Biomedical subjects

Jennifer L Waller

Publications and source records attributed to Jennifer L Waller.

At least 19 recordsLinked to original sources

PubMed2007

Infiltration/evaporation-induced shrinkage of demineralized dentin by solvated model adhesives.

During dentin bonding, solvated adhesive comonomers are applied to water-saturated decalcified dentin matrices. When alcohol-solvated hydrophilic or hydrophobic methacrylate monomers are applied, they chemically remove water and cause matrix shrinkage during comonomer infiltration. Evaporation of solvent induces further shrinkage. The purpose of this work was to compare the shrinkage of water-saturated dentin matrices infiltrated with ethanol- or methanol-solvated 2-hydroxyethyl methacrylate (HEMA), 2,2-bis[4(2-hydroxy-3-methacryloyloxy-propyloxy)-phenyl] propane (BisGMA), or triethyleneglycol dimethacrylate (TEGDMA) at 90/10, 70/30, 50/50, and 30/70 mass fraction % alcohol/monomer before and after evaporation of alcohol. Thin (ca 0.2 mm) disks of human mid-coronal dentin were demineralized and placed in a well beneath the contact probe of a linear variable differential transformer (LVDT). The height of the matrix was measured before and after random application of one of the twelve alcohol/monomer mixtures. Matrix height was measured during infiltration and during solvent evaporation. Between trials, residual monomer was extracted using ethanol. These studies were repeated on specimens in which 100% alcohol was used to substitute for water in the matrix. Both studies revealed that matrices shrink 30-50% but that pretreatment of matrices with alcohol prevents BisGMA phase separations from occurring. Wet bonding with ethanol instead of water permits infiltration of relatively hydrophobic alcohol/monomers.

Adhesives↗

PubMed2006

Penetration of fluids into periodontal pockets using a powered toothbrush/irrigator device.

UNLABELLED: This study was a single-blind, randomized, controlled clinical trial. The researchers evaluated a powered brush/irrigating device (HydraBrush Oral Health System; OHS) for its safety and ability to deliver a solution to the bottom of 5-6 mm pockets, compared to rinsing alone with a solution following brushing with a powered toothbrush (Sonicare Elite 7800; SE). An evaluation technique to measure the quantity and quality of solution able to enter the pocket was also introduced in this project. METHODS: Subjects were randomized in one of two-groups: brush plus simultaneous irrigation (OHS) versus brush plus rinsing (SE). Subjects used their devices at home for two weeks. At the measurement visit, subjects used the OHS to irrigate and brush simultaneously for 1 minute (30 seconds per each side of the mouth) with a 0.01% erythrosine disclosing solution in 10 oz of distilled water. Control subjects brushed for 2 minutes with a SE followed by a 1 minute rinse with an identical disclosing solution. A blinded evaluator collected six samples of approximately of 1 microL of sucular fluid from six 5-6 mm evaluation sites. This was accomplished by inserting a microcapillary tip with a 20 microL micropipette in the sulcus. Two-group repeated measures ANOVA was used to examine differences in two measures of the disclosing solution between OHS and SE subjects; the spectrometer reading of the disclosing solutions, and by visual inspection of the samples (positive/negative) to determine the presence or absence of solution in the samples. Subjects' diaries were collected. Bleeding and discomfort during the evaluation period was reported. RESULTS: Visually, OHS had a significantly greater proportion of solution taken from the base of 5-6 mm sites than the SE (p=0.0001). However, there was no statistical difference between the two groups (p=.1359) in the spectrophotometer readings. CONCLUSION: The experimental device is more efficient in delivering a solution to the base of 5-6 mm pockets than rinsing following use of a control powered toothbrush. Both devices have demonstrated they are safe and well accepted by patients. The technique developed provides a useful method for quantitative and qualitative studies of solutions from the base of periodontal pockets.

Adult↗

PubMed2006

Improving the performance of EndoREZ root canal sealer with a dual-cured two-step self-etch adhesive. II. Apical and coronal seal.

This study tested the hypothesis that the seal of EndoREZ may be improved with an adhesive-modified technique. Instrumented single-rooted teeth were filled with: (a) Warm vertical compaction with AH Plus (control); (b). EndoREZ with master cones and passive application of accessory cones; (c) Application of Clearfil Liner Bond 2V before EndoREZ and gutta-percha condensation. Leakage was assessed by fluid filtration at 10 psi before root resection and after 3 to 12 mm apical resections. Statistical analyses revealed significant differences in filling technique and resection lengths. EndoREZ exhibited significantly higher overall leakage, while no difference was found between AH Plus and the adhesive-modified EndoRez technique. Apical resection of EndoREZ to 12 mm exhibited more leakage than all other interactions, but was not significantly different from the same material resected to 9 mm. Although EndoREZ exhibited an acceptable apical seal, its coronal seal may be improved with the use of a dual-cured self-etch adhesive.

Analysis of Variance↗

PubMed2006

Net expansion of dried demineralized dentin matrix produced by monomer/alcohol saturation and solvent evaporation.

The purpose of this work was to determine if nonaqueous methacrylate monomer/alcohol mixtures could expand dried collapsed demineralized dentin matrix. Thin disks (ca. 200 microm) of human dentin were demineralized and placed in wells beneath contact probes of linear variable differential transformers. The probes were placed on water-saturated expanded matrices to record the shrinkage associated with drying. Monomer mixtures containing hydroxyethyl methacrylate, 2,2-bis[4-(2-hydroxy-3 methacryloyloxy)propoxyphenyl] propane, or triethyleneglycol dimethacrylate were mixed with methanol or ethanol at alcohol/monomer mass fraction % of 90/10, 70/30, 50/50, or 30/70. They were randomly applied to the dried matrices to determine the rate and magnitude of expansion; then shrinkage was recorded during evaporation of the alcohols. The results indicated that matrix expansion was positively correlated with the Hoy's solubility parameters for hydrogen bonding forces (delta(h)) of the monomer/solvent mixtures (p < 0.001). Expansions were more rapid with methanol-containing than with ethanol-containing monomer mixtures. For the test solutions, triethyleneglycol dimethacrylate-containing mixtures produced the slowest rate of matrix expansion and hydroxyethyl methacrylate-containing mixtures the most rapid expansion. When the solvents were evaporated, the matrix shrank in proportion to the solvent content and the delta(h) of the monomer-solvent mixtures. The results indicate that expansion of dried, collapsed dentin matrices requires that the delta(h) of the mixtures be larger than 17 (J/cm(3))(1/2). The greater the delta(h) of the monomer solutions, the greater the rate and extent of expansion.

Alcohols↗

PubMed2006

Outcomes of antipsychotic drug use in community-dwelling elders with dementia.

This study used administrative data from a large health care insurer in the southeast United States to describe the utilization pattern and health care outcomes of antipsychotic drug use in community-dwelling elders with dementia. Claims data from 959 unique cases were analyzed to address research aims. Overall, 27% of the sample was dispensed antipsychotic drugs, with the most prevalent type being atypical antipsychotic drugs. Individuals on any type of antipsychotic drug experienced more delirium, depression, hip fracture, falls, and syncope than those not on these drugs, even after controlling for age, sex, comorbidity, and number of other drugs prescribed. Implications for practice are discussed.

Accidental Falls↗

PubMed2006

Relationship between glycosylated hemoglobin and arterial elasticity.

Arterial elasticity is decreased in diabetes, but it is unclear whether there is a relationship between glycosylated hemoglobin (HbA1c) and arterial elasticity. To evaluate this question, 111 subjects with diabetes mellitus had HbA1c and arterial elasticity determined in an academic outpatient setting. Three measurements of arterial elasticity indices were obtained supine using the HDI/PulseWave CR-2000 Research CardioVascular Profiling System (Hypertension Diagnostics Inc., Eagan, MN). The study population was 49% black and 51% women. Population characteristics included age, 49.2 years; duration of diabetes, 12.1 years; HbA1c, 8.9%; large artery elasticity, 11.8 mL/mm Hg x 10; and small artery elasticity, 4.7 mL/mm Hg x 100. Age correlated with diminished large artery elasticity. Women had a lower large artery elasticity than men (10.6 vs. 13.3 mL/mm Hg x 10; p = 0.0002). Decreasing small artery elasticity was associated with increasing age (p = 0.0001), HbA1c (p = 0.0184), and African-American ethnicity (p = 0.0306). Women had less small artery elasticity than men (3.8 vs. 5.8 mL/mm Hg x 100; p = 0.0001). Black diabetic patients had a reduced arterial elasticity compared with whites. Increasing HbA1c is associated with decreasing small artery elasticity, but not large artery elasticity. In diabetic patients, small artery elasticity is reduced to a greater extent in women than men and in blacks than whites.

Age Factors↗

PubMed2006

Arterial elasticity and erectile dysfunction in hypertensive men.

Erectile dysfunction is a common symptom among hypertensive patients that impairs quality of life and adherence to antihypertensive pharmacologic therapy. It is also associated with cardiovascular risk factors and disease. The Sexual Health Inventory in Men (SHIM) was administered to 105 ambulatory hypertensive patients, and large and small artery elasticity indices were measured. Each variable was examined in a simple linear regression model or 1-way analysis of variance model to determine each variable's relationship with the SHIM score. Variables that were significantly associated with the SHIM score in the univariate models included age, duration of hypertension, peripheral vascular disease, and small artery elasticity. Large artery elasticity was not significantly associated with the SHIM score. In the multivariate model, age, hypertension duration, and peripheral vascular disease were associated with a lower SHIM score. This study demonstrates a relationship between erectile dysfunction and reduced artery elasticity.

Blood Pressure↗

PubMed2006

Tobacco prevention in children and cessation in family members.

PURPOSE: To examine the effects of a theory-driven tobacco prevention program in sixth-grade children with a family tobacco cessation component implemented by school nurses in conjunction with the initiation of a statewide toll-free Quit Line. DATA SOURCES: Self-report questionnaires completed by the sixth-grade children and their parents/guardians (N= 1024) representing largely rural southern school systems from disparate areas with high prevalence rates of tobacco use and lung cancer diagnoses. Pre- and posttest measures that evaluated the impact of both student and parent/guardian interventions were obtained over a 10-week period. Paired t-tests were used to examine differences between pre- and posttest scores for all student and parent/guardian variables. Repeated-measures analysis of variance was used to examine the effect of parent/guardian smoking on student pre- and posttest scores. CONCLUSIONS: The student program resulted in significant improvements in drug knowledge, refusal skills, attitudes, normative expectations, assertiveness, and anxiety reduction techniques. In addition, the effectiveness of several components of the tobacco prevention program for the children was impacted by the smoking status of their parents/guardians. Drug-use intentions and behaviors were lower at posttest for children from homes of nonsmokers versus children from homes of smokers. Parents/guardians consistently reported that smoking was detrimental to themselves, the public, and their children. Of those parents/guardians who identified themselves as smokers (26%) and received cessation materials, 46.4% indicated that the information motivated them to want to quit. IMPLICATIONS FOR PRACTICE: Tobacco use continues to be the leading cause of preventable death in the United States, with greater than 2000 new youth becoming regular smokers each day. School nurses and nurse practitioners are in various pivotal positions to address tobacco and its related health concerns through delivery of effective family interventions that target children for tobacco prevention and parent/guardian smokers for cessation.

Attitude to Health↗

PubMed2006

Evaluation of internal medicine residents as exercise role models and associations with self-reported counseling behavior, confidence, and perceived success.

BACKGROUND: Patients perceive physicians who practice healthy personal behaviors as more credible and better able to motivate patients to make healthy lifestyle choices. PURPOSES: To evaluate internal medicine resident physicians as role models for promoting exercise by an assessment of physician physical activity behavior, cardiovascular fitness, physical activity knowledge, personal use of behavior modification techniques, attitudes toward personal physical activity practice, and confidence (i.e., self-efficacy) in the knowledge and personal utilization of behavior modification techniques and to explore the associations with self-reported patient counseling behavior, confidence, and perceived success. METHODS: Cross-sectional study of internal medicine resident physicians with a self-administered survey, treadmill fitness testing, and a 7-day physical activity recall. RESULTS: Fifty-one resident physicians agreed to participate (response rate = 81%). Fitness levels were below average for 60%, average for 25%, and above average or excellent for 15%. The mean energy expenditure was 234 kcal/kg/week, with 41% of physicians meeting recommended physical activity guidelines. Few reported high self-efficacy (33%) or perceived success (25%) in the ability to be regularly active. Few demonstrated adequate knowledge useful for patient counseling (e.g., listing 3 ways to integrate physical activity into daily life [27%], calculating target heart rate [29%], and identifying personal exercise stages of change [25%]). Personal use of behavior modification techniques was reported infrequently. Although 88% reported confidence in the knowledge of exercise benefits, less than half reported confidence in the knowledge of local facilities, American College of Sports Medicine (ACSM) guidelines, and behavior modification techniques. Multiple linear regression demonstrated that a higher level of training (p = .02) and a greater confidence in the knowledge of ACSM guidelines (p = .048, total R2 = .21) independently predicted more frequent self-reported counseling. Sex (i.e., male; p = .01) and greater physical activity self-efficacy (p = .017, total R2 = .23) independently predicted greater perceived counseling success. Greater physical activity enjoyment (p = .03) and greater perceived success at engaging in regular physical activity (p = .028, total R2 = .28) independently predicted greater counseling self-efficacy. CONCLUSIONS: Most internal medicine resident physicians may not be adequate role models for promoting exercise adherence. Confidence in the knowledge of current guidelines, personal physical activity enjoyment, and perceived success and self-efficacy in engaging in regular physical activity may be useful targets for enhancing resident physician physical activity counseling for their patients.

Adult↗

PubMed2006

Identification and management of intrathecal baclofen pump complications: a comparison of pediatric and adult patients.

OBJECT: Intrathecal baclofen therapy is an effective means of treating intractable spasticity and dystonia in the pediatric and adult population. The authors present a review of complications encountered in a series of 314 pump and catheter-related procedures. The identification and management of these complications will be reviewed. The authors will also identify populations that may be at increased risk for complications. METHODS: A retrospective review was performed of all procedures undertaken during the last 5 years by two surgeons at the authors' institution. Postoperative complications were reviewed. A total of 314 surgical procedures (226 pediatric and 88 adult) were performed in 195 pediatric and adult patients. This included 171 new pump and catheter implants (116 pediatric and 55 adult), 26 elective pump replacements due to end of battery life (15 pediatric and 11 adult), five elective pump repositionings per physiatrist request (three pediatric and two adult), 14 elective catheter repositionings (10 pediatric and four adult), and two normal pediatric catheter explorations. Surgical procedures for complication management included seven pump revisions (five pediatric and two adult), 48 catheter revisions (38 pediatric and 10 adult), and 41 wound revisions (37 pediatric and four adult). The majority of adult pumps were implanted subdermally, whereas in pediatric patients they were placed subfascially. In general, intrathecal catheters were placed under fluoroscopic guidance with the catheter tip placed at T-1 to T-2 for spastic quadriplegia, T-6 to T-10 for spastic diplegia, and midcervical for dystonia. No significant intraoperative complications were encountered. Overall, there was a statistically significantly higher percentage of procedures for overall complication management and wound complication management in pediatric patients compared with adult patients. CONCLUSIONS: Intrathecal baclofen therapy is a highly effective treatment option for patients with medically refractory spasticity. The catheter, pump, and wound are subject to numerous complications both at the time of implantation and throughout the life of the implanted system. Careful technique, close observation, and aggressive evaluation and correction of problems can reduce the incidence and severity of the complications when they occur.

Adult↗

PubMed2005

REACH: clinical feasibility of a rural telestroke network.

BACKGROUND AND PURPOSE: Development of stroke networks is critical to bringing guideline-driven stroke care to rural, underserved areas. METHODS: A Web-based telestroke tool, REACH, was developed to provide a foundation for a rural stroke network that delivered acute stroke consults 24 hours per day 7 days per week to 8 rural community hospitals in Georgia. RESULTS: There were 194 acute stroke consults delivered. Thirty patients were treated with tissue plasminogen activator (tPA). The mean National Institutes of Health Stroke Score (NIHSS) was 15.4, and the median NIHSS was 12.5. The mean onset to treatment time (OTT) was 122 minutes. The OTT dropped from 143 minutes in the first 10 patients treated to 111 minutes in last 20 patients. Of the 30 patients treated with tPA, 23% (7) were treated in < or =90 minutes and 60% (18) were treated within 2 hours. There were no symptomatic intracerebral hemorrhages. CONCLUSIONS: The REACH telestroke system permits the rapid and safe use of tPA in rural community hospitals. Over time, the system became more efficient and OTT decreased.

Aged↗

PubMed2005

Delirium superimposed on dementia in a community-dwelling managed care population: a 3-year retrospective study of occurrence, costs, and utilization.

BACKGROUND: Dementia is a growing public health problem and a well-described risk factor for delirium. Yet little is known about delirium superimposed on dementia in community-dwelling populations. The purpose of this study was to examine the 3-year occurrence, healthcare utilization, and costs associated with delirium superimposed on dementia in community-dwelling persons. METHODS: We used a 3-year cross-sectional, retrospective design with an administrative database from a large managed care organization. Four individually matched samples of 699 individuals each were selected for comparison purposes: delirium superimposed on dementia (DSD), dementia alone, delirium alone, and a control group with neither delirium nor dementia. The occurrence rate of DSD was calculated by measuring those individuals with a dementia diagnosis that were also coded with an International Classification of Diseases, Ninth Edition Clinical Modification (ICD-9 CM) code for delirium or delirium with dementia. RESULTS: Of the total sample of 76,688 persons aged 65 years or older in the managed care organization, 7347 (10%) were coded as having dementia, and an additional 763 (1%) as having delirium alone. Among the 7347 with dementia, 976 (13%) had DSD, representing 1.3% of the total sample. After log transformation of total costs and adjustment for multiple covariates, the adjusted mean total health care costs remained significantly higher for the DSD group than for all other groups. CONCLUSIONS: This study is the first to report the occurrence rate of DSD in a community-dwelling population, and to demonstrate the substantial health care costs and utilization associated with DSD.

Aged↗

PubMed2005

Assessment of test repeatability of arterial stiffness index.

BACKGROUND: Increased arterial stiffness is an early indicator of vascular disease. Several methods may be used to determine arterial stiffness. One method obtains an arterial stiffness index from the vascular dynamics of oscillometric-derived brachial artery pressure. METHODS: To determine the test-retest repeatability of the CardioVision MS-2000, 47 healthy hospital employees had five consecutive measurements of arterial stiffness index measured after a 5-10 min period of rest and then repeated after an average of 146.8 days. Their mean age was 37 years and 71% were women. RESULTS: The mean arterial stiffness index was 39.6+/-9.7 and 37.2+/-10.5 mmHg x10 (P=0.22) for the first and second time period, respectively. We computed an intraclass correlation coefficient of 0.31 and 0.33 for the first and second time periods, which is the measure of consistency or agreement of arterial stiffness index values within cases. The intraclass correlation coefficient for systolic blood pressure, diastolic blood pressure, heart rate and arterial stiffness index were 0.68 (P=0.0001), 0.70 (P=0.0001), 0.35 (P=0.02) and 0.25 (P=0.08), respectively. CONCLUSION: The results of this study suggest poor test-retest repeatability if consecutive measurements are used. The intraclass correlation coefficient, however, could be improved by eliminating the highest and lowest value from a set of measurements.

Adult↗

PubMed2005

A physician fitness program: enhancing the physician as an "exercise" role model for patients.

BACKGROUND: Physically active physicians are more apt to counsel patients about exercise. PURPOSES: The purpose of this study was to determine the effect of a physician fitness program on resident physician cardiovascular fitness, physical activity behavior/stage of change, and physical activity counseling behavior/attitudes. METHODS: A prospective, intervention study with measurements at baseline (before intervention), 3 months (immediately after intervention), and 6 months (3 months after intervention) evaluated a multifaceted exercise program for 48 internal medicine residents. Resident physician cardiovascular fitness, energy expenditure, physical activity stage of change, knowledge, attitudes, and counseling behavior were measured. RESULTS: Resident physician fitness significantly declined over time (baseline VO(2)-170 = 29.1 ml/kg/min, first follow-up VO(2)-170 = 27.3 ml/kg/min, and second follow-up VO(2)-170 = 26.2 ml/kg/min; p = .001). Although there was no change in overall energy expenditure, the number of resident physicians in the precontemplation or contemplation stage of change significantly declined with a corresponding increase in the number in a "higher" stage of change at first (p = .0034) and second follow-up (p = .024). There was a nonsignificant increase in self-reported patient counseling. Resident physician counseling confidence and perceived success significantly improved at first follow-up only (p = .01 and p = .03, respectively). CONCLUSION: Although resident physician fitness and energy expenditure did not improve after intervention, a significant improvement in resident physician physical activity stage of change and attitudes toward patient counseling was noted. Randomized controlled trials are needed to confirm whether these changes are attributable to the intervention.

Attitude of Health Personnel↗

PubMed2005

Relationship between age of ear piercing and keloid formation.

OBJECTIVE: Keloids occur commonly after trauma to the skin, with ear piercing being a well-known inciting event. We surveyed 32 patients with keloids resulting from ear piercing, to examine a potential relationship between age of piercing and keloid formation. METHODS: A total of 32 consecutive patients completed a survey about ear-piercing and keloid formation. Fisher's exact test was used for data analysis. RESULTS: Fifty percent (n = 16) of surveyed patients developed a keloid after their first piercing. Twenty surveyed patients developed keloids with subsequent piercings. Those who had piercings at > or =11 years of age were more likely to develop keloids (80%) than were those who had piercings at <11 years of age (23.5%). CONCLUSIONS: Keloids are more likely to develop when ears are pierced after age 11 than before age 11. This observation holds true for patients with a family history of keloids. Given the difficulty and cost of treating keloids, prevention remains the best approach. Patients with a family history of keloids should consider not having their ears pierced. If this is not an option, then piercing during early childhood, rather than later childhood, may be advisable. Primary care physicians and pediatricians should educate children and their parents about the risk of keloid formation.

Adolescent↗

PubMed2005

Antibiotic use in children who have asthma: results of retrospective database analysis.

OBJECTIVE: Inappropriate antibiotic use is a well-recognized public health problem because of its association with the emergence of resistant bacteria. It also is a source of unnecessary health care costs and of potentially severe adverse drug reactions. Although there are no evidence-based indications for the use of antibiotics in the treatment of asthma in the absence of comorbid bacterial conditions, physicians might feel more pressure to prescribe them to children with this common chronic disease. The objectives of this study were to (a) determine if antimicrobial prescription utilization rates are higher for pediatric patients with asthma than a matched comparison group and (b) identify common variables (gender and age) that might explain higher antibiotic utilization rates in children. METHODS: Using administrative claims data, we conducted a retrospective cohort study of children with asthma (age range 5 to 18 years) who were members of a large health plan from January 1, 2000, to December 31, 2002, in the southeastern United States. A comparison group was created that was matched according to age, sex, regional codes, and insurance product line. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes were used to identify asthmatic patients (493.xx), as well as to link antibiotic prescriptions to diagnosis codes from claims for medical office visits. RESULTS: Asthmatics consistently received significantly more services, including a mean of 1.74 (SD 1.82) antibiotics per patient per year (PPPY) compared with a mean of 0.96 (SD 1.32) antibiotics PPPY for nonasthmatics (t=25.71, P <0.001). Asthmatics received antibiotics more often for all diagnoses. The more frequent receipt of antibiotics was true for conditions related to the respiratory tract (e.g., upper respiratory infection and bronchitis) as well as for conditions unrelated to the respiratory tract (e.g., urinary tract infection and acne). A diagnosis of asthma significantly increased the likelihood of a prescribed antibiotic by 26% to 86%. CONCLUSION: This study demonstrated that pediatric asthmatic patients received significantly more antibiotic prescriptions than nonasthmatics for conditions caused by bacteria as well as for conditions more likely to be viral in origin. In this era of concern about the widespread use of antibiotics and consequent antimicrobial resistance, further research needs to be conducted concerning the appropriateness of antibiotics in the treatment of asthma. Studies on the appropriate use of antibiotics in asthma could help reduce the overall use of antibiotics in children.

Adolescent↗

PubMed2005

Effects of multiple coatings of two all-in-one adhesives on dentin bonding.

PURPOSE: Simple changes to bonding technique can improve resin-dentin bond strengths. The objective of this study was to evaluate the effects of multiple coatings of two all-in-one adhesive resins on both microtensile bond strength (microTBS) and nanoleakage. MATERIALS AND METHODS: The mid-coronal occlusal dentin of extracted human molars was used. Two all-in-one adhesives--iBond (Heraeus Kulzer) and Xeno III (Caulk Dentsply)--were applied to 320-grit abraded dentin surfaces. In groups 1 and 3 during bonding, monomer application and solvent evaporation were done 1, 2, 3, 4 or 5 times on the dentin surface before light curing. In groups 2 and 4 after light curing the first layer, the adhesive was re-applied, the solvent evaporated, and the layer light cured. This was repeated from 2 to 5 times, followed by creation of composite buildups. After 24 h storage in 37 degrees C water, the teeth were sectioned perpendicular to the adhesive interface to produce multiple beams of composite-bonded dentin, approximately 0.9 mm2 in area. These were tested to failure in tension. Data were evaluated by three-way ANOVA (material vs coatings vs light curing) followed by multiple comparisons at alpha = 0.05. Additionally, nanoleakage of silver uptake and adhesive layer thickness were evaluated using transmission electron microscopy (TEM). RESULTS: The results indicated that bond strengths increased with the number of coatings (p < 0.0001) with both adhesives, up to 3 layers, especially if each layer was light cured. Nanoleakage of silver tended to decrease with each coat in both adhesive systems. CONCLUSION: By simply applying more coats of adhesive, the strength and quality of dentin adhesion can be improved.

Composite Resins↗

PubMed2004

Assessing coughing and wheezing in lung cancer: a pilot study.

PURPOSE/OBJECTIVES: To establish reliability and validity of two self-report questionnaires, the Lung Cancer Cough Questionnaire and the Lung Cancer Wheezing Questionnaire. DESIGN: Prospective, exploratory pilot study. SETTING: Clinical oncology settings in the southern United States. SAMPLE: 31 adult women with lung cancer. METHODS: Content validity of both questionnaires was assessed through a comprehensive literature review and an expert judge panel. Concurrent validity was established by Spearman rank correlation coefficients and Wil-coxon Rank Sum tests with items from other valid tools. Test-retest reliability was assessed by percent agreement, kappa, paired t tests, and correlations. Internal consistency was determined by Cronbach's alpha. MAIN RESEARCH VARIABLES: Cough, wheeze. FINDINGS: Cronbach's alpha showed excellent internal consistency and percent agreement, and kappa showed similarity of item responses across test-retest administrations. Nonsignificant paired t tests indicated similar mean scores, and significant test-retest correlations supported test-retest reliability. CONCLUSIONS: Preliminary testing indicates good reliability and validity for both questionnaires. Both instruments can identify people with problems of coughing and wheezing and have the potential for monitoring these symptoms over time and determining effectiveness of interventions. IMPLICATIONS FOR NURSING: Assessment of coughing and wheezing is an important component of monitoring respiratory symptoms of lung cancer. Both of these symptoms can be amenable to interventions. Further research is needed to confirm psychometrics and sensitivity of these tools.

Cough↗