Search

Valerie Wilson,1,2 Sheree Paterson,3 Kelly Kornman1 1Nursing Research and Practice Development Unit, The Children’s Hospital at Westmead, Westmead, NSW, Australia; 2Faculty of Nursing Midwifery Health, The University of Technology, Sydney, Broadway, NSW, Australia; 3Formerly of the Nursing Research and Practice Development Unit, The Children’s Hospital at Westmead, Westmead, NSW, Australia Purpose: The aim of the leadership development program was to enhance participants’ understanding of person-centered leadership in the context of their nursing unit manager (NUM) roles. Materials and methods: This article details the results of the NUM leadership development program (LDP). Twenty-one NUMs from an Australian pediatric hospital participated in the 8-month program. The evaluation encompassed a group claims/concerns/issues session, one-on-one interviews, and written feedback. Data were themed using a four-step sequential process. Results: The NUM LDP had a positive impact on the leadership practices of the participants. Six key themes were identified from the evaluation: “forming the group”; “being in the group”; “translating into practice”; “how we see ourselves; how do we want to be seen?”; “positive outcomes for me”; and “positive outcomes for others”. Conclusion: This study showed improvements in the leadership understanding and practice of NUMs who participated in the program. Further research, particularly into the transferability of skills and active participatory aspects of these types of evaluation studies, is required. Keywords: nurse, evaluation, person-centered care, experiential learning

Objective: The aim of the present study was to describe the nature and extent of food marketing on popular children's websites and food product websites in Australia.Methods: Food product websites (n 119) and popular children's websites (n 196) were selected based on website traffic data and previous research on frequently marketed food brands. Coding instruments were developed to capture food marketing techniques. All references to food on popular children's websites were also classified as either branded or non-branded and according to food categories.Results: Websites contained a range of marketing features. On food product websites these marketing features included branded education (79.0% of websites), competitions (33.6%), promotional characters (35.3%), downloadable items (35.3%), branded games (28.6%) and designated children's sections (21.8%). Food references on popular children's websites were strongly skewed towards unhealthy foods (60.8% v. 39.2% healthy food references; P<0.001), with three times more branded food references for unhealthy foods. Branded food references displayed similar marketing features to those identified on food product websites.Conclusions: Internet food marketing uses a range of techniques to ensure that children are immersed in brand-related information and activities for extended periods, thereby increasing brand familiarity and exposure. The relatively unregulated marketing environment and increasing use of the Internet by children point to the potential increase in food marketing via this medium. Further research is required to investigate the impact of Internet food marketing on children's food preferences and consumption, and regulatory options to protect children. [ABSTRACT FROM AUTHOR]

Localized prepubertal periodontitis has been described as a host-defect mediated form of bacterially induced periodontitis, with an early onset and rapid progression around a few teeth in children prior to puberty. To further our understanding of the etiology of this disease, we have examined the microbiological components of subgingival dental plaque in 9 children with localized prepubertal periodontitis to determine if patterns of putative pathogens existed, and have compared these results with those obtained from 4 children with no periodontitis. Subgingival plaque samples were plated onto a selective medium for Actinobacillus actinomycetemcomitans and onto a non-selective medium for anaerobes, and the predominant cultivable microbiota of 2 sites per child was determined. The subgingival microbiota of children with localized prepubertal periodontitis clearly differs from non-diseased children in the detection of high levels of several suspected pathogens, including A. actinomycetemcomitans, Bacleroides intermedius, Eikenella corrodens, and Capnocytophaga sputigena. These putative pathogens were found in various combinations. These findings suggest that localized prepubertal periodontitis is associated with specific subgingival bacteria which are generally not found in children without periodontitis. [ABSTRACT FROM AUTHOR]

The purpose of the study was to validate a rapid resistance screening (RRS) method for antimicrobial susceptibility testing of a selected periodontopathic microorganism using the standard broth dilution method as a control. Twenty-five subgingival plaque samples fiom gingivitis or periodontitis sites were plated on Trypticase soy agar supplemented with 5% rabbit blood with antibiotic discs (RRS method) and without (control). The antibiotics tested were Augmentin®, clindamycin, erythromycin, metronidazole, penicillin G and tetracycline hydrochloride. Bacteroides intermedius isolated from both groups of plates were placed onto antibiotic supplemented Trypticase soy broth. The antibiotic susceptibilities of B. intermedius isolated from the plates with antibiotic discs and the standard broth method were compared. The results showed high sensitivity and predictability for the RRS method compared with the control. The percentage of agreement was: 100% for Augmentin® 30 μg; clindamycin 2 μg and tetracycline 30 μg; 96% for erythromycin 15 μg, metronidazole 80 μg and penicillin 10 IU, 92% for Penicillin 2 IU; 88% for erythromycin 2 μg and 84% for tetracycline 5 μg. The results of this study document the feasibility of the RRS method for testing antimicrobial resistance of whole samples if its efficacy can be demonstrated for other bacteria. This method may be a quick and useful test for the periodontal Practitioner in determining the antibiotic susceptibility of periodontal plaque Pathogens, [ABSTRACT FROM AUTHOR]

Histological observations were made on ligature-induced periodontitis in two adult female monkeys (Macaca fascicularis). Silk ligatures were placed around posterior teeth and the shift from gingivitis to periodontitis was followed radiographically and bacteriologically for eight and nine weeks, respectively. Fifteen tissue blocks with ligatures in situ were obtained. Following decalcification with EDTA and epon embedding, sections one micron in thickness were prepared in the mesio-distal plane to study the interproximal regions. Two additional blocks were processed for routine histology. Radiographically, progressive bone loss was observed in the interproximal regions that had a ligated tooth surface. Histologically, prominent features included supragingival and subgingival plaque (with dense accumulations of bacteria around and within the ligature), apical migration of the junctional epithelium, loss of collagen and connective tissue attachment, and osteoclastic bone resorption. A chronic inflammatory reaction was evidenced by a dense infiltration of leukocytes in the connective tissue, with a high proportion of plasma cells. Numerous polymorphonuclear leukocytes were seen in pathways between epithelial cells and in a zone around the plaque-laden ligature. These morphological observations, similar to descriptions of human periodontitis, lend support for the usefulness of this model in the study of human periodontitis. [ABSTRACT FROM AUTHOR]

Histologic observations were made on the primate Macaca fascicularis in order to describe the features of both naturally-occurring gingivitis and gingivitis present at non-experimental sites when selected teeth were ligated to induce periodontitis. Semi-thin sections of glutaraldehyde-paraformaldehyde fixed, EDTA-decalcified, and epon-embedded specimens were used, supplemented by routine histologic methods. The microscopic picture of the interdental areas was identical for the two types of gingivitis specimens and consisted of a chronic inflammatory reaction resembling the established lesion in humans. The highly infiltrated gingival tissue exhibited a predominance of plasma cells. Leukocytes were seen in pathways from the connective tissue, through the epithelium and to the surface of the plaque, and many neutrophils were interposed between the plaque and soft-tissue. The apical extent of the junctional epithelium was at or slightly below the cemento-enamel junction. Although perivascular inflammation was observed in the transseptal fiber region, the alveolar crest exhibited only evidence of normal bone remodelling. [ABSTRACT FROM AUTHOR]

The article focuses on the detection and quantitation of Bacteroides gingivalis in bacterial mixtures by means of flow cytometry. Flow cytometry have been used routinely for several years to analyze and sort lymphocytes and other eukaryotic cell populations on the basis of either light scattering or fluorescence. The technique holds great promise for monitoring a few species in large scale studies and for evaluating the efficiency of different cultural techniques for the viable recovery of certain bacteria.

Octenidine, a new bispyridine antimicrobial compound, has significant antiplaque activity in animals. The present study was designed to assess the effectiveness of this agent in inhibiting plaque formation in humans. Sixty males (age 22-36 years) were randomly assigned 4 formulations which included 1) 0.1% octenidine in vehicle, 2) 0.1% octenidine in aqueous solution, 3) 0.05% octenidine in vehicle, and 4) vehicle only. After establishment of minimal levels of plaque and gingivitis, each subject rinsed twice daily under supervision with his assigned test agent. Over the next seven days, the subjects were not permitted any other means of tooth cleaning. Plaque accumulation was measured daily and gingival fluid and stain levels determined on days 0 and 7. Analysis of the data showed that both formulations of 0.1% octenidine almost completely inhibited plaque formation over the 7 day period. The vehicle had no effect on the agent's activity. The 0.05% concentration allowed some plaque accumulation, but all octenidine groups had significantly less plaque than the control group. Gingival fluid flow was significantly lower in all octenidine groups than in the control group. Tooth stain increased in all groups using the agent but remained unchanged in the group using the vehicle alone. Results of this short term clinical trial suggest that octenidine may be a useful topical antiplaque agent. [ABSTRACT FROM AUTHOR]

Collagenolytic activity was assessed in a variety of microorganisms with particular emphasis on members of the indigenous oral flora. Organisms were grown in complete and peptide depleted basal anaerobic broth. Cell sonicates and media preparations were assayed for collagenolytic activity using 14C-labelled collagen in solution and as fibrils. Assay reaction products were evaluated by acrylamide gel electraphoresis. All tested species of Bacteroides. including B. gingivalis, B. melaninogenicus ss. melaninogenicus and intermedius, B. capillus, B. oris, B. thetaiotaomicron, and B. fragilis produced collagenase which was primarily associated with the cell fraction. Collagenolytic activity was also observed in both media and cell sonicates of Actinobacillus ac-. tinomycetemcomitans, Strain 511. The Bacteroides and Actinobacillus enzymes were heat labile, inhibited by EDTA and human serum. Enzyme activity appeared to be enhanced when these organisms were grown in peptide depleted medium. Collagenase production by tested species of Bacteroides and A. actinomycetemcomitans (511) was unique among other members of the oral microflora including species of Fusobacterium, Actinomyces, Capnocytophaga, and Selenomonas, which did not demonstrate collagenolytic activity under the saint cultural conditions. [ABSTRACT FROM AUTHOR]

Strains of a new Bacteroides species were isolated from three cases of severe localized periodontitis in adults, in which the organism comprised greater than 50 % of the cultivable subgingival flora. The isolates were Gram-negative, obligately anaerobic short rods, which required CO2 for growth. The strains were esculin-positive, oxidase- and gelatinase-negative, and produced acid from a variety of carbohydrates, including arabinose, xylose, raffinose, rhamnose, and cellobiose. The major acid end-products from glucose were acetic and succinic acids. The isolates all possessed an extra-layer external to the outer membrane, as well as an extensive fibrous or hair-like network of intensely staining, ruthenium red, and malachite green material, indicative of a glycolipid or a glycolipoprotein polymer. The physiological and ultrastructural observations are discussed in relation to other known bacteroides and show these isolates to be representative of a new Bacteroides species named Bacteroides capillus. [ABSTRACT FROM AUTHOR]

The cultivable subgingival microflora in the cynomolgus monkey, Macaca fascicularis, was monitored during the ligature-induced progression of naturally occurring gingivitis to periodontitis. Clinical and microbiological observations were divided into four stages. Stage I, prior to ligature placement, was characterized clinically by chronic generalized gingivitis and microbiologically by Gram-positive cocci and rods with B. melaninogenicus ss. intermedius the dominant Gram-negative organism. Stage III, 1 to 3 weeks following ligature placement, exhibited slightly greater gingival inflammation but no clinical evidence of attachment loss. The subgingival flora showed a significant increase in motile and surface translocating Gram-negative rods, primarily Capnocytophaga species and Campylobacter sputorum. Stage III, 4 to 7 weeks following ligature placement, revealed increased pocket depth and radiographic evidence of alveolar bone loss. This stage was characterized by a Gram-negative anaerobic flora with B. asaccharolyticus as the dominant cultivable organism. Stage IV encompassed the remainder of the experimental period, 8 to 17 weeks, during which time no further change in the clinical parameters occurred and levels of B. asaccharolyticus decreased. The subgingival microflora of ligature induced periodontitis in Macaca fascicularis closely resembled that reported for human periodontal disease and the episodic clinical pattern of attachment loss was associated with levels of Gram-negative anaerobes, primarily B. asaccharolyticus.

Ligature-induced periodontitis was evaluated microbiologically in 8 beagle dogs. Gingival health was established by repeated cleaning. At day 0 subgingival plaque was sampled from individual sites in two quadrants. All teeth in one quadrant were then ligated at the CEJ, and the other quadrant served as a non-ligated control which was cleaned three times each week. At day 14, Four dogs were given metronidazole for seven days. Plaque was cultured anaerobically on nonselective media, and the predominant cultivable flora was characterized. At day 0 Gram-negative facultative rods represented 56.8 % of the flora, with motile and surface translocating organisms predominating. At day 14 Bacteroides asaccharolyticus, including catalase positive B.asaccharolyticus-like organisms, increased at ligated sites to 34.7 % of the cultivable flora. After metronidazole therapy the total bacterial count decreased, and Gram-negative anaerobic rods became non-detectable, Gram-negative facultative bacteria which were motile or surface translocating represented 52.7 % of the cultivable flora after metronidazole treatment. In the beagle dog ligature placement was associated with a shift in the flora from Gram-negative facultative rods to Gram-negative anaerobic rods. Metronidazole treatment reduced the total cultivable flora and selectively reversed the microflora shifts which followed ligature placement. [ABSTRACT FROM AUTHOR]

Twenty-four beagle dogs were divided into three groups of eight dogs each. Periodontitis was induced in three of the dental quadrants of each dog using wire ligatures while one quadrant was not ligated and was kept cleaned. One group of dogs received no additional treatment, one group received systemic metronidazole and the third group received systemic indomethacin. The in vitro bone resarbing activity of extracts from freeze dried gingiva from the groups was compared. Extracts of gingiva from ligated teeth produced significant bone resorption. Metron- idazole treatment suppressed this ligature-induced bone resorbing activity while indomethacin had no effect. Extracts from gin giva from around clean non-ligated teeth had somewhat less activity than extracts from gingiva of ligated teeth. although some significant resorption remained in all treatment groups, Bacterial cultures from metronidazole- treated groups showed a change from a predominantly Gram negative obligatory anerobic flora (B. assacharolyticus). to one predominated by Gram negative, facultative anaerobes (Capnocytophaga and Campylobacter). It was concluded that metronidazole suppressed hone resorbing activity by inducing a change in the flora of the gingival crevice. [ABSTRACT FROM AUTHOR]

The influence of supragingival plaque control on the subgingival microflora and clinical parameters of ligature-induced periodontitis in the Cynomolgus monkey was investigated. No clinical changes were observed during the six-week experimental period. The total cultivable flora and the proportions of total black-pigmented Bacteroides (BPB) and asaccharolytic black-pigmented Bacteroides decreased significantly in the cleaned test sites as compared to those in the non-cleaned controls. The study suggests that six wk of supragingival plaque control in the presence of periodontal disease may alter the periodontitis-associated microflora in the monkey, but not sufficiently to alter clinical signs of disease in this time period. [ABSTRACT FROM AUTHOR]

Existing paradigms in the biology of periodontitis have supported the detection of elevated levels of prostaglandins and leukotrienes in gingival crevicular fluid and tissues isolated from progressing periodontitis sites. These mediators have generally been associated with destructive inflammation. The article presents a study that compared inflammatory mediator patterns regulated by host responses at individual sites of periodontal health, gingivitis and periodontitis. Previous studies of these mediators have generally compared the levels in tissues or fluids of healthy subjects with those at sites of overt destruction in periodontitis patients.

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been shown to alter periodontitis in both animals and humans. This study was initiated in the nonhuman primate (Nhp) model to determine the effect of two NSAIDs on preexisting gingivitis, the conversion of gingivitis to periodontitis, the associated subgingival microbiota, and the gingival PMN response. Eighteen cynomolgus monkeys were divided into three groups and treated on a blind basis with ibuprofen 8%, meclofenamic acid 5%, or placebo applied topically 5 days/week for 20 wk. After 4 wk of treatment, periodontitis was initiated in one quadrant by the placement of silk ligatures. Clinical parameters, bone loss by densitometric analysis of radiographs (CADIA). and cultural microbiology of subgingival plaque were monitored. In situ PMN chemotaxis was assessed by quantitating the PMNs which entered the sulcus in response to a challenge with n-formyl-methionyl-leucyl-phenylalanine (FMLP). No significant differences in the clinical parameters were noted by treatment groups. Radiographic bone toss was detected in all experimental sites in placebo animals as compared with 67% and 44% for ibuprofen and meclofenamic acid animals, respectively. Mean CADIA scores/animal showed a significant loss in bone density for placebo at 6 and 16 wk, no change for ibuprofen animals, and a significant increase in density for meclofenamic acid animals. The microbiota of all groups changed with ligation consistent with previous reports of disease initiation in the Nhp. Similar patterns of PMN response to FMLP were elicited in the gingiva of the ibuprofen and placebo groups. with minimal change in PMN levels detected during disease induction: however, sulcular PMNs were significantly higher than placebo in meclofenamic acid animals at all time periods. In this study, ibuprofen inhibited significant bone loss and meclofenamic acid not only inhibited bone loss but produced a significant increase in bone density in the non-human primate model. These effects were achieved without eliminating clinical gingivitis and without significant effects on the subgingival microbiota. In the meclofenamic acid-treated animals this was accompanied by a significant increase in PMNs in the local area. Based on this report it appears that topical ibuprofen and meclofenamic acid do not affect the progression of alveolar bone loss equally. In addition, the local increase in PMNs at sites which did not exhibit bone loss may provide insights to the mechanisms involved in the initiation of periodontitis in the cynomolgus monkey. [ABSTRACT FROM AUTHOR]

Quantitative evaluation of radiographic changes by computer-assisted densitometric image analysis (CADIA) requires exact knowledge about method errors. In the present study, density change errors were determined from pairs of films with "no change". From this distribution of error values, a series of threshold values for correction of changes due to method errors was selected. The threshold values were then applied to results from analysis of densitometric changes in sites with "known loss" or "no change" of the alveolar bone among films from cynomolgus monkeys. The density errors formed non-normal distributions with no difference in magnitudes between the absolute values expressing density decreases and density increases in the same areas. Calculation of sensitivity. specificity, type 1 and type 2 errors showed that these variables were clearly influenced by selection of different threshold values for correction of the density change errors. It is therefore recommended that threshold values be determined for each analytical system initially as well as following any equipment or computer program modification. Before selecting the threshold value for a specific radiographic analysis, the desired level of sensitivity and specificity should be evaluated. [ABSTRACT FROM AUTHOR]

Electron microscopic observations were made on naturally occurring gingivitis, on gingivitis at non-ligated sites of an experimental animal, and on ligature-induced periodontitis in a periodontal disease model using female cynomolgus monkeys. For bath types of gingivitis specimens, a plaque associated chronic inflammatory reaction was observed, comparable to that described for the human established lesion. Bacterial accumulations on tooth surfaces were separated from the epithelium by neutrophils which exhibited variations in fine structure and extent of bacterial phagocytosis related to their proximity to the plaque. In the inflamed connective tissue of the papillac, collagen was reduced to strands extending between the cellular elements. The plasma cell was the most common inflammatory cell and had three major variations in form. With ligature-induced periodontitis, similar inflammatory features were observed in the gingiva. A complex flora like that encountered in human periodontitis was observed around and within the ligature as well as more apically in the pocket. As compared to the flora in gingivitis, more spirochetes were encountered, a larger proportion of the microorganisms appeared to be in a living state, and bacteria were in contact with the epithelial surface, rather than being walled off by the neutrophils. This seemingly more aggressive plaque was associated with an advanced lesion characterized by changes that indicated sequential destruction of the collagenous attachment to cementum and concommitant apical migration or the epithelial attachment. No bacteria were observed in the soft tissues, even in the wide intercellular spaces between the epithelial cells. [ABSTRACT FROM AUTHOR]