Antibiotic prescribing by general dental practitioners in the Greater Glasgow Health Board, Scotland

OBJECTIVE: To investigate antibiotic prescribing patterns by general dental practitioners (GDPs) in the Greater Glasgow Health Board Area, Scotland. STUDY DESIGN: A 10% sample of prescriptions were selected at random from 35,545 prescriptions written by GDPs over a 6-month period. MAIN OUTCOME MEASURES: Absolute and relative frequencies were used to describe the different classes of antibiotics used and the variations in prescribing practice. RESULTS: GDPs prescribed a wide range of antibiotics. Seventeen different antibiotics were prescribed with amoxycillin, metronidazole and penicillin V accounting for almost 90% of the prescriptions. In general the antibiotics were prescribed at the British National Formulary (BNF) recommended doses. There were, however, wide variations in the frequencies and durations of the prescriptions for all antibiotics. CONCLUSIONS: The present study provides evidence of sub-optimal prescribing of antibiotics by dentists in Scotland, with considerable variation from the recommended frequencies and doses

A flipped classroom approach to teaching oral pathology using virtual microscopy - the Glasgow experience

This paper describes a student-centred, integrated teaching model in which oral pathology and oral medicine staff members jointly deliver tutorials in a combined online and face-to-face format. Students are provided with clinical and histopathological information, which they must review and use to answer questions via a Virtual Learning Environment before the tutorial takes place. By reviewing the students’ answers online before the teaching session, staff can focus the tutorial itself on resolving knowledge gaps and afterwards post a set of gold standard answers online for students to reflect upon. CPD/Clinical Relevance: This article illustrates a combination of teaching methods and modern technologies which integrate clinical with laboratory sciences and enhance the access of students to histopathological materials without the need for access to a traditional microscopy facility

Water, water everywhere but not a drop to drink?

Biofilms are emerging as an increasing problem as medical technology advances. Dental practice is no exception and interest in the role of biofilms within dental units as a possible source of cross-infection is intensifying. It is difficult to quantitate the risks associated with aerosolised bacteria for the majority of patients seen in general practice. However, it seems prudent to eliminate this source of infection during treatment of compromised patients. This article attempts to provide a brief overview of current concepts and problems in this area of infection control

Resultatsclustering und einfache POI Exploration für OSCAR

Die von der Abteilung FMI/ALG entwickelte Suchmaschine „OSCAR“ (OSM Cell ARrangement) erlaubt flexibles Suchen im weltweiten OpenStreetMap (OSM) Datenbestand. Hierbei werden sowohl Teilwort- und Präfixsuche auf Textinhalte, als auch alle üblichen Mengenoperationen und geometrischen Einschränkungen unterstützt. Während die zu Grunde liegende Suchmaschine bereits sehr weit entwickelt ist, gibt es bei der Bedienung beziehungsweise der grafischen Oberfläche von „OSCAR“ weiterhin Verbesserungspotenzial. Bisher wird bei einer Suche, welche mehr als eine bestimmte Anzahl an Treffern liefert, lediglich eine Teilmenge auf der Karte dargestellt und der Benutzer kann bei Bedarf weitere Treffer nachladen. Dies führt vorerst zu einer unvollständigen Präsentation des Suchergebnis als auch zu Unübersichtlichkeit, falls die Suchtreffer geografisch sehr dicht liegen, da für jeden Treffer ein eigenes Kennzeichen auf der Karte gezeichnet wird. Hierbei wäre es wünschenswert, dem Nutzer die geografische Lage aller Suchtreffer präsentieren zu können ohne die gesamten Metainformationen der Treffer komplett auf den Rechner des Nutzers laden zu müssen. Dabei sollte ebenfalls die Präsentation der Resultate auf der Karte verbessert werden, indem geografisch dicht gelegene Resultate zusammengefasst werden (geografisches Clustering). Die Granularität der dargestellten Ergebnisse sollte hierbei abhängig vom Vergrößerungslevel der Karte gewählt werden und somit zu einem dynamischen Nachladen von Informationen führen. Darüber hinaus kann die in den Kartendaten vorhandene Hierarchie von Gebieten genutzt werden, um dem Benutzer eine detaillierte Inspektion des Suchergebnis zu ermöglichen. Dies soll durch eine interaktive Visualisierung erreicht werden, wobei das Laden von Subregionen und Suchtreffern unterstützt wird. Des Weiteren kann der Benutzer bei der Eingabe einer Suche unterstützt werden, um genauere Suchergebnisse zu erzielen. Um nach spezifischen Institutionen in den OSM-Daten suchen zu können, muss der Benutzer die zugehörigen OSM-Tags (Schlüssel-Wert Paare) zur Verfügung haben. Um beispielsweise nach Pizzerien zu suchen ist es nötig das OSM-Tag „@cuisine:pizza“ zu kennen. Hierfür kann dem Benutzer ein Menü angeboten werden, welches diese Tags bereitstellt. Zusätzlich können Suchtreffer, insbesondere bei Suchen nach Restaurants, Parks oder interessanten Plätzen (sogenannte POI: „Point-of-Interest“) durch Bilder verbessert werden. OSM enthält hierfür keine eigenen Bilderdaten, jedoch kann untersucht werden, inwiefern öffentliche Bilderportale dazu geeignet sind Suchtreffer zu verbessern

Investigation into the Use of the Concept Laser QM System as an In-Situ Research and Evaluation Tool

The NASA Marshall Space Flight Center (MSFC) is using a Concept Laser Fusing (Cusing) M2 powder bed additive manufacturing system for the build of space flight prototypes and hardware. NASA MSFC is collecting and analyzing data from the M2 QM Meltpool and QM Coating systems for builds. This data is intended to aide in understanding of the powder-bed additive manufacturing process, and in the development of a thermal model for the process. The QM systems are marketed by Concept Laser GmbH as in-situ quality management modules. The QM Meltpool system uses both a high-speed near-IR camera and a photodiode to monitor the melt pool generated by the laser. The software determines from the camera images the size of the melt pool. The camera also measures the integrated intensity of the IR radiation, and the photodiode gives an intensity value based on the brightness of the melt pool. The QM coating system uses a high resolution optical camera to image the surface after each layer has been formed. The objective of this investigation was to determine the adequacy of the QM Meltpool system as a research instrument for in-situ measurement of melt pool size and temperature and its applicability to NASA's objectives in (1) Developing a process thermal model and (2) Quantifying feedback measurements with the intent of meeting quality requirements or specifications. Note that Concept Laser markets the system only as capable of giving an indication of changes between builds, not as an in-situ research and evaluation tool. A secondary objective of the investigation is to determine the adequacy of the QM Coating system as an in-situ layer-wise geometry and layer quality evaluation tool

Computational Process Modeling for Additive Manufacturing

Computational Process and Material Modeling of Powder Bed additive manufacturing of IN 718. Optimize material build parameters with reduced time and cost through modeling. Increase understanding of build properties. Increase reliability of builds. Decrease time to adoption of process for critical hardware. Potential to decrease post-build heat treatments. Conduct single-track and coupon builds at various build parameters. Record build parameter information and QM Meltpool data. Refine Applied Optimization powder bed AM process model using data. Report thermal modeling results. Conduct metallography of build samples. Calibrate STK models using metallography findings. Run STK models using AO thermal profiles and report STK modeling results. Validate modeling with additional build. Photodiode Intensity measurements highly linear with power input. Melt Pool Intensity highly correlated to Melt Pool Size. Melt Pool size and intensity increase with power. Applied Optimization will use data to develop powder bed additive manufacturing process model

IPM10: Computational Process Modeling for Additive Manufacturing (OSU)

No abstract availabl

Barriers to the use of a diagnostic oral microbiology laboratory by general dental practitioners

OBJECTIVE: To identify barriers on the use of diagnostic microbiology facilities in general dental practice. DESIGN: A cross-sectional survey using a postal questionnaire. SETTING: Primary/secondary care interface between the diagnostic oral microbiology laboratory, University of Glasgow Dental Hospital and School, Glasgow and dental practitioners within the surrounding health boards, 1998. SUBJECTS: All GDPs (797) within Argyll and Clyde, Ayrshire and Arran, Lanarkshire and Greater Glasgow Health Boards. MAIN OUTCOME MEASURES: The responses were expressed as both absolute and relative frequencies. RESULTS: Responses were received from 430 (55%). The most frequent reason for failure to use the service was lack of information, with more than half of the respondents claiming to be unaware of the facility. Lack of request forms and sampling equipment were also viewed as barriers to using the service. CONCLUSIONS: The laboratory is failing to successfully communicate its role in addressing the growing burden of antibiotic resistance in the community and must be more proactive in encouraging appropriate use and increasing accessibility of the service to GDPs

Risk factors for chest infection in acute stroke: a prospective cohort study

<p><b>Background and Purpose:</b> Pneumonia is a major cause of morbidity and mortality after stroke. We aimed to determine key characteristics that would allow prediction of those patients who are at highest risk for poststroke pneumonia.</p> <p><b>Methods:</b> We studied a series of consecutive patients with acute stroke who were admitted to hospital. Detailed evaluation included the modified National Institutes of Health Stroke Scale; the Abbreviated Mental Test; and measures of swallow, respiratory, and oral health status. Pneumonia was diagnosed by set criteria. Patients were followed up at 3 months after stroke.</p> <p><b>Results:</b> We studied 412 patients, 391 (94.9%) with ischemic stroke and 21 (5.1%) with hemorrhagic stroke; 78 (18.9%) met the study criteria for pneumonia. Subjects who developed pneumonia were older (mean±SD age, 75.9±11.4 vs 64.9±13.9 years), had higher modified National Institutes of Health Stroke Scale scores, a history of chronic obstructive pulmonary disease, lower Abbreviated Mental Test scores, and a higher oral cavity score, and a greater proportion tested positive for bacterial cultures from oral swabs. In binary logistic-regression analysis, independent predictors (P<0.05) of pneumonia were age >65 years, dysarthria or no speech due to aphasia, a modified Rankin Scale score ≥4, an Abbreviated Mental Test score <8, and failure on the water swallow test. The presence of 2 or more of these risk factors carried 90.9% sensitivity and 75.6% specificity for the development of pneumonia.</p> <p><b>Conclusions:</b> Pneumonia after stroke is associated with older age, dysarthria/no speech due to aphasia, severity of poststroke disability, cognitive impairment, and an abnormal water swallow test result. Simple assessment of these variables could be used to identify patients at high risk of developing pneumonia after stroke.</p&gt

Staphylococcus aureus in the oral cavity: a three-year retrospective analysis of clinical laboratory data

OBJECTIVE: A retrospective analysis of laboratory data to investigate the isolation of Staphylococcus aureus from the oral cavity and facial area in specimens submitted to a regional diagnostic oral microbiology laboratory. METHODS: A hand search of laboratory records for a three-year period (1998-2000) was performed for specimens submitted to the regional diagnostic oral microbiology laboratory based at Glasgow Dental Hospital and School. Data were collected from forms where S. aureus was isolated. These data included demographics, referral source, specimen type, methicillin susceptibility and clinical details. RESULTS: For the period 1998-2000, there were 5,005 specimens submitted to the laboratory. S. aureus was isolated from 1,017 specimens, of which 967 (95%) were sensitive to methicillin (MSSA) and 50 (5%) were resistant to methicillin (MRSA). The 1,017 specimens were provided from 615 patients. MRSA was isolated from 37 (6%) of patients. There was an increasing incidence of S. aureus with age, particularly in the greater than 70 years age group. The most common specimen from which MSSA was isolated was an oral rinse (38%) whilst for MRSA isolates this was a tongue swab (28%). The clinical condition most commonly reported for MSSA isolates was angular cheilitis (22%). Erythema, swelling, pain or burning of the oral mucosa was the clinical condition most commonly reported for MRSA isolates (16%). Patients from whom the MSSA isolates were recovered were most commonly (55%) seen in the oral medicine clinic at the dental hospital, whilst patients with MRSA were more commonly seen in primary care settings such as nursing homes, hospices and general dental practice (51%). CONCLUSION: In line with more recent surveys, this retrospective study suggests that S. aureus may be a more frequent isolate from the oral cavity than hitherto suspected. A small proportion of the S. aureus isolates were MRSA. There were insufficient data available to determine whether the S. aureus isolates were colonising or infecting the oral cavity. However, the role of S. aureus in several diseases of the oral mucosa merits further investigation