Trends in socioeconomic inequality of periodontal health status among Dutch adults: a repeated cross-sectional analysis over two decades

Background Studies exclusively focusing on trends in socioeconomic inequality of oral health status in industrialized countries are relatively sparse. This study aimed to assess possible differences in oral hygiene and periodontal status among people of different socioeconomic status (SES) in the Netherlands over two decades. Methods A repeated cross-sectional analysis of 3083 participants aged 25–54 years was conducted on the Dutch National Oral Health Surveys of 1995, 2002, 2007, and 2013. Plaque-free was defined according to the Simplified Oral Hygiene Index (OHI-S = 0). Periodontal status was classified in two different ways, either periodontal health/disease (probing pocket depth index [PDI] = 0/ ≥ 1) or with/without deep pockets (PDI = 2). We used the regression-based absolute and relative effect index to measure the absolute and relative socioeconomic inequalities. Multivariable logistic regressions were used to explore temporal trends in oral hygiene and periodontal status by low- and high-SES groups. Results Age-standardized percentages of individuals with plaque-free increased in the whole population from 1995 to 2013 (12.7% [95% CI 10.5–14.9] to 28.1% [24.8–31.5]). Plaque-free showed significant socioeconomic differences in absolute and relative inequalities in 2007 and 2013. Between 1995 and 2013, age-standardized percentage of periodontal health increased (from 51.4% [48.1–54.7] to 60.6% [57.0–64.1]). The significant absolute inequalities for periodontal health were seen in 2002 and 2013. The relative scale presented a similar pattern. Regarding deep pockets, there was little difference in the age-standardized overall prevalence in 1995 versus 2013 (from 6.5% [4.9–8.2] to 5.4% [3.7–7.0]). The significant absolute and relative inequalities in deep pockets prevalence were found in 1995. Yet, all interaction terms between survey year and SES did not reach significance (plaque-free: P = .198; periodontal health: P = .490; deep pockets: P = .678). Conclusions Socioeconomic inequalities in oral hygiene and periodontal status were present in the Netherlands in the last two decades.

Single flap approach with or without enamel matrix derivative in the treatment of severe supraosseous defects: a retrospective study

Aim To comparatively evaluate the clinical effectiveness of the single flap approach (SFA) with and without enamel matrix derivative (EMD) in the treatment of supraosseous defects (SDs) associated with deep pockets. Materials and methods Twenty patients, each contributing one SD associated with a deep (≥ 6 mm) pocket and treated with buccal SFA either alone (SFA group; n = 10) or in combination with EMD (SFA+EMD group; n =10), were retrospectively selected. Clinical parameters (probing depth, PD; clinical attachment level, CAL; gingival recession, REC) had been assessed at pre-surgery and 12 months post-surgery. Results Complete wound closure was observed in 70% and 80% of defects treated with SFA and SFA+EMD, respectively. Treatments resulted in a significant PD reduction of 3.1±1.0 mm (p=0.005). In SFA+EMD group, 100% of closed pockets was obtained, while 90% of closed pockets was observed in SFA group. Both treatments resulted in a significant CAL gain of 2.1±0.9 mm and 1.9±1.7 mm in SFA and SFA+EMD group, respectively (p= 0.465). In both groups, REC significantly increased 1.0±1.1 mm in SFA group and 1.1±1.1 mm in SFA+EMD group (p= 0.722). Conclusions Within their limits, the findings of present study suggest that SFA may represent a valuable option for the surgical treatment of SDs associated with deep pockets. EMD did not result in a significant clinical benefit to the procedure. Clinical relevance SFA may represent a valuable option in obtaining pocket closure when treating SDs associated with deep residual pockets.

A Triple Cornerstone Framework for Software Startups

Software startups are increasingly under high pressure to deliver successful products to survive and thrive in the modern highly competitive technology market. Larger organizations with deep pockets can replicate the same business ideas used by startups with relative ease. So how does the average startup stand a chance at succeeding at this seemingly David vs. Goliath contest? This chapter looks at the available literature and identifies factors that can affect the success of software development startups. Using causal loop constructs from the field of system dynamics, the interactions among the various identified factors are visualized to reveal the dynamics of the system. The result is as a three-dimensional view of success factors in form of time, capital, and (product) differentiation. The chapter also explores the cornerstones in the context of the product and business dimensions of software startups. This research acts as groundwork for analyzing the workings of software startups and sets the stage for a more holistic study upon which further research can be carried out.

The Enduring Popularity of Legacy Journalism: An Analysis of Online Audience Data

As news publishers continue to lose subscribers and advertising revenue, journalism practitioners and researchers have looked to newcomers to the field for ideas of how to adapt and succeed in a much more saturated and unstable media environment. Many have specifically looked to digital native news organizations to understand the ways that journalism is attempting to reinvent itself for a media landscape that is very different from the previous one. Yet what often gets lost in this focus on the newest news organizations is the resilience of many of journalism’s older ones. In this study, I analyze a year’s worth of U.S.-based<strong> </strong>online news consumption data to show that, even in a media environment increasingly saturated with digital native news outlets, legacy news brands continue to comprise a majority of the most popular news sites. Drawing on audience studies literature, I argue that these findings likely reflect audience preferences for familiar, established brands, as well as structural advantages these brands maintain due to their size and capital. I conclude that the fate of digital news organizations is not just a question of their innovativeness or nimbleness. It is also a question of their ability to combat a combination of powerful, stubborn forces: the habits of the people they hope to reach, and the deep pockets of their competitors.

Evaluating Niche E-commerce Indian Retail Websites: User Perspective

Big retailers with deep pockets offer an extensive array of merchandise to persuade customers. Offering wide variety of products to capture diverse buyers may look like an eye-catching opportunity. Nevertheless, this may not always be the paramount tactic especially for small and mid-size businesses, as it often requires big investments. The research aims at evaluating the attributes of some prominent niche websites like Big Small, Chumbak, etc. This evaluation is based on the user’s perspective of what and how they feel and experience about these niche e-retailer’s website. The objective of the research is to identify the factors influencing efficiency of niche Indian retail websites and rank them on the basis of the factors identified in influencing efficiency.A two-phase methodology is adopted for the assessment of niche websites strategies. The two phase methodology adopted includes, identification of the factors for measuring website efficiency. Analytical network process (ANP) is utilized for evaluating these prominent niche websites. The study is based on the information gathered from users of online unique gifting websites. This study suggests a ranking of a set of assessment criteria that can be applied to measure efficiency of niche e-commerce websites. Based on the identified evaluation criteria the niche retailers are also ranked by applying ANP. The outcome will enable e-retails to identify the crucial attributes and allignalign the website with the customer’s preference to provide them with enriched customer experience It will also help the e-retail companies in developing a responsive and performance driven e-commerce website.