Evaluation of a Pilot Hands-on Course in Surgical Dentistry for Primary Care Dental Practitioners in Oxfordshire

2003 ◽  
Vol os10 (4) ◽  
pp. 119-123
Author(s):  
Jeyanthi H John ◽  
David Thomas ◽  
Derek Richards ◽  
Richard Juniper ◽  
Stephen Henderson
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Small Group ◽  
Surgical Procedures ◽  
Questionnaire Survey ◽  
Specialist Care ◽  
Impacted Teeth ◽  
Dental Practitioners ◽  
Hands On ◽  
The Impact

Objectives To evaluate the impact of a course in surgical dentistry on the confidence of 32 general dental practitioners, each of whom attended a one-day hands-on course. Design Questionnaire survey. Setting General dental practitioners attending a course on surgical dentistry, which was run over a day, for eight participants per day. Results The course was rated highly by participants. The hands-on component was particularly well received. Confidence scores increased for several surgical procedures, particularly for removal of impacted teeth and for apicectomies of single-rooted teeth. There were concomitant decreases in the proportion of participants who said that they would refer patients requiring these surgical procedures. Confidence scores remained low for complex procedures such as molar apicetomies. However, it would be appropriate to refer these cases for specialist care. Conclusions The results of this pilot study indicated that a course in surgical dentistry was successful in increasing the confidence of a small group of general dental practitioners. More research is needed to determine whether this is the most effective way of helping practitioners maintain and improve skills and confidence in surgical dentistry.

Cross-sectoral Analysis of 1.4 Million AOK-insured Patients with Back Pain in Baden-Württemberg – What Influence does Outpatient Specialist Care Have?

2021 ◽  
Author(s):  
Tom R. Jansen ◽  
Heinz Endres ◽  
Lina Barnewold ◽  
Petra Kaufmann-Kolle ◽  
Sabine Knapstein ◽  
...  
Keyword(s):  
Primary Care ◽  
Back Pain ◽  
Surgical Procedures ◽  
Regional Differences ◽  
Pain Medication ◽  
Hospital Treatment ◽  
Specialist Care ◽  
Billing Data ◽  
Primary Care Clinics ◽  
The Mean

Abstract Background Back pain is one of the leading causes of disability globally and the most common musculoskeletal pain in Germany. The lifetime prevalence of back pain ranges from 74% to 85%, and the point prevalence ranges from 32% to 49%. One in five individuals with statutory health insurance visits a doctor at least once a year for back pain, and 1 in 20 individuals is on sick leave at least once a year. The question as to what extent can different outpatient care concepts substantially contribute to improving care and avoiding inpatient hospital treatment has repeatedly been the subject of controversial political discussions. This study aimed to present a description of the reality of care in Baden-Württemberg (BW), Germany, based on claims data. Material and Methods Anonymised routine billing data of AOK Baden-Württemberg were analysed in compliance with data protection regulations. The billing data cover the outpatient and inpatient care sectors. All AOK patients in BW who received at least one ICD10 diagnosis from their physician in the first half of 2015 were considered for the analysis. Patients with at least one diagnosis of back pain were evaluated as patients with back pain, whereby the assignment to the diagnosis group of specific or non-specific back pain was made based on the code. Results In the first half of 2015, nearly 988 925 patients with back pain were registered in the 6696 primary care clinics in BW, approximately 302 524 patients in 1172 orthopaedic clinics and 17 043 patients in 89 neurosurgical clinics. Primary care clinics reported back pain diagnosis in 34.6%, orthopaedic clinics in 51.9% and neurosurgical clinics in 78.6% of cases. Primary care clinics diagnosed a specific cause in approximately one-third of patients with back pain, orthopaedic clinics in approximately 40% of their patients and neurosurgery clinics in one in two cases. Overall, approximately 1.2% of 1.3 million patients with back pain (January to December 2015 in BW) were hospitalised. Inpatient therapy consisted of surgical therapy and conservative therapy. Nucleotomy, decompression and spondylodesis were the three most common surgical procedures performed. Pain medication and remedy prescriptions decreased pain after spinal surgery. There are significant regional differences in referral and surgery rates. The mean inpatient referral rate was 535 of 100 000 AOK insurants, and the median was 536 of 100 000 AOK insurants. The mean surgery rate among all admitted patients with back pain was 49.9%, and the median was 49.8%. Conclusion The vast majority of patients with back pain are treated as outpatients. Only approximately 1.2% of all patients with back pain were treated as inpatients in 2015. Of these, approximately half underwent surgery. Spinal surgeries led to a decrease in pain medication and remedy prescription postoperatively. The three most frequent surgical procedures were ‘decompression’, ‘excision of disc tissue’ and ‘spondylodesis’. There were significant regional differences.

scholarly journals The PUPPY Study - Protocol for a Longitudinal Mixed Methods Study Exploring Problems Coordinating and Accessing Primary Care for Attached and Unattached Patients Exacerbated During the COVID-19 Pandemic Year

2021 ◽  
Author(s):  
Emily Gard Marshall ◽  
Mylaine Breton ◽  
Benoit Cossette ◽  
Jennifer Isenor ◽  
Maria Mathews ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Nurse Practitioners ◽  
Qualitative Interviews ◽  
Mixed Methods Study ◽  
Specialist Care ◽  
Policy And Practice ◽  
Care Systems ◽  
Multi Stakeholder ◽  
The Impact

Background: The COVID-19 pandemic significantly disrupted primary care in Canada, with many walk-in clinics and family practices initially closing or being perceived as inaccessible, pharmacies remaining open with restrictions on patient interactions, rapid uptake of virtual care, and reduced referrals for lab tests, diagnostics, and specialist care. The PUPPY Study seeks to understand the impact of COVID-19 across the quadruple aim of primary care, with particular focus on the impacts on patients without attachment to a regular provider and those with chronic health conditions. Methods: The PUPPY study builds on an existing research program exploring patient access and attachment to primary care, pivoted to adapt to the emerging COVID-19 context. We will undertake a longitudinal mixed methods study to understand critical gaps in primary care access and coordination, comparing data pre- and post-pandemic in three Canadian provinces (Quebec, Ontario, and Nova Scotia). Multiple data sources will be used including: a policy review; qualitative interviews with primary care policymakers, providers (i.e., family physicians, nurse practitioners, and pharmacists), and patients (N=120); and medication prescribing and healthcare billings. The findings will inform the strengthening of primary care during and beyond the COVID-19 pandemic. Interpretation: This is the first study of its kind exploring the impacts of COVID-19 on primary care systems, with particular focus on the issues of patient's attachment and access to primary care. Our multi-stakeholder, cross-jurisdictional team will collaborate to rapidly disseminate findings and share implications for future policy and practice.

scholarly journals A Randomized, Crossover Pilot Study of a Novel Web-Based/Mobile Platform for Collaborative Small Group Practice in Therapeutic Reasoning

2020 ◽  
Vol 7 ◽  
pp. 238212052097718
Author(s):  
Katherine Gruenberg ◽  
Tina Brock ◽  
Joshua Garcia ◽  
Conan MacDougall
Keyword(s):  
Pilot Study ◽  
Small Group ◽  
Student Performance ◽  
Student Perceptions ◽  
Health Professions ◽  
Mobile Platform ◽  
Web Based ◽  
Usual Practice ◽  
Student Responses ◽  
The Impact

Background and Purpose: Therapeutic reasoning—the mental process of making judgments and decisions about treatment—is developed through acquisition of knowledge and application in actual or simulated experiences. Health professions education frequently uses collaborative small group work to practice therapeutic reasoning. This pilot study compared the impact of a web-based/mobile tool for collaborative case work and discussion to usual practice on student perceptions and performance on questions designed to test therapeutic knowledge and reasoning. Methods: In a therapeutics course that includes case-based workshops, student teams of 3 to 4 were randomly assigned to usual workshop preparation (group SOAP sheet) or preparation using the Practice Improvement using Virtual Online Training (PIVOT) platform. PIVOT was also used in the workshop to review the case and student responses. The next week, groups crossed over to the other condition. Students rated favorability with the preparatory and in-workshop experiences and provided comments about the PIVOT platform via a survey. Student performance on examination items related to the 2 workshop topics was compared. Results: One hundred and eleven students (94%) completed post-workshop surveys after both workshops. The majority of students (57%) preferred using the PIVOT platform for workshop collaboration. Favorability ratings for the in-workshop experience did not change significantly from first to second study week, regardless of sequence of exposure. There was no relationship between examination item scores and the workshop platform the students were exposed to for that content ( P = .29). Student responses highlighted the efficiency of working independently before collaborating as a group and the ability to see other students’ thought processes as valuable aspects of PIVOT. Students expressed frustration with the PIVOT user interface and the lack of anonymity when discussing their answers in the workshop. Conclusion: A web-based/mobile platform for student team collaboration on therapeutic reasoning cases discussed in small group settings yielded favorable ratings, examination performance comparable to standard approaches, and was preferred by a majority of students. During the rapid shift to substantial online learning for the COVID-19 pandemic, virtual collaboration tools like PIVOT may help health professions teachers to better support groups working virtually on scaffolded therapeutic reasoning tasks.

The impact of a primary care stress management and wellbeing programme (RENEW) on occupational participation: A pilot study

2018 ◽  
Vol 82 (2) ◽  
pp. 112-121 ◽  
Author(s):  
Deirdre Connolly ◽  
Melanie Anderson ◽  
Mary Colgan ◽  
Jennifer Montgomery ◽  
Jennifer Clarke ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Stress Management ◽  
Occupational Participation ◽  
The Impact

scholarly journals Impact of the Presenting Symptom on Time Intervals and Diagnostic Routes of Patients with Symptomatic Oral Cancer

Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5163
Author(s):  
Pablo Ignacio Varela-Centelles ◽  
Daniel Pérez López ◽  
José Luis López-Cedrún ◽  
Álvaro García-Rozado ◽  
Pablo Castelo Baz ◽  
...  
Keyword(s):  
Primary Care ◽  
Oral Cancer ◽  
Time Interval ◽  
Time Intervals ◽  
Cross Sectional ◽  
Presenting Symptoms ◽  
Relative Contribution ◽  
Dental Practitioners ◽  
Incident Cases ◽  
The Impact

This investigation was aimed at determining the time intervals from the presenting symptoms until the beginning of oral cancer treatment and their relative contribution to the total time, and to assess the impact of the presenting symptom on diagnostic timelines and patient referral routes. A cross-sectional, ambispective study was designed to investigate symptomatic incident cases. The Aarhus statement was used as a conceptual framework. Strategies for minimizing potential recall biases were implemented. A sample of 181 patients was recruited (power: 99.5%; α = 0.05). The patient interval reached 58.2 days (95% CI, 40.3–76.2), which accounted for 74% of the whole prereferral interval and for more than one third of the total time interval. The presenting symptom (trigger for consultation) influenced both the number of primary care consultations and the length of time to diagnosis. General dental practitioners generated longer intervals to diagnosis (p < 0.005) and needed more consultations before referring a patient (RR = 0.76; 95% CI, 0.61–0.93), than general medical practitioners. The current study identifies the patient as the main target for interventions to improve awareness and reinforces the need for increased alertness amongst healthcare professionals about presenting symptoms of oral cancer and to diminish the number of prereferral consultations in order to optimize the primary care interval.

The impact of specialist care for low back pain on health service utilization in primary care patients: A prospective cohort study

2008 ◽  
Vol 12 (3) ◽  
pp. 275-283 ◽  
Author(s):  
Jean-François Chenot ◽  
Corinna Leonhardt ◽  
Stefan Keller ◽  
Martin Scherer ◽  
Norbert Donner-Banzhoff ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Low Back Pain ◽  
Back Pain ◽  
Health Service ◽  
Health Service Utilization ◽  
Low Back ◽  
Specialist Care ◽  
Primary Care Patients ◽  
The Impact

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

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