YouTube™ as an information resource for orthognathic surgery

Objective: To investigate video content on YouTube? related to orthognathic surgery.

Materials and methods: YouTube? was searched using the terms: orthognathic surgery; orthodontic surgery; jaw surgery; jaw corrective surgery. Inclusion criteria included English language; primary content orthognathic surgery and acceptable audio-visual quality. Videos were sorted into the top 50 for each search term by view-count and into an overall top 60 from the four searches. The following parameters were recorded for each video: number of views; likes; dislikes; source; primary intention. Each was classified according to information content as ‘excellent’, ‘moderate’ or ‘poor’. A pre-determined list of orthognathic surgery-related information domains was also evaluated.

Results: The top 60 videos had a combined total of 6,986,141 views. Videos predominantly involved patients describing their personal experience (41.67%) with the majority positively biased (61.67%). Only 9.17% of videos were classified as having excellent general information content and 55.83% were rated as poor. Surgical procedures were described in 45% whilst the need for pre- and post-surgical orthodontics was discussed in 33% and 16%, respectively. Post-operative paraesthesia was discussed in 17.5% of videos outcome.

Conclusions: Video content on YouTube? relating to orthognathic surgery is substandard and patients should be advised to view it with caution.     

An in vivo investigation into the use of resin-modified glass poly(alkenote) cements as orthodontic bonding agents.

The aim of this study was to investigate the in vivo bonding of orthodontic brackets using two resin-modified glass poly(alkenoate) cements and to compare them with a conventional light-cured diacrylate bonding agent. Twenty consecutive patients attending for bond up appointments took part in this randomized cross-mouth control study. Alternate quadrants were bonded with either Fuji Ortho LC or 3 M Multi-Cure. Transbond [Adhesive Pre-Coated Brackets (APC)] acted as the control in the other quadrants. Failed brackets were rebonded with the same material. Bond failure rates were collected over a 1-year period. The bond failure rates over 1 year were 7.2 per cent for Transbond (APC), 5.9 per cent for 3 M Multi-Cure, and 5.8 per cent for Fuji Ortho LC. Statistically, there was no significant difference between the bond failure rates of the materials and there was no effect of time. This clinical investigation confirmed the suitability of the resin-modified glass poly(alkenoate) cements under test as orthodontic bonding agents.     

Effectiveness of a computer based medication calculation education and testing programme for nurses

The aim of the study was to evaluate the effect of an on-line, medication calculation education and testing programme. The outcome measures were medication calculation proficiency and self efficacy. This quasi-experimental study involved the administration of questionnaires before and after nurses completed annual medication calculation testing. The study was conducted in two hospitals in south-east Queensland, Australia, which provide a variety of clinical services including obstetrics, paediatrics, ambulatory, mental health, acute and critical care and community services. Participants were registered nurses (RNs) and enrolled nurses with a medication endorsement (EN(Med)) working as clinicians (n=107). Data pertaining to success rate, number of test attempts, self-efficacy, medication calculation error rates and nurses' satisfaction with the programme were collected. Medication calculation scores at first test attempt showed improvement following one year of access to the programme. Two of the self-efficacy subscales improved over time and nurses reported satisfaction with the online programme. Results of this study may facilitate the continuation and expansion of medication calculation and administration education to improve nursing knowledge, inform practise and directly improve patient safety.     

Careers in paediatrics: Community paediatrics revisited

The concept of ‘community paediatrics’, as enunciated by Robert Haggerty in 1968, has informed and shaped many paediatric careers. The principle tenets of inclusiveness: attention to unmet needs; addressing common health problems of children and youth; using and applying preventive and harm-reduction strategies; and securing community input and control, were part of the Haggerty model. The present article revisits Haggerty’s model and describes how the concepts have shaped contemporary paediatrics in North America.     

Fatal accident during an epileptic automatism.

The case of an adult male involved in a motor accident, in which the driver of the other car was killed, is described. A plea of epileptic automatism was used successfully to defend the charges.     

A laboratory investigation of the role of guide planes in the retention of cast cobalt-chromium alloy partial denture frameworks

OBJECTIVES: This in vitro study examined the resistance to displacement offered by guide planes and the displacement mechanics of a bilateral bounded saddle cast cobalt chrome alloy removable partial denture framework under conditions simulating an average initial fit. METHODS: A specially designed model mouth jig fitted with strain gauges to monitor the forces across the guiding plane/guiding surface interfaces was used. Guiding planes of enamel, silver tin amalgam and dental composite with seven combinations of guide planes and three angles of withdrawal were examined. Guiding plane size was also examined for dental enamel. RESULTS: A statistically significant difference in retention was found for all factors examined. Retention increased with increasing angle of withdrawal. Size effects were found but considered unreliable. CONCLUSIONS: It was concluded that with a tight fit guiding plane retention may be readily predicted for any given material, combination of mesial, distal and lingual guiding planes and angulation conditions by the application of mechanical principles providing the basic parameters are known. Attention is drawn to the reasons for further work to fully understand the clinical situation.