Continuing professional development systems and requirements for graduate dentists in the EU: survey results from the DentCPD project

INTRODUCTION

By maintaining skills and keeping dentists up-to-date, continuing professional development (CPD) supports safe clinical practice. However, CPD for dentists across Europe is not harmonised.

AIM

One aim of the 'DentCPD' project (www.dentcpd.org) was to identify and agree essential CPD requirements for EU dentists. As part of the process, data were collected on existing approaches to CPD for EU dentists. This paper reports those findings.

METHODS

Informed by a review of the literature and internet search, the CPD for Graduate Dentists questionnaire gathered data from dental educators on CPD systems, requirements, provision and accreditation in Europe. It sought opinion on mandatory CPD and e-learning.

RESULTS

Responses were received from 143 individuals from 30 EU countries. About half the countries had a compulsory CPD system which typically included mandatory core topics. Elsewhere CPD was optional or based on recommended hours. University dental schools and professional dental associations were the most common CPD providers. National regulatory bodies were the most common accrediting body. Only 41% of respondents thought they knew the criteria for successful accreditation of CPD. Eighty-one percent agreed that 'CPD should be obligatory for all dentists'.

CONCLUSION

These results present an overview of the status of CPD for EU dentists. Despite a notable trend towards regulated CPD systems, current requirements for dentists to engage in CPD show variation. The harmonisation of requirements would enhance both dentist mobility and safe clinical practice.

Core continuing professional development (CPD) topics for the European dentist

INTRODUCTION

In the context of free movement, EU-citizens need assurance that dental practitioners providing their care have a degree/license to practice that meets EU-standards and that they maintain their knowledge and skills through ongoing education.

AIM

One aim of the 'DentCPD' project (HYPERLINK 'http://www.dentcpd.org' www.dentcpd.org) was to identify and agree essential CPD requirements for EU dentists. This paper reports the consensus process and outcomes.

METHODS

Agreement on core components of CPD was achieved through a three stage process: an online survey of dental educators' (n = 143) views on compulsory topics; a paper-based questionnaire to practitioners (n = 411); leading to a proposal discussed at the Association for Dental Education (ADEE) 2011 Lifelong Learning special interest group (SIG).

RESULTS

From the online survey and practitioner questionnaire, high levels of agreement were achieved for medical emergencies (89%), infection control (79%) and the medically compromised patient (71%). The SIG (34 attendees from 16 countries) concluded that these three CPD topics plus radiation protection should be core-compulsory and three CPD topics should be core-recommended (health and safety, pain management, and safeguarding children & vulnerable adults). They also agreed that the teaching of all topics should be underpinned by evidence-based dentistry.

CONCLUSION

Building four core topics into CPD requirements and making quality-approved education and training available will ensure that all dentists have up-to-date knowledge and skills in topic areas of direct relevance to patient safety. In turn, this will contribute to patients having access to comparably high standards of oral health care across Europe.

Evaluation of novel renal biomarkers with a cisplatin model of kidney injury: gender and dosage differences

A number of novel urinary biomarkers have been identified and partially qualified for use as markers for renal injury in rats. We use two novel multiplex assays to quantify biomarker concentration in multiple urine collections made prior to and following administration of cisplatin, a common nephrotoxicant, to rats. We investigate the correlation of the magnitude of biomarker changes with the severity of histopathological observations and explore the relationship of these to both dose and sex. The novel biomarkers evaluated are urinary albumin, alpha glutathione s-transferase (α-GST), glutathione S-transferase-yb1 (GSTYb1), lipocalin-2, kidney injury molecule-1 (KIM-1), osteopontin, and renal papillary antigen 1 (RPA-1) and plasma cystatin C, alongside the traditional biomarkers of plasma urea, creatinine, and urinary n-acetyl-beta-d-glucosaminidase (NAG), total protein, and glucose. We show for all time points, and for almost all doses, that male rats consistently had either more severely graded or a higher incidence of histologically observed lesions than females; that changes in urinary glucose, total urinary protein, NAG, and the novel urinary biomarkers albumin, osteopontin, and KIM-1 are clearly temporally associated; and that changes are related to the severity of injury. We also found that receiver operating characteristic curve analysis and area under the curve are significantly higher than urea or creatinine for all new biomarkers except aGST, GSTYb1, cystatin c, and total protein in both sexes.

Stable unstable reliability theory

Classical reliability theory assumes that individuals have identical true scores on both testing occasions, a condition described as stable. If some individuals' true scores are different on different testing occasions, described as unstable, the estimated reliability can be misleading. A model called stable unstable reliability theory (SURT) frames stability or instability as an empirically testable question. SURT assumes a mixed population of stable and unstable individuals in unknown proportions, with w(i) the probability that individual i is stable. w(i) becomes i's test score weight which is used to form a weighted correlation coefficient r(w) which is reliability under SURT. If all w(i) = 1 then r(w) is the classical reliability coefficient; thus classical theory is a special case of SURT. Typically r(w) is larger than the conventional reliability r, and confidence intervals on true scores are typically shorter than conventional intervals. r(w) is computed with routines in a publicly available R package.

Explosions of xenon clusters in ultraintense femtosecond x-ray pulses from the LCLS free electron laser

Explosions of large Xe clusters (<N> ~ 11,000) irradiated by femtosecond pulses of 850 eV x-ray photons focused to an intensity of up to 10(17) W/cm(2) from the Linac Coherent Light Source were investigated experimentally. Measurements of ion charge-state distributions and energy spectra exhibit strong evidence for the formation of a Xe nanoplasma in the intense x-ray pulse. This x-ray produced Xe nanoplasma is accompanied by a three-body recombination and hydrodynamic expansion. These experimental results appear to be consistent with a model in which a spherically exploding nanoplasma is formed inside the Xe cluster and where the plasma temperature is determined by photoionization heating.

Ultrafast x-ray scattering of xenon nanoparticles: imaging transient states of matter

Femtosecond x-ray laser flashes with power densities of up to 10(14) W/cm(2) at 13.7 nm wavelength were scattered by single xenon clusters in the gas phase. Similar to light scattering from atmospheric microparticles, the x-ray diffraction patterns carry information about the optical constants of the objects. However, the high flux of the x-ray laser induces severe transient changes of the electronic configuration, resulting in a tenfold increase of absorption in the developing nanoplasma. The modification in opaqueness can be correlated to strong atomic charging of the particle leading to excitation of Xe(4+). It is shown that single-shot single-particle scattering on femtosecond time scales yields insight into ultrafast processes in highly excited systems where conventional spectroscopy techniques are inherently blind.

A flexible quantitative methodology for the analysis of gene-flow between conventionally bred maize populations using microsatellite markers

Previous studies of gene-flow in agriculture have used a range of physical and biochemical markers, including transgenes. However, physical and biochemical markers are not available for all commercial varieties, and transgenes are difficult to use when trying to estimate gene flow in the field where the use of transgenes is often restricted. Here, we demonstrate the use of simple sequence repeat microsatellite markers (SSRs) to study gene flow in maize. Developing the first quantitative analysis of pooled SSR samples resulted in a high sampling efficiency which minimised the use of resources and greatly enhanced the possibility of hybrid detection. We were able to quantitatively distinguish hybrids in pools of ten samples from non-hybrid parental lines in all of the 24 pair-wise combinations of commercial varieties tested. The technique was used to determine gene flow in field studies, from which a simple model describing gene flow in maize was developed.

Catabolites of chlorophyll in senescing barley leaves are localized in the vacuoles of mesophyll cells

Senescing barley leaves accumulate a series of pink pigments with the chemical properties of catabolites derived from chlorophyll. Levels of the major component of this group of pigments were quantified by HPLC and shown to be maximal in tissues exhibiting maximal rates of chlorophyll degradation. Protoplasts were isolated from senescent leaf tissue and fractionated to yield intact vacuoles and plastids. Although small but significant proportions both of total catabolites and of the dominant component of the series were recovered from the plastid fraction, the vast bulk of these compounds could be assigned to the vacuole. These observations suggest a role for the vacuole in the later stages of chlorophyll breakdown during senescence.

Infant attention, heart rate, and looking time during habituation/dishabituation

Six-month-olds (N=60) were tested in a habituation/dishabituation paradigm during which their heart rate was recorded. In the attention getter condition a salient stimulus appeared prior to each trial. In the no attention getter condition a blank slide appeared. It was hypothesized that the attention getter would lead to a heart rate decrease putting the infant into a state of sustained attention, and facilitate infants' encoding of the habituation stimulus. The encoding hypothesis was strongly supported. Infants in the attention getter condition showed shorter looking times during habituation and correspondingly an increased dishabituation response.

[Transradial approach for interventional cardiology in women]

The treatment of cardiovascular disease has considerably evolved over the past 20 years, resulting in a reduction in cardiovascular mortality among the general population. Such improvement in patient outcome may be partly attributed to interventional cardiology procedures. However, these encouraging results are not uniformly observed in men and women and the rate of cardiovascular mortality in female patients remains unchanged. A number of studies have shown a poorer outcome in women with coronary artery disease undergoing percutaneous coronary intervention. Several reasons may explain the difference in post-PCI outcome between men and women. More advanced age and higher percentage of diabetics are documented clinical factors. Other angiographic factors such as vessel size, smaller in the female population, may also account for such a difference. Finally, the occurrence of vascular complications is one of the reasons affecting the outcome of female patients. The radial vascular approach contributes to the reduction in the incidence of complications which may compromise survival. This vascular route may be more complex in the female population because of the size of the radial artery which is smaller than in men. Nevertheless, the transradial approach is very safe and efficient in experienced hands and it is probably one of the techniques which may help close the prognosis gap between men and women undergoing PCI.

Effect of an integrated reality orientation programme in acute care on post-traumatic amnesia in patients with traumatic brain injury

PRIMARY OBJECTIVE

To assess the effect of an integrated reality orientation programme (North Star Project) in acute care on the duration of post-traumatic amnesia (PTA) of patients suffering from traumatic brain injury (TBI). It was hypothesized that those patients having participated in this programme would show a shorter PTA than those patients that did not.

METHOD

Duration of PTA for 12 patients with TBI who were part of the North Star Project was compared with that of 26 patients matched for initial GCS and age for whom this approach was not available (control group).

RESULTS

Length of PTA was shorter by 5 days for the North Star patients. This result was not statistically significant (p = 0.19) but is clinically relevant. No between-group difference was found for Glasgow Coma Scale.

CONCLUSIONS

Consequences of shorter PTA would include increased and more appropriate patient interaction and earlier transfer to rehabilitation. The North Star project also allows the family to become more actively involved in the treatment of their loved one. Further study is required to evaluate this intervention strategy to improve orientation for the patient with TBI.

Core-hole screening as a probe for a metal-to-nonmetal transition in lead clusters

Metal clusters serve as model systems to study basic problems of electronic correlation. Vacuum ultraviolet light from the free-electron laser FLASH ionizes 5d electrons from mass-separated negatively charged clusters, thus transiently leading to core-ionized neutral systems. Shielding of the core hole affects the electron binding energy. From the strong deviation from expectations of the metallic droplet and jellium models we conclude on reduced electronic shielding once the cluster size falls below about 20 atoms. This suggests a metal-to-nonmetal transition, in agreement with previous local density approximation calculations.