Dental caries prevalence in early Polynesians from the Hawaiian Islands

We examined the skeletal remains of 1338 early Hawaiians (preserved in the Bishop Museum, Honolulu) to determine total caries and root surface caries prevalence. Specimens from seven islands were represented in the collection. Estimation of age at death was made by a combination of dental developmental staging for younger individuals and occlusal attrition and/or alveolar bone loss in adults. Museum records were also consulted for age estimation of adults which was primarily based on osteological criteria. The material was divided into six age groups. Predentate infants and edentulous adults were not included. A total of 19,425 teeth was examined. Caries lesions were observed in 462 individuals (34.5%) and 1895 teeth (9.8%). Coronal caries lesions in children and adolescents tended to be small and not particularly destructive of tooth structure. Root surface lesions in young adults were also small but increased progressively in size in the older groups, resulting in pulp exposure and coronal amputation. Although coronal caries was apparently not a significant dental health problem in children and young adults (compared with contemporary Hawaiians), root surface caries was an increasingly important source of tooth morbidity and tooth mortality in the older population groups. This age-related caries pattern was similar for all of the islands.     

Obstacles and Opportunities for Multi-disciplinary Working in Drug Misuse: a case study

This paper examines the lack of congruence between national policy documents and local practice in multi-disciplinary working with drug users, by reporting on a case study within one English county. It gives an analysis of the roles and responsibilities of generic service providers and a minority of specialists, based on 100 interviews and questionnaires with representatives from professional groups involved with drug issues. The respondents worked with a range of young people and adults. Whilst professionals worked well within broad disciplines such as health or education, they did not operate as well across disciplinary boundaries. Many of the respondents were unsure about the specific role of their own profession, and which group they should target for drug interventions. There was a lack of clarity about what approach was appropriate to their traditional target group in terms of drugs, and consequently many did not utilize their established approach for that group. When the reasons for the lack of co-working were examined, it was found that there were many misconceptions among professionals concerning what other professional groups actually did in response to drugs. The authors clarify the reasons for the apparent confusion and highlight the possibility that a traditional generic approach and target group may not provide an appropriate match in terms of drug intervention. They make recommendations for overcoming these obstacles to multi-disciplinary working and consider the implications for training.     

Highly resolved in vivo 1H NMR spectroscopy of the mouse brain at 9.4 T.

An efficient shim system and an optimized localization sequence were used to measure in vivo 1H NMR spectra from cerebral cortex, hippocampus, striatum, and cerebellum of C57BL/6 mice at 9.4 T. The combination of automatic first- and second-order shimming (FASTMAP) with strong custom-designed second-order shim coils (shim strength up to 0.04 mT/cm2) was crucial to achieve high spectral resolution (water line width of 11-14 Hz). Requirements for second-order shim strengths to compensate field inhomogeneities in the mouse brain at 9.4 T were assessed. The achieved spectral quality (resolution, S/N, water suppression, localization performance) allowed reliable quantification of 16 brain metabolites (LCModel analysis) from 5-10-microL brain volumes. Significant regional differences (up to 2-fold, P < 0.05) were found for all quantified metabolites but Asp, Glc, and Gln. In contrast, 1H NMR spectra measured from the striatum of C57BL/6, CBA, and CBA/BL6 mice revealed only small (<13%, P < 0.05) interstrain differences in Gln, Glu, Ins, Lac, NAAG, and PE. It is concluded that 1H NMR spectroscopy at 9.4 T can provide precise biochemical information from distinct regions of the mouse brain noninvasively that can be used for monitoring of disease progression and treatment as well as phenotyping in transgenic mice models.     

颈内动脉接近完全闭塞时的处理

目的由于卒中风险随着狭窄严重程度的增加而升高，因此认为颈内动脉（ICA）接近闭塞患者的卒中风险很高。在现有的随机试验中，还没有专门针对这种情况进行探讨，因此其处理尚存在争汶。方法：对相关文献进行系统评价。结果：对ICA接近闭塞患者的处理还存在争议：一些学者支持进行干预，而另一些学者则认为存在风险或没有益处而反对进行干预。在ICA接近闭塞的有症状患者中进行一项比较外科治疗与最佳内科治疗的多中心前瞻性随机试验似乎非常困难，因为这类研究需要大量的患者。尽管如此，基于目前的证据，似乎很难拒绝手术治疗。结论：由于目前对ICA接近闭塞患者的最佳处理方案仍存在着争议，因此需要前瞻性观察性研究以证实其在有症状和无症状人群中的患病率以及相关的卒中风险。基于目前的证据，大多数医疗中心选择手术治疗，但它相对干内科治疗的特粱尚右待证章．     

The structure of wandering in dementia

‘Wandering’ is one of the most troublesome of behavioural problems in dementia. The term ‘wandering’ covers many different types of behaviour. We examined the hypothesis that the different types of wandering behaviour seen in dementia from a scale using data collected on 83 elderly subjects suffering from either Alzheimer's disease or multiinfarct dementia. We reject the scaling hypothesis. Our data suggest that there are three main categories of wandering behaviour, and that one of these categories is usefully divided into four subcategories.