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Background: A total of 18%-30% of Canadians live in a rural area and are served by 8% of the country's general surgeons. The demographic characteristics of Canada's population and its geography greatly affect the health outcomes and needs of the population living in rural areas, and rural general surgeons hold a unique role in meeting the surgical needs of these communities. Rural general surgery is a distinct area of practice that is not well understood. We aimed to define the Canadian rural general surgeon to inform rural health human resource planning. Methods: A scoping review of the literature was undertaken of Ovid, MEDLINE, and Embase using the terms 'rural,' 'general surgery,' and 'workforce.' We limited our review to articles from North America and Australia. Results: The search yielded 425 titles, and 110 articles underwent full-text review. A definition of rural general surgery was not identified in the Canadian literature. Rurality was defined by population cut-offs or combining community size and proximity to larger centres. The literature highlighted the unique challenges and broad scope of rural general surgical practice. Conclusion: Rural general surgeons in Canada can be defined as specialists who work in a small community with limited metropolitan influence. They apply core general surgery skills and skills from other specialties to serve the unique needs of their community. Surgical training programs and health systems planning must recognize and support the unique skill set required of rural general surgeons and the critical role they play in the health and sustainability of rural communities. Contexte : En tout, 18%-30% de la population canadienne vit en milieu rural et est desservie par 8% des effectifs en chirurgie g n rale au pays. Les caract ristiques d mographiques de sa population et la g ographie du Canada influent grandement sur l' tat de sant et les besoins de la population rurale, et la chirurgie g n rale en milieu rural joue un r le central en r pondant aux besoins chirurgicaux de ces communaut s. La chirurgie g n rale en milieu rural est un domaine de pratique part, et elle n'est pas bien comprise. Nous avons voulu d finir la chirurgie g n rale en milieu rural au Canada pour en faciliter la planification des ressources humaines. M thodes : Nous avons proc d une synth se exploratoire de la litt rature aupr s des bases de donn es Ovid, MEDLINE, et Embase partir des termes anglais <>, <>, et <>. Nous avons limit notre interrogation aux articles provenant de l'Am rique du Nord et de l'Australie. R sultats : L'interrogation a g n r 425 titres, et 110 articles ont fait l'objet d'une revue du texte int gral. Nous n'avons trouv aucune d finition de la chirurgie g n rale en milieu rural dans la litt rature canadienne. La ruralit tait d finie par des seuils de population ou le rapport entre la taille d'une communaut et sa proximit d'un grand centre. La litt rature a fait ressortir les d fis particuliers et la port e du champ de pratique de la chirurgie g n rale en milieu rural. Conclusion : La chirurgie g n rale en milieu rurale au Canada peut se d finir comme un champ de sp cialit qui dessert une petite communaut et qui subit peu l'influence de la m tropole. Elle applique les techniques fondamentales de la chirurgie g n rale et emprunte certains actes m dicaux d'autres sp cialit s pour r pondre aux besoins particuliers des communaut s. Les programmes de formation en chirurgie et la planification des syst mes de sant devraient reconna tre et soutenir l'ensemble unique des habilet s requises pour exercer en chirurgie g n rale en milieu rurale et son r le dans la sant et la pr servation des communaut s rurales., According to the Canadian Institute for Health Information, 8% of general surgeons in Canada work in a rural setting, whereas 18%-30% of the population lives in rural areas, which are [...]

To determine if microetching the mandibular premolars and first molars prior to acid-etching reduced bracket failures during the first six months of orthodontic treatment.

To compare the clinical failure rates over six months of indirectly bonded brackets with and without methyl methacrylate monomer (MMM) conditioned custom bases.

To compare the effectiveness of a self-ligating (SL) porcelain bracket with a conventional porcelain (CP) bracket tied with ligatures for initial alignment in the upper arch, to compare the discomfort of both bracket – archwire combinations and to compare the times taken (both assisted and unassisted) to untie and ligate both bracket – archwire combinations.

Background: The scope of practice of general surgeons in Canada is highly variable. The objective of this study was to examine the demographic characteristics of general surgeons in Canada and compare surgical procedures performed across community sizes and specialties. Methods: Data from the Canadian Institute for Health Information's National Physician Database were used to analyze fee-for-service (FFS) care provided by general surgeons and other providers across Canada in 2015/16. Results: Across 8 Canadian provinces, 1669 general surgeons provided FFS care. The majority of the surgeons worked in communities with more than 100 000 residents (71%), were male (78%), were aged 35-54 years (56%) and were Canadian medical graduates (76%). Only 7% of general surgeons practised in rural areas and 14% in communities with between 10 000 and 50 000 residents. Rural communities were significantly more likely to have surgeons who were international medical graduates or who were older than 65 years. The surgical procedures most commonly performed by general surgeons were hernia repairs, gallbladder and biliary tree surgery, excision of skin tumours, colon and intestine resections and breast surgery. Many general surgeons performed procedures not listed in their Royal College of Physicians and Surgeons of Canada training objectives. Conclusion: Canadian general surgeons provide a wide array of surgical services, and practice patterns vary by community size. Surgeons practising in rural and small communities require proficiency in skills not routinely taught in general surgery residency. Opportunities to acquire these skills should be available in training to prepare surgeons to meet the care needs of Canadians. Contexte : La pratique des chirurgiens generalistes au Canada varie grandement. Cette etude vis ait a examiner les caracteristiques demographiques des chirurgiens generalistes au Canada et a comparer les interventions realisees selon la specialite et la taille des collectivites. Methodes : Des donnees de la Base de donnees nationale sur les medecins de l'Institut canadien d'information sur la sante ont ete utilisees pour analyser les soins remuneres a Facte dispenses par des chirurgiens generalistes et d'autres fournisseurs de soins au Canada en 2015-2016. Resultats : Dans 8 provinces canadiennes, 1669 chirurgiens generalistes ont fourni des soins remuneres a Facte. La majorite d'entre eux travaillaient dans des collectivites de plus de 100 000 residents (71 %), etaient des hommes (78%), avaient entre 35 et 54 ans (56 %) et avaient obtenu leur diplome de medecine au Canada (76 %). Seuls 7 % des chirurgiens generalistes travaillaient en region rurale et 14 %, dans des collectivites comptant entre 10 000 et 50 000 residents. En region rurale, la probabilite que les chirurgiens soient des diplomes internationaux en medecine ou aient plus de 65 ans etait significativement plus elevee. Les interventions les plus frequent es etaient la reparation d'une hernie, la chirurgie de la vesicule biliaire et des voies biliaires, le re trait de tumeurs de la peau, la resection du colon ou de Fintestin et la chirurgie mammaire. De nombreux chirurgiens generalistes ont realise des procedures ne faisant pas partie des objectifs de formation du College royal des medecins et chirurgiens du Canada. Conclusion : Les chirurgiens generalistes canadiens realisent une large gamme d'interventions chirurgie ales et leur pratique varie selon la taille de la collectivite dans laquelle ils travaillent. Les chirurgiens exercant en milieu rural et dans les petites collectivities doivent avoir des competences qui ne sont habituellement pas enseignees durant la residence en chirurgie generale. La formation devrait integrer des occasions d'acquerir ces competences pour preparer les chirurgiens a repondre aux besoins en matiere de soins des Canadiens., The scope of practice of general surgeons in Canada is highly variable. (1) Despite having vastly different practice profiles, all graduates must meet the training objectives set forth by the [...]

Many techniques and appliances claim to reduce orthodontic treatment time, one of which is micro-vibration applied by the AcceleDent Aura appliance.

This second survey of Australian Society of Orthodontists members was conducted to assess their treatment preferences and compare with the results of the 2013 survey.

Aim: This survey of Australian orthodontists was conducted to assess treatment preferences.

Our professional organizations have prepared this paper as part of an integrated, multidisciplinary plan to ensure the availability of well-trained practitioner teams to sustain safe, effective and high-quality rural surgical and operative delivery services. Without these robust local (or nearby) surgical services, sustaining rural maternity care is much more difficult. This paper describes the 'network model' as a health human resources solution to meet the surgical needs, including operative delivery, of rural residents; outlines necessary policy directions for achieving this solution; and poses a series of enabling recommendations. Nos organisations professionnelles ont prepare cet article dans le cadre d'un plan multidisciplinaire integre visant a assurer la disponibilite d'equipes soignantes bien formees pour offrir des services obstetricaux interventionnels et chirurgicaux securitaires, efficaces et de grande qualite en milieu rural. Sans de tels solides services chirurgicaux locaux (ou de proximite), il est beaucoup plus difficile d'assurer les soins obstetricaux en milieu rural. Cet article decrit le << modele en reseau >> comme une solution au chapitre des ressources humaines en sante pour repondre aux besoins chirurgicaux des populations rurales, y compris pour les services obstetricaux interventionnels. On y decrit aussi les orientations politiques necessaires a l'application de cette solution et on formule une serie de recommandations preparatoires., OVERVIEW The precipitous attrition of small-volume surgical programs in rural Canada over the past 2 decades has led to the need for rural residents to travel for even the most [...]

Introduction: The aim of this study was to assess the rate of tooth movement and discomfort experienced by orthodontic patients using a vibrational appliance (Tooth Masseuse).

Objective: To compare the effectiveness of SmartClip brackets and conventional twin brackets for initial alignment of the lower arch.

Research involving the upper airway has assessed linear measurements of certain structures on the assumption that the landmarks involved can be reliably identified.

This study compared the retention rates of thermally-cured (TC) and light-cured (LC) custom bases attached to metal mini-diamond brackets and clear Spirit MB brackets, when used in indirect bonding procedures. The custom base comprised either the light-cured or thermally-cured material attached to the bracket base and prepared in the laboratory, the whole unit later being bonded to the natural teeth. Thirty consecutively treated patients had fixed appliances fitted in both arches, with Spirit MB brackets on the maxillary anterior teeth, and metal brackets on the maxillary posterior and all mandibular teeth. All brackets were bonded using either the LC or TC method. All procedures and treatment was by the same operator, using identical techniques. Observation was for six months. All bonding failures were recorded. The results indicated no significant differences in the retention rates of either of the custom-base materials when used with metal brackets. However, the Spirit MB brackets exhibited a significantly higher bonding failure rate when a TC custom base was used. It was therefore concluded that either material could be used in the indirect bonding of metal brackets, and that LC custom bases should be used in the indirect bonding of Spirit MB brackets.

The objective of this study was to compare the effectiveness and comfort of Damon 2 brackets and conventional twin brackets during initial alignment. Sixty consecutive patients participated in a split mouth design. One side of the lower arch was bonded with the Damon 2 bracket and the other with a conventional twin bracket. The sides were alternated with each consecutive patient. The irregularity index (II) was measured for each half of the arch at baseline, at 10 weeks at the first archwire change, and at another 10 weeks at the second archwire change. Any difference in discomfort was assessed within the first few days of archwire placement and again at the first archwire change. Comfort on the lips, preferred look, and bracket failure rates were also recorded. The twin bracket was more uncomfortable with the initial archwire (P = .04). However, at 10 weeks, substantially more patients reported discomfort with the Damon 2 bracket when engaging the archwire (P = .004). At both archwire changes at 10 and 20 weeks (P = .001), the conventional bracket had achieved a lower II than the Damon 2 bracket by 0.2 mm, which is not clinically significant. Patients preferred the look of the twin bracket over the Damon 2 (P < .0005) and more Damon 2 brackets debonded during the study (P < .0005). The Damon 2 bracket was no better during initial alignment than a conventional bracket. Initially, the Damon 2 bracket was less painful, but it was substantially more painful when placing the second archwire and had a higher bracket failure rate. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare and evaluate the clinical failure rates of the chemically cured composite bonding resin Maximum Cure (MC) and the flowable light-cured resin Filtek Flow (FF) when used in an indirect bonding technique. A total of 112 consecutive patients satisfying the selection criteria were assigned to alternating groups in a split-mouth study design. In Group 1, the maxillary right and mandibular left quadrants were indirectly bonded using MC adhesive, whereas the contralateral quadrants were bonded using FF adhesive. In Group 2, the sides bonded were opposite to those in Group 1. One patient was lost from group 1, so the adjacent patient from group 2 was excluded. Over a six-month observation period, all loose brackets were recorded and the data compared with a Wilcoxon signed ranks test. Of the 2468 brackets placed, 36 with the MC adhesive came loose (2.9% failure rate) compared with 30 in the FF group (2.4% failure rate, P = .95). In the maxillary arch, 12 brackets from the MC quadrants came loose vs 24 in the FF (P = .02). In the mandibular arch, 24 brackets from the MC quadrants came loose during the six-month observation period compared with six from the FF quadrants (P = .03). These results suggest that both adhesives examined in this study (MC and FF) were suitable for the indirect bonding of brackets. The failure rates were low for both adhesives, so either could be recommended for clinical use, the choice being dictated more by operator preference. [ABSTRACT FROM AUTHOR]