Extending dental nurses' duties: a national survey investigating skill-mix in Scotland's child oral health improvement programme (Childsmile)

Background: Childsmile is Scotland’s national child oral health improvement programme. To support the delivery of prevention in general dental practice in keeping with clinical guidelines, Childsmile sought accreditation for extended duty training for dental nurses to deliver clinical preventive care. This approach has allowed extended duty dental nurses (EDDNs) to take on roles traditionally undertaken by general dental practitioners (GDPs). While skill-mix approaches have been found to work well in general medicine, they have not been formally evaluated in dentistry. Understanding the factors which influence nurses’ ability to fully deliver their extended roles is necessary to ensure nurses’ potential is reached and that children receive preventive care in line with clinical guidance in a cost-effective way. This paper investigates the supplementation of GDPs’ roles by EDDNs, in general dental practice across Scotland. Methods: A cross-sectional postal survey aiming to reach all EDDNs practising in general dental practice in Scotland was undertaken. The survey measured nurses’: role satisfaction, perceived utility of training, frequency, and potential behavioural mediators of, preventive delivery. Frequencies, correlations and multi-variable linear regression were used to analyse the data. Results: Seventy-three percent of practices responded with 174 eligible nurses returning questionnaires. Respondents reported a very high level of role satisfaction and the majority found their training helpful in preparing them for their extended role. While a high level of preventive delivery was reported, fluoride vanish (FV) was delivered less frequently than dietary advice (DA), or oral hygiene advice (OHA). Delivering FV more frequently was associated with higher role satisfaction (p < 0.001). Those nurses who had been practising longer reported delivering FV less frequently than those more recently qualified (p < 0.001). Perceived difficulty of delivering preventive care (skills) and motivation to do so were most strongly associated with frequency of delivery (p < 0.001 for delivery of FV, DA and OHA). Conclusions: This study has provided insight into EDDNs’ experiences and demonstrates that with appropriate training and support, EDDNs can supplement GDPs’ roles in general dental practice in Scotland. However, some barriers to delivery were identified with delivery of FV showing scope for improvement

The Association of Virtual Exercise Classes and Well-Being During COVID-19 Among University Employees

This cross-sectional study sought to examine the association of virtual exercise with physical activity (PA), general, and mental health during COVID-19 among university employees. Individuals completed an online survey with questions about demographic, sleep, substance use, and virtual exercise participation. The International Physical Activity Questionnaire and 36-Item Short Form Health Survey assessed PA, general, and mental health. Data were analyzed for descriptive, correlation, and multiple regression models. Complete data were collected from 122 participants with a mean age of 45.6±13.1 years. Participation in virtual exercise were highest for twice a week (24.6%) followed by once a month (17.2%) and never (17.2%). Over a quarter of participants reported an increase (29.1%) in alcohol use. No significant differences were found in total MET-min between before (1952 ± 1373) and during-COVID (1973 ± 1692) (p \u3e .05); however, virtual exercise participation significantly associated with an increase in PA (β = 609.08, p=.01). Statistically significant positive relationships were also found between higher PA and better general health (β = .005, p \u3c 0.01), and emotional well-being (β = .004, p \u3c .05). Self-reported COVID disruptiveness was negatively associated with emotional well-being (β = -3.28, p \u3c 0.001). This data suggested that virtual exercise courses were associated with maintaining PA which may indirectly regulate general and mental well-being during the pandemic for university employees

A Satisfação do visitante do Parque Nacional de Anavilhanas (AM) Uma Análise de Comentários Abertos

O Parque Nacional de Anavilhanas (PNA) é uma Unidade de Conservação (UC) localizada no Amazonas, e que possui uso público. No sentido de identificar quais são os aspectos negativos e positivos observados durante a visitação no PNA, o objetivo deste estudo foi analisar a satisfação do visitante, em relação às perguntas em aberto “o que mais gostou” e “o que menos gostou”. Foram analisados 7.309 questionários, que totalizaram 2.628 comentários negativos e 8.243 comentários positivos. Os dados de levantamentos de campo (survey) foram coletados na UC, entre 2015 e 2017. A metodologia utilizada classificou cada comentário em 3 categorias e 22 subcategorias, conforme palavras-chave. Os resultados identificam a satisfação do público visitante, entendendo melhor a Unidade de Conservação e seu processo de visitação. Assim, os gestores tem dados que podem embasar melhores programas de uso público e o manejo de visitação. Relatos de Experiência apresentando estudos como esse são importantes para auxiliar a criar subsídios para a gestão, bem como a melhoria das atividades, estruturas e procedimentos realizados na UC.

Lifetime cardiovascular management of patients with previous Kawasaki disease.

Kawasaki disease (KD) is an inflammatory disorder of young children, associated with vasculitis of the coronary arteries with subsequent aneurysm formation in up to one-third of untreated patients. Those who develop aneurysms are at life-long risk of coronary thrombosis or the development of stenotic lesions, which may lead to myocardial ischaemia, infarction or death. The incidence of KD is increasing worldwide, and in more economically developed countries, KD is now the most common cause of acquired heart disease in children. However, many clinicians in the UK are unaware of the disorder and its long-term cardiac complications, potentially leading to late diagnosis, delayed treatment and poorer outcomes. Increasing numbers of patients who suffered KD in childhood are transitioning to the care of adult services where there is significantly less awareness and experience of the condition than in paediatric services. The aim of this document is to provide guidance on the long-term management of patients who have vascular complications of KD and guidance on the emergency management of acute coronary complications. Guidance on the management of acute KD is published elsewhere

1000 Norms Project: Protocol of a cross-sectional study cataloging human variation

Background Clinical decision-making regarding diagnosis and management largely depends on comparison with healthy or ‘normal’ values. Physiotherapists and researchers therefore need access to robust patient-centred outcome measures and appropriate reference values. However there is a lack of high-quality reference data for many clinical measures. The aim of the 1000 Norms Project is to generate a freely accessible database of musculoskeletal and neurological reference values representative of the healthy population across the lifespan. Methods/design In 2012 the 1000 Norms Project Consortium defined the concept of ‘normal’, established a sampling strategy and selected measures based on clinical significance, psychometric properties and the need for reference data. Musculoskeletal and neurological items tapping the constructs of dexterity, balance, ambulation, joint range of motion, strength and power, endurance and motor planning will be collected in this cross-sectional study. Standardised questionnaires will evaluate quality of life, physical activity, and musculoskeletal health. Saliva DNA will be analysed for the ACTN3 genotype (‘gene for speed’). A volunteer cohort of 1000 participants aged 3 to 100 years will be recruited according to a set of self-reported health criteria. Descriptive statistics will be generated, creating tables of mean values and standard deviations stratified for age and gender. Quantile regression equations will be used to generate age charts and age-specific centile values. Discussion This project will be a powerful resource to assist physiotherapists and clinicians across all areas of healthcare to diagnose pathology, track disease progression and evaluate treatment response. This reference dataset will also contribute to the development of robust patient-centred clinical trial outcome measures

The Carnegie Supernova Project. I. Third Photometry Data Release of Low-redshift Type Ia Supernovae and Other White Dwarf Explosions

We present final natural-system optical (ugriBV) and near-infrared (YJH) photometry of 134 supernovae (SNe) with probable white dwarf progenitors that were observed in 2004-2009 as part of the first stage of the Carnegie Supernova Project (CSP-I). The sample consists of 123 Type Ia SNe, 5 Type Iax SNe, 2 super-Chandrasekhar SN candidates, 2 Type Ia SNe interacting with circumstellar matter, and 2 SN 2006bt-like events. The redshifts of the objects range from to 0.0835; the median redshift is 0.0241. For 120 (90%) of these SNe, near-infrared photometry was obtained. Average optical extinction coefficients and color terms are derived and demonstrated to be stable during the five CSP-I observing campaigns. Measurements of the CSP-I near-infrared bandpasses are also described, and near-infrared color terms are estimated through synthetic photometry of stellar atmosphere models. Optical and near-infrared magnitudes of local sequences of tertiary standard stars for each supernova are given, and a new calibration of Y-band magnitudes of the Persson et al. standards in the CSP-I natural system is presented.Fil: Krisciunas, Kevin. Texas A&M University; Estados UnidosFil: Contreras, Carlos. University Aarhus; Dinamarca. Las Campanas Observatory; ChileFil: Burns, Christopher R.. Las Campanas Observatory; ChileFil: Phillips, M. M.. Las Campanas Observatory; ChileFil: Stritzinger, Maximilian D.. Las Campanas Observatory; Chile. University Aarhus; DinamarcaFil: Morrell, Nidia Irene. Las Campanas Observatory; ChileFil: Hamuy, Mario. Universidad de Chile; ChileFil: Anais, Jorge. Las Campanas Observatory; ChileFil: Boldt, Luis. Las Campanas Observatory; ChileFil: Busta, Luis. Las Campanas Observatory; ChileFil: Campillay, Abdo. Las Campanas Observatory; ChileFil: Castellón, Sergio. Las Campanas Observatory; ChileFil: Folatelli, Gaston. Las Campanas Observatory; Chile. Universidad Nacional de La Plata. Facultad de Ciencias Astronómicas y Geofísicas; ArgentinaFil: Freedman, Wendy L.. University of Chicago; Estados UnidosFil: González, Consuelo. Las Campanas Observatory; ChileFil: Hsiao, Eric Y.. Florida State University; Estados Unidos. University Aarhus; Dinamarca. Las Campanas Observatory; ChileFil: Krzeminski, Wojtek. Las Campanas Observatory; ChileFil: Persson, Sven Eric. Carnegie Observatories;Fil: Roth, Miguel. Gmto Corporation; Chile. Las Campanas Observatory; ChileFil: Salgado, Francisco. Leiden Observatory Research Institute; . Las Campanas Observatory; ChileFil: Serón, Jacqueline. Las Campanas Observatory; Chile. Cerro Tololo Inter American Observatory; ChileFil: Suntzeff, Nicholas B.. Texas A&M University; Estados UnidosFil: Torres, Simón. Soar Telescope; Chile. Las Campanas Observatory; ChileFil: Filippenko, Alexei V.. University of California at Berkeley; Estados UnidosFil: Li, Weidong. University of California at Berkeley; Estados UnidosFil: Madore, Barry F.. Jet Propulsion Laboratory, California Institute Of Technology; . Las Campanas Observatory; ChileFil: DePoy, D.L.. Texas A&M University; Estados UnidosFil: Marshall, Jennifer L.. Texas A&M University; Estados UnidosFil: Rheault, Jean Philippe. Texas A&M University; Estados UnidosFil: Villanueva, Steven. Texas A&M University; Estados Unidos. Ohio State University; Estados Unido

Fiction Fix 08

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