A Review of the Global Literature on Dental Therapists

OBJECTIVE: Access to adequate oral health care is deficient in many parts of the world. Many countries are now using dental therapists to increase access, particularly for children. To inform the discussion on dental therapists in the workforce, particularly in the United States, the W.K. Kellogg Foundation funded a review of the global literature to identify as many documents as possible related to the practice of dental therapists since the establishment of the School Dental Service in New Zealand in 1921. METHODS: Consultants in each of the countries considered to have a substantive literature on dental therapists were asked to participate in the research; seventeen in total. In addition to identifying and reviewing published articles, a focus of the research was on identifying \u27gray\u27 documents. Standard databases were searched for key words associated with dental therapists. In addition, searches were conducted of the governmental and dental association websites of all countries known to have dental therapists in their oral health workforce. RESULTS: Fifty-four countries, both developing and developed, were identified where dental therapists are members of the workforce. Eleven hundred documents were identified from 26 of these countries, with over 2/3 of them cited in the published monograph. Reliable evidence from the related literature and verbal communication confirmed the utilization of dental therapists in an additional 28 countries. Thirty-three of the countries were members of the Commonwealth of Nations, suggesting a mechanism of spread from New Zealand. Variable lengths of training/education existed for dental therapists with the tradition being 2 years postsecondary. In a few countries, the training of therapists and hygienists is now being combined in a three academic year program. Historically, dental therapists have been employed by government agencies caring for children, typically in school-based programs. Initiatives in some countries allow limited care for adults by dental therapists with additional training. CONCLUSIONS: The evidence indicates that dental therapists provide effective, quality, and safe care for children in an economical manner and are generally accepted both by the public and where their use is established, by the dental profession

Intervention for mixed receptive-expressive language impairment : a review

Children with receptive-expressive language impairment (RELI), also referred to as 'receptive language disorder' or 'mixed receptive-expressive disorder',2 form a subset of those with speech, language, and communication needs who commonly have problems understanding both spoken and written language; they have particular difficulties in comprehending vocabulary and grammar and inferring meaning. They will have problems with expressive language and some will also have difficulties in pragmatics, i.e. the use of language in social contexts

Tenacity: The American Pursuit of Corporate Responsibility

This article attempts to answer the question, “What are the most important ideas from serving as Executive Editor of the five-year history project that culminated in the book, Corporate Responsibility: The American Experience?” The ideas focus on (1) clarifying the phenomenon of tenacity; (2) looking at three foundations of our tenacity; and (3) asking “How fragile is our tenacity?” This article also presents three foundational principles that underlie the American experience of corporate responsibility. First, the Checks & Balances Principle tells us that there are checks and balances in democratic capitalism which give us confidence that the pursuit of economic goals will be moderated for the common good. Second, the Moral Projection Principle shows that there is good reason to consider the corporation not only as a legal person under corporate law but also as a moral person. And, last, the Moral Common Ground Principle reflects that there are shared moral values ascertainable by well-developed consciences in individuals and in corporations. The article concludes with this argument: The tenacity regarding corporate responsibility that has been so characteristic of American capitalism is fragile—calling for serious vigilance if it is to endure

Do student nurses experience Imposter Phenomenon? An international comparison of Final Year Undergraduate Nursing Students readiness for registration

Background: The transition shock sometimes associated with moving from student to registered nurse can lead to feelings of self-doubt and insecurity especially with the increased expectations and responsibilities that registration brings. Known as Imposter Phenomena, individuals often express a lack of self-confidence, uncertainty in their abilities or that others have an over inflated opinion of them. Aim: The aim of this study is to examine the extent at which imposter phenomenon is evident in four final year nursing student cohorts in Australia, New Zealand and the United Kingdom. Design: A survey design. Settings: The study took place at 4 higher education institutes – two metropolitan campuses and two regional campuses between October 2014 and February 2015 in Australia, New Zealand and the United Kingdom. A sample of 223 final year nursing students undertaking nationally accredited nursing programmes were approached. Results: Each cohort exhibited mild to moderate feelings of Imposter Phenomena. A positive weak correlation between imposter phenomena and preparedness for practice was found. The New Zealand cohort scored higher than both the Australian and United Kingdom cohorts on both feelings of imposterism and preparedness for practice. Conclusions: Nursing students possess internalised feelings which suggest their performance and competence once qualified could be compromised. There is some speculation that the respective curriculums may have some bearing on preparing students for registration and beyond. It is recommended that educational programmes designed for this student cohort should be mindful of this internal conflict and potential external hostility

Sediment structure and physicochemical changes following tidal inundation at a large open coast managed realignment site

Managed realignment (MR) schemes are being implemented to compensate for the loss of intertidal saltmarsh habitats by breaching flood defences and inundating the formerly defended coastal hinterland. However, studies have shown that MR sites have lower biodiversity than anticipated, which has been linked with anoxia and poor drainage resulting from compaction and the collapse of sediment pore space caused by the site's former terrestrial land use. Despite this proposed link between biodiversity and soil structure, the evolution of the sediment sub-surface following site inundation has rarely been examined, particularly over the early stages of the terrestrial to marine or estuarine transition. This paper presents a novel combination of broad- and intensive-scale analysis of the sub-surface evolution of the Medmerry Managed Realignment Site (West Sussex, UK) in the three years following site inundation. Repeated broad-scale sediment physiochemical datasets are analysed to assess the early changes in the sediment subsurface and the preservation of the former terrestrial surface, comparing four locations of different former land uses. Additionally, for two of these locations, high-intensity 3D-computed X-ray microtomography and Itrax micro-X-ray fluorescence spectrometry analyses are presented. Results provide new data on differences in sediment properties and structure related to the former land use, indicating that increased agricultural activity leads to increased compaction and reduced porosity. The presence of anoxic conditions, indicative of poor hydrological connectivity between the terrestrial and post-inundation intertidal sediment facies, was only detected at one site. This site has experienced the highest rate of accretion over the terrestrial surface (ca. 7 cm over 36 months), suggesting that poor drainage is caused by the interaction (or lack of) between sediment facies rather than the former land use. This has significant implications for the design of future MR sites in terms of preparing sites, their anticipated evolution, and the delivery of ecosystem services

Modelling the impacts of agricultural management practices on river water quality in Eastern England

Agricultural diffuse water pollution remains a notable global pressure on water quality, posing risks to aquatic ecosystems, human health and water resources and as a result legislation has been introduced in many parts of the world to protect water bodies. Due to their efficiency and cost-effectiveness, water quality models have been increasingly applied to catchments as Decision Support Tools (DSTs) to identify mitigation options that can be introduced to reduce agricultural diffuse water pollution and improve water quality. In this study, the Soil and Water Assessment Tool (SWAT) was applied to the River Wensum catchment in eastern England with the aim of quantifying the long-term impacts of potential changes to agricultural management practices on river water quality. Calibration and validation were successfully performed at a daily time-step against observations of discharge, nitrate and total phosphorus obtained from high-frequency water quality monitoring within the Blackwater sub-catchment, covering an area of 19.6 km2. A variety of mitigation options were identified and modelled, both singly and in combination, and their long-term effects on nitrate and total phosphorus losses were quantified together with the 95% uncertainty range of model predictions. Results showed that introducing a red clover cover crop to the crop rotation scheme applied within the catchment reduced nitrate losses by 19.6%. Buffer strips of 2 m and 6 m width represented the most effective options to reduce total phosphorus losses, achieving reductions of 12.2% and 16.9%, respectively. This is one of the first studies to quantify the impacts of agricultural mitigation options on long-term water quality for nitrate and total phosphorus at a daily resolution, in addition to providing an estimate of the uncertainties of those impacts. The results highlighted the need to consider multiple pollutants, the degree of uncertainty associated with model predictions and the risk of unintended pollutant impacts when evaluating the effectiveness of mitigation options, and showed that high-frequency water quality datasets can be applied to robustly calibrate water quality models, creating DSTs that are more effective and reliable

Modelo de programación matemática para la cadena productiva del biocombustible biodiésel, en el departamento del Meta, Colombia

Trabajo de investigaciónLos beneficios asociados a los biocombustibles se ven reflejados en un creciente número de países, introduciendo o planeando introducir, políticas para incrementar la proporción de su producción dentro de su matriz energética. Actualmente, sólo pequeñas cantidades de biocombustibles se transan en los mercados internacionales ya que la mayoría se consume domésticamente. Sin embargo, se espera que el comercio de biocombustibles se expanda rápidamente dado que numerosos países no tendrán la capacidad doméstica para abastecer sus mercados internos. Con base en el tendiente crecimiento del negocio de los biocombustibles, tanto a nivel mundial como local, resulta pertinente contar con herramientas técnicas que apoyen la toma de decisiones en la gestión agroindustrial para aprovechar de mejor manera un mercado por ahora naciente, pero que a mediano y largo plazo se escenifica como un gran sector productivo que podrá generar desarrollo a las regiones productivas. Esta investigación presenta un estado del arte sobre la cadena de abastecimiento del biocombustible biodiesel y un Modelo de Programación Lineal Entera Mixta, en el Departamento del Meta, Colombia, desarrollado para apoyar la toma de decisiones en la gestión de la cadena de suministro mencionada.MaestríaMagister en Ingeniería Industria

Dental therapists in general dental practice. A literature review and case study analysis to determine what works, why, how and in what circumstances

Introduction In the United Kingdom, policy and guidance changes regarding the role of Dental Therapists (DTs) were implemented in recent years with a view to changing dental care to a more preventive‐focussed, teamwork approach. However, success in the adoption of this model of working has been varied. Aims Adopting a realist approach, our aim was, to examine the use of DTs in general dental practices in Wales, exploring what works, why, how and in what circumstances. Materials and Methods The research comprised two stages. (i) A structured literature search, dual‐coding papers for high‐level factors describing the conditions or context(s) under which the mechanisms operated to produce outcomes. From this, we derived theories about how skill‐mix operates in the general dental service. (ii) Six case studies of general dental practices (three with a Dental Therapist/three without a Dental Therapist) employing a range of skill‐mix models incorporating semi‐structured interviews with all team members. We used the case studies/interviews to explore and refine the theories derived from the literature. Results Eighty‐four papers were coded. From this coding, we identified seven theories which reflected factors influencing general dental practices within three broad contexts: the dental practice as a business, as a healthcare provider, and as a workplace. We tested these theories in interviews with 38 dental team members across the six care studies. As a result, we amended five of the theories. Conclusion Our analysis provides theory about outcomes that DTs may facilitate and the mechanisms that may assist the work of DTs within different contexts of general dental practice