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Adolescent patients may present with unique and challenging ethical dilemmas and legal considerations during dental treatment. From the moment the patient registers with the practice, the issues of medical history, informed consent, treatment decisions, and role of the patient and parent affect the dynamic of the doctor-patient relationship. Providers are challenged with balancing the physical, psychological, and social changes occurring in these patients and the changing relationships between the patients and their parents/guardians. State laws, practice standards, and consumerism in dental practice all affect the relationship between the practice, the adolescent, and the parent/guardian.

Direct access care provided by dental hygienists can reduce oral health disparities for the underserved, yet legal, regulatory, and ethical considerations create complexities and limits. Background and purpose Individual state dental practice acts regulate the scope of practice and level of supervision required when dental hygienists deliver care. Yet, inconsistent state practice act regulations contribute to ethical and legal limitations and dilemmas for practitioners. The dental hygienist is positioned to assume an increasingly larger role in the management of oral health disparities. However, there are several legal and ethical considerations that impact both dental hygienists and dentists providing care in complex community settings. This article informs dental hygienists and other related constituencies about conundrums that are encountered when providing care ‘beyond the operatory.’ Methods An evidence-based view of ways in which dental hygienists are reducing oral health disparities illustrates the complex issues involved in providing such care. Potential scenarios that can occur during care provision in underserved settings provide the basis for a discussion of legal and other associated issues impacting dental hygiene practice.

The introduction of mid-level providers to the U.S. dental workforce is currently a topic of heated debate. As little is known about the opinions of those who educate oral health professionals on the subject of such practitioners, a survey of U.S. dental school deans was undertaken to gauge their attitudes about alternative workforce models in the dental profession. The survey was sent to deans of the then-fifty-eight U.S. schools of dentistry; forty-four responded for a 76 percent response rate. Over three-fourths of the respondents agreed that the scope of practice for both dental hygienists and dental assistants should be expanded; significantly, over half agreed that the future of dentistry should include a dental therapist-type practitioner. Moreover, three-fourths agreed that such practitioners or expanded-duty hygienists would improve access to care for the underserved, and between half and two-thirds agreed that the quality of care delivered by these professionals would not be a problem. The attitudes of the deans about mid-level providers falls somewhere between that reported for U.S. dentists generally, who tend to be skeptical, and for dentists in other countries, who, once they have worked in a system with dental therapists, tend to be supportive.

The aim of this study was to evaluate the vitamin levels of ram seminal plasma and the relationship between vitamins and spermatological characteristics. For this aim, nine 3-5 year old rams of Norduz, Karakas and Ile-de-France x Akkaraman (G1) genotypes were provided. Sperm of each ram was collected once per month from June to October of the year 2007 by artificial vagina. In each month, the concentrations of retinol acetate, alpha tocopherol, delta tocopherol, alpha tocopherol acetate and vitamin D-3 in seminal plasma were analyzed by using HPLC. Spermatological characteristics viz. sperm volume, pH, mass activity, sperm motility, abnormal spermatozoid, death/alive ratio and sperm concentration were evaluated. As testicular characteristics, scrotal circumference and testicular diameter were measured. Monthly changes and breed differences on the vitamin levels were statistically insignificant, whereas there was a positive correlation was obtained between testis diameter and retinol acetate levels (p

With issues such as shrinking revenue, access to care, faculty workloads, and graying faculty, dental schools are faced with difficult challenges that fall to dental school deans to manage. Do dental school deans have the organizational skill sets and ethical frameworks necessary to address the challenges now facing dental schools? The purpose of this article is to pose questions and suggestions regarding some of the key issues in dental colleges today and to stimulate discussion in the dental community about needed changes in dental education.

This study explores the little-understood process of evaluating the performance of assistant and associate deans at dental colleges in the United States and Canada. Specifically, this research aimed to identify the methods, processes, and outcomes related to the performance appraisals of assistant/associate deans. Both deans and assistant/associate deans were surveyed. Forty-four of sixty-six deans (66.7 percent) and 227 of 315 assistant/associate deans (72.1 percent) completed surveys with both close-ended and open-ended questions. In addition, ten individuals from each group were interviewed. Results indicate that 75-89 percent of assistant/associate deans are formally evaluated, although as many as 27 percent may lack formal job descriptions. Some recommended best practices for performance appraisal are being used in a majority of colleges. Examples of these best practices are having at least yearly appraisals, holding face-to-face meetings, and setting specific, personal performance objectives/benchmarks for assistant/associate deans. Still, there is much room to improve appraisals by incorporating other recommended practices. Relatively high levels of overall satisfaction were reported by both assistant/associate deans and deans for the process and outcomes of appraisals. Assistant/associate deans rated the value of appraisals to overall development lower than did deans. Qualitative data revealed definite opinions about what constitutes effective and ineffective appraisals, including the use of goal-setting, timeliness, and necessary commitment. Several critical issues related to the results are discussed: differences in perspectives on performance reviews, the importance of informal feedback and job descriptions, the influence of an assistant/associate deans' lack of tenure, and the length of service of deans. Lastly, recommendations for enhancing performance evaluations are offered.

Improving the adaptation of resin composites during placement is necessary to increase durability and reduce microleakage. Flowable resin liners have been introduced to improve adaptation in composite restorations. In addition, a device that lowers the viscosity of regular dental composites has been introduced (Calset, AdDent Inc, Danbury, CT, USA). This device lowers the viscosity of composites by preheating them to 54.4 degrees C, which should lead to improved adaptation. This study compared microleakage in Class II composite restorations prepared using: 1) preheated resin composite, 2) unheated composite and 3) a flowable liner followed by unheated composite. Class II cavities were prepared on the mesial and distal surfaces of extracted third molars. Ten preparations were restored with resin composite (Esthet-X, Dentsply, York, PA, USA) for each of the following four techniques: Control (Esthet-X with Prime & Bond NT, Dentsply), Flowable (f) (as Control but used Esthet-X Flow liner), Preheated (p) (as Control but with preheating composite to 54.4 degrees C) and Delay (d) (as Preheated but followed by a 15-second delay before curing). The teeth were restored, finished, stored in distilled water for 24 hours, then thermocycled between water bath temperatures of 5 degrees C and 55 degrees C with a one-minute dwell time for 1000 cycles. Tooth apices were sealed with epoxy and varnish was applied to within 1 mm of the restoration margins. The teeth were placed in 0.5% basic fuschin dye for 24 hours, rinsed, then embedded in self-curing resin. The embedded teeth were sectioned mesiodistally with a slow-speed diamond saw, providing multiple sections per restoration. Microleakage was rated by two evaluators using a 0-4 ordinal scale at the occlusal and cervical margins of each restoration and light microscopy (40x). The data were analyzed with Kruskal-Wallis ANOVA and pairwise testing with the Sign test (alpha=0.05). No statistical differences were observed among materials at the occlusal margin. However, at the cervical margin, the preheated samples P showed statistically lower microleakage than the controls and all other treatments. The D samples showed higher microleakage than the P and F samples. Ranked sum scores for the cervical were D (4516), C (3974), F (2756) and P (1958). There was a statistically greater amount of leakage at the cervical margins compared to the occlusal p

This study explores the little understood process of evaluating the performance of department chairs/division heads in dental schools. Specifically, this research aimed to elucidate the methods, processes, and outcomes related to the job performance of department chairs/division heads. Forty-three deans and 306 chairs completed surveys with both close-ended and open-ended questions. In addition, ten deans and ten chairs were interviewed. Results indicate that 80 to 90 percent of department chairs are formally evaluated, although as many as 50 percent may lack job descriptions. Recommended best practices for performance appraisal—such as having at least yearly appraisals, holding face-to-face meetings, and setting specific, personal performance objectives/benchmarks for chairs—are being used in most schools. Still, there is much room to improve appraisals by incorporating other recommended practices. Overall high levels of satisfaction were reported by both chairs and deans for the process and outcomes of appraisals. Qualitative data showed some convergence of opinions about appraisals with the notable exception of informal feedback. We explore some implications of these results, especially as they relate to improving performance appraisals.

Objective This study aims to assess patient attitudes toward mid-level dental providers, known as dental therapists (DTs), by surveying those likely to be their patients. The recent adoption of accreditation standards by the Commission on Dental Accreditation has reignited a debate surrounding the state-by-state legalization of DTs in the United States; while the dental profession is divided on DTs, it is important to understand how potential patients may view the DT model. Methods A questionnaire that asks about oral health experience, and comfort with the model of a dually trained dental therapist–hygienist, based on a provided definition, was administered to 600 patients and their waiting room companions at a large urban university-based dental clinic. Results Forty percent of respondents indicated they would be comfortable being treated by a DT for all 7 of the procedures referenced, and over 75% were comfortable with each of 5 procedures. Having caps or crowns placed was the only treatment about which respondents were evenly divided. Factors associated with greater odds of comfort with various procedures include being uninsured and being under the age of 65. Uninsured patients were 1.5 to 2 times more likely than privately insured patients to accept a DT. Conclusions The introduction of mid-level dental providers is a strategy that those lacking regular care appear on the whole to be comfortable with.

The main goal of this paper is to evaluate civil engineering internship programs for educational improvements by doing statistical analyses on comprehensive survey data gathered from inquiry sheets. A web base online survey tool was prepared and 251 inquiry sheets were statistically analyzed. Univariate analyses were performed to describe the interns' population and their needs. Levene's test was used to test equality of variances and the t-value was used for equality of means. The One-Way ANOVA procedure was used to test the hypothesis that the means of groups are not significantly different. Finally, binary logistic regression was conducted to identify factors that predict the students' satisfaction level. A positive, statistically significant relationship was identified between internship satisfaction level, future carrier planning, multidisciplinary team working, learning theoretical and practical applications, food service during the internship period and worksite internship. This study proved that the civil engineering students are keen to participate in practical training programs during their period of education and also that civil engineering departments should update the theoretical courses taking into consideration the practical applications.

Представлена 84-летняя женщина с жалобами на тошноту, не сопровождающуюся рвотой, у которой обнаружено фиксированное левостороннее образование в брюшной полости, которое пальпировалось на 15 см латеральнее пупка. В анамнезе – хирургическое лечение по поводу двусторонних паховых грыж, пупочной грыжи и эпигастральной грыжи. При КТ с контрастированием выявлена грыжа спигелевой линии, включающая контрастированную толстую кишку как причину опухолевого образования в левой половине брюшной полости. Во время операции было выявлено, что грыжа спигелевой линии содержала большой сальник, пораженный метастазами, прилежащий к левой части толстой кишки. Локализация первичной опухоли не была определена как во время, так и после операции. Обсуждаются причины образования вентральной грыжи и необычной опухоли, расположенной в левой половине брюшной полости – грыжи спигелевой линии, содержащей метастатическую опухоль., The 84 year old lady presented with nausea, but without vomiting showing a fixed left sided abdominal mass that could be palpated 15 cm lateral to the umbilical. She had a history for bilateral inguinal hernia, umbilical hernia and epigastric hernia surgery. Contrast CT revealed a Spieghelian hernia containing contrasted large bowel as the reason for the left side abdominal mass. On operation the Spieghelian hernia contained metastatic greater omental cake adhering to the left colon. The site of the primary adenocarcinoma could not be located intraand postoperatively. Reasons for ventral abdominal mass and this unusual left side abdominal mass – a Spieghelian hernia containing in fact metastatic tumor – are discussed.

With issues such as shrinking revenue, access to care, faculty workloads, and graying faculty, dental schools are faced with difficult challenges that fall to dental school deans to manage. Do dental school deans have the organizational skill sets and ethical frameworks necessary to address the challenges now facing dental schools? The purpose of this article is to pose questions and suggestions regarding some of the key issues in dental colleges today and to stimulate discussion in the dental community about needed changes in dental education.

This study explores the little-understood process of evaluating the performance of assistant and associate deans at dental colleges in the United States and Canada. Specifically, this research aimed to identify the methods, processes, and outcomes related to the performance appraisals of assistant/associate deans. Both deans and assistant/associate deans were surveyed. Forty-four of sixty-six deans (66.7 percent) and 227 of 315 assistant/associate deans (72.1 percent) completed surveys with both close-ended and open-ended questions. In addition, ten individuals from each group were interviewed. Results indicate that 75-89 percent of assistant/associate deans are formally evaluated, although as many as 27 percent may lack formal job descriptions. Some recommended best practices for performance appraisal are being used in a majority of colleges. Examples of these best practices are having at least yearly appraisals, holding face-to-face meetings, and setting specific, personal performance objectives/benchmarks for assistant/associate deans. Still, there is much room to improve appraisals by incorporating other recommended practices. Relatively high levels of overall satisfaction were reported by both assistant/associate deans and deans for the process and outcomes of appraisals. Assistant/associate deans rated the value of appraisals to overall development lower than did deans. Qualitative data revealed definite opinions about what constitutes effective and ineffective appraisals, including the use of goal-setting, timeliness, and necessary commitment. Several critical issues related to the results are discussed: differences in perspectives on performance reviews, the importance of informal feedback and job descriptions, the influence of an assistant/associate deans' lack of tenure, and the length of service of deans. Lastly, recommendations for enhancing performance evaluations are offered.

Serum levels of T-3, T-4, and TSH hormones, some elements, and glucose with regard to their involvement for growth retardation in yearling rams were investigated. A total of 70 yearling rams of the Akkaraman breed, 50 of which were classified with a retarded growth, and the remaining 20 were classified as normal, were included in the study. Serum total T-3, total T-4, and TSH were measured using chemiluminescent enzyme-labelled immunometric assay with immulite kits. Serum levels of Zn, Cu, and Co were measured using atomic absorption spectrophotometer. Serum glucose was measured using auto analyser. There were significant differences between the yearling rams, with and without retarded growth for serum levels of T-3, Zn, Cu, Co, and glucose. However, there no significant differences for T-4, and TSH between the yearling rams, with and without retarded growth. The results of the study suggest that retarded growth in yearling rams is associated with the lower levels of serum total T-3, Zn, Cu, Co, and glucose: however, there is no scientific evidence for the association of T-4, and TSH in the condition.

This study explores the little understood process of evaluating the performance of department chairs/division heads in dental schools. Specifically, this research aimed to elucidate the methods, processes, and outcomes related to the job performance of department chairs/division heads. Forty-three deans and 306 chairs completed surveys with both close-ended and open-ended questions. In addition, ten deans and ten chairs were interviewed. Results indicate that 80 to 90 percent of department chairs are formally evaluated, although as many as 50 percent may lack job descriptions. Recommended best practices for performance appraisal--such as having at least yearly appraisals, holding face-to-face meetings, and setting specific, personal performance objectives/benchmarks for chairs--are being used in most schools. Still, there is much room to improve appraisals by incorporating other recommended practices. Overall high levels of satisfaction were reported by both chairs and deans for the process and outcomes of appraisals. Qualitative data showed some convergence of opinions about appraisals with the notable exception of informal feedback. We explore some implications of these results, especially as they relate to improving performance appraisals.

The aim of this study is to evaluate serum urea, creatinine, vitamin E, GSH content, GPx, SOD activities, and MDA values in rats with experimental acute renal failure induced by gentamicin.