Dental skill mix: a cross-sectional analysis of delegation practices between dental and dental hygiene-therapy students involved in team training in the South of England

BACKGROUND: Research suggests that health professionals who have trained together have a better understanding of one another’s scope of practice and are thus equipped for teamwork during their professional careers. Dental hygiene-therapists (DHTs) are mid-level providers that can deliver routine care working alongside dentists. This study examines patterns of delegation (selected tasks and patients) by dental students to DHT students training together in an integrated team. METHODS: A retrospective sample of patient data (n = 2,063) was extracted from a patient management system showing the treatment activities of two student cohorts (dental and DHT) involved in team training in a primary care setting in the South of England over two academic years. The data extracted included key procedures delegated by dental students to DHT students coded by skill-mix of operator (e.g., fissure sealants, restorations, paediatric extractions) and patient demography. χ(2) tests were conducted to investigate the relationship between delegation and patient age group, gender, smoking status, payment-exemption status, and social deprivation. RESULTS: A total of 2,063 patients managed during this period received treatments that could be undertaken by either student type; in total, they received 14,996 treatment procedures. The treatments most commonly delegated were fissure sealants (90%) and restorations (51%); whilst the least delegated were paediatric extractions (2%). Over half of these patients (55%) had at least one instance of delegation from a dental to a DHT student. Associations were found between delegation and patient age group and smoking status (P <0.001). Children under 18 years old had a higher level of delegation (86%) compared with adults of working age (50%) and patients aged 65 years and over (56%). A higher proportion of smokers had been delegated compared with non-smokers (45% cf. 26%; P <0.001). CONCLUSIONS: The findings suggest that delegation of care to DHT students training as a team with dental students, involved significantly greater experience in treating children and adult smokers, and providing preventive rather than invasive care in this integrated educational and primary care setting. The implications for their contribution to dentistry and the dental team are discussed, along with recommendations for primary care data recording

Towards a positive cross-cultural lexicography: Enriching our emotional landscape through 216 ‘untranslatable’ words pertaining to well-being

Although much attention has been paid to culture-specific psychopathologies, there have been no comparable attempts to chart positive mental states that may be particular to certain cultures. This paper outlines the beginnings of a positive cross-cultural lexicography of ‘untranslatable’ words pertaining to wellbeing, culled from across the world’s languages. A quasi-systematic search uncovered 216 such terms. Using grounded theory, these words were organised into three categories: feelings (comprising positive and complex feelings); relationships (comprising intimacy and pro-sociality); and character (comprising personal resources and spirituality). The paper has two main aims. First, it aims to provide a window onto cultural differences in constructions of wellbeing, thereby enriching our understanding of wellbeing. Second, a more ambitious aim is that this lexicon may help expand the emotional vocabulary of English speakers (and indeed speakers of all languages), and consequently enrich their experiences of wellbeing. The paper concludes by setting out a research agenda to pursue these aims further

Effect of Lactobacillus plantarum on microbial population of Iranian fermented pickle

Pickle fermentation is a natural process in which microorganisms could affect the quality of the product. Amongst, Lactobacillus plantarum strains that improve the quality of fermented pickle. In this study, in order to produce safe and desirable fermented pickle, local cucumbers were immersed in 5% and 7% (w/v) brine solutions. The samples were inoculated with 0, 4 ´106, 4 ´107 and 6 ´108 cfu/ml of L. plantarum. The samples were kept at ambient temperature for 15 days followed by 30 days storage at 4 °C and 25 °C. The bacterial populations were analyzed during the aforementioned stages of fermentation and storage. According to the results, the maximum quantity (8.57 log10 cfu/ml) of L. plantarum was observed in the 9 day of fermentation and in the samples inoculated with 6 ´108 cfu/ml and kept in 5% brine solution. Moreover, compared to the other samples, the population of yeasts and aerobic mesophilic count were the least in the samples inoculated with 6 ´108 cfu/ml of L. plantarum and stored in 7% brine solution. During the storage period, the population of L. plantarum, yeasts and aerobic mesophilic in the samples stored at 25 °C were higher than the samples stored at 4 °C. Results revealed that in the 30 day of storage, the highest load (5.47 log10 cfu/ml) of L. plantarum was observed in the samples kept in 7% brine solution at 4 °C. It was concluded that providing the condition that favors the appropriate growth of L. plantarum could help to hinder the growth of undesirable organisms in fermented pickle

Variational Phase Imaging Using the Transport-of-Intensity Equation

We introduce a variational phase retrieval algorithm for the imaging of transparent objects. Our formalism is based on the transport-of-intensity equation (TIE), which relates the phase of an optical field to the variation of its intensity along the direction of propagation. TIE practically requires one to record a set of defocus images to measure the variation of intensity. We first investigate the effect of the defocus distance on the retrieved phase map. Based on our analysis, we propose a weighted phase reconstruction algorithm yielding a phase map that minimizes a convex functional. The method is nonlinear and combines different ranges of spatial frequencies—depending on the defocus value of the measurements—in a regularized fashion. The minimization task is solved iteratively via the alternating-direction method of multipliers. Our simulations outperform commonly used linear and nonlinear TIE solvers. We also illustrate and validate our method on real microscopy data of HeLa cells

Supporting newly qualified dental therapists into practice: a longitudinal evaluation of a foundation training scheme for dental therapists (TFT)

Objectives Focused on the dental therapists foundation training (TFT) scheme run by the Postgraduate Dental Deaneries of Oxford and Wessex (NHS Education South Central – NESC) the objectives were (1) to evaluate the TFT 2010/11 scheme, identifying strengths, areas for development and drawing comparisons with the 2009 evaluation; and (2) to follow-up previous cohorts, reporting current work and retrospective reflections on the scheme. Methods Data were collected from 2010/11 ('current') trainees (n = 10) through group discussion, questionnaire and portfolio extracts. Eleven past-trainees from 2008/09 and 2009/10 took part in a structured telephone interview or responded to questions via e-mail. Results Data from 2011 consolidated that collected earlier. The scheme was highly valued. Current participants thought the scheme should be mandatory and all past-participants would recommend it to others. Trainees attributed an increase in confidence and ability in their clinical skills to participation in TFT. Current trainees' concerns about finding therapy work were echoed in past-participants' post-scheme employment. Conclusions At the point of qualification, trainees do not feel well-prepared for starting work as dental therapists. Opportunity to develop confidence and skills in a supportive environment is a key benefit of the scheme. Maintaining ability in the full range of duties requires continued use of skills and the opportunity to do this remains an ongoing challenge