Evaluation about clinical risk knowledge in Italian medicine students: How to implement the concept of healthcare quality among future doctors

The aim of the study is to offer to all the future health providers an opportunity of education in the specific field of patient's safety and clinical risk management. The study develops a complete picture of the knowledge of a whole class of future physicians about clinical risk theme, involved 1228 students of a medicine course. We elaborated a survey (18 explorative questions) that evaluated the levels about basic concepts in clinical risk management and investigated the future doctors' opinion about the use of these instruments. The results emphasize a deep delay compared to international standards about basic notions. We propose as future target both monitoring the notional trend about investigated themes of the survey and sensitizing the future health operators and decision makers about basic clinical risk concepts. Moreover, we try to give the timing of fundamental steps to improve the awareness and the management of Clinical Risk

Patient Safety Walkaround: a communication tool for the reallocation of health service resources: An Italian experience of safety healthcare implementation

The study aims to evaluate the use of Patient Safety Walkaround (SWR) execution model in an Italian Hospital, through the adoption of parametric indices, survey tools, and process indicators.In the 1st meeting an interview was conducted to verify the knowledge of concepts of clinical risk management (process indicators). One month after, the questions provided by Frankel (survey tool) were administered.Each month after, an SWR has been carried trying to assist the healthcare professionals and collecting suggestions and solutions.Results have been classified according to Vincent model and analyzed to define an action plan. The amount of risk was quantified by the risk priority index (RPI).An organizational deficit concerns the management of the operating theatre.A state of intolerance was noticed of queuing patients for outpatient visits. The lack of scheduling of the operating rooms is often the cause of sudden displacements. A consequence is the conflict between patients and caregivers. Other causes of the increase of waiting times are the presence in the ward of a single trolley for medications and the presence of a single room for admission and preadmission of patients.Patients victims of allergic reactions have attributed such reactions to the presence of other patients in the process of acceptance and collection of medical history.All health professionals have reported the problem of n high number of relatives of the patients in the wards.Our study indicated the consistency of SWR as instrument to improve the quality of the care

Clinical activities suspended: How the COVID-19 affected the self-confidence of Italian dental students

Introduction: COVID-19 emergency caused several effects on the dental educational system, especially affecting courses including practical activities. The study aims to evaluate the impact of the suspension of dental clinical activities on the Italian dental students' self-confidence. Furthermore, the other purpose of the research is to find an integrative didactics solution to improve the clinical training of dentistry during the COVID-19 pandemic. Materials and methods: A questionnaire was administered to evaluate the impact of the suspension of clinical activities on dental students' self-confidence. A 67-questions survey tested the students' self-confidence in several dental disciplines (Conservative Dentistry, Endodontics, Oral Surgery and Dental Emergency). The study reached a sample of 193 dental students and the answers from 9 different Italian dental schools were analysed. Results: The degree of students' self-confidence for all the dental disciplines investigated was found statistically different between the periods before and after the interruption of clinical activities. The students proposed, as a potential solution to improve their practice during the COVID-19 pandemic, to combinate the use of a video tutorials and dental simulators. Conclusion: The interruption of the training in clinical practice significantly affected the educational career and the self-confidence of students. An alternative teaching method involving the use of video tutorials as support in teaching clinical procedures deserves to be considered

Proposal for Introducing a Digital Aesthetic Dentistry Course in Undergraduate Program: Contents and Ways of Administration

Background: Nowadays, digital dentistry is a fundamental skill that dentists need to acquire at this time. The digital workflow has gained acceptance and is widely used in most disciplines of dentistry. For this reason, it might be advisable to include this content in the undergraduate curriculum. The aim of this work was to create a course in digital aesthetic dentistry and evaluate its effectiveness. Methods: Dental students at the University of Verona (from third to sixth year) participated in a 2-h course on photography, digital aesthetic analysis, and digitally planned rehabilitations. Students were randomly divided into two groups, the first group attending the course with video tutorials and the second group attending the traditional class with slides. The students’ ability to perform digital aesthetic analysis and rehabilitation was tested. In addition, a questionnaire was completed to determine student satisfaction with the course and method of delivery. Statistical analysis was performed. Results: The course was highly appreciated, especially by the students who received the video tutorials. Good results were obtained in the performance of digital analysis and rehabilitation, which were better in the first group. Conclusions: Digital aesthetic dentistry was a success in terms of newly acquired skills. From this point of view, the proposal of a course on this subject in the undergraduate curriculum deserves a close evaluation. The video tutorial method seems to be a good way to teach operative digital procedure

Digital Dental Models: Is Photogrammetry an Alternative to Dental Extraoral and Intraoral Scanners?

Background: 3D models are nowadays part of daily clinical practice. Photogrammetry is a brand-new method for transforming small objects into 3D models while keeping their original shape and size. The aim of this study was to evaluate the accuracy, in terms of precision and trueness, of a digital dental model acquired with photogrammetry compared with those obtained using extraoral scanners and intraoral scanners, starting from the same plaster model. Methods: A plaster model was converted into a digital model using photogrammetry, an extraoral scanner and an intraoral scanner. Different references were measured twice at a distance of 30 min for each model, on the digital models using the software Blender and on the plaster model using a calibre. The Interclass Correlation Coefficient was calculated for each pair of measurements. A volumetric analysis was performed by superimposing the digital models. The coefficient of variation was calculated. A two-way ANOVA test was conducted. Results: For each reference, the coefficient of variation was less than 3%, and the two ANOVA tests resulted in a non-significant value in both cases (p > 0.05). The volumetric analysis demonstrated good agreement between the models derived from the different acquisition methods. Conclusions: Photogrammetry seems to be a good method for acquiring digital models starting from a plaster model, all the methods tested seem to be good for obtaining an accurate three-dimensional digital model. Other studies are needed to evaluate clinical efficacy

Aesthetic Dentistry, How You Say and How You See: A 500-People Survey on Digital Preview and Color Perception

Purpose: Digital technologies have improved ways to perform aesthetic dentistry in the last few years. The aims of this survey were to investigate the most preferred way to preview the result of an aesthetic dental rehabilitation among a population of dental professionals and laypeople and to compare aesthetic standards of the general population and dentists in terms of the color of teeth for aesthetic dental rehabilitations. Patients and Methods: A questionnaire was sent to the subjects (dentists and laypeople) during a 1-year period and, together with their demographic data, different ways to preview the result of an aesthetic rehabilitation were submitted, such as digital smile design, dental wax-up and oral explanation. Furthermore, an additional section of the questionnaire inves-tigated the most suitable color for an aesthetic rehabilitation based on the colors of the VITA Scale. Results were statistically analyzed (with Chi-square of independence and Mann\u2013 Whitney U-test) highlighting differences of answers based on age groups, educational attainment, gender, and belonging or not to the dental field. Results: Findings showed that digital smile design (digital preview) is a high-appreciated method for previewing and communicating with patients both by dental professionals and laypeople. Furthermore, lighter colors were found to be more valued by laypeople and significant differences were highlighted between the two populations assessed. Conclusion: It seems to be viable to use digital preview for dentists and laypeople to improve previewing and communicating ways. It might be advisable to better motivate patients in recognizing aesthetical features and to raise their awareness in preferring more mimetic aesthetic results. Great opportunities are opened up by digital smile design in teaching, learning, and routine practic

Violence in forensic psychiatric facilities. A risk management perspective

Violence against healthcare workers is a global phenomenon. Psychiatric settings are among the places at greatest risk of being a victim of aggression. Several strategies aimed at preventing violence in healthcare settings and implement protective measures have been proposed. Nevertheless, forensic psychiatric settings have been poorly investigated from the point of view of clinical risk management, especially in Italy. The recent process of deinstitutionalization of forensic psychiatric patients in Italy, with the replacement of former forensic psychiatric hospitals with small regional-based community structures (REMS), deserves particular attention in terms of clinical risk management. We propose in the following contribution a methodology that allows to measure the risk of violent behavior in different psychiatric forensic settings, from the point of view of clinical risk management. This includes a proposed adaptation of the Modified Overt Aggression Scale (MOAS) for the specific purpose. The use of such approach, including the calculation of a structure’s “risk score” could allow comparisons between different facilities as well as the implementation of strategies aimed at minimizing the frequency of violent acts, as well as activating the most suitable measures to prevent the

Seroprevalence of infection-induced SARS-CoV-2 antibodies among health care users of Northern Italy: results from two serosurveys (October-November 2019 and September-October 2021)

OBJECTIVES: The objective was to estimate the seroprevalence of SARS-CoV-2 in autumn 2019 (before case zero was identified in Italy) and 2021 among residual sera samples from health care users in the Piedmont region of northwestern Italy. METHODS: Two serosurveys were conducted. Using a semiquantitative method, samples were tested for the presence of immunoglobulin G (IgG) antibodies against the S1 domain of the spike protein. Samples with positive test results from the 2019 survey were independently retested using a multiplex panel to detect IgG antibodies against the receptor binding domain, S1 and S2 domains, and nucleocapsid. Samples with positive test results from the 2021 survey underwent repeat testing with enzyme-linked immunosorbent assay to detect anti-nucleocapsid IgG antibodies. Prevalence rates according to gender and age groups, together with their respective 95% confidence intervals (CIs), were calculated. RESULTS: Overall, the proportion of samples with positive test results was 2/353 in 2019 and 22/363 in 2021, with an estimated seroprevalence of 0.27% (95% CI 0-1.86) and 6.21% (95% CI 3.9-9.31) in 2019 and 2021 respectively. CONCLUSION: Results of this study support the hypothesis that the virus was circulating in Italy as early as autumn 2019. The role of these early cases in broader transmission dynamics remains to be determined

Observing the Evolution of the Universe

How did the universe evolve? The fine angular scale (l>1000) temperature and polarization anisotropies in the CMB are a Rosetta stone for understanding the evolution of the universe. Through detailed measurements one may address everything from the physics of the birth of the universe to the history of star formation and the process by which galaxies formed. One may in addition track the evolution of the dark energy and discover the net neutrino mass. We are at the dawn of a new era in which hundreds of square degrees of sky can be mapped with arcminute resolution and sensitivities measured in microKelvin. Acquiring these data requires the use of special purpose telescopes such as the Atacama Cosmology Telescope (ACT), located in Chile, and the South Pole Telescope (SPT). These new telescopes are outfitted with a new generation of custom mm-wave kilo-pixel arrays. Additional instruments are in the planning stages.Comment: Science White Paper submitted to the US Astro2010 Decadal Survey. Full list of 177 author available at http://cmbpol.uchicago.ed