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A feasiblity and acceptability study of an e-training intervention to facilitate health behaviour change conversations in dental care settings.
No full textIntroduction: Health behaviours result in oral health problems. Behaviour change techniques, informed by behaviour science, are rarely utilised by dental care professionals (DCPs) within routine care.Aim: To develop a theory-informed intervention to support DCPs’ behaviour change conversations and evaluate its feasibility and acceptability.Intervention: A behaviour change toolkit (Toothpicks) comprising 33 behaviour change techniques (BCTs) relevant to dentistry, delivered within an interactive online course.Design: Development and mixed-methods evaluation of the intervention.Materials and methods: Participants’ motivation to discuss behaviour change with patients was measured before and after training using a validated questionnaire. Acceptability was assessed through semi-structured interviews.Results: DCPs’ (N=32) motivation increased significantly post-training. Participants found the training acceptable and reported subsequently implementing techniques into their practice. Potential barriers preventing implementation to clinical practice include perceived lack of opportunities to effect change within the constraints of the clinical context.Conclusions: Acceptable theory-informed training that is acceptable and accessible can be developed that increases DCPs’ motivation to discuss behaviour change with patients. Further research is necessary to establish the longer-term impact of brief behaviour change training on DCPs clinical practice and patient health behaviour
The cooling-down central star of the planetary nebula SwSt 1: a late thermal pulse in a massive post-AGB star?
No full textSwSt 1 (PNG001.5-06.7) is a bright and compact planetary nebula containing a late [WC]-type central star. Previous studies suggested that the nebular and stellar lines are slowly changing with time. We studied new and archival optical and ultraviolet spectra of the object. The [O iii] 4959 and 5007°A to Hβ line flux ratios decreased between about 1976 and 1997/2015. The stellar spectrum also shows changes between these epochs. We modeled the stellar and nebular spectra observed at different epochs. The analyses indicate a drop of the stellar temperature from about 42 kK to 40.5 kK between 1976 and 1993. We do not detect significant changes between 1993 and 2015. The observations show that the star performed a loop in the H-R diagram. This is possible when a shell source is activated during its post-AGB evolution. We infer that a late thermal pulse (LTP) experienced by a massive post-AGB star can explain theevolution of the central star. Such a star does not expand significantly as the result of the LTP and does not became a born-again red giant. However, the released energy can remove the tiny H envelope of the star
The antiseptic Miramistin: a review of its comparative in vitro and clinical activity
No full textMiramistin is a topical antiseptic with broad antimicrobial action, including activity against biofilms, and a clinical profile showing good tolerability. Miramistin was developed within a framework of the Soviet Union Cold War Space Program. It is available for clinical use in several prior Soviet bloc countries, but barely known outside of these countries and there is almost no mention of miramistin in the English literature. However, considering emerging antimicrobial resistance, the significant potential of miramistin justifies its re-evaluation for use in other geographical areas and conditions. The review consists of two parts: 1) a review of the existing literature on miramistin in English, Russian, and Ukrainian languages; 2) a summary of most commonly used antiseptics as comparators of miramistin. The oral LD50 was 1200 mg/kg, 1000 mg/kg and 100 g/L in rats, mice and fish respectively. Based on the results of the review, we suggest possible applications of miramistin and potential benefits over currently used agents. Miramistin offers a novel, low toxicity antiseptic with many potential clinical uses that need better study which could address some of the negative impact of antimicrobial, antiseptic and disinfectant resistance
Strictly negative imaginary state feedback control with a prescribed degree of stability
No full textThis paper presents conditions for the synthesis of a strictly negative imaginary closed-loop system with a prescribed degree of stability under the assumption of full state feedback. A perturbation method is used to ensure the closed-loop system has both the strict negative imaginary property and a prescribed degree of stability. This approach involves the real Schur decomposition of a matrix followed by the solution to two Lyapunov equations. Also, we present and clarify the perturbation properties of strictly negative imaginary systems
The COVID-19 pandemic and dentistry: the clinical, legal and economic consequences.:Part II: consequences of withholding dental care
No full textAs routine care was suspended in most countries, one could anticipate progression of undiagnosed and managed oral disease. Patients are usually unaware of the development of oral disease as it is not visible to them and largely asymptomatic, especially in its early stages. The natural progression of conditions such as caries and periodontitis is inevitable without diagnosis and management. The full extent of patient harm because of the suspension of routine dental care can only be estimated when routine oral examinations are fully re-established and even then, we will probably never know the number of individuals impacted or the extent of disease progression and harm. In first-world countries, there has always been a back-up emergency treatment system for dental problems. For example in the UK, the safety net for life-threatening swellings and for acute pain relief is Accident & Emergency services. This system remained in place during the COVID-19 pandemic. Courts could be expected to understand the coronavirus context and would take this into account should there be a complaint as against the clinician about access to care. The suspension of routine dental care to save lives will lead to the closure of many dental practices due to substantial financial impact. The return to routine care will be slow with prioritisation of non-AGPs whilst we look to further understand methods to mitigate transmission risk via an infected aerosol and spatter. Inevitably, the cost of personal protective equipment and the lower volume of patients pose a continued threat to businesses
Implications of a US study on infection prevention and control in home care (community) settings for the UK
No full textHealthcare associated infections are a significant reason for re-admission to hospital post discharge to the community. In this paper we describe some of the key findings from a programme of work conducted in a home care agency (community care organisation) in the USA. We conducted a survey to explore home care nurses’ knowledge, attitudes and beliefs around infection control (n=415), observed 400 nurse-patient visits and interviewed 50 nurses about their infection control practices. Nurses reported high compliance with infection control practices. However, the overall average adherence rate to observed hand hygiene practices was 45.6%. Interview data provided valuable insights into specific challenges faced by nurses in a home care setting. Our study provides insights that can be that can be used to enhance infection control practice in community care in the UK
Inflammaging and the skin
No full textAs global life expectancy continues to rise we are challenged with maintaining health into old age. One strategy is to target the chronic low level inflammation associated with aging, termed ‘inflammaging’. This is characterized by increased levels of circulating pro-inflammatory cytokines and a shift toward cellular senescence; changes that are believed to drive many age-associated conditions including dementia, arthritis and type-2 diabetes. As with other organs the skin undergoes functional decline during aging, becoming more fragile and susceptible to infection; however, the contribution of inflammaging is not well understood. This review article describes the evidence for inflammaging in the skin, its relationship with senescence, and how this relates to declining skin structure and function
Functional evaluation of STOX1 in placentation, preeclampsia and preterm birth
No full textRevaluation of the association of the STOX1 transcription factor mutation (Y153H, C allele) with the early uterovascular origins of placental pathology is warranted. To investigate if placental STOX1 Y153H genotype affects uterovascular remodeling -compromised in both PTB and PE we utilised extravillous trophoblast (EVT) explant and placental decidual co-culture models, transfection of STOX1 wildtype and mutant plasmids into EVT-like trophoblast cell lines, and a cohort of 75 placentas from obstetric pathologies. Primary EVT and HTR8/SVneo cells carrying STOX1 Y153H secreted lower levels of IL6, and IL8, and higher CXCL16 and TRAIL than wildtype EVT and Swan71 cells. Media from wildtype EVT or Swan71 cells transfected with wildtype STOX1 stimulated: endothelial chemokine expression, angiogenesis and dNK and monocyte migration. In contrast, Y153H EVT conditioned medium, Swan71 transfected with the Y153H plasmid, or HTR8/SVneo media had no effect. Genotyping of placental decidual co cultures demonstrated association of the placental STOX1 CC allele with failed vascular remodeling. Decidual GG NODAL R165H increased in failed co-cultures carrying the placental CC alleles of STOX1. Multivariate analysis of the placental cohort showed that the STOX1 C allele correlated with premature birth, with or without severe early onset PE and SGA babies. In conclusion, placental STOX1 Y153H is a precipitating factor in preterm birth and placental PE due to defects in early uteroplacental development
The mainstream school experiences of adolescent autistic girls
No full textResearch into the school experiences of autistic adolescents tends to utilise predominantly male samples, effectively neglecting the views of autistic girls. This study explores the perspectives of three autistic girls attending a mainstream secondary school recognised for its good autism practice. Semi-structured interviews were conducted with the girls, their mothers and a therapeutic member of staff at the school. Findings highlight the unique experiences of secondary school and common challenges including anxiety resulting from sensory issues and inconsistencies in staff understanding of individual need. Implications for practice include ensuring effective sharing of information about individual needs and specialised support for developing social skills, to enable autistic girls to navigate the complexity of female friendships during adolescence
Breast Cancer Management Pathways during the COVID-19 pandemic. Outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study
No full textBackgroundThe B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and potential impact of these treatment decisions. MethodsThis was a national cohort study of patients with early BC undergoing multi-disciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the pre-operative, operative, and post-operative setting.FindingsOf 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n=951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n=299). Where adjuvant chemotherapy was omitted (n=81), median benefit was only 3% (IQR 2%-9%) using ‘NHS Predict’. There was rapid adoption of new evidence-based hypofractionated radiotherapy (n=781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey.Conclusions The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, outwith this study, the potential impact of delays to BC presentation or diagnosis remains unknown.<br/