A public health-academic education partnership.

This article presents an academic-public health partnership needs assessment. Given the many health systems changes, the Delaware Division of Public Health and the University of Delaware joined forces to study partnership options and public health staff's education needs. This assessment was the first phase of a four-stage, multiyear research-service partnership. The top three education needs identified by the sample (n = 36) of public health staff were (1) community assessment, (2) partnership building, and (3) core functions. Distance education formats were selected as the most popular choice for education updates. Findings support the need for continued education and the use of academic-government partnerships as an education-service delivery resource. Perceived benefits of academic-public health partnerships include staff training, student learning opportunities, improved community services, and increased collaborative research.

Youth safety education and injury prevention program.

Unintentional injury remains the leading cause of death in U.S. children. This article provides a case evaluation of a school based youth safety education program based on the Think First National Injury Prevention Program curriculum. Partners for the program included an urban elementary school, a school of nursing, a Safe Kids Coalition, a regional trauma center, and pediatric, community, and critical care nurses. A convenience sample of 140 second grade children in a mid-Atlantic elementary school participated in a 1 hour-a-week injury prevention class over the course of 6 weeks. The Think First National Injury Prevention Program served as the core curriculum and evaluation framework. At the end of the program, knowledge test scores increased an average of 35% over pre-test measures. Ninety-eight percent of the faculty, staff nurses, student nurses, children, and parents indicated a positive overall value of the program and the need for it to continue on an ongoing basis. Safety resources are provided for pediatric nurses to use in their diverse practice settings.

Never too soon: a pilot first and third grade drug education program.

Substance use is a leading national health problem, and school nurses are in pivotal positions to assist with prevention activities to reduce this growing epidemic. In response to increasing rates of parental and youth substance use and abuse, a collaborative research-service-education partnership was established between a college of nursing and an elementary school in a low-income, urban community. A two-part pilot study of parental knowledge and behaviors of drug use, and the evaluation of a first- and third-grade drug education model, are described in this paper. Although the findings cannot be generalized, they yield useful information for parental, youth, and neighborhood teaching and future research. Over half of parents consumed alcohol, and 60% smoked cigarettes. Forty-seven percent of parents reported discussing drugs with their child. However, only 22% of the parents who used substances reported talking about drugs with their children. The pilot drug education sessions, two, 30-45 minute sessions a week for 8 weeks, resulted in an average of 30% higher posttest knowledge scores in the first and third graders. Drug education classes should be offered every year for patients and youth, kindergarten through twelfth grade.

Comparative in vitro effectiveness of closed root debridement with fine instruments on specific areas of mandibular first molar furcations. I. Root trunk and furcation entrance.

The purpose of this study was to compare curets with a small blade to slim ultrasonic inserts on their efficacy in removing artificial deposits from the root trunk and furcation entrance areas of mandibular molars using an in vitro model simulating a clinically closed root debridement approach. The study was conducted on 100 artificial mandibular first molars (50 right side and 50 left side) with anatomical roots. Root trunks, furcation entrances, and furcation areas of each molar were colored by a coat of black model paint. The teeth were fixed in a custom acrylic model and maintained in a firm position by modified acrylic occlusal splints. The root areas were covered with a heavy rubber dam imitating gingival tissue. The model was attached to a mannequin and mounted on a dental chair. Fifty molars (25 right, 25 left) were instrumented with the experimental curets and an equivalent number of molars with the ultrasonic inserts. The instrumentation was carried out by one experienced operator, spending 4 minutes on each molar. The instrumented areas were individually analyzed to determine the percentage of deposits remaining, using a computerized imaging routine system. One-way analysis of variance was conducted to test for differences between both types of instruments. Results revealed that the curets were significantly more efficient (P < 0.01) than the ultrasonic inserts in removing paint from both root trunks and furcation entrances. These findings should be corroborated in a clinical study to determine the potential value of the instruments tested during initial therapy or supportive care of involved mandibular furcations.

Comparative in vitro effectiveness of closed root debridement with fine instruments on specific areas of mandibular first molar furcations. II. Furcation area.

The purpose of this study was to demonstrate the extent of deposits removed from within the furcation area of mandibular first molars following the use of curets with a modified blade and slim ultrasonic inserts in an in vitro model simulating a closed root debridement approach to furcation treatment. The furcation areas of 100 artificial mandibular first molars were uniformly coated with black model paint. The molars were fixed into a custom acrylic model, maintained in a firm position with modified occlusal splints, and the roots covered with a heavy rubber dam. The model was set in a mannequin and mounted on a dental chair recreating a clinical situation. Fifty molars (25 right, 25 left) were instrumented with the experimental curets and an equivalent number of molars with the ultrasonic inserts. An experienced dental hygienist completed all the instrumentation, spending 4 minutes on each molar. The molars were sectioned buccolingually from the crown apically to separate the roots, and areas in the internal surface of mesial and distal roots were analyzed to determine the percentage of deposits remaining using a computerized imaging routine system. A 2-factor analysis of variance was conducted to test for differences between both types of instruments. The curets produced furcation root surfaces with significantly less percentage of residual deposits than the ultrasonic inserts (P < 0.01). This study indicates the potential value of small bladed curets in debriding involved furcations during initial therapy and supportive periodontal therapy. The current findings should be corroborated in a clinical study.

Limiting ischemic spinal cord injury using a free radical scavenger 21-aminosteroid and/or cerebrospinal fluid drainage.

Traumatic spinal cord injury occurs in two phases: biomechanical injury, followed by ischemia and reperfusion injury. Biomechanical injury to the spinal cord, preceded or followed by various pharmaceutical manipulations or interventions, has been studied, but the ischemia/reperfusion aspect of spinal cord injury isolated from the biomechanical injury has not been previously evaluated. In the current study, ischemia to the lumbar spinal cord was induced in albino rabbits via infrarenal aortic occlusion, and two interventions were analyzed: the use of U74006F (Tirilazad mesylate), a 21-aminosteroid, and cerebrospinal fluid (CSF) drainage. These treatment modalities were tested alone or in combination. In Phase 1 of this study, the rabbits received 1.0 mg/kg of Tirilazad or an equal volume of vehicle (controls) prior to the actual occlusion, three doses of Tirilazad (1 mg/kg each) during the occlusion, then several doses after the occlusion. Of the Tirilazad-treated animals, 30% became paraplegic while 70% of the control animals became paraplegic. Phase 2 involved the same doses of Tirilazad as in Phase 1 and, in addition, CSF pressure monitoring and drainage were performed. The paraplegia rate was 79% in the control animals, 36% in the group receiving Tirilazad alone, 25% in the group with CSF drainage alone, and 20% in the Tirilazad plus CSF drainage group. This rate also correlated with changes noted in CSF pressure; both Tirilazad administration alone and CSF drainage alone induced a decrease in CSF pressure and the two combined produced a further decrease. There was marked improvement in the perfusion pressure when using Tirilazad alone, CSF drainage alone, and Tirilazad therapy in combination with CSF drainage, with the last group producing the largest increase. This change in CSF pressure and perfusion pressure correlated with improved functional neurological outcome. Pathological examination revealed that Tirilazad therapy reduced the extensive and diffuse neuronal, glial, and endothelial damage to (in its most severe form) a more patchy focal region of damage in the gray matter. Cerebrospinal fluid drainage resulted in pyknosis of some motor neurons, and some eosinophilia. The combination of CSF drainage and Tirilazad administration resulted in the least abnormality, with either normal or near-normal spinal cords. It is concluded that Tirilazad administration decreased CSF pressure during spinal cord ischemia and reperfusion and, like CSF drainage, increased and improved the perfusion pressure to the spinal cord, decreased spinal cord damage, and improved functional outcome.(ABSTRACT TRUNCATED AT 400 WORDS)

An imaging routine for assessing the efficacy of instruments used for scaling and root planing.

Deposits of dental plaque or calculus are typically quantified using planimetric techniques. However, error is introduced into a quantitative analysis of plaque deposits using these methods, since they require a significant amount of human intervention. The purpose of this study is to describe and validate a computerized imaging routine which has the potential to objectively identify material on dental roots and measure the area covered by these deposits. Dentiform teeth with simulated plaque were videorecorded. A computer routine was developed based on a flood-fill algorithm which analyzed images of the dentiform teeth and determined the amount of simulated plaque on their root surfaces. Results showed that the dentiform teeth and their simulated plaque patterns are duplicated by the imaging routine in a rapid and reliable fashion. The system shows a high degree of accuracy with an average error factor of only 0.58%. As well, the system enables precise reproducibility with an average error factor of only 0.71%.

Evaluation of a new periodontal curet. An in vitro study.

Removal of plaque and calculus from subgingival root surfaces is a fundamental aspect of periodontal therapy. A new type of periodontal curet (Gracey Curvette Sub-0) has been designed to better adapt to the root surfaces that may be encountered in periodontal pockets of incisor teeth. The new curet (test) was compared to a Gracey curet 1/2 (conventional) in their ability to remove deposits from the subgingival root surfaces of incisor teeth in an in vitro model. A dentiform model mounted on a dental chair was used with artificial gingiva, 6 mm pocket depths and subgingival root surfaces covered with black enamel paint. 2 groups of 12 hygienists used, on a timed basis, either the test or conventional curet on 4 of the incisor teeth and then switched to the alternate instrument for the remaining four incisors. The extent of surface material removal was determined using a computerized video routine. The test curet removed significantly (p less than 0.001) more of the surface material from all subgingival incisor root surfaces than the conventional curet (60.7% versus 46.3%). Both instruments were most effective at labial surfaces. The test curet was least effective at proximal surfaces and the conventional curet least effective at lingual surfaces. The greatest statistical difference between instruments was apparent at lingual surfaces of maxillary incisors and the least at mesial surfaces of mandibular incisors.