Laser Phototherapy as Topical Prophylaxis Against Head and Neck Cancer Radiotherapy-Induced Oral Mucositis: Comparison Between Low and High/Low Power Lasers

Background and Objective: Oral mucositis is a dose-limiting and painful side effect of radiotherapy (RT) and/or chemotherapy in cancer patients. The purpose of the present study was to analyze the effect of different protocols of laser phototherapy (LPT) on the grade of mucositis and degree of pain in patients under RT. Patients and Methods: Thirty-nine patients were divided into three groups: G1, where the irradiations were done three times a week using low power laser; G2, where combined high and low power lasers were used three time a week; and G3, where patients received low power laser irradiation once a week. The low power LPT was done using an InGaAlP laser (660 nm/40 mW/6 J cm(-2)/0.24 J per point). In the combined protocol, the high power LPT was done using a GaAlAs laser (808 nm, 1 W/cm(2)). Oral mucositis was assessed at each LPT session in accordance to the oral-mucositis scale of the National Institute of the Cancer-Common Toxicity criteria (NIC-CTC). The patient self-assessed pain was measured by means of the visual analogue scale. Results: All protocols of LPT led to the maintenance of oral mucositis scores in the same levels until the last RT session. Moreover, LPT three times a week also maintained the pain levels. However, the patients submitted to the once a week LPT had significant pain increase; and the association of low/high LPT led to increased healing time. Conclusions: These findings are desired when dealing with oncologic patients under RT avoiding unplanned radiation treatment breaks and additional hospital costs. Lasers Surg.Med. 41:264-270,2009. (C) 2009Wiley-Liss, Inc.

Marital status, farm size and other influences on the extent of cash cropping in Kenya: A household case study

This article examines the effects of marital status, farm size and other factors on the extent of cash cropping (and allocation of land use) by means of a case study in the Nyeri district in Kenya. It was found that married women are involved in the production of a relatively greater amount of output of cash crops than unmarried women since husbands prefer to have more land under cash crops than food crops. Farmers with better quality land allocate a high proportion of it to non-food cash crops, which may expose some households to greater risks of possible famine. The proportion of land allocated to food crops declines as the farm size increases while the proportion of land allocated to non-food cash crops rises as the size of farm increases. Age is also inversely associated with subsistence. Education, though inversely associated with subsistence farming does not appear to be statistically very significant as an influence on the composition of land use and composition of farm output. With growing commercialisation, married women work more hours than unmarried ones, working not only on non-cash food crops but also on non-food cash crops. Married women seem to lose their decision-making ability with growth of agricultural commercialisation, as husbands make most decisions to do with cash crops. Married women in Kenya also have little or no power to change the way land is allocated between food and non-food cash crops.

Testing for Market Power in Multiple-Input, Multiple-Output Industries: The Australian Grains and Oilseeds Industries

Recent empirical studies have found significant evidence of departures from competition in the input side of the Australian bread, breakfast cereal and margarine end-product markets. For example, Griffith (2000) found that firms in some parts of the processing and marketing sector exerted market power when purchasing grains and oilseeds from farmers. As noted at the time, this result accorded well with the views of previous regulatory authorities (p.358). In the mid-1990s, the Prices Surveillence Authority (PSA 1994) determined that the markets for products contained in the Breakfast Cereals and Cooking Oils and Fats indexes were "not effectively competitive" (p.14). The PSA consequently maintained price surveillence on the major firms in this product group. The Griffith result is also consistent with the large number of legal judgements against firms in this sector over the past decade for price fixing or other types of non-competitive behaviour. For example, bread manufacturer George Weston was fined twice during 2000 for non-competitive conduct and the ACCC has also recently pursued and won cases against retailer Safeway in grains and oilseeds product lines.

Regional investment strategies (RIS) and coastal catchment initiative (CCI) project alignmnet to Great Barrier Reef Water Quality Protection Plan

The Great Barrier Reef Water Quality Protection Plan (the Reef Plan) is a joint initiative of the Australian and Queensland Governments. The Reef Plan aims to progress an integrated approach to natural resource management planning by building on the existing partnerships between the different levels of government, industry groups, the community and research providers within the Reef catchments, principally through partnerships with the regional natural resource management (NRM) bodies.

A longitudinal study of quality of life of elderly with mandibular implant-supported fixed prostheses

Objectives: To verify the consequences of implant-supported fixed oral rehabilitation on the quality of life (QL) of elderly individuals. Material and methods: Fifteen patients were studied, being 10 females and five males; all were aged > 60 years, were completely edentulous, wore removable dentures on both arches, and were treated with implant-supported fixed dentures. Three QL questionnaires were applied, two related to the oral conditions (Oral Impact on Daily Performance - OIDP - and Oral Health Impact Profile, short version - OHIP-14) and one dealing with global aspects (World Health Organization Quality of Life - WHOQOL-BREF), before 3, 6, and 18 months after surgical placement of implants. Results: Scores in the OIDP and OHIP-14 questionnaires were better after dental treatment. The WHOQOL-BREF was less sensitive, confirming the higher reliability of specific questionnaires (focal) compared with general questions in such situations. Conclusion: Treatment with implant-supported fixed prostheses improved QL in the elderly; these effects are better detected by specific instruments focused on the subject.

Image quality assessment and medical physics evaluation of different portable dental X-ray units

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.

Morphodigital study of bone quality in the mandibular angle in patients with third molar impacted

The aim of this study was to analyze if the presence of impacted third molars, and their positions in the mandibular angle, can change the bone quality in this area, considering the measure of the cortical thickness in this region as representative or not for mandible fracture risk. Software was used to analyze 50 digital images from panoramic radiographs of patients who had one or two impacted third molars in the mandible, and 30 digital images of patients with agenesis of the mandibular third molar. The thickness of the cortical region of the mandible was measured; it was possible to draw a parallel line to the posterior portion of the mandible and a parallel line to the body of this bone on each side of the image. At the intersection of these lines near the distal portion of the second molar, another line was set up to serve as reference in the cortical thickness measurement. It could be concluded that the cortical thickness of the mandibular angle in male patients without impacted third molars was greater than the thickness in patients with these teeth, and no difference in thickness was found for the female group.

Conceptualizing quality of life for elderly people with stroke

Purpose : Despite increased interest in quality of life (QOL) as an outcome measure and as a means of identifying client needs in health care, its conceptualisation and the identification of its constituents have been poorly researched for elderly people with stroke in Hong Kong. Method: This article analysed the literature to identify components relevant to the QOL of Chinese elderly people with stroke living in the community in Hong Kong. Results : While common components of QOL for elderly people with and without stroke and regardless of cultural background were identified, a number were specific to an elderly Chinese stroke population. Conclusion : Recommendations for future research have been made with reference to further exploring and validating these components for the target population. A clear understanding of these aspects is essential for the development of sensitive QOL measures to guide and evaluate service delivery to this population.

Developments in the understanding of South African style SAG mills

The South African style SAG (RoM) mills operate in a window that is almost exclusive from the operation of the Australian and North American mills that have been used for the development of SAG mill models. Combining good quality, test data from the RoM mills is extending and improving these models, and assisting in a practical manner in improving our understanding of SAG/AG milling. Data from high mill loads, both in absolute filling and ball loading, have been used to extend and improve the JK SAG mill model. This improved understanding has been successfully applied to increasing the throughput of a mill by 8%. Data is presented on relationships between power and load for high mill loading. Slurry pooling is common in closed-circuit RoM mills, and the detrimental effect of this has been dramatically demonstrated at ALCOA with a mill throughput increase of over 20%. Techniques for calculating the effects of slurry pooling have been developed and a new pulp lifter system designed to give optimal slurry discharge. The influence of mill speed in shifting the product size distribution has also been measured. (C) 2001 Elsevier Science Ltd. All rights reserved.