The influence of educational information on understanding and perceptions of root canal treatment

Patients frequently have a negative perception of root canal treatment (RCT) often due to a lack of understanding and knowledge of what the treatment involves. This may lead to patients being more anxious and fearful of their RCT. This can result in discomfort, dissatisfaction, and an increased rate of appointment cancellation or failures, or restorable teeth being extracted. Information is lacking about how patient education affects patient understanding, experience and overall perception of RCT. Research in other fields of healthcare has shown the benefit of patient education in aiding the informed consent process and enabling patients to be more accepting of their treatment, increasing understanding of treatment and decreasing anxiety. If patients are more aware of what to expect during RCT, it is anticipated that treatment would be less intimidating, perceived more positively, enabling patients to feel more informed to provide consent and less anxious throughout their treatment. This Practice Based Research study used a mixed-methods scientific approach and had three aims. The first aim was to develop and compare educational material on RCT in written and website form with existing written material. The second aim was to determine if delivering enhanced education to patients prior to treatment influences anxiety, understanding and perception of the procedure. The third aim was to gain an understanding of the current methods used by general dental practitioners (GDPs) to provide patient education and obtain informed consent prior to RCT and to seek their feedback on the enhanced educational material for RCT. In New Zealand (NZ), dental practitioners have access to an information sheet on RCT, produced by the New Zealand Dental Association (NZDA). In this study, a more detailed educational pamphlet and website were developed. Participants who required RCT were recruited by their GDP in private practices throughout NZ. Participants received a standardised verbal description of the treatment sequence from their dentist and were randomly assigned to one of three educational information groups: 1) the NZDA pamphlet (n=23), 2) the new pamphlet (n=21), or 3) an electronic link to a website which contained the same information as the new pamphlet (n=17). Patients completed a questionnaire before and after treatment which collected data on themes, dental pain, knowledge of RCT, anxiety, educational material, understanding and perception of RCT. Data was analysed using descriptive statistics and thematic analysis. General dental practitioners were also interviewed to provide feedback on RCT education and to understand their process of obtaining informed consent. An insight into the perceptions and understanding of RCT of a group of patients in NZ was obtained. Prior to commencing RCT, 42.6% of participants reported feeling anxious about having the treatment. Over one third (39%) of the participants felt anxious prior to attending the dentist. Patients found the new pamphlet and website informative and easy to understand. Over half (59.6%) of the participants felt that they had increased knowledge about RCT after education and treatment. The presentation of educational material prior to treatment increases understanding and lowers their anxiety and improves perception of treatment and meant they could more confidently make an informed decision and feel more positive about RCT. General dental practitioners interviewed all placed great importance on having an in-depth shared discussion of treatment with their patients prior to commencing RCT and obtaining verbal consent. Written consent is not routinely gained by the GDPs. The GDPs preferred the enhanced educational material to the existing NZDA pamphlet as it was more clear and comprehensive. The outcomes from this study, can be translated to clinical practice. It is crucial that GDPs understand that anxiety is often felt by patients prior to RCT and patients do not always present with a knowledge of treatment. The provision of enhanced educational material facilitates the informed consent process and improves the patient experience

Identification of Sensory Processing and Integration Symptom Clusters: A Preliminary Study

Rationale. This study explored subtypes of sensory processing disorder (SPD) by examining the clinical presentations of cluster groups that emerged from scores of children with SPD on the Sensory Processing 3-Dimension (SP-3D) Inventory. Method. A nonexperimental design was used involving data extraction from the records of 252 children with SPD. Exploratory cluster analyses were conducted with scores from the SP-3D Inventory which measures sensory overresponsivity (SOR), sensory underresponsivity (SUR), sensory craving (SC), postural disorder, dyspraxia, and sensory discrimination. Scores related to adaptive behavior, social-emotional functioning, and attention among children with different sensory modulation patterns were then examined and compared. Results. Three distinct cluster groups emerged from the data: High SOR only, High SUR with SOR, and High SC with SOR. All groups showed low performance within multiple domains of adaptive behavior. Atypical behaviors associated with social-emotional functioning and attention varied among the groups. Implications. The SP-3D Inventory shows promise as a tool for assisting in identifying patterns of sensory dysfunction and for guiding intervention. Better characterization can guide intervention precision and facilitate homogenous samples for research

Monitoring of zebra mussels in the Shannon-Boyle navigation, other

The zebra mussel (Dreissena polymorpha) population has been closely monitored in Ireland following its discovery in 1997. The species has spread from lower Lough Derg, where it was first introduced, to most of the navigable areas of the Shannon and other interconnected navigable waters. This study took place in the summers of 2000 and 2001 and investigated the relative abundance and biomass of zebra mussels found in the main navigations of the Shannon and elsewhere in rivers, canals and lakes where colonisation was likely. During 2000 zebra mussels were found for the first time in Carnadoe, Kilglas and Grange Loughs on the River Shannon. In 2001, they were discovered on the Ballinasloe Navigation at Poulboy Lough and in Ballinasloe Harbour. For the first time outside of the Shannon-Boyle navigation, established populations were discovered in Garadice Lough on the Shannon-Erne Waterway and in Ringsend Basin and Tullamore Harbour on the Grand Canal. Zebra mussels continue to have their greatest densities in lakes and large reservoirs of the Shannon-Boyle navigation. A maximum biomass of 4.1kg per sq.m was recorded in Lough Key. No zebra mussel larvae or their attached stages were found in the larger lakes outside of the Shannon-Boyle and Erne Navigations. Larvae were found however, in Tullamore Harbour for the first time. In separate studies approximately two hundred adults were found in Lough Bo, Co. Sligo and less than ten specimens were found in Lough Gill, Co. Sligo. The only living population of native freshwater mussels (Anodonta spp.) presently known in the lake regions of the Shannon is in the Carnadoe Cut, between Carnadoe Lough and Kilglas Lough. This population of Anodonta spp. is fouled with zebra mussels. Freshwater mussels were also found in Garadice Lough and Assaroe Reservoir. These were also fouled with zebra mussels.Funder: Marine Institut

A Further Look at Potential Impact of Satlets on Design, Production, and Cost of Satellite Systems

For the past 50 years, the morphology for satellites has remained fundamentally unchanged despite evolutions in manufacturing, communications, and software occurring in other industries. Primary spacecraft support systems—power, attitude control, and others—are designed in the same way, whether in space telescopes, large communications satellites, interplanetary spacecraft, or Cubesats. This paradigm has been the status quo in spacecraft design and construction and has precluded any industry-wide, large-scale cost savings while maintaining performance. To change this trend and ensure performance and utility at low cost, that can scale, DARPA postulated the concept of a cellularized satellite, or “satlet,” as a satellite architectural unit. In this new morphology, each satlet would provide some fraction of the overall functions that, when aggregated via hardware and software, provide spacecraft space system with its complete required capabilities. The DARPA Phoenix program has developed this satlet morphology in Phase I and plans to validate and demonstrate it in a series of steps that exercise various applications and levels of configuration flexibility enabled by a satlet architecture. The first system experiment is planned to be conducted on orbit in 2015. This paper aims to take a deeper look at the potential impact of space systems with cellular based designs, and using historical data showcases how design, production and ultimately cost can form the foundation for next generation spacecraft opportunities. A first order analysis conducted in a previous paper indicated that U.S.-launched satellites alone could create a market demand for 2,000-8,000 satlets flown per year, while the overall annual world satellite market could create demand for 10,000-40,000 satlets. This paper explores the instantiation of a cellular morphology to design, production and development to further quantify the impact of this revolutionary space system capability

Genetic and environmental determinants of children's food preferences

Omnivores have the advantage of a variety of food options but face a challenge in identifying foods that are safe to eat. Not surprisingly, therefore, children show a relative aversion to new foods (neophobia) and a relative preference for familiar, bland, sweet foods. While this may in the past have promoted survival, in the modem food environment it could have an adverse effect on dietary quality. This review examines the evidence for genetic and environmental factors underlying individual differences in children's food preferences and neophobia. Twin studies indicate that neophobia is a strongly heritable characteristic, while specific food preferences show some genetic influence and are also influenced by the family environment. The advantage of the malleability of human food preferences is that dislike of a food can be reduced or even reversed by a combination of modelling and taste exposure. The need for effective guidance for parents who may be seeking to improve the range or nutritional value of foods accepted by their children is highlighted

American Clinical Neurophysiology Society Guideline 1: Minimum Technical Requirements for Performing Clinical Electroencephalography

PublishedN/

Zebra mussels (Dreissena polymorpha) are effective sentinels of water quality irrespective of their size

Zebra mussels (Dreissena polymorpha) are recognised biomonitors in determining the presence and viability of the human\ud waterborne pathogens Cryptosporidium parvum, C. hominis, Giardia intestinalis and microsporidia in surface waters. This study\ud investigated whether the size of zebra mussels is a significant factor in the concentration of protozoan Cryptosporidium oocysts,\ud Giardia cysts and microsporidian spores. Zebra mussels were collected in Lough Arrow, a small Irish lake, which is utilized for\ud drinking water abstraction and is subject to agricultural and human wastewater pollution drivers, both recognised risk factors for\ud human waterborne pathogens. Zebra mussels were cleaned, divided into size (5 mm) interval classes based on their shell length\ud and made up to 150 g samples (wet weight with shell). Combined fluorescence in situ hybridization (FISH) and\ud immunofluorescent antibody (IFA) techniques were utilized as biomolecular techniques to assess the presence and concentration\ud of the pathogens. PCR analysis provided source-tracking information on human and animal pollution sources. There was no\ud significant relationship between the size of D. polymorpha and pathogen loads in similar sized samples, indicating that different\ud sites in the same or different waterbody can be compared in terms of relative concentrations of human waterborne parasites\ud irrespective of the zebra mussels’ size. Cryptosporidium was the most abundant species, with lower counts of Giardia and the\ud microsporidian Encephalitozoon hellem, respectively. Cryptosporidium oocysts and Giardia cysts were detected in zebra mussel\ud samples at all three lake water abstraction points. A lake transect showed a decline in Cryptosporidium with increasing distance\ud from a stream discharging sewage. Samples from agricultural sites indicated faecal inputs contaminated with these pathogens.\ud Species identification implicated both human and animal faecal inputs to the lake from treated effluent, septic tanks, and\ud agriculture. The research demonstrates the efficacy of zebra mussels as sentinels of water quality irrespective of their size

Extracting clean supernova spectra

We use a new technique to extract the spectrum of a supernova from that of the contaminating background of its host galaxy, and apply it to the specific case of high-redshift Type Ia supernova (SN Ia) spectroscopy. The algorithm is based on a two-channel iterative technique employing the Richardson-Lucy restoration method and is implemented in the IRAF code 'specinholucy'. We run the code both on simulated (SN Ia at z=0.5 embedded in a bright host galaxy) and observed (SNe Ia at various phases up to z=0.236) data taken with VLT+FORS1 and show the advantages of using such a deconvolution technique in comparison with less elaborate methods. This paper is motivated by the need for optimal supernova spectroscopic data reduction in order to make meaningful comparisons between the low and high-redshift SN Ia samples. This may reveal subtle evolutionary and systematic effects that could depend on redshift and bias the cosmological results derived from comparisons of local and high-z SNe Ia in recent years. We describe the various aspects of the extraction in some detail as guidelines for the first-time user and present an optimal observing strategy for successful implementation of this method in future high-z SN Ia spectroscopic follow-up programmes.Comment: 15 pages, 14 figures, accepted for publication in A&

Structure of the murine CD94 – NKG2A receptor in complex with Qa‐1b presenting an MHC‐I leader peptide

The heterodimeric natural killer cells antigen CD94 (CD94)–NKG2‐A/NKG2‐B type II integral membrane protein (NKG2A) receptor family expressed on human and mouse natural killer (NK) cells monitors global major histocompatibility complex (MHC) class I cell surface expression levels through binding to MHC class Ia‐derived leader sequence peptides presented by HLA class I histocompatibility antigen, alpha chain E (HLA‐E; in humans) or H‐2 class I histocompatibility antigen, D‐37 (Qa‐1b; in mice). Although the molecular basis underpinning human CD94–NKG2A recognition of HLA‐E is known, the equivalent interaction in the murine setting is not. By determining the high‐resolution crystal structure of murine CD94–NKG2A in complex with Qa‐1b presenting the Qa‐1 determinant modifier peptide (QDM), we resolved the mode of binding. Compared to the human homologue, the murine CD94–NKG2A–Qa‐1b–QDM displayed alterations in the distribution of interactions across CD94 and NKG2A subunits that coincide with differences in electrostatic complementarity of the ternary complex and the lack of cross‐species reactivity. Nevertheless, we show that Qa‐1b could be modified through W65R + N73I mutations to mimic HLA‐E, facilitating binding with both human and murine CD94–NKG2A. These data underscore human and murine CD94–NKG2A cross‐species heterogeneity and provide a foundation for humanising Qa‐1b in immune system models