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

Logistic Knowledge Tracing: A Constrained Framework for Learner Modeling

Adaptive learning technology solutions often use a learner model to trace learning and make pedagogical decisions. The present research introduces a formalized methodology for specifying learner models, Logistic Knowledge Tracing (LKT), that consolidates many extant learner modeling methods. The strength of LKT is the specification of a symbolic notation system for alternative logistic regression models that is powerful enough to specify many extant models in the literature and many new models. To demonstrate the generality of LKT, we fit 12 models, some variants of well-known models and some newly devised, to 6 learning technology datasets. The results indicated that no single learner model was best in all cases, further justifying a broad approach that considers multiple learner model features and the learning context. The models presented here avoid student-level fixed parameters to increase generalizability. We also introduce features to stand in for these intercepts. We argue that to be maximally applicable, a learner model needs to adapt to student differences, rather than needing to be pre-parameterized with the level of each student's ability

Mean proton and alpha-particle reduced widths of the Porter-Thomas distribution and astrophysical applications

The Porter-Thomas distribution is a key prediction of the Gaussian orthogonal ensemble in random matrix theory. It is routinely used to provide a measure for the number of levels that are missing in a given resonance analysis. The Porter-Thomas distribution is also of crucial importance for estimates of thermonuclear reaction rates where the contributions of certain unobserved resonances to the total reaction rate need to be taken into account. In order to estimate such contributions by randomly sampling over the Porter-Thomas distribution, the mean value of the reduced width must be known. We present mean reduced width values for protons and α particles of compound nuclei in the A = 28–67 mass range. The values are extracted from charged-particle elastic scattering and reaction data that weremeasured at the riangle Universities Nuclear Laboratory over several decades. Our new values differ significantly from those previously reported that were based on a preliminary analysis of a smaller data set. As an example for the application of our results, we present new thermonuclear rates for the 40Ca(α,γ)44Ti reaction, which is important for 44Ti production in core-collapse supernovae, and compare with previously reported results.Peer ReviewedPostprint (published version

Prophecy, alchemy and strategies of dissident communication: a 1630 letter from the Bohemian chiliast Paul Felgenhauer (1593-c.1677) to the Leipzig physician Arnold Kerner

This article concerns a short but significant letter of April 1630 from the Bohemian prophet, alchemist and theosopher Paul Felgenhauer (1593-c. 1677) to the Leipzig alchemist and physician Arnold Kerner. The letter is presented in transcription, with an annotated English translation. It is prefaced by an introduction incorporating a new biographical account of Felgenhauer, which draws on overlooked or unknown manuscript material preserved in Germany and England. The letter itself shines a rare light on a variety of different areas of interest concerning Felgenhauer's life and activities in the years prior to 1630. These areas include his immediate contacts and associates (such as with the Silesian prophet Christoph Kotter), interest and undertakings in alchemical experimentation, publishing and bibliographical activities, methods of communication, his circle of wider contacts and the nature and extent of broader interpersonal and epistolary networks in which he participated. However, it also illuminates tangential issues, such as the scale of social and informational economy in a heterodox correspondence network, the intricacies of dissident book production in the United Provinces, the history of trade in Leipzig, the role of commercial agents in facilitating contact between dissident personalities throughout the Holy Roman Empire, and the postal history of Bremen

Nuclear star cluster formation in energy-space

In a virialized stellar system, the mean-square velocity is a direct tracer of the energy per unit mass of the system. Here, we exploit this to estimate and compare root-mean-square velocities for a large sample of nuclear star clusters and their host (late- or early-type) galaxies. Traditional observables, such as the radial surface brightness and second-order velocity moment profiles, are subject to short-term variations due to individual episodes of matter infall and/or star formation. The total mass, energy and angular momentum, on the other hand, are approximately conserved. Thus, the total energy and angular momentum more directly probe the formation of galaxies and their nuclear star clusters, by offering access to more fundamental properties of the nuclear cluster-galaxy system than traditional observables. We find that there is a strong correlation, in fact a near equality, between the root-mean-square velocity of a nuclear star cluster and that of its host. Thus, the energy per unit mass of a nuclear star cluster is always comparable to that of its host galaxy. We interpret this as evidence that nuclear star clusters do not form independently of their host galaxies, but rather that their formation and subsequent evolution are coupled. We discuss how our results can potentially be used to offer a clear and observationally testable prediction to distinguish between the different nuclear star cluster formation scenarios, and/or quantify their relative contributions.Comment: 12 pages, 3 figures, 4 tables; accepted for publication in MNRA