Exercise intervention for a musculoskeletal disorder in an oral health student: a case report.

OBJECTIVES: to describe and evaluate the effect of an exercise self-management programme for an oral health student who was suffering from a musculoskeletal disorder which had developed in the clinical environment during the course of training. DESIGN: Single participant case report. SETTING: The University of Otago Faculty of Dentistry and School of Physiotherapy. METHODS: The participant was a 21-year-old female student, enrolled in the University of Otago Bachelor of Oral Health (BOH) course, who was suffering back and neck pain which had developed during her training. A series of chairside stretches, regular home-based stretches, aerobic conditioning and postural strengthening exercises was prescribed. Pain and function was assessed using standardised questionnaires at the commencement of the exercise programme, and again at 6 weeks and 13 weeks. RESULTS: The participant demonstrated an improvement in her outcome questionnaires exceeding the MCID scores after 13 weeks. CONCLUSIONS: This case report provides a basis for highlighting the importance of measuring and monitoring MSD in a student learning oral health skills; it supports the findings of previous studies showing that an exercise intervention has some benefit for MSD in oral health students.

Effect of cationic polyacrylamides on the interactions between cellulose fibers.

The interaction between cellulose fibers in the presence of cationic polyacrylamide (CPAM) was analyzed by rheology as a function of polyelectrolyte concentration, charge density, and molecular weight. CPAM was found to strongly influence the yield stress of cellulose suspensions; low doses of CPAM increased the yield stress, but at higher concentrations the yield stress declined. The charge density of the CPAM was the most significant factor in how yield stress responded to CPAM concentration; this effect was able to be normalized to a master curve by considering only the charged fraction of the polymer. The molecular weight of CPAM samples had some effect at high concentrations, but for lower CPAM doses the yield stress was independent of molecular weight over the range studied. The data suggest that CPAM modifies the interaction between cellulose surfaces via several mechanisms, with electrostatic interactions in the form of charge neutralization and charged patch formation dominating; polymer bridging and steric repulsion also influence the overall balance of forces between interacting cellulose fibers.

Clinical working postures of bachelor of oral health students.

OBJECTIVE: To observe and describe the clinical working postures of final-year Bachelor of Oral Health (BOH) students. DESIGN: Pilot observational study. SETTING: The University of Otago Faculty of Dentistry and School of Physiotherapy. METHODS: Eight final-year BOH students voluntarily participated in this study, where postural data were collected using a digital video camera during a standard clinical treatment session. The postural data were analysed using 3D Match biomechanical software. RESULTS: Final-year BOH students who work in the seated position are exposed to neck flexion of greater than 35 degrees, together with trunk flexion greater than 20 degrees and bilateral elbow flexion greater than 90 degrees. CONCLUSIONS: The findings of this study agree with the findings of previous postural studies of dental professionals. Dental hygiene students, together with their clinical supervisors, need to be aware of the importance of good working posture early in their careers, and pay particular attention to the degree of neck flexion occurring for prolonged periods.

Complexity in nanoparticle assembly and function obtained by direct-grafted peptides.

We synthesize peptide-functionalized nanoparticles by growing the peptide directly from the nanoparticles in a grafting-from process. We demonstrate the procedure by grafting a short, pH and oxidation responsive peptide sequence from 300 nm silica nanoparticles. The peptide allows destabilization of the particles in response to pH by neutralization of electrostatic charge, while manipulation of oxidizing conditions in the system offers the ability to select for irreversible, covalent bonding between the particles. In one system, we show the assembly of an asymmetrically functionalized set of particles, which may have applications in the formation of binary particle networks. The method of preparing peptide-coated particles should greatly simplify existing processes used to create peptide-functionalized nanoparticles.

Peptides grafted from solids for the control of interfacial properties.

We have used solid-phase peptide synthesis to graft a peptide monolayer from a solid in order to modify the interfacial properties. We grafted a 15-residue peptide, EKEKEKEKEKEKEGG, containing a zwitterionic sequence of alternating lysine and glutamic acid residues from the surface of an aminosilanized silicon wafer by placing the silicon wafer within a commercial microwave peptide synthesizer. Such synthesizers are routinely used to make peptides on porous beads, but the peptides are subsequently cleaved and used independently of the solid support; our aim is to utilize the covalently bound peptide to control the surface properties without the need for cleavage and reattachment. We confirmed the presence of this peptide layer on the surface by X-ray photoelectron spectroscopy and ellipsometry. Atomic force microscopy was then used to study the forces between the peptide-modified surface and a borosilicate glass sphere as a function of the solution pH. The adsorbed peptide makes the silicon wafer pH responsive: at high pH the glass particle is repelled from the wafer, and at low pH it is attracted. Previous studies with synthetic polymers have shown that the "grafting from" method allows a much higher film density than "grafting to". We propose that the application of grafting from strategies to peptide layers may offer three additional benefits: (1) the film density can be controlled independently of the primary sequence of the peptide, (2) the sequence constraints for spontaneous adsorption are removed, and (3) the procedure is fast and efficient, which may lead to lower costs and the ability for high-throughput surface biofunctionalization. Moreover, peptide layers offer increased sequence diversity, control, and functionality compared to conventional polymer brushes.

Surface chemistry and rheology of polysulfobetaine-coated silica.

We have measured the viscosity of suspensions of colloidal silica particles (d = 300 nm) and the properties of silica surfaces in solutions of a polymer consisting of zwitterionic monomer groups, poly(sulfobetaine methacrylate), polySBMA. This polymer has potential use in modifying surface properties because the polymer is net uncharged and therefore does not generate double-layer forces. The solubility of the polymer can be controlled and varies from poor to good by the addition of sodium chloride salt. Ellipsometry was used to demonstrate that polySBMA adsorbs to silica and exhibits an increase in surface excess at lower salt concentration, which is consistent with a smaller area per molecule at low salt concentration. Neutron reflectivity measurements show that the adsorbed polymer has a thickness of about 3.7 nm and is highly hydrated. The polymer can be used to exercise considerable control over suspension rheology. When silica particles are not completely covered in polymer, the suspension produces a highly viscous gel. Atomic force microscopy was used to show this is caused by bridging of polymer between the particles. At higher surface coverage, the polymer can produce either a high or very low viscosity slurry depending on the sodium chloride concentration. At high salt concentration, the suspension is stable, and the viscosity is lower. This is probably because the entrainment of many small ions renders the polymer film highly hydrophilic, producing repulsive surface forces and lubricating the flow of particles. At low salt concentrations, the polymer is barely soluble and more densely adsorbed. This produces less stable and more viscous solutions, which we attribute to attractive interactions between the adsorbed polymer layers.

An evaluation of five protocols for surgical handwashing in relation to skin condition and microbial counts.

Five protocols for surgical handwashing (scrubbing) were evaluated for their efficiency of removal of micro-organisms and their drying effect on the skin. The scrubbing protocols tested were: (1) an initial scrub of 5 min and consecutive scrubs of 3.5 min with chlorhexidine gluconate 4% (CHG-5); (2) an initial scrub of 3 min and consecutive scrubs of 2.5 min with chlorhexidine gluconate 4% (CHG-3); (3) an initial scrub of 3 min and consecutive scrubs of 2.5 min with povidone iodine 5% and triclosan 1% (PI-3); (4) an initial scrub of 2 min with chlorhexidine gluconate 4% followed by a 30 s application of isopropanol 70% and chlorhexidine gluconate 0.5%, and a 30 s application of isopropanol 70% and chlorhexidine gluconate 0.5% for consecutive scrubs (IPA); and (5) an initial scrub of 2 min with chlorhexidine gluconate 4% followed by a 30 s application of ethanol 70% and chlorhexidine gluconate 0.5%, and a 30 s application of ethanol 70% and chlorhexidine gluconate 0.5% for consecutive scrubs (EA). A convenience sample of 23 operating theatre nurses completed each scrub protocol for one week in a randomized order. A week of normal work activities intervened between each protocol. Subjects were assessed before commencing and after completing the week of each protocol to determine changes in the microbial counts and skin condition of the hands. Specimens for microbial analysis were collected before, immediately after and 2 h after an initial scrub, and 2 h after a consecutive scrub. The CHG-5, CHG-3 and PI-3 protocols, which used detergent-based antiseptics only, were compared with protocols incorporating an alcohol-based antiseptic (IPA and EA). The protocols incorporating alcohol-based antiseptics and the CHG-5 protocol were generally associated with the lowest post-scrub numbers of colony forming units (cfu). No difference between the CHG-5 protocol and the alcohol-based antiseptics was found at the beginning of the test week, but after exclusive use of the respective protocols for a week, the alcohol-based antiseptics were associated with significantly lower cfu numbers in two out of the three post-scrub samples (P = 0.003, P = 0.035). Although virtually no statistically significant differences in skin condition were found, many subjects reported the alcohol-based antiseptic protocols to be less drying on the skin. The findings of this study support the proposition that a scrub protocol using alcohol-based antiseptics is as effective and no more damaging to skin than more time-consuming, conventional methods using detergent-based antiseptics.

Failed suction termination of pregnancy: case reports and review.

This paper presents two case reports of failed suction termination of first trimester pregnancies which occurred at Geelong Hospital over a short period of time and thus drew our attention to this very difficult problem. The international experience with such failed terminations is then reviewed, with discussion of the recognized associations, prevention and management of such cases.

The effect of surgical handwashing routines on the microbial counts of operating room nurses.

Many factors may affect the efficiency of handwashing techniques. This study examined two interdependent factors: the time taken to wash the hands and the type of antiseptic solution used. A 3-minute initial scrub and 30-second consecutive scrub regimen was compared with a current standard regimen of a 5-minute initial scrub and a 3-minute consecutive scrub. Chlorhexidine gluconate 4% and povidone-iodine 7.5% were the antiseptics used in the two regimens. The sample (n = 34) was drawn from nurses employed in the operating room suite of a 950-bed hospital. Chlorhexidine gluconate was found to be responsible for lower numbers of colony-forming units of bacteria than povidone-iodine. The duration of the scrub had no significant effect on the numbers of bacteria when povidone-iodine was used. The optimal regimen was found to be the 5-minute initial and 3-minute consecutive scrubs with chlorhexidine gluconate.