Three-part Series Research Articles

Removable partial dentures: Part 3.

The provision of removable partial dentures (RPDs) is an important skill for practitioners and it can often be challenging to make a successful prosthesis which the patient finds satisfactory. This three-part series has been designed to provide an overview of the clinical management of patients requiring RPDs. This final part describes more complex techniques that may be faced by dentists with additional training or experience in fixed and removable prosthodontics. These scenarios include the use of precision attachments to provide additional retention for an RPD, swinglock dentures to aid retention in cases with unfavourable tooth or alveolar undercuts, and sectional dentures for patients with challenging paths of insertion. For each clinical technique, the advantages, disadvantages and indications are summarised.

The adult orthodontic–restorative interface. part 2: treatment strategies for the management of developmental conditions

This is the second article in a three-part series that discusses joint orthodontic–restorative care for the adult patient. Part 2 considers the clinical presentations, challenges and strategies for developmental conditions presenting in adulthood, including the management of hypodontia, ectopic canine teeth and disorders of tooth structure. CPD/Clinical Relevance: The challenges and treatment strategies for providing orthodontic–restorative care for an adult patient presenting with developmental conditions and anomalies are outlined.

Removable partial dentures: Part 2.

The provision of removable partial dentures (RPDs) is an important skill for practitioners. It can often be challenging to make a successful prosthesis which the patient finds satisfactory. This three-part series has been designed to provide an overview of the clinical management of patients requiring RPDs. This second part discusses three clinical scenarios that may be commonly faced in general dental practice: the use of immediate dentures for patients requiring extractions; the management of patients with lone-standing teeth using windowed dentures; and the incorporation of surveyed crowns into cobalt chromium RPDs. For each clinical technique, the advantages, disadvantages and indications are summarised.

Removable partial dentures: Part 1.

The provision of removable partial dentures (RPDs) is an important skill for practitioners and it can often be challenging to make a successful prosthesis which the patient finds satisfactory. This three-part series has been designed to provide an overview of the clinical management of patients requiring RPDs. This first part provides a refresher of the aspects of the history and examination that are relevant to RPDs. We describe some key principles that are relevant to challenging denture cases. This will help the reader begin the treatment planning process and understand some of the factors which influence the prognosis of dentures.

The Adult Orthodontic– Restorative Interface. Part 1: Concepts of Treatment and Presenting Challenges

This is the first article in a three-part series that discusses joint orthodontic–restorative care for the adult patient. Part 1 presents an overview of the clinical presentations, challenges and strategies that may be employed to treat this complex patient group. CPD/Clinical Relevance: The reader should be able to describe a care pathway, with potential associated complications, for the provision of adult orthodontic–restorative treatment.

Facing Cancer as a Chronic Disease: Shared Decision-Making at Critical Points in a Long Illness Journey

This is the third installment of a three-part series on decision support tools and shared decision-making. The first two articles centered on the devel­opment of person-centered standards for decision support tools and creating a taxonomy for classifying them.1,2 In this article, we describe how patients with­in three diverse communities who are living with cancer understand and make shared decisions. We used interactive sessions and storytelling in a qualitative setting to assess what matters to patients and caregivers, what language they use to describe their decision-making processes, and how individuals perceive their interactions with their health care providers. We also included qualitative assessment of the regional factors that affect equitable access to health care in the communities included in the study. For the second year of this work, we will combine the quantitative data from the first two articles with more in-depth analysis of patient priorities and values to develop and test prototypes of deci­sion support tools for this target population.

No Drone’s Sky: Full Spectrum Drone Surveillance and Neutralisation Concept for Enhanced Counter-UAS Framework

Unmanned Aircraft Systems (UAS), commonly known as drones, have witnessed substantial global proliferation in the past decade. Their constructive applications hold the promise of being a useful, yet critical component in creating a more efficient society with the enhancement of safety, efficiency, and facilitating advancements in various domains, ultimately contributing to our modern daily lives. However, the escalating dependence on computer and communication technologies renders, especially small, UAS susceptible to various threats, posing risks to public safety, national security, and individual privacy. Addressing these concerns necessitates the development of innovative technologies designed to detect, track, identify, and eliminate UAS in a manner that upholds safety, security, and privacy. A Counter-Unmanned Aircraft System (C-UAS) is defined as a system or apparatus capable of legally and securely incapacitating, disrupting, or assuming control over an UAS. Recent years have witnessed significant research endeavours aimed at detecting and eliminate drone threats. Detection methodologies encompass acoustic, visual, passive radio frequency, radar, and data fusion techniques, while neutralisation strategies encompass physical capture and jamming approaches. This paper, delving into the realm of small drone surveillance, is the opening segment of a three-part series aims to envision a C-UAS framework; it provides an exhaustive review of existing literature in the domain of UAS surveillance, delineating the challenges associated with countering unauthorised or unsafe drone operations, and evaluating the trajectory of detection to prepare against UAS-induced threats. Therefore, the fundamental objective of this paper is to offer a comprehensive surveillance baseline for a structured vision to a C-UAS framework, thus fostering a research community dedicated to the secure integration of drones into the airspace system.

Heart Failure in Older People Part 1: Disease State Review and Lifestyle Interventions.

The care for patients with heart failure (HF) has evolved greatly over the past decade. While new guidelines have provided more clarity on categorization and staging, and novel agents have been approved for use, there are still questions surrounding the optimal strategies as they relate to diet and exercise. Additionally, overall health care costs have increased for patients, driven in part by medication therapy. Given the myriad comorbidities associated with the diagnosis of HF, senior care pharmacists are positioned to positively impact the care for patients with HF, regardless of setting. As the guidelines continue to evolve, addressing a wider spectrum of the disease, including iron deficiency, mental health, and pain, so must the pharmacist's role in caring for patients with HF. Senior care pharmacists engaged in the management of older people with HF must be especially attuned to the unique and individualized care each patient needs, offering guidance and education in balancing treatment modalities across all aspects of care. In this three-part series, we will explore a number of areas central to the management of HF. This first section will focus on the cost of treatment, pathophysiology, and non-pharmacologic management. Series two and three will address guideline-directed medication therapy and special population management, respectively.

The nuts & bolts of being a nursing leader. Part 1: Leadership in nursing series

BackgroundThis article is the first in a three-part series on nursing leadership. It begins by providing new, existing, and future nurse leaders and managers a clear understanding of the commonalities that exist and differences between their roles within healthcare. InnovationNurse leaders and managers play a vital role. Their leadership can foster effective communication between nurses, patients, and interdisciplinary teams. Leaders create positive work environments that build effective nursing teams; thereby positively changing outcomes. ImplicationsImplications highlight important role leaders can have on nurses, patients, and healthcare outcomes. By evaluating and gaining insight into effective ways to lead, one can also examine and bring to the forefront the results of ineffective leadership. Awareness builds and positively strengthen the future trajectory of leaders. ConclusionsEffective nurse leaders are critical to the future of healthcare. As nurse leaders and managers enhance their understanding of leadership and effectively apply various leadership styles to practice, positive impacts can ensue within healthcare. Changes benefit the future of nursing and the overall landscape of healthcare and experience for all.

Geography and ethics III: Description as a matter of moral concern

This report focuses on moral description. It considers how comparative practices often entangle moral geography in philosophical dilemmas, such as debates over moral relativism. Using examples from geographic work on language, algorithms, the appropriation of anti-colonial critique, and Indigenous data sovereignty, the report shows how and why descriptive praxis matters to accounts of moral geography. As the final installation of a three-part series of reports on ethics and geography, it draws together a broader critique of moral geography's initial distinctions and suggests a more constitutive view of ethics for geographic scholarship.

The Unsteady Shock-Boundary Layer Interaction in a Compressor Cascade – Part 3: Mechanisms of Shock Oscillation

Abstract The shock-boundary layer interaction in transonic flows is known to cause strong unsteady flow effects that negatively affect the performance and operability of blade and cascade designs. Despite decades of research on the subject, little is still known about the physical mechanisms that drive the different oscillation frequencies observed with different designs. In the conclusion of this three-part series, the experimental and numerical data obtained with the Transonic Cascade TEAMAero are analyzed together in detail in order to test the main theories of continuous shock oscillation. This analysis exposes a main mechanism of shock oscillation, where pressure waves generated inside the passage of the cascade propagate upstream and interact strongly with the main shock when the latter is also in the passage. The interaction of these features causes a breakdown of the flow that is shown to propagate upstream, inevitably causing strong variations in the inflow angle and therefore on the operating conditions of the cascade. The high frequency content of these pressure waves is also shown to be responsible for weaker high-frequency variations of the shock movement throughout the cycle. Parallels are also drawn with previous experimental campaigns in order to search for a global understanding of the different observations made. Although various parts of the described interaction are not fully understood yet, and the dataset of experimental measurements compiled is still rather small, a good basis is provided on which to further study the underlying mechanisms of unsteady flows in transonic cascades.

WIMPs versus axions

From the smallest of interactions to the most powerful galactic phenomena, scientists are searching far and wide for the signatures of dark matter. In the second of a three-part series, Keith Cooper discovers that with so little known about this mysterious part of the universe, scientists find their theories of dark matter pitted against each other.

Supporting social & emotional skills

In the second article in a three-part series, Dr Christopher Halls, head of Early Years at Dulwich Prep London, explores some of the sustained consequences of the pandemic and national lockdowns on children's current attainment in early years.

Nonlinear ray tracing in focused fields, part 2. Tracing the flux: tutorial

In this three-part paper series, we develop a method to trace the lines of flux through a three-dimensional wavefield by following a direction that is governed by the derivative of the phase at each point, a process that is best described as flux tracing but which we interchangeably name “nonlinear ray tracing.” In the first part we focused on the high-speed calculation of focused three-dimensional complex wavefields in the paraxial approximation for TEM00 and TEM01 laser modes. The algorithms developed in the first paper are first used to generate the three-dimensional grid of samples of the complex wavefield in the focal region. In this second part, we focus on tracing a flux through this three-dimensional point cloud. For a given “ray” at an arbitrary position in the 3D volume, interpolation of the three-dimensional samples is applied to determine the derivative of the phase (normal to the direction of propagation) at the ray position, which is then used to direct the ray as it “propagates” forward in a straight line over a short distance to a subsequent plane; the process is repeated between consecutive planes. The initial origin of the ray can be chosen arbitrarily at any point, and the ray can then be traced through the volume with appropriate interpolation. Results are demonstrated for focused wavefields in the absence of aberrations, corresponding to the cases highlighted in the first paper. Some of the most interesting results relate to focused Laguerre-Gaussian beams, for which the rays are found to spiral at different rates of curvature. In the third paper we extend the application of this algorithm to the investigation of lens aberration.

Nonlinear ray tracing in focused fields, part 1. Calculation of 3D focused wavefields: tutorial

In this three-part paper series, we develop a method to trace the lines of flux through a three-dimensional wavefield by following a direction that is governed by the derivative of the phase at each point, a process that is best described as flux tracing but which we interchangeably name “nonlinear ray tracing.” In this first part, we provide a tutorial on the high-speed calculation of three-dimensional complex wavefields, which is a necessary precursor to flux tracing. The basis of this calculation is the angular spectrum method, a well-known numerical algorithm that can be used to efficiently and accurately calculate diffracted fields for numerical apertures <0.7. It is known that this approach yields identical predictions to the first Rayleigh–Sommerfeld solution. We employ the angular spectrum method to develop two algorithms that generate the 3D complex wavefield in the region of focus of a lens. The first algorithm is based on the thin lens approximation, and the second is based on the concept of an ideal lens, which can be modeled using an optical Fourier transform. We review how these algorithms can be used to calculate focused laser beams with TEM00 and TEM01 laser profiles. The three-dimensional sampling requirements of the focused field are explained in detail, and expressions for the computational and memory efficiency of the two algorithms are developed. These two algorithms generate the 3D scaffold for the flux tracing method developed in the second paper, and in the third paper we highlight the application of the method to understanding monochromatic lens aberration. Disregarding the second and third papers, this first paper will serve as a practical tutorial for anyone seeking to compute focused fields in three dimensions.

Optimized Stokes imaging for highly resolved optical speckle fields, Part I: optimized experimental setup

In this first article of a three-part series focusing on the Stokes polarimetry of optical speckle fields resolved at the individual speckle grain scale, a review of the state-of-the-art techniques for such experimental investigations is provided. An optimized experimental setup is then extensively described, which allows polarimetric Stokes measurements on such complex interference patterns to be carried out at each location of the speckle field without disturbing the wavefront. Specific calibration procedures are also described to provide an estimation of the reliable polarimetric properties of light across a resolved speckle field.

Implementation of Cultural Awareness and Cognitive Bias Training Within Graduate Nursing Programs.

Cognitive bias negatively affects patient outcomes, resulting in medical errors, sentinel events, and legal claims. The brunt of bias-induced inequities and disparities has fallen on Black and Brown people, women, and the LGBTQ+ communities. Faculty training programs have rapidly increased in number, whereas student training has lagged. A three-part curricular series was developed for students seeking nurse practitioner (NP) training. The series addressed racial bias, microaggression, and gender bias using vignettes and guided pre- and debriefing. The series was initially implemented to 70 students from four different specialty areas of study. Students resoundingly reported the content as valuable and challenging and the environment as a safe space to learn, be vulnerable, and be empathetic to the experiences of others. This three-part series has been implemented across eight NP majors and has become a required component of the NP on-campus intensive experience. [J Nurs Educ. 2024;63(11):777-780.].

Supporting language skills post pandemic

In the first article in a three-part series, Dr Christopher Halls, head of Early Years at Dulwich Prep London, explores some of the sustained consequences of the pandemic and the national lockdowns on children's current attainment in early years.

Plant a seed series: the impact of an online outreach package on school pupils’ knowledge, skills, and attitudes to medicine

BackgroundMedicine is one of the most inaccessible professions in the United Kingdom (UK). The Plant a Seed (PAS) series was created to address this; it is an online pre-recorded three-part video series to “Inspire”, “Educate” and “Motivate” pupils from widening participation backgrounds on Medicine. We explored the impact of PAS on pupils’ knowledge, skills and attitude to Medicine.MethodsWe conducted a national pretest-posttest study of Years 7–9 pupils in the UK. 503 schools were invited to PAS, following ethics approval. Consented pupils viewed all three episodes asynchronously and completed a pre-and post-series Likert scale confidence questionnaire, which evaluated their knowledge, skills and attitudes to a medical career. A Shapiro-Wilk test showed the lack of a normal distribution (p < 0.05); therefore, a Wilcoxon signed-rank test statistically compared pretest-posttest results of each pupil.Results70 pupils in Years 7–9 from 2 schools participated in this study. PAS was shown to significantly increase pupils’ knowledge of the role and life of a doctor, medicine as a degree, admissions requirements, and careers in medicine (p < 0.05). There was a significant increase in pupils believing they could study medicine. The intervention did not significantly increase the desire for pupils to study medicine (p = 0.187).ConclusionPAS significantly improved pupils’ knowledge, skills and confidence demonstrating the need and benefit to enrolment of the programme at scale. It did not significantly increase the number of pupils wishing to study medicine. Analysis at scale is required to evaluate the effectiveness of PAS as a key intervention to break down barriers to medicine.

Satisficing in dentistry. Who decides? who benefits? part 2

This three-part series of articles challenges some popular myths about supposedly ‘ideal’ treatment plans and is designed to provoke reflection and stimulate debate. It explains the concept of ‘satisficing’, as opposed to ‘maximizing’, in dentistry, and illustrates how subconscious bias and self-interests might lead supposed experts to promote arbitrary aspirational standards and confuse them with what the law expects (the Bolam Test standard), and what is genuinely in the best interests of an individual patient. It is argued that sound, patient-centred pragmatic planning and treatment is equally valid, with wider applicability than routinely defaulting to a self-serving ‘maximalist’ approach. CPD/Clinical Relevance: The ‘satisficing’ concept has wide and profound application across many fields of dentistry.