Attitude of School-Based Nurses Towards Incorporating Advanced Dental Therapist in School Settings: Increasing Access to Care

Objectives: The disparities in access to dental care experienced by children of underserved families have been documented. Despite being largely preventable, oral diseases are highly prevalent. Around 3.5 billion people worldwide live with dental conditions.These conditions are associated with lower academics and missed school days among children. Dental therapy has a long history and is seen in multiple countries. Comparatively, dental therapy is in the early stages of implementation in the United States. Minnesota is the most diverse state to recognize dental therapists to practice in various settings. Commentary showcasing how a dental therapist works in a school-based setting while addressing the needs of children with dental disease, pain, and lack of access to dental care is provided. Method: Data were collected from participants without intervention through an anonymous Qualtrics® online survey. The collected data were analyzed to establish the level of support by school nurses based on the need seen in school children providing dental services by the Advanced Dental Therapist (ADT). Results: Survey results indicate that more than ninety percent of the school nurses agree that students are likely to miss school due to oral pain. Having a dental therapist position in schools will help increase access to dental care for students who do not have access to it. Conclusion: Utilizing an ADT in this role has been proven in some MN schools. Continued advocacy for kids is desperately needed to eliminate dental pain throughout our country, and ADTs can play an essential role in this

Decision-making role preferences and information needs: a comparison of colorectal and breast cancer

Objective: An exploratory study has been carried out to examine decision-making role preferences and information needs for a sample of people with colorectal cancer (n = 48). The work replicated a larger study carried out for women with breast cancer (n = 150), and this paper compares and contrasts findings for both disease groups. Design: A cross-sectional design was employed, involving structured interviews. The main variables investigated were decision-making preference (using a decisional role preference card sort), perceived decisional role and information need (using an information needs questionnaire). Results: The majority (78%) of the colorectal cancer patients preferred to play a passive role in decision making, in contrast to 52% of women with breast cancer in previous work. Eighty per cent of the colorectal sample and 61% of the women with breast cancer perceived that the doctor had made treatment decisions. Priority information needs for both groups related to cure, spread of disease and treatment options. Conclusions: The two most striking findings from the comparison between the two disease groups relate to the differences in decision-making role preferences and the similarities in information needs. The process of involving people with colorectal cancer in treatment decision making warrants further investigation. The similarity in information needs of the two disease groups has implications for health care professionals providing information to people with cancer

Preferred roles in treatment decision making among patients with cancer: A pooled analysis of studies using the control preferences scale

OBJECTIVES: To collect normative data, assess differences between demographic groups, and indirectly compare US and Canadian medical systems relative to patient expectations of involvement in cancer treatment decision making. STUDY DESIGN: Meta-analysis. METHODS: Individual patient data were compiled across 6 clinical studies among 3491 patients with cancer who completed the 2-item Control Preferences Scale indicating the roles they preferred versus actually experienced in treatment decision making. RESULTS: The roles in treatment decision making that patients preferred were 26% active, 49% collaborative, and 25% passive. The roles that patients reported actually experiencing were 30% active, 34% collaborative, and 36% passive. Roughly 61% of patients reported having their preferred role; only 6% experienced extreme discordance between their preferred versus actual roles. More men than women (66% vs 60%, P = .001) and more US patients than Canadian patients (84% vs 54%, P <.001) reported concordance between their preferred versus actual roles. More Canadian patients than US patients preferred and actually experienced (42% vs 18%, P <.001) passive roles. More women than men reported taking a passive role (40% vs 24%, P <.001). Older patients preferred and were more likely than younger patients to assume a passive role. CONCLUSIONS: Roughly half of the studied patients with cancer indicated that they preferred to have a collaborative relationship with physicians. Although most patients had the decision-making role they preferred, about 40% experienced discordance. This highlights the need for incorporation of individualized patient communication styles into treatment plans

On the spin-statistics connection in curved spacetimes

The connection between spin and statistics is examined in the context of locally covariant quantum field theory. A generalization is proposed in which locally covariant theories are defined as functors from a category of framed spacetimes to a category of $*$-algebras. This allows for a more operational description of theories with spin, and for the derivation of a more general version of the spin-statistics connection in curved spacetimes than previously available. The proof involves a "rigidity argument" that is also applied in the standard setting of locally covariant quantum field theory to show how properties such as Einstein causality can be transferred from Minkowski spacetime to general curved spacetimes.Comment: 17pp. Contribution to the proceedings of the conference "Quantum Mathematical Physics" (Regensburg, October 2014

Quantifying single nucleotide variant detection sensitivity in exome sequencing

BACKGROUND: The targeted capture and sequencing of genomic regions has rapidly demonstrated its utility in genetic studies. Inherent in this technology is considerable heterogeneity of target coverage and this is expected to systematically impact our sensitivity to detect genuine polymorphisms. To fully interpret the polymorphisms identified in a genetic study it is often essential to both detect polymorphisms and to understand where and with what probability real polymorphisms may have been missed. RESULTS: Using down-sampling of 30 deeply sequenced exomes and a set of gold-standard single nucleotide variant (SNV) genotype calls for each sample, we developed an empirical model relating the read depth at a polymorphic site to the probability of calling the correct genotype at that site. We find that measured sensitivity in SNV detection is substantially worse than that predicted from the naive expectation of sampling from a binomial. This calibrated model allows us to produce single nucleotide resolution SNV sensitivity estimates which can be merged to give summary sensitivity measures for any arbitrary partition of the target sequences (nucleotide, exon, gene, pathway, exome). These metrics are directly comparable between platforms and can be combined between samples to give “power estimates” for an entire study. We estimate a local read depth of 13X is required to detect the alleles and genotype of a heterozygous SNV 95% of the time, but only 3X for a homozygous SNV. At a mean on-target read depth of 20X, commonly used for rare disease exome sequencing studies, we predict 5–15% of heterozygous and 1–4% of homozygous SNVs in the targeted regions will be missed. CONCLUSIONS: Non-reference alleles in the heterozygote state have a high chance of being missed when commonly applied read coverage thresholds are used despite the widely held assumption that there is good polymorphism detection at these coverage levels. Such alleles are likely to be of functional importance in population based studies of rare diseases, somatic mutations in cancer and explaining the “missing heritability” of quantitative traits