Preformed metal crowns for decayed primary molar teeth

BackgroundPreformed metal crowns (PMCs) are recommended by the British Society of Paediatric Dentistry (BSPD) for restoring badly broken down primary molar teeth. However, few dental practitioners adopt this technique in clinical practice, citing cost and clinical difficulty as reasons for this. Whilst there is a subjective impression by clinical academics that PMCs provide a more durable restoration than filling materials, there appears to be little evidence within the literature to support this.ObjectivesThe primary aim of this systematic review was to compare clinical outcomes for primary molar teeth restored using PMCs compared to those restored with filling materials.Search methodsThe literature was searched using: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2005, Issue 3); MEDLINE (1966 to August 2005); EMBASE (1980 to August 2005); System for Information on Grey Literature in Europe (SIGLE) (1976 to August 2005). Relevant publications' reference lists were reviewed for relevant articles. The most recent search was carried out on 24 August 2005.Selection criteriaRandomised controlled trials (RCTs) that assessed the effectiveness of PMCs compared with filling materials or where there had been no treatment in children with untreated tooth decay in one or more primary molar teeth.Data collection and analysisTwo review authors independently assessed the title and abstracts for each article from the search results to decide whether it was likely to be relevant. Full papers were obtained for relevant articles and all three review authors studied these.Main resultsForty‐seven records were retrieved by the search strategies of which some were duplicates. Of these, 14 studies were scrutinised. No studies met the inclusion criteria and six studies were excluded from the review as they were either retrospective in design or reported as prospective outcomes but not randomised. No data were available for extraction and analysis and therefore, no conclusion could be made as to whether PMCs were more successful than filling materials for restoring primary molar teeth.Authors' conclusionsNo RCTs were available for appraisal. Whilst this technique is recommended by the BSPD for use in clinical practice, the evidence to support this is not strong, consisting mainly of case reports and uncontrolled studies. It is important that the absence of evidence for PMCs is not misinterpreted as evidence for their lack of efficacy.There is a strong need for prospective RCTs comparing PMCs and fillings for managing decayed primary molar teeth. The lower levels of evidence that have been produced, however, have strength in that the clinical outcomes are consistently in favour of PMCs, despite many of the studies placing PMCs on the most damaged of the pair of teeth being analysed

Minimum intervention children's dentistry - the starting point for a lifetime of oral health

Child-friendly minimum intervention dentistry (MID) dominates modern thinking and practice around delivery of oral care for children. It is an enormous challenge for our profession to move away from the narrow focus of a mechanistic, cavity-orientated surgical approach for managing dental caries to one which embraces new strategies for caries prevention and management, delivered in the context of a partnership with children, families and other adults involved in the child's life environment. It is also time for a shift in the orientation of dentistry towards 'patient self-care' becoming a core goal of dental care, where dentists help their patients assume responsibility for achieving and maintaining their own oral health, and that of their children. Holistic care, which improves oral health and maximises ability to maintain oral health, should be regarded with the same importance and rewarded with a similar level of remuneration as 'traditional operative dentistry'. This paper gives an overview of a model of care involving the principles of this new approach, and the application of MID in clinical practice for primary teeth

Planar Josephson Tunnel Junctions in a Transverse Magnetic Field

Traditionally, since the discovery of the Josephson effect in 1962, the magnetic diffraction pattern of planar Josephson tunnel junctions has been recorded with the field applied in the plane of the junction. Here we discuss the static junction properties in a transverse magnetic field where demagnetization effects imposed by the junction geometry and configuration of the electrodes are important. Measurements of the critical current versus magnetic field in planar Nb-based high-quality junctions with different geometry, size and critical current density show that it is advantageous to use a transverse magnetic field rather than an in-plane field to suppress the Josephson tunnel current and Fiske resonances in practical applications.Comment: 5 pages, 2 figures, submitted to Journal of Applied Physic

‘Our voice started off as a whisper and now it is a great big roar’ : The Salford Dementia Associate Panel as a model of involvement in research activities

This paper presents the work of the ‘Salford Dementia Associate Panel’, based at the Salford Institute for Dementia, Salford University (UK). We discuss the roles of the Dementia Associates, in particular around the areas of engagement and research. The panel is made up of people living with dementia, and current and former care partners. It highlights the development of this group over a four-year period and demonstrates over time how the role of a Dementia Associate member has evolved. The panel is involved in research, education and public engagement activities conducted by staff and students within the Institute. The motivations for becoming involved are clearly articulated and demonstrate how the personal backgrounds of individuals have driven the collective involvement and desire to bring about change. The benefits and challenges associated with working as part of a panel are discussed. We conclude by bringing together our experiences as a set of suggestions for others who may wish to create a similar forum to promote the involvement of people living with dementia and former and current care partners

Eco Global Evaluation: Cross Benefits of Economic and Ecological Evaluation

This paper highlights the complementarities of cost and environmental evaluation in a sustainable approach. Starting with the needs and limits for whole product lifecycle evaluation, this paper begins with the modeling, data capture and performance indicator aspects. In a second step, the information issue, regarding the whole lifecycle of the product is addressed. In order to go further than the economical evaluations/assessment, the value concept (for a product or a service) is discussed. Value could combine functional requirements, cost objectives and environmental impact. Finally, knowledge issues which address the complexity of integrating multi-disciplinary expertise to the whole lifecycle of a product are discussing.EcoSD NetworkEcoSD networ

Mixed income housing (MIH)

Mixed Income Housing (MIH) is the outcome of a deliberate effort to build a mixed-income development, usually including a variety of housing typologies, sometime combined with the goal of creating a mixed-tenure development. International consensus on a more specific definition of MIH does not exist; instead, multiple expressions can be equally used, with similar meaning. The expression MIH is mainly used within the USA context where it is sometime replaced by mixed-income neighborhood. In Europe, MIH tend to fall within initiatives on (sustainable) urban regeneration, neighborhood restructuring, urban renewal, while the UK legislation often refers to “pepper-potting” with respect to different tenures in the same neighborhood aimed to achieve MIH. Non-English-speaking countries tend to use different terms. The MIH policies are challenged by a specific connotation, i.e., in the United States it is the combination between urban poverty and black or Latinos ghettoes; hence, spatial segregation is combined with racial considerations which are less present in other countries, except for South Africa. In the USA, desegregation in public housing estates became a legal obligation following the famous 1969 Gautreaux case, because of the application of the 1964 Civil Rights Act prohibiting racial discrimination in federally funded activities

The role of temperature in the magnetic irreversibility of type-I Pb superconductors

Evidence of how temperature takes part in the magnetic irreversibility in the intermediate state of a cylinder and various disks of pure type-I superconducting lead is presented. Isothermal measurements of first magnetization curves and magnetic hysteresis cycles are analyzed in a reduced representation that defines an equilibrium state for flux penetration in all the samples and reveals that flux expulsion depends on temperature in the disks but not in the cylinder. The magnetic field at which irreversibility sets in along the descending branch of the hysteresis cycle and the remnant magnetization at zero field are found to decrease with temperature in the disks. The contributions to irreversibility of the geometrical barrier and the energy minima associated to stress defects that act as pinning centers on normal-superconductor interfaces are discussed. The differences observed among the disks are ascribed to the diverse nature of the stress defects in each sample. The pinning barriers are suggested to decrease with the magnetic field to account for these results

"I guess it looks worse to me, it doesn't look like there's been a problem solved but obviously there is":a qualitative exploration of children's and their parents' views of silver diamine fluoride for the management of carious lesions in children

Abstract Background Despite growing evidence to support the use of silver diamine fluoride (SDF) for managing carious lesions, and the increased interest in SDF worldwide, uptake in the UK remains limited. This study explored parents’ and children’s views and acceptability of SDF for the management of carious lesions in children. Methods Eleven semi-structured face-to-face interviews were conducted with 11 parent–child dyads recruited from patients attending Dundee Dental Hospital and School. Interviews were transcribed verbatim, coded and thematically analysed. Results Previous dental experience varied across all child participants. Of the 11 children, five had undergone general anaesthesia (GA) for multiple primary tooth extractions. Two had received SDF treatment. Child participants expressed concerns about being picked on by their peers, if they had discoloured anterior teeth. Younger children appeared less concerned about the discolouration and child’s gender did not appear to influence parents’ decision-making, nor the child’s preferences regarding the use of SDF. Parents considered SDF to be particularly useful for anxious or uncooperative children but raised concerns about potential bullying at schools due to the unacceptable dental aesthetics when SDF is applied to anterior teeth. They believed they may be judged by others as neglecting their child’s oral health due to the black staining. Both parents and children were more accepting of the SDF when applied to less-visible posterior teeth. Parents accepted the use of SDF if such treatment avoided extractions under GA. Conclusion Despite the unfavourable aesthetics of SDF (black staining), parents appreciated SDF treatment, especially for uncooperative or younger children. However, both parents and children shared concerns about bullying at schools as a consequence of the black staining. Raising awareness about SDF was identified as one approach to encourage the uptake of SDF

Impact of previous hepatitis B infection on the clinical outcomes from chronic hepatitis C? A population-level analysis

Chronic coinfection with hepatitis C virus (HCV) and hepatitis B virus (HBV) is associated with adverse liver outcomes. The clinical impact of previous HBV infection on liver disease in HCV infection is unknown. We aimed at determining any association of previous HBV infection with liver outcomes using antibodies to the hepatitis B core antigen (HBcAb) positivity as a marker of exposure. The Scottish Hepatitis C Clinical Database containing data for all patients attending HCV clinics in participating health boards was linked to the HBV diagnostic registry and mortality data from Information Services Division, Scotland. Survival analyses with competing risks were constructed for time from the first appointment to decompensated cirrhosis, hepatocellular carcinoma (HCC) and liver‐related mortality. Records of 8513 chronic HCV patients were included in the analyses (87 HBcAb positive and HBV surface antigen [HBsAg] positive, 1577 HBcAb positive and HBsAg negative, and 6849 HBcAb negative). Multivariate cause‐specific proportional hazards models showed previous HBV infection (HBcAb positive and HBsAg negative) significantly increased the risks of decompensated cirrhosis (hazard ratio [HR]: 1.29, 95% CI: 1.01‐1.65) and HCC (HR: 1.64, 95% CI: 1.09‐2.49), but not liver‐related death (HR: 1.02, 95% CI: 0.80‐1.30). This is the largest study to date showing an association between previous HBV infection and certain adverse liver outcomes in HCV infection. Our analyses add significantly to evidence which suggests that HBV infection adversely affects liver health despite apparent clearance. This has important implications for HBV vaccination policy and indications for prioritization of HCV therapy