Curing capability of halogen and LED light curing units in deep class II cavities in extracted human molars

Class II cavities were prepared in extracted lower molars filled and cured in three 2-mm increments using a metal matrix. Three composites (Spectrum TPH A4, Ceram X mono M7 and Tetric Ceram A4) were cured with both the SmartLite PS LED LCU and the Spectrum 800 continuous cure halogen LCU using curing cycles of 10, 20 and 40 seconds. Each increment was cured before adding the next. After a seven-day incubation period, the composite specimens were removed from the teeth, embedded in self-curing resin and ground to half the orofacial width. Knoop microhardness was determined 100, 200, 500, 1000, 1500, 2500, 3500, 4500 and 5500 microm from the occlusal surface at a distance of 150 microm and 1000 microm from the metal matrix. The total degree of polymerization of a composite specimen for any given curing time and curing light was determined by calculating the area under the hardness curve. Hardness values 150 microm from the metal matrix never reached maximum values and were generally lower than those 1000 microm from the matrix. The hardest composite was usually encountered between 200 microm and 1000 microm from the occlusal surface. For every composite-curing time combination, there was an increase in microhardness at the top of each increment (measurements at 500, 2500 and 4500 microm) and a decrease towards the bottom of each increment (measurements at 1500, 3500 and 5500 microm). Longer curing times were usually combined with harder composite samples. Spectrum TPH composite was the only composite showing a satisfactory degree of polymerization for all three curing times and both LCUs. Multiple linear regression showed that only the curing time (p < 0.001) and composite material (p < 0.001) had a significant association with the degree of polymerization. The degree of polymerization achieved by the LED LCU was not significantly different from that achieved by the halogen LCU (p = 0.54).

Can outcome prediction data change patient outcomes and organizational outcomes?

PURPOSE OF REVIEW: Intensive care medicine consumes a high share of healthcare costs, and there is growing pressure to use the scarce resources efficiently. Accordingly, organizational issues and quality management have become an important focus of interest in recent years. Here, we will review current concepts of how outcome data can be used to identify areas requiring action. RECENT FINDINGS: Using recently established models of outcome assessment, wide variability between individual ICUs is found, both with respect to outcome and resource use. Such variability implies that there are large differences in patient care processes not only within the ICU but also in pre-ICU and post-ICU care. Indeed, measures to improve the patient process in the ICU (including care of the critically ill, patient safety, and management of the ICU) have been presented in a number of recently published papers. SUMMARY: Outcome assessment models provide an important framework for benchmarking. They may help the individual ICU to spot appropriate fields of action, plan and initiate quality improvement projects, and monitor the consequences of such activity.

Der Capability-Ansatz in der Gesundheitsförderung: Ansatzpunkte für eine Neuausrichtung der Ungleichheitsforschung

Gesundheitliches Wohlergehen geht unmittelbar auf das aktive Zutun von Personen und Kollektiven zurück. Zugleich wird gesundheitsrelevantes Handeln nur unter der Berücksichtigung der jeweiligen physischen und sozialen Kontexte zu verstehen und zu beeinflussen sein. Dementsprechend wird hier eine Ausrichtung der modernen Gesundheitsforderung auf die gesundheitsrelevanten Ressourcen und Handlungsspielräume der Menschen vorgeschlagen. Hierfür sind theoretische Grundlagen erforderlich, die die Fragen der sozialen Ungleichheit mit den praktischen Zugängen des Empowerment und der Partizipation schlüssig verbinden. Die Autoren stellen dazu den Capability-Approach (CA) von Amartya Sen vor und ergänzsa diesen mit Erkenntnissen aus der Kapital-Interaktionstheorie von Pierre Bourdieu. Beide Ansätze beleuchten Grundfragen der sozialen Ungleichheit und können mit den Leitkonzepten der Ottawa-Charta fruchtbar verbunden werden. Sie liefern damit auch Anleitungen für neue Forschungsrichtungen zur Untersuchung der komplexen Wechselwirkungen von sozialen Kontexten und gesundheitsrelevantem Handeln.