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INTRODUCTION: This study aimed to assess senior dental students' knowledge and attitudes regarding evidence-based dentistry (EBD), their use of the current literature and considerations for patient preferences. MATERIALS AND METHODS: A modified Knowledge, Attitudes, Access, and Confidence Evaluation (KACE) survey was administered to collect data from senior dental students at the University of Maryland School of Dentistry (UMSOD). The chi-squared test was used to compare the correct response rates of each question in the knowledge of scientific evidence domain. Spearman's rank correlation coefficient was conducted to examine correlations between students' knowledge of scientific evidence and their confidence in appraising the study qualities. RESULTS: 61 seniors (out of 130) answered all survey questions. Participants displayed an intermediate level of knowledge of EBD. Only 15% of participants correctly answered to the most appropriate design; the distribution of responses appeared significantly different amongst the questions in the basic knowledge section (chi-squared test, p < .0001). There was no or very weak correlation between students' knowledge of scientific evidence and their confidence in appraising study qualities (Spearman's ρ = 0-0.18). The participants highly valued the use of the current literature and patient preferences. However, their preferred sources of scientific evidence were the Internet excluding Cochrane reviews (60%) and colleagues (56%). Forty per cent of participants rarely or never used textbooks. CONCLUSION: Whilst seniors felt confident in evaluating study qualities and implementing EBD in routine practice, their understanding of the study design was poor. Seniors' preferred sources of scientific evidence were non-peer-reviewed Internet sources and colleagues.
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Odontología Basada en la Evidencia , Estudiantes de Odontología , Educación en Odontología , Odontología Basada en la Evidencia/educación , Humanos , Conocimiento , Encuestas y CuestionariosRESUMEN
Purpose: Human papillomavirus-positive oropharyngeal cancer (HPV-OPC) is the most common HPV-associated cancer. The purpose of this study was to explore the role of a curriculum that utilized brief motivational interviewing (BMI) strategies on the knowledge, attitudes, comfort, and confidence of dental hygiene students regarding communication about HPV.Methods: Junior and senior dental hygiene (DH) and dental therapy (DT) students participated in this retrospective study. Senior students (n=26) were assigned to the control group while junior students (n=31) were assigned to the intervention group. Both groups completed an online HPV education module. The intervention group was trained in BMI techniques for communication on HPV while the control group did not receive any additional guidance. Both groups were required to have HPV discussions with two patients. Pre-test/post-test questionnaires were administered via an online software program for each patient encounter. Descriptive statistics were used to analyze the data.Results: Thirty-one intervention group and 26 control group participants completed the pre- and post-test quizzes and questionnaires. While knowledge improved for both groups from pre-test to post-test one (+5.3 % correct, p=0.001) and post-test two (+3.2, p=0.04) it was not statistically significantAttitude scores were higher in the control group at post-test one (3.25 vs 3.01, p=0.07) and post-test two (3.14 vs 2.91, p=0.05). Confidence was higher in the control group at post-test one (3.16 vs 2.82, p=0.05) and post-test two (3.21 vs 2.69, p=0.006). Comfort was higher in the control group at post-test one (3.16 vs 2.56, p=0.002) but not at post-test two (2.65 vs 2.83, p=0.45).Conclusion: Results from this study suggest that dental hygiene education programs should include didactic instruction on HPV, the use of BMI strategies, as well as multiple opportunities to practice HPV related conversations to improve student knowledge, attitudes, comfort, and confidence levels. Interactive continuing education programs with a focus on HPV and BMI techniques can also assist oral health care providers in the delivery of provider-patient communication on HPV.
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Infecciones por Papillomavirus , Comunicación , Conocimientos, Actitudes y Práctica en Salud , Humanos , Higiene Bucal , Infecciones por Papillomavirus/prevención & control , Estudios Retrospectivos , EstudiantesRESUMEN
PURPOSE: To determine whether low-dose computed tomography (LD-CT) affects the rate of early lung cancer detection in a high-risk population, how that rate compares with the rate given in the National Lung Screening Trial (NLST), whether using LD-CT provides a stage shift in lung cancer, and whether NLST results are reproducible. METHODS: Patient medical records from a Kentucky community hospital were retrospectively reviewed. Patients who were included had received LD-CT scans from January 2015 through December 2017, were aged 55 years to 79 years, had smoked for at least 30 pack-years or quit smoking in the past 15 years and were able to lie on their backs with their arms over their heads. Patients with any previous cancer were excluded. Retrospective chart review employed to collect data, and summarized quantitative data were used as measures of central tendency (ie, mean and mode). RESULTS: The study included 2924 patients, with 1483 men (50.7%) and 1441 women (49.3%). Sixty-six patients (42 men, 24 women) had lung cancer, all of whom smoked a maximum of 3.5 packs of cigarettes a day. Of the 66 patients, 7 patients (10.6%) died during the 3-year study timeframe. The study found an average of 2 cancer diagnoses per 100 LD-CT scans, whereas the NLST noted 1 diagnosis for every 320 scans. Mortality rate was associated with lung cancer in this high-risk population, calculated at 239 per 100 000 patients. DISCUSSION: Compared with NLST findings, this current study found that lung cancer is diagnosed in Kentucky residents at a higher rate, and that this group is at greater risk for developing smoking-related lung cancer. In addition, LD-CT is useful in early lung cancer detection for asymptomatic, high-risk populations and can improve quality of life, prolong life, and reduce overall health care costs. CONCLUSION: Lung cancer is a public health care problem in the United States and specifically in Kentucky. This situation might improve if legislation prioritizes educating the medical community about the tools available for early detection of lung cancer, including LD-CT.
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Neoplasias Pulmonares , Calidad de Vida , Detección Precoz del Cáncer , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Masculino , Tamizaje Masivo , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Estados UnidosRESUMEN
During initial education for primary pathway certification, radiologic science professionals learn the physics of the electromagnetic spectrum, mass, and energy. They also learn the principles of x-ray production (including requisite background information in general physics), human biology, radiation biology, and radiation protection. This information can be forgotten as time lengthens from initial learning, and reviewing these topics reminds technologists of the basic premise on which the profession is founded.
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Diagnóstico por Imagen , Física Sanitaria , Protección Radiológica/métodos , Tecnología Radiológica , Humanos , Exposición Profesional , Dosis de Radiación , Radiación IonizanteRESUMEN
We assessed overall job satisfaction and factors of job satisfaction among physician assistants (PAs) practicing cardiovascular medicine in the United States. Job satisfaction among health care providers is associated with provider satisfaction and retention, reduced health care costs, increased patient satisfaction, and improved health care. Research regarding job satisfaction among physicians and nurse practitioners has been conducted, but knowledge of job satisfaction among PAs is limited, dated, and inadequate. Job satisfaction among PAs in cardiology, a specialty with a disparity between provider supply and demand, has not been investigated. A quantitative, correlational, descriptive study was conducted using participants from the Association of Physician Assistants in Cardiology database. Overall job satisfaction, 45 factors of job satisfaction, and 6 composite factors were calculated. Correlational analysis was performed for factors most associated with overall job satisfaction. Overall job satisfaction was high. Most PAs (87.3%) were satisfied or very satisfied. Physician assistants were most satisfied with job factors related to challenge and autonomy, and these factors had the greatest correlation to overall job satisfaction. Findings can guide employers, health care administrators, and policy makers to promote job satisfaction among PAs in cardiology and provide insights into job satisfaction among PAs in general.
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Cardiología , Satisfacción en el Trabajo , Asistentes Médicos/psicología , Asistentes Médicos/estadística & datos numéricos , Bases de Datos Factuales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Autonomía Profesional , Encuestas y Cuestionarios , Estados UnidosRESUMEN
BACKGROUND: The American Nurses Association recognizes the specialty practice of Clinical Research Nursing, but many new nurses are unaware of the specialty and lack knowledge to effectively interact with research teams. METHOD: Participants completed a novel online survey to describe the level of awareness and understanding of the clinical research nursing specialty and the effect of clinical studies on nursing practice in fourth-year baccalaureate nursing program students. RESULTS: Ninety-three participants completed the survey. Most were aware that some nurses specialize in the care of clinical study participants, and most did not know how to effectively support research teams. Years of nursing experience was associated with an understanding of how to effectively collaborate with clinical research nurses and an interest in a career as a clinical research nurse. CONCLUSION: Entry-level nursing programs should expose students to the clinical research nurse role and provide the knowledge needed to collaborate with researchers when caring for patients in clinical studies. [J Nurs Educ. 2018;57(10):598-603.].
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Competencia Clínica , Investigación en Enfermería Clínica/métodos , Bachillerato en Enfermería/métodos , Enfermeras Clínicas/estadística & datos numéricos , Estudiantes de Enfermería/estadística & datos numéricos , Curriculum , Humanos , Enfermeras Clínicas/psicología , Estudiantes de Enfermería/psicologíaRESUMEN
Iodinated contrast agents used in computed tomography (CT) examinations have the potential to cause adverse reactions in patients. The possibility of acute kidney injury should be of concern to radiologic technologists performing CT examinations. Although prevention is paramount, identifying and treating contrast-induced nephropathy, for example, as well as following appropriate guidelines regarding the handling and usage of contrast material, are crucial. This article discusses recent research in these areas.
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Lesión Renal Aguda/inducido químicamente , Medios de Contraste/efectos adversos , Yodo/toxicidad , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/fisiopatología , Humanos , Factores de RiesgoRESUMEN
Harmful algal blooms caused by cyanobacteria can present a risk to the safety of drinking- and recreational waters and beachfronts through the production of toxins, particularly microcystin, which are highly resilient to degradation. These blooms are difficult to predict, vary in appearance and toxicity, and can show significant spatial heterogeneity: wind- and current-borne scums can produce an order of magnitude range in toxin levels along shorelines. The growing demand for reliable, cost-effective and rapid methods to detect toxins in bloom material and reduce the risk of public exposure cannot be met by most analytical lab turnaround times. Commercial microcystin test kits are now available, but few have been rigorously field-tested or incorporated into monitoring programmes. Working with a local health agency, we evaluated two kits with different operative ranges of detection, applied to samples covering a wide range of water quality, sample matrices, and bloom composition. We compared their performance against lab analyses using Enzyme-Linked Immunosorbent and Protein Phosphatase Inhibition assays. Both kits could resolve samples with high (<10 µg/L microcystin equivalents (MCequiv)) and low/no toxins, but failed to reliably detect toxin levels between 1 and 5 µg/L, at which threshold there were few false negatives (8%) but â¼ one third of the samples (32%) yielded false positives. We conclude that these kits are potentially useful for screening and informed risk management decisions e.g. on beach closures, but should be followed up with more rigorous tests where needed. We describe how, based on these results, the kits have been successfully incorporated into the routine municipal beach monitoring and advisory programme by the Hamilton Public Health Services (Ontario).
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Cianobacterias , Monitoreo del Ambiente , Floraciones de Algas Nocivas , Microcistinas/análisis , Gestión de Riesgos , Análisis Costo-Beneficio , Lagos/análisis , Lagos/microbiología , Reproducibilidad de los ResultadosRESUMEN
PURPOSE: To determine whether a relationship exists between the number of clinical sites available in radiography programs accredited by the Joint Review Committee on Education in Radiologic Technology and the job placement rates of graduates. METHODS: We performed a secondary analysis of data on job placement rates and the number of clinical sites available in 438 degree-granting radiography programs from January 2015 to March 2015. RESULTS: A weak, negative, nonsignificant correlation existed between the number of clinical sites and the job placement rate (Spearman's rho = -.113, n = 438, P = .018). The coefficient of determination was 1.28%.Discussion Research evaluating factors contributing to graduate employability is limited but indicates no need for radiography program administrators to adjust clinical site numbers solely on the basis of improving graduate employability. CONCLUSION: The number of clinical sites available in a radiography program is not related to the job placement rate of its graduates.
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Empleo/estadística & datos numéricos , Tecnología Radiológica/educación , Selección de Profesión , Humanos , Estados Unidos , Recursos HumanosRESUMEN
BACKGROUND CONTEXT: Somatosensory evoked potentials (SSEPs) are effective in detecting upper extremity positional injuries; however, causal factors for which patient population is most at risk are not well established. PURPOSE: To review causal factors for intraoperative SSEP changes due to patient positioning. STUDY DESIGN: A case series with retrospective chart analysis was performed. PATIENT SAMPLE: 398 patient charts and intraoperative neurophysiological monitoring data from patients who underwent thoracolumbar and lumbosacral spine surgery were reviewed in a consecutive sequence from 2012 to 2013. OUTCOME MEASURES: Adverse events (AE) with the upper extremity SSEP recordings were compared to the independent variables, sex, positioning, length of procedure, and body habitus. METHODS: Thoracolumbar and lumbosacral spine surgeries using contemporaneous ulnar and median nerve SSEPs were reviewed. The one-way analysis of variance (ANOVA) test, Chi-square, and independent samples t test were used to determine statistical significance in having an upper extremity SSEP AE to the aforementioned independent variables. RESULTS: The sample consisted of 209 males (52.5 %) and 189 females (47.5 %) (n = 398). AE to the upper extremity SSEP was seen in 44 patients. Sex was found to be statistically significant for isolated ulnar nerve AE (P ≤ 0.001) with males being most at risk (87.5 %). AE for isolated median nerve SSEP was statistically significant for supine and prone positions (P = 0.043). Length of procedure was statically significant for isolated ulnar nerve SSEP AE (P = 0.039). BMI was statistically significant for generalized upper extremity SSEP AE (P = 0.016), as well as isolated ulnar SSEP AE (P = 0.006), isolated median SSEP AE (P ≤ 0.001) and contemporaneous median and ulnar SSEP AE of the same limb (P ≤ 0.001). CONCLUSION: Sex, patient positioning, length of procedure, and BMI are determinants for upper extremity neural compromise during thoracolumbar and lumbosacral spine surgeries.
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Potenciales Evocados Somatosensoriales/fisiología , Monitorización Neurofisiológica Intraoperatoria/métodos , Columna Vertebral/cirugía , Adulto , Índice de Masa Corporal , Femenino , Humanos , Complicaciones Intraoperatorias/prevención & control , Masculino , Nervio Mediano/fisiología , Persona de Mediana Edad , Tempo Operativo , Posicionamiento del Paciente , Complicaciones Posoperatorias/prevención & control , Estudios Retrospectivos , Factores Sexuales , Nervio Cubital/fisiologíaRESUMEN
INTRODUCTION: Evidence-based practice (EBP) has been widely studied and adopted in allied health professions education. Current practitioners may have challenges in adopting EBP into current practice. EBP skills have not been previously assessed in perfusionists, therefore, the purpose of this study is to identify a preliminary analysis of perfusionists' EBP knowledge and its possible relationship to clinical behavior and educational level METHODS: A non-randomized convenience study using the Evidence-Based Practice Questionnaire (EBPQ) was used to measure EBP of practicing U.S. perfusionists. The EBPQ is a validated survey instrument designed to measure EBP practice, attitude and knowledge subscales. The EBPQ consisted of 24 items on a 1 to 7 Likert Scale, with higher numbers indicating frequent use of skill. Practitioner experience, educational background and employment type were also collected. RESULTS: Two hundred and fifty-four responses met the inclusion criteria and were analyzed. The mean EBPQ score was 5.0 (SD = 0.9) with similar means for the subscales. There were important differences found in the EBPQ scores, depending on the educational level and work status. There was a positive correlation between the knowledge and practice subscales, demonstrating a relationship in the sample and a possible relationship in the population as a whole. CONCLUSION: The results suggest that perfusionists' use of EBP in practice does vary, based upon educational level and employment type. The findings also demonstrated areas of lower EBP aptitude. The correlation between EBP knowledge and practice may guide educational efforts at improving EBP practice.
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Educación Médica Continua , Práctica Clínica Basada en la Evidencia/educación , Encuestas y Cuestionarios , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados UnidosRESUMEN
The former family Trachelostenidae is returned to tribal status in Tenebrionidae-Tenebrioninae and reconstituted to include Trachelostenus Solier, 1851 of southern Chile, currently in a separate family Trachelostenidae, Myrmecodema Gebien, 1943 of central Chile, currently in Stenochiinae-Cnodalonini, and Leaus Matthews & Lawrence, 1992 of eastern Australia, currently in Tenebrioninae-Titaenini. The three genera are redescribed in both the adult and larval stages. Three new species: Leaus tropicalis sp.n. L. monteithi sp. n. and L. elusus sp. n. are described. Trachelostenine larval characters are compared with those of related tribes of Tenebrioninae: Titaenini, Heleini, Helopini, Helopinini, Ulomini and Toxicini. The Chilean genus Homocyrtus Dejean is briefly discussed and left incertae sedis in Tenebrionidae. Examination of Lagriola Kirsch (Lagriinae), originally associated with Trachelostenus, leads to the following name changes: Lagriola Kirsch, 1873 = Paratenetus Spinola, 1844, syn. n.; Paratenetus operosus (Kirsch, 1873) (Lagriola), comb. n.; Paratenetus championi, nom. n. for P. denticulatus Champion, 1886 nec P. denticulatus (Kirsch, 1873) (Lagriola) comb. n.
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Escarabajos/clasificación , Larva/crecimiento & desarrollo , Distribución Animal , Estructuras Animales/anatomía & histología , Estructuras Animales/crecimiento & desarrollo , Animales , Australia , Tamaño Corporal , Chile , Escarabajos/anatomía & histología , Escarabajos/crecimiento & desarrollo , Ecosistema , Femenino , Larva/anatomía & histología , Larva/clasificación , Masculino , Tamaño de los ÓrganosRESUMEN
At every stage of their careers, radiologic technologists and student technologists must adhere to high ethical standards, obey the law, and consistently conduct themselves with professionalism. This article explains how modern health care ethics evolved, focusing on 8 important theorists. It also describes the ethical responsibilities of health care providers and the rights of patients. Important civil rights laws are discussed, focusing on the rights of health care workers as employees. A brief overview of the U.S. legal system follows, including the causes of action that most commonly involve health care professionals. Finally, this article discusses professionalism and its implications for radiologic technologists.
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Empleo/ética , Empleo/legislación & jurisprudencia , Ética Médica , Mala Praxis/legislación & jurisprudencia , Tecnología Radiológica/ética , Tecnología Radiológica/legislación & jurisprudencia , Estados UnidosRESUMEN
Although the advent of nonionic low-osmolar contrast agents has reduced the probability of a reaction to radiopaque contrast media derived from tri-iodinated benzoic acid, reactions still occur. Radiologic technologists must understand and know how to manage adverse effects of contrast media. Prompt attention to patients who exhibit the early signs of an adverse reaction can help to ensure the reaction does not progress to become severe or life-threatening.
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Medios de Contraste/efectos adversos , Hipersensibilidad a las Drogas/etiología , Compuestos de Yodo/efectos adversos , Anafilaxia/inducido químicamente , Anafilaxia/terapia , Bradicardia/inducido químicamente , Broncodilatadores/uso terapéutico , Embolia Aérea/etiología , Epinefrina/uso terapéutico , Extravasación de Materiales Terapéuticos y Diagnósticos/complicaciones , Antagonistas de los Receptores Histamínicos/uso terapéutico , Humanos , Hipotensión/inducido químicamente , Inyecciones Intravenosas , Terapia por Inhalación de OxígenoRESUMEN
A ministudy was conducted to collect self-reported employee turnover rates in US hospitals. The results indicate many hospitals are struggling with high employee turnover rates. Widespread variances in ratings were observed across hospitals, which may be due to lack of consistency in how they each calculate their employee turnover. This makes benchmarking for the purposes of performance improvement challenging.
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Hospitales/estadística & datos numéricos , Reorganización del Personal/estadística & datos numéricos , Lealtad del Personal , Reorganización del Personal/tendencias , Estados UnidosRESUMEN
The purpose of this study was to determine the levels of perceived cultural self-efficacy of senior students in second-degree pre-licensure nursing programs in the provision of culturally appropriate care to immigrants. The study employed a quantitative, non-experimental design with survey methodology. The convenience sample consisted of 117 senior students enrolled in accelerated bachelor of sciences in nursing and entry levels master of sciences programs. The study used Bernal and Froman's Cultural Self-Efficacy Scale (CSES). The study found that the participants had low levels of transcultural self-efficacy. There was no association between the participants' demographic characteristics and their CSES scores. These findings were consistent with the findings of previous studies that surveyed traditional nursing students. The study provided important assessment data on learning needs of second-degree nursing student concerning the provision of culturally congruent care.
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Competencia Cultural/educación , Bachillerato en Enfermería/normas , Emigración e Inmigración , Rol de la Enfermera , Autoeficacia , Estudiantes de Enfermería/psicología , Adulto , Competencia Clínica/normas , Curriculum/normas , Femenino , Humanos , Masculino , Investigación en Educación de EnfermeríaRESUMEN
Research performed on soldiers in the military far exceeds that of research performed on military health care providers. The focus of this study was to explore the prevalence of burnout among the health care providers of the 101 st Airborne Division in relation to deployments. A cross-sectional survey was electronically dispersed to 158 health care professionals including combat medics, physician assistants, and physicians. Over one-third of these professionals completed the online anonymous survey successfully. Results revealed that the majority of those surveyed were, in fact, burnt out. The study showed no correlation between burnout and deployment, though it did demonstrate correlation to the number of leave days accrued. More in-depth research and analysis is needed to further explain this correlation of health care providers in the military, the amount of leave days they have accrued, and burnout. Further research is also needed to see if this high level of burnout is present among military providers of other services, in different locations, and between different professions.
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Agotamiento Profesional/epidemiología , Personal de Salud/psicología , Personal Militar/psicología , Adulto , Campaña Afgana 2001- , Estudios Transversales , Femenino , Humanos , Guerra de Irak 2003-2011 , Masculino , Prevalencia , Estados Unidos/epidemiologíaRESUMEN
This study is a reanalysis of employer incentives for healthcare managers. In 2007, a survey was administered to determine the top incentives used in healthcare as well as which individuals are receiving the most creative incentive packages; technical, managerial, or executive employees. A similar survey was distributed in 2012 in order to compare and see what changes have taken place in the last five years in respect to the incentives and the incentive packages used in healthcare that were first identified in 2007.
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Planes para Motivación del Personal , Sector de Atención de Salud , Encuestas de Atención de la Salud , Humanos , Personal de Hospital , Estados UnidosRESUMEN
A study was conducted to revisit the perceptions of chief executive officers in US hospitals regarding the origin of leadership and how they felt about internally developed successors versus externally recruited successors. Furthermore, the study sought to develop understanding of how this group of executives utilizes the succession planning process, what factors impact successor identification, what positions are applicable for succession planning activities, and who is ultimately held responsible for leadership continuity within the hospital industry. The results of this 2012 study were compared with a previous study conducted in 2007 to determine if the perceptions had changed over time.
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Directores de Hospitales/organización & administración , Planificación en Salud , Administración Hospitalaria , Humanos , Liderazgo , Selección de Personal/organización & administración , Desarrollo de Personal/organización & administración , Estados Unidos , Recursos HumanosRESUMEN
The US Bureau of Labor Statistics reports the "employment of medical and health services managers is expected to grow by 22% from 2010 to 2020" (http://www.bls.gov.ooh/management/medical-and-health-services-managers.htm#tab-6). The US Bureau of Labor Statistics notes this is substantially faster than the national average for other occupations. Information from this report finds its way into popular media, news shows, and other information outlets, which increases the number of prospective applicants to college and university health care management programs. (For the purposes of this article, no differentiation is made between various programs geared toward preparing health care managers; this includes, but is not limited to, degrees in hospital administration, hospital services administration, health care management, etc.) In 2007, the authors conducted a survey of chief executive officers in US hospitals that sought to identify educational and demographic information of individuals holding top management positions in US health care institutions. The survey was repeated in 2012, at the 5-year interval, to determine if chief executive officer information had changed.