Effect of adding daytime Class III Elastics to the alternate rapid maxillary expansion-constriction and reverse headgear therapy - A randomized clinical trial.

OBJECTIVE: To evaluate the skeletal, dental and soft tissue cephalometric changes by addition of daytime Class III elastics to the Alternate Rapid Maxillary Expansion-Constriction (AltRAMEC) and Reverse Headgear (RH) protocol in skeletal Class III patients with maxillary retrusion. MATERIAL AND METHODS: 54 patients with maxillary retrusion and CVMI (Cervical vertebral maturity index)

Comparative evaluation of the efficiency of canine retraction using modified Marcotte and T-loop retraction springs - A split-mouth, randomized clinical trial.

OBJECTIVE: The aim of this study was to compare the efficiency of canine retraction using modified Marcotte and T-loop retraction springs. MATERIALS AND METHODS: Twenty-four subjects with a treatment plan involving bilateral extractions of upper first premolars were included in the study. A split-mouth design was used to randomly allocate opposite quadrants to either modified Marcotte spring (MS) or T-loop spring (TLS) for canine retraction. Cephalometric radiographs and models were used to measure the rate of canine retraction (primary outcome) and compare the angular/rotational changes in the canines and anchorage loss in molars (secondary outcomes) following retraction. Subjective assessment of pain and discomfort was compared using visual analog scale (VAS). Paired and independent t-tests were used to evaluate changes. RESULTS: The mean amount and rate of retraction of the canine were found to be significantly higher for MS (3.56 ± 0.696 mm and 1.188 ± 0.232 mm, respectively) when compared with TLS (2.125 ± 0.472 mm and 0.71 ± 0.157 mm, respectively). Distopalatal rotation of the canine was also significantly lesser for MS (2.42°±1.868°) than TLS (5.65° ±2.84°, P < 0.001). However, the amount of anchorage loss and canine tipping were significantly higher for MS. Statistically significant higher values in the VAS score for TLS indicated greater discomfort. CONCLUSION: MS exhibited increased rate of retraction and rotation control when compared with TLS during sectional canine retraction. Patient comfort was better for MS as evidenced by the VAS scores. However, the amount of tipping and anchorage loss obtained with MS were significantly higher than TLS.

Implementing an initiative to promote evidence-informed practice: part 1 - a description of the Evidence Rounds programme.

BACKGROUND: Evidence-informed practice is fundamental to the delivery of high quality health care. Delays and gaps in the translation of research into practice can impact negatively on patient care. Previous studies have reported that problems facing health care professionals such as information overload, underdeveloped critical appraisal skills, lack of time and other individual, organisational and system-level contextual factors are barriers to the uptake of evidence. Health services research in this area has been restricted largely to the evaluation of program outcomes. This paper aims to describe the implementation process of an educational initiative for health care professionals working in midwifery, neonatology or obstetrics aimed at disseminating evidence and enhancing evidence-informed clinical care. METHODS: We designed and implemented an educational initiative called Evidence Rounds for health care professionals working in the women and children's division of an urban hospital in Ireland. It consisted of three core components: (1) group educational sessions examining evidence on topics chosen by staff (2) a dedicated website and (3) facilitation, enablement and support from a knowledge translation professional. We evaluated user engagement in the educational program by monitoring attendance figures and website analytics. We followed up with staff at 3, 16 and 21-month intervals after the last educational session to find out whether evidence had been implemented. We use Lavis's organising framework for knowledge transfer and the Template for Intervention Description and Replication (TIDieR) checklist to describe the educational program and document the implementation process. RESULTS: Six educational sessions presented by 18 health care professionals took place over a nine month period with 148 attendances of which 85 were unique (individuals who attended at least one session). During the period spanning from one month before, during and one month after the running of the group sessions, 188 unique visitors, 331 visits and 862 page views were recorded on our website. CONCLUSIONS: Audit and feedback processes can provide quantitative data to track practice outcomes. Achieving sustainable educational programs can be challenging without dedicated resources such as staffing and funding.

Climate research priorities for policy-makers, practitioners, and scientists in Georgia, USA.

Climate change has far-reaching effects on human and ecological systems, requiring collaboration across sectors and disciplines to determine effective responses. To inform regional responses to climate change, decision-makers need credible and relevant information representing a wide swath of knowledge and perspectives. The southeastern U. S. State of Georgia is a valuable focal area for study because it contains multiple ecological zones that vary greatly in land use and economic activities, and it is vulnerable to diverse climate change impacts. We identified 40 important research questions that, if answered, could lay the groundwork for effective, science-based climate action in Georgia. Top research priorities were identified through a broad solicitation of candidate research questions (180 were received). A group of experts across sectors and disciplines gathered for a workshop to categorize, prioritize, and filter the candidate questions, identify missing topics, and rewrite questions. Participants then collectively chose the 40 most important questions. This cross-sectoral effort ensured the inclusion of a diversity of topics and questions (e.g., coastal hazards, agricultural production, ecosystem functioning, urban infrastructure, and human health) likely to be important to Georgia policy-makers, practitioners, and scientists. Several cross-cutting themes emerged, including the need for long-term data collection and consideration of at-risk Georgia citizens and communities. Workshop participants defined effective responses as those that take economic cost, environmental impacts, and social justice into consideration. Our research highlights the importance of collaborators across disciplines and sectors, and discussing challenges and opportunities that will require transdisciplinary solutions.

Impacts of Combined Cooling, Heating and Power Systems, and Rainwater Harvesting on Water Demand, Carbon Dioxide, and NOx Emissions for Atlanta.

The purpose of this study is to explore the potential water, CO2 and NOx emission, and cost savings that the deployment of decentralized water and energy technologies within two urban growth scenarios can achieve. We assess the effectiveness of urban growth, technological, and political strategies to reduce these burdens in the 13-county Atlanta metropolitan region. The urban growth between 2005 and 2030 was modeled for a business as usual (BAU) scenario and a more compact growth (MCG) scenario. We considered combined cooling, heating and power (CCHP) systems using microturbines for our decentralized energy technology and rooftop rainwater harvesting and low flow fixtures for the decentralized water technologies. Decentralized water and energy technologies had more of an impact in reducing the CO2 and NOx emissions and water withdrawal and consumption than an MCG growth scenario (which does not consider energy for transit). Decentralized energy can reduce the CO2 and NOx emissions by 8% and 63%, respectively. Decentralized energy and water technologies can reduce the water withdrawal and consumption in the MCG scenario by 49% and 50% respectively. Installing CCHP systems on both the existing and new building stocks with a net metering policy could reduce the CO2, NOx, and water consumption by 50%, 90%, and 75% respectively.

Unusual foreign body in a routine lateral cephalogram.

Routine radiographs made in the orthodontic office can often give way to detection and diagnosis of unusual syndromes, signs or foreign bodies. A case report of one such accidental detection of a very unusual foreign body within the nasal cavity of an orthodontic patient has been presented here to emphasize the importance of routine radiographic views, which over and above aiding in Orthodontic diagnosis, can also often detect potentially life threatening problems in the Oro-facial region.

Psychosocial effects of breast cancer on women in Jamaica

The psychosocial effects of breast cancer are many and should be managed in a way to encompass the psychological and social well-being of all these women and their families. The rationale of the study was to identify methods of assisting women with the disease to improve their coping skills. This cross-sectional study was conducted in Kingston and St. Andrew where one hundred and seven patients were interviewed at clinics. The principal objective and scope of the investigation was to assess the emotional reaction to the diagnosis, to compare the advice given by doctor and that of family. To assess the effects of treatment, if any, on behavioural changes, relationships with partners and families, self esteem and employment. The results demonstrated that acceptance of diagnosis was the dominant emotional reaction. The family agreed to follow treatment recommended by doctor. Almost all women expected a cure as partner and family support them in their fight to achieve it. Several had adopted a healthier lifestyle. The illness did not affect self-esteem and ability to work.(Au)

Psychosocial effects of breast cancer on women in Jamaica

The psychosocial effects of breast cancer are many and should be managed in a way to encompass the psychological and social well-being of all these women and their families. The rationale of the study was to identify methods of assisting women with the disease to improve their coping skills. The cross-sectional study was conducted in Kingston and St. Andrew where one hundred and seven patients were interviewed at clinics. The principal objective and scope of the investigation was to assess the emotional reaction to the diagnosis, to compare the advice given by doctor and that of family. To assess the effects of treatment, if any, on behavioural changes, relationships with partners and families, self esteem and employment. The results demonstrated the acceptance of diagnosis was the dominant emotional reaction. The family agreed to follow treatment recommended by doctor. Almost all women expected a cure as partner and family supported them in their fight to achieve it. Several had adopted a healthier lifestyle. The illness did not affect self-esteem and abillity to work. In conclusion, one may say that the study showed an acceptance of the diagnosis by these women with breast cancer. They were driven to positive action and acceptance of treatment which would effect a cure. For them, life had meaning and purpose and they were willing to see some of their goals accomplished (AU)

A prospective study of genital infections in a family-planning clinic. 2. chlamydia infection - the identification of a high risk group

During a study of genital infection in inner-city family-planning patients we examined 452 women for Chlamydia trachomatis. The prevalence of infection was 7.3 percent. There was no significant difference between patients attending because of genital symptoms and those who were attending for routine family-planning advice. Infection was found to be correlated with five main demographic parameters; age less than 25, no stable partnership, hormonal contraception, nulliparity and West Indian Ethnic origin. Using these parameters a simple scoring system was devised which allowed a high-risk population to be defined in whom screening would be economically justified. (AU)