A survey of stress, burnout and well-being in UK dentists.

Introduction: It is well established that dentistry is a stressful profession, primarily due to the nature and working conditions in the dental surgery. With dramatic changes taking place in the profession in recent years it is important to establish the impact this has on dentists' well-being. Aims: To determine the levels of stress and burnout in UK dentists and how this relates to well-being and identify the sources of work-related stress dentists report in different fields of practice. Materials and method: An online survey comprising of validated measures examining stress, burnout and well-being in dentists was administered to British Dental Association (BDA) members and non-members. Results: Valid responses were received from 2053 respondents. Dentists working in the UK exhibit high levels of stress and burnout and low well-being. General dental practitioners (GDPs) seem to be particularly affected. Issues relating to regulation and fear of litigation were deemed to be the most stressful aspects of being a dentist. Conclusions: The findings from this study build upon existing research showing that dentistry is a stressful profession. The sources of this stress appear to have shifted over the years, highlighting the changing landscape of dentistry. Interventions should focus on addressing these stressors by making changes to the working conditions of dentists.

Dental corporates abroad and the UK dental market.

The UK government opened NHS dentistry to competition in 2006. By 2015-2016 just over three quarters of NHS contracts were held by non-corporate providers with corporate contracts, on average, having a lower £:UDA (unit of dental activity) value and higher UDA targets than non-corporate contracts. The corporate market share continues to expand through inorganic and organic growth and new financial backers are entering the arena. It is not known how these changes will affect the profession though inspiration can be drawn from overseas markets. In this article I aim to provide an overview of the dental corporate market in the USA and Australia as well as some insight as to how the sector stands in England.

Associates and their working environment: a comparison of corporate and non-corporate associates.

Introduction The share of the dental market held by corporate bodies continues to increase. With the profession currently facing many challenges it is important to understand their place in the profession and their effect.Aim This exploratory study aims to provide an insight into dental associates in relation to their working environment. Specifically, the differences between working in corporate and non-corporate environments in England.Materials and methods Secondary analysis of a self-report questionnaire examining demographics, pay, working conditions, job satisfaction and morale using a combination of closed and open-ended responses sent to randomly selected associate dentists who are BDA members. Responses from associates working in England solely in either the corporate or non-corporate sector were analysed.Results Significant differences were seen between associates working in corporate practice when compared to those in non-corporates practice, for example, significantly less corporate associates were female and corporate associates reported relatively lower levels of autonomy and control.Discussion The differences seen between sectors could be related to rationalisation and should this be the reality it could have far reaching effects on the profession and its ability to manage itself.Conclusion This study highlights some differences between the corporate and non-corporate dental sectors. Further work is needed to build a deeper understanding of the sector.

The history of dental bodies corporate and the role of the BDA in their development.

Dental bodies corporate are not a new phenomenon with companies having practised dentistry in the UK for over a hundred years. At the turn of the twentieth century, unregistered practice was common with dental companies resulting in extensive malpractice. Corporate dentistry introduced commercial interests into the profession and brought further dangers such as treatment not being patient-centred. The British Dental Association (BDA) was among those who continuously worked to mitigate these effects. Increasingly strict measures were introduced by governments to protect the public from harm from corporate practice with the government eventually remedying concerns, in the 1950s, by restricting corporate practice. In 2006 this restriction was lifted, with the support of the BDA, in an effort to increase competition and choice and open up the market to new providers. While the profession continues to develop, concerns remain. Some are long held with others, such as a negative effect on working conditions and UDA values, being relatively recent developments.

Prominent features in isotopic, chemical and dust stratigraphies from coastal East Antarctic ice sheet (Eastern Wilkes Land).

In this work we present the isotopic, chemical and dust stratigraphies of two snow pits sampled in 2013/14 at GV7 (coastal East Antarctica: 70°41' S - 158°51' E, 1950 m a.s.l.). A large number of chemical species are measured aiming to study their potentiality as environmental changes markers. Seasonal cluster backward trajectories analysis was performed and compared with chemical marker stratigraphies. Sea spray aerosol is delivered to the sampling site together with snow precipitation especially in autumn-winter by air masses arising from Western Pacific Ocean sector. Dust show maximum concentration in spring when the air masses arising from Ross Sea sector mobilize mineral dust from ice-free areas of the Transantarctic mountains. The clear seasonal pattern of sulfur oxidized compounds allows the dating of the snow-pit and the calculation of the mean accumulation rate, which is 242 ± 71 mm w.e. for the period 2008-2013. Methanesulfonic acid and NO3- do not show any concentration decreasing trend as depth increases, also considering a 12 m firn core record. Therefore these two compounds are not affected by post-depositional processes at this site and can be considered reliable markers for past environmental changes reconstruction. The rBC snow-pit record shows the highest values in summer 2012 likely related to large biomass burning even occurred in Australia in this summer. The undisturbed accumulation rate for this site is demonstrated by the agreement between the chemical stratigraphies and the annual accumulation rate of the two snow-pits analysed in Italian and Korean laboratories.

Abrupt change of Antarctic moisture origin at the end of Termination II.

The deuterium excess of polar ice cores documents past changes in evaporation conditions and moisture origin. New data obtained from the European Project for Ice Coring in Antarctica Dome C East Antarctic ice core provide new insights on the sequence of events involved in Termination II, the transition between the penultimate glacial and interglacial periods. This termination is marked by a north-south seesaw behavior, with first a slow methane concentration rise associated with a strong Antarctic temperature warming and a slow deuterium excess rise. This first step is followed by an abrupt north Atlantic warming, an abrupt resumption of the East Asian summer monsoon, a sharp methane rise, and a CO(2) overshoot, which coincide within dating uncertainties with the end of Antarctic optimum. Here, we show that this second phase is marked by a very sharp Dome C centennial deuterium excess rise, revealing abrupt reorganization of atmospheric circulation in the southern Indian Ocean sector.

Orbital and millennial Antarctic climate variability over the past 800,000 years.

A high-resolution deuterium profile is now available along the entire European Project for Ice Coring in Antarctica Dome C ice core, extending this climate record back to marine isotope stage 20.2, approximately 800,000 years ago. Experiments performed with an atmospheric general circulation model including water isotopes support its temperature interpretation. We assessed the general correspondence between Dansgaard-Oeschger events and their smoothed Antarctic counterparts for this Dome C record, which reveals the presence of such features with similar amplitudes during previous glacial periods. We suggest that the interplay between obliquity and precession accounts for the variable intensity of interglacial periods in ice core records.

An oceanic cold reversal during the last deglaciation.

A detailed deuterium excess profile measured along the Dome C EPICA (European Project for Ice Coring in Antarctica) core reveals the timing and strength of the sea surface temperature changes at the source regions for Dome C precipitation. We infer that an Oceanic Cold Reversal took place in the southern Indian Ocean, 800 years after the Antarctic Cold Reversal. The temperature gradient between the oceanic moisture source and Antarctica is similar to the Dome C sodium profile during the deglaciation, illustrating the strong link between this gradient and the strength of the atmospheric circulation.