The evolution of patient safety procedures in an oral surgery department.

NHS Improvement highlights the importance of providing consistently safe care within the NHS. For dental professionals, this particularly concerns the reporting and avoidance of never events such as wrong tooth extraction and other serious incidents. Within the authors' unit, a number of infrequent never events and the national drive to introduce safety frameworks (NatSSIPs) has led to a reassessment of our safety procedures. In this paper, as part of our safety improvements, we discuss the chronological changes made in safety procedures following untoward events. Subsequently, we introduced a surgical safety briefing (the 'huddle') within the outpatient setting where we undertake invasive oral surgery procedures under local anaesthetic including intravenous sedation. By supplementing the 'huddle' with human factors training for all clinical staff there have been no further never events or serious incidents in the last two and a half years.

The senescence-accelerated mouse prone 8 as a model for oxidative stress and impaired DNA repair in the male germ line.

The discovery of a truncated base excision repair pathway in human spermatozoa mediated by OGG1 has raised questions regarding the effect of mutations in critical DNA repair genes on the integrity of the paternal genome. The senescence-accelerated mouse prone 8 (SAMP8) is a mouse model containing a suite of naturally occurring mutations resulting in an accelerated senescence phenotype largely mediated by oxidative stress, which is further enhanced by a mutation in the Ogg1 gene, greatly reducing the ability of the enzyme to excise 8-hydroxy,2'-deoxyguanosine (8OHdG) adducts. An analysis of the reproductive phenotype of the SAMP8 males revealed a high level of DNA damage in caudal epididymal spermatozoa as measured by the alkaline Comet assay. Furthermore, these lesions were confirmed to be oxidative in nature, as demonstrated by significant increases in 8OHdG adduct formation in the SAMP8 testicular tissue (P<0.05) as well as in mature spermatozoa (P<0.001) relative to a control strain (SAMR1). Despite this high level of oxidative DNA damage in spermatozoa, reactive oxygen species generation was not elevated and motility of spermatozoa was found to be similar to that for the control strain with the exception of progressive motility, which exhibited a slight but significant decline with advancing age (P<0.05). When challenged with Fenton reagents (H2O2 and Fe2+), the SAMP8 spermatozoa demonstrated a highly increased susceptibility to formation of 8OHdG adducts compared with the controls (P<0.001). These data highlight the role of oxidative stress and OGG1-dependent base excision repair mechanisms in defining the genetic integrity of mammalian spermatozoa.

Non-visible print set-off of photoinitiators in food packaging: detection by ambient ionisation mass spectrometry.

Direct analysis in real time coupled to time-of-flight mass spectrometry (DART/TOF-MS) was used to detect the non-visible set-off of photoinitiators on the food contact surface of three different packages. The samples were intentionally under-cured to provoke set-off. Twelve commercially available photoinitiators were included in the ink formulations including α-amino-, morpholino, and α-hydroxy benzophenones, thioxanthones, aryl-phosphine oxide and three polymeric versions of these. Major colours of the packages' prints were analysed, as well as the specific areas of the inner surface in contact with them. Larger quantities of photoinitiators were detected on the food contact areas in contact with the darker colours of the images. Speed-cure 7005 and 4-phenylbenzophenone were the compounds most susceptible to set-off in each of the samples by DART response. An identification protocol for unknown set-off compounds was tested, resulting in the set-off detection of diethylene glycol ethers, erucamide and acrylates, and confirmed by solvent extraction GC-MS analysis. Finally, DART/TOF-MS was scanned across transects of the food contact side of packages to map the presence of photoinitiators. Higher photoinitiator signals were observed in patterns corresponding to the printed image, suggesting DART/TOF-MS might "image" print set-off.

On methods for the detection of reactive oxygen species generation by human spermatozoa: analysis of the cellular responses to catechol oestrogen, lipid aldehyde, menadione and arachidonic acid.

Oxidative stress is known to have a major impact on human sperm function and, as a result, there is a need to develop sensitive methods for measuring reactive oxygen species (ROS) generation by these cells. A variety of techniques have been developed for this purpose including chemiluminescence (luminol and lucigenin), flow cytometry (MitoSOX Red, dihydroethidium, 4,5-diaminofluorescein diacetate and 2',7'-dichlorodihydrofluorescein diacetate) and spectrophotometry (nitroblue tetrazolium). The relative sensitivity of these assays and their comparative ability to detect ROS generated in different subcellular compartments of human spermatozoa, have not previously been investigated. To address this issue, we have compared the performance of these assays when ROS generation was triggered with a variety of reagents including 2-hydroxyestradiol, menadione, 4-hydroxynonenal and arachidonic acid. The results revealed that menadione predominantly induced release of ROS into the extracellular space where these metabolites could be readily detected by luminol-peroxidase and, to a lesser extent, 2',7'-dichlorodihydrofluorescein. However, such sensitivity to extracellular ROS meant that these assays were particularly vulnerable to interference by leucocytes. The remaining reagents predominantly elicited ROS generation by the sperm mitochondria and could be optimally detected by MitoSOX Red and DHE. Examination of spontaneous ROS generation by defective human spermatozoa revealed that MitoSOX Red was the most effective indicator of oxidative stress, thereby emphasizing the general importance of mitochondrial dysregulation in the aetiology of defective sperm function.

Shear ordering in polymer photonic crystals.

Optical scattering spectra are recorded in situ on flowing colloidal polymeric nanocomposites which are sheared into photonic crystals at 150 degrees C using a high-pressure quartz-cell multipass rheometer. Broadband spectroscopy of the resonant Bragg scattering peak allows the direct observation of crystal formation and melting of monodisperse core-shell particles. A range of flow conditions of this solventless, highly viscous melt reveals four distinct regimes of crystal growth and decay which match a simple rheological model. Extraction of crystal thickness, order and lattice spacing are validated by one-dimensional electromagnetic simulations.

College students' performance on associated, corresponding tasks for horizontality.

500 college biology students were asked to predict the axisymmetry (horizontal-vertical position) of the water surface and a swimming goldfish in a masked, sealed container. Subjects were shown the fish submerged in the semifilled container before it was slipped into a terry cloth stocking. The researcher then asked subjects to predict the position of the fish and the water surface as the sealed container was rotated to different angles. Many college students did not understand that liquids and submerged organisms remain invariantly horizontal regardless of the rotation of the container.

Single view radiographic screening of midfacial trauma.

Sidebottom et al. have previously shown that one occipitomental 15 degrees view (OM15) is sufficient for screening the majority of cases of midfacial injury. This audit study investigates the effect of introducing a one-view OM15 screening policy into the Accident & Emergency department (A&E) of a district general hospital. Six hundred and twenty-one patients had midfacial radiographic screening over a one-year period. Six hundred and one patients had all notes and radiographs available. Only eight required further views to confirm diagnosis. Thirty-eight fractures were diagnosed with two insignificant fractures of the antral wall missed. The cost saving was Pound Sterling 2082.50 for films alone. Eighty hours of radiographer time were additionally saved. There was no increase in referrals to the maxillofacial team. Single-view radiographic screening for midfacial injuries in A&E attenders is both safe and economical. Extrapolated to the UK population as a whole this would amount to a cost saving to the National Health Service of Pound Sterling 500000.

Comparing spatial abilities of collegiate athletes in different sports.

Researchers indicated that androgen enhances spatial ability in women but inhibits it in men. Since studies also indicate that athletes have higher than normal levels of androgen, whether spatial perception scores differed for men and women in different sports was examined. Spatial tests (visualization and orientation) were given to 150 men and 150 women collegiate athletes in different varsity sports. Analysis showed the women scored significantly higher than the men. In basketball, a sport common to both sexes, women did significantly better but this was not found in the other mixed-sex sports (baseball, swimming, and track).

Comparing scores on spatial-perception tests for intercollegiate athletes and nonathletes.

Many researchers believe that the amount of testosterone in the blood is directly associated with visuospatial perception. If this is the case, men and women who participate in intercollegiate athletics (and have high androgen levels) should show significantly better spatial ability than nonathletes. Two paper-and-pencil tests to measure spatial ability were given to 200 men and women on university sport teams. Men's scores, compared to national norms, were significantly lower than those in the national sample but no difference was found between the women athletes and the national sample or between the male and female athletes.

Hydrolysis studies on oleamide in simulated gastrointestinal fluids.

Hydrolysis studies using simulated gastrointestinal fluids have been performed on oleamide, an important fatty acid amide slip additive used in plastics food packaging. Experiments have been conducted using the simulated gastrointestinal fluids, specified by the Scientific Committee for Food for hydrolysis studies, and with slightly modified preparations believed to be more representative of the in vivo situation. The degree of hydrolysis in simulated gastric fluids was found to be negligible after incubation for 4 h at 37 degrees C. Addition of 'bile salts' to simulated intestinal fluid was found to significantly increase the degree of hydrolysis to about 95% loss of oleamide after incubation for 4 h at 37 degrees C. Stoichiometric formation of oleic acid, an innocuous substance, was also demonstrated. It has therefore been concluded that ingestion of the very low levels of oleamide expected to migrate into most foods from food packaging is unlikely to pose a threat to the health of the consumer.

A controlled trial of nurse counselling on lifestyle change for hypertensives treated in general practice: preliminary results.

1. We assessed whether a lifestyle modification programme implemented by nurse counsellors in a general practice setting would improve blood pressure (BP) control in treated hypertensive patients. 2. Patients were randomized into a control group or one of two intervention groups who received either a high or low level of counselling. 3. Patients in the intervention groups had appointments every 4th week for 18 weeks. The low intervention group had one practice appointment and five telephone counselling appointments while the high intervention group had six appointments in their general practice. The patients were counselled using a stage of change behavioural model and motivational interviewing to: reduce alcohol consumption, dietary fat and salt intake and weight; cease smoking; and increase leisure time physical activity. 4. Compared with controls the low intervention group showed significant decreases in alcohol and salt intake while the high intervention resulted in significant decreases in both weight and BP. 5. We conclude that nurse counselling targeted to specific aspects of lifestyle can improve BP control and weight in treated hypertensive patients over 18 weeks. Its longer term effectiveness in the management of hypertension warrants further evaluation.

Effects of music on Alzheimer patients.

From a large nursing care facility, 60 elderly patients diagnosed as having Alzheimer disease were randomly separated into three groups of equal size and given tests to measure their mood and mental state. For music Group 1, "Big Band" music from the 1920s and 1930s was played during their daily recreation period while Group 2 were given puzzle exercises during their activity sessions. Members of Group 3 participated in the standard recreational activities of drawing and painting. After six months, the questionnaire was again given to all participants. Analysis of variance showed the individuals in Group 1 were more alert, happier, and had higher recall of past personal history than patients in the other two groups. This suggests that music can be of therapeutic value to Alzheimer patients.

Rehab managers prepare to meet the challenge of the 90s.

In this article, Health Systems REVIEW reports on the changes taking place in the lively rehabilitation hospital industry. Although exempt from the Medicare prospective payment system, rehabilitation hospitals are feeling the payment pinch experienced by their acute-care and psychiatric brethren in the delivery of government-paid services, as well as increased pressures from private payers.

Monthly fluctuation in task concentration in female college students.

50 university women with consistent and rhythmic menstrual cycles were given Golden's version of the Stroop color-word test to evaluate their concentration accuracy. 50 male undergraduates were also tested as a control sample. The participants took the Stroop test every seven days for four consecutive weeks to allow examination of whether change in the color and word naming activity occurred. A split-plot analysis of the variance of the scores gave a significant difference for the sequence in which the tests were taken, the measures recited during the testing, and the sex of the respondent. When the values for the women were ordered to correspond to stages of their menstrual cycle, the over-all mean accuracy rose slowly to midcycle, then dropped as menses approached. This supports the hypothesis that the women's concentration was at the lowest level during the latter part of the monthly cycle. Women scored significantly higher on the color and word naming task on the Stroop test than men.

Identification of self through olfaction.

To study olfactory communication in humans, 100 undergraduates ranging from age 18 to 45 yr. wore freshly washed, identical T-shirts continuously for 24 hr. During this time, the participants did not bathe or shower or apply any scent producing substance to their bodies, i.e., deodorants, perfumes. Upon retrieval, each shirt was placed in an identical brown bag. In groups of 10, each participant attempted to identify the T-shirt he had worn the previous 24 hr. The task was administered separately for each individual so that no participants knew the choice by a previous colleague. Analysis shows that the participants were able to identify correctly their own shirts on the first try three-quarters of the time. Furthermore, sex, age, smoking habit of the participant, and menstrual cycle phase in the women were factors in successful outcomes.