Fracture Resistance of Esthetic Post and Core Systems

Fracture Resistance of Esthetic Post and Core Systems Comparison of fracture resistance of three recent esthetic post and core systems with cast metal post and core to compressive loading An in vitro Study ABSTRACT: Aim: To determine and compare the fracture resistance of three recently introduced esthetic post and core systems with a cast metal post and core to compressive loading using a clinically related test method. Materials and Methods: Forty maxillary central incisors were selected, sectioned and their roots endodontically treated and assigned to 4 experimental groups (n=10).The cast metal post and core (CMPC) served as control group.The other groups are zirconium dioxide post and ceramic core group (ZCER), zirconium dioxide posts and composite core group (ZCOM) and glass fiber post and composite core group (GFCOM).The post spaces were prepared, posts were seated and cores were formed. A compressive load was applied to the inclined surface on each specimen until failure occurred and measured in newtons. Results: CMPC and ZCER groups exhibited the highest resistance fracture and the values are : 680.6 N and 630.03 N respectively . ZCOM group exhibited fracture resistance greater than GFCOM but less than ZCER and CMPC. Conclusion: CMPC group and ZCER group were found to be more fracture resistant than the ZCOM group and GFCOM group. Aside from its desirable esthetic properties,the ZCER group demonstrated high resistance to fracture. Keywords: compressive loading, endodontic treatment, fracture resistance, post and core INTRODUCTION Endodontic therapy has provided dentistry the ability to retain teeth that just a few decades ago would have been extracted without hesitation.When there is substantial loss of coronal tooth structure due to caries, trauma or both, a post and core is often required to retain a definitive restoration. A post is usually placed in an attempt to strengthen the tooth.1,2,3 However, in vitro and in vivo studies have demonstrated that a post cannot reinforce endodontically treated teeth.4,5,6 Posts are required for supporting a core foundation when there is insufficient clinical crown remaining.4,5,6,7 Although cast post and core foundations are the gold standard for endodontically treated teeth, due to their superior physical properties and proven clinical effectiveness8 yet its mechanical properties may increase the risk of root fracture9. The esthetic properties of these materials are limited since the gray colored post is apparent when used to support translucent all ceramic restorations. Coupled with a high lip line, cast metal post and core foundation may create esthetic problems. In the recent times, there has been a tremendous increase in the use of all ceramic crowns, particularly for anterior teeth because of their superior natural appearance compared to metal ceramic restorations.10 Both the declining acceptance of cast post and core restorations as well as patients interest in dental esthetics has resulted in the development of esthetic posts, especially Glass Fiber and Zirconia Ceramics.These increase the transmission of light within the root and overlying gingival tissues, enhancing the esthetics. They also eliminate the potential hazards of corrosion and allergic hypersensitivity as they are metal free materials.11 Glass fibers such as silica or quartz reinforced epoxy resin posts have low modulus of elasticity similar to that of dentin.12 This property has been reported to reduce the risk of root fracture. 13,14 Glass fiber reinforced posts also have the advantage of easy removal if endodontic re-treatment is required. 15,16 A prefabricated zirconia ceramic post system has been introduced to satisfy esthetic needs presented by endodontically treated anterior teeth. The translucency of all ceramic crowns can be successfully maintained with the use of ceramic post and core materials. Moreover improvements in adhesive porcelain bonding systems have accelerated the trend toward the use of ceramic core materials. Many dentists prefer to use prefabricated post systems because they are more practical, less expensive and in some situations less invasive than customized post and core systems. They also save time and can provide satisfactory results. 17,18,19 The purpose of this in vitro study is to determine and compare fracture resistance of three esthetic post and core systems, Zirconia post and Ceramic core, Zirconia post and Composite core and Glass Fiber post and Composite core with cast posts under compressive loading. METHODOLOGY Forty extracted human permanent central incisors were selected based on similar dimensions,caries free,no restorations and cracks.The teeth were soaked in 3% sodium hypochlorite (Vishal Dentocare PVT LTD), for 6 hours. These forty teeth were divided into 4 groups: Group 1: Cast Metal post and core (CMPC) Group 2: Zirconia posts and Ceramic core (ZCER) Group 3: Zirconia posts and Composite core (ZCOM) Group 4: Glass Fiber posts and Composite core (GFCOM) The coronal aspect of each tooth was resected perpendicular to the long axis and 1mm incisal to the cementoenamel junction, with a diamond coated disc (Horico) mounted in a straight handpiece (NSK, Japan). Labiolingual and mesiodistal measurements of the sectioned tooth surfaces were made with a digital vernier calipers (Aero space, China).The roots were endodontically instrumented to the apex using protaper rotary instruments (Dentsply,Maillefer) till F3 and obturated with protaper GP points (Dentsply,Maillefer) using ZOE sealer. Procedure for fabricating standardized cores: To obtain standardized cores, a wax pattern was fabricated from casting wax (Sk Dental waxes, Bombay) which had 6.5mm diameter base, 7.3 mm diameter cervico incisally and 6.2mm buccolingually. Impression of the wax pattern was taken with rubber base impression material (Exaflex). Then dies were made from the impression material. Polyvinyl material was vacuum pressed on these dies.In this way a hollow matrix was fabricated which had the same dimensions as that of the wax pattern. The base of the matrix was fitted flush to the sectioned tooth surfaces. Then 1 mm of the matrix was cut at the open end so that it acted as an inlet for the placement of composite resin. Procedure for preparation of forty samples: For all the groups the post spaces were enlarged with peeso reamers no 2 and 3 (MANI CE 0197 Prime Dental Products PVT LTD) initially to a depth of 9mm. The final enlargements were accomplished with the 1.4 mm diameter drills that were specifically given with 1.4mm zirconia posts (Cosmoposts,Ivoclar Vivadent) and 1.4mm GF posts (Bioloren,Ammdent). All the posts have 1.4mm diameter and were sectioned to a standard length of 13mm using carbide fissure bur and high speed airotor handpiece The length of the posts was 4 mm from the finish line into the core.In groups 2, 3 and 4 all the post spaces were etched using 37% orthorphosphoric acid (3M ESPE), for 30 sec and bonding was done using a bonding agent (3M ESPE) polymerized for 20 sec. Cementation was done using dual curing resin luting agent ( Kerr,Orange,CA). Group 1: A direct technique was used. The post pattern was fabricated using inlay wax. For the core part ,the polyvinyl matrix was placed on the tooth, resin wax (Leva) was injected in to the matrix and polymerized. After polymerization, the matrix was removed from the molded core. Then the entire pattern was retrieved from the root, invested and cast. The cast post and core systems were then cemented into the roots using GIC. Group 2: Posts were seated into the prepared post space.Polyvinyl matrix was placed on the tooth surface, resin wax was then injected in to the matrix and polymerized for 20 sec to form the core. Matrix was then removed and retrieved post and core foundations from the roots were invested with a phosphate bonded investment (Deguvest). Wax was eliminated from the invested units in a pre heated furnace (Unident) (800ËÅ ¡C for 45 minutes). Cores around zirconia posts were prepared using ceramic ingots (e-max, Ivoclar vivadent) heat-pressing process (975ËÅ ¡C for 45 min.) in a heat pressing furnace (Ivoclar vivadent). The formed ZCER foundations were then cemented into the post spaces. Group 3: After etching and bonding,posts were cemented in to the prepared post spaces. The matrix was seated on the sectioned tooth surface and composite core material (Z350, 3M ESPE) was placed in 2mm increments and polymerized for 20 sec. After polymerization, the matrix was removed from the molded cores. Group 4: Following etching and bonding posts were cemented into the prepared post spaces. The matrix was placed on the sectioned tooth surface and composite was placed in 2mm increments and was then polymerized for 20 sec. After polymerization, the matrix was removed from the molded cores. LOADING PROCEDURE: Following thermal cycling (5000 cycles between 5ËÅ ¡C and 55ËÅ ¡ C with a dwell time of 30 second) a universal testing machine (Shimadzu, Japan) was used to apply a constant compressive load at a crosshead speed of 1mm/min, at a 130Â º angle to the long axes of the test specimens, until failure ocurred. The tip of the loading bar was positioned to contact the centre of the palatoincisal surface at an angle of 90Â ºC. The force at failure was measured in newtons. RESULTS One-way Analysis of Variance (ANOVA) with Post HocTukey test was used to compare the score between the groups. A 95% confidence level was used for the ANOVA test. Results showed that there was significant difference in the fracture resistance values obtained with different groups (p

Explication of John Donnes The Flea :: John Donne Flea Essays

Explication of John Donne's The Flea John Donne's, "The Flea," is a persuasive poem in which the speaker is attempting to establish a sexual union with his significant other. However, based on the woman's rejection, the speaker twists his argument, making that which he requests seem insignificant. John Donne brings out and shapes this meaning through his collaborative use of conceit, rhythm, and rhyme scheme. In the beginning, Donne uses the flea as a conceit, to represent a sexual union with his significant other. For instance, in the first stanza a flea bites the speaker and woman. He responds to this incident by saying, "And in this flea our bloods mingled be." He is suggesting that they are united in this flea and ,thus, would equally be united in intimacy. In addition, he states, "This flea is you and I, and this our marriage bed, and marriage temple is." The speaker is suggesting that through the flea the two are married. Again, the flea represents marriage, union, and consummation through intimacy. However, the woman crushes the flea, thus, refusing his request, and states that neither she nor he is weakened by its death. Based on her reaction, the speaker states, "Tis true...Just so much honor, when they yield'st to me, Will waste, as this flea's death took life from thee." In other words, he twists his argument to make the point that the woman will lose as much giving herself to him as she lost killing the flea - NOTHING! Secondly, Donne's use of rhythm aids in shaping the poem's meaning. The poem has alternating lines of iambic tetrameter and pentameter. However, Donne varies this rhythm to create emphasis on particular words or phrases. For instance, in the first stanza he states, "Mark but this flea, and mark in this." Instead of beginning with an unstressed word or syllable as in iambic, Donne stresses the word "Mark." This is important in accentuating his argument.

Alan Patons Cry the Beloved Country Essay -- Alan Paton Cry Beloved C

Alan Paton's Cry the Beloved Country The book I have chosen to write about is Cry the Beloved Country. This book is about ambiguity and reconciliation. The main character in the story Stephan Kumalo has to deal his the struggle of his family, and trying to keep them together. The first few chapters of this book are place in a small town called Ndotshenti. But the action in this takes place in the largest city on South Africa, Johannesburg. Stephan Kumalo finds out there can be day light even when nothing in you life is going right. The area of Ndoshenti is known as the â€Å"Velds†, which in Zulu means the green grassland. The rural country is what describes Ndotshenti best; on the other side of the town lies the European part of Ndotshenti. This is Ndoshenti where blacks are not allowed to go. Primarily because apartheid, which means total separation between blacks and whites. Stephan Kumalo is the minister in the small town. Stephan Kumalo helps those in need of help. Also find out very early, he is in need of help too. His son Absalom decides to leave home, because he does not like his father’s new wife. He goes with his friends Johannesburg to work the gold mines. However his son is not the only person causing stress on Stephan Kumalo, because with in a few days of his son leaving, he receives a letter pertaining to his sister. She very sick, but the man writing the letter says not physically, but mentally. At this point Kumalo is befu...

A Dream?

The soft soil squeezed through the holes in my boots as I stood upon the sorrowful shore. The day was wild the clouds dark and heavy, taunted me with the threat of rain. The trees blew from side to side like flags waving in the breeze. The ocean not to far from where I stood, was beating upon the shore with military precision bearing deep into my soul. The forest stretched away from me, as far as I could see taunting me to enter into its hidden safety†¦ away from it all†¦ away†¦ from what I had done. My mind now centering painfully on the memories that sent me running to this droned hollow place, realizing what I had done†¦ the true horror of it, turned my mind psychotic while jumbled and baffled thoughts overloaded my memory†¦ it was plain even to me, I just didn't want to believe it†¦ but it was real, it was true. I stood there contemplating what I had done, thinking of everything that would happen to me†¦ everything I lost the moment I did it, It made me sick, it made my heart skip beats, I collapsed onto the mud at the edge of the forest. I almost fainted right there†¦ I looked into the dark tangle of forest knowing what I had to do. The forest taunted me yet more†¦ seeming to watch me†¦ stare at me, almost waiting for me to enter so it could devour me†¦ destroy me. In the distance I could see a small dim light tear through the black velvet night inside the forest. I watched as it grew nearer†¦ swaying from side to side, my heart beat faster and faster my thought becoming more rampant and wild. The light almost upon me now, knowing I should run†¦ but I couldn't†¦ I simply couldn't†¦ I froze, I could not move nor breath. My legs throbbed with pain, my feet bursted with soars, my mind was to wild to let me move. Suddenly the light came upon me, there stood a heavy, sturdy, strong looking man. His presence sent a chill of awe through my spine. I could not make out a face, he wore a thick overcoat, his body was motionless†¦ not a twitch†¦ nothing, he held a simple flashlight in his hand and nothing in the other. Some questions arose in my mind to what he was doing here†¦ unarmed, almost seeming completely unprepared except for his flashlight. Suddenly realizing just how much I should run I sprang to my feet and shot into the forest as if it was my only way to live, I stumbled through the branches and twigs while they tore away at my clothes and face, the clouds without any warning burst out in rain, I was soaked in an instant yet still found the strength to run on. I ran for what felt like an eternity, I turned to look if the man was behind me†¦ there was nothing†¦ not a glint of light†¦ nothing, just the sound of the rain beating down on the trees, hanging spindly on the leaves before dropping to the ground. I stared, wondering if the man had even attempted to chase after me†¦ after all, if he did he wouldn't have given up like that†¦ he would have at least stopped and looked for me with his flashlight†¦ but there was nothing. I laid there on the ground for a few moments to catch my breath, and turned to run again, as I stood to start running there he was†¦ the very same man†¦ with the very same light, in the very same clothes†¦ I felt a sharp pain of terror like a bullet ripping through my bones, I stood in silence for what seemed hours. The man raised his arm, flashlight in hand up to his face†¦ I screamed I almost fainted there but something inside me urged me to stay up. I could not believe who it was that stood before me†¦ I felt my blood freeze. I woke†¦ in my bed, with a cold sweat, I was tired, my legs ached. It was raining outside, the ocean waves still beat upon the shore with their same drone tune, I was sweating and out of breath. Was it real?†¦ or just a dream?

Children and parents Essay

A new age man is a man that a man that believes in equality and shares all household chores with is partner exactly and contributes equally as much as the women. This is different from a house husband because this is a man who has had a complete role reversal and takes on the traditional role of a house wife and stays at home full time. We cannot generalise about role relationships across society because changes in role relationships have not occurred at the same pace or to the same extent through all sectors of society. Role relationships vary according to social class and ethnicity. Home based entertainment, for example DIY give spouses’ things in common which gives them a friendlier and more loving relationship. Contraception has allowed couples to have children later and also it means that a lot of couples choose to have smaller families or no children at all. This does not apply to some religions such as Catholics who do not believe in using contraception. Women can now plan when to start their families and to have children resulting in them planning them around their careers. Feminism is an approach that fights for the equal rights of women. This is a large factor in the changing equality in the home because more women demand to be treat as their partner’s equal. It has lead to the rejection of the housewife role. There is an increase in male unemployment more men have become more involved in domestic tasks. Jane Wheelock (1990) conducted research into this topic and found that men undertook a lot more housework and childcare while unemployed. One survey showed that mothers that also worked outside home had it worse because they still spend more hours on housework a week then they do at their paid place of work. On average these women spend 62 hours a week on house hold tasks were fathers who also worked only spent 23 hours on house work. Another survey shows that some traditional gender role are still being passed down to the younger generations( 1992-93) such as girls still taking more of a part in cooking, cleaning and child care but boys are doing more things for themselves like cleaning their own rooms, making beds and washing their own clothes. Sometimes sociologists say that social class and ethnicity change role relationships. It is suggested that working class families are more male dominated (patriarchal). Evidence proves that middle class conjugal relationships are more equal than working class ones but it is also said that working class fathers are more involved in childcare. It is believed that Asian families are usually based on unfair patriarchal relationships. Westwood and Bhachu (1988) challenge this idea arguing that images of the Asian family are usually based on prejudice and prejudgement. They point out that Asian families are in fact British families and are a strong source of resistance against the racism of British society. In reality there are ethnic differences between Asian people in Britain according to religion and social class, which makes it hard to generalise about the Asian family. Henriques and Slaugher talk about the patriarchal relationships between men and women. This means that the relationship is male dominated. They talk about the two different segregated roles. Relationships between children and parents have changed over time but it has always varied between working, middle and upper class families. Throughout the nineteenth century life chances varied a lot for different classes for children. A paid employee such as a nanny would often look after higher-class children. This would often separate their children from their parents and so it would be harder for them to develop a strong bond. Working class children on the other hand, especially boys would often have to start work very young. There was a wider range of jobs for boys were available but girls would often have to work in cotton factories. The hours would be long and the pay and conditions would often be unfair. Poverty prevented parents sending their children to school and sometimes they would only send their boys but keep the girls at home to teach them how to be a good housewife. Mothers would often have a close relationship with her daughter. People used to have children so they could send them out to work to earn money for the family. Sometimes parents thought that education just blocked this. Another reason why people used to have children was so they had someone to take care of them in old age. Factors that changed these relationships included the growth of the welfare state, which meant people no longer needed children to look after them in old age. Parents could no longer send children out to work at such a young age because of protective legislation, this meant that law including factory and mine acts stopped it. There was a growth of the meaning of childhood and they remained children for longer because of the state of education in 1870 meant you had to attend school. Children were given more attention by parents, media and toys invented a new childhood and children and parents spent more time together. Today the relationship is usually warmer and more caring than in the past. Children are seen as more important and taken a lot more seriously. There have been changing attitudes towards discipline and laws against hitting children in Scotland. It is now seen as wrong to hurt a child, if they do organisations (social services) get involved. There is more of an emphasis on freedom and children’s rights. Relationships are more children centred and because family sizes are smaller children get more attention. In 1976 a law was passed to say that the minimum age of leaving school was 16 and though a child can work before then the hours and law restricts times. This means that children are financially dependent on their families for long periods of time especially if they go on to further education. Children are fully dependent on their parents and this can sometimes bring stress and tension to the family. Not all relationships between child and parents have improved as sadly cruelty to children is still widespread and the National Society for the Prevention of Cruelty to Children (NSPCC) estimate that around 600 children are intentionally harmed by their parents each year.

Children Act 1989 Essay

Task 1 links to learning outcome 1, assessment criteria 1.1. Produce an information sheet which outlines the following:  · the current legislation for home based childcare †¢ the role of regulatory bodies. The two most important pieces of legislation covering home-based childcare are the Children Act (2004) and the Childcare Act (2006(. Children Act (2004) This influential piece of legislation which arose from ‘Every Child Matters’ and identifies five outcomes for all children: * Be healthy * Stay safe * Enjoy and achieve * Make a positive contribution * Achieve economic well-being These outcomes should underpin all practice of a childminder. Childcare Act (2006) This Act introduced the Early Years Foundation Stage (EYFS) curriculum into England and Wales, and place a statutory duty on the local authority to work towards ensuring the five outcomes set out in the Children Act (2004) are being met. Other relevant legislation of importance is: Equality Act (2010) The intention of this Act is to combine the fragmented discrimination legislation, bringing together the Sex Discrimination Act (1975), Race Relations Act (1976), and DDA (1995). Promotion of equal opportunities in all settings is essential, and relevant policies and procedures should be developed, monitored and assessed. Education Act (1997) This Act incorporates all previous Acts since 1944. It recognise the rights of parents regarding their children’s education and set a time frame on the legal process for identifying and assessing a child’s needs as set out in the Code of Practice. Public Health (Control of Disease) Act (1984), RIDDOR (1995) and Health Protection Agency Act (2004) All these legislations are focused on protecting people’s health, covering notification and exclusion periods for certain infectious diseases and reporting of certain accidents and incidents. OFSTED is the regulating body for England & Wales. Ofsted is the Office for Standards in Education, Children’s Services and Skills. They report directly to Parliament and are independent and impartial. They inspect and regulate services which care for children and young people, and those providing education and skills for learners of all ages. Their aim is to promote improvement and value for money in the childcare services they inspect and regulate, so that all children and young people, parents and carers, adult learners and employers benefit. OFSTEDs job is to check places where children and young peopleare looked after the people who look after children and young people schools and colleges adult learning and training how teachers are trained

Facilitate the Counselling Process Assessment Essay

I declare that this assessment is my own work, based on my own personal research/study . I also declare that this assessment, nor parts of it, has not been previously submitted for any other unit/module or course, and that I have not copied in part or whole or otherwise plagiarised the work of another student and/or persons. I have read the ACAP Student Plagiarism and Academic Misconduct Policy and understand its implications. I also declare, if this is a practical skills assessment, that a Client/Interviewee Consent Form has been read and signed by both parties, and where applicable parental consent has been obtained. 1. Name two signs you would look for to let you know Vara is ready to end counselling. Two signs I would look for to let me know that Vara is ready to end counselling are, firstly, if Vara is sounding a lot more confident and she looks a lot happier, then she probably is. Secondly, if Vara started to run out of issues to raise and discuss in counselling. I would be able to recognise that Vara is ready to end counselling. 2. Briefly describe how you would support Vara’s sense of autonomy. I would support Vara’s sense of autonomy by, acknowledging and helping her to recognise, her achievements since beginning with counselling. I would summarise these achievements for Vara. Vara has spoken to her husband Alec, and made him aware of her feelings. This is something she found quite difficult to do in the past. Since Vara communicated her feelings of ‘being fed up and wanting to end the marriage’, Vara and Alec have decided to trial a three month separation. In speaking up for herself she has generated real change in her life. Both Vara and her husband Alec, are looking into the possibility of seeing a marriage counsellor. In seeking this kind of counselling she is showing strength of character, she is looking for solutions and not just running away from her problems. She has the friendship and support of Julie and is trying to increase her work hours as a translator. I would acknowledge that it was Vara that made these changes in her life, not me. This will empower Vara with the confidence to know that she is a strong and capable women who can stand up for herself. 3. Briefly describe how you would inform her about opportunities for further support. I would inform Vara about opportunities for further support, by communicating to her that although our counselling sessions will be coming to an end, she is always able to reconnect with me, if she feels the need. Vara has indicated that she and her husband are interested in pursuing marriage counselling. I could provide Vara with some contacts for marriage counselling in her local area. Or, if she felt more comfortable, I could arrange a referral for her to a marriage counsellor that I think would be a good match for her. 4. Briefly describe three key steps to assist the process of ending the counselling process with this client. I would start this process a few sessions before the final counselling appointment. Firstly, I would encourage Vara to express any concerns she may have in regards to managing on her own without the support of the counselling relationship. I would be encouraging Vara to express her feelings about ending the counselling relationship. This will give Vara an opportunity to reflect and prepare for ending the counselling sessions. I would set the final appointment sometime in the future, so that Vara can have time to adjust to the thought of managing on her own. Secondly, I would plan with Vara to have a longer interval between our appointments, so that Vara can try out coping with her issues on her own. This will enable Vara to discuss any lingering issues that may need some attention before ending the counselling relationship. Lastly I would summarise for Vara the progress she has made, and acknowledge all the accomplishments she has made. She is now a stronger more capable women, who can stand up for herself and take care of herself. I would make sure that Vara knows that I have an open door policy, and that if she ever felt the need to reconnect with me, I would be happy to see her again. 5. Give an example of what you might say to Vara when ending counselling to ensure the underlying issues are managed. An example of what I might say to Vara when ending counselling to ensure any underlying issues are managed is, ‘Vara can you describe for me some of the strategies you have been using to help bring about the changes you have made’. This will give Vara the opportunity to reflect on how she has implemented these changes, and will reinforce the fact that it was Vara who has facilitated these changes, not me. I would also say ‘what do you think could be some coping skills you could use if these issues start to come up again’. This will give Vara the opportunity to reflect on how she has coped with these issues in the past, and to list some coping strategies that work best for her and her situation. Again this will reinforce the fact that Vara is the one who is coping with her situation, not me. I would also say ‘can you tell me again, what some of your underlying issues have been’. This will help Vara identify what the core issues are, and will make it easier for her to recognise if these issues come up again, so that she is ready to deal with them. 6. Provide an example of one of your session client notes. Client session notes. Clients Name: Vara Clients Age: 56 Date of session: 20/11/14 Session # 8 Session Duration: 60 minutes Others present: Nil Status of session: Kept Location: Office Information given by client: Vara is a 56 year old Polish immigrant. Came to Australia 25 years ago. She has raised 3 children who have all left home. Feeling very unhappy and ‘trapped’ in her marriage. Husband is ‘traditional’ male, who controls finances and has a ferocious temper. She has been secretly working and saving money. She wants to live her own life, but fearful of how she will cope on her own. She still loves her husband Alec. Summary of client’s issues: Vara has spoken to Alec and they have agreed to a 3 month trial separation, they are looking into marriage counselling. I have offered her a list of marriage counsellors in her area and offered a referral if preferred. Vara will be living with her friend Julie during her separation, and will be seeking more work hours as a translator. Notes of counsellor: I feel that Vara has made enormous progress in counselling, and believe that at this point she would benefit from marriage counselling. I have agreed to see her again if she feels the need arises.