A titration model for evaluating calcium hydroxide removal techniques

Objective Calcium hydroxide (Ca(OH)2) has been used in endodontics as an intracanal medicament due to its antimicrobial effects and its ability to inactivate bacterial endotoxin. The inability to totally remove this intracanal medicament from the root canal system, however, may interfere with the setting of eugenol-based sealers or inhibit bonding of resin to dentin, thus presenting clinical challenges with endodontic treatment. This study used a chemical titration method to measure residual Ca(OH)2 left after different endodontic irrigation methods. Material and Methods Eighty-six human canine roots were prepared for obturation. Thirty teeth were filled with known but different amounts of Ca(OH)2 for 7 days, which were dissolved out and titrated to quantitate the residual Ca(OH)2 recovered from each root to produce a standard curve. Forty-eight of the remaining teeth were filled with equal amounts of Ca(OH)2 followed by gross Ca(OH)2 removal using hand files and randomized treatment of either: 1) Syringe irrigation; 2) Syringe irrigation with use of an apical file; 3) Syringe irrigation with added 30 s of passive ultrasonic irrigation (PUI), or 4) Syringe irrigation with apical file and PUI (n=12/group). Residual Ca(OH)2 was dissolved with glycerin and titrated to measure residual Ca(OH)2 left in the root. Results No method completely removed all residual Ca(OH)2. The addition of 30 s PUI with or without apical file use removed Ca(OH)2 significantly better than irrigation alone. Conclusions This technique allowed quantification of residual Ca(OH)2. The use of PUI (with or without apical file) resulted in significantly lower Ca(OH)2 residue compared to irrigation alone

A confessional representation of ethnographic fieldwork in an academy sport setting

Methodological ‘confessions’ are an established genre of ethnographic writing and have contributed to the development of reflexivity in the practice of qualitative research. Yet despite their prevalence, methodological reflections on the specific challenges of conducting ethnography in institutional sport settings have not been developed. The aim of this article, therefore, is to provide a confessional representation of ethnographic fieldwork in a male academy sport environment in the UK which exhibited several institutional characteristics. Five images are used as stimuli for further methodological reflection in order to illustrate and analyse some practical, ethical and relational qualities of ethnographic fieldwork. The interpretation and analysis draws attention to strategic ways ethnographers adapt their ethnographic presence in response to specific contextual challenges and constraints. The paper concludes with a series of recommendations to guide ethnographic fieldworkers (especially novice ethnographers) in settings of a similar nature

A confessional representation of ethnographic fieldwork in an academy sport setting

Methodological “confessions” are an established genre of ethnographic writing and have contributed to the development of reflexivity in the practice of qualitative research. Yet despite their prevalence, methodological reflections on the specific challenges of conducting ethnography in institutional sport settings have not been developed. The aim of this article, therefore, is to provide a confessional representation of ethnographic fieldwork in a male academy sport environment in the United Kingdom which exhibited several institutional characteristics. Five images are used as stimuli for further methodological reflection in order to illustrate and analyze some practical, ethical, and relational qualities of ethnographic fieldwork. The interpretation and analysis draw attention to strategic ways ethnographers adapt their ethnographic presence in response to specific contextual challenges and constraints. The article concludes with a series of recommendations to guide ethnographic fieldworkers (especially novice ethnographers) in settings of a similar nature.</p

The experience of competition stress and emotions in cricket

The purpose of the study was to conduct an in-depth examination of the stress and emotion process experienced by three sub-elite level male cricketers over a series of five competitive performances. Using reflective diaries and follow up semi-structured interviews, the findings highlighted the impact of appraisal, coping, and emotion on performance, with perceptions of control and self-confidence emerging as variables that can influence the emotive and behavioral outcomes of a stressful transaction. Post-performance, guided athlete reflection was advanced as a valuable tool in the production and application of idiographic coping behaviors that could enhance perceptions of control and self-confidence and influence stress and emotion processes

Use of the Palliative Performance Scale to estimate survival among home hospice patients with heart failure

AimsEstimating survival is challenging in the terminal phase of advanced heart failure. Patients, families, and health‐care organizations would benefit from more reliable prognostic tools. The Palliative Performance Scale Version 2 (PPSv2) is a reliable and validated tool used to measure functional performance; higher scores indicate higher functionality. It has been widely used to estimate survival in patients with cancer but rarely used in patients with heart failure. The aim of this study was to identify prognostic cut‐points of the PPSv2 for predicting survival among patients with heart failure receiving home hospice care.Methods and resultsThis retrospective cohort study included 1114 adult patients with a primary diagnosis of heart failure from a not‐for‐profit hospice agency between January 2013 and May 2017. The primary outcome was survival time. A Cox proportional‐hazards model and sensitivity analyses were used to examine the association between PPSv2 scores and survival time, controlling for demographic and clinical variables. Receiver operating characteristic curves were plotted to quantify the diagnostic performance of PPSv2 scores by survival time. Lower PPSv2 scores on admission to hospice were associated with decreased median (interquartile range, IQR) survival time [PPSv2 10 = 2 IQR: 1–5 days; PPSv2 20 = 3 IQR: 2–8 days] IQR: 55–207. The discrimination of the PPSv2 at baseline for predicting death was highest at 7 days [area under the curve (AUC) = 0.802], followed by an AUC of 0.774 at 14 days, an AUC of 0.736 at 30 days, and an AUC of 0.705 at 90 days.ConclusionsThe PPSv2 tool can be used by health‐care providers for prognostication of hospice‐enrolled patients with heart failure who are at high risk of near‐term death. It has the greatest utility in patients who have the most functional impairment.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/148390/1/ehf212398_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/148390/2/ehf212398.pd

Effects of Process-Induced Voids on the Properties of Fibre Reinforced Composites

It is well known that voids have detrimental effects on the performance of composites. This study aims to provide a practical method for predicting the effects of process induced voids on the properties of composites. Representative volume elements (RVE) for carbon fibre/epoxy composites of various fibre volume fractions and void contents are created, and the moduli and strengths are derived by finite element analysis (FEA). Regression models are fitted to the FEA data for predicting composite properties including tensile, compressive and shear. The strengths of composite laminates including tensile strength and interlaminar shear strength (ILSS) are calculated with the aid of the developed models. The model predictions are compared with various experimental data and good agreement is found. The outcome from this study provides a useful optimisation and robust design tool for realising affordable composite products when process induced voids are taken into account

Exposure-based interventions for the management of individuals with high levels of needle fear across the lifespan: A clinical practice guideline and call for further research

Needle fear typically begins in childhood and represents an important health-related issue across the lifespan. Individuals who are highly fearful of needles frequently avoid health care. Although guidance exists for managing needle pain and fear during procedures, the most highly fearful may refuse or abstain from such procedures. The purpose of a clinical practice guideline (CPG) is to provide actionable instruction on the management of a particular health concern; this guidance emerges from a systematic process. Using evidence from a rigorous systematic review interpreted by an expert panel, this CPG provides recommendations on exposure-based interventions for high levels of needle fear in children and adults. The AGREE-II, GRADE, and Cochrane methodologies were used. Exposure-based interventions were included. The included evidence was very low quality on average. Strong recommendations include the following. In vivo (live/in person) exposure-based therapy is recommended (vs. no treatment) for children seven years and older and adults with high levels of needle fear. Non-in vivo (imaginal, computer-based) exposure (vs. no treatment) is recommended for individuals (over seven years of age) who are unwilling to undergo in vivo exposure. Although there were no included trials which examined children < 7 years, exposure-based interventions are discussed as good clinical practice. Implementation considerations are discussed and clinical tools are provided. Utilization of these recommended practices may lead to improved health outcomes due to better health care compliance. Research on the understanding and treatment of high levels of needle fear is urgently needed; specific recommendations are provided

Exposure-based Interventions for the management of individuals with high levels of needle fear across the lifespan: a clinical practice guideline and call for further research

Needle fear typically begins in childhood and represents an important health-related issue across the lifespan. Individuals who are highly fearful of needles frequently avoid health care. Although guidance exists for managing needle pain and fear during procedures, the most highly fearful may refuse or abstain from such procedures. The purpose of a clinical practice guideline (CPG) is to provide actionable instruction on the management of a particular health concern; this guidance emerges from a systematic process. Using evidence from a rigorous systematic review interpreted by an expert panel, this CPG provides recommendations on exposure-based interventions for high levels of needle fear in children and adults. The AGREE-II, GRADE, and Cochrane methodologies were used. Exposure-based interventions were included. The included evidence was very low quality on average. Strong recommendations include the following. In vivo (live/in person) exposure-based therapy is recommended (vs. no treatment) for children seven years and older and adults with high levels of needle fear. Non-in vivo (imaginal, computer-based) exposure (vs. no treatment) is recommended for individuals (over seven years of age) who are unwilling to undergo in vivo exposure. Although there were no included trials which examined children \u3c 7 years, exposure-based interventions are discussed as good clinical practice. Implementation considerations are discussed and clinical tools are provided. Utilization of these recommended practices may lead to improved health outcomes due to better health care compliance. Research on the understanding and treatment of high levels of needle fear is urgently needed; specific recommendations are provided