas since 2006, with 48% recorded in 2016. There was an association between the remoteness areas and the education and income levels of the ageing cohort. However, this association differed between the states and territories. This socioeconomic gap becomes more evident in the very remote areas of the country. Conclusions: The ageing population in Australia is increasing rapidly; this was associated with an evolving socioeconomic disparity among this ageing society. Our results demonstrated that socioeconomic inequalities were to be found among the older people based on their distribution over the remoteness areas in Australia. This information should be used to target healthcare and ageing policies that meet the specific needs of older people. [ABSTRACT FROM AUTHOR]

A review of adult education in Australia in the context of changes in demography, workplaces, knowledge, and the role of the state finds that adult education has been reconfigured as adult learning and is a major postsecondary provider. Adult education is now more widely recognized, inclusive, better managed, and responsive to changing contexts. (SK)

A culturally appropriate oral health training course tailored to the needs of rural Aboriginal health workers was developed in Western Australia. The course is taught in three modules ranging from introductory material to comprehensive practical and theoretical knowledge of basic dental health care. The program encourages Aboriginal health workers to implement long-term preventive measures at the local level. (TD)

Argues that the current move at Australian universities toward instrumental programs of work-based learning threatens the existence of the liberal university, where knowledge is pursued predominantly for its own sake. Four dominant discourses--the liberal, the utilitarian, the reformist, and the liberal-vocational models--are identified as forces shaping the mission of higher education. (KS)

Background: Prescribing medicine is integral to clinical dentistry. Infective endocarditis may be rare but fatal if left untreated. As a result, judicious prescribing of antibiotics should be implemented due to potential. To our knowledge, no Australian study has examined dental students' knowledge and perceptions about antibiotic prophylaxis for dental procedures. Methods: Australian dental students were invited to undertake the survey comprising case vignettes to investigate their medication knowledge. A total of 117 responses were received. The questions were 12 clinically relevant questions and three perception-based questions. Results were analysed using descriptive statistics as well as the chi-squared test. Results: The 117 respondents had a mean correct response of 7.34 ± 2.64 (range 3–12 out of 12). Out of 117 students, 89 (76%) answered more than half of the questions correctly. Only three students (3%) answered all the questions correctly. Nearly two-thirds felt that they knew about antibiotic prophylaxis used for dental procedures. Conclusion: Most respondents answered more than half, but not all, of the clinical questions correctly. It is crucial to highlight that dental student may never receive any more training on antimicrobial stewardship (AMS) at any point in their future careers. It may be ideal that this issue is addressed at the dental school. One way to target this is to potentially nationalised teaching delivery of dental AMS across Australia. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to analyse and map the distribution of the ageing population, by sociodemographic profiling, in private and public dental practices in Australia. Background: The rapid increase in the aged population in Australia requires a comprehensive approach to ensure accessibility to geriatric dental services. However, the availability of dental services for the older people requires further investigation of the demographic distribution of need. Materials and Methods: Dental practices were located and mapped against the ageing population data. The address for each dental practice in Australia was compiled from online access sources. Australian socioeconomic data were integrated with dental practices, clinic locations and older populations using Geographic Information System (GIS) technology. Results: There was an uneven distribution of dental practices across Australia's States and Territories (NT and ACT). Tasmania had the highest ratio of private practices to the older population (1:1000) and the highest percentages of this ageing cohort (32%, 61%) that lived more than 5 km from private and public dental practices respectively. Higher percentages of dental practices were located in areas of lower socioeconomic status in Tasmania, Queensland and South Australia (47%, 42% and 38%) respectively, however, these areas were associated with higher ageing population densities. Conclusion: There is a geographic maldistribution of dental practices in relation to the spatial distribution of Australia's older population, with the inequity most pronounced in the most disadvantaged areas. This inequality requires a National approach to match dental services to the population that they serve. [ABSTRACT FROM AUTHOR]

Background: In Australia, because of inequity in dental service accessibility and affordability, patients can see general medical practitioners (GPs) for acute dental conditions. Methods: This cross‐sectional study consisted of surveys distributed to the board registered GPs practising in Australia. The main outcome measures included statistical analysis of GPs managing different dental emergency scenarios and their confidence and expectations in managing dental emergencies. Results: A total of 425 GPs participated in the study. The sample primarily consisted of GPs practising in metropolitan clinics (n = 315). Most participants reported that they would refer to the dentist for mobilized tooth (n = 402). There was a negative correlation between GPs with 5–29 years of experience and traumatized tooth management (P < 0.05). GPs aged between 40 and 49 years were more inclined to treat patients with mobilized teeth [Multivariate (MV): 0.42(0.09–0.74)]. However, GPs with 0–5 years of experience were less likely to manage patients with dental abscess [MV: −0.52(−0.80 to −0.24)]. Conclusion: Most GPs referred dental emergencies to dentists. GP management of dental emergencies were predominantly palliative. Therefore, opportunities for collaborative practice models amongst GPs and dentists may be needed to bridge the gap in the regional and remote locations. [ABSTRACT FROM AUTHOR]

AIM: To determine the perceptions of carers of people with a disability in terms of the problems they face in accessing dental care. METHOD: The survey was based on the modified Penchansky's 5A classification. It focused on members of a local disability suppo rt agency and was completed as part of their ongoing quality improvement processes. RESULT: A total of 169 carers took part, with a quarter indicating that the person they cared for did not have a regular dentist. Nearly 25% of the participants found it extremely difficult to obtain appropriate oral health care. Amongst the participants 10% had to abandon dental treatment due to difficulties, while 13% have yet to receive any sort of dental care. Amongst school-aged children, 64.5% were unable to receive dental care from the school dental service. CONCLUSION: The study was conducted to obtain an insight and understanding of how people with a disability and their primary caregivers experience dental care. Several concerns were identified, with most related to the process of providing care (patient-professional interaction factors) and the structure of the dental health system and its operation (factors related to access, affordability and information systems.) Targeted strategies aimed at providing affordable and appropriate services to people with disabilities should be prioritised. SO WHAT? The study showed emerging concerns among the participants relating to providing information regarding dental care options, as well as concerns regarding the availability and accessibility of the services. Further research will be conducted using the standardized tool the Measure of Processes of Care, and findings will translate to help initiate a program with the help of Developmental Disability Western Australia to provide information. [ABSTRACT FROM AUTHOR]

Background: The Northern Sydney Local Health District was one of the first health regions to be affected by COVID‐19 in Australia. Aims: To describe the clinical characteristics, risk factors and outcomes in our low‐prevalence Australian population. Methods: This is a retrospective analysis of 517 laboratory‐confirmed COVID‐19 cases between January and June 2020. Patient information was collected as part of routine care within the COVID‐19 Virtual Hospital system. Outcomes examined were death, recovery at 30 days and intensive care unit (ICU) admission. Results: The case fatality rate was 1.8%. Multivariate analysis showed factors independently associated with death, composite outcome of death/ICU admission or incomplete recovery at 30 days were age >80 years and presence of two or more comorbidities. Most cases acquired COVID‐19 through international (50.9%) or cruise ship travel (9.1%). Healthcare workers comprised 12.8% of the cohort and represented a disproportionately high percentage of the 'unknown' source group (27.6%). The median incubation period was 5 days (interquartile range 3–8); one patient had an incubation period of 15 days. Hospitalisation was required in 11.8%, ICU admission in 2.1% and ventilation in 1.4%. A Radiographic Assessment of Lung Oedema score on chest X‐ray of >10 was independently associated with death. Conclusions: In this low prevalence, well resourced Australian setting, we report an overall low mortality. Factors associated with adverse patient outcomes on multivariate analysis were age greater than 80 and the presence of two or more comorbidities. These data can assist in early risk stratification of COVID‐19 patients, and in surge capacity planning for hospitals. [ABSTRACT FROM AUTHOR]

Background: Capitation models of care in dentistry started around 1973 with varying degrees of success in meeting the needs of the individuals and expectations of the participating private practitioners. These studies mostly identified that capitation payments resulted in under treatment whilst fee-for-service models often led to over treatment. The objective of this study was to develop a new way of doing business using an outsourcing capitation model of care to meet population health needs and activity-based funding requirements of rural Local Health Districts with a local university dental school. This payment model is an alternate referral pathway for public oral health practitioners from the existing New South Wales Oral Health Fee-for-Service Scheme that focuses on urgent treatment to one that offers an all-inclusive preventive approach that concentrates on sustaining good long-term oral health for the individual. Method: The reflective study analysed various adult age cohorts (18–24, 25–34, 35–44, 45–54, 55–64, 65–74 and 75 + years) based on 950 participants randomly selected from the Greater Southern adult public dental waiting lists. The study's capitation formula was derived from NSW government adult treatment items (n = 447,625). Dental care was provided through the local university's dental clinics utilising only dental students under clinical supervision. All data were sourced from NSW Oral Health Data Warehouse during 1 January 2012–30 June 2018 and analysed by using SAS 9.3 and Version 13 Microsoft Excel. Results: There were 10,305 dental care items and 1129 capitation courses of care totalling A$599,026. This resulted in an average of 11 dental care items being provided to each participant. The capitation payment formula utilising the most provided dental care items of 100 individual patients proved to be economical and preventive focused. Conclusion: The systematic reflection showed that this unique methodology in developing an adult capitation payment formula associated to diagnostic pathways that resulted in: (i) more efficient usage of government expenditure on public dental services, (ii) provision of person-centred courses of dental care, and (iii) utilisation of university dental education programs to best practice treatment and holistic care. [ABSTRACT FROM AUTHOR]

Purpose: Many studies of tooth dimensions have reported both diversity among populations and sexual dimorphism. This study aimed to collect data on mesiodistal dimensions and sexual dimorphism of permanent teeth of contemporary Western Australian adolescents.Methods: The mesiodistal dimensions of teeth from 500 adolescents (177 males, 323 females; age, 13-18 years) were obtained from pre-orthodontic treatment digital dental records of examinations using Invisalign technology. Differences between contralateral teeth and sexual dimorphism were analyzed by using SPSS.Results: Mesiodistal dimensions significantly differed between right and left teeth in both sexes. Males had larger teeth than females, and the difference was significant for most teeth. Reverse dimorphism (females had slightly larger teeth than males) was observed for the maxillary second premolar. Mandibular canines exhibited the greatest dimorphism. In addition, secular trends-specifically, a reduction in the degree of dimorphism-were observed in mesiodistal dimensions.Conclusion: Mesiodistal dimensions significantly differed between teeth in contralateral quadrants, in both arches. Most teeth exhibited sexual dimorphism, which was the greatest for permanent mandibular canines. Dimorphism was less obvious in this population than in other populations. [ABSTRACT FROM AUTHOR]

From late January to early February 2019, a quasi-stationary monsoon depression situated over northeast Australia caused devastating floods. During the first week of February, when the event had its greatest impact in northwest Queensland, record-breaking precipitation accumulations were observed in several locations, accompanied by strong winds, substantial cold maximum temperature anomalies, and related wind chill. In spite of the extreme nature of the event, the monthly rainfall outlook for February issued by Australia's Bureau of Meteorology on 31 January provided no indication of the event. In this study, we evaluate the dynamics of the event and assess how predictable it was across a suite of ensemble model forecasts using the Met Office numerical weather prediction (NWP) system, focusing on a 1-week lead time. In doing so, we demonstrate the skill of the NWP system in predicting the possibility of such an extreme event occurring. We further evaluate the benefits derived from running the ensemble prediction system at higher resolution than used operationally at the Met Office and with a fully coupled dynamical ocean. We show that the primary forecast errors are generated locally, with key sources of these errors including atmosphere–ocean coupling and a known bias associated with the behavior of the convection scheme around the coast. We note that a relatively low-resolution ensemble approach requires limited computing resources, yet has the capacity in this event to provide useful information to decision-makers with over a week's notice, beyond the duration of many operational deterministic forecasts. [ABSTRACT FROM AUTHOR]

Objective: This cost-analysis study explored Pharmaceutical Benefits Scheme (PBS) data to determine the financial patient contribution (PC) towards dispensed medications prescribed by dentists and temporal trends in cost contributions. Methods: For this study we used the PBS online dataset and only included concessional data in the analysis. Data on dental medications dispensed under the PBS from 2006 to 2018 were accessed. For all medicines aggregated to different pharmacological categories (antibiotics, analgesics and opiates, anti-inflammatories, antifungals, benzodiazepines, anticonvulsants and anti-emetics, and emergency medications), a temporal trend was generated using annual PC data. Cumulative patient and mean annual PC data were also generated in a similar manner. Results: Cumulative PC over the study period for dental PBS prescriptions was A$28 783 361 (A$5.55 per dispensing). The mean annual PC for dental PBS was A$2 214 105 (for the entire concessional population from 2006 to 2018), with a statistically significant and strong correlation between year and PC (Dental PBS, A$59 756 per year; r = 0.98: P < 0.0001). Antibiotics represented the highest proportion of PC (87.8%), whereas the lowest proportion of PC was for emergency medications (e.g. adrenaline, atropine, glucagon, naloxone), which amounted to 0.003%. Conclusions: This study highlights the increasing contributions made by patients towards antibiotic prescriptions. What is known about the topic?: Australian dentists can independently prescribe subsidised medications as per a set scope for general and specialist dentists, regulated under the PBS with requisite adherence to specific legal requirements. What does this paper add?: This is the first study highlighting the increased level of patient financial contributions towards dental medicines, according to different pharmacological categories, dispensed by pharmacists in Australia. What are the implications for practitioners?: This study creates a base for future research assessing the appropriateness of the PBS subsidy and the PBS Safety Net threshold, possibly reassessing the out-of-pocket pricing on brand substitution and appropriately reassessing the current dental PBS schedule. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to identify the gaps in public dental service locations for people living with a disability in Australia, with in-depth analysis of Western Australia (WA). Methods: Data from the Survey of Disability, Ageing and Carers and national census data were used to geographically model the prevalence of disability. Private and public dental practice data were integrated using QGIS, and a catchment area of 5 km was used for public dental practices. This was then used to identify residential areas outside the 5-km catchment area. Further analysis was then done to determine how a potential service at these sites would improve geographic access for people with a disability residing within the area. Results: In this study, 6162 private and 178 public dental practices were geo-coded, covering 39 915 Statistical Area Level 1 regions and approximately 16 million people. Overall slightly more than half the people living with any disability resided within the 5-km catchment area of a public dental practice. WA (Perth) had the lowest coverage (48%), whereas New South Wales (Sydney) had the highest (71%). In WA (Perth), four sites were identified that would improve the overall coverage from 48% to 75%. Conclusion: This study highlights the areas where there is low access to a dental service, particularly access to a public dental service, for people living with a disability. What is known about the topic?: The distribution of people with a disability is associated with area-level measures of socioeconomic disadvantage. Access to dental care is a function of affordability, availability, accessibility, accommodation and acceptability. Previous studies identified problems in relation to access to dental care for people living with a disability, including wait times, costs and physical access to buildings. What does this paper add?: This paper shows how geographical access to a dental service can be improved, by locating services in identified areas targeting people living with a disability. What are the implications for practitioners?: The results of this study could be used to plan funding targeted at areas of need with a high burden of disease and low accessibility to services. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine whether there has been a change in access to private dental services in regional and remote areas of Australia by comparing the distribution of private dental practices and dentists in 2011 to the distribution in 2018 according to state and territory and the Accessibility/Remoteness Index of Australia Plus. Design and setting: A database of dental practices and dentists in Australia was compiled from open‐access sources for 2011 and 2018; dental practices were mapped by state, Accessibility/Remoteness Index of Australia Plus and Statistical Area 2 census district and linked to population data. Main outcome measures: Change in number of private dental practices, mean number of dentists per private practice, population per dental practice and mean number of dentists per population by geographic location from 2011 to 2018. Results: There were more dental practices in rural and remote areas in 2018 than in 2011. The percentage of Statistical Area 2s without a private dental practice was lower in 2018 but remained high in rural areas and increased with remoteness—inner regional 23.1%; outer regional 31.6%; and remote and very remote 48%. Growth in registered dentist numbers did not match population growth, and on average, there were less dentists per practice in inner regional and remote and very remote areas by the end of the study. Conclusion: There has been an improvement in spatial access to private dental services in regional areas of Australia, but slower rate of growth of dentist numbers compared to population growth resulted in poorer access to dental services and large population numbers must still travel outside their local Statistical Area 2 census district to access dental care. [ABSTRACT FROM AUTHOR]

Purpose/objectives: Prescribing medicine is integral to clinical dentistry. Future dental practitioners need to have a thorough knowledge of how to prescribe safely and effectively. To date, medication knowledge among dental students in Australia has not been assessed at a national scale.Methods: Australian dental students were invited to undertake the survey comprising 12 multiple choice questions to investigate their medication knowledge. A total of 185 responses were received. The questions were 11 clinically relevant questions and 1 opinion-based question with 4 options from which to select. Results were analyzed using descriptive statistics.Results: The 185 respondents had a mean correct response of 6.77 ± 1.8 (range: 2-11 out of 11). Out of 185 students, 142 students (77%) answered more than half of the questions correctly. Only 1 student (1%) answered all 11 questions correctly. There were 135 students (73%) who either agreed or strongly agreed that they would feel confident to prescribe safe and effective medication for their patients after having completed dental school.Conclusion: Most respondents answered more than half, but not all, of the clinical questions correctly. Despite this, many reported confidence in their prescribing skills. Future research needs to further investigate pharmacotherapeutic knowledge to determine detailed knowledge gaps in prescribing. [ABSTRACT FROM AUTHOR]

Objective: The Child Dental Benefit Scheme (CDBS), which provides dental services for targeted children in Australia, was implemented in 2014. Currently there is no information available on the cost and utilisation patterns of this publicly funded scheme. This study aimed to analyse the pattern of dental visits under the CDBS, as well as the cost of the CDBS over the first 2 years of operation. Methods: This study was a retrospective descriptive analysis, using data from Medicare Statistics (an Australian Government website) from two calendar years (2014 and 2015). Results: Nationally, the number of CDBS patients declined by 16.3% after the first year, and patients were predominantly aged 5–14 years. Preventive services were the most used service, and contributed to approximately 30% of total expenditure. Conclusion: The utilisation of CDBS is considered to be low. What is known about the topic?: Previous government dental schemes in Australia resulted in inequalities in utilisation of the scheme by targeted groups. The CDBS was implemented with an extension of eligibility criteria and services offered as a means to improve access to dental care. What does this paper add?: There is no information available on the utilisation and cost patterns of the CDBS; hence, this study analysed the pattern of utilisation and the cost of the CDBS over the first 2 years of operation. What are the implications for practitioners?: It is important that practitioners promote the scheme among those eligible to enable targeted populations access to the scheme and to ultimately improve child oral health. [ABSTRACT FROM AUTHOR]

Progressive realisation of equitable access to health services is a fundamental measure of a state's resolve to achieve universal health coverage. The World Health Organization has reprioritised the importance of oral health services as an integral element of the roadmap towards health equity. This study sought to determine whether there is an indication of progressive realisation of equitable spatial access to public dental services for Australians <18 years of age through a comparison of travel times to the nearest public dental clinic at successive census dates. The distribution of children classified by rural remoteness and level of socioeconomic disadvantage, as well as the location of public dental clinics at the 2011 and 2016 Australian Bureau of Statistics censuses, was mapped using geographic imaging software. OpenRouteService software was used to calculate the travel time by car between each statistical census district and the nearest public dental clinic. There has been an improvement in the percentage of the population <18 years of age living within a reasonable travel time of a public dental clinic. The most socioeconomically disadvantaged groups in more densely populated areas have better spatial access to publicly funded dental services than less disadvantaged groups. Children living in very remote areas continue to experience lengthy travel times to access fixed oral health services. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to test the hypothesis that all Australians based on clinical need have equal access to health services for the removal of impacted teeth as hospital in-patients. Methods: Data for the current analysis were obtained from the Western Australian Hospital Morbidity Data System (HMDS) for the six financial years 1999/00 to 2004/05. All cases of in-hospital treatment for impacted teeth were analysed and then correlated with socioeconomic status, geographic location of the patients, place of primary residence, and age. Results: In-patient extraction rates are significantly higher in the 10- to 19-year-old and the 20- to 29-year-old age groups when compared to the other age groups. A young adult from a higher socioeconomic group is 4 times more likely to have an impacted tooth removed in a hospital than his or her counterpart from a lower socioeconomic group, which is significant. Similarly, people living in highly accessible metropolitan areas have a 3 times greater chance of being hospitalised for this procedure than those from the remote and rural areas. Conclusion: There are significant differences among different groups based on socioeconomic status and access to health services for in-hospital removal of impacted teeth, thus rejecting the hypothesis. This raises doubts over the nature of the procedure, considering that most patients are young, non-Indigenous, and live in metropolitan areas. This implies that some of the procedures seem to be elective and there is a need for introduction of guidelines in Australia for removal of impacted teeth, which could reduce expenditures significantly. However, further research is required in this area. [ABSTRACT FROM AUTHOR]

Objectives: Analysis of the distribution of allied dental practitioners relative to the socio-economic profile of the population, to develop a baseline of employment demographics at a time of proposed deregulation of practicing restrictions.Methods: A database of allied dental practitioners (ADP - oral health therapists, dental therapists and dental hygienists) was compiled from the public access register of the Australian Health Practitioner Regulation Agency. The principal practice locations limited to suburb and postcode were geocoded by latitude and longitude and superimposed on a map of the Australian landmass using QGIS software. Using Australian Bureau of Statistics data, the number of ADPs for each Statistical Area 2 (SA2) was counted and apportioned according to proportion of the population within each SA2 for each quintile of the Index of Relative Socio-economic Disadvantage (IRSD). The results were reported according to oral health therapists, dental therapists and dental hygienists per 100 000 population for each IRSD quintile, by state and territory, and the Australian Regional Index for Areas (ARIA+).Results: The ADP to population ratio was not consistent for each professional class between states and territories, IRSD quintiles and (ARIA+) regional areas. Across major cities, South Australia was the state with the highest ratio of oral health therapists (10.6-12.9) and dental hygienists (14.6-24.5) for all IRSD quintiles. Western Australia had the highest ratio of dental therapists (9.3-16.0), CONCLUSION: There is no consistent pattern of distribution of ADPs relative to the socio-economic profile of the population across states and territories, and regional (ARIA+) areas of Australia. [ABSTRACT FROM AUTHOR]

Background: The International Classification of Functioning, Disability and Health is the international standard for describing and monitoring functioning. While the categories, the units of the classification, were not designed with measurement in mind, the hierarchical structure of the classification lends itself to the possibility of summating categories into some higher order domain. Focusing on the chapters of d4 Mobility, d5 Self-Care and d6 Domestic Life, this study seeks to ascertain if qualifiers rating of categories (0-No problem to 4-Complete problem) within those chapters can be summated, and whether such derived measurement is consistent with estimates obtained from well-known instruments which purport to measure the same constructs. Methods: The current study applies secondary analysis to data previously collected in the context of validating Core Sets for stroke, rheumatoid arthritis, and osteoarthritis. Data included qualifier-based ratings of the categories in the Core Sets, and the physical functioning sub-scale of the Short-Form 36, and the World Health Organization Disability Assessment Schedule 2.0. To examine qualifier-comparator scale item agreement Kappa statistics were used. To identify whether appropriate gradients of the comparator scales were observed across qualifier levels, an Independent Sample Median Test of the ordinal scores was deployed. To investigate the internal validity of the summated ICF categories, the Rasch model was applied. Results: Data from 2,927 subjects from Europe, Australasia, Middle East and South America were available for analysis; 36.3% had experienced a stroke, 35.8% osteoarthritis, and 27.9% had rheumatoid arthritis. The items from the Short-Form 36 could not match directly the qualifier categories as the former had only 3 response options. The Kappa between World Health Organization Disability Assessment Schedule 2.0 items and categories was low. For all qualifiers, a significant (<0.001) overall gradient was observed across the comparator scales. Only in few of the World Health Organization Disability Assessment Schedule 2.0 items could no discrete level be detected. The aggregation of the qualifiers at the Chapter and higher order levels mostly revealed fit to the Rasch model. Almost all ICF qualifiers showed ordered thresholds suggesting that the current structure and response options of the qualifiers worked as intended. Conclusions: The findings of this study provide supporting evidence for the use of the professionally rated categories and associated qualifiers to measure functioning. Implication for Rehabilitation: This study provides evidence that functioning data can be collected directly with the International Classification of Functioning, Disability and Health (ICF) by using the ICF categories as items and the ICF qualifiers as rating scale. The findings of this study show the aggregated ratings of ICF categories from the chapters d4 Mobility, d5 Self-care, and d6 Domestic life capture a broader spectrum of the construct than the corresponding summated items from the SF36-Physical Function sub-scale and the corresponding items of the World Health Organization Disability Assessment Schedule 2.0. This study illustrates the potential of building quantitative measurement by aggregating ICF categories and their qualifier ratings into meaningful domains. [ABSTRACT FROM AUTHOR]