A comprehensive examination of the local- and long-range structure of Sb6O13 pyrochlore oxide.

The crystal structure of the Sb6O13 oxide, exhibiting a defect pyrochlore crystal structure with atomic vacancies, has been studied using a complete set of state-of-the-art techniques. The degree of antimony disproportionation in Sb3+ and Sb5+ valence states has been directly determined around 36% and 64%, respectively, using X-ray absorption near edge structure (XANES). These findings are in excellent agreement with our Rietveld analysis of synchrotron X-ray (SXRD) and neutron powder diffraction (NPD) results. Moreover, the highly distorted Sb3+ coordination due to its lone electron pair has been critically revisited. The bonding distances and coordination of Sb3+ and Sb5+ species closely agree with an extensive dynamic and crystallographic determination using the Extended X-ray Absorption Fine Structure (EXAFS) technique. Most importantly, the specific local disorder of the two distinctive Sb ions has been crosschecked monitoring their unusual Debye-Waller factors.

In vitro cavity and crown preparations and direct restorations: A comparison of performance at the start and end of the FD programme.

Aim To assess the performance and thereby the progress of the FDs when they carried out a number of simulated clinical exercises at the start and at the end of their FD year.Methods A standardised simulated clinical restorative dentistry training exercise was carried out by a group of 61 recently qualified dental graduates undertaking a 12 months' duration foundation training programme in England, at both the start and end of the programme. Participants completed a Class II cavity preparation and amalgam restoration, a Class IV composite resin restoration and two preparations for a porcelain-metal full crown. The completed preparations and restorations were independently assessed by an experienced consultant in restorative dentistry, using a scoring system based on previously validated criteria. The data were subjected to statistical analysis.Results There was wide variation in individual performance. Overall, there was a small but not statistically significant improvement in performance by the end of the programme. A statistically significant improvement was observed for the amalgam preparation and restoration, and, overall, for one of the five geographical sub-groups in the study. Possible reasons for the variable performance and improvement are discussed.Conclusions There was variability in the performance of the FDs. The operative performance of FDs at the commencement and end of their FD year indicated an overall moderately improved performance over the year and a statistically significant improvement in their performance with regard to amalgam restoration.

An audit of cavity and crown preparations and two direct restorations carried out by foundation dentists in the Oxford and Wessex Deaneries.

It is likely that many foundation dentists (FDs) will have completed only minimal amounts of restorative dentistry for a number of months immediately prior to commencing work as FDs. Thus this audit aimed to assess the performance of the FDs when they carried out a number of simulated clinical exercises: amalgam cavities and restoration; Class IV resin composite restorations; and full crown preparations for metal-ceramic restorations. A total of 67 FDs completed the assessments and some results did indicate a high level of concern and need for further evaluation of restorative practice.

Supporting newly qualified dental therapists into practice: a longitudinal evaluation of a foundation training scheme for dental therapists (TFT).

OBJECTIVES: Focused on the dental therapists foundation training (TFT) scheme run by the Postgraduate Dental Deaneries of Oxford and Wessex (NHS Education South Central - NESC) the objectives were (1) to evaluate the TFT 2010/11 scheme, identifying strengths, areas for development and drawing comparisons with the 2009 evaluation; and (2) to follow-up previous cohorts, reporting current work and retrospective reflections on the scheme. METHODS: Data were collected from 2010/11 ('current') trainees (n = 10) through group discussion, questionnaire and portfolio extracts. Eleven past-trainees from 2008/09 and 2009/10 took part in a structured telephone interview or responded to questions via e-mail. RESULTS: Data from 2011 consolidated that collected earlier. The scheme was highly valued. Current participants thought the scheme should be mandatory and all past-participants would recommend it to others. Trainees attributed an increase in confidence and ability in their clinical skills to participation in TFT. Current trainees' concerns about finding therapy work were echoed in past-participants' post-scheme employment. CONCLUSIONS: At the point of qualification, trainees do not feel well-prepared for starting work as dental therapists. Opportunity to develop confidence and skills in a supportive environment is a key benefit of the scheme. Maintaining ability in the full range of duties requires continued use of skills and the opportunity to do this remains an ongoing challenge.

Could situational judgement tests be used for selection into dental foundation training?

OBJECTIVE: To pilot and evaluate a machine-markable situational judgement test (SJT) designed to select candidates into UK dental foundation training. DESIGN: Single centre pilot study. SETTING: UK postgraduate deanery in 2010. PARTICIPANTS AND METHODS: Seventy-four candidates attending interview for dental foundation training in Oxford and Wessex Deaneries volunteered to complete the situational judgement test. INTERVENTIONS: The situational judgement test was developed to assess relevant professional attributes for dentistry (for example, empathy and integrity) in a machine-markable format. Test content was developed by subject matter experts working with experienced psychometricians. MAIN OUTCOME MEASURES: Evaluation of psychometric properties of the pilot situational judgement test (for example, reliability, validity and fairness). Scores in the dental foundation training selection process (short-listing and interviews) were used to examine criterion-related validity. Candidates completed an evaluation questionnaire to examine candidate reactions and face validity of the new test. RESULTS: Forty-six candidates were female and 28 male; mean age was 23.5-years-old (range 22-32). Situational judgement test scores were normally distributed and the test showed good internal reliability when corrected for test length (α = 0.74). Situational judgement test scores positively correlated with the management, leadership and professionalism interview (N = 50; r = 0.43, p <0.01) but not with the clinical skills interview, providing initial evidence of criterion-related validity as the situational judgement test is designed to test non-cognitive professional attributes beyond clinical knowledge. Most candidates perceived the situational judgement test as relevant to dentistry, appropriate for their training level, and fair. CONCLUSION: This initial pilot study suggests that a situational judgement test is an appropriate and innovative method to measure professional attributes (eg empathy and integrity) for selection into foundation training. Further research will explore the long-term predictive validity of the situational judgement test once candidates have entered training.

An evaluation of a vocational training scheme for dental therapists (TVT).

Commissioned by NHS Education South Central (NESC) Postgraduate Dental Deanery, this work provided an external, independent formative evaluation of the Dental Therapists Vocational Training (TVT) scheme in its first year of operation. Undertaken between March-September 2009, the evaluation engaged with all those involved in the TVT scheme: the newly qualified dental therapists (n = 9; group discussion and questionnaire; portfolio extracts) and interviews with their trainers (n = 9), Associate Postgraduate Dental Dean and TVT Scheme Adviser. Most of those on the scheme did not feel well prepared for work at the point of initial qualification and benefitted from enhancement of confidence and skills. Although the number of treatments undertaken by each of the trainees varied considerably, there was commonality in terms of treatment types. Benefits for trainers included the opportunity to work with a dental therapist and develop a better understanding of their role. They praised the trainees' skills with nervous patients and children and their preventative work. A therapist on the team released the dentist for more complex treatments. Challenges related to the recruitment of trainees and trainers, the relative lack of knowledge about the work of dental therapists, concerns about maintaining the range of therapy skills and issues about UDA (unit of dental activity) distribution. There was widespread support for a mandatory TVT scheme. This scheme could be improved by providing further guidance on the amount and type of clinical experience required.

Summary of: Modelling workforce skill-mix: how can dental professionals meet the needs and demands of older people in England?

Background There is an urgent need to consider the skill-mix of the dental team to meet the oral health needs and demands of the population in general, and older people in particular. As people live longer and retain their teeth there will be a progressive change in both the volume and type of dental care required, and the demand for care. Operational research modelling provides the opportunity to examine and test future scenarios for National Health Service (NHS) care.Aim The aim of this research was to explore the required skill-mix of the dental team to meet future need and demand of older people in England to 2028 utilising operational research methods and to examine a range of future scenarios.Method A three-stage computer model was developed to consider demand for dental care, workforce supply and skill-mix. First, the demand model combined population demography and a marker of oral health with attendance and treatment rates based on NHS activity data. Monte Carlo simulation was used to give an indication of the uncertainty surrounding this projected demand. Second, projections on workforce supply and other assumptions relating to clinical hours, NHS commitment and workforce whole time equivalents (WTEs) were analysed to produce a range of estimates for the current and future workforce. Third, staff skill-mix competencies were examined and the data fed into an optimisation model. Linear programming was used to give the optimal workforce makeup and predictions for workforce requirements. Five future scenarios were run from 'no skill-mix' through to 'maximum skill-mix' in the dental team, and the outputs compared.Results The results indicate that by 2028 there will be an increase in demand for care among older people of over 80% to almost 8.8 million hours; however, Monte Carlo simulation suggests considerable uncertainty surrounding the demand model outputs with demand deviating from the average in terms of treatment hours by as much as 22%. Modelling a healthcare system with 'no skill-mix' resulted in the lowest volume of clinical staff equivalents (dentists: 8,668) providing care for older people, whereas maximum skill-mix involved more staff (clinical staff = 10,337, of whom 2,623 were dentists, 4,180 hygienist/therapists and 3,534 clinical dental technicians) if all care is provided at the relevant level of competence.Conclusion The model suggests that with widening skill-mix, dental care professionals can play a major role in building dental care capacity for older people in future. The implications for health policy, professional bodies and dental teamworking are discussed.

Developing guidelines for postgraduate dental educators in the UK.

Commissioned by the UK Committee of Postgraduate Dental Deans and Directors (COPDEND), the purpose of this work was to establish UK guidelines for dental educators. The final document comprises 79 statements, in eight domains. Each domain has four zones related to what dental educators (1) know, (2) do with members of the dental team as learners, (3) do with other dental educators as learners and (4) lead on. Launched in November 2008, the document provides a framework of good practice for use in the employment, development and management of dental educators in the UK. The guidelines are readily available from the COPDEND website. A key purpose of this paper is to report on the process of development and a central part of that was the integration of feedback and consultation on early drafts. These processes elicited a total of 102 responses. Issues raised in consultation included: (1) how the zones interrelate; (2) differentiation between domains; (3) measurability; and (4) implementation challenges. This paper includes our responses to these issues.

High-pressure synthesis and study of the crystal and magnetic structure of the distorted SeNiO3 and SeMnO3 perovskites.

We describe the preparation of SeMO(3) (M = Ni, Mn) under high pressure conditions (3.5 GPa), starting from reactive H(2)SeO(3) and MO mixtures, contained in sealed gold capsules under the reaction conditions 850 degrees C for 1 h. The polycrystalline samples have been studied by neutron powder diffraction (NPD) data and magnetization measurements. SeMO(3) (M = Ni, Mn) are orthorhombically distorted perovskites (space group Pnma). Below T(N) approximately 104 K (M = Ni) and T(N) approximately 53.5 K (M = Mn) these oxides experience an antiferromagnetic ordering, as demonstrated by susceptibility and NPD measurements. The magnetic reflections observed in the neutron patterns can be indexed with a propagation vector k = 0. Both compounds present the same magnetic structure, which is given by the basis vector (0, 0, A(z)). It can be described as antiferromagnetic (010) layers of magnetic moments lying along the c direction, which are antiferromagnetically coupled along the b direction. For the Ni(2+) ions, the ordered magnetic moment at T = 2.3 K is 2.11(3) micro(B), whereas for Mn(2+) at T = 2.6 K, |m| = 4.64(2) micro(B), consistent with the electronic configurations te (Ni(2+)) and te (Mn(2+)).

Developing an index of restorative dental treatment need.

The process undertaken to establish an initial pilot index for restorative dental treatment is described. Following consultation with a wide range of clinicians and others, an outline framework for the index was developed and comprised three main components: 1. Patient identified need for treatment: the data from the patient perceived need questionnaire were inconclusive; 2. Complexity of treatment (assessed by clinicians): this was found to be a practical tool capable of being used by a range of dentists. A booklet has been produced which describes the process of using the scoring system; 3. Priority for treatment (assessed by clinicians): three levels of priority were identified; the highest priority was assigned to patients with inherited or developmental defects that justify complex care (eg clefts of the lip and palate). The initial development of the index has had some success in a difficult area. The treatment complexity component is the most developed and may allow both referrers and commissioners of specialist restorative dentistry to determine appropriate use of skilled clinicians' expertise.

A public perception of access to NHS dentistry.

OBJECTIVE: To quantify the level of unmet dental access need which had been reported locally and to provide information about the perceived need for dental treatment with particular reference to those not registered for continuing NHS care. DESIGN: A postal survey of adults resident in Aylesbury Vale, Buckinghamshire was carried out toward the end of 1994. SUBJECTS AND METHODS: 2000 adults aged between 35 and 54 years were randomly selected: RESULTS: A response rate of 68% matched well with the population under study. 16% of people were unable to access any regular dental care and this group had the highest treatment need, with more experience of broken fillings and toothache within the previous year. 15% thought they were registered with an NHS dentist, but were not. Only 28% of all respondents were confirmed registered with an NHS dentist. 27% said they received private care, and one-third of these said it was because they had been unable to find an NHS dentist. In total, 74% of the population under study thought they were receiving regular dental care and only 6% did not want regular care. More than one-third of respondents volunteered comments about dental services. The majority were supportive of dentists but critical of the lack of NHS provision. CONCLUSIONS: This survey indicates a substantial unmet perceived need in Aylesbury Vale, with more than one-third of this population unable to access continuing NHS dental services which they prefer. There is also a need for emergency and occasional dental treatment for a small proportion of this population. It is likely that a similar situation exists elsewhere in England.

Pattern-visual evoked potentials in thinner abusers.

Organic solvents cause injury to lipids of neuronal and glial membranes. A well known characteristic of workers exposed to thinner is optic neuropathy. We decided to look for neurophysiologic signs of visual damage in patients identified as thinner abusers. Pattern reversal visual evoked potentials was performed on 34 thinner abuser patients and 30 controls. P-100 wave latency was found to be longer on abuser than control subjects. Results show the possibility of central alterations on thinner abusers despite absence of clinical symptoms.