In-Office dental bleaching efficacy assessment in function of the light exposure regime by digital colometric reflectance spectroscopy

In-office dental bleaching has been subject of several studies. Generally those studies quantify through visual analysis, the shade reduction of the teeth submitted to different bleaching protocols (light sources, bleaching agent concentrations and irradiation time). The objective of this work is the determination of the influence of four irradiation protocols on the obtainment of better aesthetic results using a colorimetric spectrophotometer that quantifies color changes in each situation imposed. Forty bovine incisors were selected in function of similar anatomic characteristics; a concentrated coffee solution was used to stain the teeth. A commercial spectrophotometer was used to measure the color changes during evolution of the experiment (stain and bleaching phases) and the obtained data was analyzed by the ANOVA test. The obtained data showed the evolution of teeth color during the staining period, as well as, the color reduction that each bleaching protocol achieved. Based on our findings it is possible to conclude that bleaching protocols with larger irradiation periods did not showed significant differences when compared with shorter irradiation protocols, in that way the use of protocols with 30 min or more of consecutive irradiation are not clinically justified and also can cause several side effects.

An update on metabolic assessment in patients with urinary lithiasis

The objective of this study was to evaluate the prevalence of urinary metabolic abnormalities in patients with urolithiasis and their potential risk factors.A total of 905 stone patients were evaluated in a prospective trial from February 2000 to January 2012. Inclusion criteria were as follows: history and/or imaging tests confirming at least 2 separate or concurrent stone episodes; creatinine clearance a parts per thousand yen60 mL/min; and negative proteinuria and urine culture. Metabolic study consisted of two 24-h urine collections separated by a period of 3 months for dosing Ca, P, uric acid, Na, K, Mg, oxalate, and citrate. Serum levels of Ca, P, uric acid, Na, K, Cl, Mg, creatinine, and glucose were assessed. Urinary pH and urinary acidification tests were also performed.A total of 735 patients were included, with a mean age of the 40 +/- A 1.0 year; 96.8 % of patients presented diagnosis of one or more urinary metabolic abnormalities. The most prevalent metabolic abnormalities were hypercalciuria (50.8 %), hypomagnesuria (50.1 %), hypocitraturia (35.4 %), and hyperuricosuria (30.7 %). Body weight was significantly higher in patients with hyperuricosuria (81.20 +/- A 15.67 kg vs. 70.17 +/- A 14.13 kg, respectively, p = 0.001). Urinary sodium was significantly higher in patients with hypercalciuria than without (246.97 +/- A 103.9 mEq/24 h vs. 200.31 +/- A 91.6 mEq/24 h, p = 0.001) and hyperuricosuria compared to without (283.24 +/- A 107.95 mEq/24 h vs. 198.57 +/- A 85.3 mEq/24 h, p = 0.001).Urinary metabolic disturbances were diagnosed in 96.8 % of patients in the study. These results warrant metabolic study and follow-up in patients with recurrent lithiasis in order to decrease recurrence rate through specific treatments, modification in alimentary, and behavioral habits.

Reliability of pelvic floor muscle strength assessment in healthy continent women

Background: The aim of this study was to compare pelvic floor muscle (PFM) strength using transvaginal digital palpation in healthy continent women in different age groups, and to compare the inter- and intra-rater reliability of examiners performing anterior and posterior vaginal assessments.Methods: We prospectively studied 150 healthy multiparous women. They were distributed into four different groups, according to age range: G1 (n = 37), 30-40 years-old; G2 (n = 39), 41-50 years-old; G3 (n = 39), 51-60 years-old; and G4 (n = 35), older than 60 years-old. PFM strength was evaluated using transvaginal digital palpation in the anterior and posterior areas, by 3 different examiners, and graded using a 5-point Amaro's scale.Results: There was no statistical difference among the different age ranges, for each grade of PFM strength. There was good intra-rater concordance between anterior and posterior PFM assessment, being 64.7%, 63.3%, and 66.7% for examiners A, B, and C, respectively. The intra-rater concordance level was good for each examiner. However, the inter-rater reliability for two examiners varied from moderate to good.Conclusions: Age has no effect on PFM strength profiles, in multiparous continent women. There is good concordance between anterior and posterior vaginal PFM strength assessments, but only moderate to good inter-rater reliability of the measurements between two examiners.

Husserl's two notions of completeness: husserl and hilbert on completeness and imaginary elements in mathematics

In this paper I discuss Husserl's solution of the problem of imaginary elements in mathematics as presented in the drafts for two lectures he gave in Göttingen in 1901 and other related texts of the same period, a problem that had occupied Husserl since the beginning of 1890, when he was planning a never published sequel to Philosophie der Arithmetik (1891). In order to solve the problem of imaginary entities Husserl introduced, independently of Hilbert, two notions of completeness (definiteness in Husserl's terminology) for a formal axiomatic system. I present and discuss these notions here, establishing also parallels between Husserl's and Hilbert's notions of completeness. © 2000 Kluwer Academic Publishers.

Creating Meaningful Homework and Implementing Homework Presentations to Aid in Mathematics Instruction

In this action research study of sixth grade mathematics, I investigated the use of meaningful homework and the implementation of presentations and its effect on students’ comprehension of mathematical concepts. I collected data to determine whether the creating of meaningful homework and the implementation of homework presentations would have a positive impact on the students’ understanding of the concepts being taught in class and the reasoning behind assigning homework. The homework was based on the lesson taught during class time. It was grade-level appropriate and contained problems similar to those students completed in class. A pre-research and post-research survey based on homework perceptions and my teaching practices was given, student interviews were conducted throughout the research period, weekly teacher journals were kept that pertained to my teaching practices and the involvement of the students that particular week, and homework assignments were collected to gauge the students’ understanding of the mathematics lessons. Most students’ perceptions on homework were positive and most understood the reasoning for homework assignments.

Journal Writing in Mathematics: Exploring the Connections between Math Journals and the Completion of Homework Assignments

In this action research study of sixth grade mathematics, I investigate how the use of written journals facilitates the learning of mathematics for my students. I explore furthermore whether or not these writing journals support students to complete their homework. My analysis reveals that while students do not access their journals daily, when students have the opportunity to write more about one specific problem--such as finding the relationship between the area of two different sized rectangles – they, are nevertheless, more likely to explain their thoughts in-depth and go beyond the traditional basic steps to arrive at a solution. This suggests the value of integrating journal writing in a math curriculum as it can facilitate classroom discussion from the students’ written work.

Meaningful Independent Practice in Mathematics

In this action research of my seventh grade mathematics classroom, I investigated how students’ explanations of math homework would improve their learning in math. I discovered these explanations can be very beneficial in helping students to improve their understanding of current skills although it did not affect all students. As a result of this study, I plan to incorporate these student explanations in my instruction next year but not as a daily expectation.

Oral Communication and Presentations in Mathematics

In this action research study of my classroom of eighth grade mathematics, I investigated the attitudes of students toward mathematics along with their achievement levels with the use of oral presentations in my Algebra class. During the second semester the class was divided into groups of two for each presentation, changing partners each time. Every other week each group was given a math problem that required more work than a normal homework type problem. On the last day of that week the students gave a short presentation on their problem. I discovered that while there was no significant evidence that student achievement increased, the students did enjoy the different aspect of presentations in a math class. I plan to implement presentations in my classroom more often with the intent to increase student enjoyment.

Generating Interest in Mathematics Using Discussion in the Middle School Classroom

In this action research study of my classroom of 8th grade algebra, I investigated students’ discussion of mathematics and how it relates to interest in the subject. Discussion is a powerful tool in the classroom. By relying too heavily on drill and practice, a teacher may lose any individual student insight into the learning process. However, in order for the discussion to be effective, students must be provided with structure and purpose. It is unrealistic to expect middle school age students to provide their own structure and purpose; a packet was constructed that would allow the students to both show their thoughts and work as a small group toward a common goal. The students showed more interest in the subject in question as they related to the algebra topics being studied. The students appreciated the packets as a way to facilitate discussion rather than as a vehicle for practicing concepts. Students still had a need for practice problems as part of their homework. As a result of this research, it is clear that discussion packets are very useful as a part of daily instruction. While there are modifications that must be made to the original packets to more clearly express the expectations in question, discussion packets will continue to be an effective tool in the classroom.

Integrated sediment quality assessment in Paranagua Estuarine System, Southern Brazil

Sediment quality from Paranagua Estuarine System (PES), a highly important port and ecological zone, was evaluated by assessing three lines of evidence: (1) sediment physical-chemical characteristics; (2) sediment toxicity (elutriates, sediment-water interface, and whole sediment); and (3) benthic community structure. Results revealed a gradient of increasing degradation of sediments (i.e. higher concentrations of trace metals, higher toxicity, and impoverishment of benthic community structure) towards inner PES. Data integration by principal component analysis (PCA) showed positive correlation between some contaminants (mainly As, Cr, Ni, and Pb) and toxicity in samples collected from stations located in upper estuary and one station placed away from contamination sources. Benthic community structure seems to be affected by both pollution and natural fine characteristics of the sediments, which reinforces the importance of a weight-of-evidence approach to evaluate sediments of PES. (C) 2008 Elsevier Inc. All rights reserved.

Influence Assessment in an Heteroscedastic Errors-in-Variables Model

The main goal of this article is to consider influence assessment in models with error-prone observations and variances of the measurement errors changing across observations. The techniques enable to identify potential influential elements and also to quantify the effects of perturbations in these elements on some results of interest. The approach is illustrated with data from the WHO MONICA Project on cardiovascular disease.

NURSES AND THE ASSESSMENT IN HEALTH SYSTEM MANAGEMENT

The objective of this study was to undertake a critical reflection regarding assessment as a managerial tool that promotes the inclusion of nurses in the health system management process. Nurses, because of their education and training, which encompasses knowledge in both the clinical and managerial fields and is centered on care, have the potential to assume a differentiated attitude in management, making decisions and proposing health policies. Nevertheless, it is necessary to first create and consolidate an expressive inclusion in decisive levels of management. Assessment is a component of management, the results of which may contribute to making decisions that are more objective and allow for improving healthcare interventions and reorganizing health practice within a political, economic, social and professional context; it is also an area for the application of knowledge that has the potential to change the current panorama of including nurses in management.

Water Quality Assessment in Piracicamirim Creek Upstream and Downstream a Sugar and Ethanol Industry Through Toxicity Tests With Cladocerans

An environmental impact study was conducted to determine the Piracicamirim's creek water quality in order to assess the influence of effluents from a sugar industry in this water body. For this, toxicity tests were performed with a water sample upstream and downstream the industry using the microcrustaceans Daphnia magna, Ceriodaphnia dubia and Ceriodaphnia silvestrii as test organisms, as well as physical and chemical analysis of water. Results showed that physical and chemical parameters did not change during the sampling period, except for the dissolved oxygen. No toxicity was observed for D. magna and reproduction of C. dubia and C. silvestrii in both sampling points. Thus, the industry was not negatively impacting the quality of this water body.

Strategic environmental assessment in tourism planning - Extent of application and quality of documentation

Strategic environmental assessment (SEA) has been applied throughout the world in different sectors and in various ways. This paper reports on results of a PhD research on SEA applied to tourism development planning, reflecting the situation in mid-2010. First, the extent of tourism specific SEA application world-wide is established. Then, based on a review of the quality of 10 selected SEA reports, good practice, as well as challenges, trends and opportunities for tourism specific SEA are identified. Shortcomings of SEA in tourism planning are established and implications for future research are outlined. (C) 2012 Elsevier Inc. All rights reserved.

Accuracy of positron emission tomography/computed tomography and clinical assessment in the detection of complete rectal tumor regression after neoadjuvant chemoradiation Long-Term Results of a Prospective Trial (National Clinical Trial 00254683)

BACKGROUND: Neoadjuvant chemoradiation (CRT) therapy may result in significant tumor regression in patients with rectal cancer. Patients who develop complete tumor regression have been managed by treatment strategies that are alternatives to standard total mesorectal excision. Therefore, assessment of tumor response with positron emission tomography/computed tomography (PET/CT) after neoadjuvant treatment may offer relevant information for the selection of patients to receive alternative treatment strategies. METHODS: Patients with clinical T2 (cT2) through cT4NxM0 rectal adenocarcinoma were included prospectively. Neoadjuvant therapy consisted of 54 grays of radiation and 5-fluorouracil-based chemotherapy. Baseline PET/CT studies were obtained before CRT followed by PET/CT studies at 6 weeks and 12 weeks after the completion of CRT. Clinical assessment was performed at 12 weeks after CRT completion. PET/CT results were compared with clinical and pathologic data. RESULTS: In total, 99 patients were included in the study. Twenty-three patients were complete responders (16 had a complete clinical response, and 7 had a complete pathologic response). The PET/CT response evaluation at 12 weeks indicated that 18 patients had a complete response, and 81 patients had an incomplete response. There were 5 false-negative and 10 false-positive PET/CT results. PET/CT for the detection of residual cancer had 93% sensitivity, 53% specificity, a 73% negative predictive value, an 87% positive predictive value, and 85% accuracy. Clinical assessment alone resulted in an accuracy of 91%. PET/CT information may have detected misdiagnoses made by clinical assessment alone, improving overall accuracy to 96%. CONCLUSIONS: Assessment of tumor response at 12 weeks after CRT completion with PET/CT imaging may provide a useful additional tool with good overall accuracy for the selection of patients who may avoid unnecessary radical resection after achieving a complete clinical response. Cancer 2012;35013511. (C) 2011 American Cancer Society.