Snapshot: Emergency Department Visits for Preventable Dental Conditions in California

Provides an overview of dental health in California, the supply of providers, and out-of-pocket expenses. Presents data on emergency room visits for preventable conditions, by condition, county, age, gender, race/ethnicity, and insurance status and type

Denti-Cal Facts and Figures

Provides an overview of Denti-Cal, California's public financer of dental care, including benefits, recent policy changes, analyses of expenditures and utilization by beneficiaries and procedures, barriers to access, and questions for the program

Effect of Student Involvement on Patient Perceptions of Ambulatory Care Visits

OBJECTIVE: To determine if patient satisfaction with ambulatory care visits differs when medical students participate in the visit. DESIGN: Randomized controlled trial. SETTING: Academic general internal medicine practice. PARTICIPANTS: Outpatients randomly assigned to see an attending physician only (N = 66) or an attending physician plus medical student (N = 68). MEASUREMENTS AND MAIN RESULTS: Patient perceptions of the office visit were determined by telephone survey. Overall office visit satisfaction was higher for the “attending physician only” group (61% vs 48% excellent), although this was not statistically significant (P = .16). There was no difference between the study groups for patient ratings of their physician overall (80% vs 85% excellent; P = .44). In subsidiary analyses, patients who rated their attending physician as “excellent” rated the overall office visit significantly higher in the “attending physician only” group (74% vs 55%; P = .04). Among patients in the “attending physician plus medical student” group, 40% indicated that medical student involvement “probably” or “definitely” did not improve their care, and 30% responded that they “probably” or “definitely” did not want to see a student at subsequent office visits. CONCLUSIONS: Although our sample size was small, we found no significant decrement in patient ratings of office visit satisfaction from medical student involvement in a global satisfaction survey. However, a significant number of patients expressed discontent with student involvement in the visit when asked directly. Global assessment of patient satisfaction may lack sensitivity for detection of dissatisfaction. Future research in this area should employ more sensitive measures of patient satisfaction

The cortisol awakening response predicts same morning executive function: results from a 50-day case study

A relationship between individual differences in trait estimates of the cortisol-awakening response (CAR) and indices of executive function (EF) has been reported. However, it is difficult to determine causality from such studies. The aim of the present study was to capitalise upon state variation in both variables to seek stronger support for causality by examining daily co-variation. A 50 days researcher–participant case study was employed, ensuring careful adherence to the sampling protocol. A 24-year-old healthy male collected saliva samples and completed an attention-switching index of EF on the morning of each study day. Subsidiary control measures included wake time, sleep duration, morning fatigue, and amount of prior day exercise and alcohol consumption. As the CAR preceded daily measurement of EF, we hypothesised that, over time, a greater than average CAR would predict better than average EF. This was confirmed by mixed regression modelling of variation in cortisol concentrations, which indicated that the greater the increase in cortisol concentrations from 0 to 30 min post-awakening (CAR) the better was subsequent EF performance at 45 min post-awakening (t = 2.29, p = 0.024). This effect was independent of all potential confounding measures. Results are discussed in terms of implications for the understanding of the relationship between the CAR and the cognitive function, and the previously suggested role of the CAR in “boosting” an individual’s performance for the day ahead

Bildungsbeteiligung von Menschen in der zweiten Lebenshälfte: Befunde des Deutschen Alterssurveys (DEAS) 2020/21

Bildung und lebenslanges Lernen eröffnen Möglichkeiten der gesellschaftlichen Teilhabe und der individuellen Weiterentwicklung. So kann die Teilnahme an Fort- oder Weiterbildungen Partizipationsmöglichkeiten auf dem Arbeitsmarkt erhalten oder verbessern. Darüber hinaus ist die Bildungsbeteiligung von Menschen im höheren Erwachsenenalter aber auch eine Facette des Aktiven Alterns als Leitbild zur Förderung eines gesunden und selbstbestimmten Alterns. Das Fact-Sheet betrachtet die Bildungsbeteiligung von Menschen in der zweiten Lebenshälfte anhand von zwei Dimensionen: der beruflichen Fort- und Weiterbildung als Bildungsbeteiligung im Rahmen der Erwerbsarbeit und der Teilnahme an Kursen und Vorträgen als Bildungsbeteiligung außerhalb der Erwerbsarbeit. Kernaussagen: Über die Hälfte der erwerbstätigen Menschen im Alter von 46 bis 65 Jahren hat in den letzten drei Jahren an beruflichen Weiterbildungen teilgenommen. Als Hauptzweck der beruflichen Weiterbildung wird die Erweiterung beruflicher Kenntnisse, um zusätzlich Aufgaben übernehmen zu können, angegeben, gefolgt von der Auffrischung veralteter beruflicher Kenntnisse und dem Erlernen des Umgangs mit neuen Techniken wie neuen Maschinen oder Programmen. Drei Fünftel der älteren Erwerbstätigen können sich vorstellen, künftig eine berufliche Weiterbildung zu absolvieren. Bei den 46- bis 55-Jährigen ist die Weiterbildungsbereitschaft mit über zwei Dritteln besonders ausgeprägt, aber auch von den 55- 65-Jährigen ist noch knapp die Hälfte hierzu bereit. Ein Drittel der Menschen in der zweiten Lebenshälfte gibt an, in ihrer Freizeit Kurse oder Vorträge zur Fort- oder Weiterbildung zu besuchen. In höherem Alter ist der Anteil derjenigen, die Kurse oder Vorträge besuchen, geringer, allerdings machen auch bei den 75- bis 90-Jährigen noch 15 Prozent von dieser Fort- oder Weiterbildungsmöglichkeit Gebrauch. Personen im Ruhestandsalter nehmen zwar anteilig seltener an Kursen oder Vorträgen teil als Personen im Erwerbsalter, wenn sie teilnehmen, dann allerdings mit höherer Frequenz

Digitalisation and Employees’ Subjective Job Quality in the Second Half of Working Life in Germany

Since digitalisation alters occupational task profiles via automation processes, job quality is also likely to be affected. While existing literature mainly focusses on objective job quality, this study asks if and how digitalisation is associated with employees' subjective job quality in the second half of working life in Germany. Analyses are based on the German Ageing Survey 2014. Our sample includes n = 1541 employees aged 40–65 years who are subject to social insurance contributions. Subjective job quality is operationalised with regards to job satisfaction and perceived occupational stress in general, and ten aspects of job quality in detail. Digitalisation is approximated by substitution potentials of occupations. We control the association for compositional effects in the workforce, as well as for the moderating effect of perceived job insecurity. The results indicate that digitalisation is predominantly beneficial but also unfavourable in a few other respects for employees' subjective job quality. The higher the degree of digitalisation, the higher is the employee's general job satisfaction on average; for general perceived occupational stress, we find no significant association. Regarding single aspects of subjective job quality, employees working in more digitalised occupations are found to report on average higher satisfaction with working hours and earnings, and lower levels of stress due to tight schedules. However, they also report higher levels of stress due to negative environmental factors

Inpatient Pharmacist Intervention Helps Sustain Improved Rates of Baseline Metabolic Monitoring for Patients Initiated on Atypical Antipsychotics

Class of 2014 AbstractSpecific Aims: The purpose of this study is to assess whether baseline rates of metabolic monitoring of scheduled atypical antipsychotics are sustained as a result of a pharmacist intervention. Methods: This study was a retrospective chart review assessing rates of metabolic monitoring two months after a pharmacist intervention that utilized a pharmacist-physician metabolic monitoring recommendation form was discontinued. Patients ages 18 years or older with orders for a scheduled atypical antipsychotic were included. Patients with orders for first-generation antipsychotics or who have orders for as needed atypical antipsychotics were excluded. Main Results: Data from the two month post intervention period was compared to those obtained during the pharmacist intervention. For the monitoring of hemoglobin A1c and fasting lipid panels, which improved during the pharmacist intervention, there was a non-statistically significant trend towards decreased monitoring. For hemoglobin A1c, the rates of monitoring decreased from 21.59% to 12.32% (p = 0.09). For fasting lipid panels, monitoring decreased from 39.77% to 28.99% (p = 0.125). Conclusion: A pharmacist intervention utilizing a recommendation form was effective in sustaining the improvement of baseline metabolic monitoring of personal history of diabetes and cardiovascular disease and monitoring of hemoglobin A1c and lipid panels. However, a trend towards decreased monitoring was observed in both the percentage of hemoglobin A1c and lipid panels ordered. Thus, continuing pharmacist intervention may be necessary in order to ensure that baseline metabolic monitoring for atypical antipsychotics occurs.This item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Librarian and Clinical Instructor, Pharmacy Practice and Science, [email protected]

Probiotics for the management of infantile colic: A systematic review

BACKGROUND: Colic is defined as periods of inconsolable crying, fussing, or irritability that have no apparent cause and present in healthy infants under 5 months of age. Although colic is a benign and self-limiting condition, it can be distressing to parents and there are few robust treatment interventions. This systematic review explored the evidence for administration of probiotics to prevent or decrease symptoms of colic. METHODS: Literature searches were conducted in PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, and Web of Science. SAMPLE: Twenty articles were included: 15 randomized controlled trials and 5 meta-analyses. RESULTS: Based on the evidence in this systematic review, the oral administration of probiotics to breastfed infants with colic resulted in at least a 50% reduction in crying time compared with placebo. Efficacy of probiotics to reduce colic symptoms in formula-fed infants needs further study. In this review, we did not find evidence to support or refute efficacy of probiotics to prevent infantile colic. CLINICAL IMPLICATION: Probiotics (especially the strain Lactobacillus reuteri DSM 17938) can safely be recommended if parents desire a treatment option for their infants with colic