Management of Wide Alar Lobule Using Preservation Rhinoplasty Philosophy: Alar Coring Technique.

A broad alar base disrupts nasal harmony and facial aesthetic balance and is an aesthetic concern for many patients. This wide appearance may be related to excessive nostril sill, alar flare, wide alar lobule, or a combination. Many techniques are described in literature to address the alar base with resultant scars to a variable degree. Management of alar lobule thickness is particularly challenging. Our technique presented here introduces a novel method to reduce the thickness of the alar lobule with excellent aesthetic outcome.

MANAGERIAL COMPETENCE DEVELOPMENT IN THE CONTEXT OF PHILOSOPHY OF EDUCATION.

OBJECTIVE: The aim: To analyze the problem of university management in the cultural and philosophical aspects. PATIENTS AND METHODS: Materials and methods: The research was conducted in the form of a written questionnaire. Students were supposed to give a single answer to each question. The survey was conducted in September 2017-2018 and 2018-2019 academic year at Ternopil National Medical University. It encompassed 274 second-year Ukrainian students of medical, dental and pharmaceutical faculties and Institute of Nursing and 228 first, second and third year foreign students, who have come from the USA and study at the faculty of foreign students and International School of Medicine. Although the number of foreign students who participated in the survey was small, we believe that the number of respondents was sufficient enough to draw conclusions about the general trends in the issue under study. RESULTS: Results: Analysis of responses given by Ukrainian and American students allowed us to single out certain trends and specific differences in their outlook and professionally relevant persuasions and attitudes. A positive peculiarity is that the main motive that prompted Ukrainian students to choose a medical profession was that they believe it to be humane and noble (36%). Despite this, many students consider other important criteria when choosing a profession; particularly that it is prestigious and well-paid (21 % and 13 % respectively). The negative sign is that relatively big amount of students in the comparison with Western countries (the USA in particular), indicate that the occupational choice was influenced by their parents' desire (14 %). CONCLUSION: Conclusions: The role of pedoetology as one of the priorities of pedagogical science and practice, which should generalize managerial aspects, has been proved. The experience of university education of the USA in the questions of educational management has been analyzed. An overview of the basic concepts relevant to the management of American higher education has been conducted. The features of university management in the USA in modern conditions have been characterized. The differences in the field of professionally significant value orientations between Ukrainian and American students have been investigated. The emphasis is given to the role of teachers' philosophical culture in successful teaching and learning.

The emergence of objectivity: Fleck, Foucault, Kuhn and Hacking.

The analytical notions of 'thought style', 'paradigm', 'episteme' and 'style of reasoning' are some of the most popular frameworks in the history and philosophy of science. Although their proponents, Ludwik Fleck, Thomas Kuhn, Michel Foucault, and Ian Hacking, are all part of the same philosophical tradition that closely connects history and philosophy, the extent to which they share similar assumptions and objectives is still under debate. In the first part of the paper, I shall argue that, despite the fact that these four thinkers disagree on certain assumptions, their frameworks have the same explanatory goal - to understand how objectivity is possible. I shall present this goal as a necessary element of a common project -- that of historicising Kant's a priori. In the second part of the paper, I shall make an instrumental use of the insights of these four thinkers to form a new model for studying objectivity. I shall also propose a layered diagram that allows the differences between the frameworks to be mapped, while acknowledging their similarities. This diagram will show that the frameworks of style of reasoning and episteme illuminate conditions of possibility that lie at a deeper level than those considered by thought styles and paradigms.

Cerebral gustatory activation in response to free fatty acids using gustatory evoked potentials in humans.

There is some evidence of specific oro-detection of FFAs in rodents and humans. The aim of this study was to record gustatory evoked potentials (GEPs) in response to FFA solutions and to compare GEPs in response to linoleic acid solution with GEPs obtained after stimulation with sweet and salty tastants. Eighteen healthy men were randomly stimulated with fatty (linoleic acid), sweet (sucrose), and salty (NaCl) solutions at two concentrations in the first experiment. Control recordings (n = 14) were obtained during stimulation by a paraffin oil mixture without FFA or by water. In the second experiment, 28 men were randomly stimulated with five FFA solutions and a paraffin emulsion. GEPs were recorded with electroencephalographic electrodes at Cz, Fz, and Pz. GEPs were observed in response to FFA in all participants. GEP characteristics did not differ according to the quality and the concentration of the solutions in the first experiment and according to the FFA in the second experiment. This study describes for the first time GEPs in response to FFA and demonstrates that the presence of FFA in the mouth triggers an activation of the gustatory cortex. These data reinforce the concept that fat taste could be the sixth primary taste.

A revolution without tooth and claw-redefining the physical base units.

A case study is presented of a recent proposal by the major metrology institutes to redefine four of the physical base units, namely kilogram, ampere, mole, and kelvin. The episode shows a number of features that are unusual for progress in an objective science: for example, the progress is not triggered by experimental discoveries or theoretical innovations; also, the new definitions are eventually implemented by means of a voting process. In the philosophical analysis, I will first argue that the episode provides considerable evidence for confirmation holism, i.e. the claim that central statements in fundamental science cannot be tested in isolation; second, that the episode satisfies many of the criteria which Kuhn requires for scientific revolutions even though one would naturally classify it as normal science. These two observations are interrelated since holism can provide within normal science a possible source of future revolutionary periods.

The ethics of corporate social responsibility.

Corporations as well as individual professionals have an ethical obligation to help those in need. There is a sound tradition in American business for companies including social outreach as part of business strategy. This approach works best when corporations and community and professional experts work in partnership. Henry Schein's Corporate Social Responsibility program contributes expertise, logistics, connections, and funds to these partnerships in the United States and worldwide.

The phenomenological approach in dentistry - a narrative review.

PURPOSE: Phenomenology is a branch of philosophy that focuses on human lived experience. Illness including dental diseases can affect this living experience. Within the dental literature, there is very little reported on the use of phenomenology compared to other healthcare sciences. Hence, the aim was to review the literature and provide an overview of various applications of phenomenology in dental research. METHODS: This study was a narrative review using literature in the last 10 years identified by web-based search on PubMed and Scopus using keywords. A total of 33 articles that were closely related to the field and application in dentistry were included. The methodology, main results, and future research recommendations, if applicable, were extracted and reviewed. RESULTS: The authors in this study had identified several areas such as orofacial pain and pain control research, dental anxiety, dental education, oral healthcare perceptions and access, living with dental diseases and dental treatment experience in which the phenomenological method was used to gain an in-depth understanding of the topic. CONCLUSIONS: There are several advantages of using the phenomenological research method, such as the small sample size needed, the diverse and unique perspective that can be obtained and the ability to improve current understanding, especially from the first-person perspective.

Cluster randomization and political philosophy.

In this paper, I will argue that, while the ethical issues raised by cluster randomization can be challenging, they are not new. My thesis divides neatly into two parts. In the first, easier part I argue that many of the ethical challenges posed by cluster randomized human subjects research are clearly present in other types of human subjects research, and so are not novel. In the second, more difficult part I discuss the thorniest ethical challenge for cluster randomized research--cases where consent is genuinely impractical to obtain. I argue that once again these cases require no new analytic insight; instead, we should look to political philosophy for guidance. In other words, the most serious ethical problem that arises in cluster randomized research also arises in political philosophy.

Case analysis in ethics instruction: bootlegging theory in a topical structure.

Robert Veatch was a notable and prolific author in a variety of areas in philosophy, health care practice, and policy. However, it is evident by the sheer number of case study in ethics books, eighteen editions of case collections in all, that this approach to teaching ethics in the health sciences was especially important to him. A few of these case study collections he wrote alone, but the majority were written with co-authors from nursing, dentistry, pharmacy, allied health, and medicine, drawing on their respective areas of disciplinary expertise and experience as educators. The aim of this article is to focus on the pedagogy and framework Veatch developed to expose students to the rudiments of philosophical ethics so they could understand the conflicts between values, principles, and ethical theories. Authentic clinical cases, he believed, were a useful way to engage students. Putting the two ideas together, Veatch argued the best method of structuring cases is "bootlegging theory in a topical structure" (Veatch, Robert M., Case analysis in ethics instruction. In: Amy Haddad (ed) Teaching and learning strategies in pharmacy ethics, Creighton University, Omaha, 85-97, 1992). Veatch's rationale for this carefully planned systematic arrangement between case topics and philosophical ethics content are presented. The influence and input of co-authors from different disciplines are explored regarding case development and commentary content. Finally, the impact of these interdisciplinary case study textbooks on ethics instruction in the health sciences is evaluated.

Changes in Occlusal Philosophies for Full Mouth Rehabilitation.

This article reviews some of the main tenets of different occlusal philosophies involved in 'full mouth rehabilitation' and evolved since the late 19th century. This review is not intended as a comprehensive historical review of all the people who wrote, researched, or taught on the topic, and it is certainly not intended to disparage their well-meaning contributions. It is intended to highlight some of the changes that occurred in relation to full mouth rehabilitation occlusal concepts along with the dates when they were articulated.

Facts and Fallacies About Occlusal Philosophies for Full Mouth Rehabilitation.

This article reviews various full mouth rehabilitation occlusal concepts along with their main beliefs and controversies. Many of those occlusal teachings were well-meant at the time they were introduced. However, closer examination reveals that many of them involved serious destruction of sound tooth tissue - without delivering many of their purported benefits.The biologic and structural disadvantages of 'subtractive' dental procedures, which were, and still are, undertaken to provide traditional full mouth rehabilitation are discussed. Those approaches are contrasted with the proven advantages of minimally destructive additive techniques, which can solve frequently encountered clinical problems previously deemed to require traditional 'full mouth rehabilitations'. Pragmatic clinical cases are used to illustrate how to solve common clinical problems by using minimally destructive means, without causing structural damage to residual sound tooth tissue.

Philosophies of full mouth rehabilitation: A systematic review of clinical studies.

Aim: To systematically review the available literature on full mouth rehabilitation of the worn out dentition to help the clinician to choose a suitable philosophy to treat an individual Turner and Missirlian classification. Settings and Design: Systematic review following PRISMA guidelines. Materials and Methods: The electronic search engine explored for relevant published studies from the earliest available date, from January 1960 till October 2018. Search terms included were "full mouth rehabilitation OR occlusion OR philosophies of full mouth rehabilitation OR oral rehabilitation OR Pankey Mann Schuyler philosophy OR Hobo Twin stage OR Hobo Twin Table OR worn out dentition OR Turner and Missirlian classification". All collected studies were analyzed and a total of 54 articles and 2 hand searches were extracted, among which 32 articles were selected for the systematic review. Of these 32 articles, 8 were original research studies, 23 case reports and 1 study which comprised 3 case reports were incorporated. Hence, a total of 26 case reports were considered for this systematic review based on CAse REport guidelines. Statistical Analysis Used: Qualitative analyisis. Results: Among 26 case reports, 15 cases (57.69%) were treated by Pankey Mann Schuyler philosophy, 2 cases (7.69%) by Hobo twin table and 9 cases (34.61%) by Hobo twin stage philosophy. 21 out of 26 cases were introduced for category no. 1 (80.76%) and 4 cases for category no. 2 (15.38%) and only 1case presented for category no.3 (3.84%) of Turner and Missirlian classification. Conclusion: : No philosophies are universally applicable. Although the most commonly used philosophy is Pankey Mann Schuyler. Hobo Twin stage philosophy is the second most commonly used followed by Hobo Twin table. Maximum patients with worn out dentition are grouped under category no.1 of Turner and Missirlian classification system. Maximum cases of this category are treated by Pankey Mann Schuyler's philosophy.

Brow and Masticatory Muscle Activity Senses Subjective Hedonic Experiences during Food Consumption.

Sensing subjective hedonic or emotional experiences during eating using physiological activity is practically and theoretically important. A recent psychophysiological study has reported that facial electromyography (EMG) measured from the corrugator supercilii muscles was negatively associated with hedonic ratings, including liking, wanting, and valence, during the consumption of solid foods. However, the study protocol prevented participants from natural mastication (crushing of food between the teeth) during physiological data acquisition, which could hide associations between hedonic experiences and masticatory muscle activity during natural eating. We investigated this issue by assessing participants' subjective ratings (liking, wanting, valence, and arousal) and recording physiological measures, including EMG of the corrugator supercilii, zygomatic major, masseter, and suprahyoid muscles while they consumed gel-type solid foods (water-based gellan gum jellies) of diverse flavors. Ratings of liking, wanting, and valence were negatively correlated with corrugator supercilii EMG and positively correlated with masseter and suprahyoid EMG. These findings imply that subjective hedonic experiences during food consumption can be sensed using EMG signals from the brow and masticatory muscles.

Overall job satisfaction among dentists in Sweden and Denmark: A comparative study, measuring positive aspects of work.

OBJECTIVE: Human service work differs from industrial work, which should be considered when organizing work. Previous research has shown organizational differences in the perceptions of work, often with a focus on negative aspects. The aim of this study was to analyse the overall job satisfaction among private- and public-practising dentists in Sweden and Denmark. This also implied a description of the questionnaire Swedish and Danish Dentists' Perceptions of Good Work about opportunities and positive and rewarding aspects of work. MATERIAL AND METHODS: A questionnaire covering the multidimensional concept of good work was developed. A total of 1835 dentists randomly sampled from the dental associations were sent a questionnaire in November 2008. A special non-response study was performed. Principal components analysis (PCA) was used to create a measure of overall job satisfaction, comparing four organizational subgroups. RESULTS: The average net response rate was 68% (n = 1226). The special non-response study of the Danish private practitioners showed more males, managers and dentists with more working hours than the respondents. PCA of three satisfaction questions showed a stable one-factor solution. There were differences in job satisfaction, with Danish public dentists ranked highest in overall job satisfaction and Swedish public dentists lowest. CONCLUSIONS: There were organizational differences in the perception of job satisfaction. Further analysis of how the human service is organized in the different groups is needed.

A discourse on the nature of dental hygiene knowledge and knowing.

OBJECTIVE: Historically, dental hygiene has adopted theory and research from other health disciplines, without adequately modifying these concepts to reflect the unique dental hygiene practice context, leaving dental hygiene's research and theory base underdeveloped. Dental hygiene has yet to articulate its epistemological assumptions--the nature, scope and object of dental hygiene knowledge--or to fully describe the patterns of knowing that are brought to practice. METHODS: This paper uses a method of inquiry from philosophy to begin the discourse about dental hygiene ways of knowing. In nursing, Carper identified four fundamental patterns of knowing: empirics or the science of nursing; aesthetics or the art of nursing; personal knowledge and ethical or moral knowledge. These patterns were used to explore this concept within dental hygiene. RESULTS: There is more to the nature of dental hygiene knowledge and knowing than rote application of technique-related or research-based information in practice, including judgements about when and how to use different types of information that are used. Currently, empirical forms of knowledge seem to be disproportionately valued, yet evidence was found for all of Carper's four patterns of knowing. CONCLUSIONS: Carper's work on patterns of knowing in nursing provided a useful framework to initiate the discourse on ways of knowing in dental hygiene. These results are submitted for others to challenge, refine and extend, for continuing the discussion. Dental hygiene leaders and scholars need to engage in discourse about extending the epistemological assumptions to reflect reality.

A dialectical analysis of an art of dental hygiene practice.

OBJECTIVE: There has been little in the literature to date that speaks of an art of dental hygiene compared to science. Yet, science, conceived as the findings from research, does not apply itself; it is the knowledge, judgement and skill of practitioners to apply these findings in a particular setting that, at its highest level, informs artful dental hygiene practice. The purpose of this paper is to question whether an art of dental hygiene exists, if it is important, and how it relates to science. METHODS: The method used in the analysis contained in this paper is a dialectical approach used to examine contrary positions, i.e. whether art exists or does not exist, by outlining the structure of each position and clarifying explicit and implicit similarities and dissimilarities. A framework of conceptualizations of art from nursing has been used to examine dental hygiene literature for evidence of art. RESULTS: A preliminary conceptualization, substantiated within dental hygiene, sees the art of dental hygiene as abilities to grasp meaning in client encounters, establish meaningful connections with clients, perform dental hygiene actions skillfully and proficiently, rationally determine courses of dental hygiene action, and conduct dental hygiene practice morally and ethically. CONCLUSIONS: That an art of dental hygiene exists is not in doubt and the analysis is presented. To understand better how dental hygienists make practice decisions to develop this process to its optimum - the pursuit of perfection and excellence in dental hygiene practice, we must pursue understanding the art of dental hygiene practice.

Philosophical reflections on the mission of the European College of Sport Science: Challenges and opportunities.

The European College of Sport Science (ECSS) was established in part to promote the integrated study of sports and related phenomena from multi- and interdisciplinary perspectives. There are significant and enduring philosophical, epistemological and professional challenges and opportunities that arise from this integrationist perspective. In this article, we reflect upon the challenges that have arisen in the development of sport sciences in the attempt to realize the ECSS mission. We identify three paradigmatic approaches to sports science: (1) the mechanistic; (2) the hermeneutic and (3) the critical. We critically evaluate these paradigms and their potential within the broad framework of integrationist ambitions for sports science as a scientific field.

Radiation protection standards: their evolution from science to philosophy.

The concept of applying constraints on individual sources to a small fraction of the public dose limit has been deemed inappropriate when shielding the medical X-ray sources. This represents a broad-based consensus of medical physics and radiological societies in the United States, and the report series on the shielding design for medical X-ray sources (including dental, X-ray imaging and therapeutic X ray) from the National Council on Radiation Protection and Measurements (NCRP) utilises 1 mSv y(-1) as a source control limit. In the present study, the rationale for such a conclusion is discussed, and a somewhat critical look at the current model of radiation protection of the public is made.

Sandwich theory: bioactivity-based explanation for posterior capsule opacification.

PURPOSE: To present a bioactivity-based explanation for posterior capsule opacification (PCO) formation after cataract surgery. SETTING: Central Hospital, Vaasa, Finland. METHODS: The sandwich theory was based on findings in a keratoprosthesis study in which bioactivity of the prosthesis seemed to prevent epithelial downgrowth and clinical findings of the behavior of the AcrySof intraocular lens (IOL). The theory was formulated to explain PCO formation after cataract surgery with posterior chamber IOL implantation. RESULTS: If the IOL were of a bioactive material, it would allow a single lens epithelial cell to bond both to the IOL and the posterior capsule. This would produce a sandwich pattern including the IOL, the cell monolayer, and the posterior capsule. The sealed sandwich structure might prevent further epithelial ingrowth and PCO. CONCLUSION: The degree of IOL bioactivity could explain the difference in PCO and the neodymium:YAG rates with different IOL materials. In theory, a bioactive IOL would prevent PCO better than poly(methyl methacrylate) and silicone IOLs, which have good biocompatibility but are bioinert.

The fluoridation war: a scientific dispute or a religious argument?

Communal water fluoridation is not considered controversial by the vast majority of the scientific community; however, politically it has persisted as an issue that many legislators and community leaders have avoided because of an aura of dispute, it has been a battleground for vigorous opposition by a very small but outspoken minority who have fought it with the dedication of religious zealots. This paper reviews the nature of the opposition, who they are, the broad thrust of their arguments, some of the specific issues they have raised, and their techniques.