CAD/CAM nitinol bonded retainer versus a chairside rectangular-chain bonded retainer: A multicentre randomised controlled trial.

BACKGROUND: Bonded retainers are widely used to maintain the positions of anterior teeth after orthodontic treatment. Various types of bonded retainer exist however, there is a lack of evidence to indicate which type is superior. AIM: To compare upper and lower CAD/CAM nitinol bonded retainers (Memotain®) with upper and lower chairside rectangular-chain bonded retainers (Ortho-FlexTech™), in terms of stability, retainer failures and patient satisfaction. TRIAL DESIGN: Multi-centre, two-arm, parallel-group, randomised controlled clinical trial with 1:1 allocation. SETTING: Three trial centres: University Teaching Hospital; District General Hospital; and Specialist Orthodontic Practice. All treatment was provided free as part of a state-funded healthcare system. MATERIALS AND METHODS: A total of 68 patients were randomly allocated to receive either upper and lower Memotain® bonded retainers or upper and lower Ortho-FlexTech™ bonded retainers. Ten trained operators placed and reviewed the bonded retainers. Measurements were carried out on study models taken at debond and after six months. Patient satisfaction questionnaires were completed at six months following debond. RESULTS: The trial was terminated due to the high number of failures (50%) of the upper Memotain® retainers within six months. Memotain® retainers were three times more likely to fail (unadjusted hazard ratio = 2.82, 95% confidence interval = 1.00-7.99) than Ortho-FlexTech™ retainers at six months in the upper arch. Patients were satisfied with both types of retainer. LIMITATIONS: Early termination of the trial means that the a priori sample size was not reached, so outcomes should be interpreted with caution. CONCLUSION: The trial was terminated early due to the high failure rate of upper Memotain® bonded retainers. They had a higher risk of failure in the maxillary arch when compared to upper Ortho-FlexTech™ bonded retainers after six months.

The British Orthodontic Society MOrth Cases Prize 2019.

This paper describes the orthodontic treatment of two cases that were successful in winning the British Orthodontic Society (BOS) Membership in Orthodontics (MOrth) Cases Prize in 2019. The first case describes the management of a 12-year-old girl with a Class II division 2 malocclusion complicated by moderate upper and lower arch crowding, multiple unerupted teeth, restored lower first permanent molars, pseudo-transposition of the lower left lateral incisor and canine, and diminutive upper lateral incisors. Treatment involved a combination of an upper removable appliance followed by upper and lower preadjusted edgewise fixed appliances. Anteroposterior correction and overbite reduction was achieved with triangular Class II elastics with posterior occlusal disengagement. Both upper permanent canines were exposed and aligned, and the diminutive upper incisors built up with resin-based composite. Treatment was completed over a period of 23 months. The second case describes the management of a 13-year-old boy with a Class II division 2 malocclusion complicated by severe upper and lower arch crowding with unerupted UR5, UL4, LR3, rotated LR5, an increased overbite complete to tooth, buccally displaced upper canines and hypoplastic upper first premolars. Treatment involved a first phase of functional appliance therapy, followed by the extraction of UR4, UL4, LL5, LR4 and upper and lower preadjusted edgewise fixed appliances over a 28-month period.

Research priorities for the COVID-19 pandemic and beyond: A call to action for psychological science.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that has caused the coronavirus disease 2019 (COVID-19) pandemic represents the greatest international biopsychosocial emergency the world has faced for a century, and psychological science has an integral role to offer in helping societies recover. The aim of this paper is to set out the shorter- and longer-term priorities for research in psychological science that will (a) frame the breadth and scope of potential contributions from across the discipline; (b) enable researchers to focus their resources on gaps in knowledge; and (c) help funders and policymakers make informed decisions about future research priorities in order to best meet the needs of societies as they emerge from the acute phase of the pandemic. The research priorities were informed by an expert panel convened by the British Psychological Society that reflects the breadth of the discipline; a wider advisory panel with international input; and a survey of 539 psychological scientists conducted early in May 2020. The most pressing need is to research the negative biopsychosocial impacts of the COVID-19 pandemic to facilitate immediate and longer-term recovery, not only in relation to mental health, but also in relation to behaviour change and adherence, work, education, children and families, physical health and the brain, and social cohesion and connectedness. We call on psychological scientists to work collaboratively with other scientists and stakeholders, establish consortia, and develop innovative research methods while maintaining high-quality, open, and rigorous research standards.

Challenges in implementing and assessing outcomes of school start time change in the UK: experience of the Oxford Teensleep study.

OBJECTIVE: Later school start times for adolescents have been implemented in the US and associated benefits found, although no randomised controlled trials (RCT) have been undertaken. The objective of this study was to evaluate the impact of two school interventions in the UK, a delayed start time and a sleep education programme, on students' academic performance, sleep outcomes and health-related quality of life. METHODS: The study had an RCT design to enable an investigation into the differential effects of two interventions or a combination of both: schools were to delay their start time to 10:00am and/or provide a classroom-based sleep education programme. The recruitment target was 100 state (non-fee-paying) secondary schools. Participants were to be students in Year 10/11 (14-16-year-olds). RESULTS: Despite much media coverage, only two schools volunteered to take part in the RCT. The main challenges faced in recruitment fell under three categories: research design, school, and project-specific issues. The delayed start time and prospect of randomisation to this intervention were the overwhelming reasons cited for not taking part. Facilitators and barriers to research were identified. Recommendations include carrying out a feasibility study prior to a main trial, allowing adequate time for recruitment, involving stakeholders throughout the decision-making process, incorporating independent (fee-paying) schools in recruitment, focusing on students not taking important examinations or involving an older year group with greater independence. CONCLUSION: The Teensleep study provides supporting evidence that evaluating the effects of a change in school start times through an RCT is unfeasible in the UK.

Rhetoric and Etiological Beliefs About Sexuality: Reader Responses to Cynthia Nixon's New York Times Interview.

In 2012, the U.S. actress Cynthia Nixon was quoted in the New York Times Magazine as having stated that "for me, it [being gay] is a choice. I understand that for many people it's not, but for me it's a choice, and you don't get to define my gayness for me." The interview attracted international media attention and public criticism by lesbian and gay activists. This article suggests a rhetorical approach to understanding etiological beliefs and provides a discursive analysis of 198 online comments by readers of Pink News, a gay news Web site that reported on Nixon's controversial interview. This article explores common arguments used in readers' comments about Nixon and examines the rhetorical construction of sexuality. The analysis examines three themes within the data. First, biological essentialism was treated by many readers as common knowledge; second, readers suggested that only bisexuals have "choice"; and, third, it was suggested by both Nixon's critics and her supporters that counterarguments colluded with homophobia. The article suggests that there is an ideological dilemma whereby both "born-this-way" and "choice" arguments can be understood as colluding with anti-gay prejudice.

Gendered accounts of managing diabetes in same-sex relationships: A discursive analysis of partner support.

The gendered dimensions of partner support in relationships where one partner has a chronic condition has been a recurring focus within the literature on gender and health. Such literature however typically focuses exclusively on heterosexual couples while same-sex relationships are rendered invisible, leading to the discourse around partner support being heteronormative. This article examines gendered dimensions within accounts of lesbian, gay and bisexual people with diabetes using a discursive psychological approach. The analysis identifies how participants drew upon a range of interpretative repertoires, including: (1) notions that women are more caring than men; (2) that men can take control in an emergency; (3) that gay men are caring; (4) that grown men can take care of themselves; and (5) that gay men are more independent than heterosexual men. It is argued that rather than simply dismissing heteronormative repertoires of gender and health, non-heterosexuals draw upon them in ways that display ideological tensions.

Poststroke Trajectories: The Process of Recovery Over the Longer Term Following Stroke.

We adopted a grounded theory approach to explore the process of recovery experienced by stroke survivors over the longer term who were living in the community in the United Kingdom, and the interacting factors that are understood to have shaped their recovery trajectories. We used a combination of qualitative methods. From the accounts of 22 purposively sampled stroke survivors, four different recovery trajectories were evident: (a) meaningful recovery, (b) cycles of recovery and decline, (c) ongoing disruption, (d) gradual, ongoing decline. Building on the concept of the illness trajectory, our findings demonstrate how multiple, interacting factors shape the process and meaning of recovery over time. Such factors included conception of recovery and meanings given to the changing self, the meanings and consequences of health and illness experiences across the life course, loss, sense of agency, and enacting relationships. Awareness of the process of recovery will help professionals better support stroke survivors.

Pathological fracture of the coronoid process secondary to medication-related osteonecrosis of the jaw (MRONJ).

INTRODUCTION: Medication-related osteonecrosis of the jaw (MRONJ) is a growing problem within the field of oral and maxillofacial surgery. It is defined as the presence of exposed necrotic alveolar bone that does not resolve over a period of 8 weeks in a patient taking bisphosphonates, who has not had radiotherapy to the jaw [1]. Since the first report in 2003 that highlighted the potential harm caused by MRONJ, many more patients have been diagnosed with the condition [2]. The growth in recent years is likely due to the more potent drugs delivered intravenously however there is some evidence that oral bisphosphonates given over longer periods of time can have similar effects. Bone exposure may occur spontaneously or most commonly occurs following an invasive dental procedure, as shown in the case below [3]. PRESENTATION OF CASE: This case report demonstrates the unpredictable nature of symptoms associated with medication related osteonecrosis and its management within the hospital environment. DISCUSSION: This case demonstrastes the unpredictable nature of MRONJ and how the disease can progress to cause significant morbidity. In this case extensive surgery was required to remove the necrotic fragments of bone with no guarnatee that the necrosis will stop spreading. CONCLUSION: It seems a matter of great importance that the lasting effects of MRONJ are known to general dental and medical practitioners alike. Nationally recognised evidence based guidelines are lacking and uniformity in the management of MRONJ is required amongst the speciality.

Sex and diabetes: a thematic analysis of gay and bisexual men's accounts.

Around 50 per cent of men with diabetes experience erectile dysfunction. Much of the literature focuses on quality of life measures with heterosexual men in monogamous relationships. This study explores gay and bisexual men's experiences of sex and diabetes. Thirteen interviews were analysed and three themes identified: erectile problems; other 'physical' problems; and disclosing diabetes to sexual partners. Findings highlight a range of sexual problems experienced by non-heterosexual men and the significance of the cultural and relational context in which they are situated. The personalized care promised by the UK government should acknowledge the diversity of sexual practices which might be affected by diabetes.