Infection control: current status. risks, research, rules and recycling

We are living through a period of immense change following the outbreak of the COVID-19 pandemic in mainland China in December 2019. Even before the pandemic, the cost of managing healthcare-associated infections in the UK was considerable. The risk of acquiring any infection from the dental environment must be reduced to a minimum. As we have observed in recent years, new infectious agents emerge frequently, and the dental profession must be ready to respond appropriately and quickly. Orthodontic practice presents unique challenges in relation to infection control procedures. The impact of healthcare waste on the environment must also be considered. CPD/Clinical Relevance: This paper describes the range of infectious agents posing a risk to dental team members and patients. The aim is to place the recent coronavirus pandemic in the context of other recent emerging infections. Some of the latest research regarding infection control procedures is reviewed. Current best practice is described.

Download Full-text

Strong governance: a result of evolutionary and revolutionary processes

Journal of Family Business Management ◽

10.1108/jfbm-08-2014-0020 ◽

2014 ◽

Vol 4 (2) ◽

pp. 99-109 ◽

Cited By ~ 1

Author(s):

Lorna Collins ◽

Ken McCracken ◽

Barbara Murray ◽

Martin Stepek

Keyword(s):

Family Business ◽

Best Practice ◽

Family Dynamics ◽

Family Businesses ◽

Formal Structure ◽

Governance Mechanisms ◽

Content Type ◽

The Family ◽

The Uk ◽

The Impact

Purpose – This paper is the first in a regular series of articles in JFBM that will share “a conversation with” thought leaders who are active in the family business space. The world of family business is, like many other arenas, constantly evolving and as the authors learn more about how and why families “do business” the approaches and tools for working with them also evolve. The purpose of this paper is to stimulate further new research in areas that practically affect family businesses and to “open the door” to practical insights that will excite researchers and provide impetus for new and exciting study. The specific purpose of this paper is to explore “what is strong governance.” There has been much interest in governance lately yet there is a tendency to treat governance in a formulaic way such that, at the moment, the notion that every family business must have a family council or a formal structure in order to be considered “effective” and “successful” predominates. The authors’ panel challenges and discusses this notion drawing on the experience and knowledge as family business advisors, consultants and owners. Design/methodology/approach – The impetus for this particular conversation is a result of a brainstorming conversation that Lorna Collins and Barbara Murray held in February 2014 where they focussed on “how JFBM can encourage and stimulate researchers to engage in aspects of research that makes a difference to the family business in a practical way.” This paper reports a conversation between Barbara Murray (Barbara), Ken McCracken (Ken) and Martin Stepek (Martin), three leading lights in the UK family business advising space, all of whom have been involved in running or advising family businesses for more than three decades, held in August 2015. The conversation was held via telephone and lasted just over 60 minutes. Lorna Collins acted as moderator. Findings – Strong governance is not just about instituting a “family council” or embedding formal governance mechanisms in a family business. Evolutionary adaption by family members usually prevails such that any mechanism is changed and adapted over time to suit and fit the needs of the family business. Many successful family businesses do not have recognized “formal” governance mechanisms but, it is contended, they are still highly successful and effective. Future areas of research in governance are also suggested. Originality/value – This paper contributes to the family business discourse because the debate it reports challenges the basic assumptions upon which much consulting and advisory practice is conducted. It also challenges the notion of “best practice” and what is “new best practice” and how is it that any “best practice” is determined to be “best.” Furthermore, the panel provides insights in to the “impact of family dynamics on governance” and “the impact of family dynamics on advisors.” The paper content is original in that it provides an authentic and timely narrative between active family business practitioners who are also scholars and owners.

Download Full-text

A Review of COVID-19 and the Implications for Orthodontic Provision in England

Orthodontic Update ◽

10.12968/ortu.2020.13.3.117 ◽

2020 ◽

Vol 13 (3) ◽

pp. 117-124

Author(s):

Sally Zahran ◽

Natasha Wright

Keyword(s):

Infection Control ◽

Recovery Phase ◽

High Risk Group ◽

Dental Procedures ◽

Close Proximity ◽

Control Procedures ◽

Dental Profession ◽

The Uk ◽

Guidelines And Recommendations

COVID-19 is an unprecedented virus that is destroying the lives of many people worldwide. Dentistry as a profession falls into a high-risk group due to our close proximity to patients and the aerosols generated in routine dental procedures. The UK dental community has frantically searched for answers to questions about the new virus and guidance on provision of dental care. This article will review the most up-to-date recommendations for infection control procedures and use of personal protective equipment (PPE) in England. PubMed, Embase and Google Scholar databases were searched up until 9 June. This is a review of the current information, guidelines and recommendations about the COVID-19 virus and use of PPE for dentists and orthodontists. As of 9 June, the dental profession has received mixed guidance on how best to manage our patients whilst national lockdown is eased and we enter a recovery phase, but uncertainty remains for the long-term provision of Orthodontics. CPD/Clinical Relevance: This article gives an overview of guidance and recommendations for dentists and orthodontists in the UK during the COVID-19 pandemic, especially with regards to infection control and use of PPE.

Download Full-text

British-Slovak Foreign Trade Relations: Consequences of Brexit

Marketing and Management of Innovations ◽

10.21272/mmi.2019.3-26 ◽

2019 ◽

pp. 341-353

Author(s):

Marcel Kordos

Keyword(s):

European Union ◽

Foreign Trade ◽

Policy Instruments ◽

Current Status ◽

The European Union ◽

Economic Relations ◽

Trade Relations ◽

The Future ◽

The Uk ◽

The Impact

The possibility of the UK's withdrawal from the European Union has never been more realistic and up-to-date since joining the European Communities (EC) as it is today. The UK is facing a unique situation. At present, this depends solely on the capabilities of European and British government officials, who negotiate the terms of withdrawal and future cooperation between the two entities. The main goal of this paper is based on the British – Slovak trade relations development analysis to figure out their impact within the Brexit consequences on the future Slovak economy and its current status in international economic relations. The paper also provides a basic overview of Brexit process and its possible impact on the EU's further functioning. Basic data will be drawn from generally accepted institutions, evaluating the UK and Slovak trade and economic performance. To accomplish this goal, methods such as analysis and comparison to illustrate the UK-Slovak foreign trade development, synthesis and logical deduction to discuss the Brexit impact on Slovak economic environment in the future are to be used; data from scientific and professional publications, periodical and non-periodical press. The paper presents the results of an empirical analysis, which showed that because of the size of economic relations between Slovakia and the United Kingdom and the number of goods and services being exported to the UK, the «hard» Brexit will be very unfavourable for Slovak foreign trade due to the possible tariffs being imposed. The research empirically confirms and theoretically proves that it can cause a significant weakening and slowdown in the Slovak economy. Either way, the upcoming Brexit process, that is the withdrawal of Great Britain from the European Union, would have a major impact not only on British, European but also on the world economy. The impact of Brexit on Slovakia's economy will not only be in reducing the possible growth of the economy, but also in employment and price increases. Keywords: EU single market, Britain's withdrawal from the EU, foreign trade policy instruments analysis, international economics, Slovak economy slowdown prediction, Slovak foreign trade commodity structure analysis.

Download Full-text

International ENGOs in China: a Significant Presence and a Fast-Changing Reality

Sinología hispánica ◽

10.18002/sin.v5i2.5413 ◽

2018 ◽

Vol 5 (2) ◽

pp. 113 ◽

Cited By ~ 1

Author(s):

Marco Volpe

Keyword(s):

Mainland China ◽

Current Status ◽

Font Size ◽

Republic Of China ◽

The Public ◽

China Studies ◽

International Climate ◽

The Impact ◽

Historical Profile ◽

Chinese Civil Society

Received:Revised:Accepted:Sinologia Hispanica, China Studies Review,5, 2 (2017), pp. 113-148September 2017November 2017Devember 2017The paper examines the impact that international ENGOs have had on Chinese environment situation and the implication of the Law of People’s Republic of China on the Administration of the Activities of Overseas Nongovernmental Organisations in Mainland China. Based on the review of historical profile of NGOs and their enhanced role within the international politics, the paper analyzes China’s leadership evolutionary behaviour in international climate change conferences and investigates the international ENGOs’ current status, strategies and projects in China. The paper argues that international ENGOs have had a positive, even if limited, impact in protecting Chinese environment and in supporting Chinese civil society to emerge and strengthening the public participation and awareness. It also argues that, the implementation of the new law certainly puts international NGOs under higher scrutiny; however, further implications are, to date, only partially predictable.

Download Full-text

The impact of a spinal best practice tariff on compliance with the British Spine Registry

Bone & Joint Open ◽

10.1302/2633-1462.23.bjo-2020-0182 ◽

2021 ◽

Vol 2 (3) ◽

pp. 198-201

Author(s):

Awais Habeebullah ◽

Harshadkumar Dhirajlal Rajgor ◽

Adrian Gardner ◽

Morgan Jones

Keyword(s):

Spinal Surgery ◽

Best Practice ◽

Financial Incentive ◽

Future Research ◽

Electronic Patient Records ◽

Spine Registry ◽

Patient Consent ◽

Surgical Data ◽

The Uk ◽

The Impact

Aims The British Spine Registry (BSR) was introduced in May 2012 to be used as a web-based database for spinal surgeries carried out across the UK. Use of this database has been encouraged but not compulsory, which has led to a variable level of engagement in the UK. In 2019 NHS England and NHS Improvement introduced a new Best Practice Tariff (BPT) to encourage input of spinal surgical data on the BSR. The aim of our study was to assess the impact of the spinal BPT on compliance with the recording of surgical data on the BSR. Methods A retrospective review of data was performed at a tertiary spinal centre between 2018 to 2020. Data were collated from electronic patient records, theatre operating lists, and trust-specific BSR data. Information from the BSR included operative procedures (mandatory), patient consent, email addresses, and demographic details. We also identified Healthcare Resource Groups (HRGs) which qualified for BPT. Results A total of 3,587 patients were included in our study. Of these, 1,684 patients were eligible for BPT. Between 2018 and 2019 269/974 (28%) records were complete on the BSR for those that would be eligible for BPT. Following introduction of BPT in 2019, 671/710 (95%) records were complete having filled in the mandatory data (p < 0.001). Patient consent to data collection also improved from 62% to 93%. Email details were present in 43% of patients compared with 68% following BPT introduction. Conclusion Our study found that following the introduction of a BPT, there was a statistically significant improvement in BSR record completion compliance in our unit. The BPT offers a financial incentive which can help generate further income for trusts. National data input into the BSR is important to assess patient outcome following spinal surgery. The BSR can also aid future research in spinal surgery. Cite this article: Bone Jt Open 2021;2-3:198–201.

Download Full-text

Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice

Geriatrics ◽

10.3390/geriatrics5010004 ◽

2020 ◽

Vol 5 (1) ◽

pp. 4

Author(s):

Carol A. Fairfield ◽

David G. Smithard

Keyword(s):

Acute Phase ◽

Best Practice ◽

Evidence Base ◽

Post Stroke ◽

Effortful Swallow ◽

The Us ◽

Screening Assessment ◽

The Uk ◽

Management Of Dysphagia ◽

The Impact

The international approach to the assessment and management of dysphagia in the acute phase post stroke is little studied. A questionnaire was sent to clinicians in stroke services that explored the current practice in dysphagia screening, assessment, and management within the acute phase post stroke. The findings from four (the UK, the US, Canada, and Australia) of the 22 countries returning data are analysed. Consistent approaches to dysphagia screening and the modification of food and liquid were identified across all four countries. The timing of videofluoroscopy (VFS) assessment was significantly different, with the US utilising this assessment earlier post stroke. Compensatory and Postural techniques were employed significantly more by Canada and the US than the UK and Australia. Only food and fluid modification, tongue exercises, effortful swallow and chin down/tuck were employed by more than fifty percent of all respondents. The techniques used for assessment and management tended to be similar within, but not between, countries. Relationships were found between the use of instrumental assessment and the compensatory management techniques that were employed. The variation in practice that was found, may reflect the lack of an available robust evidence base to develop care pathways and identify the best practice. Further investigation and identification of the impact on dysphagia outcome is needed.

Download Full-text

An uncertain, erratic story: the pandemic in the UK

Journal of Accounting & Organizational Change ◽

10.1108/jaoc-08-2020-0125 ◽

2020 ◽

Vol 16 (4) ◽

pp. 549-555

Author(s):

Irvine Lapsley

Keyword(s):

Health Care ◽

Risk Management ◽

Asset Management ◽

Best Practice ◽

Content Type ◽

Individual Account ◽

Reform Processes ◽

The Uk ◽

The Impact ◽

Practical Implications

Purpose The purpose of this paper is to study the pandemic from the perspective of the UK health-care system and risk management. Design/methodology/approach This paper follows a storytelling perspective. The author reflects on his experiences through the lens of research on health care and risk management. Findings The impact of the pandemic has been so massive that it has challenged the capacity of the UKs National Health Service. The political influences at work have not always promoted best practice in risk management and indicate blame-avoidance strategies by politicians. Research limitations/implications A single country experience of COVID-19. Practical implications There are major issues of asset management, of delays in decision-making, of supply chain problems and the need to reform processes of handling of crisis management. Originality/value This is an individual account of experiences of the pandemic.

Download Full-text

Tissue banking in ENT: challenges and methods

The Journal of Laryngology & Otology ◽

10.1017/s0022215113001321 ◽

2013 ◽

Vol 127 (7) ◽

pp. 630-637 ◽

Cited By ~ 5

Author(s):

E Warner ◽

M Birchall ◽

M W Lowdell

Keyword(s):

Human Tissue ◽

Best Practice ◽

Tissue Banking ◽

Tissue Storage ◽

High Quality ◽

Diagnostic Significance ◽

Tissue Samples ◽

The Uk ◽

The Impact ◽

And Storage

AbstractBackground:Biobanking is the process of storing high quality human biospecimens alongside linked clinical data, for research purposes. The aim is to identify novel biomarkers with prognostic or diagnostic significance. However, the challenges implicit in the collection and storage of human tissue for research have curtailed the impact of this technique to date.Aim:This paper aims to summarise the challenges faced by biobanking within the ENT specialty in the UK, and to present protocols used for the routine collection, freezing and storage of tissue specimens at the Royal National Throat, Nose and Ear Hospital. These protocols could be used to guide other ENT departments (in the UK and worldwide) wishing to initiate the routine collection and storage of tissue samples. Their publication could also help to establish basic standards and ensure consistency in ENT tissue storage.Methods:Interviews conducted with industry experts, and a literature review of ‘best practice’ in biobanking.Conclusion:The ENT specialty must stay abreast of progress in human tissue research in order to ensure the best possible management of its patients. Our protocol for the routine banking of ENT tissue at the Royal National Throat, Nose and Ear Hospital could be used as a template for other ENT departments (in the UK and worldwide) to encourage widespread implementation of high quality tissue banking.

Download Full-text

Using Keeper Questionnaires to Capture Zoo-Housed Tiger (Panthera tigris) Personality: Considerations for Animal Management

Journal of Zoological and Botanical Gardens ◽

10.3390/jzbg2040047 ◽

2021 ◽

Vol 2 (4) ◽

pp. 650-663

Author(s):

Natalie Bullock ◽

Charlotte James ◽

Ellen Williams

Keyword(s):

Best Practice ◽

Principal Component ◽

Animal Husbandry ◽

Panthera Tigris ◽

Individual Level ◽

Personality Differences ◽

Best Practice Guidelines ◽

Animal Management ◽

The Uk ◽

The Impact

Individual personalities affect animal experiences of zoo environments, impact on an animal’s coping ability and have potential implications for welfare. Keeper assessments have been identified as a quick and reliable way of capturing data on personality in a range of species and have practical application in improving animal welfare on an individual level. Despite widespread recognition of the importance of animal personality within a zoo environment, there is a paucity of research into tiger personality and the potential impact of this on tiger experiences within zoos. This research investigated the personality of 34 tigers (19 Amur and 15 Sumatran) across 14 facilities in the UK using keeper ratings and identified changes keepers made in animal husbandry to support tiger welfare. Reliability across keepers (n = 49) was established for nine adjectives and a principal component analysis identified three personality components: ‘anxious’, ‘quiet’ and ‘sociable’. When subspecies were combined, there was no relationship between tiger scores on the personality components and age or sex of tigers (p > 0.05). Subspecies of tiger was not related to scores on the ‘quiet’ or ‘sociable’ components (p > 0.05). Sumatran tigers scored more highly than Amur tigers on the ‘anxious’ component (mean ± SD, Sumatran: 3.0 ± 1.7, Amur: 1.8 ± 0.6, p < 0.05). Analysis within subspecies found that male Amur tigers were more sociable than females (mean ± SD, males: 5.5 ± 0.707; females: 4.15 ± 0.55). Amur tiger age was also negatively correlated with scores on the sociable personality component (R = −0.742, p < 0.05). No significant differences were seen in Sumatran tigers. Keepers reported a number of changes to husbandry routines based on their perceptions of their tigers’ personality/needs. However, there was no significant relationship between these changes and tiger personality scores (p > 0.05). Despite significant evolutionary differences between Amur and Sumatran tigers, there are no subspecies specific guidelines for zoo tigers. This research has highlighted the potential for these two subspecies to display personality differences and we advocate further research into this area. Specifically, we highlight a need to validate the relationship between tiger personality, management protocols and behavioural and physiological metrics of welfare. This will enable a fuller understanding of the impact of personality on zoo tiger experiences and will enable identification of evidence-based best practice guidelines.

Download Full-text

A pandemic in the age of next-generation sequencing

The Biochemist ◽

10.1042/bio_2021_187 ◽

2021 ◽

Author(s):

Angela H. Beckett ◽

Kate F. Cook ◽

Samuel C. Robson

Keyword(s):

Public Health ◽

Next Generation Sequencing ◽

Infection Control ◽

Control Measures ◽

Molecular Medicine ◽

Next Generation ◽

Healthcare Settings ◽

The Uk ◽

The Impact ◽

Generation Sequencing

Since December 2019, the world has found itself rocked by the emergence of a highly contagious novel coronavirus disease, COVID-19, caused by the virus SARS-CoV-2. The global scientific community has rapidly come together to understand the virus and identify potential treatments and vaccine strategies to minimise the impact on public health. Key to this has been the use of cutting-edge technological advances in DNA and RNA sequencing, allowing identification of changes in the viral genome sequence as the infection spreads. This approach has allowed a widespread ‘genomic epidemiology’ approach to infection control, whereby viral transmission (e.g. in healthcare settings) can be detected not only by epidemiological assessment, but also by identifying similarities between viral sub-types among individuals. The UK has been at the forefront of this response, with researchers collaborating with public health agencies and NHS Trusts across the UK to form the COVID-19 Genomics UK (COG-UK) Consortium. Genomic surveillance at this scale has provided critical insight into the virulence and transmission of the virus, enabling near real-time monitoring of variants of concern and informing infection control measures on local, national and global scales. In the future, next-generation sequencing technologies, such as nanopore sequencing, are likely to become ubiquitous in diagnostic and healthcare settings, marking the transition to a new era of molecular medicine.

Download Full-text