Developing a Sealant Program: the Massachusetts Approach *

This paper describes the program structure and strategies being used by the Massachusetts Department of Public Health to promote the utilization of sealants. The program design includes four components: clinical demonstration, consumer education, professional education, and reimbursement. Eighteen Massachusetts neighborhood health centers and six local health departments are participating in the clinical demonstration component. Since March 1984, dental personnel from these sites have applied sealants to 4,398 schoolchildren. The promotional theme “Save Teeth: Seal Them” has been incorporated into brochures designed to increase knowledge and awareness of consumers. Curriculum materials have been developed to educate dentists and dental hygienists to apply sealants and understand the rationale and scientific basis for their use. Since January 1984, 18 sealant educational sessions have been conducted statewide for 630 dental providers. Information is being presented to third-party carriers, some of whom have subsequently adopted a policy to include reimbursement for sealants.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65721/1/j.1752-7325.1986.tb03128.x.pd

Holographic Metamagnetism, Quantum Criticality, and Crossover Behavior

Using high-precision numerical analysis, we show that 3+1 dimensional gauge theories holographically dual to 4+1 dimensional Einstein-Maxwell-Chern-Simons theory undergo a quantum phase transition in the presence of a finite charge density and magnetic field. The quantum critical theory has dynamical scaling exponent z=3, and is reached by tuning a relevant operator of scaling dimension 2. For magnetic field B above the critical value B_c, the system behaves as a Fermi liquid. As the magnetic field approaches B_c from the high field side, the specific heat coefficient diverges as 1/(B-B_c), and non-Fermi liquid behavior sets in. For B<B_c the entropy density s becomes non-vanishing at zero temperature, and scales according to s \sim \sqrt{B_c - B}. At B=B_c, and for small non-zero temperature T, a new scaling law sets in for which s\sim T^{1/3}. Throughout a small region surrounding the quantum critical point, the ratio s/T^{1/3} is given by a universal scaling function which depends only on the ratio (B-B_c)/T^{2/3}. The quantum phase transition involves non-analytic behavior of the specific heat and magnetization but no change of symmetry. Above the critical field, our numerical results are consistent with those predicted by the Hertz/Millis theory applied to metamagnetic quantum phase transitions, which also describe non-analytic changes in magnetization without change of symmetry. Such transitions have been the subject of much experimental investigation recently, especially in the compound Sr_3 Ru_2 O_7, and we comment on the connections.Comment: 23 pages, 8 figures v2: added ref

Census politics in deeply divided societies

Population censuses in societies that are deeply divided along ethnic, religious or linguistic lines can be sensitive affairs – particularly where political settlements seek to maintain peace through the proportional sharing of power between groups. This brief sets out some key findings from a research project investigating the relationship between census politics and the design of political institutions in Bosnia and Herzegovina, Kenya, Lebanon and Northern Ireland

Technical challenges to surgical clipping of aneurysmal regrowth with coil herniation following endovascular treatment – a case report

In recent years, technical developments have made endovascular procedures attractive therapeutic options and enabled the endovascular surgeon to redefine the management of cerebral aneurysms. However, as the number of aneurysms undergoing endovascular therapy has grown, so has the number of patients with incompletely treated aneurysms who are presenting for further management. In cases of failure of endovascular treatment caused by either incomplete occlusion or regrowth of the aneurysm, a complementary treatment is often necessary. Surgical treatment of these patients is challenging. We present a case of a ruptured posterior cerebral artery aneurysm treated initially with endovascular coiling that left behind significant residual aneurysmal sac. Regrowth of the aneurysm documented on follow-up was treated surgically. At surgery, the coil was found to have herniated through the aneurysmal sac into the subarachnoid space, and the aneurysm was successfully clipped without removing the coils. We review the regrowth of aneurysms following endovascular therapy and potential problems and challenges of surgically managing these lesions

Procedural confidence in hospital based practitioners: implications for the training and practice of doctors at all grades

<p>Abstract</p> <p>Background</p> <p>Medical doctors routinely undertake a number of practical procedures and these should be performed competently. The UK Postgraduate Medical Education and Training Board (PMETB) curriculum lists the procedures trainees should be competent in. We aimed to describe medical practitioner's confidence in their procedural skills, and to define which practical procedures are important in current medical practice.</p> <p>Methods</p> <p>A cross sectional observational study was performed measuring procedural confidence in 181 hospital practitioners at all grades from 2 centres in East Anglia, England.</p> <p>Results</p> <p>Both trainees and consultants provide significant service provision. SpR level doctors perform the widest range and the highest median number of procedures per year. Most consultants perform few if any procedures, however some perform a narrow range at high volume. Cumulative confidence for the procedures tested peaks in the SpR grade. Five key procedures (central line insertion, lumbar puncture, pleural aspiration, ascitic aspiration, and intercostal drain insertion) are the most commonly performed, are seen as important generic skills, and correspond to the total number of procedures for which confidence can be maintained. Key determinants of confidence are gender, number of procedures performed in the previous year and total number of procedures performed.</p> <p>Conclusion</p> <p>The highest volume of service requirement is for six procedures. The procedural confidence is dependent upon gender, number of procedures performed in the previous year and total number of procedures performed. This has implications for those designing the training curriculum and with regards the move to shorten the duration of training.</p

Moving forward during major goal blockage: situational goal adjustment in women facing infertility

Individuals confronting chronic medical conditions often face profound challenges to cherished life goals. The primary aim of this study was to examine the associations of goal adjustment with psychological adjustment in the context of infertility. At study entry (T1; n = 97) and 6 months later (T2; n = 47), women in fertility treatment completed measures of goal blockage, goal adjustment ability, and psychological adjustment. At T1, greater perceived and actual goal blockage were related to negative psychological adjustment. Ability to disengage from the goal of biological parenthood was associated with less infertility-specific thought intrusion, whereas engagement with other goals was related to fewer depressive symptoms and greater positive states of mind. Greater general goal engagement was protective against the negative relationships between low goal disengagement and the dependent variables. Promoting letting go of the unattainable and investing in the possible may be a useful intervention to foster well-being among individuals experiencing profound goal blockage

Soft wall model for a holographic superconductor

We apply the soft wall holographic model from hadron physics to a description of the high-$T_c$ superconductivity. In comparison with the existing bottom-up holographic superconductors, the proposed approach is more phenomenological. On the other hand, it is much simpler and has more freedom for fitting the conductivity properties of the real high-$T_c$ materials. We demonstrate some examples of emerging models and discuss a possible origin of the approach.Comment: 17 pages, 16 figure

Cardy and Kerr

The Kerr/CFT correspondence employs the Cardy formula to compute the entropy of the left moving CFT states. This computation, which correctly reproduces the Bekenstein--Hawking entropy of the four-dimensional extremal Kerr black hole, is performed in a regime where the temperature is of order unity rather than in a high-temperature regime. We show that the comparison of the entropy of the extreme Kerr black hole and the entropy in the CFT can be understood within the Cardy regime by considering a D0-D6 system with the same entropic properties.Comment: 20 pages; LaTeX; JHEP format; v.2 references added, v.3 Section 4 adde

Exact exchange-correlation potential of a ionic Hubbard model with a free surface

We use Lanczos exact diagonalization to compute the exact exchange-correlation (xc) potential of a Hubbard chain with large binding energy ("the bulk") followed by a chain with zero binding energy ("the vacuum"). Several results of density functional theory in the continuum (sometimes controversial) are verified in the lattice. In particular we show explicitly that the fundamental gap is given by the gap in the Kohn-Sham spectrum plus a contribution due to the jump of the xc-potential when a particle is added. The presence of a staggered potential and a nearest-neighbor interaction V allows to simulate a ionic solid. We show that in the ionic regime in the small hopping amplitude limit the xc-contribution to the gap equals V, while in the Mott regime it is determined by the Hubbard U interaction. In addition we show that correlations generates a new potential barrier at the surface

Semi-Holographic Fermi Liquids

We show that the universal physics of recent holographic non-Fermi liquid models is captured by a semi-holographic description, in which a dynamical boundary field is coupled to a strongly coupled conformal sector having a gravity dual. This allows various generalizations, such as a dynamical exponent and lattice and impurity effects. We examine possible relevant deformations, including multi-trace terms and spin-orbit effects. We discuss the matching onto the UV theory of the earlier work, and an alternate description in which the boundary field is integrated out.Comment: 26 pages, 4 figures; v2: typos corrected and report number adde