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Biomedical subjects

T Jenner

Publications and source records attributed to T Jenner.

11 recordsLinked to original sources
PubMed2001

Matching dental practice board data to the health authority population register.

OBJECTIVE: To evaluate the process of matching Dental Practice Board (DPB) registration data to the health authority (HA) register for a defined locality. This included testing for the presence of socio-economic bias in the postcodes held in the DPB data sets and to determine if patients travelling to obtain primary dental care would have an effect on the matching process at health authority level. BASIC RESEARCH DESIGN: All 21 general dental practitioners in Ellesmere Port, South Cheshire gave written consent for the DPB to provide files of their registered patients to the health authority. The registered patients were electronically matched against residents in the HA register in a four stage process. Testing for the presence of a socio-economic bias in the postcodes included in the DPB data set was undertaken by constructing frequency distributions of the proportions of postcoded, and non or partially postcoded DPB records by Super Profiles Lifestyle group. A chi square test was used to test for significant differences. The extent of patients travelling to access primary dental care was assessed by comparing the proportions of registered patients of under 6 years, 25-60 years and those aged 65+ who lived outside South Cheshire Health Authority yet obtained their GDS care within Ellesmere Port. MAIN OUTCOME MEASURES: Out of a total of 39,474 records, 458 (1.2%) were duplicates. Some 35,447 (90.9%) of DPB records could be matched to those contained in the HA register. No significant (chi2 =10.85, df=9, P=0.27) socio-economic difference was found in the proportions of DPB records originally with, and without postcodes by Super Profiles Lifestyle group. Some 1,688 (47.3%) of the unmatched subjects were resident in health authorities other than South Cheshire and therefore could not be expected to be found in the HA register. Nearly 90% of children under 6 years registered with an Ellesmere Port GDP were South Cheshire residents, compared to approximately 85% of adults of working age and older adults. CONCLUSIONS: In this locality DPB data could be matched to the HA register with a reasonable degree of success. However, because of the time taken to clean and make the data sets compatible, the methodology used is inappropriate for routine use. In this locality no socio-economic bias could be found in the records with missing postcodes in the DPB data set. Patients travelling to access dental care would have little influence on the matching process at health authority level in this locality, irrespective of the age group under study.

Adult↗
PubMed2000

Sentinel practices in dentistry: a preliminary evaluation.

The objectives of this study were to compare the socioeconomic make-up and the dental caries and dental treatment patterns of a general dental practice (GDP) population of five-year-old children with those of the total resident population of five-year-old children in a specific locality, and, secondly, to examine the process of gathering information on oral healthcare needs in primary dental care. The study was set in Halton, North Cheshire. Data were collected retrospectively from the patient records of four GDP sentinel' practices using a common data abstraction form. The socioeconomic profiles of the GDP population and the 1995/6 NHS child dental health survey population were compared using the Super Profiles geodemographic classification by plotting frequency distributions. The dmft of each population was compared by calculating 95% confidence intervals. The GDP population showed a slight over-representation in the more affluent groupings of the Super Profiles Lifestyle categories and a more dramatic under-representation in two of the more deprived groupings. The confidence intervals for dt and dmft of the GDP data did not include the mean figures produced by the NHS survey, indicating a significant difference at the P < 0.05 level. These differences may be accounted for by the differences in the socioeconomic make-up of the two populations. Local practice policies on patient selection may also have a consequential effect on population disease estimates derived from primary dental care. Data on population disease experience from primary dental care could only be produced by hand-sorting through patient records, which was time-consuming and inefficient. Standardised electronic systems will need to be developed to make GDP data-collection a viable proposition. Information from primary dental care has the potential to make a major contribution to locality oral health needs assessment and it should be seen as being complementary to information gathered from epidemiological surveys.

Child, Preschool↗
PubMed2000

Comparing the ability of different area measures of socioeconomic status to segment a population according to caries prevalence.

OBJECTIVE: to compare the ability of different area based indicators of socio-economic status to segment a population of 5-year-old children according to caries prevalence. BASIC RESEARCH DESIGN: The study population consisted of all 5-year-old children in seven districts in the North West Region of England who were examined in whole population surveys during the 1995/6 NHS epidemiological survey. This population was segmented according to caries prevalence by market penetration analyses using Super Profiles and the ONS geodemographic classifications, Jarman and Townsend (at ward and ED level) deprivation indices, the single census variables of unemployment and percentage of households without a car, and also the school that the children attended. Lorenz curves were plotted from the outputs of the penetration analyses. MAIN OUTCOME MEASURES: Overall caries prevalence for the population was 55.3%. All the indicators provided a very similar picture. Large differences were detected between the highest and lowest market penetration rankings for each indicator, ranging from 42.5% for the ONS geodemographic classification to 31.4% for the Townsend index at enumeration district level. However, for each indicator, the fall between these two extremes was gradual. This picture was represented by the similar effectiveness scores of around 10% for each indicator which were derived from the Lorenz curves. Each indicator could identify approximately 30% of those with disease in the topmost 25% of the total population in the penetration ranking. When the analysis was restricted to those children with severe disease (dmft> or =5) a similar picture was found, however the effectiveness score increased to 19%. CONCLUSIONS: There was a remarkably consistent inequitable distribution of population disease prevalence found between deprived and affluent area types, irrespective of what measuring instrument was used. Although there was a large difference in prevalence (dmft>0 and dmft>5) found between deprived and affluent areas, there was a gradual fall between the two extremes. This gradual fall has implications for oral health improvement strategies.

Child, Preschool↗
PubMed2000

The utility of anonymised postcoded registration data provided by the Dental Practice Board.

OBJECTIVE: To evaluate the completeness of the postcodes held in the data sets of the Dental Practice Board (DPB), and the use of the location of the dental practice at which a patient is registered, as a proxy for the location of their residential address. BASIC RESEARCH DESIGN: A cross-sectional evaluation of anonymised person-based registration data held by the DPB. The study population was all children aged under 6 years registered with a dentist in the North West Region of England. The percentage of records that could be geo-referenced from the postcodes contained within the DPB's data sets was calculated. For all records which could be geo-referenced, the proportion of children who lived in the same health authority as the dental practice they were registered with was also calculated. MAIN OUTCOME MEASURES: A total of 193,466 children in the North West Region were registered with a general dental practitioner (GDP). Of this total 117,607 (60.8 percent) could be geo-referenced from the contents of the postcode field. However, there was considerable variation in the match across the region. The majority of children lived in the same health authority as the dental practice they were registered with. It was noticeable that a greater proportion (28.5 percent) of residents registered with a dentist located within the boundaries of Manchester Health Authority were not Manchester residents. CONCLUSIONS: Due to a significant proportion of missing postcodes, data presently held by the DPB cannot be used to calculate accurate registration rates at a small area level. Using the dental practice location as a proxy for residential address is inaccurate at health authority level, especially for large conurbations. This inaccuracy will increase at small area level. Registration data held by DPB are a potentially valuable information source, but before this information can be of use to commissioners the problem of poor postcode coverage will need to be resolved.

Child, Preschool↗
PubMed1999

alpha-MSH can control the essential cofactor 6-tetrahydrobiopterin in melanogenesis.

In the human epidermis both keratinocytes and melanocytes express POMC m-RNA. Immunohistochemical studies of both cell types demonstrate significantly higher levels of alpha-MSH in melanocytes than in keratinocytes. Both cell types also hold the full capacity for de novo synthesis/recycling of the essential cofactor (6R)-L-erythro-5,6,7,8-tetrahydrobiopterin (6BH4). 6BH4 is critical for the hydroxylation of the aromatic amino acids L-phenylalanine, L-tyrosine, and L-tryptophan, for nitric oxide production and in various immune modulatory processes. Recently it was shown that tyrosinase activity is regulated by 6BH4 through a specific allosteric inhibition. The tyrosinase/6BH4 inhibition can be activated by 1:1 complex formation between 6BH4 and alpha-MSH, but an excess of alpha-MSH over 6BH4 can inhibit tyrosinase due to complex formation by tyr2 in the alpha-MSH sequence. In both melanocytes and keratinocytes 6BH4 controls the L-tyrosine supply via phenylalanine hydroxylase (PAH). Recently we were able to show that the cellular uptake of L-phenylalanine and its intracellular turnover to L-tyrosine is crucial for melanogenesis. alpha-MSH can promote the production of L-tyrosine via PAH due to activation of the PAH tetramer to the more active dimer by removing 6BH4 from the regulatory binding domain on the enzyme. In conclusion, alpha-MSH can control (1) intracellular L-tyrosine formation from L-phenylalanine in both melanocytes and keratinocytes, and (2) tyrosinase activity, directly, in melanocytes.

Animals↗
PubMed1999

The effects of socioeconomic status and dental attendance on dental caries' experience, and treatment patterns in 5-year-old children.

OBJECTIVE: To compare the dental caries' experience and treatment received by 5-year-old children registered with a GDP. DESIGN: Retrospective case note review of all 5-year-old children registered with seven GDPs. SETTING: The study was carried out in 1996/7 in Wirral and North Cheshire in the north west of England. SUBJECTS AND MATERIALS: Clinical, demographic and attendance data were collected from each practice using a common data abstraction form. Subjects were categorised according to regular/irregular attenders, and into five groups ranging from affluent to deprived using the Super Profiles geodemographic classification. The relationships between disease experience, treatment, attendance and socioeconomic status were compared using cross-tabulations, t-tests and multiple linear regression. RESULTS: The dental records of 430 5-year-old children were available for analysis. Irregular attenders had significantly higher dmft, dt and mt, and fewer filled teeth. Only 29% of disease experience of regular attenders was treated by restoration. Both socioeconomic status and visiting behaviour exerted significant independent effects on dmft, but dental attendance alone had a significant effect on ft. CONCLUSIONS: Significant inequalities remain in the disease experience and service use of young children. Regularly attending children have less than a third of their diseased teeth restored. Consensus is needed across the profession on the care of the diseased deciduous dentition.

Child, Preschool↗
PubMed1998

Toward a standardised information system for dentistry.

Information technology is growing rapidly in both its capability and capacity to support the delivery of health care. This paper describes the work of the Dental Interspec project, commissioned by the Department of Health. The aim of the project is to provide a framework for the development of information management and technology in dentistry. It is hoped that the work of this project can be built on to eventually produce integrated information systems which would have the potential to improve primary dental care delivery for both patients and dentists.

Computer Communication Networks↗
PubMed1995

Fused pyrazine mono-N-oxides as bioreductive drugs. III. Characterization of RB 90740 in vitro and in vivo.

RB 90740 is the lead compound in a series of aromatic mono-N-oxide bioreductive drugs. The compound shows considerably greater toxicity towards hypoxic verses aerobic mammalian cells in vitro. The differential in concentration required to give the same level of cell killing under these conditions ranges from 3.5 in a human bronchio-alveolar tumor cell line up to 120 in a rodent cell line defective in the repair of DNA strand breaks. The ability of RB 90740 to cause DNA strand breaks under hypoxic conditions was confirmed by alkaline sucrose gradient and pulsed field gel electrophoresis techniques. Despite these properties demonstrated in vitro, RB 90740 was shown not to be cytotoxic to hypoxic cells in experimental murine tumors in vivo. This may be due, in part, to the level of hypoxia (< 0.02% O2) necessary to produce toxicity in vitro.

Animals↗