SHO training results.
Explore the source record for details and available documents.
Clinical Competence↗
Biomedical subjects
H R Chapman
Publications and source records attributed to H R Chapman.
Teaching of the assessment of head and brain injury in UK dental schools--The Headway Survey.
Under the auspices of Headway--the brain injury association, the charity supplies information on head/brain injury and runs a telephone advice line: (0115 924 0800). Questionnaires regarding the undergraduate teaching related to head/brain injuries were sent to, and returned by, all 12 UK dental schools. The replies suggest that undergraduate teaching of this subject is patchy and inadequately prepares dentists to recognise and cope with patients who may have had head, and consequently brain, injuries. It is recommended that dental schools review their teaching of this subject and ensure that it is consistent with the current guidelines issued by the National Institute of Clinical Excellence (NICE) on the recognition of head injury and that the findings are brought to the attention of the General Dental Council in the context of the GDC's "The first five years" report.
Clinical Competence↗
Bicycle helmets--does the dental profession have a role in promoting their use?
OBJECTIVES: To review the available literature regarding the: epidemiology of bicycle related head injuries; consequences of head injuries; rates of cycle helmet use; impact of educational campaigns and legislation on usage rates; effectiveness of cycle helmets in protecting against head and facial injuries; arguments against the compulsory use of bicycle helmets. DATA SOURCES: A computerised Medline search was conducted using the keywords: head injury, facial injury, bicycle helmets, accidents. DATA SELECTION: All available information was considered. DATA SYNTHESIS: Data was collated manually. CONCLUSIONS: The wearing of bicycle helmets contributes significantly to the prevention of head injuries (HI) and traumatic brain injury (TBI), particularly in children and adolescents. There is evidence to support the role of cycle helmets in the prevention of injuries to the middle third of the face and some dental injuries. There is a case for the implementation of legislation accompanied by educational campaigns to increase significantly the use of cycle helmets. The dental profession could: play an active role in promoting cycle helmet use; support calls for the compulsory wearing of cycling helmets, particularly for children; press for modification of helmet design and standards to increase protection of the face.
Accidents, Traffic↗
Visual/verbal analogue scales: examples of brief assessment methods to aid management of child and adult patients in clinical practice.
The flexible use of a visual/verbal analogue scale--the thermometer--is described as a means of monitoring patients' levels of cognitive fear, trust, pain and self-esteem during treatment visits. Variations for use with very young children and those with physical and learning disabilities are also described.
Adaptation, Psychological↗
Dental fear in children--a proposed model.
Over the past eleven years, we have worked together to treat children who are dentally phobic. This has enabled us to develop an understanding of how children come to be dentally fearful. We have constructed a model of child dental fear which helps us in our work. It is important to acknowledge that fear is a normal phenomenon when any of us are exposed to threat. Helping dentally fearful children appraise or evaluate threat, face their fear and build upon their strengths is the task facing dentists and, occasionally, psychologists. The consequences for children of not doing so are extreme difficulty with accepting and ultimately total avoidance of treatment. Both of these can persist into adulthood. First, we propose to discuss the normality of fear in children, placing dental fear within a developmental context. We will then outline a model for assessing and treating dental fear which identifies five discrete but interrelated factors. Each of the factors and its treatment is illustrated with examples.
Attitude↗
The composition of milk xanthine oxidase.
The composition of milk xanthine oxidase has been reinvestigated. When the enzyme is prepared by methods that include a selective denaturation step in the presence of sodium salicylate the product is obtained very conveniently and in high yield, and is homogeneous in the ultracentrifuge and in recycling gel filtration. It has specific activity higher than previously reported preparations of the enzyme and its composition approximates closely to 2mol of FAD, 2g-atoms of Mo and 8g-atoms of Fe/mol of protein (molecular weight about 275000). In contrast, when purely conventional preparative methods are used the product is also homogeneous by the above criteria but has a lower specific activity and is generally comparable to the crystallized enzyme described previously. Such samples also contain 2mol of FAD/mol of protein but they have lower contents of Mo (e.g. 1.2g-atom/mol). Amino acid compositions for the two types of preparation are indistinguishable. These results confirm the previous conclusion that conventional methods give mixtures of xanthine oxidase with an inactive modification of the enzyme now termed ;de-molybdo-xanthine oxidase', and show that salicylate can selectively denature the latter. The origin of de-molybdo-xanthine oxidase was investigated. FAD/Mo ratios show that it is present not only in enzyme purified by conventional methods but also in ;milk microsomes' (Bailie & Morton, 1958) and in enzyme samples prepared without proteolytic digestion. We conclude that it is secreted by cows together with the active enzyme and we discuss its occurrence in the preparations of other workers. Studies on the milks of individual cows show that nutritional rather than genetic factors determine the relative amounts of xanthine oxidase and de-molybdo-xanthine oxidase. A second inactive modification of the enzyme, now termed ;inactivated xanthine oxidase', causes variability in activity relative to E(450) or to Mo content and formation of it decreases these ratios during storage of enzyme samples including samples free from demolybdo-xanthine oxidase. We conclude that even the best purified xanthine oxidase samples described here and by other workers are contaminated by significant amounts of the inactivated form. This may complicate the interpretation of changes in the enzyme taking place during the slow phase of reduction by substrates. Attempts to remove iron from the enzyme by published methods were not successful.
Amino Acids↗