Child caries management: A randomized controlled trial in dental practice

This multicenter 3-arm, parallel-group, patient-randomized controlled trial compared clinical effectiveness of 3 treatment strategies over 3 y for managing dental caries in primary teeth in UK primary dental care. Participants aged 3 to 7 y with at least 1 primary molar with dentinal carious lesion were randomized across 3 arms (1:1:1 via centrally administered system with variable-length random permuted blocks): C+P, conventional carious lesion management (complete carious tooth tissue removal and restoration placement) with prevention; B+P, biological management (sealing in carious tooth tissue restoratively) with prevention; and PA, prevention alone (diet, plaque removal, fluorides, and fissure sealants). Parents, children, and dentists were not blind to allocated arm. Co–primary outcomes were 1) the proportion of participants with at least 1 episode of dental pain and/or infection and 2) the number of episodes of dental pain and/or infection during follow-up (minimum, 23 mo). In sum, 1,144 participants were randomized (C+P, n = 386; B+P, n = 381; PA, n = 377) by 72 general dental practitioners, of whom 1,058 (C+P, n = 352; B+P, n = 352; PA, n = 354) attended at least 1 study visit and were included in the primary analysis. The median follow-up was 33.8 mo (interquartile range, 23.8 to 36.7). Proportions of participants with at least 1 episode of dental pain and/or infection were as follows: C+P, 42%; B+P, 40%; PA, 45%. There was no evidence of a difference in incidence of dental pain and/or infection when B+P (adjusted risk difference [97.5% CI]: −2% [−10% to 6%]) or PA (4% [−4% to 12%]) was compared with C+P. The mean (SD) number of episodes of dental pain and/or infection were as follows: C+P, 0.62 (0.95); B+P, 0.58 (0.87); and PA, 0.72 (0.98). Superiority could not be concluded for number of episodes between B+P (adjusted incident rate ratio (97.5% CI): 0.95 [0.75 to 1.21]) or PA (1.18 [0.94 to 1.48]) and C+P. In conclusion, there was no evidence of a difference among the 3 treatment approaches for incidence or number of episodes of dental pain and/or infection experienced by these participants with high caries risk and established disease (trial registration: ISRCTN77044005)

'That boy needs therapy' : constructions of psychotherapy in popular song lyrics

Despite a plethora of academic and clinical descriptions of psychotherapy, less research attention has been focused on the ways in which psychotherapy is talked about and represented in popular culture. This study investigates constructions of psychotherapy in the lyrics of popular songs and identifies the vocabularies, versions and relevant discourses that are invoked or crafted. A critical discourse analysis was applied to 24 songs and yielded three broad themes: 'Banal therapy', the 'Non-therapeutic relationship' and 'I know therefore I can'. These discursive objects are examined in light of a constructionist understanding of knowledge and power within a discussion of how their interplay is implicated in the status of psychotherapeutic concepts and practices as 'expert knowledge'. Some clinical implications are attended to without making claims that this study has identified ontological representations of psychotherapy in popular culture

Toward a high-power, brightness-enhanced, polarized, diode-bar pumped planar waveguide laser

We present recent results obtained in the design and construction of diode-bar pumped planar waveguide lasers. The Au coating of a Nd:Ga:Lu:Y3Al5O12 on Y3Al5O12 planar waveguide to produce a TE polarised laser with improved beam quality in the guided direction is also reported

In-plane diode-bar pumped, multi-Watt, Nd:Y₃Al₅O₁₂ planar waveguide lasers

We report monolithic, planar, Nd:Y3Al5O12 waveguide lasers pumped by a 20W diode-bar giving output powers of 6W and 3W from end and side-pumped geometries respectively. Control of the output mode quality is also investigated

Towards a high-power, brightness-enhanced, polarised, diode-bar pumped planar waveguide laser

We present recent results obtained in the design and construction of diode-bar pumped planar waveguide lasers. The Au coating of a Nd:Ga:Lu:Y3Al5O12 on Y3Al5O12 planar waveguide to produce a TE polarised laser with improved beam quality in the guided direction is also reported

Oceanographic and climatic evolution of the southeastern subtropical Atlantic over the last 3.5 Ma

The southeast Atlantic Ocean is dominated by two major oceanic systems: the Benguela Upwelling System, one of the world's most productive coastal upwelling cells and the Agulhas Leakage, which is important for transferring warm salty water from the Indian Ocean to the Atlantic Ocean. Here, we present a multi-proxy record of marine sediments from ODP Site 1087. We reconstruct sea surface temperatures (View the MathML source and TEX86 indices), marine primary productivity (total chlorin and alkenone mass accumulation rates), and terrestrial inputs derived from southern Africa (Ti/Al and Ca/Ti via XRF scanning) to understand the evolution of the Southeast Atlantic Ocean since the late Pliocene. In the late Pliocene and early Pleistocene, ODP Site 1087 was situated within the Benguela Upwelling System, which was displaced southwards relative to present. We recognize a series of events in the proxy records at 3.3, 3.0, 2.2, 1.5, 0.9 and 0.6 Ma, which are interpreted to reflect a combination of changes in the location of major global wind and oceanic systems and local variations in the strength and/or position of the winds, which influence nutrient availability. Although there is a temporary SST cooling observed around the initiation of Northern Hemisphere glaciation (iNHG), proxy records from ODP Site 1087 show no clear climatic transition around 2.7 Ma but instead most of the changes occur before this time. This observation is significant because it has been previously suggested that there should be a change in the location and/or strength of upwelling associated with this climate transition. Rather, the main shifts at ODP Site 1087 occur at ca. 0.9 Ma and 0.6 Ma, associated with the early mid-Pleistocene transition (EMPT), with a clear loss of the previous upwelling-dominated regime. This observation raises the possibility that reorganisation of southeast Atlantic Ocean circulation towards modern conditions was tightly linked to the EMPT, but not to earlier climate transitions