Categories of indigenous 'homelessness' people and good practice responses to their needs

Mainstream concepts of homelessness do not serve Indigenous people well. Those designing policies or programs for Indigenous homeless people may need to re-think or change their concepts of homeless in order to adequately understand and respond to the needs of this group of people.

Clinical versus laboratory adhesive performance to wet and dry demineralized primary dentin

Purpose: To evaluate the influence of dentin moisture on bond strengths of an etch-and-rinse bonding agent to primary dentin clinically and in the laboratory. Methods: The sample consisted of two groups of 20 caries-free primary second molars: molars in exfoliation period (clinical group) and extracted molars (laboratory group). Class I cavities were prepared in all specimens leaving a flat dentin surface on the pulpal floor. A two-step etch-and-rinse adhesive was vigorously rubbed on either dry (n= 5) or wet demineralized dentin (n= 5) under clinical or laboratory conditions. After restorative procedures, the teeth from the clinical group were extracted after 20 minutes. All samples were processed and underwent microtensile bond strength test and silver nitrate uptake evaluation under scanning electron microscopy. Results: Statistically higher bond strength values were observed when the bonding was performed under laboratory conditions and on a wet demineralized dentin. Most of the failures were adhesive and mixed irrespective of the experimental condition. Silver nitrate uptake occurred in all groups irrespective of the experimental condition. Resin-dentin bond strengths produced in the laboratory in primary teeth may overestimate those produced under clinical circumstances. (Am J Dent 2011;24:221-225).

Thermal/mechanical simulation and laboratory fatigue testing of an alternative yttria tetragonal zirconia polycrystal core-veneer all-ceramic layered crown design

This study evaluated the stress levels at the core layer and the veneer layer of zirconia crowns (comprising an alternative core design vs. a standard core design) under mechanical/thermal simulation, and subjected simulated models to laboratory mouth-motion fatigue. The dimensions of a mandibular first molar were imported into computer-aided design (CAD) software and a tooth preparation was modeled. A crown was designed using the space between the original tooth and the prepared tooth. The alternative core presented an additional lingual shoulder that lowered the veneer bulk of the cusps. Finite element analyses evaluated the residual maximum principal stresses fields at the core and veneer of both designs under loading and when cooled from 900 degrees C to 25 degrees C. Crowns were fabricated and mouth-motion fatigued, generating master Weibull curves and reliability data. Thermal modeling showed low residual stress fields throughout the bulk of the cusps for both groups. Mechanical simulation depicted a shift in stress levels to the core of the alternative design compared with the standard design. Significantly higher reliability was found for the alternative core. Regardless of the alternative configuration, thermal and mechanical computer simulations showed stress in the alternative core design comparable and higher to that of the standard configuration, respectively. Such a mechanical scenario probably led to the higher reliability of the alternative design under fatigue.

Laboratory evaluation of the physicochemical properties of a new root canal sealer based on Copaifera multijuga oil-resin

Aim To compare a new root canal sealer based on Copaifera multijuga oil-resin (Biosealer) using three other established sealers (Sealer 26 (R), Endofill (R) and AH plus (R)) in terms of their physicochemical properties. Methodology The study was carried out according to the requirements of Specification Number 57 of the American Dental Association (ADA) and consisted of the following tests: setting time, flow, film thickness, dimensional stability, radiopacity and solubility/disintegration. Data were analysed statistically using anova and Tukey`s test for multiple comparisons. The significance level was set at 5% for all analyses. Results Sealer 26 (R) and AH Plus (R) had the longest setting time (P < 0.05). All materials presented flow in with the ADA`s guidelines. Regarding film thick-ness, Sealer 26 (R) did not have a satisfactory performance, as it had a higher mean value than the maximum allowed by the ADA (0.05 mm), being significantly different from the other materials (P < 0.05), which had mean values for film thickness in accordance with the ADA`s recommendations. Regarding the solubility and disintegration, only Endofill (R) did not meet the ADA`s specifications and presented the worst results of all materials (P < 0.05). Sealer 26 (R) presented the greatest dimensional changes and differed significantly from all other sealers (P < 0.05). Biosealer had the lowest radiopacity values and was significantly different from the other sealers (P < 0.05). Conclusion The experimental sealer based on Copaifera multijuga oil-resin presented satisfactory results in the physicochemical tests required by the ADA.

Back, chest and abdominal pain: How good are spinal signs at identifying musculoskeletal causes of back, chest or abdominal pain?

Background: Spinal signs found in association with atypical chest and abdominal pain may suggest the pain is referred from the thoracic spine. However, the prevalence of such signs in these conditions has rarely been compared with that in those without pain. In this study, the prevalence of spinal signs and dysfunction in patients with back, chest and abdominal pain is compared with that in pain free controls. The aim of the study is to determine the significance of spinal findings in patients with such pain. Methods: A general practitioner blinded to the patients' histories performed a cervical and thoracic spinal examination on general practice patients with back, chest and/or abdominal pain and on controls without pain. Thoracic intervertebral dysfunction was diagnosed on the basis of movement and palpation findings. Results: Seventy three study patients plus 24 controls, were examined. For cervical spinal signs, pain in the back, chest and/or abdomen was associated with pain with active movements and overpressure at end range and with loss of movement range. For thoracic spinal signs, this association held for pain with active movements and overpressure, but not with loss of movement range. The prevalence of thoracic intervertebral dysfunction was 25.0% in controls, 65.5% with chest/abdominal pain, 72.0% with back pain and 79.0% with back pain with chest/abdominal pain. This prevalence was higher with chest pain than with abdominal pain. Conclusions: The results show an association, but not a causal link between thoracic intervertebral dysfunction and atypical chest/abdominal pain. A spinal examination should be performed routinely assessing these conditions. The minimum examination for the detection of intervertebral dysfunction is testing for pain with spinal movements and palpation for tenderness. The interpretation of positive signs requires knowledge of their prevalence in pain free controls and in patients with visceral disease

Outcomes of cephalosporin treatment for serious infection due to apparently susceptible organisms producing extended-spectrum b-Lactamases: Implications for the clinical microbiology laboratory

Although extended-spectrum beta-lactamases (ESBLs) hydrolyze cephalosporin antibiotics, some ESBL-producing organisms are not resistant to all cephalosporins when tested in vitro. Some authors have suggested that screening klebsiellae or Escherichia coli for ESBL production is not clinically necessary, and when most recently surveyed the majority of American clinical microbiology laboratories did not make efforts to detect ESBLs, We performed a prospective, multinational study of Klebsiella pneumoniae bacteremia and identified 10 patients who were treated for ESBL-producing K. pneumoniae bacteremia with cephalosporins and whose infecting organisms were not resistant in vitro to the utilized cephalosporin. In addition, we reviewed 26 similar cases of severe infections which had previously been reported. Of these 36 patients, 4 had to be excluded from analysis. Of the remaining 32 patients, 100% (4 of 4) patients experienced clinical failure when MICs of the cephalosporin used for treatment were in the intermediate range and 54% (15 of 28) experienced failure when MICs of the cephalosporin used for treatment were in the susceptible range, Thus, it is clinically important to detect ESBL production by klebsiellae or E, coli even when cephalosporin MICs are in the susceptible range (less than or equal to 8 mug/ml) and to report ESBL-producing organisms as resistant to aztreonam and all cephalosporins (with the exception of cephamycins).

Probabilistic modelling of CO2 corrosion laboratory data using neural networks

The present paper addresses two major concerns that were identified when developing neural network based prediction models and which can limit their wider applicability in the industry. The first problem is that it appears neural network models are not readily available to a corrosion engineer. Therefore the first part of this paper describes a neural network model of CO2 corrosion which was created using a standard commercial software package and simple modelling strategies. It was found that such a model was able to capture practically all of the trends noticed in the experimental data with acceptable accuracy. This exercise has proven that a corrosion engineer could readily develop a neural network model such as the one described below for any problem at hand, given that sufficient experimental data exist. This applies even in the cases when the understanding of the underlying processes is poor. The second problem arises from cases when all the required inputs for a model are not known or can be estimated with a limited degree of accuracy. It seems advantageous to have models that can take as input a range rather than a single value. One such model, based on the so-called Monte Carlo approach, is presented. A number of comparisons are shown which have illustrated how a corrosion engineer might use this approach to rapidly test the sensitivity of a model to the uncertainities associated with the input parameters. (C) 2001 Elsevier Science Ltd. All rights reserved.