Successful splint therapy for embouchure dystonia in a trumpet player.

This clinical report describes a straightforward oral device technique that successfully allowed a patient with embouchure dystonia to regain his ability to play the trumpet.

Strategies to Avoid Underdiagnosing Pit-and-Fissure Caries.

Traditionally, testing for whether pit-and-fissure caries should be restored involved probing with a sharp explorer and evaluating resistance to withdrawal (ie, "stick"). Alternative visual methods of evaluation and classification have been proposed, validated, and accepted formally in the core curriculum on caries management in both Europe and North America. This article examines the resistance to occlusal breakdown of fluoridehardened enamel despite progression of underlying dentin caries with accompanying difficulty in diagnosis.

Caries Management with the International Caries Detection and Assessment System II: Established Pit and Fissure Lesions.

Introduction: Operative dentistry addresses the surgical management of caries, a significant portion of dental practice. Dental students, who typically develop their skill sets in this important discipline by creating idealized preparations in plastic teeth, are often confused by the wide variety of tooth anatomy and caries presentation they see when they subsequently treat patients. To address this significant clinical transition issue, we developed this resource on preparing the moderate carious lesion using a stepwise, structured technique.

Dental Anatomy and Occlusion: Mandibular Incisors-Flipped Classroom Learning Module.

Introduction: This dental anatomy module is the second in a series that develops skills in analyzing the morphology, function, anomalies, and development of human teeth. Learning the visual details associated with teeth has often proven difficult using the lecture format; thus, we have utilized computer-assisted flipped learning, which has been shown to be just as effective as lectures and frees up class time for active learning.

Methods: In a flipped classroom approach, students learn basic knowledge with a self-paced, interactive tutorial prior to class.

Setting Expectations About Feedback in Dental Education.

Introduction: Many dental students find the amount of direct feedback they receive in dental school to be both unfamiliar and uncomfortable, as many new hand-skill courses are added to familiar lecture courses and traditional paper-and-pencil tests. In turn, when students react poorly to routine professional feedback, dental school faculty often complain they are too fragile. To address this clear gap in expectations between students and faculty in regard to feedback activities, this half-day workshop was developed for use during student orientation.

Design and development of the MacTSQ measure of satisfaction with treatment for macular conditions used within the IVAN trial.

Background: The purpose of the study was to design a measure of patient satisfaction with treatment for macular disease, the MacTSQ, and to carry out psychometric evaluation of the measure. The measure was designed along the lines of the widely used Diabetes Treatment Satisfaction Questionnaire (DTSQ) and sister measures of treatment satisfaction for other conditions including diabetic retinopathy. Information was also gathered during in-depth interviews with 20 people who had experienced one of a range of treatments for macular degeneration.

Scrupulous Monitoring of Physician-Assisted Dying: The Case for Mandatory Reporting to Coroners and Medical Examiners of All Physician-Assisted Deaths in Canada.

Although the practice of physician-assisted dying (hereinafter "PAD") will soon be lawful in Canada, opponents of PAD claim that it might result in involuntary deaths. The Supreme Court of Canada in Carter v. Canada (Attorney General) rejected such arguments holding that involuntary deaths are preventable provided that jurisdictions devise stringent limits to the practice of PAD and that these stringent limits are "scrupulously monitored and enforced".

Effect of nanolayering of calcium salts of phosphoric acid ester monomers on the durability of resin-dentin bonds.

Unlabelled: To investigate the contribution of nanolayering on resin-dentin bond durability, two phosphoric acid ester resin monomers, 10-methacryloyloxy-decyl-dihydrogen-phosphate (10-MDP) or its analog, methacryloyloxy-penta-propyleneglycol-dihydrogen-phosphate (MDA), were examined for their affinity for mineralized dentin powder in a column chromatography setup. Hydroxyapatite (HA) powder was dispersed in experimental primers consisting of 10-MDP or MDA solvated in ethanol/water and examined with FTIR, (31)P MAS-NMR and XPS. Light-curable 10-MDP or MDA primers were used for bonding to dentin, and examined after 24h or one-year of water-aging by TEM for evidence of nanolayering, and for microtensile bond strength evaluation.

The effect of initial irrigation with two different sodium hypochlorite concentrations on the erosion of instrumented radicular dentin.

Objective: This study evaluated the effects of different NaOCl concentrations and contact times on removal of the organic phase from mineralized dentin with and without the adjunctive use of EDTA, and the effect of NaOCl concentrations on canal wall erosion after the use of EDTA as the final active irrigant.

Methods: Dentin powders were immersed in 5.25% or 1.

Development of real-time PCR assays for the specific detection of Francisella tularensis ssp. tularensis, holarctica and mediaasiatica.

Real-time polymerase chain reaction (PCR) assays were developed to detect Francisella tularensis (Ft), the causative agent of tularaemia in humans. Two real-time PCRs (FTT0376 and FTT0523) were designed in genetic sequences identified by the Insignia genome comparison tool (http://insignia.cbcb.

Responding to aggression in long term care: lessons from five case studies.

Violence by patients against staff has been a growing concern in hospitals not only in the U.S., but in Canada and the U.

Promoting a cultural shift and a system change to respond to agitated and excessive behaviours (REAB).

The Responding to Excessive & Agitated Behaviour (REAB) Program was designedas a system change model to create a healthy work culture and to promote quality, client-centered care. It is a unique program that has integrated best clinical practices with workplace safety policy and criteria promoting continuous assessment ofa facility's ability to meet the requirements of the REAB model. Funding was received from the BC Nursing Directorate.

The MacDQoL individualized measure of the impact of macular degeneration on quality of life: reliability and responsiveness.

Purpose: To investigate the MacDQoL test-retest reliability and sensitivity to change in vision over a period of one year in a sample of patients with age-related macular degeneration (AMD).

Design: A prospective, observational study.

Method: Patients with AMD from an ophthalmologist's list (n = 135) completed the MacDQoL questionnaire by telephone interview and underwent a vision assessment on two occasions, one year apart.

Pain, distress, and adult-child interaction during venipuncture in pediatric oncology: an examination of three types of venous access.

This study examined pain and distress from needles in children undergoing blood sampling as a function of adult-child interaction and type of venous access (i.e., central external venous lines, internalized ports, or peripheral access via venipuncture).

Quality of life and health economic assessments of age-related macular degeneration.

In this article, we review measures of patient-reported outcomes that can show whether a treatment for age-related macular degeneration also provides patient-perceived benefits. In addition, we look at health economic measurements currently being used to develop cost-effectiveness models for age-related macular degeneration.

Quality of life in age-related macular degeneration: a review of the literature.

Background: The Age-related Macular Degeneration Alliance International commissioned a review of the literature on quality of life (QoL) in macular degeneration (MD) with a view to increasing awareness of MD, reducing its impact and improving services for people with MD worldwide.

Method: A systematic review was conducted using electronic databases, conference proceedings and key journal hand search checks. The resulting 'White Paper' was posted on the AMD Alliance website and is reproduced here.

+Psychometric evaluation of the MacDQoL individualised measure of the impact of macular degeneration on quality of life.

Background: The MacDQoL is an individualised measure of the impact of macular degeneration (MD) on quality of life (QoL). There is preliminary evidence of its psychometric properties and sensitivity to severity of MD. The aim of this study was to carry out further psychometric evaluation with a larger sample and investigate the measure's sensitivity to MD severity.

N-acetylcysteine reduces contrast-associated nephropathy but not clinical events during long-term follow-up.

Background: Contrast-associated nephropathy (CAN) is associated with increased morbidity and mortality following percutaneous coronary intervention (PCI). N-acetylcysteine (NAC) has been shown to reduce the risk of nephropathy; however, the impact of NAC on long-term clinical outcomes has not been assessed.

Methods: This randomized, double-blind, placebo-controlled trial enrolled 180 patients with moderate renal dysfunction undergoing PCI or coronary angiography with a high likelihood of ad hoc PCI; 171 patients completed the clinical follow-up.

Design of an individualised measure of the impact of macular disease on quality of life (the MacDQoL).

The aim of this study was to design an individualised questionnaire to measure the impact of macular disease (MD) on quality of life (QoL). Principles underlying the Schedule for the Evaluation of Individual Quality of Life (SEIQoL) interview method and the Audit of Diabetes-Dependent Quality of Life (ADDQoL) diabetes-specific questionnaire influenced the Macular Disease-Dependent Quality of Life (MacDQoL) design. The MacDQoL specifies domains of QoL that were selected using focus group methodology and refined following a postal pilot study of members of the UK Macular Disease Society (MDS).