The behaviour of extended duties dental nurses and the acceptance of fluoride varnish application in preschool children.

BACKGROUND: Extended duties dental nurses (EDDNs) have been trained to deliver fluoride varnish applications to preschool children as part of the Childsmile initiative in Scotland. OBJECTIVES: To determine a detailed behavioural profile of the EDDNs during the administration of the fluoride varnish to confirm professional manner and identify differences in nurse behaviours between successful and unsuccessful application sessions. METHODS: Nurse-child interactions were video recorded and nurse behaviours coded and analysed using a specially developed coding scheme (SABICS). Behaviour frequency and duration were measured and correlations were calculated. Differences in behaviour were examined between successful and unsuccessful application sessions. RESULTS: Three hundred and three interactions were coded out of 456 recorded application sessions. No incident occurred where nurses threatened or placed undue stress on a child. In unsuccessful, compared with successful, application sessions, nurses demonstrated higher frequency and duration of the following behaviours: 'permission seeking', 'offer of task alternative', 'information seeking' and 'reassurance', controlling for length of procedure. Whereas with successful applications, 'praise', 'instruction' and 'information-giving' were used more frequently and for a longer duration, compared with unsuccessful applications. CONCLUSIONS: The EDDNs demonstrated a professional manner working with preschool children. They behaved differently between successful and unsuccessful application sessions. Sequential analysis is needed to examine causal effects of behaviours and its effects on delivery outcomes.

Childsmile: the national child oral health improvement programme in Scotland. Part 1: Establishment and development.

This paper is the first of two reviewing the Childsmile programme. It sets out to describe the development and implementation of this national oral health improvement programme for children in Scotland over its initial three-year period (January 2006 to December 2008) and into its second phase of development. It outlines the context in which the initiative was conceived, the initial development of its various components, and how monitoring and evaluation are shaping the delivery and direction of the programme.

Childsmile: the national child oral health improvement programme in Scotland. Part 2: Monitoring and delivery.

This paper, the second of two reviewing the Childsmile programme, describes monitoring arrangements and summarises monitoring data covering the period 2006-2009. By mid-2009, around 28,000 infants in deprived areas of the West of Scotland had been given caries risk assessments by Health Visitors; 14,000 were enrolled with 142 Childsmile practices or clinics; and over 10,000 had begun making practice visits. The Childsmile Nursery and School programmes had provided 28,000 fluoride varnish treatments to nursery and primary school children. Daily supervised toothbrushing and distribution of oral health packs covered almost 100% of nursery schools and P1 and P2 classes in primary schools in the most deprived areas of Scotland. Feedback of monitoring information to programme managers is used to identify any variation or shortfall in programme coverage and delivery.

Out-of-hours emergency dental services in Scotland--a national model.

A model of out-of-hours telephone triage for patients with a dental emergency has been piloted in an area of Scotland since 2001. This is linked to an integrated patient booking service. The model has been developed into a national emergency dental service which is currently being made available to all NHS Board areas. This new national service incorporates a single point of telephone access, triage by trained dental nurses using a clinical decision support system and centralised patient booking arrangements. The new service is complemented by Emergency Dental Care Guidance published by the Scottish Dental Clinical Effectiveness Programme. This paper describes the model of out-of-hours dental care, its underlying principles and the process of development.

Diversity of Carabidae (Insecta, Coleoptera) in epiphytic Bromeliaceae in central Veracruz, Mexico.

This paper documents the existence of carabid assemblages associated with bromeliads on the Cofre de Perote, Veracruz, Mexico. Based on bromeliads sampled over three altitudinal ranges, the assemblages included at least 26 species with an arboreal lifestyle and another 11 species that are not strictly arboreal. Seven species are new to science, urging us to pay attention to the arboreal fauna in forest conservation studies. Composition of carabid assemblages associated with bromeliads changes with altitude. In lowlands, it is comprised almost entirely of species of Lebiini, with the Platynini dominating assemblages found in bromeliads >1,000 m above sea level. Our data suggest that carabids use bromeliads to reduce stresses associated with drought periods, the exact timing of which depends on altitude. The unexpected low diversity of the carabid fauna associated with bromeliads at middle altitude is explained in terms of anthropogenic conversion of the original forest to pastureland. Given the importance of arboreal elements, further fragmentation of subtropical and tropical mountain forest significantly threatens overall carabid diversity.

Regulation of the balance of one-carbon metabolism in Saccharomyces cerevisiae.

One-carbon metabolism in yeast is an essential process that relies on at least one of three one-carbon donor molecules: serine, glycine, or formate. By a combination of genetics and biochemistry we have shown how cells regulate the balance of one-carbon flow between the donors by regulating cytoplasmic serine hydroxymethyltransferase activity in a side reaction occurring in the presence of excess glycine. This control governs the level of 5,10-methylene tetrahydrofolate (5,10-CH(2)-H(4)folate) in the cytoplasm, which has a direct role in signaling transcriptional control of the expression of key genes, particularly those encoding the unique components of the glycine decarboxylase complex (GCV1, GCV2, and GCV3). Based on these and other observations, we propose a model for how cells balance the need to supplement their one-carbon pools when charged folates are limiting or when glycine is in excess. We also propose that under normal conditions, cytoplasmic 5,10-CH(2)-H(4)folate is mainly directed to generating methyl groups via methionine, whereas one-carbon units generated from glycine in mitochondria are more directed to purine biosynthesis. When glycine is in excess, 5, 10-CH(2)-H(4)folate is decreased, and the regulation loop shifts the balance of generation of one-carbon units into the mitochondrion.

Pyruvate metabolism in Campylobacter spp.

The metabolism of pyruvate by Campylobacter spp. was investigated employing one- and two-dimensional 1H, 13C and 31P nuclear magnetic resonance spectroscopy. Metabolically competent cells incubated aerobically with pyruvate yielded acetate, acetolactate, alanine, formate, lactate, and succinate. The production of acetolactate, alanine and lactate indicated the presence of acetohydroxy acid synthase, alanine transaminase and lactate dehydrogenase activities, respectively. Accumulation of acetate and formate as metabolic products provided evidence for the existence of a mixed acid fermentation pathway in the microorganism. Formation of succinate suggested the incorporation of the pyruvate carbon skeleton to the Kreb's cycle, and the observation of pyruvate dehydrogenase activities in bacterial lysates supported this interpretation. Generation of pyruvate from L-serine in incubations with intact cells and lysates indicated the presence of serine dehydratase activity in the bacterium. Pyruvate was also formed in cell suspensions and lysates from phosphoenol pyruvate. The existence of anaplerotic sequences involving phosphoenol pyruvate carboxykinase and a malic enzyme were established in bacterial lysates. The activities of enzymes involved in the biosynthesis of isoleucine and valine were measured. Addition of pyruvate to different solid culture media inhibited bacterial growth, and the inhibition was attributed to the accumulation of acetate and formate. The variety of products formed using pyruvate as the sole substrate and the existence of anaplerotic sequences and anabolic pathways which employ pyruvate, showed the important role of this metabolite in the energy and biosynthesis metabolism of Campylobacter spp.