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  • Weiner Villumsen posted an update 5 days, 8 hours ago

    Objective Attendance at accident and emergency departments (A&E) for non-traumatic dental conditions (NTDC) is increasing in high-income countries. Not all NTDC visits to A&E are inappropriate; however, those that are take up capacity with conditions which are adding to the pressure regarding cost and healthcare utilisation for A&E departments. The scale of this problem is yet to be understood in the United Kingdom (UK). The aim of this study was to systematically review the literature to identify peer-reviewed research publications reporting non-traumatic dental presentations at A&E departments in the UK.Data sources A structured search of Cochrane Library, EMBASE, MEDLINE, CINAHL, PsycINFO, Scopus and Web of Science databases from their earliest date to May 2018. Hand-searching of identified articles that met the inclusion criteria was also reviewed.Data selection Publications were included if they were primary research on A&E users in the UK with NTDC as the primary reason for the A&E visit.Data extraction Data were extracted on the study, patient and visit characteristics.Data synthesis Studies were assessed for methodological quality and the analysis took the form of a narrative review.Conclusion There is limited evidence, of variable quality, to inform on the extent of inappropriate presentations of patients with non-urgent NTDC to A&E departments in the UK. The evidence supports the hypothesis that dental patients are inappropriately seeking care for NTDC at A&E departments and this may be a driver of unnecessary antibiotic prescriptions. Further research should focus on the reasons for this occurrence.Introduction Oral health promotion interventions should be evidence-based and designed with community involvement. In England, Family Hubs are attended by families from a range of social backgrounds and provide an ideal setting for co-design of health interventions.Aim To co-design and evaluate an animated film for promoting oral health in community settings.Methods Families attended two co-design workshops at a Family Hub in Portsmouth, during which they discussed oral health priorities and commented on the animation design. A before-and-after survey questionnaire assessed its impact on oral health knowledge in another Family Hub in Portsmouth. Qualitative data were analysed using the Framework method, while the survey data were analysed descriptively.Results Families prioritised evidence-based advice for inclusion in the film and contributed to the film storyline. This enabled relevant alterations to ensure the animation was engaging and age-appropriate. Although the survey response rate was low for inferential statistics, descriptive analysis indicated variation in the oral health knowledge of parents and carers.Conclusion Families can offer valuable contributions to the design of health promotion interventions. A co-design method provides an approach for communicating health advice in a form that is relevant and applicable to target audiences.This paper explains how to screen tooth wear in general practice using the Basic Erosive Wear Examination (BEWE) index. It explains how stakeholders in the UK acknowledged the convenience of the BEWE and that it could be recorded at the same time as the Basic Periodontal Examination (BPE). The article contains examples of anterior and posterior tooth wear for each BEWE score to help dentists in their evaluation.Ongoing social, political and ecological changes in the 21st century have placed more people at risk of life-threatening acute and chronic infections than ever before. The development of new diagnostic, prophylactic, therapeutic and curative strategies is critical to address this burden but is predicated on a detailed understanding of the immensely complex relationship between pathogens and their hosts. Traditional, reductionist approaches to investigate this dynamic often lack the scale and/or scope to faithfully model the dual and co-dependent nature of this relationship, limiting the success of translational efforts. With recent advances in large-scale, quantitative omics methods as well as in integrative analytical strategies, systems biology approaches for the study of infectious disease are quickly forming a new paradigm for how we understand and model host-pathogen relationships for translational applications. Here, we delineate a framework for a systems biology approach to infectious disease in three parts discovery – the design, collection and analysis of omics data; representation – the iterative modelling, integration and visualization of complex data sets; and application – the interpretation and hypothesis-based inquiry towards translational outcomes.The microbiota colonizing the root endophytic compartment and surrounding rhizosphere soils contribute to plant growth and health. Salubrinal However, the key members of plant soil and endophytic microbial communities involved in inhibiting or assisting pathogen invasion remain elusive. By utilizing 16S high-throughput sequencing and a molecular ecological network (MEN) approach, we systematically studied the interactions within bacterial communities in plant endophytic compartments (stem and root) and the surrounding soil (bulk and rhizosphere) during bacterial wilt invasion. The endophytic communities were found to be strongly influenced by pathogen invasion according to analysis of microbial diversity and community structure and composition. Endophytic communities of the infected plants were primarily derived from soil communities, as assessed by the SourceTracker program, but with rare migration from soil communities to endophytic communities observed in healthy plants. Soil and endophytic microbiomes from infected plants showed modular topology and greater complexity in network analysis, and a higher number of interactions than those in healthy plants. Furthermore, interactions among microbial members revealed that pathogenic Ralstonia members were positively correlated with several bacterial genera, including Delftia, Stenotrophomonas, Bacillus, Clostridium XlVa, Fontibacillus, Acidovorax, Herminiimonas, and three unclassified bacterial genera, in infected plant roots. Our findings indicated that the pathogen invasion in the rhizosphere and endophytic compartments may be highly associated with bacteria that are normally not detrimental, and sometimes even beneficial, to plants.

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