Short- and long-term skeletal relapse after mandibular advancement surgery

This study analyzes short- and long-term skeletal relapse after mandibular advancement surgery and determines its contributing factors. Thirty-two consecutive patients were treated for skeletal Class II malocclusion during the period between 1986 and 1989. They all had combined orthodontic and surgical treatment with BSSO and rigid fixation excluding other surgery. Of these, 15 patients (47%) were available for a long-term cephalography in 2000. The measurement was performed based on the serial cephalograms taken preoperatively; 1 week, 6 months and 14 months postoperatively; and at the final evaluation after an average of 12 years. Mean mandibular advancement was 4.1 mm at B-point and 4.9 mm at pogonion. Representing surgical mandibular ramus displacement, gonion moved downwards 2 mm immediately after surgery. During the short-term postoperative period, mandibular corpus length decreased only 0.5 mm, indicating that there was no osteotomy slippage. After the first year of observation, skeletal relapse was 1.3 mm at B-point and pogonion. The relapse continued, reaching a total of 2.3 mm after 12 years, corresponding to 50% of the mandibular advancement. Mandibular ramus length continuously decreased 1 mm during the same observation period, indicating progressive condylar resorption. No significant relationship between the amount of initial surgical advancement and skeletal relapse was found. Preoperative high mandibulo-nasal plane (ML-NL) angle appears to be associated with long-term skeletal relapse.

Effects of short- and long-term variations in RLS severity on perceived health status - the COR-study.

In a cohort study among 2751 members (71.5% females) of the German and Swiss RLS patient organizations changes in restless legs syndrome (RLS) severity over time was assessed and the impact on quality of life, sleep quality and depressive symptoms was analysed. A standard set of scales (RLS severity scale IRLS, SF-36, Pittsburgh Sleep Quality Index and the Centre for Epidemiologic Studies Depression Scale) in mailed questionnaires was repeatedly used to assess RLS severity and health status over time and a 7-day diary once to assess short-term variations. A clinically relevant change of the RLS severity was defined by a change of at least 5 points on the IRLS scale. During 36 months follow-up minimal improvement of RLS severity between assessments was observed. Men consistently reported higher severity scores. RLS severity increased with age reaching a plateau in the age group 45-54 years. During 3 years 60.2% of the participants had no relevant (±5 points) change in RLS severity. RLS worsening was significantly related to an increase in depressive symptoms and a decrease in sleep quality and quality of life. The short-term variation showed distinctive circadian patterns with rhythm magnitudes strongly related to RLS severity. The majority of participants had a stable course of severe RLS over three years. An increase in RLS severity was accompanied by a small to moderate negative, a decrease by a small positive influence on quality of life, depressive symptoms and sleep quality.

Do avoidance goals always impair performance? How neuroticism moderates the short- and long-term effects of avoidance versus approach goals on performance

Previous research agrees that approach goals have positive effects whereas avoidance goals have negative effects on performance. By contrast, the present chapter looks at the conditions under which even avoidance goals may have positive effects on performance. We will first review the previous research that supports the positive consequences of avoidance goals. Then we will argue that the positive and negative consequences of approach and avoidance goals on performance depend on an individual‘s neuroticism level and the time frame of their goal striving. Because neuroticism is positively related to avoidance goals, we assume that individuals with high levels of neuroticism may derive some benefits from avoidance goals. We have specified this assumption by hypothesizing that the fit between an individual‘s level of neuroticism and their avoidance goals leads to favorable consequences in the short term – but to negative outcomes in the long run. A short-term, experimental study with employees and a long-term correlative field study with undergraduate students were conducted to test whether neuroticism moderates the short- and long-term effects of avoidance versus approach goals on performance. Experimental study 1 showed that individuals with a high level of neuroticism performed best in the short term when they were assigned to avoidance goals, whereas individuals with a low level of neuroticism performed best when pursuing approach goals. However, study 2 indicated that in the long run individuals with a high level of neuroticism performed worse when striving for avoidance goals, whereas individuals with a low level of neuroticism were not impaired at all by avoidance goals. In summary, the pattern of results supports the hypothesis that a fit between a high level of neuroticism and avoidance goals has positive consequences in the short term, but leads to negative outcomes in the long run. We strongly encourage further research to investigate short- and long-term effects of approach and avoidance goals on performance in conjunction with an individual‘s personality, which may moderate these effects.