Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management.

OBJECTIVES: Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e-Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour. METHODS: Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action. RESULTS: The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied. DISCUSSION: Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care.

The Argo: a high channel count recording system for neural recording in vivo.

OBJECTIVE: Decoding neural activity has been limited by the lack of tools available to record from large numbers of neurons across multiple cortical regions simultaneously with high temporal fidelity. To this end, we developed the Argo system to record cortical neural activity at high data rates. APPROACH: Here we demonstrate a massively parallel neural recording system based on platinum-iridium microwire electrode arrays bonded to a CMOS voltage amplifier array. The Argo system is the highest channel count in vivo neural recording system, supporting simultaneous recording from 65 536 channels, sampled at 32 kHz and 12-bit resolution. This system was designed for cortical recordings, compatible with both penetrating and surface microelectrodes. MAIN RESULTS: We validated this system through initial bench testing to determine specific gain and noise characteristics of bonded microwires, followed by in-vivo experiments in both rat and sheep cortex. We recorded spiking activity from 791 neurons in rats and surface local field potential activity from over 30 000 channels in sheep. SIGNIFICANCE: These are the largest channel count microwire-based recordings in both rat and sheep. While currently adapted for head-fixed recording, the microwire-CMOS architecture is well suited for clinical translation. Thus, this demonstration helps pave the way for a future high data rate intracortical implant.

Osteomyelitis: an overview of imaging modalities.

Diagnosis, early intervention, and treatment of patients who have an infection are the basic foundations of patient care. Early, appropriate interventions are associated with decreased patient morbidity and mortality. Diagnostic procedures with clinical information and laboratory results are integral in the assessment of inflammatory diseases and the prevention of sepsis. Some of the imaging modalities currently used for the assessment of inflammation include computed tomography, plain radiography, positron emission tomography, technetium Tc 99m bone scintigraphy, magnetic resonance imaging, and leukocyte scintigraphy. In the case of patients who exhibit signs of osteomyelitis, it is necessary to understand that acute and chronic conditions are not based on the duration of the disease but on the histopathologic features of the disease. Although several imaging modalities are considered appropriate, there is not one singular procedure that is considered ideal. Rather, it is a combination of procedures and various other clinical factors. This article addresses some of the advantages and disadvantages of the modalities, with a focus on molecular imaging and the assessment of osteomyelitis.

Advanced conscious sedation training--the pilot course, training and impact on a hospital service.

UNLABELLED: Advanced conscious sedation techniques for dental procedures include continuous propofol infusion and combinations of midazolam and fentanyl. A course based on the Independent Expert Group on Training & Standards for Sedation in Dentistry (IEGTSSD) training syllabus was set up in 2012 to provide training in these techniques. Training involved: self-directed study modules; attendance at didactic teaching day; presentation by candidates of knowledge; medical emergency simulated training; written examination; supervised cases; and submission of case logbook. A dedicated clinic was set up by dentists to provide training for supervised cases. RESULTS: nine dentists are now trained in advanced sedation techniques and over 250 patients have been successfully treated using continuous propofol infusion. CONCLUSION: the advanced sedation training course based on the EGTSSD curriculum was a successful way to train dentists experienced in standard sedation techniques to be confident and knowledgeable to deliver advanced sedation in a dental setting. Patients mostly preferred propofol to midazolam, however, as amnesia is not guaranteed; propofol may be more appropriate for mild to moderately anxious patients.

The Emperor Seamounts: southward motion of the Hawaiian hotspot plume in Earth's mantle.

The Hawaiian-Emperor hotspot track has a prominent bend, which has served as the basis for the theory that the Hawaiian hotspot, fixed in the deep mantle, traced a change in plate motion. However, paleomagnetic and radiometric age data from samples recovered by ocean drilling define an age-progressive paleolatitude history, indicating that the Emperor Seamount trend was principally formed by the rapid motion (over 40 millimeters per year) of the Hawaiian hotspot plume during Late Cretaceous to early-Tertiary times (81 to 47 million years ago). Evidence for motion of the Hawaiian plume affects models of mantle convection and plate tectonics, changing our understanding of terrestrial dynamics.