Four different methods of in vitro residual composite removal following debonding performed by two different operators (an orthodontist and a hygienist) were assessed for enamel surface damage (using scanning electron microscopy) and the time involved. There was no difference in the quality of enamel surface appearance between the two operators, regardless of the method used for composite removal. There was a statistically significant difference (P < 0·05) for the time taken for composite removal between the two operators using a tungsten carbide bur method only. It is suggested that an expanded duties auxiliary with the practical skills of the hygienist would be able to remove residual composite debris and produce a satisfactory polished enamel surface using tungsten carbide burs and aluminium oxide polishing discs, thus becoming a safe and cost-effective member of the orthodontic team.

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Background: Informed decision making is the theoretical basis in the UK for men's decisions about Prostate Specific Antigen (PSA) testing for prostate cancer testing. The aim of this study is to evaluate the effect of a web-based PSA decision-aid, Prosdex, on informed decision making in men. The objective is to assess the effect of Prosdex on six specific outcomes: (i) knowledge of PSA and prostate cancer-related issues -the principal outcome of the study; (ii) attitudes to testing; (iii) decision conflict; (iv) anxiety; (v) intention to undergo PSA testing; (vi) uptake of PSA testing. In addition, a mathematical simulation model of the effects of Prosdex will be developed.

Various approaches have been used to identify possible routes for improvement of patient flow within an emergency unit (EU). One such approach is to use simulation to create a 'real world' model of an EU and carry out various tests to gauge ways of improvement. This paper proposes a novel approach in which simulation is used to create a 'perfect world model'. The EU at a major UK hospital is modelled not as it is, but as it could be. The 'efficiency gap' between the 'perfect world' and the 'real world' demonstrates how operational research can be used effectively to identify the location of bottlenecks in the current 'whole hospital' patient pathway and can be used in the planning and managing of hospital resources to ensure the most effective use of those resources.

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