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Emerging parallel to long-standing, academic and policy inquiries on personal responsibility for health is the empirical assessment of lay persons’ views. Yet, previous studies rarely explored personal responsibility for health among lay persons as dynamic societal values. We sought to explore lay persons’ views on personal responsibility for health using the Fairness Dialogues, a method for lay persons to deliberate equity issues in health and health care through a small group dialogue using a hypothetical scenario. We conducted two 2-h Fairness Dialogues sessions (n = 15 in total) in Nova Scotia, Canada. We analyzed data using thematic analysis. Our analysis showed that personal choice played an important role in participants’ thinking about health. Underlying the concept of personal choice was considerations of freedom and societal debt. In participants’ minds, personal and social responsibilities co-existed and they were unwilling to determine health care priority based on personal responsibility. The Fairness Dialogues is a promising deliberative method to explore lay persons’ views as dynamic values to be developed through group dialogues as opposed to static, already-formed values waiting to be elicited.

Objective The objective of this scoping review is to examine pedagogies used to teach interprofessional health learners how to break bad news collaboratively. Introduction Breaking bad news is a skill health care professionals must be equipped to deliver well, yet literature shows that this skill receives little attention in program curricula. Consequently, health care professionals feel inadequately prepared to deliver bad news, leading to greater burnout, distress, and fatigue. Inclusion criteria Studies that describe pedagogies used to teach breaking bad news will be considered for inclusion. Studies must include two or more undergraduate and/or postgraduate learners working towards a professional health or social care qualification or degree at a university or college. Studies including lay, complementary and alternative, or non-health or social care professional learners will be excluded. Methods The JBI three-step process will be followed for developing the search. Databases to be searched include MEDLINE, CINAHL, Embase, Education Resource Centre, and Social Work Abstracts. Title and abstract screening through to data extraction will be completed by two independent reviewers and any disagreements will be resolved through discussion, or with a third reviewer. Results will be presented in tabular or diagrammatic form, together with a narrative summary.

Background Engaging youth in research provides substantial benefits to research about youth‐related needs, concerns and interventions. However, researchers require training and capacity development to work in this manner. Methods A capacity‐building intervention, INNOVATE Research, was co‐designed with youth and adult researchers and delivered to researchers in three major academic research institutions across Canada. Fifty‐seven attendees participated in this research project evaluating youth engagement practices, attitudes, perceived barriers, and perceived capacity development needs before attending the intervention and six months later. Results The intervention attracted researchers across various career levels, roles and disciplines. Participants were highly satisfied with the workshop activities. Follow‐up assessments revealed significant increases in self‐efficacy six months after the workshop (P = .035). Among possible barriers to youth engagement, four barriers significantly declined at follow‐up. The barriers that decreased were largely related to practical knowledge about how to engage youth in research. Significantly more participants had integrated youth engagement into their teaching activities six months after the workshop compared to those who were doing so before the workshop (P = .007). A large proportion (71.9%) of participants expressed the need for a strengthened network of youth‐engaged researchers; other future capacity‐building approaches were also endorsed. Conclusions The INNOVATE Research project provided improvements in youth engagement attitudes and practices among researchers, while lifting barriers. Future capacity‐building work should continue to enhance the capacity of researchers to engage youth in research. Researchers notably pointed to the need to establish a network of youth‐engaged researchers to provide ongoing, sustainable gains in youth engagement.

Background There is increasing emphasis on engaging youth in research about youth, their needs, experiences and preferences, notably in health services research. By engaging youth as full partners, research becomes more feasible and relevant, and the validity and richness of findings are enhanced. Consequently, researchers need guidance in engaging youth effectively. This study examines the experiences, needs and knowledge gaps of researchers. Methods Eighty‐four researchers interested in youth engagement training were recruited via snowball sampling. They completed a survey regarding their youth engagement experiences, attitudes, perceived barriers and capacity development needs. Data were analysed descriptively, and comparisons were made based on current engagement experience. Results Participants across career stages and disciplines expressed an interest in increased capacity development for youth engagement. They had positive attitudes about the importance and value of youth engagement, but found it to be complex. Participants reported requiring practical guidance to develop their youth engagement practices and interest in a network of youth‐engaged researchers and on‐going training. Those currently engaging youth were more likely to report the need for greater appreciation of youth engagement by funders and institutions. Conclusions Engaging youth in research has substantial benefits. However, skills in collaborating with youth to design, conduct and implement research have to be learned. Researchers need concrete training and networking opportunities to develop and maximize these skills. They also need mechanisms that formally acknowledge the value of engagement. Researchers and those promoting youth engagement in research are encouraged to consider these findings in their promotion and training endeavours.

Context. Public engagement efforts in health policy have posed many value-laden questions, yet those that appreciate the complexity and diversity of the concept of health equity are rare. We introduce the Fairness Dialogues, a new method for deliberating health equity among the general public. We provide its theoretical underpinning and present its empirical illustration and qualitative assessment. Methods. Primarily informed by the scholarship of deliberation, we designed the Fairness Dialogues, featured by reason-giving and inclusive group deliberation using a hypothetical scenario (the town of Troutville) that presents carefully designed, simple, open-ended cases focusing on a chosen equity and fairness issue. To assess whether the Fairness Dialogues encourages reflective views, we conducted a qualitative investigation by focusing on fairness and unfairness of inequalities in life expectancy. Findings. Our results revealed the complex intuitions that people have and their curiosity, patience, and willingness to scrutinize them in-depth through a small group dialogue. Intuitions shared by our study participants are similar to those presented in the scholarly philosophical literature. Conclusions. The Fairness Dialogues is a promising method to incorporate the public’s views into policy-making involving value judgment and to develop the capacity of the public to discuss value-laden questions in a reflective and inclusive manner., Contexte. Les efforts d’engagement du public en politique de santé ont posé de nombreuses questions chargées de valeur, mais celles qui tiennent compte de la complexité et de la diversité du concept d’équité en matière de santé sont rares. Nous présentons les Fairness Dialogues, une nouvelle méthode pour débattre de l’équité en matière de santé auprès du grand public. Nous en fournissons les fondements théoriques et en présentons l’illustration empirique et l’évaluation qualitative. Méthodes. Principalement inspirés par l’érudition de la délibération, nous avons conçu les Fairness Dialogues, caractérisés par une délibération de groupe objective et inclusive utilisant un scénario hypothétique (la ville de Troutville) qui présente des cas soigneusement conçus, simples, ouverts et axés sur une question d’équité et de justice. Pour évaluer si les Fairness Dialogues encouragent la réflexion, nous avons mené une enquête qualitative en nous concentrant sur l’équité et l’iniquité des inégalités en matière d’espérance de vie. Résultats. Nos résultats ont révélé les intuitions complexes des gens et leur curiosité, leur patience et leur volonté de les examiner en profondeur dans le cadre d’un dialogue en petit groupe. Les intuitions partagées par les participants à notre étude sont similaires à celles présentées dans la littérature philosophique académique. Conclusions. Les Fairness Dialogues sont une méthode prometteuse pour intégrer les points de vue du public dans l’élaboration de politiques impliquant un jugement de valeur et pour développer la capacité du public à discuter de questions chargées de valeurs de manière réfléchie et inclusive.

Children and youth whose lives intersect with child welfare systems are amongst the most vulnerable paediatric populations. Despite the increased rates of chronic conditions, these children and youth often experience unmet health care needs.To examine patterns of health care utilization from birth for children and youth in the care of a child welfare authority.This retrospective matched cohort design study examined children/youth aged 0-18 who had visited a paediatric tertiary care facility from 2016 April 1 to 2017 March 31 and had "social worker" documented as their guardian. A control cohort was matched based on age and sex. Primary outcomes of interest included primary health care, emergency, outpatient, and inpatient visits. Visits for immunizations, physiological development, well-baby checks, mental health, and oral health were also examined.A total of 200 cases and 200 controls were included in our cohort. No statistically significant differences were found between primary care visits, well-baby checks, inpatient admissions, outpatient mental health visits, or immunizations for children in care in comparison to their controls. There was a significant difference in oral health visits, lack of physiological development, and emergency department visits for children in care when compared to their controls.Our study revealed disparities in health care utilization amongst children in the care of child welfare in comparison to those who are not, highlighting the need for improved practice, policy, and research initiatives. A collaborative data collection/sharing system is needed to identify and track the health care of this vulnerable population.Children and youth whose lives intersect with child welfare systems are amongst the most vulnerable pediatric populations. Despite the increased rates of chronic health conditions, these children and youth often experience unmet health care needs. Using a retrospective matched cohort design, we sought to examine patterns of health care utilization from birth to age 18 for children and youth in the care of a child welfare authority in comparison to children/youth who were not in the care of child welfare. No statistically significant differences were found between primary care visits, well-baby checks, inpatient admissions, outpatient mental health visits, or immunizations for children in care when compared to their counterparts not in care. There was a significantly higher number of oral health visits, physiological development concerns, and emergency department visits for children in care when compared to their controls. Our study revealed differences in health care use amongst children in the care of a child welfare in comparison to those who are not, highlighting the need for improved practice, policy and research initiatives. A collaborative data collection and sharing system is needed to help accurately identify and track the health care use of this vulnerable population.

Chronic pain is debilitating and depressing. ‘Chronic primary pain has no clear underlying condition or the pain (or its impact) appears to be out of proportion to any observable injury or disease. ’1 In July 2014, Sir Simon Wessely stated in an article in The Times entitled, Pain may be in the mind , that: ‘Many of them [chronic pain patients] have mental health disorders — anxiety, depression, etc’, and that, ‘patients felt dismissed and denigrated when they were referred to mental health services … ’. 2 As patient safety campaigners, we are hearing from many people who are developing ‘unexplained’ chronic pain conditions after taking antidepressants (ADs), as prescribed, and sometimes over many years — and this has often led to polypharmacy with other drugs added ‘for symptoms’ along the way, most likely including ADs, benzodiazepines, Z-drugs, opioids, …

This February 2020 edition of the BJGP contains topics that are more closely interrelated than first appears, and the relationship is crucial for GPs to recognise. As you say, language matters and ‘The chances of a successful outcome are less good when … the consultation includes topics such as common mental health disorders and the highly contested territories of persistent but “medically” unexplained symptoms and maladaptive responses to commonplace adversities’ :1 …

This article presents the results and theorization of a 4-year Grounded Theory project that sought to understand the processes and dynamics involved in the professional adaptation of internationally educated social workers now practicing in Canada. In-depth interviews with 66 participants, who undertook social work education outside of Canada and have subsequently settled to practice in the country, were conducted. Results highlight that the social work educational background of the professionals not only offers key conceptual, theoretical, and analytical foundations needed to adapt knowledge and skills to practice abroad, but also provides tools to navigate and negotiate professional adaptation processes as a whole. We conclude that ultimately, social workers may adapt well to their new work contexts because of the transferability of social work skills, knowledge, and values to new practice settings, thus facilitating interventions with services users and also their own process of professional adaptation.

Every year, a number of social workers who have studied and obtained their qualifications abroad immigrate to Canada. They do so to start a new life and pursue their careers in one of the Canadian provinces (Brown et al, 2015; Pullen Sansfaçon et al, 2012). However, even with the ‘Global Qualifying Standards’ (International Federation of Social Workers [IFSW], 2015), a document that recognises the increased labour mobility within the profession and aims for consistency within and between the different qualifications, social work still needs to adapt to local variations and is considered highly dependent on the cultural and socio-political context where it is practised (Fouché et al, 2013; Beddoe et al, 2012; Hussein et al, 2010; Welbourne et al, 2007). This specific social work imperative led us to investigate the processes by which transnational social workers adapt to new work contexts in Canada and, more specifically, to explore issues related to knowledge transfer in different practice contexts, and to further investigate how social workers really adapt to local variations.

This paper presents the results of a prospective study on the clinical effect of grafting the buccal gap with platform switching, following flapless tooth extraction and immediate implant placement and provisional restoration, on (1) alterations in buccolingual ridge dimension and (2) midfacial peri-implant soft tissue thickness. Fifty-six patients were placed in one of four treatment groups: (1) a non-platform-switching implant (Non-PS, n = 14); (2) a non-platform-switching implant and bone graft (BG/Non-PS, n = 14); (3) a platform-switching implant (PS, n = 15); and (4) a platform-switching implant and bone graft (BG/PS, n = 13). Buccolingual ridge dimensional change and peri-implant soft tissue thickness at 2 mm below the free gingival margin were measured. Both PS and BG/PS groups showed an increase in buccolingual dimension compared to the contralateral natural tooth site as well as peri-implant soft tissue thickness of > 2.5 mm, clinically. Platform switching was associated with significantly greater midfacial soft tissue thickness than bone grafting (mean ± standard deviation: 2.17 ± 0.04 for Non-PS and 3.55 ± 0.14 for PS). Using platform-switched implants, in conjunction with immediate implant placement and immediate provisional restoration, was associated with a significantly greater stability of ridge dimension and peri-implant soft tissue thickness than using non-platform-switched implants when measured 12 months after placement of the final restoration. Platform switching may help achieve preservation of ridge dimension and enhance the stability of peri-implant soft tissue following immediate implant placement and provisional restoration without bone grafting. Further research is required to assess the long-term outcome.

Drawing upon psychoanalysis, sociology, and group dynamics, the basic clinical model of group analysis was first described by Foulkes (1948, 1964) and Foulkes and Anthony (1964): Four men a...

Background: Stopping antidepressants commonly causes withdrawal symptoms, which can be severe and long-lasting. National Institute for Health and Care Excellence (NICE) guidance has been recently updated to reflect this; however, for many years withdrawal (discontinuation) symptoms were characterised as ‘usually mild and self-limiting over a week’. Consequently, withdrawal symptoms might have been misdiagnosed as relapse of an underlying condition, or new onset of another medical illness, but this has never been studied. Method: This paper outlines the themes emerging from 158 respondents to an open invitation to describe the experience of prescribed psychotropic medication withdrawal for petitions sent to British parliaments. The accounts include polypharmacy (mostly antidepressants and benzodiazepines) but we focus on antidepressants because of the relative lack of awareness about their withdrawal effects compared with benzodiazepines. Mixed method analysis was used, including a ‘lean thinking’ approach to evaluate common failure points. Results: The themes identified include: a lack of information given to patients about the risk of antidepressant withdrawal; doctors failing to recognise the symptoms of withdrawal; doctors being poorly informed about the best method of tapering prescribed medications; patients being diagnosed with relapse of the underlying condition or medical illnesses other than withdrawal; patients seeking advice outside of mainstream healthcare, including from online forums; and significant effects on functioning for those experiencing withdrawal. Discussion: Several points for improvement emerge: the need for updating of guidelines to help prescribers recognise antidepressant withdrawal symptoms and to improve informed consent processes; greater availability of non-pharmacological options for managing distress; greater availability of best practice for tapering medications such as antidepressants; and the vital importance of patient feedback. Although the patients captured in this analysis might represent medication withdrawal experiences that are more severe than average, they highlight the current inadequacy of health care systems to recognise and manage prescribed drug withdrawal, and patient feedback in general.

I was on the TV and radio news recently. I have no media training nor a PA to help me. I don’t enjoy it; I always mumble and speak too quickly. My kids don’t help by saying, ‘Who’s that hideous middle-aged man on the telly?’ But I don’t care, because the topic is so important. A petition was recently sent to the Scottish Parliament to highlight the harm caused by prescription drugs1 — a topic I have been droning on about for decades. With a tripling of the use of antidepressants and painkillers in a decade, which are causing widespread dependence and addiction, …

Psychologically Informed Planned Environments (PIPEs) are an additional stage in the Offender Management Personality Disorder Pathway. The author describes the context, the impact of the work on both offenders and staff, and discusses the importance of paying close attention to the psychological process level from both a service and an organisational perspective. It is argued that the group analytic understanding of group and individual process is an important element of the psychological containment within PIPE for both offenders and staff. The group analytic focus on the here and now relational level linking to the historical context and the unconscious group and individual process provides a structure and concept for understanding the intrapersonal, interpersonal, group process, psychosocial process and the organisational context and its impact. Reference is made to the necessity of addressing the environment offender's move onto following their PIPE experience.

Transnational mobility of internationally educated social workers has been on the rise for the past 20 years, with little empirical study regarding their experiences of professional adaptation. This paper contextualises and presents data from a study with 15 social workers who undertook their professional education outside Canada and have migrated to Canada within the past 10 years, regarding their professional acculturation and adaptation. The analysis focuses on elements that facilitated and mitigated their professional acculturation and the resulting adaptations participants have experienced in their practice in the Canadian context. The paper's discussion outlines the importance of a stronger grounding in professional values of social work in order to facilitate professional acculturation and adaptation of internationally educated social workers.

This chapter provides an overview of group analysis and how it lends itself to research on interpersonal relating espoused by Relating Theory (Birtchnell 1993/1996). Members of an analytic group within an NHS Mental Health Psychological Service rated their own relating using the Person’s Relating to Others Questionnaire (PROQ3; Birtchnell et al., Clinical Psychology and Psychotherapy, 20(1), 36–48, 2013) and the relating of others using the Observed Person’s Relating to Others Questionnaire (OPROQ; Birtchnell et al., The application to psychotherapy of measures based upon the interpersonal octagon: Measurement in group psychotherapy, 2006). These measures were scored and charts were provided to group members to view their own rating together with the other group members’ ratings of them. In some instances there were marked differences between a member’s self-rating and the rating made of him/her by the other group members, which generated in-depth discussion within the group of the member’s relational pattern, what the group members perceived and how this reflected difficulties in the patient’s outside relationships.

This article engages with the research method of collective biography. We are particularly interested in what the question of difference brings to bear on the collective biography process. The aim of embodied writing in the collective biography process is “to tell the memory in such a way that it is vividly imaginable by others, such that those others can extend their own imaginable experience of being in the world through knowing the particularity of another” (Davies & Gannon). However, our own attempt to work with the method had us grappling with how to engage with a story that did not elicit understanding and identification but rather evoked, for some, a sense of incommensurable difference. By bringing together a poststructural concern with power relationships and a Deleuzian interest in engendering new synergies and possibilities, the article makes a theoretical contribution to new conceptual repertoires on the question of difference and its implications for feminist research.

Introduction: When the soft tissue around an implant is inadequate or poorly contoured, soft tissue augmentation techniques such as connective tissue grafts are used to enhance the gingiva and gingival contour around an implant-supported restoration. There have been some case reports of cystic lesions occurring after a connective tissue graft, but this appears to be the first case report of a cyst in alveolar mucosa adjacent to an implant.Case Presentation: Following the placement of implants in the #6 and #7 positions, a cosmetic soft tissue deficiency was visible and inadequate papilla height was evident interproximally. The #7 implant was subsequently submerged, and multiple connective tissue grafts were placed to reconstruct the soft tissue on the buccal aspect of #5 to #7. Four years later the patient returned for evaluation of a 6 × 3 mm raised, fluid-filled vesicle on the alveolar mucosa, buccal to the submerged #7 implant. A submarginal incision with a semilunar design was placed from #6 to #8. A ...

Globalized labour mobility has led to questions regarding the degree to which social work education in one country can be applicable to practice in another. This paper examines social work education programmes and practice contexts in South Africa, England and Canada as examples through which to examine this question.

This case report examined the effectiveness of a home program using neuromuscular electrical stimulation (NMES) during voluntary task-oriented exercise to achieve functional and impairment improvements for an individual with primarily proximal arm paresis after a stroke. The subject initially achieved a Fugl-Meyer Assessment (FMA) score of 58/66, but she reported minimal functional use of her involved, dominant arm. The 6-wk intervention consisted of NMES-assisted task practice involving repetitive reaching for and manipulation of small objects for three daily 1 5-min sessions. The subject applied NMES to the deltoid and triceps brachii muscles to augment shoulder flexion and abduction and elbow extension during task practice. Outcome measures included the FMA, the Action Research Arm Test (ARAT), and the Motor Activity Log Quality of Movement subscale (MAL-QOM). The FMA remained unchanged, but the ARAT and MAL-QOM showed improvements, from the beginning to the conclusion of the intervention, that were maintained at 6-wk follow-up.

The presence of the highly toxic antifouling agent tributyltin (TBT) and its degradation products was determined in four species of mussels collected from 34 locations in fresh water in Ontario and in sea water on Canada's west and east coasts. The purpose of the study was to establish baseline information in order to assess TBT trends in mussels after the 1989 Canadian regulation of antifouling uses of TBT. In fresh water, concentrations of TBT were much higher in zebra mussels (Dreissena polymorpha) than in Elliptio complanata or Lampsilis radiata radiata. High concentrations of TBT were also found in Mytilus edulus in sea water. Residues of TBT in all species were similar to those that have been determined in other parts of the world before and after the regulation of antifouling uses of TBT in various countries. Analyses for degradation products indicated that zebra mussels metabolize TBT at about the same rate as L. radiata radiata and M. edulis, but more slowly than E. complanata. © 1997 John Wiley & Sons, Ltd.

A survey was conducted of water and sediment from across Canada in 1993-94 to assess the effectiveness of the 1989 regulation of antifouling uses of tributyltin (TBT) under the Canadian Pest Control Products Act. The survey was also designed to assess concentrations of 13 other organotin species in water and sediment, and in sewage treatment plant influents, effluents and sludges. The main conclusion is that the 1989 regulation has only been partially effective. It has had some effect in the reduction of TBT concentrations in fresh water, but not in sea water. It has had less effect in the reduction of TBT concentrations in sediment, probably because of the longer persistence of TBT in sediment than in water. In many locations the TBT concentration was high enough to cause acute and chronic toxicity to aquatic and benthic organisms. In some areas there may be potential for recycling TBT from contaminated sediments back into the water column. In addition, it appears that large harbours that handle ships legally painted with TBT-containing antifouling paints continued to experience ecotoxicologically significant TBT contamination. Other organotin species found appear to pose no acute or chronic hazards to fresh water or marine organisms, but nothing is known of their hazards to benthic organisms. The presence of monooctyltin and dioctyltin in sediments and sewage treatment plant influents, effluents and sludges is reported for the first time, and tripropyltin is quantified in sediments for the first time.

The two commonly used derivatization techniques for the speciation of organotin compounds in biological tissue, namely, (1) direct in situ derivatization with sodium tetraethylborate, and (2) tropolone extraction followed by derivatization with ethyl Grignard reagent, were evaluated and validated using a spiked tissue and reference fish tissue (NIES No. 11). Their applications in the analysis of real mussels are given.

A highly sensitive and specific method is described for the determination of methyl-cyclopentadienylmanganese tricarbonyl (MMT) in gasoline and environmental samples by gas chromatography-plasma atomic emission detection (GC-AED). The procedure is simple, rapid and free from interferences. The absolute limit of detection is 0.5 fg of MMT (0.5 x 10 -15 g) expressed as Mn. The precision for replicate injections (n=5) of an MMT solution (10 pg Mn) was 2.8% relative standard deviation (RSD). Applications of the method to analysis of gasoline (petrol), and preliminary results of the analyses of environmental samples such as air and roadside dirt, are given.

An investigation of the extraction recovery of butyltin species in sediment by supercritical fluid extraction (SFE) is presented. Satisfactory recoveries for TBT (93.5 ± 3.7%) and DBT (91.5 ± 3%) are achieved. The recovery for MBT from spiked sediment (62 ± 5.1%) is the highest value so far achieved by the SFE technique. A comparison of the supercritical fluid extraction with the improved tropolone solvent extraction technique for the butyltin species is presented. The results of the analysis of a reference sediment (PACS-1) are also given.

This article describes the application of Compendium, a knowledge cartography software tool, for the recording of group process. As a hypertext tool, it enables analysts to visualize connections between people, ideas and information, establishing an evidence base within and across contexts (such as group sessions). After customizing its visual language, templates and keyword system, it has been piloted as a research tool for the measurement of group process. This would appear to hold the promise of providing a 'digital substrate' for recording, discussing and analysing long term group dynamics in new ways. While the project is in its early stages, early indications are that it is a useful tool, which can highlight group process and record change over time. In the longer term, it seems plausible that group processes such as multiple mirroring and identification, and such complex structures as the matrix, could be made visible and researchable through this methodology. © The Group-Analytic Society 2011.

Annual Editions: Aging 12/13 provides a condensed yet comprehensive preview into the field of aging. The book consists of 39 articles that are categorized into eight units. Unit 1, The Phenomenon o...

The chapter begins with an overview of the current momentum toward interprofessional education and practice, citing specific trends in Canada as reflections of a global emerging consciousness. Initiatives undertaken at Dalhousie University are discussed in setting the context for this pilot study. Next, the pedagogy of critical diversity education is introduced and explained, with particular relevance for interprofessional education and practice. Comparison of face-to-face and online delivery of an interprofessional module based upon critical diversity education principles is then detailed, including research design and findings. The chapter concludes with a discussion of implications from this study.

A new approach to the replacement of four mandibular incisors with localized, chronic, severe periodontitis is proposed in this clinical report. Their replacement with immediately placed implants and a nonocclusally loaded provisional restoration is a simple, predictable, and successful treatment modality. Data from 10 consecutive clinical cases are presented, and a 100% implant survival rate is reported for a 6-year period of follow-up. Treatment outcomes for this approach compare favorably with alternative treatment options and should be considered an important primary treatment option for most patients requiring the replacement of the four mandibular incisors.

An international mixed methods study of resilience of 14 sites in eleven countries identified seven tensions that youth resolve in culturally specific ways. Resolution of these tensions is foundational to experiences of resilience. This paper reports on the qualitative findings from interviews with 89 youth. Results support a culturally embedded understanding of positive youth development that better accounts for young people's resilience in western and non-western countries. Specifically, the seven tensions identified include: access to material resources, relationships, identity, cohesion, power and control, social justice, and cultural adherence. Findings show that no one pattern in the resolution of these tensions predicts resilience better than another. A case study of a Palestinian boy demonstrates the intersection of the seven tensions and the uniqueness of their resolution. The implications of this work for interventions is discussed.

Cell surface receptors are important mediators of pathogen recognition and intercellular communication. The SLAM-family receptors are a group of Immunoglobulin Superfamily receptors that signal through the small SH2 domain-containing adapters SAP and EAT-2. These adapters promote cellular activation through interactions with Src-family kinases and PKC-θ, though putative inhibitory signaling can be found under some conditions. Our laboratory previously reported a novel interaction between the adapter protein EAT-2 and PLCγ1, suggesting a potent activating potential for EAT-2 in NK cells. Subsequent experiments have demonstrated that EAT-2 phosphorylated on Tyr-127 specifically recruits PLCγ1 but not PLCγ2. By shRNA-mediated knockdown of human NK cell gene expression, we determined that activation of cytotoxicity through SLAM-family receptors was critically dependent on PLCγ1. Importantly, cytotoxicity through other receptors such as CD2 or NKp30 was unaffected by the absence of PLCγ1. While mouse studies have implicated PLCγ2 as a primary mediator of NK cell activation, our study indicates parallel pathways for induction of calcium flux, and demonstrates the importance of the EAT-2/PLCγ1 pathway in human NK cell activity. Further experiments to measure the individual contributions of SAP and EAT-2 have revealed important roles for these proteins in NK cell cytotoxicity.