215 resultados para CPD


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Aims: To determine the self-assessed continuing professional development (CPD) needs of dental practitioners and identify how each discipline can best be served by a dental CPD programme. To set findings in the context of the available literature and contribute to the development of CPD programmes. Method: Topics were arranged into eight disciplines: practice management; paediatric dentistry; preventive dentistry; orthodontics; behaviour management; dentistry for people with a disability; oral medicine and surgery; and, restorative dentistry. A web-based questionnaire was constructed and administered using a MarkClass 2.21 online survey tool. Results: Fifty-six self-reported assessment responses were received, with three-quarters of participants having graduated within the past 10 years. Topics in oral medicine and surgery attracted consistently high levels of interest. A tendency to favour topics with a perceived direct clinical application was observed. Topics recommended by the Dental Council as core areas for CPD were given a high level of priority by respondents. Conclusions: Traditional lectures remain a valued mode of CPD participation. Practical courses were valued across all dental topics offered. A varied approach to determining the requirements of dentists is essential to appropriately support the practitioner.

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The recently proposed global monsoon hypothesis interprets monsoon systems as part of one global-scale atmospheric overturning circulation, implying a connection between the regional monsoon systems and an in-phase behaviour of all northern hemispheric monsoons on annual timescales (Trenberth et al., 2000). Whether this concept can be applied to past climates and variability on longer timescales is still under debate, because the monsoon systems exhibit different regional characteristics such as different seasonality (i.e. onset, peak, and withdrawal). To investigate the interconnection of different monsoon systems during the pre-industrial Holocene, five transient global climate model simulations have been analysed with respect to the rainfall trend and variability in different sub-domains of the Afro-Asian monsoon region. Our analysis suggests that on millennial timescales with varying orbital forcing, the monsoons do not behave as a tightly connected global system. According to the models, the Indian and North African monsoons are coupled, showing similar rainfall trend and moderate correlation in rainfall variability in all models. The East Asian monsoon changes independently during the Holocene. The dissimilarities in the seasonality of the monsoon sub-systems lead to a stronger response of the North African and Indian monsoon systems to the Holocene insolation forcing than of the East Asian monsoon and affect the seasonal distribution of Holocene rainfall variations. Within the Indian and North African monsoon domain, precipitation solely changes during the summer months, showing a decreasing Holocene precipitation trend. In the East Asian monsoon region, the precipitation signal is determined by an increasing precipitation trend during spring and a decreasing precipitation change during summer, partly balancing each other. A synthesis of reconstructions and the model results do not reveal an impact of the different seasonality on the timing of the Holocene rainfall optimum in the different sub-monsoon systems. They rather indicate locally inhomogeneous rainfall changes and show, that single palaeo-records should not be used to characterise the rainfall change and monsoon evolution for entire monsoon sub-systems.

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Introduction
The intersection between the law of negligence and sport coaching in the UK is a developing area (Partington, 2014; Kevan, 2005). Crucially, since the law of negligence may be regarded as generally similar everywhere (Magnus, 2006), with the predominance of volunteer coaches in the UK reflective of the majority of countries in the world (Duffy et al., 2011), a detailed scrutiny of this relationship from the perspective of the coach uncovers important implications for coach education beyond this jurisdiction.  
Argumentation
Fulfilment of the legal duty of discharging reasonable care may be regarded as consistent with the ethical obligation not to expose athletes to unreasonable risks of injury (Mitten, 2013). More specifically, any ‘profession’ requiring ‘special skill or competence’ (Bolam v Friern Hospital Management Committee [1957] 1 WLR 582), including the coaching of sport (e.g., Davenport v Farrow [2010] EWHC 550), requires a higher standard of care to be displayed than would be expected of the ordinary reasonable person (Lunney & Oliphant, 2013; Jones & Dugdale, 2010). For instance, volunteer coaches with no formal qualifications (e.g., Fowles v Bedfordshire County Council [1996] ELR 51) would be judged by this benchmark of professional liability (Powell & Stewart, 2012). Further, as the principles of coaching are constantly assessed and revised (Cassidy et al., 2009; Taylor & Garratt, 2010), so too is the legal standard of care required of coaches (Powell & Stewart, 2012). Problematically, ethical concerns may include coaches being unwilling to increase knowledge, abusive treatment of players and incompetence/inexperience (Haney et al., 1998). These factors accentuate coaches’ exposure to civil liability.
Implications
It is imperative that coaches have an awareness of this emerging intersection and develop a ‘proactive risk assessment lens’ (Hartley, 2010). In addition to supporting the professionalisation of sport coaching, coach education/CPD focused on the legal and ethical aspects of coaching (Duffy et al., 2011; Telfer, 2010; Haney et al., 1998) would enhance the safety and welfare of performers, safeguard coaches from litigation risk, and potentially improve all levels of coaching (Partington, 2014). Interestingly, there is evidence to suggest a demand from coaches for more training on health and safety issues, including risk management and (ir)responsible coaching (Stirling et al., 2012). Accordingly, critical examination of the issue of negligent coaching would inform coach education by: enabling the modelling and sharing of best practice; unpacking important ethical concerns; and, further informing the classification of coaching as a ‘profession’.

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Résumé : Les télomères sont des structures nucléoprotéiques spécialisées qui assurent la stabilité du génome en protégeant les extrémités chromosomiques. Afin d’empêcher des activités indésirables, la réparation des dommages à l’ADN doit être convenablement régulée au niveau des télomères. Pourtant, il existe peu d’études de la réparation des dommages induits par les ultraviolets (UVs) dans un contexte télomérique. Le mécanisme de réparation par excision de nucléotides (NER pour « Nucleotide Excision Repair ») permet d’éliminer les photoproduits. La NER est un mécanisme très bien conservé de la levure à l’humain. Elle est divisée en deux sous voies : une réparation globale du génome (GG-NER) et une réparation couplée à la transcription (TC-NER) plus rapide et plus efficace. Dans notre modèle d’étude, la levure Saccharomyces cerevisiae, une forme compactée de la chromatine nommée plus fréquemment « hétérochromatine » a été décrite. Cette structure particulière est présente entre autres, au niveau des régions sous-télomériques des extrémités chromosomiques. La formation de cette chromatine particulière implique quatre protéines nommées Sir (« Silent Information Regulator »). Elle présente différentes marques épigénétiques dont l’effet est de réprimer la transcription. L’accès aux dommages par la machinerie de réparation est-il limité par cette chromatine compacte ? Nous avons donc étudié la réparation des lésions induites par les UVs dans différentes régions associées aux télomères, en absence ou en présence de protéines Sir. Nos données ont démontré une modulation de la NER par la chromatine, dépendante des nucléosomes stabilisés par les Sir, dans les régions sous-télomériques. La NER était moins efficace dans les extrémités chromosomiques que dans les régions plus proches du centromère. Cet effet était dépendant du complexe YKu de la coiffe télomérique, mais pas dépendant des protéines Sir. La transcription télomériques pourrait aider la réparation des photoproduits, par l’intermédiaire de la sous-voie de TC-NER, prévenant ainsi la formation de mutations dans les extrémités chromosomiques. Des ARN non codants nommés TERRA sont produits mais leur rôle n’est pas encore clair. Par nos analyses, nous avons confirmé que la transcription des TERRA faciliterait la NER dans les différentes régions sous-télomériques.

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Este módulo presenta una introducción a la situación macroeconómica del sector del retail español con el fin de situarnos en el tema que vamos a estudiar. Así se analizará la situación financiera del país, haciendo referencia al PIB, tasas de paro, tasas de ahorro y de consumo de los hogares, y nivel de importaciones y exportaciones. También se comentará cuál es el estado de ánimo de los españoles ante la situación actual, tanto de empresas como de consumidores; y las expectativas de recuperación de los mismos.

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Purpose: the aim of this pilot study was to test whether retinitis pigmentosa patients would benefit from filter contact lenses as an effective optical aid against glare and photophobia. Methods: fifteen subjects with retinitis pigmentosa were enrolled in this study. All of them were evaluated with filter soft contact lenses (MaxSight), filter glasses (CPF 527) and without filters (control). All patients were assessed for the three aid conditions by means of best corrected visual acuity (BCVA), contrast sensitivity (without glare and with central and peripheral glare)(CSV-1000) and a specific subjective questionnaire about quality of vision. Results: BCVA was slightly better with filters than without filter but the differences were not statistically significant. Contrast sensitivity without glare improved significantly with the contact lenses (p<0.05). The central glare had significant differences for the frequencies of 3 cpd and 18 cpd between the contact lens filter and the control group (p=0.021 and p=0.044, respectively). For the peripheral glare contrast sensitivity improved with contact lens versus control group for highest frequencies, 12 and 18 cpd (p<0.001 and p=0.045, respectively). According to the questionnaire the contact lens filter gave them more visual comfort than the glasses filter under the scenarios of indoors glare, outdoors activities and indoors comfort. Conclusion: the filter contact lenses seem to be a good option to improve the quality of vision of patients with retinitis pigmentosa.

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El objetivo de este estudio fue determinar el efecto de un programa de ejercicio aeróbico y un programa de circuito con pesas sobre la calidad de vida, disnea y resistencia cardiorrespiratoria en sujetos con Enfermedad Pulmonar Crónica (EPC). Metodología: el programa de rehabilitación se hizo durante ocho semanas, se realizó un pretest y un postest, se cumplió con una sesión semanal presencial, y las otras dos domiciliarias, se tuvo comunicación directa vía telefónica los días que realizaban el ejercicio en la casa. Instrumentos: el cuestionario St. George Respiratory Questonnaire para medir calidad de vida, la escala de Borg para medir la disnea y el test de caminata de los 6 min. para medir la resistencia cardiorrespiratoria. Sujetos: participaron 38 personas con diagnóstico previo de EPC, 18 hombres y 20 mujeres; 27 sujetos con patología obstructiva y 11 sujetos con restrictiva., con una edad promedio de 69.8 ± 9.34 años, divididos aleatoriamente en dos grupos, uno que realizó ejercicio aeróbico (22 sujetos) y otro que ejecutó ejercicio aeróbico y de contrarresistencia con pesas (16 sujetos). Análisis estadístico: ANOVA mixta de cuatro vías (2x2x2x2) para las variables mediciones, sexo, tratamiento y patología. Resultados: se encontraron diferencias significativas entre mediciones para la variable disnea (pre: 7.18 ± 0.69 puntos y post: 4.89 ± 0.68 puntos) (F = 228.770; p < 0,05), calidad de vida (pre: 59.68 ± 7.50 puntos y post 81.75 ± 7.33 puntos) (F = 228.770; p < 0,05), resistencia cardiorrespiratoria (pre 384,95 ± 51,02 mts. y post 432 ± 37,41 mts.) (F: 59.9; p<0.01), pero no se encontraron diferencias por sexo, actividad ni enfermedad (p>0,05), ni interacción entre las variable (p>0,05). Conclusión: la realización de ejercicio físico aeróbico y anaeróbico mejoran el grado de disnea, la calidad de vida y resistencia cardiorrespiratoria en pacientes con EPC.

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Background In recent years new models of intraocular lenses are appearing on the market to reduce requirements for additional optical correction. The purpose of this study is to assess visual outcomes following bilateral cataract surgery and the implant of a FineVision® trifocal intraocular lens (IOL). Methods Prospective, nonrandomized, observational study. Vision was assessed in 44 eyes of 22 patients (mean age 68.4 ± 5.5 years) before and 3 months after surgery. Aberrations were determined using the Topcon KR-1 W wave-front analyzer. LogMAR visual acuity was measured at distance (corrected distance visual acuity, CDVA 4 m), intermediate (distance corrected intermediate visual acuity, DCIVA 60 cm) and near (distance corrected near visual acuity, DCNVA 40 cm). The Pelli-Robson letter chart and the CSV-1000 test were used to estimate contrast sensitivity (CS). Defocus curve testing was performed in photopic and mesopic conditions. Adverse photic phenomena were assessed using the Halo v1.0 program. Results Mean aberration values for a mesopic pupil diameter were: total HOA RMS: 0.41 ± 0.30 μm, coma: 0.32 ± 0.22 μm and spherical aberration: 0.21 ± 0.20 μm. Binocular logMAR measurements were: CDVA −0.05 ± 0.05, DCIVA 0.15 ± 0.10, and DCNVA 0.06 ± 0.10. Mean Pelli-Robson CS was 1.40 ± 0.14 log units. Mean CSV100 CS for the 4 frequencies examined (A: 3 cycles/degree (cpd), B: 6 cpd, C: 12 cpd, D: 18 cpd) were 1.64 ± 0.14, 1.77 ± 0.18, 1.44 ± 0.24 and 0.98 ± 0.24 log units, respectively. Significant differences were observed in defocus curves for photopic and mesopic conditions (p < 0.0001). A mean disturbance index of 0.28 ± 0.22 was obtained. Conclusions Bilateral FineVision IOL implant achieved a full range of adequate vision, satisfactory contrast sensitivity, and a lack of significant adverse photic phenomena. Trial registration Eudract Clinical Trials Registry Number: 2014-003266-2.

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Practice Links is a free e-publication for practitioners working in Irish social services, voluntary and nongovernmental sectors. Practice Links was created to enable practitioners to keep up-to-date with new publications, electronic resources and conference opportunities.

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Practice Links is a free e-publication for practitioners working in Irish social services, voluntary and nongovernmental sectors. Practice Links was created to enable practitioners to keep up-to-date with new publications, electronic resources and conference opportunities.

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Practice Links is a free e-publication for practitioners working in Irish social services, voluntary and nongovernmental sectors. Practice Links was created to enable practitioners to keep up-to-date with new publications, electronic resources and conference opportunities.

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Practice Links is a free e-publication for practitioners working in Irish social services, voluntary and nongovernmental sectors. Practice Links was created to enable practitioners to keep up-to-date with new publications, electronic resources and conference opportunities.

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Practice Links is a free e-publication for practitioners working in Irish social services, voluntary and nongovernmental sectors. Practice Links was created to enable practitioners to keep up-to-date with new publications, electronic resources and conference opportunities.

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Practice Links is a free e-publication for practitioners working in Irish social services, voluntary and nongovernmental sectors. Practice Links was created to enable practitioners to keep up-to-date with new publications, electronic resources and conference opportunities.