848 resultados para language, communication, patient safety


Relevância:

100.00% 100.00%

Publicador:

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Dentin bonding performed with hydrophobic resins using ethanol-wet bonding should be less susceptible to degradation but this hypothesis has never been validated. Objectives. This in vitro study evaluated stability of resin-dentin bonds created with an experimental three-step BisGMA/TEGDMA hydrophobic adhesive or a three-step hydrophilic adhesive after one year of accelerated aging in artificial saliva. Methods. Flat surfaces in mid-coronal dentin were obtained from 45 sound human molars and randomly divided into three groups (n = 15): an experimental three-step BisGMA/TEGDMA hydrophobic adhesive applied to ethanol (ethanol-wet bonding-GI) or water-saturated dentin (water-wet bonding-GII) and Adper Scotchbond Multi-Purpose [MP-GIII] applied, according to manufacturer instructions, to water-saturated dentin. Resin composite crowns were incrementally formed and light-cured to approximately 5 mm in height. Bonded specimens were stored in artificial saliva at 37 degrees C for 24h and sectioned into sticks. They were subjected to microtensile bond test and TEM analysis immediately and after one year. Data were analyzed with two-way ANOVA and Tukey tests. Results. MP exhibited significant reduction in microtensile bond strength after aging (24 h: 40.6 +/- 2.5(a); one year: 27.5 +/- 3.3(b); in MPa). Hybrid layer degradation was evident in all specimens examined by TEM. The hydrophobic adhesive with ethanol-wet bonding preserved bond strength (24 h: 43.7 +/- 7.4(a); one year: 39.8 +/- 2.7(a)) and hybrid layer integrity, with the latter demonstrating intact collagen fibrils and wide interfibrillar spaces. Significance. Coaxing hydrophobic resins into acid-etched dentin using ethanol-wet bonding preserves resin-dentin bond integrity without the adjunctive use of MMPs inhibitors and warrants further biocompatibility and patient safety`s studies and clinical testing. (C) 2009 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

Introduction: Recently developed portable dental X-ray units increase the mobility of the forensic odontologists and allow more efficient X-ray work in a disaster field, especially when used in combination with digital sensors. This type of machines might also have potential for application in remote areas, military and humanitarian missions, dental care of patients with mobility limitation, as well as imaging in operating rooms. Objective: To evaluate radiographic image quality acquired by three portable X-ray devices in combination with four image receptors and to evaluate their medical physics parameters. Materials and methods: Images of five samples consisting of four teeth and one formalin-fixed mandible were acquired by one conventional wall-mounted X-ray unit, MinRay (R) 60/70 kVp, used as a clinical standard, and three portable dental X-ray devices: AnyRay (R) 60 kVp, Nomad (R) 60 kVp and Rextar (R) 70 kVp, in combination with a phosphor image plate (PSP), a CCD, or a CMOS sensor. Three observers evaluated images for standard image quality besides forensic diagnostic quality on a 4-point rating scale. Furthermore, all machines underwent tests for occupational as well as patient dosimetry. Results: Statistical analysis showed good quality imaging for all system, with the combination of Nomad (R) and PSP yielding the best score. A significant difference in image quality between the combination of the four X-ray devices and four sensors was established (p < 0.05). For patient safety, the exposure rate was determined and exit dose rates for MinRay (R) at 60 kVp, MinRay (R) at 70 kVp, AnyRay (R), Nomad (R) and Rextar (R) were 3.4 mGy/s, 4.5 mGy/s, 13.5 mGy/s, 3.8 mGy/s and 2.6 mGy/s respectively. The kVp of the AnyRay (R) system was the most stable, with a ripple of 3.7%. Short-term variations in the tube output of all the devices were less than 10%. AnyRay (R) presented higher estimated effective dose than other machines. Occupational dosimetry showed doses at the operator`s hand being lowest with protective shielding (Nomad (R): 0.1 mu Gy). It was also low while using remote control (distance > 1 m: Rextar (R) < 0.2 mu Gy, MinRay (R) < 0.1 mu Gy). Conclusions: The present study demonstrated the feasibility of three portable X-ray systems to be used for specific indications, based on acceptable image quality and sufficient accuracy of the machines and following the standard guidelines for radiation hygiene. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

This paper examines the so-called ’Unagi-sentence‘ in Japanese. So far, it has been taken for granted that the Unagi-sentence is incomplete syntactically and/or semantically. Because its structure apparently neither provides a fully-fledged semantic meaning, nor furnishes a plausible syntactic pattern (such as ‘subject-predicate‘), a number of previous works have considered the Unagi-sentence to be elliptic, and consequently reconstructed it as a complete sentence or established intermediate structures to account for its grammatical form. Other researchers have not used elliptic solutions, but sought to discover logical connections between the parts of the Unagi-sentence themselves. As a result, fixing their entire attention on the internal structure of the Unagi-sentence, these researchers inevitably needed to establish hypothetical constructs in order to explain the structure of the Unagi-sentence. The present author believes that the Unagi-sentence is neither incomplete nor a result of some hypothetical processes. The Unagi-sentence stands on its own as a complete utterance. It is basically an NP utterance which can be expanded to the form NP1 wa + NP2 da and its variations. The occurrence of the Unagi-sentence depends heavily on a presupposed context and its pragmatic features, without which the Unagi-sentence cannot exist. It is these features that the present article seeks to elucidate.

Relevância:

100.00% 100.00%

Publicador:

Relevância:

100.00% 100.00%

Publicador:

Resumo:

In this study of articulation issues related to languages other than English (LOTE), "articulation" is defined and the challenges surrounding it are overviewed. Data taken from an independent school's admission documents over a 4-year period provide insights and reveal trends concerning students' preferences for language study, LOTE study continuity, and reasons for LOTE selection. The data also provides an accounting of some multiple LOTE learning experiences. The analysis indicates that many students who begin a LOTE in the early grades are thwarted in becoming proficient, because (1) continuation in the language is impossible due to unavailability of instruction; (2) expanded learning is hampered by teachers' inability to deal with a range of learners, (3) extended learning is hampered by administrative decisions or policies, or (4) students lose interest in the first LOTE and switch to another. Finally, a call is made for data gathering and research in local contexts to gain a better understanding of LOTE articulation challenges at the local, state, national, and international levels.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

OBJECTIVE. The purpose of this study was to examine occupational therapists' use and perceptions of written education materials for clients and the factors that therapists consider before distributing written materials to clients This study also aimed to determine whether use and perceptions of these materials differed for older clients METHOD. A random sample of 50 occupational therapists from Queensland, Australia, working in adult physical disabilities settings was surveyed with a structured questionnaire Data were analyzed descriptively and with nonparametric statistics RESULTS. Of 49 participants who used written materials, 54% had given them to more than halt of their last 10 clients, regardless of the clients' age Written materials, most often information sheets developed by the participants themselves; handwritten notes; and pamphlets were principally used to reinforce verbal information. Clients' cognitive abilities, primary language, communication skills, vision, and level of education most often were considered before distributing written materials Although participants generally were positive about the content and effectiveness of materials, ratings were significantly less positive related to older clients CONCLUSION. Client education was a core treatment modality for participants in this study, with written media most commonly being used to supplement verbal education Because participants were least positive about the effectiveness of written materials for older clients, further development of materials for this audience may be indicated.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

The purpose of this study was to examine attitudinal barriers to effective pain management in a consecutively recruited cohort of 114 cancer patients from four Australian hospitals. When surveyed, 48% of this sample reported experiencing pain within the previous 24 hours. Of these, 56% reported this pain to be distressing, horrible or excruciating, with large proportions indicating that this pain had affected their movement, sleep and emotional well-being. Three factors were identified as potentially impacting on patients responses to pain-poor levels of patient knowledge about pain, low perceived control over pain, and a deficit in communication about pain. A trend for older patients to experience more severe pain was also identified. These older patients reported being more willing to tolerate pain and perceive less control over their pain. Suggestions are made for developing patient education programs and farther research using concepts drawn from broader social and behavioral models. J Pain Symptom Manage 2002:23:393-405. (C) U.S. Cancer Pain Relief Committee, 2002.