Covid-19 and dental emergencies: reflections on teledentistry

Early in 2020, the COVID-19 virus spread throughout the world. On March 11, 2020 the World Health Organization declared COVID-19 a pandemic due to the level of spread and the severity of the disease. In efforts to control the spread of COVID-19 and reduce the number of new infections and deaths, people around the world took steps that had not been taken in modern history. As countries and locales issued “shelter in place edicts” the economic and social impact on businesses and professions was dramatic. The field of dentistry was similarly affected as edicts were made by governmental officials that elective dental procedures be stopped. In the state of Iowa, Governor Kim Reynolds issued a proclamation mandating that effective March 27, 2020 all dentists and their staff refrain from performing “elective dental procedures and nonessential or elective surgeries”. With this turn of events, dental practices across the state were effectively shut down, only being allowed to treat emergency patients. Prior to the COVID-19 pandemic, the Iowa Dental Board, Delta Dental of Iowa, and the University of Iowa College of Dentistry shared an interest in exploring telehealth as a means of improving access to dental care for vulnerable populations. While steady progress was being made prior to the Pandemic, once the practice of dentistry in Iowa was restricted, the interest in telehealth, or “Teledentistry” soared. At the University Of Iowa College Of Dentistry, procedures were put in place to allow all emergency patients to be triaged through Teledentistry prior to being appointed in the Clinic. Using synchronous Teledentistry systems, “e-visits” prior to emergency care became the “new normal”. Patients calling in for an emergency appointment were offered a menu of options for these e-visits including: 1) phone call; 2) phone call and sharing of images; or 3) a ZOOM meeting. All e-visits were provided by Dental faculty members at the University of Iowa with experience overseeing patient care in the Dental Emergency Clinic ranging from three to ten years. Final decisions on appointing patients were made by the provider based on existing records (when available), subjective symptoms (pain), objective findings (visible swelling), patients distress level, expectations and availability. During the initial 8-weeks following closure of our dental clinics (March 16-May 15), a total of 491 patients were seen in our dental emergency clinics, all of whom had been triaged by phone calls or e-visits. Most Patients reported overall satisfaction about the procedure. Based on our experience, Teledentistry (e-visits) are a useful tool to help in prioritizing dental emergencies.KeywordsTeledentistry; E-visits; Zoom visits.

Introductory Remarks by Adrien K. Wing

My name is Adrien Wing. I am Associate Dean of International and Comparative Law Programs at the University of Iowa College of Law where I have been teaching for thirty-two years. I am also pleased to be with you today because I have been a member of ASIL for thirty-seven years. When I joined, we did not have any topics like today's subject. We certainly did not have the demographic diversity that is represented in this room. We have come a long way in some respects, and so at least for programming, it is wonderful that we have this topic “Diverse Perspectives on the Impact of Colonialism on International Law.” Three of the speakers will emphasize Africa. One person will focus on Latin America. The MILIG Interest Group, the minority interest group, is sponsoring this session. We are fortunate to have the co-chairs of the Interest Group here: Rafael Porrata-Doria and Christina Beharry.

Voice of a “Seasoned” OB Professor

I will be making some highly personalized comments on the Aguinis et al. (2017) focal article concerning rigor versus relevance, renaming/rebranding industrial and organizational (I-O) psychology, and I-O psychology versus business school organizational behavior (OB). Before commenting, however, I feel compelled to briefly frame my remarks from the perspective of my 50-year academic career. For example, I think it is important to note that I go back to the early 1960s at the University of Iowa, College of Business. I was studying for my PhD in the just emerging field of management and organizations (nothing was offered called organizational behavior or strategic management). However, and very unusual for the times for management majors, I also took a minor in the psychology department concentrating on social and I-O psychology. Also, after receiving my PhD in 1965, for my 2-year military obligation, after infantry officer training I was assigned to West Point and taught cadets the required psychology course and military leadership. This background had a formative and lasting impact on my thinking about OB and I-O psychology.

Dental restoration longevity among geriatric and adult special needs patients

This study aimed to describe the survival trajectory of dental restorations placed in an outpatient population of geriatric and adult special needs patients over a 15-year span, with particular interest in longevity of subsequent restorations in teeth that received multiple restorations over time. Dental restorations of different types and sizes in patients age ≥65 years treated between 2000-14 at the University of Iowa, College of Dentistry were followed until they incurred an event (i.e., restoration replacement, extraction of the tooth, or endodontic treatment of the tooth). Survival analysis and extended Cox regression models were used to generate hazards ratios for selected predictor variables. A total of 9184 restorations were followed in 1551 unique patients. During the follow-up period, 28.7% of these restorations incurred an event; and overall the restorations had a median lifespan of 6.25 years. In multivariable regression models, after controlling for gender and age, composite restorations and greater number of restoration surfaces were associated with higher risks of failure; and the initial restoration recorded in the database for each subject tended to have lower risk of failure than restorations placed later that included any of those same surfaces. This information potentially could be helpful to elderly patients considering various restorative treatment options during the dental treatment planning and informed consent process.

When Regulation Was Religious: College Philanthropy, Antislavery Politics, and Accreditation in the Mid-Nineteenth-Century West

The college accreditation movement that arose at the turn of the twentieth century had an important antecedent in the Society for the Promotion of Collegiate and Theological Education at the West. Founded in 1843, this nondenominational philanthropy aspired to direct the development of higher education by dispersing eastern funds to Protestant colleges that met its standards for instruction, administration, and piety. For all its ambitions, the Society did not always offer dependable or disinterested supervision. Its relationships with Knox College and Iowa College (now Grinnell) exposed its shortcomings. Coinciding with the rising sectional conflict over slavery, the activities of these institutions forced the regulatory association to engage in the very brand of ecclesiastical politics it had vowed to transcend. This article shows how institutional resistance and church rivalry helped delay the growth of accreditation until the turn of the twentieth century, when secular organizations took up the reins of regulation.

Análise da produção científica sobre a Classificação das Intervenções de Enfermagem (NIC) de 1980 a 2004

Este estudo objetivou revisar o conhecimento produzido sobre a Classificação das Intervenções de Enfermagem (NIC), disponível na literatura científica, no período de janeiro de 1980 a janeiro de 2004. A NIC é uma taxonomia que inclui atividades realizadas pelos enfermeiros. Foram consultadas as bases de dados Lilacs, Medline e realizado levantamento manual no Centro de Classificação em Enfermagem da Universidade de Iowa - College of Nursing, além da inclusão de uma tese obtida em acervo particular. Os trabalhos analisados referiam-se à aplicação da NIC na prática, comparação de linguagens em sistemas informatizados e uso da NIC nesses sistemas, apresentação, construção e desenvolvimento da taxonomia, validação, entre outros. Concluiu-se que várias são as possibilidades relativas à produção do conhecimento sobre a NIC no Brasil e que são necessários estudos sobre essa taxonomia que levantem questionamentos, gerem novos conhecimentos e que contribuam em mais esse aspecto relativo ao avanço da enfermagem brasileira.