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To evaluate the response process validity of the Resident Assessment Instrument-Minimum Data Set 2.0 (RAI) oral/dental items and the organisational processes for assessing nursing home (NH) residents' oral/dental status.Although care aides provide most direct care to NH residents, including oral care, they are not directly involved in structured care planning activities, including RAI assessments. This most likely affects the accuracy of RAI assessments, as well quality of care. However, we neither know how well regulated and unregulated care staff understand the RAI oral/dental items, nor what processes are used in completing oral/dental assessments.We conducted nine focus groups with 44 care aides, nurses, allied health providers, clinical specialists and managers. We discussed randomly selected RAI oral/dental assessments with focus group participants, including participants' understanding of the items and why the options were selected. Participants also explained the communication and process for completing the RAI.Participants' perceptions of the oral/dental items aligned fairly well with the item definitions. However, responses primarily focused on severe oral/dental problems with obvious physical characteristics (eg black teeth denoting caries). For non-visual oral problems, such as pain, staff relied on resident verbalisation. No formal mechanisms were described for care aides to update nurses on residents' oral health needs.Performance problems of RAI oral/dental items are largely rooted in poor communication between care aides and nurses and not integrating care aides in assessment processes. We need policies that address these problems in order to improve NH residents' poor oral health.

AIMS AND OBJECTIVES To describe the proportion of toothbrushing task steps, long-term care residents had an opportunity to complete; the duration and quality of toothbrushing by both residents and caregivers; and the feedback caregivers provided. BACKGROUND Poor oral health is widespread among older adults in long-term care homes; however, little is known about their actual oral health practices. DESIGN Secondary analysis of video recordings. METHODS A total of 58 video-recorded sessions were analysed from two long-term care homes in Canada. Eligible residents had at least one natural tooth, required oral care assistance, had Alzheimer's disease and understood English. Eligible caregivers spoke English and had worked for at least 1 year with people with dementia. Toothbrushing success was identified by the resident's participation in, and completion of, nine toothbrushing steps. Total time spent brushing teeth was calculated by summing the duration of time spent brushing teeth. Quality was described by time spent brushing the facial versus the lingual or occlusal surfaces. Caregiver verbal feedback was pulled from transcripts and analysed using content analysis. STROBE guidelines were used in reporting this study. RESULTS The two step residents most frequently completed or attempted were brushing their teeth (77% complete, 7% attempt) and rinsing their mouth (86% complete, 2% attempt). The average time spent brushing teeth was 60.33 s (SD = 35.15). In 66% of observed videos, toothbrushing occurred only on the facial tooth surfaces, with no time spent brushing the lingual or occlusal surfaces. CONCLUSION Caregivers are supporting residents to independently complete toothbrushing; however, the duration and quality of toothbrushing are not sufficient to ensure optimal oral health. RELEVANCE TO CLINICAL PRACTICE Clear, detailed guidelines are required to ensure adequate oral care for long-term care residents. Staff need to be aware that all surfaces should be brushed to ensure proper oral health.

OBJECTIVE To evaluate the response process validity of the Resident Assessment Instrument-Minimum Data Set 2.0 (RAI) oral/dental items and the organisational processes for assessing nursing home (NH) residents' oral/dental status. BACKGROUND Although care aides provide most direct care to NH residents, including oral care, they are not directly involved in structured care planning activities, including RAI assessments. This most likely affects the accuracy of RAI assessments, as well quality of care. However, we neither know how well regulated and unregulated care staff understand the RAI oral/dental items, nor what processes are used in completing oral/dental assessments. METHODS We conducted nine focus groups with 44 care aides, nurses, allied health providers, clinical specialists and managers. We discussed randomly selected RAI oral/dental assessments with focus group participants, including participants' understanding of the items and why the options were selected. Participants also explained the communication and process for completing the RAI. RESULTS Participants' perceptions of the oral/dental items aligned fairly well with the item definitions. However, responses primarily focused on severe oral/dental problems with obvious physical characteristics (eg black teeth denoting caries). For non-visual oral problems, such as pain, staff relied on resident verbalisation. No formal mechanisms were described for care aides to update nurses on residents' oral health needs. CONCLUSIONS Performance problems of RAI oral/dental items are largely rooted in poor communication between care aides and nurses and not integrating care aides in assessment processes. We need policies that address these problems in order to improve NH residents' poor oral health.

doi: 10.1111/j.1741-2358.2011.00513.xHealth care professionals’ perspectives on oral care for long-term care residents: Nursing staff,speech–language pathologists and dental hygienistsBackground: Oral health has been identified as a key factor in general health and systemic disease inlong-term care populations. To optimise oral health of this population, it is important to understand theoral care perspectives held by health care professionals involved in oral care provision.Objectives: To explore perspectives regarding oral care held by nursing staff, speech–language patholo-gists (SLPs) and dental hygienists (DHs) in long-term care institutions and to understand how their per-spectives impact activities and processes involved in the delivery of oral care.Methods: A focus group methodology was utilised. Separate focus groups for each targeted professionwere held. Transcribed data were analysed using constant comparative analysis.Results: Daily oral health maintenance and monitoring was considered a role of nursing staff. SLPs andDHs have roles focusing on advocacy, education and supplemental care. Social factors motivate nursingstaff to provide oral care, whereas factors related to the general health consequences of poor oral healthunderlined the motivations of SLPs and DHs.Conclusions: Education and training initiatives incorporating social aspects of oral health may be moreeffective for motivating nursing staff than approaches emphasising physical risk factors. Organisations canfoster environments that support collaboration and communication amongst the members of multidisci-plinary teams in order to promote oral health as a priority.Keywords: oral health, long-term care, qualitative research.Accepted 24 February 2011

Backgrounds: Recent studies have shown that thermal therapy by means of warm waterbaths and sauna has beneficial effects in chronic heart failure. However, a comprehensive investigation of the hemodynamic effects of thermal vasodilation on coronary arteries has not been previously undertaken. In this study, we studied the effect of a warm footbath (WFB) on coronary arteries in patients with coronary artery disease (CAD), as well as any adverse effect. Methods: We studied 21 patients (33.3% men, mean age 60.8 ± 13.5 years) with CAD. Coronary flow Doppler examination of the left anterior descending coronary artery and coronary flow reserve (CFR) were performed and measured using adenosine before and after a WFB. Results: Systolic and diastolic blood pressure and heart rate did not change with the WFB. Mean velocity of diastolic coronary flow significantly increased (diastolic mean flow velocity: 18.3 ± 7.1 cm/sec initial, 21.5 ± 8.0 cm/sec follow-up, P = 0.002) and CFR significantly improved (1.6 ± 0.4 vs. 2.2 ± 0.5, P < 0.001) after WFB. The WFB was well accepted and no relevant adverse effects were observed. The change of CFR after WFB correlated well with diastolic function (E’, r = 0.51, P = 0.031; E/E’, r =–0.675, P = 0.002). Conclusions: A WFB significantly improved CFR without any adverse effects in patients with mild-to-moderate CAD and can be applied with little risk of a coronary artery event if appropriately performed. (Echocardiography 2011;28:1119-1124)

When sintered Al2O3 is annealed with CaMgSiAlO glass at 1600°C, polyhedral MgAl2O4 grains form and glass pockets are entrapped within the grains. After annealing for 13 h at 1600°C, the liquid pockets show a regular octahedron shape which is expected to represent the equilibrium shape. All grain surfaces in contact with the glass matrix show the same shape. The small grains, which must be shrinking, thus have the equilibrium shape, because their shrinkage shape is is identical to the equilibrium and growth shape. However, the octahedral shape also represents the growth shape for the growing large grains. The grains also form grain boundaries with neighboring grains.

When partially stabilized zirconia with 6 mol% MgO and 4 mol% CaO is aged at 1450°C, intragranular precipitation occurs and concurrently the boundaries between the grains migrate, forming a Ca-enriched precipitate-free cubic phase and large tetragonal precipitates behind them. At these compositions and temperature the boundary migration is rapid and shows the characteristics of a discontinuous coarsening. A uniaxial compressive stress applied to this specimen during the aging treatment increases or decreases the migration rate of the boundaries parallel or perpendicular to the stress axis, respectively, in agreement with the prediction that a compressive coherency strain due to the diffusion of Ca atoms is produced at the surface of the retreating grains and drives the migration. The diffusional coherency strain energy is thus expected to be the dominant driving force for the discontinuous coarsening in this solid.

When partially sintered cubic Zr-O{sub 2}-10 mol% Y{sub 2}O{sub 3} specimens are heat-treated at 1500{degrees}C with 5MgO {center dot} 95(ZrO{sub 2}-10 mol% Y{sub 2}O{sub 3}) powder mixture in the pores, the intergranular boundaries, which may be either grain boundaries or thin glass films, migrate, leaving behind them a new solid solution slightly enriched with MgO but depleted of Y{sub 2}O{sub 3}. The boundary curvatures generally increase during the migration and the average migration distance initially increases linearly with the heat treatment time. The observed boundary migration behavior is similar to that observed previously in a number of metallic systems, and its driving force is believed to arise from the coherency strain in the thin solute diffusion zone ahead of the moving boundaries.

The process of densification and shrinkage during the final stage of liquid-phase sintering is described. The densification occurs by the liquid filling of pores during grain growth. The pore filling results in an instantaneous drop of liquid pressure in the compact and causes gradual accommodation of grain shape. The grain shape accommodation by the growth causes the specimen shrinkage. At the same time, the grains tend to restore their spherical shape, resulting in microstructure homogenization around filled pores. The process of densification and shrinkage appears to be determined by the growth of grains during sintering.

By using α-Si3N4 and β-Si3N4 starting powders with similar particle size and distribution, the effect of α-β (β') phase transition on densification and microstructure is investigated during the liquid-phase sintering of 82Si3N4·9Al2O3·9Y2O3 (wt%) and 80Si3N4·13Al2O3·5AIN·5AIN·2Y2O3. When α-Si3N4 powder is used, the grains become elongated, apparently hindering the densification process. Hence, the phase transition does not enhance the densification.

In order to simplify the array manufacturing process of FFS TFT-LCD, novel four-mask process which is adopted to the optimum multiple-slit design in the common electrode and contact hole has been developed. The adoption of the optimum multiple-slit design is able to support stable process margin without ripple of gray-tone. Moreover, continuous process by etching of the gate and transparent common electrode simplify array process of FFS devices.

The effects of combined pressure and temperature on the mechanical behavior of polypropylene have been studied. Tests were conducted in tension and compression superimposed on various hydrostatic pressures up to 7 kbar at temperatures of 20, 50, and 75°C. The experimental data have been analyzed in view of molecular and continuum approaches. It has been observed that the Young's modulus and the yield strength in both tension and compression increased significantly with increasing pressure at all temperatures studied. However, the rate of increase of the Young's modulus undergoes abrupt change about the glass-transition pressure (Pg). The Pg is linearly dependent on the test temperature and the pressure coefficient of the Tg is estimated, from Pg versus temperature relations, to be about 18°C/kbar for the polypropylene samples of this study. Pressure dependence of the yield stress is described by a generalized Eyring theory incorporating pressure effects and two flow mechanisms, the α- and the β-relaxation processes. The theory predicts a bilinear dependence of the yield stress of polypropylene on hydrostatic pressure as observed in the tests. The paper also described a method of healing stress whitening in polypropylene by a combination of shear stress and hydrostatic pressure.

The solid-state extrusion of polypropylene by hydrostatic pressure has been investigated at four different temperatures: 25, 50, 75, and 100°C. The pressure to effect extrusion was found to be essentially a linear function of the extrusion ratio at each temperature, while the magnitude of the extrusion pressure, for any given extrusion ratio, decreased appreciably with increasing temperature. With increase in extrusion-ratio, the polypropylene extrudates became increasingly transparent. After passing through the extrusion dies; the Sample showed some elastic recovery. The amount of this recovery decreased with increasing extrusion ratio, X-Ray diffraction measurements taken before and after extrusion showed reduction in sharpness of the crystalline Peaks. Differential, scanning calorimetric measurements, on the other hand, indicate that the relative heat of fusion of the extrudates increases with the extrusion ratio at each extrusion temperature. It also increases with extrusion temperature for a given ratio. Tensile stress-strain tests were made at various hydrostatic pressure levels on the extrudates obtained at 25°C and the extrusion ratio of 2.8. Unlike on the virgin sample of polypropylene, ho yield maximum was observed on the extrudate sample at all pressures investigated. However, the effects of pressure on the relative increase in the yield stress-and the modulus of the extrudate are comparable to those of original, unoriented samples.

The shrinkage behavior of isolated pores during the liquidphase sintering of MgO-CaMgSiO4 at 1650°C in O2 and N2 atmospheres has been studied. When 90MgO- 10Ca MgSiO4 specimens containing artificially produced large spherical pores are sintered in O2, the liquid and grains flow into the pores as oxygen diffuses out. When sintered in N2 the pores remain intact even after a long time, because the N2 gas entrapped in them does not diffuse out. The effect of the sintering atmosphere has also been studied in a fine powder mixture of 80MgO 20CaMgSiO4 composition. Changing the atmosphere from O2 to N2 during the sintering treatment reduces the porosity, probably because of the enhanced oxygen diffusion from the pores. The pores grow when the sintering atmosphere is changed from N2 to O2, probably because of oxygen diffusion into the pores from the specimen surface. The practical implication of these results is that changing the atmosphere from O2 to air during the liquid-phase sintering of oxide ceramics can greatly reduce the porosity.

During the liquid-phase sintering of MgO-CaMgSiO4 systems in N2 atmosphere, the total porosity and the average pore size increase while the number of pores decreases. The negligible permeability of entrapped nitrogen through the liquid matrix and the observed linear relationship between the number of pores and that of the MgO grains suggest that the pores coalesce as a consequence of grain growth during sintering. An analysis of the balance between the pressure of the entrapped N2 gas and the capillary pressure shows that pore coalescence in turn causes the observed porosity increase. When Fe2O3 or Cr2O3 is added to MgO-CaMgSiO4, the pore size and the total porosity become larger or smaller, because the grain growth is accelerated or retarded, respectively.

The shrinkage behavior of isolated pores during the liquidphase sintering of MgO-CaMgSiO4 at 1650°C in O2 and N2 atmospheres has been studied. When 90MgO- 10Ca MgSiO4 specimens containing artificially produced large spherical pores are sintered in O2, the liquid and grains flow into the pores as oxygen diffuses out. When sintered in N2 the pores remain intact even after a long time, because the N2 gas entrapped in them does not diffuse out. The effect of the sintering atmosphere has also been studied in a fine powder mixture of 80MgO 20CaMgSiO4 composition. Changing the atmosphere from O2 to N2 during the sintering treatment reduces the porosity, probably because of the enhanced oxygen diffusion from the pores. The pores grow when the sintering atmosphere is changed from N2 to O2, probably because of oxygen diffusion into the pores from the specimen surface. The practical implication of these results is that changing the atmosphere from O2 to air during the liquid-phase sintering of oxide ceramics can greatly reduce the porosity.

The rates of forming the superconducting YBa2Cu3Ox phase during the calcination of the Y2O3, BaCO3, and CuO powder mixture at 790° and 850°C are considerably enhanced when an inert atmosphere of N2 or He is used instead of O2. Sintering in an inert atmosphere also produces higher density and larger grain size than in O2. These results are consistent with the possibility of rapid atomic diffusion in tetragonal YBa2Cu3Ox due to either high oxygen vacancy concentration or expanded lattice in an inert atmosphere.

Alumina powder compacts sintered at various temperatures were isostatically hot-pressed. The specimens sintered to the closed-pore state can be densified further by hot isostatic pressing. If the open pores are eliminated during sintering, sintering at a low temperature is desirable to achieve a full densification after hot-pressing. Sintering at high temperatures causes pores to be trapped inside the grains; these pores are difficult to eliminate by subsequent hot-pressing.

Microstructures of Y-Ba-Cu-O superconductors were observed using a polarized microscope. Orthorhombic and tetragonal phases were easily distinguished by the optical etching with cross-polarized light. In the specimen cooled rapidly in oxygen, it was possible to see the path of oxygen diffusion by observing the variation of the twin concentration. At the boundary between transformed and untransformed materials, evidence for diffusion-driven transformation could be clearly seen.