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In 2012, the country's land-grant colleges and universities will celebrate their sesquicentennial. This anniversary provides a good opportunity to consider how these distinctively American institutions have evolved over the past 150 years and how well they are doing today in preparing students for the 21st century. Resilience will be a key capability for thriving in a world of constant flux. Land-grant colleges and universities have an urgent role to play in cultivating this capacity in their students in order to support the economic vitality of their communities. To a large extent, the emergence and growth of these institutions in the 20th century helped this country to become a leader in scientific and technical innovation and laid the educational foundation for the affluence that Americans have enjoyed. Today, they are responsible for educating more than 1.5 million undergraduate and graduate students annually and are among the country's leading academic research institutions. But have these institutions been able to update their missions to serve the needs of a post-industrial economy? In particular, how have they responded to the increasing rate of change and intensifying global competition that are hallmarks of the 21st-century? In this article, the authors attempt to answer these questions. They describe North Carolina State University, a 120-year-old land-grant institution located in Raleigh, North Carolina, which serves as a model of learning for the 21st century. (Contains 6 resources.)

Background. Although caries is prevalent in adults, investigators have tested few preventive therapies in adult populations. In a randomized controlled trial, the authors evaluated the effectiveness of xylitol lozenges in preventing caries in adults at elevated risk of developing caries. Methods. The Xylitol for Adult Caries Trial (X-ACT) was a three-site placebo-controlled randomized trial. Participants (n = 691) aged 21 through 80 years consumed five 1.0-gram xylitol or placebo lozenges daily for 33 months. They underwent clinical examinations at baseline and at 12, 24 and 33 months. Results. Xylitol lozenges reduced the caries increment 10 percent. This reduction, which represented less than one-third of a surface per year, was not statistically significant. There was no indication of a dose-response effect. Conclusions. Daily use of xylitol lozenges did not result in a statistically or clinically significant reduction in 33-month caries increment among adults at an elevated risk of developing caries. Clinical Implications. These results suggest that xylitol used as a supplement in adults does not reduce their caries experience significantly. [ABSTRACT FROM AUTHOR]

Background: Dental caries incidence in adults is similar to that in children and adolescents, but few caries preventive agents have been evaluated for effectiveness in adults populations. In addition, dentists direct fewer preventive services to their adult patients. Xylitol, an over-the-counter sweetener, has shown some potential as a caries preventive agent, but the evidence for its effectiveness is not yet conclusive and is based largely on studies in child populations., Methods/design: X-ACT is a three-year, multi-center, placebo controlled, double-blind, randomized clinical trial that tests the effects of daily use of xylitol lozenges versus placebo lozenges on the prevention of adult caries. The trial has randomized 691 participants (ages 21-80) to the two arms. The primary outcome is the increment of cavitated lesions., Discussion: This trial should help resolve the overall issue of the effectiveness of xylitol in preventing caries by contributing evidence with a low risk of bias. Just as importantly, the trial will provide much-needed information about the effectiveness of a promising caries prevention agent in adults. An effective xylitol-based caries prevention intervention would represent an easily disseminated method to extend caries prevention to individuals not receiving caries preventive treatment in the dental office., Trial Registration: ClinicalTrials.Gov NCT00393055.