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General Objectives (general + objective)

Distribution by Scientific Domains

Medical Sciences	50%

Selected Abstracts

Interventions for replacing missing teeth: bone augmentation techniques for dental implant treatment

AUSTRALIAN DENTAL JOURNAL, Issue 1 2009
M Esposito
Background:, Dental implants require sufficient bone to be adequately stabilized. For some patients implant treatment would not be an option without bone augmentation. A variety of materials and surgical techniques are available for bone augmentation. Objectives:, General objectives: To test the null hypothesis of no difference in the success, function, morbidity and patient satisfaction between different bone augmentation techniques for dental implant treatment. Specific objectives: (A) to test whether and when augmentation procedures are necessary; (B) to test which is the most effective augmentation technique for specific clinical indications. Trials were divided into three broad categories according to different indications for the bone augmentation techniques: (1) major vertical or horizontal bone augmentation or both; (2) implants placed in extraction sockets; (3) fenestrated implants. Search strategy:, The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched. Several dental journals were handsearched. The bibliographies of review articles were checked, and personal references were searched. More than 55 implant manufacturing companies were also contacted. Last electronic search was conducted on 9 January 2008. Selection criteria:, Randomized controlled trials (RCTs) of different techniques and materials for augmenting bone for implant treatment reporting the outcome of implant therapy at least to abutment connection. Data collection and analysis:, Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted independently and in duplicate. Authors were contacted for any missing information. Results were expressed as random-effects models using mean differences for continuous outcomes and odd ratios for dichotomous outcomes with 95% confidence intervals. The statistical unit of the analysis was the patient. Main results:, Seventeen RCTs out of 40 potentially eligible trials reporting the outcome of 455 patients were suitable for inclusion. Since different techniques were evaluated in different trials, no meta-analysis could be performed. Ten trials evaluated different techniques for vertical or horizontal bone augmentation or both. Four trials evaluated different techniques of bone grafting for implants placed in extraction sockets and three trials evaluated different techniques to treat bone dehiscence or fenestrations around implants. Authors' conclusions:, Major bone grafting procedures of resorbed mandibles may not be justified. Bone substitutes (Bio-Oss or Cerasorb) may replace autogenous bone for sinus lift procedures of atrophic maxillary sinuses. Various techniques can augment bone horizontally and vertically, but it is unclear which is the most efficient. It is unclear whether augmentation procedures at immediate single implants placed in fresh extraction sockets are needed, and which is the most effective augmentation procedure, however, sites treated with barrier plus Bio-Oss showed a higher position of the gingival margin when compared to sites treated with barriers alone. Non-resorbable barriers at fenestrated implants regenerated more bone than no barriers, however it remains unclear whether such bone is of benefit to the patient. It is unclear which is the most effective technique for augmenting bone around fenestrated implants. Bone morphogenetic proteins may enhance bone formation around implants grafted with Bio-Oss. Titanium may be preferable to resorbable screws to fixate onlay bone grafts. The use of particulate autogenous bone from intraoral locations, also taken with dedicated aspirators, might be associated with an increased risk of infective complications. These findings are based on few trials including few patients, sometimes having short follow up, and often being judged to be at high risk of bias. [source]

Willingness to pay for a hearing aid: comparing the payment scale and open-ended question

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2009
Janneke P. C. Grutters MSc
Abstract Rationale & objectives, Different question formats elicit different willingness-to-pay (WTP) results, but there is no consensus on which method elicits the most valid WTP. In spite of the methodological controversies, WTP is a potentially valuable tool in health economics to value health services. Our general objective was to provide additional evidence on the validity of two WTP elicitation formats: the open-ended question and the payment scale. Methods, We elicited WTP for a hearing aid among hearing aid users (n = 108), using both a payment scale and an open-ended question. We compared the results from both formats. We tested criterion validity by comparing both formats with the actual out-of-pocket payment. Construct validity was tested by examining whether WTP was consistent with positive income elasticity. Results, The WTP results elicited with the payment scale and open-ended question were not statistically significantly different. Both formats showed good criterion validity, although the open-ended question showed a stronger association with the actual out-of-pocket payment. The open-ended format showed better construct validity, as it was influenced by family income. Conclusion, The results of the present study showed that the open-ended question was more valid than the payment scale question. We, therefore, recommend that in future WTP studies on hearing aids the open-ended question is used to directly elicit WTP values. The same recommendation may apply to other studies where respondents are familiar with costs or payments for the intervention under evaluation. [source]

Progress with Molecular Electronic Junctions: Meeting Experimental Challenges in Design and Fabrication

ADVANCED MATERIALS, Issue 43 2009
Richard L. McCreery
Abstract Molecular electronics seeks to incorporate molecular components as functional elements in electronic devices. There are numerous strategies reported to date for the fabrication, design, and characterization of such devices, but a broadly accepted example showing structure-dependent conductance behavior has not yet emerged. This progress report focuses on experimental methods for making both single-molecule and ensemble molecular junctions, and highlights key results from these efforts. Based on some general objectives of the field, particular experiments are presented to show progress in several important areas, and also to define those areas that still need attention. Some of the variable behavior of ostensibly similar junctions reported in the literature is attributable to differences in the way the junctions are fabricated. These differences are due, in part, to the multitude of methods for supporting the molecular layer on the substrate, including methods that utilize physical adsorption and covalent bonds, and to the numerous strategies for making top contacts. After discussing recent experimental progress in molecular electronics, an assessment of the current state of the field is presented, along with a proposed road map that can be used to assess progress in the future. [source]

Mothering and child protection practice: rethinking risk assessment

CHILD & FAMILY SOCIAL WORK, Issue 1 2000
Krane
In recent years, across North America and the UK, child protective service agencies have increasingly begun to rely on bureaucratic, technocratic, and regulatory mechanisms for detecting and managing abuse and neglect. Coupled with a shift from concern for the general social welfare of children to a heightened preoccupation with risk or dangerousness to children, risk assessment systems are becoming integral to child protection practice. Though risk assessment systems aim to enhance the effectiveness of child protection investigations and service provision, as well as filter out high risk cases from the rest, such systems may foster and reproduce often concealed relations of gender, race, and class. This paper presents a review of the risk assessment trend in child welfare, its general objectives, and some criticisms raised to date. Through a feminist analysis of the social construction of mothering, we re-examine risk assessment. We argue that the risk assessment trend has the potential to entrench oppressive relations of gender, race, and class in child welfare practice with mothers. We suggest that an approach to risk assessment which incorporates a ,mothering narrative' might offer a more thorough evaluation of the conditions that shape the context within which risk to children emerges. [source]