Determining the Level of Patient Satisfaction in a Dental Hygiene Setting.

Not many studies have been conducted in the past to determine patients\u27 level of satisfaction in academic dental hygiene settings. This patient satisfaction study analyzed the level of patient satisfaction with the dental hygiene clinic at East Tennessee State University, Johnson City, TN. The purpose of the study was to determine if there was a statistically significant influence of demographic characteristics of the patients and the affective behavior of the care providers on level of patient satisfaction. It was concluded that except for age, other demographic variables did not have any statistically significant influence on patient satisfaction. Also, care provider\u27s affective behavior significantly influenced patient satisfaction. Overall, the dental hygiene patients were satisfied with the clinic. As patients\u27 needs are prioritized in this customer-driven industry, such positive patient satisfaction data can be used for the welfare of the patients, the care providers, and the health care organization

Florida child care center directors' intention to implement oral health promotion practices in licensed child care centers

BACKGROUND: To determine the factors associated with child care center directors' (CCCDs) intention to implement oral health promotion practices (OHPPs) in licensed childcare centers (CCCs) within the next year, and their self-perceived barriers in successfully implementing those practices. METHODS: For this cross-sectional study, a pretested 45-item online survey was sent to 5142 CCCDs assessing pediatric oral health knowledge, attitudes towards oral health, intention to implement OHPPs, and self-perceived barriers to implementing OHPPs. An adjusted logistic regression model determined the factors associated with CCCDs intention to implement OHPPs within the next year. RESULTS: Participants were 877 CCCDs, with mean age of 48.5 ± 10.5 years, of whom 96 % were women, and 74 % were whites (Response rate = 19.4 %). The majority (67 %) of respondents reported that they intended to implement OHPPs in their center within a year. Insufficient funding, lack of enough training in oral health, and limited time to promote oral health were the most frequently cited barriers to implementing OHPPs. CCCDs of non-White race (p = 0.02), with a college degree or above (p = 0.05), and with positive attitudes (p < 0.0001), were more likely to report that they will implement OHPPs within the next year compared to their counterparts. CONCLUSIONS: CCCDs reported fewer barriers to implementing OHPPs within the next year, indicating that CCCs can be a suitable setting to promote oral health. CCCDs race, educational status and attitudes towards oral health strongly predicted their intention to implement OHPPs. Though this study assessed the intention of CCCDs to implement OHPPs in CCCs, it did not access the actual implementation of OHPPs by them. Therefore future research could longitudinally assess predictors for true implementation of OHPPs. In addition, researchers should adopt a more comprehensive, multi-level approach to assess the actual dental health needs of children attending these centers, along with parental, staff and center level characteristics, and other relevant factors related to implementing OHPPs

Impact of intra operative ultra sonogram (IOUS) in drainage surgery for Chronic Pancreatitis.

INTRODUCTION : Chronic pancreatitis is a benign inflammatory disease characterised by progressive & permanent destruction of pancreas parenchyma resulting in endocrine and exocrine insufficiency. Alcoholism is the common etiology in western population, other etiological factors include hereditary, autoimmune, tropical pancreatitis, malnutrition and idiopathic. Tropical pancreatitis is the commonest etiology in Indian population. Patients with chronic pancreatitis present with episodic, chronic abdominal pain. They can present with functional insufficiency such as steatorrhoea, weight loss or malnutrition and the development of diabetes mellitus. Most patients of chronic pancreatitis are managed medically, however up to 20% patients may require surgery. The main indication for surgery in the management of chronic pancreatitis is intractable pain. Other indications include biliary & pancreatic ductal obstruction , mass effect impinging on other organs or suspicion of malignancy. A number of surgical procedures have been developed in the 20th century. Literature review indicates maximum efficacy of any procedure is up to 85 to 90%. The surgical treatment is based on two main concepts – drainage procedure & resective procedure. Some procedures have combined both the concepts. Surgery for chronic pancreatitis is technically demanding. Localising the calculi, identification of duct, cystic lesion, assessment of associated mass lesion, relationship to vascular structures are sometimes difficult to assess because of dense fibrosis. In recent years, the preoperative assessment of chronic pancreatitis has been significantly improved by use of imaging techniques. Imaging modalities such as ultra sonogram (USG), computerised tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangio pancreaticogram (ERCP) & endosonogram (EUS) have greatly facilitated surgical care . Although such preoperative evaluation is key to surgical management, imaging can be used in the operating room to enable to enable the surgeon to attain further information about the clinical problem. To complement direct exploration, operating imaging has been applied to many fields of surgery. For the pancreas, a procedure that appears to be highly applicable for operating imaging is real time ultra sonogram. Intra operative ultra sonogram (IOUS) is a newer application used in surgery of chronic pancreatitis to define lesions, characterise them & delineate their anatomic relationship and influencing the surgical procedure. AIM : The aim of study was to analyze the usefulness of intra operative ultra sonogram (IOUS) in surgery for chronic pancreatitis and its benefits in the outcome of drainage surgery for chronic pancreatitis. MATERIALS & METHODS : Consecutive patients (n=52) with chronic pancreatitis who underwent drainage procedures (longitudinal pancreatico jejunostomy [LPJ] & Frey’s procedure) between Sep 2006 and Feb 2009 constituted the study population. The diagnosis of chronic pancreatitis was made on the basis of history of typical abdominal pain & pancreatic parenchymal changes, ductal dilatation & calcification on imaging {Ultra sonogram [USG], computerised tomography [CT] & or magnetic resonance cholangio pancreatography [MRCP]}. None of the patients with an enlarged head underwent an Endoscopic ultrasound (EUS) evaluation, as the facility was not available in our deptartment. CONCLUSION : Intra operative ultra sonogram (IOUS) detected malignancy in one patient, there by altering the management. IOUS was useful in 73% of our patients. IOUS enabled us to obtain more complete information & was useful in the complete evaluation of chronic pancreatitis to provide greater assurance that all structures that require drainage have been identified & managed. Pain relief though was slightly better in IUOS group, was not found to be statistically significant. Duration of surgery was longer in IOUS group. Peroperative blood loss was lower in IOUS group, but was not statistically significant. Morbidity was similar in both groups. Short term outcome of weight gain, endocrine & endocrine insufficiency were not significantly altered by IOUS

AN OVERVIEW OF VARIOUS SCALES USED IN CAUSALITY ASSESSMENT OF ADVERSE DRUG REACTIONS

Establishing a relationship of causality between the medications received and the events occurred utilizing causality assessment scale is much needed to reduce the occurrence of Adverse Drug Reactions (ADRs) and to prevent exposure of patients towards additional drug hazards. Causality assessment can be defined as the determination of chance, whether a selected intervention is the root cause of the adverse event observed. The causality assessment is the responsibility of either a single expert or an established committee. As it is a common phenomenon of variable perception of knowledge and experience by each expert, there is a high possibility of disagreement and inter-individual variability on assessment. Many of the causality assessment methods have their advantages and disadvantages. However, no single scale has been adopted as standardized and considered for uniform acceptance

Suppression of uPAR Retards Radiation-Induced Invasion and Migration Mediated by Integrin β1/FAK Signaling in Medulloblastoma

Despite effective radiotherapy for the initial stages of cancer, several studies have reported the recurrence of various cancers, including medulloblastoma. Here, we attempt to capitalize on the radiation-induced aggressive behavior of medulloblastoma cells by comparing the extracellular protease activity and the expression pattern of molecules, known to be involved in cell adhesion, migration and invasion, between non-irradiated and irradiated cells.We identified an increase in invasion and migration of irradiated compared to non-irradiated medulloblastoma cells. RT-PCR analysis confirmed increased expression of uPA, uPAR, focal adhesion kinase (FAK), N-Cadherin and integrin subunits (e.g., α3, α5 and β1) in irradiated cells. Furthermore, we noticed a ∼2-fold increase in tyrosine phosphorylation of FAK in irradiated cells. Immunoprecipitation studies confirmed increased interaction of integrin β1 and FAK in irradiated cells. In addition, our results show that overexpression of uPAR in cancer cells can mimic radiation-induced activation of FAK signaling. Moreover, by inhibiting FAK phosphorylation, we were able to reduce the radiation-induced invasiveness of the cancer cells. In this vein, we studied the effect of siRNA-mediated knockdown of uPAR on cell migration and adhesion in irradiated and non-irradiated medulloblastoma cells. Downregulation of uPAR reduced the radiation-induced adhesion, migration and invasion of the irradiated cells, primarily by inhibiting phosphorylation of FAK, Paxillin and Rac-1/Cdc42. As observed from the immunoprecipitation studies, uPAR knockdown reduced interaction among the focal adhesion molecules, such as FAK, Paxillin and p130Cas, which are known to play key roles in cancer metastasis. Pretreatment with uPAR shRNA expressing construct reduced uPAR and phospho FAK expression levels in pre-established medulloblastoma in nude mice.

SPARC Overexpression Inhibits Cell Proliferation in Neuroblastoma and Is Partly Mediated by Tumor Suppressor Protein PTEN and AKT

Secreted protein acidic and rich in cysteine (SPARC) is also known as BM-40 or Osteonectin, a multi-functional protein modulating cell–cell and cell–matrix interactions. In cancer, SPARC is not only linked with a highly aggressive phenotype, but it also acts as a tumor suppressor. In the present study, we sought to characterize the function of SPARC and its role in sensitizing neuroblastoma cells to radio-therapy. SPARC overexpression in neuroblastoma cells inhibited cell proliferation in vitro. Additionally, SPARC overexpression significantly suppressed the activity of AKT and this suppression was accompanied by an increase in the tumor suppressor protein PTEN both in vitro and in vivo. Restoration of neuroblastoma cell radio-sensitivity was achieved by overexpression of SPARC in neuroblastoma cells in vitro and in vivo. To confirm the role of the AKT in proliferation inhibited by SPARC overexpression, we transfected neuroblastoma cells with a plasmid vector carrying myr-AKT. Myr-AKT overexpression reversed SPARC-mediated PTEN and increased proliferation of neuroblastoma cells in vitro. PTEN overexpression in parallel with SPARC siRNA resulted in decreased AKT phosphorylation and proliferation in vitro. Taken together, these results establish SPARC as an effector of AKT-PTEN-mediated inhibition of proliferation in neuroblastoma in vitro and in vivo

Serious Gaming and Gamification interventions for health professional education

This is the protocol for a review and there is no abstract. The objectives are as follows: To evaluate the effectiveness of Serious Gaming and Gamification interventions for delivering pre- and post-registration health professional education compared with traditional learning, other types of eLearning, or other Serious Gaming and Gamification interventions. We will primarily assess the impact of these interventions on students' knowledge, skills, professional attitudes and satisfaction

Adjunctive benzodiazepine treatment of hospitalized schizophrenia patients in Asia from 2001 to 2008

10.1017/S146114571000163XThe International Journal of Neuropsychopharmacology146735-74