bluuebunny/crossref_metadata_2025_split huggingface dataset:
Special Care Dentistry Association consensus statement on sedation, anesthesia, and alternative techniques for people with special needs
Authors: Glassman Paul , Caputo Anthony , Dougherty Nancy , Lyons Ray , Messieha Zakaria , Miller Christine , Peltier Bruce , Romer Maureen 
Published: January 2009

ABSTRACTMany people with special needs (PSN) have difficulty having good oral health or accessing oral health services because of a disability or medical condition. The number of people with these conditions living in community settings and needing oral health services is increasing dramatically due to advances in medical care, deinstitutionalization, and changing societal values. Many of these individuals require additional supports beyond local anesthesia in order to receive dental treatment services. The purpose of this consensus statement is to focus on the decision‐making process for choosing a method of treatment or a combination of methods for facilitating dental treatment for these individuals. These guidelines are intended to assist oral health professionals and other interested parties in planning and carrying out oral health treatment for PSN. Considerations for planning treatment and considerations for each of several alternative modalities are listed. Also discussed are considerations for the use of combinations of modalities and considerations for the repeated or frequent use of these modalities. Finally, the need to advocate for adequate education and reimbursement for the full range of support alternatives is addressed. The Special Care Dentistry Association (SCDA) is dedicated to improving oral health and well being of PSN. The SCDA hopes that these guidelines can help oral health professionals and other interested individuals and groups to work together to ensure that PSN can achieve a “lifetime of oral health.”
A review of guidelines for sedation, anesthesia,and alternative interventions for people with special needs
Authors: Glassman Paul 
Published: January 2009

ABSTRACTThere are significant numbers of people in our society with disabilities or other special needs. Their number and percentage are growing, in some cases, dramatically. Many of these individuals need special support in order to receive dental treatment. Modalities that can be used to provide dental treatment include pharmacological approaches to produce various levels of sedation or anesthesia. In addition to the use of medications, there are also techniques that employ behavioral or psychological interventions. In some circumstances, physical support or protective stabilization is used. There are also social supports and prevention strategies that can impact the individual's preparation for and need for dental treatment.This review of the numerous guidelines, which have been published for the use of sedation and anesthesia to facilitate the delivery of dental treatment, indicates that there are fewer guidelines for the inclusion of behavioral or psychological interventions or for the incorporation of social supports or prevention strategies. In addition, most published guidelines do not include considerations for people with special needs. There is a need for increased research and documentation of combined treatment modalities, and these combined approaches need to be incorporated into guidelines for patient care for people with special needs.There is also a need to advocate for reimbursement systems that support all appropriate treatment options so that practitioners can be free to recommend treatment options based on the efficacy and safety of each option.
Providing deep sedation and general anesthesia for patients with special needs in the dental office‐based setting
Authors: Caputo Anthony Charles 
Published: January 2009

ABSTRACTThis article discusses the issues of morbidity and mortality associated with deep sedation and general anesthesia specifically in the dental office‐based setting for patients with special needs (PSN). A focused review of a particular environment and patient population was challenging as it was difficult to identify articles that discuss the unique scope of this subject. During the review of the literature, no article was identified that discussed this exact topic. There were articles that discussed the delivery of general anesthesia for PSN in an outpatient setting and associated issues of morbidity and mortality. There were also articles and sources of information that discussed the delivery of general anesthesia for other patient populations in the office‐based setting. In an effort to support the scope of this article, some of these articles are discussed as they pertain to the subject of this article. In addition, an analysis of the author's practice over a 4‐year period is discussed in an effort to present relevant data per the scope of this article. After reviewing the literature and the author's clinical practice, it appears that the incidence of mortality for PSN in the dental office‐based setting is minimal and the incidence of morbidity for this same population is limited to relatively minor events. Ultimately, it was concluded that the delivery of general anesthesia for PSN in the dental office‐based setting can be considered a very safe and successful procedure.
Social supports and prevention strategies as adjuncts and alternatives to sedation and anesthesia for people with special needs
Authors: Glassman Paul , Miller Christine 
Published: January 2009

ABSTRACTPeople with special needs are assuming a more prominent place in our society. The number of people living in communities with medical, physical, and psychological conditions is increasing dramatically. In spite of the advances that people with special needs have made in recognition of their right to live in society and access services open to other people, their oral health is still significantly poorer than that of other groups.There are a number of modalities that can complement or replace pharmacological interventions and allow individuals to have dental treatment in a dental office or clinic. These include behavioral or psychological interventions and social support and prevention strategies. Social supports include care management and integration of oral health services with general health and social service systems.Preventive programs using modern “medical model” oral health prevention strategies also have the potential to reduce the burden of disease among people with special needs and therefore reduce the need for dental procedures. A social support system using community‐based Dental Hygienists acting as Dental Coordinators, is described along with outcomes demonstrating improved oral health for people with special needs living in community residential care facilities. Combined social support systems and community prevention strategies have the potential to reduce the need for pharmacological interventions in order to maintain oral health in populations of people with special needs. Social supports and modern preventive strategies must be included in the range of options available in communities in order to improve and maintain oral health for people with special needs.
Understanding basic behavioral support techniques as an alternative to sedation and anesthesia
Authors: Lyons Ray A. 
Published: January 2009

ABSTRACTPatients with special needs often present a challenge for the dental care team. The exacting and surgical nature of dental procedures requires significant patient cooperation to ensure the safe delivery of care. Some individuals who have special care needs have difficulty cooperating during treatment, thus creating a potentially harmful situation. Modern dentistry, particularly pediatric dentistry, provides the dental team with a variety of strategies designed to enable the team to safely provide comprehensive care in the least restrictive manner. These techniques range from tell‐show‐do, to medical stabilization, to general anesthesia. The effective use of noninvasive, nonpharmacologic behavioral guidance/support techniques cannot only avoid the need for sedation or general anesthesia, they can teach the patient to develop coping skills that may enable them to receive comprehensive care in a traditional dental setting over a lifetime. Unfortunately, many providers are inadequately trained in behavioral support strategies. This paper presents a review of noninvasive, nonpharmacologic behavioral support techniques with discussion regarding their application to persons with special care needs.
Psychological treatment of fearful and phobic special needs patients
Authors: Peltier Bruce 
Published: January 2009

ABSTRACTDental fears and phobias trouble patients with and without special needs, and they are a problem for dentists, as well. This article reviews current research and literature related to methods used to alleviate dental fear and concludes that while some important psychological methods are available, much work is left to be done in this area. It is clear that there is an important role for psychological and behavioral input to the dentist–patient interaction. While dental phobia represents a class of special needs itself, patients with other important disabilities (e.g., physical or cognitive impairments) are sometimes comorbidly phobic, a condition often missed or misdiagnosed by treating practitioners. Office‐based techniques that focus on relaxation, breathing, imagery, hypnosis, and effective use of operatory language are described. The methods advocated here can be used with patients having mild or moderate cognitive impairments.Readings are recommended for the dentist or auxiliary practitioner interested in learning these techniques.
Consent,restraint,and people with special needs:a review
Authors: Romer Maureen 
Published: January 2009

ABSTRACTDentists providing treatment to individuals with developmental disabilities are often faced with unique medical/legal issues. Obtaining informed consent when a patient does not have capacity can be an involved process. Issues regarding therapeutic aides used for immobilization (i.e., restraint) during treatment may further complicate the situation. This area is controversial and has even resulted in legal difficulties for some dentists. Several topics related to the use of restraint are addressed in this article. A review of the literature and applicable laws pertaining to consent issues for people with special needs is presented and appropriate use of medical immobilization is discussed.Existing guidelines are reviewed. Informed consent and the use of restraint should be incorporated into overall guidelines for the use of anesthesia, sedation, and alternative behavior management techniques in providing dental care to patients with special needs.
Effect of Pimobendan on Echocardiographic Values in Dogs with Asymptomatic Mitral Valve Disease
Authors: Ouellet M. , Bélanger M.C. , DiFruscia R. , Beauchamp G. 
Published: January 2009

Background:Pimobendan (PIMO) is a novel inodilator that has shown promising results in the treatment of advanced mitral valve disease (MVD), but little is known about its hemodynamic effects, especially regarding the mitral regurgitant volume in naturally occurring MVD.Hypothesis:The addition of pimobendan to treatment decreases the regurgitant fraction (RF) in dogs with asymptomatic MVD.Animals:Twenty‐four client‐owned dogs affected by International Small Animal Cardiac Health Council class Ib MVD.Methods:Prospective, blinded, and controlled clinical trial. Dogs were assigned to a PIMO treatment group (n = 19) (0.2–0.3 mg/kg q12h) or a control group (n = 5). Echocardiographic evaluations were performed over a 6‐month period.Results:The addition of PIMO to treatment did not decrease the RF of dogs affected by asymptomatic class 1b MVD over the study period (P= .85). There was a significant increase in the ejection fraction of the PIMO treated dogs at 30 days (80.8 ± 1.42 versus 69.0 ± 2.76, correctedP= .0064), and a decrease in systolic left ventricular diameter (correctedP= .011) within the PIMO group compared with baseline. However, this improvement in systolic function was not sustained over the 6‐month trial period.Conclusion and Clinical Importance:This study did not identify beneficial long‐term changes in the severity of mitral regurgitation after addition of PIMO to angiotensin converting enzyme inhibitor treatment of dogs with asymptomatic MVD.
Histological scoring of fibrosis and activity in HIV–chronic hepatitis B related liver disease: performance of the METAVIR score assessed on virtual slides
Authors: Wendum D , Lacombe K , Chevallier M , Callard P , Valet F , Miailhes P , Bonnard P , Molina J-M , Lascoux-Combe C , Fléjou J-F , Girard P-M 
Published: January 2009

Background:The METAVIR score, which is the most widely used score in France, was specifically elaborated and evaluated in chronic hepatitis C and has never been validated in HIV–hepatitis virus B (HBV) co-infected patients.Aims:To validate the use of the METAVIR scoring system for activity and fibrosis on liver biopsies in co-infected HIV–HBV patients.Methods:METAVIR scoring for activity and fibrosis was first conducted on both original and virtual slides by one pathologist for comparison. Then 55 biopsies turned into virtual slides were scored by three pathologists independently.Results:The scoring comparison between virtual slides and glass slides showed an almost perfect agreement for fibrosis (weighted κ (κw) 0.8) and a substantial agreement for activity (κw0.68). The inter-observer agreement on virtual slides was moderate to almost perfect (κw0.52 to 0.84) for fibrosis and was dependent on the pair of pathologists considered. The best agreement was obtained in scoring advanced fibrosis and cirrhosis versus significant fibrosis versus no or mild fibrosis (κw0.70 to 0.84). The agreement for cirrhosis was rated moderate to substantial (κw0.54 to 0.79). Agreement for activity was substantial (κw0.66 to 0.8).Conclusions:This study validates the use of virtual slide technology to assess fibrosis and activity on liver biopsies. It also validates the use of the METAVIR score in co-infected HIV–HBV patients and illustrates the challenges in establishing the histological diagnosis of cirrhosis in the HIV–HBV context.
A molecular marker closely linked to the region of Rht-D1c and Ms2 genes in common wheat (Triticum aestivum)
Authors: Cao Wenguang , Somers Daryl J. , Fedak George 
Published: January 2009

A male sterile wheat mutant, Triticum aestivum L. ‘Taigu’, was found in a wheat field in China in 1972. The male sterility was controlled by a single dominant gene that was referred to as Ms2. Recently, this gene was found to be linked to a dwarfing gene through crossing Taigu with the short wheat T. aestivum ‘Ai-Bian 1’ carrying the dwarfing gene Rht-D1c. The objective of this study was to develop molecular markers linked to the male sterility Ms2 gene in common wheat. One hundred and twenty-two near-isogenic lines were developed through backcrossing and sib intercrossing and used as the mapping population for the development of molecular markers. Bulked segregant analysis was used to screen 48 pairs of SSR primers, and a marker, MS2-WMC617, was identified closely linked to the male sterile Ms2 gene that mapped at the distal position of chromosome arm 4DS. The use of the molecular marker MS2-WMC617 can facilitate recurrent selection in a wheat breeding program based on marker-assisted selection.
HIERARCHICAL REACTIVE CONTROL FOR HUMANOID SOCCER ROBOTS
Authors: BEHNKE SVEN , STÜCKLER JÖRG 
Published: January 2009

Humanoid soccer serves as a benchmark problem for artificial intelligence research and robotics. Every year, more teams are competing, for example, in the RoboCup Humanoid League. As the robots improve in the basic skills of walking, kicking, and getting up, teams can focus on soccer skills and team coordination. The complexity of soccer behaviors and team play calls for structured behavior engineering. In this paper, we describe the design of the behavior control software for the Humanoid League team NimbRo. The software is based on a framework that supports a hierarchy of reactive behaviors. It is structured both as an agent hierarchy (joint–body part–player–team) and as a time hierarchy. The speed of sensors, behaviors, and actuators decreases when moving up in the hierarchy. The lowest levels of this framework contain position control of individual joints and kinematic interfaces for body parts. At the next level, basic skills are implemented. Soccer behaviors like searching for the ball, approaching the ball, avoiding obstacles, and defending the goal reside on the player level. Finally, on the tactical level, the robots communicate via a wireless network to negotiate roles and use allocentric information to configure the soccer behaviors. Our robots performed very well at RoboCup 2007, which took place in Atlanta, Georgia, USA. They won both the KidSize and the TeenSize humanoid soccer competitions.
Extent and Determinants of Burden of Care in Indian Families: a Comparison Between Obsessive-Compulsive Disorder and Schizophrenia
Authors: Kalra Harish , Nischal Anil , Jitendra Kumar Trivedi  , Pronob Kumar Dalal  , Pramod Kumar Sinha  
Published: January 2009

Background: Limited data is available for family burden in anxiety disorders such as obsessive-compulsive disorder (OCD), particularly from the developing world where families are the primary source of support for patients. Aim: To compare family burden in patients with OCD and schizophrenia in an Indian setting and to examine the influence of caregivers' demographics, patients' illness severity and disability on family burden. Method: This comparative cross-sectional study assessed family burden in key relatives of patients with OCD ( n = 50) and schizophrenia ( n = 30) respectively. Results: Indian families experience significant degrees of burden in the care of their relatives with OCD and schizophrenia. Key relatives' demographic characteristics did not influence burden severity. Illness severity and patients' disability had a direct positive relationship with perceived family burden. Conclusion: Indian families of patients with OCD experience burden comparable to that of families of patients with schizophrenia. There is a need to develop local needs-based support programmes for families of patients with psychiatric disorders in India.
Long-Term Outcome of Leucotomy On Behaviour of People With Schizophrenia
Authors: Helmes Edward , Velamoor Varadaraj R. 
Published: January 2009

Background: Prefrontal leucotomy was widely used from the late 1930s to early 1950s as a treatment for disorders involving obsessive agitation. Comparatively few studies of the enduring behavioural effects of such surgery exist, while data on mortality and cognition have been better reported. Aims: We contrast the psychosocial functioning of older individuals with schizophrenia who had undergone prefrontal leucotomy with two groups of their peers who had not undergone such surgery. Method: A total of 87 individuals (one female) with a mean age of 70.3 years ( SD = 6.84) were evaluated twice 25 months apart using a standardized rating scale. Twenty of the residents, all with schizophrenia, had undergone prefrontal leucotomy approximately 45 years previously. All diagnoses of schizophrenia were confirmed by multiple psychiatrists using DSM-III criteria at the time of the ratings, which were completed by two care staff who knew the residents well. Results: Repeated measures comparisons with schizophrenia and non-schizophrenia patient groups showed no significant differences between the leucotomy and unoperated comparison groups on four of the five Multidimensional Observation Scale for Elderly Subjects (MOSES) scales. Conclusions: These results are consistent with reports of compromised function among individuals who had undergone leucotomy and contrast with some reports of positive changes in behaviour.
Exploring the Possibilities of an Expanded Practice Repertoire in Child Protection
Authors: D'Cruz Heather , Gillingham Philip , Melendez Sebastian 
Published: January 2009

• Summary: This article discusses research that explored an alternative to proceduralized child protection practice informed by the risk paradigm, by expanding the repertoire available to practitioners through combining features of the risk paradigm with social constructionism. This approach incorporates three dimensions: theories of knowledge and power, related professional roles, and practice skills. In this article, we discuss and critically evaluate only the first dimension: theories of knowledge and power. Through dialogue facilitated by semi-structured questions, we explored practitioners' perspectives about the relevance and appropriateness of the alternative approach for practice. • Findings: The practitioners' participation and feedback offer insights into complex connections between `theory' and `practice' with the practitioner as a positioned subject and mediator of practical meanings of formal concepts. • Applications: 1) Recognition of each practitioner's interpretation of formal concepts and how they are applied in actual practice, even within shared organizational contexts. 2) The importance of dialogue to expand the range of possibilities that maintain openness to ongoing learning. 3) The value of theoretical pluralism that may offer greater opportunities for professional discretion, rather than single self-contained approaches that may constrain effective and ethical practice.
The Principles and Provisions of Relationships
Authors: Huxley Peter , Evans Sherrill , Beresford Peter , Davidson Bill , King Sarah 
Published: January 2009

• Summary: Health and social care services in the UK have been in the process of modernization since the New Labour government came to power in 1997. A central feature of modernization has been the scrutiny of existing work roles and the development and introduction of new work roles. The present article is concerned with the nature and content of work in one of these new roles, the Support, Time and Recovery worker which was introduced on the advice of service users, among others. • Findings: Qualitative data revealed that both workers and service users valued the relationship they developed. The nature of that relationship and its important component qualities are analysed using Biestek's Principles of the Casework relationship and Weiss's categories of social relationship provision. • Applications : The results provide further support to a growing literature that emphasizes the value service users place on the nature and quality of the relationship with the worker in social care practice, and the importance of positive human qualities in workers.