Introduction: Cancer for adolescents and young adults (AYA) differs from younger and older patients; AYA face medical challenges while navigating social and developmental transitions. Research suggests that these patients are under or inadequately served by current support services, which may affect health-related quality of life (HRQOL).Methods: We examined unmet service needs and HRQOL in the National Cancer Institute’s Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) study, a population-based cohort (n = 484), age 15–39, diagnosed with cancer 6–14 months prior, in 2007–2009. Unmet service needs were psychosocial, physical, spiritual, and financial services where respondents endorsed that they needed, but did not receive, a listed service. Linear regression models tested associations between any or specific unmet service needs and HRQOL, adjusting for demographic, medical, and health insurance variables.Results: Over one-third of respondents reported at least one unmet service need. The most common were financial (16%), mental health (15%), and support group (14%) services. Adjusted models showed that having any unmet service need was associated with worse overall HRQOL, fatigue, physical, emotional, social, and school/work functioning, and mental health (p’s < 0.0001). Specific unmet services were related to particular outcomes [e.g., needing pain management was associated with worse overall HRQOL, physical and social functioning (p’s < 0.001)]. Needing mental health services had the strongest associations with worse HRQOL outcomes; needing physical/occupational therapy was most consistently associated with poorer functioning across domains.Discussion: Unmet service needs in AYAs recently diagnosed with cancer are associated with worse HRQOL. Research should examine developmentally appropriate, relevant practices to improve access to services demonstrated to adversely impact HRQOL, particularly physical therapy and mental health services.

The best seating of complete crowns during cementation can be achieved by venting the crown and using a tapping cementation technique. When the crown is not vented, a dynamic seating method provides the best seating. 39 Impressions were made, stone dies fabricated, die spacer was applied and the crowns were waxed and cast in type III gold. The respective crowns were placed on the teeth and preloaded. The distance between reference marks on the tooth and crown were measured at four points around each tooth. Zinc phosphate cement was mixed and the crowns were cemented in the following groups: 1) vented, tapping the crown into place with a mallet, 2) non-vented, tapping the crown into place, 3) vented static seating with a 25 kg load, 4) non-vented dynamic seating, 5) non-vented static loading with a 25 kg load. A 25 kg load was then maintained on the crowns during the cement setting time. Distances between reference marks were then measured and the change in post-cementation distances calculated.Results. ANOVA (F=14.995, p<.0001) and multiple range tests revealed significant differences between the groups. The mean increased postcementation distances for the seating groups were (µm): 1) 132 ± 20, 2) 372 ± 26, 3) 367 ± 59, 4) 239 ± 35, 5) 537 ± 45.

evidence-based dentistry. Of course we must. The future of dentistry depends on our consistent and concerted marriage, as it were, of the "best available" research evidence with the diagnostic modalities and the treatment interventions our patients need.The concerns over variability of practice is not a question of style or individuality. It is a question of quality and standards. Patients expect and deserve the best care available for them based on the evidence, personal preferences, and the skills and knowledge of the provider. The pressure on the dental care industry to have evidence for even its most basic of treatments and products is wellfounded. Take for example the recent NIH Consensus Conference (http://www.nidcr.nih.gov/news/consensus.asp), which discusses dental caries. Among many other conclusions, the panelists agreed that more rigorous studies are needed not only to support current methods but also to improve them.The American Dental Association Commission on Accreditation requires that dental students acquire a wide variety of skills in managing scientific information with critical thinking. However, most dentists were not taught the skills and tools of evidence-based dentistry in dental school. Therefore, they have little confidence in or respect for the scientific method, and place little or no demands for higher standards of research evidence. Certain dental manufacturers may be content to publish their research in the form of abstracts, and to support their products with statements such as "University studies show...". It is time that dentists take control of the products they utilize: The liability is theirs. Therefore, dentists must take it upon themselves to evaluate the validity of the research evidence for or against any given products they use. It is also time for the socio-political environment that surrounds dentistry (e.g., the insurance companies for the coverage of dental treatment, Congress for the funding of dental research) to have access to the "best available" evidence to make the better-informed and cost-effective decision.The well-being of our patients depends upon the successful integration of the "best available" evidence into novel and improved treatment modalities. The question is not "why" but "how". How can we actualize this union? How can we identify the "best available" research evidence? How can we most effectively integrate it into the common day-to-day exercise of dental practice? These are fundamental and timely questions for dentistry in the 21st Century.There are many approaches to evidence-based dentistry, but it may suffice to paint a very broad picture at the onset and

No abstract

No abstract