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Aim: Despite Australia's high vaccination rates, an estimated 3.3% of children are under-vaccinated due to vaccine refusal and the proportion of parents with concerns is unclear. Amongst Australian parents, we aimed to determine the prevalence of vaccine concerns, resources and health-care providers (HCPs) accessed and satisfaction with these resources in two different settings. We also aimed to identify relationships between the level of vaccine concern, socio-economic status and vaccine uptake., Methods: Parents of children under 5 years attending general paediatric clinics in a tertiary paediatric hospital (n = 301/398, 76%) and children under 19 months attending community maternal child health centres (n = 311/391, 81%) completed the survey. Vaccination status was obtained from the Australian Childhood Immunisation Register., Results: Despite high support for vaccination (98%, confidence interval (CI) 97-99), 43% of parents reported vaccine concerns (CI 40-47) including the number of vaccines given in the first 2 years (25%, CI 22 to 29), vaccine ingredients (22%, CI 19-25), allergies (18%, CI 15-21), weakening of the immune system (17%, CI 14-20) and autism (11%, CI 8-13). HCPs were the most commonly accessed and trusted information source. In all, 23% of parents reported insufficient knowledge to make good vaccination decisions (CI 20-26). There was little evidence of an association between parental vaccine acceptance or socio-economic status and vaccination status., Conclusions: Despite high support for vaccines, nearly half of Australian parents have some concerns and a quarter lack vaccine decision-making confidence regarding childhood vaccines. Parents frequently access and report high trust in HCPs, who are best placed to address parental vaccine concerns through provision of clear information, using effective communication strategies. Further research in more highly hesitant populations is required to determine the relationship between the level and nature of vaccination concerns and vaccine uptake., (© 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)

Objective: The purpose of this study was to evaluate if the apical third enlargement of root canal is the determinant factor for the repair of periapical lesions in endodontic treatment., Methods: Eighty upper and lower incisors, canines and premolars with periapical lesions were randomly divided in 2 groups and were treated by undergraduate students. Canals were instrumented with up to 3 files in group I (n = 40) and up to 4 files in group II (n = 40) 1 mm short of the apex and were filled with a calcium hydroxide dressing. After removing calcium hydroxide 14 days later, both groups were filled using the lateral condensation technique. In the 2-year follow-up, a few patients did not return, and some cases did not present conditions for accurate comparisons. Therefore, only 43 patients (24 in group I and 19 in group II) presented conditions for radiographic comparisons. Data were statistically analyzed using Fisher's exact test., Results: Comparison of the initial and follow-up radiographs showed that 22 out of 24 (91.67%) patients in group I and 17 out of 19 patients (89.47%) in group II showed repair. Statistical analysis revealed no significant differences between the groups (P>.05)., Conclusion: The results of this study show that the apical third enlargement did not alter the outcome of endodontic treatment of teeth with periapical lesion performed by undergraduate students.

Induction of heme oxygenase-1 (HO-1) expression in recipients of allogeneic islets can lead to long-term survival (>100 d) of those islets. We tested whether administration of bilirubin would substitute for the beneficial effects of HO-1 expression in islet transplantation. Administering bilirubin to the recipient (B6AF1) or incubating islets in a bilirubin-containing solution ex vivo led to long-term survival of allogeneic islets in a significant percentage of cases. In addition, administering bilirubin to only the donor frequently led to long-term survival of DBA/2 islets in B6AF1 recipients and significantly prolonged graft survival of BALB/c islets in C57BL/6 recipients. Donor treatment with bilirubin up-regulated mRNA expression of protective genes such as HO-1 and bcl-2 and suppressed proinflammatory and proapoptotic genes including monocyte chemoattractant protein-1 and caspase-3 and -8 in the islet grafts before transplantation. Furthermore, treatment of only the donor suppressed the expression of proinflammatory cytokines including TNF-alpha, inducible nitric oxide synthase, monocyte chemoattractant protein-1, and other proapoptotic and proinflammatory genes normally seen in the islets after transplantation. Donor treatment also reduced the number of macrophages that infiltrated the islet grafts in the recipients. Preincubation of betaTC3 cells with bilirubin also protected the cells from lipid peroxidation. Our data suggests that the potent antioxidant and antiinflammatory actions of bilirubin may contribute to islet survival.