Clinical effectiveness of direct anterior restorations-A meta-analysis.

OBJECTIVES: This is the first meta-analysis on the efficacy of composite resin restorations in anterior teeth. The objective of the present meta-analysis was to verify whether specific material classes, tooth conditioning methods and operational procedures influence the result for Class III and Class IV restorations. MATERIAL AND METHODS: The database SCOPUS and PubMed were searched for clinical trials on anterior resin composites without restricting the search to the year of publication. The inclusion criteria were: (1) prospective clinical trial with at least 2 years of observation; (2) minimal number of restorations at last recall=20; (3) report on drop-out rate; (4) report of operative technique and materials used in the trial, and (5) utilization of Ryge or modified Ryge evaluation criteria. For the statistical analysis, a linear mixed model was used with random effects to account for the heterogeneity between the studies. p-Values smaller than 0.05 were considered to be significant. RESULTS: Of the 84 clinical trials, 21 studies met the inclusion criteria, 14 of them for Class III restorations, 6 for Class IV restorations and 1 for closure of diastemata; the latter was included in the Class IV group. Twelve of the 21 studies started before 1991 and 18 before 2001. The estimated median overall success rate (without replacement) after 10 years for Class III composite resin restorations was 95% and for Class IV restorations 90%. The main reason for the replacement of Class IV restorations was bulk fractures, which occurred significantly more frequently with microfilled composites than with hybrid and macrofilled composites. Caries adjacent to restorations was infrequent in most studies and accounted only for about 2.5% of all replaced restorations after 10 years irrespective of the cavity class. Class III restorations with glass ionomer derivates suffered significantly more loss of anatomical form than did fillings with other types of material. When the enamel was acid-etched and no bonding agent was applied, significantly more restorations showed marginal staining and detectable margins compared to enamel etching with enamel bonding or the total etch technique; fillings with self-etching systems were in between of these two outcome variables. Bevelling of the enamel was associated with a significantly reduced deterioration of the anatomical form compared to no bevelling but not with less marginal staining or less detectable margins. The type of isolation (absolute/relative) had a statistically significant influence on marginal caries which, however, might be a random finding.

Educational intervention for parents of adolescents with chronic illness: a pre-post test pilot study.

OBJECTIVE: This pilot experimental study tested the feasibility and intended effect of an educational intervention for parents to help them assist their adolescent child with chronic illness (CI) in becoming autonomous. METHODS: A two-phase pre-post pilot intervention study targeting parents of adolescents with CI was conducted. Parents were allocated to group 1 and 2 and received the four-module intervention consecutively. Intended effect was measured through online questionnaires for parents and adolescents before, at 2 months after, and at 4-6 months after the intervention. Feasibility was assessed through an evaluation questionnaire for parents. RESULTS: The most useful considered modules concerned the future of the adolescent and parents and social life. The most valued aspect was to exchange with other parents going through similar problems and receiving a new outlook on their relationship with their child. For parents, improvement trends appeared for shared management, parent protection, and self-efficacy, and worsening trends appeared for coping skills, parental perception of child vulnerability, and parental stress. For adolescents, improvement trends appeared for self-efficacy and parental bonding and worsening trends appeared for shared management and coping skills. CONCLUSION: Parents could benefit from peer-to-peer support and education as they support the needed autonomy development of their child. Future studies should test an online platform for parents to find peer support at all times and places.

New opportunities in vasopressin and oxytocin research: a perspective from the amygdala.

In the present review, we discuss how the evolution of oxytocin and vasopressin from a single ancestor peptide after gene duplication has stimulated the development of the vertebrate social brain. Separate production sites became possible with a hypothalamic development, which, interestingly, is triggered by the same transcription factors that underlie the development of various subcortical regions where vasopressin and oxytocin receptors are adjacently expressed and which are connected by inhibitory circuits. The opposite modulation of their output by vasopressin and oxytocin could thus create a dynamic equilibrium for rapid responsiveness to external stimuli. At the level of the individual, nurturing early in life can long-lastingly program oxytocin signaling, maintaining a capability of learning and sensitivity to external stimuli that contributes to development of social behavior in adulthood. Oxytocin and vasopressin are thus important for the development of a vertebrate brain that supports bonding between individuals and building of an interactive community.

Facing Structural Disadvantage: The Role of Ingroup Connectedness

This thesis focuses on the social-psychological factors that help coping with structural disadvantage, and specifically on the role of cohesive ingroups and the sense of connectedness and efficacy they entail in this process. It aims to complement existing group-based models of coping that are grounded in a categorization perspective to groups and consequently focus exclusively on the large-scale categories made salient in intergroup contexts of comparisons. The dissertation accomplishes this aim through a reconsideration of between-persons relational interdependence as a sufficient and independent antecedent of a sense of groupness, and the benefits that a sense of group connectedness in one's direct environment, regardless of the categorical or relational basis of groupness, might have in the everyday struggles of disadvantaged group members. The three empirical papers aim to validate this approach, outlined in the first theoretical introduction, by testing derived hypotheses. They are based on data collected with youth populations (15-30) from three institutions in French-speaking Switzerland within the context of a larger project on youth transitions. Methods of data collection are paper-pencil questionnaires and in-depth interviews with a selected sub-sample of participants. The key argument of the first paper is that members of socially disadvantaged categories face higher barriers to their life project and that a general sense of connectedness, either based on categorical identities or other proximal groups and relations, mitigates the feeling of powerlessness associated with this experience. The second paper develops and tests a model that defines individual needs satisfaction as antecedent of self-group bonds and the efficacy beliefs derived from these intragroup bonds as the mechanism underlining the role of ingroups in coping. The third paper highlights the complexities that might be associated with the construction of a sense of groupness directly from intergroup comparisons and categorization-based disadvantage, and points out a more subtle understanding of the processes underling the emergence of groupness out of the situation of structural disadvantage. Overall, the findings confirm the central role of ingroups in coping with structural disadvantage and the importance of an understanding of groupness and its role that goes beyond the dominant focus on intergroup contexts and categorization processes.