Conclusions from the symposium: Two decades of ART: success through research

Two decades of ART research has served as the catalyst for a new way of thinking about oral health care. It is now necessary to build on the success of ART research by educating existing and future oral health professionals and health decision makers about the benefits of the ART approach. It is also important to build upon the sound research base that already exists on ART even though enough is known about ART to consider it is a reliable and quality approach to control caries. While oral health promotion through prevention remains the essential foundation of oral health, the ART approach is an important corner stone in the building of global oral health

Survival of ART restorations assessed using selected FDI and modified ART restoration criteria

A new set of criteria for assessing the quality of restorations using modern restorative materials, named FDI criteria, was recently introduced. This study tested the null hypothesis that there is no significant difference in survival estimate percentages of ART restorations assessed using selected FDI and modified ART criteria after 1 and 5 years. One operator placed a total of 60 class I and 30 Class II high-viscosity glass-ionomer ART restorations in ninety 14- to15-year-olds. Two calibrated and independent evaluators using both criteria evaluated restorations on diestone replicas at baseline and after 1 and 5 years. Statistical analyses were done using the Kaplan–Meier method and log-rank test. The survival results of ART restorations assessed using both sets of criteria after 1 and 5 years (p = 0.27) did not differ significantly. Three ART restorations were assessed as failures according to the ART criteria, while they were assessed as survived using the FDI criteria. We conclude that the modified ART criteria enable reliable assessment of ART restorations in permanent teeth from diestone replicas and that there was no significant difference in survival estimates of ART restorations assessed using both sets of criteria. The null hypothesis was accepted

Utilization of the ART approach in a group of public oral health operators in South Africa: a 5-year longitudinal study

Contains fulltext : 80990.pdf (publisher's version ) (Open Access)BACKGROUND: A significant increase in the proportion of restorations to the number of tooth extractions was reported after the introduction of ART in an academic mobile dental service in South Africa. The changes were ascribed to its less threatening procedure. Based on these findings, ART was subsequently introduced into the public oral health service of Ekurhuleni district in the South African province of Gauteng. This article reports on the 5-year restorative treatment pattern of operators in the Ekurhuleni district, who adopted the ART approach into their daily dental practice. METHODS: Of the 21 trained operators, 11 had placed more than 10% of restorations using ART at year 1 and were evaluated after 5 years. Data, including number of restored and extracted teeth and type of restoration, were drawn from clinical records 4 months before, and up to 5 years after training. The restoration/extraction ratio (REX score) and the proportion of ART restorations to the total number of restorations were calculated. The paired sample t-test and linear regression analysis were applied. RESULTS: The mean percentage of ART restorations after 1 year was 24.0% (SE 7.2) and significantly increased annually to 42.7% (SE 9.2) after 5 years in permanent dentitions. In primary dentitions the mean percentage of ART restorations after 1 year was 80.6% (SE 4.9) and 72.6% (SE 8.8) after 5 years. The mean REX score before ART training was 0.08 (SE 0.03) and 0.07 (SE 0.04) for permanent and primary teeth, respectively and 0.11 (SE 0.03) and 0.17 (SE 0.05) after 5 years. CONCLUSION: Five years after training, ART had been used consistently in this selected group of operators as the predominant restorative treatment used for primary teeth and showed a significant annual increase in permanent teeth. However, this change had not resulted in an increase in the REX score in both dentitions

Three-year survival of single- and two-surface ART restorations in a high-caries child population

The aim of this study was to evaluate the survival of single- and two-surface atraumatic restorative treatment (ART) restorations in the primary and permanent dentitions of children from a high-caries population, in a field setting. The study was conducted in the rainforest of Suriname, South America. ART restorations, made by four Dutch dentists, were evaluated after 6 months, 1, 2, and 3 years. Four hundred seventy-five ART restorations were placed in the primary dentition and 54 in first permanent molars of 194 children (mean age 6.09 ± 0.48 years). Three-year cumulative survivals of single- and two-surface ART restorations in the primary dentition were 43.4 and 12.2%, respectively. Main failure characteristics were gross marginal defects and total or partial losses. Three-year cumulative survival for single-surface ART restorations in the permanent dentition was 29.6%. Main failure characteristics were secondary caries and gross marginal defects. An operator effect was found only for two-surface restorations. The results show extremely low survival rates for single- and two-surface ART restorations in the primary and permanent dentitions. The variable success for ART may initiate further discussion about alternative treatment strategies, especially in those situations where choices have to be made with respect to a well-balanced, cost-effective package of basic oral health care

Leren van, voor en in de toekomst; Leerpraktijken in 2020

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'Just Little Things': Nurses' perceptions of quality of life for people with severe multiple impairments.

ABSTRACT Notions of quality of life dictate philosophies and policies for services for people with developmental disabilities. There is an abundance of research on quality of life, much of which has influenced the significant amount of study of quality of life for people with developmental disabilities. According to specialist developmental disability nurses, however, this research has little meaning for one group of people with developmental disabilities with whom they work - people with severe multiple impairments. Nevertheless, judgements and decisions about the lives of this group continue to be driven by the idea of quality of life. While the literature review found that researchers are urged to seek the perceptions of people regarding their own quality of life by asking them, some authors have noted the difficulty in pursuing such a method with people, such as people with severe multiple impairments, who are unable to communicate in the usual ways. Given, then, that it is difficult to directly determine the views of people with severe multiple impairments, this study sought the perceptions of nurses about the quality of life of the people with whom they work. In order to discover and conceptualise nurses' views, a symbolic interaction perspective was chosen to guide this study and data were analysed using the grounded theory approach. The study was conducted in two stages. Stage One consisted of semi-structured indepth interviews with expert nurses to explore their perceptions of quality of life for the people with whom they worked. A significant finding in these interviews was that perceptions of quality of life are mediated by interaction. Consequently, Stage Two involved a participant observation study in which the interactions of nurses and people with severe multiple impairments were examined. Specialist developmental disability nurses have a unique view of quality of life for people with severe multiple impairments. They refer to it as 'just little things', a phrase which masks complex nursing knowledge and skills, and which can be described by four interrelated categories which emerged from the data: humans being, supporting, becoming intimate, and situated belonging. As nurses become more intimate with individuals, they perceive that people with severe multiple impairments are humans being as they wish, and that quality resides in supporting their everyday lives in a context of situated belonging. This thesis represents a new conceptualisation of quality of life for people with severe multiple impairments, a conceptualisation which may have significance for other groups and, indeed, for the whole quality of life enterprise. This conceptualisation draws on knowledge not usually related to quality of life, that is, knowledge of the body, of the emotions, of identity and of humanness. Such findings demonstrate the power of an interpretive approach in explicating the meanings nurses have regarding quality of life. Further, these findings have implications for how the question of quality of life is approached, for how different ways of thinking about people impact on quality of life, and for the importance of the life in quality of life

Impact of Atraumatic Restorative Treatment (ART) on the treatment profile in pilot government dental clinics in Tanzania

\ud The predominant mode of treatment in government dental clinics in Tanzania has been tooth extraction because the economy could not support the conventional restorative care which depends on expensive equipment, electricity and piped water systems. Atraumatic Restorative Treatment (ART) was perceived as a suitable alternative. A 3.5-year study was designed to document the changes in the treatment profiles ascribed to the systematic introduction of ART in pilot government dental clinics. Dental practitioners who were working in 13 government dental clinics underwent a 7-day ART training. Treatment record data on teeth extracted and teeth restored by the conventional and ART approaches were collected from these clinics for the three study periods. The mean percentage of ART restorations to total treatment, ART restorations to total restorations, and total restorations to total treatments rendered were computed. Differences between variables were determined by ANOVA, t-test and Chi-square. The mean percentage of ART restorations to total treatment rendered was 0.4 (SE = 0.5) and 11.9 (SE = 1.1) during the baseline and second follow-up period respectively (ANOVA mixed model; P < 0.0001). The mean percentage of ART restorations to total restorations rendered at baseline and 2nd follow-up period was 8.4% and 88.9% respectively (ANOVA mixed model; P < 0.0001). The mean percentage of restorations to total treatment rendered at baseline and 2nd follow-up was 3.9% and 13.0%, respectively (ANOVA mixed model; P < 0.0001). Ninety-nine percent of patients were satisfied with ART restorations, 96.6% willing to receive ART restoration again in future, and 94.9% willing to recommend ART treatment to their close relatives. ART introduction in pilot government dental clinics raised the number of teeth saved by restorative care. Countrywide introduction of the ART approach in Tanzania is recommended\u

Examining the reliability and predictive validity of performance assessments by soccer coaches and scouts:The influence of structured collection and mechanical combination of information

Soccer coaches and scouts typically assess in-game soccer performance to predict players’ future performance. However, there is hardly any research on the reliability and predictive validity of coaches’ and scouts’ performance assessments, or on strategies they can use to optimize their predictions. In the current study, we examined whether robust principles from psychological research on selection – namely structured information collection and mechanical combination of predictor information through a decision-rule – improve soccer coaches’ and scouts’ performance assessments. A total of n = 96 soccer coaches and scouts participated in an elaborate within-subjects experiment. Participants watched soccer players’ performance on video, rated their performance in both a structured and unstructured manner, and combined their ratings in a holistic and mechanical way. We examined the inter-rater reliability of the ratings and assessed the predictive validity by relating the ratings to players’ future market values. Contrary to our expectations, we did not find that ratings based on structured assessment paired with mechanical combination of the ratings showed higher inter-rater reliability and predictive validity. In contrast, unstructured-holistic ratings yielded the highest reliability and predictive validity, although differences were marginal. Overall, reliability was poor and predictive validities small-to-moderate, regardless of the approach used to rate players’ performance. The findings provide insights into the difficulty of predicting future performance in soccer

Q-Curves with Complex Multiplication

The Hecke character of an abelian variety A/F is an isogeny invariant and the Galois action is such that A is isogenous to its Galois conjugate A^σ if and only if the corresponding Hecke character is fixed by σ. The quadratic twist of A by an extension L/F corresponds to multiplication of the associated Hecke characters. This leads us to investigate the Galois groups of families of quadratic extensions L/F with restricted ramification which are normal over a given subfield k of F. Our most detailed results are given for the case where k is the field of rational numbers and F is a field of definition for an elliptic curve with complex multiplication by K. In this case the groups which occur as Gal(L/K) are closely related to the 4-torsion of the class group of K. We analyze the structure of the local unit groups of quadratic fields to find conditions for the existence of curves with good reduction everywhere. After discussing the question of finding models for curves of a given Hecke character, we use twists by 3-torsion points to give an algorithm for constructing models of curves with known Hecke character and good reduction outside 3. The endomorphism algebra of the Weil restriction of an abelian variety A may be determined from the Grössencharacter of A. We describe the computation of these algebras and give examples in which A has dimension 1 or 2 and its Weil restriction has simple abelian subvarieties of dimension ranging between 2 and 24

The validity of small-sided games in predicting 11-vs-11 soccer game performance

Predicting performance in soccer games has been a major focus within talent identification and development. Past research has mainly used performance levels, such as elite vs. non-elite players, as the performance to predict (i.e. the criterion). Moreover, these studies have mainly focused on isolated performance attributes as predictors of soccer performance levels. However, there has been an increasing interest in finer grained criterion measures of soccer performance, as well as representative assessments at the level of performance predictors. In this study, we first determined the degree to which 7-vs-7 small-sided games can be considered as representative of 11-vs-11 games. Second, we assessed the validity of individual players' small-sided game performance in predicting their 11-vs-11 game performance on a continuous scale. Moreover, we explored the predictive validity for 11-vs-11 game performance of several physiological and motor tests in isolation. Sixty-three elite youth players of a professional soccer academy participated in 11 to 17 small-sided games and six 11-vs-11 soccer games. In-game performance indicators were assessed through notational analysis and combined into an overall offensive and defensive performance measure, based on their relationship with game success. Physiological and motor abilities were assessed using a sprint, endurance, and agility test. Results showed that the small-sided games were faster paced, but representative of 11-vs-11 games, with the exception of aerial duels. Furthermore, individual small-sided game performance yielded moderate predictive validities with 11-vs-11 game performance. In contrast, the physiological and motor tests yielded small to trivial relations with game performance. Altogether, this study provides novel insights into the application of representative soccer assessments and the use of continuous criterion measures of soccer performance