Oral Health Status of Patients with Mental Disorders in Southwest Ethiopia

BACKGROUND: Psychiatric disorders are known to be a risk factor for the development of different oral health problems especially for dental caries and periodontal diseases. In spite of this fact, no study has been conducted to reveal its magnitude in Ethiopia. Hence, this study was conducted to determine the oral health status of psychiatric patients at Jimma University Specialized Hospital (JUSH), Psychiatric Clinic. METHODS: A hospital based cross- sectional study was used from January to May 2011. A total of 240 participants were included in the study. Dental examination was done to measure indices of oral health: decayed, missing, and filled teeth (DMFT) index and community periodontal index (CPI). Oral examination was performed using mirror, probe and explorer by experienced dental doctors. A simple random sampling technique was implemented to collect data. ANOVA test, binary logistic and multinomial logistic regression analyses were done using SPSS 16.0 statistical software. RESULTS: The mean DMFT score among the psychiatric patients was 1.94 ± 2.12 (mean ± SD) with 1.28 ± 1.69, 0.51 ± 1.19 and 0.14 ± 0.48 (mean ± SD) for decayed, missed and filled teeth respectively. Only about 24% of the psychiatric patients had a healthy CPI score. Incorrect tooth brushing technique was significantly associated with a DMFT score greater than 2 (AOR = 3.58; 95% CI: 1.65, 7.79). The habit of sweet intake was also associated with dental caries (AOR = 2.91; 95% CI: 1.43, 5.95). Similarly, patients with a smoking habit also demonstrated statistically significant association with dental caries (AOR = 18.98; 95% CI: 5.06, 71.24). CONCLUSION: The oral health status of the psychiatric patients was poor. Thus, health education about oral hygiene should be given for psychiatric patients so they can avoid the frequent intake of sweets, smoking and learn correct tooth brushing technique

Stage I-II nodular lymphocyte-predominant Hodgkin lymphoma: a multi-institutional study of adult patients by ILROG

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is an uncommon histologic variant, and the optimal treatment of stage I-II NLPHL is undefined. We conducted a multicenter retrospective study including patients ≥16 years of age with stage I-II NLPHL diagnosed from 1995 through 2018 who underwent all forms of management, including radiotherapy (RT), combined modality therapy (CMT; RT+chemotherapy [CT]), CT, observation after excision, rituximab and RT, and single-agent rituximab. End points were progression-free survival (PFS), freedom from transformation, and overall survival (OS) without statistical comparison between management groups. We identified 559 patients with median age of 39 years: 72.3% were men, and 54.9% had stage I disease. Median follow-up was 5.5 years (interquartile range, 3.1-10.1). Five-year PFS and OS in the entire cohort were 87.1% and 98.3%, respectively. Primary management was RT alone (n = 257; 46.0%), CMT (n = 184; 32.9%), CT alone (n = 47; 8.4%), observation (n = 37; 6.6%), rituximab and RT (n = 19; 3.4%), and rituximab alone (n = 15; 2.7%). The 5-year PFS rates were 91.1% after RT, 90.5% after CMT, 77.8% after CT, 73.5% after observation, 80.8% after rituximab and RT, and 38.5% after rituximab alone. In the RT cohort, but not the CMT cohort, variant immunoarchitectural pattern and number of sites >2 were associated with worse PFS (P 2 (P = .0006). OS for patients with stage I-II NLPHL was excellent after all treatments

WE‐C‐214‐05: A Quantification of the Effectiveness of Standard QA Measures at Preventing Errors in Radiation Therapy and the Promise of in Vivo EPID‐Based Portal Dosimetry

Purpose: We analyze the ability of standard quality assurance (QA) checks in radiation therapy to prevent errors commonly observed in the course of clinical operations. Methods and Materials: Near‐miss and error reports were collected over a 3‐year period by means of voluntary reporting systems at two academic medical centers. We analyzed 250 near‐misses, events that did not affect patients but which had the potential to do harm with at least “moderate side effects” (level 3 or greater on the French ASN scale) if they had not been detected prior to treatment. We determined which of these events could be detected by 13 commonly employed QA measures, including but not limited to physician plan review, physics chart check, port films, cone‐beam CT. We then determined which events could have been detected by in vivo portal dosimetry with an electronic portal imaging device (EPID). Results: QA checks vary greatly in their ability to detect reported errors. Port films, one of the most effective measures in place, had a 53% detection efficiency, while pre‐treatment IMRT QA had a detection efficiency close to 0%. EPID‐dosimetry had a detection rate of 83%. In some cases, EPID‐dosimetry would have detected errors which were introduced after the initial IMRT QA. Conclusions: No single QA check currently employed is 100% effective at detecting common errors. Most checks currently in use are less than 50% effective. By contrast, the data indicate that in vivo EPID‐dosimetry may be substantially more effective. Further work is needed to determine if these patterns hold across multiple institutions. Pilot research grant from Elekta Inc

Investigation of rolling contact fatigue cracks in a grade 900A rail steel of a metro track

Rolling contact fatigue (RCF) has been of increasing concern in the recent years in respect of the safe operation of high-speed railway track with high traffic intensity. The present paper summarizes the results of the first investigation of RCF damage encountered in the Athens Metro. The objective of the investigation was to determine the initiation and propagation of RCF cracks and to determine their geometrical characteristics. A thorough metallographic investigation of track regarding shelling and spalling defects showed the development of a subsurface network of cracks. An analysis of the Hertzian stress field was used to determine the conditions for first yield and shakedown limits as a function of loading

Radiation oncology resident training in patient safety and quality improvement: a national survey of residency program directors

Abstract Background Physicians and physicists are expected to contribute to patient safety and quality improvement (QI) in Radiation Oncology (RO), but prior studies suggest that training for this may be inadequate. RO and medical physics (MP) program directors (PDs) were surveyed to better understand the current patient safety/QI training in their residency programs. Methods PDs were surveyed via email in January 2017. Survey questions inquired about current training, curriculum elements, and barriers to development and/or improvement of safety and QI training. Results Eighty-nine RO PDs and 84 MP PDs were surveyed, and 21 RO PDs (28%) and 31 MP PDs (37%) responded. Both RO and MP PDs had favorable opinions of current safety and QI training, and used a range of resources for program development, especially safety and QI publications. Various curriculum elements were reported. Curriculum elements used by RO and MP PDs were similar, except RO were more likely than MP PDs to implement morbidity and mortality (M&M) conference (72% vs. 45%, p < 0.05). RO and MP PDs similarly cited various barriers, but RO PDs were more likely to cite lack of experience than MP PDs (40% vs. 16%, p < 0.05). PDs responded similarly independent of whether they reported using a departmental incident learning system (ILS) or not. Conclusions PDs view patient safety/QI as an important part of resident education. Most PDs agreed that residents are adequately exposed to patient safety/QI and prepared to meet the patient safety/QI expectations of clinical practice. This conflicts with other independent studies that indicate a majority of residents feel their patient safety/QI training is inadequate and lacks formal exposure to QI tools