The Advanced Dental Hygiene Practitioner: An Exploration of the Patient Perspective Regarding the Advancement of a Mid-level Dental Provider

The purpose of this study was to examine patient attitudes and opinions regarding the advancement of a mid-level dental provider, such as the ADHP, in an effort to better understand the perceptions of those who may one day be in a position to receive care from this type of provider. In this quantitative study, I analyzed the differences between those with and without access to dental care and evaluated differences among respondents based upon their socioeconomic and demographic attributes. I collected data from patients treated at Mt. Juliet Family & Cosmetic Dentistry and at the Coweta Samaritan Clinic via a 17-item questionnaire. Most respondents would be willing to accept treatment from someone in this role. The majority of respondents also believed it would be a positive step towards meeting the needs of the uninsured and underserved. Demographic data had no significant impact on their opinion of this role

The meaning of place : a study of geographical imagery with particular reference to Kingston upon Hull

One of the fundamental themes in geography has been the exploration of urban and regional character: - a uniqueness of environments often expressed in terms of an ambience or a sense of place. However, this area of study has been neglected in recent years: there have not been sufficiently sensitive techniques available and the predominant philosophical orientation of the subject has not been receptive to the more subjective aspects of environmental experience. The development of environmental perception - an interdisciplinary approach to the study of the relationship of man and environment - has alleviated these problems to some extent. By focussing on the environmental experiences of individuals and the language they use to describe their impressions of places, this research project has taken up and extended the question of environmental character.The thesis is concerned with the meanings of places and work focusses upon the images of Kingston upon Hull in particular. The meaning of a place is defined as the associations of ideas and emotions it evokes in the individual both as a result of direct environmental stimulation and other secondary sources of information. The image represents the synthesis of these connotations: as they are communicated to other people an image or verbal picture will emerge which conveys not only information about it but also the emotive value placed upon it by the individual. The main proposition, therefore, is that people have cognitive representations of places which they are able to communicate. The underlying assumption is that the language people use is a true indication of these internal representations. The first two chapters of the thesis provide a review of the evidence to support the propositions: chapter one discusses various theoretical frameworks used in the study of environmental perception whilst chapter two seeks to establish that there has been a neglect of the phenomenological and linguistic aspects of urban imagery. The main body of the thesis is concerned with the development and substantiation of a model of urban imagery. On the basis of survey and experimental work reported in chapters three and four, a categorisation of images dependent upon the type of information available to the individual is proposed. As reported in succeeding chapters, partial support for this model is achieved by reference to two larger social surveys. The validity of this work is then assessed in relation to comparable projects completed recently. The final chapter provides a summary of the findings and considers their implications for further work in urban and regional perception.It must be stressed that this project has been subject to the usual constraints of time and finance. The lack of more extensive facilities is reflected in the size and organisations of the surveys undertaken. The possible biases inherent in these surveys have been recognised and the interpretation of results has erred on the side of caution rather than running the risk of making unjustified assertions. A more serious criticism of the study must also be conceded . An extensive monitoring of the media and other information sources was not made during the course of the study. This was not feasible and it was felt to be of more value to explore the verbal content of environmental images, illustrating these with media examples where appropriate. The importance of more extensive work into the relationship between image and information sources is recognised, however

The Female Video Game Player-character Persona and Emotional Attachment

This research, using online qualitative survey questions, explored how players of the PlayStation 4 console game, Horizon Zero Dawn, formed emotional attachments to characters while playing as, and assuming the persona of the female player-character, Aloy. It was found that the respondents (approximately 71% male) formed emotional attachments to the female player-character (PC) and non-player characters. Players found the characters to be realistic and well developed and they also found engaging with the storyworld via the female PC a profound experience. This research advances knowledge about video games in general and video game character attachment specifically, as well as the emerging but under-researched areas of Persona Studies and Game Studies

Improving Patient Safety: Engaging Students in Interprofessional Team-Based Learning (TBL)

Complex healthcare systems and ambiguous clinical decisions can result in medical errors which threaten patient safety. There is a need for improved awareness of medical errors across healthcare disciplines. We utilised team-based learning (TBL) to pilot an interprofessional patient safety module for senior health professional students. We evaluated the use of TBL within the interprofessional context to achieve student learning outcomes. Twenty-seven students from pharmacy (n=11), nursing (n=8) and medicine (n=8) faculties participated. Data were collected via questionnaires, focus groups, class observation and student test scores. Quantitative data were analysed using descriptive statistics. Framework analysis was used to code qualitative data using social capital as a conceptual framework. In total, 26/27 (96%) of participants completed the questionnaire and 20/27 (70%) attended focus groups. There was no significant difference in prior knowledge between the disciplines. The TBL module enriched the learning environment and enabled students to prepare, problem-solve and interact with facilitators. The TBL pedagogy and interprofessional framework enabled the development of social capital among students. The module demonstrated the potential of interprofessional education to shift knowledge and attitudes towards a greater appreciation of patient safety issues and better prepare health professional students for the workforce. The TBL pedagogy strengthened knowledge sharing and fostered collaboration across disciplines

Characterisation of serum IgG(T) responses to potential diagnostic antigens for equine cyathostominosis

Cyathostomins are ubiquitous parasitic nematodes of horses. These worms spend substantial periods as intestinal wall stage encysted larvae, which can comprise up to 90% of the total burden. Several million larvae have been reported in individuals. Emergence of these larvae from the gut wall can lead to life-threatening colitis. Faecal egg count tests, increasingly used by horse owners to inform anthelmintic treatments, do not correlate with the intra-host burden of cyathostomins; this represents a key gap in the diagnostic toolbox. Previously, a cyathostomin Gut Associated Larval Antigen was identified as a promising marker for the intra-host stages of infection. Here, cyathostomin Gut Associated Larval Antigen and an additional protein, Cyathostomin Immuno-diagnostic antigen, were investigated to examine their value in providing information on cyathostomin burden. ELISA analyses examined serum IgG(T) responses to recombinant proteins derived from individual cyathostomin species. Receiver Operator Characteristic curve analysis was performed on the ELISA data; proteins with the highest Area Under the Curve values were selected to test protein combinations to investigate which were the most informative in identifying the infection status of individuals. Three cocktail combinations were tested, comprising: (a) Cy-GALA proteins from two species and a Cy-CID protein from a third species (CT3), (b) Cy-GALA proteins from five species (CT5), and (c) all CT5 components, plus a Cy-CID protein from an additional species (CT6). The best predictive values for infection were obtained using CT3 and CT6, with similar values achieved for both. Proteins in CT3 are derived from the most commonly reported species, Cyathostomum catinatum, Cylicocyclus nassatus and Cylicostephanus longibursatus. This combination was selected for future development since it represents a more commercially viable format for a diagnostic test

Dedicatoria

Dedicatori

Salmon lice (Lepeophtheirus salmonis) showing varying emamectin benzoate susceptibilities differ in neuronal acetylcholine receptor and GABA-gated chloride channel mRNA expression

Background: Caligid copepods, also called sea lice, are fish ectoparasites, some species of which cause significant problems in the mariculture of salmon, where the annual cost of infection is in excess of €300 million globally. At present, caligid control on farms is mainly achieved using medicinal treatments. However, the continued use of a restricted number of medicine actives potentially favours the development of drug resistance. Here, we report transcriptional changes in a laboratory strain of the caligid Lepeophtheirus salmonis (Krøyer, 1837) that is moderately (~7-fold) resistant to the avermectin compound emamectin benzoate (EMB), a component of the anti-salmon louse agent SLICE® (Merck Animal Health).Results: Suppression subtractive hybridisation (SSH) was used to enrich transcripts differentially expressed between EMB-resistant (PT) and drug-susceptible (S) laboratory strains of L. salmonis. SSH libraries were subjected to 454 sequencing. Further L. salmonis transcript sequences were available as expressed sequence tags (EST) from GenBank. Contiguous sequences were generated from both SSH and EST sequences and annotated. Transcriptional responses in PT and S salmon lice were investigated using custom 15 K oligonucleotide microarrays designed using the above sequence resources. In the absence of EMB exposure, 359 targets differed in transcript abundance between the two strains, these genes being enriched for functions such as calcium ion binding, chitin metabolism and muscle structure. γ-aminobutyric acid (GABA)-gated chloride channel (GABA-Cl) and neuronal acetylcholine receptor (nAChR) subunits showed significantly lower transcript levels in PT lice compared to S lice. Using RT-qPCR, the decrease in mRNA levels was estimated at ~1.4-fold for GABA-Cl and ~2.8-fold for nAChR. Salmon lice from the PT strain showed few transcriptional responses following acute exposure (1 or 3 h) to 200 μg L-1 of EMB, a drug concentration tolerated by PT lice, but toxic for S lice.Conclusions: Avermectins are believed to exert their toxicity to invertebrates through interaction with glutamate-gated and GABA-gated chloride channels. Further potential drug targets include other Cys-loop ion channels such as nAChR. The present study demonstrates decreased transcript abundances of GABA-Cl and nAChR subunits in EMB-resistant salmon lice, suggesting their involvement in avermectin toxicity in caligids

Iron and hepcidin as risk factors in atherosclerosis: what do the genes say?

BACKGROUND: Previous reports suggested a role for iron and hepcidin in atherosclerosis. Here, we evaluated the causality of these associations from a genetic perspective via (i) a Mendelian randomization (MR) approach, (ii) study of association of atherosclerosis-related single nucleotide polymorphisms (SNPs) with iron and hepcidin, and (iii) estimation of genomic correlations between hepcidin, iron and atherosclerosis. RESULTS: Analyses were performed in a general population sample. Iron parameters (serum iron, serum ferritin, total iron-binding capacity and transferrin saturation), serum hepcidin and genome-wide SNP data were available for N = 1,819; non-invasive measurements of atherosclerosis (NIMA), i.e., presence of plaque, intima media thickness and ankle-brachial index (ABI), for N = 549. For the MR, we used 12 iron-related SNPs that were previously identified in a genome-wide association meta-analysis on iron status, and assessed associations of individual SNPs and quartiles of a multi-SNP score with NIMA. Quartile 4 versus quartile 1 of the multi-SNP score showed directionally consistent associations with the hypothesized direction of effect for all NIMA in women, indicating that increased body iron status is a risk factor for atherosclerosis in women. We observed no single SNP associations that fit the hypothesized directions of effect between iron and NIMA, except for rs651007, associated with decreased ferritin concentration and decreased atherosclerosis risk. Two of six NIMA-related SNPs showed association with the ratio hepcidin/ferritin, suggesting that an increased hepcidin/ferritin ratio increases atherosclerosis risk. Genomic correlations were close to zero, except for hepcidin and ferritin with ABI at rest [-0.27 (SE 0.34) and -0.22 (SE 0.35), respectively] and ABI after exercise [-0.29 (SE 0.34) and -0.30 (0.35), respectively]. The negative sign indicates an increased atherosclerosis risk with increased hepcidin and ferritin concentrations. CONCLUSIONS: Our results suggest a potential causal role for hepcidin and ferritin in atherosclerosis, and may indicate that iron status is causally related to atherosclerosis in women

Australian cultures of Botryosphaeriaceae held in Queensland and Victoria plant pathology herbaria revisited

The Botryosphaeriaceae is one of the most widespread and cosmopolitan endophytic group of fungi. However, the species of this group can cause severe disease when the hosts are under stressful conditions. The aim of this study was to identify living cultures from the Botryosphaeriaceae family preserved in the Queensland and Victorian Plant Pathology Herbaria using DNA sequence analyses. The 51 isolates were collected between 1971 and 2017, from 35 different host genera, with the dominant host genera being Mangifera (11 isolates), Acacia (10), and Persea (5). Multilocus sequence analyses resulted in the re-identification of 41 isolates to the genera Botryosphaeria (2 isolates), Diplodia (4), Dothiorella (1), Lasiodiplodia (19), and Neofusicoccum (15), as well as some that belonged to genera outside of the Botryosphaeriaceae (10). New records for Australia were Botryosphaeria sinensis, Diplodia alatafructa, Lasiodiplodia gonubiensis, Neofusicoccum cryptoaustrale, and N. mangroviorum. These were identified as a result of a workshop organised by the Subcommittee on Plant Health Diagnostics. The results of this study provide the fundamental information regarding the diversity of Botryosphaeriaceae species present in Australian.Plant Health Australia (PHA) who provided funds for the workshop on the identification and classification of Botryosphaeriaceae species. PHA sourced funding from the Department of Agriculture and Water Resources through a grant from the Modern Diagnostics initiative.http://link.springer.com/journal/133132020-01-01hj2019Forestry and Agricultural Biotechnology Institute (FABI