Blood levels of lead and dental caries in permanent teeth

ObjectivesThe purpose of this study was to determine whether there is an association between lead exposure within the ages of 1- 4- years and dental caries in the permanent dentition between ages 9- 17 among Mexican youth.MethodsData were collected for the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) cohort from a group of 490 children born and reared in Mexico City. Among ages 1- 4- years, blood lead levels were measured in micrograms of lead per deciliter of blood (μg/dL) and the presence of caries in adolescence was determined using the International Caries and Detection and Assessment System (ICDAS). The relationship between blood levels of lead and decayed, missing, or filled surfaces (DMFS) was examined using negative binomial regression. Covariates were selected based on previous studies and included age, gender, socioeconomic status, oral hygiene, body mass index, and diet. The nonlinear relationship between lead and DMFS was examined using smoothing splines.ResultsThe mean overall blood lead level (BLL) was 4.83- μg/dL (S.D. of 2.2). The mean overall caries level (DMFS) was 4.1. No statistically significant association was found between early childhood blood lead levels and dental caries in adolescence.ConclusionThis study shows a lack of association between exposure to lead between the ages of 1- 4- years of age and dental caries in permanent dentition later in life. Other covariates, such as age and sugar consumption, appeared to play a more prominent role in caries development.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163870/1/jphd12384.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163870/2/jphd12384_am.pd

The Terms ἐγκόλπιον and τενάντιον and the Conversion of Theophilus in the <i>Life of Theodora</i> (BHG 1731)

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Race, power, & workforce diversity: awareness, perceptions, & experiences among nursing home leaders

In response to the changing demographic profile of the U.S., there is an increasing presence of minorities in the workforce. Nursing homes, in particular, are facing issues on how to manage such a diverse workforce. Furthermore, nursing homes have a bureaucratic structure with limited diversity at the administrative level, yet significant diversity at the direct-care levels. While workforce diversity (WD) is well research among large corporations, little to no information is known about the state of WD in nursing homes. This research focused on how nursing home leaders understand WD and how diversity is managed in the nursing home. The researcher interviewed 10 administrators from a community nursing home to discuss the following concepts: diversity and leadership experiences, perceptions of WD and diversity management, and influences of WD on work process. The data analysis revealed a model for how diversity manifests in the nursing home. The results revealed that while issues of race were not openly discussed in this racially diverse facility, WD in nursing homes manifests through a focus on fairness, teamwork, and trust. There were reports of subtle forms of racial discrimination across the interviews; however, higher-level administrators were less likely to be aware of these issues. There were individual and organizational level influences that effected how WD was enacting in the home. Some of the individual factors included, personal racial experiences, the leaders' understanding of WD, and their managerial philosophies. Organizational initiatives and hiring practices were among the organizational influences. The results of this research will aid in developing diversity promotion strategies and improve work-life in nursing homes. (Published By University of Alabama Libraries

An exploration of workforce diversity management principles & practices in nursing homes

There is a lack of research related to workforce diversity (WD) specifically in nursing homes. However, there is a need to understand how WD manifests in nursing homes because nursing homes have several distinct characteristics that are unlike other organizations. The study sought to explore WD among nursing homes. The study aims were to 1) examine how nursing home leaders understand and characterize WD; 2) identify specific diversity management practices currently being implemented in nursing homes; 3) examine how internal factors (i.e. profit status, chain affiliation, Medicaid census, culture change adoption, and workforce racial composition) influence WD management practices; and 4) demonstrate how external factors such as geographic location and community racial composition influence WD management practices. Survey methodology was used to survey 1,111 nursing homes across the Deep South (AL, GA, MS, TN). The 39-item survey included items on participant demographics, racial composition of the staff and residents, knowledge of and attitudes toward WD, culture change adoption, and diversity management practices. The final sample included data for 166 individuals. The sample was predominately Caucasian (90.1%) and 58% female with a mean age of 51 years. The results revealed that managers had positive to neutral attitudes toward diversity and tended to narrowly define diversity using terms more commonly associated with Equal Employment Opportunity/Affirmative Action (EEO/AA) programs, such as race, age gender, and national origin. Recruitment, customer service, and communication/interpersonal skills were most frequently reported as activities associated with diversity. Human resources personnel, administrators, and corporate officers were most likely to initiate diversity management programs. One in five leaders reported having diversity policies that addressed the concept of diversity beyond EEO/AA requirements. The influence of internal and external factors on diversity management perceptions and practices was examined with regression analyses. Among the internal factors, chain affiliation and increasing levels of culture change adoption were found to be significant predictors of diversity management principles and practices. The external organizational factors did not significantly predict diversity management. The current study has implications for long-term care management practice and policy development, as well as diversity management interventions. (Published By University of Alabama Libraries

Benefits and Costs to Community-Based Physicians Teaching Primary Care to Medical Students

The purpose of this study was to determine the benefits and costs to community-based primary care physicians teaching medical students in their offices. Survey data were collected from 185 preceptors between 1990 and 1996. Respondents reported increases in their enjoyment of the practice of medicine (82%), time spent reviewing clinical medicine (66%), desire to keep up with recent developments in medicine (49%), and patients' perception of their stature (44%). However, 61% reported a decrease in the number of patients seen when a student was present. We conclude that despite the costs associated with teaching medical students in their offices, preceptors derived many benefits