Patient perceptions regarding benefits of single visit scale and polish : a randomised controlled trial

Peer reviewedPublisher PD

Supporting induction: relationships count

This article examines the structural changes to the induction of teachers in Scotland using the perceptions of a group of final year student teachers. This group would be the first probationer teachers to experience revised arrangements for new teacher induction in 37 years. Their preferences and concerns are highlighted, as the new procedures roll out in schools nationwide, in an attempt to stress the importance of relationships to the success of the induction scheme. The argument put forward in this article is based on the notion that personal intelligence is central to effective relationships and therefore crucially important in the context of this mentoring relationship. The views of our sample provide evidence to suggest that the quality of interactions between the mentor and the probationer teacher are paramount in providing a good induction experience. These views are substantiated by experiences in England and in induction literature elsewhere. A synthesis of this evidence is used to make recommendations for those involved in supporting induction in schools, local authorities or teacher education institutions

Socioeconomic disparities in orthodontic treatment outcomes and expenditure on orthodontics in England's state-funded National Health Service:A retrospective observational study

Percentage distribution/means of variables used in the adjusted treatment outcomes analyses, by socioeconomic status (SES). Additional file 1 contains information on the distribution of variables used to adjust for potential confounding: IOTN AC scores, gender, and age. This information is provided by IMD quintile. (DOCX 16 kb

Productive efficiency and its determinants in the Community Dental Service i nthe north-west of England

To assess the efficiency of service provision in the Community Dental Services and its determinants in the North-West of England.40 Community Dental Services sites operating across the North-West of England.A data envelopment analysis was undertaken of inputs (number of surgeries, hours worked by dental officers, therapists, hygienists and others) and outputs (treatments delivered, number of courses of treatment and patients seen) of the Community Dental Services to produce relative efficiency ratings by health authority. These were further analyzed in order to identify which inputs (determined within the Community Dental Services) or external factors outside the control of the Community Dental Services are associated with efficiency.Relative efficiency rankings in Community Dental Services production of dental healthcare.Using the quantity of treatments delivered as the measure of output, on average the Community Dental Services in England is operating at a relative efficiency of 85% (95% confidence interval 77%- 99%) compared to the best performing services. Average efficiency is lower when courses of treatment and unique patients seen are used as output measures, 82% and 68% respectively. Neither the input mix nor the patient case mix explained variations in the efficiency across Community Dental Services.Although large variations in performance exist across Community Dental Services, the data available was not able to explain these variations. A useful next step would be to undertake detailed case studies of several best and under-performing services to explore the factors that influence relative performance levels

What makes a good induction supporter?

The Teacher Induction Scheme, introduced in 2002, marked the first major change to new teacher induction in Scotland in 37 years. This paper gives an outline of these changes set against developments in mentoring theory in the wider context. It argues that the personal qualities of the induction supporter are crucial to developing an effective mentoring relationship. The views of student teachers are used to describe preferred characteristics of effective mentors and effective induction provision. A person specification is created by the comments of the "Class of 2002" — the first probationer teachers to have taken part in the Scheme

Adhesion between cells, diffusion of growth factors, and elasticity of the AER produce the paddle shape of the chick limb

This paper has been withdrawnComment: This paper has been withdraw

Determining the optimal model for role substitution in NHS dental services in the UK: a mixed-methods study.

Background: Maximising health gain for a given level and mix of resources is an ethical imperative for health-service planners. Approximately half of all patients who attend a regular NHS dental check-up do not require any further treatment, whereas many in the population do not regularly attend. Thus, the most expensive resource (the dentist) is seeing healthy patients at a time when many of those with disease do not access care. Role substitution in NHS dentistry, where other members of the dental team undertake the clinical tasks previously provided by dentists, has the potential to increase efficiency and the capacity to care and lower costs. However, no studies have empirically investigated the efficiency of NHS dental provision that makes use of role substitution. Research questions: This programme of research sought to address three research questions: (1) what is the efficiency of NHS dental teams that make use of role substitution?; (2) what are the barriers to, and facilitators of, role substitution in NHS dental practices?; and (3) how do incentives in the remuneration systems influence the organisation of these inputs and production of outputs in the NHS? Design: Data envelopment analysis was used to develop a productive efficiency frontier for participating NHS practices, which were then compared on a relative basis, after controlling for patient and practice characteristics. External validity was tested using stochastic frontier modelling, while semistructured interviews explored the views of participating dental teams and their patients to role substitution. Setting: NHS ‘high-street’ general dental practices. Participants: 121 practices across the north of England. Interventions: No active interventions were undertaken. Main outcome measures: Relative efficiency of participating NHS practices, alongside a detailed narrative of their views about role substitution dentistry. Social acceptability for patients. Results: The utilisation of non-dentist roles in NHS practices was relatively low, the most common role type being the dental hygienist. Increasing the number of non-dentist team members reduced efficiency. However, it was not possible to determine the relative efficiency of individual team members, as the NHS contracts only with dentists. Financial incentives in the NHS dental contract and the views of practice principals (i.e. senior staff members) were equally important. Bespoke payment and referral systems were required to make role substitution economically viable. Many non-dentist team members were not being used to their full scope of practice and constraints on their ability to prescribe reduced efficiency further. Many non-dentist team members experienced a precarious existence, commonly being employed at multiple practices. Patients had a low level of awareness of the different non-dentist roles in a dental team. Many exhibited an inherent trust in the professional ‘system’, but prior experience of role substitution was important for social acceptability. Conclusions: Better alignment between the financial incentives within the NHS dental contract and the use of role substitution is required, although professional acceptability remains critical. Study limitations: Output data collected did not reflect the quality of care provided by the dental team and the input data were self-reported. Future work: Further work is required to improve the evidence base for the use of role substitution in NHS dentistry, exploring the effects and costs of provision. Funding: The National Institute for Health Research Health Services and Delivery Research programme

Clinical outcomes of Single-Visit oral Prophylaxis: A practice-based randomised controlled trial

Peer reviewedPublisher PD

csal1 Is Controlled by a Combination of FGF and Wnt Signals in Developing Limb Buds

While some of the signaling molecules that govern establishment of the limb axis have been characterized, little is known about the downstream effector genes that interpret these signals. In Drosophila, the spalt gene is involved in cell fate determination and pattern formation in different tissues. We have cloned a chick homologue of Drosophila spalt, which we have termed csal1, and this study focuses on the regulation of csal1 expression in the limb bud. csal1 is expressed in limb buds from HH 17 to 26, in both the apical ectodermal ridge and the distal mesenchyme. Signals from the apical ridge are essential for csal1 expression, while the dorsal ectoderm is required for csal1 expression at a distance from the ridge. Our data indicate that both FGF and Wnt signals are required for the regulation of csal1 expression in the limb. Mutations in the human homologue of csal1, termed Hsal1/SALL1, result in a condition known as Townes–Brocks syndrome (TBS), which is characterized by preaxial polydactyly. The developmental expression of csal1 together with the digit phenotype in TBS patients suggests that csal1 may play a role in some aspects of distal patterning