Evaluating Streptococcus mutans Strain Dependent Characteristics in a Polymicrobial Biofilm Community.

Aim: The purpose of this study was to investigate strain dependent differences of the cariogenic biofilm forming Streptococcus mutans within both simple and complex communities. Methods: A mono-species containing representative S. mutans clinical isolates (caries and non-caries), and a multispecies in vitro caries biofilm model containing Lactobacillus casei, Veillonella dispar, Fusobacterium nucleatum and Actinomyces naeslundii, and either of two representative S. mutans clinical isolates (caries and non-caries), was developed as a comparison model. Compositional analysis of total and live bacteria within biofilms, and transcriptional analysis of biofilm associated virulence factors were evaluated by live/dead PCR and quantitative PCR, respectively. Scanning electron microscopy (SEM) was used to analyze the architecture of biofilm. One-way analysis of variance and t-tests were used to investigate significant differences between independent groups of data. Results: Within a mono-species biofilm, different S. mutans strains responded similarly to one another during biofilm formation in different carbohydrate sources, with sucrose showing the highest levels of biofilm biomass and galactose showing the lowest. Within the polymicrobial biofilm system, compositional analysis of the bacteria within the biofilm showed that S. mutans derived from a caries-free patient was preferentially composed of both total and viable L. casei, whereas S. mutans derived from a caries patient was dominated by both total and viable S. mutans (p < 0.001). Normalized gene expression analysis of srtA, gtfB, ftf, spaP, gbpB, and luxS, showed a general upregulation within the S. mutans dominant biofilm. Conclusion: We were able to demonstrate that individual strains derived from different patients exhibited altered biofilm characteristics, which were not obvious within a simple mono-species biofilm model. Influencing the environmental conditions changed the composition and functionality S. mutans within the polymicrobial biofilm. The biofilm model described herein provides a novel and reproducible method of assessing the impact on the biofilm microbiome upon different environmental influences.

Emergency Nursing Review Questions: July 2017.

The review questions that are featured in each of issue of JEN are based on the Emergency Nursing Core Curriculum and other pertinent resources to emergency nursing practice, pediatric and adult. These questions offer emergency nurses an opportunity to test their knowledge about their practice.

Emergency Nursing Review Questions: November 2016.

The review questions that are featured in each of issue of JEN are based on the Emergency Nursing Core Curriculum and other pertinent resources to emergency nursing practice, pediatric and adult. These questions offer emergency nurses an opportunity to test their knowledge about their practice.

Development and process evaluation of a Web-based responsible beverage service training program.

BACKGROUND: Responsible beverage service (RBS) training designed to improve the appropriate service of alcohol in commercial establishments is typically delivered in workshops. Recently, Web-based RBS training programs have emerged. This report describes the formative development and subsequent design of an innovative Web-delivered RBS program, and evaluation of the impact of the program on servers' knowledge, attitudes, and self-efficacy. METHODS: Formative procedures using focus groups and usability testing were used to develop a Web-based RBS training program. Professional alcohol servers (N = 112) who worked as servers and/or mangers in alcohol service settings were recruited to participate. A pre-post assessment design was used to assess changes associated with using the program. RESULTS: Participants who used the program showed significant improvements in their RBS knowledge, attitudes, and self-efficacy. CONCLUSIONS: Although the current study did not directly observe and determine impact of the intervention on server behaviors, it demonstrated that the development process incorporating input from a multidisciplinary team in conjunction with feedback from end-users resulted in creation of a Web-based RBS program that was well-received by servers and that changed relevant knowledge, attitudes, and self-efficacy. The results also help to establish a needed evidence base in support of the use of online RBS training, which has been afforded little research attention.

Developing and pretesting case studies in dental and dental hygiene education: using the diffusion of innovations model.

Case-based learning offers exposure to clinical situations that health professions students may not encounter in their training. The purposes of this study were to apply the Diffusion of Innovations conceptual framework to 1) identify characteristics of case studies that would increase their adoption among dental and dental hygiene faculty members and 2) develop and pretest interactive web-based case studies on sensitive oral-systemic health issues. The formative study spanned two phases using mixed methods (Phase 1: eight focus groups and four interviews; Phase 2: ten interviews and satisfaction surveys). Triangulation of quantitative and qualitative data revealed the following positive attributes of the developed case studies: relative advantage of active learning and modeling; compatibility with a variety of courses; observability of case-related knowledge and skills; independent learning; and modifiability for use with other oral-systemic health issues. These positive attributes are expected to increase the likelihood that dental and dental hygiene faculty members will adopt the developed case study once it is available for use. The themes identified in this study could be applied to the development of future case studies and may provide broader insight that might prove useful for exploring differences in case study use across dental and dental hygiene curricula.

Factors for increasing adoption of e-courses among dental and dental hygiene faculty members.

The incorporation of web-based learning into the dental curriculum has been consistently recommended in the literature on reform in dental education. There has been growing support for web-based learning in dental and dental hygiene education as demonstrated by deans' identifying this as a planned curricular innovation. The purpose of our study was to explore characteristics of e-courses that may serve to increase adoption among dental and dental hygiene faculty members. Eight ninety-minute focus groups (three dental; five dental hygiene) were conducted with dental (n=27) and dental hygiene (n=23) faculty members from six academic institutions. The resulting data were analyzed to identify two overarching themes and associated subthemes with regard to benefits and barriers influencing adoption of e-courses. A working conceptual framework, based on the Diffusion of Innovations, was developed from these themes to understand the characteristics that may influence the rate of adoption of e-courses among dental and dental hygiene faculty members. Analysis of the data revealed four main adoption barriers: 1) low perceived relative advantage to faculty members; 2) low compatibility with current curriculum; 3) high perceived time commitment; and 4) complexity of e-course development. This exploratory assessment identifies leverage points for facilitating the adoption and sustainability of e-courses in dental and dental hygiene education.

Development and evaluation of a web-based training program for oral health care providers on secondary prevention of eating disorders.

Although oral health care providers (OHP) are key in the secondary prevention of eating disorders (ED), the majority are not engaged in assessment, referral, and case management. This innovative pilot project developed and evaluated a web-based training program for dental and dental hygiene students and providers on the secondary prevention of ED. The intervention combined didactic and skill-based objectives to train OHP on ED and its oral health effects, OHP roles, skills in identifying the oral signs of ED, communication, treatment, and referral. Using a convenience sample of OHP (n=66), a pre-/post-test evaluated short-term outcomes and user satisfaction. Results revealed statistically significant improvements in self-efficacy (p<.001); knowledge of oral manifestations from restrictive behaviors (p<.001) and purging behaviors (p<.001); knowledge of oral treatment options (p<.001); and attitudes towards the secondary prevention of ED (p<.001). Most participants strongly agreed or agreed that the program provided more information (89 percent) and resources (89 percent) about the secondary prevention of ED than were currently available; 91 percent strongly agreed or agreed that they would access this program for information regarding the secondary prevention of ED. This pilot project provides unique training in the clinical evaluation, patient approach, referral, and oral treatment that takes a multidisciplinary approach to address ED.

Pharmacological characterisation of a cell line expressing GABA B1b and GABA B2 receptor subunits.

The gamma-aminobutyric acid (GABA(B)) receptor has been shown to be a heterodimer consisting of two receptor subunits, GABA(B1) and GABA(B2). We have stably co-expressed these two subunits in a CHO cell line, characterised its pharmacology and compared it to the native receptor in rat brain membranes. Radioligand binding using [3H]CGP54626A demonstrated a similar rank order of potency between recombinant and native receptors: CGP62349>CGP54626A>SCH 50911>3-aminopropylphosphinicacid(3-APPA)>GABA>baclofen>saclofen>phaclofen. However, differences were observed in the affinity of agonists, which were higher at the native receptor, suggesting that in the recombinant system a large number of the receptors were in the low agonist affinity state. In contrast, [35S]GTPgammaS binding studies did not show any differences between recombinant and native receptors with the full agonists GABA and 3-APPA. Measurement of cAMP accumulation in the cells revealed a degree of endogenous coupling of the receptors to G-proteins. This is most likely to be due to the high expression levels of receptors (B(max)=22.5+/-2.5pmol/mg protein) in this experimental system. There was no evidence of GABA(B2) receptors, when expressed alone, binding [3H]CGP54626A, [3H]GABA, [3H]3-APPA nor of GABA having any effect on basal [35S]GTPgammaS binding or cAMP levels.