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

Is EMDR an Evidenced-Based Treatment for Depression? A Review of the Literature

It is not unusual for proponents of eye movement desensitization and reprocessing (EMDR) to claim it can be used to treat many mental health problems. Depression is an illness that affects the lives of millions across the world; the costs are high, economically and socially, and depression can be devastating for the individual. Despite this, depression is not well treated, so a desire to find other treatments is admirable. However, these treatments must be evidence based and although there is some evidence that EMDR may be a promising new approach, it cannot currently be described as an evidenced-based treatment for depression. There are studies under way across Europe that may produce the evidence needed to expand the recommendations for using EMDR with more than just posttraumatic stress disorder (PTSD)

Training health visitors in cognitive behavioural and person-centred approaches for depression in postnatal women as part of a cluster randomised trial and economic evaluation in primary care: the PoNDER trial

Aim: This paper aims to describe the training preparation for health visitors who took part in the intervention arm of a cluster randomised controlled trial and economic evaluation of training for health visitors – the POstNatal Depression Economic evaluation and Randomised (the PoNDER) trial. A secondary aim is to make available, by electronic links, the training manuals developed for and used for the cognitive behavioural approach (CBA) and the person-centred approach (PCA) training for the health visitors. The paper is of relevance to health visitors, general practitioners, nurse practitioners, midwives, clinical psychologists, mental health nurses, community psychiatric nurses, counsellors, and service commissioners. Background: The trial clinical outcomes have been published, indicating the pragmatic effectiveness of the package of training for health visitors to identify depressive symptoms and provide a psychologically informed intervention. The training was associated with a reduction in depressive symptoms at six months postnatally among intervention group women and some evidence of a benefit for the intervention group for some of the secondary outcomes at 18 months follow-up. Methods: The two experimental interventions examined in the PoNDER trial built upon promising work on the potential for psychological interventions to help women recover from postnatal depression as an alternative to pharmaceutical interventions and to address the limitations of previous research in the area. Findings: The package of health visitor training comprised the development of clinical skills in assessing postnatal women and identifying depressive symptoms, and the delivery of a CBA or a PCA for eligible women. This was the largest trial a health visitor intervention and of postnatal depression ever conducted. We are aware of no other rigorously performed trial that has published details of an extensively tested training programme for the benefit of health-care professionals and clients

Making Communities More Viable: Four Essential Factors for Successful Community Leadership

A recent study was undertaken to compare two particularly successful rural communities, focusing on the importance of leadership within the community. Four significant factors set these successful communities apart from those less viable-effective communication, development of social capital, community engagement, and collaboration across and within communities. This article describes each component and provides specific suggestions for improvement. Ultimately, these factors could be used as focus areas to improve community leadership through the development of community-appropriate curricula, seminars, and workshops

What are the barriers and facilitators to implementing Collaborative Care for depression? A systematic review.

Background: Collaborative Care is an evidence-based approach to the management of depression within primary care services recommended within NICE Guidance. However, uptake within the UK has been limited. This review aims to investigate the barriers and facilitators to implementing Collaborative Care. Methods: A systematic review of the literature was undertaken to uncover what barriers and facilitators have been reported by previous research into Collaborative Care for depression in primary care. Results: The review identified barriers and facilitators to successful implementation of Collaborative Care for depression in 18 studies across a range of settings. A framework analysis was applied using the Collaborative Care definition. The most commonly reported barriers related to the multi-professional approach, such as staff and organisational attitudes to integration, and poor inter-professional communication. Facilitators to successful implementation particularly focussed on improving inter-professional communication through standardised care pathways and case managers with clear role boundaries and key underpinning personal qualities. Limitations: Not all papers were independent title and abstract screened by multiple reviewers thus limiting the reliability of the selected studies. There are many different frameworks for assessing the quality of qualitative research and little consensus as to which is most appropriate in what circumstances. The use of a quality threshold led to the exclusion of six papers that could have included further information on barriers and facilitators. 3 Conclusions: Although the evidence base for Collaborative Care is strong, and the population within primary care with depression is large, the preferred way to implement the approach has not been identified

Cooperation Between Secondary Agricultural Educators and Extension Agents

The study reported here explored cooperation between agriculture teachers and Extension agents and characterized the environment surrounding interdisciplinary cooperation. A researcher-developed questionnaire was used to explore individual perceptions regarding cooperation, behavioral intentions, and individual experiences with cooperation. Means and standard deviations were compared between disciplines. Results indicated that agriculture teachers and Extension agents seemed to have very similar ideas concerning personal perceptions, motivations, and experiences regarding cooperation. Recommendations include joint preparation for teachers and agents, pre-service and in-service incorporation of different facets of cooperation, and assembling an integrated discussion group where future interdisciplinary associations could be discussed

NASP aeroservothermoelasticity studies

Some illustrative results obtained from work accomplished under the aerothermoelasticity work breakdown structure (WBS) element of the National Aerospace Plane (NASP) Technology Maturation Program (TMP) are presented and discussed. The objectives of the aerothermoelasticity element were to develop analytical methods applicable to aerospace plane type configurations, to conduct analytical studies to identify potential problems, to evaluate potential solutions to problems, and to provide an experimental data base to verify codes and analytical trends. Work accomplished in the three areas of experimental data base, unsteady aerodynamics, and integrated analysis methodology are described. Some of the specific topics discussed are: (1) transonic wind tunnel aeroelastic model tests of cantilever delta wing models, of an all-moveable delta-wing model, and of aileron buzz models; (2) unsteady aerodynamic theory correlation with experiment and theory improvements; and (3) integrated analysis methodology results for thermal effects on vibration, for thermal effects on flutter, and for improving aeroelastic performance by using active controls

An anatomical study of additional radial wrist extensors including a unique extensor carpi radialis accessorius

Background: In this study, 82 forearms from 41 cadavers were dissected to establish the incidence of variant additional radial wrist extensors. Three variants have been described in the literature: extensor carpi radialis intermedius (ECRI), extensor carpi radialis accessorius (ECRA) and extensor carpi radialis tertius (ECRT). Materials and methods: Of the 41 cadavers studied, 5/41 (12%) had an additional radial wrist extensor. Of these 5 individuals, 2 had bilateral additional muscles and 3 were unilateral. Of the 82 forearms, 7/82 (9%) had additional radial wrist extensors. Results: We found 4 examples of ECRI and 3 examples of ECRA. We did not find any examples of ECRT. One specimen of ECRA had an atypical, previously undescribed, course. Conclusions: These accessory muscles are of clinical relevance, as they may be a contributing factor in tennis elbow and nerve entrapment, or cause diagnostic confusion, especially in ultrasound scans. However, they may also be used for tendon transfer. Of the 7 muscles found in the current study, 3 would have been suitable for such procedures.

Assessment of an allelic series of mouse TDP43 mutations

A chemical mutagenesis approach has been used to generate novel models carrying point mutations in mouse Tardbp, the gene encoding TDP43. TDP43 is a highly conserved protein, which in humans has been shown to be critical in amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD-TDP). The aims of the work described in this thesis are to assess ten TDP43 point mutations at a behavioural, cellular and molecular level to determine whether they are functional and if they can be used as tools or models to understand TDP43 function and dysfunction in the mouse. A comprehensive behavioural assessment of four mouse mutant lines has been completed to assess for TDP43 mutant phenotypes. Behavioural assessment has encompassed general health assessment through to motor capabilities. Tests regularly applied include SHIRPA, grip strength, rotarod and open field. All mutations have also been assessed in vitro using a cystic fibrosis transmembrane regulator (CFTR) add-back assay. The data presented in this thesis characterises the nonsense mutation Q101X, and a missense mutation K160R, generated in mice. The K160R mutation lies within the first RNA recognition motif of TDP43. Compound mutants (TardbpQ101X/K160R) were also generated and assessed. Q101X causes homozygous lethality as occurs in knockout TDP43 mice. This supports the Q101X mutation as being an alternative null allele. Q101X, K160R and compound mutants (TardbpQ101X/K160R) show common neuronal associated phenotypes in the SHIRPA, including limb grasping and a softer body tone. The compound mutants (TardbpQ101X/K160R) also present novel alterations at six months as demonstrated using electron microscopy. Additionally, weight and preliminary anxiety phenotypes have been shown. Q101X heterozygotes were also crossed to transgenic SOD1G93A mice to generate double mutants. Mutations in SOD1 also cause ALS. Modifying effects were assessed through behavioural characterisation with no overt interaction identified. All missense mutations were assessed in vitro using a CFTR mini-gene assay. Out of ten identified point mutations, F210I, a mutation in the second RNA recognition motif of TDP43 showed deficient splicing activity. This was further confirmed ex vivo in mouse embryonic fibroblasts (MEFs). The F210I mutation is an RNA-binding hypomorphic allele. It shows disrupted Tardbp transcript regulation, supporting potential perturbations in TDP43 auto-regulation. There are also further alterations in RNA metabolism, two processes potentially critical to ALS and FTLD-TDP. F210I demonstrates the importance of the second RNA recognition motif in RNA-binding function

Helios-2 Vela-Ariel-5 gamma-ray burst source position

The gamma-ray burst of 28 January 1976, one of 18 events thus far detected in interplanetary space with Helios-2, was also observed with the Vela-5A, -6A and the Ariel-5 satellites. A small source field is obtained from the intersection of the region derived from the observed time delays between Helios-2 and Vela-5A and -6A with the source region independently found with the Ariel-5 X-ray detector. This area contains neither any steady X-ray source as scanned by HEAO-A nor any previously catalogued X-ray, radio or infrared sources, X-ray transients, quasars, seyferts, globular clusters, flare stars, pulsars, white dwarfs or high energy gamma-ray sources. The region is however, within the source field of a gamma-ray transient observed in 1974, which exhibited nuclear gamma-ray line structure