Management of sleep bruxism in adults: a qualitative systematic literature review

This paper updates the bruxism management review published by Lobbezoo et al. in 2008 (J Oral Rehabil 2008; 35: 509–23). The review focuses on the most recent literature on management of sleep bruxism (SB) in adults, as diagnosed with polysomnography (PSG) with audio–video (AV) recordings, or with any other approach measuring the sleep‐time masticatory muscles' activity, viz., PSG without AV recordings or electromyography (EMG) recorded with portable devices. Fourteen (N = 14) papers were included in the review, of which 12 were randomised controlled trials (RCTs) and 2 were uncontrolled before–after studies. Structured reading of the included articles showed a high variability of topics, designs and findings. On average, the risk of bias for RCTs was low‐to‐unclear, whilst the before–after studies had several methodological limitations. The studies’ results suggest that (i) almost every type of oral appliance (OA) (seven papers) is somehow effective to reduce SB activity, with a potentially higher decrease for devices providing large extent of mandibular advancement; (ii) all tested pharmacological approaches [i.e. botulinum toxin (two papers), clonazepam (one paper) and clonidine (one paper)] may reduce SB with respect to placebo; (iii) the potential benefit of biofeedback (BF) and cognitive–behavioural (CB) approaches to SB management is not fully supported (two papers); and (iv) the only investigation providing an electrical stimulus to the masseter muscle supports its effectiveness to reduce SB. It can be concluded that there is not enough evidence to define a standard of reference approach for SB treatment, except for the use of OA. Future studies on the indications for SB treatment are recommended.     

Making Meals in Small Seasonal Restaurants

Since restaurateurs can benefit by analyzing the production of meals, particularly with the dominant framework for meal experiences, the five aspects meal model (FAMM), this study examined FAMM’s relevance as an analytical tool for understanding meal production via field observations and interviews in eight small restaurants in a rural destination in Sweden. Results showed that FAMM’s aspect of the management control system and the factor of time are critical to the entire meal production process in restaurants. This article closes with a discussion of FAMM’s usefulness as a qualitative checklist for restaurateurs.     

腹腔镜辅助下子宫肌瘤剥除手术患者的临床路径管理研究

目的 探讨腹腔镜辅助下子宫肌瘤剥除手术患者的临床路径管理.方法 选取2011年3月-2013年3月我院收治行腹腔镜辅助下子宫肌瘤剥除手术患者80例,随机分为实验组和对照组各40例,其中实验组实施临床路径管理,而对照组采用传统的医疗护理干预.结果 实验组患者给予临床路径管理后,其住院时间住院费用均获得了减少,且患者的满意度得到了提高,差异均存在统计学意义（P＜0.05）.结论 临床路径管理在行腹腔镜辅助下子宫肌瘤剥除手术患者围手期的护理模式具有良好的疗效,同时提高了患者的满意度,也有利于新护士的培训.     

VMware医用虚拟桌面优化及性能监控策略

随着桌面虚拟化应用的日趋广泛，对桌面的性能和安全性的考虑也变得非常重要。本文根据虚拟桌面实际使用环境，提出并实施了虚拟桌面模板优化以及监测桌面的性能和安全防护策略，有效提高了桌面的连接效率和运行的稳定性。