Field observations made at Harvard Forest [Petersham, MA, U.S.A. (42 degrees 54' N, 72 degrees 18' W)] during early July 2002 show clear evidence of long-range transport of gaseous mercury (Hg) in a smoke plume from a series of boreal forest fires in northern Quebec. These measurements indicated significant and highly correlated increases in Hg and CO during the plume event. The Hg:CO emissions ratio determined from the data (8.61 x 10(-8) mol mol(-1)) was combined with previously published information on CO emissions and biomass burned to determine a mean area-based Hg emission flux density for boreal forest fires (1.5 g Hg ha(-1)), annual Hg emissions from Canadian forest fires (3.5 tonnes), and annual global Hg emissions from boreal forest fires (22.5 tonnes). Annual Hg emissions from boreal fires in Canada may equal 30% of annual Canadian anthropogenic emissions in an average fire year and could be as high as 100% during years of intense burning. The Hg:CO emissions ratio of this study was much lower than those reported for a temperate forest in Ontario and a pine/shrub vegetation in South Africa, suggesting that fire emission is dependent on biome/species and that any extrapolation from a single fire event to determine the global fire emission is speculative.

Background: Residential aged care facility residents experience high rates of hospital admissions which are stressful, costly and often preventable. Design: Prospective pre-post cohort study and decision model analysis. Intervention: A decision-support tool was implemented to enable nursing staff to detect, refer and quickly respond to early signals of a deteriorating resident. Advanced clinical skills training, new diagnostic equipment and guided support from clinical lead nurses and nurse practitioners was provided to support nursing staff in the delivery of appropriate sub-acute care. Outcome measures: Rate of hospital admissions; length of stay; incremental cost per QALY; net monetary benefit. Results: The hospital avoidance program was associated with a 19% reduction in annual hospital admissions and a 31% reduction in the average length of stay. When modelled in a cohort of 1,000 residents the program resulted in a total of 1,606 fewer hospital bed days per annum. This contributed to a total cost saving of $2.6 million and 0.62 incremental QALYs gained per 1,000 residents. The program had a positive net monetary benefit and was considered cost-effective, even when the willingness to pay for health care gains was set to zero. A probabilistic sensitivity analysis estimated that there was an 86% probability that the program was cost-effective after taking the uncertainty of the model inputs into account. Conclusions: This study provides compelling evidence for the effectiveness and cost-effectiveness of a RACF nurse led sub-acute care program in preventing unnecessary hospital admissions.

RESUMENToda función del sistema estomatognático involucra la acción sinérgica de la musculatura paraprotética, representada por estructuras complejas tales como lengua, labios, mejillas y piso de boca. Al rehabilitar a través de prótesis completas no siempre se considera la influencia de la dinámica muscular, y menos aún cuando alguna de estas estructuras presenten alguna patología, por ejemplo, el compromiso del nervio facial que genera espasmos musculares involuntarios. En tal situación, la ubicación de los dientes y la forma de las superficies pulidas pueden llegar a ser decisivos entre éxito o fracaso de la rehabilitación. Se sabe que los implantes oseointegrados proveen retención, soporte y estabilidad, sin embargo existen situaciones especiales en que no es posible acceder a este tipo de tratamiento, tanto por razones médico quirúrgicas o costos asociados. En este estudio se ha utilizado un registro Piezográfico de la Zona Neutra en un paciente con compromiso del nervio facial que genera espasmos musculares involuntarios del lado afectado, obteniéndose una rehabilitación protésica basada en la apropiada relación entre superficie protésica externa y tejidos circundantes, mejorando requisitos funcionales tales como retención y estabilidad. Se ha utilizado el sistema de tomografía computarizada Cone Beam, con el objetivo de evidenciar el registro piezográfico. Los resultados obtenidos con estas prótesis piezográficas demuestran ser superior en factores como comodidad y fonoarticulación pero inferior en eficiencia masticatoria comparada con la técnica convencional. ABSTRACTEvery function of the stomatognathic system involves the synergistic action of the musculature around the prosthesis, consisting of complex and individual structures such as tongue, lips, cheeks and mouth floor. When planning and making complete prostheses, the muscular dynamic is not always considered. This can generate instability of the device during function, the location of the artificial teeth is made arbitrarily on the top and middle parts of the flange, and the configuration of the polished areas is made according to mechanistic concepts. This factor takes more relevance in patients with severe atrophy of their residual flanges, where the prosthetic stability can be a decisive factor between the success or failure of the rehabilitation. It is known that the osseointegrated implants provide retention, support and stability. However, there are special situations in which it is not possible to access to this type of treatment, both for medical surgical reasons or associated costs. In this study, a Piezographyc record of the Neutral Zone was used in a patient with facial nerve involvement generating involuntary muscle spasms of the affected side. A prosthetic rehabilitation based on the appropriate relation between external prosthetic surface and surrounding tissues was obtained, improving functional requirements such as retention and stability. The computerized tomographic Cone Beam system was used, with the objective to show the piezo...