How useful are voluntary codes of practice in achieving corporately Essay

How useful are voluntary codes of practice in achieving corporately responsible behaviour - Essay Example This research will begin with the statement that it has become a necessity for corporations to regulate themselves regardless of the rules and guidelines in place to regulate them. Ability of industries to regulate themselves is composed of programmes that are not actually needed by law, but are meant to supplement the law and provide the necessary conducive environment for corporations to operate in. These programmes consist of initiatives such as policies, environment codes of conduct and consensus with government. These self regulations by corporations can be termed as voluntary corporate initiatives. Nevertheless, voluntary codes of practice are most important as they avail an all-round environment inside and outside the corporation. Responsibility and accountability are two vital terms that are used day in day out in governments and corporations. Government plays very decisive and important roles in monitoring corporations. It does this by structuring regulatory guidelines requi red to protect the society and environment upon which all corporations under its jurisdiction have an influence over. This enables it to solve the intricate challenges that are as a result of development. While the government can formulate, pass, amend and impose rules and regulations governing actions of corporations, it is not omnipresent. Hence, government cannot be everywhere every time to make sure that rules and regulations are followed in equal measure by all corporations.

Civil Liberties, Habeas Corpus, and the War on Terror Essay - 2

Civil Liberties, Habeas Corpus, and the War on Terror - Essay Example The work that follows discusses the right of habeas corpus in the war on terror and its historical evolution. Historical Evolution of habeas corpus According to English tradition, habeas corpus fought for liberty of citizens after English land owners forced it on King John in their constitutional document named Magna Charta (Halliday, 2010). The constitutional document declared that no seizure, imprisonment, exile or injury shall occur on anyone except by lawful judgment by the law of the land. In other words everyone had a right to freedom unless they pass through due law process. The common-law courts became the first to use habeas corpus in the thirteenth and fourteenth centuries competing with feudal courts, which local land owners controlled (King & Hoffmann, 2011:). These feudal courts had no consistency in their procedures, and the common-law courts began issuing orders demanding release of prisoners in the feudal courts. According to the U.S tradition, Americans believed habe as corpus as a weapon used to defend an individual’s liberty, and planned to protect it from suspension in times of peace through inclusion of a provision in Article I of their constitution (King & Hoffmann, 2011:). ... ?s war against terrorism, habeas corpus checks abuse of government power on alleged terrorists or suspected aliens or criminals to ensure protection of individuals’ liberty. Examples from U.S. history of the suspension of habeas corpus and their applicability to the present There are several examples of suspension of habeas corpus in the United States history, which are in application at present. An example of habeas corpus suspension is during the reign of Abraham Lincoln. Although authorizing order of the suspension took place in the year 1861, the suspension took place in March 1863 (Dueholm, 2008). The orders given stated that, first, throughout the war period, any person committing a disloyal practice or giving aid to rebels against the U.S authority would be liable to punishment by military commission or courts martial. Secondly, the orders stated that the suspension of habeas corpus was in respect to all persons arrested in places confined by military commission or auth ority. As Article I in the U. S constitution stated, the government had authority to suspend the writ of habeas corpus incase there is risk of security, and when the public safety requires it. Lincoln got authority to suspend habeas corpus after Congress passed an act, two years to the war (Dueholm, 2008). According to the article, the president had executive power vested in them, which gave authority to conduct any changes in the government. The suspension of habeas corpus still applies at present, as the president still has powers to execute changes in the government. Another example in U. S history is seen when Bush signed a law in October 2006 that suspended the rights of habeas corpus to persons whom United States considered an enemy in the war against terror (Longley, 2013). However, this

How to teach literacy and Multi-literacy Essay Example | Topics and Well Written Essays - 250 words

How to teach literacy and Multi-literacy - Essay Example Multi-literacy requires students to integrate technological educational tools. One of the ways teachers can teach literary and multi-literacy is by integrating them teaching. This means that teachers should integrate four essential components of multi-literacy teaching. These are overt instructions, situated practices, transformed action and critical framing (Gambrell, Marrow & Pressley, 2011). Situated practice focuses students to meaningful learning through the integration of primary knowledge. Overt instruction directs students to systematic processes of learning. Critical framing enables students to learn how to approach the diverse environment in order to improve their learning experiences. Teachers can also use transformed action teaching to teach students how to apply lessons to real life experiences. Teaching literacy and multi-literacy can lead to the adoption of new ideas and practices. It can also help in overcoming the limitations experienced in traditional learning approaches. Teaching literacy and multi-literacy introduces teachers to new pedagogical approaches and practices, which creates opportunities for future learning and teaching. The four ways in which teachers can teach literary and multi-literacy are the use of situated practices, critical framing, overt instructions and transformed actions. These methods have the potential to guide teachers to provide equal access to teaching and learning

Critically analyse the territorial and extraterritorial ambit of the Assignment

Critically analyse the territorial and extraterritorial ambit of the offence of murder under English Criminal Law - Assignment Example die of the wound or hurt etc. within a year and a day after the same† (Allen 309). It is imperative to note that under the English criminal system, murder is classified into the category of homicide and manslaughter. Legally, homicide is a more serious offence in comparison to manslaughter. In order for a person to be charged with homicide or manslaughter, the elements of the definition of murder must be proved to be true. Actus Reus Under the English Law, the Actus Reus for murder must be present before one can be convicted for the offence of murder. One aspect of Actus Reus is that act of murder must be unlawful. This implies that act should not have any legal basis to justify its occurrence. Under the English criminal system, the law recognizes some circumstances under which murder can be justified. For instance, killing someone in self defense can be admissible in a court as a legally permissible reason for murder. The justification for killing also depends on the circumsta nces under which the deceased was killed and the role of the accused in the murder (Chalmers & Fiona 219). In essence, killing under English law may include accelerating another person’s death due to an act or an omission. ... This means that any killing that occurs under all circumstances except during war are is classified as an offence of murder. Enemy killing is not justified by law unless it occurs during a war or events thereof (David 453). English Law is precise in regards to the concept of â€Å"Queen’s peace† by expressly stating that all situations except during war are classified as â€Å"Queen’s peace†. Even formally identified foreign enemies cannot be lawfully killed under the pretext that they are outside the scope of the Queen’s peace. It is imperative to that this principle applies both within and outside the territories of the English criminal law. The specific act or omission that results in the murder of a person must have a substantial contribution as cause of death for an accused person to be convicted for the offence of murder. The act or omission and the death must be linked in order for a conviction to be upheld. In essence, the prosecution has th e burden of proving that the accused did more than minimally or negligibly contribute to the death. The contribution of the accused person to the death must be considered substantial in the context of the law (Hirst 229). In this regard, even if the action or omission just accelerated the death, the accused is legally liable for the death. For instance, in R v Dyson (1908), it was held that the defendant was liable for the offence of murder even though the defendant had only hastened death. In order to break the causation chain, it is upon the defendant to prove that the intervening act was the main cause of the death (Cryer 152). This may occur in instances whereby a person’s actions or inactions are part of a chain of actions that can be attributed to the death. It is only an unforeseeable or unexpected action

BHM 443 -Legal Aspects of Health Care (Module 4-CBT) Essay

BHM 443 -Legal Aspects of Health Care (Module 4-CBT) - Essay Example ness and promptly transfers the responsibility for the patients care to another provider who is willing to act in accordance with the agents direction. 2. Failing to consult a disabled or incapacitated patients surrogate if the surrogate cannot be contacted after the health care provider has made a reasonable effort to do so or if an emergency situation does not provide the health care provider with sufficient time to locate and consult with the surrogate. D. This section does not relieve a health care provider from civil or criminal liability or prevent a provider from being subjected to professional disciplinary action for the providers negligent treatment of a patient if the negligence is unrelated to the providers reliance on a health care directive, directions from a surrogate or the recommendations of an institutional ethics committee pursuant to section 36-3231. For example, Michigan laws prohibit healthcare providers to perform duty under the influence of alcohol or a substance ( Public Act 235) since this results to criminal liability ( cited in Miller, Johnson, Snell and Cummiskey, 2007 ) . A doctor who performs an operation under the influence of alcohol and impairs/injure a patient can be considered an act of gross negligence. In this case, the doctor is criminally liable especially if the patient died under his care. In the first place, it is unethical for a doctor to be under the influence of liquor while doing his duty; moreover, he is negligent when performs an operation under the influence of liquor or substance since this impair one’s ability. The law stipulates alcohol content of .05 or more grams which is not visually detected by the healthcare organization. Besides, the healthcare organization has definitely issued policies and directives about this law and has done its obligation to its employees. Therefore, the doctor is responsible for his behavior. On the other hand, Vicarious liability is legally defined as â€Å" a principal’s

Introduction to Linguistics Essay Example for Free

Introduction to Linguistics Essay What is meant by the field of linguistics? This introductory chapter concerns some dimensions of linguistics, which give us a general idea of what linguistics is, including the history of linguistic, grammar, and other disciplines of linguistics study. What does grammar consist of and what are the relationship between one and another? How many languages do human beings have the capacity to acquire? What other studies are made in recent centuries? Each of these aspects are clearly described, and other chapters will go into further details. While in this chapter we will provide some less detailed information on the various aspects of linguistics mentioned so far. 1. 1 Defining Linguistics There is nothing that can be said by mathematical symbols and relations which cannot also be said by words. The converse, however, is false. Much that can be and is said by words cannot successfully be put into equations, because it is nonsense. C. Truesdell Linguistics is a study to describe and explain the human faculty of language. There is no doubt that linguistics has changed through human development. 1. 1. 1 History of linguistics See more: how to write an introduction The history of linguistics can be divided into three periods: antiquity, middle ages and modern linguistics. 1. 1. 1. 1 Antiquity Dating back to earlier period of linguistics, linguistics is often associated with a need to disambiguate discourse, especially for ritual texts or in arguments. Ancient Indians made a big contribution to linguistics development. Similarly, ancient Chinese played a key role in improving linguistics development. Around the same time as the Indian developed, ancient Greek philosophers were also debating the nature and origins of language. During this period, syntax and the use of particles developed fast. In addition, scholars proposed that word meanings are derived from sentential usage. 1. 1. 1. 2 Middle Ages In Middle East, in terms of expanding Islam in 8th century, a large number of people learn Arabic. Because of this, the earliest grammar came to being gradually. At the same time, Sibawayh, a famous scholar, wrote a book to distinguish phonetics from phonology. In the 13th century, Europeans introduced the notion of universal grammar. 1. 1. 1. 3 Modern Linguistics Modern linguistics beginning can date back to the late 18th century. With time passing by, the study of linguistics contains increasing contents. Meanwhile, it is used in other fields, computer, e. g. , has come to be called computational linguistics. The study of applications (as the recovery of speech ability) is generally known as applied linguistics. But in a narrower sense, applied linguistics refers to the application of linguistic principles and theories of language teaching and learning, especially the teaching of foreign and second language. Other related branches include anthropological linguistics, neurological linguistics, mathematical linguistics, and computational linguistics. However, linguistics is only a part of a much larger academic discipline, semiotics. It is the scientific study of language. It studies not just one single language of any one society, just like Chinese or French, but the language of all human beings. A linguist, though, does not have to know and use a large number of languages, but to investigate how each language is constructed. In short, linguistics studies the general principles whereupon all human languages are constructed and operated as systems of communication in their societies or communities. 1. 1. 2 An Interesting Comparison. Linguistics is a broad field to study, therefore, a linguist sometimes is only able to deal with one aspect of language at a time, and thus various branches arise: phonetics, phonology, morphology, syntax, semantics, applied linguistics, pragmatics, psycholinguistics, lexicology, lexicography, etymology and so on. Suppose that the study of linguistics can be considered to be a computer, so linguistics is equal to the CPU, which supports all the other parts. Moreover, sound card would stand for phonetics and phonology, and then morphology and semantics are like the memory of the computer. Whats more, syntax plays as an important role to translate single words to a whole sentence which is full of meaning, just like a graphics card, which uses picture to make sense of the idea of memory stick. Finally, everything is ready, it s time to use computer and the same goes for language acquisition. Very interestingly, the properties of computer are amazingly similar to human language. from www. iflytek. com/english/Research-Introduction%20to%20TTS. htm Above all, linguistics is concerned with the study of verbal language particularly speech and written language. Whats more, language is a system and there is a set of options of which one must be chosen depending on the purpose and context. (Marie E. John P. , 1991, p. 64). 1. 2 The broad study of language Language is a highly complex system of communication, so it sometimes will be called a ‘system of systems’. It is used to construct, exchange, express, and record information and ideas. It performs these functions effectively because it is based upon systems that are understood by those using the language. In this chapter, four topics will be concerned. They are phonology, morphology, syntax, and semantics. In this section, some overall definitions and interactions among the four parts will be talked about. 1. 2. 1 Phonology In order to assist learners at the early stages of literacy, it is very important to understand the relationship between sounds and letters. The sounds of speech are studied in phonetics and phonology. (Marie E. John P, 1991) 1. 2. 1. 1 Definitions of phonology and phonetics Phonology is the study of sound systems- the invention of distinctive speech sounds that occurs in a language and the patterns wherein they fall. In other words, we study the abstract side of the sounds of language, a related but different subject that we call phonology (Peter, 2000). In short, it is about patterns and roots. On the other hand, it is more strict linguistics. Phonetics is the science which studies the characteristics of human sound-making, especially sounds used in speech, and provides methods for their description, classification and transcription. In common, speech sound is used everywhere, and it can be divided into three parts: articulatory phonetics, auditory phonetics, and acoustic phonetics. 1. 2. 1. 2 The difference between phonology and phonetics It seems that phonology and phonetics are similar. That is why both of them make learners confused. In fact, they have great difference. Phonology pays attention to how speech sounds of a language pattern are put together according to regular rules. On the contrary, phonetics focuses mainly on description of how speech sounds are made. For instance, if someone says â€Å"we should get our two lips close together and then push them open with a strong air†, that means he or she is relevant to phonetics field. Another example is â€Å"no words should begin with the ‘ng’/N/ sound, the sound only occurs at the end of words†, and this concerns phonology area. Plenty of terms are used to describe different patterns of letters and sounds. Some of the common used terms are blend, digraph, schwa, syllable and phonics, which are widely and frequently applied. 1. 2. 2 Morphology Morphology has been regarded as a necessarily synchronic discipline. That means the rules focusing on the study of word structure instead of the development of words (Katamba, 1993, p.3). It is the basic element used in a language, and the concept of morphemes is one of the main aspects in the study of morphology (Yule, 2006, p. 66). Basically, it is the branch of linguistics that studies the internal structure of words. In morphology, morphemes are the minimal units that have semantic meaning. It is the linguistic term for the most elemental units of grammatical form (Fromkin, Rodman, Hyams, 2006, p. 77). 1. 2. 2. 1 The classification of morphemes Morphemes are composed of free and bound morphemes. Free morphemes are the morphemes that can stand by themselves as single words, while bound morphemes are those that can not normally stand alone, but that can be attached to affixes (Yule, 2000, p. 75). Free morphemes contain lexical and functional morphemes. The first category, free morphemes, is the set of ordinary nouns, adjectives, adverbs and verbs which carry the content of the conveyed messages (Yule, 2000, p. 76), and most English words refer to this category. The functional morphemes consist largely of the functional words, including conjunctions, prepositions, articles and pronouns (Yule, 2000). Bound morphemes can also be divided into two categories. They are derivational and inflectional morphemes. Derivational morphemes are those which make new words in the language and make words of a different grammatical category from the stem (Yule, 2000, p. 76), which means that it can change the meaning or the word class, whereas the inflectional morphemes are used to indicate aspects of the grammatical function of a word (Yule, 2000, p. 77). 1. 2. 2. 2 The interaction with other aspects Morphology has interactions with phonology. The selection of the form that manifests given morpheme may be affected by the sounds that realize neighboring morphemes (Katamba, 1993). For example, prefixes and suffixes will normally affect the stress. Meanwhile, there is interaction between morphology and syntax. The form of words may be influenced by the syntactic construction in which the word is used (Katamba, 1993, p. 13). 1. 2. 3 Syntax So far in our study of language, we have made studies of phonetics, phonology and morphology. We have analyzed the structure of sounds and words. Therefore, we have been concentrated on the level of small units of language. After our analysis of words, we move to the consideration of larger structural units of language: phrases and sentences. If we concentrate on the structure and ordering of components within a sentence, we are studying what is technically known as the syntax of a language (Yule, 2000, p. 100). Syntax can be simply defined as the scientific study of sentence structure. According to Geoffrey (2005), syntax is a term used for the study of the rules governing the way words are combined to form sentences. The origin of this word is from Greek and it means a setting out together or arrangement (Yule, 2000). In the sentence The boy hits the door, we can discover that the words are related to each other in this order that it only has one meaning. If we change the order of the words The door hits the boy, the sentences meaning has totally changed and it is nonsense. The reason is that the parts of the sentence are structurally related to each other, and this structure is reflected in the word order. In English, the word order is very necessary and important for the meaning of the sentence according to linguistic rules. In some languages, word order plays a less important role. The meaning of the sentence depends more on the form of the words themselves. In such cases, it is possible for sentences with totally different word order to have the same meaning. English used to be one of these languages. The following examples are taken from Old English: Se cyning metech thone biscop-The king meets the bishop Thone biscop meteth se cyning-The king meets the bishop Although the words are arranged differently, they still mean the same. However, nowadays, the word order is very crucial for meaning. As a consequence, there is a great need for us to explore syntax. Some important concepts are included in the study of syntax. 1. 2. 3. 1Complex and compound sentence Three sentence types are basic in the syntax. There are simple sentence, compound sentence and complex sentence. A simple sentence includes one word. However, in some situation, the simple sentence contains two words. A compound sentence contains at least two simple sentences. The sentences are linked with a conjunction. A Complex sentence composes of at least one main clause and one subordinate clause. 1. 2. 3. 2 Syntax Analysis The following example is provided for syntax analysis. The football team won the match last year. S NP VP NP Det N Vt Det N Adv Ext(time) The football team won the match last year. The chart above is called tree diagram. The letters above each indicate: S = sentence, NP = noun phrase, VP = verb phrase, N = noun, V = verb, and so on. The syntacticians use this method to analyze the sentences. 1. 2. 3. 3 Basic Syntactic Structure In English, the structure of sentence depends heavily on word order. The four basic structures are listed as follows: SNP + Vc + NP ( NPN, NP Det + N) SNP + VP ( NPN, VPVc + Adj) SNP + VP ( NPN, VPV) SNP + VP (NPN, VPVt + NP, NPDet + N) 1. 2. 3. 4 Basic Syntactic Generative Process. There are four basic syntactic generative processes: substitution, expansion, extension, transformation. Take the following sentence as an example to clarify these three concepts. Ken is a policeman. Substitution: Ken is a policeman. Tom is a policeman. Expansion: Ken is a policeman. Ken is a bad policeman. Extension: Ken is a policeman. Ken is a policeman at that time. Transformation: Ken is a policeman. Is Ken a policeman? 1. 2. 4 Semantics Semantics, a subfield of linguistics, is the study of literal meaning. It is the recent addition to the English language. (Palmer, 1976, p. 1). According to Matthews (2007), during the early years the study of meaning focused on the lexicon alone. The scope of the study has expended since 1960s to include both semantics and pragmatics (analyzed in 1. 3), which come to the main fields of the study of linguistic meaning(Katamba, 2000 Matthews, 1997). Semantic meaning is fixed and abstract. It can be understood by surface. However, it is de-contextualized. In another word, it is easily subverted by different gestures or intonations. Semnatics interacts with other aspects of linguistics. For example, when synonyms are used, they can be understood, so it fits the rule of syntax. However, synonyms are used to describe something similar. In a sentence, a synonym can be substituted by another synonym. However, the meaning of synonyms speaker or writer determines or predicates have different degrees, which indicates the meaning is actually different (Alan, 2004). Thus, it is the interaction between syntax and semantics. As for the interaction with phonology, the term tonic syllable in phonology has three kinds of functions. The first one is the accentual function, which is to indicate the focus of the information. The second one is the attitudinal function that is to indicate the speakers attitude. And the last one is grammatical function. If speakers use these functions, the same sentence will turn out to have various meanings. To conclude, in this section, linguistics is analyzed from the aspects of sounds, word structure, grammatical rules and meaning. Each of them is in charge of a certain system. Thus linguistics can help people to communicate, to express, and to be understood. 1. 3 Other disciplines Apart from the core subparts of linguistics, which we have demonstrated before, for further reading, we introduce some other exciting aspects in the field of linguistics. There are a lot more to discover than those areas. 1. 3. 1 Sociolinguistics People may know something about you through the way you speak, for example, where you come from, where you spend most of your life time, your social identity and so on. Two people growing up in the same geographical area, at the same time, may speak differently owing to a number of social factors (Yule, 2000). Consequently, it’s very important to consider the social aspects of language. It’s because speech is a form of social identity and is used, consciously or unconsciously (Yule, 2000). The study of the social aspect of language is known as sociolinguistic. â€Å"Sociolinguistic is concerned with investigation of the relationship between language and society† (Ronald, 2006, p. 13). It consists of cultural norms, expectations, and context on the way language is used. The first linguists who studied the social aspect of language are Indian and Japanese in the 1930s. Another person called Gauchat who came from Switzerland had a analysis of this in 1900s as well. However, these three people didn’t receive much attention in the West. Until the late 19th century, the study of social aspects of language laid its foundation. Sociolinguistics gradually appeared in the 1960s in the West. Linguistics such as William Labov in the US and Basil Bernstein in the UK first brought out this concept and explored it. (Wikipedia, 2007, para. 1) 1. 3. 2 Neurolinguistics Though the neural structures of most animal species are very distant from man, there are still resemblances between human and animal languages (Marler, 1981; Nottebohm, 1970), since neurons work in both. Human brain contains billions of neural cells, and so far, the exact number of those so-called neurons is still to be defined (Fabbro, 1999, p. 21). These teeny tiny neurons have close link with the production of language. There can be innate or learnt vocal utterances. Oral language can be the innate property of the human brain, written language, however, is an invention of humankind. Dogs can bark, cats can miaow, and man can cry even after the removal of the midbrain, whereas parrots cannot imitate human sounds, and we cannot produce human language (Fabbro, 1999, p. 21). Therefore, the neural center of our brain is playing an irreplaceable role in the production of language. How does the main cerebral structure serve the production of human  vocalizations? The study of neurolinguistic rely on the study of neurology and neurophysiology, and in these fields, all parts of the nervous system, each having different functions in generating language, are discovered. Theories are found based on lots of experiments concerning the removals of different sections of the brain. The destruction of different language areas destroys language distinguishingly. 1. 3. 3 Historical linguistics Historical linguistics definitely is not concerned with the history of linguistics, though historical linguistics has played an important role in the development of linguistics. It is the main kind of linguistics practiced in the 19th century (Campbell, 1998, p. 5). Historical linguistics concerns the investigation and description of how languages change or maintain their structure in the course of time. Language change can be easily proved by documents written in the same language but at different periods of history. The differences of wording and structure of sentences can reflect the historical development of language. From series of datable documents, Lord’s Prayer widely recorded the history of mankind, and different versions help us analyze the language of each period (Bynon, 1978, p. 7). Meanwhile we can also discover that certain structure rules are still used in current language. There are some constructs and rule that link the grammars of two different but related languages, which descend from a single original language, sharing a common ancestor. More accurately, historical linguistics deals with the kinds of changes, and the techniques and methods we have use to discover history, rather than the origin of words themselves (Campbell, 1998, p. 5). 1. 3. 4 Anthropological linguistics Anthropological linguistic is the study of relations between language and culture. It is related to human biology, cognition and language. It belongs to the field of linguistic anthropology, which is a branch of anthropology that studies human-beings through the language they use(Wikipedia, 2007, para. 1). Some Linguists who explore theanthropological linguistics consider these topics such as chimpanzee communication, pidgins and creoles, structural linguistics,total languages, whorf hypothesis, etc. 1. 3. 5 Pragmatics According to Kate (2000), pragmatics is one of the two main fields in the study of linguistic meaning. Pragmatics deals with natural language, while language is always used in context for an intended purpose. The listeners must try to grasp the meaning implied, enrich the ideas, and finally make out the opinion that what the speakers meant when talking about a particular expression (Kate, 2000). According to Yule (1996), ‘pragmatics studies the context in which the utterance is produced as well as the intention of language user. ’ That means pragmatic meaning depends on context or situation. Without context, meanings can be vague and may be misunderstood by people. Two of the branches are: speech acts that cover ‘requesting’, ‘commanding’, ‘questioning’ and ‘informing’, and politeness that shows the awareness of another person’s face. In short, sociolinguistics is the analysis of interrelationship of language and society. Neurolinguistics is the study of the brain and how it functions in language. Historical linguistics is the consideration of language change and how different languages are related to each other. Anthropological linguistics is the study of language and culture. There are some other disciplines in linguistics. Pragmatics deals with the speakers meaning. The five mentioned above are some main disciplines in linguistics. Different disciplines of linguistics enrich the content of linguistic. The study of linguistics tends to be more and more detailed and completed. 1. 4 Language Acquisition This chapter began with a general introduction to language study. It ends with a consideration of the acquisition of language, containing first, second and foreign language, which is affected by the relationship between teacher and learner. Some experienced educators advise that it is only through learning to speak a language that you can fully analyze it (Everett 2001). Acquisition is described as occurring in spontaneous language contexts (Krashen, 1982), is subconscious, and leads to conversational fluency. 1. 4. 1 First language acquisition For a child, learning first language is automatic, not after starting school, not in specific circumstance and not by great efforts (Yule, 2006). It requires only basic physical capability of sending and receiving sounds directly or indirectly, and interaction with others using this language. Children are brought up in particular environments, being affected by different surroundings, especially by those people whom they spend most of their time interacting with. Infants start express themselves through some simple utterance, such as some vowel-like sounds. Children gain increasing abilities at different development stages, from producing single-unit utterance to producing speech by communicating through expressions (Yule, 2006), since they are able to understand what others said. This a big step forward, like quitting toddling and being capable of walking steadily, forwards, or backwards. As children are being increasingly exposed to communication and interaction, their language skills are developing rapidly because of the expansion of vocabulary. They are never forced to speak first language and seldom be corrected by others, but they correct themselves through interactions every day. Then children learn to use verbs in different sentences, and how to use different words to form a sentence (Yule, 2006). They gradually learn to ask questions correctly and how to use the word no in their speeches to express negative meanings. The last stage of first language acquisition is the ability of making meaningful sentence (Yule, 2006). There is massive variation in the rate at which features of ones first language are acquired. 1. 4. 2 Second language acquisition  Being able to speak first language is one of the basic skills of second language acquisition. Except for the minority of people who are bilingual speakers, most of the learners have no access to a second language until our late childhood. Actually most of the Chinese learners are now learning English as a foreign language, because it is immediately back to Chinese speaking time out of the classroom. But later on they may have the chance of learning it as a foreign language in a native speaking environment, during immersion semesters, when they will acquire this second language in circumstances similar to those of Chinese acquisition. There are obviously differences in foreign language achievement, sometimes related to differences in aptitude (Carroll, 1982), sometimes to affective factors (Gardner Lambert, 1972), sometimes to learner strategies (Naiman, Frohlicn, Stern Tedesco, 1978), sometimes to environmental factors such as opportunities for language use or instructional conditions (Long, 1982), and sometimes simply to time (Carroll, 1975). Human beings have the ability to learn more than one language all through ones live. Farwell (1963) (cited in Taylor, 1976) reports that a British explorer in the 19th century claimed to have spoken more than 40 languages and dialects. Usually, however, after the age of 10, the acquisition of second language is very different from the way one acquired his first language, which is relatively slower and cannot achieve native-like proficiency. 1. 4. 3 Educational factors Most of us begin learning second language in teenage years, spending only few hours on it every day and for most of the daily activities we use our mother tongue. Accordingly, we will encounter lots of difficulties in learning second language without enough exposure to it. Therefore, the largely distinguished part of acquiring first and second language should be language teachers. In order to learn a second language, we must learn from a teacher, or at least follow their guidance. The classroom is a very powerful instrument of instruction and it can control language learning in a very direct way (Richard, T. Roger,H. ). As language teachers, we should focus on students requirements and follow learner-centered approaches. We should impart knowledge in a more practical way so the students can receive easily. Keep the class disciplined and orderly so that students can learn most effectively from the lessons. There are often the situations that the students seldom volunteer answers, and the teacher sometimes has to call on someone and wait for a long time before a response is forthcoming. Why not try breaking away from typical Hong Kong classroom practices in class? Like, students do not have to stand up to greet teachers, and they do not have to raise their hands or stand up when they answer questions. In a relaxed classroom atmosphere, students will feel free to interact. They will not fall silent when the teacher enters the room, then stand up and chant a choral greeting. If the pupils are put in this position in the classroom, they can be more effectively kept in their place in social life. During the class, we teachers should never say like this: I am your teacher. By the authority vested in me I have the right to ask you to behave in a certain way, whether you like it or not. And you, in your role have the obligation to obey (Widdowson, H. G. ). Whereas, we should say that in another way: Do this because I am the teacher and I know whats best for you, but not Do this because I am telling you and I am the teacher. This difference has the advantage of largely increasing participation in the use and practice of language. 1. 4. 4 Summary Approaches to the acquisition of language account for different backgrounds of learns first language, and different conditions of exposure. In acquiring language, learners often go through transitional stages of development, which is at distinguished rates. References Cruse, A. (2004). Meaning in language : an introduction to semantics and pragmatics. Oxford, New York, Oxford University Press. Bynon, T. (1983). Historical Linguistics. Cambridge: Cambridge University Press. Campbell, L. (1998). Historical Linguistics-An Introduction. Edinburgh: Edinburgh University Press. Dechert, H. W. (1990). Current trends in European second language. Great Britain: WBC Print, Bristol. Fabbro, F. (1999). The Neurolinguistics of Bilingualism. Psychology Press Ltd. Fromkin, V. , Rodman, R. , Hyams, N. (2006). An introduction to language (8th ed. ). Boston, MA: Heinle Heinle. Palmer, F. R. (1976). Semantics: a new outline. Cambridge; New York : Cambridge University Press. Geoffrey, F. (2005). Key Concepts In Language And Linguistics. USA: Palgrave Macmillan. Kate, K. (2000). Semantics. Basingstoke, England, Macmillan. Katamba, F. (2006). Morphology. Basingstoke : Macmillan Press. Marie E. John P. (1991). Language and Learning. Melbourne: Oxford University Press O Mally, J. M. , Chamot, A. U. (1990). Learning strategies in second language acquisition. Cambridge University Press. Matthews, P. H. (1997). Oxford Concise Dictionary of Linguistics. Oxford. University Press, USA. Peter, R. (2000). English Phonetics and Phonology. Cambridge University Press. Ronald, W. (2006). An Introduction to Sociolinguistics. USA: Blackwell Publishing. Widdowson, H. G. (1990). Aspects of Language Teaching. Oxford University Press. Wikepedia: Sociolinguistics (n. d. ). Retrieved 30 October 2007 from http://en. wikipedia. org/wiki/Sociolinguistics Wikepedia: Anthropological linguistics (n. d. ). Retrieved 30 October 2007 from http://en. wikipedia. org/wiki/Anthropological_linguistics Yule, G. (2006). The study of language (3rd ed. ). Cambridge, New York: Cambridge University Press.

Immediate Dentin Sealing Of Crown Health And Social Care Essay

Immediate Dentin Sealing Of Crown Health And Social Care Essay Background: Dental crowns are ideal restoration to protect teeth that have been extremely worn down, broken, weakened by caries, and heavily filled or root canal treated. They can be also used for aesthetic purposes. Full crown preparation requires more tooth removal than other restorations and is associated with dentine exposure. When a two-stage crown fabrication is planned, there is a risk of bacterial contamination of the pulpal tissue through dentine and eventually vitality loss. The main objective of this protocol is to assess whether immediate sealing of the exposed dentine surface following crown preparation of back teeth can lead to a decrease in microleakage and bacterial infiltration from the oral environment. Methods: This protocol, immediate dentine sealing of crown preparations, demonstrates a model for a one year, three years and six years follow-up, in-vivo, randomised controlled trial with a balanced treatment allocation of 1:1 (immediate dentine sealing vs. delayed sealing). The treatment will include tooth preparation, impression taking, temporary crown placement and full crown fit on a posterior tooth. Discussion: The results of the study would provide insight into the question of whether immediate sealing of dentine after crown preparation reduces the bacterial ingression and incidence of vitality loss of teeth. The results would also help to provide evidence based suggestions for clinicians and other researchers. Overview This dissertation consists of literature review and a representation of the study design and methodology, followed by data management, statistical analysis and quality assurance of proposed study. Other sections are allocated to ethical consideration and reflection on thesis procedure. DECLARATION No portion of the work referred to in the dissertation has been submitted in support of an application for another degree or qualification of this or any other university or other institute of learning. INTELLECTUAL PROPERTY STATEMENT The author of this dissertation (including any appendices and/or schedules to this dissertation) owns certain copyright or related rights in it (the Copyright) and s/he has given The University of Manchester certain rights to use such Copyright, including for administrative purposes. Copies of this dissertation, either in full or in extracts and whether in hard or electronic copy, may be made only in accordance with the Copyright, Designs and Patents Act 1988 (as amended) and regulations issued under it or, where appropriate, in accordance with licensing agreements which the University has entered into. This page must form part of any such copies made. The ownership of certain Copyright, patents, designs, trade marks and other intellectual property (the Intellectual Property) and any reproductions of copyright works in the dissertation, for example graphs and tables (Reproductions), which may be described in this dissertation, may not be owned by the author and may be owned by third parties. Such Intellectual Property and Reproductions cannot and must not be made available for use without the prior written permission of the owner(s) of the relevant Intellectual Property and/or Reproductions. Further information on the conditions under which disclosure, publication and commercialisation of this dissertation, the Copyright and any Intellectual Property and/or Reproductions described in it may take place is available in the University IP Policy (see http://documents.manchester.ac.uk/display.aspx?DocID=487), in any relevant Dissertation restriction declarations deposited in the University Library, The University Librarys regulations (see http://www.manchester.ac.uk/library/aboutus/regulations) and in The Universitys Guidance for the Presentation of Dissertations. Acknowledgements I have great pleasure to express my gratitude to my Tutor (Juliette Kendall). She has been most helpful and supportive throughout. Introduction, Research question and PICO 1.1 Introduction Restoring teeth with full-coverage crowns is a routine treatment in general dental practice. This normally requires two visits, one for crown preparation and impression taking and one for final cementation of the crown once the restoration has been produced in the dental laboratory. Provisional crowns which will be provided to protect the tooth between two visits could cause problems since they are not bonded to the prepared tooth surface permanently and require removal prior to final cementation. Problems may occur if the bacteria from oral cavity gain access to the pulpal tissue. The consequence could be pulp inflammation or even irreversible pulp infection, which requires endodontic treatment. There are some evidence in the literature that suggests that applying a sealant material on the freshly prepared teeth may reduce the invasion of the pulp by bacteria (Magne et al., 2007). Any effort needs to be made to reduce the risk of vitality loss in teeth requiring a full-coverage crow n. There are other alternatives to reduce the bacterial ingression like CAD/CAM technology. This method allows restoring a tooth with a crown in a single visit. Reis 2006 believes that using this system may decrease the possibility of bacterial infection of the pulp as there is no need for provisional coverage of the prepared tooth. 1.2 Research question Protecting the exposed dentine with a sealant after a crown preparation requires some additional steps and is more expense and time-consuming than the traditional procedure. The research question is if it is clinically necessary to seal the exposed dentine immediately after the preparation with a dentine sealing agent or not. 1.3 PICO Population: NHS and private patients between the age of 18 and 58 years of age in general dental practice requiring full-coverage crowns of a posterior tooth. Intervention: Sealing the exposed dentine of prepared teeth for full crown coverage with a dentine sealing agent instantly after the preparation before taking a final impression and temporisation. Control: Not sealing the exposed dentine of prepared teeth for full crown coverage with a dentine sealing agent instantly after the preparation. Outcome measure: Comparing the vitality loss of the prepared teeth for full crown restoration at one year, three years and six years. Aims and objectives Aims: The aim of the study is to evaluate the efficiency of instant sealing of posterior teeth prepared for full crown coverage prior to impression taking and temporisation in terms of vitality loss compared with teeth without any sealant application. Objectives: The primary objective is to assess whether an instant sealing of prepared posterior teeth for full crown restorations with a dentine sealant results in a reduction in vitality loss. To organise a clinical trial and to allocate two groups of participants (NHS and private) aged between 18 and 58 requiring a crown on a posterior tooth. One group will have their prepared teeth covered and one group not. To analyse the achieved data and to determine whether there is a difference between groups in terms of loss of vitality. Literature review 3.1 Introduction The assumption of this protocol is the proposition that the instantaneous sealing of exposed dentine after crown preparation, will help against the bacterial contamination of the pulpal tissue and decreases the probability of the treated tooth requiring root canal treatment in the future. 3.2 Search Strategy The strategy conducted for this literature review included an electronic search of the following databases: EMBASE (1995 Oct 2011), MEDLINE (1995 Oct 2011) and Cochrane Library. The reference list includes hand-searched articles and key journals related to researching. Key words: REFER TO KEY WORD EITHER HERE OR APPENIX 3.3 Background Where tooth destruction by dental disease is extensive, restoration may only be possible with full coverage restorations or crowns. There is a big number of NHS and private patients in UK requiring a full coverage of posterior teeth due to failed huge previous restorations, fractured cusps or following a root canal therapy. Tooth preparation for full coverage crown requires more tooth removal than other restorations. It should be carried out in a conservative way. The reason is to reduce the post-preparation sensitivity and pulp tissue protection in vital teeth and to maximise the remaining tooth structure. 3.4 Crown Preparation and pulp Health of pulp tissue can be affected by any restorative treatment. This is due to a continuous extension between dentinal and pulpal fluid (Pashley 1992). Preparation for a full-coverage restoration requires removal of most of the enamel resulting in an exposed dentine surface and may affect the pulp. In one study by Jackson et al. (1992) irreversible pulpitis occurred in 5.7% of cases in which crowns were placed. The bigger the exposed dentine surfaces during tooth preparation like for a crown, the greater the risk of bacterial infiltration from the oral environment (Pashley, 1990). Saunders and Saunders (1998) considered the vitality loss in adults who received full crowns in a dental hospital based on radiographic analysis and found that 19% of the patients in the study have lost vitality of the prepared teeth. A study by Cheung et al. (2005) aimed to investigate the influence of factors connected with pulpal damage in teeth restored with porcelain fused to metal (PFM) crowns or crowned as a fixed bridge abutment. The study reveals that the preparation for either of the restorations requires a considerable reduction of dentine and may cause trauma to pulp tissue but the survival rate of pulp in single-unit crowns is higher than in abutment teeth. Bergenholtz and Nyman (1984) and Karlsson (1986) demonstrated a permanent pulpal damage rate of 1% year for vital teeth following a crown restoration. 3.5 Crown Vs. other restorations Many previous studies have supported the use of indirect intracoronal restorations (porcelain or composite) in vital teeth as advantageous against full-coverage restorations due to their less invasively preparation and more conservative nature (Jackson, 2008, Magne et al., 1996, Dietschi et al., 1994). They have been also considered to be easier to do than a crown and are no more expensive than crowns or root canal treatments. A literature review by Kerschbaum and Voß 1981 showed that inlay restorations at 10 years have 9.5% lower rate of vitality loss compared to full crown restorations. When aesthetic aspect is not the first priority properly designed and provided inlays and onlays have the same longevity and durability as crowns (Jackson, 2008). Cusp replacement with resin composite can be considered as alternative to traditional cusp replacement by crowns due to advanced adhesive technology. Deliperi et al. (2006) highlight that if the bonding agent is not stressed, an acceptable success rate could be achieved by using this method. According to van Dijken et al. (2001) an indirect cusp replacement restoration with ceramic might be considered indicated. This has the benefit of saving valuable remaining tooth substance and eventually avoiding endodontic therapy. 3.6 Dentin Bonding There are recommendations in the literature for sealing the dentine with a Dentine Bonding Agent (DBA) following crown preparations in order to minimise the associated complications like hypersensitivity (Clinical Research Associates 1993). Dentine bonding agents have shown to be advantageous over the smear layer itself due to their mechanical retention (Nakabayashi et al. 1982) and moisture and acid resistance (Brunton et al. 2000). Over the last decades they have been considered as a modern way of sealing exposed dentine (Ferrari M. et al. 1999, Swift EJ et.al 2001). Some authors have compared the effectiveness of DBA with smear layer as a natural barrier. Pashley (1984) states that dentine permeability can be reduced up to 98% when smear layer is produced by slow or fast rotary headpieces but it would not last for more than a few days due to acidic PH from the oral cavity (Kerns DG. et al. 1991) .There are several advantages of DBAs over the smear layer like hybrid layer as described by Nakabayashi (1982) and resisting moisture and acid (Brunton et al. 2000). The result of various in-vitro studies on humans teeth (Pashley et al. 1992, White et al. 1992, Al-Fawaz et al. 1993) and animals teeth (Suzuki et al. 1994) supports the idea of sealing the dentine of prepared teeth for a crown restoration. A literature review by Lam, C.W. and Wilson, P.R. (1999) revealed that dentine sealing with bonding agents prior to crown cementation could be beneficial due to fluid flow reduction in dentine tubules. Magne (2005) believes that immediate application of dentine bonding agents or Immediate Dentine Sealing (IDS) prior to impression taking can reduce the postoperative sensitivity and bacterial contamination. 35% H3PO4 is normally used to remove the smear layer before DBA application. There are different ways of sealing dentinal tubules after the preparation. Edward and swift (2009) reviewed several in vitro research studies on the immediate dentine sealing technique in a critical appraisal and came to following conclusions. First, immediate sealing of fresh dentin improves the resin adhesion and the bond strength will be affected by late application. Second, the IDS provide a mechanical barrier which minimises the postoperative sensitivity, bacterial contamination and eventually the necessity of local anaesthesia. Most Practitioners prefer to use self-etch-adhesives. However, Magne et al. (2007) believe that a three-step, etch-and-rinse adhesive has shown to be more efficient. In order to avoid complications after the IDS, some clinical steps need to be taken. The appearance of an O2 -inhibitory layer is not desirable and should be prevented by light-curing the dentine adhesive twice under a glycerine coating. This step avoids the reaction between inhibitory layer and impression material. The reaction between temporary crown and sealed tooth should also be prevented by applying a separating material. The influence of dentine on antimicrobial effect of ingredients added to one-step dentine sealants was assessed by Gondim et al. (2008) and revealed a reduced affectivity after polymerisation with UV light. 3.7 Temporary Crowns Temporary crowns are provisional restorations that are fitted on the teeth between preparation and fit appointment. They have various functions, mainly dentine protection and tooth movement prevention. Their role is often overlooked by practitioners (Wassel et al. 2002). Pre-formed crowns (plastic, metal) and self or light cured resins are usually used in the dental practices as convenient for temporary restorations. Many temporary crowns have poor-fitting margins based on production procedure and material used. Some materials create a gap between the temporary and the prepared tooth due to polymerisation shrinkage (Robinson and Hovijitra, 1982)( Tjan et al. 1987). Cervical border of a temporary crown is the primary area to be reached by bacteria from the oral environment. Richardson et al. (1991) believe that dentine in the cervical margin shows higher permeability than dentine in other surfaces of the prepared tooth and that confirms the importance of good marginal adaptation of temporary crowns. A paper by Cagidiaco et al. (1996) considers the exposure of vital pulp tissue to bacterial contamination and irritants after dentine preparation in the base of a cavity, especially if temporary shows an unsatisfactory sealing. Exposed dentinal tubules after a crown preparation provide a way for transfer of substances between the pulpal tissue and periphery (Garberoglio and Brannstrom M. 1976). These tubules are expected to be sealed by cement. Different researchers (White et al. 1992, White et al. 1994, Lyons. et al, 1997, Baldissare. et al. 1998, Goldman et al. 1992) have found microleakage to be present after either permanent or temporary crown cementation. Literature review supports the evidence of benefit of immediate dentine bonding as a technique during temporisation of indirect provided restorations but reveals a lack of in vivo evidence. This fact supports the requirement for this clinical study. Study design methodology The study design and methodology will be presented in accordance with the CONSORT explanation for reporting on clinical trials (Moher et al., 2010). 4.1 Trial Design This will be a randomised controlled parallel two-armed trial-pragmatic group trial to take place over the duration of a six-year period. The study will provide a 1:1 allocation ratio. One molar tooth will be randomly chosen per participant. The evaluation of the outcome will take place at one year, three years and five years (Fig 1). 4.1.1 Changes to trial design The Data Monitoring Committee (DMC) will have access to the un-blinded data. The study protocol may be altered by DMC due to their recommendations. 4.2 Participants Participant selection will take place utilising new and existing patient population that attends the dental practice. Recruitment will be on a continuous basis until the required numbers of participants have been enrolled into the study (see section 5 for sample size calculation). This will ensure the pragmatic nature of the trial as no proactive recruitment of patients from leaflet drops and advertising will take place. A trained member of staff will administrate the consent process once a patient has been identified as having an eligible tooth suitable for the study. 4.2.1 Inclusion criteria for participants: Healthy adult patients between 18-58 years of age Provide a written informed consent, understand spoken and written English. Regular attenders (at least every six months) with a two-year record Require a full coverage of a Molar (Upper or Lower arch) With a crown Selected tooth must be periodontally healthy. Selected tooth must be vital and without any history of pulpitic symptoms within the last 12 months. Are able to attend follow-up appointments. In terms of periodontal status, the chosen teeth for study have to have a BPE less than three mm as per guidelines published by British Society of Periodontology (BSP). The teeth must be also radiographically free of any pre-operative pathological signs meaning intact pulp with no evidence of radiopaque foreign materials in the pulp chamber and/or root canals(s) and no periradicular radiolucent area. 4.2.2 Exclusion criteria for participants: Irregular attenders to dental practice History of pulpitic symptoms in the last 12 months Patients participating in any other medical trials Notable medical history change or pregnancy Existing periapical pathology (radiographically) Periodontal pockets more than three mm Pulpal exposure or extending caries into the pulp chamber Vulnerable adults or children 4.3 Study location and settings The trial will take place in twenty dental practices based in the United Kingdom. General Dental Practitioners with more than five years experience and qualification in a post-graduate restorative dentistry will be recruited. 4.4 Withdrawals Patients may be disqualified if they experience medical complications or refuse to attend routine check-ups. A patient may also be withdrawn from the study if the tooth suffers from a trauma, requires extraction or develops pockets deeper than 3mm due to insufficient oral hygiene. Information on all patients, including the reason for the withdrawal will be collected and added to trial data report. Patients may also choose to withdraw from the study themselves. 4.5 Randomisation Initial selection process will include all teeth that are suitable per patient. To maintain allocation concealment and to limit the occurrence of selection bias (Vickers A.J. 2006) a remote allocation officer in the central generates the allocation of teeth for either the intervention or control group. The participants initials, gender, date of birth and tooth notation will be submitted to a centre securely, where randomisation will occur within the patients to select the eligible tooth and to allocate the patient to the treatment or control group using a computer generated sequential number list. The trial will include only one allocated tooth per patient per control or treatment group. The indication of allocation will be sent to the general dental practitioner in an envelope with the patients identification code and the tooth number. The code for trial remains hidden until the clinical procedure to treat all eligible teeth is ready. At this time, it will be opened by the operator but not revealed to the participants. The randomisation will be balanced to a 1:1 ratio for each provider in each practice. Simple randomisation is suitable to generate a balanced group. Balance between the groups at each location will be verified by the trial allocation operator regularly. 4.6 Baseline assessment A baseline examination will be carried out by operators once the suitable patients have completed the consent procedure. The assessment will include: Patients Identification, age and gender Medical and social history Dental history Extra-oral examination: Musculoskeletal assessment, Soft tissue profile, TMJ Intra-oral examination: Oral Hygiene, periodontal assessment, soft tissue, occlusal analysis, vitality testing, Ridge mapping, Radiographic evaluation of tooth prior to preparation Reason for Crown placement 4.7 GDP training Each of the operators will attend a one-day training program on techniques. Clinical consensus will be ensured and standardised in a discussion with investigators in a separate session and will include a clinical protocol for the preparation of teeth for a full coverage with a crown, impression taking and temporisation. Additional clinical protocols will be prepared for immediate dentine sealing after preparation and for final cementation of the restoration. A clinical team member will be appointed as the independent observer to evaluate the compliance to the study criteria. All materials and Instruments used will be applied as per manufacturers instructions. The Crown system used in the study is Cercon ht (Dentsply) full Contour Zirconia. The high strength of zirconia-based ceramic restorations increases the indications for choice. They can be a near ideal choice for restoring crowns, fixed partial dentures, and implants in aesthetic areas. Because of their high strength, zirconia-based ceramic restorations can be cemented with traditional cements or bonded with adhesive resin cements. Like gold, Cercon ht has a simple, clinical protocol, requiring conservative tooth reductions of as little as 0.5 to 1.0 mm. A feature that is friendly to both patients dentition and dentists chair time. All clinical and laboratory techniques for teeth involved in the study are specified as per Dentsply protocol. 4.8 Intervention A universal self-priming dental adhesive system (Prime Bond NT Dual cure, Dentsply) and a dual cure resin cement (Calibra, Dentsply) will be used to bond the indirect restoration to the tooth. The literature supports the chosen material for this proposed study (Barnes et al., 2006). 4.8.1 Intervention protocol for Immediate Dentine Sealing (IDS) The teeth will be sealed immediately after preparation with Prime Bond NT Dual Cure (Dentsply). To avoid any bond contamination, retraction cord will be placed before dentine sealing. The protocol for dentine bonding is as manufacturers instructions: Clean freshly instrumented dentine with water spray and air dry. It is recommended not to etch dentine to minimize the possibility of post-operative sensitivity. Place 1-2 drops of Prime Bond NT adhesive into a clean plastic mixing well. Place an equal number of drops of Self Cure activator into the same mixing well. Mix Contents for 1-2 seconds with a clean, unused brush tip. Immediately apply mixed adhesive/activator to thoroughly wet all the tooth surfaces. These surfaces should remain wet for 20 seconds and may necessitate additional application of mixed adhesive/activator. Remove excess solvent by gently drying with clean, dry air at least for 5 seconds. Surface should have a uniform glossy appearance. Cure mixed adhesive/activator for 10 seconds using a curing light. Check curing light for minimum curing output of at least 550mw/cm2 and a spectral output, including 470nm (peak absorption of the CQ photoinitiator). Control Group Exactly the same procedure will be used for the control group prior to final bonding of the Crown. 4.8.2 Protocol for Impression taking Study Group (IDS) In practice, freshly cut dentin is present only at the time of tooth preparation (before impression). Freshly cut dentin is the ideal substrate for dentin bonding. Most studies on Dentine Bonding Agents (DBA) bond strength use freshly prepared dentin (Magne 2005). There is a possibility for the oxygen inhibition layer of filled resin of the dentine bonding agent to inhibit the setting of the impression material. The bonded teeth have to be cleaned with pumic and a rubber prophylactic cup and washed with water and air dried before the impression (Magne and Nielsen, 2009b). Impressions will be taken with an A-silicone double-mix technique (Aquasil ultra, Dentsply) as per manufactures Instruction. Control Group (no sealing) Impressions will be taken as per study group without sealing the dentine with DSA. 4.8.3 Protocol for temporisation Study Group (IDS) A prefabricated light curable temporary Crown (Protemp Crown temporisation material, 3M ESPE) will be fitted on the prepared tooth standard temporary cements. The occlusion will be controlled and if necessary adjusted. Control group A temporary crown will be fitted as above without any DBA application and after Impression taking as per clinical consensus guidelines. 4.8.4 Protocol for final cementation Study group (IDS) Just prior to the luting procedures (when placing the final restoration), it is recommended to roughen the existing adhesive resin using a coarse diamond bur at low speed or by microsandblasting (Magne 2005). The tooth and the restoration will be treated as per manufacturers instructions, and the crown can be cemented with dual cure resin (Calibra, Dentsply). Control group The same procedure as for study group will be carried out except the adhesive resin roughening step. 4.9 Outcomes The outcome measures will be assessed, and the CRF forms updated at baseline and at recall appointments of 1 year, 3 years and 5 years. Any relevant clinical incident between these times affecting the trial tooth needs to be recorded on CRF. Base-line findings and post-operative taken periapical (PA) of each trial tooth at one year and five years will be studied, assessed and recorded by two blind assessors. These precalibrated, independent observers will examine the radiographs and categorize the periapical status of the selected teeth according to a written set of criteria (Cheung et al. 2005) (Table 1). Categories 1, 2 or 3 are deemed to be associated with a non-vital pulp. If there are any disagreement, a third assessor will be involved as an arbitrator before a final score is reached. The protocol for Periapicals will adhere to the guidelines produced by the faculty of General Dental Practitioners (Pendlebury et al., 2004). An Independent assessor will audit each practice participating in the study to ensure compliance with radiology regulations (IRMER). 4.10 Blinding Every effort will be made to prevent disclosure of the exact nature of the study aim and to which arm of the study the participants have been allocated. This will be specified to minimise assessment reactivity, which has been hypothesised by McCambridge and Strang (2005). The date collection statistician who assesses and calculates the outcome results will also be blinded to the individual patient allocation to limit detection bias. The operators will not be blinded but the allocation of whether the tooth is to be control or intervention will be concealed until intervention procedure is to be carried out. 4.11 Follow up An important selection criterion to minimise drop-out is the eligibility of the patients to be regular attenders at the relevant dental practices. Patients lost to follow up will be recorded.. Category Status Description 0 Intact pulp No evidence of radiopaque foreign material in pulp chamber and/or root canal(s), and no periradicular radiolucent area 1 Widening of the PDL space Widening of the apical part of the periodontal ligament space, not exceeding two times the width of the lateral periodontal ligament space 2 Periapical radiolucency Radiolucency in connection with the apical part of the root, the diameter exceeding two times the width of the lateral periodontal ligament space 3 Endodontically treated tooth Tooth with radiopaque material in pulp chamber (if discernible) and/or root canal(s) Table 1- Radiographic categorization of pulpal status (Cheung et al. 2005) 4.12 Safety This study will not be utilising any investigational medicinal products; it will therefore be classed as a non- Clinical Trial of an Investigative Medicinal Product trial (non-CMITP). All untoward incidents will be adverse events rather than adverse reaction. The study is also compatible with Data Protection and Mental Capacity Act. The treatment options being studied are non-life threatening on non-vulnerable adults with no risk of harm and no unknown or uncertain risks. A Data Monitoring Committee (DMC) will be appointed who makes recommendations, as required, to the chair of the Trial Steering Committee. This committee is responsible for ensuring that the intervention and control techniques will be carried out under the guidance provided by the EU directive for Good Clinical Practice. 4.12.1 Assessment of Safety There are no expected unexpected adverse events since the intervention is used routinely in general dental practice. The using of etching gel has expected adverse events should it come into contact with the soft tissues (Material Safety Data Sheet (MSDS) sheet). All other dental materials involved (Prime Bond NT Dual Cure, Calibra dual cure resin cement (Dentsply), Protemp Crown temporisation material, 3M ESPE) are fully licensed within the medical devices regulations for use in dentistry in UK. All operators are experienced dental practitioners having handled these materials routinely and will be trained in dealing with expected adverse reactions should the product inadvertently come into contact with pati