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Background Methods Results Conclusions So What? The ComEx3 community‐based extended maintenance pulmonary rehabilitation (PR) randomised controlled trial (RCT) aimed to determine the optimal strategy for maintaining the benefits of exercise for people with chronic obstructive pulmonary disease (COPD). We conducted a process evaluation of this RCT to determine if the trial was implemented per protocol, and to explore the barriers and facilitators of the trial, and mechanisms of impact.This was a mixed methods study consisting of analysis of PR class records, study diaries and interviews of those involved in the trial. We developed a reporting framework from available literature and performed a content analysis.Eleven of the 12 participants in the intervention group attended ≥70% of available classes before the trial was terminated due to the COVID‐19 pandemic. Analysis of the study diaries found that adherence to the home exercise program was higher in the intervention than the control group. Analyses of interviews (n = 21) highlighted the complexity of standardising the processes across multiple sites, but revealed behaviour change amongst class physiotherapists who were able to conform with the required processes. Facilitators of participation included the desire to improve function and quality of life, while barriers included illnesses and lack of motivation. Mechanisms of impact included confidence in exercising and benefits from the education sessions.The ComEx3 RCT was implemented as planned largely due to commitment by the research team and the desire by patients to improve their quality of life by attending a PR program that they are familiar with. Successful implementation of PR RCTs requires good organisational skills, clear and consistent trial documentation, broad understanding of participant needs while being conscious of challenges experienced by people with COPD, and dedication by everyone involved in the RCT.This article shows the importance of running a process evaluation alongside an RCT. Although this RCT did not progress to completion, this process evaluation which was guided by a robust framework, will provide guidance for future interventions in this area. [ABSTRACT FROM AUTHOR]

Introduction: Well‐being issues are increasing amongst dental students. Social relationships can be important for student support during their studies. The aim of the study was to explore dental students' feelings towards studying dentistry, social networks and chosen support during this journey. Materials and Methods: An anonymous electronic cross‐sectional survey was carried out. All dental students in a single dental school were invited to participate. Participation and answering questions was voluntary. Descriptive analyses were used for categorical data, and qualitative data were analysed thematically. Results: In total, 109 students responded. One third reported having a family member from a healthcare profession but most were not related to dental professionals. The majority of students 83% liked the course, 14% said they felt "neutral", and 5% said they did not like it. The following three themes explained this: (a) demands of the course, (b) being suited to dentistry (eg patient care) and (c) passion for dentistry as a career (or lack of). Most felt their peers were friendly (92%) and supportive (78%) but also competitive (64%). Irrespective of stress, 70% of participants sought help from family and two thirds sought help from student peers. Discussion: Most students enjoy studying dentistry despite the demands of the course. Support, workload, feeling suited to the course and a passion for dentistry as a career can affect the experience. Conclusions: Family and friends are an important source of support in this process. Further work is needed to explore mechanisms to help family and friends support students. [ABSTRACT FROM AUTHOR]

The number of international students coming to the U.S. for post-secondary education has been steadily increasing. Prior research has found that international students encounter many barriers to academic success, but this topic has not been previously studied for the discipline of dental hygiene. The aims of this study were to investigate the barriers and challenges to academic success faced by international students in U.S. dental hygiene programs and to explore the students' thoughts on the value they bring to those programs. The overlapping qualitative methods of semi-structured focus groups and one-on-one interviews with 12 students in three U.S. dental hygiene programs were used for this phenomenological study. In the results, six themes emerged: language proficiency, communication challenges with faculty and patients, ability to adapt to a new educational system, adjusting to cultural differences, feelings of belonging, and the value of diversity. The most significant barrier for the participants was comprehension of the English language. Didactically, these students reported that they needed additional time to study and to process examination questions. This study found that these international students studying dental hygiene in the U.S. had academic challenges similar to international students studying in other disciplines. Dental hygiene educators may need to evaluate their didactic and test-taking strategies to ensure the academic success of international students. [ABSTRACT FROM AUTHOR]

Introduction: This study gathered information about life outside of the course for undergraduates studying at the School of Dentistry, Cardiff University. The aim was to explore how these external factors to the course may affect an individual's academic performance and well‐being. Materials and Methods: A cross‐sectional study design was used. An online questionnaire designed for the purpose of the study was used to capture (quantitative and qualitative) data. Questions with dichotomous options, a range of statements with Likert scales (level of agreement) and open (free‐text) questions were used. Data were analysed in SPSS using simple descriptive statistics and frequency distributions. Spearman's Rho was used to explore relationships for scaled categorical data. Content analysis was used for qualitative data. Results: Two‐thirds (n = 69, 63%) of participants reported being very stressed about their studies in the previous 12 months. The majority felt that external factors to their course (eg, lack of sleep, health issues, financial concerns, hobbies and issues with friends) had impacted on their academic lives with only 9% (n = 10) stating that their lives outside dentistry had no effect. Discussion: Those who felt able to pursue hobbies and activities reported a better work‐life balance and less stress. Questions about pursuing hobbies and sleep may help identify students at risk of being stressed or who may benefit from additional support in order to achieve a better work‐life balance. Conclusion: This study has highlighted key areas for further investigation and opportunities for improving support to reduce student stress and improve well‐being. [ABSTRACT FROM AUTHOR]

Background: Non‐human primate models of developmental programing by maternal mismatch between pregnancy and lactation diets are needed for translation to human programing outcomes. We present baboon offspring morphometry from birth to 3 years, and blood cortisol and adrenocorticotropin (ACTH) from 2 to 24 months. Methods: Control mothers ate chow; mismatch mothers ate 30% less than controls during pregnancy and high‐fat high‐energy diet through lactation. Results: Mismatch mothers lost weight during pregnancy. At birth, there were trends toward lower weight in mismatch offspring of both sexes (P = 0.06). From 0‐3 years, catch‐up growth occurred. Mismatch offspring male and female body weight increased faster than controls (P < 0.001). Mismatch female offspring showed greater increase in BMI (P < 0.001) and abdominal circumference (P = 0.008) vs controls. ACTH and cortisol slopes from 2 to 24 months of age were similar between groups in both sexes. Cortisol and ACTH increased after weaning in all groups. Conclusions: Mismatch produces sexually dimorphic post‐natal growth phenotypes. [ABSTRACT FROM AUTHOR]

Background: Non‐human primate models of developmental programming by maternal obesity (MO) are needed for translation to human programming outcomes. We present baboon offspring (F1) morphometry, blood cortisol, and adrenocorticotropic hormone (ACTH) from 0.9 gestation to 0‐2 years. Methods: Control mothers ate chow; MO mothers ate high‐fat high‐energy diet pre‐pregnancy through lactation. Results: Maternal obesity mothers weighed more than controls pre‐pregnancy. Maternal obesity gestational weight gain was lower with no correlation with fetal or placenta weights. At 0.9 gestation, MO and control F1 morphometry and ACTH were similar. MO‐F1 0.9 gestation male cortisol was lower, rising slower from 0‐2 years vs control‐F1. At birth, male MO‐F1 and control‐F1 weights were similar, but growth from 0‐2 years was steeper in MO‐F1; newborn female MO‐F1 weighed more than control‐F1 but growth from 0‐2 years was similar. ACTH did not change in either sex. Conclusions: Maternal obesity produced sexually dimorphic fetal and postnatal growth and hormonal phenotypes. [ABSTRACT FROM AUTHOR]

Background Most developmental programming studies on maternal nutrient reduction ( MNR) are in altricial rodents whose maternal nutritional burden and offspring developmental trajectory differ from precocial non-human primates and humans. Methods Control ( CTR) baboon mothers ate ad libitum; MNR mothers ate 70% global control diet in pregnancy and lactation. Results We present offspring morphometry, blood cortisol, and adrenocorticotropin ( ACTH) during second half of gestation (G) and first three postnatal years. Moderate MNR produced intrauterine growth restriction ( IUGR). IUGR males (n=43) and females (n=28) were smaller than CTR males (n=50) and females (n=47) in many measurements at many ages. In CTR, fetal ACTH increased 228% and cortisol 48% between 0.65G and 0.9G. IUGR ACTH was elevated at 0.65G and cortisol at 0.9G. 0.9G maternal gestational weight gain, fetal weight, and placenta weight were correlated. Conclusions Moderate IUGR decreased body weight and morphometric measurements at key time points and altered hypothalamo-pituitary-adrenal function. [ABSTRACT FROM AUTHOR]

We investigated menstrual cycles in intrauterine growth restricted (IUGR, 7‐10 years, n = 8) and age‐matched control (n = 10) baboons. Cycle duration and plasma anti‐Mullerian hormone were similar. IUGR spent more days per cycle swollen and had elevated early morning fasted serum cortisol, suggesting normal fertility in the presence of increased psychosocial stress. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the association between distance education (DE) and students' sense of classroom community (SCC) in U.S. dental hygiene programs. The concept of SCC is recognized to have an influence on students' educational outcomes. With the goal of increasing diversity among future dental professionals, there comes a need to accommodate students of various backgrounds through the use of DE. The impact of DE on students' SCC has not been studied in previous research. This 2014 cross-sectional survey study looked at a convenience sample of dental hygiene students finishing their first or second clinical year to assess their SCC. Participating programs had both host and satellite campuses and utilized DE for didactic course delivery at the remote sites. To calculate the students' sense of community, Rovai's Classroom Community Scale (CCS) was utilized, and demographic information was collected. Six of the 13 eligible programs agreed to participate; the overall response rate for individual students was 25%. When evaluated on their sense of community, the satellite college-based students scored 26.47 CCS units and 14.51 learning subscale units lower than the host college-based students. These results suggested a negative association between the students' sense of community and their affiliation with satellite campuses when controlled for demographic variables. The findings suggest a negative trend in the SCC for dental hygiene students on remote campuses and utilizing DE for a portion of their curriculum. This trend can potentially decrease students' educational success and satisfaction and should be addressed. [ABSTRACT FROM AUTHOR]

The normal ranges of hematological cell profiles and biochemistry are documented in adult non-pregnant, pregnant, juvenile, and neonatal baboons. Despite the extensive use of the baboon as a model for the study of various aspects of pregnancy, there is no data from paired mothers and their fetuses at different stages of gestation. Hematologic and biochemical profile data were obtained from eight non-pregnant female baboons, 37 mothers and 38 fetal baboons at 30 ± 2, 90 ± 2, 125 ± 2, and 175 ± 2 days of gestation (mean ± range; dGA; term, 180 dGA). Changes observed in fetal and maternal blood during normal baboon pregnancy were similar to those reported in human pregnancy. The level of alkaline phosphatase was two times higher in fetal blood circulation than that reported in human pregnancy. [ABSTRACT FROM AUTHOR]

We developed a system that allows individual feeding of adult baboons, 8-15 years of age, maintained in an outdoor group social environment. The purpose of the system is to allow careful monitoring and control of individual diet. Baboons were housed in two group cages, 16 females and a single male in one and 12 females and a single male in the other. Baboons exited the group cage once daily and passed along a chute and over a scale into individual cages where they received their individual diets. Food intake was monitored during their 2-hour stay in the individual cages. Baboons rapidly learned to use this system. Food intake and weight were stable within 20 days. Food consumed decreased during the period of sexual receptivity. The maintenance of the group social environment allowed observations on the group's dominance structure and the relationship of dominance to food consumption. Speed of food access in the group cage was related to dominance. Dominance was not related to food consumed in individual cages. The system permits study of many variables related to behavior and food intake while still retaining critical social interactions. [ABSTRACT FROM AUTHOR]

ABSTRACT Background and Purpose. Physiotherapists use a variety of techniques aimed at improving lung volumes and secretion clearance in patients after surgery. Periodic continu-ous positive airway pressure (PCPAP) is used to treat patients following elective upper abdominal surgery. However, the optimal method of application has not been identified, more specifically, the dosage of application of PCPAP. The present randomized controlled trial com-pared the effects of two dosages of PCPAP application and 'traditional' physiotherapy upon functional residual capacity (FRC), vital capacity (VC), oxyhaemoglobin saturation (SpO 2 ), incidence of post-operative pulmonary complications and length of stay with a control group receiving 'traditional' physiotherapy only. Method. Fifty-seven subjects were randomly allo-cated to one of three groups. All groups received 'traditional' physiotherapy twice daily for a minimum of three post-operative days. In addition, two groups received PCPAP for 15 or 30 minutes, four times per day, for three days. Results. Fifty subjects (39 male; 11 female) com-pleted the study. There were no significant differences in any variables between the three groups. The overall incidence of post-operative pulmonary complications was 22% in the con-trol group, 11% and 6% in the PCPAP 15-minute and PCPAP 30-minute groups, respectively. Length of hospital stay was not significantly different between the groups but for subjects who developed post-operative pulmonary complications, the length of stay was significantly greater (Z = -2.32; p = 0.021). Conclusions. The addition of PCPAP to a traditional physio-therapy post-operative treatment regimen after upper abdominal surgery did not significantly affect physiological or clinical outcomes. [ABSTRACT FROM AUTHOR]

A number of chlorhexidine mouthwashes are available commercially which differ in formulation and regimen of use. As a comparative measure of antimicrobial persistance, this study evaluated the effect of 4 chlorhexidine mouthwash formulations on salivary bacterial counts after a single rinse. The study was a randomised single-examiner blind 5-way crossover investigation employing a panel of 10 young healthy human volunteers. The 0.12% and 0.2% commercial formulations when rinsed according to the respective manufacturers instructions produced similar large and prolonged reductions in salivary bacterial counts during the 7-h period. A 0.1% formulation also commercially available produced minimal effects on salivary bacterial counts and was little different to the saline rinse. A reformulated 0.1% rinse, not commercially available at the time of the study, produced significant salivary bacterial count reductions over the 7-h period albeit to a lesser degree of magnitude than to the 0.2% and 0.12% rinses. The results were consistent with comparative plaque inhibitory studies of the formulations and suggest that the method is a quick and simple way of screening products for antimicrobial and antiplaque potential. [ABSTRACT FROM AUTHOR]

A number of antimicrobial compounds could be incorporated into toothpastes to enhance plaque inhibitory effects. However, the number of possible formulations is immense and makes clinical testing in plaque and gingivitis studies difficult. In this study, the effects on salivary bacterial counts of a number of chlorhexidine and triclosan toothpastes was evaluated as a predictor of persistance of antimicrobial action in the mouth. The study was a supervised. randomised 15-way crossover study employing 10 healthy human volunteers. All toothpastes were brushed for 1 min and comparison made with a 0.2% chlorhexidine rinse. The latter produced a large drop in salivary bacterial counts to the end of the 7-h study period. The toothpastes decreased salivary bacterial counts and all but two had notably more effect than a water brushing. No toothpaste showed a significant persistance of antimicrobial effect beyond 5 h. In the light of available plaque inhibition data for the toothpastes, persistance of antimicrobial activity beyond 5 h will be necessary for a clinical effect on plaque and gingival health. The method appears to be a simple and rapid screening technique for products formulated to enhance plaque inhibition mediated through an antimicrobial action. [ABSTRACT FROM AUTHOR]

A number of compounds have been added to toothpastes to inhibit plaque regrowth. The inclusion of cationic antiseptics, such as chlorhexidine, poses formulation difficulties because of interactions with other ingredients particularly anionic detergents. More recently, Triclosan/zinc citrate formulations have been shown effective plaque inhibitors. The aim of this study was to compare a commercially available 0.2% Triclosan/0.5% zinc citrate toothpaste with a number of experimental 0.5% chlorhexidine/detergent toothpastes for effects on plaque regrowth over 4 days. Subjects rendered plaque free at each baseline rinsed twice a day with toothpaste slurries and disclosed plaque was scored at the end of each period. All toothpastes significantly reduced plaque by comparison with a control toothpaste, but were significantly less effective than a 0.2% chlorhexidine rinse. Some significant differences in favour of one chlorhexidine toothpaste were noted but these were small in magnitude. Whether the plaque inhibition obtained with Triclosan/zinc citrate toothpaste was greater than would be expected from other commercially available preparations cannot be determined from this study and is the subject of a further investigation. [ABSTRACT FROM AUTHOR]

The analogues of the coenzyme NADP+, nicotinamide-8-bromo-adenine dinucleotide phosphate (Nbr8ADP+) and 3-iodopyridine-adenine dinucleotide phosphate (io3PdADP+), were prepared. Nbr8ADP+ was found to be active in the hydrogen transfer and io3PdADP+ is a coenzyme competitive inhibitor for 6-phosphogluconate dehydrogenase. The binding of NADP+, NADPH and NADPH together with 6-phosphogluconate as well as that of both analogues to crystals of the enzyme 6-phosphogluconate dehydrogenase has been investigated at 0.6-nm resolution using difference electron density maps. The molecules bind in a similar position in a cleft in the enzyme subunit distant from the dimer interface. The orientation of the coenzyme in the site has been determined from the io3pdADP+-NADP+ difference density. The ternary complex difference density extends beyond that of the nicotinamide moiety of the coenzyme and tentatively indicates substrate binding. No clear identification of the bromine atom of Nbr8ADP+ can be made. How- ever, the analogue is bound more deeply in the cleft than is NADP+. The NADPH density is the most clearly defined and has thus been used to fit a molecular model using an interactive graphics system, checking for preferred geometry. A possible conformation is presented which is significantly different from that of NAD+ in the lactate dehydrogenase ternary complex. [ABSTRACT FROM AUTHOR]

The article describes English, French, and Japanese business letter writing. English business letter writing is reader oriented. The purpose of a business letter is to attempt to get the reader to appreciate the benefits of doing what that writer wants. It is a medium through which ideas are made acceptable to the reader. French business letter writing in writer oriented. The primary virtues of the French business letter are prudence, conciseness, and precision. It is extremely important to convey the required degree of respect and the writer's expectations of the response. Japanese business letter writing is oriented to the relationship, or the space, between the writer and the reader. The concern is with the format and language which will most effectively establish or maintain the appropriate relationship between reader and writer. A Japanese business letter consists of three parts, an introduction, body and conclusion. The body of the Japanese business letter consists of a statement of the reason for writing.

ABSTRACT: This study of 167 nurses in 10 rural Georgia agencies examines the relationships among personal characteristics, factors of job satisfaction, autonomy, and job retention. The findings indicate that, contrary to expectations, personal characteristics (e.g., age, education, salary, marital status, and number of dependents) are not strong predictors of job retention in this sample. Some of the factors of job satisfaction do correlate negatively with indicators of impending job change, but the strongest relationships were those related to nursing autonomy. The study concludes that, of the variables studied, autonomy was the most effective predictor of job satisfaction and intention to remain in the current position. [ABSTRACT FROM AUTHOR]

Encouraging findings have been reported for the effects of Triclosan/zinc citrate toothpastes on plaque regrowth and in some studies gingival health. To date, commercially-available toothpastes contain 0.2% Triclosan with or without 0.5% zinc citrate. The aim of this study was to evaluate the effects on 4-day plaque regrowth, of a number of 0.2% Triclosan toothpastes with or without zinc citrate. All of the toothpastes contained varying levels of anionic detergent sodium lauryl sulphate and were compared with a commercially available tooth-paste without Triclosan or zinc citrate and a 0.2% chlorhexidine mouthrinse. The toothpastes were used as slurry twice a day and plaque regrowth scored by area and the criteria of the debris index. Plaque inhibition was significantly greater with the chlorhexidine mouthrinse than with all of the toothpastes. There were no significant differences in plaque scores between any of the toothpastes. It would appear that at the concentration of 0.2% Triclosan with or without 0.5% zinc citrate provides little if any additional benefit to plaque inhibition to that produced by a conventional toothpaste containing sodium lauryl sulphate. [ABSTRACT FROM AUTHOR]

Poor nutrition during pregnancy is a worldwide public health problem. Maternal nutrient reduction (MNR) is associated with maternal and fetal stress and a sex‐dependent decrease in nonhuman primate (NHP) cognitive performance. Early life stress potentiates epileptogenesis in a sex‐specific manner, and temporal lobe (TL) epilepsy is associated with neurocognitive disorders. The endogenous cannabinoid system (ECS) demonstrates remarkable developmental changes and plays a key role in aging‐related diseases (e.g., dementia). Baboons have been studied as a natural model of epilepsy and express all ECS system components. We therefore evaluated baboon fetal temporal cortex ECS ontogenic and MNR‐dependent changes. At 120 days gestational age (dGA) (term 185 days), maternal, fetal, and placental morphometry were similar between control and MNR pregnancies. MNR maternal weight gain was decreased compared with controls at 165 dGA independent of fetal sex. In male fetuses, expression of ECS synthesizing and degrading enzymes was gestational age‐dependent, with the exception of fatty acid amide hydrolase (FAAH). MNR had a sex‐specific effect on the protein expression of CB1R during development: CB1R protein expression was decreased in fetal temporal cortex of male fetuses at 120 and 140 dGA. Our data reveal that the MNR has sex‐specific effects on temporal cortical expression of the ECS in baboon offspring and shows vulnerability of ECS in male fetuses during gestation. Maternal nutrient reduction (MNR) is associated with maternal and fetal stress and a sex‐dependent decrease in nonhuman primate (NHP) cognitive performance. The endogenous cannabinoid system (ECS) demonstrates remarkable developmental changes and plays a key role in aging‐related diseases. Baboons have been studied as a natural model of epilepsy and express all ECS system components; therefore, we evaluated baboon fetal temporal cortex ECS ontogenic and MNR‐dependent changes. [ABSTRACT FROM AUTHOR]