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1.
Eur J Dent Educ ; 2024 Jul 18.
Artículo en Inglés | MEDLINE | ID: mdl-39030866

RESUMEN

INTRODUCTION: To evaluate different factors affecting two different cohorts of dental students' perceptions with the flipped classroom (FC) model in a preclinical dental course over six years. MATERIALS AND METHODS: In 2016 (cohort #1) and 2022 (cohort #2), second-year dental students participated in FC model in a preclinical dental course consisting of pre-class recorded videos and lectures along with classroom interactive exercises. Students then completed an anonymous pen-and-paper survey evaluating three factors influencing students' overall study experience with the FC model. Survey responses from cohort #1 and cohort #2 were compared to assess the effect of generation, student demographics and COVID-19 pandemic on students' perceptions. RESULTS: When asked to rate the FC experience out of 5, the mean ratings of cohort #1 and cohort #2 were 4.3 (±0.9) and 4.0 (±0.8), respectively. Cohort #2 preferred viewing slides and videos prior to class and had a higher agreement that pre-class course materials were beneficial to class preparation. Conversely, cohort #1 had a higher agreement that in-class discussion and exercises helped them to learn course content. From cohort #2, 88.6% of males and 71.6% of females preferred the FC approach over traditional lecture. CONCLUSION: Both cohorts reported positively with the FC model of teaching. Cohort #2 had higher positive reports with the pre-class work and cohort #1 had a higher positive report with in-class work. Course design should reflect the students' points of view and learning perspectives with careful consideration of the student population in the classroom.

4.
J Dent Educ ; 88(1): 42-50, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37920097

RESUMEN

PURPOSE/OBJECTIVES: A patient-centered care (PCC) paradigm undergirds modern dental education. PCC is particularly relevant in the management of patient dental fear. The aims of this study were three-fold: (a) to examine the preliminary psychometric properties of an author-designed survey administered to explore dental fear knowledge and perceptions, (b) to assess how 4th-year dental students regard dental fear, (c) and to investigate the relationship between students' knowledge and perceptions of dental fear and their clinical behavior. METHODS: In 2022, 4th-year dental students (N = 453) participated in a cross-sectional study. Participants completed a 16-item survey that assessed (a) knowledge and perceptions about dental fear, (b) common biases in patient fear assessment, and (c) patient management behaviors when fear is encountered. Exploratory factor analysis, descriptive statistics, and logistic regressions were run to address the study's aims. RESULTS: Exploratory factor analysis revealed three factors, with the two strongest factors pertaining to beliefs about the importance of dental fear (α = 0.87) and self-efficacy in managing fear (α = 0.74). Participants indicated that it is important to assess for dental fear and rated their self-efficacy in ability managing it as high. Ratings on both factors slightly increased the odds of engaging in routine patient screening for dental fear. Students also displayed assessment biases commonly seen among practicing dentists. CONCLUSION(S): Results indicate educational gaps within the current behavioral-science training for dental students. Changes to improve advanced dental students' appreciation of their patients' dental fear are warranted.


Asunto(s)
Ansiedad al Tratamiento Odontológico , Estudiantes de Odontología , Humanos , Estudios Transversales , Autoeficacia , Actitud del Personal de Salud , Atención Dirigida al Paciente , Encuestas y Cuestionarios , Conocimientos, Actitudes y Práctica en Salud
5.
Disaster Med Public Health Prep ; 17: e555, 2023 Dec 06.
Artículo en Inglés | MEDLINE | ID: mdl-38053415

RESUMEN

OBJECTIVE: This study assesses the difference in professional attitudes among medical students, both before and after coronavirus disease 2019 (COVID-19), and identifies the determinants closely associated with it, while providing precise and scientific evidence for implementing precision education on such professional attitudes. METHODS: A pre-post-like study was conducted among medical students in 31 provinces in mainland China, from March 23, to April 19, 2021. RESULTS: The proportion of medical students whose professional attitudes were disturbed after the COVID-19 pandemic, was significantly lower than before the COVID-19 pandemic (χ2 = 15.6216; P < 0.0001). Compared with the "undisturbed -undisturbed" group, the "undisturbed-disturbed" group showed that there was a 1.664-fold risk of professional attitudes disturbed as grade increased, 3.269-fold risk when others suggested they choose a medical career rather than their own desire, and 7.557-fold risk for students with COVID-19 in their family, relatives, or friends; while the "disturbed-undisturbed" group showed that students with internship experience for professional attitudes strengthened was 2.933-fold than those without internship experience. CONCLUSIONS: The professional attitudes of medical students have been strengthened during the COVID-19 pandemic. The results provide evidence of the importance of education on professional attitudes among medical students during public health emergencies.


Asunto(s)
COVID-19 , Estudiantes de Medicina , Humanos , COVID-19/epidemiología , SARS-CoV-2 , Pandemias , Escolaridad
7.
J Dent Educ ; 87(12): 1692-1704, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37653454

RESUMEN

PURPOSE/OBJECTIVES: Emotional intelligence (EI) supports the clinical and social competencies of a practicing dentist. Reuven Bar-On's EI model is an array of inter-related emotional and social competencies, skills, and behaviors, which consist of five key domains: Self-Perception, Self-Expression, Interpersonal, Decision Making, and Stress Management, and associated with the domains are 15 emotional quotient (EQ) subskills. This study measured the impact of COVID-19 on dental students' EI by comparing measures pre-COVID-19 and during COVID-19 matriculation. METHODS: This retrospective longitudinal study measured EI with the EQ-i 2.0 for higher education. Dental students completed an EQ-i 2.0 assessment (Attempt) at the beginning of matriculation, at the mid-point, and prior to graduation. Ten groups were included, of which the first three completed matriculation prior to the pandemic and the remaining seven matriculated during timeframes intersecting at different times during the pandemic. A paired t-test dependent sample of means (p ≤ 0.05) compared EQ scores for each attempt for all groups. The study compared means for three EQ attempts with the t-test independent sample of means (p ≤ 0.05) for cohorts matriculating pre-COVID-19 and during COVID-19. RESULTS: The pre-COVID-19 groups showed significant increases in EQ with each subsequent attempt. COVID-19-impacted groups demonstrated significant increase in Stress Tolerance and significant decreases, most notably in the domains of Interpersonal and Self-Perception, and subscales of Optimism and Happiness. CONCLUSION(S): COVID-19-related stressors impacted dental students' EI as multiple EI areas declined significantly. Dental educators should minimize organizational stressors and support EI during years 2 and 3 of matriculation.


Asunto(s)
COVID-19 , Estudiantes de Odontología , Humanos , Estudios Longitudinales , Estudios Retrospectivos , COVID-19/epidemiología , Inteligencia Emocional
8.
Br J Pain ; 17(4): 352-365, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37538944

RESUMEN

Fibromyalgia remains a difficult condition to diagnose and treat. Research suggests that this leads to frustrating experiences for service users and healthcare professionals. This has led to negative healthcare professional attitudes towards working with those with fibromyalgia. The research to date reports negative attitudes and predominantly investigates attitudes of primary care physicians. This study explores the attitudes of a range of healthcare professionals towards those diagnosed with fibromyalgia. Using Q-methodology, 27 healthcare professionals completed a sorting task and questionnaire to prioritise statements relating to a range of different attitudes towards service users. All participants significantly loaded onto three factors that explained a total of 64% of the data variance. Factor 1 reflected the attitude 'Service users with fibromyalgia are no different to other service users and I enjoy working with them'. Factor 2 reflected the attitude 'Service users with fibromyalgia are inaccurate informants of their own condition due to lack of understanding of their condition and are not likely to engage in treatments'. Factor 3 reflected the attitude 'Service users with fibromyalgia are trustworthy with a lot of clinical problems [but I lack confidence in specialist skills to support them]'. Contrary to the current literature, there appears to be supportive attitudes from healthcare professionals towards service users diagnosed with fibromyalgia. Increased specialised training, clinical exposure to working with fibromyalgia and reflective practice spaces were identified as elements that could improve healthcare professional attitudes.

9.
Clin Psychol Psychother ; 30(6): 1369-1379, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37394242

RESUMEN

INTRODUCTION: This study explored the current knowledge, attitudes, and clinical practices regarding psychedelics among mental health professionals in California, where state legislation to decriminalize psychedelics has been proposed. METHOD: Two hundred thirty-seven mental health providers (74% female; mean age 54; 83% White; 46% psychologists) completed a 37-item online survey between November 2021 and February 2022, disseminated through local and state-wide professional organizations in California. RESULTS: Providers endorsed limited knowledge about the risks and benefits of psychedelic use (M = 4.7 and 5.4, respectively, with 10 = high knowledge) and inadequate knowledge to counsel patients on use (45%). Gaps in knowledge related to psychedelic drug scheduling and current use in clinical research were identified. Providers expressed support for additional psychedelic research (97%), approval of recreational (66%) and medical (91%) psychedelic use, belief in the potential therapeutic benefits of psychedelics (89%), and concerns about safety (33%) and potential psychiatric risks (27%). Results indicated that most providers discuss psychedelic use with patients (73%), yet many do not feel comfortable addressing the effects of use (49%). There were significant correlations between knowledge and attitudes towards psychedelics (r = 0.2, p = .006; r = 0.31, p < .001) and attitudes and clinical practices (r = 0.34, p < .001). CONCLUSIONS: Findings suggest that providers are interested in psychedelic-assisted treatments and hold favourable attitudes towards the therapeutic use of psychedelics yet lack the knowledge to appropriately counsel patients, highlighting the need for additional provider education about psychedelics.


Asunto(s)
Alucinógenos , Síndrome de Abstinencia a Sustancias , Humanos , Femenino , Persona de Mediana Edad , Masculino , Alucinógenos/farmacología , Alucinógenos/uso terapéutico , Psicoterapeutas , Conocimientos, Actitudes y Práctica en Salud , Emociones , Salud Mental , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico
10.
J Dent Educ ; 87(6): 813-824, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36928643

RESUMEN

PURPOSE: The aim of this study is to investigate the literature to evaluate dental students' attitudes regarding the treatment of older adults. METHODS: A scoping review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses/PRISMA guidelines to identify articles from four electronic databases: MEDLINE via the PubMed interface, Embase, Cumulative Index to Nursing and Allied Health Literature, and AgeLine. Gray literature searches were also performed in Scopus, Web of Science, and ProQuest Dissertations and Theses-Health and Medicine. RESULTS: Eleven articles were assessed. The majority (72, 72%) were published between 2011 and 2020, evidencing various contexts of dental students, such as different countries and cultures, and levels of education. The most commonly used tool/instrument to survey dental students' attitudes was the Aging Semantic Differential Scale. Student age, race, and marital status did not seem to interfere with dental students' attitudes regarding the treatment of older adults. CONCLUSIONS: Dental students tend to have a positive attitude toward older people. In this context, female students, students who interact with older people, and clinical students have more positive attitudes than male and nonclinical students.


Asunto(s)
Estudiantes de Odontología , Estudiantes de Enfermería , Anciano , Femenino , Humanos , Masculino , Actitud , Escolaridad
11.
Acta Obstet Gynecol Scand ; 102(3): 355-369, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36629126

RESUMEN

INTRODUCTION: The aim of this study was to investigate the effect of organizational belonging and profession on clinicians' attitudes toward supporting vaginal birth and interprofessional teamwork in Swedish maternity care. MATERIAL AND METHODS: The study used a cross-sectional design, with a web-based survey sent to midwives, physicians and nurse assistants at five labor wards in Sweden. The survey consisted of two validated scales: the Swedish version of the Labor Culture Survey (S-LCS), measuring attitudes toward supporting vaginal birth, and the Assessment of Collaborative Environments (ACE-15), measuring attitudes toward interprofessional teamwork. Two-way ANOVA was conducted to assess the main effect of and interaction effect between organizational belonging and profession for the different subscales of the S-LCS and the ACE-15, together with Tukey's honest significant difference post-hoc analysis and partial eta squared to determine effect size. The relation between the subscales was assessed using the Pearson's correlation analysis. RESULTS: A total of 539 midwives, physicians and nurse assistants completed the survey. Organizational belonging significantly influenced attitudes toward supporting vaginal birth and interprofessional teamwork, with the largest effect for Positive team culture (F = 38.88, effect size = 0.25, p < 0.001). The effect of profession was strongest for the subscale Best practices (F = 59.43, effect size = 0.20, p < 0.001), with midwives being more supportive of strategies proposed to support vaginal birth than physicians and nurse assistants. A significant interaction effect was found for four of the subscales of the S-LCS, with the strongest effect for items reflecting the Unpredictability of vaginal birth (F = 4.49, effect size = 0.07, p < 0.001). Labor ward culture (unit microculture) specifically related to supporting vaginal birth was strongly correlated to interprofessional teamwork (r = 0.598, p < 0.001). CONCLUSIONS: In the current study, both organizational belonging and profession influenced attitudes toward supporting vaginal birth and interprofessional teamwork. Positive team culture was positively correlated to an organizational culture supportive of vaginal birth. Interventions to support vaginal births should include efforts to strengthen teamwork between professions, as well as considering women's values, preferences and informed choices.


Asunto(s)
Servicios de Salud Materna , Partería , Humanos , Femenino , Embarazo , Estudios Transversales , Actitud del Personal de Salud , Parto , Relaciones Interprofesionales , Grupo de Atención al Paciente
12.
Transcult Psychiatry ; 60(1): 176-198, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-34986056

RESUMEN

Migrants living in Europe constitute over half of the world's international migrants and are at higher risk of poor mental health than non-migrants, yet also face more barriers in accessing and engaging with services. Furthermore, the quality of care received is shaped by the experiences and attitudes of health professionals. The aim of this review was to identify professionals' attitudes towards migrants receiving mental healthcare and their perceptions of barriers and facilitators to service provision. Four electronic databases were searched, and 23 studies met the inclusion criteria. Using thematic synthesis, we identified three themes: 1) the management of multifaceted and complex challenges associated with the migrant status; 2) professionals' emotional responses to working with migrants; and 3) delivering care in the context of cultural difference. Professionals employed multiple strategies to overcome challenges in providing care yet attitudes towards this patient group were polarized. Professionals described mental health issues as being inseparable from material and social disadvantage, highlighting a need for effective collaboration between health services and voluntary organizations, and partnerships with migrant communities. Specialist supervision, reflective practice, increased training for professionals, and the adoption of a person-centered approach are also needed to overcome the current challenges in meeting migrants' needs. The challenges experienced by health professionals in attempting to meet migrant needs reflect frustrations in being part of a system with insufficient resources and without universal access to care that effectively stigmatizes the migrant status.


Asunto(s)
Servicios de Salud Mental , Refugiados , Migrantes , Humanos , Atención a la Salud , Europa (Continente) , Personal de Salud/psicología , Accesibilidad a los Servicios de Salud , Investigación Cualitativa
13.
Clin Exp Optom ; 106(4): 386-394, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-35298892

RESUMEN

CLINICAL RELEVANCE: To explore optometric practices and attitudes in the management of keratoconus patients in LatinAmerica and how they are influenced by eye-care technology will help to minimise disease progression and their impact on patients' quality of life in Latin America. BACKGROUND: Keratoconus is a progressive, bilateral and asymmetric corneal disorder that requires a multidisciplinary approach, the use of different eye assessment technology, and different management approaches; mainly contact lenses and surgery. METHODS: Self-reported answers to an online survey (adapted to primary eye care) distributed via a newsletter emailed by various professional organisations across 15 Latin American countries were assessed and compared with those previously reported in three European countries. RESULTS: Answers from 977 eye care practitioners (60%) with >10 years of experience (396 in Latin America and 581 in Europe) were assessed. A total of 65.9% of Latin American responders prescribed rigid corneal lenses (RCL), although more than half of the respondents (54.0%) would fit more RCL if they underwent further training in RCL fitting. A majority of Latin American practitioners (74.0%) considered that RCL fitting is more difficult in keratoconus, requiring more diagnostic lenses (4.6 ± 2.7; median 4; range 1-10) than are necessary for healthy eyes. Low availability of corneal topography was reported in Latin America (23%), although practitioners with topographers are more likely to prescribe RCL (92.3%) and detect more new patients with keratoconus per year (83.5%). A minority of respondents referred keratoconus patients to another optometrist (25.8%) or (40.4%) participated in comanagement with ophthalmologists. CONCLUSION: This study provides initial evidence regarding keratoconus management in Latin America and suggests that actions are necessary to improve RCL training, facilitate eye-care technology accessibility and encourage comanagement between eye care practitioners to minimise disease progression and their impact on patients' quality of life in Latin America.


Asunto(s)
Queratocono , Humanos , Queratocono/diagnóstico , Queratocono/terapia , América Latina , Calidad de Vida , Topografía de la Córnea , Actitud , Progresión de la Enfermedad
14.
J Dent Educ ; 87(4): 441-453, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36449210

RESUMEN

OBJECTIVES: Oral and maxillofacial surgeons (OMS) treat adult and pediatric patients with obstructive sleep apnea (OSA). Objective 1 assessed sleep apnea-related education, knowledge, and professional behavior of OMS residents in the United States. Objective 2 was to compare the responses of junior versus senior residents and residents in single- versus dual-degree programs. METHODS: OMS residents in the United States received a recruitment email with a link to an anonymous online survey; 81 residents responded. The survey included 20 questions to assess respondents' OSA-related education, knowledge, attitudes, and professional behavior. RESULTS: Respondents generally agreed that they had received OSA-related didactic-based education (5-point scale with "5" = agree strongly: mean = 3.62) and clinical training (mean = 3.75). Clinical and classroom educational gaps were identified in relation to treatment with oral appliances and hypoglossal nerve stimulation. The residents scored on average 10.38 out of 18 (58%) possible correct answer points for the knowledge questions. Findings about pediatric OSA suggest that only 43.8% of residents understand diagnostic criteria for pediatric OSA, with only 26.6% screening pediatric patients for OSA. A case analysis showed that only 1.5% of residents correctly identified an apnea-hypopnea index of 17 as moderate sleep apnea. CONCLUSION(S): This survey found knowledge gaps in several areas that can be improved upon. It identifies deficiency in objective knowledge about OSA among OMS residents and a specific lack of clinical training and confidence with hypoglossal nerve stimulation and management of pediatric patients with OSA. Junior and senior residents and single- and dual-degree residents showed no statistically significant differences in any category except senior residents in regard to surgical management of OSA, particularly with maxillomandibular advancement.


Asunto(s)
Cirujanos Oromaxilofaciales , Apnea Obstructiva del Sueño , Adulto , Humanos , Estados Unidos , Niño , Encuestas y Cuestionarios , Escolaridad , Apnea Obstructiva del Sueño/terapia , Apnea Obstructiva del Sueño/cirugía , Actitud del Personal de Salud
15.
Front Oncol ; 12: 891874, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35814480

RESUMEN

Background: Lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ+) people experience healthcare inequalities in cancer care. Previous studies have focused on knowledge, attitudes and behaviours of healthcare professionals (HCPs) treating adults with cancer and how these contribute to inequalities. To date, no research has focused on HCPs treating LGBTQ+ children and adolescents with cancer in the UK. This is important given that this group may be at a critical time for exploring their gender identity and sexual orientation, whilst also facing a cancer diagnosis. We aimed to explore the knowledge, attitudes and behaviours of paediatric, teenage and young adult oncology HCPs treating LGBTQ+ patients in the UK. Methods: We carried out semi-structured interviews with 8 HCPs in paediatric, teenage and young adult (TYA) oncology from the Royal Marsden NHS Foundation Trust. Eight questions were asked, which centred around participants' knowledge, attitudes and behaviours regarding management of LGBTQ+ patients in oncology. Interview transcripts were analysed by inductive thematic analysis. Results: We identified 10 themes, including novel themes (how HCPs acquire knowledge and expectations of a 'third party' to be the expert) which may underlie previously observed trends in knowledge, attitudes and behaviours of HCPs. We highlight other themes and HCP concerns specific to care of LGBTQ+ patients in paediatrics (influence of the parental-carer dynamic, concerns around patient age and development as a barrier to disclosure) which require further research. We found evidence of the interrelatedness of HCP knowledge, attitudes and behaviours and the ability of these elements to positively influence each other. We mapped our themes across these elements to form a new suggested framework for improving HCP-patient interactions in LGBTQ+ Cancer Care. We found a need both for individual HCP education and organisational change, with creation of a culture of psychological safety to improve patient care. Conclusion: Knowledge, attitudes and behaviours of HCPs are closely interdependent when providing care to young LGBTQ+ patients with cancer. The authors suggest that future efforts to improve care of these patients address this complexity by spanning the domains of our suggested framework. Whilst HCP education is essential, change must also occur at an organisational level.

16.
J Child Sex Abus ; 31(5): 593-615, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35469541

RESUMEN

Child sexual abuse is a serious problem in Brazil and requires actions taken together by Justice, Security, Health and Social Welfare to effectively protect and guarantee victims' rights. Professionals working in these fields have difficulty in evaluating cases, owing to limitations of the Brazilian Welfare Network and lack of specialized training. Such difficulty may cause professionals to carry out poorly substantiated assessments and fail to properly protect victims. Instruments to measure professionals' attitudes in the assessment of situations of sexual violence are scarce. As a result, this study aimed to adapt and evaluate validity evidence of the Child Forensic Attitude Scale (CFAS) in the Brazilian context. A total of 177 professionals (86.4% females), with a mean age of 37.6 years (SD = 10.1 years) participated in the survey. The results of the confirmatory factor analysis showed that in the Brazilian context, the scale structure presents three first-order oblique factors, namely "Fear of Not Identifying Abuse" (F-Under), "Fear of Overcalling Abuse" (F-Over) and "Skepticism" (Skep). The internal consistency of the three dimensions was satisfactory (F-Under, α = 0.66, F-Over, α = 0.80, and Skep, α = 0.92). Evidence has shown that the CFAS can be used to evaluate health professionals' attitudes when assessing cases of sexual violence against children and adolescents in Brazil. This instrument can support the assessment of health professionals' attitudes, and it emphasizes the importance of qualifying Brazilian professionals in the Welfare Network services by providing training opportunities regarding work with victims of sexual abuse.


Asunto(s)
Actitud del Personal de Salud , Abuso Sexual Infantil , Encuestas y Cuestionarios , Adolescente , Adulto , Brasil , Niño , Abuso Sexual Infantil/diagnóstico , Comparación Transcultural , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados
17.
Int J Offender Ther Comp Criminol ; : 306624X221086571, 2022 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-35373628

RESUMEN

Studies indicated that people tend to consider female-perpetrated sexual abuse (FPSA) less serious and damaging than male-perpetrated abuse (MPSA) and the possible roles of gender stereotypes on attitudes to minimize FPSA. This study aimed to explore the role of gender stereotypes and sexuality myths on the attitudes toward FPSA among professionals. A secondary aim was to explore the role of training and experience with child sexual abuse (CSA) cases on the attitudes toward FPSA. The sample consisted of Turkish professionals (N = 502), including mental health/social, health, and justice workers. The participants were recruited via a face-to-face online survey. The results of one-way ANOVAs showed that females and mental health/social workers were more likely to consider FPSA as a serious problem and believe the negative impact of abuse. A five-step hierarchical multiple regression analysis demonstrated that the experience with FPSA cases, belief in gender stereotypes, and myths about female sexuality accounted for 21.7% of the variance in the attitudes toward FPSA. Although the level of professional minimization of FPSA is above average, the influential roles of gender stereotypes and sexual myths on the attitudes toward FPSA exist among professionals. Our findings supported the necessity of additional training addressing gender stereotypes and sexual myths. Future studies should also be conducted with different populations and other influential possible factors on the attitudes toward FPSA.

18.
Int J Gynaecol Obstet ; 159(3): 810-816, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35396724

RESUMEN

OBJECTIVE: To investigate the effect of a quality improvement project with an educational/motivational intervention in northern Italy on the implementation of the trial of labor after cesarean section (CS). METHOD: A pre-post study design was used. Every birth center (n = 23) of the Emilia-Romagna region was included. Gynecologist opinion leaders were first trained about Italian CS recommendations. Barriers to implementation were discussed and shared. Educational/motivational interventions were implemented. Data of multipara with previous CS, with a single, cephalic pregnancy at term, were collected during two periods, before (2012-2014) and after (2017-2019) the intervention (2015-2016). The primary outcome was the rate of vaginal birth after CS (VBAC) and perinatal outcomes. RESULTS: A total of 20 496 women were included. The VBAC rate increased from 18.1% to 23.1% after intervention (P < 0.001). The likelihood of VBAC-adjusted for age 40 years or older, Caucasian, body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) at least 30, previous vaginal delivery, and labor induction-was increased by the intervention by 42% (odds ratio 1.42, 95% confidence interval 1.31-1.54). Neonatal well-being was improved by intervention; neonates requiring resuscitation decreased from 2.1% to 1.6% (P = 0.001). CONCLUSION: Educating and motivating gynecologists toward the trial of labor after CS is worth pursuing. Health quality improvement is demonstrated by increased VBAC even improving neonatal well-being.


Asunto(s)
Trabajo de Parto , Parto Vaginal Después de Cesárea , Recién Nacido , Femenino , Embarazo , Humanos , Adulto , Esfuerzo de Parto , Cesárea , Trabajo de Parto Inducido
19.
J Dent Educ ; 86(10): 1304-1316, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35415838

RESUMEN

OBJECTIVE: In 2021, US dental school deans were surveyed to update and expand ADEA deans' profiles developed in 2002 and 2014. METHODS: The American Dental Education Association (ADEA) and the Academy for Advancing Leadership (AAL) collaborated on an updated version of the 2014 dental deans' profile survey. On July 1, 2021, the research project was approved as exempt from IRB oversight. The survey was distributed in electronic format on July 31, 2021, to the deans of the 70 US dental schools, including 3 schools that had not yet held their first year of classes. A total of 60 responses were considered. RESULTS: Administration/management activities continue to consume deans' time the most, followed by fundraising. Managing personnel issues and financial/budget issues, including fundraising, represent the top aspects of the position deans must master and the greatest challenges they face and expect to face for the next 5 years. Deans found these same issues the most surprising aspects of their position, reporting a low level of preparedness to meet those challenges. Most deans advocated for additional leadership programs to supplement the current training received through ADEA and AAL. CONCLUSION: In recent years, gradual changes have occurred in the dental deans' profile, with more women and underrepresented groups assuming this leadership role and the average and median ages of deans increasing. Substantial turnover occurred among deans in recent years; when the 2014 survey was conducted, one respondent was an interim/acting dean. By comparison, seven reported their deanship status as interim/acting in 2021.


Asunto(s)
Personal Administrativo , Docentes de Odontología , Facultades de Odontología , Femenino , Humanos , Liderazgo , Facultades de Odontología/organización & administración , Desarrollo de Personal , Estados Unidos
20.
J Dent Educ ; 86(10): 1332-1349, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35347714

RESUMEN

OBJECTIVES: To explore dental students' attitudes toward professionalism and the environmental, institutional, and student-related factors that may be associated with these attitudes. METHODS: A cross-sectional online survey, conducted in 2020, analyzed data from a convenience sample of undergraduate dental students at the Faculty of Dentistry, University of Toronto. Attitudes toward professionalism were assessed using Likert scale statements related to the American Dental Education Association professionalism values of "Fairness," "Responsibility," "Respect," and "Service-mindedness." Codes ranging from 1 to 5 were assigned for the different levels of agreement and an "attitudes toward professionalism score" (ATPS) was computed by summing the codes for all the statements. Greater agreement with the statements or a higher ATPS indicated more positive attitudes toward professionalism. Association of the ATPS with environmental, institutional, and student-related factors was investigated using non-parametric tests and linear regression. RESULTS: The survey yielded a response rate of 51.4% (n = 221). The majority of respondents agreed with all professionalism statements. Results showed that the ATPS was significantly associated with and decreased for students who viewed their future patients as consumers (ß = -3.41, 95% confidence interval [CI]: -5.21, -1.60), experienced unprofessional faculty behavior (ß = -2.45, 95% CI: -4.88, -0.01), and chose to pursue dentistry for financial benefit (ß = -2.55, 95% CI: -4.63, -0.47). CONCLUSION: This sample of dental students generally had positive attitudes toward professionalism and numerous factors were associated with these attitudes. Enhancing the instruction and reinforcement of professional attitudes may be important to students' application of professionalism in decisions regarding clinical practice.


Asunto(s)
Profesionalismo , Estudiantes de Odontología , Actitud , Estudios Transversales , Humanos , Profesionalismo/educación
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