Bond Strength and Etching Pattern of Adhesive Systems to Enamel: Effects of Conditioning Time and Enamel Preparation

Statement of the problem: The performance of self-etch systems on enamel is controversial and seems to be dependent on the application technique and the enamel preparation. Purpose of the Study: To examine the effects of conditioning time and enamel surface preparation on bond strength and etching pattern of adhesive systems to enamel. Materials and Methods: Ninety-six teeth were divided into 16 conditions (N = 6) in function of enamel preparation and conditioning time for bond strength test. The adhesive systems OptiBond FL (Kerr, Orange, CA, USA), OptiBond SOLO Plus (Kerr), Clearfil SE Bond (Kuraray, Osaka, Japan), and Adper Prompt L-Pop (3M ESPE, St. Paul, MN, USA) were applied on unground or ground enamel following the manufacturers` directions or doubling the conditioning time. Cylinders of Filtek Flow (0.5-mm height) were applied to each bonded enamel surface using a Tygon tube (0.7 mm in diameter; Saint-Gobain Corp., Aurora, OH, USA). After storage (24 h/37 degrees C), the specimens were subjected to shear force (0.5 mm/min). The data were treated by a three-way analysis of variance and Tukey`s test (alpha = 0.05). The failure modes of the debonded interfaces and the etching pattern of adhesives were observed using scanning electron microscopy. Results: Only the main factor ""adhesive"" was statistically significant (p < 0.001). The lowest bond strength value was observed for OptiBond FL. The most defined etching pattern was observed for 35% phosphoric acid and for Adper Prompt L-Pop. Mixed failures were observed for all adhesives, but OptiBond FL showed cohesive failures in resin predominantly. Conclusions: The increase in the conditioning time as well as the enamel pretreatment did not provide an increase in the resin-enamel bond strength values for the studied adhesives. CLINICAL SIGNIFICANCE The surface enamel preparation and the conditioning time do not affect the performance of self-etch systems to enamel. (J Esthet Restor Dent 20:322-336, 2008)

The role and theoretical evolution of knowledge translation and exchange in public health

Background There is an increased emphasis in public health research on effective models and strategies to support knowledge translation (KT), the exchange, synthesis and ethically sound application of research findings within a complex set of interactions among researchers and knowledge users. In other words, KT can be seen as an acceleration of the knowledge cycle—an acceleration of the natural transformation of knowledge into use (Canadian Institutes of Health Services Research. Knowledge Translation Strategy, 2004). The most recent conceptualizations consider the complexities of public health decision-making. The role of practitioners and communities is increasingly considered.

Methods We identify, describe and discuss the theoretical underpinnings of KT and recommend a way forward to build the evidence for more effective practice.

Results Theoretical perspectives increasingly influence research on KT in public health. A range of innovative work is being conducted to explore methods for KT using practical tools, often with the support of government.

Conclusions KT describes a crucial and to date under-developed element of the research process. There is an important gap in theoretically informed empirical studies of effectiveness of proposed approaches in public health, health promotion and preventive medicine, and thus much of the debate remains abstract. There is clearly an urgent policy need to establish the effectiveness of KT models in a range of contexts. This must include both the consideration of development and the utilization of knowledge.

Neighborhood walkability and the walking behavior of Australian adults

Background
The physical attributes of residential neighborhoods, particularly the connectedness of streets and the proximity of destinations, can influence walking behaviors. To provide the evidence for public health advocacy on activity-friendly environments, large-scale studies in different countries are needed. Associations of neighborhood physical environments with adults’ walking for transport and walking for recreation must be better understood.

Method
Walking for transport and walking for recreation were assessed with a validated survey among 2650 adults recruited from neighborhoods in an Australian city between July 2003 and June 2004, with neighborhoods selected to have either high or low walkability, based on objective measures of connectedness and proximity derived from geographic information systems (GIS) databases. The study design was stratified by area-level socioeconomic status, while analyses controlled for participant age, gender, individual-level socioeconomic status, and reasons for neighborhood self-selection.

Results
A strong independent positive association was found between weekly frequency of walking for transport and the objectively derived neighborhood walkability index. Preference for walkable neighborhoods moderated the relationship of walkability with weekly minutes, but not the frequency of walking for transport—walkability was related to higher frequency of transport walking, irrespective of neighborhood self-selection. There were no significant associations between environmental factors and walking for recreation.

Conclusions
Associations of neighborhood walkability attributes with walking for transport were confirmed in Australia. They accounted for a modest but statistically significant proportion of the total variation of the relevant walking behavior. The physical environment attributes that make up the walkability index are potentially important candidate factors for future environmental and policy initiatives designed to increase physical activity.

Neighborhood walkability and TV viewing time among Australian adults

Background
Built-environment attributes of a neighborhood are associated with participation in physical activity and may also influence time spent in sedentary behaviors. Associations of neighborhood walkability (based on dwelling density, street connectivity, land-use mix, and net retail area) and television viewing time were compared in a large, spatially-derived sample of Australian adults.

Methods
Neighborhood-level variables (walkability and socioeconomic status [SES]) were calculated in 154 Australian census collection districts using Geographic Information Systems. Individual-level variables (TV viewing time, time spent in leisure-time physical activity, height, weight, and sociodemographic variables) were collected from adults living in urban areas of Adelaide, Australia using a mail survey (N=2224) in 2003–2004. Multilevel linear regression analysis was conducted in 2006 separately for men and women to examine variations in TV viewing time across tertiles of walkability.

Results
Neighborhood walkability was negatively associated with TV viewing time in women, but not in men. After controlling for neighborhood SES, body mass index, physical activity, and sociodemographic variables, women living in medium- and high-walkable neighborhoods reported significantly less TV viewing time per day (14 minutes and 17 minutes, respectively) compared to those residing in low-walkable neighborhoods.

Conclusions
Built-environment attributes of neighborhoods that are related to physical activity also may play an important role in influencing sedentary behavior, particularly among women. Considering the effects of prolonged sedentary time on health risks, which are independent of physical activity, there is the need for further research to explore how environmental characteristics may contribute to the amount of time spent in sedentary behavior.

Sex and the surgeon's knife: the family court's dilemma...informed constent and the specter of iatrogenic harm to children with intersex characteristics

The article focuses on the opinion of the Australian High Court on the doctrine of informed consent and the judicial reasoning including the supporting medical evidence in sex assignment cases. The author explains that the remaining credible basis for the jurisdiction assumed by the Family Court in such cases rests in the inability of parents as guardians to give their informed consent to irreversible surgical procedures.

Blood-nourishing and hard-softening capsule costs less in the management of osteoarthriticknee pain : A randomized controlled trial

The blood-nourishing and hard-softening (BNHS) capsule is a traditional Chinese formula used in the symptomatic treatment of inflammation and pain. We conducted this randomized controlled trial to compare the efficacy of BNHS with other commonly prescribed drugs. We recruited 120 patients from two teaching hospitals; 30 patients in each hospital were randomly assigned to receive BNHS. In one hospital, the 30 controls were given another traditional Chinese drug; whereas a Western medicine (chondroprotection drug/Viartril-s) was used as the control in the other hospital. Intervention was carried out over a period of 4 weeks. Primary outcome measures included self-reported pain level, and changes in stiffness and functional ability as measured by the Western Ontario McMaster Universities Osteoarthritis (WOMAC) index. Mixed models were used for statistical analysis. Substantial improvements in disease-specific symptoms were observed, after 4 weeks of treatment, in patients taking BNHS capsules. As assessed by the WOMAC index, pain level of the BNHS group decreased by 57% [95% confidence interval (CI) = 50, 63], stiffness by 63% (95% CI = 55, 71) and functional ability increased by 56% (95% CI = 50, 63). No significant differences were found in any of the outcome measures between the BNHS group and either of the comparison groups. No severe adverse effects were reported. However, this study lacked a placebo group; therefore, we conclude that BNHS appears to be as effective as commonly prescribed medicines for the relief of pain and dysfunction in knee osteoarthritis patients, but costs a lot less than other Western and herbal drugs in the study.

Survey commentaries and analysis on Singapore biotechnology international alliances and Singapore biotechnology boom in 2010

The article presents survey commentaries and analysis on biotechnology international alliances and biotechnology boom in Singapore in 2010. The survey revealed that the government and other key government industries are not keen in investing money in areas such as agricultural biotechnology, vaccine production, natural medicine, alternative therapeutics and plant biotechnology which have economic future globally. Most stakeholders expect international alliances and biopartnering with Singapore. They identified that the industry's strengths are biomedical and pharmaceuticals.

The struggle for the body, mind and soul of AFL footballers

"The book discusses the profound, often troubling, always complex struggles for the body, mind and soul of elite performers in contemporary sports entertainment environments. This struggle is shaped by two powerful processes. On the one hand we witness the translation and application of a range of rationalities and knowledges from fields such as psychology, sport science and medicine, dietetics, education and management. All of which have the consequence of subjecting elite performers to often intrusive regimes of measurement, testing, medical intervention, surveillance, education and regulation in the pursuit of performance and success. At the same time we can identify ways in which the commodification of sports/games, the drive to develop and grow as a sports entertainment business and the pursuit and maintenance of a media presence and profile on which brand relationships can be established and grown has the consequence of transforming elite performers into highly paid sports celebrities whose image, persona and brand is positioned in a crowded, highly competitive marketplace to be scrutinised, judged and consumed.
[The] struggle that takes on new dimensions in the evolution of sports/games into global sports entertainment industries and businesses....The book reveals new insights into the tensions that emerge between different levels of the AFL sports entertainment industry about what it means to be a professional footballer at the start of the 21st century. The book analyses aspects of this struggle for the body, mind and soul at different stages in a playing career."--Media release.

Preschool children and physical activity : a review of correlates

Background
Several reviews have summarized the research on correlates of older children's and adolescents' physical activity behaviors, but none have been published on preschool children. Over the past 27 years, a number of studies have investigated the correlates of preschool children's physical activity behaviors. It is timely and necessary to review the extant literature in this area. This paper reviews articles investigating correlates of preschool children's physical activity behaviors published in peer-reviewed journals between 1980 and March 2007.

Methods
A literature search was conducted to identify studies that investigated correlates of preschool children's physical activity. Data were collected and analyzed in 2007.

Results
Twenty-four articles were identified that met the inclusion criteria. From those articles, 39 variables were identified across five domains. Results showed that boys were more active than girls, that children with active parents tended to be more active, and that children who spent more time outdoors were more active than children who spent less time outdoors. Age and BMI were consistently shown to have no association with preschool children's physical activity. Other variables produced largely inconclusive results.

Conclusions
The influences on the physical activity behaviors of preschool children are multidimensional. Further research is required to enhance an understanding of these influences.

Prevalence and cost of musculoskeletal disorders: a population-based, public hospital system healthcare consumption approach.

Objective: To use a population-level, public-hospital approach to compare the prevalence and cost of musculoskeletal diseases (MSD) with other clinical specialties.

Methods: A healthcare utilization survey of 4 million individual records over 4 years, from all major public hospitals in the state of Victoria (estimated population 4.8 million residents in 2000/01) from 1997/98 to 2000/01. Main outcome measures were inpatient episodes of care, bed-days, and outpatient clinic encounters. MSD was defined as the combination of orthopedics and rheumatology.

Results: After obstetrics, MSD was the most frequent outpatient service, with orthopedics accounting for 9.9% of all visits in 2000/01. The proportion of MSD outpatient encounters (on average 11.6% of the total) was constant over the study period. Among 26 medical specialties, MSD had the sixth highest number of inpatient episodes (6.2% in 2000/01), following renal dialysis (14.6%), general surgery (8.2%), obstetrics (7.6%), gastroenterology (7.1%), and general medicine (6.7%). MSD was the fifth highest consumer of bed-days, occupying on average 7.7% of all beds per annum in the period 1997/98 to 2000/01, behind psychiatry (10.1%), respiratory medicine (8.5%), rehabilitation (8.3%), and general medicine (7.8%). MSD was the third most-costly discipline in 2000/01, with total costs of over A dollars 169 million (9.7% of total inpatient costs that year), behind respiratory medicine (11.6%) and general surgery (11.5%).

Conclusion: Compared to other diseases, MSD consumes a substantial proportion of healthcare resources in Victorian public hospitals. These data have important implications for allocation of healthcare resources, clinical care pathways, and prevention strategies.

History of contact and change in the Goroka Valley, Central Highlands of New Guinea, 1934-1949

The thesis traces the interaction of the Goroka Valley people with European and coastal New Guinean intruders during the pacification stage of contact and change. In this 15 year period the people moved from a traditional subsistence culture to the threshold of a modern, European-influenced technological society. The contact experiences of the inhabitants of the Valley and the outsiders who influenced them are examined, using both oral and documentary sources. A central theme of this study is the attempts by Europeans and their coastal New Guinean collaborators to achieve the pacification of a people for whom warfare has been described as 'the dominant orientation'. The newcomers saw pacification as being inextricably linked with social, economic and religious transformation, and consequently it was pursued by patrol officers, missionaries and soldiers alike. Following an introductory chapter outlining the pre-contact and early-contact history of the Goroka Valley people, there is a discussion of the causes of tribal fighting in Highlands communities and two case studies of violent events which, although occurring beyond the Goroka Valley, had important consequences for those who lived within its bounds. The focus then shifts to the first permanent settlement of the agents of change -initially these were coastal New Guinean evangelists and policemen - and their impact on the local people. A period of consolidation is then described, as both government and missions established a permanent 'European presence in the Valley'. This period was characterised by vigorous pacification coupled with the introduction of innovations in health and education, agriculture, technology, law and religion. The gradual transformation of Goroka Valley society as a result of the people's interaction with the newcomers was abruptly accelerated in 1943, when many hundreds of Allied soldiers occupied the Valley in anticipation of a threatened Japanese invasion. Village life was disrupted as men were conscripted as carriers and labourers and whole communities were obliged to grow food to assist the Allied war effort. Those living close to military airfields-and camps were subject to Japanese aerial attacks and the entire population was exposed to an epidemic of bacillary dysentery introduced by the combatants. However the War also brought some positive effects, including paradoxically, the almost total cessation of tribal fighting, the construction of an ail-weather airstrip at Goroka which ensured its future as a town and administrative and commercial centre, and the compulsory growing of vegetables, coffee, etc, which laid the foundations for a cash economy and material prosperity. The final chapter examines the aftermath of military occupation, the return of civil administration and the implementation of social and economic policies which brought the Goroka Valley people into the rapid-development phase of contact. By 1949 Gorokans were ready to channel their aggressive energies into commercial competitiveness and adopt a cash-crop economy, to accept the European rule of law, to take advantage of Western innovations in medicine, education, transport and communications, to seek employment opportunities at home and in other parts of the country and to modify their primal world view with European religious and secular values. A Stone Age people was in process of being transformed into a modern society.

Renal and gastrointestinal amyloidosis in an HIV-infected injection drug user

A 30-year-old HIV-infected intravenous drug user presented with sepsis, acute renal failure, oedema, proteinuria and iron deficiency anaemia. After extensive investigation, a diagnosis of reactive systemic AA (amyloid, serum amyloid A protein) amyloidosis was made on the basis of renal, gastric and duodenal biopsies.

Nurses and personal attendants' diabetes knowledge : in regional public residential care

Aim: Identify staff knowledge about diabetes medicines and organisational factors that influence safe medicines use in two large Australian regional public RACs that comply with national accreditation standards.

Background: Diabetes management is complicated in residential aged care facilities (RAC). Managing medicines is complex, especially in older people. Little is known about diabetes-specific medicine knowledge of various care staff (registered nurses (RN), enrolled nurses (EN) and patient care attendants (PCA) working in RAC.

Methods: A triangulation of methods was used to collect the data: anonymous self-complete questionnaire (ADKnowl) staff interviews to clarify practice issues that could affect safe medicine use, and a case file audit to identify medicine-related data. Questionnaires were distributed to all RNs, ENs and PCAs in the two services via nursing management (N=540). The ADKnowl was supplemented with additional questions and vignettes derived from actual case notes in each RAC to assess translation of knowledge into practice. Only medicine related data are reported.

Results: Sixty-eight people returned completed questionnaires (12.5% response rate). Knowledge deficits were identified in administering oral hypoglycaemic agents and insulin, their action and potential adverse events. Most ENs and PCAs did not know why HbA1c was measured. Almost half the RNs and ENs and 80% of PCAs did not know how diabetes comorbidities affect medicine choices. RN achieved higher overall average knowledge scores,74.3%, compared to ENs and PCA, 49%. The interviews suggest lack of time, unclear communication processes, inadequate knowledge about medications and resident behaviour compromises optimal medicine administration. Twenty case files audits were undertaken in each RAC and revealed residents were taking on average nine medicines.

Conclusion: Staff involved in caring for residents with diabetes had suboptimal general and medicine-specific diabetes knowledge to deliver optimal care. System issues and unpredictable resident behaviours made medicine management difficult and compromised safety.