The knowledge mobilisation challenge: does producing evidence lead to its adoption within dentistry?

The transfer of evidence into clinical practice is the ultimate aim of those engaged in health research. But is this a process that occurs naturally? Can health researchers take it for granted that the evidence they produce will be embraced by clinicians and incorporated into their everyday practice? In this article, we use the example of oral healthcare in dependent older people and the issue of antibiotic prescribing by GDPs to illustrate the fact that successful knowledge transfer between researchers and practitioners cannot be automatically assumed. What is needed, so we argue, are certain tools to facilitate the knowledge transfer, exchange and implementation process. These tools may take the form of human intermediaries, who can occupy the space in between the worlds of research and practice, acting as brokers to mobilise knowledge, or through the establishment of communities of practice. We outline both of these approaches here as a potential solution to the problem of knowledge mobilisation in dentistry.

Detecting the earliest radiological signs of bisphosphonate-related osteonecrosis.

Introduction Oral bisphosphonates are the most commonly prescribed anti-resorptive drugs used in the treatment of osteoporosis, but osteonecrosis of the jaw is a serious complication. The early diagnosis of this destructive side effect is crucial in preventing excessive bone loss, pain and infection.Objective To aid dental practitioners in the early identification of bisphosphonate-related osteonecrosis of the jaw.Method A scoping review was carried out.Data sources We searched MEDLINE via OVID, EMBASE via OVID, Dentistry and Oral Sciences Source (DOSS), Proquest Dissertation and Theses Search, to identify references that described clinical and radiological findings in medication-related osteonecrosis of the jaw (MRONJ).Data selection Nineteen references mentioned the earliest radiological changes in MRONJ with a description of the observations and were included in the analysis.Data synthesis The radiographic signs included osteosclerosis/lysis, widening of the periodontal ligament and thickening of the lamina dura and cortex. To assess the quality of original data on which recommendations had been made, these 19 studies were subjected to a quality appraisal.Conclusion Using bone exposure as a criterion for diagnosis of MRONJ, leads to delayed diagnosis and a poor response to treatment. In those patients at risk of bone exposure with MRONJ, insufficient information is present in the literature to allow the general dental practitioner to reliably identify the radiographic features indicating imminent bone exposure. A well-designed prospective study is needed.

Guidelines on the timing and frequency of bitewing radiography: a systematic review.

Objectives To identify guidelines on when and how frequently bitewing radiographs should be used in dentistry for the diagnosis of caries, and to provide an objective appraisal of their quality.Data sources MEDLINE (OVID), US National Guideline Clearinghouse (www.guideline.gov) and the Royal College of Surgeons of England (https://www.rcseng.ac.uk/fds/publications-clinical-guidelines/clinical_guidelines) websites were searched using a variety of relevant search terms (2 August 2016).Data selection Publications were included if they made recommendations on the issue of when and how frequently radiographs should be used in any dentally-related specialty pertaining to the diagnosis of caries; and/or if they were aimed at the individual practitioner (any health professional working within dentistry) and/or patients.Data analysis Thirteen published guidelines were included and assessed using the AGREE II instrument.Conclusions There was a significant variation amongst the guidelines in the recommendations at what age radiography should be undertaken. There was also disagreement on the frequency of repeat radiographs and how this is influenced by the age of the patient and their caries risk.

Feather meal as a nonspecific nitrogen source for abdominal fat reduction in broilers during the finishing period.

Earlier studies have shown that excessive abdominal fat deposition in broilers can be overcome by feeding feather meal (FM) during the finishing period (7 or 14 days prior to slaughter). Studies were conducted to determine if the observed fat reduction in FM-fed birds was due to factors other than supplying excess protein. The FM was added at levels of 4, 6, and 8% and glycine at levels of .125, .25, and .5%, similar to amounts contributed by corresponding levels of FM. Corn-soybean diets were also formulated at protein levels corresponding to those of FM diets. All experimental diets were fed from 35 to 49 or from 42 to 49 days of age. There were no significant differences in weight gain and feed efficiency of treatment and control groups during the study. The addition of glycine resulted in a significant (P less than .05) reduction in abdominal fat content and appeared to be partially responsible for the observed reduction in FM-fed birds. Increasing the dietary protein level also significantly (P less than .05) reduced abdominal fat deposition regardless of protein source. The study indicates that lower quality protein sources such as FM can be effectively used as a nonspecific nitrogen source for reducing abdominal fat deposition during the finishing period.

The effects of increased levels of niacin supplementation on growth rate and carcass composition of broiler chickens.

Four experiments were conducted to examine the response of broiler chickens to different levels of niacin. Practical-type diets, calculated to contain from 20.7 to 23.7 mg niacin per kg from intact ingredients, were fortified with a complete vitamin mixture which provided 33 mg supplemental niacin per kg of diet, in excess of the National Research Council (1977) suggested requirement of 27 mg per kg through 6 weeks of age. A niacinamide supplement was used to provide additional levels of 0, 33, or 66 mg per kg. Diets differed in content of added fat and energy levels in two of the experiments and in the presence or absence of animal protein sources in two others. The addition of niacinamide at 33 and 66 mg per kg to a diet already supplemented with 33 mg per kg from a complete vitamin premix, calculated to exceed the present NRC suggested requirement, resulted in improved body weight gains with sex differences noted in some experiments. Feed utilization was improved in some studies. There was no effect on the amount of abdominal fat or carcass dressing percentage. The results of these studies indicate that the modern rapidly growing broiler chick may require niacin levels greater than those generally recommended by the National Research Council (1977), which are based largely on studies where performance was considerably lower than obtained with the modern strains of broilers.

Steam versus hot-water scalding in reducing bacterial loads on the skin of commercially processed poultry.

A comparison of two types of scalders was conducted to determine their effectiveness in reducing bacterial contamination of poultry carcasses. A conventional hot-water scalder and a prototype model of a steam scalder were tested under commercial conditions. Total plate counts from steam-scalded birds were significantly lower than the counts of water-scalded birds immediately after scalding and again after picking. No differences in the two methods could be found after chilling. Coliform counts from steam-scalded birds were significantly lower than the counts from water-scalded birds immediately after scalding. No significant differences in coliform counts were detected when the two scald methods were compared after defeathering and chilling.