Molecular aspects of tissue engineering in the dental field

Tissue engineering is a multidisciplinary field with the potential to replace tissues lost as a result of trauma, cancer surgery, or organ dysfunction. The successful production, integration, and maintenance of any tissue-engineered product are a result of numerous molecular interactions inside and outside the cell. We consider the essential elements for successful tissue engineering to be a matrix scaffold, space, cells, and vasculature, each of which has a significant and distinct molecular underpinning (Fig. 1). Our approach capitalizes on these elements. Originally developed in the rat, our chamber model (Fig. 2) involves the placement of an arteriovenous loop (the vascular supply) in a polycarbonate chamber (protected space) with the addition of cells and an extracellular matrix such as Matrigel or endogenous fibrin (34, 153, 246, 247). This model has also been extended to the rabbit and pig (J. Dolderer, M. Findlay, W. Morrison, manuscript in preparation), and has been modified for the mouse to grow adipose tissue and islet cells (33, 114, 122) (Fig. 3)...

The New Lawyer

This text is designed to implement the Threshold Learning Outcomes (TLOs) for law in the first year, and to incorporate Sally Kift’s First Year Curriculum principles: http://tls.vu.edu.au/portal/site/trans/Resources/KiftTransitonPedagogySixPrinciples_16Nov09.pdf This is a learning-centered text book intentionally designed for first year students and written by experts in legal education and the first year experience. It is written in a tone and style that engages and communicates effectively with first year law students, without compromising its rigour. It provides students with opportunities to contextualise and make sense of their learning by connecting that learning with what they already know, and with current contemporary issues and affairs. This work is designed to ease students through the transition from a diverse variety of backgrounds (such as high school, work or other disciplines) to the first year of law. It provides practical guidance about adjusting to law school and to university. Students are asked to regularly reflect upon why they are studying law. The book also prepares law students for success in their latter year studies in law by ensuring that they are equipped with the necessary threshold concepts and foundational skills to do well: for example, research skills (particularly, online research skills), reasoning skills, written communication skills, negotiation skills, and self-management skills. A range of practical tips on studying law are provided throughout the book. The work also asks students to engage with developing an emergent sense of professional identity – including what it means to ‘think like a lawyer’. In supporting the students to engage with the concept of professional identity, the work begins a process of preparing students for transition from law school to legal practice. This is achieved by providing explanations of how the material being presented relates to the practice of law, as well as practical information relating to employability skills as a new graduate. This work has a number of learning and teaching objectives to enhance the quality of student learning in their first year of law by engaging, motivating and supporting that learning. First, the work is designed to engage first year students with their legal education and with a future sense of professional identity. It does this through its: • Dynamic writing style • Engaging format • Inclusion of contemporary issues and events • Flowcharts, checklists, mind-maps, tables and timelines • Inclusion of real-world problems and dilemmas. Second, the text motivates student learning by promoting active learning. It does this by: • Demonstrating, and asking students to practice, what they need to do – that is, the work is not simply focussed on telling students what they need to know • Including regular self-directed learning exercises throughout each chapter, such as practical exercises for the development of important foundational legal skills • Including exercises that promote student collaboration, and that require students to apply their learning to practical situations, and • Incorporating a range of interesting active thinking points and research activities. Third, the book supports student learning by encouraging reflective learning and independent learning. It does this by including: • Specific content on how to be a reflective practitioner and an independent learner • Exercises that require students to engage in independent learning, particularly in relation to legal research skill development • Exercises requiring students to reflect upon what they have learned, and encouraging students to keep a reflective learning journal • Exercises requiring students to reflect upon their own views and beliefs • Reflection on whether students have achieved the learning objectives articulated at the beginning of the chapter. The work also: • Demonstrates respect for student experiences, views, opinions and values • Acknowledges student diversity • Recognises the importance of being globally minded law students and lawyers • Supports law teachers in using the work in their classrooms through the provision of comprehensive teaching materials.

The Australian rise of esomeprazole - was expenditure on samples a contributor?

Background Administrative data from the Australian Pharmaceutical Benefits Scheme (PBS) showed rapid growth of esomeprazole dispensing when it was launched. Australia has universal prescription medicine coverage (the PBS), which included esomeprazole from August 2002. Free samples of new medicines are commonly provided to doctors. Objectives To determine if a relationship exists between marketing expenditure on samples and the dispensing rate for esomeprazole in Australia between June 2002 and September 2006. Methods Quarterly sample expenditures at product/brand level for proton pump inhibitors (PPIs) for Australian general practitioners were obtained for July 2002 to September 2006. Corresponding PBS dispensing data were obtained for all PPIs and converted to defined daily dose (DDD)/1000 population/day. Spending on samples was calculated as dollars per dispensed prescription and plotted against time on the Australian market. Results: Total PPI usage increased from 34.2 to 50.8 DDD/1000 population/ day over the study period. Expenditure on samples per dispensed prescription was higher when a PPI was new on the market and diminished over 5-6 years to a relatively constant level. The rapid decline in this ratio was demonstrated by a case study following esomeprazole from launch in Australia for almost 5 years clearly demonstrating the initial investment to drive sales. Conclusion A relationship appears to exist between expenditure on esomeprazole samples and its usage in Australia. A high initial investment was followed by a rapid reduction in cost per prescription dispensed, predominantly due to growth in market share. This trend was consistent with other PPIs

Clinical pathways for chronic cough in children

Background Chronic cough (a cough lasting longer than four weeks) is a common problem internationally. Chronic cough has associated economic costs and is distressing to the child and to parents; ignoring cough may lead to delayed diagnosis and progression of serious underlying respiratory disease. Clinical guidelines have been shown to lead to efficient and effective patient care and can facilitate clinical decision making. Cough guidelines have been designed to facilitate the management of chronic cough. However, treatment recommendations vary, and specific clinical pathways for the treatment of chronic cough in children are important, as causes of and treatments for cough vary significantly from those in adults. Therefore, systematic evaluation of the use of evidence-based clinical pathways for the management of chronic cough in children would be beneficial for clinical practice and for patient care. Use of a management algorithm can improve clinical outcomes; such management guidelines can be found in the guidelines for cough provided by the American College of Chest Physicians (ACCP) and the British Thoracic Society (BTS). Objectives To evaluate the effectiveness of using a clinical pathway in the management of children with chronic cough. Search methods The Cochrane Register of Controlled Trials (CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE, EMBASE, review articles and reference lists of re levant articles were searched. The latest search was conducted in January 2014. Selection criteria All randomised controlled trials of parallel-group design comparing use versus non-use of a clinical pathway for treatment of chronic cough in children (< 18 years of age). Data collection and analysis Results of searches were reviewed against predetermined cr iteria for inclusion. Two review authors independently selected studies and performed data extraction in duplicate. Main results One study was included in the review. This multi-centre trial was based in five Australian hospitals and recruited 272 children with chronic cough. Children were randomly assigned to early (two weeks) or delayed (six weeks) referral to respiratory specialists who used a cough management pathway. When an intention-to-treat analysis was performed, clinical failure at six wee ks post randomisation (defined as < 75% improvement in cough score, or total resolution for fewer than three consecutive days) was significantly less in the early pathway arm compared with the control arm (odds ratio (OR) 0.35, 95% confidence interval (CI) 0.21 to 0.58). These results indicate that one additional child will be cured for e very five children treated via th e cough pathway (number needed to treat for an additional beneficial outcome (NNTB) = 5, 95% CI 3 to 9) at six weeks. Cough-specific parent-reported quality of life scores were significantly better in th e early-pathway group; the mean difference (MD) between groups was 0.60 (95% CI 0.19 to 1.01). Duration of cough post randomisation was significantly shorter in the intervention group (early-pathway arm) compared with the control group (delayed-pathway arm) (MD -2.70 weeks, 95% CI -4.26 to -1.14). Authors’ conclusions. Current evidence suggests that using a clinical algorithm for the management of children with ch r onic cough in h ospital outpatient settings is more effective than providing wait-list care. Futher high-quality randomised controlled trials are needed to perform ongoing evaluation of cough management pathways in general practitioner and other primary care settings.