A 19-week exercise program for people with chronic stroke enhances bone geometry at the tibia: a peripheral quantitative computed tomography study.

BACKGROUND: We assessed the impact of a 19-week exercise program on bone health in chronic stroke. RESULTS: Those who underwent the program reported significantly more gain in tibial trabecular bone content and cortical bone thickness on the affected side. CONCLUSION: Regular exercise is thus beneficial for enhancing bone health in this population.

Remuneration for blood donation and attitudes towards blood donation and receipt in Leeds.

In a survey of attitudes towards remuneration for blood donation in Leeds, the following questions were completed by 489 adults (N), of whom 89 were regular donors, 105 were lapsed donors and 295 had never donated: 'If you needed blood, would you be content if the donor had been paid: yes/no'. 'If I were paid enough I would be less/equally/more likely to donate blood '. The majority (67.7%) of potential recipients would be content if the donor had been paid. The prospect of remuneration made 16.4% of respondents more likely and 14.5% less likely to donate. As the difference is less than 2% of N, offering remuneration may not lead to a significant increase in the number of donations. A statistical comparison (chi2 = 45, d.f. = 2, P << 0.001) showed associations between the responses 'more likely to donate if paid' and 'content to receive blood from a paid donor', and between the responses 'less likely to donate if paid' and 'not content to receive blood from a paid donor'. Age distributions are presented for the donor status categories and the responses to the main questions. Of 129 people who stated a minimum, nonzero payment that would persuade them to donate, 103 (80%) suggested pound sterling 10 or less.

Effects of isokinetic strength training on walking in persons with stroke: a double-blind controlled pilot study.

OBJECTIVES: The goal most often stated by persons with stroke is improved walking function. The purpose of this study was to determine the effects of isokinetic strength training on walking performance, muscle strength, and health-related quality of life in survivors of chronic stroke. METHODS: Twenty participants (age, 61.2 +/- 8.4 years) with chronic stroke were randomized into 2 groups. The experimental group undertook maximal concentric isokinetic strength training, whereas the control group received passive range of motion of the paretic lower extremity 3 times a week for 6 weeks. The Kin-Com Isokinetic Dynamometer (Chattanooga Group Inc., TN) was used for both the strengthening and passive range of motion exercises. The Mann-Whitney U test was used to compare the changes in scores (postintervention minus baseline) between the control and experimental groups for a composite lower extremity strength score, walking speed (level-walking and stair-walking) and health-related quality of life measure (36-Item Short Form Health Survey [SF-36]). RESULTS: Both the experimental and control groups increased their strength and walking speed postintervention; however, there were no differences in the changes in walking speed between the groups. There was a trend (P = .06) toward greater strength improvement in the experimental group compared with the control group. No changes in SF-36 scores were found in either group. CONCLUSIONS: Intervention aimed at increasing strength did not result in improvements in walking. The results of this study stress the importance of controlled clinical trials in determining the effect of specific treatment approaches. Strength training in conjunction with other task-related training may be indicated.

Dental health changes in an Australian Defence Force population.

The dental histories of 100 long-term members of the Royal Australian Air Force were obtained from their dental records. Data relating to dental health status, as measured by the DMF indices and the T-Health scores, were tested to determine if there were any correlations present between changes in dental health and certain risk factors which had been identified by previous studies in the General Dental Service in Scotland. These studies had demonstrated positive relationships between the frequency of dental examination and the frequency with which patients changed their dentist, with the amount of dental treatment the patients received. However, within the potential limitations imposed by the sample size, the present long-term study did not detect any significant associations between the frequencies of dental examination or change of dentist, with changes in dental health.

Potential risk factors for overtreatment in military dentistry.

Recent studies in the National Health Service in Scotland have suggested that frequent changes of dentist, and frequent dental examinations, subject individuals to an increased risk of receiving dental treatment. The present study tested the influence of these two factors on dental health changes, the amount of dental treatment received, and restoration longevity in a population of 100 long-term members of the Royal Australian Air Force. Despite the predictions possible from the Scottish research, the present study failed to find any significant links between frequent attendance or frequent change of dentist and dental health or restoration longevity. However, the type of treatment provided appeared to be influenced by frequency of attendance and military rank.

The influence of examination frequency and changing dentist on dental treatment provision in an Australian defence force population.

During the early 1980s, a number of studies into dental treatment provision in the General Dental Service were conducted in Scotland. These studies indicated that the frequency with which an individual attended the dentist for treatment, or changed their dentist, influenced the amount of dental treatment that they received. The present study was designed to test these findings in an independent population, in this case, 100 members of the Royal Australian Air Force. While the frequency of attending the dentist did not have any significant effect on restoration longevity or the number of restorations a subject received, it did influence the cost of such treatment, indicating that frequent attenders received more expensive treatments rather than more treatment. Changing dentist did not display any significant influence on any of the parameters used in the present study.

Restoration longevity in an Australian Defence Force population.

Replacement of restorations comprises a considerable portion of the work of most dentists. Consequently, factors that affect restoration longevity can influence the pattern of dental practice in a given community. Based on the results of research into treatment provision in the General Dental Service in Scotland, it was considered possible that factors such as the frequency with which patients were examined, and the frequency with which they changed dentists, might influence restoration longevity in other populations. Therefore, the present study was initiated to investigate the effects of these two factors in a population of 100 long-term members of the Royal Australian Air Force. No statistically significant relationship could be found between examination frequency, or frequent changes in dental practitioner, and restoration longevity. It is proposed that the large differences found in restoration longevity between this study and the Scottish study upon which it was based, may be due in part to the differing modes of remuneration of the dentists in the two studies.

Dental treatment and dental health. Part 2. An alternative philosophy and some new treatment modalities in operative dentistry.

In this, the second of two papers on the relationships between dental treatment and dental health, the philosophical basis of Minimum Intervention Dentistry is presented. This approach to patient care has several distinct treatment modalities. These range from preventive measures and fissure sealants, through monitoring carious lesions for active progression or arrest, to minimal cavity designs such as tunnel preparations and preventive resin restorations which employ adhesive dental restorative materials. This paper discusses these techniques and the implications of this change in philosophy for dental teaching, research and manpower considerations.

Dental treatment and dental health. Part 1. A review of studies in support of a philosophy of Minimum Intervention Dentistry.

An international movement emerged in 1986-1987 which heralded a major change in the role of conservative dentistry. This shift was away from the traditional operative dentistry, with its relatively frequent replacement of restorations, to a concept of 'Minimum Intervention Dentistry', which advocates the use of adhesive dental materials, remineralization techniques and monitoring of initial carious lesions. The move away from some of Black's concepts started as investigations examined the dental health of patients in the National Health Service of Great Britain. These investigations, and the report of the Committee of Enquiry into Unnecessary Dental Treatment, have resulted in an extensive re-education programme being initiated by the British Department of Health and Social Security in conjunction with the British Dental Association. This paper, and a subsequent one, were written to enable widespread dissemination of these ideologies to Australian practitioners. While they may appear provocative to some, these papers were merely meant to stimulate discussion on the implications of this research for dentistry in this country. In this paper the results from the British investigations are presented, as is a discussion of some of the outcomes of this and other related research.

Replacement of low copper amalgams by a group of general dental practitioners.

The replacement of low copper amalgams was studied in a number of general practices in Adelaide in 1975 duplicating, by design, the method of a similar Canadian study. The results of this study are in surprising agreement with the Canadian data, and are still relevant to modern practice as the high copper alloys have not proven to have greatly superior longevity. This study involved 60 dentists who, over 271 working days, replaced an average of 6.7 amalgam surfaces/dentist/day. This is equivalent to 1541 amalgam surfaces replaced/dentist/year. In addition, the reasons given for the removal of existing amalgam restorations were closely congruent with those given by the Canadian dentists. This study also indicated that many of these restorations increased in size. This is evident through restorations extending from two surfaces to involve three surfaces.

Prediction of amalgam restoration longevity.

The purpose of the present study was to assess predictions of longevity for amalgam restorations using a fitted Weibull distribution against base estimates using actuarial methods. The 1345 restorations involved were from 100 members of the Royal Australian Air Force whose dental conditions had been monitored regularly over a minimum period of 10 years. Based on maximum likelihood estimates of the parameters of a Weibull distribution, Weibull curves could be determined and were found to be very close to actuarial survival curves established from the same data set. However, Weibull estimates based on survival experience of less than 5-6 years failed to predict long-term survival. Using the 6 year actuarial survival data, the predicted and observed survival curves disagreed by less than 10 per cent for every time period. Twenty-five per cent of restorations had failed for the 6 year data, compared to 22 per cent in these first 6 years for the full 17 year data set.

False aneurysm of femoral artery from cancellous exostosis of femur. Report of a case in a boy of fourteen.

A boy aged fourteen trapped and tore at its origin a branch of the terminal part of the superficial femoral artery over a cancellous exostosis during extension of the knee from the position of full flexion. Three months later an expanding false aneurysm necessitated arteriography, after which suture of the tear gave a successful result.